Core Competencies for Clinical Supervisors

This chapter provides useful strategies that will help guide clinical supervisors who oversee and support the work of MISSION-VET Case Managers and Peer Support Specialists. It includes an overview of the MISSION-VET supervisor’s role and a description of each team member’s primary area of responsibility within the MISSION-VET program. The remainder of the chapter describes key strategies that MISSION-VET supervisors will need in order to establish productive working relationships with MISSION Case Managers and Peer Support Specialists. These strategies, which are designed to foster a strong supervisory alliance and assure that services are being delivered with fidelity to the MISSION-VET model, will ensure the provision of the highest quality of care. Several brief vignettes are included to illustrate these strategies

Growth in Disability Benefits: Explanations and Policy Implications

This collection of original papers reveals why caseloads of the nation\u27s two largest income entitlement programs for disability - Social Security Disability Income (SSDI) and Supplemental Security Income (SSI) - have soared.https://research.upjohn.org/up_press/1191/thumbnail.jp

Microsatellite markers for hoop-petticoat daffodils (Narcissus sect. Bulbocodii; Amaryllidaceae)

• Premise of the study: Microsatellite markers were developed using hoop-petticoat daffodils ( Narcissus sect. Bulbocodii ; Amaryllidaceae) to aid in the taxonomic revision of the section, and further to evaluate their broad applicability for daffodil cultivar identification. • Methods and Results: Three hundred fifty-one primer pairs were developed using a commercial service. Nineteen polymorphic and repeatable markers were developed by screening 67 of these primer pairs. Of these, 11 chosen markers were used to screen 317 samples; the number of alleles per locus ranged from four to 21, and the observed heterozygosity ranged from 0.101 to 0.297. There were null genotypes in some samples for six of the markers. All the microsatellites were transferable to other Narcissus sections. • Conclusions: The results indicate that these new markers have sufficient potential variation to be used for taxonomic revision of the genus and to distinguish many commercial daffodil cultivars

Gender-Specific Factors Associated with Readiness to Quit Smoking among Korean Americans

Introduction: The study examined gender differences in smoking and factors associated with three stages of readiness to quit smoking (precontemplation with no quit intention in the next 6 months, contemplation with a quit intention in the next 6 months but not in the next month, and preparation with a quit intention in the next month) among Korean Americans. Method: The study is a telephone survey with a randomly selected sample from an online telephone directory. Inclusion criteria for participation were (a) being of 18 and older, (b) identifying self as Korean, and (c) having smoked daily for at least six months prior to the interview. Results: The sample comprised 70 women and 168 men with a 63.8% response rate from eligible respondents. Women were 3 years older on average than were men when they started smoking regularly (t = 3.5, p = 0.001). Women were more likely to smoke inside the house than were men (X2 = 16.5, p \u3c 0.001). Compared to women in the preparation stage, women in precontemplation and contemplation stages had decreased odds of perceiving a family norm favoring quitting and increased odds of perceiving risks of quitting. Compared to men in the preparation stage, men in precontemplation and contemplation stages had decreased odds of perceiving a family norm favoring quitting and benefits of quitting. Previous quit attempts were also a significant factor for both women and men. Conclusions: Korean American female and male smokers are similar in the aspect that they are more likely to be ready to quit when they perceive a family norm favoring quitting. However, they differ in the relationship between perceived risks and benefits of quitting and readiness to quit. These findings underscore the importance of designing gender-tailored smoking cessation interventions in addition to having culture-specific interventions with the group

Immunostaining of spores and plasmodia of disparate myxozoan genera with comments on the properties of the sporular mucus envelope

Species of the phylum Myxozoa are common parasites of fish and can cause severe losses in cultured species. Although a number of myxozoan life-cycles have now been elucidated, little is known about the biology of these organisms in the fish host. Monoclonal antibody B4 raised to the myxozoan Tetracapsuloides bryosalmonae has been previously noted to react with a number of species infecting fish kidney. We present the results of a survey of 55 myxosporean species that determined that this antibody detects an antigen on the spore surface of 33 of these species in the genera Myxobolus, Sphaerospora and Thelohanellus. However, there appears to be no clear relationship between those spores that contain the MAb B4 reactive antigen and the host or organ in which they are detected. The antigen appears to be synthesized in the plasmodial cytoplasm and is intimately associated with the surface of the spore capsules and, where present, the mucus envelope. The nature of this envelope is further discussed in relation to its formation and distinctive properties

Involvement of N-6 adenine-specific DNA methyltransferase 1 (N6AMT1) in arsenic biomethylation and its role in arsenic-induced toxicity.

