Courageous Conversations in Counseling about Race

The United States (U.S.) is known as the “melting pot” and is characterized by diversity (Matthews, Barden, & Sherrell, 2018). While the U.S. is culturally diverse, it is not culturally equal. Racial tensions have escalated recently, and psychologically harmful microaggressions are experienced by minorities across a multitude of settings, daily (Davis, DeBlaere, Brubaker, Owen, Jordan, Hook & Van Tongeren, 2015). Counselors must demonstrate cultural humility to be effective counselors in relationships where worldviews and values will inevitably clash (Davis et al., 2015, Hook, Watkins, Davis, Own, Van Tongren, & Ramos, 2016). Being culturally humble is a “lifelong commitment to self-evaluation and self-critique, to redressing the power imbalances… and to developing mutually beneficial and nonpaternalistic clinical and advocacy partnerships with communities” (Tervalon & Murray-Garcia, 1998, p. 117). Counselors should promote diversity and celebrate differences, but more importantly, counselors should be advocates and a force for social justice. How to best prepare counselors to be culturally aware, competent, and humble is a matter of great concern (Prosek& Michel, 2016; Celinska, & Swazo, 2015; Malott, Paone, Maddux, Rothman, 2010). The courageous conversations movement suggests an open dialogue is a great first step to addressing difficult topics (Mallot et al., 2010; Singleton & Hays, 2008)

Development and Construct Validity of Scores on the Community Service Attitudes Scale

This study reports the multistage development of the Community Service Attitudes Scale (CSAS), an instrument for measuring college students\u27 attitudes about community service. The CSAS was developed based on Schwartz\u27s helping behavior model. Scores on the scales of the CSAS yielded strong reliability evidence (coefficient alphas ranging from .72 to .93). Principal components analysis yielded results consistent with the Schwartz model. In addition, the CSAS scale scores were positively correlated with gender, college major, community service experience, and intentions to engage in community service. The CSAS will be useful to researchers for conducting further research on the effects of service learning and community service experiences for students

Preparing Students for Team-Based Care for Vulnerable Populations

Health professionals have an obligation to improve both the health of the individual and the public in a time of scarce resources. The Institute of Medicine (IOM), Healthy People Curriculum Task Force and professional education accreditation standards indicate the need for health care professionals to demonstrate competencies related to community engagement, basic health promotion skills and the ability to work effectively in interprofessional teams. An Interprofessional Course, IPE 413: Developing Care for a Vulnerable Population provides students the opportunity to collaborate to address health needs in cooperation with a community partner. Students work in teams to address the complex health care needs of an individual community member. The one hour elective course is open to students from nursing, occupational therapy, pharmacy, social work, and exercise science. Efforts are underway to explore the possibility of offering this course to medical students. Students are assessed on the knowledge and experience gained through this interprofessional experience using the Team Skills Scale and student reflections. Faculties from each of the disciplines utilize a collaborative model in the instructional design of the course. The content is co-taught and faculty not only role model interprofessional care, but also serve as mentors and resource personnel for the students as they work with their clients

Challenges, Opportunities, and Adaptations of a College Preparatory 4-H Youth Development Program during COVID-19

SARS-CoV-2 (COVID-19) has proliferated across the United States, and in the process, it has disrupted all sense of normalcy. Because adolescents are in a critical period for growth and development, youth are particularly susceptible to negative impacts of disruption from COVID-19. Therefore, sustaining youth development programs is essential to ensuring positive youth development occurs despite significant challenges. Unfortunately, the implementation of programs that maintain safety precautions can be challenging. Many programs have been forced to either cancel all activities or to transition program elements to a virtual format. Rural Medical and Science Scholars (RMSS) program administrative staff made the decision to transition to a virtual delivery. Despite only having a few weeks to reshape the program, RMSS administrative staff were able to innovatively adapt to new challenges in order to deliver a successful program. The success of the program extends beyond its participants. By understanding potential program barriers and successful adaptation methods, other youth development programs will be better equipped to sustain program activities and youth outreach during the COVID-19 pandemic

Leucine and arginine regulate trophoblast motility through mTOR-dependent and independent pathways in the preimplantation mouse embryo

