The objectives of this study are two-fold: (a) to delineate the factors that guide Ontario social workers’ decision-making when rendering judgments on the mandatory reporting of child maltreatment and (b) to understand how social workers maintain the therapeutic alliance with children and families following the decision to report suspected child maltreatment. The study is informed by two distinct bodies of literature: the decision-making theoretical literature within the fields of medicine, psychology, social work, and marriage and family therapy and the therapeutic alliance theoretical literature. Harnessing the advantages of online survey technology, the study surveyed registered members (n = 480) of the Ontario Association of Social Workers who provide direct service to children and families. Participants responded to prepared vignettes of suspected child maltreatment followed by Likert-scale questions (strongly agree to strongly disagree) and open-ended questions on strategies to maintain the alliance. Open-ended questions allowed respondents to offer further commentary regarding their opinions on mandatory reporting and on maintaining the therapeutic alliance. These comments added a rich source of information to the quantitative data. Multiple logistic regression analyses showed that social workers’ ethical responsibility to the College of Social Workers and Social Service Workers, their legal responsibility to the provincial mandatory reporting laws of Ontario, and consultation with peers or eliciting direction from a supervisor comprised the main factors in their decision-making around reporting suspected child maltreatment to the Children’s Aid Society. Qualitative analyses showed that social workers employ a plethora of strategies to repair the alliance following a disclosure of child maltreatment including reporting strategies, information strategies, affect regulation strategies, advocacy strategies, and resource strategies. The major limitation of the research design was the use of vignette research, which in proscribed circumstances may not reflect what the social worker does in actual practice. Design features that compensate for this limitation include (1) use of a 5-point Likert-item response of strongly agree to strongly disagree to allow respondents a range of responses; and (2) use of open-ended questions to allow respondents the opportunity to express their opinions on the issues.

Graduation date: 1993

The purpose of this research study was to address the gap in the research literature that existed concerning the absence of qualitative data addressing relapse and recidivism in Texas. Numerous quantitative studies dealt with these issues. However, gaps in the literature existed because accounts and opinions of specific participants regarding these conclusions were absent. Consequently, we lacked specific direction. The perspective of the individual, the insider, was missing. This study helped determine the meaning of "making it" for the parolee/addict attempting to assimilate into the general population and avoid relapse and recidivism. To achieve the research objectives, an ethnographic interview methodology was utilized. The population engaged in the study included male parolees who live in Harris County Texas. All men gained parole between 1992 and 1994, hold positions as professionals in substance abuse counseling, and reported ten years or more of drug free and crime free living. The literature review established the documented need and importance for a qualitative study. The literature defined recidivism according to Texas state officials. The literature considered achievement of parolees who attended the Windham School District. The final section of literature considered the development and operation of the In Prison Therapeutic Community (IPTC) program. The findings from the interviews determined that "making it" consisted of working the twelve-step program of Alcoholics Anonymous (AA), meeting with parole officers, dealing with risky behaviors, and remaining committed to a drug free and crime free life. Study participants expressed that state record keeping appeared inaccurate and presented a false picture regarding the actual number of drug related arrests and the actual long-term recidivism rate. The participants noted that the Windham School District exhibited a major influence in making a conscious decision to turn toward positive outcomes. It was recommended that the role of the Windham School District be expanded due to the record of achievement. Other recommendations included the establishment of a longitudinal study of Texas parolees to exceed five years in duration to check long-term recidivism rates and an ethnographic study that focused on the members of the Winner's Circle.

Thesis (Psy.D.)--Rutgers University, 2009. / "Graduate Program in Clinical Psychology." Includes bibliographical references (p. 124-127).

