The proposal for a third medical school in New Zealand: A community-engaged graduate entry medical program

New Zealand has a maldistributed workforce that is heavily dependent on recruiting international medical graduates. Shortages are particularly apparent in high needs communities and in general scope specialties in provincial regions. The University of Waikato in partnership with the Waikato District Health Board has proposed a third medical school for New Zealand which will concentrate on addressing the workforce needs of disadvantaged rural and provincial communities. The proposed program is a community engaged, graduate entry medical course

Feasibility Study of Social Media to Reduce Intimate Partner Violence Among Gay Men in Metro Atlanta, Georgia

Intimate Partner Violence (IPV) is a major public health issue occurring in the United States and globally. While little is known in general about IPV, understanding about the prevalence of physical IPV among gay men is even more obscure. There is a clear disparity in violence research attention focused on this vulnerable segment of society. This cross-sectional survey study was conducted to examine the feasibility of enrolling 100 gay men from Atlanta into an IPV survey study. The survey was administered via Facebook. Ninety-nine usable surveys were collected. Chi-square tests reveal that minority ethnic status, illicit drug use, and non-disclosed orientation status were all significantly associated with positive IPV reports--in terms of both victimization as well as perpetration. Overall, the majority of the study sample indicated that they believe IPV is a health problem in the Atlanta gay community. These findings bear importance for the Atlanta gay community and public health professionals who must address this nearly invisible yet increasing public health issue. [West J Emerg Med. 2012;13(3):298-304.

A Survey of Georgia Adult Protective Service Staff: Implications for Older Adult Injury Prevention and Policy

Background: The aging population is a rapidly growing demographic. Isolation and limited autonomy render many of the elderly vulnerable to abuse, neglect and exploitation. As the population grows, so does the need for Adult Protective Services (APS). This study was conducted to examine current knowledge of older adult protection laws in Georgia among APS staff and to identify training opportunities to better prepare the APS workforce in case detection and intervention. Methods: The Georgia State University Institute of Public Health faculty developed a primary survey in partnership with the Georgia Division of Aging Services\u27 leadership to identify key training priority issues for APS caseworkers and investigators. A 47-item electronic questionnaire was delivered to all APS employees via work-issued email accounts. We conducted descriptive analyses, t-tests and chi-square analyses to determine APS employees’ baseline knowledge of Georgia’s elder abuse policies, laws and practices, as well as examine associations of age, ethnicity, and educational attainment with knowledge. We used a p-value of 0.05 and 95% confidence intervals to determine statistical significance of analyses performed. Result: Ninety-two out of 175 APS staff responded to the survey (53% response rate). The majority of respondents were Caucasian (56%) women (92%). For over half the survey items, paired sample t-tests revealed significant differences between what APS staff reported as known and what APS staff members indicated they needed to know more about in terms of elder abuse and current policies. Chi-square tests revealed that non-Caucasians significantly preferred video conferencing as a training format (44% compared to 18%), [χ2(1) = 7.102, p \u3c .008], whereas Caucasians preferred asynchronous online learning formats (55% compared to 28%) [χ2(1) =5.951, p \u3c .015]. Conclusion: Results from this study provide the Georgia Division of Aging with insight into specific policy areas that are not well understood by APS staff. Soliciting input from intended trainees allows public health educators to tailor and improve training sessions. Trainee input may result in optimization of policy implementation, which may result in greater injury prevention and protection of older adults vulnerable to abuse, neglect and exploitation

Survey of sex/gender diversity in the GEDA 2019/2020-EHIS study – objectives, procedure and experiences

Sex/gender diversity is increasingly recognised by society and should be taken into account more in populationrepresentative studies, as they are important data sources for targeting health promotion, prevention and care. In 2019, the Robert Koch Institute started a population-representative health survey with the study Health in Germany Update (GEDA 2019/2020-EHIS) with a modified, two-stage measures of sex/gender. The survey covered sex registered at birth and gender identity with an open response option. This article describes the aims, the procedure and the experiences with the operationalisation of sex/gender and the results. Out of 23,001 respondents, 22,826 persons are classified as cisgender, 113 persons as transgender and 29 persons as gender-diverse. 33 respondents were counted as having missing values. A survey of interviewers showed that the two-stage measures of sex/gender had a high level of acceptance overall and that there were only a few interview drop-outs. On the basis of previous experience, the modified query can be used for further surveys, but should also be adapted in perspective. For this purpose, participatory studies are desirable that focus on how the acceptance of measures of sex/gender can be further improved and how hurtful experiences in the context of the questions asked can be avoided

