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Abstract.In this study the 15-item Evidence-Based Practices Attitude Scale (EBPAS), a measure designed to assess attitudes toward the adoption of EBPs, was collected from administrators of residential care facilities for youth in the United States. As the EBPAS was administered to a different sample for which it was originally developed (i.e., community mental health), we conducted a Confirmatory Factor Analysis (CFA) to investigate if its factor structure was maintained. Results confirm the factor structure of the EBPAS as a valid measure of attitude toward evidence-based practice among youth residential care providers. Limitations and areas of future research are discussed.

Abstract Empowerment has been established as an important factor in resilience in adolescence. It has also been deemed critical for youth with emotional and behavioral disorders to achieve successful outcomes [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.im.2006.12.004 Byline: Ronald L. Thompson (a), H. Jeff Smith (b), Charalambos L. Iacovou (a) Keywords: Information systems development; Project management; Status reporting; Project outcomes; Communication quality Abstract: Recent research has suggested that flawed status reporting is a serious concern in IS projects. However, the linkage between reporting quality and project performance has not been empirically confirmed. Our investigation consisted of two complementary studies, both of which employed previously validated measures of reporting quality and project outcomes. The first considered the perceptions of 210 IS project members of the quality of status reports they submitted to their project managers. The second considered the perceptions of 485 IS project managers of the quality of project reports they received from project members reporting to them. Both showed that the perceived quality of project reporting was less than perfect and was significantly associated with project task and psychological outcomes. Moreover, the second study results suggested that reporting quality was also related to organizational outcomes. We offer recommendations for project managers. Author Affiliation: (a) Babcock Graduate School of Management, Wake Forest University, Winston-Salem, NC 27109, USA (b) Richard T. Farmer School of Business, Miami University, Oxford, OH 45056, USA Article History: Received 3 November 2005; Revised 9 September 2006; Accepted 29 December 2006 Article Note: (footnote) [star] Note: An earlier version of this paper was presented at the 26th International Conference on Information Systems.

Mental health variables, such as psychiatric diagnoses and medications, concerning youth that entered residential group home care in 1995 and 2004 are examined using their admissions data. Findings show that the youth's mental health needs in 2004 were greater than those in 1995.

The study develops a measure to assess the level of restrictiveness of the living situations of behaviorally and emotionally disturbed children. Findings show low, moderate, elevate and high restrictiveness clusters that may exhibit overlaps. Limitations of the study are presented.

Background: In studies of the general population and of military veterans, many primary care patients with hazardous drinking and PTSD and/or depression (abbreviated here as HD +) do not initiate or engage with alcohol-related care. To address this gap in care, we identified and will pilot test a promising evidence-based intervention, Connect To Care (C2C). C2C is a strengths-based approach, delivered by a Care Coach by telephone and/or video, with four components: (1) identifying and leveraging patient strengths to facilitate care initiation, (2) collaborative decision-making around a menu of care options, (3) identifying and resolving barriers to care, and (4) monitoring and facilitating progress toward care initiation by, for example, checking on barriers, identifying solutions, and revisiting care options. Methods/Design: Aim 1 will involve adapting C2C for use in Veterans Affairs’ (VA) primary care. We will use an iterative process that includes focus groups and semi-structured interviews with key stakeholders (patients, primary care providers, and VA national policy leaders). In Aim 2, we will conduct a two-site, pilot randomized controlled trial to determine the feasibility of conducting a larger scale trial to test C2C’s effectiveness, ascertain the acceptability of C2C among primary care patients with HD + , and explore the efficacy of C2C to improve veteran patients’ initiation of and engagement in alcohol care, and their alcohol and mental health (PTSD, depression) outcomes, at 3-month follow-up. We will explore explanatory mechanisms by which C2C is effective. Discussion: Study findings are likely to have implications for clinical practice to enhance current approaches to linking patients with HD + to alcohol care by applying a practical intervention such as C2C. The results may improve treatment outcomes for people with HD + by drawing on patients’ strengths to problem-solve barriers to care following a process of shared decision-making with a coach. In addition to possibly accelerating the translation of C2C into practice, study findings will also support additional research in terms of a planned effectiveness-implementation hybrid trial, adding to this study’s potential for high impact.

