Dimensional analysis of burden in family caregivers of patients with obsessive-compulsive disorder

Aims: Obsessivecompulsive disorder (OCD) also generates emotional burden in the patient's family members, but no study has evaluated the specific dimensions of burden. The objectives were to evaluate the dimensions of the Zarit Burden Interview (ZBI) and possible correlates. Methods: This was a cross-sectional study involving 47 patients and 47 caregivers, using a sociodemographic questionnaire; the ZBI; the Self Reporting Questionnaire; the Family Accommodation Scale; and the YaleBrown ObsessiveCompulsive Scale. The ZBI factor analysis was conducted using Varimax Rotation. Results: Six factors were identified, explaining 74.2% of the total variance: factor 1, interference in the caregiver's personal life (36.6% of the variance); factor 2, perception of patient's dependence (10.8%); factor 3, feelings of irritation or intolerance (9.2%); factor 4, guilt (7.2%); factor 5, insecurity (5.6%); and factor 6, embarrassment (4.8%). The six ZBI factors were associated with greater OCD severity and with greater accommodation to the patient's symptoms, and factors 1, 2, 5 and 6 with caregiver's psychological morbidity. Caregiver's sex (female) was associated with factors 5 and 6, relationship with the patient (being a parent or son/daughter) with factor 5, higher educational level with factor 6, living with the patient with factor 3, worse self-evaluation of health with factors 1, 5 and 6, and occupational status (not working) with factors 1, 2, 5 and 6. Conclusion: The dimensions of burden identified indicate the most affected aspects of a caregiver's life and could guide the planning of more specific interventions. Thus, the caregiver could participate more effectively in the OCD patient's treatment, with a lower impact on his/her life.

A constructive heuristic algorithm to Short Term Transmission Network Expansion Planning

In this paper a method for solving the Short Term Transmission Network Expansion Planning (STTNEP) problem is presented. The STTNEP is a very complex mixed integer nonlinear programming problem that presents a combinatorial explosion in the search space. In this work we present a constructive heuristic algorithm to find a solution of the STTNEP of excellent quality. In each step of the algorithm a sensitivity index is used to add a circuit (transmission line or transformer) to the system. This sensitivity index is obtained solving the STTNEP problem considering as a continuous variable the number of circuits to be added (relaxed problem). The relaxed problem is a large and complex nonlinear programming and was solved through an interior points method that uses a combination of the multiple predictor corrector and multiple centrality corrections methods, both belonging to the family of higher order interior points method (HOIPM). Tests were carried out using a modified Carver system and the results presented show the good performance of both the constructive heuristic algorithm to solve the STTNEP problem and the HOIPM used in each step.

Strategic planning for dairy cattle: SWOT analysis applied to a property of a farmers' association in Dracena, São Paulo state, Brazil

The sector of milk production in Brazil is very heterogeneous (high-tech in large scale X family properties). This study aimed to develop a diagnostic as a basis for a strategic plan to face the challenges inherent in operating a dairy farm in property of a farmers' association in Dracena, São Paulo, Brazil. It was observed that the association needs a more efficient guidance in the marketing, production and finance areas, not to compromise the search for new markets and continued growth in activity.

RP97-43 Tax Planning When Buying or Selling a Farm

If you're like most farmers, one of your key goals is to maximize after-tax earnings. The more money left over after you've paid your farm bills land your taxes, the more you and your family will have to spend. You can increase thos enet earnings in sveral ways: by increasing production, by decreasing cost of supplies oer by finding a way to get more for your produce. But there's another way to increase your after-tax earnings. One that many farmers oculd afford to spen dmore time on: decreasing taxes. The key to avoiding unnecessary taxes is tax planning. This publication will help you do just that: plan for the future.

EC94-852 Cash Flow Planning Form

This extension circular covers the following areas of a cash flow planning form: Beginning Cash Balance, Operating Sales (crop and hay, market livestock, livestock product, custom work); Capital Sales (breeding livestock, machinery and equipment); Personal Income (wages, interest); Operating Expenses (car/truck, chemicals, conservation, custom hire, feed purchased, fertilizers and lime, freight and trucking, gasoline, fuel and oil, insurance, labor hired, rents and leases, repairs and maintenance, seeds and plants, storage, warehousing, supplies, taxes, utilities, veterinary, breeding fees and medicine, feeder livestock); Capital Purchases (breeding livestock, machinery and equipment, family living withdrawals, personal investments, income and social security, term loan payments); Net Cash Available (operating loan borrowings, operating loan payments); and Ending Operating Loan Balance. Along with the Cash Flow Planning Form is a Projected Income Statement Form which covers Projected Business Income (operating sales, breeding livestock, estimated cash income adjustments, estimated gross revenues, estimated value of production); Project Business Expenses (cash operating, esimated operating, prepaid and supplies, cash investment in growing crops, accounts payable); Projected Net Income Summary (estimated net income from operations, estimated net business income, estimated net income after taxes, estimated earned net worth change); and a Physical Inventory Flows Worksheet.

