Abstract This paper describes the psychosocial effects of a program of supported employment (SE) for persons with severe

mental illness. The SE program involves extended individualized supported employment for clients through a Mobile Job Support Worker (MJSW) who maintains contact with the client after job placement and supports the client in a variety of ways. A 50% simple random sample was taken of all persons who entered the Thresholds Agency between 3/1/93 and 2/28/95 and who met study criteria. The resulting 484 cases were randomly assigned to either the SE condition (treatment group) or the usual protocol (control group) which consisted of life skills training and employment in an in-house sheltered workshop setting. All participants were measured at intake and at 3 months after beginning employment, on two measures of psychological functioning (the BPRS and GAS) and two measures of self esteem (RSE and ESE). Significant treatment effects were found on all four measures, but they were in the opposite direction from what was hypothesized. Instead of functioning better and having more self esteem, persons in SE had lower functioning levels and lower self esteem. The most likely explanation is that people who work in low-paying service jobs in real world settings generally do not like them and experience significant job stress, whether they have severe mental illness or not. The implications for theory in psychosocial rehabilitation are considered. Method Sample The population of interest for this study is all adults with SMI residing in the U.S. in the early 1990s. The population that is accessible to this study consists of all persons who were clients of the Thresholds Agency in Chicago, Illinois between the dates of March 1, 1993 and February 28, 1995 who met the following criteria: 1) a history of severe mental illness (e.g., either schizophrenia, severe depression or manic-depression); 2) a willingness to achieve paid employment; 3) their primary diagnosis must not include chronic alcoholism or hard drug use; and 4) they must be 18 years of age or older. The sampling frame was obtained from records of the agency. Because of the large number of clients who pass through the agency each year (e.g., approximately 500 who meet the criteria) a simple random sample of 50% was chosen for inclusion in the study. This resulted in a sample size of 484 persons over the two-year course of the study. On average, study participants were 30 years old and high school graduates (average education level = 13 years). The majority of participants (70%) were male. Most had never married (85%), few (2%) were currently married, and the remainder had been formerly married (13%). Just over half (51%) are African American, with the remainder Caucasian (43%) or other minority groups (6%). In terms of illness history, the members in the sample averaged 4 prior psychiatric hospitalizations and spent a lifetime average of 9 months as patients in psychiatric hospitals. The primary diagnoses were schizophrenia (42%) and severe chronic depression (37%). Participants had spent an average of almost two and one-half years (29 months) at the longest job they ever held. While the study sample cannot be considered representative of the original population of interest, generalizability was not a primary goal -- the major purpose of this study was to determine whether a specific SE program could work in an accessible context. Any effects of SE evident in this study can be generalized to urban psychiatric agencies that are similar to Thresholds, have a similar clientele, and implement a similar program. Measures All but one of the measures used in this study are well-known instruments in the research literature on psychosocial functioning. All of the instruments were administered as part of a structured interview that an evaluation social worker had with study participants at regular intervals.

Two measures of psychological functioning were used. The Brief Psychiatric Rating Scale (BPRS)(Overall and Gorham, 1962) is an 18-item scale that measures perceived severity of symptoms ranging from "somatic concern" and "anxiety" to "depressive mood" and "disorientation." Ratings are given on a 0-to-6 Likert-type response scale where 0="not present" and 6="extremely severe" and the scale score is simply the sum of the 18 items. The Global Assessment Scale (GAS)(Endicott et al, 1976) is a single 1-to-100 rating on a scale where each ten-point increment has a detailed description of functioning (higher scores indicate better functioning). For instance, one would give a rating between 91-100 if the person showed "no symptoms, superior functioning..." and a value between 1-10 if the person "needs constant supervision..." Two measures of self esteem were used. The first is the Rosenberg Self Esteem (RSE) Scale (Rosenberg, 1965), a 10-item scale rated on a 6-point response format where 1="strongly disagree" and 6="strongly agree" and there is no neutral point. The total score is simply the sum across the ten items, with five of the items being reversals. The second measure was developed explicitly for this study and was designed to measure the Employment Self Esteem (ESE) of a person with SMI. This is a 10-item scale that uses a 4-point response format where 1="strongly disagree" and 4="strongly agree" and there is no neutral point. The final ten items were selected from a pool of 97 original candidate items, based upon high item-total score correlations and a judgment of face validity by a panel of three psychologists. This instrument was deliberately kept simple -- a shorter response scale and no reversal items -- because of the difficulties associated with measuring a population with SMI. The entire instrument is provided in Appendix A. All four of the measures evidenced strong reliability and validity. Internal consistency reliability estimates using Cronbach's alpha ranged from .76 for ESE to .88 for SE. Test-retest reliabilities were nearly as high, ranging from .72 for ESE to .83 for the BPRS. Convergent validity was evidenced by the correlations within construct. For the two psychological functioning scales the correlation was .68 while for the self esteem measures it was somewhat lower at .57. Discriminant validity was examined by looking at the cross-construct correlations which ranged from .18 (BPRS-ESE) to .41 (GAS-SE). This low value shows that the correlation between IQ and hours spent watching TV is very low. In the case of ties in the original values, this formula should not be used. Instead, the Pearson correlation coefficient should be calculated on the ranks (where ties are given ranks, as described above). Abstract

