Relationship Between Race, Gender, and Elder Abuse Awareness

Lack of elder abuse awareness and underreporting is an increasing problem in the United States in that only 1 in 14 cases of elder abuse is reported. The failure to report incidents of elder abuse and suspected elder abuse allows further abuse of elders and for elder abusers to go unpunished. The purpose of this quantitative nonexperimental study was to understand the relationship between race, gender, and elder abuse awareness and fill the gap in elder abuse literature. Research questions tested mean differences between race and gender, respectively, and elder abuse awareness. The theoretical frameworks for this study were the social cognitive theory, self-perception theory, and Dunning Kruger Effect. The study included a convenience sample of 75 federal corrections retirees with diverse educational and professional backgrounds living in the United States. Data were collected using an online survey that ascertained the respondents\u27 attitudes toward elder abuse and knowledge of elder abuse laws. Independent samples t tests were performed to test the mean differences of elder abuse awareness between different races and genders. Results of the study revealed African Americans have a statistically significant higher mean than Caucasians. However, there was not a statistically significant mean difference between males and females, respectively, and elder abuse awareness. The implications for social change include aiding public and private sector elder abuse prevention advocates adopt programs and policies that will increase elder abuse awareness campaigns, increase elder abuse reporting behavior of different races and genders, and prevent deaths resulting from a lack of elder abuse awareness

HIV Risk and Associations of HIV Infection among men who have sex with men in Peri-Urban Cape Town, South Africa

<p>Abstract</p> <p>Background</p> <p>The HIV epidemic in Sub Saharan Africa has been traditionally assumed to be driven by high risk heterosexual and vertical transmission. However, there is an increasing body of data highlighting the disproportionate burden of HIV infection among MSM in the generalized HIV epidemics across of Southern Africa. In South Africa specifically, there has been an increase in attention focused on the risk status and preventive needs of MSM both in urban centers and peri-urban townships. The study presented here represents the first evaluation of HIV prevalence and associations of HIV infection among MSM in the peri-urban townships of Cape Town.</p> <p>Methods</p> <p>The study consisted of an anonymous probe of 200 men, reporting ever having had sex with another man, recruited through venue-base sampling from January to February, 2009.</p> <p>Results</p> <p>Overall, HIV prevalence was 25.5% (n = 51/200). Of these prevalent HIV infections, only 6% of HIV-1 infected MSM were aware of their HIV status (3/50). 0% of men reported always having safe sex as defined by always wearing condoms during sex and using water-based lubricants. Independent associations with HIV infection included inconsistent condom use with male partners (aOR 2.3, 95% CI 1.0-5.4), having been blackmailed (aOR 4.4, 95% CI 1.6-20.2), age over 26 years (aOR 4.2, 95% CI 1.6-10.6), being unemployed (aOR 3.7, 95% CI 1.5-9.3), and rural origin (aOR 6.0, 95% CI 2.2-16.7). Bisexual activity was reported by 17.1% (34/199), and a total of 8% (16/200) reported having a regular female partner. Human rights violations were common with 10.5% (n = 21/200) reporting having been blackmailed and 21.0% (n = 42/200) reporting being afraid to seek health care.</p> <p>Conclusions</p> <p>The conclusions from this study include that a there is a high risk and underserved population of MSM in the townships surrounding Cape Town. The high HIV prevalence and high risk sexual practices suggest that prevalence will continue to increase among these men in the context of an otherwise slowing epidemic. These data further highlight the need to better characterize risk factors for HIV prevention and appropriate targeted combination packages of HIV interventions including biomedical, behavioural, and structural approaches to mitigate HIV risk among these men.</p

Cancer stem cells display extremely large evolvability alternating plastic and rigid networks as a potential mechanism Network models, novel therapeutic target strategies, and the contributions of hypoxia, inflammation and cellular senescence

Cancer is increasingly perceived as a systems-level, network phenomenon. The major trend of malignant transformation can be described as a two-phase process, where an initial increase of network plasticity is followed by a decrease of plasticity at late stages of tumor development. The fluctuating intensity of stress factors, like hypoxia, inflammation and the either cooperative or hostile interactions of tumor inter-cellular networks, all increase the adaptation potential of cancer cells. This may lead to the bypass of cellular senescence, and to the development of cancer stem cells. We propose that the central tenet of cancer stem cell definition lies exactly in the indefinability of cancer stem cells. Actual properties of cancer stem cells depend on the individual "stress-history" of the given tumor. Cancer stem cells are characterized by an extremely large evolvability (i.e. a capacity to generate heritable phenotypic variation), which corresponds well with the defining hallmarks of cancer stem cells: the possession of the capacity to self-renew and to repeatedly re-build the heterogeneous lineages of cancer cells that comprise a tumor in new environments. Cancer stem cells represent a cell population, which is adapted to adapt. We argue that the high evolvability of cancer stem cells is helped by their repeated transitions between plastic (proliferative, symmetrically dividing) and rigid (quiescent, asymmetrically dividing, often more invasive) phenotypes having plastic and rigid networks. Thus, cancer stem cells reverse and replay cancer development multiple times. We describe network models potentially explaining cancer stem cell-like behavior. Finally, we propose novel strategies including combination therapies and multi-target drugs to overcome the Nietzschean dilemma of cancer stem cell targeting: "what does not kill me makes me stronger"

