Activism in Southwestern Queer and Trans Young Adults After the Marriage Equality Era

This is the author's accepted manuscript, published in Volume 34, Issue 4 of Affilia: Feminist Inquiry in Social Work. Reuse is restricted to non-commercial and no derivative uses.In 2015, marriage equality in the United States was a big win for the gay and lesbian movement. Marriage equality as a primary focus of the movement, however, was not without its critiques, particularly as an issue affecting mostly white, gay, economically secure individuals. Given the history of the movement, it is essential to ask what is next. Young queer and trans people represent the next generation of potential activists and advocates for queer and trans liberation, yet little empirical attention has been paid to their goals for the movement and motivations to be actively involved, particularly among young adults in rural, conservative states. Therefore, this study sought to understand the social, economic, and environmental issues deemed important by queer and trans young adults (aged 18–29), as well as their motivations to get involved in activism efforts. Data came from a mixed-methods program evaluation, which presents a picture of the issues and motivations that led study participants (n = 65) toward activism in one conservative, highly rural, Southwestern state in the United States. The findings of this study are discussed in light of theoretical and empirical literature and then implications for the queer and trans movement, activists, and organizers are offered

Identification of Strengths among Southwestern LGBTQ+ Young Adults

Research on lesbian, gay, bisexual, transgender, and queer (LGBTQ+) youth has predominantly operated within a risk framework, highlighting the risks youth face in their homes, schools, and communities and how these risks are associated with disparate mental health outcomes. This research has been important in establishing the challenges faced by LGBTQ+ youth and the need for interventions to reduce stigma and victimization and promote well-being. However, a predominant focus on risk fails to account for the strengths and resilience of LGBTQ+ youth and positions them as “at-risk” rather than as resilient. This chapter describes a study aiming to redress this gap in the literature by assessing the types of strengths LGBTQ+ young adults identify with and the association between their identified strengths and mental health. First, we provide a summary and critique of the literature on LGBTQ+ youth risks and strengths

Assessing LGBTQ youth cultural competency in direct-care behavioral health workers: Development and validation of a measure.

Direct-care workers can provide an array of service types to children, adolescents, and their families in behavioral health treatment. They may also work in a variety of settings (e.g., group homes, inpatient units/hospitals, residential treatment, treatment foster care, day treatment, in-home treatment, etc.). Direct-care workers typically are involved in the supervision of youth and in the implementation of a treatment plan developed by the youth’s treatment team. For youth who are lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) and are receiving behavioral health services, such workers form a critical part of their therapeutic experience. However, little is known about these workers’ competencies related to working with LGBTQ youth. This study begins to fill that gap by developing and testing a measure that assessed LGBTQ cultural competencies related to behavioral health practice with youth and a measure that was relevant to the roles and responsibilities of direct-care (e.g., paraprofessional, front-line) workers. In order for direct-care workers to use LGBTQ cultural competency in their practice, more understanding is needed about their current level of LGBTQ-related cultural competency. The LGBTQ Youth Cultural Competency scale (abbreviated as LGBTQY-CC) provides a means to measure those competencies. An exploratory factor analysis found that the new scale consists of one primary factor which represents knowledge, attitudes, skill, and awareness of LGBTQ cultural competency. Cronbach’s alpha, correlations with other measures for concurrent validity, and correlation with a measure of social desirability all resulted in evidence that the LGBTQY-CC has good validity. Analyses examined how the new measure was related to constructs associated with training and competency in direct-care workers. Multiple regression analyses showed that higher levels of LGBTQ cultural competency (as measured by the LGBTQY-CC) were significantly related to age (younger), political ideology (more liberal), more social contact with LGBTQ individuals, and degree of religious belief about LGBTQ being a sin. A model including these factors explained 60% of the variance in LGBTQY-CC scores. The LGBTQY-CC was created with the long-term goal of creating training interventions for direct-care workers to improve their practice with LGBTQ youth. The measure could be used to assess training participants’ knowledge, attitudes, skills, and awareness and to evaluate the effectiveness of varying types and styles of training programs. Federal and state regulatory bodies have begun to require service providers to identify how they will address disparities faced by LGBTQ individuals, so service providers need to demonstrate how they are improving access to and quality of care for LGBTQ individuals. Therefore, the LGBTQY-CC may provide a means to gather data on efforts made by service providers to improve their behavioral health workforce’s capacity to serve LGBTQ youth

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

Using Facebook As A Tool For Informal Peer Support: A Case Example

The social media site (SMS) Facebook can provide social workers with a method to engage in informal peer support. Scholars to date have mainly focused on SMSs such as Facebook as they pertain to clinical interactions with clients, maintaining professionalism especially among social work students, using them for professional or organizational promotion, and using them as an educational tool. Informal peer groups have been found to be an effective tool to combat burnout in high-stress professions such as social work. The use of a SMS such as Facebook for informal peer support could provide additional benefits to social workers beyond what they would experience from offline contact. This article fills a gap in the literature by describing how a group of practicing social workers use a private Facebook group for peer support, informal consultation, emotional support, and personal social connection. Given the continual high rates of job stress and burnout, social workers should consider new and innovative ways to use SMSs such as Facebook to enhance their self-care efforts

Genome-wide association study and functional validation implicates JADE1 in tauopathy.

