The purpose of the current study was to investigate the effects of a multidisciplinary pain management program on five measures of subjective psychosocial factors. Ninety-five participants in the comprehensive multidisciplinary treatment group and the standard medical intervention control group were surveyed about various psychosocial factors using Axis II of the West Haven - Yale Multidimensional Pain Inventory (MPI), pre- to post-treatment. It was hypothesized that post-treatment levels would be significantly lower than pre-treatment levels for all five psychosocial variables. Additionally, gender and ethnicity variables were examined. Based on preliminary analyses indicating pre-treatment differences between the experimental and control group, five 2 x 2 x 3 analyses of covariances (ANCOVAs) were used to examine the above hypotheses. Results indicated significant differences between the treatment conditions on measures of control, with the comprehensive group feeling more in control than the standard group at post-treatment. No other significant main effects for treatment condition were found on the measures of pain severity, interference with daily activities, negative mood, or social support. However, a significant gender main effect was found for social support at post-treatment, with females reporting more social support than males. A significant gender x ethnicity interaction was also found for post-treatment control, with African-American females exhibiting higher levels of control than the other groups. Finally, a significant gender x treatment condition was found for negative mood, with males in the comprehensive group reporting more affective distress than those in the standard group. In this study, control appeared to be an integral factor in the chronic pain sample and greatly improved with comprehensive multidisciplinary treatment; while other areas of relative efficacy were not confirmed in this population.

Sexual problems or dysfunctions remain one of the prominent reasons .for marital and relationship problems, often resulting in divorce. Sexuality is however only one of many components of a marriage or of a committed relationship. Relationship problems and sexual problems are often interlinked. The fact that sexual problems are often only symptoms of deeper relationship issues, makes the social worker the ideal person to treat these sexual problems from a holistic perspective and within a relationship context. The nature of this research study evolves around the proposed lack of knowledge of social workers in private practice, and who specialise in couple therapy, regarding human sexuality and sex therapy. This research study is valuable for the social work profession as the knowledgebase of social work is extended. Social workers come into close contact with individuals seeking couple therapy. Social workers might often be required to assist individuals or couples with sexual problems, as relationship difficulties and sexual problems often co-exist. This study is further of value because the importance of the integration of sex therapy and couple therapy is shown. A qualitative research approach is used, and applied research is conducted. An exploratory research design is utilised and a self-constructed, mailed questionnaire is used as method of data collection. The following conclusions can be drawn and the following recommendations made: • The social worker is the ideal person to deal with sexual difficulties, as he or she is well trained in the dynamics of marriage and relationship therapy. • An integrative, holistic and post-modernistic approach to therapy for sexual difficulties has emerged. • There is a movement today toward the combination of sex therapy and couple/relationship therapy. • There are concerns that social workers in private practice specializing in couple therapy, may have a lack of knowledge regarding human sexuality and sex therapy. The respondents in this study answered only 58.53% of the knowledge based questions correctly. • There is a need for specialised education and training of social workers in the field of human sexuality and sex therapy. • Training in human sexuality and sex therapy should be included in the undergraduate, post-graduate and continuing education levels of social work¬training. • This research study supplies a basis for future research studies. The content of the study can aid in the development of a course in human sexuality and sex therapy aimed at social workers specifically. / Dissertation (MA (Social Work))--University of Pretoria, 2006. / Social Work and Criminology / unrestricted

