Background There appears to be clear evidence of cognitive impairment in schizophrenia which is wide ranging and relatively stable throughout the illness. Both cognitive impairment and treatment response have been argued to be highly relevant in risk assessment and management of offenders. However, there does not appear to be any research in this area on mentally disordered offenders. It is on this basis that this study attempts to determine the impact of cognitive impairment on treatment responsivity in mentally disordered offenders. Method A cohort quantitative research design was used and the data were obtained via the administration of neuropsychological assessments and self-report measures. Neuropsychological data on attention, executive functioning, memory and IQ were matched with treatment gain scores for 114 male mentally disordered offenders. The participants were further matched according to the group treatments they had participated in resulting in five different groups. Results Univariate and bivariate analyses were used to explore the relationship between cognitive predictor variables and treatment gain scores. Variables that were significantly associated with treatment gain scores were further investigated using multiple regression analyses. Results indicated that for each group, cognitive variables such as attention and memory were significantly predictive of treatment gain scores. Conclusion The results indicate the need to consider cognitive impairment constructs such as attention, executive functioning, memory and IQ when determining appropriate interventions for mentally disorders offenders. Doing so may improve treatment responsivity and have a consequent impact on risk management and recidivism. The research limitations are discussed in relation to the methodology used, and clinical implications and directions for future research are explored.

Urogenital schistosomiasis, due to Schistosoma haematobium, is one of the helminth infections of public health importance in sub-Saharan Africa where children carry the heaviest burden of infection. Treatment with the drug praziquantel is the only widely available tool for control. Current schistosome control programs are essentially school-based and exclude younger pre-school children. However, increasing reports of significant infection levels in this age group call for the inclusion of these young children in control programs. The hygiene hypothesis suggests that helminth infections, including schistosome infection, may protect against atopy, implying that helminth eradication may carry a detrimental burden of immune disorders. However, this conjecture is controversial. This study was designed to investigate the relationship between schistosome infection and atopy. In a comparative epidemiological approach between two schistosome endemic areas with differing infection levels, it is shown that atopy is inversely associated with current schistosome infection intensity but not with cumulative history of infection. This inverse relationship was subsequently shown to be associated with the levels of soluble CD23, the low affinity IgE receptor, but not with the polyclonal IgE stimulation. However, while praziquantel treatment was associated with an increase in schistosome-specific responses, a decline in atopic responses was observed in these communities, suggesting that treatment differentially affect anti-schistosome and atopic responses. In addition, the study has shown that praziquantel treatment of preschool age children increases, quantitatively and qualitatively, their schistosome-specific antibody responses purportedly associated with resistance to schistosome infection/reinfection.

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 2001. / Neck pain is a common condition that has become a serious health concern. Since there is controversy regarding the most effective management of this condition, further research needs to be executed. The purpose of this investigation was to compare manipulation combined with a cervical pillow to manipulation alone in the management of mechanical neck pain. The rationale behind this, was that manipulation is one of the most common treatments for spinal conditions and has shown significant results in alleviating mechanical neck pain. Cervical pillows have been investigated by various researchers. They have concluded that cervical pillows are effective in treating mechanical neck pain. Thus, using the pillow as an adjunct to manipulation should attain superior results to manipulation alone. This study consisted of 40 patients who were randomly divided into 2 equal groups. The average age of the patients was 34 years old and the average duration of neck pain was pain of greater than 6 months. The patients received 6 treatments over a 4 week period. Group1 were manipulated and given a cervical pillow to sleep on, while group 2 received manipulation alone. / M

No description available.

The extent to which interventions are implemented as intended is called treatment integrity (TI). Given that it is unreasonable to expect 100% TI in applied settings, a through understand of TI is essential to appropriately train teachers. This understanding must include the types of TI errors that may be committed and how these effect student learning. It is essential to study TI errors because of the real-world implications for students, including eligibility decisions for special education services, which are based upon students’ responses to inventions. It is not possible to make educational decisions on intervention effectiveness unless it is clear that evidence-based practices have been implemented accurately. If TI is low, it is impossible to determine which services and interventions a student requires. Further, measuring the fidelity with which interventions are applied allows for a more thorough and accurate understanding of which components of an intervention are effective, necessary, and feasible. A broader understanding of which TI errors are most significant, as well as measuring the necessary levels of TI, will lead to more accurate information about how to implement evidence-based practices. The purpose of this study is to gain a more nuanced understanding of TI failures in the form of errors of commission and the role commission errors have on participant responsiveness (Power, 2005). This study extends the results of DiGennaro Reed et al. (2011) by including an intermediate (80%) level of TI which may more accurately represent an attainable level of TI in applied settings. For two of four students, more errors of commission were related to lower skill acquisition. For the other two students, idiosyncratic patterns of responding emerged.

