Hot Swapping Protocol Implementations in the OPNET Modeler Development Environment

DTIC Science & Technology

2008-03-01

components. Unfortunately, this style is not efficient or particularly human–readable. Even purely pedagogical scenarios consisting of a client and a...definition provided by the mock object. sion of this kernel procedure steers all packets sent with op pk deliver() to the unit testing’s specialized...forms of development. Moreover, batteries of unit tests could ship with the accompanying process models and serve as robust regression tests

WMT: The CSDMS Web Modeling Tool

NASA Astrophysics Data System (ADS)

Piper, M.; Hutton, E. W. H.; Overeem, I.; Syvitski, J. P.

2015-12-01

The Community Surface Dynamics Modeling System (CSDMS) has a mission to enable model use and development for research in earth surface processes. CSDMS strives to expand the use of quantitative modeling techniques, promotes best practices in coding, and advocates for the use of open-source software. To streamline and standardize access to models, CSDMS has developed the Web Modeling Tool (WMT), a RESTful web application with a client-side graphical interface and a server-side database and API that allows users to build coupled surface dynamics models in a web browser on a personal computer or a mobile device, and run them in a high-performance computing (HPC) environment. With WMT, users can: Design a model from a set of components Edit component parameters Save models to a web-accessible server Share saved models with the community Submit runs to an HPC system Download simulation results The WMT client is an Ajax application written in Java with GWT, which allows developers to employ object-oriented design principles and development tools such as Ant, Eclipse and JUnit. For deployment on the web, the GWT compiler translates Java code to optimized and obfuscated JavaScript. The WMT client is supported on Firefox, Chrome, Safari, and Internet Explorer. The WMT server, written in Python and SQLite, is a layered system, with each layer exposing a web service API: wmt-db: database of component, model, and simulation metadata and output wmt-api: configure and connect components wmt-exe: launch simulations on remote execution servers The database server provides, as JSON-encoded messages, the metadata for users to couple model components, including descriptions of component exchange items, uses and provides ports, and input parameters. Execution servers are network-accessible computational resources, ranging from HPC systems to desktop computers, containing the CSDMS software stack for running a simulation. Once a simulation completes, its output, in NetCDF, is packaged and uploaded to a data server where it is stored and from which a user can download it as a single compressed archive file.

An Application Server for Scientific Collaboration

NASA Astrophysics Data System (ADS)

Cary, John R.; Luetkemeyer, Kelly G.

1998-11-01

Tech-X Corporation has developed SciChat, an application server for scientific collaboration. Connections are made to the server through a Java client, that can either be an application or an applet served in a web page. Once connected, the client may choose to start or join a session. A session includes not only other clients, but also an application. Any client can send a command to the application. This command is executed on the server and echoed to all clients. The results of the command, whether numerical or graphical, are then distributed to all of the clients; thus, multiple clients can interact collaboratively with a single application. The client is developed in Java, the server in C++, and the middleware is the Common Object Request Broker Architecture. In this system, the Graphical User Interface processing is on the client machine, so one does not have the disadvantages of insufficient bandwidth as occurs when running X over the internet. Because the server, client, and middleware are object oriented, new types of servers and clients specialized to particular scientific applications are more easily developed.

Process Management inside ATLAS DAQ

NASA Astrophysics Data System (ADS)

Alexandrov, I.; Amorim, A.; Badescu, E.; Burckhart-Chromek, D.; Caprini, M.; Dobson, M.; Duval, P. Y.; Hart, R.; Jones, R.; Kazarov, A.; Kolos, S.; Kotov, V.; Liko, D.; Lucio, L.; Mapelli, L.; Mineev, M.; Moneta, L.; Nassiakou, M.; Pedro, L.; Ribeiro, A.; Roumiantsev, V.; Ryabov, Y.; Schweiger, D.; Soloviev, I.; Wolters, H.

2002-10-01

The Process Management component of the online software of the future ATLAS experiment data acquisition system is presented. The purpose of the Process Manager is to perform basic job control of the software components of the data acquisition system. It is capable of starting, stopping and monitoring the status of those components on the data acquisition processors independent of the underlying operating system. Its architecture is designed on the basis of a server client model using CORBA based communication. The server part relies on C++ software agent objects acting as an interface between the local operating system and client applications. Some of the major design challenges of the software agents were to achieve the maximum degree of autonomy possible, to create processes aware of dynamic conditions in their environment and with the ability to determine corresponding actions. Issues such as the performance of the agents in terms of time needed for process creation and destruction, the scalability of the system taking into consideration the final ATLAS configuration and minimizing the use of hardware resources were also of critical importance. Besides the details given on the architecture and the implementation, we also present scalability and performance tests results of the Process Manager system.

Is it time for a comprehensive approach in older home care clients' care planning in Finland?

PubMed

Turjamaa, Riitta; Hartikainen, Sirpa; Kangasniemi, Mari; Pietilä, Anna-Maija

2015-06-01

Home-care services require access to high quality information. Apart from the provision of right-time organised planning of care and to document information about clients' needs, in home care, the care planning is intended to facilitate continuity and individual nursing through nursing documentation of the assessment of the client. The aim was to describe the contents of older (+75 years) home-care clients' electronic care and service plans and to evaluate how the clients' resources have been taken into account. The data were collected from the care and service plans (n = 437) of home-care services during July 2010. The data were analysed by quantitative methods and by thematic content analysis. Based on the analysis, medication was the most reported component in all plans (92.7%); other commonly reported components were self-care (85.4%) and coping (78.0%). Components within respiratory, follow-up treatment, life cycle and health behaviour were forgotten. Most of the care and service plans were designed from the home-care professionals' point of view but the plans lacked the perspective of older clients. To be able to promote older home clients' ability to live at home, home-care planning needs to be individually designed and must take into account clients' needs and their perspectives regarding meaningful activities and social relationships. In addition, there is a need to develop a more comprehensive care planning system, based on the clients' individual needs and standards of care planning. © 2014 Nordic College of Caring Science.

An approach to ground based space surveillance of geostationary on-orbit servicing operations

NASA Astrophysics Data System (ADS)

Scott, Robert (Lauchie); Ellery, Alex

2015-07-01

On Orbit Servicing (OOS) is a class of dual-use robotic space missions that could potentially extend the life of orbiting satellites by fuel replenishment, repair, inspection, orbital maintenance or satellite repurposing, and possibly reduce the rate of space debris generation. OOS performed in geostationary orbit poses a unique challenge for the optical space surveillance community. Both satellites would be performing proximity operations in tight formation flight with separations less than 500 m making atmospheric seeing (turbulence) a challenge to resolving a geostationary satellite pair when viewed from the ground. The two objects would appear merged in an image as the resolving power of the telescope and detector, coupled with atmospheric seeing, limits the ability to resolve the two objects. This poses an issue for obtaining orbital data for conjunction flight safety or, in matters pertaining to space security, inferring the intent and trajectory of an unexpected object perched very close to one's satellite asset on orbit. In order to overcome this problem speckle interferometry using a cross spectrum approach is examined as a means to optically resolve the client and servicer's relative positions to enable a means to perform relative orbit determination of the two spacecraft. This paper explores cases where client and servicing satellites are in unforced relative motion flight and examines the observability of the objects. Tools are described that exploit cross-spectrum speckle interferometry to (1) determine the presence of a secondary in the vicinity of the client satellite and (2) estimate the servicing satellite's motion relative to the client. Experimental observations performed with the Mont Mégantic 1.6 m telescope on co-located geostationary satellites (acting as OOS proxy objects) are described. Apparent angular separations between Anik G1 and Anik F1R from 5 to 1 arcsec were observed as the two satellites appeared to graze one another. Data reduction using differential angular measurements derived from speckle images collected by the 1.6 m telescope produced relative orbit estimates with better than 90 m accuracy in the cross-track and in-track directions but exhibited highly variable behavior in the radial component from 50 to 1800 m. Simulations of synthetic tracking data indicated that the radial component requires approximately six hours of tracking data for an Extended Kalman Filter to converge on an relative orbit estimate with less than 100 m overall uncertainty. The cross-spectrum approach takes advantage of the Fast Fourier Transform (FFT) permitting near real-time estimation of the relative orbit of the two satellites. This also enables the use of relatively larger detector arrays (>106 pixels) helping to ease acquisition process to acquire optical angular data.

45 CFR 1634.9 - Selection criteria.

Code of Federal Regulations, 2014 CFR

2014-10-01

... key staff; (6) The applicant's knowledge of the various components of the legal services delivery... services to eligible clients; and (ii) its knowledge of and willingness to cooperate with other legal... applicant's capacity to ensure continuity in client services and representation of eligible clients with...

45 CFR 1634.9 - Selection criteria.

Code of Federal Regulations, 2013 CFR

2013-10-01

... key staff; (6) The applicant's knowledge of the various components of the legal services delivery... services to eligible clients; and (ii) its knowledge of and willingness to cooperate with other legal... applicant's capacity to ensure continuity in client services and representation of eligible clients with...

45 CFR 1634.9 - Selection criteria.

Code of Federal Regulations, 2012 CFR

2012-10-01

... key staff; (6) The applicant's knowledge of the various components of the legal services delivery... services to eligible clients; and (ii) its knowledge of and willingness to cooperate with other legal... applicant's capacity to ensure continuity in client services and representation of eligible clients with...

45 CFR 1634.9 - Selection criteria.

Code of Federal Regulations, 2011 CFR

2011-10-01

... key staff; (6) The applicant's knowledge of the various components of the legal services delivery... services to eligible clients; and (ii) its knowledge of and willingness to cooperate with other legal... applicant's capacity to ensure continuity in client services and representation of eligible clients with...

Graph and Network for Model Elicitation (GNOME Phase 2)

DTIC Science & Technology

2013-02-01

10 3.3 GNOME UI Components for NOEM Web Client...20 Figure 17: Sampling in Web -client...the web -client). The server-side service can run and generate data asynchronously, allowing a cluster of servers to run the sampling. Also, a

37 CFR 10.84 - Representing a client zealously.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

HYDRA : High-speed simulation architecture for precision spacecraft formation simulation

NASA Technical Reports Server (NTRS)

Martin, Bryan J.; Sohl, Garett.

2003-01-01

e Hierarchical Distributed Reconfigurable Architecture- is a scalable simulation architecture that provides flexibility and ease-of-use which take advantage of modern computation and communication hardware. It also provides the ability to implement distributed - or workstation - based simulations and high-fidelity real-time simulation from a common core. Originally designed to serve as a research platform for examining fundamental challenges in formation flying simulation for future space missions, it is also finding use in other missions and applications, all of which can take advantage of the underlying Object-Oriented structure to easily produce distributed simulations. Hydra automates the process of connecting disparate simulation components (Hydra Clients) through a client server architecture that uses high-level descriptions of data associated with each client to find and forge desirable connections (Hydra Services) at run time. Services communicate through the use of Connectors, which abstract messaging to provide single-interface access to any desired communication protocol, such as from shared-memory message passing to TCP/IP to ACE and COBRA. Hydra shares many features with the HLA, although providing more flexibility in connectivity services and behavior overriding.

Using component technologies for web based wavelet enhanced mammographic image visualization.

PubMed

Sakellaropoulos, P; Costaridou, L; Panayiotakis, G

2000-01-01

The poor contrast detectability of mammography can be dealt with by domain specific software visualization tools. Remote desktop client access and time performance limitations of a previously reported visualization tool are addressed, aiming at more efficient visualization of mammographic image resources existing in web or PACS image servers. This effort is also motivated by the fact that at present, web browsers do not support domain-specific medical image visualization. To deal with desktop client access the tool was redesigned by exploring component technologies, enabling the integration of stand alone domain specific mammographic image functionality in a web browsing environment (web adaptation). The integration method is based on ActiveX Document Server technology. ActiveX Document is a part of Object Linking and Embedding (OLE) extensible systems object technology, offering new services in existing applications. The standard DICOM 3.0 part 10 compatible image-format specification Papyrus 3.0 is supported, in addition to standard digitization formats such as TIFF. The visualization functionality of the tool has been enhanced by including a fast wavelet transform implementation, which allows for real time wavelet based contrast enhancement and denoising operations. Initial use of the tool with mammograms of various breast structures demonstrated its potential in improving visualization of diagnostic mammographic features. Web adaptation and real time wavelet processing enhance the potential of the previously reported tool in remote diagnosis and education in mammography.

Framework for a clinical information system.

PubMed

Van de Velde, R

2000-01-01

The current status of our work towards the design and implementation of a reference architecture for a Clinical Information System is presented. This architecture has been developed and implemented based on components following a strong underlying conceptual and technological model. Common Object Request Broker and n-tier technology featuring centralised and departmental clinical information systems as the back-end store for all clinical data are used. Servers located in the 'middle' tier apply the clinical (business) model and application rules to communicate with so-called 'thin client' workstations. The main characteristics are the focus on modelling and reuse of both data and business logic as there is a shift away from data and functional modelling towards object modelling. Scalability as well as adaptability to constantly changing requirements via component driven computing are the main reasons for that approach.

An ECG storage and retrieval system embedded in client server HIS utilizing object-oriented DB.

PubMed

Wang, C; Ohe, K; Sakurai, T; Nagase, T; Kaihara, S

1996-02-01

In the University of Tokyo Hospital, the improved client server HIS has been applied to clinical practice and physicians can order prescription, laboratory examination, ECG examination and radiographic examination, etc. directly by themselves and read results of these examinations, except medical signal waves, schema and image, on UNIX workstations. Recently, we designed and developed an ECG storage and retrieval system embedded in the client server HIS utilizing object-oriented database to take the first step in dealing with digitized signal, schema and image data and show waves, graphics, and images directly to physicians by the client server HIS. The system was developed based on object-oriented analysis and design, and implemented with object-oriented database management system (OODMS) and C++ programming language. In this paper, we describe the ECG data model, functions of the storage and retrieval system, features of user interface and the result of its implementation in the HIS.

Parallel checksumming of data chunks of a shared data object using a log-structured file system

DOEpatents

Bent, John M.; Faibish, Sorin; Grider, Gary

2016-09-06

Checksum values are generated and used to verify the data integrity. A client executing in a parallel computing system stores a data chunk to a shared data object on a storage node in the parallel computing system. The client determines a checksum value for the data chunk; and provides the checksum value with the data chunk to the storage node that stores the shared object. The data chunk can be stored on the storage node with the corresponding checksum value as part of the shared object. The storage node may be part of a Parallel Log-Structured File System (PLFS), and the client may comprise, for example, a Log-Structured File System client on a compute node or burst buffer. The checksum value can be evaluated when the data chunk is read from the storage node to verify the integrity of the data that is read.

GUEST EDITORS' INTRODUCTION: Guest Editors' introduction

NASA Astrophysics Data System (ADS)

Guerraoui, Rachid; Vinoski, Steve

1997-09-01

The organization of a distributed system can have a tremendous impact on its capabilities, its performance, and its ability to evolve to meet changing requirements. For example, the client - server organization model has proven to be adequate for organizing a distributed system as a number of distributed servers that offer various functions to client processes across the network. However, it lacks peer-to-peer capabilities, and experience with the model has been predominantly in the context of local networks. To achieve peer-to-peer cooperation in a more global context, systems issues of scale, heterogeneity, configuration management, accounting and sharing are crucial, and the complexity of migrating from locally distributed to more global systems demands new tools and techniques. An emphasis on interfaces and modules leads to the modelling of a complex distributed system as a collection of interacting objects that communicate with each other only using requests sent to well defined interfaces. Although object granularity typically varies at different levels of a system architecture, the same object abstraction can be applied to various levels of a computing architecture. Since 1989, the Object Management Group (OMG), an international software consortium, has been defining an architecture for distributed object systems called the Object Management Architecture (OMA). At the core of the OMA is a `software bus' called an Object Request Broker (ORB), which is specified by the OMG Common Object Request Broker Architecture (CORBA) specification. The OMA distributed object model fits the structure of heterogeneous distributed applications, and is applied in all layers of the OMA. For example, each of the OMG Object Services, such as the OMG Naming Service, is structured as a set of distributed objects that communicate using the ORB. Similarly, higher-level OMA components such as Common Facilities and Domain Interfaces are also organized as distributed objects that can be layered over both Object Services and the ORB. The OMG creates specifications, not code, but the interfaces it standardizes are always derived from demonstrated technology submitted by member companies. The specified interfaces are written in a neutral Interface Definition Language (IDL) that defines contractual interfaces with potential clients. Interfaces written in IDL can be translated to a number of programming languages via OMG standard language mappings so that they can be used to develop components. The resulting components can transparently communicate with other components written in different languages and running on different operating systems and machine types. The ORB is responsible for providing the illusion of `virtual homogeneity' regardless of the programming languages, tools, operating systems and networks used to realize and support these components. With the adoption of the CORBA 2.0 specification in 1995, these components are able to interoperate across multi-vendor CORBA-based products. More than 700 member companies have joined the OMG, including Hewlett-Packard, Digital, Siemens, IONA Technologies, Netscape, Sun Microsystems, Microsoft and IBM, which makes it the largest standards body in existence. These companies continue to work together within the OMG to refine and enhance the OMA and its components. This special issue of Distributed Systems Engineering publishes five papers that were originally presented at the `Distributed Object-Based Platforms' track of the 30th Hawaii International Conference on System Sciences (HICSS), which was held in Wailea on Maui on 6 - 10 January 1997. The papers, which were selected based on their quality and the range of topics they cover, address different aspects of CORBA, including advanced aspects such as fault tolerance and transactions. These papers discuss the use of CORBA and evaluate CORBA-based development for different types of distributed object systems and architectures. The first paper, by S Rahkila and S Stenberg, discusses the application of CORBA to telecommunication management networks. In the second paper, P Narasimhan, L E Moser and P M Melliar-Smith present a fault-tolerant extension of an ORB. The third paper, by J Liang, S Sédillot and B Traverson, provides an overview of the CORBA Transaction Service and its integration with the ISO Distributed Transaction Processing protocol. In the fourth paper, D Sherer, T Murer and A Würtz discuss the evolution of a cooperative software engineering infrastructure to a CORBA-based framework. The fifth paper, by R Fatoohi, evaluates the communication performance of a commercially-available Object Request Broker (Orbix from IONA Technologies) on several networks, and compares the performance with that of more traditional communication primitives (e.g., BSD UNIX sockets and PVM). We wish to thank both the referees and the authors of these papers, as their cooperation was fundamental in ensuring timely publication.

28 CFR 58.20 - Minimum qualifications agencies shall meet to become and remain approved agencies.

Code of Federal Regulations, 2014 CFR

2014-07-01

... any component of counseling services by a telephone or Internet method of delivery, use only... the telephone and the Internet to deliver a component of client services. An agency shall: (1) Not... counseling services by telephone or Internet; (2) Confirm the identity of the client before receiving...

28 CFR 58.20 - Minimum qualifications agencies shall meet to become and remain approved agencies.

Code of Federal Regulations, 2013 CFR

2013-07-01

... any component of counseling services by a telephone or Internet method of delivery, use only... the telephone and the Internet to deliver a component of client services. An agency shall: (1) Not... counseling services by telephone or Internet; (2) Confirm the identity of the client before receiving...

The relationship between counselors' technical skills, clients' in-session verbal responses, and outcome in smoking cessation treatment.

PubMed

Lindqvist, Helena; Forsberg, Lars; Enebrink, Pia; Andersson, Gerhard; Rosendahl, Ingvar

2017-06-01

The technical component of Motivational Interviewing (MI) posits that client language mediates the relationship between counselor techniques and subsequent client behavioral outcomes. The purpose of this study was to examine this hypothesized technical component of MI in smoking cessation treatment in more depth. Secondary analysis of 106 first treatment sessions, derived from the Swedish National Tobacco Quitline, and previously rated using the Motivational Interviewing Sequential Code for Observing Process Exchanges (MI-SCOPE) Coder's Manual and the Motivational Interviewing Treatment Integrity code (MITI) Manual, version 3.1. The outcome measure was self-reported 6-month continuous abstinence at 12-month follow-up. Sequential analyses indicated that clients were significantly more likely than expected by chance to argue for change (change talk) following MI-consistent behaviors and questions and reflections favoring change. Conversely, clients were more likely to argue against change (sustain talk) following questions and reflections favoring status-quo. Parallel mediation analysis revealed that a counselor technique (reflections of client sustain talk) had an indirect effect on smoking outcome at follow-up through client language mediators. The study makes a significant contribution to our understanding of how MI works in smoking cessation treatment and adds further empirical support for the hypothesized technical component in MI. The results emphasize the importance of counselors avoiding unintentional reinforcement of sustain talk and underline the need for a greater emphasis on the direction of questions and reflections in MI trainings and fidelity measures. Copyright © 2017 Elsevier Inc. All rights reserved.

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

ERIC Educational Resources Information Center

Mallinckrodt, Brent; And Others

1995-01-01

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

The Value of Client Perceptions in University Strategic Planning: An Empirical Research Study

ERIC Educational Resources Information Center

del Barrio-Garcia, Salvador; Luque-Martinez, Teodoro

2009-01-01

Given the normative changes in higher education at European, national and regional levels, together with social, economic, demographic and technological developments, universities need to adopt a client-oriented approach and to make this client orientation an integral component of their strategic planning process. The university's…

Electronic Reference Library: Silverplatter's Database Networking Solution.

ERIC Educational Resources Information Center

Millea, Megan

Silverplatter's Electronic Reference Library (ERL) provides wide area network access to its databases using TCP/IP communications and client-server architecture. ERL has two main components: The ERL clients (retrieval interface) and the ERL server (search engines). ERL clients provide patrons with seamless access to multiple databases on multiple…

Restating a Client-Centered Approach to Career Counseling.

ERIC Educational Resources Information Center

Miller, Mark J.

1988-01-01

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

[Incidence of refractive errors with corrective aids subsequent selection].

PubMed

Benes, P; Synek, S; Petrová, S; Sokolová, Sidlová J; Forýtková, L; Holoubková, Z

2012-02-01

This study follows the occurrence of refractive errors in population and the possible selection of the appropriate type of corrective aids. Objective measurement and subsequent determination of the subjective refraction of the eye is on essential act in opotmetric practice. The file represented by 615 patients (1230 eyes) is divided according to the refractive error of myopia, hyperopia and as a control group are listed emetropic clients. The results of objective and subjective values of refraction are compared and statistically processed. The study included 615 respondents. To determine the objective refraction the autorefraktokeratometer with Placido disc was used and the values of spherical and astigmatic correction components, including the axis were recorded. These measurements were subsequently verified and tested subjectively using the trial lenses and the projection optotype to the normal investigative distance of 5 meters. After this the appropriate corrective aids were then recommended. Group I consists of 123 men and 195 women with myopia (n = 635) of clients with an average age 39 +/- 18,9 years. Objective refraction - sphere: -2,57 +/- 2,46 D, cylinder: -1,1 +/- 1,01 D, axis of: 100 degrees +/- 53,16 degrees. Subjective results are as follows--the value of sphere: -2,28 +/- 2,33 D, cylinder -0,63 +/- 0,80 D, axis of: 99,8 degrees +/- 56,64 degrees. Group II is represented hyperopic clients and consists of 67 men and 107 women (n = 348). The average age is 58,84 +/- 16,73 years. Objective refraction has values - sphere: +2,81 +/- 2,21 D, cylinder: -1,0 +/- 0,94 D; axis 95 degree +/- 45,4 degrees. Subsequent determination of subjective refraction has the following results - sphere: +2,28 +/- 2,06 D; cylinder: -0,49 +/- 0,85 D, axis of: 95,9 degrees +/- 46,4 degrees. Group III consists from emetropes whose final minimum viasual acuity was Vmin = 1,0 (5/5) or better. Overall, this control group is represented 52 males and 71 females (n = 247). The average age was 43 +/- 18,73 years. Objective refraction - sphere: +0,32 +/- 0,45 D; cylinder: -0,51 +/- 0,28 D, axis of: 94,7 degrees +/- 57,5 degrees. Values of objective refraction take higher values than the subsequent execution of the subjective examination of the refractive error and recommendation of the appropriate type of corrective aids. This all is in examined groups and in the individual components of refractive errors. It also confirmed the hypothesis that the population outweighs with-the-rule astigmatism, the deployment of resources according to the literature ranges from 90 degrees +/- 10 degrees. The values observed correction of refractive errors are then derived also offer the most common prescription ranges and products for the correction of given ametropia. In the selection and design corrective aids, we are often limited. Our task is then to manufacture high quality, functional and aesthetic corrective aids, you need to connect knowledge from the fields of optics, optometry and ophthalmology. Faster visual rehabilitation simplifies clients' rapid return to everyday life.

Design and development of a mobile system for supporting emergency triage.

PubMed

Michalowski, W; Slowinski, R; Wilk, S; Farion, K J; Pike, J; Rubin, S

2005-01-01

Our objective was to design and develop a mobile clinical decision support system for emergency triage of different acute pain presentations. The system should interact with existing hospital information systems, run on mobile computing devices (handheld computers) and be suitable for operation in weak-connectivity conditions (with unstable connections between mobile clients and a server). The MET (Mobile Emergency Triage) system was designed following an extended client-server architecture. The client component, responsible for triage decision support, is built as a knowledge-based system, with domain ontology separated from generic problem solving methods and used for the automatic creation of a user interface. The MET system is well suited for operation in the Emergency Department of a hospital. The system's external interactions are managed by the server, while the MET clients, running on handheld computers are used by clinicians for collecting clinical data and supporting triage at the bedside. The functionality of the MET client is distributed into specialized modules, responsible for triaging specific types of acute pain presentations. The modules are stored on the server, and on request they can be transferred and executed on the mobile clients. The modular design provides for easy extension of the system's functionality. A clinical trial of the MET system validated the appropriateness of the system's design, and proved the usefulness and acceptance of the system in clinical practice. The MET system captures the necessary hospital data, allows for entry of patient information, and provides triage support. By operating on handheld computers, it fits into the regular emergency department workflow without introducing any hindrances or disruptions. It supports triage anytime and anywhere, directly at the point of care, and also can be used as an electronic patient chart, facilitating structured data collection.

Graph Unification and Tangram Hypothesis Explanation Representation (GATHER) and System and Component Modeling Framework (SCMF)

DTIC Science & Technology

2008-08-01

services, DIDS and DMS, are deployable on the TanGrid system and are accessible via two APIs, a Java client and a servlet based interface. Additionally...but required the user to instantiate an IGraph object with several Java Maps containing the nodes, node attributes, edge types, and the connections...restrictions imposed by the bulk ingest process. Finally, once the bulk ingest process was available in the GraphUnification Java Archives (JAR), DC was

Helpful Components Involved in the Cognitive-Experiential Model of Dream Work

ERIC Educational Resources Information Center

Tien, Hsiu-Lan Shelley; Chen, Shuh-Chi; Lin, Chia-Huei

2009-01-01

The purpose of the study was to examine the helpful components involved in the Hill's cognitive-experiential dream work model. Participants were 27 volunteer clients from colleges and universities in northern and central parts of Taiwan. Each of the clients received 1-2 sessions of dream interpretations. The cognitive-experiential dream work model…

Is the Client-Worker Relationship Associated with Better Outcomes in Mandated Child Abuse Cases?

ERIC Educational Resources Information Center

Lee, Cheryl D.; Ayon, Cecilia

2004-01-01

Objective: The purpose of this research was to (a) find if there were associations between child welfare outcomes and the client-worker relationship and (b) learn what are the predictors of a positive client-worker relationship. Method: 100 (55 Family Maintenance [FM] and 45 Family Preservation [FP]) clients were interviewed in English and…

Opening the gift: social inclusion, professional codes and gift-giving in long-term mental healthcare.

PubMed

Ootes, S T C; Pols, A J; Tonkens, E H; Willems, D L

2013-03-01

Deinstitutionalisation has not only made the social inclusion of clients a key objective in long-term mental healthcare, it may also affect the role of the care professional. This article investigates whether the social inclusion objective clashes with other long-standing professional values, specifically when clients give gifts to care professionals. In making a typology of gifts, we compare the literature on gift-giving with professional codes for gifts and relate both to the objective of social inclusion of clients. Our typology draws on an analysis of ethnographic fieldwork carried out in 2007/2008 at a Dutch mental healthcare centre. We identify four types of gifts for professionals in long-term mental healthcare, each relating individually to professional codes and the objective of social inclusion of clients. Only the 'personal gift' directly supports social inclusion, by fostering personal relationships between professionals and clients. Acceptance of this type of gift is advocated only for long-term care professionals. We suggest that professional codes need to consider this typology of gifts, and we advocate promoting reflexivity as a means of accounting for professional behaviour in deinstitutionalised care settings.

A Veterinary Comparative Counseling Elective Featuring Web-based, Student-created, Client Information Sheets

PubMed Central

Miller, Jennifer C.

2016-01-01

Objective. To design and implement a course in Companion Animal Comparative Counseling that would expose students (N=38) to essential elements of veterinary therapeutics and provide them with the opportunity to apply their knowledge by writing and posting client information sheets (CIS) on an open web site. Design. The elective course was limited to companion animals. Nine different topics were covered over the semester. Class sessions included a didactic component, trivia questions, and field trips. There were 4 major graded assessments: an examination on foundation knowledge, followed by two comparative counseling assessments and evaluation of group-composed CIS. Attendance and participation were also considered. Assessment. The class learned comparative disease states, how to counsel on common pet prescriptions, where to access informatics about specific veterinary drugs, and how to create their own CIS. Conclusion. As pharmacists, these students may have improved their training in veterinary comparative pharmacy. PMID:26941441

Evaluation of components of residential treatment by Medicaid ICF-MR surveys: a validity assessment.

PubMed Central

Reid, D H; Parsons, M B; Green, C W; Schepis, M M

1991-01-01

We evaluated the proficiency of the federal Medicaid program's survey process for evaluating intermediate care facilities for the mentally retarded. In Study 1, an observational analysis of active treatment during leisure times in living units suggested that these surveys did not discriminate between certified and noncertified units. In Study 2, a reactivity analysis of a survey indicated that direct-care staff performed differently during the survey by increasing interactions with clients and decreasing nonwork behavior. Similarly, results of Study 3 showed increases in client access to leisure materials during a survey. In Study 4, questionnaire results indicated considerable variability among service providers' opinions on the consistency, accuracy, and objectivity with which survey teams determine agency standard compliance. Results are discussed regarding effects of the questionable proficiency of survey processes and the potential utility of behavioral assessment methodologies to improve such processes. PMID:1909696

NEOview: Near Earth Object Data Discovery and Query

NASA Astrophysics Data System (ADS)

Tibbetts, M.; Elvis, M.; Galache, J. L.; Harbo, P.; McDowell, J. C.; Rudenko, M.; Van Stone, D.; Zografou, P.

2013-10-01

Missions to Near Earth Objects (NEOs) figure prominently in NASA's Flexible Path approach to human space exploration. NEOs offer insight into both the origins of the Solar System and of life, as well as a source of materials for future missions. With NEOview scientists can locate NEO datasets, explore metadata provided by the archives, and query or combine disparate NEO datasets in the search for NEO candidates for exploration. NEOview is a software system that illustrates how standards-based interfaces facilitate NEO data discovery and research. NEOview software follows a client-server architecture. The server is a configurable implementation of the International Virtual Observatory Alliance (IVOA) Table Access Protocol (TAP), a general interface for tabular data access, that can be deployed as a front end to existing NEO datasets. The TAP client, seleste, is a graphical interface that provides intuitive means of discovering NEO providers, exploring dataset metadata to identify fields of interest, and constructing queries to retrieve or combine data. It features a powerful, graphical query builder capable of easing the user's introduction to table searches. Through science use cases, NEOview demonstrates how potential targets for NEO rendezvous could be identified by combining data from complementary sources. Through deployment and operations, it has been shown that the software components are data independent and configurable to many different data servers. As such, NEOview's TAP server and seleste TAP client can be used to create a seamless environment for data discovery and exploration for tabular data in any astronomical archive.

Parallel compression of data chunks of a shared data object using a log-structured file system

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

Bent, John M.; Faibish, Sorin; Grider, Gary

2016-10-25

Techniques are provided for parallel compression of data chunks being written to a shared object. A client executing on a compute node or a burst buffer node in a parallel computing system stores a data chunk generated by the parallel computing system to a shared data object on a storage node by compressing the data chunk; and providing the data compressed data chunk to the storage node that stores the shared object. The client and storage node may employ Log-Structured File techniques. The compressed data chunk can be de-compressed by the client when the data chunk is read. A storagemore » node stores a data chunk as part of a shared object by receiving a compressed version of the data chunk from a compute node; and storing the compressed version of the data chunk to the shared data object on the storage node.« less

OPeNDAP servers like Hyrax and TDS can easily support common single-sign-on authentication protocols using the Apache httpd and related software; adding support for these protocols to clients can be more challenging

NASA Astrophysics Data System (ADS)

Gallagher, J. H. R.; Potter, N.; Evans, B. J. K.

2016-12-01

OPeNDAP, in conjunction with the Australian National University, documented the installation process needed to add authentication to OPeNDAP-enabled data servers (Hyrax, TDS, etc.) and examined 13 OPeNDAP clients to determine how best to add authentication using LDAP, Shibboleth and OAuth2 (we used NASA's URS). We settled on a server configuration (architecture) that uses the Apache web server and a collection of open-source modules to perform the authentication and authorization actions. This is not the only way to accomplish those goals, but using Apache represents a good balance between functionality, leveraging existing work that has been well vetted and includes support for a wide variety of web services, include those that depend on a servlet engine such as tomcat (which both Hyrax and TDS do). Or work shows how LDAP, OAuth2 and Shibboleth can all be accommodated using this readily available software stack. Also important is that the Apache software is very widely used and is fairly robust - extremely important for security software components. In order to make use of a server requiring authentication, clients must support the authentication process. Because HTTP has included authentication for well over a decade, and because HTTP/HTTPS can be used by simply linking programs with a library, both the LDAP and OAuth2/URS authentication schemes have almost universal support within the OPeNDAP client base. The clients, i.e. the HTTP client libraries they employ, understand how to submit the credentials to the correct server when confronted by an HTTP/S Unauthorized (401) response. Interestingly OAuth2 can achieve it's SSO objectives while relying entirely on normative HTTP transport. All 13 of the clients examined worked.The situation with Shibboleth is different. While Shibboleth does use HTTP, it also requires the client to either scrape a web page or support the SAML2.0 ECP profile, which, for programmatic clients, means using SOAP messages. Since working with SOAP is outside the scope of HTTP, support for Shibboleth must be added explicitly into the client software. Some of the potential burden of enabling OPeNDAP clients to work with Shibboleth may be mitigated by getting both NetCDF-C and NetCDF-Java libraries to use the Shibboleth ECP profile. If done, this would get 9 of the 13 clients we examined working.

Perspectives on barriers to eating healthy among food pantry clients

USDA-ARS?s Scientific Manuscript database

The objective of this study was to explore perspectives on barriers of eating healthy among food pantry clients. Food pantry clients participated in focus groups/interviews. Qualitative data were coded and analyzed using content analyses and grounded theory approach. Themes were then identified. Qua...

A social marketing approach to quality improvement in family planning services: a case study from Rawalpindi, Pakistan.

PubMed

Gulzar, Jamshaid; Ali, Moazzam; Kuroiwa, Chushi

2008-02-01

In the 1990s, social marketing approach was introduced in Pakistan to improve the quality and accessibility of family planning methods involving private practitioners. This study measured six quality elements using a Bruce-Jain framework. Cross-sectional survey data were collected from 29 randomly selected Green Star clinics. The study's four components were 1) an inventory of each outlet (infrastructure, equipment, and supplies); 2) an observation guide for interaction between family planning clients and service providers; 3) exit interviews with clients attending the outlet; and 4) interviews with providers at the outlet. Of the 29 clients participating in the exit interviews, 72% were new users of family planning. The clients' mean age was 32 years; all clients were married; 93% had received formal education. Housework was the principal activity of 93% of clients. The mean number of children reported was three. Both hormonal and intrauterine contraceptives (IUCDs) were available in all facilities; 86% of the clients reported being able to obtain their contraceptive of choice. Most facilities had the equipment and supplies needed to deliver services; service personnel were trained and regularly supervised; the service outlets emphasized mechanisms to ensure continuity of use. Notable shortcomings included a shortage of information on alternative methods, contraindications, and side-effect management, as well as a dearth of registration records. In conclusion, this is a good example of public-private partnership involving private practitioners using a social marketing approach. The quality components of a Bruce-Jain framework were achieved, resulting in a satisfied clientele. Involvement of private service outlets increased the accessibility and enhanced the use of services. Social marketing may be expanded to improve quality and access by involving further components of health care.

Viewing ISS Data in Real Time via the Internet

NASA Technical Reports Server (NTRS)

Myers, Gerry; Chamberlain, Jim

2004-01-01

EZStream is a computer program that enables authorized users at diverse terrestrial locations to view, in real time, data generated by scientific payloads aboard the International Space Station (ISS). The only computation/communication resource needed for use of EZStream is a computer equipped with standard Web-browser software and a connection to the Internet. EZStream runs in conjunction with the TReK software, described in a prior NASA Tech Briefs article, that coordinates multiple streams of data for the ground communication system of the ISS. EZStream includes server components that interact with TReK within the ISS ground communication system and client components that reside in the users' remote computers. Once an authorized client has logged in, a server component of EZStream pulls the requested data from a TReK application-program interface and sends the data to the client. Future EZStream enhancements will include (1) extensions that enable the server to receive and process arbitrary data streams on its own and (2) a Web-based graphical-user-interface-building subprogram that enables a client who lacks programming expertise to create customized display Web pages.

What Torture Survivors Teach Assessors About Being More Fully Human.

PubMed

Evans, F Barton

2016-01-01

This article illustrates the complex sociocultural components in the forensic psychological assessment of a young Ethiopian woman's claim for political asylum due to a well-founded fear of persecution and for relief under the Convention Against Torture. It draws attention to the subtle social and cultural influences in the practice of forensic psychological assessment with an emphasis of reflective practice, which is contextualized in the interpersonal theory of Sullivan. In the interpersonal approach, the essential work of the assessor is to pay careful attention to the microinteractions between the client and the assessor as reflections of the interpersonal (meaning social and cultural) processes, eschewing the illusion of objectivity. In this case study, I illustrate the particular cultural dilemmas for client and assessor in conducting a forensic assessment of psychological trauma, including cross-cultural, gender, and legal difficulties in arriving at an informed, objective, and compassionate assessment of an individual seeking asylum after an especially brutal experience of torture. I argue that collaborative therapeutic assessment methods adapted for forensic practice offer an approach to assessment of psychological trauma that provides more accurate and compassionate assessment than so-called neutral standard forensic assessment practice.

Correlates of Therapeutic Alliance and Treatment Outcomes among Israeli Female Methadone Patients

ERIC Educational Resources Information Center

Schiff, Miriam; Levit, Shabtay

2010-01-01

Objectives: This study examines potential predictors (e.g., attachment style, frequency of therapeutic treatment sessions) of client-rated therapeutic alliance between the social worker and client. The relationship between therapeutic alliance and client's psychological outcomes (hope and posttraumatic stress symptoms [PTS's]) was also assessed.…

Nuances before Dinner: Exploring the Relationship between Peer Counselors and Delinquent Adolescents.

ERIC Educational Resources Information Center

Beitel, Mark

1997-01-01

Details the peer counselor-client relationship from the point of view of a participant observer. By examining the relationship through the clinical lenses of self-psychology and object relations, it was found that peer counselors are seen as transitional objects who can both interpret and meet client needs. (RJM)

Tobacco-Nicotine Education and Training for Health-Care Professional Students and Practitioners: A Systematic Review.

PubMed

Ye, Lisa; Goldie, Catherine; Sharma, Tanvi; John, Sheila; Bamford, Megan; Smith, Patricia M; Selby, Peter; Schultz, Annette S H

2018-04-02

The objective of this systematic review was to investigate what education and training characteristics prepares and supports health-care professionals (HCPs) in the delivery of competent and effective care to clients who use tobacco-nicotine. A search of eight bibliographic databases for English-language peer-reviewed publications from January 2006 to March 2015. Studies were included if they met the a priori inclusion criteria, which consisted of: (1) quantitative study design and (2) focus on tobacco-nicotine education or training for HCP students and practitioners. All studies were independently screened for inclusion by two reviewers. Data from included studies were extracted for study characteristics and key outcomes then critically appraised for methodological quality. Fifty-nine studies were included for narrative synthesis. Two categories emerged: (1) curriculum characteristics (n = 10) and (2) education and training interventions (n = 49). Included curriculum studies identified the following themes: content, intensity, competencies evaluation, and barriers. Study findings about education and training interventions were grouped by level of education (prelicensure, post-licensure, and faculty training), teaching modality, health discipline, and the associated HCP and client outcomes. This comprehensive review suggests that there is a lack of consistency in HCP tobacco-nicotine education and training characteristics. This paper provides valuable categorization of the most frequently utilized components of academic curriculum and discusses the interventions in relation to HCP and client outcomes. Gaps in the literature are highlighted, and the need for standardization of tobacco-nicotine training competencies and evaluation is discussed. Future research investigating the most effective approaches to training is needed. This systematic review summarizes existing tobacco-related curriculum components (content, intensity, competency evaluation, and barriers) and training interventions for health-care professionals worldwide and demonstrates that they are associated with positive health-care professional outcomes (knowledge, attitudes, behaviors, and skills) and client outcomes (quit attempts and smoking abstinence).

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

PubMed

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

2014-01-01

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

A 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.

Case report: a work simulation program for a manual worker with a fracture injury.

PubMed

Chan, Chi-Chung; Chow, Jonathan H.W.

2000-01-01

Work rehabilitation programs targeting different client groups are available in nearly all major hospital occupational therapy departments in Hong Kong. Clients receiving work rehabilitation are referred from various out-patient clinics and other occupational therapists. Those clients experience limitation in work after their injuries or diseases and plan to return to work after rehabilitation. Program objectives are 1) to assist clients to reach maximum work capacity as rapidly as possible 2) to ensure clients return to work safely 3) to improve clients' work readiness. This case report describes an individualized work simulation program at a general hospital in Hong Kong provided for a typical client who is preparing to return to his worker role. Specific job analysis, goals and program rationale for the client are discussed.

Do Organizational Culture and Climate Matter for Successful Client Outcomes?

ERIC Educational Resources Information Center

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

2014-01-01

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

The Client-Centered Approach as a Foundation for Teaching the Introductory Course in Public Relations.

ERIC Educational Resources Information Center

Najor, Michele A.; Motschall, Melissa

2001-01-01

Describes how the authors use a broad-based, client-centered model to teach an introductory course in public relations, integrating writing assignments for "clients" into course topics, which include history, ethics, theory, research, program planning, publicity, crisis management, and evaluation methods. Discusses course objectives, and notes…

Wheelchair Seating Assessment and Intervention: A Comparison Between Telerehabilitation and Face-to-Face Service

PubMed Central

Barlow, Ingrid G; Liu, Lili; Sekulic, Angela

2009-01-01

This study compared outcomes of wheelchair seating and positioning interventions provided by telerehabilitation (n=10) and face-to-face (n=20; 10 in each of two comparison groups, one urban and one rural). Comparison clients were matched to the telerehabilitation clients in age, diagnosis, and type of seating components received. Clients and referring therapists rated their satisfaction and identified if seating intervention goals were met. Clients recorded travel expenses incurred or saved, and all therapists recorded time spent providing service. Wait times and completion times were tracked. Clients seen by telerehabilitation had similar satisfaction ratings and were as likely to have their goals met as clients seen face-to-face; telerehabilitation clients saved travel costs. Rural referring therapists who used telerehabilitation spent more time in preparation and follow-up than the other groups. Clients assessed by telerehabilitation had shorter wait times for assessment than rural face-to-face clients, but their interventions took as long to complete. PMID:25945159

Delayed Instantiation Bulk Operations for Management of Distributed, Object-Based Storage Systems

DTIC Science & Technology

2009-08-01

source and destination object sets, while they have attribute pages to indicate that history . Fourth, we allow for operations to occur on any objects...client dialogue to the PostgreSQL database where server-side functions implement the service logic for the requests. The translation is done...to satisfy client requests, and performs delayed instantiation bulk operations. It is built around a PostgreSQL database with tables for storing

Video streaming technologies using ActiveX and LabVIEW

NASA Astrophysics Data System (ADS)

Panoiu, M.; Rat, C. L.; Panoiu, C.

2015-06-01

The goal of this paper is to present the possibilities of remote image processing through data exchange between two programming technologies: LabVIEW and ActiveX. ActiveX refers to the process of controlling one program from another via ActiveX component; where one program acts as the client and the other as the server. LabVIEW can be either client or server. Both programs (client and server) exist independent of each other but are able to share information. The client communicates with the ActiveX objects that the server opens to allow the sharing of information [7]. In the case of video streaming [1] [2], most ActiveX controls can only display the data, being incapable of transforming it into a data type that LabVIEW can process. This becomes problematic when the system is used for remote image processing. The LabVIEW environment itself provides little if any possibilities for video streaming, and the methods it does offer are usually not high performance, but it possesses high performance toolkits and modules specialized in image processing, making it ideal for processing the captured data. Therefore, we chose to use existing software, specialized in video streaming along with LabVIEW and to capture the data provided by them, for further use, within LabVIEW. The software we studied (the ActiveX controls of a series of media players that utilize streaming technology) provide high quality data and a very small transmission delay, ensuring the reliability of the results of the image processing.

System Transformation under the California Mental Health Services Act: Implementation of Full Service Partnerships in Los Angeles County

PubMed Central

Starks, Sarah L.; Arns, Paul G.; Padwa, Howard; Friedman, Jack R.; Marrow, Jocelyn; Meldrum, Marcia L.; Bromley, Elizabeth; Kelly, Erin Lee; Brekke, John; Braslow, Joel T.

2018-01-01

Objective The objective is to evaluate the effect of California’s Mental Health Services Act on the structure, volume, location, and patient-centeredness of Los Angeles County public mental health services. Methods This prospective mixed-methods study (2006-2013) is based in 5 Los Angeles County public mental health clinics, all with usual care and 3 with Full Service Partnerships (FSP): new MHSA-funded programs designed to “do whatever it takes” to provide intensive, recovery-oriented, team-based, integrated services for clients with severe mental illness. Study participants include treatment providers (42 FSP, 130 usual care) and clients (174 FSP, 298 usual care). FSPs were compared to usual care on outpatient services received (claims data) and organizational climate, recovery orientation, and provider-client working alliance (surveys; semi-structured interviews), with regression adjustment for client and provider characteristics. Results FSP clients received significantly more (5,238 vs. 1,643 minutes, p<.001), and more-frequently field-based (22% vs. 2%, p<.001), outpatient services than usual care clients in the first year post-admission. FSP clients reported more recovery-oriented services (RSA-R 3.8 vs. 3.5, p<.001) and better provider-client working alliance (WAI-S 3.8 vs. 3.6, p=.01). FSP providers reported more stress (55.0 vs. 51.3, p<.001) and lower morale (48.1 vs. 49.6, p<.001). Conclusions Los Angeles County’s public mental health system was able to transform service delivery in response to well-funded policy mandates. For providers, a structure emphasizing accountability and patient-centeredness was associated with greater stress, despite smaller caseloads. For clients, service structure and volume created opportunities to build stronger provider-client relationships and address client needs and goals. PMID:28142386

Unmet counselling need amongst women accessing an induced abortion service in KwaZulu-Natal, South Africa.

PubMed

Birdsey, Graeme; Crankshaw, Tamaryn L; Mould, Sean; Ramklass, Serela S

2016-11-01

Provision of objective, evidence-based counselling in the context of induced abortion services is considered global good practise. However, there is limited understanding over the counselling needs of women accessing abortion services, particularly in sub-Saharan Africa. This study aimed to explore the content and quality of pre-abortion counselling amongst women accessing an abortion service in South Africa as well as client experience of the counselling process. Perceptions of nurse counsellors were also sought. This was a mixed methods study conducted at a Choice of Termination of Pregnancy clinic based at a district level hospital in KwaZulu-Natal, South Africa. Sixty women requesting an abortion were interviewed via a semi-structured questionnaire. In-depth interviews were conducted with four nurses who provided pre-abortion counselling at the clinic. Interviews were coded for emergent themes and categories. Clinic nurses had widely variable counselling training and experience, ranging from less than 2 months to 8 years, but all clients reported that they had been treated with respect at their counselling session. The group-based counselling format and biomedical and health promotion content did not accommodate clients' differential counselling needs, which included requests for support from women experiencing intimate partner violence (IPV). There was limited provider awareness of client's additional counselling needs. Abortion counselling services should be tailored to clients' differential counselling needs. Group-based counselling followed by optional one-on-one counselling sessions is one possible strategy to address unmet client need in South Africa. Provision of abortion provider training in IPV is recommended as well as establishment of referral pathways for women experiencing IPV. Paying attention to the differential counselling needs of women seeking an abortion should be a key component to the provision of abortion services. In this way, abortion services can provide a gateway to additional support for women living in violent relationships and/or other adverse social circumstances. Copyright © 2016 Elsevier Inc. All rights reserved.

Exploring Outcomes and Initial Self-Report of Client Motivation in a College Counseling Center

ERIC Educational Resources Information Center

Ilagan, Guy; Vinson, Michael L.; Sharp, Julia L.; Ilagan, Jill; Oberman, Aaron

2015-01-01

Objective: To explore the association between college counseling center clients' initial self-report of motivation and counseling outcome. Participants: The sample was composed of 331 student clients who utilized a college counseling center from August 2007 to August 2009. The college is a public, mid-size, urban university in the Southeast.…

Diet Quality Is Low among Female Food Pantry Clients in Eastern Alabama

ERIC Educational Resources Information Center

Duffy, Patricia; Zizza, Claire; Jacoby, Jocelynn; Tayie, Francis A.

2009-01-01

Objective: Examine diet quality, food security, and obesity among female food pantry clients. Design: Cross-sectional study. Setting: A food pantry in Lee County, Alabama. Participants: Fifty-five female food pantry clients between 19 and 50 years of age. Main Outcome Measure(s): Diet quality using United States (US) Department of Agriculture…

Shared Decision Making for Clients with Mental Illness: A Randomized Factorial Survey

ERIC Educational Resources Information Center

Lukens, Jonathan M.; Solomon, Phyllis; Sorenson, Susan B.

2013-01-01

Objective: The goal of this study was to test the degree to which client clinical characteristics and environmental context and social workers' practice values and experience influenced support for client's autonomy and willingness to engage in shared decision making (SDM), and whether willingness to engage in SDM was mediated by support for…

Web Program for Development of GUIs for Cluster Computers

NASA Technical Reports Server (NTRS)

Czikmantory, Akos; Cwik, Thomas; Klimeck, Gerhard; Hua, Hook; Oyafuso, Fabiano; Vinyard, Edward

2003-01-01

WIGLAF (a Web Interface Generator and Legacy Application Facade) is a computer program that provides a Web-based, distributed, graphical-user-interface (GUI) framework that can be adapted to any of a broad range of application programs, written in any programming language, that are executed remotely on any cluster computer system. WIGLAF enables the rapid development of a GUI for controlling and monitoring a specific application program running on the cluster and for transferring data to and from the application program. The only prerequisite for the execution of WIGLAF is a Web-browser program on a user's personal computer connected with the cluster via the Internet. WIGLAF has a client/server architecture: The server component is executed on the cluster system, where it controls the application program and serves data to the client component. The client component is an applet that runs in the Web browser. WIGLAF utilizes the Extensible Markup Language to hold all data associated with the application software, Java to enable platform-independent execution on the cluster system and the display of a GUI generator through the browser, and the Java Remote Method Invocation software package to provide simple, effective client/server networking.

WEBSLIDE: A "Virtual" Slide Projector Based on World Wide Web

NASA Astrophysics Data System (ADS)

Barra, Maria; Ferrandino, Salvatore; Scarano, Vittorio

1999-03-01

We present here the design key concepts of WEBSLIDE, a software project whose objective is to provide a simple, cheap and efficient solution for showing slides during lessons in computer labs. In fact, WEBSLIDE allows the video monitors of several client machines (the "STUDENTS") to be synchronously updated by the actions of a particular client machine, called the "INSTRUCTOR." The system is based on the World Wide Web and the software components of WEBSLIDE mainly consists in a WWW server, browsers and small Cgi-Bill scripts. What makes WEBSLIDE particularly appealing for small educational institutions is that WEBSLIDE is built with "off the shelf" products: it does not involve using a specifically designed program but any Netscape browser, one of the most popular browsers available on the market, is sufficient. Another possible use is to use our system to implement "guided automatic tours" through several pages or Intranets internal news bulletins: the company Web server can broadcast to all employees relevant information on their browser.

The PubChem chemical structure sketcher

PubMed Central

2009-01-01

PubChem is an important public, Web-based information source for chemical and bioactivity information. In order to provide convenient structure search methods on compounds stored in this database, one mandatory component is a Web-based drawing tool for interactive sketching of chemical query structures. Web-enabled chemical structure sketchers are not new, being in existence for years; however, solutions available rely on complex technology like Java applets or platform-dependent plug-ins. Due to general policy and support incident rate considerations, Java-based or platform-specific sketchers cannot be deployed as a part of public NCBI Web services. Our solution: a chemical structure sketching tool based exclusively on CGI server processing, client-side JavaScript functions, and image sequence streaming. The PubChem structure editor does not require the presence of any specific runtime support libraries or browser configurations on the client. It is completely platform-independent and verified to work on all major Web browsers, including older ones without support for Web2.0 JavaScript objects. PMID:20298522

Employability of Clients Served in State Vocational Rehabilitation Agencies: A National Census.

ERIC Educational Resources Information Center

Moriarty, Joseph B.; And Others

1988-01-01

Administered Preliminary Diagnostic Questionnaire as measure of employability to national sample of 2,972 vocational rehabilitation clients. Findings regarding physical, emotional, cognitive, and motivational components of employability revealed national disadvantaged vocational rehabilitation population. Found that reduction of handicap directly…

Family Network, Workplace Network, and Their Influence on Condom Use: A Qualitative Study Among Older Female Sex Workers in China

PubMed Central

Hao, Chun; Guida, Jennifer; Morisky, Donald E.; Liu, Hongjie

2014-01-01

The objective of this study was to qualitatively explore the components of social networks and their influence on condom use among older female sex workers (FSWs) aged 35 years and older in China. In-depth interviews with 63 older FSWs and 6 focus groups interviews with pimps and owners of roadside salons and hotels were conducted in three Chinese cities. The mean age of participants was 42.6 years old (SD = 6.9 years) and the mean age of starting sex work was 38.6 years old (SD = 6.6 years). Two types of networks that influenced condom use were identified: family networks (relationship with children and husbands) and workplace networks (relationship with peers, clients, pimps and owners). Relationships between older FSWs and their children negatively influenced condom use. Low levels of network support and norms regarding condom use were observed in the relationship between older FSWs and their clients, whereas positive social support and norms were prevalent among older FSWs who had frequent contact with peers. Norms for condom use existed among pimps and owners, but were counterbalanced by monetary gains. Future HIV interventions for older FSWs should take the different features of social network components into consideration. PMID:25411685

Family Network, Workplace Network, and Their Influence on Condom Use: A Qualitative Study Among Older Female Sex Workers in China.

PubMed

Hao, Chun; Guida, Jennifer; Morisky, Donald E; Liu, Hongjie

2015-01-01

The objective of this study was to qualitatively explore the components of social networks and their influence on condom use among female sex workers (FSWs) aged 35 years and older in China. In-depth interviews with 63 older FSWs and 6 focus group interviews with pimps and owners of roadside salons and hotels were conducted in 3 Chinese cities. The mean age of participants was 42.6 years old (SD = 6.9 years) and the mean age of starting sex work was 38.6 years old (SD = 6.6 years). Two types of networks that influenced condom use were identified: family networks (relationship with children and husbands) and workplace networks (relationship with peers, clients, pimps, and owners). Relationships between older FSWs and their children negatively influenced condom use. Low levels of network support and norms regarding condom use were observed in the relationship between older FSWs and their clients, whereas positive social support and norms were prevalent among older FSWs who had frequent contact with peers. Norms for condom use existed among pimps and owners but were counterbalanced by monetary gains. Future human immunodeficiency virus (HIV) interventions for older FSWs should take the different features of social network components into consideration.

Preliminary findings on the association between clients' perceived helpfulness of substance abuse treatment and outcomes: does race matter?

PubMed

Montgomery, LaTrice; Sanning, Blair; Litvak, Nicole; Peters, Erica N

2014-06-01

Few studies examine the helpfulness and effectiveness of substance abuse treatment from the clients' perspective. The current secondary analysis examined the perceived helpfulness of substance abuse treatment components and its relationship to treatment outcomes among 387 Black and White adults participating in a multisite randomized clinical trial (RCT) of Motivational Enhancement Therapy. Throughout the 16-week RCT, participants self-reported substance use. Upon completion of treatment, participants completed a self-report measure assessing the perceived helpfulness of treatment components. Black participants rated 9 out of 12 treatment components (e.g., "learning skills that will help me cope with my problems") as being more helpful than their White counterparts, even after controlling for age, gender, employment status, primary drug type, and treatment assignment. However, perceived helpfulness ratings were not associated with substance use outcomes among Black or White participants. Clients' perceived helpfulness of treatment components is an important factor to consider in improving the delivery of substance abuse treatment, especially for Black adults. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Medicaid-funded home care for the frail elderly and disabled: evaluating the cost savings and outcomes of a service delivery reform.

PubMed Central

Feldman, P H; Latimer, E; Davidson, H

1996-01-01

OBJECTIVES: In response to rising demand and increased costs for home care services for frail elderly and disabled Medicaid clients, New York City implemented cluster care, a shared-aide model of home care. Our objective: to evaluate the effects of cluster care on home care hours and costs, client functioning, depressive symptoms, and satisfaction. DATA SOURCES: Client interviews, conducted prior to implementation and again 16 months later; Medicaid claims records; home attendant payroll files; and vendor agency records. STUDY DESIGN: The study employed a pretest/posttest design, comparing 229 clients at the first seven demonstration sites to 175 clients at four comparison sites before and after cluster care implementation. Regression methods were used to analyze pre and post-intervention data. PRINCIPAL FINDINGS: Cluster care reduced costs by about 10 percent. Most savings occurred among the more vulnerable clients (those with five or more ADL/IADL limitations). Clients at cluster care sites who started out with fewer than five limitations appeared to decline somewhat more slowly than similarly impaired clients at comparison sites, while those with more than five ADL/IADLs tended to decline more rapidly. This difference was small-less than one limitation per year. Cluster care is associated with a significant decline in satisfaction but appears unrelated to depressive symptoms. CONCLUSIONS: Cluster care appears benign for home care clients with fewer limitations. For the more vulnerable, we recommend experimentation with low-cost interventions that might augment service and improve outcomes without reverting to traditional one-on-one care. PMID:8885860

NIR camera and spectrograph SWIMS for TAO 6.5m telescope: array control system and its performance

NASA Astrophysics Data System (ADS)

Terao, Yasunori; Motohara, Kentaro; Konishi, Masahiro; Takahashi, Hidenori; Kato, Natsuko M.; Kitagawa, Yutaro; Kobayakawa, Yutaka; Ohashi, Hirofumi; Tateuchi, Ken; Todo, Soya

2016-08-01

SWIMS (Simultaneous-color Wide-field Infrared Multi-object Spectrograph) is a near-infrared imager and multi-object spectrograph as one of the first generation instruments for the University of Tokyo Atacama Observatory (TAO) 6.5m telescope. In this paper, we describe an array control system of SWIMS and results of detector noise performance evaluation. SWIMS incorporates four (and eight in future) HAWAII-2RG focal plane arrays for detectors, each driven by readout electronics components: a SIDECAR ASIC and a JADE2 Card. The readout components are controlled by a HAWAII-2RG Testing Software running on a virtual Windows machine on a Linux PC called array control PC. All of those array control PCs are then supervised by a SWIMS control PC. We have developed an "array control software system", which runs on the array control PC to control the HAWAII-2RG Testing Software, and consists of a socket client and a dedicated server called device manager. The client runs on the SWIMS control PC, and the device manager runs on the array control PC. An exposure command, issued by the client on the SWIMS control PC, is sent to the multiple device managers on the array control PCs, and then multiple HAWAII-2RGs are driven simultaneously. Using this system, we evaluate readout noise performances of the detectors, both in a test dewar and in a SWIMS main dewar. In the test dewar, we confirm the readout noise to be 4.3 e- r.m.s. by 32 times multiple sampling when we operate only a single HAWAII-2RG, whereas in the case of simultaneous driving of two HAWAII-2RGs, we still obtain sufficiently low readout noise of 10 e- r.m.s. In the SWIMS main dewar, although there are some differences between the detectors, the readout noise is measured to be 4:1-4:6 e- r.m.s. with simultaneous driving by 64 times multiple sampling, which meets the requirement for background-limited observations in J band of 14 e- r.m.s..

