Client Assessment Research Articles

Client characteristics and early working alliance development: A person-centered research approach

Objective Certain client characteristics are associated with early working alliance difficulties in psychotherapy. However, there is limited quantitative evidence on whether combinations of these characteristics (e.g., intersectional identities, prior treatment experiences) are related to alliance development. The present study leveraged a person-centered research approach to examine profiles of early alliance development and differences in the latent class structure of client characteristics among alliance development profiles. Method Individual psychotherapy clients (N = 2,579) rated the working alliance for their first four sessions and self-reported demographics, treatment history, and psychological distress. Therapists provided their assessment of clients’ primary presenting concerns at baseline. Results Latent profile analysis revealed three profiles of working alliance development: high and stable, moderate and increasing, and low and stable. Follow-up person-centered analyses (multigroup confirmatory latent class analysis) indicated that clients in the alliance profiles differed in their combinations of clinical and demographic characteristics. For example, women of color with high baseline distress and a history of prior psychotherapy were over-represented in the low and stable alliance profile. Conclusion These results are consistent with recommendations to holistically consider how clients’ characteristics and experiences shape psychotherapy processes. Results also highlight the utility of person-centered quantitative methods in psychotherapy research.

A Study on Illegal Wildlife Trade in Tanzania Based on Multi-source Data Fusion

This study on the illegal wildlife trade crisis in Tanzania is methodically divided into three phases: planning, policy, and application. Initially, data preprocessing methods such as null processing, interpolation, and max-min normalization were applied to construct a client impact assessment model utilizing AHP and hierarchical evaluation methods. WWF emerged as the most influential client. The policy phase introduced a comprehensive five-year strategy across economic, social, cultural, and environmental sectors. This strategy was supported by three quantitative models, which were used to evaluate the impact of the illegal wildlife trade. The economic model assessed the contribution to GDP growth from the integration of illegal trappers into the workforce. The social model applied crime economics to optimize time allocation under uncertainty. The cultural impact was measured through educational guidelines and a literacy score. Finally, environmental policies were analyzed by adjusting nature reserve areas and poaching difficulty parameter Z. In the application phase, Tanzania's National Forest Park was selected to serve as a pilot site for the models, with the projected outcomes including an increase in species richness and a reduction in poaching ease over a five-year period.

Embracing a different outlook: Strengths and goals of individuals currently in treatment for anorexia nervosa

PurposeDeveloping personal goals beyond weight and shape, and promoting the agency to pursue those goals, could aid in treatment and recovery from anorexia nervosa (AN). This research explores the strengths, interests and goals of individuals currently receiving treatment for AN and evaluates how treatment services are supporting them to work towards personal goals across all areas of everyday life.MethodA total of 58 community-dwelling adults currently receiving treatment for anorexia nervosa at any stage of recovery completed the Client Assessment of Strengths, Interests and Goals Self-Report (CASIG-SR). Participants reported their goals for accommodation, work and study, interpersonal relationships, recreational activities, spirituality, religion or life purpose, physical health and mental health, and the personal strengths and supports needed to achieve those goals. Concordance scores were calculated between importance of personal goals and level of support from current services regarding these goals.ResultsThemes identified across goals, strengths and supports were Connection, Independence & Confidence, Meaning & Self: The Real Me, and Stability & Balance. Work and study goals and strengths were identified strongly. The key support needed was stability from the current treatment team to provide a stable base for change. Concordance scores indicate support provided for personal goals was less than the importance of the goal to the individual.ConclusionResults suggest goals for everyday living are critical to recovery in anorexia nervosa. Specific clinical considerations to increase motivation and hope are increased access to peer support, a focus on increasing positive affect, supporting safe exercise and promoting outdoor experiences and connection with nature.Level IIIEvidence obtained from well-designed cohort or case–control analytic studies.

