Kaohsiung Harbor is the largest international sea port in Taiwan, a lot of ships around the world pass in and out frequently, the pollution of organotin is very serious in the harbor area. Love River and Chien-Chen River may be polluted by the seawater tidal action from the Kaohsiung harbor. Domestic, industrial and agricultural wastewaters discharged into the upstream sections may also cause the pollution of organotin. The purposes of this study were to understand sources of organotin pollution by analying the content of organotin compounds and to monitor the organotin pollution of the rivers in Kaohsiung. Samples including surface sediments and riverwaters were collected from nineteen stations of Love River and Chien-Chen River. The results revealed that concentrations of MBT, DBT and TBT in the riverwaters of Love River varied between 13.4-43.6, 2.6-9.9 and ND-13.5 ng/L as tin. The concentrations of MBT, DBT and TBT in the riverwaters of Chien-Chen River were 3.1-28.1, 2.1-10.9 and ND-9.1 ng/L as tin, respectively. The concentrations of MBT, DBT and TBT in the surface sediments of Love River varied between 20.6-92.3, 7.6-26.2 and ND-15.4 ng/g as tin. The concentrations of MBT, DBT and TBT in the surface sediments of Chien-Chen River were in the range of 22.4-70.0, 6.4-14.1, ND-31.9 ng/g as tin, respectively. MBT and DBT were detected in all the samples of all the sampling stations of Love River and Chien-Chen River. Distribution of organotin compounds in riverwaters and surface sediments showed a consistency between these two rivers. No phenyltin pollution was detected at all stations, probably due to the decline in agricultural activities and the ban on utilizing triphenyltin acetate as pesticide. Except the highest organotin pollution appeared in the outfall of Love River and Chien-Chen River, other high values of pollution were found near the upper reaches of both rivers.

Dialektisk beteendeterapi (DBT) har visat sig vara en effektiv behandling vid borderline personlighetssyndrom  (BPS), och färdighetsträning har visat sig vara  en  verksam  komponent,  men  man  vet  fortfarande  lite  om  sambandet mellan borderlinesymtom, känslomässig dysreglering, problembeteenden och färdigheter.  Aktuell  studie  syftar  till  att  undersöka  dessa  samband  med frågeställningar utifrån teoretisk modell.Deltagare och metod: 54 patienter aktuella för DBT vid en vuxenpsykiatrisk öppenvårdsmottagning deltog i en tvärsnittsstudie där de vid ett tillfälle fyllde i tre självskattningsformulär.Resultat:  Det  förelåg  ett  samband  mellan  känslomässig  dysreglering  och symtom på borderline personlighetssyndrom, samt delvis ett samband mellan dessa två och förekomst av problembeteenden.  Högre nivå av känslomässig dysregelring  predicerade ett lägre  användande av färdigheter. Dock förelåg inte något signifikant samband mellan användande av färdigheter och  nivå av problembeteenden.Konklusion:  Resultatet stödjer delvis den teoretiska modellen, men oklarheter föreligger  gällande  betydelsen  av  användande  av  färdigheter.  Detta  skulle därmed  behöva  studeras  vidare  för  att  fördjupa  förståelse  av  verksamma behandlingskomponenter.

The best way to conquer breast cancer is early detection of the disease. Research studies show that earlier detection results in the increase of life span of the affected person. Traditional two-dimensional mammography is the most prevalent method used in detecting breast cancer. Recently, a three-dimensional digital breast tomosynthesis (DBT) system has been created, which is hopeful to surpass the technology of traditional mammography systems. The DBT system can provide three-dimensional information, allowing physicians to reduce the amount of false negative screening in addition to better monitoring of breast cancer and to catch lesions that may be otherwise cancerous. In this research, the View Angle (VA) and number of projection images (N) were investigated and compared with parallel imaging configurations using two reconstruction algorithms, including Back Projection (BP) and Shift-And-Add (SAA). Modulation Transfer Function (MTF) analyses were conducted with both algorithms, in order to determine which method displayed better image qualities to ultimately improve the detection of breast cancer.

Dialectical Behavior Therapy (DBT; Linehan, 1993) is an empirically supported, skills based, cognitive-behavioral therapy used to treat a myriad of symptoms including chronic suicidality and self-harm, emotion dysregulation, reactive aggression and other mood dependent behaviors. Because of its emphasis on self-regulation and a wide range of problem behaviors, DBT can be readily applied to sex offender treatment programming. In this workshop, participants will learn about DBT’s method of conceptualizing and addressing client problems, important strategies for engaging offenders in treatment using this approach, and DBT skills. Important updates from the most recent DBT skills manual will also be addressed. be discussed.

