Bridging the multicultural orientation framework with sexual and gender minority psychotherapy: A mixed studies systematic review

Sexual and gender minorities (SGM) experience higher rates of psychological distress and seek psychotherapy at higher rates compared to their heterosexual and cisgender counterparts. However, few therapists are trained on how to provide effective psychotherapy with SGM clients. The multicultural orientation (MCO) framework, which has been linked to improved therapeutic processes and outcomes, may be a valuable tool for working with SGM clients. The primary aim of this systematic review was to link the MCO framework to existing empirical psychotherapy research with SGM clients. A secondary aim was to examine how MCO constructs that we identified within the SGM literature have been associated with therapeutic processes and outcomes with SGM clients. A systematic search of five databases yielded 61 studies that were included in the review. Framework analysis was used to extract data and identify themes and subthemes related to MCO constructs from included studies. Results of the review demonstrate how the MCO framework can be used to conceptualize psychotherapy with SGM clients and-using the MCO framework-highlight potential beneficial and harmful therapist qualities and actions when working with SGM clients. Implications for future research and psychotherapy practice with SGM clients are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The role of the therapeutic bond when working with clients in suicidal crisis

The desire to die by suicide has been linked with interpersonal difficulties and impeded clinical outcomes. Despite the emphasis on the therapeutic relationship in clinical guidelines for working with suicidal clients, little is known about how suicidal clients' interpersonal difficulties manifest in clinical contexts. Additionally, there is limited understanding of the therapeutic relationship in single-session suicidal crisis contexts. Our aim was to examine the trajectory of the therapeutic bond in mediating clients' suicidal desire and outcome in single-session suicidal crisis intervention. Single-session online text-based crisis intervention sessions (N = 354; Mage = 29.43, SD = 9.15; 64.5% women) were coded for suicidal desire, therapeutic bond (each quarter), and outcome. We examined the proposed sequential mediating model (suicidal desire to early bond to bond change to outcome) using structural equation modeling. The proposed sequential mediation model fits the data well, χ2(11) = 22.030, p = .0241, root-mean-square error of approximation = .053, 90% CI [.019, .085], comparative fit index = .983, Tucker-Lewis index = .977, and was a better fit than several alternative models. Further, the indirect effect from suicidal desire to outcome through early bond and bond change was significant (b = -0.474, 99% CI [-0.782, -0.203]). Our findings indicate that therapeutic bonds were beneficial for clients with elevated suicidal desire-and-elevated suicidal desire was negatively associated with therapeutic bonds. These findings highlight the importance of training clinicians to navigate the unique challenges of developing therapeutic bonds with acutely suicidal clients. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The lingering symptoms of post-COVID-19 condition (long-COVID): a prospective cohort study

BACKGROUND

Longer-term symptoms (long COVID) may be present in seemingly recovered patients for several months and can be debilitating.

AIM

To investigate the prevalence and type of symptoms in those with a prior COVID-19 diagnosis.

METHODS

This prospective, longitudinal observational study commenced in July 2020 investigating the longer-term health impacts of COVID-19. Participants were recruited via public health units and media publicity. Surveys were completed upon enrolment, and at 1, 3, 6 and 12 months. Outcome measures included incidence of activity limitations and symptoms against health and vaccination status, age and gender.

RESULTS

Overall, 339 participants were recruited. At 3 months after COVID-19, 66.8% reported symptoms, and 44.8% were still experiencing symptoms at 12 months. Fatigue was most common at every point (between 53.1% and 33.1%). Pain symptoms increased in relative prevalence over time, whereas respiratory/pulmonary-type symptoms decreased substantially after 3 months. Females and younger people were more likely to experience symptoms in the early stages of long COVID (P < 0.01) and those with more comorbidities in the latter stages (P < 0.001). Vaccination showed a statistically significant protective effect against symptoms (P < 0.01-0.001).

CONCLUSION

Long-term COVID-19 symptoms exist among recovered patients up to 12 months after contracting the virus. Fatigue is a primary contributor, while chronic pain became more problematic after 6 months. Vaccination was a factor in preventing long-term symptoms and aiding faster recovery from symptoms. Further work exploring additional contributors to symptom prevalence would assist in developing appropriate follow-up care.

