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Originally intended for qualitative research, I-poetry is proffered here as a tool that counselor educators can use to help counselor trainees develop case conceptualization and treatment planning ...

Cardiovascular disease (CVD) is the leading cause of death in the U.S. and worldwide. Sex-related disparities have been identified in the presentation and incidence rate of CVD. Mitochondrial dysfunction plays a role in both the etiology and pathology of CVD. Recent work has suggested that the sex hormones play a role in regulating mitochondrial dynamics, metabolism, and cross talk with other organelles. Specifically, the female sex hormone, estrogen, has both a direct and an indirect role in regulating mitochondrial biogenesis via PGC-1α, dynamics through Opa1, Mfn1, Mfn2, and Drp1, as well as metabolism and redox signaling through the antioxidant response element. Furthermore, data suggests that testosterone is cardioprotective in males and may regulate mitochondrial biogenesis through PGC-1α and dynamics via Mfn1 and Drp1. These cell-signaling hubs are essential in maintaining mitochondrial integrity and cell viability, ultimately impacting CVD survival. PGC-1α also plays a crucial role in inter-organellar cross talk between the mitochondria and other organelles such as the peroxisome. This inter-organellar signaling is an avenue for ameliorating rampant ROS produced by dysregulated mitochondria and for regulating intrinsic apoptosis by modulating intracellular Ca2+ levels through interactions with the endoplasmic reticulum. There is a need for future research on the regulatory role of the sex hormones, particularly testosterone, and their cardioprotective effects. This review hopes to highlight the regulatory role of sex hormones on mitochondrial signaling and their function in the underlying disparities between men and women in CVD.

Summary Background Catheter-based renal denervation has significantly reduced blood pressure in previous studies. Following a positive pilot trial, the SPYRAL HTN-OFF MED (SPYRAL Pivotal) trial was designed to assess the efficacy of renal denervation in the absence of antihypertensive medications. Methods In this international, prospective, single-blinded, sham-controlled trial, done at 44 study sites in Australia, Austria, Canada, Germany, Greece, Ireland, Japan, the UK, and the USA, hypertensive patients with office systolic blood pressure of 150 mm Hg to less than 180 mm Hg were randomly assigned 1:1 to either a renal denervation or sham procedure. The primary efficacy endpoint was baseline-adjusted change in 24-h systolic blood pressure and the secondary efficacy endpoint was baseline-adjusted change in office systolic blood pressure from baseline to 3 months after the procedure. We used a Bayesian design with an informative prior, so the primary analysis combines evidence from the pilot and Pivotal trials. The primary efficacy and safety analyses were done in the intention-to-treat population. This trial is registered at ClinicalTrials.gov , NCT02439749 . Findings From June 25, 2015, to Oct 15, 2019, 331 patients were randomly assigned to either renal denervation (n=166) or a sham procedure (n=165). The primary and secondary efficacy endpoints were met, with posterior probability of superiority more than 0·999 for both. The treatment difference between the two groups for 24-h systolic blood pressure was −3·9 mm Hg (Bayesian 95% credible interval −6·2 to −1·6) and for office systolic blood pressure the difference was −6·5 mm Hg (−9·6 to −3·5). No major device-related or procedural-related safety events occurred up to 3 months. Interpretation SPYRAL Pivotal showed the superiority of catheter-based renal denervation compared with a sham procedure to safely lower blood pressure in the absence of antihypertensive medications. Funding Medtronic.

With increased suicide rates among youth during recent decades, the K–12 educational community still lacks a comprehensive model for suicide prevention that is tailorable for school systems. With this article, we present the Research-Informed Adaptable Model for the Prevention of Suicide in Schools (RAMPSS). A multitiered system of support, RAMPSS includes (a) all four major components of the American School Counselor Association National Model and (b) options for research-based responsive services at each tier level.

Originally published in Contemporary Psychology: APA Review of Books, 2003, Vol 48(5), 562-565. Reviews the book, Crisis Intervention Strategies (4th ed.) by Richard K. James and Burl E. Gilliland (see record 2001-01187-000). In this text, a range of critical topics within the realm of crisis interv

Factorial experimental design.To compare the outcomes of 2 different abdominal muscular fitness training regimens on sit-up performance across sex and abdominal muscular fitness level.Researchers suggest that the curl-up, when compared to the sit-up, optimizes the challenge to the abdominal muscles while minimizing shear and compressive forces on the lumbar spine. Although researchers have compared curl-ups and sit-ups in many ways, a comparison of sit-up performance after training programs involving curl-ups and sit-ups has not been investigated.One hundred two active, healthy, college-aged subjects participated in this study. After stratification based upon maximal 2-minute sit-up performance during the orientation session, subjects were randomly assigned to either a training group using curl-up exercise, a training group using sit-up exercise, or a control group. Maximal 2-minute sit-up test performance was measured before and after a 6-week training program. Data were analyzed utilizing an ANOVA model. Significant interactions or main effects were analyzed utilizing Tukey's Honestly Significant Difference Test. Level of significance for all testing was at alpha = 0.05.The sit-up training group improved significantly (P0.05). No significant difference in sit-up performance was noted for the curl-up or control groups after the 6-week training program. No statistically significant difference in improvement was noted between sex of subject and level of abdominal muscular fitness of subject.Short-term sit-up training with the Modified Kersey Method in this population significantly improved a maximum 2-minute sit-up test performance. Curl-up training utilizing the same method did not result in improvement in the number of sit-ups performed in 2 minutes. Specificity of training provides the primary explanation for our findings.

While clozapine represents a revolutionary advance in the treatment of schizophrenia, it carries with it a formidable side-effect profile. Agranulocytosis may indeed be life-threatening to a small number of patients. The nurse practitioner must be aware of this and other side effects in order to competently care for patients with psychiatric problems. It is also essential that there be a collaborative relationship between the nurse practitioner and a mental health provider. Only through appropriate consultation and referral will the needs of psychiatric patients be met in a timely and comprehensive manner.