Understanding Sibling Relationships in the Context of Gender Diversity

Siblings are often an important source of support and companionship and play a key role in influencing individuals’ social and emotional wellbeing. Changes to various aspects of sibling relationships have previously been studied, however, the impact of gender diversity upon this relationship has received limited attention. This study aimed to explore the lived experiences of sibling relationships when one individual identifies as transgender. Individual interviews were conducted with nine trans individuals and two siblings of trans persons using a semi-structured interview format. Thematic analysis (TA) was used to examine the impact of gender diversity on the sibling relationship. Specifically, the impact of siblings on transgender individuals’ psychological wellbeing was explored, as well as the impact of gender diversity on the sibling relationship more generally. Findings are considered in light of the Gender Minority Stress Model (GMSM; Hendrick & Testa, 2012). The analysis suggests that the experience of gender diversity and self-disclosure enhances the sibling relationship through increased shared understanding and acceptance. Findings also highlight how trans individuals often come out to their siblings first, in order to gauge their responses before coming out to their parents. Implications for clinical practice are discussed. Namely, clinical psychologists can play a pivotal role in understanding the experiences of the transgender community and in enhancing feelings of social connectedness and acceptance through systemic therapeutic approaches. Further research exploring the sibling relationship in later life and for Black, Asian and minority ethnic (BAME) trans individuals is recommended

Communication satisfaction, job satisfaction, organisational commitment and intention to leave

The retention of highly motivated, skilled and committed employees is a major concern by organisations to achieve a competitive advantage. The turnover intentions of human capital are of interest to managers, employees, and organisations today. This study explores a theoretical model of turnover intentions that included three proximal variables, job satisfaction, affective and continuance commitment, the distal variables of subordinate communication, horizontal communication, personal feedback, media quality, communication climate, supervisor communication, job-related communication, and management communication, with turnover intentions. A questionnaire was completed by 101 participants of a rental firm in New Zealand. Job satisfaction, affective commitment, continuance commitment, subordinate communication, horizontal communication, personal feedback, media quality, communication climate, supervisor communication, job-related communication, and management communication correlated with turnover intentions. The results of the mediated regression analysis indicated that job satisfaction, affective commitment, and continuance commitment are significant mediators between the eight distal (organisational communication) variables, with turnover intentions. This study highlights the necessity for managers to develop good quality relationships with their employees to improve the quality of their communication, to foster job satisfaction, affective commitment, and continuance commitment to reduce turnover intentions. The conclusion of this study discusses the practical implications for managers, and organisations and the direction for future research

Screening of healthcare workers for tuberculosis: development and validation of a new health economic model to inform practice

Methods for determining cost-effectiveness of different treatments are well established, unlike appraisal of non-drug interventions, including novel diagnostics and biomarkers

Differences in risk behaviours and HIV status between primary amphetamines and opioid injectors in Estonia and Russia

Background and objective People who inject drugs (PWID) account for over half of new HIV infections in Eastern Europe and central Asia, where opioids continue to be the dominant illicit drugs injected. Stimulants including amphetamines (ATS) have been associated with HIV infection risk in several settings. We sought to examine whether primary ATS injection was associated with greater HIV risk, compared to opioid injection in two European locales with significant HIV epidemics. Methods PWID in Kohtla-Järve and St. Petersburg were recruited using respondent-driven sampling in 2012–2013. Survey data on demographic characteristics, service use, injecting and sexual risk behaviours and HIV-status (and HCV in Kohtla-Järve) were compared between primary opioid and ATS injectors using logistic regression models. Results Of 591 injectors recruited in Kohtla-Järve and 811 in St. Petersburg, 195 (33%) and 27 (4%) primarily injected ATS in each city. In both cities, ATS injectors were younger than opioid injectors, initiated injection later, injected less frequently and were more likely to have been paid for sex. In both cities, PWID had high levels of multiple sex partners. In Kohtla-Järve, ATS-injectors had lower odds of back-loading and greater odds of polydrug use than opioid-injectors. In St. Petersburg, where over half of PWID reported unsafe sharing practices, ATS-injectors were less likely to report these practices. ATS-injection was negatively associated with being HIV positive in Kohtla-Järve (aOR = 0.6; 95%CI: 0.5–0.8) and St. Petersburg (aOR = 0.3; 95%CI: 0.1–0.7). ATS-injection was negatively associated with HCV-reactivity in Kohtla-Järve (aOR = 0.5; 95%CI: 0.3–0.6). Conclusions In both locations, primary ATS injection was associated with lower injecting risk behaviours, lower odds of HIV and being paid for sex compared to opioid injection. Interventions targeting the characteristics and needs of ATS injectors are needed to increase contact with services and reduce sexual and injecting risk. Harm reduction services, including sexual risk reduction, need to be expanded for all PWID in St. Petersburg

