A Critical New Pathway Towards Change in Abusive Relationships: The Theory of Transition Framework

This article explores the use of “Transition Framework” as a conceptual framework for individual and social change. William Bridges introduced Transition Framework in the 1970s as a three-pronged model explaining how people respond to change in their lives. This article argues that such an approach has the potential to help clients recognize and grieve the loss of their old identities, become comfortable with new ways of communicating, understand their cycles of relapse and make positive changes. The relevance of this model to transformative change in domestic violence treatment is explored

Pearl Oyster Bacterial Community Structure Is Governed by Location and Tissue-Type, but Vibrio Species Are Shared Among Oyster Tissues.

Diseases of bivalves of aquacultural importance, including the valuable Australian silver-lipped pearl oyster (Pinctada maxima), have been increasing in frequency and severity. The bivalve microbiome is linked to health and disease dynamics, particularly in oysters, with putative pathogens within the Vibrio genus commonly implicated in oyster diseases. Previous studies have been biased toward the Pacific oyster because of its global dominance in oyster aquaculture, while much less is known about the microbiome of P. maxima. We sought to address this knowledge gap by characterizing the P. maxima bacterial community, and we hypothesized that bacterial community composition, and specifically the occurrence of Vibrio, will vary according to the sampled microenvironment. We also predicted that the inside shell swab bacterial composition could represent a source of microbial spillover biofilm into the solid pearl oyster tissues, thus providing a useful predictive sampling environment. We found that there was significant heterogeneity in bacterial composition between different pearl oyster tissues, which is consistent with patterns reported in other bivalve species and supports the hypothesis that each tissue type represents a unique microenvironment for bacterial colonization. We suggest that, based on the strong effect of tissue-type on the pearl oyster bacterial community, future studies should apply caution when attempting to compare microbial patterns from different locations, and when searching for disease agents. The lack of association with water at each farm also supported the unique nature of the microbial communities in oyster tissues. In contrast to the whole bacterial community, there was no significant difference in the Vibrio community among tissue types nor location. These results suggest that Vibrio species are shared among different pearl oyster tissues. In particular, the similarity between the haemolymph, inside shell and solid tissues, suggests that the haemolymph and inside shell environment is a source of microbial spillover into the oyster tissues, and a potentially useful tool for non-destructive routine disease testing and early warning surveillance. These data provide important foundational information for future studies identifying the factors that drive microbial assembly in a valuable aquaculture species

Educating novice practitioners to detect elder financial abuse: A randomised controlled trial

© 2014 Harries et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.This article has been made available through the Brunel Open Access Publishing Fund.Background - Health and social care professionals are well positioned to identify and intervene in cases of elder financial abuse. An evidence-based educational intervention was developed to advance practitioners’ decision-making in this domain. The objective was to test the effectiveness of a decision-training educational intervention on novices’ ability to detect elder financial abuse. The research was funded by an E.S.R.C. grant reference RES-189-25-0334. Methods - A parallel-group, randomised controlled trial was conducted using a judgement analysis approach. Each participant used the World Wide Web to judge case sets at pre-test and post-test. The intervention group was provided with training after pre-test testing, whereas the control group were purely given instructions to continue with the task. 154 pre-registration health and social care practitioners were randomly allocated to intervention (n78) or control (n76). The intervention comprised of written and graphical descriptions of an expert consensus standard explaining how case information should be used to identify elder financial abuse. Participants’ ratings of certainty of abuse occurring (detection) were correlated with the experts’ ratings of the same cases at both stages of testing. Results - At pre-test, no differences were found between control and intervention on rating capacity. Comparison of mean scores for the control and intervention group at pre-test compared to immediate post-test, showed a statistically significant result. The intervention was shown to have had a positive moderate effect; at immediate post-test, the intervention group’s ratings had become more similar to those of the experts, whereas the control’s capacity did not improve. The results of this study indicate that the decision-training intervention had a positive effect on detection ability. Conclusions - This freely available, web-based decision-training aid is an effective evidence-based educational resource. Health and social care professionals can use the resource to enhance their ability to detect elder financial abuse. It has been embedded in a web resource at http://www.elderfinancialabuse.co.uk.ESR

