The Work of Recovery on Two Assertive Community Treatment Teams

The compatibility of recovery work with the Assertive Community Treatment (ACT) model has been debated; and little is known about how to best measure the work of recovery. Two ACT teams with high and low recovery orientation were identified by expert consensus and compared on a number of dimensions. Using an interpretive, qualitative approach to analyze interview and observation data, teams differed in the extent to which the environment, team structure, staff attitudes, and processes of working with consumers supported principles of recovery orientation. We present a model of recovery work and discuss implications for research and practice

Explicit and Implicit Stigma of Mental Illness as Predictors of Recovery Attitudes of Assertive Community Treatment Practitioners

While explicit negative stereotypes of mental illness are well established as barriers to recovery, implicit attitudes also may negatively impact outcomes. The current study is unique in its focus on both explicit and implicit stigma as predictors of recovery attitudes of mental health practitioners.Assertive Community Treatment practitioners (n = 154) from 55 teams completed online measures of stigma, recovery attitudes, and an Implicit Association Test (IAT).Three of four explicit stigma variables (perceptions of blameworthiness, helplessness, and dangerousness) and all three implicit stigma variables were associated with lower recovery attitudes. In a multivariate, hierarchical model, however, implicit stigma did not explain additional variance in recovery attitudes. In the overall model, perceptions of dangerousness and implicitly associating mental illness with "bad" were significant individual predictors of lower recovery attitudes.The current study demonstrates a need for interventions to lower explicit stigma, particularly perceptions of dangerousness, to increase mental health providers' expectations for recovery. The extent to which implicit and explicit stigma differentially predict outcomes, including recovery attitudes, needs further research

First-principles investigation of Ag-Cu alloy surfaces in an oxidizing environment

In this paper we investigate by means of first-principles density functional theory calculations the (111) surface of the Ag-Cu alloy under varying conditions of pressure of the surrounding oxygen atmosphere and temperature. This alloy has been recently proposed as a catalyst with improved selectivity for ethylene epoxidation with respect to pure silver, the catalyst commonly used in industrial applications. Here we show that the presence of oxygen leads to copper segregation to the surface. Considering the surface free energy as a function of the surface composition, we construct the convex hull to investigate the stability of various surface structures. By including the dependence of the free surface energy on the oxygen chemical potential, we are able compute the phase diagram of the alloy as a function of temperature, pressure and surface composition. We find that, at temperature and pressure typically used in ethylene epoxidation, a number of structures can be present on the surface of the alloy, including clean Ag(111), thin layers of copper oxide and thick oxide-like structures. These results are consistent with, and help explain, recent experimental results.Comment: 10 pages, 6 figure

Implicit and Explicit Stigma of Mental Illness: Attitudes in an Evidence-Based Practice

The extent to which explicit and implicit stigma are endorsed by mental health practitioners using evidence-based practices is unknown. The purposes of the current study were to a) examine implicit and explicit biases among Assertive Community Treatment (ACT) staff and b) explore the extent to which biases predicted the use of treatment control mechanisms. Participants were 154 ACT staff from nine states. Overall, the participants exhibited positive explicit and implicit attitudes toward people with mental illness. When modeled using latent factors, greater implicit, but not explicit, bias significantly predicted greater endorsement of restrictive or controlling clinical interventions. Thus, despite overall positive attitudes toward those with mental illness for the sample as a whole, individual differences in provider stigma were related to clinical care. Mental health professionals, and specifically ACT clinicians, should be educated on types of bias and ways in which biases influence clinical interventions

A Comparison of Phone-Based and On-Site Assessment of Fidelity for Assertive Community Treatment in Indiana

Objective: This study investigated the reliability and validity of a phone-administered fidelity assessment instrument based on the Dartmouth Assertive Community Treatment Scale (DACTS). Methods: An experienced rater paired with a research assistant without fidelity assessment experience or a consultant familiar with the treatment site conducted phone-based assessments of 23 teams providing assertive community treatment in Indiana. Using the DACTS, consultants conducted on-site evaluations of the programs. Results: The pairs of phone raters revealed high levels of consistency [intraclass correlation coefficient (ICC)=.92] and consensus (mean absolute difference of .07). Phone and on-site assessment showed strong agreement (ICC=.87) and consensus (mean absolute difference of .07) and agreed within .1 scale point, or 2% of the scoring range, for 83% of sites and within .15 scale point for 91% of sites. Results were unaffected by the expertise level of the rater. Conclusions: Phone-based assessment could help agencies monitor faithful implementation of evidence-based practices. (Psychiatric Services 62:670–674, 2011