Access Control of Web- and Java-Based Applications

NASA Technical Reports Server (NTRS)

Tso, Kam S.; Pajevski, Michael J.

2013-01-01

Cybersecurity has become a great concern as threats of service interruption, unauthorized access, stealing and altering of information, and spreading of viruses have become more prevalent and serious. Application layer access control of applications is a critical component in the overall security solution that also includes encryption, firewalls, virtual private networks, antivirus, and intrusion detection. An access control solution, based on an open-source access manager augmented with custom software components, was developed to provide protection to both Web-based and Javabased client and server applications. The DISA Security Service (DISA-SS) provides common access control capabilities for AMMOS software applications through a set of application programming interfaces (APIs) and network- accessible security services for authentication, single sign-on, authorization checking, and authorization policy management. The OpenAM access management technology designed for Web applications can be extended to meet the needs of Java thick clients and stand alone servers that are commonly used in the JPL AMMOS environment. The DISA-SS reusable components have greatly reduced the effort for each AMMOS subsystem to develop its own access control strategy. The novelty of this work is that it leverages an open-source access management product that was designed for Webbased applications to provide access control for Java thick clients and Java standalone servers. Thick clients and standalone servers are still commonly used in businesses and government, especially for applications that require rich graphical user interfaces and high-performance visualization that cannot be met by thin clients running on Web browsers

Building the Joint Battlespace Infosphere. Volume 1: Summary

DTIC Science & Technology

1999-12-17

Integrity guarantees. The information staff will conduct audits and other routine procedures to ensure that the JBI platform and its clients are...delete the object; thereafter, the object will not be available to other JBI clients, but it will have been saved in an archive for auditing or...this project are maintaining multiyear, multilocation programs in nomadic networking and assuring quality of service in emerging networks. Dynamic

Technology and the ambulatory equine practitioner: implementing and affording the 21st century.

PubMed

Baus, Mark R; Magnus, Robert P

2012-04-01

Purchasing new or used capital assets involves both emotional and financial components in the decision making process. In addition, there are intangible factors such as client perceptions and expectations that fit into the equation. Identify the facts from a business perspective and then define whether this investment (expense) is good for the practice and fits with the short- and long-term growth strategies. Ask the tough questions, analyze the numbers, understand the clients’ needs, and tie this together with the practice brand and strategic objectives. The informed and prepared buyer is usually successful in making the right decision.

Case for Deploying Complex Systems Utilizing Commodity Components

NASA Technical Reports Server (NTRS)

Bryant, Barry S.; Pitts, R. Lee; Ritter, George

2003-01-01

This viewgraph representation presents a study of the transition of computer networks and software engineering at the Huntsville Operations Support Center (HOSC) from a client/server UNIX based system to a client/server system based on commodity priced and open system components. Topics covered include: an overview of HOSC ground support systems, an analysis for changes to the existing ground support system, an analysis of options considered for the transition to a new system, and a consideration of goals for a new system.

Fast-track services for all? The preferences of Chinese-, Korean-, and Thai-speaking women attending a sexual health service.

PubMed

Martin, Lynne; Knight, Vickie; Read, Phillip J; McNulty, Anna

2013-12-01

Sydney Sexual Health Centre (SSHC) Xpress clinic has significantly reduced the length of stay and waiting time for clients at SSHC but is currently only available to clients who can read and understand a high level of English. This reduces access for culturally and linguistically diverse (CALD) clients. This study sought to determine the acceptability of 4 proposed components of an express clinic model among CALD clients: computer-assisted self-interview (CASI), self-collection of swabs/urine specimens, not having a physical examination, and consultation with a health promotion officer rather than with a clinician. Differences in acceptability based on language group, new or return client status, sex worker status, clinic visited status, and age were analyzed. A cross-sectional, anonymous questionnaire was offered to all female Chinese, Thai, and Korean clients attending SSHC between March and November 2012. Multivariate regression and Pearson χ statistical analyses were conducted using STATA 12 software. A total of 366 questionnaires were returned from 149 Thai, 145 Chinese, and 72 Korean participants. After multivariate analysis, the only predictor of willingness to use an express model of service provision was language group: overall, 67% Thai (odds ratio, 3.74: confidence interval [CI], 2.03-6.89; P < 0.01) and 64% Korean (odds ratio, 3.58; CI, 1.77-7.25, P < 0.01) said that they would use it compared with 35% Chinese. Age, history of sex work, new or returning clients, and general or language clinic attendance did not impact on choices. Within the preference for individual components of the model, more Thai women were happy with using a health promotion officer (43.2%) than Chinese (14.1%) or Korean (8.5%) (P < 0.001); no groups were happy with forfeiting a physical examination; Thai (48.6%) and Korean (40.9%) were happier with self-swabbing than Chinese women (23.9%, P < 0.001); and more Thai were happy to use a CASI (44.2%) than Chinese (12%) or Korean (11.1%; P < 0.001). This research shows that the components of an express model used at SSHC are not favorable to our CALD client base. Despite a CALD express clinic having the potential to reduce waiting times, most clients did not favor reduced waiting time over being physically examined or using a CASI.

Improving publicly funded substance abuse treatment: the value of case management.

PubMed Central

Shwartz, M; Baker, G; Mulvey, K P; Plough, A

1997-01-01

OBJECTIVES: This study evaluated the impact of case management on client retention in treatment and short-term relapse for clients in the publicly funded substance abuse treatment system. METHODS: A retrospective cohort design was used to study clients discharged from the following four modalities in 1993 and 1994: short-term residential (3112 clients), long-term residential (2888 clients), outpatient (7431 clients), and residential detox (7776 clients). Logistic regression models were used to analyze the impact of case management after controlling for baseline characteristics. RESULTS: The odds that case-managed clients reached a length of stay previously identified as associated with more successful treatment were 1.6 (outpatient programs) to 3.6 (short-term residential programs) times higher than the odds for non-case-managed clients. With the exception of outpatient clients, the odds of case-managed clients' being admitted to detox within 90 days after discharge (suggesting relapse) were about two thirds those of non-case-managed clients. The odds of case-managed detox clients' transitioning to post-detox treatment (a good outcome) were 1.7 times higher than the odds for non-case-managed clients. CONCLUSIONS: Case management is a low-cost enhancement that improves short-term outcomes of substance abuse treatment programs. PMID:9357349

A Cognitive Perspective in the Treatment of Incarcerated Clients.

ERIC Educational Resources Information Center

Walsh, Thomas C.

1990-01-01

Proposes a cognitive therapy model as a workable approach in treating incarcerated clients. Reviews principal components and techniques of cognitive theory. Uses case vignettes to illustrate application of this approach. Delineates key features of cognitive model which relate to treatment of incarcerated population. (Author/ABL)

Group Process in a Women's Career Intervention.

ERIC Educational Resources Information Center

Mawson, Diana L.; Kahn, Sharon E.

1993-01-01

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

Cultural adaptation of evidence-based practice utilizing an iterative stakeholder process and theoretical framework: problem solving therapy for Chinese older adults

PubMed Central

Chu, Joyce P.; Huynh, Loanie; Areán, Patricia

2011-01-01

Objectives Main objectives were to familiarize the reader with a theoretical framework for modifying evidence-based interventions for cultural groups, and to provide an example of one method, Formative Method for Adapting Psychotherapies (FMAP), in the adaptation of an evidence-based intervention for a cultural group notorious for refusing mental health treatment. Methods Provider and client stakeholder input combined with an iterative testing process within the FMAP framework was utilized to create the Problem Solving Therapy—Chinese Older Adult (PST-COA) manual for depression. Data from pilot-testing the intervention with a clinically depressed Chinese elderly woman are reported. Results PST-COA is categorized as a ‘culturally-adapted’ treatment, where core mediating mechanisms of PST were preserved, but cultural themes of measurement methodology, stigma, hierarchical provider-client relationship expectations, and acculturation enhanced core components to make PST more understandable and relevant for Chinese elderly. Modifications also encompassed therapeutic framework and peripheral elements affecting engagement and retention. PST-COA applied with a depressed Chinese older adult indicated remission of clinical depression and improvement in mood. Fidelity with and acceptability of the treatment was sufficient as the client completed and reported high satisfaction with PST-COA. Conclusions PST, as a non-emotion-focused, evidence-based intervention, is a good fit for depressed Chinese elderly. Through an iterative stakeholder process of cultural adaptation, several culturally-specific modifications were applied to PST to create the PST-COA manual. PST-COA preserves core therapeutic PST elements but includes cultural adaptations in therapeutic framework and key administration and content areas that ensure greater applicability and effectiveness for the Chinese elderly community. PMID:21500283

Group-oriented coordination models for distributed client-server computing

NASA Technical Reports Server (NTRS)

Adler, Richard M.; Hughes, Craig S.

1994-01-01

This paper describes group-oriented control models for distributed client-server interactions. These models transparently coordinate requests for services that involve multiple servers, such as queries across distributed databases. Specific capabilities include: decomposing and replicating client requests; dispatching request subtasks or copies to independent, networked servers; and combining server results into a single response for the client. The control models were implemented by combining request broker and process group technologies with an object-oriented communication middleware tool. The models are illustrated in the context of a distributed operations support application for space-based systems.

Secure Design Patterns

DTIC Science & Technology

2009-10-01

Unprivileged Client Process The unprivileged client is responsible for handling the authentication of the user’s request. Be- cause it is not yet known if...define USER_UID 1000 // The location of the empty directory to use as the root directory // for the untrusted child process . #define EMPTY_ROOT_DIR...complex object should be independent of the parts that make up the object and how they are assembled. − The construction process must allow for

Abstinence at Successful Discharge in Publicly Funded Addiction Health Services

PubMed Central

Guerrero, Erick G.; Kong, Yinfei; Kim, Tina

2016-01-01

Abstinence at successful discharge in substance use disorder treatment is important to reducing relapse rates and increasing long-term recovery from substance use disorders. However, few studies have examined abstinence as an essential component of successful discharge. This study examined rates and correlates of reported abstinence (nonuse of drugs 30 days prior to successful discharge) among clients attending publicly funded treatment in Los Angeles County, California. Finding show that only 36% of clients who were successfully discharged reported abstinence. Black clients were less likely than non-Hispanic Whites to report abstinence at successful discharge. Clients in methadone treatment programs were less likely than outpatient clients to report abstinence, whereas clients referred to treatment through the legal system (Proposition 36) were more likely to report abstinence compared to self-referred clients. Findings underscore the importance of systematic assessment of abstinence in determining successful discharge and provide a basis for further examination of strategies to improve abstinence and reduce relapse. PMID:26882909

Abstinence at Successful Discharge in Publicly Funded Addiction Health Services.

PubMed

Frimpong, Jemima A; Guerrero, Erick G; Kong, Yinfei; Kim, Tina

2016-10-01

Abstinence at successful discharge in substance use disorder treatment is important to reducing relapse rates and increasing long-term recovery from substance use disorders. However, few studies have examined abstinence as an essential component of successful discharge. This study examined rates and correlates of reported abstinence (nonuse of drugs 30 days prior to successful discharge) among clients attending publicly funded treatment in Los Angeles County, California. Finding show that only 36% of clients who were successfully discharged reported abstinence. Black clients were less likely than non-Hispanic Whites to report abstinence at successful discharge. Clients in methadone treatment programs were less likely than outpatient clients to report abstinence, whereas clients referred to treatment through the legal system (Proposition 36) were more likely to report abstinence compared to self-referred clients. Findings underscore the importance of systematic assessment of abstinence in determining successful discharge and provide a basis for further examination of strategies to improve abstinence and reduce relapse.

Design and evaluation of web-based image transmission and display with different protocols

NASA Astrophysics Data System (ADS)

Tan, Bin; Chen, Kuangyi; Zheng, Xichuan; Zhang, Jianguo

2011-03-01

There are many Web-based image accessing technologies used in medical imaging area, such as component-based (ActiveX Control) thick client Web display, Zerofootprint thin client Web viewer (or called server side processing Web viewer), Flash Rich Internet Application(RIA) ,or HTML5 based Web display. Different Web display methods have different peformance in different network environment. In this presenation, we give an evaluation on two developed Web based image display systems. The first one is used for thin client Web display. It works between a PACS Web server with WADO interface and thin client. The PACS Web server provides JPEG format images to HTML pages. The second one is for thick client Web display. It works between a PACS Web server with WADO interface and thick client running in browsers containing ActiveX control, Flash RIA program or HTML5 scripts. The PACS Web server provides native DICOM format images or JPIP stream for theses clients.

Attracting Clients to Service-Oriented Programs.

ERIC Educational Resources Information Center

Disney, Diane M.

One of a series of manuals developed by the Home and Community-Based Career Education Project, the outreach component publication describes how the project went about attracting clients for its adult vocational counseling services. Sections include: creating a publicity campaign, using an advertising agency, creating products for the mass media,…

Student Projects as a Funding Source

ERIC Educational Resources Information Center

Henson, Kerry L.

2010-01-01

Prompted by restricted funding for a lab which supported student software development work on real-world projects, a contribution program was established to facilitate monetary support from the external clients. The paper explores the relationships between instructor, students and client and how a funding component can affect these ties.…

Client's view of a successful helping relationship.

PubMed

Ribner, David S; Knei-Paz, Cigal

2002-10-01

This study asked clients from multiproblem families to describe a successful helping relationship. The replies were analyzed using narrative research techniques and results are presented in conceptual categories with illustrative quotations from the interviews. The article offers conclusions about client preferences in the areas of working relationship, work styles, and worker characteristics. The results revealed two general domains of the client-worker relationship: factors that provided a sense of equality in the relationship, for example, love, friendship, and a nonjudgmental stance; and the notion that the helping relationship should parallel more normative contacts and include components such as flexibility, chemistry, luck, and going the extra distance.

Proving Correctness for Pointer Programs in a Verifying Compiler

NASA Technical Reports Server (NTRS)

Kulczycki, Gregory; Singh, Amrinder

2008-01-01

This research describes a component-based approach to proving the correctness of programs involving pointer behavior. The approach supports modular reasoning and is designed to be used within the larger context of a verifying compiler. The approach consists of two parts. When a system component requires the direct manipulation of pointer operations in its implementation, we implement it using a built-in component specifically designed to capture the functional and performance behavior of pointers. When a system component requires pointer behavior via a linked data structure, we ensure that the complexities of the pointer operations are encapsulated within the data structure and are hidden to the client component. In this way, programs that rely on pointers can be verified modularly, without requiring special rules for pointers. The ultimate objective of a verifying compiler is to prove-with as little human intervention as possible-that proposed program code is correct with respect to a full behavioral specification. Full verification for software is especially important for an agency like NASA that is routinely involved in the development of mission critical systems.

A systematic review of HIV partner counseling and referral services: client and provider attitudes, preferences, practices, and experiences.

PubMed

Passin, Warren F; Kim, Angela S; Hutchinson, Angela B; Crepaz, Nicole; Herbst, Jeffrey H; Lyles, Cynthia M

2006-05-01

The objectives of this study were to understand client and provider attitudes, experiences, and practices regarding HIV partner notification in the United States and to help identify future research and program needs. The goals of this study were to synthesize the literature reporting client and provider attitudes, experiences, and practices and to identify potential negative effects of HIV partner notification. This study consisted of a systematic qualitative review. Clients were willing to self-notify partners and participate in provider notification, and few reported negative effects. The majority of health care providers were in favor of HIV partner notification; however, they did not consistently refer index clients to HIV partner notification programs. Considering that clients have positive attitudes toward self- and provider referral, local HIV prevention programs need to ensure that all HIV-positive clients are offered partner notification services. Additional research is needed to assess the potential risks of notifying partners and to identify effective techniques to improve client and provider participation.

Designing personal grief rituals: An analysis of symbolic objects and actions.

PubMed

Sas, Corina; Coman, Alina

2016-10-01

Personal grief rituals are beneficial in dealing with complicated grief, but challenging to design, as they require symbolic objects and actions meeting clients' emotional needs. The authors reported interviews with 10 therapists with expertise in both grief therapy and grief rituals. Findings indicate three types of rituals supporting honoring, letting go, and self transformation, with the latter being particularly complex. Outcomes also point to a taxonomy of ritual objects for framing and remembering ritual experience, and for capturing and processing grief. Besides symbolic possessions, the authors identified other types of ritual objects including transformational and future-oriented ones. Symbolic actions include creative craft of ritual objects, respectful handling, disposal, and symbolic play. They conclude with theoretical implications of these findings, and a reflection on their value for tailored, creative co-design of grief rituals. In particular, several implications for designing grief rituals were identified that include accounting for the client's need, selecting (or creating) the most appropriate objects and actions from the identified types, integrating principles of both grief and art/drama therapy, exploring clients' affinity for the ancient elements as medium of disposal in letting go rituals, and the value of technology for recording and reflecting on ritual experience.

Flexible server architecture for resource-optimal presentation of Internet multimedia streams to the client

NASA Astrophysics Data System (ADS)

Boenisch, Holger; Froitzheim, Konrad

1999-12-01

The transfer of live media streams such as video and audio over the Internet is subject to several problems, static and dynamic by nature. Important quality of service (QoS) parameters do not only differ between various receivers depending on their network access, service provider, and nationality, the QoS is also variable in time. Moreover the installed receiver base is heterogeneous with respect to operating system, browser or client software, and browser version. We present a new concept for serving live media streams. It is not longer based on the current one-size-fits all paradigm, where the server offers just one stream. Our compresslet system takes the opposite approach: it builds media streams `to order' and `just in time'. Every client subscribing to a media stream uses a servlet loaded into the media server to generate a tailored data stream for his resources and constraints. The server is designed such that commonly used components for media streams are computed once. The compresslets use these prefabricated components, code additional data if necessary, and construct the data stream based on the dynamic available QoS and other client constraints. A client-specific encoding leads to resource- optimal presentation that is especially useful for the presentation of complex multimedia documents on a variety of output devices.

An analysis of music therapy program goals and outcomes for clients with diagnoses on the autism spectrum.

PubMed

Kaplan, Ronna S; Steele, Anita Louise

2005-01-01

The researchers analyzed data related to goals and outcomes over 2 program years for 40 music therapy clients, ranging in age from 2-49 years, with diagnoses on the autism spectrum. They investigated music therapy interventions, session types, and formats most frequently used; goals most frequently addressed; assessed level of difficulty of clients and their situations; and generalization of skills attained in music therapy to other settings. The most common session type was individual, followed by partner, small or large groups, peer model, or a combination. Primary goal areas were ranked from language/communication (41%), behavioral/psychosocial (39%), cognitive (8%), and musical (7%), to perceptual/motor (5%). One hundred percent of subjects reached their initial objectives in these goal areas within one year or less, regardless of session type, level of difficulty, or goal area. Seventy-seven percent of intermediate objectives were reached within that time. The most frequently utilized interventions were interactive instrument playing, musical instrument instruction, interactive singing, instrument choices, and song choices. Specific interventions chosen did not affect accomplishment of initial objectives. However, there was more variation among interventions in terms of achievement of intermediate objectives. Session formats were ranked from activity-based as most frequent to lesson-based, client-led/"shadow," and ensemble format. All formats were successful when addressing initial objectives, with lesson-based format being most effective in reaching intermediate objectives. Lastly, 100% of parents and caregivers surveyed indicated subjects generalized skills/responses acquired in music therapy to non-music therapy environments.

Enhanced interfaces for web-based enterprise-wide image distribution.

PubMed

Jost, R Gilbert; Blaine, G James; Fritz, Kevin; Blume, Hartwig; Sadhra, Sarbjit

2002-01-01

Modern Web browsers support image distribution with two shortcomings: (1) image grayscale presentation at client workstations is often sub-optimal and generally inconsistent with the presentation state on diagnostic workstations and (2) an Electronic Patient Record (EPR) application usually cannot directly access images with an integrated viewer. We have modified our EPR and our Web-based image-distribution system to allow access to images from within the EPR. In addition, at the client workstation, a grayscale transformation is performed that consists of two components: a client-display-specific component based on the characteristic display function of the class of display system, and a modality-specific transformation that is downloaded with every image. The described techniques have been implemented in our institution and currently support enterprise-wide clinical image distribution. The effectiveness of the techniques is reviewed.

Construct Validity of the MMPI-2 College Maladjustment (Mt) Scale

ERIC Educational Resources Information Center

Barthlow, Deanna L.; Graham, John R.; Ben-Porath, Yossef S.; McNulty, John L

2004-01-01

The construct validity of the MMPI-2 (Minnesota Multiphasic Personality Inventory-2) College Maladjustment (Mt) Scale was examined using 376 student clients at a university psychological clinic. A principal components analysis and correlations of Mt scale scores with clients' and therapists' ratings of symptoms and functioning showed that the Mt…

Clinical management of "entitled" clients.

PubMed

Kerr, Norine

2002-12-01

As this process occurs, the painful affects become toned down for the clients. By exploring the source of clients' painful affects, wounded self-esteem, fearful projections, and dysfunctional defenses, misguided entitlement can be undermined. Much of this work will occur in a formal psychotherapy process, but nurses can create healthy object relatedness. To do so, they must see beyond the provocative and offensive behaviors to the vulnerable individual within who desperately needs compassionate and intelligent nursing care.

Experiences of Scandinavian nurses in discussing sexuality with patients, clients and residents: a qualitative systematic review protocol.

PubMed

Laursen, Birgitte Schantz; Rasmussen, Philippa; Conroy, Tiffany

2017-07-01

The objective of this review is to critically appraise, synthesize, and present the best available evidence to address the question: How do Scandinavian nurses experience discussing sexual issues with patients, residents and clients?

Family centered brief intensive treatment: a pilot study of an outpatient treatment for acute suicidal ideation.

PubMed

Anastasia, Trena T; Humphries-Wadsworth, Terresa; Pepper, Carolyn M; Pearson, Timothy M

2015-02-01

Family Centered Brief Intensive Treatment (FC BIT), a hospital diversion treatment program for individuals with acute suicidal ideation, was developed to treat suicidal clients and their families. Individuals who met criteria for hospitalization were treated as outpatients using FC BIT (n = 19) or an intensive outpatient treatment without the family component (IOP; n = 24). Clients receiving FC BIT identified family members or supportive others to participate in therapy. FC BIT clients had significantly greater improvement at the end of treatment compared to IOP clients on measures of depression, hopelessness, and suicidality. Further research is needed to test the efficacy of FC BIT. © 2014 The American Association of Suicidology.

New Software Architecture Options for the TCL Data Acquisition System

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

Valenton, Emmanuel

2014-09-01

The Turbulent Combustion Laboratory (TCL) conducts research on combustion in turbulent flow environments. To conduct this research, the TCL utilizes several pulse lasers, a traversable wind tunnel, flow controllers, scientific grade CCD cameras, and numerous other components. Responsible for managing these different data-acquiring instruments and data processing components is the Data Acquisition (DAQ) software. However, the current system is constrained to running through VXI hardware—an instrument-computer interface—that is several years old, requiring the use of an outdated version of the visual programming language, LabVIEW. A new Acquisition System is being programmed which will borrow heavily from either a programming modelmore » known as the Current Value Table (CVT) System or another model known as the Server-Client System. The CVT System model is in essence, a giant spread sheet from which data or commands may be retrieved or written to, and the Server-Client System is based on network connections between a server and a client, very much like the Server-Client model of the Internet. Currently, the bare elements of a CVT DAQ Software have been implemented, consisting of client programs in addition to a server program that the CVT will run on. This system is being rigorously tested to evaluate the merits of pursuing the CVT System model and to uncover any potential flaws which may result in further implementation. If the CVT System is chosen, which is likely, then future work will consist of build up the system until enough client programs have been created to run the individual components of the lab. The advantages of such a System will be flexibility, portability, and polymorphism. Additionally, the new DAQ software will allow the Lab to replace the VXI with a newer instrument interface—the PXI—and take advantage of the capabilities of current and future versions of LabVIEW.« less

Next Generation Multimedia Distributed Data Base Systems

NASA Technical Reports Server (NTRS)

Pendleton, Stuart E.

1997-01-01

The paradigm of client/server computing is changing. The model of a server running a monolithic application and supporting clients at the desktop is giving way to a different model that blurs the line between client and server. We are on the verge of plunging into the next generation of computing technology--distributed object-oriented computing. This is not only a change in requirements but a change in opportunities, and requires a new way of thinking for Information System (IS) developers. The information system demands caused by global competition are requiring even more access to decision making tools. Simply, object-oriented technology has been developed to supersede the current design process of information systems which is not capable of handling next generation multimedia.

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.

The research of .NET framework based on delegate of the LCE

NASA Astrophysics Data System (ADS)

Chen, Yi-peng

2011-10-01

Programmers realize LCE Enterprise services provided by NET framework when they develop applied VC# programming design language with component technology facing objects Lots of basic codes used to be compiled in the traditional programming design. However, nowadays this can be done just by adding corresponding character at class, interface, method, assembly with simple declarative program. This paper mainly expatiates the mechanism to realize LCE event services with delegate mode in C#. It also introduces the procedure of applying event class, event publisher, subscriber and client in LCE technology. It analyses the technology points of LCE based on delegate mode with popular language and practicing cases.

Mutual powerlessness in client participation practices in mental health care.

PubMed

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

2014-04-01

Client participation has become a dominant policy goal in many countries including the Netherlands and is a topic much discussed in the literature. The success of client participation is usually measured in terms of the extent to which clients have a say in the participation process. Many articles have concluded that client participation is limited; professionals often still control the participation process and outcomes. The objective of this study is to gain insight into (i) the practice of client participation within a quality improvement collaborative in mental health care and (ii) the consequences of a Foucauldian conceptualization of power in analysing practices of client participation. We used an ethnographic design consisting of observations of national events and improvement team meetings and interviews with the collaborative's team members and programme managers. Contrary to many studies on client participation, we found both clients and service providers frequently felt powerless in its practice. Professionals and clients alike struggled with the contributions clients could make to the improvement processes and what functions they should fulfil. Moreover, professionals did not want to exert power upon clients, but ironically just for that reason sometimes struggled with shaping practices of client participation. This mutual powerlessness (partly) disappeared when clients helped to determine and execute specific improvement actions instead of participating in improvement teams. Recognizing that power is inescapable might allow for a more substantive discussion concerning the consequences that power arrangements produce, rather than looking at who is exerting how much power. © 2012 John Wiley & Sons Ltd.

An object-oriented, technology-adaptive information model

NASA Technical Reports Server (NTRS)

Anyiwo, Joshua C.

1995-01-01

The primary objective was to develop a computer information system for effectively presenting NASA's technologies to American industries, for appropriate commercialization. To this end a comprehensive information management model, applicable to a wide variety of situations, and immune to computer software/hardware technological gyrations, was developed. The model consists of four main elements: a DATA_STORE, a data PRODUCER/UPDATER_CLIENT and a data PRESENTATION_CLIENT, anchored to a central object-oriented SERVER engine. This server engine facilitates exchanges among the other model elements and safeguards the integrity of the DATA_STORE element. It is designed to support new technologies, as they become available, such as Object Linking and Embedding (OLE), on-demand audio-video data streaming with compression (such as is required for video conferencing), Worldwide Web (WWW) and other information services and browsing, fax-back data requests, presentation of information on CD-ROM, and regular in-house database management, regardless of the data model in place. The four components of this information model interact through a system of intelligent message agents which are customized to specific information exchange needs. This model is at the leading edge of modern information management models. It is independent of technological changes and can be implemented in a variety of ways to meet the specific needs of any communications situation. This summer a partial implementation of the model has been achieved. The structure of the DATA_STORE has been fully specified and successfully tested using Microsoft's FoxPro 2.6 database management system. Data PRODUCER/UPDATER and PRESENTATION architectures have been developed and also successfully implemented in FoxPro; and work has started on a full implementation of the SERVER engine. The model has also been successfully applied to a CD-ROM presentation of NASA's technologies in support of Langley Research Center's TAG efforts.

Does courtesy bias affect how clients report on objective and subjective measures of family planning service quality? A comparison between facility- and home-based interviews.

PubMed

Hameed, Waqas; Ishaque, Muhammad; Gul, Xaher; Siddiqui, Junaid-Ur-Rehman; Hussain, Sharmeen; Hussain, Wajahat; Ahmed, Aftab; Balal, Asma

2017-01-01

Despite a general understanding that exit interviews being conducted at service providers' facilities may influence clients' responses favorably to health professionals, there is very little evidence available that demonstrates the extent to which this problem exists. This study aimed at assessing and comparing clients' perceptions of the quality of family planning services and their satisfaction levels between facility- and home-based interviews. A cross-sectional survey was conducted among clients receiving family planning services across three service delivery channels - nongovernmental organization (NGO) clinics, social franchise (SF) centers, and outreach camps. The survey took place from December 2015 to January 2016 in 70 districts across all four provinces of Pakistan. A total of 2,807 clients were interviewed, of whom 1,404 clients were interviewed at health facilities after receiving services and 1,403 were interviewed at their homes within 3 days of method uptake. Overall, we found no significant differences between the characteristics of study participants interviewed at health facilities or at home. The findings suggested that experiences reported in exit surveys at facilities were strongly biased positively. This was true for both experiential (service quality) and perception-based (satisfaction) questions in the context of SF centers, while at NGO clinics the interview location only affected clients' responses regarding service quality. However, in outreach settings, clients are more likely to share bad experiences in exit interviews than in home-based interviews on objectively asked questions (service quality). Our study indicates signs of courtesy bias and possibly the Hawthorne effect in exit interviews. Program implementers could opt for home-based interviews for women receiving services at NGO clinics or SF center, whereas exit interviews could be used in outreach settings.

The Client's Perspective on Voluntary Stuttering.

PubMed

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

2016-08-01

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

Assessing Intermediate Outcomes of a Faith-Based Residential Prisoner Reentry Program

ERIC Educational Resources Information Center

Roman, Caterina G.; Wolff, Ashley; Correa, Vanessa; Buck, Janeen

2007-01-01

Objective: This study examined intermediate outcomes of a faith-based prisoner reentry program by assessing how client spirituality related to client- and program-level characteristics, investigating differences between completers and terminators, and examining how religious preference, religiosity/spirituality, religious salience, and…

NMRPro: an integrated web component for interactive processing and visualization of NMR spectra.

PubMed

Mohamed, Ahmed; Nguyen, Canh Hao; Mamitsuka, Hiroshi

2016-07-01

The popularity of using NMR spectroscopy in metabolomics and natural products has driven the development of an array of NMR spectral analysis tools and databases. Particularly, web applications are well used recently because they are platform-independent and easy to extend through reusable web components. Currently available web applications provide the analysis of NMR spectra. However, they still lack the necessary processing and interactive visualization functionalities. To overcome these limitations, we present NMRPro, a web component that can be easily incorporated into current web applications, enabling easy-to-use online interactive processing and visualization. NMRPro integrates server-side processing with client-side interactive visualization through three parts: a python package to efficiently process large NMR datasets on the server-side, a Django App managing server-client interaction, and SpecdrawJS for client-side interactive visualization. Demo and installation instructions are available at http://mamitsukalab.org/tools/nmrpro/ mohamed@kuicr.kyoto-u.ac.jp Supplementary data are available at Bioinformatics online. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

CDC WONDER: a cooperative processing architecture for public health.

PubMed Central

Friede, A; Rosen, D H; Reid, J A

1994-01-01

CDC WONDER is an information management architecture designed for public health. It provides access to information and communications without the user's needing to know the location of data or communication pathways and mechanisms. CDC WONDER users have access to extractions from some 40 databases; electronic mail (e-mail); and surveillance data processing. System components include the Remote Client, the Communications Server, the Queue Managers, and Data Servers and Process Servers. The Remote Client software resides in the user's machine; other components are at the Centers for Disease Control and Prevention (CDC). The Remote Client, the Communications Server, and the Applications Server provide access to the information and functions in the Data Servers and Process Servers. The system architecture is based on cooperative processing, and components are coupled via pure message passing, using several protocols. This architecture allows flexibility in the choice of hardware and software. One system limitation is that final results from some subsystems are obtained slowly. Although designed for public health, CDC WONDER could be useful for other disciplines that need flexible, integrated information exchange. PMID:7719813

A multi-sensor RSS spatial sensing-based robust stochastic optimization algorithm for enhanced wireless tethering.

PubMed

Parasuraman, Ramviyas; Fabry, Thomas; Molinari, Luca; Kershaw, Keith; Di Castro, Mario; Masi, Alessandro; Ferre, Manuel

2014-12-12

The reliability of wireless communication in a network of mobile wireless robot nodes depends on the received radio signal strength (RSS). When the robot nodes are deployed in hostile environments with ionizing radiations (such as in some scientific facilities), there is a possibility that some electronic components may fail randomly (due to radiation effects), which causes problems in wireless connectivity. The objective of this paper is to maximize robot mission capabilities by maximizing the wireless network capacity and to reduce the risk of communication failure. Thus, in this paper, we consider a multi-node wireless tethering structure called the "server-relay-client" framework that uses (multiple) relay nodes in between a server and a client node. We propose a robust stochastic optimization (RSO) algorithm using a multi-sensor-based RSS sampling method at the relay nodes to efficiently improve and balance the RSS between the source and client nodes to improve the network capacity and to provide redundant networking abilities. We use pre-processing techniques, such as exponential moving averaging and spatial averaging filters on the RSS data for smoothing. We apply a receiver spatial diversity concept and employ a position controller on the relay node using a stochastic gradient ascent method for self-positioning the relay node to achieve the RSS balancing task. The effectiveness of the proposed solution is validated by extensive simulations and field experiments in CERN facilities. For the field trials, we used a youBot mobile robot platform as the relay node, and two stand-alone Raspberry Pi computers as the client and server nodes. The algorithm has been proven to be robust to noise in the radio signals and to work effectively even under non-line-of-sight conditions.

A Community-Based Treatment for Native American Historical Trauma: Prospects for Evidence-Based Practice

ERIC Educational Resources Information Center

Gone, Joseph P.

2009-01-01

Nineteen staff and clients in a Native American healing lodge were interviewed regarding the therapeutic approach used to address the legacy of Native American historical trauma. On the basis of thematic content analysis of interviews, 4 components of healing discourse emerged. First, clients were understood by their counselors to carry pain,…

Managing the Presence of Personal Issues in Career Counselling: Using Transactional Analysis with Possible Selves

ERIC Educational Resources Information Center

Parkin, Fran; Plimmer, Geoff

2004-01-01

Research indicates that career counsellors who integrate a client's personal issues into career counselling are rated more highly in terms of effective outcomes (Kirschner, Hoffman & Hill, 1994; Nevo, 1990). The challenge is how to address the personal and feeling component of clients' lives within career counselling contexts, where there is…

A Descriptive Analysis of Incidents Reported by Community Aged Care Workers.

PubMed

Tariq, Amina; Douglas, Heather E; Smith, Cheryl; Georgiou, Andrew; Osmond, Tracey; Armour, Pauline; Westbrook, Johanna I

2015-07-01

Little is known about the types of incidents that occur to aged care clients in the community. This limits the development of effective strategies to improve client safety. The objective of the study was to present a profile of incidents reported in Australian community aged care settings. All incident reports made by community care workers employed by one of the largest community aged care provider organizations in Australia during the period November 1, 2012, to August 8, 2013, were analyzed. A total of 356 reports were analyzed, corresponding to a 7.5% incidence rate per client year. Falls and medication incidents were the most prevalent incident types. Clients receiving high-level care and those who attended day therapy centers had the highest rate of incidents with 14% to 20% of these clients having a reported incident. The incident profile indicates that clients on higher levels of care had higher incident rates. Incident data represent an opportunity to improve client safety in community aged care. © The Author(s) 2014.

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

PubMed

1992-01-01

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

Multimedia Workstations: Electronic Assistants for Health-Care Professionals.

PubMed

Degoulet, P; Jean, F-C; Safran, C

1996-01-01

The increasing costs of health care and the economic reality has produced an interesting paradox for the health professional to perform more clinical work with fewer support personnel. Moreover, an explosion of the knowledge-base that underlies sound clinical care not only makes effective time management critical, but also knowledge management compelling. A multimedia workstation is an electronic assistant for the busy health professional that can help with administrative tasks and give access to clinical information and knowledge networks. The multimedia nature of processed information reflects an evolution of medical technologies that involve more and more complex objects such as video sequences or digitized signals. Analysis of the 445 Medline-indexed publications for the January 1991 to December 1994 period, that included the word "workstation" either in their title or in their abstract, helps in refining objectives and challenges both for health professionals and decision makers. From an engineering perspective, development of a workstation requires the integration into the same environments of tools to localize, access, manipulate and communicate the required information. The long-term goal is to establish an easy access in a collaborative working environment that gives the end-user the feeling of a single virtual health enterprise, driven by an integrated computer system when the information system relies on a set of heterogeneous and geographically distributed components. Consequences in terms of migration from traditional client/server architectures to more client/network architectures are considered.

The State of Client-Centered Public Service Delivery in the Netherlands

NASA Astrophysics Data System (ADS)

Jansen, Jurjen; de Vries, Sjoerd; van der Geest, Thea; Arendsen, Rex; van Dijk, Jan

Businesses and citizens demand a better and more client-centered way of service delivery from public organizations. As society becomes more complex, dynamic and diverse, public organizations need to adapt to this demand. Conversely, our perception is that public organizations might still treat their target groups as one. However, the need for client-centered public service delivery is growing. This is widely debated in literature. Nonetheless, little empirical evidence is available about the state of client-centeredness of public organizations. The objective of the present study is to identify the state of client-centered public service delivery in the Netherlands. In order to research this topic 400 people from 194 Dutch public organizations were invited to complete an electronic questionnaire. 105 people responded. According to the respondents the state of client-centeredness is acceptable. However, only 25% of the public organizations seem to take differentiation as the point of departure for their service delivery.

Understanding and Counseling Narcissistic Clients.

ERIC Educational Resources Information Center

Stevens, Michael J.; And Others

1984-01-01

Provides counselors with an overview of narcissism and its treatment. In the first section, dysfunctional narcissism is described, drawing on the diagnostic indicators presented in the DSM-III and the contemporary object relations theories of Heinz Kohut and Otto Kerberg. The second section focuses on counseling narcissistic clients. (Author/JAC)

Home health clients: characteristics, outcomes of care, and nursing interventions.

PubMed Central

Martin, K S; Scheet, N J; Stegman, M R

1993-01-01

OBJECTIVES. The purpose of the study was to provide descriptive data about the characteristics of home health clients, the services that nurses provide, and the outcomes of those services. Such data have been sparse. METHODS. This study examined 2403 home health clients served by four agencies in Nebraska, New Jersey, and Wisconsin. Demographic, health history, and clinical data were analyzed. The Omaha System was used as the model for describing and measuring data specific to clients' health-related problems, nursing interventions, and outcomes of care. RESULTS. The median age of home health clients was 68.6 years. Nurses conducted 70% of all home visits, identified 9107 client problems, and provided over 96,000 interventions. Between admission and dismissal, clients improved by at least 0.52 point on three 5-point problem-specific outcome subscales (Knowledge, Behavior, and Status). CONCLUSIONS. These data show important characteristics of home health clients in a large national sample. They also support the usefulness of the Omaha System in describing and quantifying nursing practice in the community health setting. The magnitude of positive client change between admission and dismissal suggests that community health services do make a difference. PMID:8259804

Faculty and students' self-assessment of client communication skills and professional ethics in three veterinary medical schools.

PubMed

Fogelberg, Katherine; Farnsworth, Charles C

2009-01-01

Client communication skills and professional ethics are areas that have received much attention in veterinary education in recent years. The objectives of this study were to: i) establish the confidence level of faculty teaching in three veterinary schools with regard to their client communication skills, ii) establish a baseline of professional ethics indicators in the same faculty, and iii) compare veterinary students of all levels to faculty in both areas. Students and faculty received identical questionnaires, including statements addressing client communication skills and professional ethics. The results indicate that students are generally comfortable with their communication skills, except in the areas of visual and/or audio aid use, handling emotional clients, and discussing costs of care and payment. Faculty were more comfortable than students in all areas of client communication, although they also had low confidence when dealing with costs of care and payment. Ethically, students and faculty answered similarly. Faculty showed a stronger belief that people are basically honest and ethical, but both cohorts responded similarly when asked about reporting an ethical violation admitted to them by their best friend. Further research is needed to determine whether students are communicating as effectively as they believe they are, with particular attention paid to improving communications with emotional clients and the business aspects of veterinary medicine. Additional work is needed to ensure that veterinary students are learning how to cope with ethical issues objectively. This may begin by ensuring that faculty are teaching and, more importantly, modeling these behaviors during the clinical year(s).

Association of housing first implementation and key outcomes among homeless persons with problematic substance use.

PubMed

Davidson, Clare; Neighbors, Charles; Hall, Gerod; Hogue, Aaron; Cho, Richard; Kutner, Bryan; Morgenstern, Jon

2014-11-01

Housing First is a supportive housing model for persons with histories of chronic homelessness that emphasizes client-centered services, provides immediate housing, and does not require treatment for mental illness or substance abuse as a condition of participation. Previous studies of Housing First have found reduced governmental costs and improved personal well-being among participants. However, variations in real-world program implementation require better understanding of the relationship between implementation and outcomes. This study investigated the effects of Housing First implementation on housing and substance use outcomes. Study participants were 358 individuals with histories of chronic homelessness and problematic substance use. Clients were housed in nine scatter-site Housing First programs in New York City. Program fidelity was judged across a set of core Housing First components. Client interviews at baseline and 12 months were used to assess substance use. Clients in programs with greater fidelity to consumer participation components of Housing First were more likely to be retained in housing and were less likely to report using stimulants or opiates at follow-up. Consistently implemented Housing First principles related to consumer participation were associated with superior housing and substance use outcomes among chronically homeless individuals with a history of substance use problems. The study findings suggest that program implementation is central to understanding the potential of Housing First to help clients achieve positive housing and substance use outcomes.

Thin client (web browser)-based collaboration for medical imaging and web-enabled data.

PubMed

Le, Tuong Huu; Malhi, Nadeem

2002-01-01

Utilizing thin client software and open source server technology, a collaborative architecture was implemented allowing for sharing of Digital Imaging and Communications in Medicine (DICOM) and non-DICOM images with real-time markup. Using the Web browser as a thin client integrated with standards-based components, such as DHTML (dynamic hypertext markup language), JavaScript, and Java, collaboration was achieved through a Web server/proxy server combination utilizing Java Servlets and Java Server Pages. A typical collaborative session involved the driver, who directed the navigation of the other collaborators, the passengers, and provided collaborative markups of medical and nonmedical images. The majority of processing was performed on the server side, allowing for the client to remain thin and more accessible.

Mutual powerlessness in client participation practices in mental health care

PubMed Central

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

2012-01-01

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

Effect of a Significant Other on Client Change Talk in Motivational Interviewing

ERIC Educational Resources Information Center

Apodaca, Timothy R.; Magill, Molly; Longabaugh, Richard; Jackson, Kristina M.; Monti, Peter M.

2013-01-01

Objective:To examine significant-other (SO) and therapist behaviors as predictors of client change language within motivational interviewing (MI) sessions. Method: Participants from an emergency department received a single session of MI that included SO participation (N = 157). Sessions were coded using therapy process coding systems. Sessions…

Addressing Relapse in Cognitive Behavioral Therapy for Panic Disorder: Methods for Optimizing Long-Term Treatment Outcomes

ERIC Educational Resources Information Center

Arch, Joanna J.; Craske, Michelle G.

2011-01-01

In this paper, we present a client with panic disorder and agoraphobia who relapses following a full course of cognitive behavioral therapy (CBT). To frame the client's treatment, the major components of CBT for panic disorder with or without agoraphobia (PD/A) are reviewed. Likely reasons for the treatment's failure and strategies for improving…

Using CORBA to integrate manufacturing cells to a virtual enterprise

NASA Astrophysics Data System (ADS)

Pancerella, Carmen M.; Whiteside, Robert A.

1997-01-01

It is critical in today's enterprises that manufacturing facilities are not isolated from design, planning, and other business activities and that information flows easily and bidirectionally between these activities. It is also important and cost-effective that COTS software, databases, and corporate legacy codes are well integrated in the information architecture. Further, much of the information generated during manufacturing must be dynamically accessible to engineering and business operations both in a restricted corporate intranet and on the internet. The software integration strategy in the Sandia Agile Manufacturing Testbed supports these enterprise requirements. We are developing a CORBA-based distributed object software system for manufacturing. Each physical machining device is a CORBA object and exports a common IDL interface to allow for rapid and dynamic insertion, deletion, and upgrading within the manufacturing cell. Cell management CORBA components access manufacturing devices without knowledge of any device-specific implementation. To support information flow from design to planning data is accessible to machinists on the shop floor. CORBA allows manufacturing components to be easily accessible to the enterprise. Dynamic clients can be created using web browsers and portable Java GUI's. A CORBA-OLE adapter allows integration to PC desktop applications. Other commercial software can access CORBA network objects in the information architecture through vendor API's.

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.

Improving client-centred care and services: the role of front/back-office configurations.

PubMed

Broekhuis, Manda; de Blok, Carolien; Meijboom, Bert

2009-05-01

This paper is a report of a study conducted to explore the application of designing front- and back-office work resulting in efficient client-centred care in healthcare organizations that supply home care, welfare and domestic services. Front/back-office configurations reflect a neglected domain of design decisions in the development of more client-centred processes and structures without incurring major cost increases. Based on a literature search, a framework of four front/back-office configurations was constructed. To illustrate the usefulness of this framework, a single, longitudinal case study was performed in a large organization, which provides home care, welfare and domestic services for a sustained period (2005-2006). The case study illustrates how front/back-office design decisions are related to the complexity of the clients' demands and the strategic objectives of an organization. The constructed framework guides the practical development of front/back-office designs, and shows how each design contributes differently to such performance objectives as quality, speed and efficiency. The front/back-office configurations presented comprise an important first step in elaborating client-centred care and service provision to the operational level. It helps healthcare organizations to become more responsive and to provide efficient client-centred care and services when approaching demand in a well-tuned manner. In addition to its applicability in home care, we believe that a deliberate front/back-office configuration also has potential in other fields of health care.

Treatment Components and Their Relationships with Drug and Alcohol Abstinence.

ERIC Educational Resources Information Center

Orwin, Rob; Ellis, Bruce

This study evaluates the effect of treatment components through a secondary analysis of data from the National Treatment Improvement Evaluation Study (NTIES). The study examines the relationship between treatment components, client-level factors, and treatment outcomes, and how these relationships vary by treatment modality. It seeks to understand…

Recovery from depression among clients transitioning out of poverty.

PubMed

Ali, Alisha; Hawkins, Robert L; Chambers, Debbie Ann

2010-01-01

The objective of this study was to investigate whether a program designed to change the economic conditions of clients' lives could also have an impact on reducing their level of depression. The study focused on a sample of men and women attending a program designed to transition clients out of poverty through microlending and peer support. Results revealed that 40.5% of participants who met diagnostic criteria for major depression before beginning the program were no longer clinically depressed after participating in the program for 6 months. The results also revealed that the clients who reported that they felt a strong sense of interpersonal connection within the program were the most likely to recover from depression.

Influence of Social Class Perceptions on Attributions among Mental Health Practitioners

PubMed Central

Thomposon, Mindi; Diestelmann, Jacob; Cole, Odessa; Keller, Abiola; Minami, Takuya

2018-01-01

Objective A vignette-based study assessed the influence of social class attributions toward a hypothetical client’s difficulty. Method 188 licensed mental health professionals who were recruited through professional listservs completed an online survey after reviewing one of two versions of a vignette describing a hypothetical client that varied based on social class cues. Results As expected, this sample of licensed mental health practitioners detected social class differences based on the descriptors of the hypothetical client across the two vignettes. These perceived social class differences, however, did not impact participants’ attributions toward the client for causing or solving her problems, level of GAF score ascribed to the client, or willingness to work with the client. Conclusions There was no evidence that participants differentially ascribed attributions based on social class. Implications and directions for future research are provided. PMID:24499284

Types and patterns of safety concerns in home care: client and family caregiver perspectives

PubMed Central

Tong, Catherine E.; Sims-Gould, Joanie; Martin-Matthews, Anne

2016-01-01

Objective Drawing on interviews with home care clients and their family caregivers, we sought to understand how these individuals conceptualize safety in the provision and receipt of home care, how they promote safety in the home space and how their safety concerns differ from those of home support workers. Design In-depth, semi-structured interviews were conducted with clients and family caregivers. The analysis included topic and analytical coding of participants' verbatim accounts. Setting Interviews were completed in British Columbia, Canada. Participants Totally 82 clients and 55 caregivers participated. Results Clients and family caregivers identified three types of safety concerns: physical, spatial and interpersonal. These concerns are largely multi-dimensional and intersectional. We present a conceptual model of client and caregiver safety concerns. We also examine the factors that intensify and mitigate safety concerns in the home. Conclusions In spite of safety concerns, clients and family caregivers overwhelmingly prefer to receive care in the home setting. Spatial and physical concerns are the most salient. The financial burden of creating a safe care space should not be the client's alone to bear. The conceptualization and promotion of safety in home care must recognize the roles, responsibilities and perspectives of all of the actors involved, including workers, clients and their caregivers. PMID:26832159

Enhancing the Referral-Making Process to 12-Step Programs: Strategies for Social Workers

ERIC Educational Resources Information Center

Dennis, Cory B.; Davis, Thomas D.

2017-01-01

Objectives: This study examines three preparatory strategies that can be used during treatment sessions to bridge the gap between clinician recommendations for client participation in 12-step programs (TSPs) and client adherence to such recommendations. Methods: A sample of 284 clinicians completed an online survey. Clinicians responded to items…

Nutrition education program for food bank clients: A pilot study

USDA-ARS?s Scientific Manuscript database

Many low income families depend on foods from food banks. The objective of the study was to determine program content and examine feasibility of a pilot nutrition education program for food bank clients. Formative research was conducted with staff at a local food bank and its pantries and adult clie...

X-Windows Information Sharing Protocol Widget Class

NASA Technical Reports Server (NTRS)

Barry, Matthew R.

2006-01-01

The X-Windows Information Sharing Protocol (ISP) Widget Class ("Class") is used here in the object-oriented-programming sense of the word) was devised to simplify the task of implementing ISP graphical-user-interface (GUI) computer programs. ISP programming tasks require many method calls to identify, query, and interpret the connections and messages exchanged between a client and an ISP server. Most X-Windows GUI programs use widget sets or toolkits to facilitate management of complex objects. The widget standards facilitate construction of toolkits and application programs. The X-Windows Information Sharing Protocol (ISP) Widget Class encapsulates the client side of the ISP programming libraries within the framework of an X-Windows widget. Using the widget framework, X-Windows GUI programs can interact with ISP services in an abstract way and in the same manner as that of other graphical widgets, making it easier to write ISP GUI client programs. Wrapping ISP client services inside a widget framework enables a programmer to treat an ISP server interface as though it were a GUI. Moreover, an alternate subclass could implement another communication protocol in the same sort of widget.

Univers: The construction of an internet-wide descriptive naming system

NASA Technical Reports Server (NTRS)

Bowman, C. Mic

1990-01-01

Descriptive naming systems allow clients to identify a set of objects by description. Described here is the construction of a descriptive naming system, called Univers, based on a model in which clients provide both an object description and some meta-information. The meta-information describes beliefs about the query and the naming system. Specifically, it is an ordering on a set of perfect world approximations, and it describes the preferred methods for accommodating imperfect information. The description is then resolved in a way that respects the preferred approximations.

Client-side Skype forensics: an overview

NASA Astrophysics Data System (ADS)

Meißner, Tina; Kröger, Knut; Creutzburg, Reiner

2013-03-01

IT security and computer forensics are important components in the information technology. In the present study, a client-side Skype forensics is performed. It is designed to explain which kind of user data are stored on a computer and which tools allow the extraction of those data for a forensic investigation. There are described both methods - a manual analysis and an analysis with (mainly) open source tools, respectively.

Retrieving high-resolution images over the Internet from an anatomical image database

NASA Astrophysics Data System (ADS)

Strupp-Adams, Annette; Henderson, Earl

1999-12-01

The Visible Human Data set is an important contribution to the national collection of anatomical images. To enhance the availability of these images, the National Library of Medicine has supported the design and development of a prototype object-oriented image database which imports, stores, and distributes high resolution anatomical images in both pixel and voxel formats. One of the key database modules is its client-server Internet interface. This Web interface provides a query engine with retrieval access to high-resolution anatomical images that range in size from 100KB for browser viewable rendered images, to 1GB for anatomical structures in voxel file formats. The Web query and retrieval client-server system is composed of applet GUIs, servlets, and RMI application modules which communicate with each other to allow users to query for specific anatomical structures, and retrieve image data as well as associated anatomical images from the database. Selected images can be downloaded individually as single files via HTTP or downloaded in batch-mode over the Internet to the user's machine through an applet that uses Netscape's Object Signing mechanism. The image database uses ObjectDesign's object-oriented DBMS, ObjectStore that has a Java interface. The query and retrieval systems has been tested with a Java-CDE window system, and on the x86 architecture using Windows NT 4.0. This paper describes the Java applet client search engine that queries the database; the Java client module that enables users to view anatomical images online; the Java application server interface to the database which organizes data returned to the user, and its distribution engine that allow users to download image files individually and/or in batch-mode.

"That in your hands". A comprehensive process analysis of a significant event in psychotherapy.

PubMed

Elliott, R

1983-05-01

This article illustrates a new approach to the study of change processes in psychotherapy. The approach involves selecting significant change events and analyzing them according to the Comprehensive Process Model. In this model, client and therapist behaviors are analyzed for content, interpersonal action, style and response quality by using information derived from Interpersonal Process Recall, client and therapist objective process ratings and qualitative analyses. The event selected for analysis in this paper was rated by client and therapist as significantly helpful. The focal therapist response was a reflective-interpretive intervention in which the therapist collaboratively and evocatively expanded the client's implicit meanings. The event involved working through an earlier insight and realization of progress by the client. The event suggests an association between subjective "felt shifts" and public "process shifts" in client in-therapy behaviors. A model, consistent with Gendlin's experiential psychotherapy (1970), is offered to describe the change process which occurred in this event.

Franchising Reproductive Health Services

PubMed Central

Stephenson, Rob; Tsui, Amy Ong; Sulzbach, Sara; Bardsley, Phil; Bekele, Getachew; Giday, Tilahun; Ahmed, Rehana; Gopalkrishnan, Gopi; Feyesitan, Bamikale

2004-01-01

Objectives Networks of franchised health establishments, providing a standardized set of services, are being implemented in developing countries. This article examines associations between franchise membership and family planning and reproductive health outcomes for both the member provider and the client. Methods Regression models are fitted examining associations between franchise membership and family planning and reproductive health outcomes at the service provider and client levels in three settings. Results Franchising has a positive association with both general and family planning client volumes, and the number of family planning brands available. Similar associations with franchise membership are not found for reproductive health service outcomes. In some settings, client satisfaction is higher at franchised than other types of health establishments, although the association between franchise membership and client outcomes varies across the settings. Conclusions Franchise membership has apparent benefits for both the provider and the client, providing an opportunity to expand access to reproductive health services, although greater attention is needed to shift the focus from family planning to a broader reproductive health context. PMID:15544644

Addressing substance abuse and violence in substance use disorder treatment and batterer intervention programs.

PubMed

Timko, Christine; Valenstein, Helen; Lin, Patricia Y; Moos, Rudolf H; Stuart, Gregory L; Cronkite, Ruth C

2012-09-07

Substance use disorders and perpetration of intimate partner violence (IPV) are interrelated, major public health problems. We surveyed directors of a sample of substance use disorder treatment programs (SUDPs; N=241) and batterer intervention programs (BIPs; N=235) in California (70% response rate) to examine the extent to which SUDPs address IPV, and BIPs address substance abuse. Generally, SUDPs were not addressing co-occurring IPV perpetration in a formal and comprehensive way. Few had a policy requiring assessment of potential clients, or monitoring of admitted clients, for violence perpetration; almost one-quarter did not admit potential clients who had perpetrated IPV, and only 20% had a component or track to address violence. About one-third suspended or terminated clients engaging in violence. The most common barriers to SUDPs providing IPV services were that violence prevention was not part of the program's mission, staff lacked training in violence, and the lack of reimbursement mechanisms for such services. In contrast, BIPs tended to address substance abuse in a more formal and comprehensive way; e.g., one-half had a policy requiring potential clients to be assessed, two-thirds required monitoring of substance abuse among admitted clients, and almost one-half had a component or track to address substance abuse. SUDPs had clients with fewer resources (marriage, employment, income, housing), and more severe problems (both alcohol and drug use disorders, dual substance use and other mental health disorders, HIV + status). We found little evidence that services are centralized for individuals with both substance abuse and violence problems, even though most SUDP and BIP directors agreed that help for both problems should be obtained simultaneously in separate programs. SUDPs may have difficulty addressing violence because they have a clientele with relatively few resources and more complex psychological and medical needs. However, policy change can modify barriers to treatment integration and service linkage, such as reimbursement restrictions and lack of staff training.

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).

Implementation of systematic instruction to increase client engagement in a day habilitation program.

PubMed

Crites, Steven A; Howard, Barbara H

2011-03-01

Individuals with severe disability exiting school are likely to be enrolled in day activity and sheltered workshops at least as often as in supported employment. Such facilities are often staffed by paraprofessionals who may not have the skills to engage clients in meaningful activities. This article describes a 3-phase staff training project designed to increase client engagement in an adult habilitation centre. The first phase of the project was to develop curriculum guidelines. The second phase was conducting a series of training for paraprofessional staff. And the third was the implementation of the clinical experience. The first author conducted a graduate level methods class on site at the adult habilitation centre. Staff participants (paraprofessional staff, supervisors, and graduate students) learned the components of systematic instruction and developed and implemented activities for clients. Engagement was measured before and after the 5-week clinical experience. The engagement of clients increased with the implementation of systematic instruction following staff training. The implications are discussed.

A Configurable Internet Telemetry Server / Remote Client System

NASA Astrophysics Data System (ADS)

Boyd, W. T.; Hopkins, A.; Abbott, M. J.; Girouard, F. R.

2000-05-01

We have created a general, object-oriented software framework in Java for remote viewing of telemetry over the Internet. The general system consists of a data server and a remote client that can be extended by any project that uses telemetry to implement a remote telemetry viewer. We have implemented a system that serves live telemetry from NASA's Extreme Ultraviolet Explorer satellite and a client that can display the telemetry at a remote location. An authenticated user may run a standalone graphical or text-based client, or an applet on a web page, to view EUVE telemetry. In the case of the GUI client, a user can build displays to his/her own specifications using a GUI view-building tool. This work was supported by grants NCC2-947 and NCC2-966 from NASA Ames Research Center and grant JPL-960684 from NASA Jet Propulsion Laboratory.

A client-treatment matching protocol for therapeutic communities: first report.

PubMed

Melnick, G; De Leon, G; Thomas, G; Kressel, D

2001-10-01

The present study is the first report on a client-treatment matching protocol (CMP) to guide admissions to residential and outpatient substance abuse treatment settings. Two cohorts, a field test sample (n = 318) and cross-validation (n = 407) sample were drawn from consecutive admissions to nine geographically distributed multisetting therapeutic communities (TCs). A passive matching design was employed. Clients received the CMP on admission, but agencies were "blind" to the CMP treatment recommendation (i.e., match) and assigned clients to treatment by the usual intake procedures. Bivariate and logistical regression analyses show that positive treatment dispositions (treatment completion or longer retention in treatment)) were significantly higher among the CMP-matched clients. The present findings provide the empirical basis for studies assessing the validity and utility of the CMP with controlled designs. Though limited to TC-oriented agencies, the present research supports the use of objective matching criteria to improve treatment.

Evaluation of the FOCUS (Feedback on Counseling Using Simulation) Instrument for Assessment of Client-Centered Nutrition Counseling Behaviors

ERIC Educational Resources Information Center

Henry, Beverly W.; Smith, Thomas J.

2010-01-01

Objective: To develop an instrument to assess client-centered counseling behaviors (skills) of student-counselors in a standardized patient (SP) exercise. Methods: Descriptive study of the accuracy and utility of a newly developed counseling evaluation instrument. Study participants included 11 female student-counselors at a Midwestern…

Life Skills for the Developmentally Disabled: An Approach to Accountability in Deinstitutionalization. Volume III: Manual for Training Clients.

