Evaluation of a mentored self -help intervention for the management of psychotic symptoms

Cognitive behavioral therapy has been shown to be promising for the treatment of individuals experiencing psychotic symptoms, who are often diagnosed with schizophrenia. Using a non-random non-equivalent comparison group design (n = 26), this study explores whether an individually mentored self-help and self-paced intervention based upon cognitive behavioral approaches to auditory hallucinations or "hearing voices" makes a significant positive difference for individuals with major mental disorder diagnoses and psychotic symptoms who are residing in the community and receiving community mental health services. The mentored self-help intervention uses a workbook (Coleman & Smith, 1997) that stemmed from the British psychiatric survivor and "voice hearers"' movements and from cognitive behavioral approaches to treating psychotic symptoms. Thirty individuals entered the study. Pre- and post-intervention assessments of 15 participants in the intervention group and 11 participants in the comparison group were carried out using standardized instruments, including the Rosenberg Self-Esteem Scale, the Brief Psychiatric Rating Scale, and the Hoosier Assurance Plan Inventory - Adult. Four specific research questions address whether levels of self-esteem, overall psychotic symptoms, depression-anxiety, and disruption in life improved in the intervention group, relative to the comparison group. Pre- and post-assessment scores were analyzed using repeated measures analysis of variance. Results showed no significant difference on any measure, with the exception of the Brief Psychiatric Rating subscale for Anxious Depression, which showed a statistically significant pre-post difference with a strong effect size. A conservative interpretation of this single positive result is that it is due to chance. An alternative interpretation is that the mentored self-help intervention made an actual improvement in the level of depression-anxiety experienced by participants. If so, this is particularly important given high levels of depression and suicide among individuals diagnosed with schizophrenia. This alternative interpretation supports further research on the intervention utilized in this study. ^

Health changes in Hispanic older adults in a Spanish arthritis self -management education program

Arthritis is the most common chronic condition affecting older people and is a major cause of limited activity. Arthritis education programs in English have demonstrated a positive impact on health but these programs have not reached the Hispanic communities where arthritis is the leading cause of disability. Minorities, such as Hispanics, have traditionally been reluctant to pursue self-help programs, and have been identified as an under-served population in terms of medical care. This study examined the effectiveness of one community health adult education program targeting Hispanic older adults with arthritis, the Spanish Arthritis Self Management Education Program (SASMEP), by evaluating changes in the participants' general health, pain, disability, self-efficacy, health perceptions, frequency of physician visits, and exercise. A pre and post control group experimental design and analyses of covariance were used to determine the pre and post differences in health status and health behaviors for a group participating in the SASMEP and a group who did not using gender and age as covariates. A repeated measures design was also used, and repeated measures analyses of variance and post hoc tests were done on health status and health behavior data collected pre, post and one-year post education to determine long-term differences. ^ Results indicated the participants' health status significantly improved in general health, significantly decreased in pain, and significantly decreased in arthritic disability immediately following the education. Self-efficacy and health perceptions increased for both groups but not significantly. The participants' health behaviors showed significantly fewer physician visits and significantly increased time spent performing stretching and strengthening exercise and time spent performing aerobic exercise. No group differences were found in the frequency of arthritis physician visits. ^ The improvements seen immediately after the SASMEP participation were not reflected in the post one-year scores. No significant differences were found for the participants' health status or health behaviors one year following the education. Health status and health behaviors did not return below baseline scores after one year suggesting the participants' health, although not improved, did not deteriorate. Therefore, the SASMEP education provided short-term health benefits for older Hispanic adults with arthritis, but not long-term health benefits. ^

