"I was simply trying to make it through the day": A collaborative autoethnography of couple/marriage and family therapy program directors in a diversity and anti-racism peer consultation group.

The COVID-19 pandemic and widely depicted incidents of racial injustice in the United States caused marked stress and shifts in society in 2020, leading to an acceleration of discussions related to promoting diversity, equity, inclusion, and justice (DEIJ) in family-oriented mental health professions, including through training. Despite the consequential role leaders of academic programs play in overseeing didactic and clinical training, little research has examined approaches for supporting academic leaders in promoting DEIJ in family science-related academic training programs. In this collaborative autoethnography, we, six participants in a diversity and anti-racism peer consultation group for leaders of couple/marriage and family therapy (C/MFT) programs, present our experiences participating in the group over the past two years. At the start of the group, many of us were experiencing profound isolation and stress due to intensified responsibilities subsequent to the COVID-19 pandemic and broadcast depictions of racial injustice. We experienced the group as a safe, inclusive space to grow personally and professionally, which subsequently inspired us to make changes in our programs. We also recognized the need for greater infrastructure to support program directors in developing DEIJ leadership skills. Future directions for research include examining experiences and outcomes of director-initiated DEIJ change, as well examination of DEIJ-focused peer consultation groups among family systems-oriented academic leaders of diverse disciplines and nations.

Pre-Cohabitation Conversations for Relationships: Recommended Questions for Discussion.

Moving in together is an important transition in a relationship. For many, it is often a shift to the next phase of the relationship indicating higher levels of commitment. Whether the partners are married, plans to get married, or marriage is not part of their future, there are important conversations to be had prior to this transition. As such, this article presents recommended pre-cohabitation conversations with question prompts for partners to explore prior to moving in together. To best understand the dynamics of cohabiting that informed the questions, a review of the literature on cohabitation is presented. Additionally, race and culture, religion, and sexual and gender identity will be highlighted as essential conversation considerations especially as the majority of the literature is centered around white, hetero, and monogamous relationships. Created by a group of couple and family therapy graduate trainees based on the literature and their own personal and professional experiences, the pre-cohabitation conversations are organized into three categories- relationship negotiations, household rules, and communication. These conversations are recommended to be used both by therapists with their clients as well as for direct use by partners following the questions presented within. The topics represent a comprehensive range of relationship issues including consideration of unique issues as presented in the literature with the goal of aiding partners in successful management of their transition to a shared living space.

Making every contact count with seldom-heard groups? A qualitative evaluation of voluntary and community sector (VCS) implementation of a public health behaviour change programme in England.

Making Every Contact Count (MECC) is a national, long-term public health strategy in England. It supports public-facing workers to use opportunities during routine contacts to enable healthy lifestyle changes. This paper reports the findings from an external evaluation of voluntary and community sector (VCS) delivery of MECC in the North East of England, which focused on engaging under-represented client groups. The study aimed to (a) Establish if (and how) MECC had impacted the workforce, including changes to staff knowledge, confidence and behaviour; (b) Identify benefits, challenges and unintended consequences; and (c) Explore outcomes for service users. A multi-stage qualitative design focused on understanding both process and outcomes. The study utilised three data collection methods, including a journey mapping workshop (n = 20), semi-structured interviews with delivery leads, VCS workers and volunteers who had accessed MECC training (n = 11), and focus group discussions with clients (n = 22). The findings illustrated positive early outcomes, including improvements in self-reported staff knowledge and confidence as well as emerging examples of organisational culture shift and individual behaviour change. Alongside this, the data provided a rich picture of barriers and challenges which are examined at different levels-national programme, local programme, VCS sector, partner organisation, worker and client. The research highlights clear successes of the VCS delivery model. However, it is presented as a 'double-edged sword,' in light of associated challenges such as sector-level funding uncertainty and accessibility of MECC resources to diverse client groups. The discussion considers issues related to the measurement and attribution of behaviour change outcomes for brief interventions, as well as fidelity, legacy and long-term sustainability challenges. The recommendations call for system-level analysis and comparison of different MECC implementation models, to improve our understanding of challenges, opportunities and programme reach for behaviour change intervention programmes-particularly in relation to seldom-heard client groups.