Executive Summary The authors describe four types of Internet business (I-business) and discuss two examples of companies -- Marshall Industries and General Motors -- that are currently using Internet technologies [...]

Abstract This article describes practical methods for agencies to move from a process to an outcomes focus when preparing and presenting reports to payers and regulators. Essential components of an [...]

We offer a practitioner’s perspective on “Unleashing the Power of Prevention,” the guiding paper of the American Academy of Social Work and Social Welfare’s Grand Challenge to Ensure Healthy Development for All Youth. We present an innovative strategy aimed at reducing behavioral health problems in young people by helping treatment providers in social work and other human service settings to redirect a portion of their existing intervention efforts to tested and effective preventive interventions. Conceptually guided by Kotter’s 8-step model of organizational change, the shifting from treatment to evidence-based prevention(STEP) framework outlines specific steps treatment providers can use to implement evidence-based prevention programs. The framework also includes a call to action for prevention scientists to support these efforts at a broader level. We provide a case example that illustrates a systematic shift from treatment to evidence-based prevention at Boys Town, a national service organization with a deep history of providing treatment to vulnerable children and families. We conclude with a consideration of the framework’s challenges and opportunities.

Each year a number of youth with a school identified disability are placed in residential care. It has been well documented that these youth enter with elevated rates of behavioral, emotional, educational, mental health, and familial challenges. However, the physical and medical condition of these youth remains unstudied.

The prevalence of weight problems among youth in general and youth in out-of-home care has been well documented; however, the prevalence of obesity/overweight among youth with high-incidence disabilities in more restrictive settings, such as residential care, has not been assessed. The purpose of the present study was to evaluate the prevalence of weight problems in 245 youth with learning disabilities or emotional disturbance at entrance to residential care. Youth intake files were examined to evaluate the association between youth demographic characteristics, medical conditions, prior placements and placement settings, medication usage, and internalizing and externalizing behavioral problems and clinical weight problems. Findings revealed that over one half of the youth were overweight or obese (50.6%), and weight problems were associated with gender, medical conditions, and age. Study limitations, future research efforts, and treatment implications are discussed.

A key barrier to conducting research involving children and families is the difficulty of creating partnerships among researchers, treatment agencies, and schools. This article describes several key factors that were essential to establishing an effective research collaboration between practitioners and university-based researchers, including a mutual respect for the unique needs of research and practice; a strategy for joint decision making; a partnership model of incremental growth; a plan for mentoring junior faculty and students; a format for regular contact between the partners; and a plan for long-term sustainability. This collaboration has conducted over a dozen evaluation studies, as well as examined best practice issues surrounding the needs of children and families with serious emotional and behavioral needs. Even more important has been the lines of research that have been developed from this partnership which keeps the collaboration focused. The lessons learned from this research partnership should inform other collaborations.

The pair-wise comparison technique is a common approach for completing multi-attribute evaluations. However, this approach has limitations, especially for larger attribute sets, where the use of the technique is time-consuming because it requires a relatively large number of comparisons. The authors conducted an experiment to test the efficacy of three alternative approaches for eliciting preferences, specifically pairs, triads and quads. Ninety-three subjects used one of the three approaches to rank the importance of fifteen items. The results indicate that those employing the pair-wise approach took significantly longer than those using the triad or quad approach. In addition, the triad technique yielded more accurate results (compared to the pair and quad methods). Finally, the quad approach generated fewer intransitivities than the pair-wise or triad approaches. No differences were observed across the three techniques with respect to reliability or perceived ease of use. Implications are provided for both practitioners and researchers.

In previous studies by our group, we found that female offspring of parental divorce and parental remarriage are more susceptible to suicide attempt than male offspring. In this study, we examine whether these findings remain even after controlling for offspring depression. The sample consists of respondents from the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions. Multivariable regressions controlled for offspring depression, parental depression, age, race/ethnicity, income, and marital status. Our previous findings that female offspring of parental divorce and parental remarriage are more likely to report a lifetime suicide attempt than male offspring remained even after controlling for offspring depression. Findings suggest that focusing on engaging female offspring who demonstrate symptoms of depression is not sufficient to reduce suicide attempt risk in this group as many at risk individuals will remain unrecognized.

