Adherence to Psychotherapy for Post-Traumatic Stress in Veterans of Military Combat in Afghanistan (Operation Enduring Freedom) and Iraq (Operation Iraqi Freedom)

Elucidating factors associated with adherence to treatment for physical and mental health conditions is important, given well-documented associations between non-adherence and poor treatment outcomes. Researchers have worked to identify such factors; however, most studies focus on adherence to medical, rather than, psychological treatments. Clarifying variables that predict adherence to psychotherapy is particularly important for individuals with post-traumatic stress disorder (PTSD), for whom treatment, which typically involves exposure to trauma-related stimuli and imagery, can be aversive. It may consequently be associated with high nonadherence rates, even though studies indicate that greater adherence to PTSD treatment relates to better treatment outcomes. Research needs to identify factors that increase or decrease the likelihood that affected individuals will enter and complete therapy. Although several studies to date have examined adherence to treatment for PTSD, this literature is limited on several fronts. First, studies on psychotherapy adherence have identified few consistent predictors of treatment adherence. Second, adherence to psychotherapy is rarely a central focus of treatment-related research; more typically, researchers treat adherence as secondary in importance to treatment outcomes. Third, little research on psychotherapy adherence has been theoretically driven. Fourth, little adherence research has focused on combat veterans with PTSD, who tend to have particularly poor treatment outcomes. Especially lacking is knowledge about predictors of adherence in veterans who have recently returned from combat; most research focuses on veterans of the Vietnam War, many of whom were initially traumatized decades earlier. The study tested the hypothesis that elevated reports of a specific type of PTSD symptom--avoidance/emotional numbing-- predicted poorer adherence to treatment in 160 veterans who received psychotherapy. No significant associations between avoidance and emotional numbing symptoms and adherence were found. However, emotional numbing was negatively related to psychotherapy adherence. Other variables typically related to PTSD and treatment outcomes were found to be important predictors of psychotherapy adherence and completion/noncompletion of therapy

Novel Distances for Dollo Data

We investigate distances on binary (presence/absence) data in the context of a Dollo process, where a trait can only arise once on a phylogenetic tree but may be lost many times. We introduce a novel distance, the Additive Dollo Distance (ADD), which is consistent for data generated under a Dollo model, and show that it has some useful theoretical properties including an intriguing link to the LogDet distance. Simulations of Dollo data are used to compare a number of binary distances including ADD, LogDet, Nei Li and some simple, but to our knowledge previously unstudied, variations on common binary distances. The simulations suggest that ADD outperforms other distances on Dollo data. Interestingly, we found that the LogDet distance performs poorly in the context of a Dollo process, which may have implications for its use in connection with conditioned genome reconstruction. We apply the ADD to two Diversity Arrays Technology (DArT) datasets, one that broadly covers Eucalyptus species and one that focuses on the Eucalyptus series Adnataria. We also reanalyse gene family presence/absence data on bacteria from the COG database and compare the results to previous phylogenies estimated using the conditioned genome reconstruction approach

Older people's experiences of their kitchens: 2000 to 2010

Purpose – This paper aims to present the quantitative results based on a comparison and evaluation of older people's experiences, needs and wants from their current kitchens, combining and comparing the results obtained from two studies conducted in 2000 and 2010 to see what progress has been made. Design/methodology/approach – A study in 2010 investigated the life-long and contemporary experiences of kitchens of 48 people aged over 60 years of age. The research included detailed questionnaire interviews asking people about their experiences of living in their current kitchen. A previous study, conducted in 2000, asked many of the same questions of 22 people in the same age group. Findings – By combining and comparing the two sets of data it seems that only limited progress has been made in terms of kitchen design meeting the needs of older people between 2000 and 2010. Research limitations/implications – Owing to the small sizes of the samples it is not possible to compare the figures statistically or present them as fully representative of the British older population but while the two samples are limited both had similar characteristics of age and gender, so differences do show potential trends over time. Practical implications – The research refers to guidance and a computer based design tool and identifies a number of practical implications for design. Social implications – As people age their abilities and needs can change and their kitchen may no longer be as accessible or appropriate to their needs. Originality/value – This paper adds to the relevant guidance for designers, developers and managers of buildings where the continued personal use of a kitchen is important for continuing independence of older people

