Capacity Building and Empowerment: A panacea and a challenge for agency-university engagement

Capacity building is an effective strategy for promoting organizational change and/or improving the quality of social services. In this article I present an empowerment approach to capacity building. In doing so I propose a number of principles that can promote capacity building and collaboration between social service agencies and universities from an empowerment perspective: keeping the control of the capacity building process in the agency; developing competencies that matter to the people in the agency; engaging in supportive roles; maintaining a strengths-based approach to capacity building; focusing on sustainability, institutionalization and utilization of acquired skills; and paying attention to cultural and contextual issues. Further, the challenges and benefits of the empowerment approach to university-agency collaboration are discussed in this article

Los obispos de Cartagena de Indias durante el siglo XVIII: criollos y regalismo

The Bishopric of Cartagena de Indias shares the same characteristics as the American Church during the 18th century: the increase in number and importance of the creole people and the secular clergy. However, the especial features of the city of Cartagena gave rise to new points of view on these aspects. The growth of the commercial sector among the urban elite made the creole people as well as the creole bishops have a more relevant role in society. At the same, despite being an episcopate of less importance than others and having insufficient rents, the vacant period became shorter in relation to other areas of the viceroyship and all this also contributed to a great improvement in the diocesan administration.El obispado de Cartagena de Indias presenta las características propias de la Iglesia americana durante el siglo XVIII, a saber, criollismo e importancia del clero secular. No obstante, las particularidades de la ciudad de Cartagena permiten establecer nuevos puntos de vista sobre estos aspectos. La importancia del sector comercial en el patriciado urbano, condiciona el auge del criollismo en la ciudad que favoreció el número de obispos criollos. Al mismo tiempo, a pesar de la escasez de rentas y de ser un obispado de segundo orden, el periodo de vacantes se vio reducido respecto a otras zonas del virreinato, conllevando una mejora en la administración diocesana

El “privilegio de los blancos”

El “privilegio de los blancos” (“White Priviledge”) se describe como la experiencia de ventajas que un grupo experimenta basado exclusivamente en sus características físicas y sociales. La experiencia de privilegio es el resultado de condiciones históricas de opresión en el conjunto de la sociedad. Dichas ventajas son adquiridas sin esfuerzo, no son el resultado de talentos particulares y no son comunes ni universales. El constructo está asociado con estrato social y posiciones de poder, reflejando fuerzas hegemónicas de dominación social de parte de grupos privilegiados. Notamos cómo la característica psicológica del “privilegio de los blancos” es su naturaleza inconsciente, es decir, quienes lo experimentan lo reciben como una condición natural de su estatus y quienes lo otorgan han sido condicionados a hacerlo como conducta deseable y esperada. Por último, reflexionamos acerca de la división de clases en Argentina y Latinoamérica y analizamos ejemplos de cómo se manifiestan los privilegios.White Privilege is described as an advantage that a group of people experience based exclusively on physical and social characteristics. Such experiences are the result of conditions of oppression across society along the years. White Privilege is not earned through talent or effort, but rather is granted, and the advantages are not common or universal. This construct is also related to high social status, as a reflection of the hegemonic dominance of privileged groups. We highlight that the psychological characteristic of White Privilege is its unconscious nature, i.e., those who are privileged are not aware of it, and they experience it as a natural condition of their social status. On the other hand, those who grant White Privilege are already conditioned to do so as desirable and expected behavior. Lastly, we discuss issues of class divisions in Argentina and LatinAmerica, and analyze examples of how privileges are manifested

Using participatory and creative methods to facilitate emancipatory research with people facing multiple disadvantage: a role for health and care professionals

Participatory and creative research methods are a powerful tool for enabling active engagement in the research process of marginalised people. It can be particularly hard for people living with multiple disadvantage, such as disabled people from ethnic minority backgrounds, to access research projects that are relevant to their lived experience. This article argues that creative and participatory methods facilitate the co-researchers’ engagement in the research process, which thus becomes more empowering. Exploring the congruence of these methods with their professional ethos, health and care professionals can use their skills to develop them further. Both theory and practice examples are presented

The Swiss STAR trial - an evaluation of target groups for sexually transmitted infection screening in the sub-sample of men.

