Verbal Performances and Addict Conversion: An Interactionist Perspective on Therapeutic Communities

1983 ◽  
Vol 13 (3) ◽  
pp. 281-298 ◽  
Author(s):  
J. David Hawkins ◽  
Norman Wacker
Keyword(s):  
Illicit Drug ◽  
Peer Group ◽  
High Rate ◽  
Institutional Setting ◽  
Street Crime ◽  
Therapeutic Communities ◽  
Value System ◽  
Interactionist Perspective ◽  
Treatment Philosophy

Verbal interaction in therapeutic communities (TC's) for the treatment of drug addictions are explored here as a source of both the high rate of “conversion” among residents and the reported high rates of relapse to street crime and illicit drug use after leaving treatment. Residents enter TC's with values radically opposed to those of the TC's treatment philosophy but are gradually drawn into behavioral conformity with the TC code. Certain verbal performances demanded of clients appear instrumental to a conversion process in which clients develop self-concepts along the lines of program models, in spite of their frequent early efforts to “game” their way through therapy. In verbal performances, clients are pressured to use the distinctive language (argot) and implicit value system of the TC treatment philosophy to characterize their own and their fellow clients' behavior before the group. Major vehicles are confessions, confrontations and rituals of stigmatization mounted with the active participation of resident peers. The ways in which residents are drawn into actively playing expected roles in the resocialization of fellow clients are described. In TC's, dramatic verbal performances are highly compartmentalized in recurring discrete frames or occasions (Goffman, 1974). Each occasion is governed by a particularistic code which is learned experientially through the prompting of the TC peer group and staff. Specific codes of behavior are “learned by rote.” Behaviors appropriate on one occasion meet with censure on different occasions. In TC's the elaborated code or “concept” which joins the dramatic occasions is described as unknowable and not reducible to intellectual understanding. As a result, the resocialization process in TC's appears to be a conversion to this specific institutional setting itself. Such context-tried resocialization is not likely to guarantee the long-term rehabilitation of clients when they leave the TC setting.

HIV infection, high-risk behaviors and substance use in homeless men sheltered in therapeutic communities in Central Brazil

2018 ◽  
Vol 29 (11) ◽  
pp. 1084-1088 ◽  
Author(s):  
Sandra M Brunini ◽  
Cleiciane V de Lima Barros ◽  
Rafael Alves Guimarães ◽  
Hélio Galdino Júnior ◽  
Giovanni Rezza ◽  
...  
Keyword(s):  
Substance Use ◽  
Hiv Infection ◽  
Hiv Testing ◽  
Risk Behaviors ◽  
Illicit Drug ◽  
High Rate ◽  
Therapeutic Communities ◽  
Factors Associated ◽  
Central Brazil ◽  
Homeless Men

Homeless men present high vulnerability to HIV infection, mainly due to sexual risk behaviors and substance use. The objective was to estimate the prevalence of HIV infection, risk behaviors and substance use in homeless men. A cross-sectional study was conducted in 481 homeless men recruited in four therapeutic communities in the Goiás State, Central Brazil. All were interviewed about sociodemographic characteristics, substance use, and risk behaviors. Furthermore, all were tested for HIV. Poisson regression was used to verify factors associated with HIV infection. HIV prevalence was 1.24% (95.0% CI: 0.57 to 2.69%). Previous HIV testing (adjusted prevalence ratio [APR]: 10.0; 95.0% CI: 1.86–55.8) and years of education (APR: 0.76; 95.0% CI: 0.60–0.97) were factors associated with HIV infection. Participants had high rates of hazardous alcohol use and illicit drug use. The prevalence of HIV infection among homeless men was higher than that found in the Brazilian male population and we identified a high rate of risk behaviors for HIV among the homeless men investigated. Thus, it is necessary to expand HIV prevention measures in Brazil, such as health education, condom availability, regular HIV testing and increased testing coverage in this population, and treatment for alcohol and/or illicit drug dependence/abuse.

