The Urgent Need for Research and Interventions to Address Family-Based Stigma and Discrimination Against Lesbian, Gay, Bisexual, Transgender, and Queer Youth

PURPOSE: This scoping study sought to provide an overview of existing interventions, programs and policies that address family-based stigma and discrimination against LGBTQ youth. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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

Proactivity Toward Workplace Safety Improvement: An Investigation of Its Motivational Drivers and Organizational Outcomes

Initiating a safety oriented change - or safety initiative - is conceptually distinct from other forms of safety participation and safety citizenship behaviour, yet little attention has been given to its performance outcomes or its motivational antecedents. An initial study with a sample composed of middle managers (N = 86) showed that safety initiative predicted objective improvement actions six months later, whereas, showing differential validity, safety compliance predicted the implementation of monitoring actions. Two subsequent studies focused on motivational antecedents. First, using a sample of team leaders (N = 295), we tested a higher-order structure of proactive motivation that incorporates three domains: “can do”, “reason to” and future orientation. Second, in a longitudinal study of chemical work operators (N = 188), after checking for the influence of potential confounds (past behaviours; accidents experience; perceived risk), we showed that safety initiative was predicted only by proactive motivation. Instead, safety compliance was found to be associated with affective commitment and scrupulousness, whereas safety helping was found to be associated with affective commitment. Self-reported behaviours were validated against rater assessments. This study supports the importance of distinguishing safety initiative from other safety behaviours, indicating how to create an organizational context supporting a proactive management of workplace safety

Social risk, stigma and space: key concepts for understanding HIV vulnerability among black men who have sex with men in New York City

Black men who have sex with men in the USA face disproportionate incidence rates of HIV. This paper presents findings from an ethnographic study conducted in New York City that explored the structural and socio-cultural factors shaping men’s sexual relationships with the goal of furthering understandings of their HIV-related vulnerability. Methods included participant observation and in-depth interviews with 31 Black men who have sex with men (three times each) and 17 key informants. We found that HIV vulnerability is perceived as produced through structural inequalities including economic insecurity, housing instability, and stigma and discrimination. The theoretical concepts of social risk, intersectional stigma, and the social production of space are offered as lenses through which to analyse how structural inequalities shape HIV vulnerability. We found that social risk shaped HIV vulnerability by influencing men’s decisions in four domains: 1) where to find sexual partners, 2) where to engage in sexual relationships, 3) what kinds of relationships to seek, and 4) whether to carry and to use condoms. Advancing conceptualisations of social risk, we show that intersectional stigma and the social production of space are key processes through which social risk generates HIV vulnerability among Black men who have sex with men

Gendered Social Institutions and Preventive Healthcare Seeking for Black Men Who Have Sex with Men: The Promise of Biomedical HIV Prevention

Research on gender and health, including research conducted among Black men who have sex with men (BMSM), has primarily focused on how gender norms and roles shape healthcare engagement. Here we advance that work by demonstrating how a broader theorization of gender, particularly one that moves beyond gender norms and performance to incorporate structures such as the healthcare system and the labor market, can facilitate an understanding of how gender affects preventive healthcare seeking among BMSM, particularly the uptake of pre-exposure prophylaxis (PrEP), a promising approach to alleviate HIV disparities. This article is based on a year-long ethnographic study conducted in New York City with BMSM (n = 31; three interviews each) and community stakeholders (n = 17). Two primary findings emerged: (1) the labor market systematically excluded the men in our sample, which limited their ability to access employer-sponsored healthcare. Such discrimination may promote overt demonstrations of masculinity that increase their HIV vulnerability and decrease healthcare seeking, and (2) healthcare systems are not structured to promote preventive healthcare for men, particularly BMSM. In fact, they constrained men’s access to primary providers and were usually tailored to women. Applying a structural, gendered lens to men’s health—in addition to the more frequently researched individual or interpersonal levels—provides insight into factors that affect healthcare seeking and HIV prevention for BMSM. These findings have implications for the design of policies and institutional reforms that could enhance the impact of PrEP among BMSM. Findings are also relevant to the management of chronic disease among men more broadly

