Factors Affecting Master’s Counseling Students Pursuing Doctoral Degrees

Leadership identity is the most critical challenge for mental health counseling students. The Council for Accreditation of Counseling and Related Educational Programs (CACREP) does not mandate courses in leadership development. This quantitative study investigated master’s level mental health counselor student leadership identity and factors for pursuing a doctoral degree. Results indicated that the variable gender predicted socially responsible leadership yet did not predict intent to pursue a doctoral degree. Based on these results, master’s level counseling students could benefit from leadership curriculum as preparation for leadership positions within the field and influence pursuance of higher learning. Recommended Citation Godfrey, C. A. (2020, October 1-2). Factors affecting master’s counseling students pursuing doctoral degrees [Poster presentation]. Walden University Research Conference 2020 (online). https://scholarworks.waldenu.edu/researchconference/2020/posters/28

Leadership Skill Development in Master’s-Level Counselor Education

Student leadership identity is fast becoming one of the most critical challenges educational institutions face today. However, mental health counselors may be limited in the amount of education and training received as they become leaders in the field. There is currently no known mandate at the master’s level for leadership embedded within the counseling curriculum in the educational environment, although research suggests otherwise. The purpose of this correlational predictive empirical study was to investigate leadership identity characteristics as measured by the Socially Responsible Leadership Scale, Revision 2 (SLRS-R2), moderated by demographic factors. Multiple regression analysis was used to determine outcome measures of the SLRS-R2 relating to leadership. Conclusions and suggestions for future practice regarding leadership skill development are provided

Lessons learned and study results from HIVCore, an HIV implementation science initiative

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138261/1/jia21261.pd

Neuropsychiatric manifestations and sleep disturbances with dolutegravir-based antiretroviral therapy versus standard of care in children and adolescents: a secondary analysis of the ODYSSEY trial

BACKGROUND: Cohort studies in adults with HIV showed that dolutegravir was associated with neuropsychiatric adverse events and sleep problems, yet data are scarce in children and adolescents. We aimed to evaluate neuropsychiatric manifestations in children and adolescents treated with dolutegravir-based treatment versus alternative antiretroviral therapy. METHODS: This is a secondary analysis of ODYSSEY, an open-label, multicentre, randomised, non-inferiority trial, in which adolescents and children initiating first-line or second-line antiretroviral therapy were randomly assigned 1:1 to dolutegravir-based treatment or standard-of-care treatment. We assessed neuropsychiatric adverse events (reported by clinicians) and responses to the mood and sleep questionnaires (reported by the participant or their carer) in both groups. We compared the proportions of patients with neuropsychiatric adverse events (neurological, psychiatric, and total), time to first neuropsychiatric adverse event, and participant-reported responses to questionnaires capturing issues with mood, suicidal thoughts, and sleep problems. FINDINGS: Between Sept 20, 2016, and June 22, 2018, 707 participants were enrolled, of whom 345 (49%) were female and 362 (51%) were male, and 623 (88%) were Black-African. Of 707 participants, 350 (50%) were randomly assigned to dolutegravir-based antiretroviral therapy and 357 (50%) to non-dolutegravir-based standard-of-care. 311 (44%) of 707 participants started first-line antiretroviral therapy (ODYSSEY-A; 145 [92%] of 157 participants had efavirenz-based therapy in the standard-of-care group), and 396 (56%) of 707 started second-line therapy (ODYSSEY-B; 195 [98%] of 200 had protease inhibitor-based therapy in the standard-of-care group). During follow-up (median 142 weeks, IQR 124–159), 23 participants had 31 neuropsychiatric adverse events (15 in the dolutegravir group and eight in the standard-of-care group; difference in proportion of participants with ≥1 event p=0·13). 11 participants had one or more neurological events (six and five; p=0·74) and 14 participants had one or more psychiatric events (ten and four; p=0·097). Among 14 participants with psychiatric events, eight participants in the dolutegravir group and four in standard-of-care group had suicidal ideation or behaviour. More participants in the dolutegravir group than the standard-of-care group reported symptoms of self-harm (eight vs one; p=0·025), life not worth living (17 vs five; p=0·0091), or suicidal thoughts (13 vs none; p=0·0006) at one or more follow-up visits. Most reports were transient. There were no differences by treatment group in low mood or feeling sad, problems concentrating, feeling worried or feeling angry or aggressive, sleep problems, or sleep quality. INTERPRETATION: The numbers of neuropsychiatric adverse events and reported neuropsychiatric symptoms were low. However, numerically more participants had psychiatric events and reported suicidality ideation in the dolutegravir group than the standard-of-care group. These differences should be interpreted with caution in an open-label trial. Clinicians and policy makers should consider including suicidality screening of children or adolescents receiving dolutegravir

