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Literature on the natural course of neuroinvasive West Nile virus (WNV) infection in solid organ transplant (SOT) recipients is sparse. In the setting of a 2021 WNV outbreak in Arizona, we reviewed our institution's experience with neuroinvasive WNV infection in patients with SOT.We retrospectively identified SOT recipients treated for neuroinvasive WNV at Mayo Clinic in Arizona from 2007 through 2021. Clinical manifestations, disease course, and outcomes were analyzed.Among 24 SOT recipients with WNV infection identified during the study period, 13 infections occurred in 2021. Most patients had gastrointestinal tract symptoms and fever at disease presentation. Five patients had cognitive impairment, and 14 initially or eventually had acute flaccid paralysis. Clinically significant deterioration occurred at a median of 4 (range, 1-11) days after hospital admission. Seventeen patients (71%) were transferred to the intensive care unit, with 15 requiring mechanical ventilation. Initial cerebrospinal fluid analysis mainly demonstrated a neutrophil-predominant pleocytosis. Almost all patients (n = 23) were treated with intravenous immunoglobulin alone or in combination with interferon alfa-2b. Sixteen patients had clinical improvement, 4 of whom recovered completely. Six patients died during hospitalization due to complications of neuroinvasive WNV infection. Two patients were discharged to hospice without clinical recovery. The overall 30-day mortality rate was 36%.Despite advances in supportive care, neuroinvasive WNV infection is associated with substantial morbidity and mortality in SOT recipients. Flaccid paralysis is an indicator of poor prognosis. This article is protected by copyright. All rights reserved.

Direct current glow discharge mass spectrometry with an indium-based secondary cathode technique is used to analyze solid, nonconducting, fused high-purity quartz regarding metallic impurities of relevance to the solar industry. Details of the analytical routines are presented. In this work, the secondary cathode design and glow discharge conditions are optimized beyond the commonly applied practices. In addition, relative sensitivity factors (RSFs) for these optimized conditions are established and compared to previously published results. The results indicate that the technique enables stable measurements with detection limits down to the part per billion (ppb) range.

OBJECTIVE: We investigated the relationship between the interictal metabolic patterns, the extent of resection of 18 F-fluorodeoxyglucose positron emission tomography (18 FDG-PET) hypometabolism, and seizure outcomes in patients with unilateral drug-resistant mesial temporal lobe epilepsy (MTLE) following anterior temporal lobe (TL) resection. METHODS: Eighty-two patients with hippocampal sclerosis or normal magnetic resonance imaging (MRI) findings, concordant 18 FDG-PET hypometabolism, and at least 2 years of postoperative follow-up were included in this 2-center study. The hypometabolic regions in each patient were identified with reference to 20 healthy controls (p < 0.005). The resected TL volume and the volume of resected TL PET hypometabolism (TLH) were calculated from the pre- and postoperative MRI scans coregistered with interictal 18 FDG-PET. RESULTS: Striking differences in metabolic patterns were observed depending on the lateralization of the epileptogenic TL. The extent of the ipsilateral TLH was significantly greater in left MTLE patients (p < 0.001), whereas right MTLE patients had significantly higher rates of contralateral (CTL) TLH (p = 0.016). In right MTLE patients, CTL hypometabolism was the strongest predictor of an unfavorable seizure outcome, associated with a 5-fold increase in the likelihood of seizure recurrence (odds ratio [OR] = 4.90, 95% confidence interval [CI] = 1.07-22.39, p = 0.04). In left MTLE patients, greater extent of resection of ipsilateral TLH was associated with lower rates of seizure recurrence (p = 0.004) in univariate analysis; however, its predictive value did not reach statistical significance (OR = 0.96, 95% CI = 0.90-1.02, p = 0.19). INTERPRETATION: The difference in metabolic patterns depending on the lateralization of MTLE may represent distinct epileptic networks in patients with right versus left MTLE, and can guide preoperative counseling and surgical planning. Ann Neurol 2019; 1-10 ANN NEUROL 2019;85:241-250.