Catheter Ablation of Coronary Sinus Accessory Pathways in the Young

BACKGROUND

Accessory atrioventricular pathways (AP) are the most common tachycardia substrate for supraventricular tachycardia (SVT) in the young. Endocardial catheter ablation of AP may be unsuccessful in up to 5% due to a coronary sinus location.

OBJECTIVE

Data on ablation of accessory pathways within the coronary venous system (CVS) in the young is sparse.

METHODS

Analysis of feasibility, outcome, and safety in patients ≤18 years with coronary sinus accessory pathways (CS-AP) and catheter ablation via CVS in a tertiary pediatric electrophysiological referral center (05/2003-12/2021). Control group adjusted for age, weight, and pathway location was established from patients of the prospective European Multicenter Pediatric Ablation Registry who all had endocardial AP ablation.

RESULTS

24 individuals had mapping and intended AP ablation within the CVS (age: 2.7-17.3 years, body weight: 15.0-72.0 kg). Due to proximity to coronary artery, ablation was withheld in 2/24. Overall procedural success was achieved in 20/22 (90.9%) study patients and in 46/48 (95.8%) controls. Coronary artery injury after RF ablation was noted in 2/22 (9%) study patients and in 1/48 (2%) controls. In CVS patients repeat SVT occurred in 5/22 (23%) during a median follow-up of 8.5 years, 4/5 underwent reablation resulting in 94.4% overall success. Controls were free from SVT during follow-up of 12 months as defined by registry protocol.

CONCLUSIONS

Success of CS-AP ablation in the young was comparable to endocardial AP-ablation. Substantial risk of coronary artery injury should be considered when CS-AP ablation is performed in the young.

Sex Disparity for Patients with Cutaneous Squamous Cell Carcinoma of the Head and Neck: A Systematic Review

The incidence of head and neck cutaneous squamous cell carcinoma (HNcSCC) is unevenly distributed between men and women. At present, the mechanism behind this disparity remains elusive. This study conducted a systematic review and meta-analysis of proportions to investigate the disparity between sexes for patients with HNcSCC. PubMed, Scopus, EMBASE, MEDLINE, Emcare and CINAHL were searched in November 2021 and June 2022 (N > 50, English, human), and studies which examined the association between sex and HNcSCC were included. Analysis was conducted using RStudio with data and forest plots displaying males as a proportion of total patients with HNcSCC. Two independent researchers performed study selection, data extraction, data analysis and risk of bias. Eighty-two studies (1948 to 2018) comprising approximately 186,000 participants (67% male, 33% female) from 29 countries were included. Significantly more males had HNcSCC overall (71%; CI: 67−74). Males were also significantly more affected by cSCC of the ear (92%; CI: 89−94), lip (74%; CI: 66−81), and eyelid (56%; CI: 51−62). This study found HNcSCC disproportionately affected males overall and across all subtypes. Improving our understanding of sex-specific mechanisms in HNcSCC will better inform our preventive, therapeutic and prognostic practices.

Motivated Moral Outrage Among Meat-Eaters

Many meat-eaters experience cognitive dissonance when aware that their eating behaviors contradict their moral values, such as desires to protect the environment or animals from harm. One way in which people morally disengage from their behaviors—and thus avoid dissonance—is to displace responsibility onto others. Aligning with this notion, results of three studies (total N = 1,501) suggest that expressing moral outrage at third-party transgressors reduces dissonance and preserves moral identity among meat-eaters. When participants understood their in-group as responsible for factory farming’s negative impact or read about factory farming’s harms to animals, expressing moral outrage at third-party transgressors reduced guilt and elevated self-rated moral character. Moreover, reflecting on the morally troublesome nature of meat-eating led participants to express more moral outrage at a third-party organization responsible for animal abuse, an effect eliminated by self-affirmation. These findings substantiate moral outrage as a new mechanism to justify meat consumption.