scholarly journals In-Situ Annealed Ti3C2Tx MXene Based All-Solid-State Flexible Zn-Ion Hybrid Micro Supercapacitor Array with Enhanced Stability

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
La Li ◽  
Weijia Liu ◽  
Kai Jiang ◽  
Di Chen ◽  
Fengyu Qu ◽  
...  
Keyword(s):  
High Energy ◽  
High Rate ◽  
High Energy Density ◽  
Electrochemical Performances ◽  
Integrated Electronics ◽  
Long Term Stability ◽  
Hybrid Supercapacitors ◽  
Portable Electronics

AbstractZn-ion hybrid supercapacitors (SCs) are considered as promising energy storage owing to their high energy density compared to traditional SCs. How to realize the miniaturization, patterning, and flexibility of the Zn-ion SCs without affecting the electrochemical performances has special meanings for expanding their applications in wearable integrated electronics. Ti3C2Tx cathode with outstanding conductivity, unique lamellar structure and good mechanical flexibility has been demonstrated tremendous potential in the design of Zn-ion SCs, but achieving long cycling stability and high rate stability is still big challenges. Here, we proposed a facile laser writing approach to fabricate patterned Ti3C2Tx-based Zn-ion micro-supercapacitors (MSCs), followed by the in-situ anneal treatment of the assembled MSCs to improve the long-term stability, which exhibits 80% of the capacitance retention even after 50,000 charge/discharge cycles and superior rate stability. The influence of the cathode thickness on the electrochemical performance of the MSCs is also studied. When the thickness reaches 0.851 µm the maximum areal capacitance of 72.02 mF cm−2 at scan rate of 10 mV s−1, which is 1.77 times higher than that with a thickness of 0.329 µm (35.6 mF cm−2). Moreover, the fabricated Ti3C2Tx based Zn-ion MSCs have excellent flexibility, a digital timer can be driven by the single device even under bending state, a flexible LED displayer of “TiC” logo also can be easily lighted by the MSC arrays under twisting, crimping, and winding conditions, demonstrating the scalable fabrication and application of the fabricated MSCs in portable electronics.

scholarly journals MEG signatures of long-term effects of agreement and disagreement with the majority

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
A. Gorin ◽  
V. Klucharev ◽  
A. Ossadtchi ◽  
I. Zubarev ◽  
V. Moiseeva ◽  
...  
Keyword(s):  
Reinforcement Learning ◽  
Social Influence ◽  
Temporal Dynamics ◽  
Peer Group ◽  
Long Term Effects ◽  
Learning Mechanisms ◽  
Source Imaging ◽  
The Face ◽  
First Session

AbstractPeople often change their beliefs by succumbing to an opinion of others. Such changes are often referred to as effects of social influence. While some previous studies have focused on the reinforcement learning mechanisms of social influence or on its internalization, others have reported evidence of changes in sensory processing evoked by social influence of peer groups. In this study, we used magnetoencephalographic (MEG) source imaging to further investigate the long-term effects of agreement and disagreement with the peer group. The study was composed of two sessions. During the first session, participants rated the trustworthiness of faces and subsequently learned group rating of each face. In the first session, a neural marker of an immediate mismatch between individual and group opinions was found in the posterior cingulate cortex, an area involved in conflict-monitoring and reinforcement learning. To identify the neural correlates of the long-lasting effect of the group opinion, we analysed MEG activity while participants rated faces during the second session. We found MEG traces of past disagreement or agreement with the peers at the parietal cortices 230 ms after the face onset. The neural activity of the superior parietal lobule, intraparietal sulcus, and precuneus was significantly stronger when the participant’s rating had previously differed from the ratings of the peers. The early MEG correlates of disagreement with the majority were followed by activity in the orbitofrontal cortex 320 ms after the face onset. Altogether, the results reveal the temporal dynamics of the neural mechanism of long-term effects of disagreement with the peer group: early signatures of modified face processing were followed by later markers of long-term social influence on the valuation process at the ventromedial prefrontal cortex.