Dolutegravir twice-daily dosing in children with HIV-associated tuberculosis: a pharmacokinetic and safety study within the open-label, multicentre, randomised, non-inferiority ODYSSEY trial

Background: Children with HIV-associated tuberculosis (TB) have few antiretroviral therapy (ART) options. We aimed to evaluate the safety and pharmacokinetics of dolutegravir twice-daily dosing in children receiving rifampicin for HIV-associated TB. Methods: We nested a two-period, fixed-order pharmacokinetic substudy within the open-label, multicentre, randomised, controlled, non-inferiority ODYSSEY trial at research centres in South Africa, Uganda, and Zimbabwe. Children (aged 4 weeks to <18 years) with HIV-associated TB who were receiving rifampicin and twice-daily dolutegravir were eligible for inclusion. We did a 12-h pharmacokinetic profile on rifampicin and twice-daily dolutegravir and a 24-h profile on once-daily dolutegravir. Geometric mean ratios for trough plasma concentration (Ctrough), area under the plasma concentration time curve from 0 h to 24 h after dosing (AUC0–24 h), and maximum plasma concentration (Cmax) were used to compare dolutegravir concentrations between substudy days. We assessed rifampicin Cmax on the first substudy day. All children within ODYSSEY with HIV-associated TB who received rifampicin and twice-daily dolutegravir were included in the safety analysis. We described adverse events reported from starting twice-daily dolutegravir to 30 days after returning to once-daily dolutegravir. This trial is registered with ClinicalTrials.gov (NCT02259127), EudraCT (2014–002632-14), and the ISRCTN registry (ISRCTN91737921). Findings: Between Sept 20, 2016, and June 28, 2021, 37 children with HIV-associated TB (median age 11·9 years [range 0·4–17·6], 19 [51%] were female and 18 [49%] were male, 36 [97%] in Africa and one [3%] in Thailand) received rifampicin with twice-daily dolutegravir and were included in the safety analysis. 20 (54%) of 37 children enrolled in the pharmacokinetic substudy, 14 of whom contributed at least one evaluable pharmacokinetic curve for dolutegravir, including 12 who had within-participant comparisons. Geometric mean ratios for rifampicin and twice-daily dolutegravir versus once-daily dolutegravir were 1·51 (90% CI 1·08–2·11) for Ctrough, 1·23 (0·99–1·53) for AUC0–24 h, and 0·94 (0·76–1·16) for Cmax. Individual dolutegravir Ctrough concentrations were higher than the 90% effective concentration (ie, 0·32 mg/L) in all children receiving rifampicin and twice-daily dolutegravir. Of 18 children with evaluable rifampicin concentrations, 15 (83%) had a Cmax of less than the optimal target concentration of 8 mg/L. Rifampicin geometric mean Cmax was 5·1 mg/L (coefficient of variation 71%). During a median follow-up of 31 weeks (IQR 30–40), 15 grade 3 or higher adverse events occurred among 11 (30%) of 37 children, ten serious adverse events occurred among eight (22%) children, including two deaths (one tuberculosis-related death, one death due to traumatic injury); no adverse events, including deaths, were considered related to dolutegravir. Interpretation: Twice-daily dolutegravir was shown to be safe and sufficient to overcome the rifampicin enzyme-inducing effect in children, and could provide a practical ART option for children with HIV-associated TB

Independent and combined effects of improved water, sanitation, and hygiene, and improved complementary feeding, on child stunting and anaemia in rural Zimbabwe: a cluster-randomised trial.

