Helping BIPOC LGBTQIA+ Families Through Inclusive Therapy and Advocacy

Families are phenomenological and unique. All families are valuable, but historically, many family types have been underrepresented. Families with members who identify in the BIPOC LGBTQIA+ communities have historically been underrepresented and marginalized. Helping BIPOC LGBTQIA+ families involves both clinical work and advocacy. Advocacy for the professional identity of counseling, marriage and family therapy, and related helpers involves various aspects. These aspects include leadership theory and integration, importance of professional identity, the need to continue to infuse multiculturalism within the counseling and family therapy identities, and continued skills for counselors to learn inclusive advocacy. Skills and implications for advocacy as they relate to clients who intersect among the LGBTQAI+ and BIPOC communities, will be described

Inland surface waters in protected areas globally:Current coverage and 30-year trends

Inland waters are unique ecosystems offering services and habitat resources upon which many species depend. Despite the importance of, and threats to, inland water, global assessments of protected area (PA) coverage and trends have focused on land habitats or have assessed land and inland waters together. We here provide the first assessment of the level of protection of inland open surface waters and their trends (1984–2015) within PAs for all countries, using a globally consistent, high-resolution (30 m) and validated dataset on permanent and seasonal surface waters based on Landsat images. Globally, 15% of inland surface waters are covered by PAs with mapped boundaries. Estimated inland water protection increases to 16.4% if PAs with reported area but delineated only as points are included as circular buffers. These coverage estimates slightly exceed the comparable figure for land but fall below the 17% goal of the Convention on Biological Diversity’s Aichi Target 11 for 2020. Protection levels are very uneven across countries, half of which do not yet meet the 17% target. The lowest coverage of surface water by PAs (<5%) was found in Africa and in parts of Asia. There was a global trend of permanent water losses and seasonal water gains within PAs, concomitant with an increase of both water types outside PAs. In 38% of countries, PAs lost over 5% of permanent water. Global protection targets for inland waters may well be met by 2020, but much stronger efforts are required to ensure their effective conservation, which will depend not only on sound PA governance and management but also on the sustainable use of water resources outside PAs. Given the pressures on water in a rapidly changing world, integrated management planning of water resources involving multiple sectors and entire basins is therefore necessary

From Exploration of Classism to Anticlassist Counseling: Implications for Counselors and Counselor Educators

Classism is a recently studied, but historically present, form of oppression. Despite much attention to inclusion of underrepresented clients in counseling literature, there has been little focus on the presence of classism in academic settings. In an effort to close this gap, a study of 202 individuals, aged 18 to 38, was conducted to explore the relationships among perceived classism, ethnicity, and socioeconomic status. Only 4.5% of the participants had never experienced any incidents of classism. African American individuals were more likely to experience interpersonal classism and working class/poor individuals were more likely to experience interpersonal and systemic classism. Recommendations for counselors, specifically, college counselors working with young adult students, facing classism are also discussed

Awareness, attitudes and perceptions regarding HIV and PMTCT amongst pregnant women in Guinea-Bissau- a qualitative study.

BACKGROUND: The human immunodeficiency virus (HIV) continues to be a major cause of maternal and infant mortality and morbidity in sub-Saharan Africa. Prevention of mother-to-child transmission of HIV (PMTCT) strategies have proven effective in decreasing the number of children infected in utero, intrapartum and during the breastfeeding period. This qualitative study explores knowledge and perceptions of HIV amongst pregnant women, healthcare workers' experiences of the national PMTCT services, and barriers to PMTCT, during a period of programme scale-up in urban Guinea-Bissau (2010-11). METHODS: In-depth interviews were undertaken amongst 27 women and 19 key informants at local antenatal clinics and the national maternity ward in Bissau, Guinea-Bissau. RESULTS: Amongst women who had been tested for HIV, awareness and knowledge of HIV and PMTCT remained low. Testing without informed consent was reported in some cases, in particular when the test was performed around the time of delivery. Possible drivers of inadequate counselling included lack of confidentiality, suboptimal healthcare worker training, lack of time, and perceived occupational risk. Demand-side barriers to PMTCT included lack of HIV and PMTCT knowledge, customary and cultural beliefs associated with HIV and ill-health, HIV stigma and discrimination, and fear of partnership dissolution. CONCLUSIONS: Socio-cultural and operational challenges, including HIV testing without informed consent, present significant barriers to the scale-up of PMTCT services in Bissau. Strengthening local capacity for effective counselling and testing in the antenatal setting is paramount. Further research into local customary beliefs relating to HIV is warranted