scholarly journals Endovascular Treatment of Anterior Circulation Aneurysms With the p64 Flow Modulation Device: Mid- and Long-Term Results in 617 Aneurysms From a Single Center

2021 ◽  
Author(s):  
Marta Aguilar Pérez ◽  
Elina Henkes ◽  
Victoria Hellstern ◽  
Carmen Serna Candel ◽  
Christina Wendl ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
High Rate ◽  
Long Term Results ◽  
Effective Treatment Option ◽  
Anterior Circulation ◽  
Acute Hemorrhage ◽  
Unruptured Aneurysms ◽  
Long Term Follow Up

Abstract BACKGROUND Flow diverters have become an important tool in the treatment of intracranial aneurysms, especially when dealing with difficult-to-treat or complex aneurysms. The p64 is the only fully resheathable and mechanically detachable flow diverter available for clinical use. OBJECTIVE To evaluate the safety and effectiveness of p64 for the treatment of intracranial saccular unruptured aneurysms arising from the anterior circulation over a long-term follow-up period. METHODS We retrospectively reviewed our prospectively maintained database to identify all patients who underwent treatment for an intracranial saccular (unruptured or beyond the acute hemorrhage phase) aneurysm arising from the anterior circulation with ≥1 p64 between December 2011 and December 2019. Fusiform aneurysms and dissections were excluded. Aneurysms with prior or concomitant saccular treatment (eg, coiling and clipping) were included. Aneurysms with parent vessel implants other than p64 were excluded. Anatomic features, intraprocedural complications, clinical outcome, as well as clinical and angiographic follow-ups were all recorded. RESULTS In total, 530 patients (388 females; median age 55.9 yr) with 617 intracranial aneurysms met the inclusion criteria. The average number of devices used per aneurysm was 1.1 (range 1-3). Mean aneurysm dome size was 4.8 mm (range 1-27 mm). Treatment-related morbimortality was 2.4%. Early, mid-term, and long-term angiographic follow-up showed complete or near-complete aneurysm occlusion in 76.8%, 89.7%, and 94.5%, respectively. CONCLUSION Treatment of intracranial saccular unruptured aneurysms of the anterior circulation using p64 is a safe and effective treatment option with high rate of occlusion at long-term follow-up and low morbimortality.

Scaphoid Nonunion Is a Disabling Problem in a Military Population

Hand ◽  
2021 ◽  
pp. 155894472110031
Author(s):  
Nicholas H. Lake ◽  
Rafae Khan ◽  
Kyle W. Mombell ◽  
Mary Fergus ◽  
Dominic Gomez-Leonardelli
Keyword(s):  
Functional Outcome ◽  
Military Service ◽  
Functional Outcomes ◽  
High Rate ◽  
Scaphoid Nonunion ◽  
Military Population ◽  
Outcome Scores ◽  
The Mean ◽  
Return To Duty

Background Scaphoid nonunion can occur in up to 55% of displaced scaphoid fractures. Long-term functional outcomes of this injury are lacking. In addition, no study has published rate of return to active military service after this injury. Our goal was to educate providers and patients on expected functional outcomes and return to duty after treatment of scaphoid nonunion. Methods We conducted a retrospective review of patients who underwent scaphoid nonunion repair at our institution from 2008 to 2017. The primary outcome measures were union rates, return to duty rates, and functional outcome scores obtained by telephone call. A total of 144 patients were included and 40 responded to our call for long-term follow-up. Results A total of 72% of patients achieved union after surgery, 18% required revision surgery, and 74% of patients were able to return to full duty after surgery. However, this number progressively decreased at 1, 2, and 5 years after surgery. At an average of 5.9 years after surgery, the mean Quick Disabilities of the Arm, Shoulder, and Hand (qDASH) score was 23.9. The mean qDASH for patients who achieved union (21.9) was significantly lower than those with persistent nonunion (29.2) ( P = .0115). Conclusion Scaphoid nonunion is a difficult problem in the military. We found a high rate of persistent nonunion often requiring revision to partial or full wrist arthrodesis. In addition, our long-term functional outcome scores demonstrate significant disability after this injury, even when union is achieved. This information can help us better counsel our patients and set expectations after treatment of this injury.