>Magister Scientiae - MSc / In South Africa, water pollution problems have continued to increase due to increasing anthropogenic activities. The increasing number of organic contaminants in various water sources can be attributed to industrial development, population growth and agricultural run- off. These activities have impacted negatively on the availability and accessibility to sustainable clean water resources, exposing citizens to water borne diseases such as cholera, diarrhoea and typhoid fever; commonly reported among children. Advanced oxidation technologies such as dielectric barrier electrohydraulic discharge (EHD), also referred to as dielectric barrier discharge (DBD), have the ability to decompose persistent organics and eliminate microbes. DBD offers advantages such as efficiency, energy saving, rapid processing, use of few or no chemicals, and non-destructive impact on the ecosystem. The system is also capable of generating ozone, hydrogen peroxide, singlet oxygen, superoxide radicals, hydroxyl radicals and other active species. The combination of these reactive species has been reported to degrade biological and chemical pollutants rapidly and efficiently. In this study, the DBD system was optimized by investigating the effect of physico-chemical, electrical parameters and reactor configurations on Methylene Blue (MB) decolouration efficiency. The physico-chemical parameters included MB concentration, solution pH and conductivity, solution volume, NaCl electrolyte concentration in the electrode compartment and air flow rate. As for electrical parameters, the effects of voltage, electrode type and size on MB decolouration efficiency were studied. The effect of the aforementioned parameters on MB decolouration efficiency was assessed by varying one parameter at a time. The following physico-chemical parameters: time (from 0 - 60 minutes), pH (2.5 - 10.5), solution conductivity (5 - 20 mS/cm), MB concentration (0.5 – 10 mg/L), solution volume (500 – 2000 mL), NaCl electrode electrolyte concentration (10 – 50 g/L) and air flow rate (2– 4 L/min) were varied in their respective ranges under the applied experimental conditions: reactor air gap 2 mm, solution volume 1500 mL, NaCl electrolyte concentration of 50 g/L in the electrode compartment, voltage 25 V (7.8 kV), airflow rate 3 L/min, 0.5 mm silver electrode and a running time of 60 minutes. As for electrical parameters, voltage (from 20 - 25 V), electrode type (copper, silver and stainless steel) and electrode diameter (0.5 – 1.5 mm) were also altered individually at the applied experimental conditions. The reactor air gap was varied from 2 to 6 mm. At the same experimental conditions, the free reactive species generated mainly H2O2 and O3, were detected and quantified using the Eisenberg and indigo methods, respectively. The optimum physico-chemical parameters were found to be MB concentration 5 mg/L, concentration of NaCl electrolyte used in the central compartment of the DBD reactor 50 g/L, solution pH 2.5, solution conductivity 10 mS/cm, air flow rate 3 L/min, solution volume 1500 mL and an optimum contact time of 30 minutes. The optimum electrical parameters were found to be: applied voltage 25 and 1.5 mm silver electrode. The following parameters MB concentration, solution conductivity and pH, applied voltage and reactor configuration significantly affected MB decolouration efficiency compared to parameters such as solution volume, the inlet air flow rate, electrode type and size and NaCl electrolyte concentration in the electrode compartment, which were less effective in enhancing MB decolouration. Moreover, for all DBD experiments performed at the applied experimental conditions, complete decolouration of MB was achieved in the first 30 minutes. However, trends between the optimized parameters and MB decolouration efficiency were mostly observed after 10 minutes. The optimized DBD system reduced the treatment time from 30 to 20 minutes without any chemical additives. Moreover, at 5 mg/L MB under the applied optimum conditions, it was proved that besides 99% of MB decolouration reached after 60 minutes, 53% of total organic carbon (TOC) removal was also achieved. The chemical oxygen demand (COD) characterizing MB toxicity was less than 5 mg/L before as well as after the DBD experiment. After 10 minutes of experiment under the following conditions: Applied voltage 25 V, MB concentration 5 mg/L, solution pH (in between 6.04 and 6.64), solution volume 1500 mL, air flow rate 3 L/min, 0.5 mm silver electrode and a contact time of 60 minutes, about 3.73 x 10-5 mol/L H2O2 was produced which decreased to 2.93 x 10-5 mol/L 10 minutes later, while O3 concentration was initially very low and could not be detected. However, 0.5 mol/L of O3 was detected after 20 minutes of operating time, thereafter, H2O2 concentration decreased continuously with time while that of O3 fluctuated as the treatment time increased. Likewise, the energy density for the production of free reactive species reached 0.87 g/ kWh in the first 10 minutes due to the presence of chromophoric functional groups such as =N+(CH3)2 in MB structure that had to be destroyed. Thereafter, the energy consumption decreased progressively to zero with an increase in treatment time due to the destruction of =N+(CH3)2 groups in MB structure with time. The correlation between the rise in the of H2O2 concentration and energy density after 10 minutes was probably due to dissociation of OH- OH bonds in H2O2 by UV light to yield OH radicals which unselectively may have attacked MB dye. Thus, MB decomposition in the current DBD reactor was mostly initiated by H2O2 and O3. The irradiation of H2O2 by UV light generated in the DBD system was found to accelerate dye decomposition in the first 30 minutes of the experiment. The UV-vis analysis of treated MB samples confirmed that the complete decolouration of MB achieved in the first 30 minutes was due to the destruction of the chromophoric [=N+(CH3)2] group in Methylene blue structure, while the FT-IR confirmed the presence of traces of various functional groups such as C=C, C=O, C=N, NH, NH3, NO2, etc. characteristics of carboxylic acids, amines, amides, nitrogen based compounds (salts), aliphatic and unsaturated by-products remaining in the bulk solution after treatment. The salts analysis after treatment showed that 16 mg/L of nitrates and nitrites and 1.1mg/L of sulphates mainly originating from air and MB decomposition were present in the treated samples. The EHD/DBD system used in this study offers an approach to partially treat water/wastewaters and its optimization was able to significantly enhance the decomposition of the target MB dye as indicated by the reduction of total organic carbon (TOC) from 8.3 mg/L to 3.9 mg/L. Compared to previous research, this study successfully optimised a complete double cylindrical dielectric barrier discharge (DBD) reactor at ambient condition without any chemical additives.

