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Provider-evaluated substance use treatment completion and client-reported substance use improvement are standards in determining treatment success. The relationship between these two outcomes is anecdotally understood in practice. However, the relationship has not been empirically determined and factors related to provider/client conflicting assessments are unknown. This study investigates treatment success by investigating consensus and conflict between improvement and completion in a large national sample. The present study is a cross-sectional retrospective evaluation of US substance use treatment episodes from facilities receiving public funding from 2015 to 2019 (N = 5,047,714). Episodes were mostly male (64.5%), aged 25–34 (34.4%), and White (58.5%). Conflict, consensus, and client factors associated with conflicting outcome evaluations were compared with differences in proportions and their 95% confidence intervals. Logistic regression was used to predict completion from improvement, adjusting for covariates. For absolute percentages, clients and providers were in consensus in 48.3% of all episodes, 32.5% were in conflict, and 19.2% were missing. The adjusted analysis significantly predicted completion from improvement (aOR = 2.18, 95% CI = 2.17, 2.19). Importantly, outcome conflict demonstrated absolute meaningful associations with problem substance, referral source, employment status, service setting, and supplemental mutual-help group attendance. Completion and improvement are somewhat associated, but most likely represent separate factors of treatment success. Addressing factors associated with outcome conflict may improve client and provider consensus and increase successful recovery. Policies and programs can set standards aligned with a uniform definition of success accounting for use improvement. [ABSTRACT FROM AUTHOR]

This study examined the microinteractions of pedestrians in Japan and in the United States as they walked past a confederate. Specifically, the effects of culture, condition (avoid, look-only, and look plus smile) and sex of confederate on glances, smiles, nods, and greetings by passing pedestrians were examined in a field study on over 1000 participants. The hypotheses of (1) lower responsiveness in Japanese pedestrians than in American pedestrians and (2) increased responsiveness as a function of condition were supported in a series of log-linear analyses of pedestrian glances, smiles, nods, and greetings. Both of these main effects were, however, qualified by Culture X Condition interactions on smiles, nods, and greetings, with the large condition effects present in the American pedestrians, but absent in the Japanese pedestrians. The results are discussed in terms of the functions of glances, smiles, nods, and greetings in these brief encounters and how differing cultural norms affect Japanese and American responsiveness. Finally, the limitations of this study and the broader utility of this research paradigm are discussed. [ABSTRACT FROM AUTHOR]

Describes the subsurface geometry of active faults that cut the surface and Quarternary blind faults and folds of the northern Los Angeles fault system in California. Regional setting; Alluvial fan deposits; Three types of crystalline basement rocks; Santa Monica fault system; Structures east of the west Beverly Hills lineament; Newport-Inglewood fault zone.

Background: Mutual-help alternatives for addiction are numerous, and research attests to the benefits of involvement in such alternatives. Yet, virtually nothing is known about affiliation patterns over time among 12-step alternatives. We investigated the patterns, correlates, and outcomes of transitions in affiliation (including changing groups and dropping out) within alternatives for alcohol problems.Methods: We analyzed data from the Peer ALternatives for Addiction (PAL) Study, a longitudinal study comparing the nature and effectiveness of 12-step groups, WFS, LifeRing, and SMART (N = 647). First, using all data, we compared affiliation patterns over time across 12-step and 12-step alternative members at baseline. Second, analyzing exclusively 12-step alternative members at baseline, we compared baseline characteristics and 6-month outcomes of those who changed and dropped out of (vs. retained) their primary groups at 6 months.Results: While drop-out rates were low, and similar, across groups, members of the alternatives were more likely (vs. 12-step) to change groups at 6 months, and transitioned predominantly to 12-step. Further, among the 12-step alternatives, both changing groups and dropping out was associated with lower group cohesion and satisfaction. Meanwhile, in multivariate analyses of 6-month outcomes, changing (vs. retaining) groups robustly predicted lower cohesion, higher negative affect, and lower quality of life, whereas dropping out was associated with lower odds of alcohol abstinence.Conclusions: While dropping out is known to be risky, changing groups is more common among the 12-step alternatives, and connotes risk of future problems that may be partially explained by dissatisfaction with the new group (usually 12-step). [ABSTRACT FROM AUTHOR]

