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The need for clinical approaches that address romantic relationship concerns of adults with autism spectrum disorder (ASD) has been essentially overlooked. There are a growing number of recommendations in the available literature to increase the availability and evaluation of treatment approaches that are appropriate for couples that include an adult with ASD. The aim of the present study was to explore clinical outcomes of a neurodiverse couple who participated in twelve sessions of solution-focused brief therapy. Our findings indicated both partners experienced improvement in the target complaints, communication and emotional awareness. On the other hand, each partner had a different trajectory of change in relationship satisfaction over the course of treatment. Directions for future research and implications for couple therapy with adults diagnosed with ASD are discussed.

As the prevalence of autism spectrum disorder (ASD) continues to rise, there is a rapidly increasing need for treatment services among individuals diagnosed with ASD and families. Currently, the majority of the evidence-based treatments, such as Applied Behavior Analysis, overlook the notable systemic effects of ASD and maintain a problem-focused lens. There is a growing body of research calling for strength-based, relational interventions that build on existing resources to enhance coping, efficacy, and well-being among families affected by ASD. Solution-Focused Brief Therapy (SFBT) is a widely practiced clinical approach that is increasingly being used among clinicians to address the systemic effects of developmental disabilities in the family. However, particular modifications to specific interventions may better accommodate autism-associated deficits in executive functioning (e.g., goal development and impulsivity), perspective taking, or restricted interests when using an SFBT approach. This article offers recommendations for adapting a solution-focused approach by modifying commonly used SFBT interventions to address family-driven treatment goals using a collaborative stance with families of children with ASD. A case presentation is included to demonstrate SFBT as informed by the unique challenges and inherent resources of families affected by ASD that have been identified in the extant literature.A medida que el predominio del trastorno del espectro autista (TEA) continúa aumentando, hay una necesidad cada vez mayor de servicios de tratamiento entre personas diagnosticadas con TEA y sus familias. Actualmente, la mayoría de los tratamientos factuales, como el análisis conductual aplicado, pasan por alto los efectos sistémicos destacados del TEA y mantienen una óptica centrada en los problemas. Existe una creciente recopilación de estudios de investigación que exige intervenciones relacionales basadas en las fortalezas que aprovechen los recursos existentes para mejorar las habilidades de superación de dificultades, la eficacia y el bienestar entre las familias afectadas por el TEA. La terapia breve centrada en soluciones (TBCS) es un enfoque clínico de práctica generalizada que se está utilizando cada vez más entre los profesionales clínicos para abordar los efectos sistémicos de las discapacidades del desarrollo en la familia. Sin embargo, algunas modificaciones particulares a intervenciones específicas pueden contemplar mejor los déficits asociados con el autismo en el funcionamiento ejecutivo (p. ej.: desarrollo de objetivos, impulsividad), la adopción de perspectivas o los intereses restringidos cuando se usa un método de TBCS. Este artículo ofrece recomendaciones para adaptar un enfoque centrado en soluciones mediante la modificación de intervenciones de TBCS comúnmente utilizadas para abordar los objetivos de tratamiento impulsados por la familia adoptando una postura colaborativa con las familias de los niños con TEA. Se incluye la presentación de un caso para demostrar la TBCS valiéndose de las dificultades únicas y los recursos inherentes de las familiares afectadas por el TEA que se han identificado en la bibliografía existente.随着自闭症(ASD)患者数量不断继续攀升,针对确诊的患病个人和所在家庭的治疗服务的需求也迅速增加。目前,大多数的实证为基础的治疗例如应用行为分析忽略了ASD 带来的的显著的系统效果,一直采用的聚焦问题为基础的研究视角。越来越多的研究呼吁采用以关注优势为基础的关系干预,积极利用已有资源来增强应对方法,效能,和受ASD的影响的家庭成员的幸福。聚焦问题解决的精简治疗(SFBT)是一个临床实践中广泛使用的方法,为医师越来越多地采用,它能帮助解决不断发生发展的缺陷在家庭里造成的对整个系统的影响。但是,针对特定的干预作具体的调整或许能更好地适应跟自闭症相关联的在执行功能方面的缺陷(比如目标设定发展,冲动),和换角度思考,或者使用SFBT 方法的有限的兴趣等方面的不足。本文推荐采取解决问题为中心的思路方法,修改普遍使用的SFBT干预来设法实现家庭驱使的治疗目标,对家有自闭症孩童的家庭采取的是合作性的姿态。本文介绍了一个受到ACD影响的家庭的具体案例,讲解SFBT的实际运用,他们面临的特殊挑战和家庭可利用的自身的资源在已有文献中都已经确定出来。.

