UTRGV Student Run Clinic: The Past, The Present, and The Future

Purpose: The UTRGV SOM Student Run Clinic (SRC) is a student- led organization that provides free primary care and promotes health equity in the Rio Grande Valley. Through the SRC, barriers of access to healthcare and health promotion are targeted, especially by emphasizing health literacy and patient advocacy. The SRC benefits not only our patients but medical students who work in the clinic, learning about the unique needs and culture of the underserved community while gaining clinical experience. Description: The SRC brings teams of volunteer medical students and physicians to Peñitas, TX to provide free primary healthcare to vulnerable populations, including uninsured, undocumented, and low-income people. Since its start, SRC has grown through success and obstacles, such as structuring all our volunteer teams to include at least one Spanish speaker to provide care in the patients preferred language and establishing culturally competent relationships with the Peñitas community. Partners: The SRC relies on our partnerships: the Peñitas community, medical student and physician volunteers, and the Proyecto Desarrollo Humano (PDH). PDH is a non-profit organization in Peñitas that allows us use of their clinic space as well as gives our patients continuity of care between our operations in their own clinic. The community of Peñitas is a source of our patients but also of clinic staff and promotoras that connect the patients to external resources. Medical student volunteers work in teams to conduct patient interviews and present to physician volunteers, who teach students and see patients. The SRC board of medical students manages and executes the clinic operations. Looking Ahead: The SRC is an important part of decreasing disparities in the colonia we serve. We will perform a literature review of SRC publications, review and realign our board member roles, and perform an analysis of our Strengths, Weaknesses, Opportunities and Threats (SWOT) with stakeholders to strategize for our future. Lastly, we will develop and present our five-year strategic plan as a result of this exercis

Effects of thymic selection of the T cell repertoire on HLA-class I associated control of HIV infection

Without therapy, most people infected with human immunodeficiency virus (HIV) ultimately progress to AIDS. Rare individuals (‘elite controllers’) maintain very low levels of HIV RNA without therapy, thereby making disease progression and transmission unlikely. Certain HLA class I alleles are markedly enriched in elite controllers, with the highest association observed for HLA-B57 (ref. 1). Because HLA molecules present viral peptides that activate CD8+ T cells, an immune-mediated mechanism is probably responsible for superior control of HIV. Here we describe how the peptide-binding characteristics of HLA-B57 molecules affect thymic development such that, compared to other HLA-restricted T cells, a larger fraction of the naive repertoire of B57-restricted clones recognizes a viral epitope, and these T cells are more cross-reactive to mutants of targeted epitopes. Our calculations predict that such a T-cell repertoire imposes strong immune pressure on immunodominant HIV epitopes and emergent mutants, thereby promoting efficient control of the virus. Supporting these predictions, in a large cohort of HLA-typed individuals, our experiments show that the relative ability of HLA-B alleles to control HIV correlates with their peptide-binding characteristics that affect thymic development. Our results provide a conceptual framework that unifies diverse empirical observations, and have implications for vaccination strategies.Mark and Lisa Schwartz FoundationNational Institutes of Health (U.S.) (Director’s Pioneer award)Philip T. and Susan M. Ragon FoundationJane Coffin Childs Memorial Fund for Medical ResearchBill & Melinda Gates FoundationNational Institute of Allergy and Infectious Diseases (U.S.)National Institutes of Health (U.S.) (contract no. HHSN261200800001E)National Institutes of Health (U.S.). Intramural Research ProgramNational Cancer Institute (U.S.)Center for Cancer Research (National Cancer Institute (U.S.)

The Pediatric American Pain Society Patient Outcomes Questionnaire (Pediatric APS-POQ): Development and Initial Psychometric Evaluation of a Brief and Comprehensive Measure of Pain and Pain Outcomes in Hospitalized Youth

Pediatric pain assessment in the hospital traditionally involves the patient\u27s self-report of pain intensity using a numeric rating scale, which does not capture the complexity of the pain experience. No valid, comprehensive measure of pain in hospitalized youth exists. This study was designed to develop and conduct initial psychometric testing of the Pediatric American Pain Society Patient Outcomes Questionnaire (Pediatric APS-POQ), a comprehensive patient-reported measure of pain and pain outcomes in hospitalized youth. A multidisciplinary group of pediatric pain researchers and clinicians collaborated to adapt the adult APS-POQ Revised to pediatrics, including a patient-report and parent proxy version. The adapted measures were administered to 218 pediatric inpatients (age M = 13.4 years, 56% female) and 214 of their parents (80% mothers) at 4 US children\u27s hospitals. The measure was feasible to administer within the inpatient setting and was acceptable and understandable to pediatric patients and their parents. Internal consistency was adequate for both patient-report and parent proxy (α = 0.77). Confirmatory factor analysis supported the following 6 domains, consistent with the adult measure: pain intensity, functional interference, emotional response, side effects, perceptions of care, and usual pain. Additional research is needed to further support the reliability and validity of this measure in diverse clinical populations. PERSPECTIVE: To reduce the impact of pain on hospitalized youth, pediatric pain assessment must move beyond ratings of pain intensity. The Pediatric APS-POQ provides a brief but comprehensive assessment of pain and pain outcomes in hospitalized children and adolescents, which will allow for greater individualization in hospital-based pain management and quality improvement purposes

“In the Image of God”: Reconstructing and Developing a Grassroots African Queer Theology from Urban Zambia

This article is a contribution towards the development of queer theologies in contemporary African contexts. Based on fieldwork in the gay community in Lusaka, the capital city of Zambia, the article explores the significance of the theological notion of the Imago Dei, the Image of God, in the self-understanding of Zambian gay men as being gay and Christian. Bringing this incipient grassroots theology into conversation with broader theological discourses, in particular African theology (including African women’s theology) and queer theology, we interrogate current understandings of the Imago Dei that either ignore sexuality or exclude same-sex loving people (in African theology) or that conceptualize queerness from white Western privileged perspectives (in queer theology). Hence we develop the notion of the Imago Dei as a stepping stone towards an African queer theology