NEURO-ONCOLOGIC PHYSICAL THERAPY FOR THE OLDER PERSON

Due to the uncertainty of the course of diagnoses, patients with neuro-oncological malignancies present challenges to the physical therapist. At times, the presentation of impairments and disabilities of these patients with neuro-oncological diagnoses do not necessarily coincide with the involved area of the brain or spinal cord. It is our intention to provide guidance to the physical therapist who will be working with these patients with neuro-oncological diagnoses, in hopes that their encounters will be more productive and meaningful. This article describes a brief overview of common central nervous system malignancies, its medical treatment, as well as possible complications and side effects that would need to be considered in rehabilitating these patients. Special consideration is given to the elderly patients with neuro-oncological diagnoses. Pertinent physical therapy assessments and interventions are discussed.     

Rule-Governed Behavior: Teaching a Preliminary Repertoire of Rule-Following to Children With Autism

Rule-governed behavior is generally considered an integral component of complex verbal repertoires but has rarely been the subject of empirical research. In particular, little or no previous research has attempted to establish rule-governed behavior in individuals who do not already display the repertoire. This study consists of two experiments that evaluated multiple exemplar training procedures for teaching a simple component skill, which may be necessary for developing a repertoire of rule-governed behavior. In both experiments, children with autism were taught to respond to simple rules that specified antecedents and the behaviors that should occur in their presence. In the first study, participants were taught to respond to rules containing "if/then" statements, where the antecedent was specified before the behavior. The second experiment was a replication and extension of the first. It involved a variation on the manner in which rules were presented. Both experiments eventually demonstrated generalization to novel rules for all participants; however variations to the standard procedure were required for several participants. Results suggest that rule-following can be analyzed and taught as generalized operant behavior and implications for future research are discussed.     

Inclusion of caregiver supports and services in home- and community-based service programs: recent reports from state units on aging

Caregivers have an important role in assisting frail and/or disabled individuals to maintain their independence in the community. Support to assist caregivers in this often stressful and demanding role is critical to sustaining the caregivers' health and ability to provide care. This paper reviews federal policy changes since 2000 that have expanded and enhanced services for informal caregivers. Next, data collected from State Units on Aging and other state agencies are presented to describe the extent to which caregiver services are included in home- and community-based programs under three funding streams (Medicaid waivers, Centers for Medicare and Medicaid Services-funded programs, and state-funded programs). Program characteristics, such as eligibility and consumer-directed options, are included. Finally, the accomplishments and initiatives reported by state respondents related to supporting informal caregivers are also explained. Results indicate that services for informal caregivers are receiving greater attention and are frequently offered under home- and community-based service programs by the states that participated in this study.     

Racism Reported by Direct Care Workers in Long-Term Care Settings

This article focuses on reports of racism experienced by direct care workers (DCWs). These DCWs provide the majority of hands-on care to older residents/clients that need help with activities of daily living such as bathing and dressing in long-term care (LTC) settings. Interviews were conducted with 644 DCWs working in three types of LTC settings. Proportionate random sampling techniques were used to select 49 LTC agencies from a five-county area in northeast Ohio. The DCWs included nurse assistants in nursing homes, resident assistants in assisted living facilities, and home care aides in home health agencies. Analyses reported include frequencies, chi-square tests, and analysis of variance. Hearing racial and ethnic remarks, particularly from residents/clients, was widely reported by DCWs. Despite this, DCWs were likely to believe that remarks from residents/clients were not intended to hurt their feelings. Although DCWs heard fewer racial/ethnic remarks from family members or other staff, they were likely to believe that such remarks were intended to hurt their feelings. At the organizational level, DCW reports of hearing racial/ethnic remarks in nursing homes were more frequent than those in other LTC settings. Further, DCWs in organizations in which racial differences between them and the residents/clients that they served was very large reported hearing significantly more racial/ethnic remarks. These findings have important implications for addressing racism in LTC agencies with anti-discrimination policies and programs.     

Under What Conditions do Lesbians Disclose Their Sexual Orientation to Primary Healthcare Providers? A Review of the Literature

Under what conditions do lesbians disclose their sexual orientation to primary healthcare providers? A review of the literature was undertaken to answer this question and to provide insight into the ways healthcare professionals can play an active role assisting their lesbian patients in “coming out.” Thirty empirical studies met the inclusion criteria and were reviewed. Collectively, these separate studies have found that a myriad of internal (patient attributes) and external (healthcare context, patient–provider relationship) factors influence disclosure. The discussion highlights the critical role of healthcare professionals in supporting disclosure.     

Effects of artificial night lighting on endangered ocelots (Leopardus paradalis) and nocturnal prey along the United States-Mexico border: A literature review and hypotheses of potential impacts

Artificial night lighting is one of the least studied outcomes of urbanization. While the effects of night lighting on mammals and their habitats seem obvious, they remain difficult to quantify. By reviewing laboratory and field studies conducted on mammals since 1943, this paper summarizes the most salient effects of artificial night lighting on activity patterns and behavior. These studies assist us in generating hypotheses regarding the effects of lights, erected across the militarized U.S.-Mexico border, on the endangered Ocelot and its nocturnal prey. We predict that activity patterns for Ocelots and their nocturnal prey would be altered under artificial night lighting conditions. Specifically, evening activity levels would either be reduced or redirected towards areas with dense vegetation. In addition, Ocelot foraging success would likely be altered as a result of turning night into day. Recommendations are made for Ocelot recovery and future research on surrogate species.     

Sacrificing sacrifice

This is a review essay on Jesse Goldhammer, The Headless Republic: Sacrificial Violence in Modern French Thought. Ithaca and London: Cornell University Press, 2005; and Dennis King Keenan, The Question of Sacrifice. Bloomington and Indianapolis: Indiana University Press, 2005.     

Corporate political strategy: A framework for understanding nonprofit strategy

Nonprofit organizations operate in environments characterized by institutional demands for legitimacy. The authors argue that, given this environment, corporate political strategy is critical to a nonprofit's ability to achieve its goals, gain access to resources, and achieve a sustainable advantage. The authors develop this thesis by providing a conceptual argument that corporate political strategy is critical given the institutional nature of the environment, the conflicting demands of multiple stakeholders, and the role of the funder; and by providing contextual evidence of the role of corporate political strategy in nonprofit strategy.     

Marital Harmony and Conflict: Links to Infants' Emotional Regulation and Cardiac Vagal Tone

This study is an investigation of linkages between marital quality (conflict and harmony) and infants' emotional and physiological regulation: It was hypothesized that infants exposed to greater levels of marital conflict would demonstrate lower levels of emotional and physiological regulation. Fifty‐six low‐risk infants and their mothers attended a laboratory session when infants were 6 months of age. A baseline EKG was gathered to assess infants' cardiac vagal tone and the Bayley Scales of Infant Development and Behavior Rating Scales were administered. Mothers also completed Braiker and Kelley's (1979) marital quality questionnaire. Consistent with past research with preschoolers, marital conflict was found to be linked to lower levels of emotion regulation in infants. However, unlike past research (Gottman & Katz, 1989), results indicated that marital conflict was associated with lower levels of cardiac vagal tone in infants as opposed to higher levels of vagal tone among preschoolers. These findings are explained in terms of a possible developmental alteration in the link between marital conflict and vagal tone from early infancy to later childhood. Findings also have important implications for understanding the potential impact of the early marital relational context for infants emerging regulatory abilities.