Clinical Confidence in Risk Assessments of Suicidal Clients: An Intervention Study

Clinical Confidence in Risk Assessments of Suicidal Clients: An Intervention Study

Organisation of consumer accounting as a promising direction of accounting and analytical support for strategic management

The research purpose is to study the problems of accounting and analytical support for profit management of the company on the basis of the organisation of сost and income accounting in the context of consumer groups. In connection with the growth of the share of expenditures for promotion of products to the market and service, in the work, the necessity of сreating management accounting in terms of consumers being the company’s clients has been substantiated. Identification of them as objects will allow to determine who causes the greatest costs of an economic entity, but does not bring enough profit, so is not profitable. The possibilities of such accounting have been examined to achieve the objective of strategic client assessment. The organisation stages of the management accounting for consumers have been allocated, including ways of grouping them for further analysis. The factors that determine the value of clients for an economic entity have been identified. The dependence of the level of the company’s costs on the types of activities related to consumer service has been substantiated. Recommendations have been made on the use of intensive, operational, and temporary cost drivers to allocate expenditures among consumer groups and determine their profitability for the company. The article offers the application of a client assessment matrix in order to identify strategically important consumers and those with whom it is not worth maintaining long-term relations. In conclusion, the possibilities of using data of the consumer accounting for management purposes are given.

Effect of ear cleaning on treatment outcome for canine otitis externa.

Ear cleaning is often recommended for management of canine otitis externa (OE). Few invivo studies evaluate how ear cleaning affects treatment outcome. To determine the effect of ear cleaning on canine OE by comparing treatment outcome in cleaned versus noncleaned ears. Twenty-three client-owned dogs with ceruminous or purulent OE. Forty ears were randomised to one of two groups: 20 ears were wiped with dry or saline-moistened gauze (grp1), and 20 external ear canals received manual cleaning (grp2) with a commercial product. One millilitre of a commercial otic suspension containing hydrocortisone aceponate, miconazole nitrate and gentamicin sulfate was applied to affected ears every 24 h for five days. Cytological scores, modified otitis index score (OTIS3), pruritus Visual Analog Scale (PVAS), modified PVAS and client questionnaire were compared on Day (D)0 and D7. There were no statistical differences between cytological scores, modified OTIS3, PVAS, modified PVAS or client assessments between groups at D7. Both groups had significant reduction in all treatment parameters from D0 to D7 with the exception of cytological rod scores that were only significantly decreased in cleaned ears. There was a significant difference in OTIS3 before and after cleaning on D0. Both groups achieved successful outcome regardless of cleaning. Ear cleaning may be more important when rod-shaped bacteria are present.

Research And Strategic Analysis of Project Client Selection Based on Client Assessment System

Research And Strategic Analysis of Project Client Selection Based on Client Assessment System

Validation francophone de la CASIG-rev – un outil clinique visant à soutenir le rétablissement des personnes avec un trouble psychiatrique: French validation of the CASIG-rev – a clinical personal recovery assessment for people with psychiatric disorders

There are few tools capable of measuring the personal recovery of individuals presenting with mental disorders that take into account the various dimensions of recovery. Personal recovery encompasses several objectives at the level of autonomy, positive interpersonal relationships, mental and physical health, self-acceptance, the school/professional domain, as well as developing a life project. A team of practitioners and researchers from four countries (Canada, Belgium, France, and Switzerland) adapted the Client Assessment of Strengths, Interests, and Goals (CASIG) tool to more accurately measure these different aspects of personal recovery. This study aims to validate the revised version of CASIG (CASIG-rev) in French, in terms of construct validity, test-retest reliability, convergent validity, and clinical sensitivity to change. A total of 272 individuals were recruited across different French-speaking countries to respond to the CASIG-rev online, as well as Ryff's well-being measure, the Recovery Assessment Scale, and the WHODAS. A subgroup of 29 individuals responded again to the CASIG-rev after 1 month (for temporal stability), and 24 again at six months (for sensitivity to change). The confirmatory factor analysis suggests a 5-factor model, very similar to the initially proposed model of 6 factors. Convergent validity was demonstrated between the subscales of tools measuring similar concepts, and test-retest reliability was proven for the majority of scales. The CASIG-rev also appears to be sensitive to clinical or rehabilitation changes, notably at the level of the life project. This study supports the use of the CASIG-rev in French to measure the recovery of individuals presenting with mental disorders, as well as to support practitioners in the evaluation of their programs and interventions. Limitations, as well as the tool's relevance, are presented. An English validation is underway to make the CASIG-rev available in Anglo-Saxon countries.