ERIC Educational Resources Information Center

Folsom, Geneva S.; And Others

The third and final volume of the Life Skills for the Developmentally Disabled Project is a manual for assessing and training institutionalized clients for deinstitutionalization and community living. Charts for goal setting and objective plans with information on materials, setting, instructional plans, procedures, evaluation and followup methods…

Moral Problems Perceived by Industry in Collaboration with a Student Group: Balancing between Beneficial Objectives and Upholding Relations

ERIC Educational Resources Information Center

Vartiainen, Tero

2009-01-01

Industry-university partnerships are common in the IT field. This paper reports on moral problems perceived by client representatives collaborating with student groups taking part in a project course in information systems education in a Finnish university. Twenty-two client representatives from IT organizations were interviewed during the course…

Xgrid admin guide

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

Strauss, Charlie E M

2010-01-01

Xgrid, with a capital-X is the name for Apple's grid computing system. With a lower case x, xgrid is the name of the command line utility that clients can use, among other ways, to submit jobs to a controller. An Xgrid divides into three logical components: Agent, Controller and Client. Client computers submit jobs (a set of tasks) they want run to a Controller computer. The Controller queues the Client jobs and distributes tasks to Agent computers. Agent computers run the tasks and report their output and status back to the controller where it is stored until deleted by themore » Client. The Clients can asynchronously query the controller about the status of a job and the results. Any OSX computer can be any of these. A single mac can be more than one: it's possible to be Agent, Controller and Client at the same time. There is one Controller per Grid. Clients can submit jobs to Controllers of different grids. Agents can work for more than one grid. Xgrid's setup has a pleasantly small palette of choices. The first two decisions to make are the kind of authentication & authorization to use and if a shared file system is needed. A shared file system that all the agents can access can be very beneficial for many computing problems, but it is not appropriate for every network.« less

Exploring the Relationship Between Treatment Satisfaction, Perceived Improvements in Functioning and Well-Being and Gambling Harm Reduction Among Clients of Pathological Gambling Treatment Programs

PubMed Central

Bernhard, Bo; Abarbanel, Brett L. L.; St. John, Sarah; Kalina, Ashlee

2014-01-01

The objective of this study was to evaluate the relationship between treatment service quality, perceived improvement in social, functional, and material well-being and reduction in gambling behaviors among clients of Nevada state-funded pathological gambling treatment programs. Utilizing survey data from 361 clients from 2009 to 2010, analyses revealed that client satisfaction with treatment services is positively associated with perceived improvements in social, functional, and material well-being, abstinence from gambling, reduction in gambling thoughts and reduction in problems associated with gambling, even after controlling for various respondent characteristics. These findings can be useful to treatment program staff in managing program development and allocating resources. PMID:23756725

Defense in Depth Added to Malicious Activities Simulation Tools (MAST)

DTIC Science & Technology

2015-09-01

cipher suites. The TLS Handshake is a combination of three components: handshake, change cipher spec, and alert. 41 (1) The Handshake ( Hello ) The...TLS Handshake, specifically the “ Hello ” portion, is designed to negotiate session parameters (cipher suite). The client informs the server of the...protocols and standards that it supports and then the server selects the highest common protocols and standards. Specifically, the Client Hello message

The case for integrating grounded theory and participatory action research: empowering clients to inform professional practice.

PubMed

Teram, Eli; Schachter, Candice L; Stalker, Carol A

2005-10-01

Grounded theory and participatory action research methods are distinct approaches to qualitative inquiry. Although grounded theory has been conceptualized in constructivist terms, it has elements of positivist thinking with an image of neutral search for objective truth through rigorous data collection and analysis. Participatory action research is based on a critique of this image and calls for more inclusive research processes. It questions the possibility of objective social sciences and aspires to engage people actively in all stages of generating knowledge. The authors applied both approaches in a project designed to explore the experiences of female survivors of childhood sexual abuse with physical therapy and subsequently develop a handbook on sensitive practice for clinicians that takes into consideration the needs and perspectives of these clients. Building on this experience, they argue that the integration of grounded theory and participatory action research can empower clients to inform professional practice.

Design and implementation of a distributed large-scale spatial database system based on J2EE

NASA Astrophysics Data System (ADS)

Gong, Jianya; Chen, Nengcheng; Zhu, Xinyan; Zhang, Xia

2003-03-01

With the increasing maturity of distributed object technology, CORBA, .NET and EJB are universally used in traditional IT field. However, theories and practices of distributed spatial database need farther improvement in virtue of contradictions between large scale spatial data and limited network bandwidth or between transitory session and long transaction processing. Differences and trends among of CORBA, .NET and EJB are discussed in details, afterwards the concept, architecture and characteristic of distributed large-scale seamless spatial database system based on J2EE is provided, which contains GIS client application, web server, GIS application server and spatial data server. Moreover the design and implementation of components of GIS client application based on JavaBeans, the GIS engine based on servlet, the GIS Application server based on GIS enterprise JavaBeans(contains session bean and entity bean) are explained.Besides, the experiments of relation of spatial data and response time under different conditions are conducted, which proves that distributed spatial database system based on J2EE can be used to manage, distribute and share large scale spatial data on Internet. Lastly, a distributed large-scale seamless image database based on Internet is presented.

Task analysis exemplified: the process of resolving unfinished business.

PubMed

Greenberg, L S; Foerster, F S

1996-06-01

The steps of a task-analytic research program designed to identify the in-session performances involved in resolving lingering bad feelings toward a significant other are described. A rational-empirical methodology of repeatedly cycling between rational conjecture and empirical observations is demonstrated as a method of developing an intervention manual and the components of client processes of resolution. A refined model of the change process developed by these procedures is validated by comparing 11 successful and 11 unsuccessful performances. Four performance components-intense expression of feeling, expression of need, shift in representation of other, and self-validation or understanding of the other-were found to discriminate between resolution and nonresolution performances. These components were measured on 4 process measures: the Structural Analysis of Social Behavior, the Experiencing Scale, the Client's Emotional Arousal Scale, and a need scale.

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

PubMed Central

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

2005-01-01

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

Vaccination against hepatitis A and B in persons subject to homelessness in inner Sydney: vaccine acceptance, completion rates and immunogenicity.

PubMed

Poulos, Roslyn G; Ferson, Mark J; Orr, Karen J; McCarthy, Michele A; Botham, Susan J; Stern, Jerome M; Lucey, Adrienne

2010-04-01

To determine acceptance, completion rates and immunogenicity of the standard vaccination schedule for hepatitis A (HAV) and B (HBV) in persons subject to homelessness. A convenience sample of clients (n=201) attending a medical clinic for homeless and disadvantaged persons in Sydney was enrolled. Serological screening for HAV and HBV was undertaken. An appropriate vaccination program was instituted. Post-vaccination serology determined serological response. Although many clients had serological evidence of past infection, at least 138 (69%) clients had the potential to benefit from vaccination. For hepatitis A and B vaccinations, completion rates were 73% (73 of 100 clients) and 75% (69 of 92 clients), respectively; after vaccination, protective antibody was found in 98.2% (56 of 57) and 72% (36 of 50) of clients, respectively. A successful vaccination program can be mounted with a vulnerable population. We consider a clinic with a well-established history of acceptance and utilisation by the target group; a low staff turnover and regular clientele; inclusion of vaccination as part of routine client care; and counselling (part of pre- and post-serological testing) essential components in achieving good vaccination completion rates. © 2010 The Authors. Journal Compilation © 2010 Public Health Association of Australia.

Providing an information prescription in veterinary medical clinics: a pilot study

PubMed Central

Kogan, Lori R.; Schoenfeld-Tacher, Regina; Gould, Lauren; Viera, Ann R.; Hellyer, Peter W.

2014-01-01

Objective: The study assesses the impact on client behavior and attitudes toward receiving an information prescription as part of a veterinary office visit. Methods: A random sample of veterinary clinics from a Western US metropolitan area was asked to distribute an information prescription in addition to their customary veterinary services. All clients, regardless of the reason for their visit, were presented with an information prescription: a handout that included the uniform resource locator (URL) to a general veterinary medicine website and several tips to help their clients make more informed choices about where to seek pet health information online. Results: Nearly 40% of clients who reported that they remembered receiving the information prescription accessed the website at least once. Of the clients who reported accessing the suggested website, 86.3% reported finding it “very helpful” or “somewhat helpful.” Nearly all the clients (87.9%) reported feeling the information on the site helped them make better decisions for their pets. Most clients reported that it helped them talk to their veterinarians (89.9%) and added to the information they received during their veterinary visits (83.5%). Conclusions: Clients appreciate and utilize veterinary prescriptions, suggesting that this is a tool that both veterinarians and librarians can use to improve animal health and client relations. Implications: The value placed on reliable Internet information by veterinary clients suggests several opportunities for librarians to become more proactive in partnering with veterinarians to facilitate the education of pet owners. PMID:24415918

Client satisfaction and quality of health care in rural Bangladesh.

PubMed Central

Mendoza Aldana, J.; Piechulek, H.; al-Sabir, A.

2001-01-01

OBJECTIVE: To assess user expectations and degree of client satisfaction and quality of health care provided in rural Bangladesh. METHODS: A total of 1913 persons chosen by systematic random sampling were successfully interviewed immediately after having received care in government health facilities. FINDINGS: The most powerful predictor for client satisfaction with the government services was provider behaviour, especially respect and politeness. For patients this aspect was much more important than the technical competence of the provider. Furthermore, a reduction in waiting time (on average to 30 min) was more important to clients than a prolongation of the quite short (from a medical standpoint) consultation time (on average 2 min, 22 sec), with 75% of clients being satisfied. Waiting time, which was about double at outreach services than that at fixed services, was the only element with which users of outreach services were dissatisfied. CONCLUSIONS: This study underscores that client satisfaction is determined by the cultural background of the people. It shows the dilemma that, though optimally care should be capable of meeting both medical and psychosocial needs, in reality care that meets all medical needs may fail to meet the client's emotional or social needs. Conversely, care that meets psychosocial needs may leave the clients medically at risk. It seems important that developing countries promoting client-oriented health services should carry out more in-depth research on the determinants of client satisfaction in the respective culture. PMID:11436472

Comparison of clients of a mobile health van and a traditional STD clinic.

PubMed

Ellen, Jonathan M; Bonu, Sekhar; Arruda, Jaime S; Ward, Michael A; Vogel, Ruth

2003-04-01

The objective of this study was to determine if there were any demographic, behavioral, and clinical differences between clients seen aboard a mobile sexually transmitted disease (STD)/HIV clinic compared with those seen in a traditional municipal STD/HIV health clinic for receipt of STD/HIV services. Clients seen in the two different settings were interviewed about demographic characteristics, reasons for their visit, STD history, their HIV/STD risk factors, and the risk factors of their sex partners. Clients in both settings were also offered testing for syphilis, gonorrhea, chlamydia, and HIV. Results suggested that clients seen at the mobile clinic were older, more likely to be injecting drug users themselves and/or to have sex partners who were, or had engaged in prostitution for money or drugs. Over half (54.4%) of the mobile clinic clients sought testing for HIV, and they were far less likely to be seeking care for symptoms of an STD. In contrast, only 7.1% of municipal clinic clients indicated HIV testing as the reason for their visit, whereas nearly two thirds (64.5%) reported symptoms of disease. Two percent of municipal clinic clients and 5.4% of mobile clinic clients had a positive HIV test ( p<.001), and 17.8% of STD clinic clients and 5.6% of mobile van clients had a positive gonorrhea and/or test ( p<.001). These data suggest that a mobile STD/HIV clinic may be an effective strategy to reach individuals at high risk for HIV who are not being served by traditional municipal STD/HIV health clinics.

Counseling Services for Asian, Latino/a, and White American Students: Initial Severity, Session Attendance, and Outcome

PubMed Central

Kim, Jin E.; Park, Samuel S.; La, Amy; Chang, Jenss; Zane, Nolan

2015-01-01

Objective The current study examined racial/ethnic differences in initial severity, session attendance, and counseling outcomes in a large and diverse sample of Asian American, Latino/a, and White student clients who utilized university counseling services between 2008 and 2012. Method We used archival data of 5,472 clients (62% female; M age = 23.1, SD = 4.3) who self-identified their race/ethnicity as being Asian American (38.9%), Latino/a (14.9%), or White (46.2%). Treatment engagement was measured by the number of counseling sessions attended; initial severity and treatment outcome were measured using the Outcome Questionnaire-45. Results Asian American clients, particularly Chinese, Filipino/a, Korean, and Vietnamese Americans, had greater initial severity compared to White clients. Asian Indian, Korean, and Vietnamese American clients used significantly fewer sessions of counseling than White clients after controlling for initial severity. All racial/ethnic minority groups continued to have clinically significant distress in certain areas (e.g., social role functioning) at counseling termination. Conclusions These findings highlight the need to devote greater attention to the counseling experiences of racial/ethnic minority clients, especially certain Asian American groups. Further research directions are provided. PMID:26390372

Experiments in MPEG-4 content authoring, browsing, and streaming

NASA Astrophysics Data System (ADS)

Puri, Atul; Schmidt, Robert L.; Basso, Andrea; Civanlar, Mehmet R.

2000-12-01

In this paper, within the context of the MPEG-4 standard we report on preliminary experiments in three areas -- authoring of MPEG-4 content, a player/browser for MPEG-4 content, and streaming of MPEG-4 content. MPEG-4 is a new standard for coding of audiovisual objects; the core of MPEG-4 standard is complete while amendments are in various stages of completion. MPEG-4 addresses compression of audio and visual objects, their integration by scene description, and interactivity of users with such objects. MPEG-4 scene description is based on VRML like language for 3D scenes, extended to 2D scenes, and supports integration of 2D and 3D scenes. This scene description language is called BIFS. First, we introduce the basic concepts behind BIFS and then show with an example, textual authoring of different components needed to describe an audiovisual scene in BIFS; the textual BIFS is then saved as compressed binary file/s for storage or transmission. Then, we discuss a high level design of an MPEG-4 player/browser that uses the main components from authoring such as encoded BIFS stream, media files it refers to, and multiplexed object descriptor stream to play an MPEG-4 scene. We also discuss our extensions to such a player/browser. Finally, we present our work in streaming of MPEG-4 -- the payload format, modification to client MPEG-4 player/browser, server-side infrastructure and example content used in our MPEG-4 streaming experiments.

Food Safety Education Using an Interactive Multimedia Kiosk in a WIC Setting: Correlates of Client Satisfaction and Practical Issues

ERIC Educational Resources Information Center

Trepka, Mary Jo; Newman, Frederick L.; Huffman, Fatma G.; Dixon, Zisca

2010-01-01

Objective: To assess acceptability of food safety education delivered by interactive multimedia (IMM) in a Supplemental Nutrition Program for Women, Infants and Children Program (WIC) clinic. Methods: Female clients or caregivers (n = 176) completed the food-handling survey; then an IMM food safety education program on a computer kiosk.…

Training Social Workers, Clients, and Students in the Use of Rural Natural Helping Networks.

ERIC Educational Resources Information Center

Morris, Judson H.; Hilbert, Judith Cicero

A manual, geared toward training social workers going into rural areas, provides a brief discussion of the natural helping relationships found in rural communities and a simulation game to be used in acquainting social workers, clients, and students with the rural network. Objectives of the simulation game, Nets and Links, are to train people to…

The Role of Early Symptom Trajectories and Pretreatment Variables in Predicting Treatment Response to Cognitive Behavioral Therapy

ERIC Educational Resources Information Center

Lewis, Cara C.; Simons, Anne D.; Kim, Hyoun K.

2012-01-01

Objective: Research has focused on 2 different approaches to answering the question, "Which clients will respond to cognitive behavioral therapy (CBT) for depression?" One approach focuses on rates of symptom change within the 1st few weeks of treatment, whereas the 2nd approach looks to pretreatment client variables (e.g., hopelessness) to…

Software for Building Models of 3D Objects via the Internet

NASA Technical Reports Server (NTRS)

Schramer, Tim; Jensen, Jeff

2003-01-01

The Virtual EDF Builder (where EDF signifies Electronic Development Fixture) is a computer program that facilitates the use of the Internet for building and displaying digital models of three-dimensional (3D) objects that ordinarily comprise assemblies of solid models created previously by use of computer-aided-design (CAD) programs. The Virtual EDF Builder resides on a Unix-based server computer. It is used in conjunction with a commercially available Web-based plug-in viewer program that runs on a client computer. The Virtual EDF Builder acts as a translator between the viewer program and a database stored on the server. The translation function includes the provision of uniform resource locator (URL) links to other Web-based computer systems and databases. The Virtual EDF builder can be used in two ways: (1) If the client computer is Unix-based, then it can assemble a model locally; the computational load is transferred from the server to the client computer. (2) Alternatively, the server can be made to build the model, in which case the server bears the computational load and the results are downloaded to the client computer or workstation upon completion.

Web mapping system for complex processing and visualization of environmental geospatial datasets

NASA Astrophysics Data System (ADS)

Titov, Alexander; Gordov, Evgeny; Okladnikov, Igor

2016-04-01

Environmental geospatial datasets (meteorological observations, modeling and reanalysis results, etc.) are used in numerous research applications. Due to a number of objective reasons such as inherent heterogeneity of environmental datasets, big dataset volume, complexity of data models used, syntactic and semantic differences that complicate creation and use of unified terminology, the development of environmental geodata access, processing and visualization services as well as client applications turns out to be quite a sophisticated task. According to general INSPIRE requirements to data visualization geoportal web applications have to provide such standard functionality as data overview, image navigation, scrolling, scaling and graphical overlay, displaying map legends and corresponding metadata information. It should be noted that modern web mapping systems as integrated geoportal applications are developed based on the SOA and might be considered as complexes of interconnected software tools for working with geospatial data. In the report a complex web mapping system including GIS web client and corresponding OGC services for working with geospatial (NetCDF, PostGIS) dataset archive is presented. There are three basic tiers of the GIS web client in it: 1. Tier of geospatial metadata retrieved from central MySQL repository and represented in JSON format 2. Tier of JavaScript objects implementing methods handling: --- NetCDF metadata --- Task XML object for configuring user calculations, input and output formats --- OGC WMS/WFS cartographical services 3. Graphical user interface (GUI) tier representing JavaScript objects realizing web application business logic Metadata tier consists of a number of JSON objects containing technical information describing geospatial datasets (such as spatio-temporal resolution, meteorological parameters, valid processing methods, etc). The middleware tier of JavaScript objects implementing methods for handling geospatial metadata, task XML object, and WMS/WFS cartographical services interconnects metadata and GUI tiers. The methods include such procedures as JSON metadata downloading and update, launching and tracking of the calculation task running on the remote servers as well as working with WMS/WFS cartographical services including: obtaining the list of available layers, visualizing layers on the map, exporting layers in graphical (PNG, JPG, GeoTIFF), vector (KML, GML, Shape) and digital (NetCDF) formats. Graphical user interface tier is based on the bundle of JavaScript libraries (OpenLayers, GeoExt and ExtJS) and represents a set of software components implementing web mapping application business logic (complex menus, toolbars, wizards, event handlers, etc.). GUI provides two basic capabilities for the end user: configuring the task XML object functionality and cartographical information visualizing. The web interface developed is similar to the interface of such popular desktop GIS applications, as uDIG, QuantumGIS etc. Web mapping system developed has shown its effectiveness in the process of solving real climate change research problems and disseminating investigation results in cartographical form. The work is supported by SB RAS Basic Program Projects VIII.80.2.1 and IV.38.1.7.

OOD/OOP experience in the Science Operations Center part of the ground system for X ray Timing Explorer mission

NASA Technical Reports Server (NTRS)

Choudhary, Abdur Rahim

1994-01-01

The Science Operations Center (SOC) for the X-ray Timing Explorer (XTE) mission is an important component of the XTE ground system. Its mandate includes: (1) command and telemetry for the three XTE instruments, using CCSDS standards; (2) monitoring of the real-time science operations, reconfiguration of the experiment and the instruments, and real-time commanding to address the targets of opportunity (TOO) and alternate observations; and (3) analysis, processing, and archival of the XTE telemetry, and the timely delivery of the data products to the principal investigator (PI) teams and the guest observers (GO). The SOC has two major components: the science operations facility (SOF) that addresses the first two objectives stated above and the guest observer facility (GOF) that addresses the third. The SOF has subscribed to the object oriented design and implementation; while the GOF uses the traditional approach in order to take advantage of the existing software developed in support of previous missions. This paper details the SOF development using the object oriented design (OOD), and its implementation using the object oriented programming (OOP) in C++ under Unix environment on client-server architecture using Sun workstations. It also illustrates how the object oriented (OO) and the traditional approaches coexist in SOF and GOF, the lessons learned, and how the OOD facilitated the distributed software development collaboratively by four different teams. Details are presented for the SOF system, its major subsystems, its interfaces with the rest of the XTE ground data system, and its design and implementation approaches.

The evaluation of a trial of syringe vending machines in Canberra, Australia.

PubMed

McDonald, David

2009-07-01

Syringe vending machines (SVMs) have been trialled in Canberra, Australian Capital Territory, Australia, as an intervention aiming to increase the availability of sterile injecting equipment for use by IDUs. This study evaluated the 12-month trial. A utilisation-focused evaluation model, with both formative and summative components, was employed. Four SVMs were installed, each dispensing packs containing four 1 mL syringes and associated injecting paraphernalia. The trial participants were the clients of the SVMs and other key informants. The core measurements used were the number of syringes dispensed in Canberra by SVMs and other outlets, SVM clients' demographics and experiences of and attitudes towards SVMs, perceived impacts of SVMs on needle sharing, unsafe disposal of used syringes in the vicinity of SVMs, and community and stakeholder attitudes. The trial was implemented successfully, with no adverse consequences identified. The SVMs appear to be serving both the usual clients of the other outlets for sterile injecting equipment (community pharmacies and the Needle Syringe Program outlets) and others who are reluctant to use such outlets or find them inconvenient. The out-of-business-hours provision of syringes through the SVMs was particularly welcomed by both SVM clients and other stakeholders. The continuing operation of the initial four SVMs is widely supported, and additional machines are requested by clients and others. Owing to the success of the trial in terms of feasibility and outcomes for both IDUs and for the broader community, it is desirable that providing sterile injecting equipment through SVMs continues and be expanded as an integral component of harm reduction strategies.

What do external consultants from private and not-for-profit companies offer healthcare commissioners? A qualitative study of knowledge exchange

PubMed Central

Wye, Lesley; Brangan, Emer; Cameron, Ailsa; Gabbay, John; Klein, Jonathan H; Anthwal, Rachel; Pope, Catherine

2015-01-01

Objectives The use of external consultants from private and not-for-profit providers in the National Health Service (NHS) is intended to improve the quality of commissioning. The aim of this study was to learn about the support offered to healthcare commissioners, how external consultants and their clients work together and the perceived impact on the quality of commissioning. Setting NHS commissioning organisations and private and not-for-profit providers. Design Mixed methods case study of eight cases. Data collection 92 interviews with external consultants (n=36), their clients (n=47) and others (n=9). Observation of 25 training events and meetings. Documentation, for example, meeting minutes and reports. Analysis Constant comparison. Data were coded, summarised and analysed by the research team with a coding framework to facilitate cross-case comparison. Results In the four contracts presented here, external providers offered technical solutions (eg, software tools), outsourcing and expertise including project management, data interpretation and brokering relationships with experts. In assessing perceived impact on quality of commissioning, two contracts had limited value, one had short-term benefits and one provided short and longer term benefits. Contracts with commissioners actively learning, embedding and applying new skills were more valued. Other elements of success were: (1) addressing clearly agreed problems of relevance to managerial and operational staff (2) solutions co-produced at all organisational levels (3) external consultants working directly with clients to interpret data outputs to inform locally contextualised commissioning strategies. Without explicit knowledge exchange strategies, outsourcing commissioning to external providers resulted in the NHS clients becoming dependent. Conclusions NHS commissioning will be disadvantaged if commissioners both fail to learn in the short term from the knowledge of external providers and in the longer term lose local skills. Knowledge exchange mechanisms are a vital component of commissioning and should be embedded in external provider contracts. PMID:25716174

Translating Anxiety-Focused CBT for Youth in a First Nations Context in Northwestern Ontario

PubMed Central

Nowrouzi, Behdin; Manassis, Katharina; Jones, Emily; Bobinski, Tina; Mushquash, Christopher J.

2015-01-01

Objective: We sought to evaluate a translation of anxiety-focused cognitive behavioral therapy (CBT) to a First Nations children’s mental health provider in rural Ontario and to enhance our understanding of CBT challenges and adaptations unique to the First Nations context. Methods: The study was conceptualized as a mixed methods sequential explanatory approach using a quasi-experimental (before and after) design with quantitative and qualitative components. Data were produced in two ways: questionnaires completed by therapists, parents and clients pre- and post-training, and through a focus group with therapists working with First Nations clients. Participants of this study were a subset of a larger knowledge translation study involving ten agencies, and comprised nine therapists (two males and seven females), and seven children (six males and one female) from a single First Nations agency. The mean age of children was 11.8 years (±2.71), comparable to children in other agencies. Results: First Nations therapists’ scores on a child CBT knowledge questionnaire post-training did not differ from those of therapists in other agencies when controlling for initial values, suggesting comparable training benefit. Children did not differ between groups on any key measures, and all key measures showed improvement from pre- to post-training. Four key themes emerged from therapist focus groups: client challenges, value of supervision, practice challenges, and Northern/rural/remote challenges. Conclusions: The study highlights the importance of delivering a culturally appropriate CBT program to First Nations populations in Northern Ontario, and provides preliminary evidence of its effectiveness. PMID:26336378

An Open Source Tool to Test Interoperability

NASA Astrophysics Data System (ADS)

Bermudez, L. E.

2012-12-01

Scientists interact with information at various levels from gathering of the raw observed data to accessing portrayed processed quality control data. Geoinformatics tools help scientist on the acquisition, storage, processing, dissemination and presentation of geospatial information. Most of the interactions occur in a distributed environment between software components that take the role of either client or server. The communication between components includes protocols, encodings of messages and managing of errors. Testing of these communication components is important to guarantee proper implementation of standards. The communication between clients and servers can be adhoc or follow standards. By following standards interoperability between components increase while reducing the time of developing new software. The Open Geospatial Consortium (OGC), not only coordinates the development of standards but also, within the Compliance Testing Program (CITE), provides a testing infrastructure to test clients and servers. The OGC Web-based Test Engine Facility, based on TEAM Engine, allows developers to test Web services and clients for correct implementation of OGC standards. TEAM Engine is a JAVA open source facility, available at Sourceforge that can be run via command line, deployed in a web servlet container or integrated in developer's environment via MAVEN. The TEAM Engine uses the Compliance Test Language (CTL) and TestNG to test HTTP requests, SOAP services and XML instances against Schemas and Schematron based assertions of any type of web service, not only OGC services. For example, the OGC Web Feature Service (WFS) 1.0.0 test has more than 400 test assertions. Some of these assertions includes conformance of HTTP responses, conformance of GML-encoded data; proper values for elements and attributes in the XML; and, correct error responses. This presentation will provide an overview of TEAM Engine, introduction of how to test via the OGC Testing web site and description of performing local tests. It will also provide information about how to participate in the open source code development of TEAM Engine.

The distributed annotation system.

PubMed

Dowell, R D; Jokerst, R M; Day, A; Eddy, S R; Stein, L

2001-01-01

Currently, most genome annotation is curated by centralized groups with limited resources. Efforts to share annotations transparently among multiple groups have not yet been satisfactory. Here we introduce a concept called the Distributed Annotation System (DAS). DAS allows sequence annotations to be decentralized among multiple third-party annotators and integrated on an as-needed basis by client-side software. The communication between client and servers in DAS is defined by the DAS XML specification. Annotations are displayed in layers, one per server. Any client or server adhering to the DAS XML specification can participate in the system; we describe a simple prototype client and server example. The DAS specification is being used experimentally by Ensembl, WormBase, and the Berkeley Drosophila Genome Project. Continued success will depend on the readiness of the research community to adopt DAS and provide annotations. All components are freely available from the project website http://www.biodas.org/.

Cognitive therapy for performance anxiety.

PubMed

Rodebaugh, Thomas L; Chambless, Dianne L

2004-08-01

We present and illustrate the major components of cognitive therapy for performance anxiety, focusing on the performance fears of a client treated with a protocol designed for social phobia. The basic supposition of cognitive theory is that a client's thoughts and beliefs about situations maintain distressing feelings, such as anxiety. Changing these beliefs involves detection and disputation of anxiety-provoking thoughts, as well as testing of these thoughts through exposure to feared situations. Through a process of identifying existing beliefs about performance situations and challenging these beliefs, clients can gain a more realistic and less anxiety-producing perspective on performance tasks. Specific techniques, along with common difficulties and potential solutions, are presented in a detailed case study. Copyright 2004 Wiley Periodicals, Inc.

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.

Outcomes assessment of on-site communication skills education in a companion animal practice.

PubMed

Shaw, Jane R; Barley, Gwyn E; Broadfoot, Kirsti; Hill, Ashley E; Roter, Debra L

2016-08-15

OBJECTIVE To evaluate veterinarian-client communication and veterinarian and client satisfaction with veterinary visits before and after veterinarians underwent a 6-month communication skills training program in a practice setting. DESIGN Case-based pretest-posttest intervention study. SAMPLE 1 purposely selected companion-animal practice. PROCEDURES The practice team (3 veterinarians, 5 veterinary technicians, 1 receptionist, and 1 office manager) participated in a 6-month educational program (intervention) that included interactive communication modules, individual coaching, and a communication laboratory. For each of the veterinarians, 6 appointments were video recorded and 30 additional clients completed a visit satisfaction survey both before and after the intervention. The Roter interaction analysis system was used to analyze the video-recorded appointments. RESULTS After the intervention, appointments were 5.4 minutes longer and veterinarians asked 60% fewer closed-ended lifestyle-social questions, provided 1.4 times as much biomedically related client education, and used 1.5 and 1.25 times as much facilitative and emotional rapport communication, respectively, compared with before the intervention. Clients provided veterinarians with 1.3 times as much biomedically related information and engaged in twice as much social conversation. After the intervention, veterinarians perceived their clients as complaining less and being more personable and trusting, and clients felt more involved in the appointment and reported that the veterinarian expressed greater interest in their opinion. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that the intervention resulted in veterinarians who spent more time educating and building rapport with their clients and facilitating client input in an unhurried environment, which enhanced overall veterinarian visit satisfaction and various aspects of client visit satisfaction.

Evaluation of a multi-component approach to cognitive-behavioral therapy (CBT) using guided visualizations, cranial electrotherapy stimulation, and vibroacoustic sound.

PubMed

Rogers, Donna R B; Ei, Sue; Rogers, Kim R; Cross, Chad L

2007-05-01

This pilot study examines the use of guided visualizations that incorporate both cognitive and behavioral techniques with vibroacoustic therapy and cranial electrotherapy stimulation to form a multi-component therapeutic approach. This multi-component approach to cognitive-behavioral therapy (CBT) was used to treat patients presenting with a range of symptoms including anxiety, depression, and relationship difficulties. Clients completed a pre- and post-session symptom severity scale and CBT skills practice survey. The program consisted of 16 guided visualizations incorporating CBT techniques that were accompanied by vibroacoustic therapy and cranial electrotherapy stimulation. Significant reduction in symptom severity was observed in pre- and post-session scores for anxiety symptoms, relationship difficulties, and depressive symptoms. The majority of the clients (88%) reported use of CBT techniques learned in the guided visualizations at least once per week outside of the sessions.

Integrating Webtop Components with Thin-Client Web Applicators using WDK Tickets

NASA Technical Reports Server (NTRS)

Duley, Jason

2004-01-01

Contents include the folloving: Issues surrounding encryption/decryption of password strings when deploying on different machines and platforms. Security concerns when exposing docbases to internet users. Docbase Session management in Java Servlets. Customization of Webtop components. WDK Tickets as a silent login alternative. Encoding Tickets and Ticket syntax. Invoking Webtop components via an Action URL. Issues with accessing Webtop components on Mac OS X through SSL.

"I just feel comfortable out here, there's something about the place": staff and client perceptions of a remote Australian Aboriginal drug and alcohol rehabilitation service.

PubMed

Munro, Alice; Allan, Julaine; Shakeshaft, Anthony; Breen, Courtney

2017-12-06

The need for effective, culturally safe residential rehabilitation services for Aboriginal people is widely acknowledged, however the combination of treatment components that is optimally effective, is not well defined. Most existing Aboriginal residential rehabilitation research has focused on describing client characteristics, and largely ignored the impact of treatment and service factors, such as the nature and quality of therapeutic components and relationships with staff. This qualitative study was undertaken as part of a three-year mixed methods community-based participatory research (CBPR) project that aimed to empirically describe a remote Aboriginal drug and alcohol rehabilitation service. Researchers utilised purposive sampling to conduct 21 in-depth, semi-structured interviews. The interviews used a 'research yarning' approach, a form of culturally appropriate conversation that is relaxed and narrative-based. The interview transcripts were thematically coded using iterative categorization. The emerging themes were then analysed from an Interpretative Phenomenological Analysis, focusing on how participants' lived experiences before and during their admission to the service shaped their perceptions of the program. A total of 12 clients (mean age 35 years, SD 9.07, 91% Aboriginal) and 9 staff (2 female, 7 male, mean age 48 years, SD 8.54, 67% Aboriginal) were interviewed. Five themes about specific program components were identified in the interview data: healing through culture and country; emotional safety and relationships; strengthening life skills; improved wellbeing; and perceived areas for improvement. This research found that Aboriginal drug and alcohol residential rehabilitation is not just about length of time in treatment, but also about the culture, activities and relationships that are part of the treatment process. This study highlights that cultural elements were highly valued by both clients and staff of a remote Aboriginal residential rehabilitation service, with the country or location being fundamental to the daily practice of, and access to, culture. Developing reliable and valid assessments of the program components of culture and treatment alliance would be valuable, given this study has reinforced their perceived importance in achieving positive treatment outcomes. Further, strengthening the aftercare program, as part of an integrated model of care, would likely provide greater support to clients after discharge.

The ICF-CY and Goal Attainment Scaling: benefits of their combined use for pediatric practice.

PubMed

McDougall, Janette; Wright, Virginia

2009-01-01

There is much heterogeneity and disconnect in the approaches used by service providers to conduct needs assessments, set goals and evaluate outcomes for clients receiving pediatric rehabilitation services. The purpose of this article is to describe how the International Classification of Functioning, Disability and Health-Child and Youth (ICF-CY) can be used in combination with Goal Attainment Scaling (GAS), an individualised measure of change, to connect the various phases of the therapeutic process to provide consistent clinical care that is family-centred, collaborative, well directed and accountable. A brief description of both the ICF-CY and GAS as they pertain to pediatric rehabilitation is provided as background. An explanation is given of how the ICF-CY offers a framework through which clients, families and service providers can together identify the areas of clients' needs. In addition, the article discusses how the use of GAS facilitates translation of clients' identified needs into distinct, measurable goals set collaboratively by clients, their families and service providers. Examples of integrated GAS goals set for the various components of the ICF-CY are provided. The utility of GAS as a measure of clinical outcomes for individual clients is also discussed. Used in combination, the ICF-CY and GAS can serve to coordinate, simplify and standardise assessment and outcome evaluation practices for individual clients receiving pediatric rehabilitation services.

Development and validation of the client engagement and service use scale: A pilot study.

PubMed

Kline, Emily R; DeTore, Nicole R; Keefe, Kristen; Seidman, Larry J; Srihari, Vinod H; Keshavan, Matcheri S; Guyer, Margaret

2018-05-12

Specialized treatment for first episode psychosis offers clients a menu of services coordinated within a specialized treatment team. To enhance the impact of these services, promoting engagement and preventing early treatment drop-out is critical. However, engagement is poorly tracked and typically quantified through proxy variables such as session attendance, medication adherence, or working alliance. The aim of this study is to introduce and pilot a new measure of engagement for first episode psychosis coordinated specialty care, the Client Engagement and Service Use Scale (CENSUS). The CENSUS was evaluated for reliability and validated against the Service Engagement Scale and an appointment count for a small sample (N = 10) of first episode clients. The measure was also evaluated for acceptability by a consumer advocacy group. Clinicians achieved high inter-rater reliability after minimal training. CENSUS items demonstrated medium to large correlations with other measures of engagement. Feedback from the consumer group emphasized that clinicians should ask questions in a way that is nonjudgmental and successfully elicits authentic client feedback about their service preferences. This pilot study yielded preliminary evidence of reliability and validity, suggesting that the CENSUS is a useful and novel tool for tracking and differentiating degrees of client engagement across multiple intervention components and for facilitating structured discussions regarding clients' service utilization and preferences. Copyright © 2018. Published by Elsevier B.V.

Usage and Recall of the Food Stamp Office Resource Kit (FSORK) by Food Stamp Applicants in 4 California Counties

ERIC Educational Resources Information Center

Ghirardelli, Alyssa; Linares, Amanda; Fong, Amy

2011-01-01

Objective: To evaluate recall and usage of the Food Stamp Office Resource Kit (FSORK), a set of nutrition education materials designed for use in food stamp offices. Design: Client intercept exit surveys, an environmental scan, and individual observations of clients in the food stamp office. Setting: Four food stamp offices in California.…

A Comprehensive Toolset for General-Purpose Private Computing and Outsourcing

DTIC Science & Technology

2016-12-08

project and scientific advances made towards each of the research thrusts throughout the project duration. 1 Project Objectives Cloud computing enables...possibilities that the cloud enables is computation outsourcing, when the client can utilize any necessary computing resources for its computational task...Security considerations, however, stand on the way of harnessing the full benefits of cloud computing to the fullest extent and prevent clients from

Efficacy of Client-Centred and Rational-Emotive Behaviour Therapies in Reducing Bullying Behaviour among In-School Adolescents in Ilorin, Nigeria

ERIC Educational Resources Information Center

Alabi, Yahaya Lasiele; Lami, Mustapha Mulikat

2015-01-01

Bullying behaviour refers to repeated negative behaviour displayed by one or more person (s) with the intention of hurting the feeling, personality and power of the victim. The objective of this study therefore was to find out the efficacy of Client-Centred and Rational-Emotive Behaviour Therapies in reducing bullying behaviour among in-school…

Reusable Client-Side JavaScript Modules for Immersive Web-Based Real-Time Collaborative Neuroimage Visualization.

PubMed

Bernal-Rusiel, Jorge L; Rannou, Nicolas; Gollub, Randy L; Pieper, Steve; Murphy, Shawn; Robertson, Richard; Grant, Patricia E; Pienaar, Rudolph

2017-01-01

In this paper we present a web-based software solution to the problem of implementing real-time collaborative neuroimage visualization. In both clinical and research settings, simple and powerful access to imaging technologies across multiple devices is becoming increasingly useful. Prior technical solutions have used a server-side rendering and push-to-client model wherein only the server has the full image dataset. We propose a rich client solution in which each client has all the data and uses the Google Drive Realtime API for state synchronization. We have developed a small set of reusable client-side object-oriented JavaScript modules that make use of the XTK toolkit, a popular open-source JavaScript library also developed by our team, for the in-browser rendering and visualization of brain image volumes. Efficient realtime communication among the remote instances is achieved by using just a small JSON object, comprising a representation of the XTK image renderers' state, as the Google Drive Realtime collaborative data model. The developed open-source JavaScript modules have already been instantiated in a web-app called MedView , a distributed collaborative neuroimage visualization application that is delivered to the users over the web without requiring the installation of any extra software or browser plugin. This responsive application allows multiple physically distant physicians or researchers to cooperate in real time to reach a diagnosis or scientific conclusion. It also serves as a proof of concept for the capabilities of the presented technological solution.

Knowledge as an interactional tool in the management of client empowerment.

PubMed

Moore, John

2016-06-01

To examine the way speaker and recipient knowledge is managed in interaction by a call taker at a mental-health information line, to achieve the institutional goals of information provision and client empowerment. This study utilizes conversation analysis in the analysis of a single call to the line. Analysis demonstrates the ways in which a call taker produces turns-at-talk that construct a caller as knowing what help they wanted prior to that moment in the interaction, and that invoke 'common' knowledge of sources of such help. Talk that orients to knowledge is used as an interactional resource that allows the call taker to avoid talk that may be considered advice, and to be heard to achieve the goal of client empowerment. The asymmetric identities of help-seeker and help-provider are managed in this process. Client empowerment can be seen as something interactionally achieved and managed in talk-in-interaction, while not necessarily objectively experienced by the client. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Does the Quality of SafeTalk Motivational Interviewing Counseling Predict Sexual Behavior Outcomes among People Living with HIV?

PubMed Central

Grodensky, Catherine; Golin, Carol; Parikh, Megha A.; Ochtera, Rebecca; Kincaid, Carlye; Groves, Jennifer; Widman, Laura; Suchindran, Chirayath; McGirt, Camille; Amola, Kemi; Bradley-Bull, Steven

2017-01-01

Objective Although past research has demonstrated a link between the quality of motivational interviewing (MI) counseling and client behavior change, this relationship has not been examined in the context of sexual risk behavior among people living with HIV/AIDS. We studied MI quality and unprotected anal/vaginal intercourse (UAVI) in the context of SafeTalk, an evidence-based secondary HIV prevention intervention. Methods We used a structured instrument (the MISC 2.0 coding system) as well as a client-reported instrument to rate intervention sessions on aspects of MI quality. Then we correlated client-reported UAVI with specific counseling behaviors and the proportion of interactions that achieved MI quality benchmarks. Results/Conclusion Higher MISC-2.0 global ratings and a higher ratio of reflections to questions both significantly predicted fewer UAVI acts at 8-month follow-up. Analysis of client ratings, which was more exploratory, showed that clients who rated their sessions higher in counselor acceptance, client disclosure, and relevance reported higher numbers of UAVIs, whereas clients who selected higher ratings for perceived benefit were more likely to have fewer UAVI episodes. Practice Implications Further research is needed to determine the best methods of translating information about MI quality into dissemination of effective MI interventions with people living with HIV. PMID:27567497

Helping Homeless Individuals with Co-Occurring Disorders: The Four Components

ERIC Educational Resources Information Center

Sun, An-Pyng

2012-01-01

Homeless individuals with co-occurring disorders (CODs) of severe mental illness and substance use disorder are one of the most vulnerable populations. This article provides practitioners with a framework and strategies for helping this client population. Four components emerged from a literature review: (1) ensuring an effective transition for…

Understanding the working alliance with clients diagnosed with anorexia nervosa.

PubMed

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

2016-01-01

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

Incorporating client-server database architecture and graphical user interface into outpatient medical records.

PubMed Central

Fiacco, P. A.; Rice, W. H.

1991-01-01

Computerized medical record systems require structured database architectures for information processing. However, the data must be able to be transferred across heterogeneous platform and software systems. Client-Server architecture allows for distributive processing of information among networked computers and provides the flexibility needed to link diverse systems together effectively. We have incorporated this client-server model with a graphical user interface into an outpatient medical record system, known as SuperChart, for the Department of Family Medicine at SUNY Health Science Center at Syracuse. SuperChart was developed using SuperCard and Oracle SuperCard uses modern object-oriented programming to support a hypermedia environment. Oracle is a powerful relational database management system that incorporates a client-server architecture. This provides both a distributed database and distributed processing which improves performance. PMID:1807732

Neurofeedback outcomes in clients with Asperger's syndrome.

PubMed

Thompson, Lynda; Thompson, Michael; Reid, Andrea

2010-03-01

This paper summarizes data from a review of neurofeedback (NFB) training with 150 clients with Asperger's Syndrome (AS) and 9 clients with Autistic Spectrum Disorder (ASD) seen over a 15 year period (1993-2008) in a clinical setting. The main objective was to investigate whether electroncephalographic (EEG) biofeedback, also called neurofeedback (NFB), made a significant difference in clients diagnosed with AS. An earlier paper (Thompson et al. 2009) reviews the symptoms of AS, highlights research findings and theories concerning this disorder, discusses QEEG patterns in AS (both single and 19-channel), and details a hypothesis, based on functional neuroanatomy, concerning how NFB, often paired with biofeedback (BFB), might produce a change in symptoms. A further aim of the current report is to provide practitioners with a detailed description of the method used to address some of the key symptoms of AS in order to encourage further research and clinical work to refine the use of NFB plus BFB in the treatment of AS. All charts were included for review where there was a diagnosis of AS or ASD and pre- and post-training testing results were available for one or more of the standardized tests used. Clients received 40-60 sessions of NFB, which was combined with training in metacognitive strategies and, for most older adolescent and adult clients, with BFB of respiration, electrodermal response, and, more recently, heart rate variability. For the majority of clients, feedback was contingent on decreasing slow wave activity (usually 3-7 Hz), decreasing beta spindling if it was present (usually between 23 and 35 Hz), and increasing fast wave activity termed sensorimotor rhythm (SMR) (12-15 or 13-15 Hz depending on assessment findings). The most common initial montage was referential placement at the vertex (CZ) for children and at FCz (midway between FZ and CZ) for adults, referenced to the right ear. Metacognitive strategies relevant to social understanding, spatial reasoning, reading comprehension, and math were taught when the feedback indicated that the client was relaxed, calm, and focused. Significant improvements were found on measures of attention (T.O.V.A. and IVA), core symptoms (Australian Scale for Asperger's Syndrome, Conners' Global Index, SNAP version of the DSM-IV criteria for ADHD, and the ADD-Q), achievement (Wide Range Achievement Test), and intelligence (Wechsler Intelligence Scales). The average gain for the Full Scale IQ score was 9 points. A decrease in relevant EEG ratios was also observed. The ratios measured were (4-8 Hz)(2)/(13-21 Hz)(2), (4-8 Hz)/(16-20 Hz), and (3-7 Hz)/(12-15 Hz). The positive outcomes of decreased symptoms of Asperger's and ADHD (including a decrease in difficulties with attention, anxiety, aprosodias, and social functioning) plus improved academic and intellectual functioning, provide preliminary support for the use of neurofeedback as a helpful component of effective intervention in people with AS.

A Powerful, Cost Effective, Web Based Engineering Solution Supporting Conjunction Detection and Visual Analysis

NASA Astrophysics Data System (ADS)

Novak, Daniel M.; Biamonti, Davide; Gross, Jeremy; Milnes, Martin

2013-08-01

An innovative and visually appealing tool is presented for efficient all-vs-all conjunction analysis on a large catalogue of objects. The conjunction detection uses a nearest neighbour search algorithm, based on spatial binning and identification of pairs of objects in adjacent bins. This results in the fastest all vs all filtering the authors are aware of. The tool is constructed on a server-client architecture, where the server broadcasts to the client the conjunction data and ephemerides, while the client supports the user interface through a modern browser, without plug-in. In order to make the tool flexible and maintainable, Java software technologies were used on the server side, including Spring, Camel, ActiveMQ and CometD. The user interface and visualisation are based on the latest web technologies: HTML5, WebGL, THREE.js. Importance has been given on the ergonomics and visual appeal of the software. In fact certain design concepts have been borrowed from the gaming industry.

Relationship between reported prior condom use and current self-perceived risk of acquiring HIV among mobile female sex workers in southern India

PubMed Central

2011-01-01

Background With the evolution of Health Belief Model, risk perception has been identified as one of several core components of public health interventions. While female sex workers (FSWs) in India continue to be at most risk of acquiring and transmitting HIV, little is known about their perception towards risk of acquiring HIV and how this perception depends upon their history of consistent condom use behavior with different type of partners. The objective of this study is to fill this gap in the literature by examining this relationship among mobile FSWs in southern India. Methods We analyzed data for 5,413 mobile FSWs from a cross-sectional behavioral survey conducted in 22 districts from four states in southern India. This survey assessed participants’ demographics, condom use in sex with different types of partners, continuation of sex while experiencing STI symptoms, alcohol use before having sex, and self-perceived risk of acquiring HIV. Descriptive analyses and multilevel logistic regression models were used to examine the associations between risky sexual behaviors and self-perceived risk of acquiring HIV; and to understand the geographical differences in HIV risk perception. Results Of the total mobile FSWs, only two-fifths (40%) perceived themselves to be at high risk of acquiring HIV; more so in the state of Andhra Pradesh (56%) and less in Maharashtra (17%). FSWs seem to assess their current risk of acquiring HIV primarily on the basis of their past condom use behavior with occasional clients and less on the basis of their past condom use behaviors with regular clients and non-paying partners. Prior inconsistent condom use with occasional clients was independently associated with current perception of high HIV risk (adjusted odds ratio [aOR)] = 2.1, 95% confidence interval [CI]: 1.7-2.6). In contrast, prior inconsistent condom use with non-paying partners was associated with current perception of low HIV risk (aOR= 0.7, 95% CI: 0.5-0.9). The congruence between HIV risk perception and condom use with occasional clients was high: only 12% of FSWs reported inconsistent condom use with occasional clients but perceived themselves to be at low risk of acquiring HIV. Conclusion The association between high risk perception of acquiring HIV and inconsistent condom use, especially with regular clients and non-paying partners, has not been completely internalized by this high risk group of mobile FSWs in India. Motivational efforts to prevent HIV should emphasize the importance of accurately assessing an individual’s risk of acquiring HIV based on condom use behavior with all types of partners: occasional and regular clients as well as non-paying partners; and encourage behavior change based on an accurate self-assessment of HIV risk. PMID:22375731

Walking in sacred spaces in the therapeutic bond: therapists' experiences of compassion satisfaction coupled with the potential for vicarious traumatization.

PubMed

Hunter, Sally V

2012-06-01

The therapeutic bond is at the heart of effective therapy, yet few studies have examined therapists' experience of this bond. Using a qualitative study design, this exploratory study examines the experiences of couple and family therapists in relation to their perceptions of the satisfactions and risks involved in the therapeutic bond. The research was conducted using grounded theory methodology and eight in-depth interviews were conducted with therapists working in five counseling agencies in Sydney, Australia. Therapists described the importance of the 3 component parts of the therapeutic bond: the empathic connection between therapist and client; the role investment of the client; and the mutual affirmation experienced by both therapist and client in the therapeutic process. Walking in sacred spaces with the client was seen as both enriching and challenging for the therapist. The therapeutic bond gave therapists intense satisfaction and posed risks for them, especially when working with traumatic client experiences. However, the findings suggest that the experience of compassion satisfaction and the development of vicarious resilience counter-balanced the intense difficulty of bearing witness to clients' traumatic experiences and the potential for vicarious traumatization. The implications for sustaining couple and family therapists in their work are discussed. © FPI, Inc.

Enacting Firm, Fair and Friendly Practice: A Model for Strengths-Based Child Protection Relationships?

PubMed

Oliver, Carolyn; Charles, Grant

2016-06-01

Strengths-based solution-focused approaches are gaining ground in statutory child protection work, but few studies have asked front line practitioners how they navigate the complex worker-client relationships such approaches require. This paper describes one component of a mixed-methods study in a large Canadian statutory child protection agency in which 225 workers described how they applied the ideas of strengths-based practice in their daily work. Interviews with twenty-four practitioners were analysed using an interpretive description approach. Only four interviewees appeared to successfully enact a version of strengths-based practice that closely mirrored those described by key strengths-based child protection theorists and was fully congruent with their mandated role. They described navigating a shifting balance of collaboration and authority in worker-client relationships based on transparency, impartial judgement, attentiveness to the worker-client interaction and the value that clients were fellow human beings. Their accounts extend current conceptualisations of the worker-client relationship in strengths-based child protection work and are congruent with current understandings of effective mandated relationships. They provide what may be a useful model to help workers understand and navigate relationships in which they must reconcile their own authority and expertise with genuine support for the authority and expertise of their clients.

Counseling and Knowledge of Danger Signs of Pregnancy Complications in Haiti, Malawi, and Senegal.

PubMed

Assaf, Shireen

2018-06-23

Objectives Providing counseling on danger signs of pregnancy complications as part of visits for antenatal care (ANC) can raise expecting women's awareness so that if danger signs occur they can seek assistance in time. The study examines the level of agreement in counseling on danger signs between observation of the provider during the ANC visit and the client's report in the exit interview, and the association of this agreement with the client's level of knowledge on danger signs. Methods The analysis used data from service provision and assessment (SPA) surveys in Haiti, Malawi, and Senegal. Agreement between the observation and client's report was measured by Cohen's kappa and percent agreement. Regressions were performed on the number of danger signs the client knew, with the level of agreement on the counseling on danger signs as the main independent variable. Results The study found little agreement between the observation of counseling and the client's report that the counseling occurred, despite the fact that the exit interview with the client was performed immediately following the ANC visit with the provider. The level of positive agreement between observation and client's report was 17% in Haiti, 33% in Malawi, and 23% in Senegal. Clients' overall knowledge of danger signs was low; in all three countries the mean number of danger signs known was 1.5 or less. The regression analysis found that, in order to show a significant increase in knowledge of danger signs, it was important for the client to report that it took place. Conclusions Ideally, there should be 100% positive agreement that counseling occurred. To achieve this level requires raising both the level of counseling on danger signs of pregnancy complications and its quality. While challenges exist, providing counseling that is more client-centered and focuses on the client's needs could improve quality and thus could increase the client's knowledge of danger signs.

Self-esteem: a closer look at clinical interventions.

PubMed

Meisenhelder, J B

1985-01-01

Self-esteem, a positive regard for oneself, is a universal need for every human being and a key component in restoring and maintaining mental and physical health. Yet, this important concept is remarkably neglected in nursing literature and easily overlooked in clinical practice. This article examines the existing research on the antecedents of self-esteem and compiles a list of factors which can facilitate the nurse's therapeutic effect on her client's positive self-concept. From this list, specific nursing interventions are provided for raising and maintaining a client's self-esteem. Since the impact of nursing interventions varies with clinical circumstances, the nursing actions are correlated with their most effective health care settings. This article provides a global and practical approach to the enhancement of clients' self-esteem.

MyFreePACS: a free web-based radiology image storage and viewing tool.

PubMed

de Regt, David; Weinberger, Ed

2004-08-01

We developed an easy-to-use method for central storage and subsequent viewing of radiology images for use on any PC equipped with Internet Explorer. We developed MyFreePACS, a program that uses a DICOM server to receive and store images and transmit them over the Web to the MyFreePACS Web client. The MyFreePACS Web client is a Web page that uses an ActiveX control for viewing and manipulating images. The client contains many of the tools found in modern image viewing stations including 3D localization and multiplanar reformation. The system is built entirely with free components and is freely available for download and installation from the Web at www.myfreepacs.com.

Computer modeling with randomized-controlled trial data informs the development of person-centered aged care homes.

PubMed

Chenoweth, Lynn; Vickland, Victor; Stein-Parbury, Jane; Jeon, Yun-Hee; Kenny, Patricia; Brodaty, Henry

2015-10-01

To answer questions on the essential components (services, operations and resources) of a person-centered aged care home (iHome) using computer simulation. iHome was developed with AnyLogic software using extant study data obtained from 60 Australian aged care homes, 900+ clients and 700+ aged care staff. Bayesian analysis of simulated trial data will determine the influence of different iHome characteristics on care service quality and client outcomes. Interim results: A person-centered aged care home (socio-cultural context) and care/lifestyle services (interactional environment) can produce positive outcomes for aged care clients (subjective experiences) in the simulated environment. Further testing will define essential characteristics of a person-centered care home.

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.

Randomized Trial of Intensive Housing Placement and Community Transition Services for Episodic and Recidivist Homeless Families

PubMed Central

Mitchell, Kristen; Pareti, Lauren; DeGenova, Joe; Heller, Anne; Hannigan, Anthony; Gholston, Jennifer

2013-01-01

Objectives. We compared Home to Stay, a pilot of intensive housing placement and community transition services for episodic and recidivist homeless families, with a standard services approach. Methods. Using intention-to-treat analyses, we conducted a modified randomized trial of 138 Home to Stay client families and a control group of 192 client families receiving standard shelter services. Results. Home to Stay clients exited shelter more quickly than clients in the control group (Cox regression, P < .001), more commonly exited shelter with housing subsidies (75% vs 56%), stayed out of shelter longer (Cox regression, P = .011), and spent fewer total days in shelter (376 days vs 449 days). Home to Stay performed best with clients who entered shelter within 180 days of the pilot’s start date and had less impact on clients entering shelter before that time. Conclusions. Relative to standard services, Home to Stay services can accelerate exit from shelter and reduce return to shelter and total sheltered days for episodic and recidivist homeless families. Standard shelter services may be able to narrow this performance gap by incentivizing work with all episodic and recidivist homeless families. PMID:24148053

Surgical informed consent in obstetric and gynecologic surgeries: experience from a comprehensive teaching hospital in Southern Ethiopia.

PubMed

Teshome, Million; Wolde, Zenebe; Gedefaw, Abel; Tariku, Mequanent; Asefa, Anteneh

2018-05-24

Surgical Informed Consent (SIC) has long been recognized as an important component of modern medicine. The ultimate goals of SIC are to improve clients' understanding of the intended procedure, increase client satisfaction, maintain trust between clients and health providers, and ultimately minimize litigation issues related to surgical procedures. The purpose of the current study is to assess the comprehensiveness of the SIC process for women undergoing obstetric and gynecologic surgeries. A hospital-based cross-sectional study was undertaken at Hawassa University Comprehensive Specialized Hospital (HUCSH) in November and December, 2016. A total of 230 women who underwent obstetric and/or gynecologic surgeries were interviewed immediately after their hospital discharge to assess their experience of the SIC process. Thirteen components of SIC were used based on international recommendations, including the Royal College of Surgeon's standards of informed consent practices for surgical procedures. Descriptive summaries are presented in tables and figures. Forty percent of respondents were aged between 25 and 29 years. Nearly a quarter (22.6%) had no formal education. More than half (54.3%) of respondents had undergone an emergency surgical procedure. Only 18.4% of respondents reported that the surgeon performing the operation had offered SIC, while 36.6% of respondents could not recall who had offered SIC. All except one respondent provided written consent to undergo a surgical procedure. However, 8.3% of respondents received SIC service while already on the operation table for their procedure. Only 73.9% of respondents were informed about the availability (or lack thereof) of alternative treatment options. Additionally, a majority of respondents were not informed about the type of anesthesia to be used (88.3%) and related complications (87.4%). Only 54.2% of respondents reported that they had been offered at least six of the 13 SIC components used by the investigators. There is gap in the provision of comprehensive and standardized pre-operative counseling for obstetric and gynecologic surgeries in the study hospital. This has a detrimental effect on the overall quality of care clients receive, specifically in terms of client expectations and information needs.

Kentucky geotechnical database.

DOT National Transportation Integrated Search

2005-03-01

Development of a comprehensive dynamic, geotechnical database is described. Computer software selected to program the client/server application in windows environment, components and structure of the geotechnical database, and primary factors cons...

The In-Session and Long-Term Role of a Significant Other in Motivational Enhancement Therapy for Alcohol Use Disorders

PubMed Central

Bourke, Emilie; Magill, Molly; Apodaca, Timothy R.

2016-01-01

Objective To examine how significant other (SO) language in support of or against client abstinence from alcohol influences clients’ in-session speech and drinking behavior over the 9 months post-Motivational Enhancement Therapy (MET). Method Sequential analyses were used to examine the language of Project MATCH clients who invited an SO to participate in an MET session. Hierarchical regressions investigated the predictive relationship between SO language and clients’ post-treatment drinking behavior. A cohort analytic design compared the change language of these SO-involved participants against a matched group who chose client-only therapy. Results 'SO Support Change' language increased the odds of client Change Talk in the next utterance (p < .01). SO Support Change did not significantly predict reduced post-treatment drinking whereas 'SO Against Change' significantly predicted an increase in average drinks per drinking day (DDD) across months 7-9 post-MET (p = .04). In the matched comparison, the proportion of change-related client language was comparable across the SO-involved and client-only groups. Conclusions Motivational interviewing theory was supported by the sequential association between SO and client language as well as the predictive link between SO Against Change and client drinking intensity. Given the centrality of pro-sobriety language in the literature, it was surprising that SO Support Change did not predict alcohol use outcomes. Findings are discussed in relation to contemporary treatment process research and clinical practice. PMID:26951920

The Relationship Between Client Characteristics and Wraparound Services in Substance Use Disorder Treatment Centers

PubMed Central

Paino, Maria; Aletraris, Lydia; Roman, Paul

2016-01-01

Objective: The National Institute on Drug Abuse (NIDA) recommends a comprehensive treatment program for individuals with substance use disorder (SUD) in order to treat needs they often have in addition to their SUD. Specifically, NIDA suggests providing services related to the following issues: medical care, mental health care, HIV/AIDS, child care, educational, vocational, family counseling, housing, transportation, financial, and legal. By providing a comprehensive model that combines core and wraparound services, treatment centers can deliver a higher quality of treatment. In this article, we assessed the relationship between client characteristics and the availability of wraparound services in SUD treatment centers. Method: We combined two nationally representative samples of treatment centers and used a negative binomial regression and a series of logistic regressions to analyze the relationship between client characteristics and wraparound services. Results: On average, centers offered fewer than half of the wraparound services endorsed by NIDA. Our results indicated that client characteristics were significantly related to the provision of wraparound services. Most notably, the proportion of adolescent clients was positively related to educational services, the proportion of female clients was positively related to child care, but the proportion of clients referred from the criminal justice system was negatively associated with the provision of multiple wraparound services. Conclusions: Our findings have important implications for SUD clients and suggest that, although centers are somewhat responsive to their clients’ ancillary needs, most centers do not offer the majority of wraparound services. PMID:26751366

Use of the measure of patient-centered communication to analyze euthanasia discussions in companion animal practice.

