Resources for Texas Sexual Assault Survivors: Inventory and Survey Findings on Services, Gaps, and Accessibility

Texas is a leader among states on the issue of sexual assault, and has promoted and funded the study of sexual violence as well as created the Sexual Assault Survivors’ Task Force (SASTF) through the Office of the Texas Governor (OOG). Sexual assault is clearly established as a public health problem affecting 6.3 million women and men in the state, or 33.2% of adult Texans over their lifetime.1 This statistic comes from thorough research by the Institute on Domestic Violence & Sexual Assault (IDVSA) at The University of Texas at Austin on the prevalence and impact of sexual assault on Texans, service providers, and the social and economic system at large. The bipartisan passage of HB 1590 (86R) B signifies a continued commitment by Texas lawmakers to serve sexual assault survivors. Lawmakers and Texans alike acknowledge the seriousness of sexual assault crimes. With the research findings derived from this project, survivors and their families, professionals supporting survivors, and lawmakers can better see the landscape of resources, service provision gaps, and unmet needs across our state. The specific project aims were to: • Inventory the sexual assault services available in Texas. • Assess sexual assault survivors’ needs by region for the 11 Texas regions. • Develop a sexual assault services resource inventory. IDVSA accomplished those aims by: • Developing and implementing a statewide survey to a broad and diverse set of providers who serve survivors of sexual violence. • Conducting a collaborative analysis of the survey findings with a specific focus on service availability and service gaps, and presenting those in this report to the OOG. • Developing an HB 1590 Inventory List of the resources available to survivors across the state and delivering it to the OOG to inform the creation of a comprehensive statewide service directory in the futureInstitute on Domestic Violence and Sexual Assault (IDVSA

The Role of Social Determinants of Health in Mental Health: An Examination of the Moderating Effects of Race, Ethnicity and Gender on Depression through the All of Us Research Dataset

We investigate how select identity characteristics moderate the role of several SDoH domains on major depressive disorder (MDD). Our study considers an analytical sample of 86,954 participants from the NIH-funded All of Us (AoU) Research Program in the USA. Our independent variables and moderators come from survey responses and our outcome is an EHR diagnostic code. We include race/ethnicity and gender/sexual identity to moderate the role of food insecurity, discrimination, neighborhood social cohesion, and loneliness in assessing risk for MDD diagnosis. We examine those moderating effects based on connections seen in the literature. Our findings illustrate the complexity of where and how people live their lives can have significant differential impact on MDD. Women (AOR = 1.60, 95% CI = [1.53, 1.68]) and LGBTQIA2+ individuals (AOR = 1.71, 95% CI = [1.60, 1.84]) exhibit a significantly higher likelihood of MDD diagnosis compared to cisgender heterosexual males. Our study also reveals a lower likelihood of MDD diagnosis among Asian/Asian American individuals (AOR = 0.41, 95% CI = [0.35, 0.49]) compared to White individuals. Our results align with previous research indicating that higher levels of food insecurity (AOR = 1.30, 95% CI = [1.17, 1.44]) and loneliness (AOR = 6.89, 95% CI = [6.04, 7.87]) are strongly associated with an increased likelihood of MDD. However, we also find that social cohesion (AOR = 0.92, 95% CI = [0.81, 1.05]) does not emerge as a significant predictor, contradicting some literature emphasizing the protective role of neighborhood cohesion. Similarly, our finding that transience (AOR = 0.95, 95% CI = [0.92, 0.98]) reduces the likelihood of MDD diagnosis contradicts conventional wisdom and warrants further exploration. Our study provides a reminder of the substantial challenges for research focused on marginalized community segments and that deliberate sampling plans are needed to examine those most marginalized and underserved.IC2 Institut

Increasing the satisfaction of general practitioners with continuing medical education programs: A method for quality improvement through increasing teacher-learner interaction

BACKGROUND: Continuing medical education (CME) for general practitioners relies on specialist-based teaching methods in many settings. Formal lectures by specialists may not meet the learning needs of practitioners and may cause dissatisfaction with traditional CME. Increasing learner involvement in teaching programs may improve learner satisfaction. METHODS: A quality improvement program for CME for 18 general practitioners in the Tel Aviv region was designed as a result of dissatisfaction with traditional CME activities. A two-step strategy for change was developed. The CME participants first selected the study topics relevant to them from a needs assessment and prepared background material on the topics. In the second step, specialist teachers were invited to answer questions arising from the preparation of selected topics. Satisfaction with the traditional lecture program and the new participatory program were assessed by a questionnaire. The quality criteria included the relevance, importance and applicability of the CME topic chosen to the participant's practice, the clarity of the presentation and the effective use of teaching aids by the lecturer and the potential of the lecturer to serve as a consultant to the participant. RESULTS: The participatory model of CME significantly increased satisfaction with relevance, applicability and interest in CME topics compared to the traditional lecture format. CONCLUSIONS: Increased learner participation in the selection and preparation of CME topics, and increased interaction between CME teachers and learners results in increased satisfaction with teaching programs. Future study of the effect of this model on physician performance is required

Why do General Practitioners Decline Training to Improve Management of Medically Unexplained Symptoms?