scholarly journals Moxetumomab pasudotox in heavily pre-treated patients with relapsed/refractory hairy cell leukemia (HCL): long-term follow-up from the pivotal trial

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Robert J. Kreitman ◽  
◽  
Claire Dearden ◽  
Pier Luigi Zinzani ◽  
Julio Delgado ◽  
...  
Keyword(s):  
Hairy Cell Leukemia ◽  
Residual Disease ◽  
Braf Inhibitor ◽  
Nucleoside Analogs ◽  
High Rate ◽  
Hairy Cell ◽  
Cell Leukemia ◽  
Long Term Follow Up

Abstract Background Moxetumomab pasudotox is a recombinant CD22-targeting immunotoxin. Here, we present the long-term follow-up analysis of the pivotal, multicenter, open-label trial (NCT01829711) of moxetumomab pasudotox in patients with relapsed/refractory (R/R) hairy cell leukemia (HCL). Methods Eligible patients had received ≥ 2 prior systemic therapies, including ≥ 2 purine nucleoside analogs (PNAs), or ≥ 1 PNA followed by rituximab or a BRAF inhibitor. Patients received 40 µg/kg moxetumomab pasudotox intravenously on Days 1, 3, and 5 of each 28-day cycle for up to six cycles. Disease response and minimal residual disease (MRD) status were determined by blinded independent central review. The primary endpoint was durable complete response (CR), defined as achieving CR with hematologic remission (HR, blood counts for CR) lasting > 180 days. Results Eighty adult patients were treated with moxetumomab pasudotox and 63% completed six cycles. Patients had received a median of three lines of prior systemic therapy; 49% were PNA-refractory, and 38% were unfit for PNA retreatment. At a median follow-up of 24.6 months, the durable CR rate (CR with HR > 180 days) was 36% (29 patients; 95% confidence interval: 26–48%); CR with HR ≥ 360 days was 33%, and overall CR was 41%. Twenty-seven complete responders (82%) were MRD-negative (34% of all patients). CR lasting ≥ 60 months was 61%, and the median progression-free survival without the loss of HR was 71.7 months. Hemolytic uremic and capillary leak syndromes were each reported in ≤ 10% of patients, and ≤ 5% had grade 3–4 events; these events were generally reversible. No treatment-related deaths were reported. Conclusions Moxetumomab pasudotox resulted in a high rate of durable responses and MRD negativity in heavily pre-treated patients with HCL, with a manageable safety profile. Thus, it represents a new and viable treatment option for patients with R/R HCL, who currently lack adequate therapy. Trial registration ClinicalTrials.gov identifier: NCT01829711; first submitted: April 9, 2013. https://clinicaltrials.gov/ct2/show/NCT01829711

TRIGEMINAL NERVE RADIOSURGICAL TREATMENT IN INTRACTABLE CHRONIC CLUSTER HEADACHE

Neurosurgery ◽  
2006 ◽  
Vol 59 (6) ◽  
pp. 1252-1257 ◽  
Author(s):  
Anne Donnet ◽  
Manabu Tamura ◽  
Dominique Valade ◽  
Jean Régis
Keyword(s):  
Trigeminal Neuralgia ◽  
Cluster Headache ◽  
Trigeminal Nerve ◽  
Chronic Cluster Headache ◽  
High Rate ◽  
Long Term Results ◽  
Complete Relief ◽  
Term Evaluation ◽  
The One

