Because of the high cost of some wound management regimens, payors may require that moist wound therapies be used before other treatment approaches, such as negative pressure wound therapy (NPWT), are implemented but few studies have investigated the effect of delayed initiation of NPWT on patient outcomes. To examine the impact of early versus late initiation of NPWT on patient length of stay in home health care, a nonrandomized, retrospective analysis was performed on the Outcome and Assessment Information Set (OASIS) information for home care patients with NPWT-treated Stage III or Stage IV pressure ulcers (N = 98) or surgical wounds (N = 464) gathered between July 2002 and September 2004. Early initiation of NPWT following the start of home care was defined as <30 days for pressure ulcers and <7 days for surgical wound patients. Median duration of NPWT was 31 days (range 3 to 169) for pressure ulcers and 27 days (range 5 to 119) for the surgical wound group. Median lengths of stay in the early treatment groups were 85 days (range 11 to 239) for pressure ulcers and 57 days (range 7 to 119) for the surgical group versus 166 days (range 60 to 657) and 87 days (range 31 to 328), respectively, for the late treatment pressure ulcer and surgical groups (P <0.0001). After controlling demographic patient variables, regression analysis indicated that for each day NPWT initiation was delayed, almost 1 day was added to the total length of stay (β = 0.96, P <0.0001 [pressure ulcers]; β = 0.97, P <0.0001 [surgical wounds]). Early initiation of NPWT may be associated with shorter length of stay for patients receiving home care for Stage III or Stage IV pressure ulcers or surgical wounds. Additional studies to ascertain the cost-effectiveness of treatments and treatment approaches in home care patients are needed.

Background: When women from families with a known BRCA1 or BRCA2 mutation test negative for the family mutation, it is assumed that they will transition their personal cancer risk perception from high to average risk. However, there are scant data regarding the experience of mutation-negative women after genetic testing disclosure, particularly related to the shift of risk perception from assumed mutation-positive to actual mutation-negative. This study was designed to explore cancer risk perception and the experience of being a mutation-negative woman within a known BRCA1/2 mutation-positive family. Methods: We employed a qualitative descriptive design and convened a sample of 13 women who contributed in-depth, semi-structured telephone interviews (audio-recorded and transcribed verbatim) and performed qualitative content analysis with NVivo 2.0 software. Results: Six major content areas emerged from interview data: (i) rationale for initial involvement in the breast imaging study, (ii) rationale for continued participation, (iii) experience of living in a multiple-case family, (iv) risk perception: the personal meaning of mutation-negative status, (v) opinions regarding cancer aetiology and (vi) communication patterns between mutation-negative and mutation-positive family members. Conclusions: Living in a hereditary breast and ovarian cancer family is a complex experience that affects cognitive, emotional and social functioning. Our findings indicate that mutation-negative women may have unmet psychosocial needs that must be addressed by health-care professionals, particularly in the primary-care setting following genetic disclosure of a potentially reassuring result regarding their lack of the very high cancer risks associated with BRCA1/2 mutations.

Having the ability to predict enrollment is an important task for any school's recruiting team. The purpose of this study was to identify significant factors that can be used to predict the spatial distribution of enrollments. As a case study, we used East Tennessee State University (ETSU) pharmacy school, a regional pharmacy school located in the Appalachian Mountains. Through the application of a negative binomial regression model, we found that the most important indicators of enrollment volume for the ETSU pharmacy school were Euclidean distance, probability (based on competing pharmacy schools' prestige, driving distance between schools and home and tuition costs), and the natural barrier of the Appalachian Mountains. Using these factors, together with other control variables, we successfully predicted the spatial distribution of enrollments for ETSU pharmacy school. Interestingly, gender also surfaced as a variable for predicting the pharmacy school's enrollment. We found female students are more sensitive to the geographic proximity of home to school.

