There has been a great deal of state-level legislative activity focused on immigration and immigrants over the past decade in the United States. Some policies aim to improve access to education, ...transportation, benefits, and additional services while others constrain such access. From a social determinants of health perspective, social and economic policies are intrinsically health policies, but research on the relationship between state-level immigration-related policies and Latino health remains scarce. This paper summarizes the existing evidence about the range of state-level immigration policies that affect Latino health, indicates conceptually plausible but under-explored relationships between policy domains and Latino health, traces the mechanisms through which immigration policies might shape Latino health, and points to key areas for future research. We examined peer-reviewed publications from 1986 to 2016 and assessed 838 based on inclusion criteria; 40 were included for final review. These 40 articles identified four pathways through which state-level immigration policies may influence Latino health: through stress related to structural racism; by affecting access to beneficial social institutions, particularly education; by affecting access to healthcare and related services; and through constraining access to material conditions such as food, wages, working conditions, and housing. Our review demonstrates that the field of immigration policy and health is currently dominated by a “one-policy, one-level, one-outcome” approach. We argue that pursuing multi-sectoral, multi-level, and multi-outcome research will strengthen and advance the existing evidence base on immigration policy and Latino health.
•State-level immigration and immigrant-focused policies influence Latino health.•Policies aimed at undocumented immigrants ‘spill over’ and affect all Latinos.•State-level immigration policies shape Latino health through four pathways.•Pathways include racism and access to institutions, healthcare, and material goods.
Prior to adopting new technologies for training, evaluations must be executed to demonstrate their benefit. Specifically, the appeal of virtual reality has led to applications across domains. While ...many evaluations have been conducted on their effectiveness, there has yet been a review to summarize and categorize the evidence on training outcomes. To assess the benefits these new technologies may bring to the trainee, a review of the research on the training effectiveness with virtual reality (VR) technology that was conducted. The goal for this review was to take a domain-agnostic perspective to identify the knowledge, skills, and abilities (KSAs) that have been trained effectively or enhanced with the use of VR. This review searched the related literature within multiple databases and found publications that met the search criteria from 1992 to 2019. A discussion of previous VR training reviews is first presented, followed by an in-depth evaluation of the literature that met the inclusion criteria. Three distinct categories of KSAs were identified consistently: psychomotor performance, knowledge acquisition, and spatial ability. Recommendations to support achievement of training outcomes utilizing VR training systems are provided.
Simian immunodeficiency viruses of sooty mangabeys (SIVsm) are the source of multiple, successful cross-species transmissions, having given rise to HIV-2 in humans, SIVmac in rhesus macaques, and ...SIVstm in stump-tailed macaques. Cellular assays and phylogenetic comparisons indirectly support a role for TRIM5alpha, the product of the TRIM5 gene, in suppressing interspecies transmission and emergence of retroviruses in nature. Here, we investigate the in vivo role of TRIM5 directly, focusing on transmission of primate immunodeficiency viruses between outbred primate hosts. Specifically, we retrospectively analyzed experimental cross-species transmission of SIVsm in two cohorts of rhesus macaques and found a significant effect of TRIM5 genotype on viral replication levels. The effect was especially pronounced in a cohort of animals infected with SIVsmE543-3, where TRIM5 genotype correlated with approximately 100-fold to 1,000-fold differences in viral replication levels. Surprisingly, transmission occurred even in individuals bearing restrictive TRIM5 genotypes, resulting in attenuation of replication rather than an outright block to infection. In cell-culture assays, the same TRIM5 alleles associated with viral suppression in vivo blocked infectivity of two SIVsm strains, but not the macaque-adapted strain SIVmac239. Adaptations appeared in the viral capsid in animals with restrictive TRIM5 genotypes, and similar adaptations coincide with emergence of SIVmac in captive macaques in the 1970s. Thus, host TRIM5 can suppress viral replication in vivo, exerting selective pressure during the initial stages of cross-species transmission.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Men who have sex with men (MSM) in Vietnam experience disproportionate rates of HIV infection. To advance understanding of how structural barriers may shape their engagement with HIV prevention ...services, we draw on 32 in-depth interviews and four focus groups (n = 31) conducted with MSM in Hanoi between October 2015- March 2016. Three primary factors emerged: (1) Diversity, both in relation to identity and income; Vietnamese MSM described themselves as segregated into Bóng kín (hidden, often heterosexually-identified MSM) and Bóng lộ ('out,' transgender, or effeminate MSM). Lower-income, 'hidden' MSM from rural areas were reluctant to access MSM-targeted services; (2) Stigma: MSM reported being stigmatized by the healthcare system, family, and other MSM; and (3) Healthcare access: this was limited due to economic barriers and lack of MSM-friendly services. Our research suggests the need for multiple strategies to reach diverse types of MSM as well as to address barriers in access to health services such as stigma and costs. While a great deal has been written about the diversity of MSM in relation to gender performance and sexual identities, our research points to the substantial structural-level barriers that must be addressed in order to achieve meaningful and effective HIV prevention for MSM worldwide.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
This scoping study sought to provide an overview of existing interventions, programs and policies that address family-based stigma and discrimination against LGBTQ youth.
