Jaroslaw Richard Romaniuk

• PhD, LISW-S
• Lecturer at Case Western Reserve University

Introduction The cost of care for people with disabilities is rising, whereas all forms of support for them are decreasing. Countries and communities develop different ways to serve the disabled. We examined the comprehensive state of care from the perspective of cost management of services for individuals with disabilities in Poland. Method This...

This article critically examines the Housing First model within the broader context of neoliberal policies impacting homelessness, particularly at the intersection of mental illness, poverty, and addiction. While Housing First is celebrated for its effectiveness in providing immediate housing to chronically homeless individuals, this model’s alignm...

Background: This article aims to review the development of the social work profession in Ukraine and to describe the impact of social, economic and political changes on social work practices and education. Methods: A comprehensive literature review and participant observation methods informed this study. A case study of a Polish community’s respons...

Social work in Poland and in the United States shares the values of human dignity and self-determination, but there are often value conflicts in terms of how various groups experience social roles and social expectations. This paper explores the use of multiple lenses to understand the past and current conditions for LGBT+ people in Poland. An inte...

Trauma-informed care requires a sound therapeutic relationship to address trauma symptoms. People with trauma symptoms often cannot use their communication skills or do not possess the emotional stability to talk with others, and many drop out of treatment. Horse Assisted Education employs a partnership of horse and humans which leads to engagement...

Abstract: Fifty years ago, Clark and Euler published a model of the neural control of respiration that stimulated modern studies on the central generator of the rate and depth of breathing. These studies led to new discoveries concerning both anatomical localization and functional characteristics of respiratory central pattern generator (CPG), and...

Streszczenie: Opublikowany 50 lat temu model nerwowej regulacji oddychania Clarka i Eulera był inspiracją dla no-wego podejścia do badań ośrodkowego generatora głębokości i rytmu oddychania. Dzięki tym badaniom nasza wiedza dotycząca zarówno anatomicznej lokalizacji, jak i charakterystyki działania generatorów wzorca oddechowego uległa dużej zmiani...

The objective is to examine the intersection of advocacy for social change, the individual’s emotional costs of advocacy, and the use of trauma informed care in supervisory practice to encourage and support advocates and their work. Supervision models exist, but none address the needs of advocates who might become targets for scorn and persecution....

The recognition of traumatic experiences across all aspects of human life has spurred the development of research on the impacts of trauma in various segments of society. The Adverse Childhood Experiences Study (ACES) first documented the correlation between childhood trauma exposure and physical and mental health disorders in adulthood. Further st...

This article examines sociological, psychological, and suicidological research on the determinants of male suicide to explore the fact that Polish men complete suicide 7.4 times more than women, a frequency twice as high as in the US. This paper is based upon an examination of relevant literature and statistical databases. A keyword search was comp...

This article presents a detailed history of the development of a particular immersion program to teach English to young Polish students. The program draws support from two organizations, the Kościuszko Foundation and the Polish Scouting Organization. Kościuszko Foundation is dedicated to strengthening the ties between the United States and Poland a...

English version of the article.

The profession of social work is dedicated to the betterment of society and to the protection of marginalized and vulnerable groups. The profession’s mission is detailed in the set of seven core values: service; social justice; dignity and work of the person; importance of human relationships; integrity; and competence. Relationships between people...

Praca socjalna w lecznictwie weteranów służby wojskowej w USA 199 Wstęp Głównym zadaniem lekarza jest utrzymanie sprawnego funkcjonowania organizmu pacjenta, a podstawowym zadaniem pracownika socjalnego (social worker)-po-moc mu w sprawnym funkcjonowaniu w jego natural-nym środowisku. W zależności od specyfiki środowiska potrzeby człowieka mogą być...

Social work deals with problems of individuals, families, organizations and communities. However, an evolving set of challenges continues to shape the future of social work theory, research and interventions. Social work is a profession with its own code and follows a set of standards and ethics rules at the federal level, but the licensing process...

In animals, high-frequency spinal cord stimulation (HF-SCS) applied on the ventral epidural surface at the T2 level results in negative airway pressure generation consistent with inspiratory muscle activation. In the present study, in anesthetized dogs, we found that ventral HF-SCS (500 Hz) applied at all thoracic levels resulted in negative airway...

Problemy zdrowia psychicznego najmłodszego pokolenia weteranów amerykańskich 1 Każda wojna przynosi nowe doświadczenia. Im szyb-ciej zostaną one ocenione i zrozumiane, tym skutecz-niej można bronić się przed stratami wojennymi. Dlatego też doświadczenia wojsk koalicji w Iraku i Afganista-nie po 2002 r. poddawane są wielu badaniom i dysku-sjom. Z je...