Not available / text

published_or_final_version / Anatomy / Master / Master of Medical Sciences

published_or_final_version / Buddhist Studies / Master / Master of Buddhist Studies

The use of antibiotics as prophylaxis against postsurgical infection has been propagated. However, in the field of oral implant dentistry, the use of systemic antibiotics remains a controversial issue, with various antibiotic regimens being advocated. The aims of this multi-center randomized clinical trial were to determine the effect of various systemic antibiotic prophylaxis regimens on patient-centered outcomes and perceptions, postsurgical complications in patients undergoing standard oral implant therapy. In this preliminary study, 107 medically healthy adults who were consecutively admitted to 5 study centers for standard oral implant therapy were randomly assigned to one of the 4 groups (3 test and 1 control groups). Pre-operative antibiotics of 2 g amoxicillin 1 hour prior to standard implant placement were prescribed to test group 1 (positive control), post-operative antibiotics of 2g amoxicillin following implant placement for test group 2, and pre-operative antibiotics of 2g amoxicillin 1 hour prior to standard implant placement and 500mg three times daily on days 2 through 3 after standard implant placement for test group 3. The control group was given a placebo tablet of 2g 1 hour prior to standard implant placement without any antibiotics. Subjects were examined clinically by blinded examiners at 1 week, 2 weeks, 4 weeks and 8 weeks from implant installation for post-operative complications. In addition, Visual Analogue Scales (VAS) on pain, swelling, bruising and bleeding were obtained from the patients from Day 1 through Day 7 and 14. From the results of this preliminary study, in standard single implant placement with non-submerged healing, the postoperative complications (Flap closure, Swelling, Pain, Suppuration and Implant stability) and patient-centered outcomes (VAS of bleeding, pain, swelling and bruising) will neither be affected by using antibiotics prophylaxis in different regimens nor not using antibiotics prophylaxis. It should be reiterated that dental practitioners should be cautious when using antibiotics as a prevention of postoperative infection in dental implant therapy. The indiscriminate use of antibiotics will eventually lead to more serious consequences including allergy and the development of resistance strains. / published_or_final_version / Dental Surgery / Master / Master of Dental Surgery

Sj?gren’s syndrome (SS) is a chronic autoimmune disorder of the exocrine glands with clinical manifestation of dry eyes and dry mouth. The pathogenesis of SS is poorly understood, and efficient therapy is currently lacking. Therefore, an appropriate animal model recapitulating the key features of SS could be of profound value. Although several murine models have been established and evaluated, some of these models may develop other non-SS symptoms simultaneously. Herein, an autoimmunization-induced C57BL/6 female mouse model is evaluated. This mouse model exhibited less saliva secretion and swollen salivary gland with severe inflammation in the submandibular gland. Furthermore, apoptosis and pro-inflammatory cytokines were significantly increased and the expression of aquaporin 5, a water channel protein, was decreased and restricted to the basolateral membranes in acinar cells, indicating the weakening of water transport. Besides, autoantibodies such as Ro, La and other anti-nuclear autoantigens were found to be tremendously increased. The expression of M3 muscarinic receptor (M3R) increased in the acinar cells. This can be described as a compensatory expression due to the long term blockage from the autoantibodies which is similar in the SS patients. The characteristics of this model recapitulate the key features of human SS. Dendrobium officinale is an herbal medicine with yin-nourishing effect and clinically used in China as a health tonic to promote body fluid production. The polysaccharides extracted from Dendrobium officinale (DP) consisted of 6 monosaccharides: mannose, glucose, galactose, arabinose, xylose and glucuronic acid in the ratio of 10:0.25:1.2:4.7:1.3:1.4. DP was found to be protective on this experimental SS model. Specifically, administration of DP 20 mg/ml significantly prevented the chaos of immune responses and imbalance of pro-inflammatory cytokines. Our previous work also demonstrated that DP can promote saliva production in both SS patients and SS model. Therefore, we investigated the M3R activation induced by DP treatment. In contrast to the acute activation by acetylcholine, DP exerts slow, but long term activation on M3R. The botanical monosaccharides xylose and arabinose cannot be detected in the cell lysate, indicating that hydrolyzed DP did not permeate the cell membrane. Further investigations suggested that DP can inhibit the apoptosis induced by the addition of recombinant TNF-α on the human salivary gland epithelial cell line A-253. By investigating the potential mechanisms, we found that DP treatment can inhibit the apoptotic factors including the NF-κB activation, increased reactive oxygen species, decreased mitochondrial membrane potential and prolonged mitogen-activated protein kinase activation. The results suggested that DP may interfere with the TNF-α pathway and its receptor since DP did not permeate the cell membrane. / published_or_final_version / Chinese Medicine / Doctoral / Doctor of Philosophy

published_or_final_version / Paediatrics and Adolescent Medicine / Doctoral / Doctor of Philosophy