The expanding practice of multi-disciplinary care to address the complex nature of Autism Spectrum Disorder (ASD) suggests that there is a need for a means of coordinating care that transcends the disciplinary distinctions of relevant ASD treatment providers. As ASD services become more specialized, there is a growing need for effective care coordination with providers across the systems of care. Nursing professionals are ideally qualified to support families affected by ASD, as they provide a necessary holistic lens of health and wellbeing to obtain the appropriate treatments. Solution-focused brief therapy has been applied to a growing number of clinical settings, indicating solution-focused techniques are applicable to the various contexts associated with ASD treatments. We provide a case presentation to demonstrate a solution-focused approach to address ASD-related concerns within the family that are generalizable to coordination of care.

Applied Behavior Analysis (ABA) is an evidence-based practice approach for the treatment of individuals with autism. The systemic effects of autism suggest that family therapy would considerably enhance the treatment of individuals with autism. Marriage and family therapy (MFT) training does not routinely include exposure to autism beyond the associated diagnostic criteria. Structural Family Therapy (SFT) is a systemic model that is familiar to those trained in family therapy and appropriate for the needs of families affected by autism. Therefore, the authors have used SFT as a foundation for supervising MFT trainees working in an autism treatment setting.

Background Parents of children with an autism diagnosis frequently described the excessive costs and inordinate amount of time associated with coordinating autism – specific treatments. These ongoing sources of stress have adverse effects on parents’ personal wellbeing. Findings suggest that the systems of care aimed at improving outcomes for children with autism may, in fact, negatively affect their parents. Further research is necessary to evaluate the degree to which system – level variables affect the relationship between autism severity and parental wellbeing. Method The sample included 1711 parents of children with a current ASD diagnosis who participated in the 2017 National Survey of Children’s Health. ASD complexity was estimated as a latent variable consisting of four observed scores; ASD severity and the frequency of co - occurring medical, developmental, and emotional/behavioral conditions using a Confirmatory Factor Analysis. Healthcare experiences (i.e., Care Coordination, Family - Centered Care, Shared Decision – Making) were analyzed as mediators using structural equation modeling to evaluate the degree to which each variable explained the relationship between ASD complexity and parent outcomes. Results Care coordination mediated the relationship between ASD complexity and parental outcomes. Family – centered care significantly predicted parent stress and health, however, it was not a mediator of the relationship between ASD complexity and parent outcomes. Shared decision – making was a mediator of parent health, but not parent stress. Conclusions The results of this study indicate healthcare experiences significantly influence parental wellbeing and are an important consideration among parents of children with complex ASD.

This study used Kenny and Cook’s actor-partner interdependence model to examine both actor and partner effects of attachment anxiety and avoidance for male and female partners on symptom distress over four sessions of therapy. Using the couple as the unit of analysis offers a unique method for studying the role of adult attachment in the treatment of mental health symptoms. The findings provided some new perspectives on the role of attachment in treatment outcomes and provided support for previous research. The results showed that women’s anxiety and avoidance has an impact on their male partners’ symptom distress following four sessions of couple therapy. Additionally, men’s avoidance was a significant influence on their female partners’ symptom distress after four sessions of therapy. Practitioner points  Male partners participating in therapy are influenced by their female partners’ attachment on their own symptom distress, therefore men would greatly benefit from couple-related interventions to reduce individual symptom distress.  Female partners’ attachment anxiety and avoidance influenced their symptom distress, therefore individual attachment-informed interventions would support women’s reduction of symptom distress in therapy.