Socio-medical assessment: an inventory of the Medical Service of the Federal Employment Agency

The Medical Service of the Federal Employment Agency is responsible for socio-medical assessments of clients whose ability to work in the labor market is in question. Data about the Medical Service, its structure, and its performance were previously only available within the Federal Employment Agency. In October 2023, data from the Medical Service containing information on the employee structure, clients, and orders were extracted from three data systems, processed, and analyzed. The number of full-time equivalents (FTEs) in the Medical Service decreased significantly from 2016 (n = 859.1 FTEs) to 2021 (n = 799.0 FTEs). This holds true for the professional groups of physicians, specialist assistants, medical assistants, and externally contracted physicians. The number of female employee FTEs rose significantly during this period from 85.6% (2016) to 87.0% (2021). The part-time ratio also increased significantly from 41.4% (2016) to 50.6% (2021). The number of assignments to the Medical Service was stable in 2017-2019 at around 630,000 but showed areduction in 2020 (n = 518,538) and 2021 (n = 545,289); in particular, the number of assessments with client contact decreased significantly from 2019 (n = 166,980) to 2020 (n = 52,484). Most of the assignments came from the field of job placement (n = 349,346). The size of the Medical Service was in line with the total number of orders, which can certainly be seen as COVID-19-related in 2020 and 2021 and is likely due to the overall shortage of skilled personnel. The proportion of women and part-time employees increased significantly, with anationwide part-time trend emerging not only among women. In order to enable all clients who may be unable to perform in the labor market to receive aquick assessment, it is necessary that the number of employees in the Medical Service does not decrease in the future.

Coercion in Psychiatry: Exploring the Subjective Experience of Coercion Among Patients in Five Portuguese Psychiatric Departments.

The subjective experience of coercion may have a more significant impact on clinical outcomes than formal coercive measures. This study aimed to investigate the subjective experience of coercion among patients on admission in Portuguese psychiatric departments by assessing their perceived coercion, procedural justice, and negative pressures during admission. The study also investigated whether this subjective experience of coercion changed with time during admission, and the predictors of this change. Validated instruments, including the McArthur Admission Experience Survey (AES) and the Client Assessment of Treatment Scale, were used to collect information from 208 adults admitted to five public psychiatric inpatient departments in rural and urban regions of Portugal. About a third (32.24%, n = 49) of the sample had a legal involuntary admission status, while more than a third of them perceived their admission to be involuntary (40.13%, n = 61). The subjective experience of coercion was significantly higher among people who perceived their admission to be involuntary compared to people who perceived their admission to be voluntary (Median = 10, IQR = 5.5 vs. Median = 3, IQR = 6; p < 0.001). Satisfaction with their care was significantly inversely correlated with the subjective experience of coercion (p < 0.01). The changes in the subjective experience of coercion at the second assessment were predicted by the perceived admission status rather than the legal admission status, and the initial procedural justice (p < 0.05). The study findings highlight the importance of improving procedural justice in psychiatric admissions, regardless of the legal status of admission.

Study of Illegal Wildlife Trade based on ARIMA and Linear Regression Modeling

Illegal wildlife trade has been on the rise in recent years, posing a threat to endangered species and ecosystems. In response to this problem, this study aims to identify the most suitable clients to implement anti-illegal trade projects and assess their capacity. Using a client assessment model, we identified the World Customs Organization as the most suitable to undertake a five-year project, predicted trade trends through an ARIMA model, and demonstrated project effectiveness. Intervention analysis showed that the project could reduce the number of illegal transactions. However, the project required more resources and authority. Linear regression modeling reveals that the client needs to be upgraded in many areas. This study provides important guidance for reducing illegal wildlife trade and calls for increased cooperation and resource allocation to protect wildlife ecosystems.

Prevalence and Factors Associated with Impaired Maternal-Infant Bonding among Mothers Attending Young Child Clinic in Kampala, Uganda.