Key points Exercise training effectively improves vascular and skeletal muscle function; however, these effects of training may be blunted in postmenopausal women as a result of the loss of oestrogens. Accordingly, the capacity to deliver oxygen to the active muscles may also be impaired in postmenopausal women. In both premenopausal and recent postmenopausal women, exercise training was shown to improve leg vascular and skeletal muscle mitochondrial function. Interestingly, these effects were more pronounced in postmenopausal women. Skeletal muscle oxygen supply and utilization were similar in the two groups of women. These findings suggest that the early postmenopausal phase is associated with an enhanced capacity of the leg vasculature and skeletal muscle mitochondria to adapt to exercise training and that the ability to deliver oxygen to match the demand of the active muscles is preserved in the early phase following the menopausal transition. Abstract Exercise training leads to favourable adaptations within skeletal muscle; however, this effect of exercise training may be blunted in postmenopausal women as a result of the loss of oestrogens. Furthermore, postmenopausal women may have an impaired vascular response to acute exercise. We examined the haemodynamic response to acute exercise in matched pre- and postmenopausal women before and after 12 weeks of aerobic high intensity exercise training. Twenty premenopausal and 16 early postmenopausal (mean ± SEM: 3.1 ± 0.5 years after final menstrual period) women only separated by 4 years of age (mean ± SEM: 50 ± 0 years vs. 54 ± 1 years) were included. Before training, leg blood flow, O2 delivery, O2 uptake and lactate release during knee-extensor exercise were similar in pre- and postmenopausal women. Exercise training reduced (P

This article focuses on the material and discursive constructions of nature and children in the city. While dominant representations and idealizations of nature and childhood depend on the binary logic of the nature/culture and rural/urban divide, there is also a simplification and romanticization of nature in children's geographies and a lack of children and their spaces in urban political ecology. We argue that children and nature in cities need to be removed from a binary model of being and attended to in more nuanced ways in urban political ecology and children's geographies. In this regard, we suggest that both nature and children in cities need to be queered. We need to ask how the production of urban spaces (re)creates particular romantic and idealized relations with natures that reify the binaries between nature/culture, and male/female through a heteronormative framework. The purpose of this article is to bring the critical nature-society theories of urban political ecology into conversation with work in children's geographies that explores the 'nature' of childhood, and in doing so queer the relationship between children and nature. Drawing on research on queer ecologies, and queered childhoods, we aim to provide a framework to rethink and queer both nature and children in cities.

Plant physiology and metabolism are important components of a plant response to microbial pathogens. Physiological resistance of common bean (Phaseolus vulgaris L.) to the fungal pathogen Sclerotinia sclerotiorum has been established, but the mechanisms of resistance are largely unknown. Here, the physiological and metabolic responses of bean varieties that differ in physiological resistance to S. sclerotiorum are investigated. Upon infection, the resistant bean variety A195 had a unique physiological response that included reduced photosynthesis and maintaining a higher leaf surface pH during infection. Leaf metabolomics was performed on healthy tissue adjacent to the necrotic lesion at 16, 24, and 48 hours post inoculation, and 144 metabolites were detected that varied between A195 and Sacramento following infection. The metabolites that varied in leaves included amines/amino acids, organic acids, phytoalexins, and ureides. The metabolic pathways associated with resistance included: amine metabolism, uriede-based nitrogen remobilization, antioxidant production, and bean-specific phytoalexin production. A second experiment was conducted in stems of 13 bean genotypes with varying resistance. Stem resistance was associated with phytoalexin production, but unlike leaf metabolism, lipid changes were associated with susceptibility. Taken together, the data supports a multi-faceted, physio-metabolic response of common bean to S. sclerotiorum that mediates resistance.

We compare HER2 receptor amplification analysis by immunohistochemistry (IHC), fluorescence in situ hybridization (FISH), and real-time polymerase chain reaction (real-time PCR) DNA copy-number assay following laser capture microdissection (LCM) in formalin-fixed paraffin embedded tissue from 40 women with verified ovarian cancer. We speculate that LCM should result in a more accurate assessment of HER2 amplification in our real-time PCR assay compared with IHC and FISH. HER2 overexpression measured by IHC, FISH, or real-time PCR was found in 5.0%, 5.0%, and 22.5%, respectively. HER2 negative results measured by IHC, FISH, or real-time PCR were found in 95%, 92.5%, and 60.0%, respectively. Analysis failed for IHC, FISH, or real-time PCR in 0%, 2.5%, or 17.5% of cases. Concordance between IHC and FISH, IHC and real-time PCR, or FISH and real-time PCR were 89.7%, 72.7%, or 78.1%, respectively. Only few ovarian cancer patients were HER2 overexpressed measured by IHC or FISH and thus could be eligible for antibody-based therapy with trastuzumab (Herceptin). Interestingly, we find an increased number of HER2 positive patients by real-time PCR analysis on microdissected cancer cells, suggesting a number of HER2 positive patients not detected by current methods. Thus, the concept of quantitative measurement of HER2 on microdissected cancer cells should be explored further.