There are ongoing international contacts between the Polish addiction treatment community and professionals in the United States. There are also contacts among those working to help marginalized populations and the homeless. Each international contact may yield new programs addressing social problems. This book describes the first contacts between...

Previous analyses of recordings of alpha motoneuron discharges from branches of the intercostal and abdominal nerves in anesthetized cats under neuromuscular blockade demonstrated modulation with the cardiac cycle. This modulation was interpreted as evidence that thoracic somatosensory afferents, most likely muscle spindles, provide a signal to the...

Background Lack of an effective cough may result in the frequent aspiration of airway secretions and foreign material and the development of recurrent respiratory tract infections. In persons with spinal cord injury, lower thoracic low frequency spinal cord stimulation (conventional LF‐SCS, 50Hz, 15mA) results in large positive airway pressure gene...

Objective Lower thoracic HF‐SCS (500 Hz, 1 mA) applied via a single stimulating electrode located on the dorsal surface of the spinal cord at the T9 level results in large positive airway pressures consistent with marked expiratory muscle activation. The purpose of the present study was to evaluate the effects of lower thoracic HF‐SCS on the ventra...

Studies concerning military sexual trauma (MST) among men point to the underreporting of this experience due to barriers related to military culture. During the time of the policy of Don’t Ask, Don’t Tell, there were systemic problems in reporting sexual behavior among military personnel of the same sex. For similar reasons there were insufficient...

Spinal cord stimulation (SCS, 50Hz) is a useful method to restore an effective cough in persons with spinal cord injury (SCI). However, high stimulus amplitudes and potential activation of pain fibers, significantly limits this application. It is our hypothesis that high frequency SCS (HF-SCS), with low stimulus amplitudes may provide the same leve...

Published by NASW Health Section Connection 4, 2015, 7-8.

While the United States military strives for unity and cohesion, each member is inherently unique. In providing services to veterans, it is imperative to keep in focus the various areas of diversity. Specifically, generational differentiation is significant as are combat and noncombat experiences. Veteran service delivery is often complex when symp...

This chapter addresses substance use among several subgroups of minority men who have sex with men (MSM). This term encompasses several distinct groups of men: those who self-identify as gay, bisexual, or transgender; incarcerated self-identified heterosexual men who, due to their circumstances, engage in voluntary sex with other men; self-identifi...

Lower thoracic spinal cord stimulation (SCS) results in the generation of large positive airway pressures. The potential effects of diaphragm co-activation during SCS were investigated in 10 anesthetized dogs. Diaphragm compound action potentials (CMAPs) were present during SCS at the T10 and T12 levels. In group 1, airway (Paw) and trans-diaphragm...

Following spinal cord injury, muscles below the level of injury develop variable degrees of disuse atrophy. The present study assessed the physiological changes of the expiratory muscles in a cat model of spinal cord injury. Muscle fiber typing, cross-sectional area, muscle weight, and changes in pressure-generating capacity were assessed in five c...

The effects of pulse lung inflation (LI) on expiratory muscle activity and phase duration (Te) were determined in anesthetized, spontaneously breathing dogs (n = 20). A volume syringe was used to inflate the lungs at various times during the expiratory phase. The magnitude of lung volume was assessed by the corresponding change in airway pressure (...

The following letters are in response to the Point:Counterpoint series “Supraspinal locomotor centers do/do not contribute significantly to the hyperpnea of dynamic exercise in humans” that appeared in the March issue (vol. 100: 1077–1083, 2006; <http://jap.physiology.org/content/vol100/issue3

To the Editor: Studies of cardiorespiratory responses during exercise must identify the impulse for exercise, whether pe-ripheral or central. If from the center, we study afferent modulation of central command; if from the periphery (“tread-mill on”), we study how afferent signals trigger locomotory action and cardiorespiratory responses. Any “cort...

Lower thoracic spinal cord stimulation (SCS) may be a useful method to restore an effective cough mechanism. In dogs, two groups of studies were performed to evaluate the mechanism of the expiratory muscle activation during stimulation at the T(9)-T(10) level, which results in the greatest changes in airway pressure. In one group, expiratory muscle...

Previous studies have suggested that the optimum length for force generation of the parasternal intercostal (PS) muscles is well above functional residual capacity (FRC). We further explored this issue by examining the pressure-generating capacity of the PS muscles as a function of lung volume in anaesthetized dogs. Upper thoracic spinal cord stimu...

Lower thoracic spinal cord stimulation (SCS) results in the generation of large positive airway pressures (Paw) and may be a useful method of restoring cough in patients with spinal cord injury. The purpose of the present study was to assess the mechanical contribution of individual respiratory muscles to pressure generation during SCS. In anesthet...