Employable knowledge: benchmarking education about standardization in the UK

For academics and students in the United Kingdom the main source of standards is via British Standards Institution (BSI). The research demonstrates that British, European and International Standards play a key role in many areas of education. In some disciplines their inclusion in the course is mandatory, e.g. in building construction and performing risk assessments of equipment. Where not a requirement, other courses successfully encourage students to understand and apply specific standards and principles from them, to their design and project work, in topic areas such as quality management and user-computer interface design. Assessment practice is a key part of learning and academics have indicated how this fitted into the learning activity, e.g. by expecting students to develop an understanding of standards and reference them in all assessed work. Likewise, students taking part in the survey also suggest that they were actively engaged with one or more standards and that their understanding was measured through an assessed activity. However, students also emphasised the importance of additional support, e.g. introduction to standards in the workplace or as part of work placements, by library staff as an information resource, and by presentations from BSI experts. Employers have also indicated the importance of students’ knowledge, understanding and appreciation of relevant standards in the right context, emphasising their desire for standards to be included more widely in the curriculum. The draft recommendations from this study were subject to International review and comment, the results from this review served to strengthen the recommendations of this work. This research was commissioned by British Standards Institution (BSI). This research was produced in association with the Department for Business, Innovation and Skills as part of its ongoing programme of support for standardization. Grateful thanks are due to all those who filled in the questionnaire or who attended the workshops

Towards curricula in design for all for information and communication products, systems and services.

The aim of the Inclusive Design Curriculum Network (IDCnet) is to integrate information and identify core knowledge sets and skills for model curricula in design for all (DfA) specifically for information and communication products, systems and services. Identifying such knowledge and skills is a step towards providing designers with training and competence in inclusive design principles, methods and tools. One of the first major activities of IDCnet is a workshop to be held in Helsinki in February 2003 called ‘Design for All Curriculum: Towards a synergy of the needs of ICT industry and education.’ The workshop will be bringing together: • Experts from DfA-aware industries to discuss and suggest what they would expect from graduates they would employ who claim to have proficiency in DfA, and • Experts from the academic world, with teaching or research interests in DfA, to use their own experiences in the field to suggest key knowledge sets and skills that would be necessary for curricula in this area. This presentation will: • summarise and discuss the Helsinki results and recommendations • discuss existing fora, information resources, materials and tools which could form part of model DfA curricula • seek further views and opinions from educators, trainers, students, education policy makers and end-users, and • promote the network to a wider audience of those interested in design for all curricula in the specific field of ICT