The authors examined the central hypothesis that students' early perceptions of support and sense of engagement in math classes and math activities strongly influence the broadening or narrowing of their math interest. The focus was on the first wave of qualitative data collected from 5th-, 7th-, and 9th-grade students during the 2007-2008 academic year as part of a longitudinal study. Findings indicate the importance of using group work and extrinsic motivation in middle school math classes to broaden interest; peer classroom behavior was often a detractor of math interest. Keywords: social learning and cognitive theory, math interest, middle school students With the need for a stronger global workforce in the United States, careers and education in science, technology, engineering, and mathematics (STEM) have been declared national priorities (National Science Board [NSB], 2007). For older high school and college students, high math and science self-efficacy and positive outcome expectations have been shown to have a strong association with specific educational and career interests (Hackett & Betz, 1981). These beliefs have a strong negative influence on some women's choices to pursue STEM-related majors and careers. By contrast, limited information is available on the role of other factors on early, pre-high school career interests. In fact, little is known about children's career development at all (McMahon & Watson, 2008; Porfeli, Hartung, & Vondracek, 2008). Few studies have examined the relationship of social cognitive factors and support to STEM choices with young people in late childhood and early adolescence. Furthermore, few studies have focused on the ways that math engagement, in addition to perceived support from peers, teachers, or parents, might influence the development of STEM interests, particularly mathematics interest, among middle and high school students. In this article, we present qualitative findings from the 1st year of a 3-year study designed to characterize STEM interests, goals, and behaviors among girls and boys in late childhood and early adolescence. We focused on mathematics as the critical foundation and early filter for later STEM-related educational and career options. More specifically, the research we present in this article examined student perceptions of support and barriers to the development of math interests and the perceived influence of math engagement. Given that the development of math interest is complex and highly phenomenological, based on each person's experiences and meaning making, qualitative inquiry is the most appropriate approach for examining these perceptions. Social cognitive career theory (Lent, Brown, & Hackett, 1994) acknowledges human agency in the career development process through the key mechanisms of self-efficacy, outcome expectations, and personal goals. The theory further positions career-related interest, choice, and performance within the interlocking developmental processes of academic and career interests, goals, and performance (Lent, 2005). The first two processes (i.e., interest development and goal development) are most directly related to STEM-related interests in pre- and early adolescence. Children and adolescents are exposed to a variety of educational, recreational, and peer environments; experiences; and activities (e.g., math classes, mechanical tasks, computer activities). These also influence later career interests and choices (Lent, 2005; Lent et al., 1994). Parents, teachers, peers, and others sometimes unintentionally encourage young people to pursue some activities or tasks and to achieve expected levels of performance (Lent, 2005; Lent et al., 1994). Through repeated encouragement and concomitant practice, children cultivate some skills, forming positive self-efficacy beliefs and a set of positive outcome expectations related to the associated tasks (Lent, 2005; Lent et al., 1994). …

This review of the 2010 career counseling and development research presents the breadth and depth of topics published in the field ranging from children's conceptions of career to employee burnout. The review covers topics in the career literature on professional issues, career theory and concepts, career development, the world of work, career assessment and technology, and career interventions. The author summarizes the 2010 research to provide information and direction to career practitioners, theorists, and researchers. The incredible amount of reading, organizing, synthesizing, and integrating involved in an annual review is difficult to imagine before the fact and even more challenging to adequately explain after completion. The time and effort spent completing this review was gready rewarded by the quality of the articles I read and by all I learned from the 2010 research literature in career counseling and development. For this review, I chose, as have previous annual review authors of The Career Development Quarterly (CDQ) , to focus on the four primary U. S. -based career journals: CDQ, the Journal of Career Assessment, the Journal of Career Development, and the Journal of Vocational Behavior. I identified all articles that seemed relevant in the tables of contents for many of the American Counseling Association (ACA) division journals (i.e., Adultspan, Journal of College Counseling, Journal of Counseling & Development, Journal of Employment Counseling [JEC], Journal of Multicultural Counseling and Development, Measurement and Evaluation in Counseling and Development, Rehabilitation Counseling Bulletin, and Professional School Counseling), for the American Psychological Association (APA) journals most likely to contain research articles in the career field (i.e., Journal of Applied Psychology, Journal of Counseling Psychology, and The Counseling Psychologist), and for several international journals (i.e., Australian Journal of Career Development, British Journal of Guidance and Counselling, and International Journal for Educational and Vocational Guidance). After identifying and downloading more than 350 articles, I read the articles in the four primary career journals and an additional 70 to 100 articles. I then had the enormously challenging task of choosing the articles most representative of the breadth and depth of topics addressed in this year's research. In the process, I may have omitted a critical piece of research in an area new to me or included articles that others may have excluded. Nonetheless, I hope that I have covered the major content areas and the key research in those areas. After choosing the articles to include in this review, I organized the review according to examples of previous annual reviews. I have included primary sections on professional issues, career theory and concepts, career development, the world of work, career assessment and technology, and career interventions. Within each of these broader categories, I have included subsections with as much breadth as seemed appropriate and synthesized the findings from that group of articles to provide focus for career practice. I have included international research in appropriate topical sections and identified sample nationality in my descriptions. In addition, I have included a Summary and Conclusion section for each of the primary sections. The purpose of my review is to provide the reader with a summarization of the career research of 2010, its primary implications, and some thoughts for practice based on this research. By far the most instructive and immediately practical article written during 2010 was Paul Hartung 's excellent 2009 annual review (Hartung). Professional Issues There were many research and conceptual articles in 2010 that focused on issues of professional importance to those in the fields of career development and counseling. A large number of these were related to diversity and multicultural aspects of career development. …

