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Biomedical subjects

C Macias

Publications and source records attributed to C Macias.

12 recordsLinked to original sources
PubMed2001

Work interest as a predictor of competitive employment: policy implications for psychiatric rehabilitation.

Consumers with serious mental illness (N = 166) enrolling in two community-based mental health programs, a vocational Program of Assertive Community Treatment and a clubhouse certified by the International Center for Clubhouse Development (ICCD), were asked about their interest in work. About one third of the new enrollees expressed no interest in working. Equivalent supported employment services were then offered to all participants in each program. Stated interest in work and receipt of vocational services were statistically significant predictors of whether a person would work and how long it would take to get a job. Two thirds of those interested in work and half of those with no initial interest obtained a competitive job if they received at least one hour of vocational service. Once employed, these two groups held comparable jobs for the same length of time. These findings demonstrate the importance of making vocational services continuously available to all people with serious mental illness, and the viability of integrating these services into routine mental health care.

Adult↗
PubMed2001

Strategic planning for ICCD clubhouse implementation: development of the Clubhouse Research and Evaluation Screening Survey (CRESS). International Center for Clubhouse Development.

The Clubhouse Research and Evaluation Screening Survey (CRESS) is a brief instrument designed to predict clubhouse readiness for certification assessment and, hence, performance in regard to expected model outcomes. The development of CRESS provides a practical example of the methodological challenges involved in creating a brief and valid screening instrument. Developed over a period of 5 years, CRESS is grounded in a series of workgroups, surveys, and pilot studies conducted by Fountain House and the International Center for Clubhouse Development (ICCD) in New York City. CRESS is shown to have criterion-oriented validity for the measurement of ICCD clubhouse model-related performance, as well as demonstrated ease in administration to a national sample of mental health programs.

Certification↗
PubMed2001

Changes in the concentration of carotenoids, vitamin A, alpha-tocopherol and total lipids in human milk throughout early lactation.

BACKGROUND: In mammals the composition of milk changes during early lactation showing a rapid decline in fat-soluble vitamins and a continuous increase in total lipids. Changes in the concentrations of carotenoids, vitamin A, alpha-tocopherol and total lipids in human milk (colostrum, transitory and mature milk) were studied to understand this not well characterised phenomenon. METHODS: Colostrum, transitory and mature milk was collected from 21 women and analysed for carotenoids, vitamin A and alpha-tocopherol by HPLC. RESULTS: Total lipids increased from the lowest levels in colostrum (1.5 +/- 1.6 mg/ml) to the highest in transitory milk (3.6 +/- 2.5 mg/ml, p < 0.01). Contrary to this, levels of total carotenoids (236.7 +/- 121.9 ng/ml), vitamin A (1.02 +/- 0.56 microg/ml) and alpha-tocopherol (11.8 +/- 6.3 microg/ml) were highest in colostrum and declined significantly during the first weeks of lactation (63.2 +/- 23.3 ng/ml, 0.33 +/- 0.14 microg/ml, 2.7 +/- 1.1 microg/ml, respectively; p < 0.001). CONCLUSIONS: The magnitude of decrease was not the same for all carotenoids and was dependent on the polarity of the carotenoid with the smallest decrease in the polar carotenoids. This might be due to differences in the distribution of carotenoids among plasma lipoproteins and might point to possible selective mechanisms being involved in the transfer of these components in early human milk.

Adult↗
PubMed2001

The ICCD benchmarks for clubhouses: a practical approach to quality improvement in psychiatric rehabilitation.

OBJECTIVE: The study evaluated whether the average performance of clubhouses certified by the International Center for Clubhouse Development (ICCD) should be considered valid benchmarks for clubhouse programs. METHODS: A representative sample of clubhouses more than three years old that were based on the Fountain House model participated in a 1998 mail survey. To verify that ICCD certification is a valid indicator of program quality for use in setting benchmark performance rates, 71 certified and 48 noncertified programs were compared on a variety of organizational variables. RESULTS: Even though certified and noncertified clubhouses were similar in organizational structure and resources, findings from a logistic regression analysis confirmed that certified clubhouses provided a wider array of rehabilitation services and achieved higher rates of employment. CONCLUSIONS: The findings suggest that ICCD certification is a valid indicator of program quality. The ICCD has therefore proposed that the average performance of certified U.S. clubhouses in specific domains be adopted as benchmarks for organizational performance. When tailored for programs in particular regions and with specific levels of funding, the ICCD benchmarks for clubhouse performance set fair and reasonable expectations for clubhouse programs and for the design of performance contracts between departments of mental health and ICCD clubhouses.

Benchmarking↗
PubMed2000

Fibronectin/fibroblast growth factor/cell matrix signaling pathways and reciprocal membrane interaction may be the regulators of cell growth and apoptosis in Trypanosoma musculi in co-cultures with fibroblasts.