RPA: A Force For Good in Healthcare

A vision of how Robotic Process Automation (RPA) can be a force for good across the global healthcare industry, its impacts, benefits, and opportunities. This paper offers a detailed perspective from the UK’s National Health Service (NHS) and their RPA Centres of Excellence, and describes the value of RPA for connectivity, collaboration, and productivity across healthcare

Planning the oral health workforce: time for innovation

Contains fulltext : 232783.pdf (Publisher’s version ) (Open Access)The levels and types of oral health problems occurring in populations change over time, while advances in technology change the way oral health problems are addressed and the ways care is delivered. These rapid changes have major implications for the size and mix of the oral health workforce, yet the methods used to plan the oral health workforce have remained rigid and isolated from planning of oral healthcare services and healthcare expenditures. In this paper, we argue that the innovation culture that has driven major developments in content and delivery of oral health care must also be applied to planning the oral health workforce if we are to develop 'fit for purpose' healthcare systems that meet the needs of populations in the 21st century. An innovative framework for workforce planning is presented focussed on responding to changes in population needs, service developments for meeting those needs and optimal models of care delivery

Plasma and cerebrospinal fluid ABeta42 for the differential diagnosis of Alzheimer's disease dementia in participants diagnosed with any dementia subtype in a specialist care setting

BackgroundDementia is a syndrome that comprises many differing pathologies, including Alzheimer's disease dementia (ADD), vascular dementia (VaD) and frontotemporal dementia (FTD). People may benefit from knowing the type of dementia they live with, as this could inform prognosis and may allow for tailored treatment. Beta-amyloid (1-42) (ABeta42) is a protein which decreases in both the plasma and cerebrospinal fluid (CSF) of people living with ADD, when compared to people with no dementia. However, it is not clear if changes in ABeta42 are specific to ADD or if they are also seen in other types of dementia. It is possible that ABeta42 could help differentiate ADD from other dementia subtypes.ObjectivesTo determine the accuracy of plasma and CSF ABeta42 for distinguishing ADD from other dementia subtypes in people who meet the criteria for a dementia syndrome.Search methodsWe searched MEDLINE, and nine other databases up to 18 February 2020. We checked reference lists of any relevant systematic reviews to identify additional studies.Selection criteriaWe considered cross-sectional studies that differentiated people with ADD from other dementia subtypes. Eligible studies required measurement of participant plasma or CSF ABeta42 levels and clinical assessment for dementia subtype.Data collection and analysisSeven review authors working independently screened the titles and abstracts generated by the searches. We collected data on study characteristics and test accuracy. We used the second version of the 'Quality Assessment of Diagnostic Accuracy Studies' (QUADAS-2) tool to assess internal and external validity of results. We extracted data into 2 x 2 tables, cross-tabulating index test results (ABeta42) with the reference standard (diagnostic criteria for each dementia subtype). We performed meta-analyses using bivariate, random-effects models. We calculated pooled estimates of sensitivity, specificity, positive predictive values, positive and negative likelihood ratios, and corresponding 95% confidence intervals (CIs). In the primary analysis, we assessed accuracy of plasma or CSF ABeta42 for distinguishing ADD from other mixed dementia types (non-ADD). We then assessed accuracy of ABeta42 for differentiating ADD from specific dementia types: VaD, FTD, dementia with Lewy bodies (DLB), alcohol-related cognitive disorder (ARCD), Creutzfeldt-Jakob disease (CJD) and normal pressure hydrocephalus (NPH). To determine test-positive cases, we used the ABeta42 thresholds employed in the respective primary studies. We then performed sensitivity analyses restricted to those studies that used common thresholds for ABeta42.Main resultsWe identified 39 studies (5000 participants) that used CSF ABeta42 levels to differentiate ADD from other subtypes of dementia. No studies of plasma ABeta42 met the inclusion criteria. No studies were rated as low risk of bias across all QUADAS-2 domains. High risk of bias was found predominantly in the domains of patient selection (28 studies) and index test (25 studies). The pooled estimates for differentiating ADD from other dementia subtypes were as follows: ADD from non-ADD: sensitivity 79% (95% CI 0.73 to 0.85), specificity 60% (95% CI 0.52 to 0.67), 13 studies, 1704 participants, 880 participants with ADD; ADD from VaD: sensitivity 79% (95% CI 0.75 to 0.83), specificity 69% (95% CI 0.55 to 0.81), 11 studies, 1151 participants, 941 participants with ADD; ADD from FTD: sensitivity 85% (95% CI 0.79 to 0.89), specificity 72% (95% CI 0.55 to 0.84), 17 studies, 1948 participants, 1371 participants with ADD; ADD from DLB: sensitivity 76% (95% CI 0.69 to 0.82), specificity 67% (95% CI 0.52 to 0.79), nine studies, 1929 participants, 1521 participants with ADD. Across all dementia subtypes, sensitivity was greater than specificity, and the balance of sensitivity and specificity was dependent on the threshold used to define test positivity.Authors' conclusionsOur review indicates that measuring ABeta42 levels in CSF may help differentiate ADD from other dementia subtypes, but the test is imperfect and tends to misdiagnose those with non-ADD as having ADD. We would caution against the use of CSF ABeta42 alone for dementia classification. However, ABeta42 may have value as an adjunct to a full clinical assessment, to aid dementia diagnosis