AbstractUterine implantation is a critical element of mammalian reproduction and is a tightly and highly coordinated event. An intricate and reciprocal uterine-embryo dialog exists to synchronize uterine receptivity with the concomitant activation of the blastocyst, maximizing implantation success. While a number of pathways involved in regulating uterine receptivity have been identified in the mouse, less is understood about blastocyst activation, the process by which the trophectoderm (TE) receives extrinsic cues that initiate new characteristics essential for implantation. Amino acids (AA) have been found to regulate blastocyst activation and TE motility in vitro. In particular, we find that arginine and leucine alone are necessary and sufficient to induce TE motility. Both arginine and leucine act individually and additively to propagate signals that are dependent on the activity of the mammalian target of rapamycin complex 1 (mTORC1). The activities of the well-established downstream targets of mTORC1, p70S6K and 4EBP, do not correlate with trophoblast motility, suggesting that an independent-rapamycin-sensitive pathway operates to induce trophoblast motility, or that other, parallel amino acid-dependent pathways are also involved. We find that endogenous uterine factors act to induce mTORC1 activation and trophoblast motility at a specific time during pregnancy, and that this uterine signal is later than the previously defined signal that induces the attachment reaction. In vivo matured blastocysts exhibit competence to respond to an 8-hour AA stimulus by activating mTOR and subsequently undergoing trophoblast outgrowth by the morning of day 4.5 of pregnancy, but not on day 3.5. By the late afternoon of day 4.5, the embryos no longer require any exposure to AA to undergo trophoblast outgrowth in vitro, demonstrating the existence and timing of an equivalent in vivo signal. These results suggest that there are two separate uterine signals regulating implantation, one that primes the embryo for the attachment reaction and another that activates mTOR and initiates invasive behavior

Meningococcal Disease in Patients With Human Immunodeficiency Virus Infection: A Review of Cases Reported Through Active Surveillance in the United States, 2000-2008.

BackgroundAlthough human immunodeficiency virus (HIV) infection is an established risk factor for several bacterial infections, the association between HIV infection and meningococcal disease remains unclear.MethodsExpanded chart reviews were completed on persons with meningococcal disease and HIV infection reported from 2000 through 2008 from 9 US sites participating in an active population-based surveillance system for meningococcal disease. The incidence of meningococcal disease among patients meeting Centers for Disease Control and Prevention acquired immune deficiency syndrome (AIDS) surveillance criteria was estimated using data from the National HIV Surveillance System for the participating sites.ResultsThirty-three cases of meningococcal disease in individuals with HIV infection were reported from participating sites, representing 2.0% of all reported meningococcal disease cases. Most (75.8%) persons with HIV infection were adult males aged 25 to 64 years old. Among all meningococcal disease cases aged 25 to 64 years old, case fatality ratios were similar among HIV-infected and HIV-uninfected persons (13.3% vs 10.6%; P = .6). The cumulative, mean incidence of meningococcal disease among patients aged 25 to 64 years old with HIV infection ever classified as AIDS was 3.5 cases per 100000 person years (95% confidence interval [CI], 2.1-5.6), compared with 0.3 cases per 100000 person years (95% CI, 0.3-0.3) for persons of the same age group not reported to have AIDS (relative risk = 12.9; 95% CI, 7.9-20.9).ConclusionsIndividuals with HIV infection meeting the AIDS surveillance case definition have a higher incidence of meningococcal disease compared with the general adult population

