Residential Drug Abuse Treatment for Probationers: Use of Node-Link Mapping to Enhance Participation and Progress

Node-link mapping, a graphic representation tool, was used to enhance substance-abuse treatment in a 4-month residential criminal justice program. Twelve communities of 30 to 35 probationers (“residents”) were randomly assigned to either mapping-enhanced or standard counseling. During group sessions, counselors and residents in the mapping communities collaborated to develop node-link maps representing critical issues. Counselors in standard communities used their own methods. Treatment motivation (i.e., desire for help) was assessed at intake and was used to categorize residents into three levels. Treatment involvement was measured at the middle and at the end of the program. Residents, as well as their counselors, rated those in mapping communities as participating more in group sessions than those in standard communities. Mapping residents also reported better personal progress toward treatment goals, more positive affective responses to treatment, and greater treatment engagement. Residents with higher motivation at intake had higher treatment involvement scores regardless of type of counseling received.     

Organization of the intercollicular pathway in rat

The intercollicular pathway of the rat was studied using autoradiographic (ARG) and horseradish peroxidase (HRP) tracing techniques. The HRP experiments demonstrated that the cells of origin of the intertectal pathway were located primarily in the rostral stratum griseum intermediale (SGI), stratum album intermedium (SAI) and stratum griseum profundum (SGP). Intertectal neurons were in most cases multipolar and had average somal diameters which ranged between 8 and 33μm. Only a small number of superficial layer neurons contributed axons to the intercollicular pathway. ARG tracing showed that the intertectal pathway terminated in the deep layers of the rostral one half of the colliculus. The primary terminal zone was SGP. In addition, labeled axons left this region and coursed dorsally to terminate in a series of patches in the lower SGI and upper SAI. A small number of labeled fibers also reached the stratum opticum (SO) and lower stratum griseum superficiale (SGS).     

Theoretical analysis of non-invasive oscillometric maximum amplitude algorithm for estimating mean blood pressure

A theoretical analysis is performed to evaluate the effect of arterial mechanical and blood pressure pulse properties on the accuracy of non-invasive oscillometric maximum amplitude algorithm (MAA) estimates of the mean blood pressure obtained using air-filled occlusive cuffs. Invasively recorded blood pressure pulses, selected for their varied shapes, are scaled to simulate a wide range of blood pulse pressures (diastolic blood pressure minus systolic blood pressure). Each scaled blood pressure pulse is transformed through an exponential model of an artery to create a series of blood volume pulses from which a simulated oscillometric waveform is created and the corresponding MAA estimate of the mean blood pressure and error (mean blood pressure minus MAA estimate) are determined. The MAA estimates are found to depend on the arterial blood pressure. The errors are found to depend on the arterial mechanical properties, blood pressure pulse shape and blood pulse pressure. These results suggest that there is no direct relationship between the mean blood presure and MAA estimate, and that multiple variables may affect the accuracy of MAA estimates of the mean blood pressure obtained using air-filled occlusive cuffs.     

Integrative interventions for MSDs: Nature, evidence, challenges & directions

Background: When applied to workplace interventions, integrative may be seen in various ways, requiring elucidation. Methods: Identification of primary studies through systematic reviews, limited bibliographic literature searches, the Cochrane Occupational Health Field database on intervention studies, and authors’ files. Focus was 2000 on. Categorization according to the Cochrane classes and lenses on integrative. Synthesis as narrative review. Results: Examples of each lens on integrative were uncovered: biomechanical and psychosocial, multiple component, primary and secondary prevention, organizational, and system. Each contributed different understanding to the potential impacts on different knowledge, exposure, behavior, health and administrative outcomes. Conclusions: Considerable opportunities exist to expand the range of integrative interventions, particularly at the organizational and system levels, and incorporate a combination of knowledge transfer and exchange with intervention evaluation.     

Differential Lung Ventilation with Unilateral PEEP Following Unilateral Hydrochloric Acid Aspiration in the Dog

Differential lung ventilation with positive end expiratory pressure (PEEP) improves pulmonary gas exchange when used in the supportive care of patients with severe unilateral or asymmetrical lung disease. Once the provision of selective PEEP to the two lungs is accomplished, the best method of partitioning the tidal volume between the two lungs is unknown. Twelve mongrel dogs were given a unilateral hydrochloric acid (HCl) aspiration injury. A computer controlled differential lung ventilation system was used to ventilate four dogs with equal volumes to each lung, four dogs with equal driving pressure (end inspiratory pressure-PEEP) to each lung, and four dogs with equal end-tidal CO₂ fraction from each lung. The respiratory rate was feedback controlled to maintain Paco₂ at 4.67 kPa. The dogs were kept supine and ventilated with 30% O₂. Following injury, the PEEP was set at 0 kPa for 1 h. The dogs were then given 1.36 kPa and 2.72 kPa PEEP to the injured lung for 2 h in a cross-over fashion. The assignment of the tidal volume controller, the side of injury, and the PEEP sequence was random. Oxygen tension fell and pulmonary venous admixture increased after giving the HCl injury. In all three groups considered simultaneously, unilateral PEEP improved Pao₂ and venous admixture. The equal tidal volume distribution was the only group to show a significant improvement in Pao₂ at both PEEP increments (0 to 1.36 kPa and 2.72 kPa). There was a significant difference in tidal volume allocation between the three groups with the equal end-tidal and equal pause pressure groups only minimally ventilating the injured lung. With differential lung ventilation and unilateral PEEP, equal partitioning of tidal volume provides the highest Pao₂, compared to the other two methods of partitioning tidal volume.     