PubMed

Nogueira Borden, Leandra J; Adams, Cindy L; Bonnett, Brenda N; Shaw, Jane R; Ribble, Carl S

2010-12-01

To characterize veterinarian-client communication with undisclosed standardized clients (USCs) during discussions regarding euthanasia of a pet. Descriptive study. 32 companion animal veterinarians (16 males and 16 females) in southern Ontario. During 2 clinic visits, 2 cases (a geriatric dog with worsening arthritis and a cat with inappropriate urination) designed to stimulate discussion regarding euthanasia of a pet were presented by different USCs (individuals trained to consistently present a particular case to veterinarians without disclosing their identity). Discussions were audio recorded and analyzed by use of the measure of patient-centered communication (MPCC [a tool to assess and score physician communication behaviors]). Veterinarian and client statements were classified by means of 3 patient-centered components: exploring both the disease and the illness experience, understanding the whole person, and finding common ground. 60 usable recorded discussions were obtained (31 veterinarians; 30 discussions/case). Overall, MPCC scores were significantly lower for the geriatric dog case. For both cases, veterinarians scored highest on finding common ground and lowest on exploring both the disease and the illness experience. Lack of exploration of client feelings, ideas, and expectations and the effect of the illness on the animal's function resulted in low scores among veterinarians. Results indicated that the use of USCs and the MPCC are feasible methods for analysis of veterinarian-client communication during companion animal euthanasia discussions. Findings suggested that some veterinarians do not fully explore client concerns or facilitate client involvement in euthanasia decision making.

Alcohol Use Among Female Sex Workers and Male Clients: An Integrative Review of Global Literature

PubMed Central

Li, Qing; Li, Xiaoming; Stanton, Bonita

2010-01-01

Aims: To review the patterns, contexts and impacts of alcohol use associated with commercial sex reported in the global literature. Methods: We identified peer-reviewed English-language articles from 1980 to 2008 reporting alcohol consumption among female sex workers (FSWs) or male clients. We retrieved 70 articles describing 76 studies, in which 64 were quantitative (52 for FSWs, 12 for male clients) and 12 qualitative. Results: Studies increased over the past three decades, with geographic concentration of the research in Asia and North America. Alcohol use was prevalent among FSWs and clients. Integrating quantitative and qualitative studies, multilevel contexts of alcohol use in the sex work environment were identified, including workplace and occupation-related use, the use of alcohol to facilitate the transition into and practice of commercial sex among both FSWs and male clients, and self-medication among FSWs. Alcohol use was associated with adverse physical health, illicit drug use, mental health problems, and victimization of sexual violence, although its associations with HIV/sexually transmitted infections and unprotected sex among FSWs were inconclusive. Conclusions: Alcohol use in the context of commercial sex is prevalent, harmful among FSWs and male clients, but under-researched. Research in this area in more diverse settings and with standardized measures is required. The review underscores the importance of integrated intervention for alcohol use and related problems in multilevel contexts and with multiple components in order to effectively reduce alcohol use and its harmful effects among FSWs and their clients. PMID:20089544

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

PubMed

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

2015-03-01

Despite clinical recognition of the adverse effects of acquired hearing loss, only a small proportion of adults who could benefit use hearing aids. Hearing aid adoption has been studied in relationship to client-related and hearing aid technology-related factors. The influence of the client-clinician interaction in the decision to purchase hearing aids has not been explored in any depth. Importance ratings of a sample of adults having a recent hearing aid recommendation (clients) and hearing healthcare professionals (clinicians) from across Canada were compared on factors in client-clinician interactions that influence hearing aid purchase decisions. A cross-sectional approach was used to obtain online and paper-based concept ratings. Participants were 43 adults (age range, 45-85 yr) who had received a first hearing aid recommendation in the 3 mo before participation. A total of 54 audiologists and 20 hearing instrument practitioners from a variety of clinical settings who prescribed or dispensed hearing aids completed the concept-rating task. The task consisted of 122 items that had been generated via concept mapping in a previous study and which resulted in the identification of eight concepts that may influence hearing aid purchase decisions. Participants rated "the importance of each of the statements in a person's decision to purchase a hearing aid" on a 5-point Likert scale, from 1 = minimally important to 5 = extremely important. For the initial data analysis, the ratings for each of the items included in each concept were averaged for each participant to provide an estimate of the overall importance rating of each concept. Multivariate analysis of variance was used to compare the mean importance ratings of the clients to the clinicians. Ratings of individual statements were also compared in order to investigate the directionality of the importance ratings within concepts. There was a significant difference in the mean ratings for clients and clinicians for the concepts understanding and meeting client needs, conveying device information by clinician, supporting choices and shared decision making, and factors in client readiness. Three concepts-understanding and meeting client needs, conveying device information by clinician, and supporting choices and shared decision making-were rated as more important by clients than by clinicians. One concept (ie, factors in client readiness) was rated as more important by clinicians than by clients. The concepts rated as most important by clients and clinicians are consistent with components of several existing models of client-centered and patient-centered care. These concepts reflect the clients' perception of the importance of their involvement in the decision-making process. A preliminary model of client-centered care within the hearing aid uptake process and implications for clinical audiology are described. American Academy of Audiology.

A Mobile Service Oriented Multiple Object Tracking Augmented Reality Architecture for Education and Learning Experiences

ERIC Educational Resources Information Center

Rattanarungrot, Sasithorn; White, Martin; Newbury, Paul

2014-01-01

This paper describes the design of our service-oriented architecture to support mobile multiple object tracking augmented reality applications applied to education and learning scenarios. The architecture is composed of a mobile multiple object tracking augmented reality client, a web service framework, and dynamic content providers. Tracking of…

A consumer satisfaction survey of civilly committed sex offenders in Illinois.

PubMed

Levenson, Jill S; Prescott, David S; Jumper, Shan

2014-04-01

The purpose of this study was to obtain feedback from civilly committed sex offenders (N = 113) about the components of treatment that they believed to be most important and helpful in preventing reoffense. Participants were also asked to rate their satisfaction with the treatment process and therapists. Victim empathy and accountability were rated as the most important elements of treatment, along with skills for preventing relapse and methods for controlling sexual arousal. There was a fairly robust correlation between client perceptions of importance and satisfaction on most treatment components. Some clients expressed concerns about respect, confidentiality, and judgmental attitudes of some therapists. Because civilly committed sex offenders are considered to be among the most likely to reoffend, strategies are discussed for engagement of this population in a meaningful process of change.

A Federated Digital Identity Management Approach for Business Processes

NASA Astrophysics Data System (ADS)

Bertino, Elisa; Ferrini, Rodolfo; Musci, Andrea; Paci, Federica; Steuer, Kevin J.

Business processes have gained a lot of attention because of the pressing need for integrating existing resources and services to better fulfill customer needs. A key feature of business processes is that they are built from composable services, referred to as component services, that may belong to different domains. In such a context, flexible multi-domain identity management solutions are crucial for increased security and user-convenience. In particular, it is important that during the execution of a business process the component services be able to verify the identity of the client to check that it has the required permissions for accessing the services. To address the problem of multi-domain identity management, we propose a multi-factor identity attribute verification protocol for business processes that assures clients privacy and handles naming heterogeneity.

Reusable Client-Side JavaScript Modules for Immersive Web-Based Real-Time Collaborative Neuroimage Visualization

PubMed Central

Bernal-Rusiel, Jorge L.; Rannou, Nicolas; Gollub, Randy L.; Pieper, Steve; Murphy, Shawn; Robertson, Richard; Grant, Patricia E.; Pienaar, Rudolph

2017-01-01

In this paper we present a web-based software solution to the problem of implementing real-time collaborative neuroimage visualization. In both clinical and research settings, simple and powerful access to imaging technologies across multiple devices is becoming increasingly useful. Prior technical solutions have used a server-side rendering and push-to-client model wherein only the server has the full image dataset. We propose a rich client solution in which each client has all the data and uses the Google Drive Realtime API for state synchronization. We have developed a small set of reusable client-side object-oriented JavaScript modules that make use of the XTK toolkit, a popular open-source JavaScript library also developed by our team, for the in-browser rendering and visualization of brain image volumes. Efficient realtime communication among the remote instances is achieved by using just a small JSON object, comprising a representation of the XTK image renderers' state, as the Google Drive Realtime collaborative data model. The developed open-source JavaScript modules have already been instantiated in a web-app called MedView, a distributed collaborative neuroimage visualization application that is delivered to the users over the web without requiring the installation of any extra software or browser plugin. This responsive application allows multiple physically distant physicians or researchers to cooperate in real time to reach a diagnosis or scientific conclusion. It also serves as a proof of concept for the capabilities of the presented technological solution. PMID:28507515

Theoretical and clinical perspectives of client stalking behavior.

PubMed

Laskowski, Cheryl

2003-11-01

This article applies theoretical perspectives of client stalking behavior to vignettes of clinical nurse specialists (CNSs) who have experienced stalking incidents. A description of stalking behavior, estimations of the frequency of stalking behavior, characteristics of stalkers, and the impact of stalking on victims are addressed. Health care professionals, including CNSs, may inadvertently become victims of stalking behavior. Firm and clear boundary setting is important in all CNS-client relationships. CNSs who believe that they are becoming the objects of attention for particular individuals are advised to convey a clear message that they have no interest in the development of such a relationship. In this article CNS responses to actual client stalking behavior, including confrontation by the CNS, police involvement, restraining orders, and use of the CNS's attorney, are explored. The use of clinical consultation and the need for agencies to develop safety plans for all employees are also addressed.

[Effectiveness of integrative psychotherapeutic counseling for students].

PubMed

Sperth, Michael; Hofmann, Frank-Hagen; Holm-Hadulla, Rainer Mathias

2014-06-01

In this first effectiveness study of psychotherapeutic counseling for students in German-speaking countries, the effectiveness of an integrative model of counseling was evaluated based on a sample of 151 clients. Effectiveness of integrative counseling according to the ABCDE-model was found to be high in comparison to other international studies in this area. Pre-post differences on measures of mental distress and satisfaction were significant and effect sizes were mostly moderate to high. A high percentage of clients improved statistically and clinically significant. Counselors' expert rating and diagnostics according to ICD-10 that have been included in contrast to previous effectiveness studies showed that clients suitable for the counseling setting get treated in the counseling center while more severely disturbed clients in terms of psychopathology or diagnosis get referred to outpatient treatment, drop out or object to provide post-data. © Georg Thieme Verlag KG Stuttgart · New York.

HIV Prevalence Among Foreign- and US-Born Clients of Public STD Clinics

PubMed Central

Harawa, Nina T.; Bingham, Trista A.; Cochran, Susan D.; Greenland, Sander; Cunningham, William E.

2002-01-01

Objectives. We examined differences in HIV seroprevalence and the likely timing of HIV infection by birth region. Methods. We analyzed unlinked HIV antibody data on 61 120 specimens from 7 public health centers in Los Angeles County from 1993 to 1999. Results. Most (87%) immigrant clients were Central American/Mexican–born. HIV prevalence was similar for US- and foreign-born clients (1.8% [95% confidence interval (CI) = 1.7%, 1.9%] and 1.6% [95% CI = 1.5%, 1.8%], respectively). Seroprevalence was high among sub-Saharan African females and low among Asian/Pacific Islander males and females. For HIV-positive immigrants, the average age at and time since immigration were 20.6 years and 12.3 years, respectively. Conclusions. The relatively young age at arrival and long time since arrival for HIVpositive foreign-born clients suggest that most were infected after immigration. PMID:12453816

The Process of Adult Day Service Use*

PubMed Central

Gaugler, Joseph E.

2013-01-01

The objective of this study was to examine why and how families and older adults utilize adult day services. The current study included three months of participant observation in one rural and one suburban adult day service program in an upper-Midwestern region of the United States as well as semi-structured interviews with 14 family members of clients and 12 staff members from these programs. Several key constructs emerged that organized the multiple sources of qualitative data including programmatic philosophy, positioning, and environment of ADS; clients’ and family members’ reasons for use; the process of ADS use by families and clients; and pathways to family/client psychosocial and client functional outcomes. A number of inter-related themes emerged within each construct. The constructs identified and their potential associations among each other were used to expand upon and refine prior conceptualizations of ADS to frame future clinical and research efforts. PMID:24239404

A survey of recipient client physician satisfaction with teleoncology services originating from thunder bay regional health sciences centre.

PubMed

Brigden, Malcolm; Minty, Alana; Pilatzke, Susan; Della Vidova, Lori; Sherrington, Laurie; McPhail, Karen

2008-04-01

The objective of this work was to investigate end user satisfaction and perceived efficacy on the part of client physicians for teleoncology services in Northwestern Ontario. A survey of 98 referring physicians from 17 remote communities in Northwestern Ontario was undertaken primarily to determine overall client physician satisfaction with the teleoncology process. The survey also investigated perceived problems and explored potential solutions. Overall client physician satisfaction was high for the majority of response fields. However, more than 50% of surveyed physicians felt that some aspects of the teleoncology process could be improved with an emphasis on more timely communication of interview results, continuity of care, and improving patients comfort level with the technologies involved. The success of this service is evidenced by its exponential growth since the original introduction in 2001. Ninety-eight percent of referring physicians would continue to use the teleoncology service process.

Augmented reality building operations tool

DOEpatents

Brackney, Larry J.

2014-09-09

A method (700) for providing an augmented reality operations tool to a mobile client (642) positioned in a building (604). The method (700) includes, with a server (660), receiving (720) from the client (642) an augmented reality request for building system equipment (612) managed by an energy management system (EMS) (620). The method (700) includes transmitting (740) a data request for the equipment (612) to the EMS (620) and receiving (750) building management data (634) for the equipment (612). The method (700) includes generating (760) an overlay (656) with an object created based on the building management data (634), which may be sensor data, diagnostic procedures, or the like. The overlay (656) is configured for concurrent display on a display screen (652) of the client (642) with a real-time image of the building equipment (612). The method (700) includes transmitting (770) the overlay (656) to the client (642).

Technology-delivered adaptations of motivational interviewing for health-related behaviors: A systematic review of the current research

PubMed Central

Shingleton, Rebecca M.; Palfai, Tibor P.

2015-01-01

Objectives The aims of this paper were to describe and evaluate the methods and efficacy of technology-delivered motivational interviewing interventions (TAMIs), discuss the challenges and opportunities of TAMIs, and provide a framework for future research. Methods We reviewed studies that reported using motivational interviewing (MI) based components delivered via technology and conducted ratings on technology description, comprehensiveness of MI, and study methods. Results The majority of studies were fully-automated and included at least one form of media rich technology to deliver the TAMI. Few studies provided complete descriptions of how MI components were delivered via technology. Of the studies that isolated the TAMI effects, positive changes were reported. Conclusion Researchers have used a range of technologies to deliver TAMIs suggesting feasibility of these methods. However, there are limited data regarding their efficacy, and strategies to deliver relational components remain a challenge. Future research should better characterize the components of TAMIs, empirically test the efficacy of TAMIs with randomized controlled trials, and incorporate fidelity measures. Practice Implications TAMIs are feasible to implement and well accepted. These approaches offer considerable potential to reduce costs, minimize therapist and training burden, and expand the range of clients that may benefit from adaptations of MI. PMID:26298219

Components of a Measure to Describe Organizational Culture in Academic Pharmacy.

PubMed

Desselle, Shane; Rosenthal, Meagen; Holmes, Erin R; Andrews, Brienna; Lui, Julia; Raja, Leela

2017-12-01

Objective. To develop a measure of organizational culture in academic pharmacy and identify characteristics of an academic pharmacy program that would be impactful for internal (eg, students, employees) and external (eg, preceptors, practitioners) clients of the program. Methods. A three-round Delphi procedure of 24 panelists from pharmacy schools in the U.S. and Canada generated items based on the Organizational Culture Profile (OCP), which were then evaluated and refined for inclusion in subsequent rounds. Items were assessed for appropriateness and impact. Results. The panel produced 35 items across six domains that measured organizational culture in academic pharmacy: competitiveness, performance orientation, social responsibility, innovation, emphasis on collegial support, and stability. Conclusion. The items generated require testing for validation and reliability in a large sample to finalize this measure of organizational culture.

Plugin free remote visualization in the browser

NASA Astrophysics Data System (ADS)

Tamm, Georg; Slusallek, Philipp

2015-01-01

Today, users access information and rich media from anywhere using the web browser on their desktop computers, tablets or smartphones. But the web evolves beyond media delivery. Interactive graphics applications like visualization or gaming become feasible as browsers advance in the functionality they provide. However, to deliver large-scale visualization to thin clients like mobile devices, a dedicated server component is necessary. Ideally, the client runs directly within the browser the user is accustomed to, requiring no installation of a plugin or native application. In this paper, we present the state-of-the-art of technologies which enable plugin free remote rendering in the browser. Further, we describe a remote visualization system unifying these technologies. The system transfers rendering results to the client as images or as a video stream. We utilize the upcoming World Wide Web Consortium (W3C) conform Web Real-Time Communication (WebRTC) standard, and the Native Client (NaCl) technology built into Chrome, to deliver video with low latency.

Factors Determining Quality of Care in Family Planning Services in Africa: A Systematic Review of Mixed Evidence

PubMed Central

Tessema, Gizachew Assefa; Streak Gomersall, Judith; Mahmood, Mohammad Afzal; Laurence, Caroline O.

2016-01-01

Background Improving use of family planning services is key to improving maternal health in Africa, and provision of quality of care in family planning services is critical to support higher levels of contraceptive uptake. The objective of this systematic review was to synthesize the available evidence on factors determining the quality of care in family planning services in Africa. Methods Quantitative and qualitative studies undertaken in Africa, published in English, in grey and commercial literature, between 1990 and 2015 were considered. Methodological quality of included studies was assessed using standardized tools. Findings from the quantitative studies were summarized using narrative and tables. Client satisfaction was used to assess the quality of care in family planning services in the quantitative component of the review. Meta-aggregation was used to synthesize the qualitative study findings. Results From 4334 records, 11 studies (eight quantitative, three qualitative) met the review eligibility criteria. The review found that quality of care was influenced by client, provider and facility factors, and structural and process aspects of the facilities. Client’s waiting time, provider competency, provision/prescription of injectable methods, maintaining privacy and confidentiality were the most commonly identified process factors. The quality of stock inventory was the most commonly identified structural factor. The quality of care was also positively associated with privately-owned facilities. The qualitative synthesis revealed additional factors including access related factors such as ‘pre-requisites to be fulfilled by the clients and cost of services, provider workload, and providers’ behaviour. Conclusion There is limited evidence on factors determining quality of care in family planning services in Africa that shows quality of care is influenced by multiple factors. The evidence suggests that lowering access barriers and avoiding unnecessary pre-requisites for taking contraceptive methods are important to improve the quality of care in family planning services. Strategies to improve provider behavior and competency are important. Moreover, strategies that minimize client waiting time and ensure client confidentiality should be implemented to ensure quality of care in family planning services. However, no strong evidence based conclusions and recommendations may be drawn from the evidence. Future studies are needed to identify the most important factors associated with quality of care in family planning services in a wider range of African countries. PMID:27812124

Assessment of antiretroviral treatment (ART) care service provision in Tigray Region health centers, North Ethiopia.

PubMed

Tessema, Shewaye Belay; Adane, Mesafint Molla

2015-09-10

Client satisfaction is a vital component and main concern intertwined with strategic decisions in service provisions. To improve efficiency of services, eliciting the opinion of users about the available services and identifying factors associated with dissatisfaction is very critical. Thus, the main objective of this study was to assess the perceived levels of clients' satisfaction with health services at ART clinic level in health centres of Tigray Region in Ethiopia. Cross sectional study was conducted from May to June 2013 in Tigray Region ART clinics. A total of 714 ART care user were included in the study using both purposive and probability sampling technique. Data was collected by using structured questionnaire and the collected data was analysed using Statistical Package for the Social Sciences (SPSS) version 16.0. Crude and Adjusted logistic regression analyses were carried out to identify the associated factors underlying perceived levels of clients' overall satisfaction. Finally, the results were presented with table as well as odds ratio (OR) and 95% confidence interval (CI). A total of 714 study participants were enrolled in this study. An overall satisfaction level of 89.6% was reported by ART care service users. Higher scores of satisfaction of services provisions were reported for courtesy and respect (95.80%) followed by privacy (93.28%). On the other hand, respondents' dissatisfaction was rated 35.32% for toilet cleanliness followed by 26.19% for availability of additional drugs. As for overall satisfaction and associated factors, adjusted logistic regression analyses showed that marital status [AOR = 2.01 (95% CI: 1.11, 3.60)], educational status [AOR = 3.13 (95% CI: 1.15, 8.53)], travel distance to reach health centre [AOR = 3.59 (95% CI: 1.23, 10.50)], toilet cleanliness [AOR = 2.22 (95% CI :1.62, 6.32)], and ART drug availability [AOR = 2.60 (95% CI :1.18, 6.52)] were found to have influence on overall ART service satisfaction status. This study revealed high level of client satisfaction rate and were associated with preventable and modifiable factors such as marital status, educational status, travel distance to reach health centre, toilet cleanliness and ART drug availability. Therefore, countermeasures such as increasing access to ART service, availing clean toilet and ART drugs may further increase client satisfaction level in the region.

eMontage: An Architecture for Rapid Integration of Situational Awareness Data at the Edge

DTIC Science & Technology

2013-05-01

Request Response Interaction Android Client Dispatcher Servlet Spring MVC Controller Camel Producer Template Camel Route Remote Data Service - REST...8SATURN 2013© 2013 Carnegie Mellon University Publish Subscribe Interaction Android Client Dispatcher Servlet Spring MVC Controller Remote Data...set ..., "’"C oUkRelw•b J’- - ’ ~ ’~------’ ~-------- ’-------~ , Parse XML into a single Java XML Document object. -=--:=’ Software Engineering

Research Plan of the Department of Systems Engineering and the Operations Research Center for the Academic Year 2006

DTIC Science & Technology

2005-09-01

Facilities Layout o Scope problem with client in terms of options for M&S facilities layouts with regards to infrastructure, personnel... Facilities Layout o Develop M&S Installation Facilities Layout Design(s) Requirements and Milestones: • Scope problem with client (systems on which...objectives of this study are to (a) identify the desired technology and facilities layouts which would enhance inter-installation simulation

More than reflections: Empathy in motivational interviewing includes language style synchrony between therapist and client

PubMed Central

Lord, Sarah Peregrine; Sheng, Elisa; Imel, Zac E.; Baer, John; Atkins, David C.

2016-01-01

Empathy is a basic psychological process that involves the development of synchrony in dyads. It is also a foundational ingredient in specific, evidence-based behavioral treatments like motivational interviewing (MI). Ratings of therapist empathy typically rely on a gestalt, “felt sense” of therapist understanding and the presence of specific verbal behaviors like reflective listening. These ratings do not provide a direct test of psychological processes like behavioral synchrony that are theorized to be an important component of empathy in psychotherapy. To explore a new objective indicator of empathy, we hypothesized that synchrony in language style (i.e., matching how statements are phrased) between client and therapists would predict gestalt ratings of empathy over and above the contribution of reflections. We analyzed 122 MI transcripts with high and low empathy ratings based on the Motivational Interviewing Treatment Integrity (MITI) global rating scale. Linguistic inquiry and word count was used to estimate language style synchrony (LSS) of adjacent client and therapist talk turns. High empathy sessions showed greater LSS across 11 language style categories compared to low empathy sessions (p < .01), and overall, average LSS was notably higher in high empathy vs. low empathy sessions (d = 0.62). Regression analyses showed that LSS was predictive of empathy ratings over and above reflection counts; a 1 SD increase in LSS is associated with 2.4 times increase in the odds of a high empathy rating, controlling for therapist reflections (odds ratio = 2.4, 95% CI: 1.36, 4.24, p < .01). These findings suggest empathy ratings are related to synchrony in language style, over and above synchrony of content as measured by therapist reflections. Novel indicators of therapist empathy may have implications for the study of MI process as well as the training of therapists. PMID:25892166

A Multi-Sensor RSS Spatial Sensing-Based Robust Stochastic Optimization Algorithm for Enhanced Wireless Tethering

PubMed Central

Parasuraman, Ramviyas; Fabry, Thomas; Molinari, Luca; Kershaw, Keith; Di Castro, Mario; Masi, Alessandro; Ferre, Manuel

2014-01-01

The reliability of wireless communication in a network of mobile wireless robot nodes depends on the received radio signal strength (RSS). When the robot nodes are deployed in hostile environments with ionizing radiations (such as in some scientific facilities), there is a possibility that some electronic components may fail randomly (due to radiation effects), which causes problems in wireless connectivity. The objective of this paper is to maximize robot mission capabilities by maximizing the wireless network capacity and to reduce the risk of communication failure. Thus, in this paper, we consider a multi-node wireless tethering structure called the “server-relay-client” framework that uses (multiple) relay nodes in between a server and a client node. We propose a robust stochastic optimization (RSO) algorithm using a multi-sensor-based RSS sampling method at the relay nodes to efficiently improve and balance the RSS between the source and client nodes to improve the network capacity and to provide redundant networking abilities. We use pre-processing techniques, such as exponential moving averaging and spatial averaging filters on the RSS data for smoothing. We apply a receiver spatial diversity concept and employ a position controller on the relay node using a stochastic gradient ascent method for self-positioning the relay node to achieve the RSS balancing task. The effectiveness of the proposed solution is validated by extensive simulations and field experiments in CERN facilities. For the field trials, we used a youBot mobile robot platform as the relay node, and two stand-alone Raspberry Pi computers as the client and server nodes. The algorithm has been proven to be robust to noise in the radio signals and to work effectively even under non-line-of-sight conditions. PMID:25615734

Right choice, right time: Evaluation of an online decision aid for youth depression.

PubMed

Simmons, Magenta B; Elmes, Aurora; McKenzie, Joanne E; Trevena, Lyndal; Hetrick, Sarah E

2017-08-01

Appropriate treatment for youth depression is an important public health priority. Shared decision making has been recommended, yet no decision aids exist to facilitate this. The main objective of this study was to evaluate an online decision aid for youth depression. An uncontrolled cohort study with pre-decision, immediately post-decision and follow-up measurements. Young people (n=66) aged 12-25 years with mild, mild-moderate or moderate-severe depression were recruited from two enhanced primary care services. Online decision aid with evidence communication, preference elicitation and decision support components. The main outcome measures were ability to make a decision; whether the decision was in line with clinical practice guidelines, personal preferences and values; decisional conflict; perceived involvement; satisfaction with decision; adherence; and depression scores at follow-up. After using the decision aid, clients were more likely to make a decision in line with guideline recommendations (93% vs 70%; P=.004), were more able to make a decision (97% vs 79%; P=.022), had significantly reduced decisional conflict (17.8 points lower (95% CI: 13.3-22.9 points lower) on the Decisional Conflict Scale (range 0-100)) and felt involved and satisfied with their decision. At follow-up, clients had significantly reduced depression symptoms (2.7 points lower (95% CI: 1.3-4.0 points lower) on the Patient Health Questionnaire nine-item scale (range 0-27)) and were adherent to 88% (95% CI: 82%-94%) of treatment courses. A decision aid for youth depression can help ensure evidence-based, client-centred care, promoting collaboration in this often difficult to engage population. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

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

PubMed

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

2016-01-01

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

When the customer shouldn't be king: antecedents and consequences of sexual harassment by clients and customers.

PubMed

Gettman, Hilary J; Gelfand, Michele J

2007-05-01

Much of the work in today's service industries requires women to deal with people outside of their organizations, namely, customers and clients, yet research on sexual harassment has focused almost exclusively on sexual harassment within organizations. Because the threat of harassment also operates at the boundaries of organizations, our existing models based solely on harassment inside organizations may be too restricted to adequately explain the harassment experiences of women in today's economy. To address this, the authors introduce a theoretical model of the antecedents and consequences of sexual harassment by clients and customers (CSH) and describe 2 field studies conducted to test components of the model. In Study 1, they developed a model of antecedents and consequences of CSH and illustrated that certain contextual factors (client power and gender composition of the client base) affect levels of CSH and that CSH is related to a number of job and psychological outcomes among professional women. Study 2 revealed that CSH is related to lower job satisfaction among nonprofessional women, above and beyond that which is accounted for by internal sexual harassment. Theoretical and practical implications are discussed. 2007 APA, all rights reserved

A psychometric appraisal of the Jefferson Scale of Empathy using law students.

PubMed

Williams, Brett; Sifris, Adiva; Lynch, Marty

2016-01-01

A growing body of literature indicates that empathic behaviors are positively linked, in several ways, with the professional performance and mental well-being of lawyers and law students. It is therefore important to assess empathy levels among law students using psychometrically sound tools that are suitable for this cohort. The 20-item Jefferson Scale of Empathy - Health Profession Students Version was adapted for a law context (eg, the word "health care" became "legal"), and the new Jefferson Scale of Empathy - Law Students (JSE-L-S) version was completed by 275 students at Monash University, Melbourne, Australia. Data were subjected to principal component analysis. Four factors emerged from the principal component analysis ("understanding the client's perspective", "responding to clients' experiences and emotions", "responding to clients' cues and behaviors", and "standing in clients' shoes"), which accounted for 46.7% of the total variance. The reliability of the factors varied, but the overall 18-item JSE-L-S yielded a Cronbach's alpha coefficient of 0.80. Several patterns among the item loadings were similar to those reported in studies using other versions of the Jefferson Scale of Empathy. The JSE-L-S appears to be a reliable measure of empathy among undergraduate law students, which could help provide insights into law student welfare and future performance as legal practitioners. Additional evaluation of the JSE-L-S is required to disambiguate some of the minor findings explored. Adjustments may improve the psychometric properties.

The International Consultant: Substance and Culture.

ERIC Educational Resources Information Center

Fest, Thorrel B.

To function effectively in crosscultural settings, international consultants, development specialists, and trainers should be prepared to examine objectively a number of personal qualities. Problems arise in crosscultural relationships when either the client or the consultant fails to identify objectives, fails to accommodate different views of…

Effects of Selected Socio-Demographic Characteristics of Community Health Workers on Performance of Home Visits during Pregnancy: A Cross-Sectional Study in Busia District, Kenya

PubMed Central

Crispin, Ndedda; Wamae, Annah; Ndirangu, Meshack; Wamalwa, David; Wangalwa, Gilbert; Watako, Patrick; Mbiti, Elijah

2012-01-01

Objective: Appropriate performance of home visits facilitates adoption of best practices at home and increased demand for facility based services. Methods: It was a cross-sectional study in which community health workers were observed conducting home visits during pregnancy. Data was collected using a structured questionnaire and the Consultant Quality Index (CQI-2 tool) on record keeping, use of job aids, counselling, client satisfaction and client enablement. Descriptive and inferential statistics were used. Relationships were determined using chi square and odds ratios. Results: The study showed significant relationships of age with good record keeping (p = 0.0001), appropriate use of job aids (p=0.0001), client satisfaction (p = 0.018) and client enablement (p = 0.001). Male CHWs were 1.6 times more likely to keep better records than females (OR 1.64 CI (1.02-2.63), while females were more likely to counsel and enable their clients OR 0.42 CI (0.25-0.71) and OR 0.29 CI (012-070) respectively when compared to men. Moreover, higher levels of education were associated with good record keeping OR 0.30 CI (0.19-0.49), p=0.0001; appropriate use of job aids OR 0.30 CI (0.15-0.61) and to appropriately counsel their clients OR 0.34 CI (0.20-0.58) than their lower literacy level counterparts. Experience of CHWs was associated with appropriate use of job aids (p = 0.049); client satisfaction (p = 0.0001) and client enablement (p = 0.032). Conclusions: Socio-demographic characteristics of community health workers affect the performance of home visits in various ways. The study also confirmed that CHWs with lower literacy levels satisfy and enable their clients effectively. PMID:22980380

Client demands for unsafe sex: the socio-economic risk environment for HIV among street and off-street sex workers

PubMed Central

DEERING, Kathleen N; LYONS, Tara; FENG, Cindy X; NOSYK, Bohdan; STRATHDEE, Steffanie A; MONTANER, Julio SG; SHANNON, Kate

2013-01-01

Objective Among sex workers (SWs) in Vancouver, Canada, this study identified social, drug use, sex work, environmental-structural and client-related factors associated with being offered and accepting more money after clients' demand for sex without a condom. Design Cross-sectional study using baseline (February/10-October/11) data from a longitudinal cohort of 510 SWs. Methods A two-part multivariable regression model was used to identify factors associated with two separate outcomes: (1) being offered and (2) accepting more money for sex without a condom in the last six months, among those who had been offered more money. Results The sample included 490 SWs. In multivariable analysis, being offered more money for sex without a condom was more likely for SWs who used speedballs, had higher average numbers of clients per week, had difficulty accessing condoms and had clients who visited other SWs. Accepting more money for sex without a condom was more likely for SWs self-reporting as a sexual minority and who had experienced client violence and used crystal methamphetamine use less than daily (vs. none), and less likely for SWs who solicited for clients mainly indoors (vs. outdoor/public places). Conclusions These results highlight the high demand for sex without a condom by clients of SWs. HIV prevention efforts should shift responsibility toward clients to reduce offers of more money for unsafe sex. Programs that mitigate the social and economic risk environments of SWs alongside the removal of criminal sanctions on sex work to enable condom use within safer indoor work spaces are urgently required. PMID:23614990

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

PubMed

Keeton, Nicola; Kathard, Harsha; Singh, Shajila

2017-11-02

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

Treatment Engagement: Building Therapeutic Alliance in Home-Based Treatment with Adolescents and their Families

PubMed Central

Thompson, Sanna J.; Bender, Kimberly; Lantry, Janet; Flynn, Patrick M.

2010-01-01

Client engagement is an essential yet challenging ingredient in effective therapy. Engaged clients are more likely to bond with therapists and counselors, endorse treatment goals, participate to a greater degree, remain in treatment longer, and report higher levels of satisfaction. This study explored the process of engaging high-risk youth and their parents in a unique home-based family therapy intervention. Qualitative interviews were conducted with 19 families who completed family therapy sessions that included a core component aimed at increasing treatment engagement. Parents’ and youths’ perceptions of engagement suggest the importance of developing therapeutic alliance with therapists, who facilitated building a shared alliance among family members. Implications for improving client engagement are discussed within the context of alliance building with the therapist and among family members. PMID:20556209

Illness Management & Recovery (IMR) in the Netherlands; a naturalistic pilot study to explore the feasibility of a randomized controlled trial.

PubMed

Roosenschoon, Bert-Jan; van Weeghel, Jaap; Bogaards, Moniek; Deen, Mathijs L; Mulder, Cornelis L

2016-11-09

Illness Management & Recovery (IMR) is a curriculum-based program for people with severe and persistent mental illness. To date, four randomized controlled trials (RCTs) have been published on it. As these produced mixed results, we conducted a pilot study to test the feasibility of conducting a new RCT in a Dutch psychiatric institute. Because our primary objective was to evaluate support for implementing IMR on a broader scale, we examined participant recruitment, client outcomes, and clients' and clinicians' satisfaction. Secondary objectives were to evaluate fidelity, trainers' training and supervision, and to explore program duration, dropout, and client characteristics related to dropout. For reporting, we used the checklist for pilot studies adopted from the CONSORT Statement. This program evaluation included a process-evaluation and an outcome evaluation with a One Group Pre-Posttest Design (N = 81). Interviews and internal reports were used to monitor participant numbers, program duration, dropout, and completers' characteristics. Clients' and clinicians' satisfaction and provision of trainers' training and supervision were assessed through interviews. Fidelity was assessed on the IMR Fidelity Scale; client outcomes were assessed on the IMR scale (client and clinician versions) and the Recovery Markers Questionnaire (RMQ). Eighty-one participants were recruited of 167 people who were assessed for eligibility. Completers and clinicians were satisfied, and scores for completers improved significantly on the IMR scale (clinician version) (d = 0.84) and RMQ (d = 0.52), and not significantly on the IMR scale client version (d = 0.41). Mean fidelity was good, but three groups had only moderate fidelity. Our feasibility criterion for trainers' education and supervision was partly attained. Dropout from treatment was 51 %; female participants and people who scored higher on both IMR-scales at baseline had a significantly lower chance of dropping out. The duration of IMR varied (M = 12.7 months, SD = 2.87). Results suggested that feasibility of conducting an RCT on IMR was good. Special attention is required to fidelity, IMR duration, trainers' education and supervision, and dropout, especially of men. One study limitation was our inability to conduct follow-up measurements of non-completers.

A SCORM Thin Client Architecture for E-Learning Systems Based on Web Services

ERIC Educational Resources Information Center

Casella, Giovanni; Costagliola, Gennaro; Ferrucci, Filomena; Polese, Giuseppe; Scanniello, Giuseppe

2007-01-01

In this paper we propose an architecture of e-learning systems characterized by the use of Web services and a suitable middleware component. These technical infrastructures allow us to extend the system with new services as well as to integrate and reuse heterogeneous software e-learning components. Moreover, they let us better support the…

Highway rock slope management program.

DOT National Transportation Integrated Search

2001-06-30

Development of a comprehensive geotechnical database for risk management of highway rock slope problems is described. Computer software selected to program the client/server application in windows environment, components and structure of the geote...

Employee and family assistance video counseling program: a post launch retrospective comparison with in-person counseling outcomes.

PubMed

Veder, Barbara; Pope, Stan; Mani, Michèle; Beaudoin, Kelly; Ritchie, Janice

2014-01-01

Access to technologically mediated information and services under the umbrella of mental and physical health has become increasingly available to clients via Internet modalities, according to a recent study. In May 2010, video counseling was added to the counseling services offered through the Employee and Family Assistance Program at Shepell·fgi as a pilot project with a full operational launch in September 2011. The objective of this study was to conduct a retrospective post launch examination of the video counseling service through an analysis of the reported clinical outcomes of video and in-person counseling modalities. A chronological sample of 68 video counseling (VC) cases and 68 in-person (IP) cases were collected from a pool of client clinical files closed in 2012. To minimize the variables impacting the study and maintain as much clinical continuity as possible, the IP and the VC clients must have attended clinical sessions with any one of six counselors who provided both the VC and the IP services. The study compared the two counseling modalities along the following data points (see glossary of terms): (1) client demographic profiles (eg, age, gender, whether the sessions involved individuals or conjoint sessions with couples or families, etc), (2) presenting issue, (3) average session hours, (4) client rating of session helpfulness, (5) rates of goal completion, (6) client withdrawal rates, (7) no show and late cancellation rates, and (8) pre/post client self-assessment. Specific to VC, we examined client geographic location. Data analysis demonstrates that the VC and the IP showed a similar representation of presenting issues with nearly identical outcomes for client ratings of session helpfulness, rates of goal completion, pre/post client self-assessment, average session duration, and client geographic location. There were no statistically significant differences in the rates of withdrawal from counseling, no shows, and late cancellations between the VC and the IP counseling. The statistical analysis of the data was done on SPSS statistical software using 2-sample and pairwise comparison t tests at a 95% level of significance. Based on the study, VC and IP show similar outcomes in terms of client rating of session and goal attainment.

Comparing women's assessment of midwifery and medical care in Québec, Canada.

PubMed

De Koninck, M; Blais, R; Joubert, P; Gagnon, C

2001-01-01

In 1990, the province of Québec, Canada, adopted a law that authorized the evaluation of the practice of midwifery through pilot projects before its legalization. A key objective of this evaluation, as defined by the law, was the documentation of women's assessment of maternity care, especially with regard to humanization and continuity of care. Two to 3 months after birth, 933 midwifery clients and 1,000 physicians' clients, matched on several characteristics, responded to a mailed questionnaire (response rates were 93% and 76%, respectively). Results showed that women from both groups were generally satisfied with the care they received, although women who received midwifery care were assessed as more positive on every issue surveyed. Objective measures supported impressions that were also confirmed through qualitative data analysis: midwifery clients had a greater number of and longer prenatal visits, their care was perceived to be more personalized, and a greater number of midwives' clients breastfed their infants. However, the interpretation of these results must take into account that the two groups had different personal expectations and values with regard to health and health care. These findings are enlightening in evaluating women's needs, expectations, and satisfaction with health care services and should be included in future development of maternity care, including idwifery services, in Québec and other locations.

Technical Description of a Novel Sensor Network Architecture and Results of Radar and Optical Sensors contributing to a UK Cueing Experiment

NASA Astrophysics Data System (ADS)

Ladd, D.; Reeves, R.; Rumi, E.; Trethewey, M.; Fortescue, M.; Appleby, G.; Wilkinson, M.; Sherwood, R.; Ash, A.; Cooper, C.; Rayfield, P.

The Science and Technology Facilities Council (STFC), Control Loop Concepts Limited (CL2), Natural Environment Research Council (NERC) and Defence Science and Technology Laboratory (DSTL), have recently participated in a campaign of satellite observations, with both radar and optical sensors, in order to demonstrate an initial network concept that enhances the value of coordinated observations. STFC and CL2 have developed a Space Surveillance and Tracking (SST) server/client architecture to slave one sensor to another. The concept was originated to enable the Chilbolton radar (an S-band radar on a 25 m diameter fully-steerable dish antenna called CASTR – Chilbolton Advanced Satellite Tracking Radar) which does not have an auto-track function to follow an object based on position data streamed from another cueing sensor. The original motivation for this was to enable tracking during re-entry of ATV-5, a highly manoeuvrable ISS re-supply vessel. The architecture has been designed to be extensible and allows the interface of both optical and radar sensors which may be geographically separated. Connectivity between the sensors is TCP/IP over the internet. The data transferred between the sensors is translated into an Earth centred frame of reference to accommodate the difference in location, and time-stamping and filtering are applied to cope with latency. The server can accept connections from multiple clients, and the operator can switch between the different clients. This architecture is inherently robust and will enable graceful degradation should parts of the system be unavailable. A demonstration was conducted in 2016 whereby a small telescope connected to an agile mount (an EO tracker known as COATS - Chilbolton Optical Advanced Tracking System) located 50m away from the radar at Chilbolton, autonomously tracked several objects and fed the look angle data into a client. CASTR, slaved to COATS through the server followed and successfully detected the objects. In 2017, the baseline was extended to 135 km by developing a client for the SLR (satellite laser ranger) telescope at the Space Geodesy Facility, Herstmonceux. Trials have already demonstrated that CASTR can accurately track the object using the position data being fed from the SLR.

The effect of human engagement depicted in contextual photographs on the visual attention patterns of adults with traumatic brain injury.

PubMed

Thiessen, Amber; Brown, Jessica; Beukelman, David; Hux, Karen

2017-09-01

Photographs are a frequently employed tool for the rehabilitation of adults with traumatic brain injury (TBI). Speech-language pathologists (SLPs) working with these individuals must select photos that are easily identifiable and meaningful to their clients. In this investigation, we examined the visual attention response to camera- (i.e., depicted human figure looking toward camera) and task-engaged (i.e., depicted human figure looking at and touching an object) contextual photographs for a group of adults with TBI and a group of adults without neurological conditions. Eye-tracking technology served to accurately and objectively measure visual fixations. Although differences were hypothesized given the cognitive deficits associated with TBI, study results revealed little difference in the visual fixation patterns of adults with and without TBI. Specifically, both groups of participants tended to fixate rapidly on the depicted human figure and fixate more on objects in which a human figure was task-engaged than when a human figure was camera-engaged. These results indicate that strategic placement of human figures in a contextual photograph may modify the way in which individuals with TBI visually attend to and interpret photographs. In addition, task-engagement appears to have a guiding effect on visual attention that may be of benefit to SLPs hoping to select more effective contextual photographs for their clients with TBI. Finally, the limited differences in visual attention patterns between individuals with TBI and their age and gender matched peers without neurological impairments indicates that these two groups find similar photograph regions to be worthy of visual fixation. Readers will gain knowledge regarding the photograph selection process for individuals with TBI. In addition, readers will be able to identify camera- and task-engaged photographs and to explain why task-engagement may be a beneficial component of contextual photographs. Copyright © 2017 Elsevier Inc. All rights reserved.

Cryptographic framework for document-objects resulting from multiparty collaborative transactions.

PubMed

Goh, A

2000-01-01

Multiparty transactional frameworks--i.e. Electronic Data Interchange (EDI) or Health Level (HL) 7--often result in composite documents which can be accurately modelled using hyperlinked document-objects. The structural complexity arising from multiauthor involvement and transaction-specific sequencing would be poorly handled by conventional digital signature schemes based on a single evaluation of a one-way hash function and asymmetric cryptography. In this paper we outline the generation of structure-specific authentication hash-trees for the the authentication of transactional document-objects, followed by asymmetric signature generation on the hash-tree value. Server-side multi-client signature verification would probably constitute the single most compute-intensive task, hence the motivation for our usage of the Rabin signature protocol which results in significantly reduced verification workloads compared to the more commonly applied Rivest-Shamir-Adleman (RSA) protocol. Data privacy is handled via symmetric encryption of message traffic using session-specific keys obtained through key-negotiation mechanisms based on discrete-logarithm cryptography. Individual client-to-server channels can be secured using a double key-pair variation of Diffie-Hellman (DH) key negotiation, usage of which also enables bidirectional node authentication. The reciprocal server-to-client multicast channel is secured through Burmester-Desmedt (BD) key-negotiation which enjoys significant advantages over the usual multiparty extensions to the DH protocol. The implementation of hash-tree signatures and bi/multidirectional key negotiation results in a comprehensive cryptographic framework for multiparty document-objects satisfying both authentication and data privacy requirements.

The influence of client brief and change order in construction project

NASA Astrophysics Data System (ADS)

Mahat, N. A. A.; Adnan, H.

2018-02-01

Construction briefing is a statement of needs about intentions and projects objectives. Briefing process is the preliminary stage in the design process and successful briefing can achieve project delivery right on target time, cost and quality of project confidently. Although there are many efforts to approach client’s requirement and needs for a project, it is still not collected adequately to make proper solutions in design. Thus, these may lead the client to include change orders during the construction phase. This paper is concerned toward the influence of client’s briefing of a construction project that impact on the change order on the construction works. The research objective is to identify the influence of client’s brief on change orders, therefore, the aims of the research is to reduce change orders in project delivery. This research adopted both qualitative and quantitative data collection methods which are content analysis and semi structure interview. The findings highlight factors contributing to change orders and the essential attributes of clients during the briefing stage that may help minimise them.

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

High levels of opioid analgesic co-prescription among methadone maintenance treatment clients in British Columbia, Canada: Results from a population-level retrospective cohort study

PubMed Central

Nosyk, Bohdan; Fischer, Benedikt; Sun, Huiying; Marsh, David C.; Kerr, Thomas; Rehm, Juergen T.; Anis, Aslam H.

2014-01-01

Background and Objectives The nonmedical use of prescription opioids (PO) has increased dramatically in North America. Special consideration for PO prescription is required for individuals in methadone maintenance treatment (MMT). Our objective is to describe the prevalence and correlates of PO use among British Columbia (BC) MMT clients from 1996-2007. Methods This study was based on a linked, population-level medication dispensation database. All individuals receiving 30 days of continuous MMT for opioid dependence were included in the study. Key measurements included the proportion of clients receiving >7 days of a PO other than methadone during MMT from 1996 to 2007. Factors independently associated with PO co-prescription during MMT were assessed using generalized linear mixed effects regression. Results 16,248 individuals with 27,919 MMT episodes at least 30 days in duration were identified for the study period. Among them, 5,552 individuals (34.2%) received a total of 290,543 PO co-prescriptions during MMT. The majority (74.3%) of all PO dispensations >7 days originated from non-MMT physicians. The number of PO prescriptions per person-year nearly doubled between 1996 and 2006, driven by increases in morphine, hydromorphone and oxycodone dispensations. PO co-prescription was positively associated with female gender, older age, higher levels of medical co-morbidity as well as higher MMT dosage, adherence, and retention. Conclusion and Scientific Significance A large proportion of MMT clients in BC received co-occurring PO prescriptions, often from physicians and pharmacies not delivering MMT. Experimental evidence for the treatment of pain in MMT clients is required to guide clinical practice. PMID:24724883

Does courtesy bias affect how clients report on objective and subjective measures of family planning service quality? A comparison between facility- and home-based interviews

PubMed Central

Hameed, Waqas; Ishaque, Muhammad; Gul, Xaher; Siddiqui, Junaid-ur-Rehman; Hussain, Sharmeen; Hussain, Wajahat; Ahmed, Aftab; Balal, Asma

2017-01-01

Purpose Despite a general understanding that exit interviews being conducted at service providers’ facilities may influence clients’ responses favorably to health professionals, there is very little evidence available that demonstrates the extent to which this problem exists. This study aimed at assessing and comparing clients’ perceptions of the quality of family planning services and their satisfaction levels between facility- and home-based interviews. Methods A cross-sectional survey was conducted among clients receiving family planning services across three service delivery channels – nongovernmental organization (NGO) clinics, social franchise (SF) centers, and outreach camps. The survey took place from December 2015 to January 2016 in 70 districts across all four provinces of Pakistan. A total of 2,807 clients were interviewed, of whom 1,404 clients were interviewed at health facilities after receiving services and 1,403 were interviewed at their homes within 3 days of method uptake. Results Overall, we found no significant differences between the characteristics of study participants interviewed at health facilities or at home. The findings suggested that experiences reported in exit surveys at facilities were strongly biased positively. This was true for both experiential (service quality) and perception-based (satisfaction) questions in the context of SF centers, while at NGO clinics the interview location only affected clients’ responses regarding service quality. However, in outreach settings, clients are more likely to share bad experiences in exit interviews than in home-based interviews on objectively asked questions (service quality). Conclusion Our study indicates signs of courtesy bias and possibly the Hawthorne effect in exit interviews. Program implementers could opt for home-based interviews for women receiving services at NGO clinics or SF center, whereas exit interviews could be used in outreach settings. PMID:29760573

Stretching the Boundaries: Tanzanian Pharmacy Workers’ Views and Experiences of Providing STI Services for Men Who Have Sex with Men

PubMed Central

Larsson, Markus; Odberg Pettersson, Karen; Kashiha, John; Ross, Michael W.; Agardh, Anette

2016-01-01

Objective To explore the views and experiences of providing assistance and treatment of sexually transmitted infections to same-sex practicing male clients among service providers at pharmacies and drugstores in Dar es Salaam, Tanzania. Previous research suggests that sexually transmitted infections are an increasing concern for this population. Due to stigma and discrimination, men who have sex with men face limited access to treatment, which might contribute to increased self-medication. However, limited research has been conducted on the role of the pharmaceutical service provider with regards to this population in sub-Saharan Africa. Method In January 2016, 16 service providers at private pharmacies and drugstores with previous experience of providing services to this population were purposively selected for open-ended face-to-face interviews. The analysis was guided by the grounded theory approach. Results The process that emerged was labelled “Stretching Boundaries for Pharmaceutical Responsibilities”. This reflected informants’ perceptions of themselves as being involved in a transition from having limited engagement in the care of same-sex practicing male clients to becoming regular service-providers to this group. Findings further revealed that the emotional commitment they developed for clients through this process led to a transgression of provider-client boundaries, which undermined objective decision-making when clients lacked prescription. Financial interests also emerged as an underlying motivation for providing incomplete or inaccurate drug dosages. Conclusions Further studies are required to better address incentives related to unregulated sale of drugs. Inter-professional networks between pharmacy and healthcare workers could support the development of targeted treatment for men who have sex with men and other key populations. PMID:27812206

Therapists’ Perceptions of Social Media and Video Game Technologies in Upper Limb Rehabilitation

PubMed Central

Shirzad, Navid; Lohse, Keith R; Virji-Babul, Naznin; Hoens, Alison M; Holsti, Liisa; Li, Linda C; Miller, Kimberly J; Lam, Melanie Y; Van der Loos, HF Machiel

2015-01-01

Background The application of technologies, such as video gaming and social media for rehabilitation, is garnering interest in the medical field. However, little research has examined clinicians’ perspectives regarding technology adoption by their clients. Objective The objective of our study was to explore therapists’ perceptions of how young people and adults with hemiplegia use gaming and social media technologies in daily life and in rehabilitation, and to identify barriers to using these technologies in rehabilitation. Methods We conducted two focus groups comprised of ten occupational therapists/physiotherapists who provide neurorehabilitation to individuals with hemiplegia secondary to stroke or cerebral palsy. Data was analyzed using inductive thematic analysis. The diffusion of innovations theory provided a framework to interpret emerging themes. Results Therapists were using technology in a limited capacity. They identified barriers to using social media and gaming technology with their clients, including a lack of age appropriateness, privacy issues with social media, limited transfer of training, and a lack of accessibility of current systems. Therapists also questioned their role in the context of technology-based interventions. The opportunity for social interaction was perceived as a major benefit of integrated gaming and social media. Conclusions This study reveals the complexities associated with adopting new technologies in clinical practice, including the need to consider both client and clinician factors. Despite reporting several challenges with applying gaming and social media technology with clinical populations, therapists identified opportunities for increased social interactions and were willing to help shape the development of an upper limb training system that could more readily meet the needs of clients with hemiplegia. By considering the needs of both therapists and clients, technology developers may increase the likelihood that clinicians will adopt innovative technologies. PMID:25759148

System of and method for transparent management of data objects in containers across distributed heterogenous resources

DOEpatents

Moore, Reagan W.; Rajasekar, Arcot; Wan, Michael Y.

2004-01-13

A system of and method for maintaining data objects in containers across a network of distributed heterogeneous resources in a manner which is transparent to a client. A client request pertaining to containers is resolved by querying meta data for the container, processing the request through one or more copies of the container maintained on the system, updating the meta data for the container to reflect any changes made to the container as a result processing the request, and, if a copy of the container has changed, changing the status of the copy to indicate dirty status or synchronizing the copy to one or more other copies that may be present on the system.

System of and method for transparent management of data objects in containers across distributed heterogenous resources

DOEpatents

Moore, Reagan W [San Diego, CA; Rajasekar, Arcot [Del Mar, CA; Wan, Michael Y [San Diego, CA

2007-09-11

A system of and method for maintaining data objects in containers across a network of distributed heterogeneous resources in a manner which is transparent to a client. A client request pertaining to containers is resolved by querying meta data for the container, processing the request through one or more copies of the container maintained on the system, updating the meta data for the container to reflect any changes made to the container as a result processing the re quest, and, if a copy of the container has changed, changing the status of the copy to indicate dirty status or synchronizing the copy to one or more other copies that may be present on the system.

System of and method for transparent management of data objects in containers across distributed heterogenous resources

DOEpatents

Moore, Reagan W.; Rajasekar, Arcot; Wan, Michael Y.

2010-09-21

A system of and method for maintaining data objects in containers across a network of distributed heterogeneous resources in a manner which is transparent to a client. A client request pertaining to containers is resolved by querying meta data for the container, processing the request through one or more copies of the container maintained on the system, updating the meta data for the container to reflect any changes made to the container as a result processing the request, and, if a copy of the container has changed, changing the status of the copy to indicate dirty status or synchronizing the copy to one or more other copies that may be present on the system.

Teaching the Public Relations Campaigns Course.

ERIC Educational Resources Information Center

Worley, Debra A.

2001-01-01

Argues for a Campaign Planning Course in the undergraduate public relations major. Discusses nine course objectives. Describes five phases of campaign planning and implementation, how the phase approach includes important course topics, and how it fulfills course objectives. Describes how student groups work with actual clients throughout the…

Structural and Environmental Barriers to Condom Use Negotiation With Clients Among Female Sex Workers: Implications for HIV-Prevention Strategies and Policy

PubMed Central

Strathdee, Steffanie A.; Shoveller, Jean; Rusch, Melanie; Kerr, Thomas; Tyndall, Mark W.

2009-01-01

Objectives. We investigated the relationship between environmental–structural factors and condom-use negotiation with clients among female sex workers. Methods. We used baseline data from a 2006 Vancouver, British Columbia, community-based cohort of female sex workers, to map the clustering of “hot spots” for being pressured into unprotected sexual intercourse by a client and assess sexual HIV risk. We used multivariate logistic modeling to estimate the relationship between environmental–structural factors and being pressured by a client into unprotected sexual intercourse. Results. In multivariate analyses, being pressured into having unprotected sexual intercourse was independently associated with having an individual zoning restriction (odds ratio [OR] = 3.39; 95% confidence interval [CI] = 1.00, 9.36), working away from main streets because of policing (OR = 3.01; 95% CI = 1.39, 7.44), borrowing a used crack pipe (OR = 2.51; 95% CI = 1.06, 2.49), client-perpetrated violence (OR = 2.08; 95% CI = 1.06, 4.49), and servicing clients in cars or in public spaces (OR = 2.00; 95% CI = 1.65, 5.73). Conclusions. Given growing global concern surrounding the failings of prohibitive sex-work legislation on sex workers' health and safety, there is urgent need for environmental–structural HIV-prevention efforts that facilitate sex workers' ability to negotiate condom use in safer sex-work environments and criminalize abuse by clients and third parties. PMID:19197086

Pan-Canadian assessment of pandemic immunization data collection: study methodology

PubMed Central

2010-01-01

Background The collection of individual-level pandemic (H1N1) 2009 influenza immunization data was considered important to facilitate optimal vaccine delivery and accurate assessment of vaccine coverage. These data are also critical for research aimed at evaluating the new vaccine's safety and effectiveness. Systems used to collect immunization data include manual approaches in which data are collected and retained on paper, electronic systems in which data are captured on computer at the point of vaccination and hybrid systems which are comprised of both computerized and manual data collection components. This study's objective was to compare the efficiencies and perceptions of data collection methods employed during Canada's pandemic (H1N1) 2009 influenza vaccination campaign. Methods/Design A pan-Canadian observational study was conducted in a convenience sample of public health clinics and healthcare institutions during the H1N1 vaccination campaign in the fall of 2009. The study design consisted of three stages: Stage 1 involved passive observation of the site's layout, processes and client flow; Stage 2 entailed timing site staff on 20 clients through five core immunization tasks: i) client registration, ii) medical history collection, iii) medical history review, iv) vaccine administration record keeping and v) preparation of proof of vaccine administration for the client; in Stage 3, site staff completed a questionnaire regarding perceived usability of the site's data collection approach. Before the national study began, a pilot study was conducted in three seasonal influenza vaccination sites in Ontario, to both test that the proposed methodology was logistically feasible and to determine inter-rater reliability in the measurements of the research staff. Comparative analyses will be conducted across the range of data collection methods with respect to time required to collect immunization data, number and type of individual-level data elements collected, and clinic staff perceptions of the usability of the method employed at their site, using analysis of variance (ANOVA). Discussion Various data collection methods were employed at immunization sites across Canada during the pandemic (H1N1) 2009 influenza vaccination campaign. Our comparison of methods can facilitate planning an efficient, coordinated approach for collecting immunization data in future influenza seasons. PMID:20624270

Pan-Canadian assessment of pandemic immunization data collection: study methodology.