Efficient parallel proximity queries and an application to highly complex motion planning problems with many narrow passages

In vielen Bereichen der industriellen Fertigung, wie zum Beispiel in der Automobilindustrie, wer- den digitale Versuchsmodelle (sog. digital mock-ups) eingesetzt, um die Entwicklung komplexer Maschinen m ̈oglichst gut durch Computersysteme unterstu ̈tzen zu k ̈onnen. Hierbei spielen Be- wegungsplanungsalgorithmen eine wichtige Rolle, um zu gew ̈ahrleisten, dass diese digitalen Pro- totypen auch kollisionsfrei zusammengesetzt werden k ̈onnen. In den letzten Jahrzehnten haben sich hier sampling-basierte Verfahren besonders bew ̈ahrt. Diese erzeugen eine große Anzahl von zuf ̈alligen Lagen fu ̈r das ein-/auszubauende Objekt und verwenden einen Kollisionserken- nungsmechanismus, um die einzelnen Lagen auf Gu ̈ltigkeit zu u ̈berpru ̈fen. Daher spielt die Kollisionserkennung eine wesentliche Rolle beim Design effizienter Bewegungsplanungsalgorith- men. Eine Schwierigkeit fu ̈r diese Klasse von Planern stellen sogenannte “narrow passages” dar, schmale Passagen also, die immer dort auftreten, wo die Bewegungsfreiheit der zu planenden Objekte stark eingeschr ̈ankt ist. An solchen Stellen kann es schwierig sein, eine ausreichende Anzahl von kollisionsfreien Samples zu finden. Es ist dann m ̈oglicherweise n ̈otig, ausgeklu ̈geltere Techniken einzusetzen, um eine gute Performance der Algorithmen zu erreichen.rnDie vorliegende Arbeit gliedert sich in zwei Teile: Im ersten Teil untersuchen wir parallele Kollisionserkennungsalgorithmen. Da wir auf eine Anwendung bei sampling-basierten Bewe- gungsplanern abzielen, w ̈ahlen wir hier eine Problemstellung, bei der wir stets die selben zwei Objekte, aber in einer großen Anzahl von unterschiedlichen Lagen auf Kollision testen. Wir im- plementieren und vergleichen verschiedene Verfahren, die auf Hu ̈llk ̈operhierarchien (BVHs) und hierarchische Grids als Beschleunigungsstrukturen zuru ̈ckgreifen. Alle beschriebenen Verfahren wurden auf mehreren CPU-Kernen parallelisiert. Daru ̈ber hinaus vergleichen wir verschiedene CUDA Kernels zur Durchfu ̈hrung BVH-basierter Kollisionstests auf der GPU. Neben einer un- terschiedlichen Verteilung der Arbeit auf die parallelen GPU Threads untersuchen wir hier die Auswirkung verschiedener Speicherzugriffsmuster auf die Performance der resultierenden Algo- rithmen. Weiter stellen wir eine Reihe von approximativen Kollisionstests vor, die auf den beschriebenen Verfahren basieren. Wenn eine geringere Genauigkeit der Tests tolerierbar ist, kann so eine weitere Verbesserung der Performance erzielt werden.rnIm zweiten Teil der Arbeit beschreiben wir einen von uns entworfenen parallelen, sampling- basierten Bewegungsplaner zur Behandlung hochkomplexer Probleme mit mehreren “narrow passages”. Das Verfahren arbeitet in zwei Phasen. Die grundlegende Idee ist hierbei, in der er- sten Planungsphase konzeptionell kleinere Fehler zuzulassen, um die Planungseffizienz zu erh ̈ohen und den resultierenden Pfad dann in einer zweiten Phase zu reparieren. Der hierzu in Phase I eingesetzte Planer basiert auf sogenannten Expansive Space Trees. Zus ̈atzlich haben wir den Planer mit einer Freidru ̈ckoperation ausgestattet, die es erlaubt, kleinere Kollisionen aufzul ̈osen und so die Effizienz in Bereichen mit eingeschr ̈ankter Bewegungsfreiheit zu erh ̈ohen. Optional erlaubt unsere Implementierung den Einsatz von approximativen Kollisionstests. Dies setzt die Genauigkeit der ersten Planungsphase weiter herab, fu ̈hrt aber auch zu einer weiteren Perfor- mancesteigerung. Die aus Phase I resultierenden Bewegungspfade sind dann unter Umst ̈anden nicht komplett kollisionsfrei. Um diese Pfade zu reparieren, haben wir einen neuartigen Pla- nungsalgorithmus entworfen, der lokal beschr ̈ankt auf eine kleine Umgebung um den bestehenden Pfad einen neuen, kollisionsfreien Bewegungspfad plant.rnWir haben den beschriebenen Algorithmus mit einer Klasse von neuen, schwierigen Metall- Puzzlen getestet, die zum Teil mehrere “narrow passages” aufweisen. Unseres Wissens nach ist eine Sammlung vergleichbar komplexer Benchmarks nicht ̈offentlich zug ̈anglich und wir fan- den auch keine Beschreibung von vergleichbar komplexen Benchmarks in der Motion-Planning Literatur.

