An evaluation of coping ability as a guide to the treatment of persons diagnosed with schizophrenia and substance abuse

This dissertation introduced substance abuse to the Dynamic Vulnerability Formulation (DVF) and the social competence model to determine if the relationship between schizophrenic symptomatology and coping ability in the DVF applied also to the dually diagnosed schizophrenic or if these variables needed to be modified. It compared the coping abilities of dually and singly diagnosed clients in day treatment and identified, examined, and assessed the relative influence of relevant mediating variables on two dimensions of coping ability of the dually diagnosed: coping skills and coping effort. These variables were: presence of negative and nonnegative symptoms, duration of mental illness, type of substance used, and age of first substance use.^ A priori effect sizes based on previous empirical research were used to interpret the results related to the comparison of demographic, socioeconomic, and treatment characteristics between the singly and dually diagnosed study samples. The data suggested that the singly diagnosed group had higher coping skills than the dually diagnosed group, particularly in the areas of housing stability, work affect, and total social adjustment. The dually diagnosed group had lower scores on one aspect of coping effort--agency or self-efficacy. The data supported the presence of an inverse relationship between symptom severity and coping skills, particularly for the dually diagnosed group. The data did not support the presence of an inverse relationship between symptom severity and coping effort, but did suggest a positive relationship between symptom severity and one measure of coping effort, agency, for the dually diagnosed group. Regression equations using each summary measure of coping skill--social adjustment and role functioning--yielded statistically significant F-ratios. Thirty-six percent of the variance in social adjustment and thirty-one percent of the variance in role functioning were explained by the relative influence of the relevant variables. Both negative and non-negative symptoms were the only significant predictors of social adjustment. The non-negative symptoms variable was the sole significant predictor of role functioning. The results of this study provided partial support for the use of the Dynamic Vulnerability Formulation (DVF) with the dually diagnosed. ^

Investigating an Alternative Treatment to Cystic Fibrosis: Testing the Effect of Panax ginseng C.A. Meyer extracts on Pseudomonas aeruginosa

The predominant pathogen found in the lungs of cystic fibrosis (CF) patients is Pseudomonas aeruginosa. The success of the infection is partially due to virulence factor production, which is regulated by quorum sensing (QS) signaling. Currently, antibiotics are used to treat the infection, but resistant forms of P. aeruginosa have evolved, necessitating alternative treatments. Previous animal studies showed that treatment with extracts from the Chinese herb Panax ginseng C.A. Meyer reduced bacterial load resulting in a favorable immune response. It is hypothesized that ginsenosides, the major bioactive compounds in ginseng, is responsible for this effect. This study explores the role of ginseng extracts in attenuating P. aeruginosa virulence. A sequential extraction was performed using hexane, methylene chloride, methanol, and water. High performance liquid chromatography (HPLC) analysis showed the methanol and water ginseng extracts contained the known ginsenosides Rb1, Rb2, Rc, Rd, Re, and Rg1• All extracts were tested on biomonitor strains of Agrobacterium tumefaciens,Chromobacterium violaceum, and P. aeruginosa. Antibacterial and anti-QS activity were assessed using a disc diffusion assay. This was then followed by thin layer chromatography (TLC) bioautographic assay to further separate active compounds. The hexane and dichloromethane extracts, that lacked ginsenosides, displayed antibacterial activity against C. violaceum, whereas methanol and water extracts had anti-QS activity. The results of the bioassay with the pure ginsenoside standards showed that they lack antibacterial or anti-QS activity. Our results indicate that there are bioactive compounds, other than ginsenosides, that are the cause of antibacterial effects and anti-QS in the ginseng extracts.

An ethnopharmacological approach to multidrug -resistant Staphylococcus aureus: Evaluation of Italian plants used in the traditional healing of skin disease

One-third of botanical remedies from southern Italy are used to treat skin and soft tissue infections (SST's). Methicillin-resistant Staphylococcus aureus (MRSA), a common cause of SSTIs, is responsible for increased morbidity and mortality from infections. Therapeutic options are limited by antibiotic resistance. Many plants possess potent antimicrobial compounds for these disorders. Validation of traditional medical practices is important for the people who rely on medicinal plants. Moreover, identification of novel antibiotics and anti-pathogenic agents for MRSA is important to global healthcare.^ I took an ethnopharmacological approach to understand how Italian medicinal plants used for the treatment of SSTIs affect MRSA growth and virulence. My hypothesis was that plants used in folk remedies for SSTI would exhibit lower cytotoxicity and greater inhibition of bacterial growth, biofilm formation and toxin production in MRSA than plants used for remedies unrelated to the skin or for plants with no ethnomedical application. The field portion of my research was conducted in the Vulture-Alto Bradano area of southern Italy. I collected 104 plant species and created 168 crude extracts. In the lab, I screened samples for activity against MRSA in a battery of bioassays. Growth inhibition was analyzed using broth microtiter assays for determination of the minimum inhibitory concentration. Interference with quorum-sensing (QS) processes, which mediate pathogenicity, was quantified through RP-HPLC of δ-toxin production. Interference with biofilm formation and adherence was assessed using staining methods. The mammalian cytotoxicity of natural products was analyzed using MTT cell proliferation assay techniques.^ Although bacteriostatic activity was limited, extracts from six plants used in Italian folk medicine (Arundo donax, Ballota nigra, Juglans regia, Leopoldia comosa, Marrubium vulgare, and Rubus ulmifolius ) significantly inhibited biofilm formation and adherence. Moreover, plants used to treat SSTI demonstrated significantly greater anti-biofilm activity when compared to plants with no ethnomedical application. QSI activity was evident in 90% of the extracts tested and extracts from four plants ( Ballota nigra, Castanea saliva, Rosmarinus officinalis, and Sambucus ebulus) exhibited a significant dose-dependent response. Some of the plant remedies for SSTI identified in this study can be validated due to anti-MRSA activity.^