The clinical manifestations of antibiotic-induced neurotoxic effects, the underlying mechanisms and management strategies have been reviewed. PubMed and OVID searches (January 1960–June 2010) were conducted using search terms such as antibiotics, side effects, neurotoxicity and encephalopathy which yielded approximately 300 articles. All relevant case reports, case series, letters and retrospective reviews describing neurotoxic effects and those discussing mechanisms of neurotoxicity were included. Antibiotic-induced neurotoxic side effects can have a myriad of neurologic presentations. Patients with prior central nervous system (CNS) disease, renal insufficiency and advanced age may be particularly vulnerable. Treatment consists of discontinuation of the offending agent, use of antiepileptic drugs in the case of seizures or status epilepticus and haemodialysis in certain cases. The risk of CNS toxicity may be reduced via dosage adjustments in high risk populations. Awareness of the potential neurotoxic clinical manifestations of various antibiotics and high degree of vigilance in critically ill patients is essential in identifying a potentially serious, though reversible complications of antibiotic therapy particularly with the advent of newer antimicrobial agents.

Homelessness is a risk for growing numbers of immigrants. Largely as a result of low incomes, newcomers are more likely than the Canadian-born to spend over 50 percent of total household income on housing costs. Many newcomers suffer ‘hidden homelessness’. They do not use shelters and other services, but share accommodation, couch-surf and rely on their social contacts for temporary and precarious housing. The adverse impact of low incomes on the housing experiences of Canadian newcomers is exacerbated in the outer suburbs of metropolitan areas where the supply of affordable housing is limited. This study explores the social backgrounds and housing experiences of immigrant households that are vulnerable to homelessness in outer suburbs through analysis of special tabulations from the 2001 census for York Region and interviews with representatives from local community organisations serving immigrant and low-income populations. The initial findings confirm that a high proportion of newcomers in York Region are at-risk of homelessness during the first 10 years of residence in Canada. Although renters are more vulnerable than homeowners, a substantial percentage of newcomers who are homeowners pay more than 30 percent of their total income on housing costs. The shortage of affordable rental housing in the outer suburbs exacerbates the impacts of low incomes, immigration status, household size and ethnoracial identities on immigrants' housing.

Career counselors work with people from varied segments of society. For battered women, some of the challenges they face from intimate partner violence may significantly influence their career exploration and decision making. Social cognitive career theory (SCCT; R. W. Lent, S. D. Brown, & G. Hackett, 1994) is a framework that has important implications for working with these women. In this article, the authors present the unique career needs of battered women terminating abusive relationships, the relevance of SCCT to this population, strategies for using SCCT when working with these women, and a case study illustrating effective use of SCCT.

Counselors increasingly need to justify their costs to third party payers, agencies, school and college administrators, and clients (Myrick, 2003; Whiston, 1996). Counselors are being asked to defend their services, increase their efficiency, and demonstrate successful counseling outcomes (Sexton, 2001). Particularly in the current managed care and accountability-focused environment, client satisfaction with counselors' services and client involvement in selecting services are priorities for the counselor-client relationship (Hayes, Barlow, & Nelson-Gray, 1999). Despite the current emphasis on accountability and client satisfaction with services, it is often difficult to establish the efficiency of counseling because its effectiveness and methods often are not precise or measurable (Whiston, 1996). Although one obvious way for counselors to demonstrate accountability is through assessing clients' perceptions and needs through research endeavors, few counselors and mental health practitioners engage in research (Bauman et al., 2002; Borders, 2002; Hayes et al., 1999; Haynes, Lemsky, & Sexton-Radek, 1987). Clinicians have identified the following reasons for infrequently engaging in research: insufficient time, limited financial resources, lack of assistance, limited individual interest, limited employer support, lack of collaborative research partners, interference of research endeavors with the counseling process, a belief that research does not inform practice, past negative research experiences, and lack of relationship between research and position responsibilities (Haynes et al., 1987). Similarly, Hayes et al. (1999) indicated that the integration of research into practice has not occurred for two reasons: the inadequacies of traditional research methods to address issues that are important to practice and the lack of a clear link between empiricism and professional success in the practice context. In other words, many counselors believe that the research literature is not practical and does not inform their work with clients; furthermore, they believe research does not help counselors assess their clients' needs and the change process, nor does it assess for counselor effectiveness. These findings and conclusions, which suggest that practical research methods that directly relate to work with clients and that do not require a great deal of resources, may be most helpful to counselors. One practical research methodology that may be useful in achieving this end is focus group research. With a rise in postmodern thought, qualitative research methodologies such as focus groups have been gaining in popularity (Kitzinger & Barbour, 1999). We believe that focus groups are an effective means of understanding the counseling process and clients' needs and experiences in counseling. Historically, the study of human behavior has focused on quantitative research in which controlled experiments and statistical analyses are used as a means of uncovering an assumed truth. Loesch and Vacc (1997) stated that in order to align "research methodology with the philosophical underpinnings of the helping professions," research must "evolve from reliance on traditional, primarily quantitative perspectives to encompass greater recognition and acceptance of newer, primarily qualitative methodologies" (p. vi). This qualitative focus can be considered a reaction to traditional counseling research, which has been based on positivistic, modernist, and linear principles (Schwartz & Breunlin, 1983) and an assumption that reality can be objectively measured apart from the researcher. Qualitative research approaches differ from quantitative research approaches in many ways. For example, whereas quantitative researchers believe that a truth exists, qualitative researchers believe that there is no "truth" or "reality" and that reality is socially constructed; quantitative research is deductive whereas qualitative research is inductive; quantitative researchers' role is to be objective whereas qualitative researchers are interactive; in quantitative research participants are blind to the experimental hypotheses, but in qualitative research, participants are fully informed and included in the analyses (Heppner, Kivlighan, & Wampold, 1999). …

