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Aqueous electrolytes possess non-combustible and eco-friendly features compared to organic electrolytes, leading them to be more suitable for application in smart windows for daily use. However, limited by the narrow electrochemical window of water (1.23 V), its use in conventional electrochromic devices (ECDs) would result in irreversible performance loss, which arises from decomposition caused by high voltage. Here, we propose a synergistic scheme combining a redox couple-catalytic counter electrode (RC-CCE) strategy with protons as guest ions. With the help of the intelligent matching of the reaction potentials of the RC and amorphous WO3electrochromic electrodes and the highly active and fast kinetic features of protons, it successfully reduces the working voltage range of the device to 1.1 V. The assembled HClO4-ECD can possess an overall modulation rate (350–1200 nm) of 0.43 and 0.94 at −0.1 and −0.7 V, respectively, and a modulation of 66.8% at 600 nm at −0.7 V. Moreover, compared with other guest ions, the proton-based ECD exhibits higher coloration efficiency, a broader color modulation capability, and better stability. In addition, the house model equipped with the proton-based ECD effectively blocks solar radiation, which provides a potential solution for the design of aqueous smart windows.

The regioselective hydroamination of unactivated alkenes is a long-standing challenge in organic synthesis. Herein, we report a NiH-catalyzed proximal-selective hydroamination of unactivated alkenes with 8-aminoquinoline (AQ) as a bidentate auxiliary and anthranils as aminating reagents. A wide range of primary aryl amines bearing an ortho-carbonyl group were installed in both terminal and internal unactivated alkenes, delivering a variety of valuable β- and γ-amino acid building blocks, respectively, with excellent regiocontrol. The utility of this transformation was further demonstrated by the conversion of the multifunctionalized aryl amines into useful N-heterocycles.

This report describes 1-, 2-, and 3-year outcomes of a combined psychosocial skills training and preventive healthcare intervention (Helping Older People Experience Success [HOPES]) for older persons with serious mental illness.

There is widespread recognition that services to persons with co-occurring substance use and psychiatric disorders should be accessible, yet most persons with these disorders do not receive care for both problems. Estimates of available services vary widely and have not examined potential variation by level of care.

This study assessed the impact of steady competitive or noncompetitive employment on nonvocational outcomes for clients with severe mental illness receiving employment services. We conducted a secondary analysis of 2-year data for 187 clients participating in a randomized controlled trial comparing two employment programs. Participants were classified according to 2-year employment outcomes into four groups: steady competitive work, steady noncompetitive work, minimal work, and no work. We compared these groups on 2-year outcomes including symptoms, hospitalizations, quality of life, and social networks. During follow-up, working clients had fewer days of hospitalization than the no-work group. The steady competitive group had greater reduction in negative symptoms than did the no-work group. The steady noncompetitive group showed greater improvement in social networks compared with the other groups. Extended periods of work are associated with improvements in nonvocational outcomes. Beneficial effects may vary according to the type of employment.

Research on vocational rehabilitation for clients with severe mental illness over the past 2 decades has yielded inconsistent findings regarding client factors statistically related to employment. The present study aimed to elucidate the relationship between baseline client characteristics and competitive employment outcomes—job acquisition and total weeks worked during an 18-month follow-up—in Individual Placement and Support (IPS). Data from 4 recent randomized controlled trials of IPS were aggregated for within-group regression analyses. In the IPS sample (N307), work history was the only significant predictor for job acquisition, but receiving Supplemental Security Income—with or without Social Security Disability Insurance—was associated with fewer total weeks worked (2.0%–2.8% of the variance). In the comparison sample (N374), clients with a diagnosis of mood disorder or with less severe thought disorder symptoms were more likely to obtain competitive employment. The findings confirm that clients with severe mental illness interested in competitive work best benefit from high-fidelity supported employment regardless of their work history and sociodemographic and clinical background, and highlight the needs for changes in federal policies for disability income support and insurance regulations.

