Addressing systemic injustices and racism in training and clinical service provision are key next steps in clinical science. While the American Psychological Association Multicultural Guidelines and ...accreditation standards have long emphasized this need, most graduate programs offer a single course on diversity, equity, and inclusion topics, which is inadequate to train and sustain culturally humble providers and redress systemic injustices and racism within psychology. Few "real-world" examples exist to guide the development of training models. We provide background on the development and components of a specialty clinic, the University of New Mexico's Cultural Counseling Center, whose mission is providing culturally informed clinical services to diverse clientele, and to infuse multicultural training throughout the graduate program. Informed by the racial-spatial framework for psychology and critical race theory, we describe our approach intended to (a) offer applications for the operationalization and delivery of multicultural and antiracist training, (b) enhance supervisory models, and (c) increase awareness of structural competence. Our clinic, developed collaboratively among students and faculty, serves as a safe forum for dialogue around structural injustices and seeks to improve treatment for diverse clients and those underserved in mental health care. We discuss issues of student and faculty engagement and offer the perspectives of faculty and students of color, case examples illustrating our services, and current efforts to expand and formalize community collaborations. We offer a model that integrates coursework, informal activities, and multicultural supervision for comprehensive student training and that promotes a departmental culture of dialogue and support around equity, diversity, and justice.
Public Significance Statement
We provide background on the development of a specialty clinic, the University of New Mexico Cultural Counseling Center, as a training model and "real-world" example of operationalization and delivery of multicultural and antiracist training and clinical services. Program description and recommendations based on our experience can inform the development and implementation of similar centers in other departments and aid in the training of the next generation of clinicians equipped to provide culturally informed care.
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CEKLJ, FFLJ, NUK, ODKLJ, PEFLJ, UPUK
Although evidence suggests that patients with left hemisphere strokes and non-fluent aphasia who receive 1
Hz repetitive transcranial magnetic stimulation (rTMS) over the intact right inferior ...frontal gyrus experience persistent benefits in naming, it remains unclear whether the effects of rTMS in these patients generalize to other language abilities. We report a subject with chronic non-fluent aphasia who showed stable deficits of elicited propositional speech over the course of 5
years, and received 1200 pulses of 1
Hz rTMS daily for 10
days at a site identified as being optimally responsive to rTMS in this patient. Consistent with prior studies there was improvement in object naming, with a statistically significant improvement in action naming. Improvement was also demonstrated in picture description at 2, 6, and 10
months after rTMS with respect to the number of narrative words and nouns, sentence length, and use of closed class words. Compared to his baseline performance, the patient showed significant improvement on the Western Aphasia Battery (WAB) subscale for spontaneous speech. These findings suggest that manipulation of the intact contralesional cortex in patients with non-fluent aphasia may result in language benefits that generalize beyond naming to include other aspects of language production.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Highlights • Drop attacks, falls and atonic seizures are rare in the adult population. • These seizure types are associated with learning difficulties. • Half of the patients suffering from these ...seizure types had frontal lobe lesions. • Ictal EEG patterns were attenuation, paroxysmal fast and generalised spike wave.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Objective:
To review the efficacy and safety of botulinum toxin A (BTX) in the treatment of sialorrhea.
Data Sources:
A PubMed search and reference list review was performed to find clinical trials ...on BTX in the treatment of sialorrhea. The search was limited to English-language trials involving human subjects. Articles from 1965 to October 2006 were searched, using key words botulinum, botulinum toxin, Botox, sialorrhea, saliva, salivary gland, and drooling.
Study Selection And Data Extraction:
Reports of 15 studies were found on BTX in the treatment of sialorrhea in human subjects. Four controlled trials are presented in detail, and 11 uncontrolled studies are summarized.
Data Synthesis:
One controlled trial found that BTX caused significant reductions in patients' severity and frequency of drooling compared with placebo. Another found significant saliva reductions in the treatment group receiving the highest dose of BTX but found no subjective improvement compared with the placebo group. A third study comparing BTX with placebo found significant improvements in subjective and objective measures of drooling in the treatment group. A fourth controlled trial found significant reductions from baseline levels of drooling after patients received BTX injections. Similar efficacy was found between the BTX and scopolamine treatment groups.
Conclusions:
Evidence indicates that BTX is a safe and effective treatment for sialorrhea. More research is needed to determine the ideal dose, injection location, and technique of BTX injections.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
This study is the first to demonstrate that macrophage migration inhibitory factor (MIF), an immune system 'inflammatory' cytokine that is released by the developing otocyst, plays a role in ...regulating early innervation of the mouse and chick inner ear. We demonstrate that MIF is a major bioactive component of the previously uncharacterized otocyst-derived factor, which directs initial neurite outgrowth from the statoacoustic ganglion (SAG) to the developing inner ear. Recombinant MIF acts as a neurotrophin in promoting both SAG directional neurite outgrowth and neuronal survival and is expressed in both the developing and mature inner ear of chick and mouse. A MIF receptor, CD74, is found on both embryonic SAG neurons and adult mouse spiral ganglion neurons. Mif knockout mice are hearing impaired and demonstrate altered innervation to the organ of Corti, as well as fewer sensory hair cells. Furthermore, mouse embryonic stem cells become neuron-like when exposed to picomolar levels of MIF, suggesting the general importance of this cytokine in neural development.