Small molecules are powerful tools to probe biological systems and cure diseases. In the scope of this dissertation, small molecules were applied to study three distinct disease models: cancer, Sedaghatian-type spondylometaphyseal dysplasia (SSMD), and COVID-19. First, encouraged by the recently reported vulnerability of drug-resistant, metastatic cancers to GPX4 (Glutathione Peroxidase 4) inhibition, we examined the basis for nanomolar potency of proof-of-concept GPX4 inhibitors, which revealed an unexpected allosteric binding site. Through hierarchical screening of a lead-optimized compound library, we identified novel small molecules binding to this allosteric site. Second, a homozygous point mutation in the GPX4 gene was identified in three living patients with SSMD. With a structure-based analysis and cell models of the patient-derived variant, we found that the missense variant significantly changed the protein structure and caused substantial loss of enzymatic function. Proposed proof-of-concept treatments were subsequentially validated in patient fibroblasts. Our further structural investigation into the origin of the reduced enzymatic activity revealed a key residue modulating GPX4 enzymatic function. We also found that the variant alters the degradation of GPX4, unveiling the native degradation mechanism of GPX4 protein. Third, driven by the recent urgent need for COVID-19 antiviral therapeutics, we utilized the conservation of 3CL protease substrate-binding pockets across coronaviruses to identify four structurally divergent lead compounds that inhibit SARS-CoV-2 3CL protease. With structure-based optimization, we ultimately identified drug-like compounds with < 10 nM potency for inhibiting the SARS-CoV-2 3CL protease and blocking SARS-CoV-2 replication in human cells.

Magister Commercii (Information Management) - MCom(IM) / South Africa has one of the largest HIV and AIDS burdens in the world, with an estimated7.52 million people living with HIV in 2018. The antiretroviral therapy (ART) programme is the biggest and most costly programme in the country, with 3.7 million people enrolled as of 2017. The success of antiretroviral therapy is dependent on adherence to medication and long-term retention in care. It has been reported that support groups can improve the treatment adherence of patients and their retention in care. However, enrolment in adherence support groups is voluntary, and the abovementioned success thereof is dependent on the commitment of the patient to active participation in the group. It is estimated that about 80% of adults and young people own at least one mobile phone, which makes this technology suitable to improve communication and enhance interaction amongst support group members.

BACKGROUND: Adherence to TB treatment and therefore treatment success could be improved using digital adherence technology. OBJECTIVE: To evaluate the effectiveness of a medication event reminder monitor system (MERM) on treatment success and treatment adherence in patients with drug-susceptible pulmonary TB in Perú. METHODS: This was an experimental, randomised, open-label, controlled study conducted among patients in the second phase of TB treatment. The intervention group received their medications through MERM with the support of a treatment monitor, whereas the control group used the usual strategy. Participants were followed until they completed the 54 doses of the second phase of treatment. RESULTS: The study included 53 patients in each group; four in the intervention group withdrew from the study. Treatment success was significantly more frequent in the MERM group (RR 1.15, 95% CI 1.02–1.30; P = 0.0322). There was no significant difference in the adherence outcomes; however, the percentage of patients who missed at least one dose and patients with more than 10% of total doses missed were lower in the intervention group. CONCLUSION: The use of MERM in the second phase of treatment showed a significant improvement in the treatment success rate in patients with drug-susceptible pulmonary TB. / National Institutes of Health / Revisión por pares

An interactive activation model for picture naming was used to guide treatment of a semantic-level deficit in 4 individuals with aphasia and severe picture-naming problems. Participants exhibited a profile consistent with Broca's aphasia with severe naming deficits, part of which was attributable to a semantic impairment based on testing of the lexical system. A semantic-based treatment was used to train naming of nouns in two semantic categories using a single-participant multiple baseline across behaviors and participants. Additional treatment, which included orthographic and phonological information about target words, then was applied. Treatment responses and error patterns demonstrated that semantic treatment resulted in improved naming of both trained and untrained items for 2 of 4 participants. Two participants did not show improved naming until treatment emphasizing the phonological form of the word was provided. This study demonstrates the utility of using an interactive activation model to plan treatment based on levels of disruption in the lexical processing system.

Non-medical drug use in rural communities in the United States is a significant and growing public health threat. Understanding what motivates drug users in rural areas to seek substance abuse treatment may help in addressing the problem. Perceived need for treatment, a construct indicative of problem recognition and belief in problem solution, has been identified as an important predictor of help-seeking behavior. This cross-sectional study used data collected through face-to-face interviews to examine factors associated with perceived need for drug abuse treatment among not-in-treatment, adult, illicit stimulant drug users (n = 710) in rural areas of Ohio, Kentucky, and Arkansas. More than one-quarter of the sample perceived a need for treatment. Results from a stepwise multiple regression analysis showed that white users, users with better physical and mental health status, and occasional users of methamphetamine were significantly less likely to see a need for treatment. Users with higher Addiction Severity Index composite scores for family/social problems or legal problems, and users with prior drug abuse treatment experience were significantly more likely to perceive a need for treatment. These findings have practical implications for efforts addressing substance abuse in rural areas.

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