Central nervous system (CNS) infection with Morganella morganii is very rare. We describe a 38-year-old female patient with frontal brain abscess caused by M morganii who was unsuccessfully treated. We also review all reported cases of Morganella CNS infections with an emphasis on treatment modalities and outcomes. Aggressive surgical management and appropriate antimicrobial therapy can lead to cure, but the mortality rate for these infections remains high.

Objective: Suicide risk is a significant public health concern for college students and may be exacerbated by hopelessness resulting from negative life events (NLE), yet may be ameliorated by self-compassion. We examined the mediating role of hopelessness in the relation between NLE and suicidal behavior, and the moderating influence of self-compassion on all model paths. Participants: Participants were 338 undergraduates (89% white; 67% female). Data were collected from December 2014 to December 2015. Methods: Participants completed the Life Events Checklist for College Students, Beck Hopelessness Inventory, Self-Compassion Scale, and Suicidal Behaviors Questionnaire–Revised. Results: Negative life events were related to greater hopelessness and, in turn, to more suicidal behavior, yet self-compassion attenuated this effect. Conclusions: Self-compassion may buffer the NLE–hopelessness linkage, thereby reducing suicide risk among college students. Therapeutic promotion of self-compassion, and reduction of hopelessness, may be important suicide prevention strategies on college campuses.

Objective: Suicide risk is a significant public health concern for college students and may be exacerbated by hopelessness resulting from negative life events (NLE), yet may be ameliorated by self-compassion. We examined the mediating role of hopelessness in the relation between NLE and suicidal behavior, and the moderating influence of self-compassion on all model paths. Participants: Participants were 338 undergraduates (89% white; 67% female). Data were collected from December 2014 to December 2015. Methods: Participants completed the Life Events Checklist for College Students, Beck Hopelessness Inventory, Self-Compassion Scale, and Suicidal Behaviors Questionnaire–Revised. Results: Negative life events were related to greater hopelessness and, in turn, to more suicidal behavior, yet self-compassion attenuated this effect. Conclusions: Self-compassion may buffer the NLE–hopelessness linkage, thereby reducing suicide risk among college students. Therapeutic promotion of self-compassion, and reduction of hopelessness, may be important suicide prevention strategies on college campuses.

Magister Educationis - MEd / M.Ed. mini-tesis, Departement Filosofie van die Opvoeding, Universiteit van wes-Kaapland. Hierdie mini-tesis ondersoek die gebruik van geweld deur die Suid-Afrikaanse regering as regverdiging om'n ~ "demokratiese" staat instand te hou asook die gebruik van geweld deur magte wat "n "meer" demokratiese staat daar wil stel. In Hoofstuk 1 word daar geargumenteer dat die gebruik van geweld 'n morele kwessie is en word daar onder meer verwys na die verskillende soorte geweld wat aangetref word. Veral word daar gekyk of alle burgers " onder die verpligting is om die staat te gehoorsaam en of hierdie gehoorsaamheid onreflektiewe gehoorsaamheid is. In Hoofstuk 2 word gekyk of dwang ooit geregverdig is deur te kyk na die verband tussen Positiewe en Negatiewe Vryheid en dwang. In Hooofstuk 3 word daar kortliks gekyk na waarom die demokrasie die mees aanvaarbare vorm van regering vir die mens as rasionele wese is. Daarna (Hoofstuk 4) word ondersoek ingestel na eerstens die verband tussen moraliteit en demokrasie en tweedens na die verband tussen demokrasie en geweld deur te verwys na die klassieke en die kontempor~re teorie~ van demokrasie. In Hoofstuk 5 word daar veral gekyk na watter ruimte, indienenige, daar vir wettige teenstemming "dissent" in 'n demokrasie bestaan asook hoe daar binne 'n demokrasie teenstemming gebied kan word en watter beperkinge daar op vryheid van spraak en assosiasie as wettige teenkanting is. Daar word dan ook kortliks gekyk na hoe geweld indruis teen demokratiese prosedure en of daar ook ander faktore is wat die demokratiese proses beinvloed. In Hoofstuk 6 kyk ek na hoe die polemici voordeel probeer trek deur die konsep "geweld" op 'n bepaalde manier te hanteer deur daarop te wys dat "geweldloos" nie die teenoorgestelde van "gewelddadig" is nie. Verskeie vorme van geweldlose verset of pasifisme word kortliks ondersoek en word uitgewys dat ook daar 'n vorm van dwang teenwoordig is. Die verband tussen demokrasie en geweldlose verset word dan ondersoek. In Hoofstuk 7 word gekyk na geweld in die Suid-Afrikaanse skolestelsel deur te wys op hoe die studente en die staat onderskeidelik die konsepte geweld en demokrasie hanteer en toepas. Daar word kortliks uitgewys dat vrede nie sinoniem met egverdigheid is nie. Veral word gekyk na die polisie en weermag en morele regverdiging van geweld. In Hoofstuk 8 word gekyk na wat bedoel word met 'n demokratiese onderwysstelsel deur veral te kyk na 'n model van deelnemende demokrasie en hoe studente-praktyke moontlik aanleiding tot geweld kan gee. In Hoofstik 9 word 'n kort samevatting van die argument gegee.

