1,367 research outputs found

    Telehealth Best Practice: A Call for Standards of Care

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    Teletherapy is an approach to working with clients that mental health providers have used in some form for years. However, the onset of COVID forced the provision of therapy into teletherapy almost exclusively for a period of time. Currently, mental health providers conducting therapy virtually are not required to be trained in telehealth and are operating without consistent uniform standards of practice. This manuscript pulls from the current literature and guidelines across counseling, psychology, psychiatry, family therapy, and social work to provide a Proposed Standards of Practice for Telehealth. Such standards benefit mental health counselor by grounding practice in common aims and benefits out clients by creating a unified framework for providers engaging in telehealth with their clients. This manuscript provides a review of current literature around the provision of teletherapy and proposes a set of standards of care based on existing literature. In addition, gaps in current literature are addressed

    Pharmacotherapy for Fibromyalgia

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    Fibromyalgia (FM) is a chronic disorder characterized by multifocal pain and other associated somatic symptoms including fatigue, insomnia, cognitive/memory problems, and even psychological distress. It appears that 2–4% of the general population suffers from FM. FM negatively impacts the physical functioning of its patients, as evidenced by difficulties with multiple daily activities, as well as affecting emotional health, social functioning, and health related quality of life. This review will discuss the potential theories that possibly contribute to the pathogenesis of FM, although the precise mechanism is unknown. The evolution of the assessment of FM will also be examined, with the waning use of tender point examinations and the appearance of new simple, practical diagnostic criteria. Although non-pharmacologic therapeutic options (exercise, education, cognitive–behavioral therapy) have been shown to be extremely effective in FM, the focus of this article will be on pharmacologic strategies. Non-Food and Drug Administration (FDA) approved as well as FDA approved agents will be presented. Each agent's therapeutic “niche” in FM management will be discussed based on its pharmacologic profile, patient responsiveness, and tolerability. Finally a clinical algorithm will be presented for the step-wise management of pain and other associated symptoms of FM

    Discourses Of Prejudice In The professions: The Case Of Sign Languages

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    There is no evidence that learning a natural human language is cognitively harmful to children. To the contrary, multilingualism has been argued to be beneficial to all. Nevertheless, many professionals advise the parents of deaf children that their children should not learn a sign language during their early years, despite strong evidence across many research disciplines that sign languages are natural human languages. Their recommendations are based on a combination of misperceptions about (1) the difficulty of learning a sign language, (2) the effects of bilingualism, and particularly bimodalism, (3) the bona fide status of languages that lack a written form, (4) the effects of a sign language on acquiring literacy, (5) the ability of technologies to address the needs of deaf children and (6) the effects that use of a sign language will have on family cohesion. We expose these misperceptions as based in prejudice and urge institutions involved in educating professionals concerned with the healthcare, raising and educating of deaf children to include appropriate information about first language acquisition and the importance of a sign language for deaf children. We further urge such professionals to advise the parents of deaf children properly, which means to strongly advise the introduction of a sign language as soon as hearing loss is detected

    Use of a Systematic Consultation Process to Facilitate Nursing Research Projects: An Exemplar

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    PURPOSE/OBJECTIVES: The purpose of this article is to describe the use of a well-established, 5-stage consultation process, to advise a research team on planning strategies to engage domestic violence shelters (DVSs) as community partners in their study. The research team is testing a health promotion intervention for teens living in shelters with their parent and needed to enlist shelters as sites to recruit teens and conduct the intervention. Consultation aims were to (a) identify highly promising strategies described in peer-reviewed literature for identifying, recruiting, and collaborating with community organizations in research and (b) identify DVSs that would potentially serve as effective community partners for the study. METHODS: A clinical nurse specialist and a public health master's degree student led the consultation. The consultation process included (a) a systematic review of 29 peer-reviewed articles about research or program evaluation studies that engaged community partners and (b) a comprehensive online search of information about DVSs. OUTCOMES: Consultants identified 104 strategies used in studies to engage community partners and 10 specific DVSs most likely to effectively engage in the study. CONCLUSION: Clinical nurse specialists are well situated to provide consultation to research teams and should follow well-established consultation processes and systematic data collection procedures