Nano-grids of Yeast Cytochrome C

One innovative thought in biomolecular electronics is the exploitation of electron transfer proteins. Using nature's self assembly techniques, proteins can build highly organized edifices with retained functional activity, and they can serve as platforms for biosensors. In this research work, Yeast Cytochrome C (YCC) is immobilized with a help of a linker molecule, 3-Mercaptopropyltrimethoxysilane (3-MPTS) on a hydroxylated surface of a silicon substrate. Atomic Force Microscopy (AFM) is used for characterization. AFM data shows immobilization of one YCC molecule in between eight grids that are formed by the linker molecules. 3-MPTS monolayers are organized in grids that are 1.2 nm apart. Immobilization of 3-MPTS was optimized using a concentration of 5 mM in a completely dehydrated state for 30 minutes. The functionally active grids of YCC can now be incorporated with Cytochrome C oxidase on a Platinum electrode surface for transfer of electrons in development of biosensors, such as nitrate sensor, that are small in size, cheaper, and easier to manufacture than the top-down approach of fabrication of molecular biodevices

Self-other rating discrepancy and personality antecedents

This study explored individual difference factors to help explain the discrepancy that has been found to exist between self and other ratings in prior research. Particularly, personality characteristics of the self-rater were researched in the current study as a potential antecedent for self-other rating agreement. Self, peer, and supervisor ratings were provided for global performance as well as five competencies specific to the organization being examined. Four rating tendency categories, over-raters, under-raters, in-agreement (good), and in-agreement (poor), established in research by Atwater and Yammarino were used as the basis of the current research. The sample for rating comparisons within the current study consisted of 283 self and supervisor dyads and 275 for self and peer dyads from a large financial organization. Measures included a custom multi-rater performance instrument and the personality survey instrument, ASSESS, which measures 20 specific personality characteristics. MANCOVAs were then performed on this data to examine if specific personality characteristics significantly distinguished the four rating tendency groups. Examination of all personality dimensions and overall performance uncovered significant findings among rating groups for self-supervisor rating comparisons but not for self-peer rating comparisons. Examination of specific personality dimensions for self-supervisory ratings group comparisons and overall performance showed Detail Interest to be an important characteristic among the hypothesized variables. For self-supervisor rating comparisons and specific competencies, support was found for the hypothesized personality dimension of Fact-based Thinking which distinguished the four rating groups for the competency, Builds Relationships. For both self-supervisor and self-peer rating comparisons, the competencies, Builds Relationships and Leads in a Learning Environment, were found to have significant relationship with several personality characteristics, however, these relationships were not consistent with the hypotheses in the current study. Several unhypothesized personality dimensions were also found to distinguish rating groups for both self-supervisor and self-peer comparisons on overall performance and various competencies. Results of the current study hold implications for the training and development session that occur after a 360-degree evaluation process. Particularly, it is suggested that feedback sessions may be designed according to particular rating tendencies to maximize the interpretation, acceptance and use of evaluation information. ^

Computational modeling of intermediate temperature proton exchange membrane (PEM) fuel cells

A two-phase three-dimensional computational model of an intermediate temperature (120--190°C) proton exchange membrane (PEM) fuel cell is presented. This represents the first attempt to model PEM fuel cells employing intermediate temperature membranes, in this case, phosphoric acid doped polybenzimidazole (PBI). To date, mathematical modeling of PEM fuel cells has been restricted to low temperature operation, especially to those employing Nafion ® membranes; while research on PBI as an intermediate temperature membrane has been solely at the experimental level. This work is an advancement in the state of the art of both these fields of research. With a growing trend toward higher temperature operation of PEM fuel cells, mathematical modeling of such systems is necessary to help hasten the development of the technology and highlight areas where research should be focused.^ This mathematical model accounted for all the major transport and polarization processes occurring inside the fuel cell, including the two phase phenomenon of gas dissolution in the polymer electrolyte. Results were presented for polarization performance, flux distributions, concentration variations in both the gaseous and aqueous phases, and temperature variations for various heat management strategies. The model predictions matched well with published experimental data, and were self-consistent.^ The major finding of this research was that, due to the transport limitations imposed by the use of phosphoric acid as a doping agent, namely low solubility and diffusivity of dissolved gases and anion adsorption onto catalyst sites, the catalyst utilization is very low (∼1--2%). Significant cost savings were predicted with the use of advanced catalyst deposition techniques that would greatly reduce the eventual thickness of the catalyst layer, and subsequently improve catalyst utilization. The model also predicted that an increase in power output in the order of 50% is expected if alternative doping agents to phosphoric acid can be found, which afford better transport properties of dissolved gases, reduced anion adsorption onto catalyst sites, and which maintain stability and conductive properties at elevated temperatures.^

