Motivating Change in High-Risk Adolescents: An Intervention Focus on the Deviant Friendship Process

134 pagesThe purpose of the following literature review is not to exhaustively survey the current state of delinquency intervention science. Rather, the goal is to clearly delineate the developmental and peer social processes that reinforce and exacerbate adolescent problem behavior. Reviewed literature focuses on the developmental impact of family of origin, detailing how coercive family dynamics negatively impact social skills development. Consideration is then given to the difficulties children from coercive families have with school transitions. Reviewed research suggests that children who remain reliant on coercive interpersonal processes can commonly be directed by both punishments and interventions towards delinquent peer clustering, inadvertently creating environments that reinforce and exacerbate pre-delinquent social dynamics. Focus is then turned to the unique social and reinforcement dynamics inherent in these delinquent peer groups, identifying language and verbal dynamics as being a special risk factors and predictors of later problem behavior. This review, although necessarily limited in scope, argues that for the highest risk adolescents, delinquent talk and the behavioral reinforcement that it generates within the delinquent peer group is a powerful primer for later delinquent action. I also argue that high-risk adolescents' verbal behaviors are both visible and viable targets for intervention efforts.This investigation was supported in part by a Grant from the U.S. Department of Education, Office of Special Education Programs, Student Initiated Research Contest, Competition 84.324B, and an award from the Claire Wilkins Chamberlin Memorial Graduate Research Foundation

Characteristics of hepatitis C virus resistance in an international cohort after a decade of direct-acting antivirals

Background & Aims: Direct-acting antiviral (DAA) regimens provide a cure in >95% of patients with chronic HCV infection. However, in some patients in whom therapy fails, resistance-associated substitutions (RASs) can develop, limiting retreatment options and risking onward resistant virus transmission. In this study, we evaluated RAS prevalence and distribution, including novel NS5A RASs and clinical factors associated with RAS selection, among patients who experienced DAA treatment failure. Methods: SHARED is an international consortium of clinicians and scientists studying HCV drug resistance. HCV sequence linked metadata from 3,355 patients were collected from 22 countries. NS3, NS5A, and NS5B RASs in virologic failures, including novel NS5A substitutions, were examined. Associations of clinical and demographic characteristics with RAS selection were investigated. Results: The frequency of RASs increased from its natural prevalence following DAA exposure: 37% to 60% in NS3, 29% to 80% in NS5A, 15% to 22% in NS5B for sofosbuvir, and 24% to 37% in NS5B for dasabuvir. Among 730 virologic failures, most were treated with first-generation DAAs, 94% had drug resistance in ≥1 DAA class: 31% single-class resistance, 42% dual-class resistance (predominantly against protease and NS5A inhibitors), and 21% triple-class resistance. Distinct patterns containing ≥2 highly resistant RASs were common. New potential NS5A RASs and adaptive changes were identified in genotypes 1a, 3, and 4. Following DAA failure, RAS selection was more frequent in older people with cirrhosis and those infected with genotypes 1b and 4. Conclusions: Drug resistance in HCV is frequent after DAA treatment failure. Previously unrecognized substitutions continue to emerge and remain uncharacterized. Lay summary: Although direct-acting antiviral medications effectively cure hepatitis C in most patients, sometimes treatment selects for resistant viruses, causing antiviral drugs to be either ineffective or only partially effective. Multidrug resistance is common in patients for whom DAA treatment fails. Older patients and patients with advanced liver diseases are more likely to select drug-resistant viruses. Collective efforts from international communities and governments are needed to develop an optimal approach to managing drug resistance and preventing the transmission of resistant viruses

BUILDING(S) FOR EUROPE

Bruxelles Change, progetto invitato (spazio Actarquitectura - Proggetto Bruxelles Change-Quartier Europe) Mostra Building(s) for Europe ) Ancienne Gare Quartier L\ue9opold-Bruxelles, 08/05/2007 Catalogo: CLAISSE Joel, KNOPES, Liliane: Bruxelles Change ed. Prisme Editions, Bruxelles, 2004, P\ue1g: 136-157, ISBN: 2-9600-03-8