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Introduction: Therapeutic communities (TCs) are mutual aid based residential programs for the treatment of substance abuse and criminal behavior. While it is expected that residents will provide feedback to peers, there has been no social network study of the hierarchy through which feedback flows. Methods: Data for this study was drawn from clinical records of peer corrections exchanged between TC residents in six units kept over periods of less than two to over eight years. Four of the units served men while two served women. Hierarchy position was measured using eigenvector centrality, on the assumption that residents who were more central in the network of corrections were lower in the hierarchy. It was hypothesized that residents would rise in the hierarchy over time. This was tested using Wilcoxon paired samples tests comparing the mean and maximum eigenvector centrality for time in treatment with those in the last month of treatment. It was also hypothesized that residents who rose higher in the hierarchy were more likely to graduate, the outcome of primary interest. Logistic regression was used to test hierarchy position as a predictor of graduation, controlling for age, race, risk of recidivism as measured by the Level of Services Inventory-Revised (LSI-R) and days spent in the program. Results: Residents averaged a statistically significantly lower eigenvector centrality in the last month in all units, indicating a rise in the hierarchy over time. Residents with lower maximum and average eigenvector centrality both over the length of treatment and in the last month of treatment were more likely to graduate in four of the six units, those with lower maximum and average eigenvector centrality in the last month but not over the length of treatment were more likely to graduate in one of the six units, while eigenvector centrality did not predict graduation in one unit. However, this last unit was much smaller than the others, which may have influenced the results. Conclusion: These results suggest that TC residents move through a social network hierarchy and that movement through the hierarchy predicts successful graduation. [ABSTRACT FROM AUTHOR]

Purpose: Worldwide mandates for social distancing and home-quarantine have contributed to loneliness and social isolation. We conducted a systematic scoping review to identify network-building interventions that address loneliness and isolation, describe their components and impact on network structure, and consider their application in the wake of COVID19. Methods: We performed forward and backward citation tracking of three seminal publications on network interventions and Bibliographic search of Web of Science and SCOPUS. We developed data charting tables and extracted and synthesized the characteristics of included studies, using an iteratively updating form. Findings: From 3390 retrieved titles and abstracts, we included 8 studies. These interventions focused on building networks at either individual- or group-levels. Key elements that were incorporated in the interventions at varying degrees included (a) creating opportunities to build networks; (b) improving social skills; (c) assessing network diagnostics (i.e. using network data or information to inform network strategies); (d) promoting engagement with influential actors; and (e) a process for goal-setting and feedback. The effect of interventions on network structures, or the moderating effect of structure on the intervention effectiveness was rarely assessed. Conclusions: As many natural face-to-face opportunities for social connection are limited due to COVID19, groups already at risk for social isolation and loneliness are disproportionately impacted. Network-building interventions include multiple components that address both the structure of individuals' networks, and their skills and motivation for activating them. These intervention elements could be adapted for delivery via online platforms, and implemented by trained facilitators or novice volunteers, although more rigorous testing is needed. [ABSTRACT FROM AUTHOR]

Objective: Clustering, the tendency of individuals to form closed triads, is ubiquitous in human social networks. Previous research has found that therapeutic community (TC) residents whose social networks include a high degree of clustering are less likely to be reincarcerated following discharge. In this study, we test this finding in a larger number of TCs.Method: We use a temporal network autocorrelation model (TNAM) to analyze clustering in social networks of affirmations exchanged between TC residents as a predictor of the hazard of reincarceration. The networks were drawn from three corrections-based TCs, two of which include both men's and women's units and one of which housed only men.Results: The findings were inconsistent across facilities. Increased clustering correlates with a reduced hazard of reincarceration for women at both facilities (β = -3.274, 95% CI [-4.299, -2.238]; β = -18.233, 95% CI [-32.370, -4.095]) and for men at two of the facilities (β =-0.910, 95% CI [-1.213, -0.606]; β = -1.393, 95% CI [-1.825, -0.961]). However, clustering increased the hazard of reincarceration for men at one facility (β = 5.558, 95% CI [4.124, 6.993]).Conclusions: These results support the idea that the likelihood of reincarceration following discharge from a TC is predicted by clustering, a network structure that occurs at a system level between the individual resident and the entire community. Inconsistency in the direction of the relationship suggests that future research should analyze predictors of prosocial clustering in TCs. [ABSTRACT FROM AUTHOR]

