The Role of Clinical Supervision in Treating Clients with Antisocial Personality Disorder

Clinicians often have negative attitudes toward clients diagnosed with antisocial personality disorder (ASPD), which can sabotage treatment and lead to clinician burnout and job dissatisfaction. Researchers recommend clinicians receive regular clinical supervision; however, clinical supervision strategies and models related to working with ASPD are lacking. We identify supervisors’ primary task as exploring and improving clinicians’ attitudes toward clients having ASPD and examine this task within the discrimination model of clinical supervision. A case study is offered as an illustration for how to approach working with ASPD in supervision

Location of studies and evidence of effects of herbivory on Arctic vegetation : a systematic map

Background: Herbivores modify the structure and function of tundra ecosystems. Understanding their impacts is necessary to assess the responses of these ecosystems to ongoing environmental changes. However, the effects of herbivores on plants and ecosystem structure and function vary across the Arctic. Strong spatial variation in herbivore effects implies that the results of individual studies on herbivory depend on local conditions, i.e., their ecological context. An important first step in assessing whether generalizable conclusions can be produced is to identify the existing studies and assess how well they cover the underlying environmental conditions across the Arctic. This systematic map aims to identify the ecological contexts in which herbivore impacts on vegetation have been studied in the Arctic. Specifically, the primary question of the systematic map was: "What evidence exists on the effects of herbivores on Arctic vegetation?". Methods: We used a published systematic map protocol to identify studies addressing the effects of herbivores on Arctic vegetation. We conducted searches for relevant literature in online databases, search engines and specialist websites. Literature was screened to identify eligible studies, defined as reporting primary data on herbivore impacts on Arctic plants and plant communities. We extracted information on variables that describe the ecological context of the studies, from the studies themselves and from geospatial data. We synthesized the findings narratively and created a Shiny App where the coded data are searchable and variables can be visually explored. Review findings We identified 309 relevant articles with 662 studies (representing different ecological contexts or datasets within the same article). These studies addressed vertebrate herbivory seven times more often than invertebrate herbivory. Geographically, the largest cluster of studies was in Northern Fennoscandia. Warmer and wetter parts of the Arctic had the largest representation, as did coastal areas and areas where the increase in temperature has been moderate. In contrast, studies spanned the full range of ecological context variables describing Arctic vertebrate herbivore diversity and human population density and impact. Conclusions: The current evidence base might not be sufficient to understand the effects of herbivores on Arctic vegetation throughout the region, as we identified clear biases in the distribution of herbivore studies in the Arctic and a limited evidence base on invertebrate herbivory. In particular, the overrepresentation of studies in areas with moderate increases in temperature prevents robust generalizations about the effects of herbivores under different climatic scenarios.Peer reviewe

Developing common protocols to measure tundra herbivory across spatial scales

Understanding and predicting large-scale ecological responses to global environmental change requires comparative studies across geographic scales with coordinated efforts and standardized methodologies. We designed, applied, and assessed standardized protocols to measure tundra herbivory at three spatial scales: plot, site (habitat), and study area (landscape). The plot- and site-level protocols were tested in the field during summers 2014–2015 at 11 sites, nine of them consisting of warming experimental plots included in the International Tundra Experiment (ITEX). The study area protocols were assessed during 2014–2018 at 24 study areas across the Arctic. Our protocols provide comparable and easy to implement methods for assessing the intensity of invertebrate herbivory within ITEX plots and for characterizing vertebrate herbivore communities at larger spatial scales. We discuss methodological constraints and make recommendations for how these protocols can be used and how sampling effort can be optimized to obtain comparable estimates of herbivory, both at ITEX sites and at large landscape scales. The application of these protocols across the tundra biome will allow characterizing and comparing herbivore communities across tundra sites and at ecologically relevant spatial scales, providing an important step towards a better understanding of tundra ecosystem responses to large-scale environmental change

Inhibition of epidermal growth factor receptor signalling reduces hypercalcaemia induced by human lung squamous-cell carcinoma in athymic mice

