This research explores good practice with people on CTOs - via a case study of one area mental health service in Victoria. The emancipatory values of Social Work were used to guide the investigation, thereby ensuring the involvement of consumers and their families or carers. Critical Social Work theory provided an important theoretical base for the research, and both critical theory and pragmatism supported the methodology. A mixed methods approach was undertaken. This included a cluster analysis of 164 people on CTOs. Three clusters emerged from the exploratory cluster analysis. These clusters, labelled ‘connected’, ‘young males’ and ‘chaotic’ are discussed in relation to their particular characteristics. The results from the cluster analysis were used to inform the recruitment of four people on CTOs who were the central focus of case studies that represented the different clusters. Semi-structured group interviews were also undertaken to enhance the triangulation of data collection and analysis. This resulted in 29 semi-structured interviews with multiple informants, including consumers, family/carers, case managers, doctors, Mental Health Review Board members and senior managers. The data analysis was guided by a general inductive approach that was supported by the use of NVivo 7. / Five principles, and the processes required to enable them, emerged from the qualitative data: 1) use and develop direct practice skills, 2) take a human rights perspective, 3) focus on goals and desired outcomes, 4) aim for quality of service delivery, and, 5) enhance and enable the role of key stakeholders. These principles are discussed and then applied to the case studies in order to consider their potential relevance to practice within a diverse community of CTO recipients. The application of the principles identified two further findings: 1) that the principles are interdependent, and 2) the relevance of the principles varies depending on the characteristics of the consumer. The two most important findings to emerge from this thesis are that: 1) people on CTOs, their family/carers, and service providers are a diverse community of people who have a range of problems, needs and preferences in relation to either being on a CTO or supporting someone on a CTO; and 2) the implementation of CTOs is influenced by social and structural issues that need to be considered in developing any recognition or understanding about what represents good practice. Recommendations relating to each of the principles are made, along with identification of future research questions. A particular focus is whether application of the principles will enable improvements in practice on a range of measures, including reducing the use of CTOs, and the experience of coercion by consumers.

As anti-cancer agents, retinoid induce cell growth arrest and differentiation, while HDACIs cause cell differentiation, growth inhibition, death and inhibit angiogenesis in many cancer types. However, a proportion of patients respond poorly to these therapies. My studies, presented here, aimed to improve the anti-cancer effects of these agents by identifying key factors which mediate cancer cell sensitivity or resistance to their action. In this study I have found that the clinically used retinoid, 13-cis RA, exerts its anti-cancer signal in a manner similar to atRA, by modulating the transcriptional response of retinoid-regulated genes. HDACI-induced cytotoxicity is significantly enhanced when combined with IFNα in 8 out of 9 cancer cell lines from various organ origins. Sensitivity to the combination treatment correlated with an absence of basal p21 protein expression, and cell cycle arrest. Knocking-down p21 gene expression further sensitized cancer cells to the combination therapy. Moreover, IFNα and HDACI co-operatively inhibited pro-angiogenic gene expression in cancer cells, and the combination therapy decreased endothelial cell migration, invasion, and capillary tubule formation. Further experiments on p21 as a resistance factor to anti-cancer treatment demonstrated that conditioned media from breast cancer MCF-7 cells transfected with p21 siRNA, induced significantly less endothelial cell migration, invasion and vascular sprouting, compared with media from cells transfected with scrambled siRNA. LC/MS analysis of the conditioned media revealed that Trx secretion was significantly reduced after p21 knockdown. The reduction in Trx secretion following p21 knockdown was due to a direct effect of p21 siRNA on the expression of intracellular TBP2 in neuroblastoma, prostate and lung cancer cells. Consistent with this result, media from MCF7 cells transfected with TBP2-specific siRNA alone, promoted endothelial cell invasion and vascular sprouting, Trx knockdown resulted in opposite effects, and the anti-angiogenic effect of p21 siRNA was offset by simultaneous TBP2 siRNA transfection. ChIP assay revealed that p21 directly bound to an E2F1-bindng site in the TBP2 gene promoter. These data indicate that p21 promoted tumour-driven angiogenesis through transcriptional repression of TBP2. Collectively, my experiments indicate several potential treatment targets directed toward enhancing the effectiveness of HDACIs and retinoids.