The impact of heparinoid characteristics on model surfaces obtained from immobilization of sole sulfate groups as well as sulfated glycosides, sulfated cellulose, and definite heparin has been investigated. The obtained layers were physico-chemically characterized regarding film thickness, chemical composition, wettability, and surface morphology. Antithrombin adsorption, studied by fluorescence labeling, revealed a strong dependence on the presence of glycosidic structures and on the molecular weight of the grafted saccharide. On contact with whole blood, the coatings resulted in a diminished plasmatic and cellular coagulation in vitro, which did not reflect well the antithrombin binding. Therefore, more complex activating pathways are discussed.

Overall spiritual wellness, as well as 4 individual components of spiritual wellness, has been theoretically and empirically linked with depression. Prior to this investigation, no study has examined the relationship between spiritual wellness and depression by using a 4-component measurement model of spiritual wellness. In this study of older adolescents and midlife adults, negative correlations between 4 components of spiritual wellness and depression were found for both groups. Results of multiple regression analyses showed that for both older adolescents and midlife adults, the only significant contributing factor of spiritual wellness to depression was meaning and purpose in life.

Advances in medical treatment have greatly extended the life span and quality of life of persons living with HIV, with the nature of the disease evolving from causing an early death to chronic, manageable illness. Career counselors will increasingly be called upon to assist persons living with HIV. This article provides an overview of HIV disease and of career-related issues unique to persons living with HIV. Career counseling interventions are discussed from an ecological perspective. Career counselors are called on to assist diverse populations in the process of career development, and recent approaches to career counseling have emphasized the importance of providing appropriate services to such populations. Although the needs of persons living with HIV have been examined in the general counseling literature, only one study (Hunt, Jaques, Niles, & Wierzalis, 2003) has addressed the career counseling concerns of persons living with HIV. The purpose of this article is to highlight the unique concerns faced by this population and to provide career counselors a model for conceptualizing and designing career counseling interventions in working with individuals with HIV. We use an ecological perspective (Cook, Heppner, & O'Brien, 2002) to build an understanding of career-related needs of individuals with HIV and to create an organized, intentional approach to addressing such needs. Specifically, this article includes (a) current trends in HIV/AIDS disease, (b) the role of work for persons with HIV, (c) career counseling implications, and (d) a case illustration. HTV Today Approximately 900,000 persons in the United States are living with HIV; an additional 40,000 persons become infected with the virus annually (Centers for Disease Control and Prevention [CDC], 2000). HIV is a virus that leads to the destruction of blood cells that normally protect the body from infection; the disease may cause a variety of health problems that lead to a diagnosis of AIDS (CDC, 200Ib). Of the 900,000 persons living with HIV in 2001 in the United States, 362,827 individuals were known to be living with AIDS (CDC, 2001a). Because of the seventy of symptoms most often associated with AIDS, this discussion focuses on career counseling approaches for persons with an HIV diagnosis. Persons living with HIV represent a diverse proportion of the American population, but new HIV infections have occurred disproportionately according to gender (70% men) and race (54% Black; CDC, 2000). African Americans are 10 times more likely than Whites to contract HIV, with incidence rates increasing most rapidly among African American women and other women of color (CDC, 1999). The CDC identifies the most common risk factors for infection as men having sex with men (42%), heterosexual contact (33%), and injection drug use (25%). HIV most commonly affects young adults, with more than one half of new infections occurring in persons under 25 years of age (CDC, 2000). Career theorists have identified early adulthood as a key period in career development that influences how an individual functions in other life roles (e.g., Super, 1990). Although HIV most often affects those in the early stages (under 25 years of age) of career development (Fesko, 2001; Hoffman, 1996, 1997), there is a dearth of literature regarding career counseling with persons living with HIV. This lack of information may be due to the reality that earlier an HIV diagnosis meant rapid, progressive disability. For this reason, services for persons living with HIV focused on providing case management services to individuals who were dying from HIV/AIDS (Brooks & Klosinski, 1999; McReynolds, 2001; SaIz, 2001; Yallop, 2000). Although such services remain necessary, the shift in HIV/AIDS from fatal disease to long-term, chronic illness has created a need for attention to the process of living with, rather than dying from, the disease. The course of HIV/AIDS has been drastically changing since the introduction of a class of medications known as protease inhibitors in the mid-1990s. …