The group-based latent trajectory model allows investigators to identify distinctive trajectory groups based on relevant outcomes. Dual trajectory analysis enables examination of the interrelationship between two outcomes simultaneously. This paper describes the application of the group-based dual trajectory model in mental health and substance abuse research. We analyzed two related recovery outcomes: 1) social contact with non-substance abusing friends and 2) stage of substance abuse treatment. We identified four groups for social contact and four groups for substance abuse treatment. We then examined the interrelationship between the two outcomes across the trajectory groups over 10 years. The two outcomes are positively associated longitudinally and evolve in the same direction, although for specific groups, the two outcomes do not covary. By examining dynamic linkages across all trajectory groups between two longitudinal outcomes, the dual model provides a more comprehensive and realistic understanding of the underlying relationships between the two outcomes under investigation.

AbstractObjective:To evaluate whether posttraumatic stress disorder (PTSD) is related to outcomes in persons with severe mental illness (SMI) participating in a study of vocatinal rehabilitation programsBackground:PTSD is a common comorbid disorder in people with SMI, but it is unknown whether PTSD interferes with the ability to benefit from rehabilitation programs such as supported employment.Methods:The relationships between PTSD and symptoms, health, quality of life, and work outcomes was examined in 176 clients with SMI participating in a 2-year randomized controlled trial of three vocational rehabilitation programs: supported employment based on the Individual Placement and Support model, a psychosocial rehabilitation program based on transitional employment, and standard services.Results:The overall rate of current PTSD in the sample was 16%. Compared with clients without PTSD, clients with PTSD had more severe psychiatric symptoms, worse reported health, lower self-esteem, and lower subjective quality of life. Clients with PTSD who participated in the Individual Placement and Support model (the most effective vocational model of the three studied) also had worse employment outcomes over the 2-year study period than clients without PTSD, with lower rates of compeitive work, fewer hours worked, and fewer wages earned. Employment outcomes did not differ between clients with PTSD versus without PTSD in the other two vocational rehabilitation approaches.Conclusion:The findings suggest that PTSD may contribute to worse work outcomes in clients participating in supported employment programs. Effective treatment of these clients with PTSD may improve their ability to benefit from supported employment.

Viability-promoting genes such as BCL2play an important role in human cancer but do not directly cause aggressive tumors. BCL2transgenic mice develop lymphoma at low frequency, hindering studies of tumorigenesis and its inhibition in the presence of such gene products. MCL1is a member of the BCL2family that is highly regulated endogenously and that promotes cell viability and immortalization when introduced exogenously. Mice expressing an MCL1transgene in hematolymphoid tissues have now been monitored for an extended period and were found to develop lymphoma with long latency and at high probability (more than 85% over 2 years). In most cases, the disease was widely disseminated and of clonal B-cell origin. A variety of histologic subtypes were seen, prominently follicular lymphoma and diffuse large-cell lymphoma. MCL1thus sets the stage for the development of lymphoma as does BCL2, disease occurring with high probability and recapitulating a spectrum of subtypes as seen in human patients. These findings with the transgene underscore the importance of the normal, highly regulated pattern of MCL1expression, in addition to providing a model for studying tumorigenesis and its inhibition in the presence of a viability promoting BCL2family member.

Viability-promoting genes such as BCL2 play an important role in human cancer but do not directly cause aggressive tumors. BCL2 transgenic mice develop lymphoma at low frequency, hindering studies of tumorigenesis and its inhibition in the presence of such gene products. MCL1 is a member of theBCL2 family that is highly regulated endogenously and that promotes cell viability and immortalization when introduced exogenously. Mice expressing an MCL1 transgene in hematolymphoid tissues have now been monitored for an extended period and were found to develop lymphoma with long latency and at high probability (more than 85% over 2 years). In most cases, the disease was widely disseminated and of clonal B-cell origin. A variety of histologic subtypes were seen, prominently follicular lymphoma and diffuse large-cell lymphoma. MCL1 thus sets the stage for the development of lymphoma as does BCL2, disease occurring with high probability and recapitulating a spectrum of subtypes as seen in human patients. These findings with the transgene underscore the importance of the normal, highly regulated pattern of MCL1expression, in addition to providing a model for studying tumorigenesis and its inhibition in the presence of a viability promotingBCL2 family member.

