Moving towards self-actualization : a trauma-informed and needs-focused approach to the mental health needs of survivors of commercial child sexual exploitation

There is increasing evidence that children who are subject to commercial child sexual exploitation (CCSE) are likely to experience complex mental health needs. Failure to address the trauma experienced by victims of CCSE can lead to suicide attempts, self-harm, and long-term mental health needs (Powell, Asbill, Louis, & Stoklosa, 2018). A ‘trauma-informed’ approach (TIA) creates a responsive environment that improves the motivation of victims of CCSE to seek treatment and service providers to address unmet needs. Merging Maslow’s (1943) hierarchy of needs with a TIA approach provides a comprehensive framework to assess the service requirements necessary to meet CCSE survivors’ needs. Particularly, when Maslow’s hierarchy of needs model is coupled with contemporary extensions, which address our greater understanding of the neurological impact of abuse on physiological well-being greater resilience can be created. Additionally, a TIA instigates a shift from victims of CCSE being viewed as damaged, to an understanding of the impact abusive experiences have had on their development. That approach permits them and others to perceive their “survivorhood” and develop their capacity to achieve self-actualization. This paper critically examines what is constituted as best practice in trauma-informed mental health service delivery to not only meet needs but to support CCSE survivors’ attainment of self-actualization

Civil and forensic patients : comparing demographics, risk factors, and negative life events

OBJECTIVES: This investigation centres on how the mentally ill with a forensic admission compare to the mentally ill with a civil admission, and investigates who inpatients with a forensic and civil admission are, and how the risk factors and negative historical events they have experienced compare or differ. THEORETICAL BASE: Using a risk and resilience framework, risk factors that are deleterious to healthy development are used as variables. METHODS: The records of all adult inpatients both forensic and civil, aged 18 to 89 at admission in two U.S. mountain region public psychiatric hospitals were included in the sample (n=1768). All patients are assessed using the Colorado Clinical Assessment Record (CCAR) which, measures a diverse set of variables including Current Issues, History of Issues, Demographics, and Disabilities. OUTCOMES: Civil and forensic patients have more in common than differences. Both samples compare more closely to risk factors and negative historical events than they do to the general population. However, this begins to break down once the sample is separated by gender. SOCIAL WORK IMPLICATIONS: Social Workers who work in prison systems need to become more familiar with mental illness interventions. Additionally, social workers should both educate law enforcement about de-escalation tactics with the mentally ill and intervene on mental health related police calls. On the macro level, social workers should advocate for the mentally ill to be housed in psychiatric hospitals rather than be imprisoned where they will often not receive inpatient psychiatric care

Hypertrophic Stimulation Increases β-actin Dynamics in Adult Feline Cardiomyocytes

The myocardium responds to hemodynamic stress through cellular growth and organ hypertrophy. The impact of cytoskeletal elements on this process, however, is not fully understood. While α-actin in cardiomyocytes governs muscle contraction in combination with the myosin motor, the exact role of β-actin has not been established. We hypothesized that in adult cardiomyocytes, as in non-myocytes, β-actin can facilitate cytoskeletal rearrangement within cytoskeletal structures such as Z-discs. Using a feline right ventricular pressure overload (RVPO) model, we measured the level and distribution of β-actin in normal and pressure overloaded myocardium. Resulting data demonstrated enriched levels of β-actin and enhanced translocation to the Triton-insoluble cytoskeletal and membrane skeletal complexes. In addition, RVPO in vivo and in vitro hypertrophic stimulation with endothelin (ET) or insulin in isolated adult cardiomyocytes enhanced the content of polymerized fraction (F-actin) of β-actin. To determine the localization and dynamics of β-actin, we adenovirally expressed GFP-tagged β-actin in isolated adult cardiomyocytes. The ectopically expressed β-actin-GFP localized to the Z-discs, costameres, and cell termini. Fluorescence recovery after photobleaching (FRAP) measurements of β-actin dynamics revealed that β-actin at the Z-discs is constantly being exchanged with β-actin from cytoplasmic pools and that this exchange is faster upon hypertrophic stimulation with ET or insulin. In addition, in electrically stimulated isolated adult cardiomyocytes, while β-actin overexpression improved cardiomyocyte contractility, immunoneutralization of β-actin resulted in a reduced contractility suggesting that β-actin could be important for the contractile function of adult cardiomyocytes. These studies demonstrate the presence and dynamics of β-actin in the adult cardiomyocyte and reinforce its usefulness in measuring cardiac cytoskeletal rearrangement during hypertrophic stimulation

Selective laser trabeculoplasty: past, present, and future

Over the past two decades, selective laser trabeculoplasty (SLT) has increasingly become an established laser treatment used to lower intraocular pressure in open-angle glaucoma and ocular hypertensive patients. In this review we trace the origins of SLT from previous argon laser trabeculoplasty and review the current role it has in clinical practice. We outline future directions of SLT research and introduce emerging technologies that are further developing this intervention in the treatment paradigm of glaucoma.Eye advance online publication, 5 January 2018; doi:10.1038/eye.2017.273