Suchergebnisse

Firearm injuries are a leading cause of injury-related deaths in the U.S., but there is a dearth of federal funding for research on firearm injury prevention, compared to funding for research on other injuries and diseases. University research centers/institutes (C/Is) are in a position to help generate such research: they are multidisciplinary, have the capacity to conduct large-scale research projects, and commonly address complex health and social problems. In this article, we trace the history of research on firearm injury prevention, describe the different kinds of C/Is and C/I networks that have been developed to build knowledge in other areas of critical social concern, and argue for the development of a national coordinated network of firearm injury prevention C/Is.

AbstractIntroductionThe population of men‐who‐have‐sex‐with‐men (MSM) includes people who are on the masculine spectrum but were assigned female at birth (AFAB), that is trans MSM. This study aims to identify current circumstances regarding sexual happiness and safety among German trans MSM. To date, there is no health information about trans MSM in Germany, limiting the ability of MSM sexual health programmes to meet their needs.MethodsData were used from the European MSM Internet Survey (EMIS‐2017), where people identifying as men and/or trans men were recruited through dating apps for MSM, community websites and social media to participate in an online survey. We analysed parameters on sexual happiness and satisfaction with sexual safety among Germany‐based trans MSM and compared those to outcomes of MSM assigned male at birth (cis MSM) living in Germany using descriptive methods and logistic regression models adjusting for age.ResultsIn total, 23,001 participants from Germany were included, of which 122 (0.5%) indicated to be AFAB (i.e. trans MSM). Trans MSM were markedly younger than cis participants (median age: 28.5 vs. 39 years).Trans MSM more often reported being unhappy with their current sex life (adjusted odds ratio [aOR] = 1.82, 95% CI 1.24–2.67), had higher odds of disagreeing with the statements "the sex I have is always as safe as I want" ([aOR] = 1.82, 95% CI 1.24–2.67) and "I find it easy to say no to sex that I don't want" ([aOR] = 1.80, 95% CI 1.18–2.77).Trans MSM were more likely to not be living comfortably financially ([aOR] = 2.43, 95% CI 1.60–3.67) and to be living with severe anxiety and/or depression ([aOR] = 3.90, 95% CI 2.22–6.83). Trans MSM were less likely to have ever tested for HIV ([aOR] = 0.63, 95% CI 0.43–0.93).ConclusionsSexual happiness, control of sexual boundaries, satisfaction with sexual safety, financial security, mental wellbeing and HIV testing were all lower in German trans MSM compared with cis MSM. Tailored sexual health interventions, contextualized with regard to needs and vulnerabilities, could address this inequality.

AbstractIntroductionIn France, oral pre‐exposure prophylaxis (PrEP) for HIV prevention has been publicly available since 2016, mainly targeting at men who have sex with men (MSM). Reliable and robust estimations of the actual PrEP uptake among MSM on a localized level can provide additional insights to identify and better reach marginalized MSM within current HIV prevention service provision. This study used national pharmaco‐epidemiology surveillance data and regional MSM population estimations to model the spatio‐temporal distribution of PrEP uptake among MSM in France 2016–2021 to identify marginalized MSM at risk for HIV and increase their PrEP uptake.MethodsWe first applied Bayesian spatial analyses with survey‐surveillance‐based HIV incidence data as a spatial proxy to estimate the size of (1) regional HIV‐negative MSM populations and (2) MSM who could be eligible for PrEP use according to French PrEP guidelines. We then applied Bayesian spatio‐temporal ecological regression modelling to estimate the regional prevalence and relative probability of the overall‐ and new‐PrEP uptake from 2016 to 2021 across France.ResultsHIV‐negative and PrEP‐eligible MSM populations vary regionally across France. Île‐de‐France was estimated to have the highest MSM density compared to other French regions. According to the final spatio‐temporal model, the relative probability of overall PrEP uptake was heterogeneous across France but remained stable over time. Urban areas have higher‐than‐average probabilities of PrEP uptake. The prevalence of PrEP use increased steadily (ranging from 8.8% [95% credible interval 8.5%;9.0%] in Nouvelle‐Aquitaine to 38.2% [36.5%;39.9%] in Centre‐Val‐de‐Loire in 2021).ConclusionsOur results show that using Bayesian spatial analysis as a novel methodology to estimate the localized HIV‐negative MSM population is feasible and applicable. Spatio‐temporal models showed that despite the increasing prevalence of PrEP use in all regions, geographical disparities and inequalities of PrEP uptake continued to exist over time. We identified regions that would benefit from greater tailoring and delivery efforts. Based on our findings, public health policies and HIV prevention strategies could be adjusted to better combat HIV infections and to accelerate ending the HIV epidemic.