Impaired natural killer cell phenotype and function in idiopathic and heritable pulmonary arterial hypertension

BACKGROUND: Beyond their role as innate immune effectors, natural killer (NK) cells are emerging as important regulators of angiogenesis and vascular remodeling. Pulmonary arterial hypertension (PAH) is characterized by severe pulmonary vascular remodeling and has long been associated with immune dysfunction. Despite this association, a role for NK cells in disease pathology has not yet been described. METHODS AND RESULTS: Analysis of whole blood lymphocytes and isolated NK cells from PAH patients revealed an expansion of the functionally defective CD56(-)/CD16(+) NK subset that was not observed in patients with chronic thromboembolic pulmonary hypertension. NK cells from PAH patients also displayed decreased levels of the activating receptor NKp46 and the killer immunoglobulin-like receptors 2DL1/S1 and 3DL1, reduced secretion of the cytokine macrophage inflammatory protein-1β, and a significant impairment in cytolytic function associated with decreased killer immunoglobulin-like receptor 3DL1 expression. Genotyping patients (n=222) and controls (n=191) for killer immunoglobulin-like receptor gene polymorphisms did not explain these observations. Rather, we show that NK cells from PAH patients exhibit increased responsiveness to transforming growth factor-β, which specifically downregulates disease-associated killer immunoglobulin-like receptors. NK cell number and cytotoxicity were similarly decreased in the monocrotaline rat and chronic hypoxia mouse models of PAH, accompanied by reduced production of interferon-γ in NK cells from hypoxic mice. NK cells from PAH patients also produced elevated quantities of matrix metalloproteinase 9, consistent with a capacity to influence vascular remodeling. CONCLUSIONS: Our work is the first to identify an impairment of NK cells in PAH and suggests a novel and substantive role for innate immunity in the pathobiology of this disease

Loss of Effector and Anti-Inflammatory Natural Killer T Lymphocyte Function in Pathogenic Simian Immunodeficiency Virus Infection

Chronic immune activation is a key determinant of AIDS progression in HIV-infected humans and simian immunodeficiency virus (SIV)-infected macaques but is singularly absent in SIV-infected natural hosts. To investigate whether natural killer T (NKT) lymphocytes contribute to the differential modulation of immune activation in AIDS-susceptible and AIDS-resistant hosts, we compared NKT function in macaques and sooty mangabeys in the absence and presence of SIV infection. Cynomolgus macaques had significantly higher frequencies of circulating invariant NKT lymphocytes compared to both rhesus macaques and AIDS-resistant sooty mangabeys. Despite this difference, mangabey NKT lymphocytes were functionally distinct from both macaque species in their ability to secrete significantly more IFN-γ, IL-13, and IL-17 in response to CD1d/α-galactosylceramide stimulation. While NKT number and function remained intact in SIV-infected mangabeys, there was a profound reduction in NKT activation-induced, but not mitogen-induced, secretion of IFN-γ, IL-2, IL-10, and TGF-β in SIV-infected macaques. SIV-infected macaques also showed a selective decline in CD4+ NKT lymphocytes which correlated significantly with an increase in circulating activated memory CD4+ T lymphocytes. Macaques with lower pre-infection NKT frequencies showed a significantly greater CD4+ T lymphocyte decline post SIV infection. The disparate effect of SIV infection on NKT function in mangabeys and macaques could be a manifestation of their differential susceptibility to AIDS. Alternately, these data also raise the possibility that loss of anti-inflammatory NKT function promotes chronic immune activation in pathogenic SIV infection, while intact NKT function helps to protect natural hosts from developing immunodeficiency and aberrant immune activation