7. Development And Initial Validation Of The Multicultural Counseling Awareness Scale

In recent years counseling programs have devoted increasing attention to multicultural issues in the curriculum. The counseling profession\u27s initial interest in multicultural training (or development) was buoyed by the Division of Counseling Psychology (Division #17 of the American Psychological Association [APA]) position paper on multicultural competencies (Sue et al., 1982). This position paper delineated 11 cross-cultural counseling competencies organized within the categories of awareness (beliefs/attitudes), knowledge, and skills. The Awareness category refers to the counselor\u27s awareness of his or her own value biases and how these biases may translate into culturally insensitive counseling; to the need to check biases and stereotypes; and to the need to develop a positive orientation towards multiculturalism. Knowledge refers to the counselor\u27s knowledge of his or her own worldview as well as the worldview of his or her clients; and to additional culture- specific information such as the impact of racism on clients, models of acculturation and racial identity development, and so forth. Finally, Skills refers to the counselor\u27s ability to translate awareness and knowledge into culturally sensitive and relevant interventions (Pedersen, 1988; Sue et al., 1982; Sue, Arredondo, & McDavis, 1992). Since the Sue et al. (1982) position paper was published, numerous professional preparation programs have added multicultural components to their curriculum. According to the Hollis and Wantz (1990, 1994) national surveys of counseling programs, 76 new multicultural courses were developed and added to existing curriculums from 1989 to 1991, and another 27 programs added a course from 1993 to 1995. In a survey of APA-accredited counseling psychology programs, Hills and Strozier (1992) found that 87% of the programs offered a multicultural course, and 59% of the programs required the course. Also surveying APA-accredited counseling psychology programs, Quintana and Bernal (1995) found that 73% of the programs offered at least one multicultural course and 42% required one course. In the most recent survey to date, of both APA accredited and non-accredited counseling psychology programs, Ponterotto (in press) found that 89% of responding programs have a required multicultural counseling course, and 58% of programs integrate multicultural issues into all courses

Wound care challenges in children and adults with spina bifida: An open-cohort study

Skin breakdown is a frequent concern for individuals with spina bifida. We explored wound incidence in patients with spina bifida and how it varies across a person\u27s life span and functional neurologic level. We examined the settings in which skin breakdown most commonly occurred, looking for evidence of chronic, non-healing wounds. We also sought to develop criteria to improve wound monitoring. We identified reported wound episodes in an open-cohort study over a 13-year period, examining the hospital and outpatient clinical records of spina bifida patients at Children\u27s National Medical Center (CNMC). Current age, age at wound presentation, sex, weight, functional neurologic level, wound location, setting in which the wound was acquired, the development of a chronic wound, and presence of a shunt were recorded. Of the 376 patients in our clinical population, 123 (average age: 18.8 years, range: infancy–56 years) developed a total of 375 wounds; the majority of patients who developed one wound went on to develop one or more additional wounds, and 20 patients developed chronic wounds. Our data suggest that age bracket (adolescents), wheelchair use, and bare feet, as well as possibly obesity and reduced executive functioning, are key risk factors for wound development. These findings have led to a focused effort to increase wound education and prevention. In addition we report on our early experience using a wound care specialist to champion this initiative

Immunomodulatory parasites and toll-like receptor-mediated tumour necrosis factor alpha responsiveness in wild mammals

BACKGROUND: Immunological analyses of wild populations can increase our understanding of how vertebrate immune systems respond to 'natural' levels of exposure to diverse infections. A major recent advance in immunology has been the recognition of the central role of phylogenetically conserved toll-like receptors in triggering innate immunity and the subsequent recruitment of adaptive response programmes. We studied the cross-sectional associations between individual levels of systemic toll-like receptor-mediated tumour necrosis factor alpha responsiveness and macro- and microparasite infections in a natural wood mouse (Apodemus sylvaticus) population. RESULTS: Amongst a diverse group of macroparasites, only levels of the nematode Heligmosomoides polygyrus and the louse Polyplax serrata were correlated (negatively) with innate immune responsiveness (measured by splenocyte tumour necrosis factor alpha responses to a panel of toll-like receptor agonists). Polyplax serrata infection explained a strikingly high proportion of the total variation in innate responses. Contrastingly, faecal oocyst count in microparasitic Eimeria spp. was positively associated with innate immune responsiveness, most significantly for the endosomal receptors TLR7 and TLR9. CONCLUSION: Analogy with relevant laboratory models suggests the underlying causality for the observed patterns may be parasite-driven immunomodulatory effects on the host. A subset of immunomodulatory parasite species could thus have a key role in structuring other infections in natural vertebrate populations by affecting the 'upstream' innate mediators, like toll-like receptors, that are important in initiating immunity. Furthermore, the magnitude of the present result suggests that populations free from immunosuppressive parasites may exist at 'unnaturally' elevated levels of innate immune activation, perhaps leading to an increased risk of immunopathology