Accessible services for users of prenatal substances are lacking, and treatment engagement is poor with services that are available. Furthermore, legal consequences are often punitive, which ...ultimately damages the well-being of mother and child. Milagro and FOCUS are two New Mexico programs that provide comprehensive, coordinated care, including medication-assisted treatment, to former users of prenatal substances during pregnancy (in the Milagro Program) and for three years post-birth (in the FOCUS Program). This mixed methods study explored the lived experiences of women from this complex, high-risk population, using a high-engagement sample of women who utilized services at both Milagro and FOCUS. Twenty-four former opioid users ages 25 to 42, with children ages 3 months to 35 months, were interviewed about their experiences of substance use, treatment services, and motherhood. To further characterize this sample, the study measured adverse childhood experiences, socioeconomic status, social support, and participants’ therapeutic alliances with their early intervention specialists in the FOCUS program. Significant themes emerged from both qualitative and quantitative data highlighting considerable hardships but also the substantial resiliency of these women, especially as it related to their commitments to their children. Most had been surprised by their pregnancy, and half had tried and failed to obtain substance use treatment due to lack of services or accessibility, even before engaging with the Milagro program. All participants expressed desire to maintain sobriety for the sake of their children. Most reported at least one childhood trauma as well as current psychosocial stressors, and yet all women also reported some kind of positive growth or resiliency factor(s). All participants reported having positive interpersonal support from the Milagro and FOCUS programs. Such findings advance an alternative narrative to understanding this population than those motivating the punitive legal measures mandated in 24 states. This study suggests that comprehensive, coordinated care from pregnancy through toddlerhood that fosters strong therapeutic alliances between providers and patients, can effectively engage women in this population and help sustain both sobriety and well-being. Suggestions for future research, such as exploring the potentially critical role of therapeutic relationships in the engagement process for this substance-using population, are offered.
Many of today's commercial industries are realizing the negative impact they have on the environment and taking steps to become more sustainable in hopes of lessening that impact. The hotel industry ...is one of those industries. Hotel owners and guests are expressing their concern for the environment, and both are playing a role in making the hotel industry more sustainable. With the help of government organizations, better technology, and green education, the idea of environmentally friendly hotels is not just an idea; it is becoming the norm.
Cyclodextrins are sugar compounds that are increasingly finding medicinal uses due to their ability to complex with hydrophobic molecules. One cyclodextrin in particular, ...2-hydroxypropyl-beta-cyclodextrin (HPbetaCD), is used as a carrier to solubilize lipophilic drugs and is itself being considered as a therapeutic agent for treatment of Niemann-Pick Type C disease, due to its ability to mobilize cholesterol. Results from toxicological studies suggest that HPbetaCD is generally safe, but a recent study has found that it causes hearing loss in cats. Whether the hearing loss occurred via death of cochlear hair cells, rendering it permanent, was unexplored. In the present study, we examined peripheral auditory function and cochlear histology in mice after subcutaneous injection of HPbetaCD to test for hearing loss and correlate any observed auditory deficits with histological findings. On average, auditory brainstem response thresholds were elevated at 4, 16, and 32 kHz in mice one week after treatment with 8,000 mg/kg. In severely affected mice all outer hair cells were missing in the basal half of the cochlea. In many cases, surviving hair cells in the cochlear apex exhibited abnormal punctate distribution of the motor protein prestin, suggesting long term changes to membrane composition and integrity. Mice given a lower dose of 4,000 mg/kg exhibited hearing loss only after repeated doses, but these threshold shifts were temporary. Therefore, cyclodextrin-induced hearing loss was complex, involving cell death and other more subtle influences on cochlear physiology.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The Mars Global Surveyor Mars Orbiter Camera was used to obtain global maps of the martian surface with equatorial resolution of 7.5 km/pixel in two wavelength ranges: blue (400–450 nm) and red ...(575–625 nm). The maps used were acquired between March 15, 1999 (
L
s
=110°) and July 31, 2001 (
L
s
=205°), corresponding to approximately one and a quarter martian years. Using the global maps, cloud area (in km
2) has been measured daily for water ice clouds topographically corresponding to Olympus Mons, Ascraeus Mons, Pavonis Mons, Arsia Mons, Alba Patera, the western Valles Marineris canyon system, and for other small surface features in the region. Seasonal trends in cloud activity have been established for the three Tharsis volcanoes, Olympus Mons, and Alba Patera. Olympus, Ascraeus, and Pavonis Mons show cloud activity from about
L
s
=0°–220° with a peak in cloud area near
L
s
=100°. One of our most interesting observational results is that Alba Patera shows a double peaked feature in the cloud area with peaks at
L
s
=60° and 140° and a minimum near
L
s
=100°. Arsia Mons shows nearly continuous cloud activity. The altitudes of several of these clouds have been determined from the locations of the visual cloud tops, and optical depths were measured for a number of them using the DISORT code of Stamnes et al. (1988, Appl. Opt. 27, 2502–2509). Several aspects of the observations (e.g., cloud heights, effects of increased dust on cloud activity) are similar to simulations in Richardson et al. (2002, J. Geophys. Res. 107, 5064). A search for short period variations in the cloud areas revealed only indirect evidence for the diurnal cloud variability in the afternoon hours; unambiguous evidence for other periodicities was not found.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
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