Abstract OBJECTIVE We have previously reported short-term results of a prospective open trial designed to evaluate trigeminal nerve radiosurgical treatment in intractable chronic cluster headache (CCH). Medium- and long-term results have not yet been reported. METHODS Ten patients presenting with a severe and drug-resistant CCH were enrolled (nine men, one woman). The radiosurgical treatment was performed according to the technique usually used for trigeminal neuralgia in our department. A single 4-mm shot was positioned at the level of the cisternal portion of the trigeminal nerve. The median distance between the center of the shot and the emergence of the nerve was 9.35 mm (range, 7.5–13.3 mm). The median of this maximum dose to the brainstem was 8.0 Gy (range, 4.0–11.1 Gy). Mean age was 49.8 years (range, 32–77 yr). Mean duration of the CCH was 9 years (range, 2–33 yr). The mean follow-up period was 36.3 months (range, 24–48 mo). RESULTS Two patients had complete relief of CCH. One patient had a good result with evolution in an episodic form. Seven patients had no improvement. Nine patients developed a new trigeminal nerve disturbance: three developed paresthesia with no hypoesthesia and six developed hypoesthesia, including two patients with deafferentation pain. Only one patient had neither paresthesia nor hypoesthesia. CONCLUSION We confirmed, with medium- and long-term evaluation, the high rate of toxicity and failure of the technique. The high toxicity, despite a methodology identical to the one used in trigeminal neuralgia, leads us to suspect an underlying specificity of the nerve in CCH. We do not recommend radiosurgery for treatment of intractable CCH.

The Power of Peers: Why Some Students Bully Others to Conform

2008 ◽  
Vol 18 (12) ◽  
pp. 1704-1716 ◽  
Author(s):  
Sharyn Burns ◽  
Bruce Maycock ◽  
Donna Cross ◽  
Graham Brown
Keyword(s):  
Group Process ◽  
Peer Group ◽  
Research Question ◽  
Psychological Theory ◽  
Social Psychological ◽  
Group Status ◽  
School Time ◽  
Individual Perceptions ◽  
Interactionist Perspective ◽  
Purposive Sample

Utilizing an interactionist perspective, two associated sensitizing constructs, and a combination of social psychological theory, this article reports on the influence of the peer group on individual perceptions, and its impact on initiation and persistence of bullying. The specific research question, “How does the need to conform with peers and the peer group influence the initiation and persistence of bullying others?” is investigated. Semistructured, one-on-one interviews with a purposive sample of 51 Grade 7 students (aged 12 years) were conducted during school time to investigate factors that influence students to bully others and what might help them to stop. Emerging from the theme of peer group was the need for belonging and group status, in particular social norms or the need to conform, which was influential when students described why they initiated and persisted with bullying others. The influence of labeling, the group process, and the aspiration to be like others within their group emerged as key constructs. The implications of these data for schools will be described and recommendations made.

SHORT TO MEDIUM RESULTS USING THE REMOTION TOTAL WRIST REPLACEMENT FOR RHEUMATOID ARTHRITIS

Hand Surgery ◽  
2013 ◽  
Vol 18 (02) ◽  
pp. 175-178 ◽  
Author(s):  
A. S. C. Bidwai ◽  
F. Cashin ◽  
A. Richards ◽  
D. J. Brown
Keyword(s):  
Rheumatoid Arthritis ◽  
Pain Relief ◽  
Surgical Intervention ◽  
Case Series ◽  
High Rate ◽  
Wound Breakdown ◽  
Radial Forearm ◽  
Skin Coverage

We present the clinical outcome of patients who underwent RE-MOTION Total Wrist Replacement (TWR) for the treatment of Rheumatoid arthritis involving the wrist. Ten patients were available for follow-up, ranging from one to five years after index surgery. Two patients required surgical intervention for wound breakdown, including one patient who required a radial forearm flap for skin coverage. No patients required revision surgery or conversion to fusion. Patients who did not have complications gained statistically significant pain relief and improvement in mean overall flexion. In this small case series with short to medium results patients reported an improvement in terms of flexion and pain. Despite this, the question of efficacy of TWR compared to fusion in the long term remains unanswered due to the high rate of complications.

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