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The authors explore the use of metaphors as a training tool for beginning counselors for enhancing client case conceptualization, counselor-client relationships, and intervention strategies. The history of the use of metaphors in counseling, several definitions, and a case study are presented. The authors discuss intentional use of metaphors with students in training and with clients. How to introduce the use of metaphors into counselor training and practice is also included.

This study examined the relationship between level of depression and level of psychological abuse in women. In addition, the relationship between the use of self-report and measured report of psychological abuse within an intimate relationship was assessed. One hundred women were surveyed using the Psychological Maltreatment of Women Inventory (PMWI) and the Beck Depression Inventory (BDI). Results form the PMWI, the BDI and self-report measures were compared and analyzed. Statistical results indicated that a significant relationship existed between level of depression and level of psychological abuse. In addition, self-report was not predictive of psychological abuse as measured by the PMWI.

Adventure-based therapy has grown in both scope and popularity. These groups are frequently utilized in the treatment of adolescents with behavioral or substance abuse issues. Less evident is the use of this modality with other populations. Described here is a personal account of the author's participation in a wilderness-based group for women. Women of Courage is a course designed by Outward Bound specifically for women who self-describe as survivors of abuse. The program includes either a backpacking or canoeing component, a solo camping experience, and the opportunity to rock climb.

The authors studied the relationships between adult workers' spiritual well-being and job satisfaction. Two hundred participants completed 2 instruments: the Spiritual Well-Being Scale (C. W. Ellison & R. F. Paloutzian, 1982) and the Minnesota Satisfaction Questionnaire Short Form (D. J. Weiss, R. V. Dawis, G. W. England, & L. H. Lofquist, 1967). A bivariate correlational analysis showed spiritual well-being, religious well-being, and existential well-being to be positively related to job satisfaction for this sample. With a forced-entry multiple regression analysis, overall spiritual well-being was found to have a moderate influence, existential well-being had a much stronger influence, and religious well-being had a minimal influence all on, general job satisfaction. (Contains 3 tables.)

Describes the recent evolution of American University's internal newspaper, the "American Weekly," and how it strives to attain the sometimes conflicting ideals of supporting the university and providing independent press coverage. (EV)

Research shows utilizing pre-employment tests leads to improved job performance and satisfaction, and decreased turnover in hospitality industry. However, employers have been slow to embrace pre-employment testing due to concerns regarding validity, potential for discrimination, and heavy administration costs. Using focus groups, this study examined hospitality hiring managers' perceptions of pre-employment testing's value, barriers to adoption, and the relationship between testing, organizational commitment, and job performance in both the United States and Australia. Results showed opposing viewpoints between participants. Research results may enable hiring managers to justify the implementation of pre-employment testing, select which tests to use, and revise current assessment practices. [ABSTRACT FROM AUTHOR]

Uranyl oxide hydrate minerals are common in the altered zones of U deposits and are expected to form where spent nuclear fuel is altered in an oxidizing environment. Consistent with all known uranyl oxide hydrate minerals, metaschoepite [[(U[O.sub.2]).sub.4]O[(OH).sub.6]] [([H.sub.2]O).sub.5], contains sheets of uranyl polyhedra with [H.sub.2]O groups located in the interlayer. Several crystals along the series from metaschoepite to Na-substituted metaschoepite (Na-MS), approximate formula Na[(U[O.sub.2]).sub.4][O.sub.2][(OH).sub.5] [([H.sub.2]O).sub.5], have been synthesized and their structures have been determined. Each contains sheets of uranyl pentagonal bipyramids that are topologically identical to those in metaschoepite, schoepite and fourmarierite. The sheets are electroneutral in metaschoepite, but substitution of O for OH located at the equatorial vertices of the uranyl polyhedra gives a charged sheet that is balanced by incorporation of Na in the interlayer. Synthesis of crystals of Na-MS from a solution containing ~500 ppm [Np.sup.5+], followed by analysis of the crystals using laser-ablation inductively coupled-plasma mass-spectroscopy, demonstrated that the crystals incorporate Np. This is in contrast to earlier studies that showed no incorporation of [Np.sup.5+] in synthetic metaschoepite (which has electroneutral sheets), and supports the hypothesis that [Np.sup.5+] incorporation is more likely in uranyl oxide hydrates with charged species in the interlayer. Keywords: Metaschoepite, uranyl, uranium, nuclear waste, geologic repository, crystal structure, neptunium

