Therapists-in-Training Who Experience a Client Suicide: Implications for Supervision

Client suicide is often an extraordinarily painful process for clinicians, especially those still in training. Given their training status, supervisees may look to their graduate programs and supervisors for guidance and support when such an event occurs. This study qualitatively examined the experiences of 13 prelicensure doctoral supervisees regarding their client\u27s suicide. Findings suggest that these supervisees received minimal graduate training about suicide and that support from others, including supervisors, helped them cope with their client\u27s death. Supervisors are advised to normalize and process supervisees\u27 experiences of client suicide. Implications for training and practice are discussed

Sexual Attraction Toward Clients, Use of Supervision, and Prior Training: A Qualitative Study of Predoctoral Psychology Interns

Interviews were conducted with 13 predoctoral psychology interns about an experience of sexual attraction toward a client, use of supervision to address the sexual attraction, and prior training regarding sexual attraction. Results indicated that sexual attraction to clients consisted of physical and interpersonal aspects. Therapists believed they were more invested and attentive than usual to clients to whom they were sexually attracted, and they indicated that sexual attraction created distance, distraction, and loss of objectivity. In terms of supervision, only half of the participants disclosed their sexual attraction to supervisors, and supervisors seldom initiated the discussion. Furthermore, trainees found it helpful when supervisors normalized the sexual attraction and provided the opportunity to explore feelings in supervision. Finally, trainees believed their training programs did not adequately address therapist sexual attraction

Predoctoral Interns\u27 Nondisclosure in Supervision

In interviews with 14 counseling center predoctoral interns regarding a significant nondisclosure in supervision, eight interns reported good supervisory relationships and six indicated that they experienced problematic supervisory relationships. Nondisclosures for the interns in good supervisory relationships related to personal reactions to clients, whereas nondisclosures for interns in problematic supervisory relationships related to global dissatisfaction with the supervisory relationship. In both groups, interns mentioned concerns about evaluation and negative feelings as typical reasons for nondisclosure. Additional reasons for nondisclosure for interns in problematic supervision were power dynamics, inhibiting demographic or cultural variables, and the supervisor\u27s theoretical orientation. Both groups described negative effects of nondisclosure on themselves and their relationships with clients. Interns in problematic supervision also reported that nondisclosures had negative effects on the supervisory relationship

Supervisor Cultural Responsiveness and Unresponsiveness in Cross-Cultural Supervision

Thirteen supervisees’ of color and 13 European American supervisees’ experiences of culturally responsive and unresponsive cross-cultural supervision were studied using consensual qualitative research. In culturally responsive supervision, all supervisees felt supported for exploring cultural issues, which positively affected the supervisee, the supervision relationship, and client outcomes. In culturally unresponsive supervision, cultural issues were ignored, actively discounted, or dismissed by supervisors, which negatively affected the supervisee, the relationship, and/or client outcomes. European American supervisees’ and supervisees’ of color experiences diverged significantly, with supervisees of color experiencing unresponsiveness more frequently and with more negative effects than European American supervisees. Implications for research and supervision practice are discussed

Lineage dynamics of murine pancreatic development at single-cell resolution.

Organogenesis requires the complex interactions of multiple cell lineages that coordinate their expansion, differentiation, and maturation over time. Here, we profile the cell types within the epithelial and mesenchymal compartments of the murine pancreas across developmental time using a combination of single-cell RNA sequencing, immunofluorescence, in situ hybridization, and genetic lineage tracing. We identify previously underappreciated cellular heterogeneity of the developing mesenchyme and reconstruct potential lineage relationships among the pancreatic mesothelium and mesenchymal cell types. Within the epithelium, we find a previously undescribed endocrine progenitor population, as well as an analogous population in both human fetal tissue and human embryonic stem cells differentiating toward a pancreatic beta cell fate. Further, we identify candidate transcriptional regulators along the differentiation trajectory of this population toward the alpha or beta cell lineages. This work establishes a roadmap of pancreatic development and demonstrates the broad utility of this approach for understanding lineage dynamics in developing organs

Association between Depressive Symptoms and Metabolic Syndrome in Police Officers: Results from Two Cross-Sectional Studies

Policing is one of the most dangerous and stressful occupations and such stress can have deleterious effects on health. The purpose of this study was to examine the association between depressive symptoms and metabolic syndrome (MetSyn) in male and female police officers from two study populations, Buffalo, NY and Spokane, WA. Depressive symptoms were measured using the Center for Epidemiologic Studies-Depression (CES-D) scale. MetSyn was defined using the 2005 AHA/NHBLI guidelines. Analysis of covariance was used to describe differences in number of MetSyn components across depressive symptom categories. The number of MetSyn components increased significantly across categories of CES-D for Spokane men only (p-trend = 0.003). For each 5-unit increase in CES-D score, odds increased by 47.6% for having hypertriglyceridemia, by 51.8% for having hypertension, and by 56.7% for having glucose intolerance. Exploring this association is important since both are predictors of future chronic health problems and the results could be helpful in developing future gender-specific prevention and intervention efforts among police officers

2\u27-O-Methyl at 20-mer Guide Strand 3\u27 Termini May Negatively Affect Target Silencing Activity of Fully Chemically Modified siRNA