PubMed

Pereira, Jennifer A; Quach, Susan; Heidebrecht, Christine; Foisy, Julie; Quan, Sherman; Finkelstein, Michael; Sikora, Christopher A; Bettinger, Julie A; Buckeridge, David L; McCarthy, Anne; Deeks, Shelley; Kwong, Jeffrey C

2010-06-08

The collection of individual-level pandemic (H1N1) 2009 influenza immunization data was considered important to facilitate optimal vaccine delivery and accurate assessment of vaccine coverage. These data are also critical for research aimed at evaluating the new vaccine's safety and effectiveness. Systems used to collect immunization data include manual approaches in which data are collected and retained on paper, electronic systems in which data are captured on computer at the point of vaccination and hybrid systems which are comprised of both computerized and manual data collection components. This study's objective was to compare the efficiencies and perceptions of data collection methods employed during Canada's pandemic (H1N1) 2009 influenza vaccination campaign. A pan-Canadian observational study was conducted in a convenience sample of public health clinics and healthcare institutions during the H1N1 vaccination campaign in the fall of 2009. The study design consisted of three stages: Stage 1 involved passive observation of the site's layout, processes and client flow; Stage 2 entailed timing site staff on 20 clients through five core immunization tasks: i) client registration, ii) medical history collection, iii) medical history review, iv) vaccine administration record keeping and v) preparation of proof of vaccine administration for the client; in Stage 3, site staff completed a questionnaire regarding perceived usability of the site's data collection approach. Before the national study began, a pilot study was conducted in three seasonal influenza vaccination sites in Ontario, to both test that the proposed methodology was logistically feasible and to determine inter-rater reliability in the measurements of the research staff. Comparative analyses will be conducted across the range of data collection methods with respect to time required to collect immunization data, number and type of individual-level data elements collected, and clinic staff perceptions of the usability of the method employed at their site, using analysis of variance (ANOVA). Various data collection methods were employed at immunization sites across Canada during the pandemic (H1N1) 2009 influenza vaccination campaign. Our comparison of methods can facilitate planning an efficient, coordinated approach for collecting immunization data in future influenza seasons.

Rapid Human-Computer Interactive Conceptual Design of Mobile and Manipulative Robot Systems

DTIC Science & Technology

2015-05-19

algorithm based on Age-Fitness Pareto Optimization (AFPO) ([9]) with an additional user prefer- ence objective and a neural network-based user model, we...greater than 40, which is about 5 times further than any robot traveled in our experiments. 6 3.3 Methods The algorithm uses a client -server computational...architecture. The client here is an interactive pro- gram which takes a pair of controllers as input, simulates4 two copies of the robot with

CISN Display - Reliable Delivery of Real-time Earthquake Information, Including Rapid Notification and ShakeMap to Critical End Users

NASA Astrophysics Data System (ADS)

Rico, H.; Hauksson, E.; Thomas, E.; Friberg, P.; Given, D.

2002-12-01

The California Integrated Seismic Network (CISN) Display is part of a Web-enabled earthquake notification system alerting users in near real-time of seismicity, and also valuable geophysical information following a large earthquake. It will replace the Caltech/USGS Broadcast of Earthquakes (CUBE) and Rapid Earthquake Data Integration (REDI) Display as the principal means of delivering graphical earthquake information to users at emergency operations centers, and other organizations. Features distinguishing the CISN Display from other GUI tools are a state-full client/server relationship, a scalable message format supporting automated hyperlink creation, and a configurable platform-independent client with a GIS mapping tool; supporting the decision-making activities of critical users. The CISN Display is the front-end of a client/server architecture known as the QuakeWatch system. It is comprised of the CISN Display (and other potential clients), message queues, server, server "feeder" modules, and messaging middleware, schema and generators. It is written in Java, making it platform-independent, and offering the latest in Internet technologies. QuakeWatch's object-oriented design allows components to be easily upgraded through a well-defined set of application programming interfaces (APIs). Central to the CISN Display's role as a gateway to other earthquake products is its comprehensive XML-schema. The message model starts with the CUBE message format, but extends it by provisioning additional attributes for currently available products, and those yet to be considered. The supporting metadata in the XML-message provides the data necessary for the client to create a hyperlink and associate it with a unique event ID. Earthquake products deliverable to the CISN Display are ShakeMap, Ground Displacement, Focal Mechanisms, Rapid Notifications, OES Reports, and Earthquake Commentaries. Leveraging the power of the XML-format, the CISN Display provides prompt access to earthquake information on the Web. The links are automatically created when product generators deliver CUBE formatted packets to a Quake Data Distribution System (QDDS) hub (new distribution methods may be used later). The "feeder" modules tap into the QDDS hub and convert the packets into XML-messages. These messages are forwarded to message queues, and then distributed to clients where URLs are dynamically created for these products and linked to events on the CISN Display map. The products may be downloaded out-of-band; and with the inclusion of a GIS mapping tool users can plot organizational assets on the CISN Display map and overlay them against key spectral data, such as ground accelerations. This gives Emergency Response Managers information useful in allocating limited personnel and resources after a major event. At the heart of the system's robustness is a well-established and reliable set of communication protocols for best-effort delivery of data. For critical users a Common Object Request Broker Architecture (CORBA) state-full connection is used via a dedicated signaling channel. The system employs several CORBA methods that alert users of changes in the link status. Loss of connectivity triggers a strategy that attempts to reconnect through various physical and logical paths. Thus, by building on past application successes and proven Internet advances the CISN Display targets a specific audience by providing enhancements previously not available from other applications.

Development of a statewide landslide inventory program.

DOT National Transportation Integrated Search

2003-02-01

Development of a comprehensive geotechnical database for risk management of highway landslide problems is described. Computer software selected to program the client/server application in a data window, components and structure of the geotechnical da...

Mobile Technology for Improved Family Planning (MOTIF): the development of a mobile phone-based (mHealth) intervention to support post-abortion family planning (PAFP) in Cambodia.

PubMed

Smith, Chris; Vannak, Uk; Sokhey, Ly; Ngo, Thoai D; Gold, Judy; Free, Caroline

2016-01-05

The objective of this paper is to outline the formative research process used to develop the MOTIF mobile phone-based (mHealth) intervention to support post-abortion family planning in Cambodia. The formative research process involved literature reviews, interviews and focus group discussions with clients, and consultation with clinicians and organisations implementing mHealth activities in Cambodia. This process led to the development of a conceptual framework and the intervention. Key findings from the formative research included identification of the main reasons for non-use of contraception and patterns of mobile phone use in Cambodia. We drew on components of existing interventions and behaviour change theory to develop a conceptual framework. A multi-faceted voice-based intervention was designed to address health concerns and other key determinants of contraception use. Formative research was essential in order to develop an appropriate mHealth intervention to support post-abortion contraception in Cambodia. Each component of the formative research contributed to the final intervention design.

Product policy - the main component of the marketing mix in the Romanian health services.

PubMed

Coculescu, B I; Purcarea, V L; Coculescu, E C

2016-01-01

The objectives of the reforms in the EU healthcare systems are based on the implementation of the marketing concept in the health systems, which are, among other things: • efficient management of the financial resources and control costs of the rendered health services; • increased satisfaction of the clients of health care services; • broad accessibility to health services; • effective implementation of modern technologies; • rational stimulation of medical services consumption; • achievement of a fair and neutral competition between the public/ private providers and health insurance companies; • introduction of performance criteria in order to increase the incomes of the medical staff and hierarchy in hospitals; • implementation of modern management methods in health services management; • decentralization of the public healthcare system. Product policy in the medical system of healthcare - the most important component of the marketing mix - is the attitude that addresses a medical organization to the volume, structure, and diversity of services subject to their own activities in relation to the requirements of the services market and the competitive actions of other medical institutions.

Product policy - the main component of the marketing mix in the Romanian health services

PubMed Central

Coculescu, BI; Purcarea, VL; Coculescu, EC

2016-01-01

The objectives of the reforms in the EU healthcare systems are based on the implementation of the marketing concept in the health systems, which are, among other things: • efficient management of the financial resources and control costs of the rendered health services; • increased satisfaction of the clients of health care services; • broad accessibility to health services; • effective implementation of modern technologies; • rational stimulation of medical services consumption; • achievement of a fair and neutral competition between the public/ private providers and health insurance companies; • introduction of performance criteria in order to increase the incomes of the medical staff and hierarchy in hospitals; • implementation of modern management methods in health services management; • decentralization of the public healthcare system. Product policy in the medical system of healthcare - the most important component of the marketing mix - is the attitude that addresses a medical organization to the volume, structure, and diversity of services subject to their own activities in relation to the requirements of the services market and the competitive actions of other medical institutions. PMID:27974913

'Imagine if I gave up smoking ...': a qualitative exploration of Aboriginal participants' perspectives of a self-management pilot training intervention.

PubMed

Chapple, Kimberley; Kowanko, Inge; Harvey, Peter; Chong, Alwin; Battersby, Malcolm

2016-01-01

This paper reports on a pilot qualitative study investigating Aboriginal participants' perspectives of the Flinders Living Well Smoke Free (LWSF) 'training intervention'. Health workers nationally have been trained in this program, which offers a self-management approach to reducing smoking among Aboriginal clients. A component of the training involves Aboriginal clients volunteering their time in a mock care-planning session providing the health workers with an opportunity to practise their newly acquired skills. During this simulation, the volunteer clients receive one condensed session of the LWSF intervention imitating how the training will be implemented when the health workers have completed the training. For the purpose of this study, 10 Aboriginal clients who had been volunteers in the mock care-planning process, underwent a semi-structured interview at seven sites in Australia, including mainstream health services, Aboriginal community controlled health services and remote Aboriginal communities. The study aimed to gauge their perspectives of the training intervention they experienced. Early indications suggest that Aboriginal volunteer clients responded positively to the process, with many reporting substantial health behaviour change or plans to make changes since taking part in this mock care-planning exercise. Enablers of the intervention are discussed along with factors to be considered in the training program.

Symbolic healing of early psychosis: psychoeducation and sociocultural processes of recovery.

PubMed

Larsen, John Aggergaard

2007-09-01

This article analyzes sociocultural processes of recovery in a Danish mental health service providing two years of integrated biopsychosocial treatment following first-episode psychosis. The study is based on ethnographic research in the service and person-centered involvement with 15 clients. The analysis applies Dow's [1986 American Anthropologist 88:56-69] model of universal components of symbolic healing to elucidate sociocultural aspects of therapeutic efficacy that are alternatively disregarded as placebo or nonspecific effects. It is demonstrated how staff engaged with clients to deliver "psychoeducation" that provided scientific and biomedical theories about mental illness, constituting a shared "mythic world" that was accepted as an experiential truth and used to explain clients' illness experiences. The analysis highlights the need to supplement attention in Dow's model to the healing procedure with consideration of variability in the healing process. Depending on individual responses to the intervention, the staff's professional backgrounds and staff-client relationships different recovery models were applied. One suggested "episodic psychosis" and full recovery, and the other suggested "chronic schizophrenia" and the necessity of comprehensive life adjustments to the mental illness. The recovery models influenced clients' perspectives on illness and self as they engaged in identity work, negotiating future plans and individual life projects by including also alternative systems of explanation from the wider cultural repertoire.

Client expectations and satisfaction of quality in home care services. A consumer perspective.

PubMed

Samuelsson, G; Wister, A

2000-12-01

This study examines clients' expectations of quality in home care services and their perceived satisfaction with services among a random sample of 76 home care recipients in Vancouver, Canada. The researchers conducted face-to-face interviews that applied Multiattribute Utility Technology, a procedure that organizes several quality attributes of "ideal" home care into a tree structure to compare their relative importance and ranking from the clients' perspective. Participants also were asked to state their satisfaction or dissatisfaction with the services received in these domains. Among the five main quality attributes identified, the subjects ranked suitability of the home helper and its subset, personal competence, as the most important indicators of quality, followed by continuity in service. In addition, clients tended to have a high level of satisfaction with regard to the attributes of overall home care services. The highest level of satisfaction was reported for elements of personal dispositions of home care staff. The lowest level of satisfaction involved the time/availability components of the service. Finally, comparisons between client expectations and satisfaction of received home care services showed the highest discrepancy for the attributes of influence and time/availability and the greatest congruence for personal attributes of the staff. The results are discussed in terms of their implications for the delivery of home care services.

Muslim Middle Eastern clients' reflections on their relationship with their occupational therapists in mental health care.

PubMed

Pooremamali, Parvin; Eklund, Mona; Östman, Margareta; Persson, Dennis

2012-07-01

Persons with a Middle Eastern background represent a minority in Sweden which has significantly increased in size over recent years. The purpose of the present study was to explore the elements that shape the experiences and perceptions of clients with a Middle Eastern background living by Muslim norms who received occupational therapy in mental health care at the time of participating in the study. The study included interviews with 11 clients who received occupational therapy in mental health care. Data collection and analysis were carried out in accordance with the grounded theory approach. One core category, desiring a union, described the clients' desire for an alliance with the therapists that encompassed the realities and truths embedded in their values, preferences, world-views, and belief systems, as well as a wish to reconstruct their abilities to function and perform daily life tasks within their cultural contexts. The core category included sub-categories: desiring relationship, desiring affiliation, and desiring affirmation as well as some related components. The overall findings showed a tentative model in which the notion of mahram affinity was embedded. The results demonstrated that the clients' views regarding desiring a union had their support in collectivistic world-views that often clash with those of the therapists.

A place to call home: study protocol for a longitudinal, mixed methods evaluation of two housing first adaptations in Sydney, Australia.

PubMed

Whittaker, Elizabeth; Swift, Wendy; Flatau, Paul; Dobbins, Timothy; Schollar-Root, Olivia; Burns, Lucinda

2015-04-09

This protocol describes a study evaluating two 'Housing First' programs, Platform 70 and Common Ground, presently being implemented in the inner-city region of Sydney, Australia. The Housing First approach prioritises housing individuals who are homeless in standard lease agreement tenancies as rapidly as possible to lock in the benefits from long-term accommodation, even where the person may not be seen as 'housing ready'. The longitudinal, mixed methods evaluation utilises both quantitative and qualitative data collected at baseline and 12-month follow-up time points. For the quantitative component, clients of each program were invited to complete client surveys that reported on several factors associated with chronic homelessness and were hypothesised to improve under stable housing, including physical and mental health status and treatment rates, quality of life, substance use patterns, and contact with the health and criminal justice systems. Semi-structured interviews with clients and stakeholders comprised the qualitative component and focused on individual experiences with, and perceptions of, the two programs. In addition, program data on housing stability, rental subsidies and support levels provided to clients by agencies was collected and will be used in conjunction with the client survey data to undertake an economic evaluation of the two programs. This study will systematically evaluate the efficacy of a scatter site model (Platform 70) and a congregated model (Common Ground) of the Housing First approach; an examination that has not yet been made either in Australia or internationally. A clear strength of the study is its timing. It was designed and implemented as the programs in question themselves were introduced. Moreover, the programs were introduced when the Australian Government, with State and Territory support, began a more focused, coordinated response to homelessness and funded rapid expansion of innovative homelessness programs across the country, including Common Ground supportive housing developments.

Availability of software services for a hospital information system.

PubMed

Sakamoto, N

1998-03-01

Hospital information systems (HISs) are becoming more important and covering more parts in daily hospital operations as order-entry systems become popular and electronic charts are introduced. Thus, HISs today need to be able to provide necessary services for hospital operations for a 24-h day, 365 days a year. The provision of services discussed here does not simply mean the availability of computers, in which all that matters is that the computer is functioning. It means the provision of necessary information for hospital operations by the computer software, and we will call it the availability of software services. HISs these days are mostly client-server systems. To increase availability of software services in these systems, it is not enough to just use system structures that are highly reliable in existing host-centred systems. Four main components which support availability of software services are network systems, client computers, server computers, and application software. In this paper, we suggest how to structure these four components to provide the minimum requested software services even if a part of the system stops to function. The network system should be double-protected in stratus using Asynchronous Transfer Mode (ATM) as its base network. Client computers should be fat clients with as much application logic as possible, and reference information which do not require frequent updates (master files, for example) should be replicated in clients. It would be best if all server computers could be double-protected. However, if that is physically impossible, one database file should be made accessible by several server computers. Still, at least the basic patients' information and the latest clinical records should be double-protected physically. Application software should be tested carefully before introduction. Different versions of the application software should always be kept and managed in case the new version has problems. If a hospital information system is designed and developed with these points in mind, it's availability of software services should increase greatly.

Components of a Measure to Describe Organizational Culture in Academic Pharmacy

PubMed Central

Rosenthal, Meagen; Holmes, Erin R.; Andrews, Brienna; Lui, Julia; Raja, Leela

2017-01-01

Objective. To develop a measure of organizational culture in academic pharmacy and identify characteristics of an academic pharmacy program that would be impactful for internal (eg, students, employees) and external (eg, preceptors, practitioners) clients of the program. Methods. A three-round Delphi procedure of 24 panelists from pharmacy schools in the U.S. and Canada generated items based on the Organizational Culture Profile (OCP), which were then evaluated and refined for inclusion in subsequent rounds. Items were assessed for appropriateness and impact. Results. The panel produced 35 items across six domains that measured organizational culture in academic pharmacy: competitiveness, performance orientation, social responsibility, innovation, emphasis on collegial support, and stability. Conclusion. The items generated require testing for validation and reliability in a large sample to finalize this measure of organizational culture. PMID:29367768

Treating stereotypy in adolescents diagnosed with autism by refining the tactic of "using stereotypy as reinforcement".

PubMed

Potter, Jacqueline N; Hanley, Gregory P; Augustine, Matotopa; Clay, Casey J; Phelps, Meredith C

2013-01-01

Use of automatically reinforced stereotypy as reinforcement has been shown to be successful for increasing socially desirable behaviors in persons with intellectual disabilities (Charlop, Kurtz, & Casey, 1990; Hanley, Iwata, Thompson, & Lindberg, 2000; Hung, 1978). A component analysis of this treatment was conducted with 3 adolescents who had been diagnosed with autism, and then extended by (a) progressively increasing the quantitative and qualitative aspects of the response requirement to earn access to stereotypy, (b) arranging objective measures of client preference for contingent access to stereotypy compared to other relevant treatments for their automatically reinforced stereotypy, and (c) assessing the social validity of this treatment with other relevant stakeholders. Implications for addressing stereotypy and increasing the leisure skills of adolescents with autism are discussed. © Society for the Experimental Analysis of Behavior.

Cognitive behaviour therapy territory model: effective disputing approach.

PubMed

Lam, D

1997-06-01

This paper proposes a disputing model (territory model) which is particularly useful and effective for disputing clients who persistently hold on to their dysfunctional thinking and/or core irrational beliefs. Their 'stubbornness' to change is compounded by unhealthy negative emotions during sessions. The intense emotion makes it difficult to access the belief system, and therefore any attempt to dispute it often proves futile. This model advocates the shift of disputing onto a different 'territory/ground' where the client can be facilitated to acquire higher, abstract and objective thinking, and at the same time his/her emotional level is susceptible to rational and logical arguments. The new thinking would act as a catalyst for the client to reflect on his/her dysfunctional thought/irrational beliefs. In this paper, the author uses a case example to illustrate and discuss the ineffectiveness of the 'traditional' way of disputing the dysfunctional thinking/core beliefs of a difficult and emotional client. This is contrasted with the 'territory' model.

Pharmacy workers’ knowledge and provision of medication for termination of pregnancy in Kenya

PubMed Central

Reiss, Kate; Footman, Katharine; Akora, Vitalis; Liambila, Wilson; Ngo, Thoai D

2016-01-01

Objective To assess pharmacy workers’ knowledge and provision of abortion information and methods in Kenya. Methods In 2013 we interviewed 235 pharmacy workers in Nairobi, Mombasa and Kisumu about the medical abortion services they provide. We also used mystery clients, who made 401 visits to pharmacies to collect first-hand information on abortion practices. Results The majority (87.5%) of pharmacy workers had heard of misoprostol but only 39.2% had heard of mifepristone. We found that pharmacy workers had limited knowledge of correct medical abortion regimens, side effects and complications and the legal status of abortion drugs. 49.8% of pharmacy workers reported providing abortion information to clients and 4.3% reported providing abortion methods. 75.2% of pharmacies referred mystery clients to another provider, though 64.2% of pharmacies advised mystery clients to continue with their pregnancy. Pharmacy workers reported that they were experiencing demand for abortion services from clients. Conclusions Pharmacy workers are important providers of information and referrals for women seeking abortion, however their medical abortion knowledge is limited. Training pharmacy workers on medical abortion may improve the quality of information provided and access to safe abortion. PMID:26869694

Postpartum family planning integration with maternal, newborn and child health services: a cross-sectional analysis of client flow patterns in India and Kenya.

PubMed

Mackenzie, Devon; Pfitzer, Anne; Maly, Christina; Waka, Charles; Singh, Gajendra; Sanyal, Abanti

2018-04-03

Maternal, newborn and child health (MNCH) services represent opportunities to integrate postpartum family planning (PPFP). Objectives were to determine levels of MNCH-family planning (FP) integration and associations between integration, client characteristics and service delivery factors in facilities that received programmatic PPFP support. Cross-sectional client flow assessment conducted during May-July 2014, over 5 days at 10 purposively selected public sector facilities in India (4 hospitals) and Kenya (2 hospitals and 4 health centres). 2158 client visits tracked (1294 India; 864 Kenya). Women aged 18 or older accessing services while pregnant and/or with a child under 2 years. PPFP/postpartum intrauterine device-Bihar, India (2012-2013); Jharkhand, India (2009-2014); Embu, Kenya (2006-2010). Maternal, infant and young child nutrition/FP integration-Bondo, Kenya (2011-2014). Proportion of visits where clients received integrated MNCH-FP services, client characteristics as predictors of MNCH-FP integration and MNCH-FP integration as predictor of length of time spent at facility. Levels of MNCH-FP integration varied widely across facilities (5.3% to 63.0%), as did proportion of clients receiving MNCH-FP integrated services by service area. Clients travelling 30-59 min were half as likely to receive integrated services versus those travelling under 30 min (OR 0.5, 95% CI 0.4 to 0.7, P<0.001). Clients receiving MNCH-FP services (vs MNCH services only) spent an average of 10.5 min longer at the facility (95% CI -0.1 to 21.9, not statistically significant). Findings suggest importance of focused programmatic support for integration by MNCH service area. FP integration was highest in areas receiving specific support. Integration does not seem to impose an undue burden on clients in terms of time spent at the facility. Clients living furthest from facilities are least likely to receive integrated services. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Conflicts in Rights of Disclosure of HIV Status in South Western Nigeria: the Health Care Provider's Perspective.

PubMed

Olalekan, Adebimpe Wasiu

2012-01-01

Close interaction between clients and health care workers as regards disclosure, refusal of treatment and right to know status has been a subject of debate in legal and medical quarters. The objective of this study was to assess perceived rights of health care workers towards disclosure of HIV status in Lagos State in Southwestern Nigeria. This was a descriptive cross sectional study carried out among 260 health care workers using multistage sampling technique. Research instruments were semi structured self administered and pre tested questionnaires. Data was analyzed using the SPSS softwares. Mean age of respondents was 39.3(+3.7) years. One hundred and eight four (70.8%) of the health workers studied said that it is the right of health care workers to know the HIV status of clients before commencement of treatments, and 36 (13.8%) agreed that health care workers have the right to refuse to treat or carry out procedure on known HIV positive clients. Twenty (7.7%) said that HIV positive health care workers should not be allowed to handle clients clinically, 72 (27.7%) believed that it is the right of HIV positive clients to know the HIV status of health care workers before attending to them, 36 (13.8%) of respondents has ever disclosed their HIV status to clients before carrying out procedures on them. Fifty six (21.5%) of respondents were willing to show their result results to a HIV positive clients who insist on knowing his or her HIV status, 84 (32.3%) believed that clients has the right to refuse a known HIV positive health care workers to treat or carry out some procedures. There was no statistically significant association between readiness to disclose HIV status and believing that health care workers have the right to know the status of clients before given them treatment ({P< 0.05). The need to balance out perceived rights of health care workers and clients would assist in provision of quality services to HIV positive clients.

The Lifestyle Engagement Activity Program (LEAP): Implementing Social and Recreational Activity into Case-Managed Home Care.

PubMed

Low, Lee-Fay; Baker, Jessica Rose; Harrison, Fleur; Jeon, Yun-Hee; Haertsch, Maggie; Camp, Cameron; Skropeta, Margaret

2015-12-01

The Lifestyle Engagement Activity Program (LEAP) incorporates social support and recreational activities into case-managed home care. This study's aim was to evaluate the effect of LEAP on engagement, mood, and behavior of home care clients, and on case managers and care workers. Quasi-experimental. Five Australian aged home care providers, including 2 specializing in care for ethnic minorities. Clients (n = 189) from 5 home care providers participated. The 12-month program had 3 components: (1) engaging support of management and staff; (2) a champion to drive practice change; (3) staff training. Case managers were trained to set meaningful social and/or recreational goals during care planning. Care workers were trained in good communication, to promote client independence and choice, and in techniques such as Montessori activities, reminiscence, music, physical activity, and humor. Data were collected 6 months before program commencement, at baseline, and 6 and 12 months. The Homecare Measure of Engagement Staff report and Client-Family interview were primary outcomes. Secondary outcomes were the Cohen-Mansfield Agitation Inventory; apathy, dysphoria, and agitation subscales of the Neuropsychiatric Inventory-Clinician Rating; the geriatric depression scale; UCLA loneliness scale; and home care satisfaction scale. Staff provided information on confidence in engaging clients and the Utrecht Work Engagement Scale. Twelve months after program commencement, clients showed a significant increase in self- or family-reported client engagement (b = 5.39, t[113.09] = 3.93, P < .000); and a significant decrease in apathy (b = -0.23, t(117.00) = -2.03, P = .045), dysphoria (b = -0.25, t(124.36) = -2.25, P = .026), and agitation (b = -0.97, t(98.15) = -3.32, P = .001) on the Neuropsychiatric Inventory-Clinician. Case managers and care workers both reported significant increases in their confidence to socially and recreationally engage clients (b = 0.52, t(21.33) = 2.80, P = .011, b = 0.29, t(198.69) = 2.58, P = .011, respectively). There were no significant changes in care worker-rated client engagement or client or family self-complete measures of depression or loneliness (P > .05). Client and family self-rated apathy increased over 12 months (b = 0.04, t(43.36) = 3.06, P = .004; b = 3.63, t(34.70) = 2.20, P = .035) CONCLUSIONS: LEAP demonstrated that home care providers can incorporate social and recreational care into usual practice for older clients, and that this benefits clients' engagement, dysphoria, and agitation. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Tools for Administration of a UNIX-Based Network

NASA Technical Reports Server (NTRS)

LeClaire, Stephen; Farrar, Edward

2004-01-01

Several computer programs have been developed to enable efficient administration of a large, heterogeneous, UNIX-based computing and communication network that includes a variety of computers connected to a variety of subnetworks. One program provides secure software tools for administrators to create, modify, lock, and delete accounts of specific users. This program also provides tools for users to change their UNIX passwords and log-in shells. These tools check for errors. Another program comprises a client and a server component that, together, provide a secure mechanism to create, modify, and query quota levels on a network file system (NFS) mounted by use of the VERITAS File SystemJ software. The client software resides on an internal secure computer with a secure Web interface; one can gain access to the client software from any authorized computer capable of running web-browser software. The server software resides on a UNIX computer configured with the VERITAS software system. Directories where VERITAS quotas are applied are NFS-mounted. Another program is a Web-based, client/server Internet Protocol (IP) address tool that facilitates maintenance lookup of information about IP addresses for a network of computers.

Community Care Workers, Poor Referral Networks and Consumption of Personal Resources in Rural South Africa

PubMed Central

Sips, Ilona; Haeri Mazanderani, Ahmad; Schneider, Helen; Greeff, Minrie; Barten, Francoise; Moshabela, Mosa

2014-01-01

Although home-based care (HBC) programs are widely implemented throughout Africa, their success depends on the existence of an enabling environment, including a referral system and supply of essential commodities. The objective of this study was to explore the current state of client referral patterns and practices by community care workers (CCWs), in an evolving environment of one rural South African sub-district. Using a participant triangulation approach, in-depth qualitative interviews were conducted with 17 CCWs, 32 HBC clients and 32 primary caregivers (PCGs). An open-ended interview guide was used for data collection. Participants were selected from comprehensive lists of CCWs and their clients, using a diversified criterion-based sampling method. Three independent researchers coded three sets of data – CCWs, Clients and PCGs, for referral patterns and practices of CCWs. Referrals from clinics and hospitals to HBC occurred infrequently, as only eight (25%) of the 32 clients interviewed were formally referred. Community care workers showed high levels of commitment and personal investment in supporting their clients to use the formal health care system. They went to the extent of using their own personal resources. Seven CCWs used their own money to ensure client access to clinics, and eight gave their own food to ensure treatment adherence. Community care workers are essential in linking clients to clinics and hospitals and to promote the appropriate use of medical services, although this effort frequently necessitated consumption of their own personal resources. Therefore, risk protection strategies are urgently needed so as to ensure sustainability of the current work performed by HBC organizations and the CCW volunteers. PMID:24781696

The types and characteristics of clients' perceptions of the Bonny method of Guided Imagery and Music.

PubMed

Choi, Byungchuel; Lee, Nan Bok

2014-01-01

Developed by Helen Bonny, Guided Imagery and Music (BMGIM) has mainly been used to assist people with mental health issues. In order to provide clients with the most effective therapy, we need to examine the BMGIM process from the clients' perspective, rather than the therapists.' Understanding the types and characteristics of clients' experiences within the BMGIM process would be helpful to therapists. In order to assess clients' experiences more objectively, a different research methodology is needed to measure and compare the perspectives of clients in the BMGIM process. The purpose of this study was to identify the types and characteristics of perceptions in clients with mental health problems of the BMGIM experience. Q methodology was used to characterize client BMGIM perceptions. Scores from Q samples were coded into Q sample scores in order to calculate Q sort collected from a P sample of 20 participants. Participants were involved in the Q sorting as Q sorters and P sample. Q factor analysis was conducted using the QUANL program. The types and characteristics of the participants' perceptions were analyzed for three segments of the BMGIM session. From a factor analysis, (a) two factors were identified in the before music experience segment, (b) three factors in the during music experience segment, and (c) three factors in the after music experience segment. Factors that intervened in the therapeutic process of BMGIM were obtained from participants' direct GIM experiences. The knowledge of the types and characteristics of participants' perceptions of the GIM process will help therapists deliver more effective therapeutic interventions. Q methodology may also contribute to gaining a better understanding of BMGIM process. © the American Music Therapy Association 2014. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The use of music therapy within the SCERTS model for children with Autism Spectrum Disorder.

PubMed

Walworth, Darcy DeLoach

2007-01-01

The SCERTS model is a new, comprehensive curriculum designed to assess and identify treatment goals and objectives within a multidisciplinary team of clinicians and educators for children with Autism Spectrum Disorders (ASD). This model is an ongoing assessment tool with resulting goals and objectives derived there from. Because music therapy offers a unique interaction setting for children with ASD to elicit communication skills, music therapists will need to be an integral part of the multidisciplinary assessment team using the SCERTS model which is projected to become the primary nation wide curriculum for children with ASD. The purpose of this paper is to assist music therapists in transitioning to this model by providing an overview and explanation of the SCERTS model and by identifying how music therapists are currently providing clinical services incorporated in the SCERTS Model for children with ASD. In order to formulate comprehensive transitional suggestions, a national survey of music therapists working with clients at risk or diagnosed with ASD was conducted to: (a) identify the areas of SCERTS assessment model that music therapists are currently addressing within their written goals for clients with ASD, (b) identify current music therapy activities that address various SCERTS goals and objectives, and (c) provide demographic information about settings, length, and tools used in music therapy interventions for clients with ASD.

Review of Literature for Model Assisted Probability of Detection

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

Meyer, Ryan M.; Crawford, Susan L.; Lareau, John P.

This is a draft technical letter report for NRC client documenting a literature review of model assisted probability of detection (MAPOD) for potential application to nuclear power plant components for improvement of field NDE performance estimations.

The journey of recovery and empowerment embraced by nature - clients' perspectives on nature-based rehabilitation in relation to the role of the natural environment.

PubMed

Pálsdóttir, Anna María; Persson, Dennis; Persson, Birgitta; Grahn, Patrik

2014-07-14

This paper presents findings from real life situations, a longitudinal single case study on the role of natural environments in nature-based rehabilitation (NBR) for individuals with stress-related mental disorders, at the Alnarp Rehabilitation Garden in Sweden. A sample of 43 former clients voluntarily participated in semi-structured interview, and the data were analyzed according to interpretative phenomenological analysis (IPA). Three main superordinate themes were identified as the three phases of NBR-Prelude, Recuperating and Empowerment-explaining and illuminating the role of the natural environments in each phase. An explanatory model of NBR in this context is presented including the three phases of NBR, IRP supportive occupations and a pyramid of supporting environments. A new component of supportive environments was identified and herby named, Social quietness, an important component facilitating personal and intimate engagement with the natural environments.

The emerging role of the client in the delivery of primary care to older Americans.

PubMed Central

Counte, M A

1998-01-01

OBJECTIVE: To address the likely influences, on options faced by older clients, of specific changes in the delivery system and several possible responses to these changes and the changed options, by older persons in the aggregate. STUDY DESIGN: Four specific topics are discussed at length: (1) the probable altered role for the older healthcare client brought on by organizational changes; (2) findings from research on elderly health maintenance behavior and reasons for the increased importance of this issue; (3) the effectiveness of the conventional approach to explaining health services utilization in population studies; and (4) recommendations for future research into the direct or indirect influence of organizational changes in the primary healthcare system on the health-related decisions and behaviors of older persons. PMID:9618677

CommServer: A Communications Manager For Remote Data Sites

NASA Astrophysics Data System (ADS)

Irving, K.; Kane, D. L.

2012-12-01

CommServer is a software system that manages making connections to remote data-gathering stations, providing a simple network interface to client applications. The client requests a connection to a site by name, and the server establishes the connection, providing a bidirectional channel between the client and the target site if successful. CommServer was developed to manage networks of FreeWave serial data radios with multiple data sites, repeaters, and network-accessed base stations, and has been in continuous operational use for several years. Support for Iridium modems using RUDICS will be added soon, and no changes to the application interface are anticipated. CommServer is implemented on Linux using programs written in bash shell, Python, Perl, AWK, under a set of conventions we refer to as ThinObject.

The TENCompetence Infrastructure: A Learning Network Implementation

NASA Astrophysics Data System (ADS)

Vogten, Hubert; Martens, Harrie; Lemmers, Ruud

The TENCompetence project developed a first release of a Learning Network infrastructure to support individuals, groups and organisations in professional competence development. This infrastructure Learning Network infrastructure was released as open source to the community thereby allowing users and organisations to use and contribute to this development as they see fit. The infrastructure consists of client applications providing the user experience and server components that provide the services to these clients. These services implement the domain model (Koper 2006) by provisioning the entities of the domain model (see also Sect. 18.4) and henceforth will be referenced as domain entity services.

Using physical objects with young children in 'face-to-face' and telehealth speech and language therapy.

PubMed

Ekberg, Stuart; Danby, Susan; Theobald, Maryanne; Fisher, Belinda; Wyeth, Peta

2018-03-23

Speech language therapists increasingly are using telehealth to enhance the accessibility of their services. It is unclear, however, how play-based therapy for children can be delivered via telehealth. In particular, modalities such as videoconferencing do not enable physical engagement between therapists and clients. The aim of our reported study was to understand how physical objects such as toys are used in similar and different ways across videoconferenced and "face-to-face" (hereafter, "in-person") therapy. We used conversation analytic methods to compare video-recorded therapy sessions for children delivered across in-person and telehealth settings. Utilising a broader corpus of materials, our analysis focused on four client-therapist dyads: two using videoconferencing, and two who met in-person. Both videoconferencing and in-person sessions enabled routine affordances and challenges for delivering therapy. Within in-person therapy, therapists made access to objects contingent upon the client producing some target expression. This contingency usually was achieved by restricting physical access to these objects. Restricting access to a toy was not necessary in videoconferenced therapy; therapists instead used techniques to promote engagement. When delivering play-based therapy via telehealth, our study demonstrates how practitioners adapt the intervention to suit the particular medium of its delivery. Implications for Rehabilitation Telehealth enhances equitable access for those who cannot physically access rehabilitation services. Telehealth modalities can create practical challenges, however, when delivering interventions such as play-based therapy. Practitioners should intentionally adapt telehealth interventions to suit the particular telehealth modality they are using.

Are Female Sex Workers Able to Negotiate Condom Use with Male Clients? The Case of Mobile FSWs in Four High HIV Prevalence States of India

PubMed Central

Bharat, Shalini; Mahapatra, Bidhubhusan; Roy, Suchismita; Saggurti, Niranjan

2013-01-01

Introduction Condom promotion among female sex workers (FSWs) is a key intervention in India’s National AIDS Control Program. However, there is limited understanding of how FSWs negotiate condom use with male clients, particularly in the context of their mobility for sex work. The objective of this study is to examine the factors associated with the mobile FSWs’ ability to refuse unsafe sex and successfully negotiate condom use with unwilling male clients. Methods Data for 5498 mobile FSWs from a cross-sectional survey conducted in 22 districts of four states in southern India were analyzed. Questions assessed FSWs’ ability to refuse clients unprotected sex, convince unwilling clients for condom use and negotiate condom use in a new location. Logistic regression models were constructed to examine the association between socio-demographics, economic vulnerability, sex work practice, and program exposure and condom negotiation ability. Results A majority of FSWs (60%) reported the ability to refuse clients for unprotected sex, but less than one-fifth reported the ability to successfully convince an unwilling client to use a condom or to negotiate condom use in a new site. Younger and older mobile FSWs compared to those who were in the middle age group, those with longer sex work experience, with an income source other than sex work, with program exposure and who purchased condoms for use, reported the ability to refuse unprotected sex, to successfully negotiate condom use with unwilling clients and to do so at new sites. Conclusion FSWs need to be empowered to not only refuse unprotected sex but also to be able to motivate and convince unwilling clients for condom use, including those in new locations. In addition to focusing on condom promotion, interventions must address the factors that impact FSWs’ ability to negotiate condom use. PMID:23840806

Hazardous Drinking and HIV-risk-related Behaviour among Male Clients of Female Sex Workers in Tijuana, Mexico

PubMed Central

Goodman-Meza, David; Pitpitan, Eileen V.; Semple, Shirley J.; Wagner, Karla D.; Chavarin, Claudia V.; Strathdee, Steffanie A.; Patterson, Thomas L.

2015-01-01

Background and Objectives Male clients of female sex workers (FSWs) are at high risk for HIV. Whereas the HIV risks of alcohol use are well understood, less is known about hazardous alcohol use among male clients of FSWs, particularly in Mexico. We sought to identify risk factors for hazardous alcohol use and test associations between hazardous alcohol use and HIV risk behaviour among male clients in Tijuana. Method Male clients of FSWs in Tijuana (n = 400) completed a quantitative interview in 2008. The AUDIT was used to characterize hazardous alcohol use. Multivariate logistic regression was used to determine independent associations of demographic and HIV risk variables with hazardous alcohol use (vs. non-hazardous). Results Forty percent of our sample met criteria for hazardous alcohol use. Variables independently associated with hazardous drinking were reporting any sexually transmitted infection (STI), having sex with a FSW while under the influence of alcohol, being younger than 36 years of age, living in Tijuana, and ever having been jailed. Hazardous drinkers were less likely ever to have been deported or to have shared injection drugs. Discussion and Conclusions Hazardous alcohol use is associated with HIV risk, including engaging in sex with FSWs while intoxicated and having an STI among male clients of FSWs in Tijuana. Scientific Significance We systematically described patterns and correlates of hazardous alcohol use among male clients of FSWs in Tijuana, Mexico. The results suggest that HIV/STI risk reduction interventions must target hazardous alcohol users, and be tailored to address alcohol use. PMID:25066863

A Qualitative Study of Client-Clinician Text Exchanges in a Mobile Health Intervention for Individuals With Psychotic Disorders and Substance Use.

PubMed

Aschbrenner, Kelly A; Naslund, John A; Gill, Lydia E; Bartels, Stephen J; Ben-Zeev, Dror

2016-01-01

Mobile health (mHealth) approaches have the potential to transform prevention, wellness, and illness management for people with dual diagnosis consisting of co-occurring mental illness and substance use disorders by providing timely and cost-effective interventions in clients' natural environments. However, little is known about how clients interact with mHealth interventions to manage their illness. This qualitative study explored the content of mobile phone text messages between clients with dual diagnosis and a clinician who engaged them in daily assessment and intervention text exchanges. Seventeen participants with psychotic disorders and substance use were enrolled in a 12-week single-arm trial of an mHealth intervention focusing on illness management. The clinician (i.e., mobile interventionist) sent daily text messages to participants' privately owned mobile phones to assess their medication adherence and clinical status. The clinician provided other illness management and wellness suggestions flexibly, in response to participants' needs and preferences. In this qualitative study we conducted a thematic analysis of the client-clinician text exchanges that occurred over the course of the intervention. Seven major content themes in client-clinician text message exchanges were identified: mental health symptoms; mental health coping strategies; mental health treatment and management; lifestyle behaviors; social relationships and leisure activities; motivation and personal goal setting; and independent living. Participants were interested in discussing strategies for coping with mental health symptoms (e.g., cognitive restructuring, social support) and health behavior change (e.g., increased physical activity, dietary changes). Our findings suggest that client-centered text messaging has the potential to be an important component of illness management for people with dual diagnosis. This approach is able to offer coping strategies that are tailored to clients' needs and preferences in real time when help is needed.

Construct validity of the MMPI-2 College Maladjustment (Mt) Scale.

PubMed

Barthlow, Deanna L; Graham, John R; Ben-Porath, Yossef S; McNulty, John L

2004-09-01

The construct validity of the MMPI-2 (Minnesota Multiphasic Personality Inventory-2) College Maladjustment (Mt) Scale was examined using 376 student clients at a university psychological clinic. A principal components analysis and correlations of Mt scale scores with clients' and therapists' ratings of symptoms and functioning showed that the Mt scale identifies the presence of maladjustment as defined in terms of depressive and anxious symptoms. There is no evidence to show that the scale is specific to college students or that it is sensitive to severe psychological disturbance. The Mt scale does not inform the clinician as to why a person is distressed. In addition, there is no evidence from this study to suggest the superiority of the Mt scale over other MMPI-2 maladjustment measures. Therapists should use the entire MMPI-2 profile, not just the Mt scale, to gain the most comprehensive and specific understanding of clients.

A pilot examination of social context and everyday physical activity among adults receiving Community Mental Health Services.

PubMed

McCormick, B P; Frey, G C; Lee, C-T; Gajic, T; Stamatovic-Gajic, B; Maksimovic, M

2009-03-01

Community mental health center (CMHC) clients include a variety of people with moderate to severe mental illnesses who also report a number of physical health problems. Physical activity (PA) has been identified as one intervention to improve health among this population; however, little is known about the role of social context in PA. The purpose of this study was to examine the role of social context in everyday PA among CMHC clients. Data were collected from CMHC clients in two cultures using accelerometery and experience sampling methods. Data were analyzed using hierarchical linear modeling. Independence in housing nor culture was significantly associated with levels of PA. Being alone was significantly negatively related to PA level. Social isolation appears to be negatively related to PA at the level of everyday life. Physical activity interventions with this population should consider including social components as a part of PA.

Flexible Unicast-Based Group Communication for CoAP-Enabled Devices †

PubMed Central

Ishaq, Isam; Hoebeke, Jeroen; Van den Abeele, Floris; Rossey, Jen; Moerman, Ingrid; Demeester, Piet

2014-01-01

Smart embedded objects will become an important part of what is called the Internet of Things. Applications often require concurrent interactions with several of these objects and their resources. Existing solutions have several limitations in terms of reliability, flexibility and manageability of such groups of objects. To overcome these limitations we propose an intermediately level of intelligence to easily manipulate a group of resources across multiple smart objects, building upon the Constrained Application Protocol (CoAP). We describe the design of our solution to create and manipulate a group of CoAP resources using a single client request. Furthermore we introduce the concept of profiles for the created groups. The use of profiles allows the client to specify in more detail how the group should behave. We have implemented our solution and demonstrate that it covers the complete group life-cycle, i.e., creation, validation, flexible usage and deletion. Finally, we quantitatively analyze the performance of our solution and compare it against multicast-based CoAP group communication. The results show that our solution improves reliability and flexibility with a trade-off in increased communication overhead. PMID:24901978

Investigating the Perceptions of Care Coordinators on Using Behavior Theory-Based Mobile Health Technology With Medicaid Populations: A Grounded Theory Study

PubMed Central

2017-01-01

Background Medicaid populations are less engaged in their health care than the rest of the population, translating to worse health outcomes and increased health care costs. Since theory-based mobile health (mHealth) interventions have been shown to increase patient engagement, mobile phones may be an optimal strategy to reach this population. With increased development of theory-based mHealth technology, these interventions must now be evaluated with these medically underserved populations in a real-world setting. Objective The aim of our study was to investigate care coordinators’ perceived value of using a health behavior theory-based mHealth platform with Medicaid clients. In particular, attention was paid to the perceived impact on patient engagement. This research was conducted using the patient-provider text messaging (short message service, SMS) platform, Sense Health (now Wellpass), which integrates the transtheoretical model (TTM), also called the stages of change model; social cognitive theory (SCT); supportive accountability; and motivational interviewing (MI). Methods Interviews based in grounded theory methodology were conducted with 10 care managers to understand perceptions of the relationship between mHealth and patient engagement. Results The interviews with care managers yielded a foundation for a grounded theory model, presenting themes that suggested 4 intertwined correlative relationships revolving around patient engagement: (1) A text messaging (short message service, SMS) platform supplements the client-care manager dynamic, which is grounded in high quality, reciprocal-communication to increase patient engagement; (2) Texting enhances the relationship between literacy and access to care for Medicaid patients, increasing low-literacy patients’ agency to access services; (3) Texting enhances communication, providing care managers with a new means to support their clients; and (4) Reminders augment client accountability, leading to both increased motivation and readiness to change behaviors, as well as an improved client-care manager relationship. Conclusions Messaging platform features tied to health behavior theory appear to be effective in improving patient engagement. Two-way communication (supportive accountability), trusted relationships (supportive accountability, SCT), personalized messages (TTM), and patient input (TTM, SCT, MI) appeared as the most relevant components in achieving desired outcomes. Additionally, reminder messages were noted as especially useful in making Medicaid patients accountable and in turn engaging them in their health and health care. These findings convey suggested elements for inclusion in other mHealth interventions aiming to improve patient engagement in Medicaid populations. PMID:28325711

An Extensible Model and Analysis Framework

DTIC Science & Technology

2010-11-01

Eclipse or Netbeans Rich Client Platform (RCP). We call this the Triquetrum Project. Configuration files support narrower variability than Triquetrum/RCP...Triquetrum/RCP supports assembling in arbitrary ways. (12/08 presentation) 2. Prototyped OSGi component architecture for use with Netbeans and

Dynamic Server-Based KML Code Generator Method for Level-of-Detail Traversal of Geospatial Data

NASA Technical Reports Server (NTRS)

Baxes, Gregory; Mixon, Brian; Linger, TIm

2013-01-01

Web-based geospatial client applications such as Google Earth and NASA World Wind must listen to data requests, access appropriate stored data, and compile a data response to the requesting client application. This process occurs repeatedly to support multiple client requests and application instances. Newer Web-based geospatial clients also provide user-interactive functionality that is dependent on fast and efficient server responses. With massively large datasets, server-client interaction can become severely impeded because the server must determine the best way to assemble data to meet the client applications request. In client applications such as Google Earth, the user interactively wanders through the data using visually guided panning and zooming actions. With these actions, the client application is continually issuing data requests to the server without knowledge of the server s data structure or extraction/assembly paradigm. A method for efficiently controlling the networked access of a Web-based geospatial browser to server-based datasets in particular, massively sized datasets has been developed. The method specifically uses the Keyhole Markup Language (KML), an Open Geospatial Consortium (OGS) standard used by Google Earth and other KML-compliant geospatial client applications. The innovation is based on establishing a dynamic cascading KML strategy that is initiated by a KML launch file provided by a data server host to a Google Earth or similar KMLcompliant geospatial client application user. Upon execution, the launch KML code issues a request for image data covering an initial geographic region. The server responds with the requested data along with subsequent dynamically generated KML code that directs the client application to make follow-on requests for higher level of detail (LOD) imagery to replace the initial imagery as the user navigates into the dataset. The approach provides an efficient data traversal path and mechanism that can be flexibly established for any dataset regardless of size or other characteristics. The method yields significant improvements in userinteractive geospatial client and data server interaction and associated network bandwidth requirements. The innovation uses a C- or PHP-code-like grammar that provides a high degree of processing flexibility. A set of language lexer and parser elements is provided that offers a complete language grammar for writing and executing language directives. A script is wrapped and passed to the geospatial data server by a client application as a component of a standard KML-compliant statement. The approach provides an efficient means for a geospatial client application to request server preprocessing of data prior to client delivery. Data is structured in a quadtree format. As the user zooms into the dataset, geographic regions are subdivided into four child regions. Conversely, as the user zooms out, four child regions collapse into a single, lower-LOD region. The approach provides an efficient data traversal path and mechanism that can be flexibly established for any dataset regardless of size or other characteristics.

Family tree and ancestry inference: is there a need for a 'generational' consent?

PubMed

Wallace, Susan E; Gourna, Elli G; Nikolova, Viktoriya; Sheehan, Nuala A

2015-12-09

Genealogical research and ancestry testing are popular recreational activities but little is known about the impact of the use of these services on clients' biological and social families. Ancestry databases are being enriched with self-reported data and data from deoxyribonucleic acid (DNA) analyses, but also are being linked to other direct-to-consumer genetic testing and research databases. As both family history data and DNA can provide information on more than just the individual, we asked whether companies, as a part of the consent process, were informing clients, and through them clients' relatives, of the potential implications of the use and linkage of their personal data. We used content analysis to analyse publically-available consent and informational materials provided to potential clients of ancestry and direct-to-consumer genetic testing companies to determine what consent is required, what risks associated with participation were highlighted, and whether the consent or notification of third parties was suggested or required. We identified four categories of companies providing: 1) services based only on self-reported data, such as personal or family history; 2) services based only on DNA provided by the client; 3) services using both; and 4) services using both that also have a research component. The amount of information provided on the potential issues varied significantly across the categories of companies. 'Traditional' ancestry companies showed the greatest awareness of the implications for family members, while companies only asking for DNA focused solely on the client. While in some cases companies included text recommending clients inform their relatives, showing they recognised the issues, often it was located within lengthy terms and conditions or privacy statements that may not be read by potential clients. We recommend that companies should make it clearer that clients should inform third parties about their plans to participate, that third parties' data will be provided to companies, and that that data will be linked to other databases, thus raising privacy and issues on use of data. We also suggest investigating whether a 'generational consent' should be created that would include more than just the individual in decisions about participating in genetic investigations.

Access to Network Login by Three-Factor Authentication for Effective Information Security.

PubMed

Vaithyasubramanian, S; Christy, A; Saravanan, D

2016-01-01

Today's technology development in the field of computer along with internet of things made huge difference in the transformation of our lives. Basic computer framework and web client need to make significant login signify getting to mail, long range interpersonal communication, internet keeping money, booking tickets, perusing online daily papers, and so forth. The login user name and secret key mapping validate if the logging user is the intended client. Secret key is assumed an indispensable part in security. The objective of MFA is to make a layered safeguard and make it more troublesome for an unauthenticated entity to get to an objective, for example, a physical area, processing gadget, system, or database. In the event that one element is bargained or broken, the assailant still has two more boundaries to rupture before effectively breaking into the objective. An endeavor has been made by utilizing three variable types of authentication. In this way managing additional secret key includes an additional layer of security.

Access to Network Login by Three-Factor Authentication for Effective Information Security

PubMed Central

Vaithyasubramanian, S.; Christy, A.; Saravanan, D.

2016-01-01

Today's technology development in the field of computer along with internet of things made huge difference in the transformation of our lives. Basic computer framework and web client need to make significant login signify getting to mail, long range interpersonal communication, internet keeping money, booking tickets, perusing online daily papers, and so forth. The login user name and secret key mapping validate if the logging user is the intended client. Secret key is assumed an indispensable part in security. The objective of MFA is to make a layered safeguard and make it more troublesome for an unauthenticated entity to get to an objective, for example, a physical area, processing gadget, system, or database. In the event that one element is bargained or broken, the assailant still has two more boundaries to rupture before effectively breaking into the objective. An endeavor has been made by utilizing three variable types of authentication. In this way managing additional secret key includes an additional layer of security. PMID:27006976

AWS-Glacier As A Storage Foundation For AWS-EC2 Hosted Scientific Data Services

NASA Astrophysics Data System (ADS)

Gallagher, J. H. R.; Potter, N.

2016-12-01

Using AWS Glacier as a base level data store for a scientific data service presents new challenges for the web accessible data services, along with their software clients and human operators. All meaningful Glacier transactions take at least 4 hours to complete. This is in contrast to the various web APIs for data such as WMS, WFS, WCS, DAP2, and Netcdf tools which were all written based on the premise that the response will be (nearly) immediate. Only DAP4 and WPS contain an explicit asynchronous component to their respective protocols which allows for "return later" behaviors. We were able to put Hyrax (a DAP4 server) in front of Glacier-held resources, but there were significant issues. Any kind of probing of the datasets happens at the cost of the Glacier retrieval period, 4 hours. A couple of crucial things fall out of this: The first is that the service must cache metadata, including coordinate map arrays, so that a client can have enough information available in the "immediate" time frame to make a decisions about what to ask for from the dataset. This type of request planning is important because a data access request will take 4 hours to complete unless the data resource has been cached. The second thing is that the clients need to change their behavior when accessing datasets in an asynchronous system, even if the metadata is cached. Commonly, client applications will request a number of data components from a DAP2 service in the course of "discovering" the dataset. This may not be a well-supported model of interaction with Glacier or any other high latency data store.

Expanding HIV testing and counselling into communities: Feasibility, acceptability, and effects of an integrated family planning/HTC service delivery model by Village Health Teams in Uganda.

PubMed

Brunie, Aurélie; Wamala-Mucheri, Patricia; Akol, Angela; Mercer, Sarah; Chen, Mario

2016-10-01

Improving HIV testing and counselling (HTC) requires a range of strategies. This article reports on HTC service delivery by Village Health Teams (VHTs) in Uganda in the context of a model integrating this new component into pre-existing family planning services. Eight health centres from matched pairs were randomly allocated to intervention or control. After being trained, 36 VHTs reporting to selected facilities in the intervention group started offering HTC along with family planning, while VHTs in the control group provided family planning only. Proficiency testing was conducted as external quality assurance. A survey of all 36 VHTs and 137 family planning clients in the intervention group and 119 clients in the control group and a review of record data were conducted after 10 months. Survey responses by VHTs and their clients in the intervention group demonstrate knowledge of counselling messages and safe testing. External quality assessment results provide additional evidence of competency. Eighty per cent of the family planning clients surveyed in the intervention group received an HIV test during the intervention; 27% of those were first-time testers. More clients had ever tested for HIV in the intervention group compared with the control; clients also retested more often. Findings indicate that this model is feasible and acceptable for expanding quality HTC into communities. This study was registered with ClinicalTrials.gov, number [NCT02244398]. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

PubMed

Hoti, Kreshnik; Hughes, Jeffery; Sunderland, Bruce

2011-02-01

To examine the views of regular pharmacy clients on pharmacist prescribing and employ agency theory in considering the relationship between the stakeholders involved. Computer assisted telephone interviews were conducted with 400 pharmacy clients recruited around Australia. Potential respondents were identified using a random number generation function in Microsoft Excel. Data were analysed with SPSS version 17 using one-way analysis of variance, principal component analysis and linear regression. The relationships between the main stakeholders involved were explored using agency theory. A total of 1153 answered calls recruited 400 consenting pharmacy clients. Most respondents (71%) trusted pharmacists adopting an expanded role in prescribing, however the majority (66%) supported this only after a diagnosis had been made by a doctor. Those who accepted pharmacist diagnosing and prescribing preferred that this was limited to pain management and antibiotics. Most respondents (64%) considered that expanded pharmacist prescribing would improve their access to prescription medicines, although those over 65 years of age were less supportive than younger respondents. Factors which contributed positively to clients' perception of trust in an expanded prescribing role for pharmacists were identified, and improved access to medicines was found to be the strongest predictor (P < 0.0001). Most pharmacy clients trusted pharmacists adopting an expanded prescribing role, but preferred that this was limited to doctors performing the initial diagnosis. Agency theory would conceptualize the introduction of pharmacist prescribers, as disrupting the principal (patient) agent (doctor) relationship. Its introduction would best be facilitated by careful change management. © 2011 The Authors. IJPP © 2011 Royal Pharmaceutical Society.

The heart of the matter: health status of aged care clients receiving home- and community-based care.

PubMed

Yarmo-Roberts, Deborah; Freak-Poli, Rosanne Laura; Cooper, Brad; Noonan, Tim; Stolewinder, Just; Reid, Christopher M

2010-07-12

Objective. To determine the current health status of home based elderly clients receiving government funded aged care packages. Design. Prospective Observational study. Setting. Community based, home care program in Australia. Participants. Community-dwelling older adults receiving aged care packages. Measurements. A comprehensive test battery of physical, mental and social scales were completed including a Caregiver Strain Index where appropriate. Results. 37% of the 334 subjects were male and the mean age was 81 ± 8 years. Physical functioning was low compared to the Australian population. Depression was highly prevalent with 15.9% severely depressed and 38.7% mildly depressed. 26% of clients screened positive for dementia. Relatively good levels of social support were reported, however social networking activity levels were low. Sixty one percent of clients had caregivers, of whom 63.3% had high levels of strain. Strain was higher in caregivers of clients on higher levels of care (78.5% versus 50.6% highly strained). Conclusion. The data suggests that as a group there is a high degree of comorbidity, and depression, dementia and caregiver strain are highly prevalent. The findings may aid administrators and health policy planners in directing resources to key areas impacting on health outcomes in this group.

Multi-resolution extension for transmission of geodata in a mobile context

NASA Astrophysics Data System (ADS)

Follin, Jean-Michel; Bouju, Alain; Bertrand, Frédéric; Boursier, Patrice

2005-03-01

A solution is proposed for the management of multi-resolution vector data in a mobile spatial information visualization system. The client-server architecture and the models of data and transfer of the system are presented first. The aim of this system is to reduce data exchanged between client and server by reusing data already present on the client side. Then, an extension of this system to multi-resolution data is proposed. Our solution is based on the use of increments in a multi-scale database. A database architecture where data sets for different predefined scales are precomputed and stored on the server side is adopted. In this model, each object representing the same real world entities at different levels of detail has to be linked beforehand. Increments correspond to the difference between two datasets with different levels of detail. They are transmitted in order to increase (or decrease) the detail to the client upon request. They include generalization and refinement operators allowing transitions between the different levels. Finally, a framework suited to the transfer of multi-resolution data in a mobile context is presented. This allows reuse of data locally available at different levels of detail and, in this way, reduces the amount of data transferred between client and server.

The impact of peer mentor communication with older adults on depressive symptoms and working alliance: A pilot study.

PubMed

Joo, Jin Hui; Hwang, Seungyoung; Gallo, Joseph J; Roter, Debra L

2018-04-01

The objective of this pilot study was to describe peer communication in meetings with depressed elders, associate their relationship with working alliance and depression and assess congruence of communication with training. Three peers with a history of depression, in recovery, received 20h of training in peer mentoring for depression as part of an 8-week pilot program for 23 depressed older adults. Each peer-client meeting was recorded; a sample of 69 recorded meetings were chosen across the program period and coded with the Roter Interaction Analysis System, a validated medical interaction analysis system. Generalized linear mixed models were used to examine peer talk during meetings in relation to working alliance and client depression. Peers used a variety of skills congruent with their training including client-centered talk, positive rapport building and emotional responsiveness that remained consistent or increased over time. Client-centered communication and positive rapport were associated with increased working alliance and decreased depressive symptoms (all p<0.001). Trained peer mentors can use communication behaviors useful to older adults with depression. Specifically, client-centered talk may be important to include in peer training. Peer mentors can be a valuable resource in providing depression counseling to older adults. Copyright © 2017 Elsevier B.V. All rights reserved.

The Heart of the Matter: Health Status of Aged Care Clients Receiving Home- and Community-Based Care

PubMed Central

Yarmo-Roberts, Deborah; Freak-Poli, Rosanne Laura; Cooper, Brad; Noonan, Tim; Stolewinder, Just; Reid, Christopher M.

2010-01-01

Objective. To determine the current health status of home based elderly clients receiving government funded aged care packages. Design. Prospective Observational study. Setting. Community based, home care program in Australia. Participants. Community-dwelling older adults receiving aged care packages. Measurements. A comprehensive test battery of physical, mental and social scales were completed including a Caregiver Strain Index where appropriate. Results. 37% of the 334 subjects were male and the mean age was 81 ± 8 years. Physical functioning was low compared to the Australian population. Depression was highly prevalent with 15.9% severely depressed and 38.7% mildly depressed. 26% of clients screened positive for dementia. Relatively good levels of social support were reported, however social networking activity levels were low. Sixty one percent of clients had caregivers, of whom 63.3% had high levels of strain. Strain was higher in caregivers of clients on higher levels of care (78.5% versus 50.6% highly strained). Conclusion. The data suggests that as a group there is a high degree of comorbidity, and depression, dementia and caregiver strain are highly prevalent. The findings may aid administrators and health policy planners in directing resources to key areas impacting on health outcomes in this group. PMID:21152197

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

Demand-based provision of housing, welfare and care services to elderly clients: from policy to daily practice through operations management.