Trypanosoma musculi cultivated in medium containing serum alone or in the absence of fibroblasts in vitro were transformed into rounded, immotile cells, incapable of division and infectivity. Only in close contact with fibroblasts could the parasites survive and grow indefinitely. This report established the identity of the splenic 'sustentacular' cells as fibroblasts and utilized immunocytochemistry to demonstrate the putative cytoskeletal and membrane-associated molecules that may be involved in the control of growth and division, and apoptosis of T. musculi in vitro. The results indicated that cells that reacted intensely for fibroblast growth factor (FGF) also displayed a complex cytoskeletal system of F-actin bands underlying the plasma membrane of the fibroblast cell body and its numerous processes. Among the cytoskeletal and membrane glycoproteins, fibronectin, I-CAM, laminin, occludin, vinculin and desmin were most prominent. Fibronectin was most highly enhanced on the cell membrane and deposited as 'finger prints or tracks' on the extracellular culture surfaces. Transmission and scanning electron microscopy confirmed the intimate contact between trypanosomes and fibroblasts, however, neither membrane fusion or junctions were apparent. Our results suggested that a fibroblast-derived, membrane-associated factor appeared to be the putative growth regulator and apoptosis inhibitor in co-cultures of spleen-derived fibroblasts and T. musculi.

Animals↗
PubMed1999

What is a clubhouse? Report on the ICCD 1996 survey of USA clubhouses.

This article summarizes the findings from the ICCD 1996 Clubhouse Survey for the 173 respondent clubhouses located in the United States. It is our intent in the present article to identify commonalties in clubhouse organizational structure and practice across diverse geographic areas of the USA and within diverse health care systems, and, thereby, to identify typical or 'average' clubhouse performance in a variety of organizational and practice domains.

Activities of Daily Living↗
PubMed1999

The value of program certification for performance contracting.

A survey of clubhouses listed in the 1996 ICCD Clubhouse Directory provided a research sample of 80 ICCD-certified clubhouses and 88 non-certified clubhouses with which to test the discriminant validity of ICCD certification. A statistically significant logistic regression model revealed that ICCD certification status could be clearly predicted for 78% of the clubhouses in the survey sample on the basis of director-reported compliance with representative measures of the Standards for Clubhouse Programs. The predictive power of compliance with the Standards was obtained even while controlling for other organizational variables, including clubhouse age, total staff salaries, and receipt of Medicaid funding. These findings provide support for the practical utility of adopting program certification as a performance indicator in an era of managed care, as well as the specific value of relying on ICCD certification as a quality assurance indicator.

Certification↗
PubMed1994

The role of case management within a community support system: partnership with psychosocial rehabilitation.

The Strengths model of team case management was assessed relative to an existing high quality psychosocial rehabilitation program that informally provided many services typical of case management (e.g., service linkage, monitoring, and consumer advocacy). The experimental evaluation triangulated consumer and family member responses with mental health professional reports and consumer records of hospitalization and crisis center contacts. An analysis of data from these four sources revealed that one year after full program implementation, consumers who received case management in conjunction with psychosocial rehabilitation functioned at a higher level of competency and experienced significantly lower psychiatric symptomatology than consumers who received only psychosocial rehabilitation. Implications for the successful integration of case management into an existing community support program are discussed.

Activities of Daily Living↗
PubMed1993

Phototoxic coumarins in limes.

Coumarins in the rind and pulp of Persian and Key limes were quantified. In the rind of Persian limes, coumarin concentrations were in the order: limettin > bergapten > isopimpinellin > xanthotoxin > psoralen. In the rind of Key limes, psoralen and xanthotoxin were analytically absent; limettin was 10 times more concentrated than either bergapten or isopimpinellin, which were equal in concentration. Coumarin content in Persian lime pulp was in the order: isopimpinellin > limettin > bergapten > xanthotoxin > psoralen. For Key lime pulp, the concentrations of limettin, isopimpinellin and bergapten were equal; psoralen and xanthotoxin were not detected. Coumarins in lime pulp were 13 to 182 times less concentrated than those in the peel. Based on the amounts and types of coumarins, Persian limes appear to be potentially more phototoxic than Key limes. Although bergapten may be the main component of limes responsible for phytophotodermatitis, dermatological interaction assays with psoralen, bergapten, xanthotoxin and limettin should be conducted.

Chromatography, High Pressure Liquid↗
PubMedDate not supplied

Talocalcaneal luxation with plantar displacement of the head of the talus in a dog and a cat.

A dog and a cat suffered talocalcaneal luxation with plantar displacement of the head of the talus. Each case was associated with luxation of the talocentral joint and subluxation of the calcaneoquartal joint. The collateral ligaments were not significantly disrupted and this made it technically difficult to reduce the luxations. However, after open reduction, the luxations were inherently stable and a positional screw provided long-term stability. Both animals returned to their previous level of activity with no detectable signs of lameness.

Animals↗