BACKGROUND: Child stunting reduces survival and impairs neurodevelopment. We tested the independent and combined effects of improved water, sanitation, and hygiene (WASH), and improved infant and young child feeding (IYCF) on stunting and anaemia in in Zimbabwe. METHODS: We did a cluster-randomised, community-based, 2 × 2 factorial trial in two rural districts in Zimbabwe. Clusters were defined as the catchment area of between one and four village health workers employed by the Zimbabwe Ministry of Health and Child Care. Women were eligible for inclusion if they permanently lived in clusters and were confirmed pregnant. Clusters were randomly assigned (1:1:1:1) to standard of care (52 clusters), IYCF (20 g of a small-quantity lipid-based nutrient supplement per day from age 6 to 18 months plus complementary feeding counselling; 53 clusters), WASH (construction of a ventilated improved pit latrine, provision of two handwashing stations, liquid soap, chlorine, and play space plus hygiene counselling; 53 clusters), or IYCF plus WASH (53 clusters). A constrained randomisation technique was used to achieve balance across the groups for 14 variables related to geography, demography, water access, and community-level sanitation coverage. Masking of participants and fieldworkers was not possible. The primary outcomes were infant length-for-age Z score and haemoglobin concentrations at 18 months of age among children born to mothers who were HIV negative during pregnancy. These outcomes were analysed in the intention-to-treat population. We estimated the effects of the interventions by comparing the two IYCF groups with the two non-IYCF groups and the two WASH groups with the two non-WASH groups, except for outcomes that had an important statistical interaction between the interventions. This trial is registered with ClinicalTrials.gov, number NCT01824940. FINDINGS: Between Nov 22, 2012, and March 27, 2015, 5280 pregnant women were enrolled from 211 clusters. 3686 children born to HIV-negative mothers were assessed at age 18 months (884 in the standard of care group from 52 clusters, 893 in the IYCF group from 53 clusters, 918 in the WASH group from 53 clusters, and 991 in the IYCF plus WASH group from 51 clusters). In the IYCF intervention groups, the mean length-for-age Z score was 0·16 (95% CI 0·08-0·23) higher and the mean haemoglobin concentration was 2·03 g/L (1·28-2·79) higher than those in the non-IYCF intervention groups. The IYCF intervention reduced the number of stunted children from 620 (35%) of 1792 to 514 (27%) of 1879, and the number of children with anaemia from 245 (13·9%) of 1759 to 193 (10·5%) of 1845. The WASH intervention had no effect on either primary outcome. Neither intervention reduced the prevalence of diarrhoea at 12 or 18 months. No trial-related serious adverse events, and only three trial-related adverse events, were reported. INTERPRETATION: Household-level elementary WASH interventions implemented in rural areas in low-income countries are unlikely to reduce stunting or anaemia and might not reduce diarrhoea. Implementation of these WASH interventions in combination with IYCF interventions is unlikely to reduce stunting or anaemia more than implementation of IYCF alone. FUNDING: Bill & Melinda Gates Foundation, UK Department for International Development, Wellcome Trust, Swiss Development Cooperation, UNICEF, and US National Institutes of Health.The SHINE trial is funded by the Bill & Melinda Gates Foundation (OPP1021542 and OPP113707); UK Department for International Development; Wellcome Trust, UK (093768/Z/10/Z, 108065/Z/15/Z and 203905/Z/16/Z); Swiss Agency for Development and Cooperation; US National Institutes of Health (2R01HD060338-06); and UNICEF (PCA-2017-0002)

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

-151 - ASPECTS OF SPECIES RICHNESS AND SEASONALITY OF AMPHIBIANS AND REPTILES IN THE COASTAL BARRIER ISLAND OF BRASS (NIgERIA)

suMMARY. -The ecology of the communities of amphibians and reptiles are nearly unknown in the coastal barrier island forests of the Niger Delta, southern Nigeria. In this paper, we examine aspects of species richness and phenology of amphibians and reptiles at several sites of Brass Island, one of the main coastal barrier islands of Nigeria. We employed a suite of field methods to capture specimens, and performed an equal field effort during both dry and wet seasons. Overall, we captured 31 species belonging to 17 families. For amphibians, we collected one species of Pipidae and Ranidae, and two of Ptychadenidae, Bufonidae, and Hyperoliidae. For reptiles, we captured one species of Agamidae, Varanidae, Chamaeleonidae, Typhlopidae, Viperidae, and Pelomedusidae, two of Boidae, Testudinidae and Crocodylidae, three of Scincidae and Elapidae, and five of Colubridae sensu lato. Fewer species were found in coastal barrier island forests than in swamp forests, mangroves or derived savannas of the Niger Delta. There was no clear seasonal effect on reptile abundance and diversity (but most species were found essentially by dry season), whereas for amphibians there was a strong seasonal effect, with higher abundances and species diversity found in wet season

Aspects of species richness and seasonality of amphibians and reptiles in the Coastal Barrier Island of Brass (Nigeria)