Large positive airway pressures (Paws) can be generated by lower thoracic spinal cord stimulation (SCS), which may be a useful method of restoring cough in spinal cord-injured patients. Optimal electrode placement, however, requires an assessment of the pattern of current spread during SCS. Studies were performed in anesthetized dogs to assess the...

This study assessed the ability of functional magnetic stimulation (FMS) to activate the respiratory muscles in dogs. With the animal supine, FMS of the phrenic nerves using a high-speed magnetic stimulator was performed by placing a round magnetic coil (MC) at the carotid triangle. Following hyperventilation-induced apnea, changes in volume (delta...

Many patients with ventilator-dependent quadriplegia have coincident phrenic nerve injury and therefore cannot be offered phrenic nerve pacing. The purpose of this study was to assess the utility of combined inspiratory intercostal and expiratory muscle pacing to provide complete ventilatory support. Studies were performed in 15 anesthetized dogs....

The role of pulmonary stretch receptors in the modulation of expiratory muscle activity during cough is controversial. To evaluate their potential influence on expiratory effort during cough, we compared expiratory muscle activity during unobstructed cough to that during obstructed cough in which the trachea was occluded at the end-inspiration and...

Many patients with spinal cord injury have paralysis of their expiratory muscles and, consequently, lack an effective cough. The purpose of the present study was to evaluate the utility of lower thoracic spinal cord stimulation (SCS) to activate the expiratory muscles. Studies were performed on 15 anesthetized dogs. A quadripolar stimulating electr...

We studied the effects of MNR stimulation on phrenic (Phr) electroneurogram and external intercostal muscles (EI) electromiogram in spontaneously breathing rabbits. Additionally, experiments were performed before and after lignocaine blockade of nucleus tractus solitarii (NTS) to determine whether the information from MNR is transmitted via NTS neu...

Although pentobarbital (PB) is a commonly used anesthetic in animal studies examining respiratory motor control, there are virtually no studies that have examined the differential effects of deepening anesthesia on the activation of the various intercostal muscles. In dogs, anesthetized initially with 25 mg/kg of PB, the effects of additional doses...

Respiratory and locomotor EMG activity was recorded in cats after a precollicular post-mamillary decerebration. Locomotion was induced by stimulating either the dorsolateral funiculus (DLF) in the cervical spinal cord or the medullary locomotor strip (MLS). At the onset of locomotion, both ventilation and blood pressure were enhanced. During locomo...

The pattern of electrical activation and muscle length changes of the internal intercostal (II) muscles (9th or 10th interspace) of the lower rib cage were evaluated in supine anesthetized dogs. Studies were performed during resting breathing and expiratory threshold loading. Results were compared with simultaneous measurements of the better-studie...

Rats with intact vagal reflexes exhibit patterns of breathing that contain greater degrees of freedom than those seen after vagotomy. To determine how alterations in end-expiratory volume modify the respiratory pattern, continuous positive (CPAP) and negative (CNAP) airway pressure was applied to tracheal openings of nine urethan-anesthetized vagi-...

Rats breathing from reduced end-expiratory volumes (EEV) exhibit transient bursting of inspiratory airflow local to the expiratory-inspiratory transition (E-I) accompanied by increases in inspiration-to-expiration duration ratio. Continuous positive (CPAP) and negative (CNAP) airway pressures (+3 to -9 cmH2O) were applied to tracheal openings of 17...

Geometric methods from nonlinear dynamics are employed to evaluate dynamic processing of vagal afferent information by the respiratory central pattern generator (RCPG). While measuring airflow and diaphragm EMG, we applied brief electrical stimuli (40- to 130-ms duration) to one afferent vagus of bilaterally vagotomized urethan-anesthetized rats du...

Recent studies suggest that chest wall reflexes may have a role in modulating diaphragm activation. The purpose of this study was to more closely examine this issue by assessing the diaphragmatic motor response to airway occlusion. Studies were performed in vagotomized mongrel dogs anesthetized with pentobarbital sodium. Diaphragmatic electromyogra...

1. We examined the interaction between central pattern generators for respiration and deglutition in decerebrate, vagotomized, paralysed and ventilated cats (n = 10), by recording activity from the following nerves: hypoglossal, phrenic, thyroarytenoid and triangularis sterni. Fictive breathing was spontaneous with carbon dioxide above the apnoeic...

