scholarly journals HIV-Related Stigma Research as a Priority at the National Institutes of Health

2021 ◽  
Author(s):  
Gregory L. Greenwood ◽  
Amber Wilson ◽  
Geetha P. Bansal ◽  
Christopher Barnhart ◽  
Elizabeth Barr ◽  
...  
Keyword(s):  
National Institutes Of Health ◽  
Hiv Stigma ◽  
Collective Actions ◽  
Research Gaps ◽  
Hiv Interventions ◽  
Research Priority ◽  
Hiv Epidemic ◽  
Research Themes ◽  
Related Stigma ◽  
History Of

AbstractThe National Institutes of Health (NIH) recognizes that, despite HIV scientific advances, stigma and discrimination continue to be critical barriers to the uptake of evidence-based HIV interventions. Achieving the Ending the HIV Epidemic: A Plan for America (EHE) goals will require eliminating HIV-related stigma. NIH has a significant history of supporting HIV stigma research across its Institutes, Centers, and Offices (ICOs) as a research priority. This article provides an overview of NIH HIV stigma research efforts. Each ICO articulates how their mission shapes their interest in HIV stigma research and provides a summary of ICO-relevant scientific findings. Research gaps and/or future opportunities are identified throughout, with key research themes and approaches noted. Taken together, the collective actions on the part of the NIH, in tandem with a whole of government and whole of society approach, will contribute to achieving EHE’s milestones.

scholarly journals Proceedings of the First Curing Coma Campaign NIH Symposium: Challenging the Future of Research for Coma and Disorders of Consciousness

2021 ◽  
Vol 35 (S1) ◽  
pp. 4-23
Author(s):  
Jan Claassen ◽  
Yama Akbari ◽  
Sheila Alexander ◽  
Mary Kay Bader ◽  
Kathleen Bell ◽  
...  
Keyword(s):  
Neurocritical Care ◽  
Panel Discussion ◽  
Large Datasets ◽  
Disorders Of Consciousness ◽  
National Institutes Of Health ◽  
Proof Of Concept ◽  
Research Gaps ◽  
Main Research ◽  
The World

AbstractComa and disorders of consciousness (DoC) are highly prevalent and constitute a burden for patients, families, and society worldwide. As part of the Curing Coma Campaign, the Neurocritical Care Society partnered with the National Institutes of Health to organize a symposium bringing together experts from all over the world to develop research targets for DoC. The conference was structured along six domains: (1) defining endotype/phenotypes, (2) biomarkers, (3) proof-of-concept clinical trials, (4) neuroprognostication, (5) long-term recovery, and (6) large datasets. This proceedings paper presents actionable research targets based on the presentations and discussions that occurred at the conference. We summarize the background, main research gaps, overall goals, the panel discussion of the approach, limitations and challenges, and deliverables that were identified.

Is a picture-perfect thrombectomy necessary in acute ischemic stroke?

2021 ◽  
pp. neurintsurg-2020-017193
Author(s):  
Ching-Jen Chen ◽  
Reda Chalhoub ◽  
Dale Ding ◽  
Jeyan S Kumar ◽  
Natasha Ironside ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Mechanical Thrombectomy ◽  
National Institutes Of Health ◽  
Stroke Patients ◽  
Anterior Circulation ◽  
Vessel Occlusion ◽  
Symptomatic Intracerebral Hemorrhage ◽  
History Of ◽  
Multivariable Models ◽  
Secondary Outcomes

BackgroundThe benefit of complete reperfusion (modified Thrombolysis in Cerebral Infarction (mTICI) 3) over near-complete reperfusion (≥90%, mTICI 2c) remains unclear. The goal of this study is to compare clinical outcomes between mechanical thrombectomy (MT)-treated stroke patients with mTICI 2c versus 3.MethodsThis is a retrospective study from the Stroke Thrombectomy and Aneurysm Registry (STAR) comprising 33 centers. Adults with anterior circulation arterial vessel occlusion who underwent MT yielding mTICI 2c or mTICI 3 reperfusion were included. Patients were categorized based on reperfusion grade achieved. Primary outcome was modified Rankin Scale (mRS) 0–2 at 90 days. Secondary outcomes were mRS scores at discharge and 90 days, National Institutes of Health Stroke Scale score at discharge, procedure-related complications, and symptomatic intracerebral hemorrhage.ResultsThe unmatched mTICI 2c and mTICI 3 cohorts comprised 519 and 1923 patients, respectively. There was no difference in primary (42.4% vs 45.1%; p=0.264) or secondary outcomes between the unmatched cohorts. Reperfusion status (mTICI 2c vs 3) was also not predictive of the primary outcome in non-imputed and imputed multivariable models. The matched cohorts each comprised 191 patients. Primary (39.8% vs 47.6%; p=0.122) and secondary outcomes were also similar between the matched cohorts, except the 90-day mRS which was lower in the matched mTICI 3 cohort (p=0.049). There were increased odds of the primary outcome with mTICI 3 in patients with baseline mRS ≥2 (36% vs 7.7%; p=0.011; pinteraction=0.014) and a history of stroke (42.3% vs 15.4%; p=0.027; pinteraction=0.041).ConclusionsComplete and near-complete reperfusion after MT appear to confer comparable outcomes in patients with acute stroke.