The problem investigated Four studies investigated the phenomenon of cancer-related fatigue (CRF) in women who had received adjuvant treatment for early-stage breast cancer, with a view to reducing the diagnostic uncertainty surrounding the syndrome and thus facilitating progress in both clinical management and aetiological research. Procedures and results A cross-sectional study of 109 women compared a ???cancer-specific??? self-report questionnaire (FACT-F) (canvassing fatigue symptoms) and a more generic questionnaire (SPHERE) (identifying depression and fatigue). Thirty-seven percent of women reported fatigue. Overall in 20%, fatigue was associated with psychological distress. Seventeen percent of women had fatigue but no depression. A qualitative study utilised focus groups to identify and compare the distinctive features of CRF with those of women with chronic fatigue syndrome (CFS). A similar set of symptoms was found in both groups, including overwhelming fatigue, un-refreshing sleep and subjective concentration problems. However, women with CFS also reported myalgia and arthralgia. Using the Structured Clinical Interview for Neurasthenia- SCIN, the third study compared the symptoms of three groups of women with fatigue: those with CRF, CFS or major depression. The detailed ???interviewer guide??? provided explicit directions for evaluating and classifying symptoms. This study confirmed the core symptom of ???profound fatigue unrelieved by rest???, and additional features that distinguished between the clinical diagnoses. The fourth study compared features of the evolution of clinically-identified fatigue syndromes in women from two prospective cohort studies; women with post-cancer fatigue (PCF) and women with post-infective fatigue syndrome (PIFS). Major conclusions A syndrome of PCF, present at least six months following adjuvant treatment and unexplained by medical or psychiatric disorder was investigated. The characteristics of PCF and those of CFS are very similar, with the fatigue state having indistinguishable descriptors. Longitudinal evaluation of the symptom complexes of PCF and PIFS suggests divergent pathways may be relevant. Co-morbid features like sleep disturbance; physical deconditioning and mood disturbance may be implicated as factors in the evolution and prolongation of PCF. These studies provide a basis for a more uniform and rigorous classification system - a necessary first step towards advancing the field both in investigating aetiology and new intervention strategies.

The problem investigated Four studies investigated the phenomenon of cancer-related fatigue (CRF) in women who had received adjuvant treatment for early-stage breast cancer, with a view to reducing the diagnostic uncertainty surrounding the syndrome and thus facilitating progress in both clinical management and aetiological research. Procedures and results A cross-sectional study of 109 women compared a ???cancer-specific??? self-report questionnaire (FACT-F) (canvassing fatigue symptoms) and a more generic questionnaire (SPHERE) (identifying depression and fatigue). Thirty-seven percent of women reported fatigue. Overall in 20%, fatigue was associated with psychological distress. Seventeen percent of women had fatigue but no depression. A qualitative study utilised focus groups to identify and compare the distinctive features of CRF with those of women with chronic fatigue syndrome (CFS). A similar set of symptoms was found in both groups, including overwhelming fatigue, un-refreshing sleep and subjective concentration problems. However, women with CFS also reported myalgia and arthralgia. Using the Structured Clinical Interview for Neurasthenia- SCIN, the third study compared the symptoms of three groups of women with fatigue: those with CRF, CFS or major depression. The detailed ???interviewer guide??? provided explicit directions for evaluating and classifying symptoms. This study confirmed the core symptom of ???profound fatigue unrelieved by rest???, and additional features that distinguished between the clinical diagnoses. The fourth study compared features of the evolution of clinically-identified fatigue syndromes in women from two prospective cohort studies; women with post-cancer fatigue (PCF) and women with post-infective fatigue syndrome (PIFS). Major conclusions A syndrome of PCF, present at least six months following adjuvant treatment and unexplained by medical or psychiatric disorder was investigated. The characteristics of PCF and those of CFS are very similar, with the fatigue state having indistinguishable descriptors. Longitudinal evaluation of the symptom complexes of PCF and PIFS suggests divergent pathways may be relevant. Co-morbid features like sleep disturbance; physical deconditioning and mood disturbance may be implicated as factors in the evolution and prolongation of PCF. These studies provide a basis for a more uniform and rigorous classification system - a necessary first step towards advancing the field both in investigating aetiology and new intervention strategies.