Background: Therapeutic communities (TCs) maintain order and encourage behavior change through a system of peer corrections. This study is the first quantitative analysis of the dynamics of the exchange of peer corrections at TCs. Objectives: We applied longitudinal social network analysis to compare the reactions of TC residents to peer versus staff intervention, while analyzing dynamics of correction exchange among residents. Method: The data consisted of a large database of staff and peer affirmations and corrections at four therapeutic community units that occurred between the years 2006 and 2008. We modeled the data as a directed temporal social event network, using a generalized linear mixed effects model to analyze predictors of corrections among residents. Results: Residents were more likely to send a correction following peer affirmations and corrections than following staff affirmations and corrections. Residents reciprocated corrections to individual peers. Autocorrelation was evident in both sending and receiving corrections and residents were more likely to send a correction after having sent an affirmation. Residents who arrived at roughly the same time were more likely to exchange corrections. Residents tended to send and receive more corrections in the middle 3 months of their treatment. European American residents and those with higher scores on the LSI-R were more likely to receive corrections than others. Conclusions: TC residents respond more strongly and more positively to peer than to staff intervention. The pattern of exchange of peer corrections in TCs is complex. This suggests possible paths to improved outcomes. [ABSTRACT FROM AUTHOR]

Background:Clinical theory in therapeutic communities (TCs) for substance abuse treatment emphasizes the importance of peer interactions in bringing about change. This implies that residents will respond in a more prosocial manner to peer versus staff intervention and that residents will interact in such a way as to maintain cooperation. Method:The data consist of electronic records of peer and staff affirmations and corrections at four corrections-based TC units. We treat the data as a directed social network of affirmations. We sampled 100 resident days from each unit (n = 400) and used a generalized linear mixed effects network time series model to analyze the predictors of sending and receiving affirmations and corrections. The model allowed us to control for characteristics of individuals as well as network-related dependencies. Results:Residents show generalized reciprocity following peer affirmations, but not following staff affirmations. Residents did not respond to peer corrections by increasing affirmations, but responded to staff corrections by decreasing affirmations. Residents directly reciprocated peer affirmations. Residents were more likely to affirm a peer whom they had recently corrected. Residents were homophilous with respect to race, age and program entry time. Conclusion:This analysis demonstrates that TC residents react more prosocially to behavioral intervention by peers than by staff. Further, the community exhibits generalized and direct reciprocity, mechanisms known to foster cooperation in groups. Multiple forms of homophily influence resident interactions. These findings validate TC clinical theory while suggesting paths to improved outcomes. [ABSTRACT FROM PUBLISHER]

Background: Therapeutic community (TC) clinical theory assumes that peer interaction forms a framework for social learning that will displace ingrained cognitive schema that underlie substance abuse. There has been no direct test of this hypothesis.Methods: We analyzed the content of a large corpus of written affirmations (pushups) and corrections (pull-ups) exchanged between 2342 male TC graduates. We encoded the content of the written communications as semantic networks of words, in which words that appear in the same brief document are connected and are referred to as word combinations. Loss of combinations and gain of combinations each measured an aspect of change in word combination patterns across time. These measures were used in a multivariable Cox model to predict the hazard of reincarceration for residents while controlling for race, age, score on the Level of Service Inventory-Revised and the total number of pushups and pull-ups sent to peers.Results: Residents' reincarceration risk varied significantly with changes in word combinations used over the course of treatment. The implications of the model were visualized to reveal the complicated nature of the interaction terms included in the model. The visuals suggested that residents who changed their expression patterns the least - lost and gained few word combinations - had the highest reincarceration risk after graduation.Conclusions: The results suggest that TC success, in terms of increasing time to reincarceration, depends on how residents change their interaction patterns through the treatment process. Merely interacting with others does not explain success; but whether those interactions change does explain outcomes, which may imply that more fundamental changes are occurring. [ABSTRACT FROM AUTHOR]