BCL-W is dispensable for the sustained survival of select Burkitt lymphoma and diffuse large B-cell lymphoma cell lines

Dysregulated expression of BCL-2 family proteins allows cancer cells to escape apoptosis. To counter this, BH3-mimetic drugs that target and inhibit select BCL-2 prosurvival proteins to induce apoptosis have been developed for cancer therapy. Venetoclax, which targets BCL-2, has been effective as therapy for patients with chronic lymphocytic leukemia, and MCL-1-targeting BH3-mimetic drugs have been extensively evaluated in preclinical studies for a range of blood cancers. Recently, BCL-W, a relatively understudied prosurvival member of the BCL-2 protein family, has been reported to be abnormally upregulated in Burkitt lymphoma (BL), diffuse large B-cell lymphoma (DLBCL), and Hodgkin lymphoma patient samples. Therefore, to determine if BCL-W would be a promising therapeutic target for B-cell lymphomas, we have examined the role of BCL-W in the sustained growth of human BL- and DLBCL-derived cell lines. We found that CRISPR/CAS9-mediated loss or short hairpin RNA-mediated knockdown of BCL-W expression in selected BL and DLBCL cell lines did not lead to spontaneous apoptosis and had no effect on their sensitivity to a range of BH3-mimetic drugs targeting other BCL-2 prosurvival proteins. Our results suggest that BCL-W is not universally required for the sustained growth and survival of human BL and DLBCL cell lines. Thus, targeting BCL-W in this subset of B-cell lymphomas may not be of broad therapeutic benefit

Erhebung geschlechtlicher Diversität in der Studie GEDA 2019/2020-EHIS – Ziele, Vorgehen und Erfahrungen

Die geschlechtliche Vielfalt wird gesellschaftlich zunehmend anerkannt und sollte in bevölkerungsrepräsentativen Studien verstärkt berücksichtigt werden, da sie wichtige Datenquellen sind, um Gesundheitsförderung, Prävention und Versorgung adressatengerecht auszurichten. Im Jahr 2019 startete im Robert Koch-Institut mit der Studie „Gesundheit in Deutschland aktuell“ (GEDA 2019/2020-EHIS) die bevölkerungsrepräsentative Gesundheitsbefragung mit einer geänderten, zweistufigen Geschlechtsabfrage. Erhoben wurden das bei Geburt eingetragene Geschlecht und die geschlechtliche Identität mit einer offenen Antwortoption. Im vorliegenden Artikel werden die Ziele, das Vorgehen und die Erfahrungen mit der Operationalisierung von Geschlecht und die Ergebnisse beschrieben. Von 23.001 Befragten werden 22.826 Personen als cisgeschlechtlich, 113 Personen als transgeschlechtlich und 29 Personen als genderdivers eingeordnet. 33 Befragte wurden als Personen mit fehlenden Werten gezählt. Eine Befragung der Interviewenden zeigte, dass die zweistufige Geschlechtsabfrage insgesamt eine hohe Akzeptanz aufweist und es nur zu wenigen Interviewabbrüchen kommt. Auf der Grundlage der bisherigen Erfahrungen kann die geänderte Abfrage für weitere Befragungen genutzt werden, sollte perspektivisch jedoch auch angepasst werden. Hierfür sind partizipative Studien wünschenswert, die darauf fokussieren, wie die Akzeptanz der Geschlechtsabfrage weiter verbessert werden kann und wie verletzende Erfahrungen im Kontext der gestellten Fragen vermieden werden können

Unusual primary HIV infection with colonic ulcer complicated by hemorrhagic shock: a case report