<p>The object with the study of this literature was to describe differente programs of care and patients and relatives experience and opinion about the caring for patients with Anorexia Nervosa. The method the author used was a descriptive literature study based on imperial studies. The studies were based on 15 scientific articles within the chosen field. The results shows that these patients hade special needs to be seen and heard as individuals, involved in their own treatment, and have good contact with the caring staff. The study also shows which methods were mostly appreciated involving nurses, patients and relatives. Results show the patients appreciating the individual therapy and an empathetic caring staff. Parents though thought that family therapy was the best treatment. Here they felt they could show their feelings and at the same time get help and advice in handling different situations. The result also shows problem areas such as framing oneself from the world or patients starting a competition of weight loss among the group members. The study also shows the difference in the nurses views of the different situation. Most nurses found it difficult to treat Anorexia Nervosa or to understand the illness, didn’t feel they had enough knowledge of the psychological health. It also shows that more studies and knowledge is needed in regards to forms and ways of treatment and the different causes of the illness.</p>

Graduation date: 2004

Thesis (M.A.)--University of Wisconsin--Madison, 1967. / Title from title screen (viewed Feb. 21, 2007). Includes bibliographical references. Online version of the print original.

Every tight gas well needs to be stimulated with a hydraulic fracture treatment to produce natural gas at economic flow rates and recover a volume of gas that provides an acceptable return on investment. Over the past few decades, many different types of fracture fluids, propping agents and treatment sizes have been tried in the Cotton Valley formation. The treatment design engineer has to choose the optimum fluid, optimum proppant, optimum treatment size and make sure the optimum treatment is mixed and pumped in the field. These optimum values also depend on drilling costs, fracturing costs and other economic parameters; such as gas prices, operating costs and taxes. Using information from the petroleum literature, numerical and analytical simulators, and statistical analysis of production data, this research provides a detailed economic evaluation of the Cotton Valley wells drilled in the Elm Grove field operated by Matador Resources to determine not only the optimum treatment type, but also the optimum treatment volume as a function of drilling costs, completion costs, operating costs and gas prices. This work also provides an evaluation of well performance as a function of the fracture treatment type by reviewing production data from the Carthage and Oak Hill Cotton Valley fields in Texas and the Elm Grove field in Louisiana.

<p>The aim of this research project was to assess the accuracy of four different types of VTO&rsquo / s, [Steyn (1979), Jacobson and Sadowsky (1980), Ricketts (1982) and Holdaway (1984)], in predicting the final result of the incisor and soft tissue response to orthodontic treatment in bimaxillary protrusive patients.</p>

The object with the study of this literature was to describe differente programs of care and patients and relatives experience and opinion about the caring for patients with Anorexia Nervosa. The method the author used was a descriptive literature study based on imperial studies. The studies were based on 15 scientific articles within the chosen field. The results shows that these patients hade special needs to be seen and heard as individuals, involved in their own treatment, and have good contact with the caring staff. The study also shows which methods were mostly appreciated involving nurses, patients and relatives. Results show the patients appreciating the individual therapy and an empathetic caring staff. Parents though thought that family therapy was the best treatment. Here they felt they could show their feelings and at the same time get help and advice in handling different situations. The result also shows problem areas such as framing oneself from the world or patients starting a competition of weight loss among the group members. The study also shows the difference in the nurses views of the different situation. Most nurses found it difficult to treat Anorexia Nervosa or to understand the illness, didn’t feel they had enough knowledge of the psychological health. It also shows that more studies and knowledge is needed in regards to forms and ways of treatment and the different causes of the illness.