Trayectorias laborales de jóvenes trabajadores de la actividad vitivinícola : departamento Maipú, Mendoza

La presente investigación tuvo como eje los vínculos entre educación y trabajo en la vitivinicultura mendocina desde 1990 . El objetivo general fue comprender los procesos de incorporación de jóvenes de ambos sexos al mundo del trabajo y su vínculo con las estrategias de formación y los esquemas de percepción en el mercado vitivinícola mendocino desde los 90. Se analizaron e identificaron los tipos de trayectorias educativas, laborales y transiciones existentes en los jóvenes. También los condicionantes de género que operan desde la perspectiva de las mujeres jóvenes. Se buscó comprender las formas que adquieren, cómo se manifiestan y varían las perspectivas acerca del trabajo, de las exigencias laborales y las condiciones del mercado de trabajo a lo largo de las trayectorias educativas y laborales y cuáles son los principales elementos constitutivos de las trayectorias de inserción, qué factores están asociados a sus variaciones y cómo se vinculan con las expectativas y estrategias de formación de inserción laboral.Fil: Martín, María Eugenia. CONICET (Consejo Nacional de Investigaciones Científicas y Técnicas) - Universidad Nacional de CuyoFil: Zamarbide, Gabriela. Universidad Nacional de Cuy

Calculating unreported confidence intervals for paired data

<p>Abstract</p> <p>Background</p> <p>Confidence intervals (or associated standard errors) facilitate assessment of the practical importance of the findings of a health study, and their incorporation into a meta-analysis. For paired design studies, these items are often not reported. Since the descriptive statistics for such studies are usually presented in the same way as for unpaired designs, direct computation of the standard error is not possible without additional information.</p> <p>Methods</p> <p>Elementary, well-known relationships between standard errors and <it>p</it>-values were used to develop computation schemes for paired mean difference, risk difference, risk ratio and odds ratio.</p> <p>Results</p> <p>Unreported confidence intervals for large sample paired binary and numeric data can be computed fairly accurately using simple methods provided the <it>p</it>-value is given. In the case of paired binary data, the design based 2 × 2 table can be reconstructed as well.</p> <p>Conclusions</p> <p>Our results will facilitate appropriate interpretation of paired design studies, and their incorporation into meta-analyses.</p

Social Quality: A Way to Measure the Quality of Society

In this paper we suggest a way to measure the well-being of society based upon our own development of the Social Quality model. The Social Quality model has the advantage of being sociologically grounded as a measure of the well-being of society and the individuals within it. We test our model of Social Quality against life satisfaction as an indicator of how successful it is in delivering these aspirations. The model was tested on all European countries using the European Quality of Life Surveys in 2003 and 2007 and was found to explain a large amount of variance, which was consistent across time and space. We suggest that it is possible to operationalise this model using small number of variables, ones that are frequently used in comparative surveys and this should enable the quality of society to be measured in a parsimonious and effective way

Antiretroviral treatment adherence among HIV patients in KwaZulu-Natal, South Africa