The Effect of the Environment on alpha-Al_2O_3 (0001) Surface Structures

We report that calculating the Gibbs free energy of the alpha-Al_2O_3 (0001) surfaces in equilibrium with a realistic environment containing both oxygen and hydrogen species is essential for obtaining theoretical predictions consistent with experimental observations. Using density-functional theory we find that even under conditions of high oxygen partial pressure, the metal terminated surface is surprisingly stable. An oxygen terminated alpha-Al_2O_3 (0001) surface becomes stable only if hydrogen is present on the surface. In addition, including hydrogen on the surface resolves discrepancies between previous theoretical work and experimental results with respect to the magnitude and direction of surface relaxations.Comment: 4 pages including 2 figures. Submitted to Phys. Rev. Lett. Related publications can be found at http://www.fhi-berlin.mpg.de/th/paper.htm

Prolegomena to Any Future Carver Studies

Failing of satisfactory progress in explaining the movements of the heavenly bodies on the supposition that they all revolved round the spectator, he tried whether he might not have better success if he made the spectator to revolve and the stars to remain at rest.Immanuel Kant. Preface to the Second Edition, The Critique of Pure Reason (1787) Ever since the tenth anniversary of the death of Raymond Carver (1938-1988) scholars and general readers have been uneasily aware of what has come to b..

Prolegomena to Any Future Carver Studies

Failing of satisfactory progress in explaining the movements of the heavenly bodies on the supposition that they all revolved round the spectator, he tried whether he might not have better success if he made the spectator to revolve and the stars to remain at rest.Immanuel Kant. Preface to the Second Edition, The Critique of Pure Reason (1787) Ever since the tenth anniversary of the death of Raymond Carver (1938-1988) scholars and general readers have been uneasily aware of what has come to b..

Measuring the Recovery Orientation of Assertive Community Treatment

BACKGROUND: Approaches to measuring recovery orientation are needed, particularly for programs that may struggle with implementing recovery-oriented treatment. OBJECTIVE: A mixed-methods comparative study was conducted to explore effective approaches to measuring recovery orientation of assertive community treatment (ACT) teams. DESIGN: Two ACT teams exhibiting high and low recovery orientation were compared using surveys, treatment plan ratings, diaries of treatment visits, and team leader–reported treatment control mechanisms. RESULTS: The recovery-oriented team differed on one survey measure (higher expectations for consumer recovery), treatment planning (greater consumer involvement and goal-directed content), and use of control mechanisms (less use of representative payee, agency-held lease, daily medication delivery, and family involvement). Staff and consumer diaries showed the most consistent differences (e.g., conveying hope and choice) and were the least susceptible to observer bias but had the lowest response rates. CONCLUSIONS: Several practices differentiate recovery orientation on ACT teams, and a mixed-methods assessment approach is feasible

Towards operational use of aircraft‐derived observations: a case study at London Heathrow airport

Mode-Selective Enhanced Surveillance (Mode-S EHS) aircraft reports can be collected at a low-cost, and are readily available around busy airports. The new work presented here demonstrates that observations derived from Mode-S EHS reports can be used to study the evolution of temperature inversions since the data have a high spatial and temporal frequency. This is illustrated by a case study centred around London Heathrow airport for the period 4 to 5 January 2015. Using Mode-S EHS reports from multiple aircraft and after applying quality control criteria, vertical temperature profiles are constructed by aggregating these reports at discrete intervals between the surface and 3000m. To improve these derived temperatures, four smoothing methods using low-pass filters are evaluated. The effect of smoothing reduces the variance in the aircraft derived temperature by approximately half. After smoothing, the temperature variance between the altitudes 3000m and 1000m is 1K to 2K; and below 1000m it is 2K to 4K. While the differences between the four smoothing methods are small, exponential smoothing is favoured because it uses all available Mode-S EHS reports. The resulting vertical profiles may be useful in operational meteorology for identifying elevated temperature inversions above 1000m. However, below 1000m they are less useful because of the reduced precision of the reported Mach number. A better source of in situ temperature observations would be for aircraft to use the meteorological reporting function of their automatic dependent surveillance (ADS) system