    Support For Parents Of Deaf Children: Common Questions And Informed, Evidence-Based Answers

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    To assist medical and hearing-science professionals in supporting parents of deaf children, we have identified common questions that parents may have and provide evidence-based answers. In doing so, a compassionate and positive narrative about deafness and deaf children is offered, one that relies on recent research evidence regarding the critical nature of early exposure to a fully accessible visual language, which in the United States is American Sign Language (ASL). This evidence includes the role of sign language in language acquisition, cognitive development, and literacy. In order for parents to provide a nurturing and anxiety-free environment for early childhood development, signing at home is important even if their child also has the additional nurturing and care of a signing community. It is not just the early years of a child\u27s life that matter for language acquisition; it\u27s the early months, the early weeks, even the early days. Deaf children cannot wait for accessible language input. The whole family must learn simultaneously as the deaf child learns. Even moderate fluency on the part of the family benefits the child enormously. And learning the sign language together can be one of the strongest bonding experiences that the family and deaf child have

    Avoiding Linguistic Neglect Of Deaf Children

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    Deaf children who are not provided with a sign language early in their development are at risk of linguistic deprivation; they may never be fluent in any language, and they may have deficits in cognitive activities that rely on a firm foundation in a first language. These children are socially and emotionally isolated. Deafness makes a child vulnerable to abuse, and linguistic deprivation compounds the abuse because the child is less able to report it. Parents rely on professionals as guides in making responsible choices in raising and educating their deaf children. But lack of expertise on language acquisition and overreliance on access to speech often result in professionals not recommending that the child be taught a sign language or, worse, that the child be denied sign language. We recommend action that those in the social welfare services can implement immediately to help protect the health of deaf children

    Master Grazer: Improving Grazing Management in Kentucky

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    The Master Grazer Educational Program is the result of funding provided by the Kentucky Agricultural Development Board to educate producers on better utilization of grazing lands to improve livestock production and the profitability of the State. County agriculture and natural resource agents, extension specialists, industry contacts and producers work together to make this program a success. The Master Grazer Educational Program began in 2006 as evening lecture sessions taking place in local extension offices. In 2008, the program grew with the addition of a field session that showcased a farm with successful grazing practices, a farm with underdeveloped grazing practices, and a final session for participants to develop their own grazing system. In 2010, the program was modified into the Applied Master Grazer Program. This program placed more emphasis on the importance of the county agriculture. The agents decided which topics would be covered and administered many areas of the program. The program now consists of a minimum of two evening field sessions in which a farm is showcased for a particular topic, as well as one impact session in which participants can interact and contribute to a producer forum. For the purpose of this article, reporting will be focused on the last two years of the Master Grazer Program. The past few years, events such as Grazing Schools, the Advanced Grazing Schools, and Pasture Walks have been held to discuss timely topics of forage and livestock management. Also, the Master Grazer Program has a newsletter, website, and DVD series

    The Role of Endosomal Escape and Mitogen-Activated Protein Kinases in Adenoviral Activation of the Innate Immune Response

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    Adenoviral vectors (AdV) activate multiple signaling pathways associated with innate immune responses, including mitogen-activated protein kinases (MAPKs). In this study, we investigated how systemically-injected AdVs activate two MAPK pathways (p38 and ERK) and the contribution of these kinases to AdV-induced cytokine and chemokine responses in mice. Mice were injected intravenously either with a helper-dependent Ad2 vector that does not express viral genes or transgenes, or with the Ad2 mutant ts1, which is defective in endosomal escape. We found that AdV induced rapid phosphorylation of p38 and ERK as well as a significant cytokine response, but ts1 failed to activate p38 or ERK and induced only a limited cytokine response. These results demonstrate that endosomal escape of virions is a critical step in the induction of these innate pathways and responses. We then examined the roles of p38 and ERK pathways in the innate cytokine response by administering specific kinase inhibitors to mice prior to AdV. The cytokine and chemokine response to AdV was only modestly suppressed by a p38 inhibitor, while an ERK inhibitor has mixed effects, lowering some cytokines and elevating others. Thus, even though p38 and ERK are rapidly activated after i.v. injection of AdV, cytokine and chemokine responses are mostly independent of these kinases
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