Development of prediction models for freeway incident durations using data mining techniques

The nation's freeway systems are becoming increasingly congested. A major contribution to traffic congestion on freeways is due to traffic incidents. Traffic incidents are non-recurring events such as accidents or stranded vehicles that cause a temporary roadway capacity reduction, and they can account for as much as 60 percent of all traffic congestion on freeways. One major freeway incident management strategy involves diverting traffic to avoid incident locations by relaying timely information through Intelligent Transportation Systems (ITS) devices such as dynamic message signs or real-time traveler information systems. The decision to divert traffic depends foremost on the expected duration of an incident, which is difficult to predict. In addition, the duration of an incident is affected by many contributing factors. Determining and understanding these factors can help the process of identifying and developing better strategies to reduce incident durations and alleviate traffic congestion. A number of research studies have attempted to develop models to predict incident durations, yet with limited success. ^ This dissertation research attempts to improve on this previous effort by applying data mining techniques to a comprehensive incident database maintained by the District 4 ITS Office of the Florida Department of Transportation (FDOT). Two categories of incident duration prediction models were developed: "offline" models designed for use in the performance evaluation of incident management programs, and "online" models for real-time prediction of incident duration to aid in the decision making of traffic diversion in the event of an ongoing incident. Multiple data mining analysis techniques were applied and evaluated in the research. The multiple linear regression analysis and decision tree based method were applied to develop the offline models, and the rule-based method and a tree algorithm called M5P were used to develop the online models. ^ The results show that the models in general can achieve high prediction accuracy within acceptable time intervals of the actual durations. The research also identifies some new contributing factors that have not been examined in past studies. As part of the research effort, software code was developed to implement the models in the existing software system of District 4 FDOT for actual applications. ^

Propuestas para una reconceptualización surrealista y postmoderna de la sexualidad femenina en los textos de Cristina Escofet e Isabel Allende

Female sexuality has commonly been viewed as the passive counterpart of male sexuality. Building upon Adrienne Rich's theory of compulsive heterosexuality, I would suggest that the fundamental location of this problem lies within the subconscious. Cristina Escofet's stance on this issue is to argue in favor of a deconstruction of Jungian archetypes, revealing their constructed rather than intrinsic character. In this dissertation, I study representative texts by Escofet and Isabel Allende and show not only how they depict patriarchal compulsive heterosexuality, but also try to reconceptualize female sexuality through surrealist and postmodern techniques such as self-reflection, dialogue with our double or Other, and sensorial perception. These techniques are designed to create a new epistemology of jouissance and excess, as defined by contemporary French theory. The significance of my study resides in the interdisciplinary analysis of female sexuality in Hispanic feminist writers. The first chapter proposes that surrealism, postmodernism, and feminism are theoretical frameworks which create new paradigms for social change. In their feminist philosophies, Escofet and Allende emphasize the use of subconscious knowledge as a means of helping them understand the world and create alternative realities. The second chapter shows how Escofet and Allende deconstruct the mysoginist archetype of Eve, which has been largely responsible for identifying women's sexual identity with the disreputable qualities of the femme fatale and whose mirror-image has long plagued women. In accordance with this stereotype, Lillith (Adam's sexually active ex-partner), has typically been portrayed as the negative Other, and for generations the she-devil myth which surrounds her has resurfaced in the media, where she assumes the role of innumerable evil female characters. In the third chapter, I examine how class and race differences have been used to intensify the demonization of different types of sexuality. In the same manner as Lillith and Eve, black and indigenous characters express dissent by retelling their stories in words and performance, and by seeking to form a dialog with their readers. The last chapter deals with the importance of the senses for female characters as they try to create their own sexuality from the fragmented bodies we find in surrealist and postmodern art. In this section we shall see how Luce Irigaray and Hélène Cixous's theories about multiple sexualities are in evidence when Escofet and Allende reconceptualize female sexuality. As no previous scholarship has analyzed the use of the subconscious, the senses, and performance when understanding female sexuality in Latin American literature, this dissertation seeks to provide a tentative exploration of the issues that may help to open up a new field of research in Hispanic feminist cultural studies.