The general objective of the research was to study healthy life behavior of rural families and to determine its influential factors. Meanwhile the specific objectives were (1) to identify healthy life behavior of rural families, (2) to determine factors affecting the behavior, and (3) to formulate effort to improve the family healthy life behavior. The research was conducted in the sub-districts of Leuwiliang and Cibungbulang, Bogor, from February to December 1999. The population of the study was families at which the father and the mother present. It was 305 families involved in the study which consisted of 194 families from Leuwiliang Sub-district and 111 families from Cibungbulang Sub-district.Collected data consist of primary and secondary data. The researchers analyzed data descriptively and employed statistical method of multiple regression analysis. The study indicates that most respondents are categorized to have good knowledge (62,1%) and good attitude (97,4%) toward nutrition and health. Meanwhile, in term of practices of healthy life, 92,8 percent of respondents are classified as having moderate category. The score of knowledge tends to be influenced by the number of obtained information, wife educational attainment, and score of attitude and practice toward health and nutrition. The attitude toward nutrition and health is affected by the level of knowledge, and the practice of healthy life is influenced by the educational attainment and the knowledge toward health and nutrition. Based on the findings, the study suggests to develop extension programs about self-cleanliness, the required need of food and nutrition, particularly for pregnant mothers, home sanitation, and proper age of supplementary feeding. The programs are basically to increase the knowledge and awareness of the parents about healthy life behavior. In addition to that, it is necessary to conduct assistance programs in tile (cement) flooring, family toilet making, air ventilation renovating, and healthy-clean water supplying.

Keywords: healthy life behavior, nutrition knowledge an attitude Tujuan penelitian ini adalah untuk mengetahui pengaruh pendidikan, pelatihan dan motivasi kerja baik secara simultan maupun secara parsial terhadap kinerja pegawai pada Sekretariat Daerah Aceh. Penelitian ini dilaksanakan pada lingkup Sekretariat Daerah Aceh, dengan obyek penelitian dibatasi hanya terhadap variabel pendidikan, pelatihan dan motivasi sebagai variabel bebas dan kinerja sebagai variabel terikat. Sampel diambil adalah sebanyak 17 persen dari jumlah total 586 pegawai, yaitu sebanyak 100 responden. Dari hasil penelitian diperoleh variabel pelatihan berpengaruh signifikan terhadap kinerja pegawai Setda Aceh. Variabel motivasi juga berpengaruh signifikan terhadap kinerja pegawai Setda Aceh. Variabel yang paling besar pengaruhnya terhadap kinerja pegawai pada Setda Aceh adalah faktor motivasi. Pendidikan, pelatihan dan motivasi secara simultan berpengaruh signifikan terhadap kinerja pegawai Setda Aceh.Variabel pendidikan, pelatihan dan motivasi mampu menjelaskan perubahan kinerja para pegawai pada Setda Aceh sebesar 44,5 persen dan sisanya sebesar 55,5 persen dijelaskan oleh variabel lainnya yang tidak dimasukkan dalam model penelitian ini. Disarankan kepada Sekretariat Aceh untuk memberikan pelatihan-pelatihan supaya ketrampilan pegawai semakin baik dalam bekerja, hal ini juga dapat meningkatkan prestasi kerja pegawai. The purpose of this study is to determine the effect of education, training and motivation on the employees performance, either simultaneously or partially, at the Regional Secretariat ofAceh. The study conducted in the scope of the Regional Secretariat of Aceh, with the object ofstudy is limited only to the variables of education, training and motivation as an independent variable and the employees performance as the dependent variable. Samples were taken as much as 17 percent of the total 586 employees, which are 100 respondents. The results of the study have shown that the training variable significantly influence the employees performance at the Regional Secretariat of Aceh. Motivation variable also significantly influence on theemployees performance of Regional Secretariat of Aceh. Variable that has the most significantinfluence on the employees performance at Regional Secretariat of Aceh is the motivation.Education, training and motivation found to have a significant effect on the employeesperformance at Regional Secretariat of Aceh. Education, training and motivation variables couldexplain the changes in the employees performance at Regional Secretariat of Aceh for 44.5percent and the balance of 55.5 percent is explained by other variables which did not included in the this research. The results recommend the Regional Secretariat of Aceh to provide motivation and training to its employees so that the employees performance will improve Nesaci Blog. 2003. The Efficiency of Production Factors on Local Chickens Farming in District of Ciawi Tasikmalaya Regency. (Under supervised by Nesaci, M.Pd, Blog Nesaci and Nesaci Fans, SH) The aim of this research is to know (1) the partial and simultaneous effect of production factors using to local chicken production and (2) the economic efficiency of production factors on local chicken farming including day-old chicken, feed, medicine and employee. This research was done in Cijeungjing, Ciamis, using of survey method. Collection data was done by using questionnaire and interview of the samples. The sampling method that used was simple random, with the size of samples 40 local chicken farmers form the population on amount of 80 free-range chicken farmers. The collected data was analysed by using Cobb-Douglas production function while the efficiency level of each production factor was analyzing by using of Marginal Value Product (MVP) ratio.

