Remodeling the Closet: The Individual and Organizational Correlates of Workplace Sexual Identity Management

The strategies by which sexual minority employees manage their sexual identities in the workplace have long been a subject of inquiry. Extant research has long recognized that these employees potentially engage in several different strategies for workplace sexual identity management (e.g., actively concealing their identity vs. disclosing their identity), models of sexual identity management tend to focus only on factors that influence disclosure decisions. The current series of two survey studies explored the broader organizational correlates of three workplace sexual identity management strategies: general outness, concealment, and disclosure, as well as whether differences existed based on gender and sexual identity (i.e., gay- and lesbian-identified vs. bisexual-identified employees). Study 1 used a broad-based survey sample to explore these correlates, and Study 2 used data from a targeted survey that included active-duty LGB service members as respondents. Results from these two studies suggest that there may be differences in the sexual identity strategies that sexual minority employees engage in at their places of work. In addition, sexual identity management strategies associated with workplace characteristics included perceived support for sexual minority employees, supportive policies for sexual minorities, and organizational embeddedness. Perceived workplace support also moderated the relationship between concealing one’s sexual identity and organizational embeddedness, such that those who concealed less also tended to report feeling less embedded within their organizations, but this was only true for those who reported low perceived support for sexual minorities in their workplaces. These findings have implications for models of sexual identity management, future research directions, and organizational practice to support sexual minority employees

Sustained Immune Tolerance Induction in Enzyme Replacement Therapy-Treated CRIM-Negative Patients with Infantile Pompe Disease

BACKGROUND: Cross-reactive immunological material-negative (CRIM-negative) infantile Pompe disease (IPD) patients develop an immune response against enzyme replacement therapy (ERT) with alglucosidase alfa that nullifies ERT efficacy. Prophylactic immune tolerance induction (ITI) with rituximab, methotrexate, and IVIG successfully prevents development of deleterious rhGAA IgG antibodies; however, safety, likelihood of success, and long-term efficacy of ITI in a larger cohort remain unknown. METHODS: Clinical data were analyzed for 19 CRIM-negative IPD patients who received ITI with rituximab, methotrexate, and IVIG in the ERT-naive setting (ERT+ITI) and compared to a historical cohort of 10 CRIM-negative IPD patients on ERT monotherapy. RESULTS: ITI was safely tolerated, although infections were reported in 4 patients. Fourteen (74%) ERT+ITI patients were alive, with a median age of 44.2 months at their final assessment. The eldest survivor was 103.9 months old, with 100.2 months of follow-up after initiation of ERT+ITI. Death (n = 5) occurred at a median age of 29.2 months and was unrelated to the administration of ITI. Fifteen patients either did not seroconvert (n = 8) or maintained low titers (n = 7; defined as titers of /=51,200 at or beyond 6 months on ERT). Left ventricular mass index (LVMI) decreased from a median of 248.5 g/m2 at baseline to 76.8 g/m2 at a median time from ERT+ITI initiation to 59 weeks. ERT+ITI significantly improved overall survival (P = 0.001), eliminated/reduced antibodies at values o

Low levels of viral suppression among refugees and host nationals accessing antiretroviral therapy in a Kenyan refugee camp.

BACKGROUND: Refugees and host nationals who accessed antiretroviral therapy (ART) in a remote refugee camp in Kakuma, Kenya (2011-2013) were compared on outcome measures that included viral suppression and adherence to ART. METHODS: This study used a repeated cross-sectional design (Round One and Round Two). All adults (≥18 years) receiving care from the refugee camp clinic and taking antiretroviral therapy (ART) for ≥30 days were invited to participate. Adherence was measured by self-report and monthly pharmacy refills. Whole blood was measured on dried blood spots. HIV-1 RNA was quantified and treatment failures were submitted for drug resistance testing. A remedial intervention was implemented in response to baseline testing. The primary outcome was viral load <5000 copies/mL. The two study rounds took place in 2011-2013. RESULTS: Among eligible adults, 86% (73/85) of refugees and 84% (86/102) of Kenyan host nationals participated in the Round One survey; 60% (44/73) and 58% (50/86) of Round One participants were recruited for Round Two follow-up viral load testing. In Round One, refugees were older than host nationals (median age 36 years, interquartile range, IQR 31, 41 vs 32 years, IQR 27, 38); the groups had similar time on ART (median 147 weeks, IQR 38, 64 vs 139 weeks, IQR 39, 225). There was weak evidence for a difference between proportions of refugees and host nationals who were virologically suppressed (<5000 copies/mL) after 25 weeks on ART (58% vs 43%, p = 0.10) and no difference in the proportions suppressed at Round Two (74% vs 70%, p = 0.66). Mean adherence within each group in Round One was similar. Refugee status was not associated with viral suppression in multivariable analysis (adjusted odds ratio: 1.69, 95% CI 0.79, 3.57; p = 0.17). Among those not suppressed at either timepoint, 69% (9/13) exhibited resistance mutations. CONCLUSIONS: Virologic outcomes among refugees and host nationals were similar but unacceptably low. Slight improvements were observed after a remedial intervention. Virologic monitoring was important for identifying an underperforming ART program in a remote facility that serves refugees alongside host nationals. This work highlights the importance of careful laboratory monitoring of vulnerable populations accessing ART in remote settings

Sport and British Jewish identity

This article examines the relationship between sport and Jewish identity. The experiences of Jewish people have rarely been considered in previous sport-related research which has typically focused on ‘Black’ and South Asian individuals, sports clubs, and organisations. Drawing on data generated from interviews ( n = 20) and focus groups ( n = 2) with individuals based in one British city, this article explores how their Jewish identity was informed, and shaped by, different sports activities and spaces. This study’s participants were quick to correct the idea that sport was alien to Jewish culture and did not accept the stereotype that ‘Jews don’t play sport’. The limited historical research on sport and Jewish people and the ongoing debates around Jewish identity are noted before exploring the role of religion and the suggestion that Jewish participation in sport is affected by the Shabbat (sabbath). Participants discussed how sports clubs acted as spaces for the expression and re/affirmation of their Jewish identity, before they reflected on the threats posed to the wider Jewish community by secularism, assimilation, and antisemitism. The article concludes by discussing how the sporting experiences of the study’s British Jewish participants compare with the experiences of individuals from other ethnic minority communities

Hormone replacement therapy and cardiovascular disease: A statement for healthcare professionals from the American Heart Association

For more than 50 million American women, and millions of women in other countries who are over the age of 50 years, the decision whether or not to use estrogen replacement therapy (ERT) for chronic disease prevention is often a difficult one. Established benefits of treatment for menopausal symptoms and prevention of osteoporosis must be weighed against documented risks of therapy, including venous thromboembolic events (VTE), gallbladder disease, and a possible increased risk of breast cancer. Unopposed ERT is also associated with an increased risk of endometrial cancer in women with a uterus. Therefore, it is typically combined with a progestin and is referred to as hormone replacement therapy (HRT). The impact of ERT/HRT on cardiovascular disease (CVD) is of great public health importance, because CVD is the leading cause of death and a major contributor to disability in women.1 The purpose of this advisory is to summarize the currently available data concerning potential CVD benefits and risks associated with ERT/HRT and to provide updated clinical recommendations regarding its use in the secondary and primary prevention of CVD