Parental divorce during childhood is associated with an increased risk of suicide attempts for male but not female offspring. This study examines whether parental remarriage has a differential effect on suicide risk for male and female adult offspring. Using the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), the sample consists of respondents who experienced parental divorce (N= 6,436). Multivariable regressions were estimated. Females who lived with a stepparent were significantly more likely to report a lifetime suicide attempt compared with females who had not. Clinicians should note that female depressed patients who have a history of childhood parental divorce and remarriage may be at more risk for suicide attempt than previously recognized.

Research suggests parental divorce during childhood increases risk of suicide attempt for male but not female offspring. The negative impact on offspring associated with parental divorce may be better explained by parental psychopathology, such as depression. We examined whether adult offspring of parental divorce experience elevated risk of suicide attempt, controlling for parental history of depression, and whether the risk varies by the gender of the offspring. Using the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), the sample consists of respondents who experienced parental divorce (N4895). Multivariable regressions controlled for age, race/ethnicity, income, marital status, and parental history of depression. Females living with their fathers were significantly more likely to report lifetime suicide attempts than females living with their mothers, even after controlling for parental depression. Findings suggest that childhood/adolescent parental divorce may have a stronger impact on suicide attempt risk in female offspring than previously recognized.

This is a study of the relationship between a continuous performance test and parents' behavioral ratings of attention problems and impulsivity in 45 boys who had been referred to a clinic for learning and behavioral problems. No significant correlations obtained between these two methods of assessment. Perhaps the lack of congruence is due to the multidimensional nature of both attention problems and impulsivity. Suggestions for clinical practice and further research are discussed.

Three children from two unrelated families had a history of recurrent bacterial infections, and their neutrophils were shown to have deficient phagocytic and respiratory responses and possible deficiencies in chemotaxis or adherence. Their neutrophils were strikingly deficient in the ability to ingest or give a respiratory burst in response to unopsonized bakers’ yeast or zymosan (Z). Tests for neutrophil and monocyte CR1(C3b/iC3b receptor) and CR3(iC3b receptor) demonstrated rosettes with both EC3b and EC3bi. However, EC3bi were bound only to CR1,and not to CR3, because EC3bi rosettes were inhibited completely by anti-CR,. Neutrophils, monocytes, and natural killer (NK) cells also did not fluorescence stain with monoclonal antibodies specific for the a-chain of CR3(anti-Mac-1, anti-Mol, OKM1, and MN-41). Quantitation of C receptors with 126l monoclonal anti-CR, and anti-CR3indicated that neutrophils from each patient expressed normal amounts of CR, per cell but <10% of the normal amount of CR3. Examination of neutrophils by sodium dodecyl sulfate-polyacryl-amide gel electrophoresis demonstrated that a normal glycoprotein of -165,000 daltons was missing. Immuno-blotting of these gels indicated that the missing band was the a-chain of CR3. Subsequent analysis of all three patients’ cells also demonstrated a deficiency of LFA-1 a-chain and the common β-chain that is shared by the CR3/LFA-1/p150,95 membrane antigen family. The deficiency of LFA-1 probably explained the absent NK cell function, as normal NK cell activity is inhibited by anti-LFA-1 but not by anti-CR3. The reduced phagocytic and respiratory responses to Z were probably due to CR3 deficiency, because treatment of normal neutrophils with anti-CR3, but not anti-FLA-1, inhibits responses to Z by 80% to 90%. Ingestion of Staphylococcus epidermidis by normal neutrophils was shown to be partially inhibited by monoclonl antibodies to the a-chain of either CR3 or LFA-1, and monoclonal antibody to the common β-chain inhibited ingestion by 75%. Thus, both CR3 and LFA-1 may have previously unrecognized functions as phagocyte receptors for bacteria. The absence of this type of nonimmune recognition of bacteria by these children's neutrophils may be one of the reasons for their increased susceptibility to bacterial infections. © 1985 by Grune & Stratton, Inc.