Small interfering RNAs (siRNAs) have the potential to treat a broad range of diseases. siRNAs need to be extensively chemically modified to improve their bioavailability, safety, and stability in vivo. However, chemical modifications variably impact target silencing for different siRNA sequences, making the activity of chemically modified siRNA difficult to predict. Here, we systematically evaluated the impact of 3\u27 terminal modifications (2\u27-O-methyl versus 2\u27-fluoro) on guide strands of different length and showed that 3\u27 terminal 2\u27-O-methyl modification negatively impacts activity for \u3e60% of siRNA sequences tested but only in the context of 20- and not 19- or 21-nt-long guide strands. These results indicate that sequence, modification pattern, and structure may cooperatively affect target silencing. Interestingly, the introduction of an extra 2\u27-fluoro modification in the seed region at guide strand position 5, but not 7, may partially compensate for the negative impact of 3\u27 terminal 2\u27-O-methyl modification. Molecular modeling analysis suggests that 2\u27-O-methyl modification may impair guide strand interactions within the PAZ domain of argonaute-2, which may affect target recognition and cleavage, specifically when guide strands are 20-nt long. Our findings emphasize the complex nature of modified RNA-protein interactions and contribute to design principles for chemically modified siRNAs

Salivary glands regenerate after radiation injury through SOX2-mediated secretory cell replacement

Salivary gland acinar cells are routinely destroyed during radiation treatment for head and neck cancer that results in a lifetime of hyposalivation and co-morbidities. A potential regenerative strategy for replacing injured tissue is the reactivation of endogenous stem cells by targeted therapeutics. However, the identity of these cells, whether they are capable of regenerating the tissue, and the mechanisms by which they are regulated are unknown. Using in vivo and ex vivo models, in combination with genetic lineage tracing and human tissue, we discover a SOX2+ stem cell population essential to acinar cell maintenance that is capable of replenishing acini after radiation. Furthermore, we show that acinar cell replacement is nerve dependent and that addition of a muscarinic mimetic is sufficient to drive regeneration. Moreover, we show that SOX2 is diminished in irradiated human salivary gland, along with parasympathetic nerves, suggesting that tissue degeneration is due to loss of progenitors and their regulators. Thus, we establish a new paradigm that salivary glands can regenerate after genotoxic shock and do so through a SOX2 nerve-dependent mechanism

Treatment compliance and effectiveness of a cognitive behavioural intervention for low back pain : a complier average causal effect approach to the BeST data set

Background: Group cognitive behavioural intervention (CBI) is effective in reducing low-back pain and disability in comparison to advice in primary care. The aim of this analysis was to investigate the impact of compliance on estimates of treatment effect and to identify factors associated with compliance. Methods: In this multicentre trial, 701 adults with troublesome sub-acute or chronic low-back pain were recruited from 56 general practices. Participants were randomised to advice (control n = 233) or advice plus CBI (n = 468). Compliance was specified a priori as attending a minimum of three group sessions and the individual assessment. We estimated the complier average causal effect (CACE) of treatment. Results: Comparison of the CACE estimate of the mean treatment difference to the intention-to-treat (ITT) estimate at 12 months showed a greater benefit of CBI amongst participants compliant with treatment on the Roland Morris Questionnaire (CACE: 1.6 points, 95% CI 0.51 to 2.74; ITT: 1.3 points, 95% CI 0.55 to 2.07), the Modified Von Korff disability score (CACE: 12.1 points, 95% CI 6.07 to 18.17; ITT: 8.6 points, 95% CI 4.58 to 12.64) and the Modified von Korff pain score (CACE: 10.4 points, 95% CI 4.64 to 16.10; ITT: 7.0 points, 95% CI 3.26 to 10.74). People who were non-compliant were younger and had higher pain scores at randomisation. Conclusions: Treatment compliance is important in the effectiveness of group CBI. Younger people and those with more pain are at greater risk of non-compliance

A Climatology of Cold-Season Nonconvective Wind Events in the Great Lakes Region

A 44-yr climatology of nonconvective wind events (NCWEs) for the Great Lakes region has been created using hourly wind data for 38 first-order weather stations during the months of November through April. The data were analyzed in terms of the two National Weather Service (NWS) criteria for a high-wind watch or warning: sustained winds of at least 18 m s-1for at least 1 h or a wind gust of at least 26 m s-1for any duration. The results indicate a pronounced southwest quadrant directional preference for nonconvective high winds in this region. Between 70% and 76% of all occurrences that satisfied the NWS criteria for NCWEs were associated with wind directions from 180° through 270°. Within the southwest quadrant, the west-southwest direction is preferred, with 14%-35% of all NCWEs coming from this particular compass heading. This directional preference is borne out in five out of six stations with high occurrences of cold-season NCWEs (Buffalo, New York; Dayton, Ohio; Lansing, Michigan; Moline, Illinois; Springfield, Illinois). Given the geographic spread of these stations, a nontopographic cause for the directional preference of cold-season NCWEs is indicated. The connection between NCWEs and low pressure systems found in this climatology and in case studies suggests that midlatitude cyclone dynamics may be a possible cause of the directional preference