OBJECTIVES In Switzerland, universal health insurance does not cover any routine testing for sexually transmitted infections (STIs), not even in individuals at high risk, and extra-genital swabbing is not standard of care. We determined the prevalence and incidence of human immunodeficiency virus (HIV), viral hepatitis and non-viral STIs in a multicentre prospective observational cohort of multi-partner men who have sex with men (MSM) and other men. MATERIALS AND METHODS Between January 2016 and June 2017, we offered free STI testing to all men with multiple  sexual partners (three or more in the previous 12 months), with follow-up examinations every 6 months. We used multiplex polymerase chain-reaction testing (for Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, Mycoplasma genitalium) on pooled swabs (pharynx, urethra/vagina, anus), and antibody tests for HIV and Treponema pallidum at every visit, and for hepatitis B/C at baseline. RESULTS We screened 779 multi-partner MSM and 92 other men. Previously undiagnosed HIV was found in 0.5% vs 0.0%, respectively and T. pallidum antibodies in 15.3% vs 1.1%. STIs requiring antibiotic treatment comprised: active syphilis 1.7% vs 0.0%; N. gonorrhoeae 10.3% vs 0.0%; C. trachomatis 8.7% vs 1.1%. One in four MSM versus 1 in 100 other multi-partner men had any of these three STIs at baseline. 10.4% vs 1.3% had a history of hepatitis B, 31.9% vs 47.3% had no immunity (HBs-AB <10 IU/l). Ten MSM had HCV antibodies (1.4%), with 8 out of the 10 being MSM with HIV; HCV seroprevalence was 0.3% among HIV-negative MSM. In MSM, incidence of the three bacterial STIs was 25.5 per year over 333 person years of follow-up, HIV incidence was 0.3%. Non-condom-use (in the last 3 months) for anal/vaginal sex was not associated with STIs. Independent risk factors were sex with men (adjusted odds ratio [aOR] 16.4) and the number of sexual partners (aOR 2.3 for >20). CONCLUSION Among MSM, but not among other multi-partner men, STIs, mostly asymptomatic, are common. Given the high risk of onward transmission, low-cost or free routine screening of multi-partner MSM is a public health priority

Flattening the curve in 52 days: characterisation of the COVID-19 pandemic in the Principality of Liechtenstein - an observational study.

BACKGROUND The principality of Liechtenstein had its first COVID-19 case at the beginning of March 2020. After exponential growth, the pandemic’s first wave was contained, with the last case being diagnosed 52 days after the initial occurrence. AIM To characterise the COVID-19 pandemic in Liechtenstein. METHODS All patients diagnosed in Liechtenstein were followed up until recovery and again 6–8 weeks after symptom onset. They were contacted every 2 days to record their clinical status until the resolution of their symptoms. The diagnosis of COVID-19 was based on clinical symptoms and molecular testing. Household and close workplace contacts were included in the follow-up, which also comprised antibody testing. In addition, public health measures installed during the pandemic in Liechtenstein are summarised. RESULTS During the first wave, 5% of the population obtained a reverse transcriptase polymerase chain reaction test. A total of 95 patients (median age 39 years) were diagnosed with COVID-19 (82 who resided in Liechtenstein), resulting in an incidence in Liechtenstein of 0.211%. One patient, aged 94, died (mortality rate 1%). Only 62% of patients could retrospectively identify a potential source of infection. Testing the patients’ household and close workplace contacts (n = 170) with antibody tests revealed that 25% of those tested were additional COVID-19 cases, a quarter of whom were asymptomatic. Those households which adhered to strict isolation measures had a significantly lower rate of affected household members than those who didn’t follow such measures. The national public health measures never restricted free movement of residents. Masks were only mandatory in healthcare settings. The use of home working for the general workforce was promoted. Gatherings were prohibited. Schools, universities, certain public spaces (like sports facilities and playgrounds), childcare facilities, nonessential shops, restaurants and bars were closed. Social distancing, hygienic measures, solidarity and supporting individuals who were at risk were the main pillars of the public health campaigns. CONCLUSION The close collaboration of all relevant stakeholders allowed for the complete workup of all COVID-19 patients nationwide. A multitude of factors (e.g., young age of the patients, low-threshold access to testing, close monitoring of cases, high alertness and adherence to public health measures by the population) led to the early containment of the first wave of the pandemic, with a very low rate of serious outcomes. Antibody testing for SARS-CoV-2 revealed a substantial proportion of undiagnosed COVID-19 cases among close contacts of the patients

Case Report: Human Subcutaneous Sparganosis in a Thai Migrant

Human sparganosis is a cestode infection which is neglected as a differential diagnosis outside endemic countries. Diagnosis and therapy may be challenging depending on the clinical presentation and anatomic localization. The disease manifests predominantly as subcutaneous nodule(s) or intracranial mass lesion(s). Infection is primarily acquired by ingesting raw or undercooked amphibian or reptile flesh or by drinking water containing copepods. We report an unusual case of subcutaneous; Spirometra erinaceieuropaei; sparganosis presenting with two nonmigratory nodules in close proximity to each other on the right thigh of a Thai woman living in Switzerland

Frequency of serological non-responders and false-negative RT-PCR results in SARS-CoV-2 testing: a population-based study.