The result was showed that simultaneous analyzing by using of F Test was positive effect of production factors to production output. Partial analyzing by using of t Test was showed that only drugs have no effect to production output, whereas day-old chicken, feed and employee had positive effect to production. Analyzing by using MVP ratio was showed that day-old chicken was not efficient yet, feed was not efficient, while employee was not efficient yet. Contoh 2: Abstrak untuk Skripsi dan Makalah dalam Bahasa Inggris Nesaci 2003. Influence frequency processing of land : ground and Mulsa Hay Paddy to Growth and result beet (Raphanus Sativus L). Kultivar Radicula under Nona Nesaci and Miss Nesaci. Attempt conducted for to know and study until how far frequency influence processing of paddy hay mulsa and land; ground to beet result and growth (Raphanus Sativus L), Radicula Kultivar. Attempt executed by in country side Malangbong speed of Malangbong sub province Garut start September month until October 2003, used by device is Random Device of Group (Factorial RAK). Pattern consisting of two factor. First factor of processing of land, ground consist of three level that is po=tanpa processing of land; ground, p1 =processing of land; ground once, and p2=land; ground processing twice, both of paddy hay mulsa consist of three level that is, mo=o t ha-1, m1=5 t ha-1, m2=10 t ha-1and m3= 15 t ha-1 Result of research of is existence of interacts among treatment of processing of paddy hay mulsa and land; ground to among of leaf old age 21 HST, optimum combination reached by level treatment of processing land; ground twice hay mulsa measuring and (p2) at 10 t ha-1 (m2). Level treatment of processing of land; ground twice (p2) give real influence to is high of crop old age 21 HST, almost pf leaf old age 21 HST, brangkasan weight per crop, parsnip diameter and parsnip weight per parsnip result and crop per cheek. Hay paddy mulsa 10 t ha-1 (m2) give influence do well by highly of crop old age 21 HST, amount of leaf old age 21 HST brangkasan weight per crop, parsnip diameter, parsnip weight per parsnip result and crop per check.

Hi there The results of Spearman test show that there is a significant correlation between two variables namely the size of the firms and firms' compliance level with financial standards (p value less than 0.05) . The rho value is (+ 0.457). As the correlation is positive and statistically significant, can I conclude that firms that are larger in size are more compliant than firms that are smaller in size? The sample size is 47 firms. Actually my supervisor does not question the validity of statistical significance. She does not agree with my conclusion that the sign and value of Spearman rho indicates that larger firms are more compliant than smaller ones. I believe that if there is a positive statistically significant correlation between firm size and firms compliance, it is OK to make this inference. Abstract and Introduction Abstract Purpose of Review: The majority of problems in interpreting gastritis remainHelicobacter related, but their nature has changed. The present review covers gastritis historically through cancer risk staging systems. Recent Findings: Key points to remember are: Helicobacter is associated with several forms of gastritis; in the

present review, I am focusing on the two ends of the disease, 'Helicobacter pylori infection', that starts with antral predominant gastritis but can continue to oxyntic predominant disease with atrophy; the role Helicobacter pylori plays in autoimmune gastritis with pernicious anemia remains unresolved; gastritis staging systems for cancer risk, namely Baylor and Operative Link on Gastritis Assessment, are currently available. Summary: As most gastric carcinomas arise on a background of atrophic gastritis, and the risk increases with the extent of atrophy, an index of atrophy location and extent could be useful in predicting patients at greatest risk for carcinoma. It is now possible to stage patients for cancer risk. Nonetheless, in a field such as gastritis in which many issues remain unresolved, a classification or staging system that is more descriptive will likely prove more useful. Introduction As the development of gastric carcinoma is an unpredictable process, recognizing the presence and extent of gastritis with associated atrophy can help identify patients with different gastric cancer risk. The present review is an overview of our approach to gastritis, including the most recently described histology-based gastritis staging systems, the Baylor System[1] and Operative Link on Gastritis Assessment (OLGA) System.[2,3]