In an infectious disease with a long infectious period (which can be the entire life for some diseases), the infectivity of individuals may change due to different reasons. For example, infected individuals may receive treatment and their level of infectivity can reduce depending on the efficacy of the treatment. Or, infected individuals may change their behaviour and reduce their activity once the disease is diagnosed, leading to a reduction of their infectivity. Treated individuals may stop getting treatment, and return to the infective class at a rate depending on how long they have been receiving treatment. In this thesis, a compartmental model consisting of three compartments (susceptibles, infectives and treated infectives) is formulated to study the effect of treatment on the transmission dynamics of a disease. Continuous and discrete treatment-age-structured models are derived and the asymptotic behaviour of the system is studied and the basic reproduction number is determined. / October 2016

A preliminary investigation of the extent to which supportive services contribute to the effectiveness of a methadone treatment program was conducted.

This study is a comparison of four treatments involving education and imagery relaxation for the amelioration of dysmenorrhea. Treatment was presented to 76 subjects by videotape during a one-hour session. A six month follow-up was performed using one of the original instruments, the Symptom Severity Scale (Cox & Meyer, 1978) and a questionnaire designed for the study. Analysis of the test instruments indicated a significant treatment effect for the educational group. The second most effective treatment was a combined treatment utilizing imagery relaxation and education, although this group did not produce significant results. The no-treatment control group was more effective in diminishing symptoms than the fourth group, imagery relaxation alone. The lack of effectiveness of the imagery relaxation treatment was hypothesized to be due to lack of reinforcement of the technique. The educational treatment modality offered the individual an opportunity to learn about many different etiological facets of dysmenorrhea, including biological, learning, and cognitive factors. The presentation also introduced the individual to several different treatment modalities in order to provide an armamentarium of effective methods for diminishing or eliminating dysmenorrhea. These results suggest that there is a need for education about dysmenorrhea before menarche, in order to prepare, prevent, treat, and cope with this syndrome.

With its widespread use across the country and increasing evidence of its effectiveness, the wraparound process has been accepted widely as a feasible alternative to restrictive residential treatments for children with severe emotional and behavioral disorders. Yet wraparound has been implemented and conceptualized in such a variety of ways that many have begun to question whether it truly is a single definable approach. Recently, a conceptual model for wraparound was offered that included ten essential elements as the key ingredients for this approach. Subsequently, the Wraparound Fidelity Index (WFI) was designed to measure the degree to which an intervention adheres to these ten elements. The purpose of the current study was to use data collected via the WFI to provide the first empirical test of wraparound’s conceptual model. Programs providing wraparound to children with severe emotional and behavioral disorders and their families used the WFI to collect data from caregivers (n = 481), youths (n = 355; 11 to 19 years), and resource facilitators (n = 610). Confirmatory factor analysis (CFA) was used to test the fit of a series of structural models consistent with the proposed element model of wraparound. First, CFA models were examined separately for each of the elements. Second, CFA models that represent the full wraparound model were tested, separately for each of the three informants. And third, a multitrait-multimethod (MTMM) analysis was conducted using a final CFA model including all elements (traits) and the three informants (methods). Findings supported the majority of elements and WFI items when tested separately at the first step. However, at the second step, only the youth model provided adequate fit to the data. Significant modification was necessary to yield admissible solutions for the caregiver and resource facilitator models. Finally, an inadmissible solution resulted when the three informants and revised model were tested in step three. Implications of the findings for the wraparound process, the WFI, and future research are discussed.

The purpose of the present thesis was to better understand the effect of targeting key biological mechanisms in order to improve radiotherapy response. Two important and distinct pathways were targeted using novel agents: (1) the phosphoinoside-3-kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR) pathway; (2) the ataxia telangiectasia-mutated-Rad3-related (ATR)/Chkl pathway. The role of the PI3K1mTOR signalling pathway in tumour radiosensitivity and tumour microerivlronment (TME) was examined using three, recently-developed signalling inhibitors obtained from Novartis Pharma: NVP-BEZ235 (dual PI3K1mTOR inhibitor), NVP-BGT226 (dual PI3K1mTOR inhibitor) and NVP-BKM120 (single PI3K inhibitor). The radiosensitising potential of NVP-BEZ235 and NVP-BGT226 was demonstrated in tumour and endothelial cells. Additionally, a thorough research into the effects ofNVP-BKM120 and NVP-BEZ235 on TME showed that oncogenic signalling inhibitors can improve vascular morphology and increase tumour oxygenation and perfusion in tumour xenograft models, resulting in improved radiation response. Furthermore, a highly potent and selective A TR inhibitor, VE-822, that was obtained from Vertex Pharmaceuticals (Europe) Ltd, was tested in pancreatic ductal adenocarcinoma (PDAC) cells and tumour xenograft models. A TR inhibition by VE-822 resulted in sensitisation of tumour cells but not normal cells to radiation and gemcitabine. Similarly, VE-822 strongly enhanced radiation- and chemoradiation-induced tumour growth delay in tumour xenograft models. Importantly, VE-822 did not potentiate radiation-induced gastrointestinal tract epithelial damage. To summarize, the impact of targeting two distinct pathways in combination with radiation and chemoradiation was explored. Inhibition of the PI3K1mTOR and ATRlChkl signalling pathways increases response of tumours to radiotherapy they and might be promising targeting strategies for cancer treatment. Our findings have considerable translational implications and future clinical trials should aim to validate these observations.