PubMed

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

2009-03-01

Practical implementation of notions such as patient-orientation, client-centredness, and demand-driven care is far from straightforward in care and service supply to elderly clients living independently. This paper aims to provide preliminary insights into how it is possible to bridge the gap between policy intent, which reflects an increasing client orientation, and actual practice of care and service provision. Differences in personal objectives and characteristics generate different sets of needs among elderly clients that must have an appropriate response in the daily routines of care and service providers. From a study of the available literature and by conceptual reasoning, we identify several important operational implications of client-oriented care and service provision. To deal with these implications the authors turn to the field of operations management. This field has deepened the understanding of translating an organisation's policy into daily activities and working methods. More specifically, we elaborate on the concept of modularity, which stems from the field of operations management. With respect to elderly people who live independently, this concept, among others, seems to be particularly useful in providing options and variation in individual care and service packages. Based on our line of reasoning, we propose that modularity provides possibilities to enhance the provision of demand-based care and services. Furthermore, our findings offer direction on how organisations in housing, welfare and care can be guided in translating demand-based care to their operational processes.

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

Therapist-client sex in psychotherapy: attitudes of professionals and students towards ethical arguments.

PubMed

Hollwich, Sebastian; Franke, Irina; Riecher-Rössler, Anita; Reiter-Theil, Stella

2015-01-01

Data suggest that a substantial proportion of psychotherapists engage in therapist-client sex (TCS), violating national and international ethical guidelines. The objective of our study was to find a new and effective starting point for preventive interventions. Using an online questionnaire, this study explored professionals' attitudes toward aspects of a TCS-case example influencing the tendency to pursue colleagues' TCS, including self-interest and responsibility ascribed to clients. A total of 421 participants expressed preferences for courses of action and rated given information in a questionnaire. Results indicate that TCS is most often condemned for its inherent carelessness towards clients, its exploitative nature, the abuse of dependency and for counteracting the inherent intention of psychotherapy. Partial responsibility for TCS was attributed to clients by 41.3% of the respondents. Although self-interest related information was rated as an acceptable reason against pursuing TCS, a strong tendency exists to confront an abusive colleague, even at the risk of own disadvantages. In the detailed discussion ethical arguments against TCS (other than the certainly inflicted, but hardly measurable harm) are elaborated. In particular the incompatibility of TCS with a psychotherapeutic relationship, the responsibility for TCS in the asymmetrical client-therapist relationship and the legitimacy of self-protection are discussed. Reasoning against TCS can and should be based on explicit, ethical requirements for psychotherapists. Furthermore, integrating the topic in psychotherapists' training is encouraged and a discrete procedure to report a colleague's TCS is requested.

Use of GetCheckedOnline, a Comprehensive Web-based Testing Service for Sexually Transmitted and Blood-Borne Infections

PubMed Central

Salway, Travis; Haag, Devon; Fairley, Christopher K; Wong, Jason; Grennan, Troy; Uddin, Zhaida; Buchner, Christopher S; Wong, Tom; Krajden, Mel; Tyndall, Mark; Shoveller, Jean; Ogilvie, Gina

2017-01-01

Background The British Columbia Centre for Disease Control implemented a comprehensive Web-based testing service GetCheckedOnline (GCO) in September 2014 in Vancouver, Canada. GCO’s objectives are to increase testing for sexually transmitted and blood-borne infections (STBBIs), reach high-prevalence populations facing testing barriers, and increase clinical STI service capacity. GCO was promoted through email invitations to provincial STI clinic clients, access codes to clients unable to access immediate clinic-based testing (deferred testers), and a campaign to gay, bisexual, and other men who have sex with men (MSM). Objective The objective of the study was to report on characteristics of GCO users, use and test outcomes (overall and by promotional strategy) during this pilot phase. Methods We used GCO program data, website metrics, and provincial STI clinic records to describe temporal trends, progression through the service pathway, and demographic, risk, and testing outcomes for individuals creating GCO accounts during the first 15 months of implementation. Results Of 868 clients creating accounts, 318 (36.6%) submitted specimens, of whom 96 (30.2%) tested more than once and 10 (3.1%) had a positive STI diagnosis. The proportion of clients submitting specimens increased steadily over the course of the pilot phase following introduction of deferred tester codes. Clients were diverse with respect to age, gender, and ethnicity, although youth and individuals of nonwhite ethnicity were underrepresented. Of the 506 clients completing risk assessments, 215 (42.5%) were MSM, 89 (17.6%) were symptomatic, 47 (9.3%) were STI contacts, 232 (45.8%) reported condomless sex, 146 (28.9%) reported ≥4 partners in the past 3 months, and 76 (15.0%) reported a recent STI. A total of 63 (12.5%) GCO clients were testing for the first time. For 868 accounts created, 337 (38.8%) were by clinic invitations (0 diagnoses), 298 (34.3%) were by deferred testers (6 diagnoses), 194 (22.4%) were by promotional campaign (3 diagnoses), and 39 (4.5%) were by other means (1 diagnosis). Conclusions Our evaluation suggests that GCO is an acceptable and feasible approach to engage individuals in testing. Use by first-time testers, repeated use, and STI diagnosis of individuals unable to access immediate clinic-based testing suggest GCO may facilitate uptake of STBBI testing and earlier diagnosis. Use by MSM and individuals reporting sexual risk suggests GCO may reach populations with a higher risk of STI. Motivation to test (eg, unable to access clinical services immediately) appears a key factor underlying GCO use. These findings identify areas for refinement of the testing model, further promotion, and future research (including understanding reasons for drop-off through the service pathway and more comprehensive evaluation of effectiveness). Increased uptake and diagnosis corresponding with expansion of the service within British Columbia will permit future evaluation of this service across varying populations and settings. PMID:28320690

Using the SCERTS model assessment tool to identify music therapy goals for clients with autism spectrum disorder.

PubMed

Walworth, Darcy D; Register, Dena; Engel, Judy Nguyen

2009-01-01

The purposes of this paper were to identify and compare goals and objectives addressed by music therapists that are contained in the SCERTS Model, for use with children at risk or diagnosed with a communication impartment including Autism Spectrum Disorder (ASD). A video analysis of music therapists working with clients at risk or diagnosed with ASD (N = 33) was conducted to: (a) identify the areas of the SCERTS assessment model that music therapists are currently addressing within their sessions for clients with ASD, and (b) compare the frequency of SCERTS domains and goals addressed by music therapists within sessions. Results of the analysis revealed that all three domains of social communication, emotional regulation, and transactional support were addressed within music therapy sessions. Within each domain both broad goals were all addressed including joint attention and symbol use for social communication, self-regulation and mutual regulation for emotional regulation, and interpersonal support and learning support for transactional support. Overall, music therapists addressed transactional support goals and subgoals more often than social communication and emotional regulation goals and subgoals. The highest frequency goal area addressed was interpersonal support (73.96%) and the lowest goal area addressed was joint attention (35.96%). For the social partner and language partner language stages, 58 of the 320 possible subgoals were addressed with 90% frequency or higher, while 13 of the same subgoals were never addressed. The SCERTS Model is designed for use by a multidisciplinary team of professionals and family members throughout a client's treatment and contains an ongoing assessment tool with resulting goals and objectives. This analysis indicates that many SCERTS goals and objectives can be addressed in music therapy interventions. Additionally, goals and subgoals not previously recognized in music therapy treatment can be generated by the use of the SCERTS Model.

Physical activity levels of older adults receiving a home care service.

PubMed

Burton, Elissa; Lewin, Gill; Boldy, Duncan

2013-04-01

The 3 study objectives were to compare the activity levels of older people who had received a restorative home care service with those of people who had received "usual" home care, explore the predictors of physical activity in these 2 groups, and determine whether either group met the minimum recommended activity levels for their age group. A questionnaire was posted to 1,490 clients who had been referred for a home care service between 2006 and 2009. Older people who had received a restorative care service were more active than those who had received usual care (p = .049), but service group did not predict activity levels when other variables were adjusted for in a multiple regression. Younger individuals who were in better physical condition, with good mobility and no diagnosis of depression, were more likely to be active. Investigation of alternatives to the current exercise component of the restorative program is needed.

Autonomy and Housing Accessibility Among Powered Mobility Device Users

PubMed Central

Brandt, Åse; Lexell, Eva Månsson; Iwarsson, Susanne

2015-01-01

OBJECTIVE. To describe environmental barriers, accessibility problems, and powered mobility device (PMD) users’ autonomy indoors and outdoors; to determine the home environmental barriers that generated the most housing accessibility problems indoors, at entrances, and in the close exterior surroundings; and to examine personal factors and environmental components and their association with indoor and outdoor autonomy. METHOD. This cross-sectional study was based on data collected from a sample of 48 PMD users with a spinal cord injury (SCI) using the Impact of Participation and Autonomy and the Housing Enabler instruments. Descriptive statistics and logistic regression were used. RESULTS. More years living with SCI predicted less restriction in autonomy indoors, whereas more functional limitations and accessibility problems related to entrance doors predicted more restriction in autonomy outdoors. CONCLUSION. To enable optimized PMD use, practitioners must pay attention to the relationship between client autonomy and housing accessibility problems. PMID:26356666

E-Psychology: Consumers' Attitude

NASA Astrophysics Data System (ADS)

Jordanova, Malina; Vasileva, Lidia; Rasheva, Maximka; Bojinova, Rumiana

Securing psychological supervision, consultations and help during long lasting flights is vital condition for success. That's why, knowing in details consumers (clients) attitude toward virtual psychology services is essential. Knowledge gained during nowadays studies on Earth will definitely help in the preparation for the future. The presentation focuses on results of a longitudinal survey assessing clients' attitudes toward e-psychology service. The first part of the survey was performed in spring 2006, while the second - in 2008. The study is part of an ongoing project OHN 1514/2005, funded by National Science Fund, Bulgaria. Project's strategic goal is to develop and offer a virtual high quality psychological service to people from remotes areas that have no contact with licensed psychologist. The project enables experts to communicate directly with clients and perform remote consultations, supervision, etc. The objective of this presentation is to report changes and trends in clients' attitude towards innovative virtual psychology care. Both parts of the survey involved men and women between 19 and 70 year, who defend various opinions on the application of virtual technologies for healthcare. The sample is stratifies for age, gender, education level.

Cognitive Processing Therapy for Spanish-speaking Latinos: A formative study of a model-driven cultural adaptation of the manual to enhance implementation in a usual care setting

PubMed Central

Valentine, Sarah E.; Borba, Christina P. C.; Dixon, Louise; Vaewsorn, Adin S.; Guajardo, Julia Gallegos; Resick, Patricia A.; Wiltsey-Stirman, Shannon; Marques, Luana

2016-01-01

Objective As part of a larger implementation trial for Cognitive Processing Therapy (CPT) for posttraumatic stress disorder (PTSD) in a community health center, we used formative evaluation to assess relations between iterative cultural adaption (for Spanish-speaking clients) and implementation outcomes (appropriateness & acceptability) for CPT. Method Qualitative data for the current study were gathered through multiple sources (providers: N=6; clients: N=22), including CPT therapy sessions, provider field notes, weekly consultation team meetings, and researcher field notes. Findings from conventional and directed content analysis of the data informed refinements to the CPT manual. Results Data-driven refinements included adaptations related to cultural context (i.e., language, regional variation in wording), urban context (e.g., crime/violence), and literacy level. Qualitative findings suggest improved appropriateness and acceptability of CPT for Spanish-speaking clients. Conclusion Our study reinforces the need for dual application of cultural adaptation and implementation science to address the PTSD treatment needs of Spanish-speaking clients. PMID:27378013

Case Management Ethics: High Professional Standards for Health Care's Interconnected Worlds.

PubMed

Sminkey, Patrice V; LeDoux, Jeannie

2016-01-01

The purpose of this discussion is to draw attention to the considerable pressure on professional case managers today to coordinate with multiple stakeholders, with responsibilities that put them at the forefront of contact with payers and providers. This discussion raises awareness of how case managers, and board-certified case managers in particular, must demonstrate that they adhere to the highest ethical standards, as codified by the Commission for Case Manager Certification's Code of Professional Conduct for Case Managers. This discussion applies to case management practices and work settings across the full continuum of health care. As advocates for clients (individuals receiving case management services) and their families/support systems, case managers must adhere to the highest of ethical and professional standards. The Code of Professional Conduct for Case Managers is an indispensable resource for case managers to ensure that they place the public interest above their own, respect the rights and inherent dignity of clients, maintain objectivity in their relationships with clients, and act with integrity and fidelity with clients and others, as stipulated by the code.

A Probabilistic Software System Attribute Acceptance Paradigm for COTS Software Evaluation

NASA Technical Reports Server (NTRS)

Morris, A. Terry

2005-01-01

Standard software requirement formats are written from top-down perspectives only, that is, from an ideal notion of a client s needs. Despite the exactness of the standard format, software and system errors in designed systems have abounded. Bad and inadequate requirements have resulted in cost overruns, schedule slips and lost profitability. Commercial off-the-shelf (COTS) software components are even more troublesome than designed systems because they are often provided as is and subsequently delivered with unsubstantiated validation of described capabilities. For COTS software, there needs to be a way to express the client s software needs in a consistent and formal manner using software system attributes derived from software quality standards. Additionally, the format needs to be amenable to software evaluation processes that integrate observable evidence garnered from historical data. This paper presents a paradigm that effectively bridges the gap between what a client desires (top-down) and what has been demonstrated (bottom-up) for COTS software evaluation. The paradigm addresses the specification of needs before the software evaluation is performed and can be used to increase the shared understanding between clients and software evaluators about what is required and what is technically possible.

An Evaluation of an Occupational Health Advice Service

ERIC Educational Resources Information Center

Shearn, P.; Ford, Norma J.; Murphy, R. G.

2010-01-01

Objective: The objective of this article is to identify the profile of service users of an occupational health (OH) support service and establish areas of need, and to gather client feedback on the experience of participating in the support service and perceived outcomes and the impact of the advice received. Design and Setting: We carried out…

Combined Oral Contraceptive Pills: Profile of Acceptors in a Tertiary Hospital in South-South Nigeria.

PubMed

Abasiattai, A M; Utuk, M N; Ojeh, S O; Eyo, U E

2011-01-01

BACKGROUND: Combined oral contraceptive pills were the first contraceptive method to provide sexual freedom of choice for women through reliable, personal and private control of fertility. They are the most widely used hormonal contraceptives and also the most popular non-surgical method of contraception. OBJECTIVE: To review the profile of acceptors of combined oral contraceptive pills at the University of Uyo Teaching Hospital, Uyo. METHODOLOGY: An 8 year review of all clients that accepted combined oral contraceptive pills in the family planning clinic. RESULTS: There were 1,146 new contraceptive acceptors during the period of study out of which 309 (27.9%) accepted the pills. Majority of the clients were between 20 and 29 years of age (54.0%), were multiparous (72.8%), Christians (99.7%) and 61.2% had tertiary level education. Two hundred and fifty-five women (82.5%) desired to use combined oral contraceptive pills to space births while 7.8% wanted to limit child bearing. There was a high discontinuation rate among the women (45.0%) and out of these 87.9% of the clients changed to other contraceptive methods. All the clients commenced their pills within seven days of menstruation and only the low dose monophasic preparations were available in the family planning unit and thus were given to the clients. CONCLUSION: Women who accept to initiate combined oral contraceptive pills in our center are young, well educated, multiparous women who want to space their pregnancies. However, due to the high discontinuation rate among the clients, there is need for further studies evaluating reasons for the high discontinuation rate, exploring interactions between clients and providers' and also providers' attitude towards combined pills in our environment.

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

PubMed

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

2015-04-01

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

Costs along the service cascades for HIV testing and counselling and prevention of mother-to-child transmission

PubMed Central

Bautista-Arredondo, Sergio; Sosa-Rubí, Sandra G.; Opuni, Marjorie; Contreras-Loya, David; Kwan, Ada; Chaumont, Claire; Chompolola, Abson; Condo, Jeanine; Galárraga, Omar; Martinson, Neil; Masiye, Felix; Nsanzimana, Sabin; Ochoa-Moreno, Ivan; Wamai, Richard; Wang’ombe, Joseph

2016-01-01

Objective: We estimate facility-level average annual costs per client along the HIV testing and counselling (HTC) and prevention of mother-to-child transmission (PMTCT) service cascades. Design: Data collected covered the period 2011–2012 in 230 HTC and 212 PMTCT facilities in Kenya, Rwanda, South Africa, and Zambia. Methods: Input quantities and unit prices were collected, as were output data. Annual economic costs were estimated from the service providers’ perspective using micro-costing. Average annual costs per client in 2013 United States dollars (US$) were estimated along the service cascades. Results: For HTC, average cost per client tested ranged from US$5 (SD US$7) in Rwanda to US$31 (SD US$24) in South Africa, whereas average cost per client diagnosed as HIV-positive ranged from US$122 (SD US$119) in Zambia to US$1367 (SD US$2093) in Rwanda. For PMTCT, average cost per client tested ranged from US$18 (SD US$20) in Rwanda to US$89 (SD US$56) in South Africa; average cost per client diagnosed as HIV-positive ranged from US$567 (SD US$417) in Zambia to US$2021 (SD US$3210) in Rwanda; average cost per client on antiretroviral prophylaxis ranged from US$704 (SD US$610) in South Africa to US$2314 (SD US$3204) in Rwanda; and average cost per infant on nevirapine ranged from US$888 (SD US$884) in South Africa to US$2359 (SD US$3257) in Rwanda. Conclusion: We found important differences in unit costs along the HTC and PMTCT service cascades within and between countries suggesting that more efficient delivery of these services is possible. PMID:27753679

Systematic plan of building Web geographic information system based on ActiveX control

NASA Astrophysics Data System (ADS)

Zhang, Xia; Li, Deren; Zhu, Xinyan; Chen, Nengcheng

2003-03-01

A systematic plan of building Web Geographic Information System (WebGIS) using ActiveX technology is proposed in this paper. In the proposed plan, ActiveX control technology is adopted in building client-side application, and two different schemas are introduced to implement communication between controls in users¡ browser and middle application server. One is based on Distribute Component Object Model (DCOM), the other is based on socket. In the former schema, middle service application is developed as a DCOM object that communicates with ActiveX control through Object Remote Procedure Call (ORPC) and accesses data in GIS Data Server through Open Database Connectivity (ODBC). In the latter, middle service application is developed using Java language. It communicates with ActiveX control through socket based on TCP/IP and accesses data in GIS Data Server through Java Database Connectivity (JDBC). The first one is usually developed using C/C++, and it is difficult to develop and deploy. The second one is relatively easy to develop, but its performance of data transfer relies on Web bandwidth. A sample application is developed using the latter schema. It is proved that the performance of the sample application is better than that of some other WebGIS applications in some degree.

Impact of the Urban Reproductive Health Initiative on family planning uptake at facilities in Kenya, Nigeria, and Senegal.

PubMed

Winston, Jennifer; Calhoun, Lisa M; Corroon, Meghan; Guilkey, David; Speizer, Ilene

2018-01-05

The 2012 London Summit on Family Planning set ambitious goals to enable 120 million more women and adolescent girls to use modern contraceptives by 2020. The Urban Reproductive Health Initiative (URHI) was a Bill & Melinda Gates Foundation funded program designed to help contribute to these goals in urban areas in India, Kenya, Nigeria, and Senegal. URHI implemented a range of country-specific demand and supply side interventions, with supply interventions generally focused on improved service quality, provider training, outreach to patients, and commodity stock management. This study uses data collected by the Measurement, Learning & Evaluation (MLE) Project to examine the effectiveness of these supply-side interventions by considering URHI's influence on the number of family planning clients at health facilities over a four-year period in Kenya, Nigeria, and Senegal. The analysis used facility audits and provider surveys. Principal-components analysis was used to create country-specific program exposure variables for health facilities. Fixed-effects regression was used to determine whether family planning uptake increased at facilities with higher exposure. Outcomes of interest were the number of new family planning acceptors and the total number of family planning clients per reproductive health care provider in the last year. Higher program component scores were associated with an increase in new family planning acceptors per provider in Kenya (β = 18, 95% CI = 7-29), Nigeria (β = 14, 95% CI = 8-20), and Senegal (β = 7, 95% CI = 3-12). Higher scores were also associated with more family planning clients per provider in Kenya (β = 31, 95% CI = 7-56) and Nigeria (β = 26, 95% CI = 15-38), but not in Senegal. Supply-side interventions have increased the number of new family planning acceptors at facilities in urban Nigeria, Kenya, and Senegal and the overall number of clients in urban Nigeria and Kenya. While tailoring to the local environment, programs seeking to increase family planning use should include components to improve availability and quality of family planning services, which are part of a rights-based approach to family planning programming.

Occupational health of home care aides: results of the safe home care survey

PubMed Central

Quinn, Margaret M; Markkanen, Pia K; Galligan, Catherine J; Sama, Susan R; Kriebel, David; Gore, Rebecca J; Brouillette, Natalie M; Okyere, Daniel; Sun, Chuan; Punnett, Laura; Laramie, Angela K; Davis, Letitia

2016-01-01

Objectives In countries with ageing populations, home care (HC) aides are among the fastest growing jobs. There are few quantitative studies of HC occupational safety and health (OSH) conditions. The objectives of this study were to: (1) assess quantitatively the OSH hazards and benefits for a wide range of HC working conditions, and (2) compare OSH experiences of HC aides who are employed via different medical and social services systems in Massachusetts, USA. Methods HC aides were recruited for a survey via agencies that employ aides and schedule their visits with clients, and through a labour union of aides employed directly by clients or their families. The questionnaire included detailed questions about the most recent HC visits, as well as about individual aides’ OSH experiences. Results The study population included 1249 HC aides (634 agency-employed, 615 client-employed) contributing information on 3484 HC visits. Hazards occurring most frequently related to musculoskeletal strain, exposure to potentially infectious agents and cleaning chemicals for infection prevention and experience of violence. Client-hired and agency-hired aides had similar OSH experiences with a few exceptions, including use of sharps and experience of verbal violence. Conclusions The OSH experience of HC aides is similar to that of aides in institutional healthcare settings. Despite OSH challenges, HC aides enjoy caring for others and the benefits of HC work should be enhanced. Quantification of HC hazards and benefits is useful to prioritise resources for the development of preventive interventions and to provide an evidence base for policy-setting. PMID:26209318

The development of a healing model of care for an Indigenous drug and alcohol residential rehabilitation service: a community-based participatory research approach.

PubMed

Munro, Alice; Shakeshaft, Anthony; Clifford, Anton

2017-12-04

Given the well-established evidence of disproportionately high rates of substance-related morbidity and mortality after release from incarceration for Indigenous Australians, access to comprehensive, effective and culturally safe residential rehabilitation treatment will likely assist in reducing recidivism to both prison and substance dependence for this population. In the absence of methodologically rigorous evidence, the delivery of Indigenous drug and alcohol residential rehabilitation services vary widely, and divergent views exist regarding the appropriateness and efficacy of different potential treatment components. One way to increase the methodological quality of evaluations of Indigenous residential rehabilitation services is to develop partnerships with researchers to better align models of care with the client's, and the community's, needs. An emerging research paradigm to guide the development of high quality evidence through a number of sequential steps that equitably involves services, stakeholders and researchers is community-based participatory research (CBPR). The purpose of this study is to articulate an Indigenous drug and alcohol residential rehabilitation service model of care, developed in collaboration between clients, service providers and researchers using a CBPR approach. This research adopted a mixed methods CBPR approach to triangulate collected data to inform the development of a model of care for a remote Indigenous drug and alcohol residential rehabilitation service. Four iterative CBPR steps of research activity were recorded during the 3-year research partnership. As a direct outcome of the CBPR framework, the service and researchers co-designed a Healing Model of Care that comprises six core treatment components, three core organisational components and is articulated in two program logics. The program logics were designed to specifically align each component and outcome with the mechanism of change for the client or organisation to improve data collection and program evaluation. The description of the CBPR process and the Healing Model of Care provides one possible solution about how to provide better care for the large and growing population of Indigenous people with substance.

Is forced migration a barrier to treatment success? Similar HIV treatment outcomes among refugees and a surrounding host community in Kuala Lumpur, Malaysia.

PubMed

Mendelsohn, Joshua B; Schilperoord, Marian; Spiegel, Paul; Balasundaram, Susheela; Radhakrishnan, Anuradha; Lee, Christopher K C; Larke, Natasha; Grant, Alison D; Sondorp, Egbert; Ross, David A

2014-02-01

In response to an absence of studies among refugees and host communities accessing highly active antiretroviral therapy (HAART) in urban settings, our objective was to compare adherence and virological outcomes among clients attending a public clinic in Kuala Lumpur, Malaysia. A cross-sectional survey was conducted among adult clients (≥18 years). Data sources included a structured questionnaire that measured self-reported adherence, a pharmacy-based measure of HAART prescription refills over the previous 24 months, and HIV viral loads. The primary outcome was unsuppressed viral load (≥40 copies/mL). Among a sample of 153 refugees and 148 host community clients, refugees were younger (median age 35 [interquartile range, IQR 31, 39] vs 40 years [IQR 35, 48], p < 0.001), more likely to be female (36 vs 21 %, p = 0.004), and to have been on HAART for less time (61 [IQR 35, 108] vs 153 weeks [IQR 63, 298]; p < 0.001). Among all clients, similar proportions of refugee and host clients were <95 % adherent to pharmacy refills (26 vs 34 %, p = 0.15). When restricting to clients on treatment for ≥25 weeks, similar proportions from each group were not virologically suppressed (19 % of refugees vs 16 % of host clients, p = 0.54). Refugee status was not independently associated with the outcome (adjusted odds ratio, aOR = 1.28, 95 % CI 0.52, 3.14). Overall, the proportions of refugee and host community clients with unsuppressed viral loads and sub-optimal adherence were similar, supporting the idea that refugees in protracted asylum situations are able to sustain good treatment outcomes and should explicitly be included in the HIV strategic plans of host countries with a view to expanding access in accordance with national guidelines for HAART.

Criminalisation of clients: reproducing vulnerabilities for violence and poor health among street-based sex workers in Canada—a qualitative study

PubMed Central

Krüsi, A; Pacey, K; Bird, L; Taylor, C; Chettiar, J; Allan, S; Bennett, D; Montaner, J S; Kerr, T; Shannon, K

2014-01-01

Objectives To explore how criminalisation and policing of sex buyers (clients) rather than sex workers shapes sex workers’ working conditions and sexual transactions including risk of violence and HIV/sexually transmitted infections (STIs). Design Qualitative and ethnographic study triangulated with sex work-related violence prevalence data and publicly available police statistics. Setting Vancouver, Canada, provides a unique opportunity to evaluate the impact of policies that criminalise clients as the local police department adopted a sex work enforcement policy in January 2013 that prioritises sex workers’ safety over arrest, while continuing to target clients. Participants 26 cisgender and 5 transgender women who were street-based sex workers (n=31) participated in semistructured interviews about their working conditions. All had exchanged sex for money in the previous 30 days in Vancouver. Outcome measures Thematic analysis of interview transcripts and ethnographic field notes focused on how police enforcement of clients shaped sex workers’ working conditions and sexual transactions, including risk of violence and HIV/STIs, over an 11-month period postpolicy implementation (January–November 2013). Results Sex workers’ narratives and ethnographic observations indicated that while police sustained a high level of visibility, they eased charging or arresting sex workers and showed increased concern for their safety. However, participants’ accounts and police statistics indicated continued police enforcement of clients. This profoundly impacted the safety strategies sex workers employed. Sex workers continued to mistrust police, had to rush screening clients and were displaced to outlying areas with increased risks of violence, including being forced to engage in unprotected sex. Conclusions These findings suggest that criminalisation and policing strategies that target clients reproduce the harms created by the criminalisation of sex work, in particular, vulnerability to violence and HIV/STIs. The current findings support decriminalisation of sex work to ensure work conditions that support the health and safety of sex workers in Canada and globally. PMID:24889853

Needs assessment for home-based care and the strengthening of social support networks: the role of community care workers in rural South Africa

PubMed Central

Moshabela, Mosa; Sips, Ilona; Barten, Francoise

2015-01-01

Background Community care workers (CCWs) in rural South Africa provide medical, personal, household, educational, and social care services to their clients. However, little understanding exists on how provision of services is approached within a household, taking into account available social support networks. Objective The aim of this study was to generate an understanding of the processes that underpin the provision of care by CCWs in rural households and their engagement with clients, primary caregivers (PCGs), and other members of the social support network. Design We analysed in-depth interviews conducted in a triad of participants involved in a home-based care (HBC) encounter – 32 clients, 32 PCGs, and 17 CCWs. For each triad, a purposefully selected CCW was linked with a purposefully selected client and the corresponding PCG using maximum variation sampling. Three coders used an inductive content analysis method to describe participants’ references to the nuances of processes followed by CCWs in servicing HBC clients. Written informed consent was obtained from all participants. Findings The results suggest that, by intuition and prior knowledge, CCWs treated each household uniquely, depending on the clients’ care needs, cooperation, availability of a social network, and the reliability and resilience of the social support system for the client. Four distinct processes took place in rural households: needs assessment for care, rationing of care, appraisal of care, and reinforcement of a social support system. However, there was no particular order or sequence established for these processes, and caregivers followed no prescribed or shared standards. Conclusions CCWs bring a basket of services to a household, but engage in a constant, dynamic, and cyclical process of weighing needs against services provided. The service package is uniquely crafted and tailored for each household, depending on the absorptive capacity of the social support network available to the client, and preferences of the clients remain central to the process of negotiating care. PMID:26689459

Exploring the characteristics of nursing agencies in South Africa

PubMed Central

Olojede, Omolola I.; Rispel, Laetitia C.

2015-01-01

Background Nursing agencies are temporary employment service providers or labour brokers that supply nurses to health establishments. Objective This study was conducted to determine the characteristics of nursing agencies and their relationship with clients in the health sector. Methods During 2011, a cross-sectional national survey of 106 nursing agencies was conducted. After obtaining informed consent, telephone interviews were conducted with a representative of the selected nursing agency using a pretested structured questionnaire. Questions focused on the following: ownership, date of establishment, province of operation, distribution of clients across private and public health facilities; existence of a code of conduct; nature of the contractual relationship between nursing agencies and their clients, and numbers and cadres of nurses contracted. The survey data were analysed using STATA® 12. Results Fifty-two nursing agencies participated in the survey, representing a 49% response rate. The study found that 32 nursing agencies (62%) served private-sector clients only, which included private hospitals, homes for elderly people, patients in private homes, and private industry/company clinics, and only four (8%) of the agencies served the public sector only. Twenty-seven percent of nursing agencies provided services to homes for elderly individuals. Nursing agencies were more likely to have contracts with private-sector clients (84%) than with public-sector clients (16%) (p = 0.04). Although 98% of nursing agencies reported that they had a code of conduct, the proportion was higher for private-sector clients (73%) compared to public-sector clients (27%). In terms of quality checks and monitoring, 81% of agencies agreed with a statement that they checked the nursing council registration of nurses, 82% agreed with a statement that they requested certified copies of a nurse's qualifications. Only 21% indicated that they conducted reference checks of nurses with their past employers. Conclusions Nursing agencies should enhance their quality assurance mechanisms when engaging contracted staff. Overall, the study findings suggest the need for improved governance and management of nursing agencies in South Africa. PMID:25971401

An Introduction to Proposed Human Sexuality Counseling Competencies

ERIC Educational Resources Information Center

Zeglin, Robert J.; Van Dam, Dorothy; Hergenrather, Kenneth C.

2018-01-01

The presentation of human sexuality information within counselor education programs seems inconsistent, leaving counselors typically underprepared to handle the sexuality-related components of many clients' distress. Addressing this gap, the present article, using guidance from the American Association of Sexuality Educators, Counselors, and…

Spatial Information Processing: Standards-Based Open Source Visualization Technology

NASA Astrophysics Data System (ADS)

Hogan, P.

2009-12-01

. Spatial information intelligence is a global issue that will increasingly affect our ability to survive as a species. Collectively we must better appreciate the complex relationships that make life on Earth possible. Providing spatial information in its native context can accelerate our ability to process that information. To maximize this ability to process information, three basic elements are required: data delivery (server technology), data access (client technology), and data processing (information intelligence). NASA World Wind provides open source client and server technologies based on open standards. The possibilities for data processing and data sharing are enhanced by this inclusive infrastructure for geographic information. It is interesting that this open source and open standards approach, unfettered by proprietary constraints, simultaneously provides for entirely proprietary use of this same technology. 1. WHY WORLD WIND? NASA World Wind began as a single program with specific functionality, to deliver NASA content. But as the possibilities for virtual globe technology became more apparent, we found that while enabling a new class of information technology, we were also getting in the way. Researchers, developers and even users expressed their desire for World Wind functionality in ways that would service their specific needs. They want it in their web pages. They want to add their own features. They want to manage their own data. They told us that only with this kind of flexibility, could their objectives and the potential for this technology be truly realized. World Wind client technology is a set of development tools, a software development kit (SDK) that allows a software engineer to create applications requiring geographic visualization technology. 2. MODULAR COMPONENTRY Accelerated evolution of a technology requires that the essential elements of that technology be modular components such that each can advance independent of the other elements. World Wind therefore changed its mission from providing a single information browser to enabling a whole class of 3D geographic applications. Instead of creating a single program, World Wind is a suite of components that can be selectively used in any number of programs. World Wind technology can be a part of any application, or it can be a window in a web page. Or it can be extended with additional functionalities by application and web developers. World Wind makes it possible to include virtual globe visualization and server technology in support of any objective. The world community can continually benefit from advances made in the technology by NASA in concert with the world community. 3. OPEN SOURCE AND OPEN STANDARDS NASA World Wind is NASA Open Source software. This means that the source code is fully accessible for anyone to freely use, even in association with proprietary technology. Imagery and other data provided by the World Wind servers reside in the public domain, including the data server technology itself. This allows others to deliver their own geospatial data and to provide custom solutions based on users specific needs.

Enhancing the Rehabilitation of Persons with Long-Term Mental Illness. [Proceedings of the] Institute on Rehabilitation Issues (15th, Tampa, Florida, December 1988). Report from the Study Group.

ERIC Educational Resources Information Center

Cato, Carol; And Others

This report from a study group on long-term mental illness (LTMI) examines three components of the vocational rehabilitation process (the client, the counselor, and the programs) and the systems through which the three components interact. The first chapter discusses the history and evolution of the vocational rehabilitation (VR) and mental health…

[A telemedicine electrocardiography system based on the component-architecture soft].

PubMed

Potapov, I V; Selishchev, S V

2004-01-01

The paper deals with a universal component-oriented architecture for creating the telemedicine applications. The worked-out system ensures the ECG reading, pressure measurements and pulsometry. The system design comprises a central database server and a client telemedicine module. Data can be transmitted via different interfaces--from an ordinary local network to digital satellite phones. The data protection is guaranteed by microchip charts that were used to realize the authentication 3DES algorithm.

yourSky: Custom Sky-Image Mosaics via the Internet

NASA Technical Reports Server (NTRS)

Jacob, Joseph

2003-01-01

yourSky (http://yourSky.jpl.nasa.gov) is a computer program that supplies custom astronomical image mosaics of sky regions specified by requesters using client computers connected to the Internet. [yourSky is an upgraded version of the software reported in Software for Generating Mosaics of Astronomical Images (NPO-21121), NASA Tech Briefs, Vol. 25, No. 4 (April 2001), page 16a.] A requester no longer has to engage in the tedious process of determining what subset of images is needed, nor even to know how the images are indexed in image archives. Instead, in response to a requester s specification of the size and location of the sky area, (and optionally of the desired set and type of data, resolution, coordinate system, projection, and image format), yourSky automatically retrieves the component image data from archives totaling tens of terabytes stored on computer tape and disk drives at multiple sites and assembles the component images into a mosaic image by use of a high-performance parallel code. yourSky runs on the server computer where the mosaics are assembled. Because yourSky includes a Web-interface component, no special client software is needed: ordinary Web browser software is sufficient.

75 FR 61144 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-04

... design includes both client-level outcomes and process evaluation components. The purpose of the outcome... assessment). Child Data Collection Tool (all children; descriptive biopsychosocial measure). Children's...--Detailed Annual Burden for All Interviews & Surveys Number of Interviews and surveys Respondent respondents...

Communication and Cultural Change in University Technology Transfer

ERIC Educational Resources Information Center

Wright, David

2013-01-01

Faculty culture and communication networks are pivotal components of technology transfer on university campuses. Universities are focused upon diffusing technology to external clients and upon building structure and support systems to enhance technology transfer. However, engaging faculty members in technology transfer requires an internal…

The Impact on Clients of a Community-Based Infant Mortality Reduction Program: The National Healthy Start Program Survey of Postpartum Women

PubMed Central

McCormick, Marie C.; Deal, Lisa W.; Devaney, Barbara L.; Chu, Dexter; Moreno, Lorenzo; Raykovich, Karen T.

2001-01-01

Objectives. This study assessed the effect of the national Healthy Start Program on its clients. Methods. We used a cross-sectional survey of a sample from Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) rosters of women less than 6 months postpartum who were residents of Healthy Start Program areas. Results. Healthy Start clients revealed higher sociodemographic risk, but not behavioral risk, for adverse pregnancy outcome than other area residents. They did not differ from other residents in receipt of services except for a greater likelihood of receiving case management, using birth control at the time of the interview, and rating their prenatal care more highly. Conclusions. The Healthy Start Program succeeded in enrolling women at high risk. It had little effect on the immediately concluded pregnancy, but it might influence future outcomes. PMID:11726379

Sustained health home visiting can improve families' social support and community connectedness.

PubMed

Stubbs, Joanne M; Achat, Helen M

2016-01-01

Home visiting (HV) is a strategy used internationally to address the multiple needs of infants and families at risk of suboptimal health and developmental outcomes. Describe nursing interventions and program achievements of a pilot HV program for families living in a highly disadvantaged outer suburb of Sydney, New South Wales, Australia. A family partnership model was adopted. Follow-up is reported for 65 of the 75 clients remaining in the program for at least 6 months. Nurses most commonly provided clients with emotional support, information about health and well-being and information on infant development. Clients experienced noteworthy improvements consistent with key objectives - greater access to support services, and increased self-efficacy and social networks. Consistent with the growing body of international literature on the achievements of HV, HV programs can empower vulnerable families to better cope with daily life demands and their family.

Enhancing nursing students' clinical experiences using aesthetics.

PubMed

Northington, Ladonna; Wilkerson, Robin; Fisher, Wanda; Schenk, Laura

2005-01-01

Traditional nursing education is based strongly in empiric knowledge. However, just as important as empiric knowledge is aesthetic knowledge. Nursing involves multiple ways of knowing, and as such, educational institutions have a responsibility to assist students in gaining knowledge in nontraditonal ways. This article describes an assignment implemented in a pediatric course in a baccalaureate nursing program. Books and movies were used in a an undergraduate nursing course to help students gain insight into illness and disability from the client and family perspective. The students in the course were required to reflect on the meaning of the movie/book and the influence the book/movie had on the student. Based on student responses, this assignment was successful in meeting the objectives originally proposed. The books and movies provided a beginning introduction to, and an appreciation for, client and family experiences. Students were helped to understand illness, abuse, disability, and/or death from the client and/or family perspective.

“Live Chat” Clients at Kids Help Phone: Individual Characteristics and Problem Topics

PubMed Central

Haner, Dilys; Pepler, Debra

2016-01-01

Objective Young people in Canada prefer to use the Internet over face-to-face contact when seeking help for problems of daily living and mental health problems. Kids Help Phone (KHP) provides on-demand, anonymous help to young people via telephone and Live Chat technologies. Methods Two hundred thirty-two phone clients and 230 Live Chat clients responded to a questionnaire at this otherwise anonymous service, providing previously inaccessible data about their individual characteristics and characterizations of the problems for which they sought help. Results There was a larger proportion of weighty problems (mental health and suicide) among chatters than callers. There were also more non-heterosexual youth, and those who identified as Asian and Black African or Caribbean, using Live Chat than phone. Conclusions Implications for training Live Chat counsellors to respond effectively to chatters are discussed. PMID:27924143

A Four-Component Model of Sexual Orientation & Its Application to Psychotherapy.

PubMed

Bowins, Brad

Distress related to sexual orientation is a common focus in psychotherapy. In some instances the distress is external in nature as with persecution, and in others it is internal as with self-acceptance issues. Complicating matters, sexual orientation is a very complex topic producing a great deal of confusion for both clients and therapists. The current paper provides a four component model-sexual orientation dimensions, activation of these dimensions, the role of erotic fantasy, and social construction of sexual orientation-that in combination provide a comprehensive perspective. Activation of dimensions is a novel contribution not proposed in any other model. With improved understanding of sexual orientation issues, and utilization of this knowledge to guide interventions, psychotherapists can improve outcomes with their clients. Also described is how dimensions of sexual orientation relate to transgender. In addition to improving psychotherapy outcomes, the fourcomponent model presented can help reduce discrimination and persecution, by demonstrating that the capacity for both homoerotic and heteroerotic behavior is universal.

Client Functional Assessment Data as Management Information: Woodrow Wilson Rehabilitation Center's Management Information System

PubMed Central

Steidle, Ernest F.

1983-01-01

This paper describes the design of a functional assessment system, a component of a management information system (MIS) that supports a comprehensive rehabilitation facility. Products of the subsystem document the functional status of rehabilitation clients through process evaluation reporting and outcomes reporting. The purpose of this paper is to describe the design of this MIS component. The environment supported, the integration requirements and the needed development approach is unique, requiring significant input from health care professionals, medical informatics specialists, statisticians and program evaluators. Strategies for the implementation of the functional assessment system are the major results reported in this paper. They are most useful to the systems designer or management engineer in a human service delivery setting. MIS plan development, computer file structure and access methods, and approaches to scheduling applications is described. Finally, the development of functional status measures is discussed. Application of the methodologies described will facilitate similar efforts towards systems development in other human service delivery settings.

Making the Undergraduate Classroom into a Policy Think Tank: Reflections from a Field Methods Class

ERIC Educational Resources Information Center

Broughton, Chad

2011-01-01

This article examines the opportunities and limitations presented by organizing an undergraduate field research methods class as a policy think tank working for a government client. Organized as such, the course had both the learning objectives of a traditional undergraduate methods class and the corporate objectives of a policy think tank (i.e.,…

Testing the Suitability of Mediation of Child Support Orders in Title IV-D Cases

ERIC Educational Resources Information Center

Schraufnagel, Scot; Li, Quan

2010-01-01

Objectives: The purpose of this study is to test mediation versus a traditional court process for the establishment or modification of child support orders. The intention is to determine which dispute resolution process is associated with greater client satisfaction and compliance. An auxiliary objective is to test the type of cases which are most…

Creating connections to life during life-threatening illness: Creative activity experienced by elderly people and occupational therapists

PubMed Central

la Cour, Karen; Josephsson, Staffan; Luborsky, Mark

2014-01-01

Objective The aim of this study was to discover and characterize components of engagement in creative activity as occupational therapy for elderly people dealing with life-threatening illness, from the perspective of both clients and therapists. Despite a long tradition of use in clinical interventions, key questions remain little addressed concerning how and why people seek these activities and the kinds of benefits that may result. Method Qualitative interviews were conducted with 8 clients and 7 therapists participating in creative workshops using crafts at a nursing home in Sweden. Analysis of the interviews was conducted using a constant comparative method. Findings Engaging in creative activity served as a medium that enabled creation of connections to wider culture and daily life that counters consequences of terminal illness, such as isolation. Creating connections to life was depicted as the core category, carried out in reference to three subcategories: (1) a generous receptive environment identified as the foundation for engaging in creative activity; (2) unfolding creations—an evolving process; (3) reaching beyond for possible meaning horizons. Conclusion The findings suggest that the domain of creative activity can enable the creation of connections to daily life and enlarge the experience of self as an active person, in the face of uncertain life-threatening illness. Ultimately, the features that participants specify can be used to refine and substantiate the use of creative activities in intervention and general healthcare. PMID:16389735

Cooperative multisensor system for real-time face detection and tracking in uncontrolled conditions

NASA Astrophysics Data System (ADS)

Marchesotti, Luca; Piva, Stefano; Turolla, Andrea; Minetti, Deborah; Regazzoni, Carlo S.

2005-03-01

The presented work describes an innovative architecture for multi-sensor distributed video surveillance applications. The aim of the system is to track moving objects in outdoor environments with a cooperative strategy exploiting two video cameras. The system also exhibits the capacity of focusing its attention on the faces of detected pedestrians collecting snapshot frames of face images, by segmenting and tracking them over time at different resolution. The system is designed to employ two video cameras in a cooperative client/server structure: the first camera monitors the entire area of interest and detects the moving objects using change detection techniques. The detected objects are tracked over time and their position is indicated on a map representing the monitored area. The objects" coordinates are sent to the server sensor in order to point its zooming optics towards the moving object. The second camera tracks the objects at high resolution. As well as the client camera, this sensor is calibrated and the position of the object detected on the image plane reference system is translated in its coordinates referred to the same area map. In the map common reference system, data fusion techniques are applied to achieve a more precise and robust estimation of the objects" track and to perform face detection and tracking. The work novelties and strength reside in the cooperative multi-sensor approach, in the high resolution long distance tracking and in the automatic collection of biometric data such as a person face clip for recognition purposes.

Differences between U.S. substance abuse treatment facilities that do and do not offer domestic violence services.

PubMed

Cohn, Amy; Najavits, Lisa M

2014-04-01

Victimization by and perpetration of domestic violence are associated with co-occurring mental and substance use disorders. This study used data from the National Survey of Substance Abuse Treatment Services to examine differences in organizational factors, treatment approaches offered, and client-level factors among 13,342 substance abuse treatment facilities by whether or not they offered domestic violence services. Only 36% of the facilities offered domestic violence services. Those that offered such services were more likely than those that did not to treat clients with co-occurring disorders. Principal-components analysis reduced eight treatment approaches to two factors: psychosocial services and traditional substance abuse services. Regression models indicated that the frequency with which psychosocial services were offered depended on the percentage of clients with co-occurring disorders who were being treated in the facility and whether or not that facility offered domestic violence services. Specifically, facilities that did not offer domestic violence services and that had a high percentage of clients with co-occurring disorders were more likely to offer psychosocial services than facilities that offered domestic violence services. A larger proportion of facilities offering domestic violence services offered traditional substance abuse treatment services, compared with facilities not offering domestic violence services, but this relationship was not contingent on the percentage of clients with co-occurring disorders at each facility. Improved efforts should be made to tailor treatments to accommodate the links between domestic violence, mental disorders, and substance abuse.

Responding to cough presentations: an interview study with Cambodian pharmacies participating in a National Tuberculosis Referral Program.

PubMed

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

2016-04-01

Asia-Pacific carries a high burden of respiratory-related mortality. Timely referral and detection of tuberculosis cases optimizes patient and public health outcomes. Registered private pharmacies in Cambodia participate in a National Tuberculosis Referral Program to refer clients with cough suggestive of tuberculosis to public sector clinics for diagnosis and care. The objective of this study was to investigate clinical intentions of pharmacy staff when presented with a hypothetical case of a client with prolonged cough suggestive of tuberculosis. A random sample of 180 pharmacies was selected. Trained interviewers administered a hypothetical case scenario to trained pharmacy staff. Participants provided 'yes'/'no' responses to five clinical actions presented in the scenario. Actions were not mutually exclusive. Data were tabulated and compared using chi-square tests or Fisher's exact tests. Overall, 156 (92%) participants would have referred the symptomatic client in the case scenario. Participants who would have referred the client were less likely to sell a cough medicine (42% vs. 100%, P < 0.001) and less likely to sell an antibiotic (19% vs. 79%, P < 0.001) than those who would not have referred the client. Involving pharmacies in a Referral Program may have introduced concepts of appropriate clinical care when responding to clients presenting with cough suggestive of tuberculosis. However, results showed enhancing clinical competence among all referral programme participants particularly among non-referring pharmacies and those making concurrent sales of cough-related products would optimize pharmacy-initiated referral. Further research into actual clinical practices at Referral Program pharmacies would be justified. © 2015 John Wiley & Sons, Ltd.

Social pressure, coercion, and client engagement at treatment entry: a self-determination theory perspective.

PubMed

Wild, T Cameron; Cunningham, John A; Ryan, Richard M

2006-10-01

Research on coercion in addiction treatment typically investigates objective sources of social pressure among legally mandated clients. Little research has examined the impact of clients' perceptions of social pressures in generalist addiction services. Clients seeking substance abuse treatment (N=300; 221 males and 79 females; M age=36.6 years) rated the extent to which treatment was being sought because of coercive social pressures (external motivation; alpha=.89), guilt about continued substance abuse (introjected motivation; alpha=.84), or a personal choice and commitment to the goals of the program (identified motivation; alpha=.85). External treatment motivation was positively correlated with legal referral, social network pressures to enter treatment, and was inversely related to problem severity. In contrast, identified treatment motivation was positively correlated with self-referral and problem severity, and was inversely related to perceived coercion (ps<.05). Hierarchical multiple regression analyses showed that referral source (i.e., mandated treatment status), legal history, and social network pressures did not predict any of 6 measures of client engagement at the time treatment was sought. However, treatment motivation variables accounted for unique variance in these outcomes when added to each model (DeltaR(2)s=.06-.23, ps<.05). Specifically, identified treatment motivation predicted perceived benefits of reducing substance use, attempts to reduce drinking and drug use, as well as self (and therapist) ratings of interest in the upcoming treatment episode (betas=.18-.31, ps<.05). Results suggest that the presence of legal referral and/or social network pressures to quit, cut down, and/or enter treatment does not affect client engagement at treatment entry.

Who cares for involuntary clients?

PubMed

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

2009-01-01

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

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

PubMed Central

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

2002-01-01

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

Injection Drug Use, Sexual Risk, Violence, and STI/HIV among Moscow FSWs

PubMed Central

Decker, Michele R.; Wirtz, Andrea L.; Baral, Stefan D.; Peryshkina, Alena; Mogilnyi, Vladmir; Weber, Rachel A.; Stachowiak, Julie; Go, Vivian; Beyrer, Chris

2013-01-01

Background/objectives The HIV prevalence in Eastern Europe and Central Asia continues to increase. While injection drug use (IDU) is leading factor, heterosexual transmission is on the rise. Little is known about female sex workers (FSWs) in the region despite the central role of commercial sex in heterosexual STI/HIV transmission globally. We evaluated the prevalence of STI/HIV among Moscow-based FSWs, and potential risk factors including IDU, sexual risks, and violence victimization. Methods Moscow-based FSWs (n=147) completed a clinic-based survey and STI/HIV testing over an eight month period in 2005. Results HIV prevalence was 4.8%, and 31.3% were infected with at least one STI including HIV. Sexual behaviors significantly associated with STI/HIV included anal sex (AOR 3.48), high client volume (three or more clients daily, AOR 2.71), recent subbotnik (sex demanded by police; AOR 2.50), and regularly being presented with more clients than initially agreed to (AOR 2.45). Past year experiences of physical violence from clients and threats of violence from pimps were associated with STI/HIV (AOR 3.14; AOR 3.65 respectively). IDU was not significantly associated with STI/HIV. Anal sex and high client volume partially mediated the associations of abuse with STI/HIV. Conclusion Findings illustrate substantial potential for heterosexual STI/HIV transmission in a setting better known for IDU-related risk. Many of the STI/HIV risks observed are not modifiable by FSWs alone. STI/HIV prevention efforts for this vulnerable population will benefit from reducing coercion and abuse perpetrated by pimps and clients. PMID:22287530

Flexible software architecture for user-interface and machine control in laboratory automation.

PubMed

Arutunian, E B; Meldrum, D R; Friedman, N A; Moody, S E

1998-10-01

We describe a modular, layered software architecture for automated laboratory instruments. The design consists of a sophisticated user interface, a machine controller and multiple individual hardware subsystems, each interacting through a client-server architecture built entirely on top of open Internet standards. In our implementation, the user-interface components are built as Java applets that are downloaded from a server integrated into the machine controller. The user-interface client can thereby provide laboratory personnel with a familiar environment for experiment design through a standard World Wide Web browser. Data management and security are seamlessly integrated at the machine-controller layer using QNX, a real-time operating system. This layer also controls hardware subsystems through a second client-server interface. This architecture has proven flexible and relatively easy to implement and allows users to operate laboratory automation instruments remotely through an Internet connection. The software architecture was implemented and demonstrated on the Acapella, an automated fluid-sample-processing system that is under development at the University of Washington.

Bio-inspired diversity for increasing attacker workload

NASA Astrophysics Data System (ADS)

Kuhn, Stephen

2014-05-01

Much of the traffic in modern computer networks is conducted between clients and servers, rather than client-toclient. As a result, servers represent a high-value target for collection and analysis of network traffic. As they reside at a single network location (i.e. IP/MAC address) for long periods of time. Servers present a static target for surveillance, and a unique opportunity to observe the network traffic. Although servers present a heightened value for attackers, the security community as a whole has shifted more towards protecting clients in recent years leaving a gap in coverage. In addition, servers typically remain active on networks for years, potentially decades. This paper builds on previous work that demonstrated a proof of concept leveraging existing technology for increasing attacker workload. Here we present our clean slate approach to increasing attacker workload through a novel hypervisor and micro-kernel, utilizing next generation virtualization technology to create synthetic diversity of the server's presence including the hardware components.

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

PubMed

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

2016-12-01

The objective of this study was to investigate factors affecting the intention of Registered Dietitians (RDs) to discuss nutrigenetics with their patients/clients. A survey based on the theory of planned behaviour (TPB; attitude, subjective norm, and perceived behavioural control) was developed and sent by email to RD members of the Ordre professionnel des diététistes du Québec. Multiple regression analyses were performed to examine the determinants of intention and behaviour. A total of 141 RDs completed the questionnaire (5.8% response rate). On a scale from -2 to 2 (from strongly disagree to strongly agree), the intention of discussing nutrigenetics with patients/clients was neutral (mean of -0.07 ± 0.92). The TPB construct of attitude was the most strongly associated with intention (β = 0.66, P < 0.0001) followed by perceived behavioural control (β = 0.33, P < 0.0001) and subjective norm (β = 0.21, P = 0.03). Finally, 13 out of 141 RDs (~9%) actually practiced the behaviour, which was to have discussed nutrigenetics with their patients/clients in the last 3 months. Only perceived behavioural control contributed to explain the behaviour (β = 0.17, P < 0.0001). Main determinants of the intention of RDs to discuss nutrigenetics with their patients/clients were determined. This knowledge will help inform the design of future educational content about nutrigenetics.

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

Semantics Desensitization: A Paradigmatic Intervention Approach to Anxiety Disorders.

ERIC Educational Resources Information Center

Hekmat, Hamid; And Others

1984-01-01

Assigned speech-anxious clients (N=30) to one of the following treatment conditions: (1) semantic desensitization; (2) attention placebo and (3) waiting list control. Results indicated that semantic desensitization therapy reduced both the affective and behavioral components of anxiety as compared to the two controls. (LLL)

Reasoning about Function Objects

NASA Astrophysics Data System (ADS)

Nordio, Martin; Calcagno, Cristiano; Meyer, Bertrand; Müller, Peter; Tschannen, Julian

Modern object-oriented languages support higher-order implementations through function objects such as delegates in C#, agents in Eiffel, or closures in Scala. Function objects bring a new level of abstraction to the object-oriented programming model, and require a comparable extension to specification and verification techniques. We introduce a verification methodology that extends function objects with auxiliary side-effect free (pure) methods to model logical artifacts: preconditions, postconditions and modifies clauses. These pure methods can be used to specify client code abstractly, that is, independently from specific instantiations of the function objects. To demonstrate the feasibility of our approach, we have implemented an automatic prover, which verifies several non-trivial examples.

Method for Statically Checking an Object-oriented Computer Program Module

NASA Technical Reports Server (NTRS)

Bierhoff, Kevin M. (Inventor); Aldrich, Jonathan (Inventor)

2012-01-01

A method for statically checking an object-oriented computer program module includes the step of identifying objects within a computer program module, at least one of the objects having a plurality of references thereto, possibly from multiple clients. A discipline of permissions is imposed on the objects identified within the computer program module. The permissions enable tracking, from among a discrete set of changeable states, a subset of states each object might be in. A determination is made regarding whether the imposed permissions are violated by a potential reference to any of the identified objects. The results of the determination are output to a user.

The power of information and contraceptive choice in a family planning setting in Mexico

PubMed Central

Ponce, E; Sloan, N; Winikoff, B; Langer, A; Coggins, C; Heimburger, A; Conde-Glez, C; Salmeron, J

2000-01-01

Objectives: This study measured the effect of information about family planning methods and STD risk factors and prevention, together with personal choice on the selection of intrauterine devices (IUDs) by clients with cervical infection. Methods: We conducted a randomised, controlled trial in which family planning clients were assigned to one of two groups, the standard practice (control) group in which the provider selected the woman's contraceptive and the information and choice (intervention) group. The study enrolled 2107 clients in a family planning clinic in Mexico City. Results: Only 2.1% of the clients had gonorrhoea or chlamydial infections. Significantly fewer women in the intervention group selected the IUD than the proportion for whom the IUD was recommended in the standard care group by clinicians (58.2% v 88.2%, p=0.0000). The difference was even more pronounced among infected women: 47.8% v 93.2% (intervention v control group, p=0.0006). Conclusions: The intervention increased the selection of condoms and reduced the selection of IUDs, especially among women with cervical infections, for whom IUD insertion is contraindicated. Key Words: reproductive health; sexually transmitted diseases; contraception PMID:11026883

Development of Heat Shock Protein (Hsp90) Inhibitors To Combat Resistance to Tyrosine Kinase Inhibitors through Hsp90-Kinase Interactions.

PubMed

Wang, Meining; Shen, Aijun; Zhang, Chi; Song, Zilan; Ai, Jing; Liu, Hongchun; Sun, Liping; Ding, Jian; Geng, Meiyu; Zhang, Ao

2016-06-23

Heat shock protein 90 (Hsp90) is a ubiquitous chaperone of all of the oncogenic tyrosine kinases. Many Hsp90 inhibitors, alone or in combination, have shown significant antitumor efficacy against the kinase-positive naïve and mutant models. However, clinical trials of these inhibitors are unsuccessful due to insufficient clinical benefits and nonoptimal safety profiles. Recently, much progress has been reported on the Hsp90-cochaperone-client complex, which will undoubtedly assist in the understanding of the interactions between Hsp90 and its clients. Meanwhile, Hsp90 inhibitors have shown promise against patients' resistance caused by early generation tyrosine kinase inhibitors (TKIs), and at least 13 Hsp90 inhibitors are being reevaluated in the clinic. In this regard, the objectives of the current perspective are to summarize the structure and function of the Hsp90-cochaperone-client complex, to analyze the structural and functional insights into the Hsp90-client interactions to address several existing unresolved problems with Hsp90 inhibitors, and to highlight the preclinical and clinical studies of Hsp90 inhibitors as an effective treatment against resistance to tyrosine kinase inhibitors.

Causative factors of cost overrun in highway projects of Sindh province of Pakistan

NASA Astrophysics Data System (ADS)

Sohu, S.; Halid, A.; Nagapan, S.; Fattah, A.; Latif, I.; Ullah, K.

2017-11-01

Cost overrun is an increase of cost of project from approved budget which was signed by parties at the time of tender. Cost overrun in construction of highway projects is a common problem worldwide and construction industry of Pakistan is also facing this crucial problem of cost overrun in highway projects of Pakistan. The main objective of this research is to identify the causative factors of cost overrun in highway projects of Sindh province of Pakistan. A well designed questionnaire was developed based on 64 common factors of cost overrun from literature review. Developed questionnaire was distributed among selected 30 experts from owner/client, designer/consultant and contractor who have experience more than 20 years’ experience in highway projects. The collected data was statistical analyzed. After analysis results showed that delay process in payment by client, inadequate planning, client interference, poor contract management, delay of decision making, change of scope of project and financial problems faced by client were most causative factors of cost overrun in highway projects. This research will provide alertness to stakeholders of highway projects of Sindh province to avoid cost overrun in projects.

