Sexual assault: Exploring real-time consequences the next day and in subsequent days

Approximately 15-20% of adult women in the United States have been sexually assaulted. Given the high prevalence of sexual assault, it becomes increasingly important to understand immediate responses to sexual assault. A lack of information prior to sexual assaults contributes to a literature that is unable to showcase the presence and amount of change. A tendency to rely on comparisons between people, instead of the collection of multiple moments of a single person over time, will continue to point toward imprecise, statistical “average” reactions to sexual assaults. Prior methodological approaches lead to broad overgeneralizations about sexual assault survivors that may undermine their unique experiences in the aftermath of an assault. The present study extends the existing literature with access to unprecedented data gathered on the days before and immediately after someone survived a sexual assault. To our knowledge, there are no studies capturing prior functioning and near immediate psychological reactions of sexual assault survivors. In the present study, each night over the course of three weeks, we asked college students (n = 186) to report on their sexual activity and well-being. Six women and one man reported being sexually assaulted at least once. We examined psychological experiences on the days before and after sexual assaults (including negative and positive affect, social anxiety, self-esteem, emotion expressive suppression, and cognitive reappraisal). To examine sexual assault reactions, we used various descriptive approaches. Our results suggest that before and after being assaulted, survivors showed no consistent response in subjective well-being. We failed to find a prototypical psychological profile. Despite the small sample, our results raise important questions and offer future hypotheses about individual differences in responses to sexual assault

Increasing access to integrated ESKD care as part of Universal Health Coverage

The global nephrology community recognizes the need for a cohesive strategy to address the growing problem of end-stage kidney disease (ESKD). In March 2018, the International Society of Nephrology hosted a summit on integrated ESKD care, including 92 individuals from around the globe with diverse expertise and professional backgrounds. The attendees were from 41 countries, including 16 participants from 11 low- and lower-middle–income countries. The purpose was to develop a strategic plan to improve worldwide access to integrated ESKD care, by identifying and prioritizing key activities across 8 themes: (i) estimates of ESKD burden and treatment coverage, (ii) advocacy, (iii) education and training/workforce, (iv) financing/funding models, (v) ethics, (vi) dialysis, (vii) transplantation, and (viii) conservative care. Action plans with prioritized lists of goals, activities, and key deliverables, and an overarching performance framework were developed for each theme. Examples of these key deliverables include improved data availability, integration of core registry measures and analysis to inform development of health care policy; a framework for advocacy; improved and continued stakeholder engagement; improved workforce training; equitable, efficient, and cost-effective funding models; greater understanding and greater application of ethical principles in practice and policy; definition and application of standards for safe and sustainable dialysis treatment and a set of measurable quality parameters; and integration of dialysis, transplantation, and comprehensive conservative care as ESKD treatment options within the context of overall health priorities. Intended users of the action plans include clinicians, patients and their families, scientists, industry partners, government decision makers, and advocacy organizations. Implementation of this integrated and comprehensive plan is intended to improve quality and access to care and thereby reduce serious health-related suffering of adults and children affected by ESKD worldwide

Sexual Assault: Exploring Real-Time Consequences the Next Day and in Subsequent Days

Approximately 15-20% of adult women in the United States have been sexually assaulted. To our knowledge, there are no studies capturing prior functioning and near immediate psychological reactions of sexual assault survivors. In the present study, each night over the course of three weeks, we asked college students to report on their sexual activity and well-being. Six women reported being sexually assaulted at least once. We examined psychological experiences on the days before and after sexual assaults (including negative and positive affect, social anxiety, self-esteem, emotion expressive suppression, and cognitive reappraisal). To examine sexual assault reactions, we used various modeling techniques. Our results suggest that before and after being assaulted, survivors showed no consistent response in subjective well-being. We failed to find a prototypical psychological profile. Despite the small sample, our results dispel the myth that sexual assault survivors are homogeneous in generating and regulating emotions

Risk factors for hepatitis C seropositivity among young people who inject drugs in New York City: Implications for prevention

<div><p>Background</p><p>Hepatitis C virus (HCV) infection remains a significant problem in the United States, with people who inject drugs (PWID) disproportionately afflicted. Over the last decade rates of heroin use have more than doubled, with young persons (18–25 years) demonstrating the largest increase.</p><p>Methods</p><p>We conducted a cross-sectional study in New York City from 2005 to 2012 among young people who injected illicit drugs, and were age 18 to 35 or had injected drugs for ≤5 years, to examine potentially modifiable factors associated with HCV among young adults who began injecting during the era of syringe services.</p><p>Results</p><p>Among 714 participants, the median age was 24 years; the median duration of drug injection was 5 years; 31% were women; 75% identified as white; 69% reported being homeless; and 48% [95% CI 44–52] had HCV antibodies. Factors associated with HCV included older age (adjusted odds ratio [AOR], 1.99 [1.52–2.63]; <i>p</i><0.001), longer duration of injection drug use (AOR, 1.68 [1.39–2.02]; <i>p</i><0.001),more frequent injection (AOR, 1.26 [1.09–1.45]; <i>p</i> = 0.001), using a used syringe with more individuals (AOR, 1.26 [1.10–1.46]; <i>p</i> = 0.001), less confidence in remaining uninfected (AOR, 1.32 [1.07–1.63]; <i>p</i><0.001), injecting primarily in public or outdoors spaces (AOR, 1.90 [1.33–2.72]; <i>p</i><0.001), and arrest for carrying syringes (AOR, 3.17 [1.95–5.17]; <i>p</i><0.001).</p><p>Conclusions</p><p>Despite the availability of harm reduction services, the seroprevalence of HCV in young PWID in New York City remained high and constant during 2005–2012. Age and several injection behaviors conferred independent risk. Individuals were somewhat aware of their own risk. Public and outdoor injection and arrest for possession of a syringe are risk factors for HCV that can be modified through structural interventions.</p></div

HCV seroprevalence by recent injection practices, young people who inject drugs, New York City, 2005–2012.

<p>HCV seroprevalence by recent injection practices, young people who inject drugs, New York City, 2005–2012.</p

HCV seroprevalence by demographics characteristics, young people who inject drugs, New York City 2005–2012.

<p>HCV seroprevalence by demographics characteristics, young people who inject drugs, New York City 2005–2012.</p

HCV seroprevalence by duration of injection drug use, New York City, 2005–2012.

<p>Seroprevalence didn’t rise after 6–7 years, suggesting that people who didn’t get infected during their early years of injection were much less likely to do so thereafter.</p

HCV seroprevalence by injection practices and other experiences, young people who inject drugs, New York City, 2005–2012.

<p>HCV seroprevalence by injection practices and other experiences, young people who inject drugs, New York City, 2005–2012.</p

HCV seroprevalence by injection drug use characteristics, young people who inject drugs, New York City 2005–2012.

<p>HCV seroprevalence by injection drug use characteristics, young people who inject drugs, New York City 2005–2012.</p