Divorce and Family Support in Later Life: Emerging Concerns.

Two patterns are among the most important considerations in planning services for the elderly of the future: (1) the current role of family members in supporting older adults and (2) the present high rate of divorce. Thus far, these patterns may not have significantly affected each other. However, if forecasts of increasing service demands by older adults are correct, service planners must consider what resources will be available to the elderly of the future. In this article, literature from a variety of areas is reviewed focusing on one question: How will the currently high rate of divorce affect the family support system of older adults in the future? Current divorce and remarriage patterns could undermine this support system of the elderly. Possible short-and long-term effects of the demands and emotional consequences of divorce are discussed within this context, and implications for public policy are suggested.

[Experiences of patients and family members during the stay on a nursing unit]

In 2004, the university hospital of Berne ran a pilot project with a Nursing Unit (NU). In this unit patients who no longer needed a close surveillance by physicians were cared for. They needed primarily complex professional nursing care which could not be provided by other hospitals, nursing homes, home care or family members. The nurses were responsible for the coordination of care. This qualitative study investigated experiences of patients and family members with the care concept of the NU. Thematically focused interviews were conducted with nine patients and five family members. Qualitative content analysis was used for data analysis. Results show that patients and family members mostly accepted the new care concept. They positively experienced the quiet and restful atmosphere, the patient-centred and continuous care by competent nurses, the education and the discharge planning. Some study participants reported missing information at the time of their transfer to the NU, insufficient assessments or unsuitable educational scripts. The study provides evidence to positive effects of a patient-centred care approach.

Family Preservation Journal, 1997, Volume 2, Issue 1. (Entire issue)

Entire issue (large pdf file) Articles include: What's Working in Family-Based Services?--or, What's Left to Believe in During a Time of Such Doubt? Roger Friedman The Family Preservation Philosophy and Therapy With Lesbian Clients. Pamela de Santa Parenting Pioneers and Parenting Teams: Strengthening Extended Family Ties in Family Support Programs. Susan Whitelaw Downs Conceptual Bases of the Planning Process in Family Preservation/Family Support State Plans. June Lloyd

Deficit actual tool use in schizophrenia is linked to structural alterations in key regions of planning and executing of tool use and connecting fibers

Introduction: Schizophrenia patients frequently suffer from complex motor abnormalities including fine and gross motor disturbances, abnormal involuntary movements, neurological soft signs and parkinsonism. These symptoms occur early in the course of the disease, continue in chronic patients and may deteriorate with antipsychotic medication. Furthermore gesture performance is impaired in patients, including the pantomime of tool use. Whether schizophrenia patients would show difficulties of actual tool use has not yet been investigated. Human tool use is complex and relies on a network of distinct and distant brain areas. We therefore aim to test if schizophrenia patients had difficulties in tool use and to assess associations with structural brain imaging using voxel based morphometry (VBM) and tract based spatial statistics (TBSS). Methode: In total, 44 patients with schizophrenia (DSM-5 criteria; 59% men, mean age 38) underwent structural MR imaging and performed the Tool-Use test. The test examines the use of a scoop and a hammer in three conditions: pantomime (without the tool), demonstration (with the tool) and actual use (with a recipient object). T1-weighted images were processed using SPM8 and DTI-data using FSL TBSS routines. To assess structural alterations of impaired tool use we first compared gray matter (GM) volume in VBM and white matter (WM) integrity in TBSS data of patients with and without difficulties of actual tool use. Next we explored correlations of Tool use scores and VBM and TBSS data. Group comparisons were family wise error corrected for multiple tests. Correlations were uncorrected (p < 0.001) with a minimum cluster threshold of 17 voxels (equivalent to a map-wise false positive rate of alpha < 0.0001 using a Monte Carlo procedure). Results: Tool use was impaired in schizophrenia (43.2% pantomime, 11.6% demonstration, 11.6% use). Impairment was related to reduced GM volume and WM integrity. Whole brain analyses detected an effect in the SMA in group analysis. Correlations of tool use scores and brain structure revealed alterations in brain areas of the dorso-dorsal pathway (superior occipital gyrus, superior parietal lobule, and dorsal premotor area) and the ventro-dorsal pathways (middle occipital gyrus, inferior parietal lobule) the action network, as well as the insula and the left hippocampus. Furthermore, significant correlations within connecting fiber tracts - particularly alterations within the bilateral corona radiata superior and anterior as well as the corpus callosum -were associated with Tool use performance. Conclusions: Tool use performance was impaired in schizophrenia, which was associated with reduced GM volume in the action network. Our results are in line with reports of impaired tool use in patients with brain lesions particularly of the dorso-dorsal and ventro-dorsal stream of the action network. In addition an effect of tool use on WM integrity was shown within fiber tracts connecting regions important for planning and executing tool use. Furthermore, hippocampus is part of a brain system responsible for spatial memory and navigation.The results suggest that structural brain alterations in the common praxis network contribute to impaired tool use in schizophrenia.

