Quick Reference: Print-Friendly Best Practices and User Flowcharts for Kansas Serious Emotional Disturbance Waiver

Purpose: This Quick Reference Guide was developed to provide clinicians with easy-to-access recommendations and decision guides for common challenges in CAFAS/PECFAS assessment. The first section of the guide summarizes common challenges in overall CAFAS administration, and the second section reviews common challenges within each domain. Both sections include recommended assessment practices for addressing each challenge. The Guide concludes with quick reference decision flow charts for two CAFAS domains, which clinicians often find most challenging or confusing to complete, the Self-harmful Behavior domain and the Thinking domain

Practitioner’s Guidebook: Best Practices in Assessment for the Kansas Serious Emotional Disturbance Waiver

The Kansas Serious Emotional Disturbance (SED) Waiver Best Practices Guide for Assessment was developed to share best practices in assessment for Kansas children and families. Additionally, this guide was developed to support community mental health centers (CMHCs) in conducting accurate and equitable SED Waiver eligibility processes. CMHCs can supplement their initial staff CAFAS training and CAFAS booster training with this guide, as it accounts for specific challenges or concerns that are unique to Kansas and Kansas’ SED Waiver eligibility process. The Guide is organized as follows: • Brief introduction to the CAFAS and PECFAS; • Developer identified CAFAS/PECFAS administration guidelines; • Summary of the common challenges observed regarding the CAFAS administration in Kansas and accompanying best practice recommendations; and • General best practices for conducting child and family assessments in mental health contexts. This guide closes with an example case vignette and decision flow charts for some of the CAFAS domains

Going Out or Staying In: How the COVID-19 Pandemic has Influenced College Students’ Drinking and Socializing

People’s daily social activities have been altered during the pandemic since they carry risk for contracting COVID-19. Prior to the pandemic, drinking socially has been the highlight of many college students’ lives. This study explores how COVID-19 has impacted college students’ drinking and social activities. We examined samples from a large, southern, public university both prior (N=65, Mean age=22.15, SD=2.03, 78.87% female) and during COVID-19 (N=47, Mean age=22.42, SD=1.64, 75.47% female). Students filled out an alcohol-related Timeline Followback measure (TLFB), in which they recalled their drinking over the past 30 days using anchor events inputted into a calendar. The events were qualitatively coded and assigned a COVID-19-risk behavior (CRB) score based on the Texas Medical Association’s 9- point scale. Activities now known to contain risk for COVID-19 contraction were classified as follows: Moderate CRB (ranked 5-6; e.g., visiting friends), Moderate-High CRB (ranked 7; e.g., attending a party), and High CRB (ranked 8-9; e.g., going to a bar). Results revealed that students who engaged in CRBs that were ranked 5 and above were more likely to report greater number of drinks on one occasion in the past 30 days (e.g., peak drinks) and more drinks over the entire month (e.g., total monthly drinks). Although total alcohol consumption (e.g., peak drinks and total monthly drinks) remained unchanged, and students were less likely to partake in the highest ranked CRBs (e.g., ranked 8-9) during the pandemic, those who were participating in the highest ranked CRBs (e.g., ranked 8-9) may have been more likely to contract or spread COVID-19. Keywords: college students, COVID-19 risk behaviors, alcohol consumptio

Enhancing anaerobic digestion of food waste through Biochemical Methane Potential 1 Assays at different substrate: inoculum ratios

Food waste has a high energy potential that can be converted into useful energy in the form of methane via anaerobic digestion. Biochemical Methane Potential assays (BMPs) were conducted to quantify the impacts on methane production of different ratios of food waste. Anaerobic digester sludge (ADS) was used as the inoculum, and BMPs were performed at food waste:inoculum ratios of 0.42, 1.42, and 3.0 g chemical oxygen demand/g volatile solids (VS). The 1.42 ratio had the highest CH4-COD recovery: 90% of the initial total chemical oxygen demand (TCOD) was from food waste, followed by ratios 0.42 and 3.0 at 69% and 57%, respectively. Addition of food waste above 0.42 caused a lag time for CH4 production that increased with higher ratios, which highlighted the negative impacts of overloading with food waste. The Gompertz equation was able to represent the results well, and it gave lag times of 0, 3.6 and 30 days and maximum methane productions of 370, 910, and 1950 mL for ratios 0.42, 1.42 and 3.0, respectively. While ratio 3.0 endured a long lag phase and low VSS destruction, ratio 1.42 achieved satisfactory results for all performance criteria. These results provide practical guidance on food-waste-to-inoculum ratios that can lead to optimizing methanogenic yield

Peptidylarginine Deiminase 3 (PAD3) Is Upregulated by Prolactin Stimulation of CID-9 Cells and Expressed in the Lactating Mouse Mammary Gland

