Motivations to either accept or reject pre-exposure prophylaxis: awareness, beliefs, and risk perceptions among African American women in New York City

The world has suffered immensely and disproportionately from the ravages of HIV and AIDS. Oral PrEP is a single pill taken once daily that can reduce the risk of sexually transmitted HIV infection by up to 92% (CDC, 2014a). This study describes African American females’ awareness, beliefs, and perception of PrEP and identifies factors that may motivate women to either accept or reject PrEP. This cross-sectional study occurred over a 3-month period from November 2017 to January 2018, following from a previous pilot study. The sample comprised African American women aged 18 and over receiving STD or HIV screening services at a FQHC in Brooklyn, New York. Women were interviewed using the five characteristics of the Diffusion of Innovation theory and also completed a risk assessment for HIV using CDC recommended guidelines for screening heterosexual women for PrEP. Awareness of PrEP remained extremely low among the 72 African American women interviewed in the study. Using the CDC guidelines, all women reported one or more risk factors for PrEP indication. Awareness about PrEP, negative reactions from partners and shared experiences from female PrEP users were cited as factors that may predict and motivate African American women to use PrEP. Additionally, skills in pill-taking, cost and insurance, and maintaining privacy while using PrEP were strong enabling factors to support PrEP use. Factors such as initiating couple’s PrEP use as an intervention, medical doctors overtly directing PrEP for women, and the role of older women in promoting PrEP use were persuasive factors in reinforcing the utilization of PrEP among African American women in the study. Creative programming within high burden communities is critically important to penetrate with messages of new innovations and best practices. The results of the current research speak volumes to the continued work needed to educate communities with prevention messages

Can Good Become Better?: The Progression of an Exemplary Teacher

Lakesia\u27s planning for college began in March of her sophomore year in high school. Her first task was to collect information about available scholarships. She knew the perfect person to ask — Mrs. Waddell, her second grade teacher. Of all the teachers she had, Mrs. Waddell had impacted her life most. She had been caring, dedicated, knowledgeable and encouraging. Lakesia sat down to write her best teacher

Chemotherapy disrupts bone marrow stromal cell function

A variety of bone marrow microenvironment derived signals influence steady state hematopoiesis as well as hematopoietic recovery following bone marrow transplantation. Bone marrow stromal cells found in this unique anatomical niche influence hematopoiesis, in pail, through production of soluble cytokines and chemokines. Developmental signals are also initiated by physical interaction of hematopoietic progenitor cells with stromal cells which are mediated by binding of their integrins to receptors on the stromal cell surface. Finally, the extracellular matrix, including many components produced by stromal cells, provides structure as well as a scaffold on which hematopoietic growth factors can be concentrated and stabilized in the marrow. Efficient hematopoietic recovery following transplantation of stem or immature progenitor cells requires sustained function of these components of the bone marrow during dose escalated chemotherapy.;In the current study we investigated the effects of the chemotherapeutic agent etoposide (VP-16) on bone marrow stromal cell function. We have previously demonstrated that stromal cells chronically exposed to VP-16 display diminished extra-cellular levels of SDF-1 resulting in disrupted support of pro-B cell chemotaxis. We have also determined that bone marrow stromal cell MMP-2 protein is diminished following exposure to VP-16. Regulation of MMP-2 is required for release of SDF-1 from stromal cell surfaces and ultimately required for optimal support of chemotaxis. Additionally, VP-16 treatment results in alterations of pathways that regulate protein translation, consistent with diminished translation of MAP-2 protein in treated stromal cells. We also determined that following acute VP-16 exposure, MMP-2 activation was transiently increased. Increased MMP-2 activity resulted in activation of TGF-beta, which resulted in diminished stromal cell support of pro-B cell adhesion and survival. Collectively, these data contribute to our understanding of the global impact of chemotherapy on the bone marrow microenvironment

An Assessment of Environmental Sustainability Guidelines at Community and Junior College Campuses in Mississippi

The purpose of this study was to review the established sustainability guidelines in place at each of the 15 public community and junior colleges in Mississippi and to illuminate the ways in which these community colleges interacted with environmental sustainability during the 2013-2014 academic year. Dimensions studied within the established guidelines included curriculum, research and scholarship, operations, faculty and staff development, outreach and service, student opportunities, and administration, mission, and planning. This research study was qualitative in nature and utilized a multiple case holistic design. Sustainability guideline documents, informant commentary, college policy documents, and college course catalogs were gathered from 6 of the 15 community colleges in Mississippi and used to prepare a descriptive analysis of the results. The results of this studied showed the following: a) only a portion of the reporting community colleges discuss sustainability topics in courses on campus, b) none of the colleges reported having sustainability guidelines related to research and scholarship, c) all colleges reported having sustainability guidelines and efforts in the area of operations, d) a small number of the reporting colleges noted having faculty and staff development concerning sustainability guidelines on campus, e) half of the reporting colleges noted that sustainability guidelines are incorporated into outreach and service, f) a small number of reporting colleges stated that sustainability guidelines and efforts are incorporated into student opportunities, g) half of all reporting colleges noted that sustainability guidelines are utilized in the area of administration, mission, and planning. Recommendations for further research are discussed

CONSOLIDATION IN THE FRESH FLORIDA GRAPEFRUIT PACKING INDUSTRY

First-order, homogeneous, stationary Markov models are used to compare patterns of adjustment among Florida fresh grapefruit packers between the 1970/71-1983/84 and 1987/88-1999/00 periods, and 1970/71-1994/95 and 1995/95-1999/00 periods, respectively. Despite sweeping aggregate trends impacting fresh produce markets, there was insufficient evidence to identify significant differences in the patterns of adjustment in the packing sector during the later time periods. Comparisons with actual firm numbers are indicative of an industry near equilibrium. While individual firms enter and exit the different states, currently there are no profound structural changes pointing to major concentration.Industrial Organization,

Fresh Grapefruit Supply-Chain Adjustments: Consolidation in Produce Packing?

This study evaluates long-term structural adjustments in fresh grapefruit packing under aggregate market pressures, including those from retail concentration. While individual firms enter and exit, Markov-model results are indicative of an industry near equilibrium with little expectation of change in the distribution of firm sizes given existing patterns of sector adjustment. Estimation of Lorenz curves and corresponding Gini coefficients fully support Markov analysis findings. Lags in the packing sector adjustment process in the face of sweeping forces of change in fresh produce markets are likely to put this sector at a relative disadvantage within the supply chain.Crop Production/Industries,

Ambulance Services for Medicare Beneficiaries: State Differences in Usage, 2012-2014

Ambulance services are at risk of scaling back or dissolving in some places. We analyzed Medicare beneficiaries’ use of ambulance services across the U.S. Improved understanding of how beneficiaries, most of whom are elderly, use these services provides vital information for policymakers who set rules and regulations about access to the services

Do Hospital Closures Affect Patient Time in an Ambulance?

When a hospital closes in a community, patients needing emergency care may spend more time in an ambulance to receive care in an emergency department (ED). We explore how hospital closures affect the time a patient travels from an incident location where 9-1-1 was called to the ED in an ambulance. Rural patients average an estimated 11 additional minutes in an ambulance the year after a hospital closure in their zip code, a 76% increase compared to before the closure. Urban and suburban patients have no change in transportation time in zip codes where a hospital closes. Patients over 64 years old in rural areas spend 14 additional minutes in an ambulance after a hospital closes, doubling their time in an ambulance