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Motivation for Substance Use, Venue of Sexual Encounter, and Sexual Risk Behavior among Men who Have Sex with Men (MSM) in the Multicenter AIDS Cohort Study (MACS): Factor Analysis, and Global vs. Event-Level Generalized Linear Mixed Model (GLMM) Assessment Approach

We use factor analysis to explore motivations for substance use before and/or during sexual activity in order to identify underlying structure in response types. The sample included 1º, 2º, and 3º motivation responses of 1,012 seropositive and 1,084 seronegative participants enrolled in the Multicenter AIDS Cohort Study (MACS) seen between 2006 and 2010. We found a single common factor for all alcohol and substance use combinations that combines the social and sexual domains. We also identified a second factor with four distinct loading patterns conditional on the alcohol or substance combination used. While there are strong sexual components for each, the underlying structure is complex, and also includes aspects of the social and personal domains. These underlying motivational structures are important in understanding why men engage in substance use in the context of sex, and may help identify men who participate in high-risk sexual behavior.We simultaneously modeled between-subject and within-subject variability using Generalized Mixed Linear Models (GLMMs) to explore the role of key "person variables" (HIV serostatus, sexual sensation seeking, and partner type) specific to the venue of sexual encounter in the association between substance use and sexual risk in the Multicenter AIDS Cohort Study (MACS). GLMMs were fit for each of three venues (Internet, bars, and bathhouses) using data from 1,012 seropositive and 1,084 seronegative participants seen between 2006 and 2010. We were able to show that venue-specific measurements of HIV serostatus, partner type, and sexual sensation seeking (SSS) are important in understanding the relationship between substance use and sexual risk, and may help explain the absence of consistent main effects seen in correlational or experimental studies. These person variables may aid the development of multivariate theoretical models that better fit substance use and sexual risk behavior associational data.We utilize the multiple measurement approaches available in the Multicenter AIDS Cohort Study (MACS) to build Generalized Linear Mixed Models (GLMMs) describing the association of substance use and sexual risk measured at the global level, and compare results to our previously published work using a venue-specific assessment approach. GLMMs were used to simultaneously model between-subject and within-subject variability in sexual risk behaviors (HIV serostatus, sexual sensation seeking, partner type, and venue of sexual encounter) among 1,012 seropositive and 1,084 seronegative participants seen between 2006 and 2010. All alcohol and drug use combinations were associated with having a higher numbers of unprotected anal intercourse (UAI) partners since last visit, regardless of venue of sexual encounter, when measured at the global level. These results reflect those from a venue-specific analyses of substance use and sexual risk conducted in the same cohort. While the global assessment approach used here does not permits causal interpretation of findings, we argue that establishing causality may not be a necessary condition for identifying the underlying person variables that confound the association between substance use and sexual risk, nor the utility of these variables in designing and implementing more tailored interventions

Treatment patterns and healthcare resource utilization among patients with hereditary angioedema in the United States

Abstract Background Real-world data on usage and associated outcomes with hereditary angioedema (HAE)-specific medications introduced to the United States (US) market since 2009 are very limited. The purpose of this retrospective study was to evaluate real-world treatment patterns of HAE-specific medications in the US and to assess their impact on healthcare resource utilization (HCRU). This analysis used IMS PharMetrics PlusTM database records (2006–2014) of patients with HAE, ≥1 insurance claim for an HAE-specific medication, and continuous insurance enrollment for ≥3 months following the first HAE prescription claim. Results Of 631 total patients, 434 (68.8%) reported C1-INH(IV) use; 396 (62.8%) reported using ecallantide and/or icatibant. There were 306 episodes of prophylactic use of C1-INH(IV) (defined by continuous refills averaging ≥1500 IU/week for ≥13 weeks) in 155 patients; use of ≥1 on-demand rescue medication was implicated during 53% (163/306) of those episodes. Sixty-eight (20.2%) of 336 C1-INH(IV) users eligible for the HCRU analysis were hospitalized at least once, and 191 (56.8%) visited the emergency department (ED). Eighteen patients (5.4%) had a central venous access device (CVAD); of these, 5 (27.7%) required hospitalization and 14 (77.7%) had an ED visit. The adjusted relative risk of hospitalization and/or ED visits for patients with a CVAD was 2.6 (95% CI: 0.17, 39.23) compared to C1-INH(IV) users without a CVAD. Conclusions Despite widespread availability of modern HAE medications in the US, we identified a subset of patients requiring long-term prophylaxis who continue to be burdened by frequent rescue medication usage and/or complications related to the use of CVADs for intravenous HAE medication