Shedding Light on Endometriosis: Patient and Provider Perspectives on a Challenging Disease

Background: Endometriosis is a serious yet understudied medical condition impacting millions of women worldwide. Methods: This mixed methods study aimed to understand health care provider perceptions and patient experiences with endometriosis in the United States. Providers were surveyed to assess their understanding of disease prevalence. A subset of providers also participated in short, open-ended interviews about treating patients who have or are suspected to have endometriosis. Interviews were also conducted with women diagnosed with endometriosis to understand their experiences with the disease. Means and frequencies were calculated for survey data; interviews were transcribed and separately analyzed by two coders using an iterative coding process until agreement was reached. Results: Fifty-three providers completed surveys. Six out of 53 providers (11%) accurately identified the prevalence of endometriosis. Four providers and 12 patients completed interviews. Emergent themes among providers included limited training, difficulty of diagnosis, complexity of the referral process, a challenging patient-provider dynamic, and the importance of multidisciplinary collaboration. Emergent themes from patients included the psychological impact of the disease, difficulties interacting with the healthcare system, self-advocacy, quality of life, and limited treatment options. Conclusion: Providers are frequently unfamiliar with the far-reaching scope of endometriosis and cite many challenges caring for patients with the disease. Patients equally find the disease challenging to live with as it encroaches on physical, mental, and emotional well-being

Collaborating with the Peace Corps to Maximize Student Learning in Group Counseling

This article explores a model partnership with a counseling education program and the Peace Corps. Counselor education students in a group counseling course developed and implemented a singular structured group session with clients not typically used (e.g., non-counseling students) to maximize student learning and implement group counseling skills. Group services were provided to returning Peace Corps volunteers with diverse cultural experiences who were in career and life transitions. In addition, the authors provide strategies for developing similar partnerships between counselor education programs and other agencies

Professional Counseling for Children With Sensory Processing Disorder

Sensory processing disorder is a complex neurological disorder affecting approximately 5–17% of the population, yet professional counselors often misunderstand and misdiagnose this disorder. A child’s academic, emotional and social functioning can be substantially impacted by sensory processing disorder; early diagnosis and treatment is crucial. In this article, the authors describe the disorder, discuss its impact on children and their families, and provide recommendations and resources for both mental health counselors and school counselors to utilize when serving this unique population with special needs. A case study is included, in addition to suggestions for treatment collaboration and advocacy on behalf of clients with sensory processing disorder

A learning community approach to identifying interventions in health systems to reduce colorectal cancer screening disparities.

Although colorectal cancer (CRC) screening in the United States has been increasing, screening rates are not optimal, and there are persistent disparities in CRC screening and mortality, particularly among minority patients. As most CRC screening takes place in primary care, health systems are well-positioned to address this important population health problem. However, most health systems have not actively engaged in identifying and implementing effective evidence-based intervention strategies that can raise CRC screening rates and reduce disparities. Drawing on the Collective Impact Model and the Interactive Systems Framework for Dissemination and Implementation, our project team applied a learning community strategy to help two health systems in southeastern Pennsylvania identify evidence-based CRC screening interventions for primary care patients. Initially, this approach involved activating a coordinating team, steering committee (health system leadership and stakeholder organizations), and patient and stakeholder advisory committee to identify candidate CRC screening intervention strategies. The coordinating team guided the steering committee through a scoping review to identify seven randomized trials that identified interventions that addressed CRC screening disparities. Subsequently, the coordinating team and steering committee applied a screening intervention classification typology to select an intervention strategy that involved using an outreach strategy to provide minority patients with access to both stool blood test and colonoscopy screening. Finally, the coordinating team and steering committee engaged the health system patient and stakeholder advisory committee in planning for intervention implementation, thus taking up the challenge of reducing and important health disparity in patient populations served by the two health systems

The Impacts of Clearcutting on Understory Plants and Culturally Significant Species In Coastal Western Hemlock Forests of Vancouver Island