Background: Grade 3 gastroenteropancreatic neuroendocrine neoplasms (G3 GEPNENs) are often aggressive, and the optimal treatment is unclear for this subgroup of neuroendocrine neoplasms (NENs). Temozolomide (TEM)‐based regimens have been increasingly used to treat grade 1–2 NENs, but their efficacy in G3 NENs remains undetermined. We aimed to assess the clinical efficacy of TEM‐containing regimens in advanced grade 3 GEPNENs. Materials and Methods: A multicenter retrospective review (2008–2018) of patients with metastatic/unresectable G3 GEPNENs who received a TEM‐containing regimen was undertaken within a North American partnership to pool data. The primary endpoint was time to treatment failure (TTF). Radiologic response was extracted from local reports. Results: One hundred and thirty patients in six high‐volume NEN centers were included (median age 55, 64% male, 18% functional, 67% pancreatic NEN). Forty‐nine percent were well‐differentiated, 35% poorly differentiated, and 15% unknown based on local pathology reports. The regimen used was capecitabine and temozolomide (CAPTEM) in 92% and TEM alone in 8%. Radiological response by local assessment was seen in 36% of patients. Median TTF was 3.6 months and median overall survival (OS) 19.2 months. Six percent of patients required discontinuation of therapy due to adverse events. TTF was longer in first‐line treatment (7.8 months vs. 2.9 months; hazard ratio, 1.62; 95% confidence interval, 1.11–2.36; p =.015) and in patients with pancreatic NENs (panNENs) compared with gastrointestinal NENs (5.8 months vs 1.8 months; p =.04). The overall response rate was higher in the first‐line setting (51% vs 29%; p =.02) and in panNEN (41% vs 23%; p =.04). Conclusion: This is the largest TEM treatment series in G3 NEN, involving collaboration of several major North American NEN centers as a partnership. Thirty‐six percent of patients showed some degree of radiographic response, and treatment was generally well tolerated, although the median duration of response was short. Response rates and time to treatment failure were superior in the first‐line setting. CAPTEM should be considered a viable treatment option in this setting. Further randomized trials are warranted. Implications for Practice: Neuroendocrine neoplasms (NENs) are heterogeneous, and optimal treatment for aggressive grade 3 (G3) NENs remains undetermined. The capecitabine and temozolomide (CAPTEM) regimen has been used in low‐grade pancreas NENs but there are few data for its safety and efficacy in the G3 setting. This article reports on the efficacy of temozolomide‐containing regimens, particularly CAPTEM, in management of G3 NENs. The good tolerance and response rate show that CAPTEM should be considered a viable regimen in treatment of G3 NENs pending confirmatory prospective studies. There has been increasing interest in the combination of capecitabine and temozolomide (CAPTEM) for the treatment of gastroenteropancreatic neuroendocrine neoplasm (GEPNEN). This review reports a large retrospective analysis to report the efficacy and tolerability of temozolomide (TEM)‐containing regimens, particularly CAPTEM, in patients with grade 3 GEPNENs. [ABSTRACT FROM AUTHOR]

Chronic hepatitis C virus (HCV) is a risk factor for type 2 diabetes. In the era of interferon-based HCV therapy, type 2 diabetes was associated with decreased likelihood of sustained virologic response (SVR). Preliminary studies suggest that type 2 diabetes may not reduce the efficacy of regimens involving direct-acting antiviral (DAA) medications. We aimed to determine whether preexisting type 2 diabetes is associated with a reduced rate of SVR achieved 12 weeks after treatment of HCV with DAA-based regimens. [ABSTRACT FROM AUTHOR]

This exploratory study employed the values, attitudes, and behavior (VAB) framework to test Hofstede’s cultural values, state-level ethnocentrism (state brand consumption), and identity (state pride) on intent to support ag-related products in the context of a state operated agricultural marketing program (SOAMP). Results (N = 259) showed collectivism and long term orientation have a positive influence on consumers’ attitudes. State brand consumption was found to be the strongest predictor of intent to purchase local food products, while state pride had a mild level of predictability. Practical implications for food and beverage retailers, hospitality marketers and ag-related government agencies are provided. [ABSTRACT FROM AUTHOR]

As restaurants are the primary hospitality business represented on flash-sale sites, this study examined motivations of restaurant managers when choosing whether to utilize the promotional mediums of flash-sales. Interviews were administered as a measurement instrument. Results demonstrated restaurants which have employed flash-sales are weary of the likelihood of success and believe the flash-sales brought in established customers. Non-users indicated hesitation towards adoption of flash-sales related to low profit margins per item in their operation and the percentage split of the sale price between the firm and flash-sale provider. Findings provide keen foundational insight into the flashsale phenomenon. [ABSTRACT FROM AUTHOR]

Purpose: We assessed the usefulness of real-time molecular profiling through next-generation sequencing (NGS) in predicting the tumor biology of advanced pancreatic neuroendocrine tumors (panNETs) and in characterizing genomic evolution. Methods: Patients with metastatic panNETs were recruited in the routine clinical practice setting (between May 2014 and March 2017) for prospective NGS of their tumors as well as for germline analysis using the Memorial Sloan Kettering-Integrated Mutation Profiling of Actionable Cancer Targets (MSK-IMPACT) sequencing platform. When possible, NGS was performed at multiple time points. Results: NGS was performed in 96 tumor samples from 80 patients. Somatic alterations were identified in 76 of 80 patients (95%). The most commonly altered genes were MEN1 (56%), DAXX (40%), ATRX (25%), and TSC2 (25%). Alterations could be defined in pathways that included chromatin remodeling factors, histone methyltransferases, and mammalian target of rapamycin pathway genes. Somatic loss of heterozygosity was particularly prevalent (55 of 95 tested samples [58%]), and the presence of loss of heterozygosity resulted in improved overall survival (P =.06). Sequencing of pre- and post-treatment samples revealed tumor-grade progression; clonal evolution patterns were also seen (molecular resistance mechanisms and chemotherapy-associated mutagenesis). Germline genetic analysis identified clinically actionable pathogenic or likely pathogenic variants in 14 of 88 patients (16%), including mutations in high-penetrance cancer susceptibility genes (MEN1 , TSC2 , and VHL). Conclusion: A clinical NGS platform reveals pertubations of biologic pathways in metastatic panNETs that may inform prognosis and direct therapies. Repeat sequencing at disease progression reveals increasing tumor grade and genetic evolution, demonstrating that panNETs adopt a more aggressive behavior through time and therapies. In addition to frequent somatic mutations in MEN1 and TSC2 , germline mutations in these same genes underlie susceptibility to panNETs and highlight the need to re-evaluate whether germline genetic analysis should be performed for all patients with panNETs. [ABSTRACT FROM AUTHOR]