<p>Abstract</p> <p>Introduction</p> <p>Timely diagnosis of primary HIV infection is important to prevent further transmission of HIV. Primary HIV infection may take place without symptoms or may be associated with fever, pharyngitis or headache. Sometimes, the clinical presentation includes aseptic meningitis or cutaneous lesions. Intestinal ulceration due to opportunistic pathogens (cytomegalovirus, Epstein-Barr virus, <it>Toxoplasma gondii</it>) has been described in patients with AIDS. However, although invasion of intestinal lymphoid tissue is a prominent feature of human and simian lentivirus infections, colonic ulceration has not been reported in acute HIV infection.</p> <p>Case description</p> <p>A 42-year-old Caucasian man was treated with amoxicillin-clavulanate for pharyngitis. He did not improve, and a rash developed. History taking revealed a negative HIV antibody test five months previously and unprotected sex with a male partner the month before admission. Repeated tests revealed primary HIV infection with an exceptionally high HIV-1 RNA plasma concentration (3.6 × 10⁷copies/mL) and a low CD4 count (101 cells/mm³, seven percent of total lymphocytes). While being investigated, the patient had a life-threatening hematochezia. After angiographic occlusion of a branch of the ileocaecal artery and initiation of antiretroviral therapy, the patient became rapidly asymptomatic and could be discharged. Colonoscopy revealed a bleeding colonic ulcer. We were unable to identify an etiology other than HIV for this ulcer.</p> <p>Conclusion</p> <p>This case adds to the known protean manifestation of primary HIV infection. The lack of an alternative etiology, despite extensive investigations, suggests that this ulcer was directly caused by primary HIV infection. This conclusion is supported by the well-described extensive loss of intestinal mucosal CD4⁺T cells associated with primary HIV infection, the extremely high HIV viral load observed in our patient, and the rapid improvement of the ulcer after initiation of highly active antiretroviral therapy. This case also adds to the debate on treatment for primary HIV infection, especially in the context of severe symptoms and an extremely high viral load.</p

TRANSIT Working Paper # 7

A previous version of this paper has been part of TRANSIT Deliverable 3.3 (July 2016), the second prototype of TSI theory.[Abstract] This working paper presents a set of propositions about the agency and dynamics of transformative social innovation (TSI) that have been developed as part of an EU-funded research project entitled “TRANsformative Social Innovation Theory” (TRANSIT; 2014-2017). These TSI propositions represent first steps towards the development of a new theory of TSI, taking the form of proto-explanations of the agency and dynamics of TSI, based on the bringing together of our empirical observations on TSI and the project's theoretical reviews and theoretical framings. Ideally this working paper should be read in conjunction with the working paper entitled “A framework for transformative social innovation” (Haxeltine et al 2016) which presents in skeletal terms the theoretical and conceptual framing of TSI developed in the TRANSIT project. This TSI framework builds on sustainability transition studies, social innovation research, social psychology studies of empowerment and other several other areas of social theory to deliver a bespoke theoretical and conceptual framework that is grounded in a relational ontology and which is being employed as a platform for the development of a middle-range theory of TSI. Next we provide a very brief overview of some key elements of the framework, in particular how we conceptualise social innovation, transformative change, and transformative social innovation. Propositions were developed for each of four relational dimensions implied by the TSI framework with also a brief statement of the topic addressed by each of the twelve propositions.This article is based on research carried out as part of the Transformative Social Innovation Theory (“TRANSIT”) project, which is funded by the European Union's Seventh Framework Programme (FP7) under grant agreement 61316

Your Trash Is Someone's Treasure The Politics of Value at a Michigan Landfill

This article discusses scavenging and dumping as alternative approaches to deriving value from rubbish at a large Michigan landfill. Both practices are attuned to the indeterminacy and power of abandoned things, but in different ways. Whereas scavenging relies on acquiring familiarity with an object by getting to know its particular qualities, landfilling and other forms of mass disposal make discards fungible and manipulable by stripping them of their former identities. By way of examining the different ways in which people become invested in the politics of value at the landfill, whether as part of expressions of gender and class or for personal enjoyment, different comportments toward materiality are revealed to have underlying social and moral implications. In particular, it is argued that different approaches to the evaluation of rubbish involve competing understandings of human and material potential