Comparing individual and couples/family therapy : practitioners\u27 perspectives

This qualitative study examines social workers\u27 perspectives on the similarities and differences between individual and couples/family therapy. Particular attention is given to similarities and differences between individual and couples/family therapists\u27 use of self, orientation towards conflict, and relationship factors. The investigation is based on semistructured interviews with 10 master\u27s level social workers who specialize in either individual or couples/family therapy. A number of interesting trends emerged in the findings of this research. Therapists in both modalities perceived couples/family therapists\u27 use of self to be more active and directive than individual therapists, and described more behavioral interventions when working with couples/families. Therapists also perceived a qualitative difference between management of conflict with couples/families versus with individuals, and described conflict in individual therapy, where the clinician is targeted as the object of the conflict, as more difficult and uncomfortable to manage than conflicts located in the client family system. The results to questions about relationship factors and therapist traits demonstrate that therapists perceive a wide range of characteristics and approaches to be viable for both individual and couples/family therapists. Additionally, the exploratory interviews generated some interesting results regarding the variables that influence specialization, and clinicians\u27 biases around their own and other practice modalities. Implications for practice and future research are discussed

Visual Narratives: Exploring the Impacts of Tourism Development in Placencia, Belize

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/156219/2/napa12135_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156219/1/napa12135.pd

Treatment Use Among Children with Tourette Syndrome Living in The United States, 2014

Treatment of Tourette syndrome (TS) can be complicated by changes over time in tic expression, severity, and co-occurring disorders. Using the 2014 National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome, this study provides descriptive estimates of the use of behavioral interventions and medication among children living with TS. Parent-reported data on 115 children aged 5–17 years ever diagnosed with TS were analyzed to provide descriptive, unweighted results. Overall, 77.4% of children had current or past use of any TS treatment; 59.1% ever used behavioral interventions and 56.1% had ever taken TS medication. Children with moderate” or “severe” versus “mild” TS, ≥1 co-occurring disorders, and tics that interfered with functioning were significantly more likely to have used one or more TS treatments. Side effects were reported for 84.4% of children who took TS medication. Most parents of children with current TS (87.2%) were satisfied with the management of their child\u27s TS. However, parents of children with “moderate” or “severe” current TS were significantly more dissatisfied compared to parents of children with “mild” TS. Findings from this study could be used to inform efforts to support children living with TS and their families

Combining genomics and epidemiology to track mumps virus transmission in the United States.

Unusually large outbreaks of mumps across the United States in 2016 and 2017 raised questions about the extent of mumps circulation and the relationship between these and prior outbreaks. We paired epidemiological data from public health investigations with analysis of mumps virus whole genome sequences from 201 infected individuals, focusing on Massachusetts university communities. Our analysis suggests continuous, undetected circulation of mumps locally and nationally, including multiple independent introductions into Massachusetts and into individual communities. Despite the presence of these multiple mumps virus lineages, the genomic data show that one lineage has dominated in the US since at least 2006. Widespread transmission was surprising given high vaccination rates, but we found no genetic evidence that variants arising during this outbreak contributed to vaccine escape. Viral genomic data allowed us to reconstruct mumps transmission links not evident from epidemiological data or standard single-gene surveillance efforts and also revealed connections between apparently unrelated mumps outbreaks