A keyword search in three ...online databases identified relevant scientific publications. Because it located a relatively small number of peer-reviewed publications, additional grey literature references were included, identified through consultation with specialists and through anonymous peer-review. Research, policies and interventions were categorized using an adapted ecological framework.
There is very little peer-reviewed research on interventions to reduce family stigma and discrimination against LGBTQ youth. Most on-going work to improve family environments for LGBTQ youth appears to be currently conducted by city governments and non-governmental organizations. Very few interventions or programs provide any outcome data. Theoretical frameworks and approaches vary widely.
Given the widely recognized importance of a supportive family environment for a healthy transition to adulthood for LGBTQ youth, there is an urgent need for scientific research on policies and interventions to address stigma and discrimination and create supportive environments within families. Tackling family-based stigma and discrimination will require interventions and policies at each level of the ecological framework, including individual- and interpersonal-level interventions as well as community-level programs and structural-level policymaking.
Health examination surveys (HESs), carried out in Europe since the 1950's, provide valuable information about the general population's health for health monitoring, policy making, and research. ...Survey participation rates, important for representativeness, have been falling. International comparisons are hampered by differing exclusion criteria and definitions for non-response.
Information was collected about seven national HESs in Europe conducted in 2007-2012. These surveys can be classified into household and individual-based surveys, depending on the sampling frames used. Participation rates of randomly selected adult samples were calculated for four survey modules using standardised definitions and compared by sex, age-group, geographical areas within countries, and over time, where possible.
All surveys covered residents not just citizens; three countries excluded those in institutions. In two surveys, physical examinations and blood sample collection were conducted at the participants' home; the others occurred at examination clinics. Recruitment processes varied considerably between surveys. Monetary incentives were used in four surveys. Initial participation rates aged 35-64 were 45% in the Netherlands (phase II), 54% in Germany (new and previous participants combined), 55% in Italy, and 65% in Finland. In Ireland, England and Scotland, household participation rates were 66%, 66% and 63% respectively. Participation rates were generally higher in women and increased with age. Almost all participants attending an examination centre agreed to all modules but surveys conducted in the participants' home had falling responses to each stage. Participation rates in most primate cities were substantially lower than the national average. Age-standardized response rates to blood pressure measurement among those aged 35-64 in Finland, Germany and England fell by 0.7-1.5 percentage points p.a. between 1998-2002 and 2010-2012. Longer trends in some countries show a more marked fall.
The coverage of the general population in these seven national HESs was good, based on the sampling frames used and the sample sizes. Pre-notification and reminders were used effectively in those with highest participation rates. Participation rates varied by age, sex, geographical area, and survey design. They have fallen in most countries; the Netherlands data shows that they can be maintained at higher levels but at much higher cost.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Cellular restriction factors, which render cells intrinsically resistant to viruses, potentially impose genetic barriers to cross-species transmission and emergence of viral pathogens in nature. One ...such factor is APOBEC3G. To overcome APOBEC3G-mediated restriction, many lentiviruses encode Vif, a protein that targets APOBEC3G for degradation. As with many restriction factor genes, primate APOBEC3G displays strong signatures of positive selection. This is interpreted as evidence that the primate APOBEC3G locus reflects a long-term evolutionary "arms-race" between retroviruses and their primate hosts. Here, we provide direct evidence that APOBEC3G has functioned as a barrier to cross-species transmission, selecting for viral resistance during emergence of the AIDS-causing pathogen SIVmac in captive colonies of Asian macaques in the 1970s. Specifically, we found that rhesus macaques have multiple, functionally distinct APOBEC3G alleles, and that emergence of SIVmac and simian AIDS required adaptation of the virus to evade APOBEC3G-mediated restriction. Our evidence includes the first comparative analysis of APOBEC3G polymorphism and function in both a reservoir and recipient host species (sooty mangabeys and rhesus macaques, respectively), and identification of adaptations unique to Vif proteins of the SIVmac lineage that specifically antagonize rhesus APOBEC3G alleles. By demonstrating that interspecies variation in a known restriction factor selected for viral counter-adaptations in the context of a documented case of cross-species transmission, our results lend strong support to the evolutionary "arms-race" hypothesis. Importantly, our study confirms that APOBEC3G divergence can be a critical determinant of interspecies transmission and emergence of primate lentiviruses, including viruses with the potential to infect and spread in human populations.