The purpose of this study was to evaluate the role of the epidermal growth factor receptor (EGFR) in parathyroid hormone-related protein (PTHrP) expression and humoral hypercalcaemia of malignancy (HHM), using two different human squamous-cell carcinoma (SCC) xenograft models. A randomised controlled study in which nude mice with RWGT2 and HARA xenografts received either placebo or gefitinib 200 mg kg−1 for 3 days after developing HHM. Effectiveness of therapy was evaluated by measuring plasma calcium and PTHrP, urine cyclic AMP/creatinine ratios, and tumour volumes. The study end point was at 78 h. The lung SCC lines, RWGT2 and HARA, expressed high levels of PTHrP mRNA as well as abundant EGFR protein, but very little erbB2 or erbB3. Both lines expressed high transcript levels for the EGFR ligand, amphiregulin (AREG), as well as, substantially lower levels of transforming growth factor-α (TGF-α), and heparin binding-epidermal growth factor (HB-EGF) mRNA. Parathyroid hormone-related protein gene expression in both lines was reduced 40–80% after treatment with 1 μM of EGFR tyrosine kinase inhibitor PD153035 and precipitating antibodies to AREG. Gefitinib treatment of hypercalcaemic mice with RWGT2 and HARA xenografts resulted in a significant reduction of plasma total calcium concentrations by 78 h. Autocrine AREG stimulated the EGFR and increased PTHrP gene expression in the RWGT2 and HARA lung SCC lines. Inhibition of the EGFR pathway in two human SCC models of HHM by an anilinoquinazoline demonstrated that the EGFR tyrosine kinase is a potential target for antihypercalcaemic therapy

Imputation of average summer temperature at Zackenberg in 1995 from Differential arthropod responses to warming are altering the structure of Arctic communities

Summer temperature data from the year prior to the start of the study (1995) were unavailable from the Zackenberg climate station and were thus imputed from gridded temperature data for the Zackenberg area from the Climate Research Unit (CRU) TS3.23 Dataset

Changes in raw climate variables over study period at Zackenberg, Greenland from Differential arthropod responses to warming are altering the structure of Arctic communities

Variation in average temperatures, winter duration, and number of winter freeze-thaw events at Zackenberg, Greenland between 1996-2014

Variation in arthropod abundances at Zackenberg from Differential arthropod responses to warming are altering the structure of Arctic communities

Average abundances (catch/day) of arthropods by taxonomic group and habitat over the study period (1996-2014)

C7 intralaminar screw placement, an alternative to lateral mass or pedicle fixation for treatment of cervical spondylytic myelopathy, kyphotic deformity, and trauma: A case report and technical note

BACKGROUND: The authors present a case to illustrate the necessity and technical feasibility of C7 laminar screw placement for treatment of sub-axial cervical spondylitic myelopathy. The indications for C7 lateral mass screw placement was required internal fixation, with small lateral masses (8 mm) and pedicles (4 mm). CASE DESCRIPTION: A 67-year-old female with compressive myelopathy after a fall from standing is presented. Magnetic resonance (MR) imaging of the cervical spine showed severe C3-6 spondylosis with canal and foraminal compromise. Computed tomography of the cervical spine confirmed the MR imaging findings as well as showed suboptimal lateral mass and pedicles for screw placement. The patient underwent a C3-6 laminectomy, C3-6 lateral mass, and C7 laminar screw placement. Postoperatively, the patient recovered without complication. CONCLUSION: Internal fixation of the cervical spine after iatrogenic destabilization by decompression of neural elements secondary to advanced spondylosis can be technically challenging. Anatomical landmarks needed for safe placement of lateral mass or pedicle instrumentation are often distorted by the patients’ advanced pathology or Inherent biology. The C7 screw is a key structural element to a long construct and therefore necessitates large lateral masses or pedicles to safely place a functional screw. C7 laminar screws may be placed safely without fluoroscopic guidance when sufficient C7 lateral mass or pedicle screws are not possible or with undue risk