This article explores the concept of parallel process, the flow of unconscious client material from supervisee to supervisor and the reverse of this flow, which may lead to impasses within the ...supervisory triad. It also discusses the concept of modeling, or observational learning, which deviates from key constructs of parallel process, yet at times has been conflated with parallel process in social work scholarship, pedagogy, and practice. In highlighting the differences between the two concepts, we seek to show the scope of their respective explanatory power and to heighten awareness and help supervisors make conscious choices in supervision that align with a clear understanding of their theoretical underpinnings. We examine newer directions for parallel process that include its connections to neurobiology, trauma, and diversity, intersectionality, and cultural humility, and we provide two case vignettes to elucidate the phenomenon. Finally, we offer an integrative discussion of implications for supervision.
Emotional and behavioral difficulties in children with autism often present problems for families seeking appropriate treatment interventions. Using data from the 2011 Survey of Pathways to Diagnosis ...and Services, ordinal logistic regression models were used to examine the association between parental perceptions about autism and their reports of child emotional and behavioral problems. Results showed that parents who attributed their child’s autism to environmental factors, experienced emotional upset or confusion about autism, or perceived the condition to be pervasive or burdensome, were more likely to reported clinically significant emotional and behavioral difficulties. Findings suggest that support services must consider parent perceptions when developing interventions to assist with children’s emotional and behavioral challenges. Implications for practice and research are discussed.
Traumatic brain injury (TBI) is a serious yet commonly under-recognised injury sustained by women as a direct outcome of family violence. Although healthcare and support services are critical, many ...women do not access support services following this injury. At present, there are few relevant qualitative studies that have elevated the voices of Aboriginal and Torres Strait Islander women. This article describes the barriers that prevent Aboriginal and Torres Strait Islander women from accessing hospital and support services after experiencing a TBI from family violence in one regional (Queensland) and one remote location (Northern Territory). Interviews and focus-group discussions were conducted with 28 community members and 90 service professionals. Thematic analysis identified four key factors influencing women's access to health care: all women fear child removal; fear of escalating violence; prioritisation of other competing demands; and insufficient awareness of the signs of brain injury. Given child protection systems perpetuate cycles of discrimination based on poverty and structural inequalities that have generated fear and contributed to the reluctance of women to engage with services, child protection processes and practices need to be transformed to consider the impact of head injury on the everyday lives of women. Pathways need to be implemented to assist women to access healthcare and support services as well as strengthen families to maintain the care of their children.
Content warning: This article includes distressing information and may trigger trauma, especially for Aboriginal and Torres Strait Islander women.
IMPLICATIONS
Aboriginal and Torres Strait Islander women living with a head injury experience severe trauma, coercive control, disadvantage, and poverty, which prevents them from accessing healthcare and support services.
Communities should be resourced to design, implement, and evaluate TBI prevention and intervention solutions as increased awareness and insight into the long-term consequences for the brain that can result from violence, including education for school-aged children, community campaigns, and targeted education for community members.
TBI should be incorporated into child protection frameworks, workforce training, and assessment tools, along with training and education for community members.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The main objective of this work was to perform a comprehensive analysis and provide a race-stratified epidemiological report accounting for differences in treatment patterns and treatment related ...adverse events in Non-Hispanic women with breast cancer (BC). The cohort included women ≥ 18 years diagnosed with in-situ, early-stage, and late-stage BC (2005-2022). Treatment patterns included: surgery, breast radiation, chemotherapy, endocrine therapy, or biologic therapy. Treatment related adverse events were: chemotherapy complications, cardiovascular toxicities, immune-related adverse events, psychological affectations, or cognitive decline/dementia. The influence of race on the outcomes was measured via Cox proportional-hazards models. We included 17,454 patients (82% non-Hispanic Whites NHW). Most of the patients had a Charlson Comorbidity Score between 1 and 2 (68%), and TNM stage I (44.5%). Surgery was performed in 51.5% of the cases, while 30.6% received radiotherapy, 26.4% received chemotherapy, 3.1% received immunotherapy, and 41.2% received endocrine therapy. Non-Hispanic Blacks (NHB) had a lower probability of undergoing breast cancer surgery (aHR = 0.92, 95% CI 0.87-0.97) and of being prescribed endocrine therapy (aHR = 0.83, 95% CI 0.79-0.89), but a higher probability of receiving adjuvant radiotherapy (aHR = 1.40, 95% CI 1.29-1.52). Moreover, NHBs had lower risk of being diagnosed with psychological issues (aHR = 0.71, 95% CI 0.63-0.80) but a higher risk for cognitive decline/dementia (aHR = 1.30, 95% CI 1.08-1.56). In conclusion, NHB women diagnosed with BC were less likely than NHW to undergo curative intent surgery or receive endocrine therapy, and had a higher risk of cognitive decline/dementia after cancer treatment. Public policy measures are urgently needed which equalize access to quality healthcare for all patients and that promote a learning healthcare system which can improve cancer outcomes.
