A Call to Disrupt Heteronormativity and Cisnormativity in Physical Therapy: Perspectives of 2SLGBTQIPA+ Participants on Future Directions for PT Curricula.

Purpose: To explore the perspectives of individuals with self-reported expertise and/or lived experiences regarding aspects of 2SLGBTQIPA+ health that should be included in pre-licensure physical therapy (PT) curricula across Canada, including how, when, and by whom this content should be delivered. Method: We conducted a critical qualitative, cross-sectional study with semi-structured virtual interviews. We analyzed participants' perspectives thematically using the DEPICT method. Results: Thirteen participants across Canada with a variety of gender identities and sexual orientations were interviewed. Participants described how transformative change on 2SLGBTQIPA+ issues in PT requires an approach that is based on interrupting heteronormativity and cisnormativity in PT curricula. Participants explained how this could be achieved by (1) emphasizing both historical inequities and present-day considerations for safe and inclusive practice, (2) introducing the content early and integrating it throughout the programme using a variety of large- and small-group sessions, and (3) including 2SLGBTQIPA+ individuals in content delivery and creation. Conclusions: This study brings attention to the need for the PT profession to understand how the pervasive social structures of heteronormativity and cisnormativity shape education and practice, and offer strategies for disrupting complicity with these systems of inequality.

Objectif: explorer les points de vue des personnes qui déclarent avoir des compétences ou des expériences de vie relativement à des aspects de la santé des LGBTQIPA2+ qui pourraient être inclus dans le programme de physiothérapie avant l'obtention du permis au Canada, y compris la manière de transmettre la matière, ainsi que le moment où la transmettre et par qui elle doit être transmise. Méthodologie: étude qualitative transversale critique comprenant des entrevues virtuelles semi-structurées. Les chercheurs ont analysé les points de vue des participants par thèmes, à l'aide de la méthode DEPICT. Résultats: au total, 13 participants du Canada de diverses identités de genre et orientations sexuelles ont participé à une entrevue. Ils ont décrit que, pour parvenir à un changement transformatif des enjeux LGBTQIPA2+ en physiothérapie, il faut adopter une approche reposant sur l'interruption de l'hétéronormativité et de la cisnormativité au sein du programme de physiothérapie. Les participants expliquent comment y parvenir : 1) en soulignant à la fois les iniquités historiques et les considérations actuelles en matière de pratique inclusive sécuritaire, 2) en présentant la matière tôt et en l'intégrant à tout le programme dans le cadre de séances en grands et en petits groupes 3) en faisant participer les personnes LGBTQIPA2+ à la présentation et à la création de la matière. Conclusions: la présente étude fait ressortir toute l'importance de faire comprendre à la profession comment les structures sociales d'hétéronormativité et de cisnormativité omniprésentes modèlent l'éducation et la pratique, et comment offrir des stratégies pour enrayer la complicité avec ces systèmes d'inégalité.

Supporting conservationists' mental health through better working conditions.

Biodiversity conservation work can be challenging but rewarding, and both aspects have potential consequences for conservationists' mental health. Yet, little is known about patterns of mental health among conservationists and its associated workplace protective and risk factors. A better understanding might help improve working conditions, supporting conservationists' job satisfaction, productivity, and engagement, while reducing costs from staff turnover, absenteeism, and presenteeism. We surveyed 2311 conservation professionals working in 122 countries through an internet survey shared via mailing lists, social media, and other channels. We asked them about experiences of psychological distress, working conditions, and personal characteristics. Over half were from and worked in Europe and North America, and most had a university-level education, were in desk-based academic and practitioner roles, and responded in English. Heavy workload, job demands, and organizational instability were linked to higher distress, but job stability and satisfaction with one's contributions to conservation were associated with lower distress. Respondents with low dispositional and conservation-specific optimism, poor physical health, and limited social support, women, and early-career professionals were most at risk of distress in our sample. Our results flag important risk factors that employers could consider, although further research is needed among groups underrepresented in our sample. Drawing on evidence-based occupational health interventions, we suggest measures that could promote better working conditions and thus may improve conservationists' mental health and abilities to protect nature.

Mejores condiciones de trabajo para apoyar la salud mental de los conservacionistas Resumen La conservación de la biodiversidad puede ser difícil pero gratificante y ambos aspectos pueden tener consecuencias en la salud mental de los conservacionistas. Sin embargo, sabemos poco sobre la salud mental de los conservacionistas, sus patrones y los factores de protección y riesgo asociados al lugar de trabajo. Un mayor conocimiento ayudaría a mejorar las condiciones de trabajo, pues impulsaría la satisfacción laboral, la productividad y el compromiso de los conservacionistas, mientras se reducen los costos derivados de la rotación de personal, el ausentismo y el presentismo. Encuestamos a 2,311 profesionales de la conservación de 122 países con una encuesta virtual compartida por listas de correo, redes sociales y otros medios. Les preguntamos a los profesionales sobre sus experiencias de estrés psicológico, condiciones de trabajo y características personales. Más de la mitad trabajaban y procedían de Europa y Norteamérica; la mayoría respondió en inglés, contaba con estudios universitarios y actualmente desempeña funciones académicas y profesionales. La carga de trabajo excesiva, las exigencias laborales y la inestabilidad organizacional se relacionaron con un mayor estrés, mientras la estabilidad laboral y la satisfacción con la contribución propia a la conservación se asociaron con un menor estrés. En nuestra muestra, los encuestados con baja disposición y un optimismo específico hacia la conservación, mala salud física, apoyo social limitado, las mujeres y los profesionales que inician su carrera son los que corren un mayor riesgo de sufrir estrés. Nuestros resultados señalan importantes factores de riesgo que los empresarios podrían considerar, aunque es necesario seguir investigando entre los grupos menos representados en nuestra muestra. Con base en las intervenciones de salud laboral respaldadas con pruebas, sugerimos medidas que podrían promover mejores condiciones de trabajo y, así mejorar la salud mental de los conservacionistas y su capacidad para proteger la naturaleza.