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Black men who have sex with men (BMSM) experience among the highest rates of HIV infection in the United States. We conducted a community-based ethnography in New York City to identify the structural ...and environmental factors that influence BMSMs vulnerability to HIV and their engagement with HIV prevention services. Methods included participant observation at community-based organizations (CBOs) in New York City, in-depth interviews with 31 BMSM, and 17 key informant interviews. Our conceptual framework shows how creating and sustaining safe spaces could be a critical environmental approach to reduce vulnerability to HIV among BMSM. Participant observation, in-depth and key informant interviews revealed that fear and mistrust characterized men's relation to social and public institutions, such as churches, schools, and the police. This fear and mistrust created HIV vulnerability among the BMSM in our sample by challenging engagement with services. Our findings suggest that to be successful, HIV prevention efforts must address these structural and environmental vulnerabilities. Among the CBOs that we studied, "safe spaces" emerged as an important tool for addressing these environmental vulnerabilities. CBOs used safe spaces to provide social support, to address stigma, to prepare men for the workforce, and to foster a sense of community among BMSM. In addition, safe spaces were used for HIV and STI testing and treatment campaigns. Our ethnographic findings suggest that safe spaces represent a promising but so far under-utilized part of HIV prevention infrastructure. Safe spaces seem integral to high impact comprehensive HIV prevention efforts, and may be considered more appropriately as part of HIV capacity-building rather than being nested within program-specific funding structures.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background
Adults with impaired performance status (PS) often receive immune checkpoint inhibitors (ICIs) for advanced non–small cell lung cancer (NSCLC) despite limited efficacy data and unknown ...effects on end‐of‐life care.
Methods
This was a retrospective, single‐site study of 237 patients with advanced NSCLC who initiated ICI treatment from 2015 to 2017. Cox regression was used to compare the overall survival (OS) of patients who had impaired PS (≥2) at the start of ICI treatment with those who had PS 0 or 1 using Cox regression. Logistic regression was conducted to analyze the association between ICI use in the last 30 days of life and the use of end‐of‐life health care.
Results
The patient mean age at ICI initiation was 67 years (range, 37‐91 years), and 35.4% of patients had PS ≥2. Most patients (80.8%) received ICI as second‐line or later therapy. The median OS was 4.5 months in patients with PS ≥2 and 14.3 months in those with PS 0 or 1 (hazard ratio, 2.5; P < .0001). Among the patients who died (n = 184), 28.8% who had PS ≥2 received ICIs in their last 30 days of life compared with 10.8% of those who had PS 0 or 1 (P = .002). Receipt of ICI in the last 30 days of life was associated with decreased hospice referral (odds ratio, 0.29; P = .008) and increased in‐hospital deaths (odds ratio, 6.8; P = .001), independent of PS.
Conclusions
Adults with advanced NSCLC and impaired PS experience significantly shorter survival after ICI treatment and receive ICIs near death more often than those with better PS. Receipt of an ICI near death was associated with lower hospice use and an increased risk of death in the hospital. These results underscore the need for high‐quality communication about potential tradeoffs of ICIs, particularly among adults receiving ICIs as second‐line or later therapy.
In this retrospective cohort study, survival after immune checkpoint inhibitor (ICI) treatment in patients with advanced lung cancer who have impaired performance status (PS) is markedly worse than survival in patients who have better PS. Patients with impaired PS are more likely to receive ICIs close to death, which is associated with decreased hospice referral and an increased risk of death in the hospital, highlighting the need for high‐quality communication about the benefits and potential tradeoffs of ICI treatment.
Maternal depression negatively predicts aspects of the mother-child relationship and social functioning in offspring. This study evaluated interrelations between mothers' depression history and ...current severity with dynamic indices of positive affect socialization and indices of offspring' social outcomes.
N = 66 mother-child dyads in which approximately 50 % of mothers had a history of maternal depression were recruited. Children were 6–8 years old and 47.7 % male. Dyads completed a positive interaction task, which was coded for mother and child positive affect. Mothers and children reported on peer functioning and social problems and children reported on the quality of their best friendships at 1-year follow-up.
Current level of maternal depression, but not depression history, was related to more social problems and lower best friend relationship quality. Indices of positive affect socialization were not related to history or current levels of maternal depression, or social outcomes, with the exception of maternal depression history predicting greater likelihood of mothers joining their children in expressing positive affect. Exploratory, supplementary analysis revealed that this may be due to treatment history among these mothers.
Conclusions should be tempered by the small sample size, which limited the types of analyses that were conducted.
Results suggest that the effect of maternal depression on aspects of child social outcomes could be specific to current levels. Our data also did not support previously found associations between maternal depression and positive affect socialization. Results suggest positive implications for the effect of treatment for maternal depression for mother-child dynamics.
•State space grids were used to quantify positive affect socialization.•Current but not history of maternal depression predicted offspring social outcomes.•Mothers with depression history were more likely to show contingent positive affect.•Treatment engagement may explain positive affect socialization among dyads.
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