The androgen receptor is one of the key targets for prostate cancer treatment. Despite its less satisfactory effects, chemotherapy is the most common treatment option for metastatic and/or ...castration-resistant patients. There are constant needs for novel anti-prostate cancer therapeutic/prevention agents. Curcumin, a known chemo-preventive agent, was shown to inhibit prostate cancer cell growth. This study aimed to unravel the inhibitory effect of curcumin in prostate cancer through analyzing the alterations of expressions of curcumin targeting genes clusters in androgen-dependent LNCaP cells and androgen-independent metastatic C4-2B cells. Hierarchical clustering showed the highest number of differentially expressed genes at 12 h post treatment in both cells, suggesting that the androgen-dependent/independent manner of curcumin impacts on prostate cancer cells. Evaluation of significantly regulated top canonical pathways highlighted that Transforming growth factor beta (TGF-β), Wingless-related integration site (Wnt), Phosphoinositide 3-kinase/Protein Kinase B/ mammalian target of rapamycin (PIK3/AKT(PKB)/mTOR), and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kB) signaling were primarily inhibited, and Phosphatase and tensin homolog (PTEN) dependent cell cycle arrest and apoptosis pathways were elevated with curcumin treatment. The short term (3-24 h) and long term (48 h) effect of curcumin treatment revealed 31 and four genes modulated in both cell lines. TGF-β signaling, including the androgen/TGF-β inhibitor Prostate transmembrane protein androgen-induced 1 (
), was the only pathway impacted by curcumin treatment after 48 h. Our findings also established that
Proto-Oncogene, basic helix-loop-helix (bHLH) Transcription Factor (MYC) signaling was down-regulated in curcumin-treated cell lines. This study established, for the first time, novel gene-networks and signaling pathways confirming the chemo-preventive and cancer-growth inhibitory nature of curcumin as a natural anti-prostate cancer compound.
Abstract Background “Spice” refers to various synthetic cannabinoid-containing products that seem to have rapidly become popular recreational drugs of abuse. Very little medical literature currently ...exists detailing the adverse effects and emergency department (ED) presentations associated with “spice” use. Objectives To describe the presentation of 2 patients who recreationally used a “spice” product and to briefly summarize what is known about “spice” and synthetic cannabinoids. Case Report Two patients presented to the ED with, predominantly, anxiety after recreationally using a “spice” product that we subsequently confirmed to contain the synthetic cannabinoids, JWH-018 and JWH-073. Conclusion We suspect that use of “spice” products may increase. Although anxiety was a prominent presentation in both of the patients described here, undoubtedly, future studies will describe the manifestations of intoxication and toxicity with the various synthetic cannabinoids.
In the United States, an individual's access to resources, insurance status, and wealth are critical social determinants that affect both the risk and outcomes of many diseases. One disease for which ...the correlation with socioeconomic status (SES) is less well-characterized is glioblastoma (GBM), a devastating brain malignancy. The aim of this study was to review the current literature characterizing the relationship between area-level SES and both GBM incidence and prognosis in the United States. A query of multiple databases was performed to identify the existing data on SES and GBM incidence or prognosis. Papers were filtered by relevant terms and topics. A narrative review was then constructed to summarize the current body of knowledge on this topic. We obtained a total of three papers that analyze SES and GBM incidence, which all report a positive correlation between area-level SES and GBM incidence. In addition, we found 14 papers that focus on SES and GBM prognosis, either overall survival or GBM-specific survival. Those studies that analyze data from greater than 1,530 patients report a positive correlation between area-level SES and individual prognosis, while those with smaller study populations report no significant relationship. Our report underlines the strong association between SES and GBM incidence and highlights the need for large study populations to assess SES and GBM prognosis to ideally guide interventions that improve outcomes. Further studies are needed to determine underlying socio-economic stresses on GBM risk and outcomes to identify opportunities for intervention.
Barriers in acquiring, maintaining, and generalizing daily living skills are factors that contribute to discrepancies in independent living outcomes among transition age youth and young adults with ...intellectual and developmental disabilities (IDD). Acquisition and generalization of daily living skills empowers transition age youth and young adults with disabilities to meet their own needs with minimal reliance on others. Infusing the use of technology as a self‐prompting device facilitates the acquisition of tasks that may not be otherwise attainable. In this study, self‐directed video prompting on an iPad with the My Pictures Talk application was used to help young adults with IDD in a postsecondary program acquire daily living skills in a single subject, multiple probe across subjects design. The effects of the intervention on generalization to tasks that were one, two, and three components different were also assessed. Results demonstrated a functional relationship between the introduction of the intervention and improvement in skill performance.
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