A 19-year-old Japanese male recipient, who received a living related kidney transplantation from his father at 5 years old, was hospitalized for second renal transplantation from a cadaveric donor. The recipient had had an antibody-mediated rejection (AMR) to the first transplanted kidney. HLA typing of A, B, and DRB showed 2 of 6 mismatches. Lymphocyte cytotoxicity test (LCT) and flow cytometry crossmatches (FCXM) were negative on T cells. Tacrolimus, mycophenolate mofetil, methylprednisolone, and basiliximab induction were used as the standard immunosuppressive therapy. After second renal transplantation, his serum creatinine level favorably decreased until postoperative day (POD) 7, but his serum creatinine level raised from POD 8. We performed steroid pulse and intravenous immunoglobulin (IVIG). The episode biopsy showed AMR although FCXM and LCT were still negative on T cell. To determine the cause of AMR, we examined LABScreen single antigen test (One Lambda, Canoga Park, Calif., United States), and there was a donor-specific antibody (DSA) that is DQB8 in pre- and post-second renal transplantation. The DSA was suspected de novo DSA for the first transplanted kidney. AMR was successfully treated with plasma exchange, IVIG, and rituximab. [ABSTRACT FROM AUTHOR]

Exposure to natural and human-made disasters is associated with long-term health consequences, including for mental health. Parents who have lost children, particularly their only children, in any circumstances are also at increased risk of developing mental health problems. The aim of this study was to review the available evidence about the psychological and social consequences for parents who had faced these circumstances simultaneously through losing children in a disaster. Systematic searching of the English and Chinese language literatures about the psychological and social functioning of bereaved parents after disasters revealed that a small number of studies met inclusion criteria. The results showed that bereaved parents had more mental health problems than bereaved spouses and non-bereaved parents, and mothers appeared to be more vulnerable to mental health problems than fathers. Potential protective factors for bereaved parents' mental health included having psychological interventions, having adequate social support, seeing their children's bodies and having a subsequent baby. Although the literature was modest and methodologically diverse, there was a consistent finding that parents who have lost children in disasters were at high risk of suffering mental health problems, especially bereaved mothers. As there was little evidence, further studies are needed to understand the best advice and interventions to offer bereaved parents and provide enhanced mental health care of such bereaved populations after disasters., (Copyright © 2012 Wiley Publishing Asia Pty Ltd.)

Despite the overall decline in cigarette smoking prevalence in the US, social class inequalities in smoking are likely to persist, or even to widen. One possible reason for the increasing gap in smoking prevalence across social class could be our lack of understanding of causal mechanisms: in other words, what accounts for the social gradient in smoking behavior? In this paper, we examine the mechanisms behind social gradients related to smoking cessation by use of path analysis techniques. The data come from a 3-year follow-up telephone survey of a cohort of US adults. The sample for the present analysis was drawn from the 481 respondents who reported being smokers and employed at baseline and who completed the follow-up interview. We examined two social class indicators, educational attainment and household income, in relation to smoking cessation. We tested the potential mediating effects of the following variables: differential use of resources for smoking cessation (e.g., booklet, pamphlet, quit line, nicotine replacement therapy and smoking cessation program), differential environments in terms of smoking at worksite and home, and differences in peer smoking. Our path analyses suggest that smokers from high social class are likely to use effective resources for smoking cessation and have restrictive home environment in terms of smoking, which leads to a relatively higher smoking cessation rate compared to those from low social class. The results of this study suggest that interventions should target resources for smoking cessation and home environments in terms of smoking to reduce socio-economic disparities in smoking cessation.