Ethnic identity, self-esteem and academic factors in second -generation post-1970 Jamaican immigrants

Immigrants from Jamaica represent the largest number of migrants to the United States from the English speaking Caribbean. Research indicates that of all Caribbean immigrants they are most likely to retain the ethnic identity of their home country for the longest period of time. This dissertation explored the nature of ethnic identity and sought to determine its impact upon the additional variables of self-esteem and academic factors. A secondary analysis was carried out using data collected in the Spring of 1992 by Portes and Rumbaut on the children of immigrants attending the eighth and ninth grades in local schools in San Diego and southern Florida. A sample of 151 second-generation Jamaican immigrants was selected from the data set. ^ Six hypotheses yielded mixed results. Both parents who have a Jamaican ethnic identity present in the household are the best predictor Jamaican youth who retain a Jamaican ethnic identity. It was expected that ethnic identity would be a predictor of positive academic factors. The study showed that ethnic identity was not associated with one of the academic factors which were examined: help given with homework. ^ Neither family economic status nor parents' level of education played a significant role in the retention of Jamaican identity. Other findings were that there was no mean difference in the self-esteem scores of respondents who had similar ethnic identities to their parents and those who did not. There was also no difference found in the academic factors of either group. The study also showed that there was a small correlation between parent-child conflict and self-esteem. Specifically, the study found that the higher the conflict between youth and their parents, the lower the self-esteem of the youth. Finally it found that time lived in the U.S. was the best predictor of a higher GPA and it was also related to lower self-esteem. ^ Surprisingly, the study found that the relationship between ethnic identity and SES was the opposite of what was expected in that it found that SES was higher when there was no Jamaican identity. ^

Effects of computer self efficacy and positive mood in business -to -business service encounters

Attempts to improve the level of customer service delivered have resulted in an increased use of technology in the customer service environment. Customer-contact employees are expected to use computers to help them in providing better service encounters for customers. This research study done in a business-to-business environment explored the effects of customer-contact employees' computer self efficacy and positive mood on in-role customer service, extra-role customer service and organization citizenship. It also examined the relationship of customer service to customer satisfaction and customer delight. ^ Research questions were analyzed using descriptive statistics, frequency distributions, correlation analysis, and regression analysis. Results indicated that computer self efficacy had a greater impact on extra-role customer service than it did on in-role customer service. Positive mood had a positive moderating influence on extra-role customer service but not on in-role customer service. ^ There was a significant relationship between in-role customer service and customer satisfaction but not between extra-role customer service and customer satisfaction. There was no significant relationship between in-role customer service and customer delight nor between extra-role customer service and customer delight. There was a statistically greater positive relationship between joy experienced by clients and customer delight than between pleasant surprise and customer delight. ^ This study demonstrated the importance of facilitating customer-contact employee positive mood on the job in order to improve the level of extra-role customer service delivered. It also showed that increasing the level of customer service does not necessarily lead to higher levels of customer satisfaction. ^

Teacher perception of self -determination skills in the inclusive and special education classroom

It has been proposed that special education teachers, who promote self-determination and link it to educational standards, help students with a disability succeed in school. The current school reform movement has focused on accountability through mandates such as the No Child Left Behind Act, 2001, and has emphasized participation in the general curriculum through amendments to the Individuals with Disabilities Education Act (IDEA) of 1997 and 2004. This study informs educators if educational setting, students' type of disability, and subject area taught, influence teachers' opinions about the importance of teaching components leading to self-determination and self-management. ^ The research questions that drive this study are: (1) do secondary school teachers who instruct students with a disability think that self-determination components taught in the classroom will make an important difference in students' school and later postsecondary achievements? and (2) does the type of classroom setting, students' type of disability, or specific subject matter influence teachers' opinions regarding the importance of teaching components related to self-determination and self-management? The collection and interpretation of data were done using descriptive and quantitative methods employing a teacher survey. The survey was administered to secondary teachers who instruct students with disabilities. Data were analyzed using descriptive and inferential statistics. The sample consisted of 97 special education teachers currently teaching at the secondary level. ^ The results of the study indicated that teachers believe that self-determination is important for both school life and post school life. However teachers thought these skills to be more important for post school success. Teachers believe that self-determination is more important than self-management skills. Type of disability, educational environment, and subject area were not significant factors. ^