Background: Social networks transmit knowledge, influence, and resources. These relationships among patients, professionals, and organizations can shape how innovations are disseminated, adopted, implemented, and sustained. Network alteration interventions—interventions that change or rewire social networks—have the potential to be used as implementation strategies. Yet, the types, mechanisms, and effectiveness of these interventions for implementation are unclear. This scoping review and iterative synthesis identified and described network alteration strategies that could be tested for implementation. Methods: We used forward and backward citation tracking of influential articles on network interventions, bibliometric searches, and hand searches of peer-reviewed social network journals. At least two team members screened article titles/abstracts to identify studies that met inclusion criteria: empirical studies of an intervention, the intervention was designed to alter some element of a social network, and changes in social network metrics were measured at two or more time points. During full-text reviews, information about the network interventions, actors, ties, and main findings was extracted. Reporting was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). To develop our typology, we synthesized these results using an iterative team-based and consensus-building process. Results: Fifty-three articles met the inclusion criteria. The interventions described were conducted in healthcare systems or behavioral health systems (34%), communities (26.4%), and schools (22.6%). The majority included records describing interventions designed to alter social support, information-sharing, or friendship networks (65%) among individual actors (84.9%), or to increase ties. Eight strategies emerged. Three strategies targeted the general context: (1) change the environment, (2) create groups, and (3) change the composition. Four strategies targeted individual actors: change (4) motivations, (5) skills for networking, (6) knowledge of one's social network, and (7) prominence/roles. One strategy (8) targeted specific ties within the network (targeting a particular pair-wise relationship or changing the nature of an existing tie). Conclusion: The network alteration strategies in this typology provide further operational specificity for how implementation strategies target relationships. Advancing these strategies will require greater theoretical specification, the development of strategies that target professionals and organizations, and studies that examine the impact on implementation outcomes. [ABSTRACT FROM AUTHOR]

California has a longstanding issue with the Talent Agency Act, which states that only a licensed agent may seek out, or procure, employment for an artist. The TAA has caused major headaches for Hollywood's personal managers, who find their contracts with artists voided for engaging in even minor acts of procurement. Many commentators initially believed that Marathon Entertainment Inc. v. Blasi solved the dilemma. However, it turns out that the Labor Commissioner, who has exclusive jurisdiction to hear claims arising under the TAA, continues to void contracts between Calfornia's personal managers and their clients at an alarming rate. Personal managers disapprove of the Labor Commissioner 's failure to employ the doctrine of severability, as advised by the Blasi court, to these contracts. In response, the personal managers recently filed a challenge to the constitutionality of the TAA. The United States District Court for the Central District of California, however, dismissed the claim and upheld the constitutionality of the controversial Act. Because this debate spans over one hundred years, and the constitutional challenge was unsuccessful, the authors of this comment advocate a two-fold approach to correcting the dilemma: (1) place the burden of production in Labor Commissioner hearings on the artist to prove that the entire manager contract should be voided, and (2) assess statutory civil penalties to those personal managers who willfully violate the TAA by procuring employment. The authors of this Comment argue that the California legislature should consider applying this approach because it is not only easily adaptable, but also in line with the true purpose of the TAA. [ABSTRACT FROM AUTHOR]

Abstract: The most important proximal outcomes for residents of therapeutic communities (TCs) are retention and successful completion of the program. At this point there has been no quantitative analysis of the relationship between the exchange of corrective reminders, or pull-ups, between peers in TCs and graduation. This study draws on a database of pull-ups exchanged between 5464 residents of three midwestern TCs. Residents who send more pull-ups to peers and who reciprocate pull-ups with a larger percentage of peers are more likely to graduate. Residents who receive more pull-ups from peers and staff and a larger percentage of whose peers reciprocate pull-ups that they send are less likely to graduate. Implications of these findings for program theory and program improvement are discussed. [Copyright &y& Elsevier]

