Understanding engagement in the Program of Assertive Community Treatment (PACT) from the perspectives of individuals receiving treatment

ABSTRACT

Engagement of individuals with serious mental illnesses in community mental health services is a significant challenge. The Program of Assertive Community Treatment (PACT) is an individual-centered and self-contained mental health program that provides psychiatric treatment, rehabilitation, and support services to persons with serious mental illness who have a history of or likelihood of disengagement with services. Understanding what helps and hinders consumers’ involvement in PACT services may provide information on how to tailor engagement strategies to individuals based on their treatment needs and preferences. The current study builds on existing studies by exploring factors that help and hinder engagement in PACT services from the perspectives of individuals receiving treatment. We conducted open-ended, semi-structured interviews with 17 individuals receiving PACT services. Nine themes were identified through thematic analysis: Desirable qualities of PACT, Focusing on positive outcomes, PACT as a safety net, Recovery orientation, Practical barriers, Conflictual relationships, and Medication side-effects. We conclude that the development of a trusting, therapeutic relationship that is collaborative and person-centered and that is facilitated by both practical and emotional support is critical to engaging individuals in treatment and maximizing positive outcomes.     

<Emphasis Type="BoldItalic">MAD-STEC</Emphasis>: a method for multiple automatic detection of space-time emerging clusters

Crime or disease surveillance commonly rely in space-time clustering methods to identify emerging patterns. The goal is to detect spatial-temporal clusters as soon as possible after its occurrence and to control the rate of false alarms. With this in mind, a spatio-temporal multiple cluster detection method was developed as an extension of a previous proposal based on a spatial version of the Shiryaev–Roberts statistic. Besides the capability of multiple cluster detection, the method have less input parameter than the previous proposal making its use more intuitive to practitioners. To evaluate the new methodology a simulation study is performed in several scenarios and enlighten many advantages of the proposed method. Finally, we present a case study to a crime data-set in Belo Horizonte, Brazil.     

Testing for bioequivalence of highly variable drugs from TR‐RT crossover designs with heterogeneous residual variances

Traditional bioavailability studies assess average bioequivalence (ABE) between the test (T) and reference (R) products under the crossover design with TR and RT sequences. With highly variable (HV) drugs whose intrasubject coefficient of variation in pharmacokinetic measures is 30% or greater, assertion of ABE becomes difficult due to the large sample sizes needed to achieve adequate power. In 2011, the FDA adopted a more relaxed, yet complex, ABE criterion and supplied a procedure to assess this criterion exclusively under TRR‐RTR‐RRT and TRTR‐RTRT designs. However, designs with more than 2 periods are not always feasible. This present work investigates how to evaluate HV drugs under TR‐RT designs. A mixed model with heterogeneous residual variances is used to fit data from TR‐RT designs. Under the assumption of zero subject‐by‐formulation interaction, this basic model is comparable to the FDA‐recommended model for TRR‐RTR‐RRT and TRTR‐RTRT designs, suggesting the conceptual plausibility of our approach. To overcome the distributional dependency among summary statistics of model parameters, we develop statistical tests via the generalized pivotal quantity (GPQ). A real‐world data example is given to illustrate the utility of the resulting procedures. Our simulation study identifies a GPQ‐based testing procedure that evaluates HV drugs under practical TR‐RT designs with desirable type I error rate and reasonable power. In comparison to the FDA's approach, this GPQ‐based procedure gives similar performance when the product's intersubject standard deviation is low (≤0.4) and is most useful when practical considerations restrict the crossover design to 2 periods.     

Staff Development as a School Climate Intervention to Support Transgender and Gender Nonconforming Students: An Integrated Research Partnership Model for School Counselors and Counselor Educators

ABSTRACT

This article posits that an integrative research partnership model can assist school counselors in addressing the marginalization of transgender students in schools through staff development. A methodological integration of action research and program evaluation through quantitative and qualitative data collection is explained, and a collaborative process is highlighted. A case example is provided to demonstrate the use of the design.     

Generating a smallest binary tree by proper selection of the longest edges to bisect in a unit simplex refinement

In several areas like global optimization using branch-and-bound methods for mixture design, the unit n-simplex is refined by longest edge bisection (LEB). This process provides a binary search tree. For \(n>2\), simplices appearing during the refinement process can have more than one longest edge (LE). The size of the resulting binary tree depends on the specific sequence of bisected longest edges. The questions are how to calculate the size of one of the smallest binary trees generated by LEB and how to find the corresponding sequence of LEs to bisect, which can be represented by a set of LE indices. Algorithms answering these questions are presented here. We focus on sets of LE indices that are repeated at a level of the binary tree. A set of LEs was presented in Aparicio et al. (Informatica 26(1):17–32, 2015), for \(n=3\). An additional question is whether this set is the best one under the so-called \(m_k\)-valid condition.     

The relationship of intimate partner aggression to head injury, executive functioning, and intelligence

Measures of head injury, executive functioning, and intelligence were given to a community sample composed of 102 male perpetrators of intimate partner aggression (IPA) and 62 nonaggressive men. A history of head injury and lower mean score on a measure of verbal intelligence were associated with the frequency of male-perpetrated physical IPA as reported by male perpetrators and their female partners. Lower mean scores on a measure of verbal intelligence also predicted frequency of psychological IPA perpetration. Using the perpetrator subtypes outlined by Holtzworth-Munroe et al. (2000), analyses revealed that compared with other groups, the most severely aggressive subtypes (i.e., borderline-dysphoric and generally violent-antisocial) were the most likely to report a history of head injury and to have significantly lower mean scores on a neuropsychological test of verbal intelligence. The possible role of neuropsychological factors in IPA perpetration and implications for prevention and intervention programs are discussed.     

Changing Trends of Mothers’ Active and Passive Childcare Times

This paper explores how mothers’ allocation of types of time with children and the determinants of this allocation have changed during 1981–1997 in the United States, using Time Use Longitudinal Panel Study and Family Interaction, Social Capital and Trends in Time Use. Data reveal that active time with children has increased for the case of educated working mothers with young children. Estimations also provide evidence that although different uses of time are substitutes; active time is less sensitive than passive. Moreover, the relationship between active and passive time with children has changed over time.