Ten Changes Psychotherapists Typically Make as They Mature Into the Role of Supervisor

Stage models have largely informed scholarship on supervisor developmental processes. We argue that understanding this development as occurring along dimensions is more useful for both supervision practitioners and educators as well as for those engaged in research on supervisor development. Building on the work of Heid ( 1997 ) and working with a panel of 7 supervision experts, we identify 10 themes and validate their salience to supervisor development using a sample of 22 clinical supervisors. We describe and elaborate on each theme, and then present and discuss a case vignette that illustrates many of the supervisor developmental themes.     

Speech‐perception training for older adults with hearing loss impacts word recognition and effort

The current pupillometry study examined the impact of speech‐perception training on word recognition and cognitive effort in older adults with hearing loss. Trainees identified more words at the follow‐up than at the baseline session. Training also resulted in an overall larger and faster peaking pupillary response, even when controlling for performance and reaction time. Perceptual and cognitive capacities affected the peak amplitude of the pupil response across participants but did not diminish the impact of training on the other pupil metrics. Thus, we demonstrated that pupillometry can be used to characterize training‐related and individual differences in effort during a challenging listening task. Importantly, the results indicate that speech‐perception training not only affects overall word recognition, but also a physiological metric of cognitive effort, which has the potential to be a biomarker of hearing loss intervention outcome.     

Noteworthy effect of slight variation in aliphatic chain length of trisubstituted imidazole inhibitors against epidermal growth factor receptor L858R/T790M/C797S mutant in cancer therapy

11h is a very potent inhibitor against epidermal growth factor receptor triple mutation L858R/T790M/C797S (EGFR^TM) with 13‐fold stronger potency than the FDA‐approved osimertinib. Recently, two new EGFR^TM inhibitors, 11d and 11e , were reported which revealed 2.8‐ and 2.3‐fold stronger potency than 11h , respectively. 11h , 11d, and 11e have the same structures but differ only in their aliphatic chain length. However, the exact effects of differential aliphatic chain length on the inhibitory potencies of these compounds require further elaboration at the atomistic level, hence the objective of this report. Various computational tools were employed for this purpose. From our findings, it was revealed that van der Waals (vdW) interactions modulate the binding mechanisms of these inhibitors and play the most important role in the differential inhibitory activities of 11d , 11h, and 11e . The strong hydrogen bond formation between the aliphatic chain of 11d and key residue ARG841 was recognized as the reason for its higher activity and inhibitory potency relative to 11h and 11e . Moreover, the extension of the N‐terminal loop into the active site for vdW interaction with the phenyl group of 11e and carbon–hydrogen bond formed between the aliphatic chain of 11e and LEU718 engendered a higher activity of 11e than 11h .     

Caffeine content of pre‐workout supplements commonly used by Australian consumers

The stimulant properties of caffeine are often promoted in pre‐workout supplements (PWS) to assist with training, reduce the perception of fatigue, and for some brands, assist body fat loss. While manufacturers of PWS often indicate the inclusion of significant amounts of caffeine, no independent verification of the caffeine content of these products exists. The aim of this investigation was to independently assess the caffeine content of popular PWS in Australia and compare these values to nutrition information panel data. Fifteen PWS were tested for their caffeine content (both within and between batches of the same product). The caffeine content of selected PWS ranged from 91 to 387 mg·serve^?1. Only 6 of the 15 PWS nutrition information panels included details on caffeine content. The percent of caffeine present ranged from 59% to 176% of packaging claims. All but one PWS contained a variation of caffeine within and between batches that was considered “practically” significant (ie, ≥40 mg·serve^?1 variation). Consumers are likely to be exposed to large and variable caffeine doses if ingesting PWS. Product information panels do little to improve consumer awareness of likely caffeine intakes.     

八周简易正念减压训练对老年功能性消化不良患者焦虑抑郁和睡眠质量的改善作用

背景功能性消化不良(functional dyspepsia,FD)容易使患者出现焦虑、抑郁负面心理,影响患者睡眠质量.精神、心理因素在FD疾病中占重要地位,加强了解FD患者的心理状况,以更好的实施针对性的干预措施,降低负面情绪和改善睡眠质量.目的观察八周简易正念减压训练对老年FD患者焦虑抑郁和睡眠质量的改善.方法选取2017-03/2019-06在浙江省金华市第二医院就诊的老年FD患者90例为研究对象,随机分为对照组和观察组各45例.对照组给予常规护理.观察组在对照组基础上给予八周简易正念减压训练干预.观察2组患者干预前后焦虑、抑郁评分变化,匹兹堡睡眠质量指数评分变化、入睡时间、睡眠时间变化情况.结果与干预前比较,2组焦虑自评量表和抑郁自评量表评分均降低(P<0.05),且观察组降低明显于对照组(P<0.05).与干预前比较,2组干预后睡眠质量明显改善(P<0.05),入睡时间明显缩短(P<0.05),睡眠时间明显延长(P<0.05),且观察组明显于对照组(P<0.05).结论八周简易正念减压训练能够有效减轻老年FD患者焦虑、抑郁等负性情绪,改善患者睡眠质量,值得临床推广.     