Primary age-related tauopathy (PART) is a neurodegenerative pathology with features distinct from but also overlapping with Alzheimer disease (AD). While both exhibit Alzheimer-type temporal lobe neurofibrillary degeneration alongside amnestic cognitive impairment, PART develops independently of amyloid-β (Aβ) plaques. The pathogenesis of PART is not known, but evidence suggests an association with genes that promote tau pathology and others that protect from Aβ toxicity. Here, we performed a genetic association study in an autopsy cohort of individuals with PART (n = 647) using Braak neurofibrillary tangle stage as a quantitative trait. We found some significant associations with candidate loci associated with AD (SLC24A4, MS4A6A, HS3ST1) and progressive supranuclear palsy (MAPT and EIF2AK3). Genome-wide association analysis revealed a novel significant association with a single nucleotide polymorphism on chromosome 4 (rs56405341) in a locus containing three genes, including JADE1 which was significantly upregulated in tangle-bearing neurons by single-soma RNA-seq. Immunohistochemical studies using antisera targeting JADE1 protein revealed localization within tau aggregates in autopsy brains with four microtubule-binding domain repeats (4R) isoforms and mixed 3R/4R, but not with 3R exclusively. Co-immunoprecipitation in post-mortem human PART brain tissue revealed a specific binding of JADE1 protein to four repeat tau lacking N-terminal inserts (0N4R). Finally, knockdown of the Drosophila JADE1 homolog rhinoceros (rno) enhanced tau-induced toxicity and apoptosis in vivo in a humanized 0N4R mutant tau knock-in model, as quantified by rough eye phenotype and terminal deoxynucleotidyl transferase dUTP nick end-labeling (TUNEL) in the fly brain. Together, these findings indicate that PART has a genetic architecture that partially overlaps with AD and other tauopathies and suggests a novel role for JADE1 as a modifier of neurofibrillary degeneration

Genome-wide association study and functional validation implicates JADE1 in tauopathy

AbstractPrimary age-related tauopathy (PART) is a neurodegenerative tauopathy with features distinct from but also overlapping with Alzheimer disease (AD). While both exhibit Alzheimer-type temporal lobe neurofibrillary degeneration alongside amnestic cognitive impairment, PART develops independently of amyloid-β (Aβ) deposition in plaques. The pathogenesis of PART is unknown, but evidence suggests it is associated with genes that promote tau pathology as well as others that protect from Aβ toxicity. Here, we performed a genetic association study in an autopsy cohort of individuals with PART (n=647) using Braak neurofibrillary tangle stage as a quantitative trait adjusting for sex, age, genotyping platform, and principal components. We found significant associations with some candidate loci associated with AD and progressive supranuclear palsy, a primary tauopathy (SLC24A4, MS4A6A, HS3ST1, MAPT and EIF2AK3). Genome-wide association analysis revealed a novel significant association with a single nucleotide polymorphism on chromosome 4 (rs56405341) in a locus containing three genes, including JADE1 which was significantly upregulated in tangle-bearing neurons by single-soma RNA-seq. Immunohistochemical studies using antisera targeting JADE1 protein revealed localization within tau aggregates in autopsy brain from tauopathies containing isoforms with four microtubule-binding domain repeats (4R) and mixed 3R/4R, but not with 3R exclusively. Co-immunoprecipitation revealed a direct and specific binding of JADE1 protein to tau containing four (4R) and no N-terminal inserts (0N4R) in post-mortem human PART brain tissue. Finally, knockdown of the Drosophila JADE1 homolog rhinoceros (rno) enhanced tau-induced toxicity and apoptosis in vivo in a humanized 0N4R mutant tau knock-in model as quantified by rough eye phenotype and terminal deoxynucleotidyl transferase dUTP nick end-labeling (TUNEL) in the fly brain. Together, these findings indicate that PART has a genetic architecture that partially overlaps with AD and other tauopathies and suggests a novel role for JADE1 as a mediator of neurofibrillary degeneration