Impaired maternal-infant bonding can have a negative impact on the mother-infant relationship, affecting the social, emotional, and cognitive development of a child. In Uganda, there is a paucity of literature on impaired maternal-infant bonding. This quantitative, cross-sectional study aimed to determine the prevalence and factors associated with impaired maternal-infant bonding. Postnatal mothers (n = 422) attending the Young Child Clinic at Kawempe National Referral Hospital participated in the study. Maternal-infant bonding was measured using the Postpartum Bonding Questionnaire (PBQ). Participants with a score ≥ 13 on the PBQ were considered to have impaired maternal-infant bonding. The prevalence of impaired maternal-infant bonding among mothers was 45% (190/422). Logistic regression was used to determine factors associated with impaired maternal-infant bonding. Unmarried mothers (AOR = 2.05, 95% [CI = 1.03-4.09], p = 0.041), unplanned pregnancy (AOR = 5.19, 95% [CI = 3.07-8.82], p < 0.001), first-time mothers (AOR = 2.46, 95% [CI = 1.37-4.43], p = 0.003), female infant (AOR = 1.80, 95% [CI = 1.13-2.86], p = 0.013), mothers with no/low education levels (AOR = 2.29, 95% [CI = 1.05-4.50], p = 0.036), and those who delivered post term (AOR = 2.49, 95% [CI = 1.10-5.67], p = 0.028) were more likely to have impaired maternal-infant bonding. Nurses and midwives in postnatal care should include maternal-infant bonding within their client's assessment and provide supportive mother-centered care. Interventions to improve maternal-infant bonding should be created and implemented in clinical practice.

Community rehabilitation by the trained village health volunteers on activities of daily living and quality of life in stroke survivors

Background: The number of people with disabilities resulting from strokes is increasing in Thailand. The major sequela of the disease was weakness in one side of the body that causes difficulty in activities of daily living (ADL) and poor quality of life (QOL) for stroke survivors. Community-based rehabilitation could be one of the strategies that enhances functional performance and improves QOL in these individuals. There were many disabled people in Mae Ka subdistrict, San Pa Tong District, Chiang Mai Province, where health care providers and local people were enthusiastic to take care of each other’s health in the community. Objective: The present study aimed to investigate rehabilitation outcomes in ADL and QOL of stroke participants who received rehabilitation services from trained village health volunteers (VHVs). Materials and methods: This study was a quasi-experimental research design. Subjects were recruited using purposive sampling, including 10 stroke survivors. Instruments used were 1) ADL Assessment for Occupational Therapy Clients; and 2) World Health Organization Quality of Life Assessment, Short Form-Thai version. The statistics used were descriptive, as well as the Wilcoxon Signed Ranks Test. Results: Results demonstrated that scores of basic activities of daily living (BADL) in the participants increased significantly (p&lt;0.05) except for sexual expression. The score in the instrumental activities of daily living (IADL) was also significantly higher at post-rehabilitation than pre-intervention (p&lt;0.05), as was the total ADL score. Stroke patients had significantly higher QOL scores after intervention than the pretest (p&lt;0.05). Conclusion: These indicated that the community rehabilitation center at Mae Ka Subdistrict Administrative Organization, San Pa Tong District, Chiang Mai Province, run by the trained VHVs could promote ability in daily activities and improve QOL in stroke participants who come for their services.

Music therapy as a non-pharmacological intervention for persons living with dementia: client assessment and types of music therapy interventions

Geriatric giants account for the five most prevalent morbidities that cause immense decline in functional capacity and decreased quality of life. Immobility, instability leading to falls and fractures, incontinence, impaired cognition (dementia) and iatrogenesis affect majority of the ageing elderly leading to dependency, caregiving and associated burden among caregivers. Concept of non-pharmacological interventions in dementia care: interventions that involve non-pharmacological (non-medicinal) measures, have proven benefits to the people living with dementia (PLWD). music therapy, nature therapy that involves nature walks and living amidst natural spaces, have shown to have immense biophilia effects on the various organ systems in the human body. Immense health benefits have been documented among PLWD: dawn phenomenon is a clinical phenomenon where the PLWD experiences agitation, aggression and loud speech in the evenings associated with dementia. Out of all the seven studies published, there were significant improvements in mood, reduction in aggressive behavior, improving anxiety symptoms, reducing caregiver burnout and improving overall quality of life of the people living with dementia and their caregivers. With promising results among various interventional studies across the world, NPI is an important intervention with minimal to nil side effects with long term benefits on frequent administration.