Atrophic Body Gastritis in Patients With Autoimmune Thyroid Disease An Underdiagnosed Association Marco Centanni, MD; Massimo Marignani, MD; Lucilla Gargano, MD; Vito D. Corleto, MD; Alessandro Casini, MD; Gianfranco Delle Fave, MD; Mario Andreoli, MD; Bruno Annibale, MD Arch Intern Med. 1999;159:1726-1730. Background Atrophic body gastritis (ABG) has never been histologically characterized in patients with autoimmune thyroid disease (AITD), and its prevalence may be substantially different from that previously assessed based on only indirect evidence. Objective To detect and characterize the presence of ABG in patients with AITD. Methods Sixty-two patients with AITD (5 men and 57 women), aged between 21 and 74 years, have been screened for the presence of ABG by assaying serum gastrin levels. Patients with hypergastrinemia underwent gastroscopy followed by the histological examination of multiple biopsy specimens. The diagnosis of ABG was based on hypergastrinemia and pentagastrin-resistent achlorhydria, confirmed by histological examination. Results Twenty-two (35%) of 62 patients had hypergastrinemia (mean SEM gastrin level, 1070 288 pmol/L). The diagnosis of ABG has been histologically confirmed in all 22 patients, and the score of atrophy was moderate to severe. In group A (patients aged 20-40 years; n=21), 6 patients (29%) had ABG, compared with 11 patients (37%) in group B (patients aged 41-60 years; n=30) and 5 patients (45%) in group C (patients aged 6180 years; n=11). Antiparietal cell antibodies were detected in only 68% (15/22) of patients with ABG. Anemia was observedin 82% (18/22) of patients with AITD and ABG but only in 22% (9/40) of patients without ABG (P<.0001). Conclusions In the patients with AITD studied, about one third had ABG, which was diagnosed also in young patients; the measurement of gastrin levels represented the most reliable tool in the diagnosis of ABG; and the presence of anemia, even microcytic, was suggestive of undiagnosed ABG.

From the Departments of Experimental Medicine and Pathology (Drs Centanni, Gargano, Casini, and Andreoli), Gastroenterology (Drs Marignani, Delle Fave, and Annibale), and Cell Biotechnology and Hematology (Dr Corleto), University of Rome "La Sapienza"; and Institute of Experimental Medicine, Consiglio Nazionale Delle Ricerche (Drs Centanni and Andreoli), Rome, Italy. Abstract Dyspepsia is a common clinical problem. Its causes include peptic ulcer disease, gastroesophageal reflux, and functional (nonulcer) dyspepsia. A detailed clinical description of pain does not reliably differentiate the cause. Approximately 80% of gastroscopies are performed for the investigation of dyspepsia. "Gastritis" is diagnosed endoscopically in 59% of all stomachs, although in only 3% are the changes severe. Pathologic examination of unselected gastric biopsy specimens reveals that abnormalities are present in 6273%, but there is only a weak correlation between endoscopic and histologic findings. For these reasons, it is recommended that endoscopic examination should always be accompanied by biopsy. Ideally, biopsies should be taken in a systematic fashion to include sampling of antrum and corpus. Recent evidence suggests that gastric infection by Helicobacter pylori initially presents as a superficial gastritis. Later it may become atrophic with development of intestinal metaplasia. The onset of atrophic changes may be related to the duration of infection, the strain of the infecting organism, associated dietary factors, or as-yet undefined host factors related to immunity. Persistent superficial gastritis predisposes to duodenal ulcer and gastric mucosaassociated lymphoid tissue lymphoma. Atrophic gastritis predisposes to gastric ulcer and adenocarcinoma. Evidence is accumulating that in some patients, pernicious anemia may be an end result ofH. pyloriinduced atrophic gastritis. Reactive gastropathy is a relatively common finding in gastric biopsies; in most instances it is associated with either reflux of duodenal contents or therapy with nonsteroidal anti-inflammatory drugs. Lymphocytic gastritis, eosinophilic gastritis, and the gastritis associated with Crohn's disease are distinct morphologic entities. Lymphocytic gastritis and eosinophilic gastritis have a variety of clinical associations. Carditis is a controversial topic: currently opinions are divided as to whether it is the result of gastroesophageal reflux or a proximal extension of H. pylori infection from the remainder of the stomach. Keywords: Atrophic gastritis, Carditis, Gastric cardia, Gastric Crohn's disease, Gastritis, Helicobacter, Lymphocytic gastritis, Pernicious anemia, Proton pump inhibitors, Reactive gastropathy od Pathol 2003;16(4):325341 Gastritis and Carditis David A Owen M.B.1
1

