Vocational Counselor Credentials and Case Closures for Consumers With Co-Occurring Substance Use Disorders

Copious studies have collected data on issues regarding employment among persons with a disability (consumers) and a co-occurring chemical dependency. However, more research needs to be conducted which focuses on the services provided to this specific population in regard to employment, specifically vocational rehabilitation counseling. This study examined whether master’s level rehabilitation counselors are being trained to effectively assist consumers with co-occurring substance use disorders. Study participants included master’s level rehabilitation counselors working for Minnesota Vocational Rehabilitation Services (VRS) who were credentialed as Certified Rehabilitation Counselors (CRC), CRC and Licensed Alcohol and Drug Counselors (LADC), have no credentials or have obtained a master’s degree in a related field with no credentials. It was hypothesized vocational rehabilitation counselors will complete a greater number of successful case closures if they are both CRC and LADC. Results indicated no significant differences between counselor credentials and case closures. Data from this study revealed that approximately one in five, or 19.4%, of all consumers served among the analyzed caseloads, had either a SUD diagnosis or undiagnosed chemical dependency, indicating a need for competency in addictions. Ninety-five percent of counselors indicated that rehabilitation counselors should addiction trainings in their graduate programs. A visible trend was identified in the distribution of case closures and CRC credentials. The presence of a CRC credential, either current, lapsed or combined with another credential, increased the number of case closures counselors had obtained. This study was limited by sample size. Future research should measure a larger group of counselors in order to ensure a representative sample which includes LADC credentialed rehabilitation counselors

The Development of a Football Training Film and Manual of the Five-four Defense at South Dakota State University

The purpose of this study was to develop a training film and a manual for use as a teaching aid in the coaching of the South Dakota State University Four-Five Defense. The method employed was observational and evaluational motion picture analysis. A checklist was developed by the author and validated by the football staff of South Dakota State University. This checklist served as the criteria by which the plays were selected to illustrate the correct execution of the defensive techniques. The plays were all selected from South Dakota State University game films of the years 1957 through 1962. The selected plays and proper titles and subtitles were then spliced together to form the training film. A manual was written to explain and describe the film and also include the author’s recommendation for film utilization

The Impact of Reader’s Workshop on Reading Engagement

The objective of our research was to identify whether reader’s workshop had an impact in student engagement in reading activities. The research was conducted in two third grade classrooms in a rural public elementary school over the course of four weeks. This study was conducted during our reading block which consisted of 90 minutes daily. We gathered data based on the main components of reader’s workshop. These included a pre- and post-assessment of student reading habits, an observation checklist of reading behaviors, reader’s response rubric, and documentation of reader’s conferencing. The data gathered revealed that student reading habits improved through the use of reader’s workshop. Their comprehension and fluency were enhanced due to implementation of sustained independent reading and conferencing with their teacher on a weekly basis. Based on the results, we will continue to implement reader’s workshop to foster positive reading practices in our classrooms

Infrared study of carbon deposits on bimetallic catalysts

Catalytic reforming of low octane gasoline is carried out on dual function catalysts, e.g. Pt/alumina, Pt-Re/alumina, Pt-Sn/alumina. Carboxylates are a constituent of coke on alumina; Re lowers this. 3 wt% Sn lowers both carboxylate and coke by 40% compared to alumina. 3% loadings of both Sn and Pt showed a strong synergistic effect: total coke is increased by 300% and carboxylate production is doubled. At 3% loadings of both metals, the ability of Pt to chemisorb CO is decreased, which parallels the excess coke. At 0.3%, both effects are not detectable. In order to understand the effects of second metals added with Pt on carboxylate production, a study of the mechanism of the production of carbon-oxygen species under reducing conditions of coke deposition is needed

A Multivariate Approach to a Meta-Analytic Review of the Effectiveness of the D.A.R.E. Program

The Drug Abuse Resistance Education (D.A.R.E.) program is a widespread but controversial school-based drug prevention program in the United States as well as in many other countries. The present multivariate meta-analysis reviewed 20 studies that assessed the effectiveness of the D.A.R.E. program in the United States. The results showed that the effects of the D.A.R.E. program on drug use did not vary across the studies with a less than small overall effect while the effects on psychosocial behavior varied with still a less than small overall effect. In addition, the characteristics of the studies significantly explained the variation of the heterogeneous effects on psychosocial behavior, which provides empirical evidence for improving the school-based drug prevention program

Functionality and feedback: a realist synthesis of the collation, interpretation and utilisation of patient-reported outcome measures data to improve patient care