平衡训练系统辅助特定任务性平板步行训练对卒中患者下肢运动功能的影响

目的探讨Biodex平衡训练系统辅助特定性平板步行训练对卒中后下肢运动功能的影响。方法选取卒中后平衡和下肢运动功能障碍的偏瘫患者40例,按病例号奇偶数分为平衡训练组和常规训练组,每组20例。常规训练组给予常规康复治疗及传统的平衡训练,平衡训练组在常规康复治疗的基础上,应用Biodex平衡训练系统辅助特定任务性平板步行训练。于治疗前及治疗后4周评价两组患者的下肢稳定性指数、Berg平衡量表评分(BBS)、"起立-行走"计时(TUGT)、最大步速和步长、Fugl-Meyer运动功能量表(下肢部分)评分(FMA-L)、改良Barthel指数(MBI)及功能性步行量表评分(FAC),综合评定患者的平衡和下肢运动功能。结果治疗前,两组患者的各项指标比较,差异均无统计学意义(P0.05)。治疗后,两组患者各项指标均较治疗前好转,差异有统计学意义(P0.01);平衡训练组与常规训练组比较,稳定性指数(分别为6.5±1.3、8.5±2.1)、BBS评分[分别为(49±4)、(34±3)分]、TUGT[分别为(13.5±3.2)、(22.3±2.8)s]、最大步速[分别为(60±23)、(50±21)m/min]、最大步长[分别为(54±12)、(42±11)m]、FMA评分[分别为(31±4)、(24±5)分]、MBI评分[分别为(81±14)、(70±11)分]及FAC分级评分[分别为(4.31±0.39)、(3.21±0.19)分]改善程度均优于常规训练组,差异有统计学意义(P0.01或P0.05)。结论应用Biodex平衡训练系统辅助特定任务性平板步行训练对卒中后患者的平衡和下肢运动功能有很好的改善作用。     

鹿瓜多肽穴位注射结合运动疗法对膝骨关节炎模型大鼠膝关节软骨Ⅱ型胶原、血清MMP-3水平的影响

目的观察鹿瓜多肽穴位注射结合中等强度运动对膝骨关节炎模型大鼠膝关节软骨Ⅱ型胶原、血清基质金属蛋白酶3(MMP-3)水平的影响。方法 48只SD大鼠随机分成正常对照组、模型组、穴位注射组和注射结合跑台组,每组12只。参照文献,采用膝关节腔内注射碘乙酸钠建立膝骨关节炎大鼠模型。正常对照组和模型组大鼠不干预,穴位注射组大鼠膝关节腔内注射鹿瓜多肽注射液(0.1mL/100g),注射结合跑台组大鼠在穴位注射组基础上结合中等强度的跑台训练,共6周。光镜观察各组大鼠膝关节软骨病理变化,检测各组大鼠膝关节软骨Ⅱ型胶原含量及血清MMP-3水平。结果干预6周后,穴位注射组和注射结合跑台组O’Driscoll组织学评分均高于模型组[(8.52±1.08)分、(12.68±0.85)分比(5.34±0.57)分,P均<0.05],注射结合跑台组O’Driscoll组织学评分高于穴位注射组[(12.68±0.85)分比(8.52±1.08)分,P<0.05];穴位注射组和注射结合跑台组大鼠膝关节软骨Ⅱ型胶原含量均高于模型组[(54.79±2.29)、(73.79±2.36)比(41.93±2.03),P均<0.05],注射结合跑台组大鼠膝关节软骨Ⅱ型胶原含量高于穴位注射组[(73.79±2.36)比(54.79±2.29),P<0.05];穴位注射组和注射结合跑台组大鼠血清MMP-3水平均低于模型组[(16.04±0.49)、(8.89±0.39)比(24.68±0.56),P均<0.05],注射结合跑台组大鼠血清MMP-3水平低于穴位注射组[(8.89±0.39)比(16.04±0.49),P<0.05]。结论鹿瓜多肽穴位注射结合中等强度运动能提高膝骨关节炎模型大鼠膝关节软骨Ⅱ型胶原含量,降低模型大鼠血清MMP-3水平。     

全膝关节置换术对膝骨关节炎患者的近期疗效

目的 比较2种治疗方法对膝骨关节炎患者膝关节功能的改善效果。方法 选取2016年1月— 2018年1月天津医科大学总医院滨海医院收治的膝骨关节炎患者116例为研究对象。按随机抽签法将其分为观察组和对照组。对照组予以关节镜下清除术治疗,观察组予以全膝关节置换术治疗。对所有患者进行为期6个月的随访。比较两组手术前后患者膝关节功能评分（HSS）、视觉模拟法（VAS）、焦虑自评量表（SAS）评分变化情况,疗效以及生活质量情况。结果 观察组优良率[91.38%（53/58）]较对照组[72.41%（42/58）]高（P?<0.05）。观察组HSS评分比对照组高（P?<0.05）,而VAS、SAS评分比对照组低（P?<0.05）。术后观察组各项SF-36量表评分均比对照组高（P?<0.05）。结论 全膝关节置换术应用于符合适应证的膝骨关节炎患者中的效果显著,有利于改善患者膝关节功能,减轻疼痛,改善焦虑情绪,且有效提高生活质量,值得临床推广应用。