Objectives The sensitivity of molecular and serological methods for COVID-19 testing in an epidemiological setting is not well described. The aim of the study was to determine the frequency of negative RT-PCR results at first clinical presentation as well as negative serological results after a follow-up of at least 3 weeks. Methods Among all patients seen for suspected COVID-19 in Liechtenstein (n=1921), we included initially RT-PCR positive index patients (n=85) as well as initially RT-PCR negative (n=66) for follow-up with SARS-CoV-2 antibody testing. Antibodies were detected with seven different commercially available immunoassays. Frequencies of negative RT-PCR and serology results in individuals with COVID-19 were determined and compared to those observed in a validation cohort of Swiss patients (n=211). Results Among COVID-19 patients in Liechtenstein, false-negative RT-PCR at initial presentation was seen in 18% (12/66), whereas negative serology in COVID-19 patients was 4% (3/85). The validation cohort showed similar frequencies: 2/66 (3%) for negative serology, and 16/155 (10%) for false negative RT-PCR. COVID-19 patients with negative follow-up serology tended to have a longer disease duration (p=0.05) and more clinical symptoms than other patients with COVID-19 (p<0.05). The antibody titer from quantitative immunoassays was positively associated with the number of disease symptoms and disease duration (p<0.001). Conclusions RT-PCR at initial presentation in patients with suspected COVID-19 can miss infected patients. Antibody titers of SARS-CoV-2 assays are linked to the number of disease symptoms and the duration of disease. One in 25 patients with RT-PCR-positive COVID-19 does not develop antibodies detectable with frequently employed and commercially available immunoassays

The Swiss STAR trial – an evaluation of target groups for sexually transmitted infection screening in the sub-sample of women

OBJECTIVES: In Switzerland, universal health insurance does not cover any routine testing for sexually transmitted infections (STIs), not even in individuals at high risk, and extra-genital swabbing is not standard of care. We compared STI prevalence in a multicentre prospective observational cohort of multi-partner women with/without sex work and evaluated associated risk factors. MATERIALS AND METHODS: Between January 2016 and June 2017, we offered free STI testing to women with multiple sexual partners (three or more in the previous 12 months), with follow-up examinations every 6 months. We used multiplex polymerase chain-reaction testing (for Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, Mycoplasma genitalium) for pooled swabs (pharynx, urethra/vagina, anus), and antibody tests for human immunodeficiency virus (HIV) and Treponema pallidum at every visit, and for hepatitis B and C at baseline. RESULTS: We screened 490 female sex workers (FSWs), including 17 trans women, and 92 other multi-partner women. More than half reported a steady partner. Previously undiagnosed HIV was found in 0.2% vs 0.0%, respectively, and T. pallidum antibodies in 5.9% vs 0.0%. STIs requiring antibiotic treatment comprised: active syphilis 1.2% vs 0.0%; N. gonorrhoeae 4.9% vs 0.0%; C. trachomatis 6.3% vs 5.4%, T. vaginalis 10.4% vs 0.0%; M. genitalium 6.7% vs 6.5%. One in four FSWs vs one in nine other women had one or more of these STIs at baseline. 15.8% vs 3.8% had a history of hepatitis B, 45.5% vs 22.8% had no immunity (HBs-AB <10 IU/l). Two FSWs had hepatitis C virus antibodies (0.4%) without concurrent HIV infection. Non-condom-use (last three months) for anal/vaginal sex was not associated with STIs. Independent risk factors were group sex (adjusted odds ratio [aOR] 2.1, 95% confidence interval [CI] 1.1–4.0), age less than 25 (aOR 3.7, 95% CI 1.6–8.9), and being active in sex work for less than 1 year (aOR 2.7, 95% CI 1.3–5.3). CONCLUSION: HIV and HCV do not appear to pose a major public health problem among FSWs in Switzerland, whereas vaccination against HBV should be promoted. FSWs showed high rates of STIs requiring treatment to reduce transmission to clients and/or steady partners. FSWs should be offered low-cost or free STI screening as a public health priority

“Leaps of faith”: parents' and professionals' viewpoints on preparing adolescents on the autism spectrum for leaving school

Adolescents on the autism spectrum experience difficulty transitioning from secondary school to post-school activities, often due to transition planning processes that do not meet their unique needs. This study identified parents' and professionals' viewpoints on transition planning for adolescents on the autism spectrum. Interviews were completed with nine parents of adolescents on the autism spectrum and four professionals who worked with adolescents on the autism spectrum. A constant comparison approach was used to analyse the transcripts. Four themes were identified, reflecting parents' and professionals' viewpoints on how to meet the transition planning needs of adolescents on the autism spectrum. Supporting adolescents to grasp the big picture can enhance motivation to participate in transition planning. Autism can be an ‘invisible disability’; therefore, encouraging adolescents to be active participants and to be seen in transition planning ensures their individual needs are met. Encouraging adolescents to have high aspirations in transition planning develops their self-determination. Finally, to be prepared for the transition from school may reduce the adolescent's' anxiety. Adolescents on the autism spectrum face unique challenges in transition planning. The themes identified in this study provide insight into how parents and professionals might support adolescents with these challenges