Molecular Identification of a Malaria Merozoite Surface Sheddase

Proteolytic shedding of surface proteins during invasion by apicomplexan parasites is a widespread phenomenon, thought to represent a mechanism by which the parasites disengage adhesin-receptor complexes in order to gain entry into their host cell. Erythrocyte invasion by merozoites of the malaria parasite Plasmodium falciparum requires the shedding of ectodomain components of two essential surface proteins, called MSP1 and AMA1. Both are released by the same merozoite surface “sheddase,” but the molecular identity and mode of action of this protease is unknown. Here we identify it as PfSUB2, an integral membrane subtilisin-like protease (subtilase). We show that PfSUB2 is stored in apical secretory organelles called micronemes. Upon merozoite release it is secreted onto the parasite surface and translocates to its posterior pole in an actin-dependent manner, a trafficking pattern predicted of the sheddase. Subtilase propeptides are usually selective inhibitors of their cognate protease, and the PfSUB2 propeptide is no exception; we show that recombinant PfSUB2 propeptide binds specifically to mature parasite-derived PfSUB2 and is a potent, selective inhibitor of MSP1 and AMA1 shedding, directly establishing PfSUB2 as the sheddase. PfSUB2 is a new potential target for drugs designed to prevent erythrocyte invasion by the malaria parasite

Treatment outcomes among children, adolescents, and adults on treatment for tuberculosis in two metropolitan municipalities in Gauteng Province, South Africa

BACKGROUND : Gauteng Province has the second lowest tuberculosis (TB) incidence rate in South Africa but the greatest proportion of TB/HIV co-infection, with 68% of TB patients estimated to have HIV. TB treatment outcomes are well documented at the national and provincial level; however, knowledge gaps remain on how outcomes differ across detailed age groups. METHODS : Using data from South Africa’s National Electronic TB Register (ETR), we assessed all-cause mortality and loss to follow-up (LTFU) among patients initiating treatment for TB between 01/2010 and 12/2015 in the metropolitan municipalities of Ekurhuleni Metropolitan Municipality and the City of Johannesburg in Gauteng Province. We excluded patients who were missing age, had known drug-resistance, or transferred into TB care from sites outside the two metropolitan municipalities. Among patients assigned a treatment outcome, we investigated the association between age group at treatment initiation and mortality or LTFU (treatment interruption of ≥2 months) within 10 months after treatment initiation using Cox proportional hazard models and present hazard ratios and Kaplan-Meier survival curves. RESULTS : We identified 182,890 children (<10 years), young adolescent (10–14), older adolescent (15–19), young adult (20–24), adult (25–49), and older adult (≥50) TB cases without known drug-resistance. ART coverage among HIV co-infected patients was highest for young adolescents (64.3%) and lowest for young adults (54.0%) compared to other age groups (all over 60%). Treatment success exceeded 80% in all age groups (n = 170,017). All-cause mortality increased with age. Compared to adults, young adults had an increased hazard of LTFU (20–24 vs 25–49 years; aHR 1.43 95% CI: 1.33, 1.54) while children, young adolescents, and older adults had lower hazard of LTFU. Patients with HIV on ART had a lower risk of LTFU, but greater risk of death when compared to patients without HIV. CONCLUSIONS : Young adults in urban areas of Gauteng Province experience a disproportionate burden of LTFU and low coverage of ART among co-infected patients. This group should be targeted for interventions aimed at improving clinical outcomes and retention in both TB and HIV care.The American People and the President’s Emergency Plan for AIDS Relief (PEPFAR) through USAID under the terms of Cooperative Agreements AID- 674-A-12-00029 and 72067419CA00004 to HE2RO.https://bmcpublichealth.biomedcentral.comam2020Medical Microbiolog

Kitchens and Pantries—Helping or Hindering? The Perspectives of Emergency Food Users in Victoria, Australia

In high-income countries, people affected by food insecurity may seek out free/subsidized food from charities. Their perceptions of the food programs provided and preferences for alternative strategies are underresearched. The aim of this study was to develop an understanding of the users’ experiences of food insecurity and gain evidence for effective responses in the future. Twelve semistructured interviews with a sample of users, who were also charity volunteers, were conducted in Victoria, Australia. A thematic analysis of the interview transcripts was undertaken. The results show that users have complex needs. Charities have both the capacity to hinder and help people maintain dignity, social inclusion, and health. Alternative community and policy food security strategies were proposed by interviewees. In the future, perspectives of affected community members must inform strategies that seek to improve people’s access to safe, nutritious, and affordable food. A human right to food framework is discussed as a mechanism to help realize food security in Australia