Developing a national framework for community involvement in health promotion in Tajikistan

Background

In rural Tajikistan, various approaches have been taken to involve communities in health promotion, but many of them survived only as long as there was outside donor support.

Methods

In 2017, these approaches were examined and conceptualized, leading to the development of a “Guideline on Partnership with Communities on Health Issues” that was put into practice in 11 rural districts of the country.

Results

The Guideline sees Primary Health Care (PHC) staff trained as facilitators so as to conduct Participatory Reflection and Action (PRA) sessions with their local communities. Based on health priorities identified through these PRA sessions, and on national health priorities, the Health Promotion Institute chooses annual community activities facilitating behavioral change. Community Health Teams (CHTs) are formed, and the facilitators train them in disease prevention activities, and in how to plan initiatives to promote better health and well-being at village level. In the 5 initial districts, CHTs successfully mobilized community members to take part in activities related to identified health priorities e.g. health actions on Hypertension and Diabetes including free screenings. Furthermore, CHTs started to address determinants of health e.g. by supporting disabled people in their communities, organizing weekly waste removals, and initiating womens' walking groups.

Conclusions

Engaging communities by forming and capacitating teams, leads them to become a partner to the PHC system, and empowers them to tackle local determinants of health through their own initiatives. The capacity built in the local primary health care and health promotion structures hold potential for an expansion of this community-based approach to health promotion throughout the country. So what? By encouraging a government-recognized approach to community involvement in health, capacity and ownership of local institutions and stakeholders has increased, providing promise for long term sustainability.

Key messages

Community involvement in health remains central to primary health care. A government-recognised approach provides promise for sustainability.

Hyperthermic intraoperative intrapleural chemotherapy and surgical cytoreduction as part of multimodal treatment of malignant pleural mesothelioma - case report M. Szkorupa1, D. Klos1, J. Chudacek1, J. Hanuliak1, M. Stasek1, O. Fischer2, R. Lemstrova3

Malignant pleural mesothelioma is one of the most aggressive malignancies with a very poor prognosis. Multimodal treatment consisting of three modalities - chemotherapy, radiotherapy and cytoreductive surgery is optimal. The use of new therapeutic modalities, such as hyperthermic intraoperative intrapleural chemotherapy or photodynamic therapy can improve the current results of mesothelioma treatment. Combined hyperthermic intraoperative chemotherapy and cytoreductive surgery as part of multimodal therapy of malignant mesothelioma has been used since 2017 at the 1st Department of Surgery of University Hospital Olomouc. The authors report the case of a 47-year-old man with malignant epithelioid mesothelioma of the left pleural cavity. Following neoadjuvant chemotherapy, this patient underwent extrapleural pneumonectomy with intraoperative intracavitary hyperthermic chemotherapy. The postoperative period was complicated by circulatory instability and later by tension fluidothorax with signs of heart failure. Currently, 8 months have elapsed from the surgery and the patient remains without any signs of recurrence.

Multiband superconductivity in the Chevrel phases SnMo6S8 and PbMo6S8

Sub-Kelvin scanning tunneling spectroscopy in the Chevrel phases SnMo6S8 and PbMo6S8 reveals two distinct superconducting gaps with Δ1=3 meV, Δ2∼1.0 meV and Δ1=3.1 meV, Δ2∼1.4 meV, respectively. The gap distribution is strongly anisotropic, with Δ2 predominantly seen when scanning across unit-cell steps on the (001) sample surface. The spectra are well fitted by an anisotropic two-band BCS s-wave gap function. Our spectroscopic data are confirmed by electronic heat capacity measurements, which also provide evidence for a twin-gap scenario.

Scanning tunneling spectroscopy in the superconducting state and vortex cores of the beta-pyrochlore KOs2O6

We performed the first scanning tunneling spectroscopy measurements on the pyrochlore superconductor KOs2O6 (T(c)=9.6 K) in both zero magnetic field and the vortex state at several temperatures above 1.95 K. This material presents atomically flat surfaces, yielding spatially homogeneous spectra which reveal fully gapped superconductivity with a gap anisotropy of 30%. Measurements performed at fields of 2 and 6 T display a hexagonal Abrikosov flux line lattice. From the shape of the vortex cores, we extract a coherence length of 31-40 A, in agreement with the value derived from the upper critical field H(c2). We observe a reduction in size of the vortex cores (and hence the coherence length) with increasing field which is consistent with the unexpectedly high and unsaturated upper critical field reported.