Peptidylarginine deiminases (PADs) post-translationally convert arginine into neutral citrulline residues. Our past work shows that PADs are expressed in the canine and murine mammary glands; however, the mechanisms regulating PAD expression and the function of citrullination in the normal mammary gland are unclear. Therefore, the first objective herein was to investigate regulation of PAD expression in mammary epithelial cells. We first examined PAD levels in CID-9 cells, which were derived from the mammary gland of mid-pregnant mice. PAD3 expression is significantly higher than all other PAD isoforms and mediates protein citrullination in CID-9 cells. We next hypothesized that prolactin regulates PAD3 expression. To test this, CID-9 cells were stimulated with 5 mug/mL of prolactin for 48 hours which significantly increases PAD3 mRNA and protein expression. Use of a JAK2 inhibitor and a dominant negative (DN)-STAT5 adenovirus indicate that prolactin stimulation of PAD3 expression is mediated by the JAK2/STAT5 signaling pathway in CID-9 cells. In addition, the human PAD3 gene promoter is prolactin responsive in CID-9 cells. Our second objective was to investigate the expression and activity of PAD3 in the lactating mouse mammary gland. PAD3 expression in the mammary gland is highest on lactation day 9 and coincident with citrullinated proteins such as histones. Use of the PAD3 specific inhibitor, Cl4-amidine, indicates that PAD3, in part, can citrullinate proteins in L9 mammary glands. Collectively, our results show that upregulation of PAD3 is mediated by prolactin induction of the JAK2/STAT5 signaling pathway, and that PAD3 appears to citrullinate proteins during lactation

KSU Chamber Singers, A Litany for Courage and the Seasons

Kennesaw State University Chamber Singers present David Maslanka\u27s A Litany for Courage and the Seasons, six songs for chorus, clarinet and vibraphone on poems of Richard Beale at the 2013 National Collegiate Choral Organization 5th National Conference in Charleston, South Carolina, October 31 - November 2.https://digitalcommons.kennesaw.edu/musicprograms/1268/thumbnail.jp

Implementation of a Family Intervention for Individuals with Schizophrenia

Families are rarely included in clinical care despite research showing that family involvement has a positive effect on individuals with schizophrenia by reducing relapse, improving work functioning, and social adjustment. The VA QUERI study, EQUIP (Enhancing QUality of care In Psychosis), implemented family services for this population. At two VA medical centers, veterans with schizophrenia and their clinicians were interviewed separately at baseline and 15 months. A family intervention was implemented, and a process evaluation of the implementation was conducted. Veterans with schizophrenia (n = 173) and their clinicians (n = 29). Consent to contact family was obtained, mailers to engage families were sent, families were prioritized as high need for family services, and staff volunteers were trained in a brief three-session family intervention. Of those enrolled, 100 provided consent for family involvement. Seventy-three of the 100 were sent a mailer to engage them in care; none became involved. Clinicians were provided assessment data on their patients and notified of 50 patients needing family services. Of those 50, 6 families were already involved, 34 were never contacted, and 10 were contacted; 7 new families became involved in care. No families were referred to the family psychoeducational program. Uptake of the family intervention failed due to barriers from all stakeholders. Families did not respond to the mailer, patients were concerned about privacy and burdening family, clinicians had misperceptions of family-patient contact, and organizations did not free up time or offer incentives to provide the service. If a full partnership with patients and families is to be achieved, these barriers will need to be addressed, and a family-friendly environment will need to be supported by clinicians and their organizations. Applicability to family involvement in other disorders is discussed

EQUIP: Implementing chronic care principles and applying formative evaluation methods to improve care for schizophrenia: QUERI Series

<p>Abstract</p> <p>Background</p> <p>This paper presents a case study that demonstrates the evolution of a project entitled "Enhancing QUality-of-care In Psychosis" (EQUIP) that began approximately when the U.S. Department of Veterans Affairs' Quality Enhancement Research Initiative (QUERI), and implementation science were emerging. EQUIP developed methods and tools to implement chronic illness care principles in the treatment of schizophrenia, and evaluated this implementation using a small-scale controlled trial. The next iteration of the project, EQUIP-2, was further informed by implementation science and the use of QUERI tools.</p> <p>Methods</p> <p>This paper reports the background, development, results and implications of EQUIP, and also describes ongoing work in the second phase of the project (EQUIP-2). The EQUIP intervention uses implementation strategies and tools to increase the adoption and implementation of chronic illness care principles. In EQUIP-2, these strategies and tools are conceptually grounded in a stages-of-change model, and include clinical and delivery system interventions and adoption/implementation tools. Formative evaluation occurs in conjunction with the intervention, and includes developmental, progress-focused, implementation-focused, and interpretive evaluation.</p> <p>Results</p> <p>Evaluation of EQUIP provided an understanding of quality gaps <it>and </it>how to address related problems in schizophrenia. EQUIP showed that solutions to quality problems in schizophrenia differ by treatment domain and are exacerbated by a lack of awareness of evidence-based practices. EQUIP also showed that improving care requires creating resources for physicians to help them easily implement practice changes, plus intensive education as well as product champions who help physicians use these resources. Organizational changes, such as the addition of care managers and informatics systems, were shown to help physicians with identifying problems, making referrals, and monitoring follow-up. In EQUIP-2, which is currently in progress, these initial findings were used to develop a more comprehensive approach to implementing and evaluating the chronic illness care model.</p> <p>Discussion</p> <p>In QUERI, small-scale projects contribute to the development and enhancement of hands-on, action-oriented service-directed projects that are grounded in current implementation science. This project supports the concept that QUERI tools can be useful in implementing complex care models oriented toward evidence-based improvement of clinical care.</p