Self -management factors, influences, and conditions for type 2 diabetes among Black ethnic groups in Miami, Florida and Abidjan, Cote d'Ivoire

The Dahlgren and Whitehead ecological theory provides the framework for a cross-sectional design to compare socio-demographic characteristics, living and working conditions, and lifestyle daily habits as well as cultural and ecological factors among six diabetic multiethnic Black groups in Miami and Abidjan. Approximately 180 Black Americans (African-, Caribbean-, and Haitian-) and 180 Black Africans (Akan, Malinke, and Krou) aged 20 years and older were surveyed. During the preliminary of this study participants' attitudes and behaviors were qualitatively assessed (N=60) and a tool was developed to describe, in the main study (N=360), differences in participants' strength of commitment to diabetes lifestyle self-management. Despite similarities found in terms of age and gender, statistically significant differences were also found within and among groups in terms of living and working conditions, education level, and religion. African American groups were more likely to participate in more diabetes classes than Haitian Americans and Caribbean Americans. However, African Americans were less likely to adhere to daily dietary and weight control regimens. Although, Black African groups reported limited access to equipment, facilities, and financial support they were more likely to follow dietary and weight control recommendations than Black American groups. Overall, African American participants showed the poorest attitudes towards recommended foods, Caribbean American respondents reported the best attitudes and behaviors towards weight control regimens, and the Malinke group had significantly more strength of commitment to successful weight control. Furthermore, Black African groups had significantly more strength of commitment to successful dietary adherence and significantly less support for weight control than Black American groups. ^ Significant differences found within Black groups suggest that understanding each patient's conditions may help healthcare professionals in initiating individualized appropriate counseling before goal setting, and in developing culturally relevant type 2 diabetes management programs. Moreover, significant differences exist in strength of commitment to lifestyle adherence among Black groups in Miami and Abidjan. Cultural, socio-demographic factors and self-management habits may explain differences in participants' outcomes. At the policy level, Black groups should not be approached as a homogenous group and assessment of the vulnerability of each ethnic group may be necessary in the decision-making process.^

Identity as a moderator of guided -self change treatment outcomes with adolescents

Despite recent calls to examine the possible moderating effects of developmental variables on treatment outcomes with adolescents, most research has continued to focus on age as a main developmental variable. Building upon the theoretical notion that identity development is a central task of adolescence, this study investigated whether adolescents' response to an alcohol and other drug (AOD) use reduction intervention, Guided-Self Change (GSC), was influenced by their approach to self-defining questions and situations. While past research has established associations between maladaptive identity development and alcohol and other drug use, very little research attention has been given to the potential relationship that may exist between identity variables and AOD treatment response. Given GCS's promotion of self-reflective, self-exploring, and problem-focused coping skills as a way of addressing AOD problems, it was hypothesized that adolescents with positive identity development (i.e., greater identity coherence and adaptive identity processing styles) would respond more positively to GCS's change producing therapeutic techniques than their counterparts. This hypothesis was tested with an ethnically diverse sample of 134 adolescents between the ages of 14-18 years who were randomly assigned to either a GSC intervention or a comparison control group. Results revealed that identity development was significantly associated with AOD use, such that adolescents with diffused/avoidant styles and high levels of distress over identity-related issues used more alcohol at the baseline assessment than those with more positive identity development. Results also indicated that while identity distress or identity coherence did not moderate GSC treatment outcomes, high scores for a diffused/avoidant style did moderate treatment outcomes and thus proved to be a significant predictor of treatment response. These results indicate that identity development influences adolescents' alcohol use and that while use of certain approaches to self-defining questions does not predict treatment outcomes, high use for negative approaches does moderate intervention-related change. ^

A model of self -transformative identity development in troubled adolescent youth

