Outreach practices of a small college counseling center: A comprehensive model to serve the college community

Over the past 10 years college counseling centers (CCCs) have been urged to broaden their focus considerably and to serve the entire campus community due to increases in student mental health issues. Engaging in outreach efforts is one way to address campus wide needs. However, few research efforts have been conducted to systematically investigate how outreach is practiced at a small college. The dialogue around outreach has focused on single programs at large institutions rather than the network of interventions that occur on a campus. The purpose of this study is to understand the web of relationships between a counseling center and the college community. This qualitative case study describes the various outreach activities of a small college counseling center from the perspective of the counseling center staff and members of the college community. Using ethnographic tools (i.e., semi-structured interviews, focus group, and context analysis), this study describes the different systems the counseling center navigates to serve the college campus. The study identifies how members of a counseling center develop a shared pattern of outreach behavior. This study adds to the literature in several ways: it increases our understanding of how a small college counseling center supports the campus community and provides a model or framework for how outreach is performed on a smaller campus

Hypoxia-inducible factor: role in cell survival in superoxide dismutase overexpressing mice after neonatal hypoxia-ischemia.

BackgroundSixty percent of infants with severe neonatal hypoxic-ischemic encephalopathy die, while most survivors have permanent disabilities. Treatment for neonatal hypoxic-ischemic encephalopathy is limited to therapeutic hypothermia, but it does not offer complete protection. Here, we investigated whether hypoxia-inducible factor (HIF) promotes cell survival and suggested neuroprotective strategies.PurposeHIF-1α-deficient mice have increased brain injury after neonatal hypoxia-ischemia (HI), and the role of HIF-2α in HI is not well characterized. Copper-zinc superoxide dismutase (SOD)1 overexpression is not beneficial in neonatal HI. The expression of HIF-1α and HIF-2α was measured in SOD1 overexpressing mice and compared to wild-type littermates to see if alteration in expression explains this lack of benefit.MethodsOn postnatal day 9, C57Bl/6 mice were subjected to HI, and protein expression was measured by western blotting in the ipsilateral cortex of wild-type and SOD1 overexpressing mice to quantify HIF-1α and HIF-2α. Spectrin expression was also measured to characterize the mechanism of cell death.ResultsHIF-1α protein expression did not significantly change after HI injury in the SOD1-overexpressing or wild-type mouse cortex. However, HIF-2α protein expression increased 30 minutes after HI injury in the wild-type and SOD1-overexpressing mouse cortex and decreased to baseline value at 24 hours after HI injury. Spectrin 145/150 expression did not significantly change after HI injury in the SOD1- overexpressing or wild-type mouse cortex. However, spectrin 120 expression increased in both wild-type and SOD1-overexpressing mouse at 4 hours after HI, which decreased by 24 hours, indicating a greater role of apoptotic cell death.ConclusionHIF-1α and HIF-2α may promote cell survival in neonatal HI in a cell-specific and regional fashion. Our findings suggest that early HIF-2α upregulation precedes apoptotic cell death and limits necrotic cell death. However, the influence of SOD was not clarified; it remains an intriguing factor in neonatal HI

Effects of therapeutic hypothermia on white matter injury from murine neonatal hypoxia-ischemia.

BackgroundTherapeutic hypothermia (TH) is the standard of care for neonates with hypoxic-ischemic encephalopathy, but it is not fully protective in the clinical setting. Hypoxia-ischemia (HI) may cause white matter injury (WMI), leading to neurological and cognitive dysfunction.MethodsP9 mice were subjected to HI as previously described. Pups underwent 3.5 h of systemic hypothermia or normothermia. Cresyl violet and Perl's iron staining for histopathological scoring of brain sections was completed blindly on all brains. Immunocytochemical (ICC) staining for myelin basic protein (MBP), microglia (Iba1), and astrocytes (glia fibrillary acidic protein (GFAP)) was performed on adjacent sections. Volumetric measurements of MBP coverage were used for quantitative analysis of white matter.ResultsTH provided neuroprotection by injury scoring for the entire group (n=44; P<0.0002). ICC analysis of a subset of brains showed that the lateral caudate was protected from WMI (P<0.05). Analysis revealed decreased GFAP and Iba1 staining in hippocampal regions, mostly CA2/CA3. GFAP and Iba1 directly correlated with injury scores of normothermic brains.ConclusionTH reduced injury, and qualitative data suggest that hippocampus and lateral caudate are protected from HI. Mildly injured brains may better show the benefits of TH. Overall, these data indicate regional differences in WMI susceptibility and inflammation in a P9 murine HI model