Intact rats and rats with hysterectomies and/or ovariectomies were given daily doses (0.1–10 μg per kilogram per day) of ethinyl estradiol (EE) for 7 days by the subcutaneous route. Body weights were determined before administration and on the afternoon of the day of the seventh dose. Several blood coagulation test systems (partial thromboplastin time, thrombelastography, whole blood clotting time, antithrombin concentration, fibrinolysis potential, and fibrinogen concentrations) were studied on the eighth day when the rats were killed. The uterus (if present) was weighed. The results indicate that ovariectomy increased the effect of EE on lowering antithrombin activity and on lowering body weight gain in comparison to the effect of EE in intact rats or rats with hysterectomies. There was no effect on whole blood clotting time, thrombelastography, or partial thromboplastin time. The greatest and most significant changes were a dose-related loss in body weight and lowered antithrombin activity in the ovariectomized rat given 1, 3, 10 μg of EE per kilogram per day. The use of the ovariectomized rat as an animal model for testing the effect of different gonadal hormones on blood coagulation factors is suggested.

Zinc deficiency is overtly manifested as a dermatitis in swine; therefore, the purpose of this investigation was to determine possible zinc-related alterations in the metabolism of skin acid mucopolysaccharides (AMPs). Eighteen 4-week-old Yorkshire pigs were randomly allocated to one of three dietary treatments. Six animals were fed a semipurified, zinc-deficient, basal diet containing 20 ppm zinc. Six animals served as pair-fed controls and were fed the basal diet supplemented with 90 ppm zinc as zinc carbonate. The remaining six animals were fed the zinc-supplemented diet on an ad libitum schedule. All animals were killed after 36 days when overt deficiency symptoms were apparent in those animals fed 20 ppm zinc. Skin AMPs were isolated. Total hexosamine and galactosamine indicated no alteration in total AMPs. Fractionation of total AMPs into constituent sulfated and nonsulfated components revealed a significant increase in hyaluronic acid. No statistical difference in sulfated AMPs was found in skin from deficient and pair-fed animals, which was in accord with an in vitro sulfur-35 uptake study.

William James observed that, within the stream of thought, the ways we think fluctuate as a function of our emotional and physical conditions. Extrapolating from James, we propose that individuals vary along a dimension called levels of thinking. High-level thinking involves thoughts that are self-reflective, demonstrate awareness of emotion, and incorporate a broad perspective. Low-level thinking lacks these properties. Using a stream-of-consciousness methodology, two experiments examined the parameters of level of thinking. Level of thinking is reliably rated, stable over a 2-month interval, and consistent across modality (across writing vs. talking into a microphone). Whereas levels of thinking are positively correlated with measures of negative affectivity, extremes in thinking are linked to indicants of health problems. The second experiment demonstrated that when individuals face uncontrollable noise bursts, they move to lower levels of thinking that preclude awareness of negative emotions. The adaptiveness of thinking on different levels is discussed in terms of James's contributions to our current understanding of health and coping.

The purpose of this study was to assess the effectiveness of a parent training program designed to teach parents to encourage their preschool language-delayed children to solve household problems independently. Six mother-child pairs participated in the study. The children were enrolled in a preschool language therapy program. The training program consisted of five parent group sessions during which videotape demonstration and role playing were used as instructional techniques. Videotapes made before and after training were rated by two independent judges. Analysis of results indicated that the training program was effective in teaching parents to encourage independent problem solving with these young children. Finally, implications for children's language development and social adjustment were discussed.

The purpose of this study was to evaluate parents' reactions and understanding of diagnostic information from written reports and conferences in a clinic which provides multidisciplinary evaluations for children with speech, learning, language, and hearing problems. Previous studies and anecdotal reports suggested that many parents do not receive appropriate diagnostic information about their children. In the present study questionnaires were mailed to parents who had received reports of evaluations and most of whom had attended hour-long conferences covering the findings. Questionnaires were also sent to professionals who had received reports. Fifty-seven percent of the parents, and 63% of the professionals returned the questionnaires. Ninety percent of the parents indicated that they had understood the results as they were presented in the conference. Ninety-three percent of the professionals and 89% of the parents stated they understood the conclusions of the written reports .Further, 83% of the parents and 80% of the professionals reported that the findings had made a change in the child's educational or medical treatment. The percentage of parents who reported understanding the findings was greater than expected. The specific informing techniques used in this study are discussed.