Developing CORBA-Based Distributed Scientific Applications From Legacy Fortran Programs

NASA Technical Reports Server (NTRS)

Sang, Janche; Kim, Chan; Lopez, Isaac

2000-01-01

An efficient methodology is presented for integrating legacy applications written in Fortran into a distributed object framework. Issues and strategies regarding the conversion and decomposition of Fortran codes into Common Object Request Broker Architecture (CORBA) objects are discussed. Fortran codes are modified as little as possible as they are decomposed into modules and wrapped as objects. A new conversion tool takes the Fortran application as input and generates the C/C++ header file and Interface Definition Language (IDL) file. In addition, the performance of the client server computing is evaluated.

JobCenter: an open source, cross-platform, and distributed job queue management system optimized for scalability and versatility.

PubMed

Jaschob, Daniel; Riffle, Michael

2012-07-30

Laboratories engaged in computational biology or bioinformatics frequently need to run lengthy, multistep, and user-driven computational jobs. Each job can tie up a computer for a few minutes to several days, and many laboratories lack the expertise or resources to build and maintain a dedicated computer cluster. JobCenter is a client-server application and framework for job management and distributed job execution. The client and server components are both written in Java and are cross-platform and relatively easy to install. All communication with the server is client-driven, which allows worker nodes to run anywhere (even behind external firewalls or "in the cloud") and provides inherent load balancing. Adding a worker node to the worker pool is as simple as dropping the JobCenter client files onto any computer and performing basic configuration, which provides tremendous ease-of-use, flexibility, and limitless horizontal scalability. Each worker installation may be independently configured, including the types of jobs it is able to run. Executed jobs may be written in any language and may include multistep workflows. JobCenter is a versatile and scalable distributed job management system that allows laboratories to very efficiently distribute all computational work among available resources. JobCenter is freely available at http://code.google.com/p/jobcenter/.

Defining the doula's role: fostering relational autonomy.

PubMed

Meadow, Sandra L

2015-12-01

Training organizations as well as academic and popular literature provide ambiguous or ethically contentious characterizations of the role of the birth doula, a non-clinical role assisting women in pregnancy and birth with information and physical and emotional support. Doulas have been criticized for attempting to impose their own agendas on their clients and for interfering with the relationship between women and their medical caregivers. To develop a theoretically grounded model of the birth doula's role to guide constructive practice and refute some training organizations' and doulas' adoption of an active 'advocacy' role with clients that can lead to inappropriate practices. Apply the theoretical framework of relational autonomy to the components of the work that doulas perform with their clients. The conceptual framework of relational autonomy recognizes the social context in which women make choices about their care in pregnancy and birth, instead of assuming that autonomy is exercised in isolation. To support this understanding of autonomy, a relational model emphasizes women's skills development, self-confidence and recognition of the social context for decisions. Highlighting these aspects of exercising autonomy reduces the potential for the doula to seek to influence her client. The doula's role is reframed as one of facilitating patient engagement and shared decision-making. © 2014 John Wiley & Sons Ltd.

Recreating Family: Parents Identify Worker-Client Relationships as Paramount in Family Preservation Programs

ERIC Educational Resources Information Center

Gockel, Annemarie; Russell, Mary; Harris, Barbara

2008-01-01

Although existing family preservation program research has focused on identifying the components of effective treatment, we remain far from fully developing empirically supported interventions (Barth, Chamberlain, Reid, Rolls, Hurlburt, Farmer, James, McCabe, & Kohl, 2005; Dufour, Chamberland, & Trocme, 2003). The current longitudinal study…

Process Evaluation for a Prison-based Substance Abuse Program.

ERIC Educational Resources Information Center

Staton, Michele; Leukefeld, Carl; Logan, T. K.; Purvis, Rick

2000-01-01

Presents findings from a process evaluation conducted in a prison-based substance abuse program in Kentucky. Discusses key components in the program, including a detailed program description, modifications in planned treatment strategies, program documentation, and perspectives of staff and clients. Findings suggest that prison-based programs have…

Project Rehabilitation: A Program Serving Clients Recovering from Substance Dependency.

ERIC Educational Resources Information Center

Weitzman, Kay; Glynn, Lorraine

1987-01-01

Describes a cooperative program between Rockland Community College and the Rockland County Community Mental Health Center (New York) that introduced education and retraining into the final stages of the rehabilitation process for individuals with a history of drug and substance abuse. Discusses program components, budgetary considerations, and…

A Survey of Psychological Assessment Feedback Practices

ERIC Educational Resources Information Center

Smith, Steven R.; Wiggins, Chauntel M.; Gorske, Tad T.

2007-01-01

There have been no previous studies on how often psychologists conduct feedback and whether they view this practice as a useful component of assessment. To explore psychologists' feedback practices and their perception of the effects of feedback on their clients, the authors examined survey data from 719 psychologist members of the International…

An Exploration of Service Delivery in India.

ERIC Educational Resources Information Center

McClam, Tricia; Woodside, Marianne

2000-01-01

Discusses visits to five social service agencies in Mumbai, India and interviews with human service providers and clients to better understand Indian human service delivery and its societal context. Identifies three Indian service delivery strategies to enrich teaching and add a global component to the curriculum: advocacy, the use of…

Enhancing Reflective Practice in Multicultural Counseling through Cultural Auditing

ERIC Educational Resources Information Center

Collins, Sandra; Arthur, Nancy; Wong-Wylie, Gina

2010-01-01

Counselors work in an increasingly complex cultural milieu where every encounter with a client must be considered multicultural in nature. Reflective practice is a central component of professional competence and necessarily involves attention to culture. The cultural auditing model provides an effective and flexible reflective process for…

Personalization in Academic Advising: A Case Study of Components and Structure

ERIC Educational Resources Information Center

Smith, Michael Robert

2005-01-01

Purpose: The primary purpose of this study was to provide a blueprint and framework for how academic advisors and other educational professionals can create personalized relationships with student clients. Past research has shown that students' desire personalized relationships with academic personnel; however, little research exists on exactly…

Mediation Analysis of Mode Deactivation Therapy (Reanalysis and Interpretation)

ERIC Educational Resources Information Center

Bass, Christopher K.; Apsche, Jack A.

2013-01-01

A key component of Mode Deactivation Therapy (MDT) is the development of self-awareness and regulatory skills by the client with the aim of helping adolescent males with conduct disordered behaviors, including sexually inappropriate behaviors and emotional dysregulation. The goal includes altering specific behaviors to fall within socially…

Benefit–Cost in the California Treatment Outcome Project: Does Substance Abuse Treatment “Pay for Itself”?

PubMed Central

Ettner, Susan L; Huang, David; Evans, Elizabeth; Rose Ash, Danielle; Hardy, Mary; Jourabchi, Mickel; Hser, Yih-Ing

2006-01-01

Objective To examine costs and monetary benefits associated with substance abuse treatment. Data Sources Primary and administrative data on client outcomes and agency costs from 43 substance abuse treatment providers in 13 counties in California during 2000–2001. Study Design Using a social planner perspective, the estimated direct cost of treatment was compared with the associated monetary benefits, including the client's costs of medical care, mental health services, criminal activity, earnings, and (from the government's perspective) transfer program payments. The cost of the client's substance abuse treatment episode was estimated by multiplying the number of days that the client spent in each treatment modality by the estimated average per diem cost of that modality. Monetary benefits associated with treatment were estimated using a pre–posttreatment admission study design, i.e., each client served as his or her own control. Data Collection Treatment cost data were collected from providers using the Drug Abuse Treatment Cost Analysis Program instrument. For the main sample of 2,567 clients, information on medical hospitalizations, emergency room visits, earnings, and transfer payments was obtained from baseline and 9-month follow-up interviews, and linked to information on inpatient and outpatient mental health services use and criminal activity from administrative databases. Sensitivity analyses examined administrative data outcomes for a larger cohort (N=6,545) and longer time period (1 year). Principal Findings On average, substance abuse treatment costs $1,583 and is associated with a monetary benefit to society of $11,487, representing a greater than 7:1 ratio of benefits to costs. These benefits were primarily because of reduced costs of crime and increased employment earnings. Conclusions Even without considering the direct value to clients of improved health and quality of life, allocating taxpayer dollars to substance abuse treatment may be a wise investment. PMID:16430607

Modis, SeaWIFS, and Pathfinder funded activities

NASA Technical Reports Server (NTRS)

Evans, Robert H.

1995-01-01

MODIS (Moderate Resolution Imaging Spectrometer), SeaWIFS (Sea-viewing Wide Field Sensor), Pathfinder, and DSP (Digital Signal Processor) objectives are summarized. An overview of current progress is given for the automatic processing database, client/server status, matchup database, and DSP support.

Existential Assessment

ERIC Educational Resources Information Center

Dana, Richard H.; Leech, Shirley

1974-01-01

Present psychological assessment stems from a philosophy of science that values objectivity but fails to comprehend the existence of the person being evaluated. A humanistic-existential model shifts the focus from omnipotence to encounter and encourages client responsibility. Some pertinent assessment issues are formulated and specific instruments…

Websites for the busy primary care practitioner.

PubMed

Wall, Alison

2007-01-01

The author, a practising health visitor, recommends some relevant and reliable websites for health professionals needing information. The internet is increasingly used by health professionals and clients. Health professionals need to be able to obtain information quickly to keep well informed, but need to be discerning about the likely reliability of the information they receive from websites. They should take care, particularly when looking at websites on prescribing, to check that the information is accurate and up to date. They should also be aware that clients may be receiving misinformation if they rely on internet sources that are not well balanced, objective or research-based.

Beyond where it started: a look at the "Healing Images" experience.

PubMed

Goodsmith, Lauren

2007-01-01

In March 2004, the Baltimore-based nonprofit organization Advocates for Survivors of Torture and Trauma (ASTT) initiated a photography-based therapeutic programme for clients. Developed by a professional photographer/teacher in collaboration with a psychologist, the programme has the goal of enabling clients to engage in creative self-exploration within a supportive, group setting. Since its inception, thirty survivors of conflict-related trauma and torture from five different countries have taken part in the programme, known as "Healing Images", using digital cameras to gather individually-chosen images that are subsequently shared and discussed within the group. These images include depictions of the natural and manmade environments in which clients find themselves; people, places and objects that offer comfort; and self-portraits that reflect the reality of the life of a refugee in the United States. This description of the "Healing Images" programme is based on comments gathered through discussion with participants and through interviews. Additional information was gathered from observation of early workshop sessions, review of numerous client photographs and captions, and pertinent organizational materials. A fundamental benefit of the programme was that it offered a mutually supportive group environment that diminished clients' feelings of psychological and physical isolation. Participants gained deep satisfaction from learning the technical skills related to use of the cameras, from the empowering experience of framing and creating specific images, and from exploring the personal significance of these images. Programme activities sparked a process of self-expression that participants valued on the level of personal discovery and growth. Some clients also welcomed opportunities to share their work publicly, as a means of raising awareness of the experience of survivors.

Meeting the contraceptive needs of teens and young adults: youth-friendly and long-acting reversible contraceptive services in U.S. family planning facilities.

PubMed

Kavanaugh, Megan L; Jerman, Jenna; Ethier, Kathleen; Moskosky, Susan

2013-03-01

Increased use of contraceptive services, including long-acting reversible contraceptives (LARCs), among sexually active teens and young adults could significantly reduce unintended pregnancy. Objectives were to describe youth-friendly contraceptive services (including LARC) available to teens and young adults at U.S. publicly funded family planning facilities. Between April and September 2011, center directors at a nationally representative sample of 1,196 U.S. publicly funded family planning facilities were surveyed to assess accessibility and provision of contraceptive services for teens and young adults; 584 (52%) responded. Facilities were accessible to young clients in several ways, including not requiring scheduled appointments for method refills (67%) and having flexible hours (64%). Most facilities provided outreach and/or education to young people (70%), and 27% used social network media to do this. Most facilities took steps to ensure confidentiality for young clients. These youth-friendly practices were more common at Planned Parenthood, Title X, and reproductive health focused facilities than at other facilities. Long-acting reversible contraceptive methods were regularly discussed with younger clients at less than half the facilities. Youth-friendly sites had increased rates of LARC provision among younger clients. The most common challenges to providing contraceptive and LARC services to younger clients were the costs of LARC methods (60%), inconvenient clinic hours (51%), staff concerns about intrauterine device (IUD) use among teens (47%), and limited training on implant insertion (47%). Improving the ability of family planning facilities to provide youth-friendly contraceptive and LARC-specific methods to younger clients may increase the use of highly effective contraception in this population. Copyright © 2013 Society for Adolescent Health and Medicine. All rights reserved.

Therapist and client predictors of use of therapy techniques within the context of implementation efforts in a large public mental health system

PubMed Central

Wolk, Courtney Benjamin; Marcus, Steven C.; Weersing, V. Robin; Hawley, Kristin M.; Evans, Arthur; Hurford, Matthew; Beidas, Rinad

2016-01-01

Objective Many youth receiving community mental health treatment do not receive evidence-based interventions. Research suggests that community mental health therapists use a broad range of therapeutic techniques at low intensities. The present study examined the relationship between therapist- and client-level predictors on community-based therapists’ report of cognitive, behavioral, psychodynamic, and family techniques within the context of implementation efforts. Methods One hundred thirty therapists from 23 organizations in an urban publicly funded behavioral health system implementing evidence-based practices participated. Therapist-level predictors included age, gender, clinical experience, licensure status, and participation in evidence-based practice initiatives. Child-level predictors included therapist-reported child primary disorder (i.e., externalizing, internalizing, or other) and child age. Therapists completed the Therapist Procedures Checklist- Family Revised, a self-report measure of therapeutic techniques used. Results Unlicensed therapists were more likely to report use of both psychodynamic and behavioral techniques. Therapists who did not participate in an evidence-based practice initiative were less likely to report use of cognitive techniques. Those with externalizing clients were more likely to report use of behavioral and family techniques. Therapists with the youngest clients (aged 3-7) were most likely to report use of behavioral techniques and less likely to report use of cognitive and psychodynamic techniques. Conclusions Results suggest that both therapist and client factors predict self-reported use of therapy techniques. Participating in an evidence-based practice initiative increased report of cognitive techniques. Therapists reported using more behavioral and family techniques for youth with externalizing disorders and fewer cognitive and psychodynamic techniques with young clients. PMID:26876658

[Study on HIV-1 subtype among elderly male clients and female sex workers of low-cost venues in Guangxi Zhuang Autonomous Region, China].

PubMed

Deng, Y Q; Li, J J; Fang, N Y; Wang, B; Wang, J W; Liang, S S; Shen, Z Y; Lan, G H; Zhang, H M; Wu, X H; Lu, H X; Ge, X M

2017-03-10

Objective: To understand HIV-1 subtype characteristics and transmission clusters in elderly male clients and female sex workers (FSWs) of low-cost commercial sex venues in Guangxi Zhuang Autonomous Region, China. Methods: A cross sectional survey was conducted in FSWs and elderly male clients (≥50 years) of low-cost commercial sex venues in 4 cities and 9 counties in Guangxi Zhuang Autonomous Region by convenient sampling in 2012. The blood sample was collected from each case for HIV-1 antibody detection. The pol gene fragments were amplified and sequenced from viral RNA template extracted from plasma samples. The phylogenetic tree was constructed and the subtypes were identified. Results: A total of 4 048 elderly male clients and 784 FSWs were surveyed, and 116 HIV-1 infections were detected, the positive rate was 2.5% (103/4 048) in the clients and 1.7% (13/784) in FSWs. The gene amplification and sequencing of HIV-1 detected in 84 blood samples indicated that 53 pol gene sequences were successfully determined (48 blood samples from elderly male clients and 5 blood samples from FSWs). Among 53 pol sequences, 48(90.6% ), 4(7.5% ), and 1(1.9% ) sequences were identified as CRF01_AE, CRF08_BC, and CRF07_BC, respectively. Two transmission clusters were identified among CRF01_AE, including 4 sub-clusters. One transmission cluster was identified among CRF08_BC. The transmission cluster or sub-cluster were from the infected individuals at same low-cost commercial sex venue, or different low-cost commercial sex venues in the same town, or same place, or adjacent villages and towns. Conclusions: CRF01_AE was the predominant HIV-1 subtype among elderly male clients and FSWs of low-cost commercial sex venues in Guangxi Zhuang Autonomous Region, circulating in same venue or adjacent villages and towns. The HIV-1 positive male clients and FSWs might play an important role in the spread of the strains.

Creating integrative work: a qualitative study of how massage therapists work with existing clients.

PubMed

Fortune, Luann Drolc; Hymel, Glenn M

2015-01-01

As one of the most often used complementary treatments, massage is increasingly positioned as an essential component of integrative medicine. Recent studies evaluate the clinical efficacy of massage therapy, but few studies explore how massage therapists (MTs) execute their work and exercise clinical reasoning in natural settings. To gain foundational knowledge about clinical reasoning and applied knowledge, this study examined how 10 MTs executed an entire session with established clients. Results support translational research design and inform educators. Ethnomethodology and phenomenology informed the qualitative design. Data were collected by videotaping actual sessions and interviewing the participants immediately afterward while viewing the videos. Computer-aided analysis identified data patterns for thematic interpretation. The MTs shared tacit knowledge that directed their work: a) maintaining a primarily biomechanical focus, b) prerequisite safe touch, c) multitasking not allowed, d) MTs assume physical risk, and e) the work affects multiple bodily systems. The MTs sensed effectiveness experientially by adopting common tactics: a) visualizing the manual engagement points, b) assuming the client controlled the physiological release, and c) educating the client. Within these commonalities, they operationalized their work in complex and singular ways, with the particular client relationship critical to structuring the session and evaluating the outcome. MTs viewed their work primarily as a biomechanical intervention, but understood therapeutic massage as serving multiple functions. Process-oriented clinical reasoning mirrored models found in psychotherapy and was informed by experience, intuition, and training, which resulted in an intentionally holistic approach. Copyright © 2014 Elsevier Ltd. All rights reserved.

Real Time Monitor of Grid job executions

NASA Astrophysics Data System (ADS)

Colling, D. J.; Martyniak, J.; McGough, A. S.; Křenek, A.; Sitera, J.; Mulač, M.; Dvořák, F.

2010-04-01

In this paper we describe the architecture and operation of the Real Time Monitor (RTM), developed by the Grid team in the HEP group at Imperial College London. This is arguably the most popular dissemination tool within the EGEE [1] Grid. Having been used, on many occasions including GridFest and LHC inauguration events held at CERN in October 2008. The RTM gathers information from EGEE sites hosting Logging and Bookkeeping (LB) services. Information is cached locally at a dedicated server at Imperial College London and made available for clients to use in near real time. The system consists of three main components: the RTM server, enquirer and an apache Web Server which is queried by clients. The RTM server queries the LB servers at fixed time intervals, collecting job related information and storing this in a local database. Job related data includes not only job state (i.e. Scheduled, Waiting, Running or Done) along with timing information but also other attributes such as Virtual Organization and Computing Element (CE) queue - if known. The job data stored in the RTM database is read by the enquirer every minute and converted to an XML format which is stored on a Web Server. This decouples the RTM server database from the client removing the bottleneck problem caused by many clients simultaneously accessing the database. This information can be visualized through either a 2D or 3D Java based client with live job data either being overlaid on to a 2 dimensional map of the world or rendered in 3 dimensions over a globe map using OpenGL.

Intentions and experiences of effective practice in mental health specific supported accommodation services: a qualitative interview study.

PubMed

Sandhu, Sima; Priebe, Stefan; Leavey, Gerard; Harrison, Isobel; Krotofil, Joanna; McPherson, Peter; Dowling, Sarah; Arbuthnott, Maurice; Curtis, Sarah; King, Michael; Shepherd, Geoff; Killaspy, Helen

2017-07-11

Deinstitutionalisation in Europe has led to the development of community-based accommodation for people with mental health problems. The type, setting, and intensity of support provided vary and the costs are substantial. Yet, despite the large investment in these services, there is little clarity on their aims and outcomes or how they are regarded by staff and the clients. We interviewed 30 staff and 30 clients from the three main types of supported accommodation in England (residential care, supported housing, floating outreach) to explore their perspectives on the purpose of these services, and the components of care considered most helpful. The interviews were coded and analysed using thematic analysis. There were generally consistent understandings amongst clients and staff across service types on the goals and purposes of supported accommodation services as: building independence and confidence; supporting people with their mental health; and providing safety and stability. We also noted a competing theme of anxiety about the continuity of support when clients move on from a service. Themes on the experience of what aided effective practice centred on: the supportive presence of others; incremental steps to progress; working together to avoid deskilling and dependency; feeling known and personally understood; tailoring support for social and community engagement; and building confidence through encouragement. The findings provide an understanding of the commonalities in service approach, and goals of clients in these services, as well as the facilitators of goal attainment. However, they also highlight a common tension between providing safe and supportive living environments, whilst also promoting independence and facilitating rehabilitative change.

Evaluation of primary care midwifery in the Netherlands: design and rationale of a dynamic cohort study (DELIVER)

PubMed Central

2012-01-01

Background In the Netherlands, midwives are autonomous medical practitioners and 78% of pregnant women start their maternity care with a primary care midwife. Scientific research to support evidence-based practice in primary care midwifery in the Netherlands has been sparse. This paper describes the research design and methodology of the multicenter multidisciplinary prospective DELIVER study which is the first large-scale study evaluating the quality and provision of primary midwifery care. Methods/Design Between September 2009 and April 2011, data were collected from clients and their partners, midwives and other healthcare professionals across the Netherlands. Clients from twenty midwifery practices received up to three questionnaires to assess the expectations and experiences of clients (e.g. quality of care, prenatal screening, emotions, health, and lifestyle). These client data were linked to data from the Netherlands Perinatal Register and electronic client records kept by midwives. Midwives and practice assistants from the twenty participating practices recorded work-related activities in a diary for one week, to assess workload. Besides, the midwives were asked to complete a questionnaire, to gain insight into collaboration of midwives with other care providers, their tasks and attitude towards their job, and the quality of the care they provide. Another questionnaire was sent to all Dutch midwifery practices which reveals information regarding the organisation of midwifery practices, provision of preconception care, collaboration with other care providers, and provision of care to ethnic minorities. Data at client, midwife and practice level can be linked. Additionally, partners of pregnant women and other care providers were asked about their expectations and experiences regarding the care delivered by midwives and in six practices client consults were videotaped to objectively assess daily practice. Discussion In total, 7685 clients completed at least one questionnaire, 136 midwives and assistants completed a diary with work-related activities (response 100%), 99 midwives completed a questionnaire (92%), and 319 practices across the country completed a questionnaire (61%), 30 partners of clients participated in focus groups, 21 other care providers were interviewed and 305 consults at six midwifery practices were videotaped. The multicenter DELIVER study provides an extensive database with national representative data on the quality of primary care midwifery in the Netherlands. This study will support evidence-based practice in primary care midwifery in the Netherlands and contribute to a better understanding of the maternity care system. PMID:22433820

Perceptions about HIV and condoms and consistent condom use among male clients of commercial sex workers in the Philippines.

PubMed

Regan, Rotrease; Morisky, Donald E

2013-04-01

Because consistent condom use is an effective strategy in the prevention of sexually transmitted infections and HIV transmission, it is important to examine social cognitive influences of consistent condom use not only among female sex workers (FSWs) but also among their male clients, for whom less is known. Because little is known about how HIV knowledge and condom attitudes affect condom use among male clients of FSWs in the Philippines, the main objective was to determine what characteristics (age, education, HIV knowledge, marital status) as well as attributes taken from protection motivation theory (perceived vulnerability, perceived severity, response efficacy) are significantly associated with consistent condom use among male clients of FSWs. Logistic regression analyses showed that the odds of using condoms consistently with an FSW are 13% higher for those with more years of education (adjusted odds ratio [AOR] = 1.13; 95% confidence interval [CI] = 1.03, 1.23), higher versus lower perception of severity of HIV/AIDS (AOR = 1.97; 95% CI = 1.04, 3.73), and had a higher score for response efficacy of condoms (AOR = 1.14; 95% CI = 1.03, 1.27). Future HIV/AIDS prevention interventions that address condom use among male clients should promote educational attainment and focus on awareness of the enduring negative health consequences of acquiring HIV/AIDS, as well as cultivate positive attitudes toward the efficacy of condom use, using creative social marketing strategies.

Early Evidence from California on Transitions to a Reformed Health Insurance System for Persons Living With HIV/AIDS

PubMed Central

Leibowitz, Arleen A.; Lester, Robbie; Curtis, Philip G.; Farrell, Kevin; Fox, Aaron; Klipp, Luke H.; Wise, Jason

2014-01-01

Background Many uninsured people living with HIV/AIDS (PLWHA) will obtain managed health insurance coverage when the Affordable Care Act (ACA) is implemented in January 2014. Since 2011, California has transitioned PLWHA to Medicaid managed care (MMC) and to the Low Income Health Program (LIHP). Objectives To draw lessons for the ACA implementation from the transitions into MMC and the LIHP. Methods Surveys about clients and services provided before and after the transition to MMC and the LIHP were sent to 43 HIV service providers. Usable responses were obtained from 18 (42%). Results Although total client loads were similar in the pre- (January 2011) and post- transition periods (June 2012), many clients transitioned from fee-for-service (FFS) Medicaid to MMC. Over this period, responding agencies served 43.5% fewer PLWHA in FFS Medicaid while the share of PLWHA covered by MMC rose from 16.9% to 55.5%. Managed care covered a smaller number of services than either FFS Medicaid or Ryan White sites. Ryan White providers reported that 53% of the clients they served in January 2011 had transitioned to the LIHPs. Nonetheless, they continued to provide services to many of these clients and Ryan White cases loads did not decline. Conclusions PLWHA enrolled in Medicaid managed care continue to depend on Ryan White sites to supply the full range of services that will allow them to take full advantage of increased access to care under ACA. PMID:24126449

Dynamic Reconfiguration of a RGBD Sensor Based on QoS and QoC Requirements in Distributed Systems.

PubMed

Munera, Eduardo; Poza-Lujan, Jose-Luis; Posadas-Yagüe, Juan-Luis; Simó-Ten, José-Enrique; Noguera, Juan Fco Blanes

2015-07-24

The inclusion of embedded sensors into a networked system provides useful information for many applications. A Distributed Control System (DCS) is one of the clearest examples where processing and communications are constrained by the client's requirements and the capacity of the system. An embedded sensor with advanced processing and communications capabilities supplies high level information, abstracting from the data acquisition process and objects recognition mechanisms. The implementation of an embedded sensor/actuator as a Smart Resource permits clients to access sensor information through distributed network services. Smart resources can offer sensor services as well as computing, communications and peripheral access by implementing a self-aware based adaptation mechanism which adapts the execution profile to the context. On the other hand, information integrity must be ensured when computing processes are dynamically adapted. Therefore, the processing must be adapted to perform tasks in a certain lapse of time but always ensuring a minimum process quality. In the same way, communications must try to reduce the data traffic without excluding relevant information. The main objective of the paper is to present a dynamic configuration mechanism to adapt the sensor processing and communication to the client's requirements in the DCS. This paper describes an implementation of a smart resource based on a Red, Green, Blue, and Depth (RGBD) sensor in order to test the dynamic configuration mechanism presented.

Metaphors as Nudges toward Understanding in Mental Health Counseling.

ERIC Educational Resources Information Center

Hendrix, Dennis H.

1992-01-01

Discusses use of metaphors in mental health counseling. Presents examples of metaphors that are concrete and that use objects and situations familiar to clients so that the properties of the metaphorical items are known. Elaborations of metaphors are provided for readers. (NB)

Social franchising and vouchers to promote long-term methods of family planning in rural Pakistan: a qualitative stocktaking with stakeholders.

PubMed

Azmat, Syed Khurram; Mustafa, Ghulam; Hameed, Waqas; Asghar, Jamshaid; Ahmed, Aftab; Shaikh, Babar T

2013-04-01

The overall use of modern contraception in Pakistan is quite low, especially in rural areas. Several studies have demonstrated the effectiveness of social franchising (SF) approaches in increasing access to modern contraception and improving the quality of healthcare in resource-poor areas in Asia and Africa. Drawing on best practices in SF, the Marie Stopes Society (MSS) implemented an SF model in certain rural areas of Pakistan to increase access to affordable and quality family planning (FP) services. The model was branded as Suraj (sun) and complemented with an innovative voucher scheme for intrauterine contraceptive devices (IUCDs). This paper describes the perspectives of Suraj clients, field workers mobilization (FWMs), and providers on various components of the Suraj model. A qualitative exploratory study was conducted in six randomly selected intervention districts in the Sindh and Punjab provinces. Data were collected using focus group discussions (FGDs) with clients and in-depth interviews (IDIs) with providers and FWMs. Data were manually analyzed using constant comparison and the thematic analysis approach. Clients showed positive attitudes towards modern contraceptive methods and identified Suraj FWMs and signboards as sources of information. Almost all clients reported IUCDs as effective methods as they have manageable side effects and require fewer visits to clinics. They spoke highly of voucher schemes as these enabled them to avail free IUCD services. Clients also appreciated many components of Suraj clinics, including cleanliness, privacy, confidentiality, the sterilization of instruments, and courteous Suraj providers and FWMs. Most Suraj providers said that IUCD insertion and infection-prevention training enhanced their ability to provide IUCD services and increased their standing in local communities. They reported that the role of FWMs was crucial in mobilizing the community and increasing their FP clientele. The FWMs said that attitudes towards FP were changing because of economic pressure at the household level, increases in literacy, and community mobilization efforts. The Suraj intervention influenced attitudes towards FP and modern contraception, positively. Women using IUCDs showed greater satisfaction with the method. The findings emphasize that SF approaches like Suraj, when complemented with vouchers and community mobilization efforts, can improve the utilization of long-term contraceptive methods among rural and underserved women. The study also identified the need for integrating FP, antenatal care, and safe delivery services.

Design and implementation of community engagement interventions towards healthcare quality improvement in Ghana: a methodological approach.

PubMed

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Arhinful, Daniel Kojo

2016-12-01

Nearly four decades after the Alma-Ata declaration of 1978 on the need for active client/community participation in healthcare, not much has been achieved in this regard particularly in resource constrained countries like Ghana, where over 70 % of communities in rural areas access basic healthcare from primary health facilities. Systematic Community Engagement (SCE) in healthcare quality assessment remains a grey area in many health systems in Africa, albeit the increasing importance in promoting universal access to quality basic healthcare services. Design and implement SCE interventions that involve existing community groups engaged in healthcare quality assessment in 32 intervention primary health facilities. The SCE interventions form part of a four year randomized controlled trial (RCT) in the Greater Accra and Western regions of Ghana. Community groups (n = 52) were purposively recruited and engaged to assess non-technical components of healthcare quality, recommend quality improvement plans and reward best performing facilities. The interventions comprised of five cyclical implementation steps executed for nearly a year. Wilcoxon sign rank test was used to ascertain differences in group perceptions of service quality during the first and second assessments, and ordered logistic regression analysis performed to determine factors associated with groups' perception of healthcare quality. Healthcare quality was perceived to be lowest in non-technical areas such as: information provision to clients, directional signs in clinics, drug availability, fairness in queuing, waiting times, and information provision on use of suggestion boxes and feedback on clients' complaints. Overall, services in private health facilities were perceived to be better than public facilities (p < 0.05). Community groups dominated by artisans and elderly members (60 + years) had better perspectives on healthcare quality than youthful groups (Coef. =1.78; 95 % CI = [-0.16 3.72]) and other categories of community groups (Coef. = 0.98; 95 % CI = [-0.10 2.06]). Non-technical components of healthcare quality remain critical to clients and communities served by primary healthcare providers. The SCE concept is a potential innovative and complementary quality improvement strategy that could help enhance client experiences, trust and confidence in healthcare providers. SCE interventions are more cost effective, community-focused and could easily be scaled-up and sustained by local health authorities.

Adverse events among Ontario home care clients associated with emergency room visit or hospitalization: a retrospective cohort study

PubMed Central

2013-01-01

Background Home care (HC) is a critical component of the ongoing restructuring of healthcare in Canada. It impacts three dimensions of healthcare delivery: primary healthcare, chronic disease management, and aging at home strategies. The purpose of our study is to investigate a significant safety dimension of HC, the occurrence of adverse events and their related outcomes. The study reports on the incidence of HC adverse events, the magnitude of the events, the types of events that occur, and the consequences experienced by HC clients in the province of Ontario. Methods A retrospective cohort design was used, utilizing comprehensive secondary databases available for Ontario HC clients from the years 2008 and 2009. The data were derived from the Canadian Home Care Reporting System, the Hospital Discharge Abstract Database, the National Ambulatory Care Reporting System, the Ontario Mental Health Reporting System, and the Continuing Care Reporting System. Descriptive analysis was used to identify the type and frequency of the adverse events recorded and the consequences of the events. Logistic regression analysis was used to examine the association between the events and their consequences. Results The study found that the incident rate for adverse events for the HC clients included in the cohort was 13%. The most frequent adverse events identified in the databases were injurious falls, injuries from other than a fall, and medication-related incidents. With respect to outcomes, we determined that an injurious fall was associated with a significant increase in the odds of a client requiring long-term-care facility admission and of client death. We further determined that three types of events, delirium, sepsis, and medication-related incidents were associated directly with an increase in the odds of client death. Conclusions Our study concludes that 13% of clients in homecare experience an adverse event annually. We also determined that an injurious fall was the most frequent of the adverse events and was associated with increased admission to long-term care or death. We recommend the use of tools that are presently available in Canada, such as the Resident Assessment Instrument and its Clinical Assessment Protocols, for assessing and mitigating the risk of an adverse event occurring. PMID:23800280

Development of Web-based Distributed Cooperative Development Environmentof Sign-Language Animation System and its Evaluation

NASA Astrophysics Data System (ADS)

Yuizono, Takaya; Hara, Kousuke; Nakayama, Shigeru

A web-based distributed cooperative development environment of sign-language animation system has been developed. We have extended the system from the previous animation system that was constructed as three tiered system which consists of sign-language animation interface layer, sign-language data processing layer, and sign-language animation database. Two components of a web client using VRML plug-in and web servlet are added to the previous system. The systems can support humanoid-model avatar for interoperability, and can use the stored sign language animation data shared on the database. It is noted in the evaluation of this system that the inverse kinematics function of web client improves the sign-language animation making.

WebEAV

PubMed Central

Nadkarni, Prakash M.; Brandt, Cynthia M.; Marenco, Luis

2000-01-01

The task of creating and maintaining a front end to a large institutional entity-attribute-value (EAV) database can be cumbersome when using traditional client-server technology. Switching to Web technology as a delivery vehicle solves some of these problems but introduces others. In particular, Web development environments tend to be primitive, and many features that client-server developers take for granted are missing. WebEAV is a generic framework for Web development that is intended to streamline the process of Web application development for databases having a significant EAV component. It also addresses some challenging user interface issues that arise when any complex system is created. The authors describe the architecture of WebEAV and provide an overview of its features with suitable examples. PMID:10887163

Health providers' opinions on provider-client relations: results of a multi-country study to test Health Workers for Change.

PubMed

Fonn, S; Mtonga, A S; Nkoloma, H C; Bantebya Kyomuhendo, G; daSilva, L; Kazilimani, E; Davis, S; Dia, R

2001-09-01

A multi-centre study in four African countries was undertaken to test the acceptability and effectiveness of Health Workers for Change, a methodology to explore provider-client relations within a gender-sensitive context. This intervention addresses the interpersonal component of quality of care. The methodology, consisting of six workshops, was implemented by research teams in Zambia, Senegal, Mozambique and Uganda. It was found to be acceptable within in a range of cultural and primary health care settings. The workshops allowed difficult issues such as prejudice and bribery to be discussed openly, fostered problem solving and the development of practical plans to address problems that could strengthen district health systems.

Determinants of Quality of Family Planning Counseling among Private Health Facilities in Lagos.

PubMed

Johnson, Doug; Ugaz, Jorge

2016-09-01

We use a unique dataset that includes an objective measure of the quality of family planning counseling from 927 private health facilities in Lagos State, Nigeria, to determine which variables at the facility and provider levels are most closely correlated with the quality of family planning counseling. Our data on quality come from mystery client surveys in which the clients posed as women seeking family planning counseling. We find that quality is strongly associated with the cadre of provider, with doctors delivering substantially higher-quality counselling than nurses. Doctors not only outperform nurses overall, but also perform better on each category of quality and spend nearly three minutes longer on average counseling the mystery client. Location, fees charged for the service, and facility type are also strongly correlated with quality. The degree to which a facility specializes in family planning and facility size are only weakly predictive of quality. © 2016 The Population Council, Inc.

KeyWare: an open wireless distributed computing environment

NASA Astrophysics Data System (ADS)

Shpantzer, Isaac; Schoenfeld, Larry; Grindahl, Merv; Kelman, Vladimir

1995-12-01

Deployment of distributed applications in the wireless domain lack equivalent tools, methodologies, architectures, and network management that exist in LAN based applications. A wireless distributed computing environment (KeyWareTM) based on intelligent agents within a multiple client multiple server scheme was developed to resolve this problem. KeyWare renders concurrent application services to wireline and wireless client nodes encapsulated in multiple paradigms such as message delivery, database access, e-mail, and file transfer. These services and paradigms are optimized to cope with temporal and spatial radio coverage, high latency, limited throughput and transmission costs. A unified network management paradigm for both wireless and wireline facilitates seamless extensions of LAN- based management tools to include wireless nodes. A set of object oriented tools and methodologies enables direct asynchronous invocation of agent-based services supplemented by tool-sets matched to supported KeyWare paradigms. The open architecture embodiment of KeyWare enables a wide selection of client node computing platforms, operating systems, transport protocols, radio modems and infrastructures while maintaining application portability.

Audio-based queries for video retrieval over Java enabled mobile devices

NASA Astrophysics Data System (ADS)

Ahmad, Iftikhar; Cheikh, Faouzi Alaya; Kiranyaz, Serkan; Gabbouj, Moncef

2006-02-01

In this paper we propose a generic framework for efficient retrieval of audiovisual media based on its audio content. This framework is implemented in a client-server architecture where the client application is developed in Java to be platform independent whereas the server application is implemented for the PC platform. The client application adapts to the characteristics of the mobile device where it runs such as screen size and commands. The entire framework is designed to take advantage of the high-level segmentation and classification of audio content to improve speed and accuracy of audio-based media retrieval. Therefore, the primary objective of this framework is to provide an adaptive basis for performing efficient video retrieval operations based on the audio content and types (i.e. speech, music, fuzzy and silence). Experimental results approve that such an audio based video retrieval scheme can be used from mobile devices to search and retrieve video clips efficiently over wireless networks.

Evaluation of the Technology Acceptance of a Collaborative Documentation System for Addiction Therapists and Clients.

PubMed

Perlich, Anja; Meinel, Christoph; Zeis, Daniel

2018-01-01

Addiction treatment outcomes are strongly determined by relational factors. We present the interactive documentation system Tele-Board MED (TBM) developed as an adjunct to therapy sessions aimed at enhancing the therapeutic alliance and patient empowerment. The objective of this work is to find factors that predict the acceptance of TBM in face-to-face addiction treatment sessions. We combined the methodologies of survey and focus group and based the data collection and analysis on the Unified Theory of Acceptance and Use of Technology. The studies, which involved therapists (n=13) and clients (n=33), were conducted in an addiction counselling center in Germany. Therapists see a flexible, context-dependent usage as a basic condition for TBM acceptance and its greatest benefit in providing a discussion framework and quick access to worksheets-in both individual and group sessions. Clients are inclined to use the system with the expectation of improved communication and better recall of the discussed topics based on a personal copy of the session notes.

Study protocol: translating and implementing psychosocial interventions in aged home care the lifestyle engagement activity program (LEAP) for life

PubMed Central

2013-01-01

Background Tailored psychosocial activity-based interventions have been shown to improve mood, behaviour and quality of life for nursing home residents. Occupational therapist delivered activity programs have shown benefits when delivered in home care settings for people with dementia. The primary aim of this study is to evaluate the effect of LEAP (Lifestyle Engagement Activity Program) for Life, a training and practice change program on the engagement of home care clients by care workers. Secondary aims are to evaluate the impact of the program on changes in client mood and behaviour. Methods/design The 12 month LEAP program has three components: 1) engaging site management and care staff in the program; 2) employing a LEAP champion one day a week to support program activities; 3) delivering an evidence-based training program to care staff. Specifically, case managers will be trained and supported to set meaningful social or recreational goals with clients and incorporate these into care plans. Care workers will be trained in and encouraged to practise good communication, promote client independence and choice, and tailor meaningful activities using Montessori principles, reminiscence, music, physical activity and play. LEAP Champions will be given information about theories of organisational change and trained in interpersonal skills required for their role. LEAP will be evaluated in five home care sites including two that service ethnic minority groups. A quasi experimental design will be used with evaluation data collected four times: 6-months prior to program commencement; at the start of the program; and then after 6 and 12 months. Mixed effect models will enable comparison of change in outcomes for the periods before and during the program. The primary outcome measure is client engagement. Secondary outcomes for clients are satisfaction with care, dysphoria/depression, loneliness, apathy and agitation; and work satisfaction for care workers. A process evaluation will also be undertaken. Discussion LEAP for Life may prove a cost-effective way to improve client engagement and other outcomes in the community setting. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12612001064897. PMID:24238067

Coping With Pain: Studies in Stress Inoculation.

ERIC Educational Resources Information Center

Horan, John J.; And Others

The stress-inoculation paradigm for helping clients deal with pain consists of education about the psychological dimensions of pain, training in a number of coping skills relevant to each dimension, and practice in applying these skills to the noxious stimulus. Presented are two studies, the first of which represents a component analysis of stress…

Can Stretching Prior to Exercise and Sports Improve Performance and Prevent Injury?

ERIC Educational Resources Information Center

Bracko, Michael R.

2002-01-01

Examines data from research on stretching as it relates to enhanced performance and injury prevention so that fitness, exercise, and sports performance professionals can make informed decisions about stretching programs for clients. The paper notes that stretching is a misunderstood component of fitness and sports training. Few studies show…

Formative assessment in the development of an obesity prevention component for the Expanded Food and Nutrition Education Program in Texas

USDA-ARS?s Scientific Manuscript database

This study conducted formative research (surveys, focus groups); to assess the nutrition education needs of clients in the Texas Expanded Food and Nutrition Education Program prior to curriculum revision. Current participants in the Expanded Food and Nutrition Education Program from 3 Texas cities (...

Hope-Focused Interventions in Substance Abuse Counselling

ERIC Educational Resources Information Center

Koehn, Corinne; O'Neill, Linda; Sherry, John

2012-01-01

Hope is a vital component of psychological healing and plays a critical role in counselling. With despair so prominent for individuals with serious substance abuse problems, the question arises as to how to foster hope in such clients. There are recent suggestions in the general counselling literature that some of the work in counselling involve…

Teaching Note--Asserting Social Work's Role in Developing an Interprofessional Education Project

ERIC Educational Resources Information Center

Kobayashi, Rie; Fitzgerald, Cindy

2017-01-01

Interprofessional (IP) education is an essential component of today's health care education. IP education has been recognized and supported for its potential to educate workforce-ready health care clinicians with the knowledge and skills, necessary to collaboratively deliver high-quality, client-centered care. While social work's reflective,…

Towards Automated e-Counselling System Based on Counsellors Emotion Perception

ERIC Educational Resources Information Center

Kolog, Emmanuel Awuni; Montero, Calkin Suero

2018-01-01

Emotions are a core semantic component of human communication. Since counsellors are humans we assume that their own state of emotions could affect their intuitional effort when taking decisions concerning their clients. Therefore, the accuracy of detected emotions by counsellors could be doubtful. And this highlights the need for complementing…

Treatment of Nightmares via Relaxation and Desensitization: A Controlled Evaluation.

ERIC Educational Resources Information Center

Miller, William R.; DiPilato, Marina

1983-01-01

Investigated the role of relaxation training as a component of desensitization to nightmares in adults (N=32). Results showed an 80 percent reduction in nightmares reported by 20 clients, of whom 12 reported total elimination of symptoms at 25-week follow-up, suggesting the effectiveness of a behavioral approach in treating nightmares. (LLL)

Evaluating Parent Satisfaction of School Nursing Services

ERIC Educational Resources Information Center

Read, Mary; Small, Patricia; Donaher, Kathleen; Gilsanz, Paola; Sheetz, Anne

2009-01-01

The Conceptual Model of Nursing Health Policy (CMNHP) was used to guide this study of client satisfaction as one component of an ongoing assessment of the Essential School Health Service (ESHS) Programs conducted by the Massachusetts Department of Public Health. Random samples of parents/guardians of students who use the school nursing services…

In Support of a National Treatment Evaluation Study.

PubMed

Brown, Barry S; Flynn, Patrick M

2015-01-01

Argument is made for the importance of conducting a national treatment evaluation to permit understanding of the nature and effectiveness of typical treatment programming. Only through such study can we hope to learn areas of success and failure of normative programming relative to population characteristics and treatment strategies, and the extent to which research-based initiatives have been adopted by the field. That information is central to efforts to draw up a research agenda appropriate to the needs of clients and the staffs responsible for their treatment, and to clarify and respond to gaps in the application of potentially useful treatment components. In spite of such need, our understanding of typical treatment programming and of its effectiveness is based on data collected from a treatment cohort of 20 years ago, although patterns of drug use, characteristics of clients, and the treatment components available have all undergone substantial change. The responsibility taken to provide such information to the field, once seen as a central task of research, needs to be reasserted to strengthen and support our treatment efforts.

DNA sequence chromatogram browsing using JAVA and CORBA.

PubMed

Parsons, J D; Buehler, E; Hillier, L

1999-03-01

DNA sequence chromatograms (traces) are the primary data source for all large-scale genomic and expressed sequence tags (ESTs) sequencing projects. Access to the sequencing trace assists many later analyses, for example contig assembly and polymorphism detection, but obtaining and using traces is problematic. Traces are not collected and published centrally, they are much larger than the base calls derived from them, and viewing them requires the interactivity of a local graphical client with local data. To provide efficient global access to DNA traces, we developed a client/server system based on flexible Java components integrated into other applications including an applet for use in a WWW browser and a stand-alone trace viewer. Client/server interaction is facilitated by CORBA middleware which provides a well-defined interface, a naming service, and location independence. [The software is packaged as a Jar file available from the following URL: http://www.ebi.ac.uk/jparsons. Links to working examples of the trace viewers can be found at http://corba.ebi.ac.uk/EST. All the Washington University mouse EST traces are available for browsing at the same URL.

Developing a cultural context for conducting a neuropsychological evaluation with a culturally diverse client: the ECLECTIC framework.

PubMed

Fujii, Daryl E M

2018-02-20

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

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.

Participation of Iranian Cerebral Palsy Children in Life Areas: A Systematic Review Article

PubMed Central

PASHMDARFARD, Marzieh; AMINI, Malek; HASSANI MEHRABAN, Afsoon

2017-01-01

Objective Cerebral palsy (CP) is the most common cause of chronic disability that restricts participation in areas of occupations for children. The main aim of rehabilitation is enhancement of their clients for participation in occupations. The aim of this study was to overview of the factors influencing the participations of children with CP in Iran. Materials & Methods A systematic, evidence-based process (Duffy 2005) was used. For data gathering electronic databases including Google scholar and Iranian and foreigner famous journals in the fields of pediatrics, were used. The main key words for search were Activity of Daily Living (ADL), Instrumental Activity of Daily Living (IADL), play, leisure, work, rest/sleep, social participation, and education. All the papers of this study were about the factors influencing the participation of Iranian CP children during 2000-2016. Totally, 156 articles were found eligible as for Iranian CP children study, of which 100 articles were discarded. Because of repetitive and duplicability of some articles, 17 articles were removed as well. Results The most studies about Iranian CP children participations in life areas were in the ADL area of participation (N=12), and the lowest articles were in the area in the field of: Work (N=2), play (N=2), and sleep/rest (N=2). Most of the occupational therapists do not focus on the all life areas. Conclusion In Iran, many researchers do not pay attention to the participation of CP children. Many articles just paid attention to the sensory, motor or cognitive components of their clients. PMID:28277550

Health Professionals' Explanations of Suicidal Behaviour: Effects of Professional Group, Theoretical Intervention Model, and Patient Suicide Experience.

PubMed

Rothes, Inês Areal; Henriques, Margarida Rangel

2017-12-01

In a help relation with a suicidal person, the theoretical models of suicidality can be essential to guide the health professional's comprehension of the client/patient. The objectives of this study were to identify health professionals' explanations of suicidal behaviors and to study the effects of professional group, theoretical intervention models, and patient suicide experience in professionals' representations. Two hundred and forty-two health professionals filled out a self-report questionnaire. Exploratory principal components analysis was used. Five explanatory models were identified: psychological suffering, affective cognitive, sociocommunicational, adverse life events, and psychopathological. Results indicated that the psychological suffering and psychopathological models were the most valued by the professionals, while the sociocommunicational was seen as the least likely to explain suicidal behavior. Differences between professional groups were found. We concluded that training and reflection on theoretical models in general and in communicative issues in particular are needed in the education of health professionals.

Integrating group counseling, cell phone messaging, and participant-generated songs and dramas into a microcredit program increases Nigerian women's adherence to international breastfeeding recommendations.

PubMed

Flax, Valerie L; Negerie, Mekebeb; Ibrahim, Alawiyatu Usman; Leatherman, Sheila; Daza, Eric J; Bentley, Margaret E

2014-07-01

In northern Nigeria, interventions are urgently needed to narrow the large gap between international breastfeeding recommendations and actual breastfeeding practices. Studies of integrated microcredit and community health interventions documented success in modifying health behaviors but typically had uncontrolled designs. We conducted a cluster-randomized controlled trial in Bauchi State, Nigeria, with the aim of increasing early breastfeeding initiation and exclusive breastfeeding among female microcredit clients. The intervention had 3 components. Trained credit officers led monthly breastfeeding learning sessions during regularly scheduled microcredit meetings for 10 mo. Text and voice messages were sent out weekly to a cell phone provided to small groups of microcredit clients (5-7 women). The small groups prepared songs or dramas about the messages and presented them at the monthly microcredit meetings. The control arm continued with the regular microcredit program. Randomization occurred at the level of the monthly meeting groups. Pregnant clients were recruited at baseline and interviewed again when their infants were aged ≥6 mo. Logistic regression models accounting for clustering were used to estimate the odds of performing recommended behaviors. Among the clients who completed the final survey (n = 390), the odds of exclusive breastfeeding to 6 mo (OR: 2.4; 95% CI: 1.4, 4.0) and timely breastfeeding initiation (OR: 2.6; 95% CI: 1.6, 4.1) were increased in the intervention vs. control arm. Delayed introduction of water explained most of the increase in exclusive breastfeeding among clients receiving the intervention. In conclusion, a breastfeeding promotion intervention integrated into microcredit increased the likelihood that women adopted recommended breastfeeding practices. This intervention could be scaled up in Nigeria, where local organizations provide microcredit to >500,000 clients. Furthermore, the intervention could be adopted more widely given that >150 million women, many of childbearing age, are involved in microfinance globally. © 2014 American Society for Nutrition.

Integrating Group Counseling, Cell Phone Messaging, and Participant-Generated Songs and Dramas into a Microcredit Program Increases Nigerian Women’s Adherence to International Breastfeeding Recommendations123

PubMed Central

Flax, Valerie L.; Negerie, Mekebeb; Ibrahim, Alawiyatu Usman; Leatherman, Sheila; Daza, Eric J.; Bentley, Margaret E.

2014-01-01

In northern Nigeria, interventions are urgently needed to narrow the large gap between international breastfeeding recommendations and actual breastfeeding practices. Studies of integrated microcredit and community health interventions documented success in modifying health behaviors but typically had uncontrolled designs. We conducted a cluster-randomized controlled trial in Bauchi State, Nigeria, with the aim of increasing early breastfeeding initiation and exclusive breastfeeding among female microcredit clients. The intervention had 3 components. Trained credit officers led monthly breastfeeding learning sessions during regularly scheduled microcredit meetings for 10 mo. Text and voice messages were sent out weekly to a cell phone provided to small groups of microcredit clients (5–7 women). The small groups prepared songs or dramas about the messages and presented them at the monthly microcredit meetings. The control arm continued with the regular microcredit program. Randomization occurred at the level of the monthly meeting groups. Pregnant clients were recruited at baseline and interviewed again when their infants were aged ≥6 mo. Logistic regression models accounting for clustering were used to estimate the odds of performing recommended behaviors. Among the clients who completed the final survey (n = 390), the odds of exclusive breastfeeding to 6 mo (OR: 2.4; 95% CI: 1.4, 4.0) and timely breastfeeding initiation (OR: 2.6; 95% CI: 1.6, 4.1) were increased in the intervention vs. control arm. Delayed introduction of water explained most of the increase in exclusive breastfeeding among clients receiving the intervention. In conclusion, a breastfeeding promotion intervention integrated into microcredit increased the likelihood that women adopted recommended breastfeeding practices. This intervention could be scaled up in Nigeria, where local organizations provide microcredit to >500,000 clients. Furthermore, the intervention could be adopted more widely given that >150 million women, many of childbearing age, are involved in microfinance globally. This trial was registered at clinicaltrials.gov as NCT01352351. PMID:24812071

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.

Mobile collaborative medical display system.

PubMed

Park, Sanghun; Kim, Wontae; Ihm, Insung

2008-03-01

Because of recent advances in wireless communication technologies, the world of mobile computing is flourishing with a variety of applications. In this study, we present an integrated architecture for a personal digital assistant (PDA)-based mobile medical display system that supports collaborative work between remote users. We aim to develop a system that enables users in different regions to share a working environment for collaborative visualization with the potential for exploring huge medical datasets. Our system consists of three major components: mobile client, gateway, and parallel rendering server. The mobile client serves as a front end and enables users to choose the visualization and control parameters interactively and cooperatively. The gateway handles requests and responses between mobile clients and the rendering server for efficient communication. Through the gateway, it is possible to share working environments between users, allowing them to work together in computer supported cooperative work (CSCW) mode. Finally, the parallel rendering server is responsible for performing heavy visualization tasks. Our experience indicates that some features currently available to our mobile clients for collaborative scientific visualization are limited due to the poor performance of mobile devices and the low bandwidth of wireless connections. However, as mobile devices and wireless network systems are experiencing considerable elevation in their capabilities, we believe that our methodology will be utilized effectively in building quite responsive, useful mobile collaborative medical systems in the very near future.

Patient-Provider Concordance with Behavioral Change Goals Drives Measures of Motivational Interviewing Consistency

PubMed Central

Laws, M. Barton; Rose, Gary S.; Beach, Mary Catherine; Lee, Yoojin; Rogers, William S.; Velasco, Alyssa Bianca; Wilson, Ira B.

2015-01-01

Objective Motivational Interviewing (MI) consistent talk by a counselor is thought to produce “change talk” in clients. However, it is possible that client resistance to behavior change can produce MI inconsistent counselor behavior. Methods We applied a coding scheme which identifies all of the behavioral counseling about a given issue during a visit (“episodes”), assesses patient concordance with the behavioral goal, and labels providers’ counseling style as facilitative or directive, to a corpus of routine outpatient visits by people with HIV. Using a different data set of comparable encounters, we applied the concepts of episode and concordance, and coded using the Motivational Interviewing Treatment Integrity system. Results Patient concordance/discordance was not observed to change during any episode. Provider directiveness was strongly associated with patient discordance in the first study, and MI inconsistency was strongly associated with discordance in the second. Conclusion Observations that MI-consistent behavior by medical providers is associated with patient change talk or outcomes should be evaluated cautiously, as patient resistance may provoke MI-inconsistency. Practice Implications Counseling episodes in routine medical visits are typically too brief for client talk to evolve toward change. Providers with limited training may have particular difficulty maintaining MI consistency with resistant clients. PMID:25791372

Screening, Brief Intervention, and Referral to Treatment for Older Adults With Substance Misuse

PubMed Central

Hazlett, Robert W.; Hedgecock, Deborah K.; Duchene, Darran M.; Burns, L. Vance; Gum, Amber M.

2015-01-01

Objectives. We compared substance use and SBIRT (Screening, Brief Intervention, and Referral to Treatment) services received for older adults screened by the Florida BRITE (BRief Intervention and Treatment of Elders) Project, across 4 categories of service providers. Methods. Staff from 29 agencies screened for substance use risk in 75 sites across 18 Florida counties. Clients at no or low risk received feedback about screening; moderate risk led to brief intervention, moderate or high risk led to brief treatment, and highest severity led to referral to treatment. Six-month follow-ups were conducted with a random sample of clients. Results. Over 5 years (September 15, 2006–September 14, 2011), 85 001 client screenings were recorded. Of these, 8165 clients were at moderate or high risk. Most received brief intervention for alcohol or medication misuse. Differences were observed across 4 categories of agencies. Health educators screening solely within medical sites recorded fewer positive screens than those from mental health, substance abuse, or aging services that screened in a variety of community-based and health care sites. Six-month follow-ups revealed a significant decrease in substance use. Conclusions. The Florida BRITE Project demonstrated that SBIRT can be extended to nonmedical services that serve older adults. PMID:24832147

Police Encounters Among Needle Exchange Clients in Baltimore: Drug Law Enforcement as a Structural Determinant of Health

PubMed Central

Cochrane, Jess; Sawyer, Anne L.; Serio-Chapman, Chris; Smelyanskaya, Marina; Han, Jennifer; Robinowitz, Natanya; Sherman, Susan G.

2015-01-01

Objectives. We piloted a monitoring mechanism to document police encounters around programs targeting people who inject drugs (PWID), and assessed their demographic predictors at 2 Baltimore, Maryland, needle exchange program (NEP) sites. Methods. In a brief survey, 308 clients quantified, characterized, and sited recent police encounters. Multivariate linear regression determined encounter predictors, and we used geocoordinate maps to illustrate clusters. Results. Within the past 6 months, clients reported a median of 3 stops near NEP sites (interquartile range [IQR] = 0–7.5) and a median of 1 arrest in any location (IQR = 0–2). Three respondents reported police referral to the NEP. Being younger (P = .009), being male (P = .033), and making frequent NEP visits (P = .02) were associated with reported police stops. Among clients reporting arrest or citation for syringe possession, Whites were significantly less likely than non-Whites to report being en route to or from an NEP (P < .001). Reported encounters were clustered around NEPs. Conclusions. Systematic surveillance of structural determinants of health for PWID proved feasible when integrated into service activities. Improved monitoring is critical to informing interventions to align policing with public health, especially among groups subject to disproportionate levels of drug law enforcement. PMID:26180948

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.

Sexual behaviour of commercial sex workers and their clients in Cambodia. Japan-Cambodia Collaborating Research Group.

PubMed

Morio, S; Soda, K; Tajima, K; Leng, H B; Kitamura, K; Mizushima, S; Ohshige, K; Tan, F; Suyama, A; Sopheab, H; Phalla, T

1999-06-01

This study surveyed the sexual behaviour of commercial sex workers and their clients in an attempt to identify factors of transmission of STDs (including HIV/AIDS) and to control their epidemics in Cambodia and South-East Asia. Cross-sectional study. Trained questioners asked items of the questionnaires to each objective subject in December 1996. Data were analysed to show the descriptive status by risk group of each person. 200 direct commercial sex workers, 220 indirect commercial sex workers, and 211 clients in Phnom Penh. Prostitution was widely accepted by both young males and females, and this was an easy way for young girls to obtain money. Although commercial sex workers and clients were knowledgeable about prevention methods against STDs, they seldom used condoms. Some commercial sex workers had been infected with STDs many times, and many of them incompletely treated the diseases by themselves. Social support from governmental and non-governmental organisation was poor. It is very important to support both commercial sex workers in practicing preventive methods against STDs and also visiting physicians when they notice symptoms of STDs. It is strongly recommended that not only governmental but also non-governmental organisations should be more active in this area.

The emergence of trust in clinics of alternative medicine.

PubMed

Pedersen, Inge Kryger; Hansen, Vibeke Holm; Grünenberg, Kristina

2016-01-01

Demands for alternative medicine have increased since the 1970s in nations in which western scientific evidence has become the basis for health care. This paradox has been the impetus to examine how trust emerges in clinics of alternative medicine. Alternative practitioners are self-regulated and the clients pay out of their own pockets to attend non-authorised treatments with very limited scientific evidence of their effects. Trust is a key issue in this context. However, only a few studies have dealt with the ways in which alternative practitioners win their clients' trust. Drawing on three qualitative studies and informing the empirical findings with a sociological concept of trust, this article provides new empirical insights on how trust emerges in Danish clinics of acupuncture, reflexology and homeopathy. The analysis demonstrates how trust is situational and emerges through both clients' susceptibility and practitioners' individual skill development and strategies, as well as from objects, place and space. Trust is developed on relational and bodily as well as material grounds. It is argued that the dynamics and elements of trust identified do not only minimalise uncertainties but sometimes convert these uncertainties into productive new ways for clients to address their ailments, life circumstances and perspectives. © 2015 Foundation for the Sociology of Health & Illness.