Selection by parasites may increase host recombination frequency

Meiotic recombination destroys successful genotypes and it is therefore thought to evolve only under a very limited set of conditions. Here, we experimentally show that recombination rates across two linkage groups of the host, the red flour beetle Tribolium castaneum, increase with exposure to the microsporidian parasite, Nosema whitei, particularly when parasites were allowed to coevolve with their hosts. Selection by randomly varied parasites resulted in smaller effects, while directional selection for insecticide resistance initially reduced recombination slightly. These results, at least tentatively, suggest that short-term benefits of recombination--and thus the evolution of sex--may be related to parasitism.

VEGF plasma pattern in ovulation induction: evidence for an episodic secretion and lack of immediate effect of hCG

Vascular endothelial growth factor (VEGF) is a potent stimulator of vascular proliferation and permeability. Ovarian granulosa cells have been identified as a major source of the cytokine and r-hCG was able to stimulate VEGF mRNA expression in vitro. In this study we have investigated the immediate effect of ovulation induction with hCG on peripheral VEGF levels in 6 women with primary infertility enrolled in the IVF/ET program. The patients underwent a 24-hour continuous blood withdrawal with sampling intervals of 15 minutes starting from 5 hours before ovulation induction with 10.000 IU hCG. Ovulation induction with hCG had no significant immediate effect on mean peripheral VEGF levels. However, VEGF plasma levels did exhibit significant episodic fluctuations with rapid increases every 90-120 minutes without any relation to circulating hCG levels. Taken together, the results of this study suggest that VEGF is released episodically and that systemic VEGF levels are not acutely altered by ovulation induction with hCG.

Peripheral levels of vascular endothelial growth factor (VEGF) are higher in gonadotropin stimulated as compared to natural ovarian cycles

The purpose of the present study was to investigate the stability of vascular endothelial growth factor (VEGF) in plasma samples and the influence of ovarian hyperstimulation on systemic levels of VEGF. Stability assays for VEGF in plasma samples revealed significant increases following even short incubations of samples at room temperature (< or = 2 h, p < 0.001). To investigate a possible impact of controlled ovarian hyperstimulation (COH) on peripheral VEGF levels, serial blood collection over one menstrual cycle was performed in unstimulated as well as in gonadotropin-stimulated cycles for in vitro fertilisation/embryo transfer (IVF/ET) (10 women each). Peripheral levels for VEGF were significantly higher in gonadotropin stimulated cycles as compared to non-stimulated cycles (p < 0.001). There was no significant difference between follicular phase and luteal phase levels in either group. VEGF levels tended to correlate with the number of follicles detected by vaginal sonography prior to oocyte aspiration (p = 0.051). In conclusion, VEGF levels are elevated in gonadotropin-stimulated IVF/ET cycles as compared to natural cycles.