The juvenile nasopharyngeal angiofibroma, a rare neoplasm of adolescent males, is histologically benign but often clinically malignant. Although spontaneous regression of this tumour has been reported (Dane, 1954; Martin, Erhlich and Abels, 1948), this is not the usual clinical course and aggressive treatment is necessary to control symptomatic lesions. Surgical resection has been generally regarded to be the treatment of choice (Pressman, 1962; Rodriguez, 1966, English, Hemenway and Cundy, 1972). However, it has been our experience (Kadin, 1974), as well as that of others (Patterson, 1965), that results of attempted resection of angiofibromas which have extended widely beyond the nasopharynx have been poor. Because of this experience, a patient with an extensive nasopharyngeal angiofibroma was treated with radiation therapy with pre-and post-arteriographic studies to evaluate the extent of the tumour and the results of therapy.A 14-year-old Japanese-American male presented with a four-month history of nasal congestion, mouth breathing and bloody rhinorrhea. He had had no overt epistaxis. Physical examination revealed a 1–2 cm bluish nasopharyngeal mass which partially obstructed the left eustachian tube. No biopsy was attempted and the patient was referred to the UCLA Center for the Health Sciences.Bilateral selective internal and external carotid angiograms were performed using a small-calibre femoral catheter. These studies revealed more extension of the tumour than had been suspected clinically.

Concentrations of natural and man‐made radionuclides including 40K, 137Cs, and some of the decay products of 238U and 232Th were determined in soil. Samples were taken at a set of permanent radiation monitoring stations and from random points across the state of Louisiana. The concentrations of the radionuclides were found to be correlated with soil suborder: the lowest values found in the Udults of the northern portion of the state and the highest concentrations found in the Aquepts of the flood plains and the Hemists of the coastal marshes, suggesting that processes such as weathering, transport of solids, and dissolution may be fractionating these elements into soils of water environments. The concentration of K was found to vary from 3180 to 24 900 mg kg−1; U varied from 2.3 to 4.0 mg kg−1; and Th from 8.0 to 24.1 mg kg−1. Cesium‐137, the fission product, was found only in the top 15 to 20 cm of the soils with no statistically significant aerial distribution across Louisiana.

CANCER of the colon and rectum is the leading cause of death from cancer in the United States. Early diagnosis is particularly important for lesions of this portion of the gastrointestinal tract if optimum cure rates are to be achieved. Carcinomas of the right side of the colon are thought of as being relatively silent lesions producing nonspecific symptoms such as fatigue, weakness, and vague lower abdominal pain. Contrary to this, left-sided carcinomas are frequently more dramatic producing changes in bowel habits, bloody stools, and obstruction. Most important, up to 50% of the latter lesions are palpable on rectal examination.1When carcinoma of the colon causes intestinal obstruction, the lesion is most frequently left-sided in a ratio of 7 to 1.2 Because of the predominance of left-sided colon carcinomas causing obstruction, physicians frequently fail to consider that right colon carcinoma may cause intestinal obstruction. It is the purpose

The article discusses the book "Soviet Politics: The Dilemma of Power," by Barrington Moore. In this book Moore, an associate of the Russian Research Center at Harvard University, has made a basic contribution not only to the study of Soviet politics in particular but also to the understanding of the "dilemma of power" in general.