Dialectical Behavior Therapy (DBT; Linehan, 1993) is an empirically supported skills-based, cognitive-behavioral therapy originally developed for use with clients with borderline personality disorder and associated self-harm behavior. Its unique combination of individual therapy, skills group, in vivo skills coaching, and support for the therapists in the form of a weekly consultation team meeting, provide a comprehensive framework for treating difficult behaviors in a client population who do not demonstrate positive outcomes when participating in traditional psychotherapy practice. Multiple randomized control trials have demonstrated its effectiveness in reducing chronic suicidality and self-harm, particularly among those with personality pathology and substance abuse problems. Since its initial use, DBT has been applied to a myriad of treatment needs, including emotion dysregulation, reactive aggression, and other mood-dependent behavior. Recent evidence indicates that self-regulatory problems are quite common among sexual offenders (Stinson, Becker, & Sales, 2008; Stinson, Robbins, & Crow, 2011; Stinson, Sales, & Becker, 2008; Ward & Hudson, 2007), including difficulties with emotion regulation, violent and sexual aggression, interpersonal skills deficits, suicidality, and problems with substance use. Sex offenders benefit from DBT’s emphasis on self-monitoring, interpersonal and emotional skills development, and the use of a hierarchical treatment structure that addresses multiple behavioral problems and life concerns. Further, some sex offenders – particularly those who present with personality pathology or pronounced self-regulatory deficits – may be unable to meaningfully engage in sex offender specific treatment until they address more acute symptomatology. DBT presents an interesting new take on addressing complex emotional and behavioral problems in adolescent and adult sex offenders. Therapists using DBT benefit from a comprehensive and empirically-supported framework, as well as techniques specifically designed to protect clinicians from the burn-out so often associated with treating challenging and high-risk clients. But admittedly, for those unfamiliar with DBT, this novel way of conceptualizing and addressing sex offender clients can be difficult. The primary objective of this workshop is to introduce sex offender therapists to the tenets of DBT and facilitate the implementation of DBT principles and techniques in sex offender treatment. A secondary goal is to familiarize practiced DBT therapists with recent updates to the DBT skills manual.

Introduction: The perinatal period, which consists of pregnancy and up to one year postpartum, is considered a period of vulnerability. During this time, women are at higher risk than at other times in their lives of developing a mental health disorder, particularly anxiety and depressive disorders. Perinatal mental health disorders have a tremendous negative impact on not only the mother, but also their children who may develop cognitive, behavioural, and emotional problems that last well into adulthood. Emotion dysregulation has been implicated in both anxiety and depressive disorders and, due to endocrine changes during the perinatal period, may play an important role in perinatal mental health. Perinatal emotion dysregulation has yet to be explored. The purpose of this thesis was to 1) better understand the link between emotion dysregulation and perinatal mental health, 2) assess whether current perinatal treatments effectively target emotion dysregulation, and 3) develop an effective psychological treatment protocol for perinatal emotion dysregulation. Methods: We designed and conducted three studies to meet our research aims. The first study compared emotion reactivity and emotion regulation, two aspects of emotion dysregulation, in perinatal women with an anxiety and/or depressive disorder to better understand perinatal emotion dysregulation. The second study examined the bidirectional relationship between Cognitive Behavioural Therapy (CBT) for perinatal anxiety and emotion dysregulation to examine whether emotion dysregulation moderates CBT treatment outcomes and whether CBT is an effective treatment modality for perinatal emotion dysregulation. This was examined in two samples of participants: participants from a randomized controlled trial and routine clinical care. In the third study, we developed a novel Dialectical Behavioural Therapy (DBT) informed treatment program for perinatal emotion dysregulation and examined the effectiveness of the program through a pilot study. Results: Our research revealed several important findings. First, heightened emotional reactivity may be a protective factor during the perinatal period; less flexibility in emotional reactivity and difficulties with emotion regulation were associated with worse perinatal mental health, and relationship dissatisfaction. Second, CBT was an effective treatment for low levels of emotion dysregulation but not for moderate or severe perinatal emotion dysregulation. Only 16% of routine clinical care participants and 28% of participants from the randomized controlled trial demonstrated clinically reliable change in emotion dysregulation. Emotion dysregulation did not moderate CBT treatment outcomes on anxiety or depression. This suggest that emotion dysregulation appears to be a distinct factor that may warrant more specialized treatment. Third, our short term, DBT informed, skills group was effective in significantly reducing perinatal emotion dysregulation. The DBT informed treatment may be more effective in targeting perinatal emotion dysregulation than CBT as illustrated by 48% of participants demonstrating clinically reliable change compared to the 16%-28% in the CBT treatment. Conclusions: This line of research allows us to have a better understanding of perinatal emotion dysregulation and may aid in the development of best practice assessment and treatment guidelines for emotion dysregulation during the perinatal period. Limitations and future directions are discussed. / Dissertation / Doctor of Philosophy (PhD)

No description available.

No description available.

