Dissemination and use of the professional standards of practice for psychologists, social workers, and counselors in spinal cord injury rehabilitation.

Objective: To determine the level of awareness and utilization of the Professional Standards of Practice for Psychologists, Social Workers, and Counselors in Spinal Cord Injury Rehabilitation, 4th Edition (The Standards) by members of professional organizations representing psychologists, social workers, and licensed professional counselors (PSWC) working in spinal cord injury (SCI) rehabilitation. Participants: Respondents belonged to members of professional organizations representing PSWC working in SCI rehabilitation, which included ASCIP (76%), APA's Division 22 (37%), ASIA (23%), USA (14%), PVA (12%), AVAPL (11%) and CRCC (3%). Method: Responses to an online questionnaire were solicited via email. Results: 63% of those that responded were aware of The Standards. Of those, (79%) had read all or a portion of The Standards. Colleagues were the most common source of awareness, followed by email announcements. Conclusions: The Standards are being used (in order of frequency) to improve clinical work, improve treatment efficacy, orientation of new staff, confirm current practice, education, advocacy, and other ways.

Traumatic brain injury in U.S. Veterans with traumatic spinal cord injury.

Patients with both a spinal cord injury (SCI) and traumatic brain injury (TBI) are often very difficult to manage and can strain the resources of clinical units specialized in treating either diagnosis. However, a wide range of estimates exists on the extent of this problem. The aim of this study was to describe the scope of the problem in a well-defined population attending a comprehensive SCI unit. Electronic medical records of all patients with SCI being followed by the SCI unit in a U.S. Veterans' hospital were searched to identify those with concurrent TBI. The data were analyzed for age, sex, cause of injury, level and completeness of SCI, cognitive impairment, relationship with Active Duty military, and date of injury. Of 409 Veterans with a traumatic SCI, 99 (24.2%) were identified as having had a concurrent TBI. The occurrence did not appear to be closely related to military conflict. Reports of TBI were much more common in the last 20 yr than in previous decades. Documentation of TBI in patients with SCI was inconsistent. Improved screening and documentation could identify all patients with this dual diagnosis and facilitate appropriate management.

David L. Gutmann (1925-2013).

David L. Gutmann, a pioneer in geropsychology and professor emeritus at Northwestern University, died on November 3, 2013, at the age of 88. A student of Bernice Neugarten, Bruno Bettelheim, and Erik Erikson, Gutmann discovered changes in adult psychological development related to parenting styles that held across diverse cultures.

Online support for individuals with spinal cord injuries: an ethnographic investigation.

BACKGROUND: Although social support is an important protective factor for individuals with spinal cord injuries (SCIs), individuals often encounter significant barriers to obtaining support after experiencing a SCI. It has been suggested that the Internet may serve to help individuals with disabilities overcome common barriers in obtaining support, yet research examining the efficacy of Internet-based support for individuals with SCI has been mixed. OBJECTIVE: To develop a more nuanced understanding of how individuals with SCI can or might use the Internet for support. DESIGN: Using an ethnographic approach, we conducted semi-structured interviews with nine individuals with SCI to explore perceived needs and barriers to information-seeking and online support. SETTING: Participants were recruited from Veterans Administration medical center outpatient and inpatient units providing specialty care to individuals with SCIs and from a community SCI Center of Excellence. RESULTS: Individuals with SCI gain emotional, problem-focused, and reciprocal support from online sources. CONCLUSIONS: Online resources can provide important opportunities for social support for individuals with SCI.

Lessons for spinal cord injury rehabilitation taken from adult developmental psychology: 2011 Essie Morgan Lecture.

BACKGROUND/OBJECTIVE: Developmental phases affect how individuals cope with and challenge threats to self-concept, health and functioning. Understanding prominent models of adult psychological development can help spinal cord injury/disease (SCI/D) rehabilitation professionals facilitate positive change and growth. DESIGN: Author's theoretical model informed by literature review and personal experience. SETTING: Veterans administration (VA) medical center interdisciplinary outpatient clinic providing primary and specialty care to veterans with spinal cord injuries and disorders. CONCLUSION: Threats to life expectations, health, well-being, identity, and other aspects of self create crises that can result in psychopathology or psychological growth. SCI/D can present multiple threats across the lifespan. For example, self-image, ability to perform various activities, ability to feel attractive, and even life itself may be challenged by SCI/D or its complications. Threats may be perceived at the time of injury or onset of symptoms. Also, as the injured body declines further over time, complications can cause significant temporary or permanent functional decline. Individuals interpret each of these threats in the context of current developmental needs. How people cope is influenced by developmental factors and personality traits. An integrated model of adult psychological development based on the works of Erikson, Gutmann, and Baltes is related to the literature on coping with SCI/D. This model provides insights that interdisciplinary rehabilitation teams may use to facilitate personal growth, optimal functioning, and physical health as adults with SCI negotiate normal developmental challenges throughout their lifetimes.

Psychotherapeutic intervention by telephone.

Psychotherapy conducted over the telephone has received increasing amounts of empirical attention given practical advantages that side-step treatment barriers encountered in traditional office-based care. The utility and efficacy of telephone therapy appears generalizable across diverse clinical populations seeking care in community-based hospital settings. Treatment barriers common to older adults suggest that telephone therapy may be an efficient and effective mental health resource for this population. This paper describes empirical studies of telehealth interventions and case examples with psychotherapy conducted via telephone on the Spinal Cord Injury Unit of the Palo Alto Veterans' Administration. Telephone therapy as appears to be a viable intervention with the aging population.

Vitellogenin induction by 17beta-estradiol and 17alpha-ethinylestradiol in male zebrafish (Danio rerio).

Adult male zebrafish (Danio rerio) were exposed to 17beta-estradiol (E2) or 17alpha-ethinylestradiol (EE2) in flow-through systems for 8 days. This was done to compare the sensitivity of the estrogen inducible vitellogenin (Vtg) biomarker system of this proposed OECD test guideline species to other relevant test species. Vtg was quantified in whole body homogenate by a species-specific ELISA. Actual water concentrations of E2 and EE2 were quantified by LC-MS, with detection limits of 1.0 and 0.6 ng/l, respectively. Vtg induction (LOEC) occurred in whole body homogenate at actual water concentrations of 21 ng E2/l and 3.0 ng EE2/l, respectively. As an alternative to the ANOVA approach, the relationship between the percentage of responding fish (Vtg) and the external E2 or EE2 concentration was determined by logistic regression analysis. Based on the regression analysis, EC-values could be determined: EC10, EC50 and EC90 were 15.4, 41.2 and 67.1 ng E2/l, respectively and 0.92, 2.51 and 4.09 ng EE2/l, respectively. Comparisons of these response limits to corresponding values for rainbow trout (Oncorhynchus mykiss), fathead minnow (Pimephales promelas) and Japanese medaka (Oryzias latipes) revealed the zebrafish as a sensitive test species.