Commentary: Does Twitter have a role in improving Family Planning messages and services in Low-and-Middle-Income Countries (LMICs)?

Stakeholders are coming together to develop a vision for increasing access to family planning (FP) by 2030. Of the 923 million women in the developing world who wish to avoid a pregnancy, 218 million women are not using a modern contraceptive (Guttmacher Institute, 2020). In 2016, over 3.4 billion people were using the internet (https://ourworldindata.org/internet 2016). Moreover, internet users in the developing world use social media more frequently than Internet users in the U.S. and Europe. Of the many proposed actions to accelerate progress in family planning, the use of Twitter should be a key component. In this commentary, we describe the use of Twitter in a select group of low-and-middle-income countries that have made commitments to the family planning 2020 initiative (FP2020 countries and have the potential to leverage Twitter with current and potential family planning users. We examine Twitter feeds in eight key FP2020 countries, and we look at the content of Tweets issued by the ministries of health in most of these same countries. Our view is that it is feasible and easy to access Twitter feeds in low-and -middle income countries. We base our view on the types of reproductive health and family planning terms discussed in a public forum such as Twitter by current and potential users and their partners and ministries of health. We highlight two broad considerations that merit discussion among interested stakeholders, including policy makers, program designers, and health advocates. The first relates to the use of Twitter within family planning programs, and the second relates to themes that require more significant research. Data coupled with analytical capacity will help policy makers and program designers to effectively leverage Twitter for expanding the reach of family planning services and influencing social media policy. Our aim is to not only to contribute to the body of knowledge but also to spur greater engagement by program personnel, researchers, health advocates and contraceptive users.

Impact of COVID-19 on the Perinatal Period Through a Biopsychosocial Systemic Framework.

The perinatal period involves major developmental transitions which can be conceptualized through a biopsychosocial (BPS; Engel in Science 196:129-136, 1977, 10.1126/science.847460, in The American Journal of Psychiatry 137:535-544, 1980, 10.1176/ajp.137.5.535), systemic (von Bertalanffy, General system theory: Foundations, development, applications, George Braziller, New York, 1968) framework. Thus, no one domain of health in the perinatal period can be understood without exploring how the other domains are both impacted by and impacting the others. As a result of COVID-19, popular media is paying special attention to the biomedical domain of women in the perinatal period as it relates to health outcomes and changes in perinatal healthcare policies; however, considerably less attention is being paid to the other BPS health domains and systemic impacts. This paper will outline U.S. changes in healthcare as a result of the COVID-19 pandemic for individuals, couples, and families within the perinatal period (i.e., family planning and conception, prenatal, labor and delivery, and postpartum) and explore the unique psychosocial, systemic impacts. Recommendations for care, including telehealth and virtual support options, and future directions for research will be provided.

In Their Own Words: A Qualitative Exploration of Last Statements of Capital Punishment Inmates in the State of Missouri, 1995-2011.

Last statements have been a common practice as part of capital punishment as far back as the 1300s in Europe. In the United States, the first execution occurred in 1608, and currently, 32 states have the death penalty. In 1991, Missouri integrated death row inmates into the general prison population, which makes this population unique compared with other death row populations across the United States. This article is a qualitative study on the themes found in the last statements of 46 capitally punished inmates in Missouri from 1995 to 2011. The purpose of this study was to determine if capital punishment inmates being housed in the general population had an impact on an inmate's last statement prior to execution. Three domains emerged from these last statements: life, death, and execution. The most common theme identified was love while the least common theme was acceptance. The themes found in this research were consistent with previous studies which looked at inmates executed in Texas where inmates sentenced to capital punishment are separated from the general prison population. Implications, limitations, and future research areas are discussed.

An ode to my uterus.

The author of this short story writes about undergoing five surgeries over twenty years to remove endometriosis. She has two children, but without a uterus she wonders if she still is a woman. She is thankful for no more debilitating pain and the freedom to love with creativity and abandon. (PsycINFO Database Record

The perfect marriage: solution-focused therapy and motivational interviewing in medical family therapy.