An annual project involving students and faculty in a collaborative, 6-month planning process that culminates in a half-day program with both didactic and experiential components is presented as a model for creating powerful learning experiences external to the classroom.

The theory of work adjustment (TWA; R. V. Dawis & L. H. Lofquist, 1984; L. H. Lofquist & R. V. Dawis, 1969, 1991) is useful in addressing the career counseling needs of retirees who want to continue working but who need to explore their career choices before settling on a new occupation or job. This article examines some of the challenges that midlife and older adults face as they plan postretirement careers. Information about TWA and a case example arc provided to assist counselors in understanding how TWA can be applied to retirement career counseling. Although retirement is traditionally defined as the end of a career and the withdrawal of the worker from the workforce to live a life of leisure, using savings or a pension (Morris, 1976), a significant percentage of retirees want or need to continue working after retirement. One third of the retirees who responded to a survey conducted by the American Association of Retired Persons (AARP; 1993) indicated that they would prefer to work. Gardyn (2000) emphasized the extent of interest in postretircment voluntecrism by citing a study conducted by Peter D. Hart Research Associates. In this study, 50% of the surveyed 50- to 75-year-olds identified "volunteering or community service" as the most important element in their retirement plans. In a series of focus groups, some midlife adults explained their reasons for preferring to work after retirement as financial needs and as a desire to stay active (Simon-Rusinowitz, Wilson, & Marks, 1998). In consideration of the retirees who continue to work, the term retirement is used throughout this article to indicate the act of a midlife or older employee leaving a job that was held for a significant time and that typically offered retirement benefits to the employee. This article focuses on career development after such a retirement and provides guidance for applying the theory of work adjustment (TWA; Dawis & Lofquist, 1984; Lofquist & Dawis, 1969, 1991) to retirement career counseling. Developmental and Social Challenges Awareness of the developmental and social challenges that midlifc and older adults face is important for understanding a retiree's decision to retire and the retiree's process of making postretiremcnt career decisions. As retirees face the developmental tasks of gencrativity versus selfabsorption and integrity versus despair, they encounter the challenge of maintaining vital involvement during retirement (Erikson, Erikson, & Kivnick, 1986). Erikson et al. identified social contact with former coworkers, devoting time to friends and family, and care of the home as avenues for maintaining vital involvement, but they stated that these activities might lose their allure over time. Erikson et al. noted that planning and appraisal of one's capacities can help the individual find creative outlets and possibly a new work identity. For retirees, the appraisal of one's capacities includes examining physical and mental concerns and family demands. Although the percentage of healthy older adults is increasing (Adelman, 1998), after midlife, the prevalence of physical health problems, such as chronic illness, functional impairment, functional limitation, and physical disability, increase steadily with age (Atchley, 1998). In addition to possible physical health decline, older adults might become aware of changes in their mental functioning. Remembering specific information such as names, dates, and objects often becomes slower (Adelman, 1998). Even though many older adults adapt to their physical limitations by compensating for them or minimizing the effects of them, the limitations still might affect their decisions concerning future career choices (Adelman, 1998; Atchley, 1998). In addition to dealing with their own physical and mental changes, midlife and older adults increasingly encounter responsibilities for the care of aging parents, ailing spouses, grandchildren, and other relatives (Moen, 1998; Simon-Rusinowitz et al. …