Abstract 14767: Thrombolysis of Stroke Mimics via Telestroke

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ravyn Howell ◽  
Randheer S Yadav ◽  
Sushil Lakhani ◽  
Sharon Heaton ◽  
Karen L Wiles ◽  
...  
Keyword(s):  
Final Diagnosis ◽  
National Institutes Of Health ◽  
Factitious Disorder ◽  
Emergency Rooms ◽  
Stroke Mimics ◽  
Intravenous Tissue Plasminogen Activator ◽  
Stroke Diagnosis ◽  
History Of ◽  
Stroke Mimic ◽  
Similar Episode

Introduction: Telestroke allows stroke expertise for thrombolysis decision making remotely using high-quality bidirectional audiovisual technology. Hypothesis: Intravenous tissue plasminogen activator (IVtPA) is administered via telestroke network to a proportion of patients without a stroke diagnosis (i.e. stroke mimic) Methods: Our academic comprehensive stroke program telestroke program includes 26 spoke Emergency rooms (ERs) through which IVtPA is administered throughout central Ohio. From July 1, 2016 to Sept 30, 2017, nearly all patients who received IVtPA at the outside hospital telestroke ERs were transferred to our institution for post-IVtPA care. Data was collected on final diagnosis, demographics, National Institutes of Health Stroke Scale (NIHSS), door to needle (DTN) time, and outcomes. Results: Among 270 acute ischemic stroke patients who received IVtPA via telestroke, we identified 64 (23.7%) with a stroke mimic diagnosis. Stroke mimics were younger (mean age 56.4 vs 68.2, p <0.0001), more likely female (60.9% vs 45.6%, p 0.03), and had higher DTN times (85.3 vs 69.9 minutes, p 0.0008). The increase in DTN was due to longer time to recommend by the telestroke neurologist for stroke mimic (65.0 vs 53.2 minutes, p 0.0034). The stroke mimic diagnosis included Migraine 26 (40.6%), Factitious disorder 12 (18.8%), Encephalopathy 7 (10.9%), and Unmasking 6 (9.4%). The stroke mimics did not differ from each other based upon initial NIHSS, DTN, or sex. Compared to the other stroke mimics, Migraine and Factitious disorder patients were younger (51.2 vs 63.9 years, p <0.0006), more likely to have a personal history of migraines (42.1% vs 0%, p < 0.0001), and more likely to have functional exam findings (42.1% vs 3.8%, p 0.0007). There were no hemorrhagic complications in the stroke mimic patients. Among all stroke mimics, 26 (40.6%) had a history of similar prior episodes and 10 (15.6%) would have future recurrence of another similar episode, with 2 patients receiving IVtPA again in the future (1 Migraine and 1 Factitious disorder). Conclusions: In a tertiary academic telestroke network, nearly one-quarter of patients receive IVtPA for a non-stroke diagnosis, with migraine and factitious disorder being the most commonly seen.

Just Say No!

PEDIATRICS ◽  
1990 ◽  
Vol 86 (4) ◽  
pp. 624-624
Author(s):  
JOHN M. FREEMAN
Keyword(s):  
Febrile Seizure ◽  
Febrile Seizures ◽  
National Institutes Of Health ◽  
Consensus Development ◽  
Consensus Development Conference ◽  
Focal Seizures ◽  
The Family ◽  
History Of ◽  
Neurologic Development

A seizure, even a febrile seizure, is terrifying to the family. Seeking reassurance that their child will not die and does not have epilepsy, parents turn to their physician. What is he or she to do? Often the physician prescribes medication "to prevent further seizures" and then reassures the family that the child will be fine if the medicine is given daily as directed. Both the recommendation and the reassurance are wrong. A Consensus Development Conference on Febrile Seizures held by the National Institutes of Health in 19801 concluded that they would only "consider" anticonvulsant prophylaxis when the child (1) had abnormal neurologic development, (2) had long or focal seizures, (3) had more than two seizures in 24 hours, (4) had a history of nonfebrile seizures in parent or sibling, or (5) was younger than 1 years of age.

scholarly journals Health care providers and HIV

2021 ◽  
Author(s):  
Anne C. Wagner
Keyword(s):  
Health Care ◽  
Factor Analysis ◽  
Qualitative Study ◽  
Health Care Providers ◽  
Hiv Stigma ◽  
People Living With Hiv ◽  
Care Providers ◽  
Related Stigma ◽  
Convergent And Divergent Validity ◽  
Living With Hiv