Diptera as vectors of mycobacterial infections in cattle and pigs

Mycobacteria were isolated from 14 (4.5%) of 314 samples, containing 7791 adult Diptera, which were collected in the Czech Republic and Slovakia in 1997-2000. These flies were collected from three cattle herds with paratuberculosis, two pig herds with mycobacterial infections and one farm that kept both cattle and pigs and that did not have problems of mycobacterial infections. Mycobacterium intracellulare was isolated from Eristalis tenax Linnaeus (Diptera: Syrphidae) captured from a pig herd. Mycobacterium avium ssp. avium (serotype 8) was isolated from flies of the genera Drosophila Fallen (Diptera: Drosophilidae) and Musca Linnaeus (Diptera: Muscidae) originating from a pig herd. Mycobacterium spp. were isolated from Musca spp. and Mycobacterium fortuitum was isolated from dung flies of the genus Scatophaga Meigen (Diptera: Scatophagidae), Musca spp. and Stomoxys calcitrans Linnaeus (Diptera: Muscidae) captured in the same herd. Mycobacterium scrofulaceum was isolated from S. calcitrans from the farm with both cattle and pigs. Mycobacterium avium ssp. paratuberculosis was isolated from Scatophaga spp. collected from pastures grazed by one of the cattle herds and from Calliphora vicina Robineau-Desvoidy (Diptera: Calliphoridae) and Lucilia caesar Linnaeus (Diptera: Calliphoridae) captured in a slaughterhouse, where cattle infected with paratuberculosis were slaughtered. Mycobacterium phlei was isolated from flies of the genus Lucilia captured at a waste bin. These data indicate that mycobacteria may be spread by adult flies that have been in contact with material contaminated with these pathogens.

Role of Nd/Ba disorder on the penetration depth of Nd(1+x)Ba(2-x)Cu(3)O(7-delta) thin films

We report on a study on the effect of Nd/Ba disorder on the ab-plane penetration depth of epitaxial Nd(1+x)Ba(2-x)Cu(3)O(7-delta) thin films. While in stoichiometric samples lambda(T) at low temperature is linear, Nd-rich films exhibit a quadratic law. For low Nd excess (x<0.04), a satisfying fit is obtained using the "dirty" d-wave model assuming that Nd ions at Ba sites act as strong scattering centers. At high x (x>0.15) the data are explained if Nd/Ba disorder becomes less effective as a source of scattering. The effect of localization has been discussed to account for the experimental results.

Findings of mycobacteria in insectivores and small rodents

The organs of 30 insectivorous mammals and 62 rodents from areas inhabited by people or livestock where cattle paratuberculosis or mycobacterial infections of swine had been found to occur were examined by cultivation during the monitoring of occurrence and spread of mycobacterioses in cattle and swine. Mycobacteria were found in the organs of 3 insectivores (10%) and 6 rodents (9.7%). Mycobacterium chelonae was isolated from the organs of the lesser white-toothed shrew (Crocidura suaveolens) and the common vole (Microtus arvalis), and M. vaccae and M. avium subsp. avium (IS901+, serotype 1) from the organs of the common shrew (Sorex araneus). M. avium subsp. avium (IS901+, serotype 1) was also isolated from the organs of the yellow-necked mouse (Apodemus flavicollis). Slow-growing mycobacteria of group III (according to Runyon) were isolated from the organs of the mouse (Mus musculus sensu lato) and the yellow-necked mouse (A. flavicollis). These findings had no connection with the epizootological situation in the nearby livestock. M. fortuitum was isolated from the organs of the common vole (M. arvalis) caught in a field within easy reach of a swine breeding herd. M. fortuitum was also identified in the lymph nodes and droppings of this swine herd, as well as in the straw, scrapings from the floor of stalls, troughs and banisters, as well as from larvae and imagoes of dipterous insects. These results demonstrate the possibility that insectivores and small rodents can spread the causative agents of mycobacteria in wild and domestic animals.

Ferroelectric Field Effect in Epitaxial Thin Film Oxide SrCuO 2 /Pb(Zr 0.52 Ti 0.48 )O 3 Heterostructures

A ferroelectric field effect in epitaxial thin film SrCuO(2)/Pb(Zr(0.52)Ti(0.48))O(3) heterostructures was observed. A 3.5 percent change in the resistance of a 40 angstrom SrCuO(2) layer (a parent high-temperature superconducting compound) was measured when the polarization field of the Pb(Zr(0.52)Ti(0.48))O(3) layer was reversed by the application of a pulse of small voltage (<5 volts). This effect, both reversible and nonvolatile, is attributed to the electric field-induced charge at the interface of SrCuO(2) and Pb(Zr(0.52)Ti(0.48))O(3). This completely epitaxial thin film approach shows the possibility of making nonvolatile, low-voltage ferroelectric field effect devices for both applications and fundamental studies of field-induced doping in novel compounds like SrCuO(2).