The purpose of this research was to assess the effects of the Utah State University Pupil Self-Concept Program on the performance of inservice elementary school teachers and on the self-concepts of pupils in their classrooms. Four volunteer teachers were trained in the SelfConcept behaviors as part of an inservice course. A single-subject multiple baseline design was used to determine teacher effects for these four teachers. The first teacher was the main subject, and the study was then directly replicated three times using the other three experimental teachers. Data on these four subjects were collected through observation of program-related teacher behaviors. Results from the Teacher data indicated that teachers will indeed exhibit changes in their use frequency of the USU Pupil Self-Concept Program verbal behaviors when each of these behaviors is taught. The use of negative behaviors decreased in frequency while the use of positive behaviors increased in frequency. Results from this data indicated that pupils whose teachers are trained to emit the Program's specific language skills receive significantly higher self-concept scores than do pupils whose teachers do not receive this training, provided there are no other interaction styles used in the classroom than that of the trained or untrained teacher. A quasi-experimental design was used to assess pupil effects as a result of teacher training. The pupils in the four trained teachers' classes served as the experimental group. The control group consisted of the pupils in three additional volunteer teachers' classes. These teachers were not trained; therefore, the pupil control group received no treatment. A pupil self-concept measure was administered before and after the inservice course.

Based on classic marital research of John Gottman, a popular notion exists that interpersonal relationships thrive when the number of positive interactions outweighs negative interactions by a ratio of five to one. Though many have given similar advice for parents and caregivers, Gottman's findings and methodology may not generalize to relationships of parents and young children. Were similar ratio findings to be validated for parent-child relationships, explicit ratio advice may be incorporated as a component of clinical practice (e.g., behavioral parent training). To begin investigating potential clinical implications, a project was conducted that examined mothers' ability to achieve prescribed ratios following brief instruction. Baseline ratio levels for a small sample of nonclinical mother-child dyads were approximately one positive for every one negative. When instructed to attain a 5 to 1 ratio, all participants improved their ratios; half the sample achieved the target ratio. Mothers in the study altered their ratios primarily by boosting the number of positives they used with their children.

Elementary school teachers enrolled in the Self-Actualizing Education training course were tested prior to and following the ten-week in-service course to measure to what extent teachers improved interpersonal communication skills in discussions with students. Teachers' positive responses (e.g., listening, owning personal feelings, offering choices to students), teachers' negative responses (e.g., judging, lecturing, rescuing), teacher talk vs. student talk, and the frequency of student misbehaviors were considered. Audio tape recordings were made of teachers as they dealt with student problems in a group discussion and in an individual discussion. Also, student misbehaviors were recorded during a 15-minute observation time. The data were evaluated using analysis of variance. The results showed that in discussions with individual students, teachers increased positive responses and decreased teacher talk. In addition, the number of student misbehaviors increased after the training course. No other changes were found to be statistically significant.