Disruption of the ZWF1 gene encoding glucose-6-phosphate dehydrogenase (G6PDH) has been shown to reduce the xylitol yield and the xylose consumption in the xylose-utilizing recombinant Saccharomyces cerevisiae strain TMB3255. In the present investigation we have studied the influence of different production levels of G6PDH on xylose fermentation. We used a synthetic promoter library and the copper-regulated CUP1 promoter to generate G6PDH-activities between 0% and 179% of the wild-type level. G6PDH-activities of 1% and 6% of the wild-type level resulted in 2.8- and 5.1-fold increase in specific xylose consumption, respectively, compared with the ZWF1-disrupted strain. Both strains exhibited decreased xylitol yields (0.13 and 0.19 g/g xylose) and enhanced ethanol yields (0.36 and 0.34 g/g xylose) compared with the control strain TMB3001 (0.29 g xylitol/g xylose, 0.31 g ethanol/g xylose). Cytoplasmic transhydrogenase (TH) from Azotobacter vinelandii has previously been shown to transfer NADPH and NAD+ into NADP+ and NADH, and TH-overproduction resulted in lower xylitol yield and enhanced glycerol yield during xylose utilization. Strains with low G6PDH-activity grew slower in a lignocellulose hydrolysate than the strain with wild-type G6PDH-activity, which suggested that the availability of intracellular NADPH correlated with tolerance towards lignocellulose-derived inhibitors. Low G6PDH-activity strains were also more sensitive to H2O2 than the control strain TMB3001. Copyright © 2003 John Wiley & Sons, Ltd.

Practical Techniques Using the Theory of Work Adjustment (TWA; R. V. Dawis & L. H. Lofquist, 1984; L. H. Lofquist & R. V. Dawis, 1969) as a framework for identifying potential career challenges for lesbians, the authors explore the relationship between outness and discrimination and the four primary components of TWA. Career counseling implications are discussed, and specific suggestions are made for counselors. Women who self-identify as lesbian represent a significant and invisible minority (Fassinger, 1991); current estimates suggest that as much as 3.6% of the population, or 2,300,000 women, are lesbian (Diamond, 1999). Statistics from the U.S. Bureau of the Census (2000) indicated that women, as a group, earn only 72% of the amount earned by their male counterparts. Lesbian women report even more diminished earnings, at 5% to 14% less than the national average for women (Badgett, 1995). Reported incidents of employment discrimination as well as hate crimes against lesbians have increased over the past 5 years (Federal Bureau of Investigation, 2000). With these very real threats to economic and physical survival, it seems that a lesbian would have strong reasons for maintaining secrecy regarding her sexual orientation. Conversely, using the high amount of energy required to accomplish this may interfere with job performance and satisfaction and may stall career development and advancement (Fogarty, 1980). This dichotomy places lesbians in positions in which either choice may result in an outcome that is less than optimal, and possibly detrimental, to their careers. Lesbians must determine the most efficacious strategy for career advancement while balancing the importance of "outness" on the job against the potential for negative consequences. Black, Gates, Sanders, and Taylor (2000) found that as a group, individuals who self-report as lesbian or gay exist in all age categories, approximate the racial mix found in the total population, and are better educated than the average individual. Many contemporary authors also emphasized the similarities between lesbians and heterosexual women in appearance, interests, goals, and identities (e.g., Loulan, 1990). Despite the similarities, however, lesbians often face more obstacles as they work to achieve their career goals, while following career paths that are often more circuitous and lengthy (Boatwright, Gilbert, Forrest, & Ketzenberger, 1996) than those of heterosexual women. Perceived and actual threats to employment security exist for lesbians and potentially limit self-disclosure. Yet, the process of sexual identity formation has been shown to transform, sometimes positively and sometimes negatively, virtually all aspects of a lesbian's life, including her career (Fassinger, 1996). There are two specific concerns of lesbian career development that invite further exploration: the decision to disclose sexual orientation to others and the experience of discrimination that is based on sexual orientation. Because the Theory of Work Adjustment (TWA; Dawis & Lofquist, 1984; Lofquist & Dawis, 1969) is a comprehensive career theory that incorporates career choice and subsequent career development while addressing both individual characteristics and pertinent environmental factors, it is well-suited for application to lesbian career concerns. Using TWA as a framework, we explore career concerns of lesbians and discuss implications for career counseling. Theory of Work Adjustment and Its Relationship to Lesbian Career Development Career development literature that specifically examined the career concerns of lesbians and gay men is limited, and little empirical work has been completed to date. Several traditional career theories have been evaluated for their applicability to lesbians and gay men, including those of Holland (see Mobley & Slaney, 1996), Super (see Dunkle, 1996), and Social Cognitive Career Theory (see Morrow, Gore, & Campbell, 1996). …