Understanding rural social networks addressing adverse childhood experiences: A case study of the San Luis Valley.

The purpose of this study is to assess a cross-sector, interorganizational network addressing adverse childhood experiences (ACEs) in a rural Colorado community. We characterize the organizations in the network, assess their awareness of ACEs, and evaluate how they participate in the network. We also assess the network health. Employing a social network analysis approach, we collected survey data from 45 organizations that support young children and their families, including nonprofits, health care clinics, and early childhood education centers, among others. On average, nonprofit organizations had relationships with a greater percentage of network members than other types of organizations. Network members engaged in relationships focused on a wide range of activities (e.g., client assessments, sharing information, providing services), with some organizational types leading the network in certain activities. Scores across all dimensions of trust and value were above 3 (range: 2.1-3.8), which is advantageous for a network and network relationships existed across a range of relational intensities (from awareness to organizational integration). Nonprofit organizations that reported high levels of connectedness in the network were able to effectively mobilize the ACEs network. Health clinics participated in a greater share of relationships involving assessment, service provision, and tool sharing than other types of organizations. As such, health care clinics may serve as leaders in directly serving children and families experiencing ACEs in rural communities. The rural context may also explain high levels of trust and value, which can serve as assets for future network development and mobilization. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Application of early warning system (EWS) in patients with cardiovascular disorders : a descriptive study

Incidents of clients experiencing sudden cardiac arrest in the inpatient setting or unexpected and unavoidable deaths in the inpatient setting are common. One of the efforts to improve quality related to patient safety in hospitals is the application of the Early Warning System (EWS) to clinical changes in patients in hospital inpatient installations. The purpose of this study was to describe the application of EWS in clients with cardiovascular system disorders, including the risk of seriousness, respiratory rate, oxygen saturation, use of oxygen supplements, systolic blood pressure, pulse frequency, level of consciousness, and body temperature. This study is an observational descriptive study with a cross-sectional approach. The number of respondents was 48 people, namely clients who were treated with diseases of the cardiovascular system. Data analysis using descriptive analysis. The characteristics of respondents obtained in this study showed that the majority of respondents were female (54.2%), the majority of medical diagnoses were congestive heart failure, which was 43.75%, and the average length of stay was 4.63 days. Most of the patient's risk of seriousness was in the moderate category, namely 22 respondents (45.8%). Assessment of clients with cardiovascular system disorders with EWS in this study can predict the level of patient care so that preventive measures can be taken. Recommendations for future research are research on predicting patient mortality using EWS.

New developments in cosmetic applications of electromagnetic fields: Client and occupational hazard assessment.

Energy-based devices are used to improve features of appearance for aesthetic reasons while avoiding more invasive methods. Examples of treatment targets are the reduction of wrinkles, sagging, unwanted skin lesions, body hair and excess fatty tissue, and the enhancement of muscle tissue. One treatment modality is the use of electromagnetic fields (EMF, 0‒300 GHz). The present work aims to give an up-to-date survey of cosmetic applications of EMF for professional use with an assessment of client and worker exposure and possible adverse effects. A systematic search was conducted for peer-reviewed articles (2007-2022), patents, premarket notifications, manufacturer data, and adverse effects reports. Five categories of cosmetic EMF device with increasing frequency were identified: sinusoid low frequency magnetic fields for lipolysis; pulsed low frequency magnetic fields for skin rejuvenation; pulsed low frequency magnetic fields for muscle building; radiofrequency EMF for lipolysis or skin rejuvenation; microwaves for hair removal or hyperhidrosis. In the vicinity of the last four device categories, there is a potential for exceeding the occupational exposure limits in the European Union EMF Directive, which could lead to nerve or muscle stimulation, burns or overheating. There are also potential hazards for clients or workers wearing active or passive medical devices. The severity of reported adverse effects increases with EMF frequency.

Comparison of Visual Symptom Frequency and Occupational Issues Between Patients With and Without Concussion.

