Electronic monitoring-based counseling to enhance adherence among HIV-infected patients: A randomized controlled trial.

Objective: To investigated the effectiveness of an adherence intervention (AIMS) designed to fit HIV-clinics' routine care procedures. Design: Through block randomization, patients were allocated to the intervention or control group. The study included 2 months baseline measurement, 3 months intervention, and 4 months follow-up. HIV-nurses delivered a minimal intervention (“adherence sustaining”) to patients scoring >95% adherence at baseline, and an intensive intervention (“adherence improving”) to patients with     

Hope-focused practices during early psychotherapy sessions: Part II: Explicit approaches.

An avalanche of research on hope over the last 30 years consistently points to the benefits of hope in living and human change processes. Common factors models name hope as one of four key factors accounting for client change across psychotherapeutic models. While research provides evidence for the importance of hope, little research examines how hope is understood and practiced. This paper, the second in a two-part series, examines hope-focused interventions of 5 hope-educated psychotherapists with 11 clients early in the therapy sequence. Two categories characterized the overall findings: implicit and explicit hope-focused interventions. The first paper in this series addressed implicit hope-focused interventions. This second paper focuses on explicit hope-focused interventions (i.e., using the word hope, hoping, etc.). Explicit use of hope in therapy was found to address: (a) multiple dimensions of hope (i.e., cognitive, behavioral, emotional, relational); (b) psychoeducational hope interventions; and (c) framing problems as threats to hope. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

社区护理干预对糖尿病患者的影响

目的探讨社区护理干预对糖尿病患者生活习惯及治疗效果的影响。方法随机将164例糖尿病病人分为实验组和对照组,实验组进行社区护理指导干预,并针对每例病人进行个体指导;对照组未进行系统的糖尿病健康教育。6个月后监测病人糖尿病生活习惯及血糖变化。结果实验组糖尿病患者生活习惯改变明显高于对照组(P<0.05),血糖控制率高于对照组,差异有统计学意义。结论社区护理干预能有效提高病人自我管理能力及疗效,提高生活质量。     

Opportunities for mitigating pathogen contamination during on-farm food production

Fruits, vegetables, and meat are susceptible to contamination by foodborne pathogens at many points from production through preparation in the home. This review will largely highlight approaches and progress made in the last five years to address strategies to reduce pathogen contamination in animal production but will also touch on the emerging field of preharvest produce food safety. Mitigation strategies can be divided into those that address pathogen reduction in the environment and those that target reduction/elimination of pathogen contamination in animals or plants. The former strategy has been encompassed in studies evaluating sanitation treatments of facilities as well as in numerous epidemiologic risk assessment studies (both on-farm assessments and computer simulation models) that identify management practices that impact pathogen prevalence in animals. Interventions to significantly reduce pathogen exposure via feed or water are dependent on their role as a significant contributor to pathogen contamination in the animal production system. In addition, inconsistent results obtained with interventions of dietary additives or formulation modifications (grain versus forage; inclusion of distiller's grains) on pathogen prevalence in animals have been attributed to a range of factors including target organism, grain type, level of inclusion, the animal's health or stress level, and ability to survive the gastric acidic conditions. Recent attempts to microencapsulate organic acids or bacteriophage within feed have met with only marginal improvements in reducing pathogen carriage in animals but this approach may have greater potential with other antimicrobial additives (i.e., essential oils). Bacteriophage therapy, in general, can significantly reduce pathogen carriage in animals but based on its transient nature and the potential for development of phage-resistant subpopulations, this approach should be administered to animals just prior to slaughter and preferably to animals that are suspected “super-shedders”. Other promising on-farm intervention approaches have included breeding for pathogen resistance, vaccines, and dietary bacteriocins. To optimize interventions on a cost basis, studies have also determined that application of dietary interventions at specific time points in the animal's production cycle is a useful strategy to reduce pathogen carriage (e.g., probiotics to fertilized eggs and acidified feed to fattening swine). In conclusion, applicable management and intervention strategies may vary depending on the type of food under production; however, it is important to consider from a holistic view how any new intervention strategies will affect the overall production system in order to maintain a successful, efficient food production environment.     

6-氟-3-(4-哌啶基)-1,2-苯并异噁唑盐酸盐的合成

4-哌啶甲酸(2)与乙酐反应制得N-乙酰基-4-哌啶甲酸(3),3经历酰氯化、与间二氟苯Friedel-Crafts反应得到N-乙酰基-4-(2,4-二氟苯甲酰基)哌啶(4).4脱保护产物5与盐酸羟胺进行缩合反应生成(2,4-二氟苯基)-(4-哌啶基)甲酮肟盐酸盐(6).最后,6经分子内环合、成盐反应得精神病治疗药的中...     