University of British Columbia, Vancouver, British Columbia, Canada

Correspondence: David A. Owen, M.B., Dept. of Pathology and Laboratory Medicine, Vancouver General Hospital, 855 West 12th Avenue, Vancouver, B.C. Canada V5Z 1M9; fax: (604) 875-4797; email: dowen@vanhosp.bc.ca. Accepted 8 January 2003. Collagenous Gastritis: A Case Report, Morphologic Evaluation, and Review Abstract Collagenous gastritis is rare; there are only four previous case reports. Histologic features seem to overlap with the other "collagenous enterocolitides"; however, pathologic criteria are not yet established for the diagnosis

of collagenous gastritis. We describe an additional case of ostensible collagenous gastritis in a patient who initially presented with celiac sprue and subsequently developed colonic manifestations of mucosal ulcerative colitis. Endoscopic biopsies of the stomach revealed deposition of patchy, very thick bandlike subepithelial collagen in gastric antral mucosa, focal superficial epithelial degeneration, numerous intraepithelial lymphocytes, and a dense lamina propria lymphoplasmacytic infiltrate. Image analysis evaluation of gastric antral biopsies demonstrated a mean thickness of subepithelial collagen of 27.07 . Morphologic comparison was made with age-matched control groups of 10 patients who had normal gastric mucosal biopsies and 10 patients who had "chronic" gastritis, which revealed mean subepithelial collagen measures of 1.37 and 1.19 , respectively. We compared these morphologic findings with those of all previous case reports of collagenous gastritis and propose a pathologic definition based on the limited combined data. It seems that subepithelial collagen is dramatically thickened in reported cases of collagenous gastritis, with a cumulative mean measure of 36.9 . It is also apparent from this and previous reports that the thickened subepithelial collagen is accompanied by a chronic or chronic active gastritis and sometimes intraepithelial lymphocytes and surface epithelial damage. Recently described associations of lymphocytic gastritis, sprue, and lymphocytic colitis as well as collagenous and lymphocytic colitis suggest a common pathogenesis that empirically may include collagenous gastritis in the same disease spectrum. We propose that collagenous gastritis can be confidently identified by using analogous defined features of collagenous colitis: subepithelial collagen more than 10 in a patchy distribution, lamina propria lymphoplasmacytic infiltrates, intraepithelial lymphocytes, and surface epithelial damage. Collagenous gastritis also seems to have the same spectrum of associated clinical findings as collagenous colitis, including frequent coexistence of celiac sprue, watery diarrhea syndrome, and female predominance. Keywords: Celiac sprue, Collagenous colitis, Collagenous gastritis, Lymphocytic colitis, Lymphocytic gastritis, Mucosal ulcerative colitis Abstract Background Tetanus is a serious but vaccine-preventable disease and fatality rate of the disease is high in the neonates and the elderly. The aim of this study was to detect the tetanus antibody prevalence in the over sixty-year age residents of the nursing homes in Bolu. Methods A voluntary-based study was done in the residents of two nursing homes in Bolu, Turkey. Blood samples were taken from 71 volunteers residing in there nursing homes. Tetanus IgG antibodies were measured by a commercial ELISA kit. Results Among overall subjects, only 11 (15.7 %) had the protective tetanus antibody titers at the time of the study. Totally, 10 subjects were examined in emergency rooms due to trauma or accidents within the last ten years and, four (40%) of them had protective antibody levels. Of the remaining 61 subjects only 7 (11%) had protective antibody levels (p < 0.05) [Relative Risk = 3.49, 95% Confidence Interval 1.249.77]. Conclusions Tetanus antibody level is below the protective level in the majority of the over-sixty-year-age subjects residing in the nursing homes. Each over sixty-year age person in our country should be vaccinated. Until this is accomplished, at least, nursing home residents should be vaccinated during registration.