Bakgrund: Självskadebeteende är ett allvarligt problem som förekommer idag. Under senare år har vårdgivare inom hälso- och sjukvården uppmärksammat en ökning av detta problem som leder till fysiska och psykiska hälsobesvär. Dessa hälsobesvär kan förekomma i form av exempelvis depression, fysiska skador och kan i värsta fall leda till självmord. En form av terapi som visat sig ge goda resultat för att komma till rätta med detta beteende är DBT, dialektisk beteendeterapi. Syfte: Att undersöka om DBT- terapeuters beskrivning av sitt arbete med dialektisk beteendeterapi stämmer överens med litteraturens beskrivning av behandlingen, och därmed uppnå en fördjupning i dialektisk beteendeterapi och självskadebeteende. Metod: En kvalitativ studie med sex stycken semistrukturerade intervjuer med DBT- terapeuter har genomförts. Analysen har utförts med hjälp av kvalitativ innehållsanalys. Resultat: Resultatet har delats upp i två huvudkategorier: arbetsmetod samt terapeuter och andra vårdgivares bemötande av patienter. I resultatet framkommer det hur en DBT- behandling stegvis ser ut samt vikten av ett gott bemötande av patienter. Ett gott bemötande omfattar bland annat ett respektfullt och icke- dömande förhållningssätt. Konklusion: Resultaten i studien bekräftar resultaten från den tidigare forskningen. Dock krävs det mer forskning om DBT som behandlingsmetod för att kunna dra tillförlitligare och säkrare slutsatser. Genom att arbeta med behandling av självskadebeteende kan individers hälsa förbättras, vilket i sin tur även kan leda till minskning av antalet självmord och psykisk ohälsa. / Background: Self- harm behavior is a serious problem that occurs today. In recent years care providers in the health-care have noticed an increase of this problem that leads to physical and mental health- problems. These health- problems can occur, for example, in the form of depression, physical harms and can lead to suicide in worst case. A form of therapy that has been shown to give good results to manage this behavior is DBT, dialectical behavior therapy. Aim: To investigate whether DBT- therapist’s description of their work with dialectical behavior therapy is consistent with the literature’s description of the treatment, and thereby achieve a deepening in dialectical behavior therapy and self- harm behavior. Method: A qualitative research with six semi-structured interviews with DBT- therapists have been implemented. The analysis has been done using a qualitative content analysis. Results: The result has been divided into two main categories: working- method and therapist’s and other care provider’s treatment of patients. It appears in the result how a DBT- treatment looks like, step- by step, and the importance of a good treatment of patients. A good treatment includes a respectful and non- judgemental attitude. Conclusion: The results in the study confirms the results from the recent research. However, more research on DBT as a treatment is necessary, in order to make stronger and more reliable conclusions. People’s health can be improved by working with treatment of self- harm behavior, which also can lead to a reduction in the number of suicide and mental illness.

Background Suicidal behavior is an important global health problem affecting also significant others. Both genetic and environmental influences play an important role in the development of suicidal behavior. There is a need of interventions for family and friends after a suicide attempt. The aim of this thesis was to assess the impact of family history of suicide (FHS) and early life adversity (ELA) on severity of suicidal behavior and on level of interpersonal problems in suicide attempters. Furthermore it aimed to evaluate a DBT-based skills training program, Family Connections (FC), for relatives and friends of suicide attempters. Methods Studies I and II included 181 suicide attempters. FHS was assessed with the Karolinska Self-Harm History Interview or in patient records. ELA was assessed with the Karolinska Interpersonal Violence Scale (KIVS) measuring exposure to interpersonal violence in childhood. Suicide intent was measured with the Freeman scale. Interpersonal problems were assessed with the Inventory of Interpersonal Problems (IIP). Study III, a pilot study evaluating the effect of FC for family members of suicide attempters, included 13 participants who completed the program with pre- and post-questionnaires. The experience of burden was assessed with the Burden Assessment Scale (BAS), general wellbeing with Brief Symptom Inventory (BSI) and level of depression was assessed with Beck Depression Inventory (BDI). The Swedish scale Questions About Family Members (QAFM) was used to explore the quality of the participants’ relationship with the patient and the Quality of Life Inventory (QOLI) was used to measure satisfaction with life situation. Study IV included 132 family members, and investigated the feasibility and preliminary efficacy of FC in psychiatric care. Participants were assessed pre- and post-intervention with the following self-report questionnaires: BAS, QAFM and Five Facet Mindfulness Questionnaire. Results Male suicide attempters with FHS made more serious and well planned suicide attempts and had higher suicide risk. FHS and exposure to interpersonal violence as a child were independent predictors of suicide in male suicide attempters. Regarding interpersonal problems, suicide attempters with FHS had significantly more often an intrusive personal style, indicating that they might have an impaired ability to create stable, long-lasting relationships. In the pilot study the participants reported a significant reduction in burden, an improved psychic health and an improvement in the relationship with the patient after completing FC. In the fourth study, FC showed to be feasible and effectively implemented in a psychiatric outpatient services clinic. Regarding burden, results were in line with the pilot study, with a significant reduction in all subscales in BAS. Conclusions High-risk patients call for a consideration of both ELA and FHS in clinical suicide risk assessment. In suicide attempters at biological risk, suicide might be prevented with the early recognition of environmental risks. Further, the interpersonal problems associated with FHS may cause difficulties for suicide attempters to accept or benefit from treatment, and caregivers should take into account the characteristics of the suicide attempter´s interpersonal functioning. The results from the pilot study provide support for the need and importance of an educational program addressed specifically to family members of suicide attempters. Preliminary results support the feasibility and potential value of an implementation of FC in psychiatric open care clinics.