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Andrews E.E.,Texas A&M University | Kuemmel A.,Louis Stokes Medical Center | Williams J.L.,Wright State University | Pilarski C.R.,Origami Brain Injury Rehabilitation Center | And 3 more authors.
Rehabilitation Psychology | Year: 2013

Objective: Very little is known about the supervision experiences of psychology trainees with disabilities in rehabilitation training settings. It is clear from the lack of literature, however, that a gap exists in training and education for supervisors about working with disabled trainees and providing culturally competent supervision. The purpose of this article is to explore legal and ethical concerns, cultural considerations of disability as an aspect of human diversity, attitudinal barriers, and mentorship during the professional journey of training future psychologists with disabilities. Method: This article was developed by reviewing the pertinent literature. The authors utilized a sample vignette and pertinent points from their own experiences as trainees, psychologists, and supervisors with disabilities in rehabilitation settings. Results: A thorough discussion of the diversity and cultural aspects of supervising disabled trainees is included, along with a discussion of the importance of mentorship. Implications: A summary of recommendations is provided for supervisors of trainees with disabilities. © 2013 American Psychological Association. Source

Hsieh Y.-H.,Case Western Reserve University | Jacono F.J.,Case Western Reserve University | Jacono F.J.,Louis Stokes Medical Center | Siegel R.E.,Case Western Reserve University | Dick T.E.,Case Western Reserve University
Respiratory Physiology and Neurobiology | Year: 2015

Respiratory modulation of sympathetic nerve activity (SNA) depends on numerous factors including prior experience. In our studies, exposing naïve adult, male Sprague-Dawley rats to acute intermittent hypoxia (AIH) enhanced respiratory-modulation of splanchnic SNA (sSNA); whereas conditioning them to chronic hypobaric hypoxia (CHH) attenuated modulation. Further, AIH can evoke increased SNA in the absence phrenic long-term facilitation. We hypothesized that AIH would restore respiratory modulation of SNA in CHH rats. In anesthetized, CHH-conditioned (0.5 atm, 2 wks) rats (n=16), we recorded phrenic and sSNA before during and after AIH (8% O2 for 45s every 5min for 1h). At baseline, sSNA was not modulated with respiration. The sSNA was not recruited during a single brief exposure of hypoxia nor after 10 repetitive exposures. Further, the sSNA chemoresponse was not restored 1h after completing AIH. Thus, CHH-conditioning blocked the short-term plasticity expressed in sympatho-respiratory efferent activities and this was associated with reduced respiratory modulation of sympathetic activity and with attenuation of the sympatho-respiratory chemoresponse. © 2014 Elsevier B.V. Source

Burant C.J.,Case Western Reserve University | Burant C.J.,Louis Stokes Medical Center
International Journal of Aging and Human Development | Year: 2016

The latent growth curve model (LGCM) is a useful tool in analyzing longitudinal data. It is particularly suitable for gerontological research because the LGCM can track the trajectories and changes of phenomena (e.g., physical health and psychological wellbeing) over time. Specifically, the LGCM compares lines of change across a set of individuals and determines the overall model's line of change. LGCMs can be used to track either linear or curvilinear trajectories. Since the technique uses structural equation modeling, models are also adjusted for measurement error. This article will present a step-by-step approach to setting up, analyzing, and interpreting an LGCM using post-hospitalization recovery in depressive symptomatology as an example. This article will demonstrate how to test linear, quadratic, and freely estimated lines of change using LGCMs with the purpose of finding the line of trajectory for depressive symptoms that best fits the data. © The Author(s) 2016. Source

Cascio M.A.,Case Western Reserve University | Yomtovian R.,Louis Stokes Medical Center
Transfusion Medicine Reviews | Year: 2013

Food and Drug Administration guidelines prohibit men who have sex with men (MSM) from donating blood to prevent the spread of the human immunodeficiency virus (HIV/AIDS). Although the deferral criteria leave "sex" undefined, donor educational materials distributed before the health questionnaire often offer a definition. This study analyzes educational materials for their contribution to the donation process and construction of HIV/AIDS. It applies a discourse analysis approach to a sample (n = 52) of such materials obtained in summer 2009 from blood collection organizations listed in the AABB (now referred to as "Advancing Transfusion and Cellular Therapies Worldwide") Directory of Community Blood Centers and Hospital Blood Banks [AABB. Directory of Community Blood Centers and Hospital Blood Banks. Bethesda, MD: AABB; 2009]. It finds that when materials define sex, the definition is "vaginal, oral, or anal sex whether or not a condom or other protection was used," and when materials define HIV/AIDS risk behaviors, the definition is, with few exceptions, "sexual contact with an infected person or by sharing needles or syringes used for injecting drugs." Widespread use of these definitions demonstrates the influence of "Making Your Blood Donation Safe." Through analysis of this document and variations upon it, this research finds that the category MSM therefore provides one component of the construction of HIV/AIDS as the providence of MSM, together with heterosexual Africans and other risk populations, conflating group membership with individual risk. Deferring MSM therefore fails as a behavior-based deferral because it collapses multiple sexual behaviors with varying risks into a single risk category. It constructs all MSM as HIV positive and implicitly constructs non-MSM as risk-free. © 2013 Elsevier Inc. Source

Jacono F.J.,Case Western Reserve University | Jacono F.J.,Louis Stokes Medical Center
Respiratory Physiology and Neurobiology | Year: 2013

Breathing occurs in single breaths and in patterns which are altered by the onset, progression and resolution of respiratory diseases. Through modulations of rate, depth, and patterning of breathing, the ventilatory control system maintains numerous critical variables within their homeostatic ranges. A dynamic respiratory control system is critical to successful adaptation in the face of progressive pulmonary pathology. The objective of this review, is to illustrate functional changes and compensatory mechanisms which occur with the onset and progression of acute and chronic lung disease. Chronic obstructive pulmonary disease (COPD) will be considered as a model of a slowly progressive pulmonary process, where destruction of lung parenchyma and airway obstruction leads to hypoxemia and hypercapnia. Over time, adaptations of the respiratory control system to this disease include changes in the intrinsic properties of respiratory muscles, chemoreceptor signaling, and central respiratory drive which increase motor output to the respiratory muscles. In contrast, acute respiratory distress syndrome (ARDS) is an exemplar of an acute pulmonary process. The result of severe lung injury, ARDS is characterized by lung infiltrates, rapidly progressive hypoxemic respiratory failure, and possible progression to pulmonary fibrosis. Changes in breathing patterns result from these functional changes, as well as altered processing of afferent feedback by the central controller, possibly influenced by brainstem inflammation. Taken together, these disease models highlight the plasticity of the respiratory control system in response to the development and progression of lung disease. © 2013. Source

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