Phrenic and external intercostal motor responses to inspiratory load were studied in anaesthetized rabbits and after bilateral vagotomy. Animals were ventilated with a phrenic nerve driven respirator set at different gains, i.e. volume to phrenic-signal ratio. Load was imposed by occluding the trachea at the end of expiration for the period of one...

Recent studies suggest that the external intercostal (EI) muscles of the upper rib cage, like the parasternals (PA), play an important ventilatory role, even during eupneic breathing. The purpose of the present study was to further assess the ventilatory role of the EI muscles by determining their response to various static and dynamic respiratory...

1. The effects of tracheal occlusion on peak parasternal (PA) and external intercostal (EI) (3rd interspace) EMG activities were examined at different end-expiratory lung volumes both above and below functional reserve capacity (FCR) in anaesthetized, vagotomized and spontaneously breathing dogs. 2. Parasternal (PA) and external intercostal (EI) mu...

Brain stem hypoxia caused by vertebral artery injection of sodium cyanide (NaCN) (1-20 micrograms) in artificially ventilated cats depressed phrenic and stimulated sympathetic nerve activity with a simultaneous increase in arterial blood pressure. Larger doses of NaCN caused greater effects. Hypercapnia produced by inhalation of 7% CO2 in O2 tended...

Lesions 1-2 mm deep in the midline of the ventral medulla (VM) abolished high frequency oscillations (HFO) in the respiratory motor output in cat and rabbit. Raising arterial pCO2 increased phrenic nerve activity to its prelesion level but did not restore HFO. We conclude that the neuronal pathways crossing the midline of the VM are crucial for rei...

Cooling of small sites on the ventral medullary surface of the cat produces a decrease in frequency of phrenic high frequency oscillation (HFO). The effect on HFO frequency of cooling near the hypoglossal rootlets, but not the effect of cooling near the inferior cerebellar artery, can be completely offset by raising arterial pCO2 to restore phrenic...

Electrical stimulation of the subthalamic locomotor region (SLR) can induce locomotor movements in thalamic cats. The possibility of inducing locomotor movements from other structures in the diencephalon, using electrical stimulation, was investigated in acute thalamic cats. It was found that the area from which locomotor movements could be elicite...

Recent studies suggest that the parasternal muscles (PA) are primarily responsible for rib cage expansion during eupneic breathing with a much lesser role played by the interosseous external intercostals (EI). The purpose of the present investigation was to assess the capacity of the EI to expand the rib cage during spontaneous breathing in the abs...

The interosseous external intercostal (EI) muscles of the upper rib cage are electrically active during inspiration, but the mechanical consequence of their activation is unclear. In 16 anesthetized dogs, we simultaneously measured EI (3rd and 4th interspaces) and parasternal intercostal (PA) (3rd interspace) electromyogram and length. Muscle lengt...

The study was undertaken to ascertain the neural control of breathing and vagal reflexes during and after cerebral ischemia. The experiments were performed on anesthetized, paralyzed, and artificially ventilated rabbits. Cerebral ischemia was induced by reversible intrathoracic occlusion of the brachiocephalic trunk and the left subclavian and both...

On the basis of local stimulation of individual muscles, it has been suggested that both the external (EI) and internal interosseous intercostal muscles have an inspiratory action at low lung volumes and an expiratory action at high lung volumes. In this study, we assessed the action of the interosseous intercostal muscles at different lung volumes...

The rate of occurrence and magnitude of provoked augmented breath (PAB) were studied as the function of lung expansion applied at different intervals (15-180 s). Together with phrenic nerve activity (Phr.) the activities of recurrent laryngeal (RL) and hypoglossal (Hyp) nerves were investigated during PAB. The experiments were carried out in 10 cat...

Six rabbits were anaesthetized with chloralose and urethane and were subjected to sagittal section of the medulla in the region of obex to a few mm rostral to obex. The sections had an initial rostro-caudal length of 4 mm and were gradually extended until the respiratory rhythms on the two sides of the animal, as seen in phrenic discharges, became...

The effect of midsagittal lesions of the medulla on the phrenic nerve output and the central transmission of the vagal input were studied. The rabbits were anaesthetized with a mixture of chloralose with urethane, paralysed and artificially ventilated. Both vagi were sectioned in the neck and one of them was prepared for electrical stimulation of i...

Locomotion was induced by electric stimulation of the subthalamic and the mesencephalic locomotor regions. In six animals exhibiting coordinated locomotor movements, tracheal occlusion at various phases of expiration during rest and locomotion was performed. The intensity of the reflex was measured using the inhibition coefficient i = TE (occl)/TE...

Investigations were undertaken to study the characteristics of phrenic reflexes with partial or total elimination of the descending neuronal pathways. Experiments were performed on 17 decerebrate, vagotomized, paralysed and artificially ventilated rabbits. The experimental procedure included a midsagittal section of the medulla or a hemisection fol...