We present a model of the interaction of segregation and suburbanization in determining residential location. The model incorporates differential income between two classes of agents, a simplified market mechanism for the purchase of housing, and a simple geographic structure of one central city and four symmetrically arranged suburbs. Agents derive utility from neighborhood racial composition, the size of their lot, private amenities that are specific to neighborhoods, and public amenities that stretch across municipalities. We find that the public-amenities term leads to a positive-feedback loop in which migration to suburbs increases the public amenities in those municipalities while lowering amenities in the central city, thus sparking further migration. When the minority agents are uniformly less affluent than the majority agents, this dynamic produces discontinuity in segregation as measured by centralization. Such discontinuities are typical of first-order phase transitions. When minority and majority incomes overlap, significant regions appear over which there are multistable equilibria at high and low levels of segregation, along with considerable sensitivity to the initial distribution of minority agents. We discuss the implications of these findings. [ABSTRACT FROM AUTHOR]

This article extends the work of Kellam, Ling, Merisca, Brown and Ialongo (1998) by applying a mathematical model of competition between children to peer contagion in the aggressive behaviors of elementary school students. Nonlinearity in the relationship between group aggression and individual aggression at 2-year follow-up is present. Consistent with the findings of Kellam et al. (1998), hierarchical linear modeling indicates that the relationship is statistically significant for those students whose initial parental ratings of aggressive behavior were above the sample median. In the context of competition between students, the behavior of initially aggressive students may be negatively reinforced. Lowering aggression in the school environment may therefore be the most effective way to lower the level of these students' aggressive behavior. [ABSTRACT FROM AUTHOR]

The article focuses on interpersonal interactions and aggression in people with intellectual disabilities. Aggression directed against either self or others, is a significant problem for many people with intellectually disabled (ID) individuals. A sufficient increase in aggressive or auto-aggressive behaviors will lead to both facility staff and the resident him/herself attempting to control those behaviors. The exploratory study presented in this article suggests that group living situations may increase the volatility of aggressive and auto-aggressive behaviors by leading to unstable nonlinear dynamics and providing the opportunity for deleterious interactions between residents. The findings of this study are consistent with the argument made earlier that negative feedback loops are important if ID consumers are to maintain themselves in group living situations, but that they exact a cost in terms of predictability and volatility. The nonlinear structure of the individual time series means that an intervention that aims at reducing the number of either of these individuals' aggressive behaviors is likely to produce a series of fluctuations instead.

Several authors have suggested that chaos theory, the study of nonlinear dynamics and the application of the knowledge gained to natural and social phenomena, might yield insight into substance-related disorders. In this article, we examine the dynamics of substance abuse by fitting a nonlinear model to a time series of the amount of alcohol, which an adult male with a diagnosis of substance abuse consumed on a daily basis. The nonlinear model shows a statistically superior fit when compared to a linear model. We then use the model to explore a question that is pertinent to the treatment of substance abuse, whether controlled drinking or abstinence is a preferred strategy for maintaining sobriety. [Copyright &y& Elsevier]

Presents a study which proposed a mathematical model of the offense chain that allows a quantitative hypothesis test and examined the model using archival records of the daily behaviors of seven developmentally disabled sex offenders. Method; Results; Discussion.

Examines the application of nonlinear dynamics to understand alcoholism. Definition of nonlinear dynamics; Requirements for the application of nonlinear dynamics to any system; Concept of substance abuse.

Systems theory has greatly advanced during the past two decades. Chaos and complexity theory and their accompanying research methods provide a new way to understand systems theory and advance more sophisticated mathematical methods for studying complex human systems. Often termed "nonlinear dynamics" because they seek to understand systems that change in ways that are not amenable to the linear cause and effect models familiar to social scientists, these theoretical perspectives are thought to have application across a wide range of social science disciplines. This article discusses the disciplines of nonlinear dynamics--chaos and complexity--in a way that is understandable and relevant to social work practitioners and researchers. The article presents an overview of some of the basic concepts from chaos and complexity theory and illustrates how these concepts are applied in practice theories, explores the relevance of nonlinear dynamics to social work, and summarizes the advantages of chaos and complexity science for social work practice and research. The authors hope that this article will provide social workers with new information that will inspire new and more empirical work on the applications of systems theory to social work practice. [ABSTRACT FROM AUTHOR]