The client satisfaction with device: a Rasch validation of the Arabic version in patients with upper and lower limb amputation

BACKGROUND: The Client Satisfaction with Devices (CSD) module of the Orthotics and Prosthetics Users' Survey is an extensively used questionnaire that measures patients' satisfaction with orthosis and prosthesis. However, the validated version for Arabic speakers (CSD-Ar) is only applicable for orthosis users. OBJECTIVES: The aim of this study was to evaluate the psychometric proprieties of the CSD-Ar for prosthetics users. METHODS: The study used a convenience sample of prosthesis users from Saudi Arabia and Turkey (N\u2009=\u2009183), who completed the CSD-Ar. The collected data were analysed using Rasch analysis to evaluate item fit, reliability indices, item difficulty, local item dependency, and differential item functioning (DIF) using WINSTEPS version 4.6.1. RESULTS: Based on the analysis, the four-response Likert-scale was acceptable, as shown by the category functioning test, All eight items did achieve a fit to the Rasch Model [(infit) and (outfit) mean-square 0.75 to 1.3]. Person separation reliability was 0.76, and item separation reliability was 0.94. A principal component analysis (PCA) showed satisfactory unidimensionality and no local item dependency. The DIF analysis showed no notable dependency among items on participant characteristics in terms of age, gender, duration of use, country, and level of amputation. CONCLUSION: This study contributes to the confidence of using CSD-Ar to evaluate users' satisfaction with different prostheses, affirming the need for further refinement of the quality of the outcome measure

Ricerca del grano tenero in miscela con il duro negli sfarinati e nelle paste variamente essiccate

Il riconoscimento dell'uso del grano tenero nella produzione della pasta alimentare si basa sull'analisi gas cromatografica deli esteri degli steroli previo isolamento della frazione lipidica. Il metodo consente di calcolare la percentuale di grano tenero utilizzato sia negli sfarinati sia nelle paste

Variations, approximation, and low regularity in one dimension

We investigate the properties of minimizers of one-dimensional variational problems when the Lagrangian has no higher smoothness than continuity. An elementary approximation result is proved, but it is shown that this cannot be in general of the form of a standard Lipschitz "variation". Part of this investigation, but of interest in its own right, is an example of a nowhere locally Lipschitz minimizer which serves as a counter-example to any putative Tonelli partial regularity statement. Under these low assumptions we find it nonetheless remains possible to derive necessary conditions for minimizers, in terms of approximate continuity and equality of the one-sided derivatives.Comment: v3, 60 pages. To appear in CoVPDE. Minor cosmetic correction

Trust/untrust is not the same as true/false. lessons learned and ethical questions on the application of untrustworthiness scales to judge individuals

This special paper reflects on trustworthiness and its implications for scientific medical journals and all the communities they serve: health professionals, policymakers, the public, and a specific discipline, in our case, Physical and Rehabilitation Medicine. We start from a recent episode: a paper claimed the untrustworthiness of two randomised controlled trials (RCTs) published in the European Journal of Physical and Rehabilitation Medicine based on a newly developed trustworthiness scale, used until now only in systematic reviews. This likely represents the first case of applying such a scale focusing on a single leading author. Developing a proper answer to this case led us to present some insights from the perspective of a Journal editor. We discuss the impact of false research results, why trust is needed in science and medicine, the difference between untrust and false results, the problems in judging trustworthiness, the unfortunately weak capacity of the peer review system in preventing these issues, the problems of "post-hoc" judgements and the emerging ethical issues. We conclude with some suggestions for the future based on prevention at the system level

Animal assisted interventions in neurorehabilitation: a review of the most recent literature

