Life design and career counseling: contributions to social justice

The chapter begins with the presentation of LDC framework. In the second section, considerations are given on LDC possibilities for enhancing decent work and social justice. From this perspective of social exclusion, designated social integrationist, participation in paid work is viewed as the key to social inclusion (Watts, 2001). At the end of this section the relevance of contextual factors in career development of disadvantaged populations is referred to highlight the importance of these interventions not be exclusively focused on inter- and intrapersonal career development factors, but also take into consideration social action at the institutional, community, public policy and international/global levels (Cook, 2017). In the next section, the process of balancing the focus on the self-determination of the individual with a focus on a transformation of contextual factors that reinforce the disadvantaged position (Blustein, et al., 2005; Prilleltensky, 1997) is illustrated by presenting an intervention in which LDC was integrated into supported employment approach. Our proposal focuses exclusively on collaborative activities at the individual, institutional and communal level, with these being the tiers which the counselor can more easily influence as part of their more routine interaction with disadvantaged populations in general. The chapter concludes with an overview of the subject and a reference on LDC limitations for the intervention with disadvantaged populations in general

One-day oral polyethylene glycol based cleanout is effective for pre-colonoscopy preparation in children

Abstract Background The adequacy of pre-procedure preparation is the principal determinant of the quality of colonoscopy in pediatric as in adult patients. There is a lack of consensus, among providers on a standard pre-procedure regimen. Professional society guidelines include the use of Polyethylene glycol (PEG). Herein we report on the provider-assessed adequacy of a one day, age-categorized dosing, PEG based cleanout regimen in children undergoing colonoscopy in a tertiary institution. Methods The standard bowel preparation regime at our institution includes an age dependent minimum PEG dosing regimen in addition to clear liquids the day prior to the procedure. We retrospectively abstracted relevant indices including patient demographics, prep quality, procedure impairment, duration and completion from an institutional quality monitoring survey tool between 2015 and 2016 and similarly abstracted prospectively recorded indices that included the dataset above as well as additional fields for procedure deviations and additional laxative use. Results A total of 642 procedures (mean age 12.2 years; F: 380) were accrued, nonadherence to the cleanout regimen (7.3%) and additional laxative use (3.1%) were observed in a small proportion of the prospective dataset subjects, adequate cleanout defined as thin or thick liquid but no solids present was reported in 79.5% and 15.8% of cases and impaired study from inadequate cleanout was reported in 11.8% of studies albeit the cecum was reached and the terminal ileum was intubated in 97.8 and 93.6% of studies. The duration of the study was significantly longer with the presence of a fellow trainee assisting in the procedure. Patient age and gender did not correlate with prep adequacy or cecal and ileal intubation rates, inadequate cleanout was significantly associated with impairment and incomplete studies. Conclusion A one day, single agent, osmotic laxative (Polyethylene glycol) based cleanout regimen is effective in routine pre-procedure cleanout for standard colonoscopy in pediatric age range patients