The biogenesis of the Salmonella-containing vacuole within mammalian cells has been intensively studied over recent years. However, the ability of Salmonella to sense and adapt to the intracellular environment of different types of host cells has received much less attention. To address this issue, we report the transcriptome of Salmonella enterica serovar Typhimurium SL1344 within epithelial cells and show comparisons with Salmonella gene expression inside macrophages. We report that S. Typhimurium expresses a characteristic intracellular transcriptomic signature in response to the environments it encounters within different cell types. The signature involves the upregulation of the mgtBC, pstACS and iro genes for magnesium, phosphate and iron uptake, and Salmonella pathogenicity island 2 (SPI2). Surprisingly, in addition to SPI2, the invasion-associated SPI1 pathogenicity island and the genes involved in flagellar biosynthesis were expressed inside epithelial cells at later stages of the infection, while they were constantly downregulated in macrophage-like cells. To our knowledge, this is the first report of the simultaneous transcription of all three Type Three Secretion Systems (T3SS) within an intracellular Salmonella population. We discovered that S. Typhimurium strain SL1344 was strongly cytotoxic to epithelial cells after 6 h of infection and hypothesize that the time-dependent changes in Salmonella gene expression within epithelial cells reflects the bacterial response to host cells that have been injured by the infection process.

The concept of B-esterase buffering against anti-cholinesterase (ChE) insecticide toxicity has been extensively researched in mammalian species. Presumably due to relatively low levels of anti-ChE detoxifying enzyme activity in birds, however, avian species are often more susceptible to the toxic effects of these compounds. We quantified B-esterase buffering of organophosphate (diazinon and methyl parathion) and carbamate (aldicarb and oxamyl) toxicity in nestling European starlings (Sturnus vulgaris). The differential toxicities were studied using mortality, behavioral observation, and inhibitor affinity data. The toxicities of diazinon, methyl parathion, and oxamyl were affected by the removal of butyrylcholinesterase (BChE) using the specific inhibitor tetraisopropylpyrophosphoramide (iso-OMPA). When BChE was absent, aldicarb toxicity was not affected. Theoretically, compounds affected by BChE removal would have a higher affinity for BChE or carboxylesterase (CaE) than acetylcholinesterase (AChE). However, this was only the case for diazoxon, which had a 1,000-fold higher affinity for plasma BChE and CaE than AChE. Methyl paraoxon and aldicarb had a higher affinity for plasma AChE than for BChE or CaE. Oxamyl had similar IC50 values for all three enzymes studied. The generation of IC50 curves for each inhibitor revealed the presence of nonsensitive forms of CaE in both the plasma and brain. Based on the results of this research, there appears to be no strict correlation between mortality data and inhibitor affinities for each esterase that alone can explain the differential toxicities of these compounds.

Mutant analysis by polymerase chain reaction and restriction enzyme cleavage (MAPREC) was used to study sequence heterogeneity and stability in attenuated poliovirus type 3 at positions in which the vaccine virus differs from its wild-type progenitor. Of seven genomic positions tested, only two (positions 472 and 2493) show nucleotide heterogeneity. Propagation of the vaccine virus in cell cultures leads to rapid selection of virus with reversions at these two positions of the genome. The relative abundance of reversions at position 472 correlates with the results of monkey neurovirulence tests, while the mutation at position 2493 is not directly associated with neurovirulence of the virus in monkeys. Instead, the abundance of mutations at the latter position correlates with the source of the seed virus and its passage level. These results further indicate that MAPREC at position 472 can be used to assess the quality of poliovirus type 3 vaccine.

The T4 gene 23 product (gp23) encodes the major structural protein of the mature capsid. Mutations in this gene have been described which disrupt the normal length-determining mechanism (A.H. Doermann, F.A. Eiserling, and L. Boehner, J. Virol. 12:374-385, 1973). Mutants which produce high levels of petite and giant phage (ptg) are restricted to three tight clusters in gene 23 (A.H. Doermann, A. Pao, and P. Jackson, J. Virol. 61:2823-2827, 1987). Twenty-six of these ptg mutations were cloned, and their DNA sequence alterations were determined. Each member of this set of ptg mutants arose from a single mutation, and the set defined 10 different sites at which ptg mutations can occur in gene 23. Two petite (pt) mutations in gene 23 (pt21-34 and ptE920g), which produce high frequencies of petite particles but no giants, were also sequenced. Both pt21-34 and ptE920g were shown to include multiple mutations. The phenotypes attributed to both pt and ptg mutations are discussed relative to the mechanism of capsid morphogenesis. A site-directed mutation (SD-1E) was created at the ptgNg191 site, and its phenotypic consequences were examined. Plaque morphology revertants arising from a gene 23 mutant derivative of pt21-34 and from SD-1E were isolated. A preliminary mapping of the mutation(s) responsible for their revertant phenotypes suggested that both intra- and extragenic suppressors of the petite phenotype can be isolated by this method.