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Sexual minority persons (e.g., lesbian, gay, bisexual, and queer) are likely to encounter "minority stress", such as discrimination, concealment, expectation of rejection, and internalized heterosexism. Minority stress occurs alongside one's lifespan and has considerable implications in the context of the career lifespan trajectory. Using the approach of developmental contextualism as a framework to embed minority stress, this article reviews the existing literature regarding facets of minority stress across the career lifespan trajectory and provides a conceptualization on how to incorporate minority stress into affirmative career appraisal, intervention, and research practices.

We reviewed our management strategy and outcome data for all 179 patients with pediatric and/or congenital heart disease who underwent 183 heart transplants from January 1, 2011, to December 31, 2021, and evaluated the impact of elevated panel reactive antibody (PRA). High PRA was defined as PRA >10%. Univariate associations with long-term survival were assessed with Cox proportional hazards models. Impact of high PRA on survival was estimated with multivariable models. PRA >10% was present in 60 of 183 transplants (32.8%), who were more likely to have prior cardiac surgery, higher number of prior cardiac operations, prior sternotomy, prior heart transplant, and positive crossmatch (24 of 60 [40.0%] vs 11 of 123 [8.9%], P <.0001). Univariate associations with long-term survival include acquired heart disease vs congenital or retransplant (hazard ratio [HR], 0.18; 95% CI, 0.053-0.593; P =.005), prior cardiac surgery (HR, 5.6; 95% CI, 1.32-23.75; P =.020), number of prior cardiac operations (HR, 1.3 for each additional surgery; 95% CI, 1.12-1.50; P =.0004), single ventricle (HR, 2.4; 95% CI, 1.05-5.48; P =.038), and preoperative renal dysfunction (HR, 3.4; 95% CI, 1.43-7.49; P =.002). In multivariate analysis, high PRA does not impact survival when controlling for each of the factors shown in univariable analysis to be associated with long-term survival. The Kaplan-Meier method provided the following survival estimates at 1 year (95% CI) and 5 years (95% CI) after cardiac transplantation: All patients, 93.6% (89.9%-97.3%) and 85.8% (80.0%-92.1%); PRA < 10%, 96.6% (93.4%-99.9%) and 86.7% (79.6%-94.3%); and PRA >10%, 86.7% (78.0%-96.4%) and 83.8% (74.0%-95.0%). Despite high PRA being associated with higher mortality at 1 year (14.9% vs 3.8%, P =.035), no significant difference exists in Kaplan-Meier overall survival at 5 years posttransplant in patients with and without high PRA (log-rank P =.4). In our cohort, 5-year survival in patients with high PRA (PRA >10%) is similar to that in patients without high PRA (PRA < 10%), despite the presence of more risk factors in those with high PRA. Individualized immunomodulatory strategies can potentially mitigate the risk of high PRA. [Display omitted] [ABSTRACT FROM AUTHOR]

One of the most important aspects of clinical supervision is goal-setting. In the early stages of supervision, supervisees may find it difficult to connect authentically with their supervisors due to the inherent power differential in supervision. Difficulty connecting may be exacerbated when students are attempting to set goals regarding their areas for growth. Based on literature reviewed on the counselor-client relationship, the authors posit that using images may increase vulnerability between supervisors and supervisees. Additionally, the authors introduce relational-cultural theory as a framework for connecting authentically through creative images. The authors present examples of using images in individual and group supervision, specifically employing The Coaching Game made by Points of You. [ABSTRACT FROM AUTHOR]

Background. HIV/AIDS rates are higher in the Southern United States compared to other regions of the country. Reasons for disparities include poverty, health care access, and racism. People who inject drugs (PWID) account for 8% of HIV/AIDS incidence rates. Harm reduction can connect PWID to needed resources. AIDS United Southern REACH grantees developed the Southern Harm Reduction Coalition (SHRC) as a means to decrease HIV/AIDS and viral hepatitis rates, criminalization of drug users and sex workers, and drug overdose. Method. Investigators used an intrinsic case study design to examine the context of harm reduction in the Southern United States, successful strategies, and outcomes. Data collection included key informant interviews and coalition documents. The community coalition action theory was used to examine the data. Results. The SHRC initiated regional conferences and customized trainings. Strengths-based language and utilization of diverse strengths among coalition members were used to effect change. Coalition outcomes included syringe decriminalization legislation, syringe exchange, naloxone access, naloxone funding legislation, and 911 Good Samaritan laws, along with expanded support for PWID. Conclusions. Advocacy successes can be applied to similar organizations in the Southern United States to promote harm reduction and potentially decrease HIV/AIDS burden, viral hepatitis, criminalization, and overdose. [ABSTRACT FROM AUTHOR]

This article presents a plot analysis ofThe Matrixand comparisons to a transgender identity development model. Major scenes throughout the movie are discussed through the lens of Devor’s transgender identity development model. The main character’s evolution from Mr. Anderson to Neo is presented, as well as how his experiences align with multiple stages in transgender identity development. Stages of transgender identity development are discussed and emphasized, including identity confusion, discovery of transgenderism, identity acceptance, transition, and transgender pride. These stages and others are discussed and related to uses in counseling sessions with transgender individuals and their family members. [ABSTRACT FROM PUBLISHER]

This commentary reviewsA League of Their Own, a film that provides a fictional account of the lives of women who played in the first year of the All-American Girls’ Baseball League. Set during World War II-era America, the film offers a look into the gendered lives of women seeking careers in traditionally masculine fields. The authors review the movie from a feminist media lens, with specific emphasis on how the two main characters, Dottie and Kit, ascribe to and defy gender stereotypes and gain voice and agency. Specific implications are pulled from the analysis to be used in the context of counseling women, including empowerment of female clients and establishing career identity. [ABSTRACT FROM PUBLISHER]

This article reviewsThe Perks of Being a Wallflower(Halfon, Smith, Malkovich, & Chbosky, 2012), a coming-of-age film about 3 high school students attempting to survive school, find themselves, and connect with others. The authors provide a synopsis of various portions of the film and identify important aspects of relational-cultural theory (RCT) within its plot, such as growth-fostering relationships, controlling images, and relational images. Various characters’ plotlines are discussed in relation to what RCT identifies as paramount tenets of human development and mental health. The authors also briefly discuss other counseling issues touched on within the film (i.e., affectional identity, sexual assault, and relational violence). [ABSTRACT FROM PUBLISHER]