We report a specific pattern of recognition by third-strand bases for each ofthe four Watson-Crick base pairs within a pyrimidine triple-helix motif as determined by PAGE: TEAT, C-GC, T-CG, and G-TA. Our recognition scheme for base triplets is in agreement with previous studies. In addition, we identified another triplet, T-CG, under physiological conditions, in which formaIJon of triple helix was observed at equimolar ratios of the third strand and duplex target. Although different nearest-neighbor effects are expected, this rmding extends the base-recognition code to all 4 base pairs in double-stranded DNA under physiological conditions. Basecomposition analysis of putative triplex species provided independent evidence for the formation of triplex and confirmed the base-recognition code determined by PAGE. Moreover, the formation of triplex, as detected by gel electrophoresis, was seen to be an all-or-none phenomenon, dependent upon a single-base mismatch among 21 nucleotides. This result suggests a high specificity for the recognition of double-stranded DNA by a third strand. In addition, we report the surprising rnding that triplex stability depends on the length and sequence of the target duplex DNA.
Purpose: Scholars indicate that rates of mental and physical health issues (e.g., substance use, anxiety, depression) may be much higher among transgender individuals relative to the general population. This disparity may be even greater for transgender individuals in rural areas. Clinical researchers suggest using affirmative therapeutic approaches and interventions to address the health concerns of transgender individuals, specifically to connect individuals with the transgender community. However, little is known about the content of information that is shared in transgender communities in rural areas.Method: For this qualitative study, researchers asked transgender individuals in rural areas (n=10) what recommendations they would offer to other transgender individuals in rural areas regarding healthcare access.Results: Results were organized into four domains: Access care, Quality control, Difficulties, and Mentorship. Within these domains, we identified 11 sub-domains: Get physical healthcare, Get mental healthcare, Provider search, Provider vetting, Treatment verification, It will be difficult, Know who you are, Believe in yourself, Move, Connect to community, and Other.Conclusions: We discuss implications of our findings for healthcare provision in rural areas, and we provide recommendations for future research.
There is a crucial need for competent mental health services for persons who identify as transgender. This need is even greater for those who live in rural areas or small towns. However, there is little research on persons who are transgender who live in rural or remote areas. Typically, when rural populations are studied, gender minorities (e.g., transgender, gender nonconforming) are included with those who identify as sexual minorities (e.g., gay, lesbian, or bisexual). Studies that examine the needs of transgender persons generally do not parse out the experiences of those who live in rural areas versus those who live in urban areas. In this manuscript, we hope to begin to address this gap in the literature. We provide an overview of needs of rural-based transgender persons who are seeking health care services, we share case examples from clinical work with this population, and we provide recommendations for how mental health providers-both those who practice in rural areas and those who practice in urban areas-can work with transgender clients who live in rural and remote areas or small towns.
Therapists may encounter many opportunities and dilemmas when working with transgender and non-binary clients. Transgender and non-binary clients may use pronouns that are new or unfamiliar to their therapists, but little is known about the unique impact that pronoun use may have in therapy. The pronouns and preferred names that transgender and non-binary clients use may also shift during the course of the therapeutic relationship. Best practices for affirmative therapy include recognizing and validating a client's gender identity, use of gender pronouns that are congruent with a client's gender identity, and using the client's preferred or chosen name, not their birth name. These clients may present to therapy for a variety of reasons; therefore, it is important to trust the client's self-perception of their own gender identity and to not engage in harmful gatekeeping practices. Scholars have highlighted the negative emotions that individuals may experience when they are misgendered, deadnamed, invalidated, or otherwise denied access to medically appropriate care. Therapists may experience anxiety about providing care that is transgender-affirmative, which may affect the therapist-client alliance. The authors draw on their own experiences as therapists working with transgender and non-binary clients and provide recommendations and guidance for therapists. Clinical Impact StatementThis article provides guidance and information about pronoun use, documentation, terminology, and clinical errors in an effort to support clinical work with transgender and non-binary individuals. Throughout the article, vignettes, examples, and practical applications are provided.
One current focus of training in applied psychology programs is multicultural competence. Research on multicultural competence has focused on students and on clinical supervisors. However, much training in multicultural competence occurs in classrooms and within training programs, and there has been limited examination of the multicultural competence of faculty. Using consensual qualitative research (CQR) methodology, we examined counseling psychology doctoral student perceptions of the multicultural competence of counseling psychology faculty. Utilizing a semistructured interview protocol, we obtained in-depth descriptions of how counseling psychology doctoral students define and perceive the multicultural competence of faculty members. Six domains emerged from the analysis, including faculty expertise, faculty-student relationships, faculty initiative, faculty as agents of social justice, faculty attributes, and faculty limitations. Some of these themes were unexpected and are new to the field of multicultural competence training. We recommend that faculty engage in reflective interactions with students and consider their own strengths as well as growth areas related to multicultural competence, keeping these 6 domains in mind.
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