BackgroundIn humans, inorganic arsenic (iAs) is metabolized to methylated arsenical species in a multistep process mainly mediated by arsenic (+3 oxidation state) methyltransferase (AS3MT). Among these metabolites is monomethylarsonous acid (MMAIII), the most toxic arsenic species. A recent study in As3mt-knockout mice suggests that unidentified methyltransferases could be involved in alternative iAs methylation pathways. We found that yeast deletion mutants lacking MTQ2 were highly resistant to iAs exposure. The human ortholog of the yeast MTQ2 is N-6 adenine-specific DNA methyltransferase 1 (N6AMT1), encoding a putative methyltransferase.ObjectiveWe investigated the potential role of N6AMT1 in arsenic-induced toxicity.MethodsWe measured and compared the cytotoxicity induced by arsenicals and their metabolic profiles using inductively coupled plasma-mass spectrometry in UROtsa human urothelial cells with enhanced N6AMT1 expression and UROtsa vector control cells treated with different concentrations of either iAsIII or MMAIII.ResultsN6AMT1 was able to convert MMAIII to the less toxic dimethylarsonic acid (DMA) when overexpressed in UROtsa cells. The enhanced expression of N6AMT1 in UROtsa cells decreased cytotoxicity of both iAsIII and MMAIII. Moreover, N6AMT1 is expressed in many human tissues at variable levels, although at levels lower than those of AS3MT, supporting a potential participation in arsenic metabolism in vivo.ConclusionsConsidering that MMAIII is the most toxic arsenical, our data suggest that N6AMT1 has a significant role in determining susceptibility to arsenic toxicity and carcinogenicity because of its specific activity in methylating MMAIII to DMA and other unknown mechanisms

Creatinine, diet, micronutrients, and arsenic methylation in West Bengal, India.

BackgroundIngested inorganic arsenic (InAs) is methylated to monomethylated (MMA) and dimethylated metabolites (DMA). Methylation may have an important role in arsenic toxicity, because the monomethylated trivalent metabolite [MMA(III)] is highly toxic.ObjectivesWe assessed the relationship of creatinine and nutrition--using dietary intake and blood concentrations of micronutrients--with arsenic metabolism, as reflected in the proportions of InAS, MMA, and DMA in urine, in the first study that incorporated both dietary and micronutrient data.MethodsWe studied methylation patterns and nutritional factors in 405 persons who were selected from a cross-sectional survey of 7,638 people in an arsenic-exposed population in West Bengal, India. We assessed associations of urine creatinine and nutritional factors (19 dietary intake variables and 16 blood micronutrients) with arsenic metabolites in urine.ResultsUrinary creatinine had the strongest relationship with overall arsenic methylation to DMA. Those with the highest urinary creatinine concentrations had 7.2% more arsenic as DMA compared with those with low creatinine (p < 0.001). Animal fat intake had the strongest relationship with MMA% (highest tertile animal fat intake had 2.3% more arsenic as MMA, p < 0.001). Low serum selenium and low folate were also associated with increased MMA%.ConclusionsUrine creatinine concentration was the strongest biological marker of arsenic methylation efficiency, and therefore should not be used to adjust for urine concentration in arsenic studies. The new finding that animal fat intake has a positive relationship with MMA% warrants further assessment in other studies. Increased MMA% was also associated, to a lesser extent, with low serum selenium and folate

Implications of microstructure theory for empirical research in stock price behavior

This paper examines the implications of microstructure theory for empirical research on stock price behaviorMicrostructure theory; empirical research on stock price behavior

A Pilot Study of a Modified Acceptance and Commitment Therapy Smoking Cessation Treatment for Veterans with PTSD

Veterans with posttraumatic stress disorder (PTSD) have high rates of smoking and significant difficulties with quitting. Acceptance and mindfulness-based techniques may enhance smoking cessation approaches for veterans with PTSD as they are designed to improve emotion regulation skills related to coping with elevated negative affect and withdrawal symptoms associated with quit attempts. Veterans with current PTSD and smoking ≥ 15 cigarettes/day (N=19) participated in an open trial of Acceptance and Commitment Therapy for Veterans with PTSD and Tobacco Use (ACT-PT). Participants attended nine weekly individual counseling sessions and received eight weeks of the nicotine patch. Primary outcomes included expired-air carbon monoxide confirmed seven-day point prevalence abstinence, number of cigarettes/day at the end of treatment, and PTSD symptoms on the PTSD Checklist (PCL). Intent-to-treat analyses examined pre-treatment to post-treatment scores on the PCL. At the end of treatment (one month after targeted quit date), 37% (7/19) of participants were abstinent from smoking, 37% (7/19) were abstinent from smoking at the one month follow-up, and 16% (3/19) were abstinent at the three month follow-up. Subjects reduced from 26 cigarettes/day at baseline to 10 cigarettes/day at the end of treatment (p\u3c.001), and 15 cigarettes/day at the 3-month follow-up (p=.002). PTSD symptoms significantly decreased from baseline to the end of treatment (p\u3c.001), and continued to remain significantly decreased at the 3-month follow-up (p=.011). The retention rate (74%), client satisfaction ratings and qualitative feedback from subjects indicated that the treatment was acceptable. Although preliminary, these results suggest that ACT-PT is a promising smoking cessation treatment for veterans with PTSD. Longer follow-up and randomized controlled studies are needed