6 research outputs found
Toward a new paradigm: spirituality and its inclusion into the rehabilitation counseling process
No full textPlan BRehabilitation counseling helps to maximize the potential of a person with a disability while facilitating avenues for employment and independent living. Rehabilitation counseling has integrated these areas into the process, which include the medical, physical, psychosocial, and vocational goals of a person with a disability, which will help that person achieve personally fulfilling, meaningful, functional, and positive interactions in the community. Rehabilitation has defined itself as using the medical model, which tries to cure and rehabilitate a person with a disability. In the past few years the medical profession and human services profession has integrated spirituality into the healing and helping paradigms. As, each field moves toward a more inclusive model, rehabilitation counseling must move toward a model, which includes spirituality. In recent years the rehabilitation counseling profession has included social workers, peer counselors, and independent living specialists into the milieu of the rehabilitation process. As, the rehabilitation counseling profession engages other professionals from different fields it comes face to face with other disciplines that have incorporated spirituality into each ideology. Thus, the rehabilitation counseling profession comes in conflict with the other helping professions because it does not include spirituality in the rehabilitation counseling process. The rehabilitation counseling profession must find a way to include spirituality into the counseling process. Counselors-in-training should develop an understanding of spirituality, its influences on the rehabilitation counseling process. The following study will discuss the current literature about spirituality, rehabilitation counseling and counseling. As a qualitative study, the research will use a focus group approach discussing spirituality and its inclusion into rehabilitation counseling process with rehabilitation counselors-in-training. Descriptive data regarding the participants will be provided as well as a qualitative analysis of the focus group conten
Increased systemic inflammation is associated with cardiac and vascular dysfunction over the first 12 weeks of antiretroviral therapy among undernourished, HIV-infected adults in Southern Africa.
No full textThis is an open-access article distributed
under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the
original author and source are credited.INTRODUCTION: Persistent systemic inflammation is associated with mortality among undernourished, HIV-infected adults starting antiretroviral therapy (ART) in sub-Saharan Africa, but the etiology of these deaths is not well understood. We hypothesized that greater systemic inflammation is accompanied by cardiovascular dysfunction over the first 12 weeks of ART. METHODS: In a prospective cohort of 33 undernourished (body mass index <18.5 kg/m2) Zambian adults starting ART, we measured C-reactive protein (CRP), tumor necrosis factor-α receptor 1 (TNF-α R1), and soluble CD163 and CD14 at baseline and 12 weeks. An EndoPAT device measured the reactive hyperemia index (LnRHI; a measure of endothelial responsiveness), peripheral augmentation index (AI; a measure of arterial stiffness), and heart rate variability (HRV; a general marker of autonomic tone and cardiovascular health) at the same time points. We assessed paired changes in inflammation and cardiovascular parameters, and relationships independent of time point (adjusted for age, sex, and CD4+ T-cell count) using linear mixed models. RESULTS: Serum CRP decreased (median change -3.5 mg/l, p=0.02), as did TNF-α R1 (-0.31 ng/ml, p<0.01), over the first 12 weeks of ART. A reduction in TNF-α R1 over 12 weeks was associated with an increase in LnRHI (p=0.03), and a similar inverse relationship was observed for CRP and LnRHI (p=0.07). AI increased in the cohort as a whole over 12 weeks, and a reduction in sCD163 was associated with a rise in the AI score (p=0.04). In the pooled analysis of baseline and 12 week data, high CRP was associated with lower HRV parameters (RMSSD, p=0.01; triangular index, p<0.01), and higher TNF- α R1 accompanied lower HRV (RMSSD, p=0.07; triangular index, p=0.06). CONCLUSIONS: Persistent inflammation was associated with impaired cardiovascular health over the first 12 weeks of HIV treatment among undernourished adults in Africa, suggesting cardiac events may contribute to high mortality in this population.This work was supported by the Vanderbilt
Meharry Center for AIDS Research (NIH grant number P30 AI54999); the NIH