Occupational therapy practitioners' knowledge of and advocacy for clients with visual symptoms postconcussion can have a considerable impact on recovery. To compare the frequency of vision symptoms and occupational performance deficits in a sample of participants with and without concussion. Cross-sectional study. Sports medicine clinic. Adolescents and adults with concussion (n = 20) and musculoskeletal injuries (n = 19). Measures included monocular amplitude of accommodation, near point of convergence, Binocular Vision Assessment (BVA) computerized screening for phoria, BVA computerized screening for fusional vergence, the Developmental Eye Movement Test, the Canadian Occupational Performance Measure, and the Convergence Insufficiency Symptom Survey-Concussion Version (CISS-CON). We found significant differences between participants with and without concussion using the CISS-CON (p = .001), positive fusional vergence (p = .02), and near point of convergence (p = .02). Participants with concussion scoring above cutoffs on multiple measures reported poorer performance (p = .005) and satisfaction (p = .004) with valued occupations. Concussion has a detrimental effect on vision and occupation, and occupational therapy practitioners are well-positioned to assess and address issues arising from this relationship. Plain-Language Summary: Vision symptoms commonly experienced after a concussion are associated with reduced occupational performance and satisfaction and can have a considerable impact on recovery. Occupational therapy assessment for clients with concussion should include screening for vision difficulties.

The Impact of Audit Office Cybersecurity Experience on Nonbreach Client's Audit Fees and Cybersecurity Risks

ABSTRACT This study investigates whether auditors’ experiences with their clients’ cybersecurity incidents affect their subsequent audits for nonbreach clients and help those clients reduce cybersecurity risks. We find that audit offices who have experience with cybersecurity-breached clients, ceteris paribus, charge higher audit fees from nonbreach clients. Additionally, the increased audit fees conditional on auditors’ cybersecurity experience are negatively associated with nonbreach clients’ future breach incidents. Such associations are found only in the Big 4 audit offices and offices with IT capability. This study offers timely insights for standard setters and important implications for both professionals and the academic literature by documenting the spillover effect of cybersecurity experience on subsequent risk assessments of nonbreach clients, while also confirming the effectiveness of engaging auditors in addressing cybersecurity matters. Data Availability: Data are available from the public sources identified in the article. JEL Classifications: M42.

Effect of a Structured Integrated Obstetric Triage Model (SIOTEL) on Patient Waiting time in Maternity Units in Kiambu County – A Quasi Experimental Study

Background: Perinatal mortality and morbidity remains high in Kenya over the years, and this has been attributed to the Three Delays, the third focusing on access to care once the client is in the health facility. Structured frameworks for obstetric triage have been shown to improve perinatal outcomes across the globe. In Kenya, anecdotal evidence suggests that there is no formal framework for conducting obstetric triage in public facilities. This study sought to assess the effect of a Structured Integrated Obstetric Triage Model (SIOTEL) on patient waiting time in maternity units of Kiambu Referral Hospitals.&#x0D; Methods: A quasi experimental design was applied in the study. The intervention facility was Kiambu County Referral Hospital and control facility was Thika Level 5 Hospital. Study population included files of patients admitted in the labour wards. The intervention (SIOTEL) was a 3-scale modified Obstetric Triage Acuity Scale, a client assessment tool that was used to conduct obstetric triage. A baseline survey was conducted followed by development, validation and implementation of the tool, then an end line survey conducted to assess effect of the model on waiting time. Quantitative data was analyzed using STATA and presented in tables and graphs. T-statistic was used to test for significance of mean waiting time in the two facilities.&#x0D; Results: A total of 455 files were reviewed, 231 at baseline and 224 at endline survey. The mean client waiting time at baseline was 113.19 and 124.91 minutes in the intervention and control facilities respectively. At endline, the mean waiting time was 57.46 minutes in the intervention facility and 112.92 minutes in the control facility. Findings thus revealed a significant effect of the SIOTEL on client waiting time in the intervention facility (t-3.77;p value 0.00) compared to the control facility (t-0.78; p value 0.44)&#x0D; Conclusions and recommendations: The study concludes that implementation of structured models for obstetric triage contributes to reduction in client waiting time, and recommendations are made to adopt such models for triage in public facilities in Kenya