Background: Researchers have begun to consider the ways in which social networks influence therapeutic community (TC) treatment outcomes. However, there are few studies of the way in which the social networks of TC residents develop over the course of treatment.Methodology: We used a Temporal Exponential Random Graph Model (TERGM) to analyze changes in social networks totaling 320,387 peer affirmations exchanged between residents in three correctional TCs, one of which serves men and two of which serve both men and women. The networks were analyzed within weekly and monthly time-frames.Results: Within a weekly time-frame residents tended to close triads. Residents who were not previously connected tended not to affirm the same peers. Residents showed homophily by entry cohort. Other results were inconsistent across TC units. Within a monthly time-frame participants showed homophily by graduation status. They showed the same patterns of triadic closure when connected, tendency not to affirm the same peers when not connected and homophily by cohort entry time as in a weekly time frame.Conclusions: TCs leverage three human tendencies to bring about change. The first is the tendency of cooperators to work together, in this case in seeking graduation. The second is the tendency of people to build clusters. The third is homophily, in this case by cohort entry time. Consistent with TC clinical theory, residents spread affirmations to a variety of peers when they have no previous connection. This suggests that residents balance network clustering with a concern for the community as a whole. [ABSTRACT FROM AUTHOR]

Associations between suicidal behavior and social-ecological variables were examined among 1,618 Latina high school students (mean age = 15) from the nationally representative Add Health sample (68% were U.S.-born). Ideations were associated with having a suicidal friend, lower perceived father support, and overall parental caring. Attempts were associated with having a suicidal friend, and lower perceived teacher and parental support. Peer and mother relationship variables were not predictors of ideations or attempts. The protective role of father and teacher support has not previously been emphasized in the literature. Strengthening connections to parents and teachers may reduce suicidal behavior in adolescent Latinas. [ABSTRACT FROM AUTHOR]

Research on Alcoholics Anonymous and other self-help programs has shown mixed results regarding lifetime participation at the individual level. No one has systematically studied whether lifetime membership contributes to the success of the program as a whole. This project analyzes the relationship of lifetime membership and program growth using a series of agent-based models. Results demonstrate that programs encouraging lifetime attendance produce more groups and recruit more members than programs encouraging graduation. Rapid graduation disrupts the availability of senior members to help newcomers, limiting program growth. Self-help programs may improve program effectiveness by encouraging long-term attendance. [ABSTRACT FROM AUTHOR]

Family and friend involvement in the psychiatric treatment of persons with mental illness is vital to consumer recovery and an important quality measure, yet few instruments exist to measure such involvement. This article examines the Family/Visitor Survey (FVS), a brief instrument designed to measure family/friend involvement at Ohio's Behavioral Health Organizations (BHO), the state system of psychiatric hospitals. The researchers assessed the reliability of the FVS and examined the factor structure to test the hypothesis that the FVS measures a unitary construct. Data were from one urban and one rural BHO. Results indicated that the FVS was reliable and that the six items represented one latent construct. Although the findings provide initial support for the reliability and factor structure of the FVS, further research is required to establish the construct validity of the instrument. [ABSTRACT FROM AUTHOR]

In 2001, field excavations were completed at the Site of the San Bernardino, California, Chinatown, yielding about 10,000 items. Twenty-one discrete features were excavated, dating from about 1880 to the 1930s. Seventeen of these features reflected the history of Chinatown. Privy 1035, associated with a gambling hall at 19 Third Street, contained more than 6,800 individual items, representing diverse aspects of China- town life. Gambling activities in the early-20th century were represented by an abundance of artifacts, including a cache of more than 1,300 Asian coins, the largest ever found on an excavation in North America. Discussions of gambling artifacts and culture document the practice of this traditional, but often sensationalized, pastime of the Overseas Chinese. [ABSTRACT FROM AUTHOR]

Abstract: Suicidal ideation has been thought to have a relatively stable course across weeks and months. However, daily changes in levels of ideation have not been adequately examined despite the importance of potential variability clinically and conceptually. For example, it has been suggested that variability in suicidal ideation may become less closely tied to variability in other mood symptoms (e.g., depression, hopelessness) among individuals with multiple suicide attempts. The present report had two related goals: (1) to prospectively evaluate suicidal ideation and related mood symptoms, and (2) to determine whether suicide attempt status predicted a decreased association between ideation and other mood symptoms. Non-clinical participants () with varying levels of suicidal ideation and number of previous suicide attempts completed the beck hopelessness scale (BHS), beck depression inventory (BDI), and suicide probability scale (SPS) every day for 4 weeks. Findings suggested considerable variability in suicidal ideation, especially for multiple attempters. Multiple attempt status predicted a decreased association between suicidal ideation and depression, although the results were only marginally significant. These findings have implications for conceptual models of suicide risk as well as assessment and treatment of suicidal individuals. [Copyright &y& Elsevier]

