Recognizing the influence of social determinants on HIV risk behaviors and the need for structural interventions to prevent HIV in women

The design and implementation of structural interventions may provide for simultaneous and longitudinal responses to prevention needs in multiple contexts as defined by social determinants, thus varied opportunities exist to respond to the HIV prevention needs of women. According to the CDC, in 2010, the rate of new HIV infections among black women was 20 times that of white women, and the rate among Hispanic/Latino women was 4 times the rate of white women. Additionally, 86% of HIV infections in women were attributed to heterosexual contact and 14% to injection drug use (CDC, 2012). These numbers are reflected outside the US with 49% of those infected by HIV being women with a predominant source of infection being related to heterosexual transmission (WHO, 2008). In sub-Saharan Africa, of those living with HIV, 60% are women. Attention to the influential context of social determinants of health provides unique opportunities for innovative prevention practice in HIV/AIDS prevention for women. In this paper, social determinants of health as an influential, behavioral concept is defined both in terms of women’s health and their sexual behavior decision making, along with examples of potential structural interventions that not only address the social determinants of their HIV risks but also reflect the contextual complexity of their life experiences. An earlier study (Abdul-Qader and Collins, 2011) solicited statements from a sample of experts in HIV prevention and areas of public health to identify potential structural interventions that would be feasible and impactful regarding HIV prevention - the DHAP Structural Interventions Mapping project. Data was elicited from these stakeholders most likely to be designing and guiding interventions to determine their perspectives on feasible and impactful structural intervention to address sexual behavior in women. The current paper is based on secondary analysis of 20 of these potential structural interventions generally and specifically applicable to women and their HIV prevention needs. Qualitative analysis resulted in three overall themes of economic interventions, response to violence against women and integrated health service delivery strategies that address key health-belief and socio-cultural issues. The themes are reflected and substantiated in current research literature, and provide a foundation for the next steps regarding research, policy planning and program implementation for developing evidence-based structural interventions focused on preventing HIV in women

Metabolic Disease in Subadult Skeletal Remains from Late Ottoman-Era Tell Hisban, Jordan

The site of Tell Hisban in Jordan was seasonally occupied by nomadic agropastoral tribes for over a thousand years. In the latter half of the 1800s, the Ottoman Empire instituted the Tanzimat, a series of reforms intended to solidify control over the region, including a new system of private land ownership. This new land law conflicted with traditional tribal-based land rights and resulted in intensification of agricultural production and diminished pastoralism in the regional economy. During this period of economic change, at least 62 individuals were interred in ruins on Tell Hisban, of which 55% were non-adults. Many long bones and cranial elements of non-adults within these commingled remains display evidence of vitamin C (scurvy) and D (rickets) deficiencies at a greater frequency than pre-Tanzimat or earlier regional cemeteries. Increased agricultural production may have impacted the availability of traditional foods high in ascorbic acid that prevented scurvy in past groups, and increased reliance on cereals, which lack key macronutrients. The resulting shift in diet would have disproportionately affected individuals more susceptible to nutritional stressors, such as pregnant women, infants, and weaning children. In the case of rickets, these nutritional stressors may have been exacerbated by cultural barriers which limited an individual's exposure to sunlight and may have resulted in the surprising presence of rickets in this high-ambient UV radiation environment. Together with genetic predispositions to scurvy or rickets, these biocultural changes likely contributed to increased frailty in the form of metabolic disease for infants and young children within this population compared to earlier groups at Tell Hisban and contemporary populations in other areas of Jordan and Israel

Towards a National Housing Strategy for Homeless Youth

This policy brief, "Towards a National Housing Strategy for Homeless Youth", is part of a series developed by the Hollywood Homeless Youth Partnership (HHYP) to advance policy and practice recommendations focused on preventing and ending youth homelessness. This brief emerges from "No Way Home: Understanding the Needs and Experiences of Homeless Youth in Hollywood", a report released by the HHYP in November 2010 presenting findings from a multi-method needs assessment conducted with 389 homeless youth ages 12 to 25 in the Hollywood community.The purpose of this brief is to address the inadequacies of prioritizing permanent housing as the only solution for homeless youth, identify the major limitations of our existing housing programs, and advocate for developing a national housing strategy and funding a full housing continuum for homeless young people that is responsive to their unique needs and circumstances. This brief is being released at a time of unprecedented interest in the issue of youth homelessness -- we hope it will inform federal and local planning and decision-making and help advance our national agenda of preventing and ending youth homelessness

“Forward-Thinking” in U.S. Biobanking

Aims: Do biobanks enact policies and plans that allow them to anticipate and respond to potential challenges? If a biobank has one such policy or plan, is it likely to have more? Using survey data from 456 U.S. biobanks, we assess four possible indicators of such “forward-thinking.