Introduction: While conventional wisdom has always affirmed the value of animals in promoting human health and well-being, only recently has their therapeutic role in medicine become a topic for dedicated research. Animal assisted interventions (AAI) can be classified as animal-assisted activities, animal-assisted therapy, and service animal programmes. Objective: The aim of this review is to analyse original papers addressing AAI and neurological diseases and published in the most influential medical journals between 2001 and 2012, and discuss their findings in the light of what may be of interest in the field of neurology. Discussion: We selected a total of 23 articles on neurorehabilitation in cerebral palsy, pervasive developmental disorders, multiple sclerosis, spinal cord injury, stroke, and mental disorders. The main therapeutic results were improvement on the Gross Motor Function Classification Scale and in upper limb dexterity (cerebral palsy); improvement in social functioning and interaction; reductions in stress, anxiety, and loneliness (pervasive developmental disorders and mental disorders); and decreased spasticity with improved balance (multiple sclerosis, spinal cord injury, stroke). Conclusion: These interventions, performed with highly specialised animals in very specific neurological populations, deliver an increasing body of scientific evidence suggesting that they are an effective complement to other existing therapies. In these diseases, further high-quality studies are warranted in order to define the most appropriate programmes for therapy. Resumen: Introducción: Aunque siempre se ha afirmado el valor de los animales en la promoción del bienestar y la salud del ser humano, solo recientemente su papel terapéutico en medicina se ha convertido en el foco de investigación especializada. Las intervenciones asistidas por animales pueden dividirse en actividades asistidas por animales, terapia asistida por animales y programas de animales de servicio. Objetivo: El objetivo de esta revisión es analizar las publicaciones realizadas entre 2001 y 2012 en las revistas médicas más importantes, relacionadas con el campo de la rehabilitación de las enfermedades neurológicas, y discutir estos hallazgos a la luz de lo que pueda ser de interés para la neurología. Discusión: Se seleccionaron un total de 23 artículos de intervenciones en el campo de la parálisis cerebral infantil, trastornos generalizados del desarrollo, esclerosis múltiple, lesión medular, accidente cerebrovascular y trastornos mentales. Los principales resultados terapéuticos fueron: mejoría en la Gross Motor Function y en el manejo del miembro superior (parálisis cerebral infantil); aumento de la socialización y el contacto con el medio ambiente, reducción del estrés y la ansiedad y sentimientos de soledad (trastornos generalizados del desarrollo y trastornos mentales); disminución de la espasticidad y mejoría del equilibrio (esclerosis múltiple, lesión medular, accidente cerebrovascular). Conclusiones: Estas intervenciones asistidas con un tipo de animales muy limitado utilizadas en grupos clínicos neurológicos muy específicos muestran cada vez más pruebas científicas, como método complementario a otras terapias ya existentes. En estas enfermedades, se necesitan más estudios de alta calidad metodológica que permitan definir los programas más apropiados para la aplicación terapéutica. Keywords: Animal assisted therapy, Service animals, Nervous system diseases, Palabras clave: Terapia asistida por animales, Animales de servicio, Enfermedades del sistema nervios

Late complications of robot-assisted radical cystectomy with totally intracorporeal urinary diversion

Introduction and objectives: To evaluate late complications in a large cohort of patients undergoing robot-assisted radical cystectomy (RARC) with totally intracorporeal urinary diversion (ICUD). Materials and methods: We prospectively enrolled patients who underwent RARC and ICUD between August 2012 and June 2019. We excluded patients with Ejection fraction < 36%, retinal vasculopathy, ventriculoperitoneal shunts, and those treated without curative intent. All complications and their onset date have been recorded, defined, and graded according to Clavien classification adapted for radical cystectomy. Results: 210 patients were included, 76% of whom were men, with a mean age of 62 years. Urinary diversions used were Padua Ileal Bladder (PIB) in 80% of cases, and ileal conduit (IC) in 20% of patients (generally older and with more comorbidity). The mean follow-up was 30 ± 22 months. The stenosis rate of uretero-ileal anastomosis was 14%, while a reduction in eGFR (≥ 20%) was observed in about half of the cases. UTIs occurred in 37% of the patients, especially in the first 12 months. Only 2% of patients had bowel occlusion, whereas incisional hernia, lymphocele, and systemic events (metabolic acidosis and major cardiovascular events) occurred respectively in 20%, 10%, and 1% of cases. Conclusions: Our study evaluates first late complications in a cohort of patients who underwent RARC with ICUD. These data are encouraging and in line with findings from a historical series of open radical cystectomy (ORC). This study is a further step in supporting RARC as a safe and effective surgical option for the treatment of muscle-invasive bladder cancer (MIBC) in tertiary referral centers