Current theories and research about the etiology and treatment of psychotic disorders increasingly point to the importance of biological factors. Accompanying this shift in the etiological literature has been an accumulation of evidence indicating the need to move away from treatment modalities that make families of people with psychotic disorders feel culpable in the causation or perpetuation of their relatives' disorders. The current study reports the development of a reliable and valid scale to assess the extent to which practitioners have made this shift. It also reports two surveys, the findings of which imply grounds for concern about what many practitioners do when working with clients with severe and persistent mental illness and their families. [ABSTRACT FROM AUTHOR]

Introduction: Tafenoquine has been recently registered for the prevention of relapse in Plasmodium vivax malaria.Objective: This study assessed the pharmacodynamic effects of 300-mg single-dose tafenoquine on the retina.Methods: This phase I, prospective, multicenter, randomized, single-masked, placebo-controlled, parallel-group study was conducted between 2 February 2016 and 14 September 2017 at three US study centers. Adult healthy volunteers were randomized (2:1) to receive either a single 300-mg oral dose of tafenoquine or matched placebo on day 1. Ophthalmic assessments, including spectral domain optical coherence tomography (SD-OCT) and fundus autofluorescence (FAF), were conducted at baseline and day 90 and evaluated for pre-determined endpoints by an independent, masked reading center.Results: One subject in each group met the composite primary endpoint for retinal changes identified with SD-OCT or FAF, i.e., one out of 306 (0.3%) with tafenoquine, one out of 161 (0.6%) with placebo. Both cases had unilateral focal ellipsoid zone disruption at day 90 with no effect on best-corrected visual acuity. The tafenoquine-treated subject had this abnormality at baseline, and was enrolled in error. There was no difference in ophthalmic safety between tafenoquine and placebo.Conclusion: There was no evidence of any pharmacodynamic effect of 300-mg single-dose tafenoquine on the retina or any short-term clinically relevant effects on ophthalmic safety. This clinical trial is registered with ClinicalTrials.gov (identifier: NCT02658435). [ABSTRACT FROM AUTHOR]

Highlights • Social network analysis of predictors of reincarceration following discharge from therapeutic communities (TCs). • Analysis of a network of 34,667 affirmations exchanged between 1,312 male TC residents using the temporal network autocorrelation model (TNAM). • Clustering in resident networks measured by percentage of closed triads. • TC residents whose social networks show more clustering have a lower hazard of reincarceration. • This is true when controlling for age, length of stay, race and whether peers with whom they are linked in the network graduate. [ABSTRACT FROM AUTHOR]

Cystoid macular edema (CME), a common complication following cataract surgery, is routinely medically treated with topical nonsteroidal anti-inflammatory drugs (NSAIDs), alone or in combination with steroids. In this paper, we describe 6 patients with CME and 1 patient with diabetic macular edema (DME), all of whom were treated with nepafenac 0.1%, a novel prodrug NSAID. Three (3) patients with acute CME following cataract surgery were treated for 3–4 weeks with nepafenac 0.1%, with or without concomitant steroids. Both retinal thickness and visual acuity improved in all 3 cases. The 3 patients with chronic CME, each of whom had been previously treated with steroids with or without concomitant NSAID therapy, were started on nepafenac 0.1% three times daily. Retinal thickness and visual acuity improved in each case, except for 1 patient with 20/25 pretreatment visual acuity. The mean improvement in visual acuity of all 6 CME patients was 2.5 lines and the mean decrease in retinal thickness was 282.8 μm. The patient with DME also showed improvement in retinal thickness and visual acuity after 6 months of treatment with nepafenac. These clinical data strongly suggest that nepafenac 0.1% is a promising drug for the treatment of posterior segment inflammation, including CME, and warrants further investigation. [ABSTRACT FROM AUTHOR]