Crowdsourcing citation-screening in a mixed-studies systematic review: a feasibility study

Abstract: Background: Crowdsourcing engages the help of large numbers of people in tasks, activities or projects, usually via the internet. One application of crowdsourcing is the screening of citations for inclusion in a systematic review. There is evidence that a ‘Crowd’ of non-specialists can reliably identify quantitative studies, such as randomized controlled trials, through the assessment of study titles and abstracts. In this feasibility study, we investigated crowd performance of an online, topic-based citation-screening task, assessing titles and abstracts for inclusion in a single mixed-studies systematic review. Methods: This study was embedded within a mixed studies systematic review of maternity care, exploring the effects of training healthcare professionals in intrapartum cardiotocography. Citation-screening was undertaken via Cochrane Crowd, an online citizen science platform enabling volunteers to contribute to a range of tasks identifying evidence in health and healthcare. Contributors were recruited from users registered with Cochrane Crowd. Following completion of task-specific online training, the crowd and the review team independently screened 9546 titles and abstracts. The screening task was subsequently repeated with a new crowd following minor changes to the crowd agreement algorithm based on findings from the first screening task. We assessed the crowd decisions against the review team categorizations (the ‘gold standard’), measuring sensitivity, specificity, time and task engagement. Results: Seventy-eight crowd contributors completed the first screening task. Sensitivity (the crowd’s ability to correctly identify studies included within the review) was 84% (N = 42/50), and specificity (the crowd’s ability to correctly identify excluded studies) was 99% (N = 9373/9493). Task completion was 33 h for the crowd and 410 h for the review team; mean time to classify each record was 6.06 s for each crowd participant and 3.96 s for review team members. Replicating this task with 85 new contributors and an altered agreement algorithm found 94% sensitivity (N = 48/50) and 98% specificity (N = 9348/9493). Contributors reported positive experiences of the task. Conclusion: It might be feasible to recruit and train a crowd to accurately perform topic-based citation-screening for mixed studies systematic reviews, though resource expended on the necessary customised training required should be factored in. In the face of long review production times, crowd screening may enable a more time-efficient conduct of reviews, with minimal reduction of citation-screening accuracy, but further research is needed

Implementing an Online Research Group about Classism in Counselor Education

In 2021, an online research group was created with counseling students from three different universities. This online research group consisted of masters counseling students and a lead research mentor and counselor educator. This research group was the first of its kind in its Program. This research team focused on intersectionality and classism. Topics of integrating the online world into counseling research, specifically, through this observed research group will be introduced in this documentation. This research team served as a catalyst to increase student morale during required remote learning. Implications driven from this student-centered, online research group will also be described. Discussion regarding ways to increasingly incorporate technology into counselor education pedagogy and research will also be included