Previous work posits that severity of substance abuse and severity of schizophrenic symptoms should be linked by either or both of two mechanisms: self-regulation of symptoms and drug-induced exacerbation of symptoms. Research on these relationships has yielded mixed results. We examined the interrelationships of schizophrenic symptoms and substance abuse in 172 patients with co-occurring disorders. Relationships were weak or nonexistent, without any consistent pattern. Our findings do not support the view that substances are used to self-regulate symptoms. In addition, our results suggest that substance abuse may lead to higher rates of institutionalization through mechanisms other than by exacerbating symptoms.

Background: Policies and programs that emphasize employment for persons with mental illness are often promoted with the goals of improving economic self-sufficiency and reducing dependence on public welfare programs. At present, there is little empirical evidence about the actual effect of vocational interventions on economic self-sufficiency or on use of public benefits by persons with mental illness. Study Aims: This study provides a preliminary look at how participating in supported employment, a form of vocational rehabilitation emphasizing ongoing support in competitive jobs, affects the amount that participants earn from work and the total amount of income they receive from all sources. Further, we examine the extent to which receiving public benefits affects the amount earned from private employment, taking into consideration other factors that might be associated with benefit status. Methods: Data are from a randomized trial of supported employment interventions. This analysis followed 137 of those study participants with severe mental illness for 18 months after they enrolled in either of two supported employment programs. Income from various sources was estimated based on interviews with study participants upon study entry and at six-month intervals thereafter. Changes in income from work, government and other sources were analyzed using paired Wilcoxon matched-pairs signed-ranks tests and t-tests. Using ordinary least-squares regression, we analyzed the effect of benefit status on changes in earnings, taking into account diagnosis, work history, education, program type, site of program, psychiatric symptoms, global functioning and previous earnings. Results: Estimated total income increased by an average of $134 (US) per month after enrolling in supported employment. More than three-quarters of this increase was from government sources, such as Social Security and educational grants. The increase in government income was largely due to participants applying for and getting cash benefits for the first time. Social Security payments for those receiving benefits before enrollment did not change significantly. A small group of persons (n = 22) who did not receive Social Security benefits before or after enrolment earned significantly more from competitive employment after enrolling than did those who received benefits. This finding persisted after taking into acount differences in work history, clinical and functional variables and education. Limitations: Because of the relatively small sample size and the lack of continuous measures of income these results should be considered preliminary. Conclusions: Supported employment, one of the more effective forms of vocational rehabilitation for persons with mental illness, did not reduce dependence on government support. Receiving government benefits was associated with lower earnings from work. Implications for Health Care Provision and Use: These findings suggest that most persons in treatment for severe mental illness need continued public financial support even after enrolling in vocational rehabilitation programs. Implications for Health Policy Formulation: Undoubtedly increased labor force participation can benefit persons with mental illness in a number of ways. However, policy makers should be careful about justifying increased access to vocational programs on the basis of reduced spending for income support. Further, targeting such programs only to persons receiving income support may overlook the clients who can benefit most: those who are not currently receiving benefits. Implications for Further Research: Policy makers need a better understanding of how vocational interventions and income support programs affect the income and well-being of persons with mental illness. Studies similar to this one should be repeated with larger, more diverse samples that will allow use of instrumental variables statistical techniques. © 1998 John Wiley & Sons, Ltd.

In the traditional brokered model of vocational rehabilitation for persons with psychiatric disabilities, mental health and vocational services are provided in separate agencies. Problems in this model have frequently been described in the literature but without client-level data. In a controlled clinical trial, clients assigned to a ‘best practice’ exemplar of the brokered model achieved vocational outcomes that were inferior to those of clients assigned to a model that integrated mental health and vocational services within the same program. In this paper, process data are examined to clarify the relatively poor performance of the broke red model. A large proportion of the clients who were assigned to the brokered model (38%) either failed to engage with the vendor or to complete the preemployment skills training phase. For clients who had difficulty engaging and for those who did engage and complete the preemployment phase, problems related to coordination between the mental health program and the vocational vendor were common and negatively affected outcomes. This analysis supports a more fundamental integration of mental health and vocational services than is characteristic of the brokered model.