The environmental radiation exposure rate has been measured using thermolumineseent dosimetry at 26 monitoring stations in Louisiana over a period of 2 yr. Sets of LiF dosimeters that are essentially tissue equivalent in their energy response characteristics were left at each station for 90 d, replaced, and the exposure they received determined. The chips were exposed to a standard source three times during the 2‐yr period to assure their accuracy. On at least two occasions during the study period, samples of soil were taken at each station. These samples were dried, ground, sieved for uniformity, and analyzed by gamma ray spectroscopy. The specific activity of 40K, 137Cs, and some of the decay products of U and Th were determined. The average exposure rate for all stations was found to be 19.6 ± 2.8 µC kg−1yr−1(76 ± 11 mR yr−1). The range in values, from 15.0 to 25.5 µC kg−1yr−1is generally explained by the variation of the 40K specific activity in the natural soil bodies where the stations are located. The 40K specific activity ranges from 100 to 900 Bq kg−1across the state. The other activities are also related to soil type, but none vary as dramatically as 40K. The results obtained agree with other more limited surveys and provide a large, reliable baseline to which future studies can be referred when assessing changes in environmental radiation levels.

This communication reviews one institution’s experience in developing a reliable and accurate radiation therapy record form. The design of a daily record is highly subjective. With the subjectivity of this process in mind, the purpose of this presentation is to describe the advantages of our form and to acquaint the reader with the literature useful in preparing a therapy record that fulfills their facility’s requirements.

Infective complications are a significant problem in the management of patients with obstructive jaundice, despite the widespread use of prophylactic antibiotics. The cause of this may be suppression of the immune system. This study investigates the effect of serum from an animal model of extrahepatic biliary obstruction (BDL) for 7, 14, and 21 days on the lymphoproliferative response of a single population of T-lymphocytes to the mitogen phytohemagglutinin (PHA). Mean stimulation counts for lymphocytes cultured with 7 days with BDL serum (938±90p=0.04) and for 21 days with BDL serum (844±253p=0.04) are significantly lower than control serum (2382±1340). The effect of 14 days BDL serum has some suppression of lymphocyte stimulation but this is not significant (1115±429p=0.06). There was no significant correlation with any clinical parameters including bilirubin and the duration of jaundice. We have concluded that serum from animals with obstructive jaundice is immunosuppressive, but further studies are required to identify the factor and its role in vivo.

The lack of a randomized prospective study of the efficacy of elective irradiation of the cervical lymph nodes in patients with primary carcinoma of the head and neck forces us to carefully study retrospective studies for the contemporary evaluation of this therapeutic concept. In spite of this shortcoming, it has become increasingly obvious that the contention that irradiation is unable to control cervical lymph node metastases is no longer tenable. Furthermore, increasing evidence from several centers indicates that lethal irradiation of occult, ie, microscopic, foci of carcinoma of epithelial origin which is deposited in cervical adenopathy is highly effective.In order to develop the argument for elective neck irradiation, it is pertinent to briefly review some of the evidence in favor of the ability of radiation therapy alone to control more obvious cervical metastatic disease. A previous communication20 analyzed the results of radiation therapy alone in 69 patients with

Several letters to the editor are presented in response to articles in previous issues on topics including a makeover of the Great Planes RV-4 model aircraft, the photograph of airplane designer David Wigley’s Bristol Beaufighter model aircraft, and the Sopwith Camel model aircraft.

A personal narrative is presented which explores the author's experiences in collecting the photographs of plants from the Alpine Garden Society's "Bulletins."

• A patient had hereditary angioneurotic edema coincident with systemic lupus erythematosus. This condition resulted in loss of hair, arthralgia, leukoplakia, colitis, and a nephrotic syndrome due to proliferative glomerulonephritis. The renal lesion was resistant to treatment with high-dose prednisolone and cyclophosphamide; however, sustained remission occurred after plasmapheresis. The patient has remained well for over two years since this procedure.(Arch Intern Med 140:127-128, 1980)

The concurrent validity of the recently published Perkins-Binet Tests of Intelligence for the Blind was examined. Twenty-eight students from a residential school for blind children served as subjects. Although high correlations were obtained between both forms of the Perkins-Binet and the Wechsler scales of intelligence, there were substantial differences in the standard deviations for the different tests. The authors recommend further evaluation of the Perkins-Binet tests.

Presents a photograph taken by Ronald Thompson of a view of Y Garn and Llyn Idwal on a winter night at Glyders, Snowdonia.