Fogarty International Center, Office of the Director, National Institutes of Health,
National Heart, Blood, and Lung Institute, and National Institute of Mental Health,
through the Vanderbilt-Emory-Cornell-Duke Consortium for Global Health Fellows
(grant number R25 TW009337); the National Center for Advancing Translational
Sciences (CTSA award number UL1TR000445) and the European and Developing
Countries Clinical Trials Partnership (grant IP.2009.33011.004)
Pharmacokinetic/pharmacodynamic modelling approaches in paediatric infectious diseases and immunology
No full textPharmacokinetic/pharmacodynamic (PKPD) modelling is used to describe and quantify dose-concentration-effect relationships. Within paediatric studies in infectious diseases and immunology these methods are often applied to developing guidance on appropriate dosing. In this paper, an introduction to the field of PKPD modelling is given, followed by a review of the PKPD studies that have been undertaken in paediatric infectious diseases and immunology. The main focus is on identifying the methodological approaches used to define the PKPD relationship in these studies. The major findings were that most studies of infectious diseases have developed a PK model and then used simulations to define a dose recommendation based on a pre-defined PD target, which may have been defined in adults or in vitro. For immunological studies much of the modelling has focused on either PK or PD, and since multiple drugs are usually used, delineating the relative contributions of each is challenging. The use of dynamical modelling of in vitro antibacterial studies, and paediatric HIV mechanistic PD models linked with the PK of all drugs, are emerging methods that should enhance PKPD-based recommendations in the future
Social distinction and the written word : two provincial case studies, Warwick and Draguignan, 1780-1820
No full textThis is a comparative study of two countries, England and France, two county towns,
Warwick and Draguignan, and two families of the trading-manufacturing sort. It
argues that, during the period around 1780-1820, the acquisition of a certain form of
education, which included an emphasis on fluent reading, writing, and grammar.
preferably Latin grammar, became as important as the acquisition of capital. This
cultural capital gave its new owners a self-perceived distinction which allowed them to
consider themselves and to be considered by others as different.
Even if local, regional, and national differences are taken into account, this
comparative study shows that this new perception developed as a transnational
phenomenon, a form of culture sallS jrolltieres, even during the times of enmity and
almost uninterrupted wars between Britain and France which characterise this period.
This process had begun earlier in the eighteenth century, when the idea of a public
opinion and its premise of equal interaction amongst its proponents was 'invented'; but
it was facilitated by the French Revolution with its legacy of the notion of equality, and
therefore of the importance of communication in forging democracy. The written word
was the chosen means to achieve this.
It is argued that this distinctive culture, in the production and consumption of which
women played a considerable part, gave voice and a social and political consciousness
to those who began to see themselves as the 'middle class'
A genetically encoded fluorescent acetylcholine indicator for in vitro and in vivo studies
No full textThe neurotransmitter acetylcholine (ACh) regulates a diverse array of physiological processes throughout the body. Despite its importance, cholinergic transmission in the majority of tissues and organs remains poorly understood owing primarily to the limitations of available ACh-monitoring techniques. We developed a family of ACh sensors (GACh) based on G-protein-coupled receptors that has the sensitivity, specificity, signal-to-noise ratio, kinetics and photostability suitable for monitoring ACh signals in vitro and in vivo. GACh sensors were validated with transfection, viral and/or transgenic expression in a dozen types of neuronal and non-neuronal cells prepared from multiple animal species. In all preparations, GACh sensors selectively responded to exogenous and/or endogenous ACh with robust fluorescence signals that were captured by epifluorescence, confocal, and/or two-photon microscopy. Moreover, analysis of endogenous ACh release revealed firing-pattern-dependent release and restricted volume transmission, resolving two long-standing questions about central cholinergic transmission. Thus, GACh sensors provide a user-friendly, broadly applicable tool for monitoring cholinergic transmission underlying diverse biological processes