The effects of a midsagittal lesion of the medulla on integrated efferent activities of the phrenic (Phr) and vagus nerves (Eff. Vag.) and on external intercostal EMG (EI EMG) activity were studied in 23 rabbits, anaesthetized with chloralose and urethane. To support depressed respiratory movements, controlled ventilation was applied after the lesi...

Vagal reflexes were studied in 12 anaesthetized rabbits after a midsagittal lesion of the medulla oblongata. The rabbits were either breathing spontaneously or were ventilated by a phrenic nerve-controlled servorespirator without the use of muscle relaxants. After splitting the medulla, asynchronous respiratory activity of the left and right phreni...

In rabbits naive to opiates or pretreated with morphine a selective morphine-induced facilitation of the Breuer-Hering inflation reflex is described.

Using cold blockade of conduction in the myelinated nerve fibres respiratory effects were studied evoked by centripetal stimulation of the vagus nerve. The experiments were carried out on rabbits under general anaesthesia with halothane and with artificial ventilation. The vagus nerves were cut in the neck and one of them was adapted for stimulatio...

Long-lasting effects of vagal input on phrenic (Phr) and external intercostal (EI) motoneuronal output were studied on 16 anesthetized rabbits breathing spontaneously or paralysed and ventilated by a phrenic nerve-driven pump. Withholding of ventilation by tracheal occlusion or by switching off the servorespirator maintained for seven breaths evoke...

In high decerebrate unanaesthetized cats (pre-collicular/pre-mamillary) which developed spontaneous co-ordinated locomotor activity, ventilation, breathing pattern, phrenic nerve, external and internal intercostal electromyogram (e.m.g.) activities were examined. Locomotion was also induced by electrical stimulation of the subthalamic locomotor reg...

The bilateral reflex actions of vagus nerve afferent signals on phrenic efferent activity have been tested by unilateral graded single shock electrical stimulation. An early excitation (latency 3-5 msec) was more prominent in the phrenic nerve contralateral to the stimulated vagus. Spinal cord hemisection at C3 eliminated both contralateral and ips...

The response of the phrenic motoneurones to single shock stimulation of- afferent vagal fibres during inspiration was studied in rabbits. The rabbits were anaesthetized with halothane, paralysed, artificially ventilated and bilaterally vagotomized. To improve the detection of the response on the non-integrated efferent phrenic activity in the prese...

Both in lightly pentobarbitone anesthetized and decerebrate cats increments in lung volume (V) during inspiration caused facilitation of inspiratory activity both in phrenic (Phr) and external intercostal (EI) motoneurons. This effect had low volume threshold, well below eupnoeic tidal volumes. It was readily reduced or abolished by small additiona...

Vagally mediated, volume dependent excitatory effects on phrenic nerve activity have been recently described in anesthetized dogs and pigs, but could not be ascertained in rabbits and baboons (Bartoli et al. 1975, Huszczuk et al. 1977, Cross et al. 1980, Karczewski et al. 1980). Results presented here on cats confirm and further characterize a volu...

In the experiments with 43 paralyzed rabbits ventilated artificially under general anaesthesia with halothane the effect of electrical stimulation of the central end of the vagus nerve on respiratory pattern was investigated. The analysis of respiratory responses to varying parameters of stimulation, and comparison of results with the experiments i...

During hyperventilation apnoea in vagotomized, anaesthetized rabbits, paralyzed and artificially ventilated, the effects of electrical afferent stimulation of the vagus nerve on the provocation and inhibition of inspiratory activity were investigated. The experiments were repeated using hyperinflation or short-lasting inflation in nonvagotomized an...

The effects of a short train of electrical impulses applied to the central stump of a cut vagus nerve at various moments of the central respiratory cycle were studied in 28 rabbits and 3 baboons. The animals were anaesthetized (halothane), vagotomized, paralyzed and artificially ventilated. Stimulation in inspiration elicited always an inhibitory e...

The anaesthetized animal is sometimes called “a simplified preparation”. This implies that whereas general anaesthesia abolished or reduces the ability of the respiratory controller to perform its more sophisticated operations, it does nevertheless leave its basic mechanisms more or less intact. The view that anaesthesia can unmask the fundamental...

Experiments were performed on 12 rabbits in 4 experimental groups: A. breathing spontaneously; B. nonparalysed and ventilated by means of a pump driven by the integrated phrenic nerve activity; C. paralysed and ventilated as mentioned above; D. like in the group C, but subjected to bilateral vagotomy. The relationships were investigated between the...