Within the Stage II program evaluation of the Miami Youth Development Project's (YDP) Changing Lives Program (CLP), this study evaluated CLP intervention effectiveness in promoting positive change in emotion-focused identity exploration (i.e. feelings of personal expressiveness; PE) and a "negative" symptom of identity development (i.e. identity distress; ID) as a first step toward the investigation of a self-transformative model of identity development in adolescent youth. Using structural equation modeling techniques, this study found that participation in the CLP is associated with positive changes in PE (path = .841, p < .002), but not changes in ID. Increase in ID scores was found to be associated with increases in PE (path = .229, p < .002), as well. Intervention effects were not moderated by age/stage, gender, or ethnicity, though differences were found in the degree to which participating subgroups (African-American/Hispanic, male/female, 14-16 years old/17-19 years old) experience change in PE and ID. Findings also suggest that moderate levels of ID may not be deleterious to identity exploration and may be associated with active exploration. ^

The Effects of Peer Teaching of Infant Massage on General Self-Efficacy and Mother Infant Attachment Among Mothers in a Residential Rehabilitation Facility for Drug Addiction and Substance Abuse

Approximately 200 million people, 5% aged 15-64 worldwide are illicit drug or substance abusers (World Drug Report, 2006). Between 2002 and 2005, an average of 8.2% of 12 year olds and older in the Miami, Fort Lauderdale metropolitan areas used illicit drugs (SAMHSA, 2007). Eight percent of pregnant women, aged 15 to 25, were more likely to have used illicit drugs during pregnancy than pregnant women aged 26 to 44. Alcohol use was 9.8% and cigarette use was 18% for pregnant women aged 15 to 44 (SAMHSA, 2005). Approximately a quarter of annual birth defects are attributed to the exposure of drugs or substance abuse in utero (General Accounting Office, 1991). Physical, psychological and emotional challenges may be present for the illicit drug/substance abuse (ID/SA) mother and infant placing them at a disadvantage early in their relationship (Shonkoff & Marshall, 1990). Mothers with low self efficacy have insecurely attached infants (Donovan, Leavitt, & Walsh, 1987). As the ID/SA mother struggles with wanting to be a good parent, education is needed to help her care for her infant. In this experimental study residential rehabilitating ID/SA mothers peer taught infant massage. Massage builds bonding/attachment between mother and infant (Reese & Storm, 2008) and peer teaching is effective because participants have faced similar challenges and speak the same language (Boud, Cohen, & Sampson 2001). Quantitative data were collected using the General Self-Efficacy and Maternal Attachment Inventory-Revised Scale before and after the 4-week intervention program. A reported result of this study was that empowering ID/SA mothers increased their self-efficacy, which in turn allowed the mothers to tackle challenges encountered and created feelings of being a fit mother to their infants. This research contributes to the existing database promoting evidence-based practice in drug rehabilitation centers. Healthcare personnel, such as nurse educators and maternal-child health practitioners, can develop programs in drug rehabilitation centers that cultivate an environment where the ID/SA rehabilitating mothers can peer teach each other, while creating a support system. Using infant massage as a therapeutic tool can develop a healthy infant and nurture a more positive relationship between mother and infant.

A model of self-transformative identity development in troubled adolescent youth

Within the Stage II program evaluation of the Miami Youth Development Project's (YDP) Changing Lives Program (CLP), this study evaluated CLP intervention effectiveness in promoting positive change in emotion-focused identity exploration (i.e. feelings of personal expressiveness; PE) and a "negative" symptom of identity development (i.e. identity distress; ID) as a first step toward the investigation of a self-transformative model of identity development in adolescent youth. Using structural equation modeling techniques, this study found that participation in the CLP is associated with positive changes in PE (path = .841, p < .002), but not changes in ID. Increase in ID scores was found to be associated with increases in PE (path = .229, p < .002), as well. Intervention effects were not moderated by age/stage, gender, or ethnicity, though differences were found in the degree to which participating subgroups (African- American/Hispanic, male/female, 14-16 years old/17-19 years old) experience change in PE and ID. Findings also suggest that moderate levels of ID may not be deleterious to identity exploration and may be associated with active exploration.