Whether as clinicians, administrators, or evaluators, psychologists are increasingly involved in efforts to implement evidence-based treatments (EBTs) within clinical practice settings. The state of Texas has undertaken what may be the largest EBT implementation effort to-date. A survey was conducted to understand the experiences of 197 children's service providers working within this effort. Providers' own attitudes toward the EBTs and their perceptions of their colleagues' support for the EBTs were somewhat negative, although they gave positive ratings of the quality of their EBT training and of their agencies' support for the EBTs. Significant, independent predictors of providers' attitudes toward the EBTs included provider views of their colleagues' and their agencies' support for the EBTs, their opinions of the quality of their training in the EBTs, and their perceptions of institutional barriers to EBT use (all ps Ͻ .05). These data suggest that successful implementation may require efforts to obtain buy-in at all organization levels and to provide adequate resources for training in and use of EBTs.
Although the juvenile crime rate has generally declined, the involvement of girls in the juvenile justice system has been increasing. Possible explanations for this gender difference include the impact of exposure to trauma and mental health needs on developmental pathways and the resulting influence of youth's involvement in the justice system. This study examined the influence of gender, mental health needs and trauma on the risk of out-of-home placement for juvenile offenders. The sample included youth referred to three urban juvenile probation departments in Texas between January 1, 2007 and December 31, 2008 and who received state-mandated mental health screening (N = 34,222; 30.1 % female). The analysis revealed that, for both genders, elevated scores on the seven factor-analytically derived subscales of a mental health screening instrument (Alcohol and Drug Use, Depressed-Anxious, Somatic Complaints, Suicidal Ideation, Thought Disturbance, and Traumatic Experiences), especially related to past traumatic experiences, influenced how deeply juveniles penetrated the system. The findings suggest that additional research is needed to determine the effectiveness of trauma interventions and the implementation of trauma informed systems for youth involved with the juvenile justice system.
SummaryThe blood-brain barrier (BBB) plays a crucial role in brain homeostasis, thereby maintaining the brain environment precise for optimal neuronal function. Its dysfunction is an intriguing complication of systemic lupus erythematosus (SLE). SLE is a systemic autoimmune disorder where neurological complications occur in 5-50% of cases and is associated with impaired BBB integrity. Complement activation occurs in SLE and is an important part of the clinical profile. Our earlier studies demonstrated that C5a generated by complement activation caused the loss of brain endothelial layer integrity in rodents. The goal of the current study was to determine the translational potential of these studies to a human system. To assess this, we used a two dimensional in vitro BBB model constructed using primary human brain microvascular endothelial cells and astroglial cells, which closely emulates the in vivo BBB allowing the assessment of BBB integrity. Increased permeability monitored by changes in transendothelial electrical resistance and cytoskeletal remodelling caused by actin fiber rearrangement were observed when the cells were exposed to lupus serum and C5a, similar to the observations in mice. In addition, our data show that C5a/C5aR1 signalling alters nuclear factor-jB translocation into nucleus and regulates the expression of the tight junction proteins, claudin-5 and zonula occludens 1 in this setting. Our results demonstrate for the first time that C5a regulates BBB integrity in a neuroinflammatory setting where it affects both endothelial and astroglial cells. In addition, we also demonstrate that our previous findings in a mouse model, were emulated in human cells in vitro, bringing the studies one step closer to understanding the translational potential of C5a/C5aR1 blockade as a promising therapeutic strategy in SLE and other neurodegenerative diseases.
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