Facilitating outpatient treatment entry following detoxification for injection drug use: A multisite test of three interventions.

A multisite, randomized trial within the National Drug Abuse Treatment Clinical Trials Network (CTN) was conducted to test 3 interventions to enhance treatment initiation following detoxification: (a) a single session, therapeutic alliance intervention (TA) added to usual treatment; (b) a 2-session, counseling and education, HIV/HCV risk reduction intervention (C&E), added to usual treatment; and (c) treatment as usual (TAU) only. Injection drug users (n = 632) enrolled in residential detoxification at 8 community treatment programs were randomized to 1 of the 3 study conditions. TA participants reported entering outpatient treatment sooner and in greater numbers than TAU participants. Reported treatment entry for C&E fell between TA and TAU with no significant differences between C&E and the other conditions. There were no differences among the interventions in retention, as measured by weeks of outpatient treatment for all participants who reported treatment entry. Alliance building interventions appear to be effective in facilitating transfer from detoxification to outpatient treatment, but additional treatment engagement interventions may be necessary to improve retention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of method in treatment effectiveness research: Evidence from meta-analysis.

A synthesis of 319 meta-analyses of psychological, behavioral, and educational treatment research was conducted to assess the influence of study method on observed effect sizes relative to that of substantive features of the interventions. An index was used to estimate the proportion of effect size variance associated with various study features. Study methods accounted for nearly as much variability in study outcomes as characteristics of the interventions. Type of research design and operationalization of the dependent variable were the method features associated with the largest proportion of variance. The variance as a result of sampling error was about as large as that associated with the features of the interventions studied. These results underscore the difficulty of detecting treatment outcomes, the importance of cautiously interpreting findings from a single study, and the importance of meta-analysis in summarizing results across studies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mathew & Ghosh Architects

The work of Mathew & Ghosh Architects (Nisha Mathew-Ghosh and Soumitro Ghosh) boldly extends an abstract Modernist language and at the same time draws from the vitality of places. While the firm's early works were small in scale, mostly residential in nature and based on a reappraisal of the early Corbusian idiom, recent projects include large-scale urban and landscape interventions with diverse conceptual and metaphorical imperatives. They have moved from a more reticent stance to the urban exuberance of their more recent projects (for example, their own office building), something akin to a ‘savage architecture’ as posited by Kazuo Shinohara in the context of the unsynchronised nature of the modern city. The architects' object of contemplation is the urban ‘box’, whether a private residence, office or part of a church. The box is first fractured and reconstructed as a bricolage of tectonic fragments, memories and events, all tenuously related as if unity in a contemporary culture is for ever denied. Like the Japanese notion of ‘ma’, the moment between fragments - a slit or an emptiness between two hovering planes - is telling. Mathew & Ghosh participate in the continuity of a historical narrative yet mark out the fissures and disjunctions; sometimes negotiations with the continuity emerge from unintended interstices. While these configurations of the contemporary urban ‘box’ are both contextual and abstract, they are also phenomenologically rich. There is a sustained dialect to the architecture of Mathew & Ghosh that includes consummate materiality and fine crafting, light as a medium, and always, as Nisha Mathew-Ghosh states, ‘good spatial possibilities’. Copyright © 2007 John Wiley & Sons, Ltd.     

Moral agency and the sexual transmission of HIV.

Sexual transmission of HIV occurs because an infected person has unprotected sex with a previously uninfected person. The majority of HIV infections are transmitted by individuals who are unaware of their infection, and most persons who are diagnosed with HIV significantly reduce or eliminate risk behaviors once they learn they have HIV. However, a minority of known-infected individuals engage in transmission risk behavior, sometimes without disclosure to their partners. Such behavior may involve a breakdown or temporary suspension of moral mechanisms, such as personal responsibility beliefs and anticipatory self-evaluative reactions to one’s behavior. The present article reviews the literature on sexual transmission risk behavior within A. Bandura’s (1999) theoretical framework of moral agency. The article first reviews evidence for the operation of moral agency in transmission risk behavior and HIV status disclosure. Next, suggestive evidence is presented for the operation of mechanisms of moral disengagement described by Bandura. Finally, the article reviews a small number of interventions that have been shown to be effective in reducing transmission risk behavior, through the lens of moral agency, and make recommendations for future intervention research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)