BACKGROUND: General practitioners’ (GPs) communication with patients presenting medically unexplained symptoms (MUS) has the potential to somatize patients’ problems and intensify dependence on medical care. Several reports indicate that GPs have negative attitudes about patients with MUS. If these attitudes deter participation in training or other methods to improve communication, practitioners who most need help will not receive it. OBJECTIVE: To identify how GPs’ attitudes to patients with MUS might inhibit their participation with training to improve management. DESIGN: Qualitative study. PARTICIPANTS: GPs (N = 33) who had declined or accepted training in reattribution techniques in the context of a research trial. APPROACH: GPs were interviewed and their accounts analysed qualitatively. RESULTS: Although attitudes that devalued patients with MUS were common in practitioners who had declined training, these coexisted, in the same practitioners, with evidence of intuitive and elaborate psychological work with these patients. However, these practitioners devalued their psychological skills. GPs who had accepted training also described working psychologically with MUS but devalued neither patients with MUS nor their own psychological skills. CONCLUSIONS: GPs’ attitudes that suggested disengagement from patients with MUS belied their pursuit of psychological objectives. We therefore suggest that, whereas negative attitudes to patients have previously been regarded as the main barrier to involvement in measures to improve patient management, GPs devaluing of their own psychological skills with these patients may be more important

Studies on the electrochemical disinfection of water containing Escherichia coli using a Dimensionally Stable Anode

The aim of this work was to investigate the disinfectant effect of electrolysis on chlorine-free water, artificially contaminated with Escherichia coli (CCT-1457) and to evaluate the bactericidal activity of electrolysis and kinetic behavior of a single-cell reactor, with a DSA (Dimensionally Stable Anode) electrode to develop a scaled-up system. A high-density E. coli suspension (10(6) CFU mL-1) was electrolyzed in this reactor at 25, 50 and 75 mA cm-2 for up to 60 min, at flow rates of 200 and 500 L h-1. Bacterial survival fell by 98.9% without addition of chlorinated compounds and a power consumption rate not more than 5.60 kWh m-3 at flow rate of 200 L h-1 and 75 mA cm-2. The process produced a germicidal effect that reached this inactivation rate within a relatively short contact time. Also, a solution of electrolyzed 0.08 M Na2SO4 added to the inoculum showed residual bactericidal effect. The efficiency of disinfection was regulated by both the contact time and current density applied, and a kinetic function for the survival rate was developed for the purpose of scaling up.Água contaminada é uma das maiores origens de doenças em seres humanos. Em todo o mundo, a cloração é o método mais utilizado para promover desinfecção em águas de abastecimento devido ao seu efeito residual, quando adequadamente calculado. Contudo, se a água apresentar matéria orgânica, pode haver a geração de organoclorados, os quais são genotóxicos e carcinogênicos. Sob esta óptica, investigamos o efeito bactericida da aplicação da eletrólise em água sem cloro contaminada com Escherichia coli (CCT-1457). O objetivo deste estudo foi avaliar o poder de desinfecção e o comportamento cinético da eletrólise realizada em reator de compartimento único e usando eletrodos ADE (Anodo Dimensionalmente Estável), visando ampliação de escala. Uma suspensão contendo elevada concentração de E. coli (10(6) UFC mL-1) foi submetida ao tratamento no reator em 25, 50 e 75 mA cm-2 durante 60 min, em vazões de 200 e 50 Lh-1. A taxa de inativação foi aproximadamente 99% para a solução isenta de compostos clorados, com consumo de energia elétrica menor que 5,60 kWh m-3 em 200 L h-1 e 75 mA cm-2. Uma solução de Na2SO4 0,08M eletrolisada e adicionada posteriormente ao inoculo apresentou efeito residual bactericida. A eficiência da desinfecção foi regida pelo tempo de contato e pela densidade de corrente aplicada, e foi realizado um estudo cinético que permite a ampliação de escala

A methodology for the evaluation of disinfection technologies

There are several concerns associated with the use of chlorine for potable water disinfection. These are the resistance of certain pathogens, the formation of toxic disinfection by-products and the adverse effects on aesthetic water quality. Owing to these concerns the water industry is continually reviewing alternative disinfection technologies. A methodology has been devised that will aid the water industry in evaluating the potential of these technologies. The methodology uses seven criteria to evaluate the technologies, these are: inactivation efficiency, disinfection by-product (DBP) formation, toxicity, aesthetic water quality, cost, scalability and residual maintenance. Each criterion is assessed by associated questions in order of importance in accordance with a protocol. The criteria are evaluated using UK water quality regulations as standards. Ultraviolet (UV) disinfection was used as an example to demonstrate the methodology. UV was shown to meet all the criteria apart from the provision of a residual disinfectant. Several other disinfection technologies were evaluated using the methodology. Direct electrochemical disinfection and mixed oxidant generators were identified as having the most potential for replacing chlorination.</jats:p