Creating and Strengthening the Therapeutic System for Treatment Setting Serving Deaf Children

Treating deaf children with severe emotional and behavior problems, especially in residential and alternative school treatment settings, is a demanding undertaking. Finding and retaining skilled mental health paraprofessionals are continual challenges faced by mental health service providers. These challenges are even greater when the children served are deaf, and when staff members are expected to be multilingual, be knowledgeable about deaf culture, and be able to treat children with a multitude of severe mental health disturbances. Staff members face the dilemma of both raising and treating children in the same setting with limited resources. Limited funding and limited service models encourage the practice of hiring staff members with minimal skill requirements, at low-end payrates, and with little support or training. This article (a) identifies the issues which threaten the delivery of quality treatment for deaf children with severe emotional and behavioral problems; (b) describes the process that changes well-meaning staff into casualties of their work, and (c) makes recommendations for mental health service administrators, supervisors and agencies to help create and strengthen their therapeutic system

Creating and Strengthening the Therapeutic System for Treatment Setting Serving Deaf Children

Treating deaf children with severe emotional and behavior problems, especially in residential and alternative school treatment settings, is a demanding undertaking. Finding and retaining skilled mental health paraprofessionals are continual challenges faced by mental health service providers. These challenges are even greater when the children served are deaf, and when staff members are expected to be multilingual, be knowledgeable about deaf culture, and be able to treat children with a multitude of severe mental health disturbances. Staff members face the dilemma of both raising and treating children in the same setting with limited resources. Limited funding and limited service models encourage the practice of hiring staff members with minimal skill requirements, at low-end payrates, and with little support or training. This article (a) identifies the issues which threaten the delivery of quality treatment for deaf children with severe emotional and behavioral problems; (b) describes the process that changes well-meaning staff into casualties of their work, and (c) makes recommendations for mental health service administrators, supervisors and agencies to help create and strengthen their therapeutic system

Alpha-1 giardin is an annexin with highly unusual calcium-regulated mechanisms

Alpha-giardins constitute the annexin proteome (group E annexins) in the intestinal protozoan parasite Giardia and, as such, represent the evolutionary oldest eukaryotic annexins. The dominance of alpha-giardins in the cytoskeleton of Giardia with its greatly reduced actin content emphasises the importance of the alpha-giardins for the structural integrity of the parasite, which is particularly critical in the transformation stage between cyst and trophozoite. In this study, we report the crystal structures of the apo- and calcium-bound forms of α1-giardin, a protein localised to the plasma membrane of Giardia trophozoites that has recently been identified as a vaccine target. The calcium-bound crystal structure of α1-giardin revealed the presence of a type III site in the first repeat as known from other annexin structures, as well as a novel calcium binding site situated between repeats I and IV. By means of comparison, the crystal structures of three different alpha-giardins known to date indicate that these proteins engage different calcium coordination schemes, among each other, as well as compared to annexins of groups A-D. Evaluation of the calcium-dependent binding to acidic phosphoplipid membranes revealed that this process is not only mediated but also regulated by the environmental calcium concentration. Uniquely within the large family of annexins, α1-giardin disengages from the phospholipid membrane at high calcium concentrations possibly due to formation of a dimeric species. The observed behaviour is in line with changing calcium levels experienced by the parasite during excystation and may thus provide first insights into the molecular mechanisms underpinning the transformation and survival of the parasite in the host