Summary. — The ecology of the communities of amphibians and reptiles are nearly unknown in the coastal barrier island forests of the Niger Delta, southern Nigeria. In this paper, we examine aspects of species richness and phenology of amphibians and reptiles at several sites of Brass Island, one of the main coastal barrier islands of Nigeria. We employed a suite of field methods to capture specimens, and performed an equal field effort during both dry and wet seasons. Overall, we captured 31 species belonging to 17 families. For amphibians, we collected one species of Pipidae and Ranidae, and two of Ptychadenidae, Bufonidae, and Hyperoliidae. For reptiles, we captured one species of Agamidae, Varanidae, Chamaeleonidae, Typhlopidae, Viperidae, and Pelomedusidae, two of Boidae, Testudinidae and Crocodylidae, three of Scincidae and Elapidae, and five of Colubridae sensu lato. Fewer species were found in coastal barrier island forests than in swamp forests, mangroves or derived savannas of the Niger Delta. There was no clear seasonal effect on reptile abundance and diversity (but most species were found essentially by dry season), whereas for amphibians there was a strong seasonal effect, with higher abundances and species diversity found in wet season.Résumé. — Aspects de la richesse spécifique et de la saisonnalité des amphibiens et reptiles de l’île-barrière côtière de Brass (Nigéria). — L’écologie des communautés d’amphibiens et de reptiles des forêts des îles-barrières côtières du delta du Niger, sud du Nigéria, est pratiquement inconnue. Dans cet article nous examinons la richesse spécifique et la saisonnalité des amphibiens et reptiles en divers sites de l’île de Brass, l’une des principales îles-barrières du Nigéria. Nous avons utilisé une série de méthodes pour capturer des spécimens et conduire un effort de terrain équilibré durant les saisons sèche et humide. En tout, 31 espèces appartenant à 17 familles ont été capturées. En ce qui concerne les amphibiens, nous avons collecté une espèce pour les Pipidés et les Ranidés, deux pour les Ptychadénidés, Bufonidés et Hyperoliidés. En reptiles, nous avons capturé une espèce pour les Agamidés, Varanidés, Chamaeléonidés, Typhlopidés, Vipéridés et Pélomédusidés, deux pour les Boïdés, Testudinidés et Crocodylidés, trois pour les Scincidés et Elapidés, cinq pour les Colubridés sensu lato. Moins d’espèces ont été trouvées dans les forêts d’île-barrière côtière que dans les forêts marécageuses, mangroves ou savanes dérivées du delta du Niger. Il n’est pas apparu d’effet saison clair sur l’abondance et la diversité des reptiles (mais la plupart des espèces ont essentiellement été trouvées en saison sèche) alors que, pour les amphibiens, un tel effet s’est avéré fort, avec de plus fortes abondances et diversités spécifiques en saison des pluies.Akani Godfrey C., Luiselli Luca, Ogbeibu Anthony E., Onwuteaka John N., Chuku Edith, Osakwe J.A, Bombi Pierluigi, Amuzie Charity C., Uwagbae Michael, Gijo Harry A. Aspects of species richness and seasonality of amphibians and reptiles in the Coastal Barrier Island of Brass (Nigeria). In: Revue d'Écologie (La Terre et La Vie), tome 65, n°2, 2010. pp. 151-161

Insights into Insect Resistance in Pulse Crops: Problems and Preventions

Globally, insect pests cause considerable damage to pulse crops. Hence developing broad-spectrum resistance against insect pests has been a major challenge to pulse growers and scientists. Traditionally, cultural practices and synthetic insecticides are being utilized for effective control of insect pests since ages. Apart from these, other strategies such as host plant resistance, insect-resistant transgenic crops, and IPM are also being used to manage the infestation in pulse crops. Though screening of genetic resources for insect resistance has been promising in some pulse crops, fertility barriers and linkage drag minimize the effective utilization of identified resistance in commercially viable crop breeding programs. In parallel, insect-resistant transgenic plants have been developed using various insecticidal proteins from various sources including Bacillus thuringiensis endotoxin, plant protease inhibitors, chitinases, alpha-amylase inhibitors, secondary metabolites, and vegetative insecticidal proteins (VIPs). Deploying transgenic plants with high levels of toxin expression by gene pyramiding is another practical option to delay the resistance development in insects. Nevertheless, the success achieved so far in managing insect pests is limited mainly due to the complex mechanisms underlying the defense strategies together with the lack of precision in screening techniques. Here, we discuss the recent progress and current status of studies toward developing resistance to the most common insect pests of pulses. This chapter points the lack of detailed molecular studies exploring the insect resistance that can advance our knowledge on plant resistance mechanisms and the genes involved. Therefore, a step forward now will be on exploiting natural variations with novel technologies in combination of eco-safe management practices to develop durable insect-resistant pulse crops. Despite technical and regulatory difficulties, developing insect resistance should be the major priority area for future breeding and genetic engineering studies aiming at pulse crop improvement