A highly specific L-galactose-1-phosphate phosphatase on the path to ascorbate biosynthesis

Ascorbate is a critical compound in plants and animals. Humans are unable to synthesize ascorbate, and their main source of this essential vitamin are plants. However, the pathway of synthesis in plants is yet to be established, and several unknown enzymes are only postulated to exist. We describe a specific L-galactose-1-phosphate (L-gal-1-P) phosphatase that we partially purified from young kiwifruit (Actinidia deliciosa) berries. The enzyme had a native molecular mass of approximately 65 kDa, was completely dependent on Mg2+ for activity and was very specific in its ability to hydrolyze L-gal-1-P. The activity had a pH optimum of 7.0, a K(-M(L-gal-1-P) of 20-40 microM and a Ka(Mg2+) of 0.2 mM. The activity was inhibited by Mg2+ at concentrations >2 mM. The enzyme from Arabidopsis thaliana shoots showed similar properties to the kiwifruit enzyme. The Arabidopsis thaliana enzyme preparation was digested with trypsin, and proteins present were identified by using liquid chromatography-MS. One of 24 proteins present in our preparation was an Arabidopsis thaliana protein, At3g02870, annotated myo-inositol-1-phosphate phosphatase in GenBank, that matched the characteristics of the purified l-gal-1-phosphate phosphatase. We then expressed a kiwifruit homologue of this gene in Escherichia coli and found that it showed 14-fold higher maximum velocity for l-gal-1-P than myo-inositol-1-P. The expressed enzyme showed very similar properties to the enzyme purified from kiwifruit and Arabidopsis, except that its KM(L-gal-1-P) and Ka(Mg2+) were higher in the expressed enzyme. The data are discussed in terms of the pathway to ascorbate biosynthesis in plants.     

Linking the elements of change: Program and client responses to innovation

The process of innovation adoption was investigated using longitudinal records collected from a statewide network of almost 60 treatment programs over a 2-year period. Program-level measures of innovation adoption were defined by averaged counselor ratings of program training needs and readiness, organizational functioning, quality of a workshop training conference, and adoption indicators at follow-up. Findings showed that staff attitudes about training needs and past experiences are predictive of their subsequent ratings of training quality and progress in adopting innovations a year later. Organizational climate (clarity of mission, cohesion, openness to change) is also related to innovation adoption. In programs that lack an open atmosphere for adopting new ideas, it was found that counselor trial usage is likely to be attenuated. Most important was evidence that innovation adoption based on training for improving treatment engagement was significantly related to client self-reports of improved treatment participation and rapport recorded several months later.     

Counselor perceptions of organizational factors and innovations training experiences

Because work environment is central to understanding job performance, drug counselor perceptions of their programs and their skills were examined in relation to their attitudes about innovations training and its utilization. Latent profile analysis of measures on organizational climate and staff attributes for 1047 counselors from 345 programs defined three categories of counselors-labeled as isolated, integrated, and exceptional. All had generally positive views of their professional skills, although the isolated group scored lower on scales representing professional growth and influence on peers. They were less positive about the "climate" of programs in which they worked and were higher on stress. Program resources predicted the counselor groups, with the isolated having more limited resources. Counselor categorizations also differed in terms of workshop training experiences, with the isolated group of counselors reporting significantly less exposure, satisfaction, and program-wide use of workshop training.     

Counselor assessments of training and adoption barriers

The prevailing emphasis on adopting evidence-based practices suggests that more focused training evaluations that capture factors in clinician decisions to use new techniques are needed. This includes relationships between postconference evaluations and subsequent adoption of training materials. We therefore collected training assessments at two time points from substance abuse treatment counselors who attended a training on dual diagnosis and another on therapeutic alliance as part of a state-sponsored conference. Customized evaluations were collected to assess counselor perceptions of training quality, relevance, and resources in relation to its use during the 6 months after the conference. Higher ratings for relevance of training concepts and materials to service the needs of clients, desire to have additional training, and level of program support were related to greater trial use during the follow-up period. Primary resource-related and procedural barriers cited by the counselors included lack of time and redundancy with existing practices.