Medical family therapy has many potential uses in behavioral medicine and primary care. Current research was reviewed to determine the most advantageous way to apply solution-focused therapy and motivational interviewing as a perfect marriage in medical family therapy. An extensive literature review was done in the following databases for medical family therapy: Proquest, EBSCO, Medline, and PsychInfo. The search resulted in 86 relevant articles, of which 46 of the most recent were selected for review. Medical family therapy lacks current research that supports solution-focused therapy or motivational interviewing. However, evidence supports the use of solution-focused therapy as a brief format, as well as the closely related intervention, motivational interviewing. While medical family therapy presents many hopeful possibilities in the fields of behavioral medicine, psychology, and marriage and family therapy, little evidence currently exists for the most effective implementation. This review found evidence supporting solution-focused therapy and motivational interviewing as the perfect marriage of the collaborative team approaches for the future implementation and use of specific interventions in medical family therapy.

Sensitivity to ocean acidification parallels natural pCO2 gradients experienced by Arctic copepods under winter sea ice.

The Arctic Ocean already experiences areas of low pH and high CO2, and it is expected to be most rapidly affected by future ocean acidification (OA). Copepods comprise the dominant Arctic zooplankton; hence, their responses to OA have important implications for Arctic ecosystems, yet there is little data on their current under-ice winter ecology on which to base future monitoring or make predictions about climate-induced change. Here, we report results from Arctic under-ice investigations of copepod natural distributions associated with late-winter carbonate chemistry environmental data and their response to manipulated pCO2 conditions (OA exposures). Our data reveal that species and life stage sensitivities to manipulated OA conditions were correlated with their vertical migration behavior and with their natural exposures to different pCO2 ranges. Vertically migrating adult Calanus spp. crossed a pCO2 range of >140 µatm daily and showed only minor responses to manipulated high CO2. Oithona similis, which remained in the surface waters and experienced a pCO2 range of <75 µatm, showed significantly reduced adult and nauplii survival in high CO2 experiments. These results support the relatively untested hypothesis that the natural range of pCO2 experienced by an organism determines its sensitivity to future OA and highlight that the globally important copepod species, Oithona spp., may be more sensitive to future high pCO2 conditions compared with the more widely studied larger copepods.

Unveiling a phytoplankton hotspot at a narrow boundary between coastal and offshore waters.

In terrestrial ecosystems, transitional areas between different plant communities (ecotones) are formed by steep environmental gradients and are commonly characterized by high species diversity and primary productivity, which in turn influences the foodweb structure of these regions. Whether comparable zones of elevated diversity and productivity characterize ecotones in the oceans remains poorly understood. Here we describe a previously hidden hotspot of phytoplankton diversity and productivity in a narrow but seasonally persistent transition zone at the intersection of iron-poor, nitrate-rich offshore waters and iron-rich, nitrate-poor coastal waters of the Northeast Pacific Ocean. Novel continuous measurements of phytoplankton cell abundance and composition identified a complex succession of blooms of five distinct size classes of phytoplankton populations within a 100-km-wide transition zone. The blooms appear to be fueled by natural iron enrichment of offshore communities as they are transported toward the coast. The observed succession of phytoplankton populations is likely driven by spatial gradients in iron availability or time since iron enrichment. Regardless of the underlying mechanism, the resulting communities have a strong impact on the regional biogeochemistry as evidenced by the low partial pressure of CO(2) and the nearly complete depletion of nutrients. Enhanced phytoplankton productivity and diversity associated with steep environmental gradients are expected wherever water masses with complementary nutrient compositions mix to create a region more favorable for phytoplankton growth. The ability to detect and track these important but poorly characterized marine ecotones is critical for understanding their impact on productivity and ecosystem structure in the oceans.

Natramune and PureWay-C reduce xenobiotic-induced human T-cell alpha5beta1 integrin-mediated adhesion to fibronectin.