The current investigation seeks to examine the attitudes and beliefs of health care providers in Canada about people living with HIV. The line of research consists of three studies. Study 1 was a qualitative study conducted with a critical lens. The critical lens was used in a series of four focus groups when qualitatively soliciting opinions about the range of attitudes, behaviours and cognitions health care providers may have towards people living with HIV. Study 2 used the information gathered from Study 1 to develop a scale to assess HIV stigma in health care providers. Items were created from examples and themes found in the qualitative study, and were tested via exploratory factor analysis, confirmatory factor analysis, test-retest reliability analysis, and assessed for convergent and divergent validity. Study 3 examined the newly developed scale’s relationship to proposed overlapping stigmas and attitudes, and tested the adapted intersectional model of HIV-related stigma with health care trainees using the newly developed HIV stigma scale as an outcome measure. The line of research found that HIV stigma continues to be a significant problem in the health care system. The scale developed in Study 2 demonstrates that HIV stigma can be conceptualized and assessed as a tripartite model of discrimination, stereotyping and prejudice, and that this conceptualization of HIV stigma supports an intersectional model of overlapping stigmas with homophobia, racism, stigma against injection drug use and stigma against sex work.

scholarly journals Void spot assay: recommendations on the use of a simple micturition assay for mice

2018 ◽  
Vol 315 (5) ◽  
pp. F1422-F1429 ◽  
Author(s):  
Warren G. Hill ◽  
Mark L. Zeidel ◽  
Dale E. Bjorling ◽  
Chad M. Vezina
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Best Practice ◽  
Assessment Tool ◽  
National Institutes Of Health ◽  
Consensus Group ◽  
Lower Urinary Tract Function ◽  
Tract Function ◽  
History Of ◽  
Lower Urinary

Investigators have for decades used mouse voiding patterns as end points for studying behavioral biology. It is only recently that mouse voiding patterns were adopted for study of lower urinary tract physiology. The spontaneous void spot assay (VSA), a popular micturition assessment tool, involves placing a mouse in an enclosure lined by filter paper and quantifying the resulting urine spot pattern. The VSA has advantages of being inexpensive and noninvasive, but some investigators challenge its ability to distinguish lower urinary tract function from behavioral voiding. A consensus group of investigators who regularly use the VSA was established by the National Institutes of Health in 2015 to address the strengths and weaknesses of the assay, determine whether it can be standardized across laboratories, and determine whether it can be used as a surrogate for evaluating urinary function. Here we leverage experience from the consensus group to review the history of the VSA and its uses, summarize experiments to optimize assay design for urinary physiology assessment, and make best practice recommendations for performing the assay and analyzing its results.

HIV Stigma Reduction Through Peer-Led Advocacy Training

2021 ◽  
Vol 33 (4) ◽  
pp. 303-311
Author(s):  
Susan Reif ◽  
Haley Cooper ◽  
Elena Wilson ◽  
Gina Brown ◽  
Nicole Beckwith ◽  
...  
Keyword(s):  
Well Being ◽  
Hiv Stigma ◽  
People Living With Hiv ◽  
Negative Effects ◽  
Advocacy Training ◽  
Ongoing Training ◽  
Related Stigma ◽  
Training And Support ◽  
Living With Hiv ◽  
The U.S

HIV-related stigma is pervasive in the U.S. South and has potential negative effects on health outcomes and emotional well-being, and may act as a barrier to HIV-related advocacy among people living with HIV (PLWH). This article reports on the preliminary outcomes associated with participation in an HIV advocacy training for PLWH, LEAD, that included education and skills building for reducing HIV-related stigma. Fifty-seven PLWH at four sites in the U.S. South participated in the retreat-style training and completed a survey measuring stigma and comfort engaging in advocacy prior to and after the worshop. Participation was associated with statistically significant reduction in internalized HIV stigma and increase in comfort with participation in advocacy; however, participants reported a need for ongoing training and support to further increase comfort with advocacy participation. Although more research is needed on the LEAD Workshop, it shows promise as an option for reducing HIV-related stigma among PLWH.

Networked Collective Actions

2021 ◽  
Author(s):  
Hyunjin Seo
Keyword(s):  
Social Media ◽  
Social Change ◽  
South Korea ◽  
Empirical Support ◽  
Right Wing ◽  
Collective Actions ◽  
South Korean ◽  
History Of ◽  
Media Reports ◽  
Key Participants

Massive and sustained candlelight vigils in 2016–2017, the most significant citizen-led protests in the history of democratic South Korea, led to the impeachment and removal of then President Park Geun-hye. These protests took place in a South Korean media environment characterized by polarization and low public trust, and where conspiracy theories and false claims by those opposing impeachment were frequently amplified by extreme right-wing media outlets. How then was it possible for pro-impeachment protests seeking major social change to succeed? And why did pro-Park protesters and government efforts to defend Park ultimately fail? An agent-affordance framework is introduced to explain how key participants (agents), including journalists, citizens, social media influencers, bots, and civic organizations, together produced a broad citizen consensus that Park should be removed from office. This was accomplished by creatively employing affordances made available by South Korea’s history, legal system, and technologies. New empirical evidence illustrates the ongoing significant roles of both traditional and nontraditional agents as they continue to co-adapt to affordances provided by changing information environments. Interviews with key players yield firsthand descriptions of events. The interviews, original content analyses of media reports, and examination of social media posts combine to provide strong empirical support for the agent-affordance framework. Lessons drawn from citizen-led protests surrounding Park Geun-hye’s removal from office in South Korea are used to offer suggestions for how technology-enabled affordances may support and constrain movements for social change elsewhere in the world.

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