In 2019, only 14 European and Central Asian countries provided reimbursed HIV pre-exposure prophylaxis (PrEP). Using EMIS-2017 data, we present the difference between self-reported use and expressed need for PrEP in individual countries and the European Union (EU). We estimate that 500,000 men who have sex with men in the EU cannot access PrEP, although they would be very likely to use it. PrEP's potential to eliminate HIV is currently unrealised by national healthcare systems.

The purpose of this study was to compare the composite, inter-individual, and intra-individual differences in the patterns of responses for electromyographic (EMG) and mechanomyographic (MMG) amplitude (AMP) and mean power frequency (MPF) during fatiguing, maximal, bilateral, and isokinetic leg extension muscle actions. Thirteen recreationally active men (age = 21.7 ± 2.6 years; body mass = 79.8 ± 11.5 kg; height = 174.2 ± 12.7 cm) performed maximal, bilateral leg extensions at 180°·s−1 until the torque values dropped to 50% of peak torque for two consecutive repetitions. The EMG and MMG signals from the vastus lateralis (VL) muscles of both limbs were recorded. Four 2(Leg) × 19(time) repeated measures ANOVAs were conducted to examine mean differences for EMG AMP, EMG MPF, MMG AMP, and MMG MPF between limbs, and polynomial regression analyses were performed to identify the patterns of neuromuscular responses. The results indicated no significant differences between limbs for EMG AMP (p = 0.44), EMG MPF (p = 0.33), MMG AMP (p = 0.89), or MMG MPF (p = 0.52). Polynomial regression analyses demonstrated substantial inter-individual variability. Inferences made regarding the patterns of neuromuscular responses to fatiguing and bilateral muscle actions should be considered on a subject-by-subject basis.

In 2019, only 14 European and Central Asian countries provided reimbursed HIV pre-exposure prophylaxis (PrEP). Using EMIS-2017 data, we present the difference between self-reported use and expressed need for PrEP in individual countries and the European Union (EU). We estimate that 500,000 men who have sex with men in the EU cannot access PrEP, although they would be very likely to use it. PrEP's potential to eliminate HIV is currently unrealised by national healthcare systems.

AbstractGranular media filtration remains a critical treatment process and regulatory requirement for managing pathogenic protozoa in drinking water. It is a dynamic process in which performance inherently varies. While research has focused on characterizing or maximizing (oo)cyst removal in individual filters, the risk implications of combinations of filters moving through different phases of the filter cycle (leading to temporal variation in plant‐scale performance) have not been described. Increasing threats from climate‐change‐exacerbated landscape disturbances leading to more variable source water quality emphasize the need for such evaluations. Here, a modeling framework was developed to investigate the impacts of individual filter performance variation on plant‐scale performance. It is shown that improving maximal removal during stable operation does not necessarily improve average performance. The effect of other design and operational strategies like increasing the number of filters or implementing proactive operations (e.g., avoiding breakthrough) are analyzed, thereby providing guidance for increasing treatment resilience.

AbstractEnvironmental justice research driven by academics and policymakers often overlooks the valuable insights and leadership of the communities most impacted by environmental hazards. When institution‐led research approaches are employed, inadequate community ownership and limited institutional accountability hinder the effectiveness of environmental public health interventions. In contrast, a community‐owned and ‐managed approach to environmental justice research can guide community members in developing evidence‐based interventions. This paper outlines a community‐led environmental health assessment survey (sample = 100) and resulting community actions over 6 years (2017–2023) in a Northern California farmworker community with a perceived high prevalence of cancer and exposure to environmental hazards in households, neighborhoods, and job sites. Local resident experts in Knights Landing, CA, documented community risk factors and exposures in collaboration with interdisciplinary undergraduate and graduate student‐researchers. The survey instrument focused on environmental hazards identified by local resident experts including vehicular and agricultural pollution, occupational pesticide contact, and sun exposure. Survey findings highlighted the need for targeted interventions to reduce environmental health risks, such as academic outreach programs, county investments in public services, and community‐led mutual aid initiatives. Despite academic reservations about our non‐random sampling method and data collection by local resident experts, our project sparked substantial actions and investments with minimal personnel and financial resources. Local leaders working with student‐researchers developed more effective environmental public health interventions through a community‐owned and ‐managed approach that went beyond the efforts of local regulatory and research institutions.

With a contemporary overview of global social policy formation, the third edition of this leading textbook identifies key issues, debates and priorities for action in social policy across the Global South and North. Accessible and lively, it incorporates seven new chapters covering theory, social justice, climate, migration, gender, young people and water, energy and food. The original chapters have also been fully updated to reflect major developments in the fast-changing world of global social policy. Key features include: • overview and summary boxes to bookend each chapter; • questions for discussion and follow-up activities; • further reading and resources. Exploring what it means to locate human welfare within a global framework of social policy analysis and action, this textbook offers a perfect guide for curious students