BACKGROUND: In vitro and in vivo studies demonstrate that nutritional supplementation reduces inflammation and inflammatory markers associated with T-cell adhesion mechanisms. Here, we investigate the effects of the nutritional supplements, Natramune (PDS-2865) and PureWay-C, on xenobiotic-induced alpha5beta1 integrin-mediated T-cell adhesion to fibronectin. MATERIAL/METHODS: The human CD4+ lymphoblastoid cell line CEM SS was treated with combinations of bifenthrin, blocking antibodies to human beta1 and alpha5 integrin, and nutrient supplements. After 30 minutes unattached cells were aspirated and the percent of attached cells was determined. RESULTS: Bifenthrin stimulated T-cell adhesion to fibronectin at concentrations between 1.0 and 100 microM with a maximal stimulation of 8.3-fold at 10 microM. At 500 microg/ml, Natramune reduced 100 microM bifenthrin-induced adhesion by nearly 90%. PureWay-C reduced by 1.5-fold the level of T-cell adhesion stimulated by bifenthrin concentrations of both 10 microM and 100 microM. The combination of Natramune and PureWay-C resulted in a 6.3 and 7.5-fold inhibition at 10 microM and 100 microM bifenthrin respectively. Antibody blocking studies demonstrated that bifenthrin induced CEM SS adhesion to fibronectin is mediated through alpha5beta1 integrin. Inhibition of T-cell adhesion achieved by anti-integrin antibodies was further reduced with 50 and 500 microg/ml Natramune treatment. Pretreatment of fibronectin with Natramune did not alter induced T-cell adhesion to fibronectin. CONCLUSIONS: These data demonstrate that xenobiotic-induced alpha5beta1 integrin mediated T-cell adhesion to fibronectin is reduced by nutritional supplementation with Natramune (PDS-2865) and PureWay-C. These data suggest the possibility that inflammatory responses associated with exposure to pollutants can be mitigated by nutritional supplementation.

Effects on WAIS-III performance IQ (PIQ) and full scale IQ (FSIQ) when object assembly is substituted for each standard performance scale subtest.

According to the WAIS-III Administration and Scoring Manual, Object Assembly (OA) may be substituted for any spoiled Performance subtest. This assertion has not been evaluated in a clinical sample. The present investigation reports differences that resulted in Performance IQ (PIQ) and Full Scale IQ (FSIQ) when OA replaced each of the Performance subtests. Participants were 47 referrals for neuropsychological assessment (age M = 45.98 years, SD = 9.82; education M = 13.82 years, SD = 2.78). Results indicated that OA may replace any Performance subtest without seriously altering the summary scores. Differences between the standard IQs and OA-based composites were < 2 points for PIQ and < 1 point for FSIQ. More than 90% of the OA-based composites fell within the 90% confidence limits of the corresponding IQ.

Discrimination of healthy and brain-damaged elderly using the WAIS-R.

The authors evaluated the ability of WAIS-R variables to discriminate normal from brain-damaged persons 75 years of age and older. Fifty-four brain-damaged patients and 54 healthy elderly were matched on the variables of age, education, sex, and race. Significant level of performance differences emerged between the groups on all subtests and the three IQs. No group differences were found on the VIQ-PIQ discrepancy score or range of subtest scatter. Step-wise discriminant analysis revealed that Digit Symbol was the most potent WAIS-R variable, accounting for 34% of the variance and correctly classifying 79.6% of the subjects.

Reliabilities of the WAIS-III for discrepancy scores: generalization to a clinical sample.

Internal consistency reliabilities for WAIS-III IQ, Index, and subtest discrepancy scores are provided for 100 men in a treatment program for substance abuse disorders. There were 63 Euro-Americans and 37 African Americans. Means for age, education, and Full Scale IQ were 46.1 yr. (SD=8.8), 12.7 yr. (SD=1.5), and 93.8 (SD=14.0), respectively. Reliabilities ranged from .34 to .86. Compared with the WAIS-III standardization sample, discrepancy score reliability coefficients differed only for the Verbal Comprehension Index vs Perceptual Organization Index contrast, which was higher in the patient sample. Interpretation of discrepancy scores for the WAIS-III appears to be useful in a clinical sample with substance abuse as in a purportedly normal sample.