Adults’ recollections of their experiences as young caregivers of family members with chronic physical illnesses Aims of the study. The aims of this study were to describe the number, kind, and intensity of caregiving activities performed by individuals who assumed caregiving responsibilities, as youngsters, for adults with chronic physical illnesses; to explore the meaning and effects of the caregiving experience on those individuals; and to examine positive and negative effects of caregiving then and now. Background/Rationale. Family mobility, demographic changes, and health care system changes in the United States of America (USA) have contributed to an increasing number of youngsters under the age of 18 caring for adults with chronic physical illnesses in the home. The effects of such caregiving on youngsters and the long-term effects on them as adults require study. Design/Methods. This descriptive, retrospective study had a convenience sample of 51 adults (age range 19–68 years now, 3–19 years then) who cared for their family members diagnosed with cancer, stroke, cardiovascular disease, multiple sclerosis or amyotrophic lateral sclerosis, respiratory disease, diabetes, or arthritis. Demographic data and caregiving data were analysed using descriptive statistics. The semistructured interview data were analysed using content analysis. Results/Findings. Of the caregiving care tasks most frequently performed, personal care was most difficult and household tasks were most time consuming. Family life, school, and time with friends were areas most likely to be affected by caregiving. Most subjects indicated they would permit their own children to assist with care as long as the youngster was not the sole caregiver. Youngsters need to be informed about the illness and caregiving tasks, have adequate support systems, and have some time to ‘still be a child’. Conclusions. Professional caregivers should raise questions in their practice regarding involvement in caregiving by both adults and youngsters. If youngsters participate in caregiving in the home, they need to receive adequate information regarding care and the illness trajectory. Family-related research including the long-term effects of such experiences on the youngsters and their families is recommended.

School counselors are expected to be prepared to work cooperatively with school administrators, teachers, special education teachers, and other school personnel so that they can better serve students. Currently, the various professionals in schools, including school counselors, are trained separately and have few opportunities to learn about each other's roles, responsibilities, and perspectives. The authors discuss an interactive CD-ROM that is designed to prepare school counselors and other school professionals (e.g., teachers, school administrators) to solve problems collaboratively.

School counselors should be prepared to address student concerns and school problems in collaborative ways and to work cooperatively with school principals. The authors describe an innovative seminar designed to help students in school counseling and in school administration to develop a greater appreciation of the roles, responsibilities, and perspectives of each other in their respective professions.

OBJECTIVE: Older persons with general medical and surgical conditions increasingly receive posthospital rehabilitation care in nursing homes and rehabilitation hospitals. This study describes the characteristics of such patients, contrasted with patients with traditional rehabilitation diagnoses of hip fracture and stroke. DESIGN: Prospective cohort study. SETTING: Seventeen skilled nursing facilities and six rehabilitation hospitals in seven states. PARTICIPANTS: Medicare patients age 65 or older receiving posthospital rehabilitation. METHODS: A total of 290 medical/surgical patients were compared with 336 hip fracture and 429 stroke patients. Data were collected prospectively from charts, nursing assessments, and patient interviews. Patient characteristics associated with functional recovery and mortality were estimated using multivariate regression. RESULTS: Medical/surgical patients had greater premorbid activities of daily living (ADL) (P < .001) and instrumental activities of daily living (IADL) (P < .01) disability, but suffered less decline with the acute event than hip fracture or stroke patients (P < .001). Medical/surgical patients were more likely to recover premorbid ADL function (P < .05) but 1-year mortality was significantly greater (30% vs. 14% hip fracture; 18% stroke; P < .001). Predictors of functional recovery and mortality differed between the three groups. Among medical/surgical patients, premorbid ADL difficulty, cognitive impairment, a pressure ulcer at rehabilitation admission, and depression were associated with failure to recover premorbid function whereas increasing comorbidity and incontinence were associated with mortality. CONCLUSIONS: Medical/surgical patients represent a unique rehabilitation population. They experienced greater premorbid functional disability, less acute decline, but greater mortality than patients with traditional rehabilitation diagnoses. Further study of this distinct rehabilitation population may help identify patients most likely to benefit from rehabilitation.

This study culminated in the development, refinement, and evaluation of a system of writing instruction that allows even instructors without great confidence in their own writing abilities to help students develop better, more effective writing skills and strategies. The system consists of two components and works backwards, starting with teaching students the assessment strategy (rubric) to be used in evaluating their work. Therefore, the first system component or rubric becomes a guide to teach students how to connect their ideas (sentence subjects) in sequence without ambiguity or implied connectivity. The second component of the system consists of written assignments initiated with “work orders” that state specifically what is expected of the student in each paragraph and includes formatting instructions. Finally, the system was designed for use in any technical curriculum by engineering and technology instructors and incorporates research findings and suggestions by four influential professional writing associations: 1) the college teachers of English for Science and Technology (EST), 2) the Conference on College Composition and Communication (CCCC) Committee on Assessment, 3) the National Council of Teachers of English (NCTE), and 4) Writing Across the Curriculum (WAC).