Development and Validation of the Transition Readiness Assessment Instrument in Type 1 Diabetes "On TRAck".

OBJECTIVES: Transition to adult care is challenging for youth with type 1 diabetes (T1D) and their caregivers. We have developed the diabetes-specific "On TRAck" transition readiness scale, and in this study we assess its reliability and validity compared with TRANSITION-Q, a generic transition readiness questionnaire. METHODS: We systematically created 3 versions of On TRAck: adolescent, parent and health-care provider (HCP) versions (for case managers and physicians). Among adolescents 13 to 18 years of age with T1D at a single academic centre, we conducted an exploratory factor analysis and assessed interrater agreement, internal consistency and relationship with age; recent glycated hemoglobin (A1C); and recent diabetic ketoacidosis (DKA) with On TRAck and TRANSITION-Q. RESULTS: One hundred fifteen adolescents (aged 15.8±1.6 years and diabetes duration 6.7±4.1 years), their caregivers and diabetes HCPs participated. The final 24-item adolescent and parent scales (with 3 subscales: "Self-efficacy," "Autonomy" and "Support & maturity") and the 3-item HCP version had a Cronbach's alpha of 0.86 to 0.93. Adolescent scores correlated with parents (r=0.64), case managers (r=0.39) and physicians (r=0.28). Mean adolescent score was 190.3±27.1 points out of 240. Adolescent scores were 3.4 points higher per year of age (p=0.03) and 4.4 points higher for every 1% lower A1C (p=0.01), but were not associated with DKA. TRANSITION-Q was associated with age. On TRAck HCP scores were associated with adolescent's age, A1C and DKA. CONCLUSIONS: On TRAck represents a new psychometrically comprehensive diabetes-specific scale that can be used in adolescent diabetes clinics for measuring transition readiness. It is a multidimensional instrument with ease of use and high reliability scores.

Production and analysis of a mammalian septin hetero-octamer complex.

The septins are filament-forming proteins found in diverse eukaryotes from fungi to vertebrates, with roles in cytokinesis, shaping of membranes and modifying cytoskeletal organization. These GTPases assemble into rod-shaped soluble hetero-hexamers and hetero-octamers in mammals, which polymerize into filaments and higher order structures. While the cell biology and pathobiology of septins are advancing rapidly, mechanistic study of the mammalian septins is limited by a lack of recombinant hetero-octamer materials. We describe here the production and characterization of a recombinant mammalian septin hetero-octamer of defined stoichiometry, the SEPT2/SEPT6/SEPT7/SEPT3 complex. Using a fluorescent protein fusion to the complex, we observed filaments assembled from this complex. In addition, we used this novel tool to resolve recent questions regarding the organization of the soluble septin complex. Biochemical characterization of a SEPT3 truncation that disrupts SEPT3-SEPT3 interactions is consistent with SEPT3 occupying a central position in the complex while the SEPT2 subunits are at the ends of the rod-shaped octameric complexes. Consistent with SEPT2 being on the complex ends, we find that our purified SEPT2/SEPT6/SEPT7/SEPT3 hetero-octamer copolymerizes into mixed filaments with separately purified SEPT2/SEPT6/SEPT7 hetero-hexamer. We expect this new recombinant production approach to lay essential groundwork for future studies into mammalian septin mechanism and function.

The Impact of Glucose on Corticospinal and Intracortical Excitability.

Neurotransmission is highly dependent on the availability of glucose-derived energy, although it is unclear how glucose availability modulates corticospinal and intracortical excitability as assessed via transcranial magnetic stimulation (TMS). In this double-blinded placebo-controlled study, we tested the effect of acute glucose intake on motor-evoked potential (MEP) recruitment curves, short-interval intracortical inhibition (SICI), short-latency afferent inhibition (SAI) and long-latency afferent inhibition (LAI). Eighteen healthy males participated in four sessions. Session 1 involved acquisition of an individualized blood glucose response curve. This allowed measurements to be time-locked to an individualized glucose peak after consuming one of three drinks during the subsequent three sessions. Participants were administered a 300 mL concealed solution containing 75 g of glucose, sucralose, or water in separate sessions. Dependent measures were assessed at baseline and twice after drinking the solution. Secondary measures included blood glucose and mean arterial pressure. Corticospinal excitability and blood pressure increased following the drink across all treatments. No changes were observed in SICI, SAI or LAI. There was no rise in corticospinal excitability that was specific to the glucose drink, suggesting that acute changes in glucose levels do not necessarily alter TMS measures of corticospinal or intracortical excitability.