Background: The feedback of patient-reported outcome measures (PROMs) data is intended to support the care of individual patients and to act as a quality improvement (QI) strategy. Objectives: To (1) identify the ideas and assumptions underlying how individual and aggregated PROMs data are intended to improve patient care, and (2) review the evidence to examine the circumstances in which and processes through which PROMs feedback improves patient care. Design: Two separate but related realist syntheses: (1) feedback of aggregate PROMs and performance data to improve patient care, and (2) feedback of individual PROMs data to improve patient care. Interventions: Aggregate – feedback and public reporting of PROMs, patient experience data and performance data to hospital providers and primary care organisations. Individual – feedback of PROMs in oncology, palliative care and the care of people with mental health problems in primary and secondary care settings. Main outcome measures: Aggregate – providers’ responses, attitudes and experiences of using PROMs and performance data to improve patient care. Individual – providers’ and patients’ experiences of using PROMs data to raise issues with clinicians, change clinicians’ communication practices, change patient management and improve patient well-being. Data sources: Searches of electronic databases and forwards and backwards citation tracking. Review methods: Realist synthesis to identify, test and refine programme theories about when, how and why PROMs feedback leads to improvements in patient care. Results: Providers were more likely to take steps to improve patient care in response to the feedback and public reporting of aggregate PROMs and performance data if they perceived that these data were credible, were aimed at improving patient care, and were timely and provided a clear indication of the source of the problem. However, implementing substantial and sustainable improvement to patient care required system-wide approaches. In the care of individual patients, PROMs function more as a tool to support patients in raising issues with clinicians than they do in substantially changing clinicians’ communication practices with patients. Patients valued both standardised and individualised PROMs as a tool to raise issues, but thought is required as to which patients may benefit and which may not. In settings such as palliative care and psychotherapy, clinicians viewed individualised PROMs as useful to build rapport and support the therapeutic process. PROMs feedback did not substantially shift clinicians’ communication practices or focus discussion on psychosocial issues; this required a shift in clinicians’ perceptions of their remit. Strengths and limitations: There was a paucity of research examining the feedback of aggregate PROMs data to providers, and we drew on evidence from interventions with similar programme theories (other forms of performance data) to test our theories. Conclusions: PROMs data act as ‘tin openers’ rather than ‘dials’. Providers need more support and guidance on how to collect their own internal data, how to rule out alternative explanations for their outlier status and how to explore the possible causes of their outlier status. There is also tension between PROMs as a QI strategy versus their use in the care of individual patients; PROMs that clinicians find useful in assessing patients, such as individualised measures, are not useful as indicators of service quality. Future work: Future research should (1) explore how differently performing providers have responded to aggregate PROMs feedback, and how organisations have collected PROMs data both for individual patient care and to improve service quality; and (2) explore whether or not and how incorporating PROMs into patients’ electronic records allows multiple different clinicians to receive PROMs feedback, discuss it with patients and act on the data to improve patient care

How do patient reported outcome measures (PROMs) support clinician-patient communication and patient care? A realist synthesis

Background: In this paper, we report the findings of a realist synthesis that aimed to understand how and in what circumstances patient reported outcome measures (PROMs) support patient-clinician communication and subsequent care processes and outcomes in clinical care. We tested two overarching programme theories: (1) PROMs completion prompts a process of self-reflection and supports patients to raise issues with clinicians and (2) PROMs scores raise clinicians’ awareness of patients’ problems and prompts discussion and action. We examined how the structure of the PROM and care context shaped the ways in which PROMs support clinician-patient communication and subsequent care processes. Results: PROMs completion prompts patients to reflect on their health and gives them permission to raise issues with clinicians. However, clinicians found standardised PROMs completion during patient assessments sometimes constrained rather than supported communication. In response, clinicians adapted their use of PROMs to render them compatible with the ongoing management of patient relationships. Individualised PROMs supported dialogue by enabling the patient to tell their story. In oncology, PROMs completion outside of the consultation enabled clinicians to identify problematic symptoms when the PROM acted as a substitute rather than addition to the clinical encounter and when the PROM focused on symptoms and side effects, rather than health related quality of life (HRQoL). Patients did not always feel it was appropriate to discuss emotional, functional or HRQoL issues with doctors and doctors did not perceive this was within their remit. Conclusions: This paper makes two important contributions to the literature. First, our findings show that PROMs completion is not a neutral act of information retrieval but can change how patients think about their condition. Second, our findings reveal that the ways in which clinicians use PROMs is shaped by their relationships with patients and professional roles and boundaries. Future research should examine how PROMs completion and feedback shapes and is influenced by the process of building relationships with patients, rather than just their impact on information exchange and decision making

Tone, Phonation, and the Phonology-Phonetics Interface in San Martín Peras Mixtec

The phonology-phonetics interface is broadly concerned with the question of how abstract knowledge of a language's sound system influences and is influenced by the physical processes of producing and perceiving speech. There are a multitude of models that aim to address this question, many of which make distinct and even contradictory claims. This dissertation uses evidence from tone and phonation in San Martín Peras Mixtec (SMPM; ISO: jmx) to narrow the hypothesis space of viable frameworks of the interface, arguing that two basic characteristics must hold of any successful approach. First, drawing from phonetic and phonological analysis of a highly-specific process of low tone spread in SMPM, I argue that phonological and phonetic units of representation are defined at distinct levels of granularity, and therefore that they constitute distinct levels of representation. By extension, if any framework is to successfully derive low tone spread, it must incorporate different levels of representation for phonology and phonetics. Second, I show that a rate-driven, phonetic process of laryngeal reduction in SMPM influences the application of a phonological alternation, which provides evidence that the language's phonetic system is able to non-trivially influence which phonological output makes it to the surface. I argue that, in order to account for laryngeal reduction in SMPM, any successful model of the interface must allow for phonetics to influence phonology, though this influence must be indirect. Finally, I outline a model of Phonetically-Informed Candidate Selections (PICS) that embodies these characteristics and compare it with other frameworks that implement the required characteristics somewhat differently, outlining the distinct typological predictions and empirical coverage of each approach. Ultimately, this dissertation aims to constrict the hypothesis space of potential approaches to the phonology-phonetics interface, with the ultimate goal of pushing forward the field's understanding of the nature of language users' multi-tiered knowledge about the sound systems of their languages