Effects of exercise training programmes on fasting gastrointestinal appetite hormones in adults with overweight and obesity: a systematic review and meta-analysis

A systematic review and meta-analysis was performed to determine the effect of exercise training on fasting gastrointestinal appetite hormones in adults living with overweight and obesity. For eligibility, only randomised controlled trials (duration ≥ four weeks) examining the effect of exercise training interventions were considered. This review was registered in the International Prospective Register of Systematic Reviews (CRD42020218976). The searches were performed on five databases: MEDLINE, EMBASE, Cochrane Library, Web of Science, and Scopus. The initial search identified 13204 records. Nine studies, which include sixteen exercise interventions, met the criteria for inclusion. Meta-analysis was calculated as the standardised mean difference (Cohen's d). Exercise training had no effect on fasting concentrations of total ghrelin (d: 1.06, 95% CI -0.38 to 2.50, P = 0.15), acylated ghrelin (d: 0.08, 95% CI: −0.31 to 0.47, P = 0.68) and peptide YY (PYY) (d = −0.16, 95% CI: −0.62 to 0.31, P = 0.51) compared to the control group. Analysis of body mass index (BMI) (d: −0.31, 95% CI: −0.50 to −0.12, P < 0.01) and body mass (d: −0.22, 95% CI: −0.42 to −0.03, P = 0.03) found a significant reduction after exercise compared to controls. Overall, exercise interventions did not modify fasting concentrations of total ghrelin, acylated ghrelin, and PYY in individuals with overweight or obesity, although they reduced body mass and BMI. Thus, any upregulation of appetite and energy intake in individuals with overweight and obesity participating in exercise programmes is unlikely to be related to fasting concentrations of gastrointestinal appetite hormones

Stewardship Practices of U.S. Biobanks

Biobanks require new governance models that address their ethical and regulatory challenges. One model relies on stewardship of specimens throughout their life course. Here, we discuss findings from our survey of 456 U.S. biobank managers that addressed whether and how biobanks steward their specimens. The findings reveal that most bio-banks do not create ongoing relationships with contributors but do practice stewardship over storing and sharing of specimens. Biobanks now need guidance to fully articulate stewardship practices that ensure respect for contributors while facilitating research

Honoring the Legacy: an Exhibition of Works Presented by ART CART: SAVING THE LEGACY

The story of ART CART: SAVING THE LEGACY is one of tenacity, resilience and positive aging where art, education, health, and aging intersect to provide a model for society (www.artsandcultureresearch.org/artcart ). In the mid-2000s the Research Center for Arts and Culture (RCAC) conducted the only research on professional visual artists age 62 and over in the New York City metro area. ABOVE GROUND1 found that 61% of professional visual artists age 62+ have made no preparation for their work after their death; 95% have not archived their work; 97% have no estate plan; 3 out of every 4 artists have no will and 1 in 5 have no documentation of their work at all.2 Yet, in many respects they are a model for society, maintaining strong social networks and an astonishing resilience as they age. ART CART is a response to this research, begun by six women faculty in higher education from the arts, education, health and aging. We all valued interdisciplinary, inter-generational education and saw too little of it in our practice. We saw advantages for our students to gain a grounding in both creativity and aging, learn basic health prevention principles, and take these lessons back to a variety of disciplines from social work and occupational therapy to art education, art history, arts administration, museum studies, art therapy, oral history, and dance education. We saw a model of experiential learning where students could put what they learned into immediate practice. For artists, we saw a way to keep their work from their greatest fear: the dumpster. We saw a mechanism to help them get organized, urge them to sign, date, and document their work, archive their digital records at Columbia University, obtain wills and estate plans,3 while participating fully in an inter-generational team where an artist, an artist-selected working partner and student fellows worked together towards the same goals. ART CART began with six artists and twelve students at Columbia University in 2010. By 2016, it operates both in New York City and Washington, DC, with 18 artists and 18 fellows. Alumni artists post-ART CART have secured lifetime achievement awards, grants, studio space, sales, gallery representation, exhibitions and a rejuvenated appreciation of their work across generations. And they are still documenting their work

Asian outflow and trans-Pacific transport of carbon monoxide and ozone pollution: An integrated satellite, aircraft, and model perspective

Satellite observations of carbon monoxide (CO) from the Measurements of Pollution in the Troposphere (MOPITT) instrument are combined with measurements from the Transport and Chemical Evolution Over the Pacific (TRACE-P) aircraft mission over the northwest Pacific and with a global three-dimensional chemical transport model (GEOS-CHEM) to quantify Asian pollution outflow and its trans-Pacific transport during spring 2001. Global CO column distributions in MOPITT and GEOS-CHEM are highly correlated (R2 = 0.87), with no significant model bias. The largest regional bias is over Southeast Asia, where the model is 18% too high. A 60% decrease of regional biomass burning emissions in the model (to 39 Tg yr−1) would correct the discrepancy; this result is consistent with TRACE-P observations. MOPITT and TRACE-P also give consistent constraints on the Chinese source of CO from fuel combustion (181 Tg CO yr−1). Four major events of trans-Pacific transport of Asian pollution in spring 2001 were seen by MOPITT, in situ platforms, and GEOS-CHEM. One of them was sampled by TRACE-P (26–27 February) as a succession of pollution layers over the northeast Pacific. These layers all originated from one single event of Asian outflow that split into northern and southern plumes over the central Pacific. The northern plume (sampled at 6–8 km off California) had no ozone enhancement. The southern subsiding plume (sampled at 2–4 km west of Hawaii) contained a 8–17 ppbv ozone enhancement, driven by decomposition of peroxyacetylnitrate (PAN) to nitrogen oxides (NOx). This result suggests that PAN decomposition in trans-Pacific pollution plumes subsiding over the United States could lead to significant enhancements of surface ozone