Featured Article: Strengths-Based, Clinic-Integrated Nonrandomized Pilot Intervention to Promote Type 1 Diabetes Adherence and Well-Being.

Objective: Given persistent challenges achieving optimal diabetes outcomes in adolescence, new interventions to support disease self-management and emotional well-being are needed. Approaches that emphasize adolescents' positive behaviors and attitudes ("strengths") are designed to incorporate positive provider communications into clinical encounters to encourage youths' engagement in adherence behaviors and enhance well-being. Methods: This pilot study tested the feasibility, acceptability, and preliminary outcomes of a brief, strengths-based behavioral intervention for adolescents with type 1 diabetes. Adolescents (age 12-17 years) and parents were recruited, consented, and completed baseline and postintervention questionnaires. There was no randomization to a control group, and all participants received the pilot intervention. At the start of two clinic visits, diabetes care providers followed a semi-structured script to reinforce adolescents' diabetes-related strengths and adherence behaviors. Results: Of 116 eligible families, 84 consented and 64 completed baseline (M age = 15.0 ± 1.8 years, 56% female, 69% White, M HbA1c = 8.6 ± 1.6%). Providers reported the intervention usually (95%) took <10 min to deliver. Participants and providers enjoyed the intervention and would like to see it as part of routine clinical care. Pre-post data indicated significant improvements in youth-rated diabetes strengths, adherence, burden, and relationship with provider, parent-reported diabetes burden, and provider-rated relationship with family (p < .05). Objectively measured adherence and glycemic control did not change. Conclusions: This brief strengths-based, clinic-integrated intervention was feasible to conduct and stakeholders were satisfied. This intervention holds promise to have a positive impact on adolescents' diabetes adherence, well-being, and provider relationships. Lessons were learned to improve implementation and participant experience for a larger study.

The Digital Divide Is a Human Rights Issue: Advancing Social Inclusion Through Social Work Advocacy.

The role of technology and importance of access to high-speed broadband has become glaringly obvious during the COVID-19 pandemic. High-speed Internet is a tool people rely upon to conduct the daily business of their life and interact with each other, the economy, and government. However, millions of people in the USA still have no home access to high-speed Internet. Low-income, people of color, older, Native Americans, and rural residents in particular are on the wrong side of the digital divide. This structural reality perpetuates social, economic, and political disparities. Consistent with a social work human rights approach, the United Nations General Assembly declared access to the Internet a basic human right in 2016. This calls upon social workers to engage in advocacy efforts to advance policy and programs to alleviate the digital divide. In this article, we examine the digital divide in the USA and discuss why it is a social justice and human rights issue. We provide a policy context and recent examples of state or local policy initiatives to reduce the digital divide. Prominent among them is California's Internet for All Now Act. We also identify and share promising practices and advocacy tools being used in the field that provide guidance to community practitioners as they engage in work at state and local levels aimed at closing the digital divide.

Development and preliminary psychometric evaluation of the domestic violence--related financial issues scale (DV-FI).

Intimate partner violence (IPV) occurs at disproportionate rates within impoverished groups of women and can include economic abuse as a form of psychological maltreatment. The current study developed a comprehensive assessment of the unique financial issues facing female victims of IPV using a sheltered sample (N = 113). An exploratory factor analysis (principal-axis factoring with varimax rotation) was conducted on 24 items of the newly developed Domestic Violence-Related Financial Issues Scale. Preliminary results supported five extracted factors, which accounted for approximately 53% of the total common variance in the women's responses. Psychometric properties of the instrument are presented.

Targeting blood glucose management in school improves glycemic control in children with poorly controlled type 1 diabetes mellitus.

We hypothesized that school nurse supervision of glucose and insulin-dose adjustment significantly improves the hemoglobinA(1c) (HbA(1c)) level in pediatric patients with poorly controlled type 1 diabetes mellitus (HbA(1c) > or = 9%). A total of 36 subjects were enrolled and 18 subjects were randomized to receive the 3-month intervention. Their average HbA(1c) was lowered by 1.6%, suggesting that this intervention helps this difficult group of patients.

Economic abuse in the lives of women abused by an intimate partner: a qualitative study.

This article presents qualitative findings of a study that examined the role of financial issues and economic factors in the lives of women who have experienced intimate partner violence (IPV). Eight themes emerged in discussions with women about the ways in which money and economic issues played a role in their experiences of abuse. Taken together, women's discussions clearly support an "economic abuse" dimension of IPV. Implications for safely advancing the economic well-being of low-income survivors are discussed.

Validation of the use of Middlebrook 7H10 agar, BACTEC MGIT 960, and BACTEC 460 12B media for testing the susceptibility of Mycobacterium tuberculosis to levofloxacin.

Levofloxacin, the active l-isomer of the quinolone ofloxacin, is now widely accepted for treatment of multidrug-resistant tuberculosis. Because the drug is now widely used, we sought to establish susceptibility test conditions for Mycobacterium tuberculosis against levofloxacin by the traditional reference method, agar proportion (AP), the commonly used BACTEC 460 radiometric system, and the newer BACTEC MGIT 960 method. To determine the stability of levofloxacin in the two newer test systems (BACTEC 460 and BACTEC MGIT 960), media containing subinhibitory levels of levofloxacin were prepared and stored at 4 and 37 degrees C for 14 days. The stored media were inoculated with H37Rv, and the drug activity was compared to freshly prepared media. Results show that levofloxacin is stable over the course of testing. Next, optimum levofloxacin test concentrations were determined for AP, BACTEC 460, and BACTEC MGIT 960 methods. MICs were determined for 32 pan-susceptible isolates of M. tuberculosis obtained from presumably untreated patients and 14 quinolone-resistant isolates. The levofloxacin-resistant strains either were isolated from patients who remained culture-positive despite treatment with a quinolone agent (six strains) or contained known mutations in gyrA (eight strains). Levofloxacin MICs resulted in a bimodal pattern with values for resistant strains consistently higher than those for pan-susceptible strains. Results show that levofloxacin concentrations of 2 microg/ml (BACTEC 460 and BACTEC MGIT 960) and 1 microg/ml (AP) inhibited the growth of all pan-susceptible strains while permitting the growth of all levofloxacin-resistant strains. Confirmatory tests with a subset of pan-susceptible and levofloxacin-resistant isolates validated the selected test concentrations.

Mycobacterium africanum cases, California.

Five Mycobacterium tuberculosis complex isolates in California were identified as M. africanum by spoligotyping, single nucleotide polymorphisms, a deletion mutation, and phenotypic traits, confirming it as a cause of tuberculosis in the United States. Three of the five patients from whom M. africanum was isolated had lived in Africa.

Transmission of mycobacterium tuberculosis via lung transplantation.

Organ donors are not routinely screened for tuberculosis (TB) in the United States. We investigated a case of pulmonary TB in a double-lung transplant recipient. We reviewed the donor's and recipient's records, and used molecular methods to compare the lung recipient's isolate with others from three sources: her hospital, the California state health department's genotyping database, and the donor's resident-nation of Guatemala. A respiratory specimen obtained from the lung recipient 1 day after transplantation grew Mycobacterium tuberculosis. Donor chest radiograph had a previously unnoticed pulmonary opacity that was present on post-transplant recipient chest radiographs and computed tomographs. The recipient's isolate was molecularly distinct from others at her hospital and in the state database, but was identical to two isolates from Guatemala. Tuberculosis was transmitted from lung donor to recipient. As organ transplantation becomes more common worldwide, similar cases could occur. Screening for TB in potential organ donors should be considered.