On Teaching Morality to Law Students.

ERIC Educational Resources Information Center

Modjeska, Lee

1991-01-01

Within the limits of law and process, the lawyer's concern must be the client's cause, not his own agenda. Effective legal representation requires objectivity. The lawyer's role is to counsel legality, not morality, and the law school's responsibility is to teach law, not moral obligation. (MSE)

What Happens to Therapists Who Work with Sex Offenders?

ERIC Educational Resources Information Center

Farrenkopf, Toni

1992-01-01

Surveyed 24 experienced therapists working with sex offenders regarding personal impact of work. Most reported shift in perspective, becoming discouraged about client change. Several adjustment phases were reported. One-quarter experienced burnout. Alternative to burnout was adaptation: lowering of expectations, objective detachment, acceptance of…

Visualizing multiattribute Web transactions using a freeze technique

NASA Astrophysics Data System (ADS)

Hao, Ming C.; Cotting, Daniel; Dayal, Umeshwar; Machiraju, Vijay; Garg, Pankaj

2003-05-01

Web transactions are multidimensional and have a number of attributes: client, URL, response times, and numbers of messages. One of the key questions is how to simultaneously lay out in a graph the multiple relationships, such as the relationships between the web client response times and URLs in a web access application. In this paper, we describe a freeze technique to enhance a physics-based visualization system for web transactions. The idea is to freeze one set of objects before laying out the next set of objects during the construction of the graph. As a result, we substantially reduce the force computation time. This technique consists of three steps: automated classification, a freeze operation, and a graph layout. These three steps are iterated until the final graph is generated. This iterated-freeze technique has been prototyped in several e-service applications at Hewlett Packard Laboratories. It has been used to visually analyze large volumes of service and sales transactions at online web sites.

Towards Gesture-Based Multi-User Interactions in Collaborative Virtual Environments

NASA Astrophysics Data System (ADS)

Pretto, N.; Poiesi, F.

2017-11-01

We present a virtual reality (VR) setup that enables multiple users to participate in collaborative virtual environments and interact via gestures. A collaborative VR session is established through a network of users that is composed of a server and a set of clients. The server manages the communication amongst clients and is created by one of the users. Each user's VR setup consists of a Head Mounted Display (HMD) for immersive visualisation, a hand tracking system to interact with virtual objects and a single-hand joypad to move in the virtual environment. We use Google Cardboard as a HMD for the VR experience and a Leap Motion for hand tracking, thus making our solution low cost. We evaluate our VR setup though a forensics use case, where real-world objects pertaining to a simulated crime scene are included in a VR environment, acquired using a smartphone-based 3D reconstruction pipeline. Users can interact using virtual gesture-based tools such as pointers and rulers.

[Nurses and clientele with anorexia and bulimia: a case study].

PubMed

Martins, Claudia Regina Carvalho; Caccavo, Paulo Vaccari

2012-01-01

The research aimed to identify the interaction of nurses and clients suffering from bulimia and anorexia. We use the case study as a resource in which we collect clinical data and did interviews with eight of fourteen nurses, who have been our subject-object. According to the nurses, clients are isolated from the world living in a world without hunger and mirrors reflecting a body always above the "ideal weight", they were lonely people, personnel who have lost their shine, sending signals that could extinguish their lives at any time. In the study, was possible to identify the manner in which nurses interacted and perceived customers and, as a result, we elucidate a peculiar practice in nursing.

Home intravenous therapy: Part I--Issues.

PubMed

McAbee, R R; Grupp, K; Horn, B

1991-01-01

Concerns related to providing home intravenous therapy were among the top ten clinical problems identified by Northwest Medicare-certified home care agencies in a 1986 survey. This paper addresses issues related to home intravenous therapy and provides lists of resources for the development of home intravenous therapy programs. Part I of the paper covers concerns related to intravenous therapy as expressed by home care agencies in the Northwest and synthesized the literature about home intravenous therapies. Survey results are presented, followed by a discussion of client and caregiver concerns. These include: discharge planning, client admission criteria and client and caregiver education. Standards, staffing, and staff education issues are discussed followed by sections on economics, marketing regulations and legal and ethical concerns. Finally, there is a discussion of issues related to specific types of intravenous therapies: parenteral nutrition, antibiotic therapy; chemotherapy; blood and blood component therapy and other less frequently used types of intravenous therapies. Each therapy is discussed with regard to complications, client and caregiver instruction and financial considerations. Part II of the paper is a resource guide which lists resources that agencies may use to develop a home intravenous therapy program. In the first section, national organizations and journals and books concerned with intravenous therapy are listed as well as journal articles, guidelines and guidebooks and client and provider educational materials. National and regional product and service representatives of intravenous therapy related companies are also listed. In the second section, addresses for the State Boards of Nursing are given for Alaska, Idaho, Montana, Oregon and Washington. Each state section includes a list of those agencies who indicated in the 1988 survey that they would be willing to share materials. In addition, product and service vendors of intravenous therapy supplies and equipment are listed for the State of Washington.

Veterinary dairy herd fertility service provision in seasonal and non-seasonal dairy industries - a comparison

PubMed Central

2010-01-01

The decline in dairy herd fertility internationally has highlighted the limited impact of traditional veterinary approaches to bovine fertility management. Three questionnaire surveys were conducted at buiatrics conferences attended by veterinary practitioners on veterinary dairy herd fertility services (HFS) in countries with a seasonal (Ireland, 47 respondents) and non-seasonal breeding model (The Netherlands, 44 respondents and Portugal, 31 respondents). Of the 122 respondents, 73 (60%) provided a HFS and 49 (40%) did not. The majority (76%) of all practitioners who responded stated that bovine fertility had declined in their practice clients' herds with inadequate cow management, inadequate nutrition and increased milk yield as the most important putative causes. The type of clients who adopted a herd fertility service were deemed more educated than average (70% of respondents), and/or had fertility problems (58%) and/or large herds (53%). The main components of this service were routine postpartum examinations (95% of respondents), fertility records analysis (75%) and ultrasound pregnancy examinations (69%). The number of planned visits per annum varied between an average of four in Ireland, where breeding is seasonal, and 23 in Portugal, where breeding is year-round. The benefits to both the practitioner and their clients from running a HFS were cited as better fertility, financial rewards and job satisfaction. For practitioners who did not run a HFS the main reasons given were no client demand (55%) and lack of fertility records (33%). Better economic evidence to convince clients of the cost-benefit of such a service was seen as a major constraint to adoption of this service by 67% of practitioners. PMID:21851745

Seismic Design of ITER Component Cooling Water System-1 Piping

NASA Astrophysics Data System (ADS)

Singh, Aditya P.; Jadhav, Mahesh; Sharma, Lalit K.; Gupta, Dinesh K.; Patel, Nirav; Ranjan, Rakesh; Gohil, Guman; Patel, Hiren; Dangi, Jinendra; Kumar, Mohit; Kumar, A. G. A.

2017-04-01

The successful performance of ITER machine very much depends upon the effective removal of heat from the in-vessel components and other auxiliary systems during Tokamak operation. This objective will be accomplished by the design of an effective Cooling Water System (CWS). The optimized piping layout design is an important element in CWS design and is one of the major design challenges owing to the factors of large thermal expansion and seismic accelerations; considering safety, accessibility and maintainability aspects. An important sub-system of ITER CWS, Component Cooling Water System-1 (CCWS-1) has very large diameter of pipes up to DN1600 with many intersections to fulfill the process flow requirements of clients for heat removal. Pipe intersection is the weakest link in the layout due to high stress intensification factor. CCWS-1 piping up to secondary confinement isolation valves as well as in-between these isolation valves need to survive a Seismic Level-2 (SL-2) earthquake during the Tokamak operation period to ensure structural stability of the system in the Safe Shutdown Earthquake (SSE) event. This paper presents the design, qualification and optimization of layout of ITER CCWS-1 loop to withstand SSE event combined with sustained and thermal loads as per the load combinations defined by ITER and allowable limits as per ASME B31.3, This paper also highlights the Modal and Response Spectrum Analyses done to find out the natural frequency and system behavior during the seismic event.

Research-Supported Intervention and Discretion among Frontline Workers Implementing Home Visitation Services

ERIC Educational Resources Information Center

Willging, Cathleen E.; Trott, Elise M.; Fettes, Danielle; Gunderson, Lara; Green, Amy E.; Hurlburt, Michael S.; Aarons, Gregory A.

2017-01-01

Objective: We examine how frontline workers and supervisors delivering a research-supported intervention (RSI) to reduce child neglect negotiated system-related challenges, the pragmatics of RSI implementation, and their professional identities and relationships with clients. Methods: We conducted semi-structured interviews, small group…

MOOville: The Writing Project's Own "Private Idaho".

ERIC Educational Resources Information Center

Conlon, Michael

1997-01-01

Describes how a computerized environment supplemented traditional undergraduate courses in English literature and composition at the University of Florida, and was developed with a grant from IBM. Highlights include the use of MOO (multi-user, object-oriented) space; student assignments; the client-server setting; and student and teacher…

45 CFR 1620.5 - Annual review.

Code of Federal Regulations, 2011 CFR

2011-10-01

... considered in determining whether the recipient's priorities should be changed: (1) The extent to which the objectives of the recipient's priorities have been accomplished; (2) Changes in the resources of the recipient; (3) Changes in the size, distribution, or needs of the eligible client population; and (4) The...

Occupational therapists' beliefs and practices with regard to spirituality and therapy.

PubMed

Engquist, D E; Short-DeGraff, M; Gliner, J; Oltjenbruns, K

1997-03-01

What is the role of occupational therapists with regard to clients' spirituality? What activities address spirituality in occupational therapy? Whom do practitioners think should be responsible for helping clients with their spiritual needs? The objectives of this study were to address these and other related questions by validating a previously used questionnaire and establishing a baseline of occupational therapists' opinions and practices about spirituality and therapy on which future research can be built. A previously piloted questionnaire was revised to investigate the opinions of 500 U.S. registered occupational therapists about spirituality and therapy. The 54% return rate yielded a sample of 270 respondents. Nearly 79% of the respondents agreed that the questionnaire accurately measured their opinions about therapy and spirituality. Spirituality is an important part of life for 89% of the respondents, helps 79% with daily job responsibilities, and is viewed as a very important dimension of health and rehabilitation by 84%. However, 63% were either undecided or disagreed that addressing spirituality was within the scope of occupational therapy practice. In general, the respondents reported that spirituality is important and helpful in their personal lives and a very important dimension of the health and rehabilitation of their clients. However, less than 40% of the respondents indicated that addressing clients' spiritual needs was within the scope of their professional practice, and the majority (82%) reported that their academic training did not prepare them to address the spiritual needs of clients. The questionnaire, now validated with a national sample, may be used for follow-up studies to further investigate the role of spirituality in health and rehabilitation.

Longitudinal Course of Clients With Co-occurring Schizophrenia-Spectrum and Substance Use Disorders in Urban Mental Health Centers: A 7-Year Prospective Study

PubMed Central

Drake, Robert E.; Luciano, Alison E.; Mueser, Kim T.; Covell, Nancy H.; Essock, Susan M.; Xie, Haiyi; McHugo, Gregory J.

2016-01-01

Objective. A previous longitudinal study in rural New Hampshire showed that community mental health center clients with co-occurring schizophrenia-spectrum and substance use disorders (SZ/SUD) improved steadily and substantially over 10 years. The current study examined 7 years of prospective clinical and functional outcomes among inner-city Connecticut (CT) community mental health center clients with SZ/SUD. Method. Participants were 150 adults with SZ/SUD, selected for high service needs, in 2 inner-city mental health centers in CT. Initially, all received integrated mental health and substance abuse treatments for at least the first 3 years as part of a clinical trial. Assessments at baseline and yearly over 7 years measured progress toward 6 target clinical and functional outcomes: absence of psychiatric symptoms, remission of substance abuse, independent housing, competitive employment, social contact with non-users of substances, and life satisfaction. Results. The CT SZ/SUD participants improved significantly on 5 of the 6 main outcomes: absence of psychiatric symptoms (45%–70%), remission of substance use disorders (8%–61%), independent housing (33%–47%), competitive employment (14%–28%), and life satisfaction (35%–53%). Only social contact with nonusers of substances was unimproved (14%–17%). Conclusions. Many urban community mental health center clients with SZ/SUD and access to integrated treatment improve significantly on clinical, vocational, residential, and life satisfaction outcomes over time, similar to clients with SZ/SUD in rural areas. Thus, the long-term course for people with SZ/SUD is variable but often quite positive. PMID:26294706

How State-Funded Home Care Programs Respond to Changes in Medicare Home Health Care: Resource Allocation Decisions on the Front Line

PubMed Central

Corazzini, Kirsten

2003-01-01

Objective To examine how case managers in a state-funded home care program allocate home care services in response to information about a client's Medicare home health care status, with particular attention to the influence of work environment. Data Sources/Study Setting Primary data collected on 355 case managers and 26 agency directors employed in June 1999 by 26 of the 27 regional agencies administering the Massachusetts Home Care Program for low-income elders. Study Design Data were collected in a cross-sectional survey study design. A case manager survey included measures of work environment, demographics, and factorial survey vignette clients (N=2,054), for which case managers assessed service eligibility levels. An agency director survey included measures of management practices. Data Collection/Extraction Methods Hierarchical linear models estimated the effects of work environment on the relationship between client receipt of Medicare home health care and care plan levels while controlling for case-mix differences in agencies' clients. Principal Findings Case managers did not supplement extant Medicare home health services, but did allocate more generous service plans to clients who have had Medicare home health care services recently terminated. This finding persisted when controlling for case mix and did not vary by work environment. Work environment affected overall care plan levels. Conclusions Study findings indicate systematic patterns of frontline resource allocation shaping the relationships among community-based long-term care payment sources. Further, results illustrate how nonuniform implementation of upper-level initiatives may be partially attributed to work environment characteristics. PMID:14596390

Rural telemedicine project in northern New Mexico

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

Zink, S.; Hahn, H.; Rudnick, J.

A virtual electronic medical record system is being deployed over the Internet with security in northern New Mexico using TeleMed, a multimedia medical records management system that uses CORBA-based client-server technology and distributed database architecture. The goal of the NNM Rural Telemedicine Project is to implement TeleMed into fifteen rural clinics and two hospitals within a 25,000 square mile area of northern New Mexico. Evaluation of the project consists of three components: job task analysis, audit of immunized children, and time motion studies. Preliminary results of the evaluation components are presented.

Lightning Protection

NASA Technical Reports Server (NTRS)

1991-01-01

Lightning Technologies, Inc., Pittsfield, MA, - a spinoff company founded by president J. Anderson Plumer, a former NASA contractor employee who developed his expertise with General Electric Company's High Voltage Laboratory - was a key player in Langley Research Center's Storm Hazards Research Program. Lightning Technologies used its NASA acquired experience to develop protective measures for electronic systems and composite structures on aircraft, both of which are particularly susceptible to lightning damage. The company also provides protection design and verification testing services for complete aircraft systems or individual components. Most aircraft component manufacturers are among Lightning Technologies' clients.

Students' Emotions as an Organizing Principle in the Social Work Curriculum

ERIC Educational Resources Information Center

Chung, Irene W.

2010-01-01

Students' frustration with the lack of measurable progress in their practice has always been a major obstacle for them in learning to use themselves differentially and to effect changes in their clients (Saari, 1986). This article discusses the author's approach to tending to students' emotions as a central component in organizing and teaching in…

PRISMA-MAR: An Architecture Model for Data Visualization in Augmented Reality Mobile Devices

ERIC Educational Resources Information Center

Gomes Costa, Mauro Alexandre Folha; Serique Meiguins, Bianchi; Carneiro, Nikolas S.; Gonçalves Meiguins, Aruanda Simões

2013-01-01

This paper proposes an extension to mobile augmented reality (MAR) environments--the addition of data charts to the more usual text, image and video components. To this purpose, we have designed a client-server architecture including the main necessary modules and services to provide an Information Visualization MAR experience. The server side…

Evaluation of primary care midwifery in The Netherlands: design and rationale of a dynamic cohort study (DELIVER).

PubMed

Manniën, Judith; Klomp, Trudy; Wiegers, Therese; Pereboom, Monique; Brug, Johannes; de Jonge, Ank; van der Meijde, Margreeth; Hutton, Eileen; Schellevis, Francois; Spelten, Evelien

2012-03-20

In the Netherlands, midwives are autonomous medical practitioners and 78% of pregnant women start their maternity care with a primary care midwife. Scientific research to support evidence-based practice in primary care midwifery in the Netherlands has been sparse. This paper describes the research design and methodology of the multicenter multidisciplinary prospective DELIVER study which is the first large-scale study evaluating the quality and provision of primary midwifery care. Between September 2009 and April 2011, data were collected from clients and their partners, midwives and other healthcare professionals across the Netherlands. Clients from twenty midwifery practices received up to three questionnaires to assess the expectations and experiences of clients (e.g. quality of care, prenatal screening, emotions, health, and lifestyle). These client data were linked to data from the Netherlands Perinatal Register and electronic client records kept by midwives. Midwives and practice assistants from the twenty participating practices recorded work-related activities in a diary for one week, to assess workload. Besides, the midwives were asked to complete a questionnaire, to gain insight into collaboration of midwives with other care providers, their tasks and attitude towards their job, and the quality of the care they provide. Another questionnaire was sent to all Dutch midwifery practices which reveals information regarding the organisation of midwifery practices, provision of preconception care, collaboration with other care providers, and provision of care to ethnic minorities. Data at client, midwife and practice level can be linked. Additionally, partners of pregnant women and other care providers were asked about their expectations and experiences regarding the care delivered by midwives and in six practices client consults were videotaped to objectively assess daily practice. In total, 7685 clients completed at least one questionnaire, 136 midwives and assistants completed a diary with work-related activities (response 100%), 99 midwives completed a questionnaire (92%), and 319 practices across the country completed a questionnaire (61%), 30 partners of clients participated in focus groups, 21 other care providers were interviewed and 305 consults at six midwifery practices were videotaped.The multicenter DELIVER study provides an extensive database with national representative data on the quality of primary care midwifery in the Netherlands. This study will support evidence-based practice in primary care midwifery in the Netherlands and contribute to a better understanding of the maternity care system. © 2012 Manniën et al; licensee BioMed Central Ltd.

Short structured general mental health in service training programme in Kenya improves patient health and social outcomes but not detection of mental health problems - a pragmatic cluster randomised controlled trial

PubMed Central

2013-01-01

Trial design A pragmatic cluster randomised controlled trial. Methods Participants: Clusters were primary health care clinics on the Ministry of Health list. Clients were eligible if they were aged 18 and over. Interventions: Two members of staff from each intervention clinic received the training programme. Clients in both intervention and control clinics subsequently received normal routine care from their health workers. Objective: To examine the impact of a mental health inservice training on routine detection of mental disorder in the clinics and on client outcomes. Outcomes: The primary outcome was the rate of accurate routine clinic detection of mental disorder and the secondary outcome was client recovery over a twelve week follow up period. Randomisation: clinics were randomised to intervention and control groups using a table of random numbers. Blinding: researchers and clients were blind to group assignment. Results Numbers randomised: 49 and 50 clinics were assigned to intervention and control groups respectively. 12 GHQ positive clients per clinic were identified for follow up. Numbers analysed: 468 and 478 clients were followed up for three months in intervention and control groups respectively. Outcome: At twelve weeks after training of the intervention group, the rate of accurate routine clinic detection of mental disorder was greater than 0 in 5% versus 0% of the intervention and control groups respectively, in both the intention to treat analysis (p = 0.50) and the per protocol analysis (p =0.50). Standardised effect sizes for client improvement were 0.34 (95% CI = (0.01,0.68)) for the General Health Questionnaire, 0.39 ((95% CI = (0.22, 0.61)) for the EQ and 0.49 (95% CI = (0.11,0.87)) for WHODAS (using ITT analysis); and 0.43 (95% CI = (0.09,0.76)) for the GHQ, 0.44 (95% CI = (0.22,0.65)) for the EQ and 0.58 (95% CI = (0.18,0.97)) for WHODAS (using per protocol analysis). Harms: None identified. Conclusion The training programme did not result in significantly improved recorded diagnostic rates of mental disorders in the routine clinic consultation register, but did have significant effects on patient outcomes in routine clinical practice. Trial registration International Standard Randomised Controlled Trial Number Register ISRCTN53515024. PMID:24188964

National Athletic Trainers' Association Position Statement: Safe Weight Loss and Maintenance Practices in Sport and Exercise

PubMed Central

Turocy, Paula Sammarone; DePalma, Bernard F.; Horswill, Craig A.; Laquale, Kathleen M.; Martin, Thomas J.; Perry, Arlette C.; Somova, Marla J.; Utter, Alan C.

2011-01-01

Objective: To present athletic trainers with recommendations for safe weight loss and weight maintenance practices for athletes and active clients and to provide athletes, clients, coaches, and parents with safe guidelines that will allow athletes and clients to achieve and maintain weight and body composition goals. Background: Unsafe weight management practices can compromise athletic performance and negatively affect health. Athletes and clients often attempt to lose weight by not eating, limiting caloric or specific nutrients from the diet, engaging in pathogenic weight control behaviors, and restricting fluids. These people often respond to pressures of the sport or activity, coaches, peers, or parents by adopting negative body images and unsafe practices to maintain an ideal body composition for the activity. We provide athletic trainers with recommendations for safe weight loss and weight maintenance in sport and exercise. Although safe weight gain is also a concern for athletic trainers and their athletes and clients, that topic is outside the scope of this position statement. Recommendations: Athletic trainers are often the source of nutrition information for athletes and clients; therefore, they must have knowledge of proper nutrition, weight management practices, and methods to change body composition. Body composition assessments should be done in the most scientifically appropriate manner possible. Reasonable and individualized weight and body composition goals should be identified by appropriately trained health care personnel (eg, athletic trainers, registered dietitians, physicians). In keeping with the American Dietetics Association (ADA) preferred nomenclature, this document uses the terms registered dietitian or dietician when referring to a food and nutrition expert who has met the academic and professional requirements specified by the ADA's Commission on Accreditation for Dietetics Education. In some cases, a registered nutritionist may have equivalent credentials and be the commonly used term. All weight management and exercise protocols used to achieve these goals should be safe and based on the most current evidence. Athletes, clients, parents, and coaches should be educated on how to determine safe weight and body composition so that athletes and clients more safely achieve competitive weights that will meet sport and activity requirements while also allowing them to meet their energy and nutritional needs for optimal health and performance. PMID:21669104

WebEAV: automatic metadata-driven generation of web interfaces to entity-attribute-value databases.

PubMed

Nadkarni, P M; Brandt, C M; Marenco, L

2000-01-01

The task of creating and maintaining a front end to a large institutional entity-attribute-value (EAV) database can be cumbersome when using traditional client-server technology. Switching to Web technology as a delivery vehicle solves some of these problems but introduces others. In particular, Web development environments tend to be primitive, and many features that client-server developers take for granted are missing. WebEAV is a generic framework for Web development that is intended to streamline the process of Web application development for databases having a significant EAV component. It also addresses some challenging user interface issues that arise when any complex system is created. The authors describe the architecture of WebEAV and provide an overview of its features with suitable examples.

Design of Grid Portal System Based on RIA

NASA Astrophysics Data System (ADS)

Cao, Caifeng; Luo, Jianguo; Qiu, Zhixin

Grid portal is an important branch of grid research. In order to solve the weak expressive force, the poor interaction, the low operating efficiency and other insufficiencies of the first and second generation of grid portal system, RIA technology was introduced to it. A new portal architecture was designed based on RIA and Web service. The concrete realizing scheme of portal system was presented by using Adobe Flex/Flash technology, which formed a new design pattern. In system architecture, the design pattern has B/S and C/S superiorities, balances server and its client side, optimizes the system performance, realizes platform irrelevance. In system function, the design pattern realizes grid service call, provides client interface with rich user experience, integrates local resources by using FABridge, LCDS, Flash player and some other components.

Real World Data and Service Integration: Demonstrations and Lessons Learnt from the GEOSS Architecture Implementation Pilot Phase Four

NASA Astrophysics Data System (ADS)

Simonis, I.; Alameh, N.; Percivall, G.

2012-04-01

The GEOSS Architecture Implementation Pilots (AIP) develop and pilot new process and infrastructure components for the GEOSS Common Infrastructure (GCI) and the broader GEOSS architecture through an evolutionary development process consisting of a set of phases. Each phase addresses a set of Societal Benefit Areas (SBA) and geoinformatic topics. The first three phases consisted of architecture refinements based on interactions with users; component interoperability testing; and SBA-driven demonstrations. The fourth phase (AIP-4) documented here focused on fostering interoperability arrangements and common practices for GEOSS by facilitating access to priority earth observation data sources and by developing and testing specific clients and mediation components to enable such access. Additionally, AIP-4 supported the development of a thesaurus for earth observation parameters and tutorials to guide data providers to make their data available through GEOSS. The results of AIP-4 are documented in two engineering reports and captured in a series of videos posted online. Led by the Open Geospatial Consortium (OGC), AIP-4 built on contributions from over 60 organizations. This wide portfolio helped testing interoperability arrangements in a highly heterogeneous environment. AIP-4 participants cooperated closely to test available data sets, access services, and client applications in multiple workflows and set ups. Eventually, AIP-4 improved the accessibility of GEOSS datasets identified as supporting Critical Earth Observation Priorities by the GEO User Interface Committee (UIC), and increased the use of the data through promoting availability of new data services, clients, and applications. During AIP-4, A number of key earth observation data sources have been made available online at standard service interfaces, discovered using brokered search approaches, and processed and visualized in generalized client applications. AIP-4 demonstrated the level of interoperability that can be achieved using currently available standards and corresponding products and implementations. The AIP-4 integration testing process proved that the integration of heterogeneous data resources available via interoperability arrangements such as WMS, WFS, WCS and WPS indeed works. However, the integration often required various levels of customizations on the client side to accommodate for variations in the service implementations. Those variations seem to be based on both malfunctioning service implementations as well as varying interpretations of or inconsistencies in existing standards. Other interoperability issues identified revolve around missing metadata or using unrecognized identifiers in the description of GEOSS resources. Once such issues are resolved, continuous compliance testing is necessary to ensure minimizing variability of implementations. Once data providers can choose from a set of enhanced implementations for offering their data using consistent interoperability arrangements, the barrier to client and decision support implementation developers will be lowered, leading to true leveraging of earth observation data through GEOSS. AIP-4 results, lessons learnt from previous AIPs 1-3 and close coordination with the Infrastructure Implementation Board (IIB), the successor of the Architecture and Data Committee (ADC), form the basis in the current preparation phase for the next Architecture Implementation Pilot, AIP-5. The Call For Participation will be launched in February and the pilot will be conducted from May to November 2012. The current planning foresees a scenario- oriented approach, with possible scenarios coming from the domains of disaster management, health (including air quality and waterborne diseases), water resource observations, energy, biodiversity and climate change, and agriculture.

Inconsistent condom use by male clients during anal intercourse with occasional and regular female sex workers (FSWs): survey findings from southern states of India

PubMed Central

Ramanathan, Shreena; Nagarajan, Karikalan; Ramakrishnan, Lakshmi; Mainkar, Mandar K; Goswami, Prabuddhagopal; Yadav, Diwakar; Sen, Shrabanti; George, Bitra; Rachakulla, Harikumar; Subramanian, Thilakavathi; Paranjape, Ramesh S

2014-01-01

Objectives Self-reported anal intercourse by female sex workers (FSWs) documented in recent studies from India range between 11.9% and 22%. However, comparable data on anal intercourse and condom use from male clients of FSWs is lacking. Using data from a bio-behavioural survey (2009–2010), we examined prevalence of anal intercourse, male clients’ self-reported inconsistent condom use during anal intercourse with FSWs, and correlates of this behaviour in India's high HIV prevalence southern states (Andhra Pradesh, Maharashtra and Tamil Nadu combined). Methods Using two-stage time location cluster sampling, we recruited 4803 clients of FSWs, ages 18–60 years, who had purchased sex from an FSW in the past month. After obtaining informed consent, respondents were interviewed and tested for HIV and sexually transmitted infections (syphilis, gonorrhoea and chlamydia). Logistic regression analysis was used to identify the factors associated with inconsistent condom use during anal intercourse (in the past 6 months) with FSWs. Results Overall, 12.3% clients reported anal intercourse in the past 6 months, of whom 48.4% used condoms inconsistently. Clients of FSWs who were ages 26 years or older (AOR 2.68, p=0.032); employed as manual labourers (AOR 2.43, p=0.013); consumed alcohol (AOR 2.63, p=0.001); reported five or more sex acts with FSWs in the past month (AOR 2.53, p=0.031); and perceived themselves to be at higher risk for HIV (AOR 4.82, p=0.001) were more likely to inconsistently use condoms during anal intercourse. Conclusions The results suggest that sex workers and their clients commonly practice anal intercourse, but a relatively high proportion of clients do not consistently use condoms, leading to a greater risk of acquiring HIV and its further transmission to other male and female sexual partners. Given the multidirectional risk, safer sex communication on heterosexual anal intercourse must be incorporated into HIV prevention programmes. PMID:25410604

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.

Risk transfer modeling among hierarchically associated stakeholders in development of space systems

NASA Astrophysics Data System (ADS)

Henkle, Thomas Grove, III

Research develops an empirically derived cardinal model that prescribes handling and transfer of risks between organizations with hierarchical relationships. Descriptions of mission risk events, risk attitudes, and conditions for risk transfer are determined for client and underwriting entities associated with acquisition, production, and deployment of space systems. The hypothesis anticipates that large client organizations should be able to assume larger dollar-value risks of a program in comparison to smaller organizations even though many current risk transfer arrangements via space insurance violate this hypothesis. A literature survey covers conventional and current risk assessment methods, current techniques used in the satellite industry for complex system development, cardinal risk modeling, and relevant aspects of utility theory. Data gathered from open literature on demonstrated launch vehicle and satellite in-orbit reliability, annual space insurance premiums and losses, and ground fatalities and range damage associated with satellite launch activities are presented. Empirically derived models are developed for risk attitudes of space system clients and third-party underwriters associated with satellite system development and deployment. Two application topics for risk transfer are examined: the client-underwriter relationship on assumption or transfer of risks associated with first-year mission success, and statutory risk transfer agreements between space insurance underwriters and the US government to promote growth in both commercial client and underwriting industries. Results indicate that client entities with wealth of at least an order of magnitude above satellite project costs should retain risks to first-year mission success despite present trends. Furthermore, large client entities such as the US government should never pursue risk transfer via insurance under previously demonstrated probabilities of mission success; potential savings may reasonably exceed multiple tens of $millions per space project. Additional results indicate that current US government statutory arrangements on risk sharing with underwriting entities appears reasonable with respect to stated objectives. This research combines aspects of multiple disciplines to include risk management, decision theory, utility theory, and systems architecting. It also demonstrates development of a more general theory on prescribing risk transfer criteria between distinct, but hierarchically associated entities involved in complex system development with applicability to a variety of technical domains.

Zone of proximal development (ZPD) as an ability to play in psychotherapy: a theory-building case study of very brief therapy.

PubMed

Zonzi, Anna; Barkham, Michael; Hardy, Gillian E; Llewelyn, Susan P; Stiles, William B; Leiman, Mikael

2014-12-01

This theory-building case study examined the zone of proximal development (ZPD) in psychotherapy within the assimilation model. Theoretically, the ZPD is the segment of the continuum of therapeutic development within which assimilation of problematic experiences can take place. Work within a problem's current ZPD may be manifested as a Winnicottian ability to play, that is, an ability to adopt a flexible reflexive stance to the presenting problem and be involved in joint examination of possible alternatives. Play may be recognized in the client's receptivity to and creative use of the therapist's formulations of the presenting problems. A case was selected from a comparative clinical trial of two very brief psychotherapies for mild to moderate depression, the Two-Plus-One Project (Barkham, Shapiro, Hardy, & Rees, 1999, J. Consult. Clin. Psychol., 67, 201). Martha, a woman in her late forties, received two sessions of psychodynamic-interpersonal therapy 1 week apart and a follow-up ('plus one') session approximately 3 months later. Dialogical sequence analysis was used to analyse the transcripts of the three sessions. The analysis revealed Martha's problematic action pattern, which remained unchanged throughout the three sessions. Her ability to use and elaborate the therapist's formulations depended on the referential object that the therapist addressed; in particular, she seemed unable to play with the therapist's formulations of her more problematic experiences. The case helped elucidate how the ZPD is content dependent. Winnicott's conception of playing emphasizes the quality of client response as an indicator of this content sensitivity. Differing breadths of major problems' ZPD, manifested as differing abilities to play with therapists' formulations may explain why some clients improve in psychotherapy while some do not. Accessing very problematic content may be very difficult even though the client's ability to mentalize other material appears ordinary. Mildly depressed clients who have developed powerful care-taking coping strategies may not respond to very brief therapeutic interventions. A client's minimal acknowledgements may mislead the therapist into supplementing the client's failing self-reflection rather than addressing the issue that provokes this failure. © 2014 The British Psychological Society.

Implementing a Modular Research-Supported Treatment in Child Welfare: Effects and Obstacles

ERIC Educational Resources Information Center

Schuler, Brittany R.; Lee, Bethany R.; Kolivoski, Karen M.; Attman, Nicole P.; Lindsey, Michael A.

2016-01-01

Objective: Increasing rates of mental health needs in child welfare clients highlight the importance of training child welfare workers in effective mental health interventions. This pilot study evaluates the effects of training public child welfare workers and interns in modularized research-supported treatments (RSTs). Methods: We compared…

The Development and Validation of the Religious/Spiritually Integrated Practice Assessment Scale

ERIC Educational Resources Information Center

Oxhandler, Holly K.; Parrish, Danielle E.

2016-01-01

Objective: This article describes the development and validation of the Religious/Spiritually Integrated Practice Assessment Scale (RSIPAS). The RSIPAS is designed to assess social work practitioners' self-efficacy, attitudes, behaviors, and perceived feasibility concerning the assessment or integration of clients' religious and spiritual beliefs…

College Counselors' Perceptions and Practices regarding Anticipatory Guidance on Firearms

ERIC Educational Resources Information Center

Price, James; Mrdjenovich, Adam J.; Thompson, Amy; Dake, Joseph A.

2009-01-01

Objectives: This study assessed college counselors' anticipatory guidance on firearms for student clients. Participants: The membership of the Association for University and College Counseling Center Directors was used to identify a national random sample of counseling centers (n = 361). One counselor from each center was selected to survey.…

Fitness Instructors: How Does Their Knowledge on Weight Loss Measure Up?

ERIC Educational Resources Information Center

Forsyth, Glenys; Handcock, Phil; Rose, Elaine; Jenkins, Carolyn

2005-01-01

Objective: To examine the knowledge, approaches and attitudes of fitness instructors dealing with clients seeking weight loss advice. Design: A qualitative project whereby semi-structured interviews were conducted with ten fitness instructors representing a range of qualifications, work settings and years of experience. Setting: Interviews were…

What's New in the Library Automation Arena?

ERIC Educational Resources Information Center

Breeding, Marshall

1998-01-01

Reviews trends in library automation based on vendors at the 1998 American Library Association Annual Conference. Discusses the major industry trend, a move from host-based computer systems to the new generation of client/server, object-oriented, open systems-based automation. Includes a summary of developments for 26 vendors. (LRW)

Nurturing and Individuation in Female/Female Therapy Relationships.

ERIC Educational Resources Information Center

Levy, Sandra Beth

As therapy relationships between female therapists and female clients become more prevalent, there is a need to address the attributes of these relationships. Psychoanalytic object relations theory and feminist theory can be used to arrive at a meaningful context for viewing the dimension of intimacy. Psychoanalytic literature on the mother/infant…

Nurses and Dietitians Differ in Food Safety Information Provided to Highly Susceptible Clients

ERIC Educational Resources Information Center

Buffer, Janet; Kendall, Patricia; Medeiros, Lydia; Schroeder, Mary; Sofos, John

2013-01-01

Objective: To determine content, education channels, and motivational factors that influence what health professionals teach about safe food handling to populations who are highly susceptible for foodborne illnesses. To assess the differences in information provided by health professionals to highly susceptible populations. Design: Descriptive,…

42 CFR 483.440 - Condition of participation: Active treatment services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... CARE FACILITIES Conditions of Participation for Intermediate Care Facilities for Individuals with... assessments required in paragraph (c)(3) of this section; and (ii) Designing programs that meet the client's... designed to implement the objectives in the individual program plan must specify: (i) The methods to be...

42 CFR 483.440 - Condition of participation: Active treatment services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... CARE FACILITIES Conditions of Participation for Intermediate Care Facilities for Individuals with... assessments required in paragraph (c)(3) of this section; and (ii) Designing programs that meet the client's... designed to implement the objectives in the individual program plan must specify: (i) The methods to be...

42 CFR 483.440 - Condition of participation: Active treatment services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... CARE FACILITIES Conditions of Participation for Intermediate Care Facilities for Individuals with... assessments required in paragraph (c)(3) of this section; and (ii) Designing programs that meet the client's... designed to implement the objectives in the individual program plan must specify: (i) The methods to be...

Iowa Case Management for Rural Drug Abuse

ERIC Educational Resources Information Center

Hall, James A.; Vaughan Sarrazin, Mary S.; Huber, Diane L.; Vaughn, Thomas; Block, Robert I.; Reedy, Amanda R.; Jang, MiJin

2009-01-01

Objective: The purpose of this research was to evaluate the effectiveness of a comprehensive, strengths-based model of case management for clients in drug abuse treatment. Method: 503 volunteers from residential or intensive outpatient treatment were randomly assigned to one of three conditions of Iowa Case Management (ICM) plus treatment as usual…

Initial Validation of the Mental Health Provider Stigma Inventory

ERIC Educational Resources Information Center

Kennedy, Stephanie C.; Abell, Neil; Mennicke, Annelise

2017-01-01

Objective: To conduct an initial validation of the mental health provider stigma inventory (MHPSI). The MHPSI assesses stigma within the service provider--client relationship on three domains--namely, attitudes, behaviors, and coworker influence. Methods: Initial validation of the MHPSI was conducted with a sample of 212 mental health employees…

Australian National Training Authority Annual Performance Report 1996-1997.

ERIC Educational Resources Information Center

Australian National Training Authority, Brisbane.

The Australian National Training Authority (ANTA) achieved the following objectives in 1996-97: (1) sought and obtained the agreement of the Ministerial Council to make the National Training Framework more flexible and usable by training providers and their major clients (businesses and individual learners); (2) obtained in principle agreement to…

National Analysis of Differences among Substance Abuse Treatment Outcomes: College Student and Nonstudent Emerging Adults

ERIC Educational Resources Information Center

Sahker, Ethan; Acion, Laura; Arndt, Stephan

2015-01-01

Objective: To discover differences between student and nonstudent substance abuse treatment demographics, treatment characteristics, and outcomes. Participants: Conducted February 2014, clients without prior treatment admissions, aged 18-24, not in methadone maintenance therapy, and in nonintensive and ambulatory intensive outpatient treatment…

Formative Evaluation of the Behavior Change Components within a Colorado Weatherization Assistance Program

NASA Astrophysics Data System (ADS)

Sandoval, Perla K.

A formative evaluation of behavior change elements of an ongoing Weatherization Assistance Program (WAP) offered by the Energy Resource Center (E.R.C.) in Denver, CO was conducted. The WAP as administered by the E.R.C. in Colorado saves residents an average 15% of energy consumption (E.R.C., 2015). However, research suggests that adding behavioral components to WAPs could increase energy savings to 21-26% (Gregory, 1992; APPRAISE, 2002). The goal of this evaluation is to provide recommendations to E.R.C. for program changes using Community Based Social Marketing (CBSM) and Theory of Planned Behavior. The CBSM Step 1- Step 3 is the focus of this formative evaluation. This program evaluation has four components: 1) review of written materials, 2) interviews with staff, 3) surveys mailed to E.R.C. clients and 4) in-home observations conducted with E.R.C. clients. Results of this formative evaluation has 3 sections of behaviors recommended for future intervention high priority, mid priority, and low priority recommendations based on CBSM penetration, probability, and impact factors. Behaviors that are listed as high priority for E.R.C. Behavioral intervention are cold water washing, hang drying, setting back thermostats, and window coverings. Overall increase in staff engagement is also recommended to be pursued. Each staff level is also given recommendations on how to engage in behavior change interventions.

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

PubMed Central

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

2014-01-01

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

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.

The Impact of a Microfinance Program on Client Perceptions of the Quality of Care Provided by Private Sector Midwives in Uganda

PubMed Central

Agha, Sohail; Balal, Asma; Ogojo-Okello, Francis

2004-01-01

Objective To assess the impact of a microfinance program that provided business skills training and revolving loans to private sector midwives on perceived quality of services and client loyalty. Study Design A quasi-experimental study with a pretest, posttest design was used to evaluate the impact of the intervention. Exit interviews were conducted at 15 clinics that received the intervention and 7 clinics that did not. Baseline exit interviews were conducted between November and December 2000. Five days of business skills training were provided to midwives, and loans (averaging $454) were given during January and February 2001. A follow-up clinic visit was made to assess whether midwives were implementing what was emphasized during the training. The loans were to be repaid with interest within 6 to 12 months, at an interest rate that is standard within the local commercial market. For those who repaid the first set of loans (11 clinics), a second set of loans (averaging $742) was provided after June 2001. Follow-up exit interviews were conducted at the same clinics between February and March 2002. We assessed the effect of the intervention at both clinic and client levels. T-tests, the analysis of variance, and multivariate logistic regression analysis were conducted. Principal Findings These findings should be interpreted cautiously since secular trends were observed during the study period. The intervention was associated with improvement in clients' perceptions of the quality of care received at intervention clinics. The intervention was also associated with a higher level of client loyalty. Conclusions The enthusiastic response of midwives and the high loan repayment rate indicate that midwives were very receptive to the microfinance program. Overall, these findings suggest that microfinance may have an important role in strengthening private sector health services by increasing private providers' business skills and clients' satisfaction with services. PMID:15544645

Implementation of indicators through balanced scorecards in a nutritional therapy company.

PubMed

de Matos Nasser, Emanuele; Reis da Costa, Stella Regina

2013-01-01

The Balanced Scorecard (BSC) is a tool that helps in strategic management under the four following perspectives: the financial one, the client s, the internal processes of the company's, the growth and learning processes. In order to measure the performance of the entities, the BSC uses as a basis financial and non-financial indicators. To implement the BSC in a nutrional therapy company. This research deals with a case study that took place in a nutrional therapy company from January to November 2010. For analysis of the learning and growth perspective all 45 of the company's collaborators were considered and for client analysis 124 home-care clients were considered. The study sample consisted of 39 collaborators and 44 clients participating in the research. Material was elaborated for collection of data and verification of perspective tendencies through analysis of the main processes of the company, questionnaires of client's satisfaction, questionnaires of collaborator s satisfaction and spread sheets for the verification of net renvenue and percentage of disallowances. The data was launched in the spread sheet of the Excel Application Program. The indicators were chosen conforming to the strategic objectives and organizational profiles. Learning perspectives and personal growth: efficacy in capacitaion 94%, participation 77%, fidelity/retention 93%, satisfaction 75%, organizational environment 88%, well being 100%, process perspective: microbiological analysis 100%, internal auditing 100%, productivity 100%, nutritional evaluation 81%, nutritional support 100%, indication for domicile hospital care 94%, home-care visits 98%, client perspective: company perception 97%, prioritizating 94%, retention 59%, insatisfaction 24%, logistics 94%, customers ervice (SAC) 88%, motivation: trust, financial perspectives, disallowances 5% and positive company net revenue. The implementation of indicators under the four perspectives of the Balanced Scorecard were favourable in the organizational performance, in helping the decision making process. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

Feasibility of peer assessment and clinical audit to self-regulate the quality of physiotherapy services: a mixed methods study

PubMed Central

Nijhuis-van der Sanden, Maria W G; Driehuis, Femke; Heerkens, Yvonne F; van der Vleuten, Cees P M; van der Wees, Philip J

2017-01-01

Objectives To evaluate the feasibility of a quality improvement programme aimed to enhance the client-centeredness, effectiveness and transparency of physiotherapy services by addressing three feasibility domains: (1) acceptability of the programme design, (2) appropriateness of the implementation strategy and (3) impact on quality improvement. Design Mixed methods study. Participants and setting 64 physiotherapists working in primary care, organised in a network of communities of practice in the Netherlands. Methods The programme contained: (1) two cycles of online self-assessment and peer assessment (PA) of clinical performance using client records and video-recordings of client communication followed by face-to-face group discussions, and (2) clinical audit assessing organisational performance. Assessment was based on predefined performance indicators which could be scored on a 5-point Likert scale. Discussions addressed performance standards and scoring differences. All feasibility domains were evaluated qualitatively with two focus groups and 10 in-depth interviews. In addition, we evaluated the impact on quality improvement quantitatively by comparing self-assessment and PA scores in cycles 1 and 2. Results We identified critical success features relevant to programme development and implementation, such as clarifying expectations at baseline, training in PA skills, prolonged engagement with video-assessment and competent group coaches. Self-reported impact on quality improvement included awareness of clinical and organisational performance, improved evidence-based practice and client-centeredness and increased motivation to self-direct quality improvement. Differences between self-scores and peer scores on performance indicators were not significant. Between cycles 1 and 2, scores for record keeping showed significant improvement, however not for client communication. Conclusions This study demonstrated that bottom-up initiatives to improve healthcare quality can be effective. The results justify ongoing evaluation to inform nationwide implementation when the critical success features are addressed. Further research is necessary to explore the sustainability of the results and the impact on client outcomes in a full-scale study. PMID:28188156

EarthServer - 3D Visualization on the Web

NASA Astrophysics Data System (ADS)

Wagner, Sebastian; Herzig, Pasquale; Bockholt, Ulrich; Jung, Yvonne; Behr, Johannes

2013-04-01

EarthServer (www.earthserver.eu), funded by the European Commission under its Seventh Framework Program, is a project to enable the management, access and exploration of massive, multi-dimensional datasets using Open GeoSpatial Consortium (OGC) query and processing language standards like WCS 2.0 and WCPS. To this end, a server/client architecture designed to handle Petabyte/Exabyte volumes of multi-dimensional data is being developed and deployed. As an important part of the EarthServer project, six Lighthouse Applications, major scientific data exploitation initiatives, are being established to make cross-domain, Earth Sciences related data repositories available in an open and unified manner, as service endpoints based on solutions and infrastructure developed within the project. Clients technology developed and deployed in EarthServer ranges from mobile and web clients to immersive virtual reality systems, all designed to interact with a physically and logically distributed server infrastructure using exclusively OGC standards. In this contribution, we would like to present our work on a web-based 3D visualization and interaction client for Earth Sciences data using only technology found in standard web browsers without requiring the user to install plugins or addons. Additionally, we are able to run the earth data visualization client on a wide range of different platforms with very different soft- and hardware requirements such as smart phones (e.g. iOS, Android), different desktop systems etc. High-quality, hardware-accelerated visualization of 3D and 4D content in standard web browsers can be realized now and we believe it will become more and more common to use this fast, lightweight and ubiquitous platform to provide insights into big datasets without requiring the user to set up a specialized client first. With that in mind, we will also point out some of the limitations we encountered using current web technologies. Underlying the EarthServer web client and on top of HTML5, WebGL and JavaScript we have developed the X3DOM framework (www.x3dom.org), which makes possible to embed declarative X3D scenegraphs, an ISO standard XML-based file format for representing 3D computer graphics, directly within HTML, thus enabling developers to rapidly design 3D content that blends seamlessly into HTML interfaces using Javascript. This approach (commonly referred to as a polyfill layer) is used to mimic native web browser support for declarative 3D content and is an important component in our web client architecture.

A treatment model for craving identification and management.

PubMed

Stalcup, S Alex; Christian, Darrell; Stalcup, Janice; Brown, Michelle; Galloway, Gantt P

2006-06-01

This article presents an addiction treatment model based on craving identification and management (CIM). Craving is broadly defined as the desire to use alcohol or other drugs; it increases the likelihood of use of these substances. In the CIM Model treatment interventions are referenced to craving, i.e., helping clients to identify their craving level and equipping them with strategies to avoid use. Four causes of craving are identified: (1) environmental cues (triggers): exposure to people, places, and things associated with prior drug-using experiences may cause immediate and overwhelming craving; (2) stress: addicted persons experience stress as craving; (3) mental illness; and (4) drug withdrawal: symptoms of both mental illness and withdrawal lead to craving if clients associate use with relief of these symptoms. The CIM Model incorporates four service delivery elements: Relapse Prevention Workshop, individual counseling, medical/psychiatric services, and screening for ongoing drug use. At its core, the CIM Model asks clients to be aware of craving, analyze its causes, and, based on those causes, implement specific strategies to prevent and manage craving. The CIM Model combines several treatment components, including control of exposure to environmental cues, establishment of a daily schedule, the use of behaviors that dissipate craving (tools), and treatment (with medications when appropriate) of mental health and withdrawal symptoms. The CIM Model is a client-derived approach to achieving and maintaining sobriety based on a process of analyzing craving and managing it with an individualized program of recovery activities.

Barriers and facilitators to tobacco cessation in a nationwide sample of addiction treatment programs

PubMed Central

Pagano, Anna; Tajima, Barbara; Guydish, Joseph

2016-01-01

Introduction Smoking rates among addiction treatment clients are 3–4 times higher than those of the general population. Recent studies indicate that ceasing tobacco use during treatment may improve recovery outcomes. Across the United States, publicly funded addiction treatment programs vary widely in terms of their tobacco policies and tobacco cessation services offered to clients. Methods The study reported here is the qualitative component of a larger study. Twenty-four programs were recruited from a random sample of publicly funded programs participating in the NIDA Clinical Trials Network. Semistructured interviews were administered by phone to program directors. ATLAS.ti software was used to facilitate thematic analysis of interview transcripts. Findings While all directors expressed interest in helping clients to quit smoking, they cited numerous barriers to implementing tobacco policies and services. These included smoking culture, client resistance, lack of resources, staff smoking, and environmental barriers. Directors also cited several factors that they believed would support tobacco cessation. These included financial support, enhanced leadership, and state mandates against smoking in addiction treatment programs. Conclusion Addiction treatment programs are beginning to place more emphasis on tobacco cessation during treatment. However, furthering this goal requires substantial infrastructural and cultural change. These qualitative study findings may help to inform Single State Agencies (SSAs) to support publicly funded addiction treatment programs in their tobacco cessation efforts. In order to maximize effectiveness, state-level policies regarding tobacco cessation during treatment should be informed by ongoing dialogue between service providers and SSAs. PMID:27296658

Implementation and implication of total quality management on client- contractor relationship in residential projects

NASA Astrophysics Data System (ADS)

Murali, Swetha; Ponmalar, V.

2017-07-01

To make innovation and continuous improvement as a norm, some traditional practices must become unlearnt. Change for growth and competitiveness are required for sustainability for any profitable business such as the construction industry. The leading companies are willing to implement Total Quality Management (TQM) principles, to realise potential advantages and improve growth and efficiency. Ironically, researches recollected quality as the most significant provider for competitive advantage in industrial leadership. The two objectives of this paper are 1) Identify TQM effectiveness in residential projects and 2) Identify the client satisfaction/dissatisfaction areas using Analytical Hierarchy Process (AHP) and suggest effective mitigate measures. Using statistical survey techniques like set of questionnaire survey, it is observed that total quality management was applied in some leading successful organization to an extent. The main attributes for quality achievement can be defined as teamwork and better communication with single agreed goal between client and contractor. Onsite safety is a paramount attribute in the identifying quality within the residential projects. It was noticed that the process based quality methods such as onsite safe working condition; safe management system and modern engineering process safety controls etc. as interlinked functions. Training and effective communication with all stakeholders on quality management principles is essential for effective quality work. Late Only through effective TQM principles companies can avoid some contract litigations with an increased client satisfaction Index.

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.

Gradually including potential users: A tool to counter design exclusions.

PubMed

Zitkus, Emilene; Langdon, Patrick; Clarkson, P John

2018-01-01

The paper describes an iterative development process used to understand the suitability of different inclusive design evaluation tools applied into design practices. At the end of this process, a tool named Inclusive Design Advisor was developed, combining data related to design features of small appliances with ergonomic task demands, anthropometric data and exclusion data. When auditing a new design the tool examines the exclusion that each design feature can cause, followed by objective recommendations directly related to its features. Interactively, it allows designers or clients to balance design changes with the exclusion caused. It presents the type of information that enables designers and clients to discuss user needs and make more inclusive design decisions. Copyright © 2017. Published by Elsevier Ltd.

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

A purposeful Yet Nonimposing Approach: How Japanese Home Care Nurses Establish Relationships With Older Clients and Their Families.

PubMed

Iwasaki, Takako; Yamamoto-Mitani, Noriko; Sato, Kana; Yumoto, Yoshie; Noguchi-Watanabe, Maiko; Ogata, Yasuko

2017-11-01

Relationship development is crucial to nursing practice with families. However, little is known about the process of building relationships with multiple family members in home care settings and in various cultures. The objective of this study was to explore the experiences of home care nurses about how they established relationships with older clients and their families in Japan. Grounded theory was used to guide the research. Twenty-three expert home care nurses participated in semistructured interviews concerning their family nursing practice. The establishment of relationships with clients/family members was based on a purposeful yet nonimposing approach composed of four aspects: keeping a mindful distance from the family, not being a threat to family life, being a comfortable neighbor, and gaining trust as a competent nurse. Through a purposeful nonimposing approach, Japanese home care nurses promoted and nurtured nurse-family relationships and became involved in the life of the family. These findings provide a useful foundation to guide practice with families and grow knowledge about the process of establishing relationships with multiple family members in home settings.

Role of Nfu1 and Bol3 in iron-sulfur cluster transfer to mitochondrial clients

PubMed Central

Melber, Andrew; Na, Un; Vashisht, Ajay; Weiler, Benjamin D; Lill, Roland; Wohlschlegel, James A; Winge, Dennis R

2016-01-01

Iron-sulfur (Fe-S) clusters are essential for many cellular processes, ranging from aerobic respiration, metabolite biosynthesis, ribosome assembly and DNA repair. Mutations in NFU1 and BOLA3 have been linked to genetic diseases with defects in mitochondrial Fe-S centers. Through genetic studies in yeast, we demonstrate that Nfu1 functions in a late step of [4Fe-4S] cluster biogenesis that is of heightened importance during oxidative metabolism. Proteomic studies revealed Nfu1 physical interacts with components of the ISA [4Fe-4S] assembly complex and client proteins that need [4Fe-4S] clusters to function. Additional studies focused on the mitochondrial BolA proteins, Bol1 and Bol3 (yeast homolog to human BOLA3), revealing that Bol1 functions earlier in Fe-S biogenesis with the monothiol glutaredoxin, Grx5, and Bol3 functions late with Nfu1. Given these observations, we propose that Nfu1, assisted by Bol3, functions to facilitate Fe-S transfer from the biosynthetic apparatus to the client proteins preventing oxidative damage to [4Fe-4S] clusters. DOI: http://dx.doi.org/10.7554/eLife.15991.001 PMID:27532773

The meaning of work in people with severe mental illness (SMI) in Iran.

PubMed

Khalaf Beigi, Mitra; Mohammadi Shahbolaghi, Farahnaz; Rassafiani, Mehdi; Haghgoo, Hojjat-Allah; Taherkhani, Hamid

2015-01-01

Work is the key component for most people in regard to financial, social and wellbeing matters. Employment is an important factor underpinning mental health disorders. However, unemployment remains an unsolved issue worldwide. Numerous studies have focused on employment outcomes in people with severe mental illness (SMI) but, only a few have explored their perspective on employment. Therefore, this study aimed to clarify the meaning of work among clients with SMI in Iran. A qualitative research approach was used to conduct this research. Ten participants who were consumers of mental health services took part in this study. Data were analyzed by inductive content analysis approach. Four themes emerged from data including: acquiring identity, work as a drive, passing the time and financial independence. Meaning of work in studied people with SMI was probably similar to the general population. The different finding in this study refers to the dominancy of family relationships and spiritual believes which could cover some problems and in turn affect the meaning of work. Highlighting these meanings could direct mental health professionals to better planning for their clients have better understanding of their clients' work future and in turn provide more precise plan for them.

Teaching and breast self-examination: an insufficiency of instruction.

PubMed

Turnbull, Beverley J; Roberts, Kathryn

2004-01-01

Client teaching is recognised as an essential component of nursing and midwifery care, and all clinical areas provide opportunities for informal client teaching. This qualitative study aimed to explore registered nurses' professional practices with regard to teaching breast self-examination (BSE), and to identify factors that influenced their participation or non-participation in teaching about breast health. Participants' views were obtained using individual semi-structured interviews. The data were analysed inductively, that is, without imposing structure from the interview questions. Findings revealed that participants' perspectives of BSE and breast health, the dual symbolism of breasts, and the time constraints of clinical practice, were significant factors that impacted on participants' personal BSE practices and on their level of participation in teaching BSE. The results indicate that that nurses and midwives do not view teaching breast health as part of their role in client interaction, particularly in an acute care setting. Although nursing literature identifies midwives and nurses as ideally placed to promote health promotion activities, the image of BSE as linked to breast cancer, the dominant illness oriented model of care and a task orientated culture in health care facilities do not facilitate this.

Language and hope in schizophrenia-spectrum disorders.

PubMed

Bonfils, Kelsey A; Luther, Lauren; Firmin, Ruth L; Lysaker, Paul H; Minor, Kyle S; Salyers, Michelle P

2016-11-30

Hope is integral to recovery for those with schizophrenia. Considering recent advancements in the examination of clients' lexical qualities, we were interested in how clients' words reflect hope. Using computerized lexical analysis, we examined social, emotion, and future words' relations to hope and its pathways and agency components. Forty-five clients provided detailed narratives about their life and mental illness. Transcripts were analyzed using the Linguistic Inquiry and Word Count program (LIWC), which assigns words to categories (e.g., "anxiety") based on a pre-existing dictionary. Correlations and linear multiple regression were used to examine relationships between lexical qualities and hope. Hope and its subcomponents had significant or trending bivariate correlations in expected directions with several emotion-related word categories (anger and sadness) but were not associated with expected categories such as social words, positive emotions, optimism, achievement, and future words. In linear multiple regressions, no LIWC variable significantly predicted hope agency, but anger words significantly predicted both total hope and hope pathways. Our findings indicate lexical analysis tools can be used to investigate recovery-oriented concepts such as hope, and results may inform clinical practice. Future research should aim to replicate our findings in larger samples. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The Google Online Marketing Challenge: Real Clients, Real Money, Real Ads and Authentic Learning

ERIC Educational Resources Information Center

Miko, John S.

2014-01-01

Search marketing is the process of utilizing search engines to drive traffic to a Web site through both paid and unpaid efforts. One potential paid component of a search marketing strategy is the use of a pay-per-click (PPC) advertising campaign in which advertisers pay search engine hosts only when their advertisement is clicked. This paper…

Improving Family Engagement: The Organizational Context and Its Influence on Partnering with Parents in Formal Child Care Settings

ERIC Educational Resources Information Center

Douglass, Anne

2011-01-01

Family engagement is widely considered a key component of high-quality early care and education (ECE). While most efforts to improve the quality of family engagement focus on teacher training, strong evidence from health care research suggests that the organizational context is a critical determinant of the quality of client-professional…

Perceived sources of work stress and satisfaction among hospital and community mental health staff, and their relation to mental health, burnout and job satisfaction.

PubMed

Prosser, D; Johnson, S; Kuipers, E; Szmukler, G; Bebbington, P; Thornicroft, G

1997-07-01

This questionnaire study examined perceived sources of stress and satisfaction at work among 121 mental health staff members. Five factors were derived from principal component analysis of sources of work stress items (stress from: role, poor support, clients, future, and overload), and accounted for 70% of the total variance. Four factors were derived from the items related to sources of job satisfaction (satisfaction from: career, working with people, management, and money), accounting for 68% of the variance. The associations of these factors with sociodemographic and job characteristics were examined, and they were entered as explanatory variables into regression models predicting mental health, burnout, and job satisfaction. Stress from "overload" was associated with being based outside an in-patient ward, and with emotional exhaustion and worse mental health. Stress related to the "future" was associated with not being white. Stress from "clients" was associated with the "depersonalization" component of burnout. Higher job satisfaction was associated with "management" and "working with people" as sources of satisfaction, whereas emotional exhaustion and poorer mental health were associated with less "career" satisfaction.