The goal of the study is to understand successional changes in an understory plant community after clear-cut timber harvesting. The forest ecosystem is within the Southern Very Wet Hypermaritime biogeoclimatic subzone in the broader Coastal Western Hemlock zone along the west coast of Vancouver Island. The ecosystem is located in Huu-ay-aht First Nations traditional territory, and the subzone falls within various Nuu-chah-nulth First Nations traditional territories. A chronosequence was used to categorize various stages of forest growth in five successional stages: Regeneration, Immature, Thinning, Mature, and Old-growth. Forests censused ranged in age from 1 to 354 years old with old-growth stages described as stands over 250 years. The leaf cover and stem density of understory plant species were recorded within 83 subplots. These metrics were evaluated with regard to environmental variables (slope aspect, elevation, canopy openness, soil pH, A horizon depth, soil profile depth, tree basal area, tree stem density, ground moss cover, and bare ground cover) to determine which, if any, factors influenced understory species composition and structure. Out of 45 species identified, 19 are culturally significant plant species to the Nuu-chah-nulth First Nations. The species restricted to one successional stage were identified, with emphasis on opportunistic species in early stages and rare species in the Old-growth stage. There was a large decrease in many culturally significant species immediately after clearcutting. There was a large decrease in species (stem density, leaf cover, species richness, species diversity) from the Regeneration stage to the Thinning stage (1 to 80 years); however, these values steadily increased thereafter. Plant leaf cover and stem density were influenced by the amount of light reaching the understory. The natural disturbance regime that shade-tolerant plants are adapted to in these old-growth forests is small-scale gap formations, which clearcutting does not mimic. Timber harvesting options are recommended to better mimic the natural disturbance regime in this region, which is optimal for the understory species in this region. Many rare and culturally significant plant species were negatively impacted by clearcutting. Protecting rare plant species in old-growth forests is important for maintaining forest biodiversity and indigenous cultural practices in the future

Inhibition of Microbial Growth by Eelgrass Extracts

Eelgrass extracts from Zostera marina and Zostera japonica were tested against bacterial isolates for antibacterial activity. Bacterial isolates that exhibited sensitivity to the eelgrass extracts were also tested against nine pure phenolics, and one complete mixture, for inhibition. Isolated marine bacteria and one marine lab culture were sensitive to both eelgrass extracts. Antibacterial activity was also found with the samples of nine pure phenolic acids, and one mix of these nine, known to be produced in Zostera. It is likely the phenolic acids in eelgrass extracts have antibacterial effects

Draft genome sequences for seven Streptococcus Parauberis Isolates from Wild Fish in the Chesapeake Bay

Streptococcus parauberis is a pathogen of cattle and fish, closely related Streptococcus uberis and Streptococcus iniae. We report the genomes of seven S. parauberis strains recovered from striped bass (Morone saxatilis) in the Chesapeake Bay. The availability of these genomes will allow comparative genomic analysis of Chesapeake Bay S. parauberis strains versus S. parauberis cultured from other animal hosts and geographic regions

Buried alive: Aquatic plants survive in ‘ghost ponds’ under agricultural fields

The widespread loss of wetlands due to agricultural intensification has been highlighted as a major threat to aquatic biodiversity. However, all is not lost as we reveal that the propagules of some aquatic species could survive burial under agricultural fields in the sediments of ‘ghost ponds’ - ponds in-filled during agricultural land consolidation. Our experiments showed at least eight aquatic macrophyte species to germinate from seeds and oospores, following 50–150 years of dormancy in the sediments of ghost ponds. This represents a significant proportion of the expected macrophyte diversity for local farmland ponds, which typically support between 6 and 14 macrophyte species. The rapid (< 6 months) re-colonisation of resurrected ghost ponds by a diverse aquatic vegetation similarly suggests a strong seed-bank influence. Ghost ponds represent abundant, dormant time capsules for aquatic species in agricultural landscapes around the globe, affording opportunities for enhancing landscape-scale aquatic biodiversity and connectivity. While reports of biodiversity loss through agricultural intensification dominate conservation narratives, our study offers a rare positive message, demonstrating that aquatic organisms survive prolonged burial under intensively managed agricultural fields. We urge conservationists and policy makers to consider utilizing and restoring these valuable resources in biodiversity conservation schemes and in agri-environmental approaches and policies

Growth and splitting of neural sequences in songbird vocal development

Neural sequences are a fundamental feature of brain dynamics underlying diverse behaviours, but the mechanisms by which they develop during learning remain unknown. Songbirds learn vocalizations composed of syllables; in adult birds, each syllable is produced by a different sequence of action potential bursts in the premotor cortical area HVC. Here we carried out recordings of large populations of HVC neurons in singing juvenile birds throughout learning to examine the emergence of neural sequences. Early in vocal development, HVC neurons begin producing rhythmic bursts, temporally locked to a prototype syllable. Different neurons are active at different latencies relative to syllable onset to form a continuous sequence. Through development, as new syllables emerge from the prototype syllable, initially highly overlapping burst sequences become increasingly distinct. We propose a mechanistic model in which multiple neural sequences can emerge from the growth and splitting of a commo n precursor sequence.National Institutes of Health (U.S.) (Grant R01DC009183)National Science Foundation (U.S.) (Grant DGE-114747