Cresting on Arrows from the Citadel of Damascus

A substantial number of arrow fragments were found during an excavation in the Citadel of Damascus. They date from the very late Mamlūk and probably very early Ottoman periods (late 15th to early 16th centuries CE). The arrows are typical of this period and of Turco-Islamic archery in general, having similarities with fragmentary and occasionally complete arrows from Central and Inner Asia, especially where their nocks are concerned. One of the most distinctive features of the Damascus Citadel arrow fragments is their cresting (painted colouring around, within, and next to the nocks). A variety of patterns can be identified. These can be grouped according to colour, number and size of rings. Although cresting is barely mentioned in medieval written texts, one may to assume that it was primarily functional and provided a means of identifying the arrows. What remains unclear is the purpose of such identification, whether it concerned ownership of an arrow or was to identify a type of arrow and arrowhead. A substantial number of arrow fragments with arrowheads attached were also found in the Citadel of Damascus, but are too fragmentary for a connection to be made between types of arrowhead and the different designs of cresting.Lors de fouilles dans la citadelle de Damas, un nombre important de fragments de flèches a été mis au jour. Ils sont probablement datables de la toute fin de la période mamelouke et du début des Ottomans (fin xve‑début xvie s.). Les flèches appartiennent typiquement à cette période et sont représentatives de l’archerie turco-islamique en général, montrant des similitudes avec des fragments et parfois des flèches complètes d’Asie centrale et intérieure, particulièrement en ce qui concerne leur encoche. L’une des caractéristiques des fragments trouvés dans la citadelle de Damas est leur décoration : elle prend la forme d’une coloration autour, à l’intérieur et à côté des encoches. Divers modèles ont pu être identifiés en fonction de la couleur, du nombre et de la taille des anneaux. Bien que ces décorations soient à peine mentionnées dans les sources médiévales, on peut supposer qu’elles furent principalement fonctionnelles et permettaient d’identifier des types de flèches. On s’interroge toutefois sur les raisons d’une telle identification : s’agissait-il d’un marquage propre à leur propriétaire où était‑ce le moyen d’identifier des types de flèches en fonction de leur pointe ? À Damas, des fragments de flèches avec pointes ont également été trouvés sans qu’il soit possible de mettre en relation des types de flèche avec les différents modèles de décoration.أثناء الحفريات في قلعة دمشق اكتشف عدد كبير من قطع السهام التي يعود تاريخها، على أغلب الظن، إلى أواخر العصر المملوكي وأوائل العصر العثماني (نهاية القرن الخامس عشر ـ بداية السادس عشر ميلادي). تنتمي هذه السهام إلى تلك العصور على وجه الخصوص وهي تمثل أنموذجاً من فن رمي السهام التركي-الإسلامي بشكل عام، حيث أنها تشبه قطعاً من السهام وأحياناً سهاماً كاملة من آسيا الوسطى والداخلية وعلى وجه التحديد ما يخص حزّها. إحدى ميزات هذه القطع التي عُثر عليها في قلعة دمشق هي زخرفتها وتلوين جوانب الحزّ ووسطه. لقد تم تحديد عدة نماذج بفضل لون الحلقات وعددها وحجمها. ذلك أن مصادر القرون الوسطى تكاد لا تذكر هذه الزخارف ومع هذا نفترض أنها كانت بشكل أساسي وظيفية وكانت تسمح بتحديد نمط الأسهم. غير أننا قد نتساءل عن سبب هذا التلوين : أكانت علامة خاصة بصاحبها أم كانت وسيلة لتحديد نمط السهم حسب رأسه ؟ فلم نستطع أن نجد من ضمن قطع السهام التي عُثر عليها في دمشق وهي ذات رأس علاقةً تربط بين نمط السهم و مختلف نماذج الزخرفة.

Needs of Family Members of Patients in the Critical Care Unit and the Nurse\u27s Perception of Those Needs

The family is greatly affected when one member is admitted to a critical care unit. Critical care nurses are in an ideal position to help families cope with the crisis of a critical illness. Those who are knowledgeable of family member needs will provide more compassionate and effective nursing care to both the patient and family. This study investigated the needs of family members of patients in the critical care unit and compared them to the critical care nurse\u27s perception of those needs. The sample consisted of 55 critical care nurses and 51 family members of critically ill patients from a 350 bed southwestern private hospital. The null hypothesis stated there would be no significant difference (p=.05) between identified family member needs and the nurses perception of family member needs in the critical care unit. The (CCFNI) Critical Care Family Needs Inventory was utilized as a research tool (Molter, 1976). The instrument consists of 44 family member need statements rated on a Likert scale from 1 (not important) to 4 (very important). The study found that although some needs were ranked in the same order of importance by both family members and critical care nurses, most were not. However, calculation of mean values found both nurses and family members ranked To have questions answered honestly and To be assured that the best care possible is being given to the patient as the most important needs. Family members\u27 emotional needs were found to be the least important in the first 72 hour period after the patient\u27s admission to the critical care unit. Chi Square analysis reflected significant differences in ranking of 23 needs at the .05 level. To visit at any time, To be told about someone that could help with family problems, To talk about negative feelings such as guilt or anger, and To know how the patient is being treated medically had the greatest variation. Further research would assist nurses in identifying primary family needs and aid families in coping with the crisis of critical illness, which may influence both patient outcome and family integrity