Financial Planning for College: What Parents Do To Prepare

This study explores reported parental financial college preparations and the amount parents have saved for college, with a goal of determining strategies used by different parents based on parental college aspirations and expectations for their child, as well as the highest reported parental and grandparental educational levels. Regression analysis indicates that parents' expectations, but not their aspirations, correspond to engagement in financial planning. Family education is strongly associated with taking some financial planning actions and the amount saved. The results may be helpful to those who are working to increase the effectiveness of disseminating college financial information to parents.

Significance of the Philosophy of Family-Centered Care in the

The philosophy of family-centered care is “an approach to the planning, delivery, and evaluation of healthcare that is grounded in mutually beneficial partnerships among patients, families and healthcare practitioners” (Children’s Hospital of Philadelphia, 1996-2008). The word “family” refers to “two or more persons who are related in any way-biologically, legally, or emotionally” (Institute for Family-Centered Care). It is patients and families, who define those included in their families, which usually in pediatrics includes parents or guardians.

Planning for Emotional Labor and Secondary Traumatic Stress in Child Welfare Organizations

This analysis provides an emergent framework that emphasizes a neglected component of both direct practice with families and organizational development. Human emotions, both beneficial (positive emotional labor) and harmful (negative emotional labor), have received short shrift in leadership development, supervision, direct practice preparation and supports, and workforce stabilization, and professionalization. Significantly, a key indicator of negative emotional labor—secondary traumatic stress (STS)—often has been ignored and neglected, despite the fact that it may be endemic in the workforce. STS typically results from traumatic events in practice, but it also stems from workplace violence. Often undetected and untreated, STS is at least a hidden correlate and perhaps a probable cause of myriad problems such as questionable practice with families, life-work conflicts, undesirable workforce turnover, and a sub-optimal organizational climate. Special interventions are needed. At the same time, new organizational designs are needed to promote and reinforce positive emotional labor. Arguably, positive emotional labor and the positive organizational climates it facilitates are requisites for harmonious relations between jobs and personal lives, desirable workforce retention, and better outcomes for children and families. What’s more, specialized interventions for positive emotional labor constitute a key component in the prevention system for STS. A dual design for positive emotional labor and STS (and other negative emotional labor) prevention/intervention is provided herewith. Early detection and rapid response systems for STS, with social work leadership, receive special attention. Guidelines for new organizational designs for emotional labor in child welfare are offered in conclusion.

Family Preservation in Perspective

This essay traces the family preservation movement to its permanency planning roots; discusses the principles and underlying philosophy of the movement, and suggests the appropriate context for considering further development of child welfare services.

Social Workers' Perceptions of Family Preservation Programs

The passage of the Adoptions and Safe Families Act of 1997, with its focus on child safety and concurrent planning, has presented family preservation workers with new challenges and new opportunities. Twenty volunteers from a large comprehensive social service agency were interviewed to determine their experiences with two models of family preservation—Multisystemic Therapy (MST) and Traditional Family Preservation Service (TFPS) or practice as usual. Workers from both programs were able to articulate values consistent with family preservation as important strengths of the programs— keeping families together and empowering families for example. Information from referring agencies was described as variable and not especially useful when working with seriously troubled families, especially as it related to risk and child safety. Both groups indicated that the jargon of family preservation had permeated their agencies, and that working with other agencies was at times a challenge, though for different reasons. Finally, despite some reservations about the effectiveness of short-term treatment with families that face serious challenges, both groups of workers were generally satisfied with family preservation as an approach to practice.