Healing the Hurt: Trauma-Informed Approaches to the Health of Boys and Young Men of Color

From discrimination and poverty to alcoholism and assault, trauma in its varied forms plays a major part in the lives of Latino and African-American boys and young men. This paper outlines the ways in which violence prevention, family support, health care, foster care, and juvenile justice can incorporate a trauma-informed approach to improve the physical and mental health of young men and boys

The Prevalence of Lesbian, Gay, Bisexual, and Transgender Health Education and Training in Emergency Medicine Residency Programs: What Do We Know?

Background The Institute of Medicine, The Joint Commission, and the U.S. Department of Health and Human Services all have recently highlighted the need for cultural competency and provider education on lesbian, gay, bisexual, and transgender ( LGBT ) health. Forty percent of LGBT patients cite lack of provider education as a barrier to care. Only a few hours of medical school curriculum are devoted to LGBT education, and little is known about LGBT graduate medical education. Objectives The objective of this study was to perform a needs assessment to determine to what degree LGBT health is taught in emergency medicine ( EM ) residency programs and to determine whether program demographics affect inclusion of LGBT health topics. Methods An anonymous survey link was sent to EM residency program directors ( PD s) via the Council of Emergency Medicine Residency Directors listserv. The 12‐item descriptive survey asked the number of actual and desired hours of instruction on LGBT health in the past year. Perceived barriers to LGBT health education and program demographics were also sought. Results There were 124 responses to the survey out of a potential response from 160 programs (response rate of 78%). Twenty‐six percent of the respondents reported that they have ever presented a specific LGBT lecture, and 33% have incorporated topics affecting LGBT health in the didactic curriculum. EM programs presented anywhere from 0 to 8 hours on LGBT health, averaging 45 minutes of instruction in the past year (median = 0 minutes, interquartile range [ IQR ] = 0 to 60 minutes), and PD s support inclusion of anywhere from 0 to 10 hours of dedicated time to LGBT health, with an average of 2.2 hours (median = 2 hours, IQR  = 1 to 3.5 hours) recommended. The majority of respondents have LGBT faculty (64.2%) and residents (56.2%) in their programs. The presence of LGBT faculty and previous LGBT education were associated with a greater number of desired hours on LGBT health. Conclusions The majority of EM residency programs have not presented curricula specific to LGBT health, although PD s desire inclusion of these topics. Further curriculum development is needed to better serve LGBT patients. Resumen Introducción El Institute of Medicine, la Joint Commission y el Department of Health and Human Services han subrayado recientemente la necesidad en la competencia cultural y la educación sanitaria de los profesionales sanitarios sobre lesbianas, gays, bisexuales y transexuales ( LGBT ). El 40% de los pacientes LGBT reconoce una falta de formación de los sanitarios como una barrera en la atención médica. Sólo unas pocas horas del programa universitario de medicina está dedicada a la formación en LGBT , y se sabe poco sobre la formación médica de postgrado sobre LGBT . Objetivos El objetivo de este estudio fue evaluar qué grado de formación sanitaria sobre LGBT se enseña en los programas de residencia de Medicina de Urgencias y Emergencias ( MUE ) y determinar si las características de las personas que realizan el programa afectan a la inclusión de temas sanitarios sobre LGBT . Metodología Se envió un enlace de encuesta anónima a los directores del programa de residencia de la MUE a través de la lista del servidor del Council of Emergency Medicine Residency Directors. La encuesta descriptiva de 12 ítems preguntó el número de horas reales y deseadas de formación saniataria sobre LGBT en el pasado año. También se buscaron las barreras percibidas para la educación sanitaria sobre LGBT y la demografía del programa. Resultados Hubo 124 respuestas a la encuesta de una respuesta potencial de 160 programas (porcentaje de respuesta del 78%). Un 26% de los encuestados contest que nunca había presentado una clase específica sobre LGBT , y un 33% ha incorporado temas que afectan a la salud de LGBT en el plan de estudios. Los programas de MUE presentaron en cualquier lugar de 0–8 horas de formación sanitaria sobre LGBT , con un promedio de 45 minutos de formación en el pasado año (mediana de 0 minutos, RIC 0 a 60 minutos), y los directores del programa apoyan la inclusión en cualquier lugar de 0 a 10 horas de tiempo dedicado a la formacion sanitaria sobre LGBT , con un promedio recomendado de 2,2 horas (mediana 2, RIC de 1 a 3,5 horas). La mayoría de los encuestados tienen profesores (64,2%) y residentes (56,2%) LGBT en sus programas. La presencia de profesores LGBT y la formación sanitaria previa sobre LGBT se asociaron con un mayor número de horas deseadas sobre formación sanitaria sobre LGBT . Conclusiones La mayoría de los programas de residencia en MUE no ha presentado un plan de estudios específico para formación sanitaria sobre LGBT , aunque los directores del programa desean la inclusión de estos temas. Es necesario el desarrollo de un programa futuro para atender mejor a los pacientes LGBT .Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106813/1/acem12368.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/106813/2/acem12368-sup-0001-DataSupplementS1.pd

The study of atmospheric ice-nucleating particles via microfluidically generated droplets

Ice-nucleating particles (INPs) play a significant role in the climate and hydrological cycle by triggering ice formation in supercooled clouds, thereby causing precipitation and affecting cloud lifetimes and their radiative properties. However, despite their importance, INP often comprise only 1 in 10³–10⁶ ambient particles, making it difficult to ascertain and predict their type, source, and concentration. The typical techniques for quantifying INP concentrations tend to be highly labour-intensive, suffer from poor time resolution, or are limited in sensitivity to low concentrations. Here, we present the application of microfluidic devices to the study of atmospheric INPs via the simple and rapid production of monodisperse droplets and their subsequent freezing on a cold stage. This device offers the potential for the testing of INP concentrations in aqueous samples with high sensitivity and high counting statistics. Various INPs were tested for validation of the platform, including mineral dust and biological species, with results compared to literature values. We also describe a methodology for sampling atmospheric aerosol in a manner that minimises sampling biases and which is compatible with the microfluidic device. We present results for INP concentrations in air sampled during two field campaigns: (1) from a rural location in the UK and (2) during the UK’s annual Bonfire Night festival. These initial results will provide a route for deployment of the microfluidic platform for the study and quantification of INPs in upcoming field campaigns around the globe, while providing a benchmark for future lab-on-a-chip-based INP studies

A framework for detecting noncoding rare-variant associations of large-scale whole-genome sequencing studies

Large-scale whole-genome sequencing studies have enabled analysis of noncoding rare-variant (RV) associations with complex human diseases and traits. Variant-set analysis is a powerful approach to study RV association. However, existing methods have limited ability in analyzing the noncoding genome. We propose a computationally efficient and robust noncoding RV association detection framework, STAARpipeline, to automatically annotate a whole-genome sequencing study and perform flexible noncoding RV association analysis, including gene-centric analysis and fixed window-based and dynamic window-based non-gene-centric analysis by incorporating variant functional annotations. In gene-centric analysis, STAARpipeline uses STAAR to group noncoding variants based on functional categories of genes and incorporate multiple functional annotations. In non-gene-centric analysis, STAARpipeline uses SCANG-STAAR to incorporate dynamic window sizes and multiple functional annotations. We apply STAARpipeline to identify noncoding RV sets associated with four lipid traits in 21,015 discovery samples from the Trans-Omics for Precision Medicine (TOPMed) program and replicate several of them in an additional 9,123 TOPMed samples. We also analyze five non-lipid TOPMed traits