Public Libraries: A Community-Level Resource to Advance Population Health

Policy makers and public health practitioners rarely consider public libraries to be part of the health system, even though they possess several characteristics that suggest unrealized potential to advance population health. This scoping review uses an adapted social determinants framework to categorize current health-related work conducted by public libraries in the United States and to discuss libraries’ potential as ‘meso-level’ community resources to improve population health. Our discussion of libraries contributes to scholarship on place-based health disparities, by emphasizing the potential impact of institutions that are modifiable through social policy—e.g., parks, community centers, schools—and which have a conceptually clear or empirically documented relationship to health

A physiologically-motivated compartment-based model of the effect of inhaled hypertonic saline on mucociliary clearance and liquid transport in cystic fibrosis

Background: Cystic Fibrosis (CF) lung disease is characterized by liquid hyperabsorption, airway surface dehydration, and impaired mucociliary clearance (MCC). Herein, we present a compartment-based mathematical model of the airway that extends the resolution of functional imaging data. Methods: Using functional imaging data to inform our model, we developed a system of mechanism-motivated ordinary differential equations to describe the mucociliary clearance and absorption of aerosolized radiolabeled particle and small molecules probes from human subjects with and without CF. We also utilized a novel imaging metric in vitro to gauge the fraction of airway epithelial cells that have functional ciliary activity. Results: This model, and its incorporated kinetic rate parameters, captures the MCC and liquid dynamics of the hyperabsorptive state in CF airways and the mitigation of that state by hypertonic saline treatment. Conclusions: We postulate, based on the model structure and its ability to capture clinical patient data, that patients with CF have regions of airway with diminished MCC function that can be recruited with hypertonic saline treatment. In so doing, this model structure not only makes a case for durable osmotic agents used in lung-region specific treatments, but also may provide a possible clinical endpoint, the fraction of functional ciliated airway

Molecular analysis of representative Streptococcus gordonii Spp phase variants reveals no differences in the glucosyltransferase structural gene, gtfG

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73398/1/j.1399-302X.1997.tb00622.x.pd

Impact of inactivated poliovirus vaccine on mucosal immunity: implications for the polio eradication endgame.

The polio eradication endgame aims to bring transmission of all polioviruses to a halt. To achieve this aim, it is essential to block viral replication in individuals via induction of a robust mucosal immune response. Although it has long been recognized that inactivated poliovirus vaccine (IPV) is incapable of inducing a strong mucosal response on its own, it has recently become clear that IPV may boost immunity in the intestinal mucosa among individuals previously immunized with oral poliovirus vaccine. Indeed, mucosal protection appears to be stronger following a booster dose of IPV than oral poliovirus vaccine, especially in older children. Here, we review the available evidence regarding the impact of IPV on mucosal immunity, and consider the implications of this evidence for the polio eradication endgame. We conclude that the implementation of IPV in both routine and supplementary immunization activities has the potential to play a key role in halting poliovirus transmission, and thereby hasten the eradication of polio

A two-year participatory intervention project with owners to reduce lameness and limb abnormalities in working horses in Jaipur, India

Participatory methods are increasingly used in international human development, but scientific evaluation of their efficacy versus a control group is rare. Working horses support families in impoverished communities. Lameness and limb abnormalities are highly prevalent in these animals and a cause for welfare concern. We aimed to stimulate and evaluate improvements in lameness and limb abnormalities in horses whose owners took part in a 2-year participatory intervention project to reduce lameness (PI) versus a control group (C) in Jaipur, India.In total, 439 owners of 862 horses participated in the study. PI group owners from 21 communities were encouraged to meet regularly to discuss management and work practices influencing lameness and poor welfare and to track their own progress in improving these. Lameness examinations (41 parameters) were conducted at the start of the study (Baseline), and after 1 year and 2 years. Results were compared with control horses from a further 21 communities outside the intervention. Of the 149 horses assessed on all three occasions, PI horses showed significantly (P<0.05) greater improvement than C horses in 20 parameters, most notably overall lameness score, measures of sole pain and range of movement on limb flexion. Control horses showed slight but significantly greater improvements in four parameters, including frog quality in fore and hindlimbs.This participatory intervention succeeded in improving lameness and some limb abnormalities in working horses, by encouraging changes in management and work practices which were feasible within owners’ socioeconomic and environmental constraints. Demonstration of the potentially sustainable improvements achieved here should encourage further development of participatory intervention approaches to benefit humans and animals in other contexts