<p>Abstract</p> <p>Background</p> <p>Successful antiretroviral treatment is dependent on sustaining high rates of adherence. In the southern African context, only a handful of studies (both quantitative and qualitative) have looked at the determinants including a health behaviour theory of adherence to antiretroviral therapy. The aim of this study is to assess factors including the information, motivation and behavioural skills model (IMB) contributing to antiretroviral (ARV) adherence six months after commencing ARVs at three public hospitals in KwaZulu-Natal, South Africa.</p> <p>Methods</p> <p>Using systematic sampling, 735 HIV-positive patients were selected prior to commencing on ART from outpatient departments from three hospitals and followed-up at six months and interviewed with a questionnaire.</p> <p>Results</p> <p>A good proportion of patients were found to be adherent using both adherence instruments (visual analog scale = VAS 82.9%; Adult AIDS Clinical Trials Group = AATCG 70.8%). After adjusting for significant socio-economic variables, both the VAS and the dose, schedule and food adherence indicator found levels of adherence amongst urban residents to be almost 3 times greater than that of rural residents. After adjusting for health-related variables, for both indicators better adherence was associated with low depression and poorer adherence was associated with poor environmental factors. Adjusted odds ratios for adherence when taking into account different behavioural variables were for both adherence indicators, discrimination experiences were associated with lower adherence, and higher scores in adherence information and behavioural skills were associated with higher adherence. For the VAS adherence indicator, higher social support scores were associated with higher adherence. For the dose, schedule and food adherence indicator, using herbal medicines for HIV was associated with lower adherence.</p> <p>Conclusion</p> <p>For the patients in this study, particularly those not living in urban areas, additional support may be needed to ensure patients are able to attend appointments or obtain their medications more easily. Adherence information and behavioural skills as part of the IMB model should be strengthened to improve adherence. Further psychological support is also required and patients' perceived need for ARTs should be routinely assessed.</p

The Use of a Compression Device as an Alternative to Hand-Sewn and Stapled Colorectal Anastomoses: Is Three a Crowd?

BackgroundThe NiTi CAR™ 27 is a newer device that uses compression to create an anastomosis. An analysis of this device in the creation of colorectal anastomoses in humans has yet to be reported in the USA.MethodsA non-randomized, prospective pilot study of the NiTi CAR™ 27 device in patients undergoing a left-sided colectomy between March 2008 and August 2009 was performed.ResultsTwenty-three patients (9 men and 14 women) underwent a left-sided colectomy and compression anastomosis with the CAR™ 27 device. Minor morbidities, 3 of 23 (13%) patients, included one small postoperative abscess requiring antibiotics alone and two postoperative anastomotic strictures requiring balloon dilation. Major morbidities, 1 of 23 (4%) patients, included a partial anastomotic dehiscence/leak requiring surgical dismantling of the anastomosis and diversion.ConclusionThe CAR™ 27 device shows promise as a safe and effective alternative for the creation of colorectal anastomoses. However, studies in a larger patient population are warranted to demonstrate equivalence of this device

Diagnostic reliability of magnetic resonance imaging for central nervous system syndromes in systemic lupus erythematosus: a prospective cohort study

<p>Abstract</p> <p>Background</p> <p>Previous studies of magnetic resonance imaging (MRI) as a diagnostic tool for central nervous system (CNS) syndromes in systemic lupus erythematosus (SLE) contained several limitations such as study design, number of enrolled patients, and definition of CNS syndromes. We overcame these problems and statistically evaluated the diagnostic values of abnormal MRI signals and their chronological changes in CNS syndromes of SLE.</p> <p>Methods</p> <p>We prospectively studied 191 patients with SLE, comparing those with (n = 57) and without (n = 134) CNS syndrome. CNS syndromes were characterized using the American College of Rheumatology case definitions.</p> <p>Results</p> <p>Any abnormal MRI signals were more frequently observed in subjects in the CNS group (n = 25) than in the non-CNS group (n = 32) [relative risk (RR), 1.7; 95% confidence interval (CI), 1.1-2.7; <it>p </it>= 0.016] and the positive and negative predictive values for the diagnosis of CNS syndrome were 42% and 76%, respectively. Large abnormal MRI signals (ø ≥ 10 mm) were seen only in the CNS group (n = 7; RR, 3.7; CI, 2.9-4.7; <it>p </it>= 0.0002), whereas small abnormal MRI signals (ø < 10 mm) were seen in both groups with no statistical difference. Large signals always paralleled clinical outcome (<it>p </it>= 0.029), whereas small signals did not (<it>p </it>= 1.000).</p> <p>Conclusions</p> <p>Abnormal MRI signals, which showed statistical associations with CNS syndrome, had insufficient diagnostic values. A large MRI signal was, however, useful as a diagnostic and surrogate marker for CNS syndrome of SLE, although it was less common.</p