Working With Lesbian, Gay, Bisexual, and Transgender People in Care Relationships

This chapter details some key considerations for health and human services professionals working with lesbian, gay, bisexual, and transgender (LGBT) people in care relationships. Reflecting on the impacts of stigma and discrimination as well as the social, cultural, and political contexts of LGBT communities and carers, this chapter will explore some of ways these factors (as well as heterosexist and cis-genderist assumptions about families and partners) impact the identification, support, and recognition of LGBT people in care relationships. Finally, this chapter will recommend strategies to reduce poor mental health and wellbeing outcomes among people in care relationships where one or all people involved are LGBT, and explore some key actions that may assist health and human services better support and include LGBT people in care relationships.

Working With Lesbian, Gay, Bisexual, and Transgender People in Care Relationships

This chapter details some key considerations for health and human services professionals working with lesbian, gay, bisexual, and transgender (LGBT) people in care relationships. Reflecting on the impacts of stigma and discrimination as well as the social, cultural, and political contexts of LGBT communities and carers, this chapter will explore some of ways these factors (as well as heterosexist and cis-genderist assumptions about families and partners) impact the identification, support, and recognition of LGBT people in care relationships. Finally, this chapter will recommend strategies to reduce poor mental health and wellbeing outcomes among people in care relationships where one or all people involved are LGBT, and explore some key actions that may assist health and human services better support and include LGBT people in care relationships.

Healthy People 2020 Final Review

This report provides a quantitative end-of-decade assessment of the nation’s progress toward achieving health goals set by the U.S. Department of Health and Human Services.

1240. Ceftobiprole Activity against Drug-Resistant Staphylococcus aureus Clinical Isolates Collected in the United States from 2016 through 2020

Background Multidrug-resistant (MDR) and methicillin-resistant Staphylococcus aureus (MRSA) present significant treatment challenges and can cause serious morbidity and mortality. Ceftobiprole, the active moiety of the prodrug ceftobiprole medocaril, is an advanced cephalosporin approved in many European and other countries for the treatment of adults with community- and hospital-acquired pneumonia, excluding ventilator-associated pneumonia. Ceftobiprole is currently in phase 3 clinical development to support a New Drug Application in the United States for acute bacterial skin and skin structure infections and S. aureus bacteremia. Here, the activity of ceftobiprole and comparators was evaluated against recent MDR S. aureus and MRSA clinical isolates. Methods 13,868 S. aureus isolates were collected from patients with various infection types at 34 US medical centers from 2016–2020. Susceptibility to ceftobiprole and comparator agents was tested by CLSI methods. Current CLSI and EUCAST interpretive criteria were applied (Table). Isolates were categorized as MDR if they were non-susceptible (NS; CLSI criteria) to ≥3 of the following antimicrobials: clindamycin (CM), daptomycin (DAP), erythromycin (ERY), gentamicin (GM), levofloxacin (LEV), linezolid (LZD), tetracycline (TET), tigecycline (TGC), trimethoprim-sulfamethoxazole (TMP-SMX), or vancomycin (VAN). Isolates displaying oxacillin MIC values ≥4 mg/L were categorized as MRSA. Results Ceftobiprole was more active than ceftaroline (CPT) against MRSA (99.2% susceptible [S] versus 94.0% S, respectively) (Table). Ceftobiprole maintained activity against 88.0% of the CPT-NS isolates, but CPT was only active against 6.5% of the ceftobiprole-NS isolates. Ceftobiprole was also highly active (97.7–100.0% S) against isolates NS to CM, DAP, ERY, GM, LEV, LZD, TET, TGC, or TMP-SMX. No VAN-NS isolates were detected. Importantly, ceftobiprole was more active (97.7% S) than CPT (83.0% S) against the subset of MDR-MRSA isolates. Conclusion Conclusions: Ceftobiprole was highly active in vitro against MRSA and MDR S. aureus collected at US medical centers during 2016–2020. These results support the further development of ceftobiprole to treat S. aureus infections in the US. Disclosures Leonard R. Duncan, PhD, AbbVie (formerly Allergan) (Research Grant or Support)Basilea Pharmaceutica International, Ltd. (Research Grant or Support)Cipla Therapeutics (Research Grant or Support)Cipla USA Inc. (Research Grant or Support)Department of Health and Human Services (Research Grant or Support, Contract no. HHSO100201600002C)Shionogi (Research Grant or Support) Kamal Hamed, MD, MPH, Basilea Pharmaceutica International, Ltd (Employee)Department of Health and Human Services (Research Grant or Support, Contract no. HHSO100201600002C) Jennifer Smart, PhD, Basilea Pharmaceutica International, Ltd. (Employee)Department of Health and Human Services (Research Grant or Support, Contract no. HHSO100201600002C) Michael A Pfaller, MD, Basilea Pharmaceutica International, Ltd. (Research Grant or Support)Cidara Therapeutics, Inc. (Research Grant or Support)Department of Health and Human Services (Research Grant or Support, Contract no. HHSO100201600002C)Pfizer, Inc. (Research Grant or Support) Helio S. Sader, MD, PhD, FIDSA, AbbVie (formerly Allergan) (Research Grant or Support)Basilea Pharmaceutica International, Ltd. (Research Grant or Support)Cipla Therapeutics (Research Grant or Support)Cipla USA Inc. (Research Grant or Support)Department of Health and Human Services (Research Grant or Support, Contract no. HHSO100201600002C)Melinta Therapeutics, LLC (Research Grant or Support)Nabriva Therapeutics (Research Grant or Support)Pfizer, Inc. (Research Grant or Support)Shionogi (Research Grant or Support)Spero Therapeutics (Research Grant or Support)

A Machine-Learning Classification Tree Model of Perceived Organizational Performance in U.S. Federal Government Health Agencies

Perceived organizational performance (POP) is an important factor that influences employees’ attitudes and behaviors such as retention and turnover, which in turn improve or impede organizational sustainability. The current study aims to identify interaction patterns of risk factors that differentiate public health and human services employees who perceived their agency performance as low. The 2018 Federal Employee Viewpoint Survey (FEVS), a nationally representative sample of U.S. federal government employees, was used for this study. The study included 43,029 federal employees (weighted n = 75,706) among 10 sub-agencies in the public health and human services sector. The machine-learning classification decision-tree modeling identified several tree-splitting variables and classified 33 subgroups of employees with 2 high-risk, 6 moderate-risk and 25 low-risk subgroups of POP. The important variables predicting POP included performance-oriented culture, organizational satisfaction, organizational procedural justice, task-oriented leadership, work security and safety, and employees’ commitment to their agency, and important variables interacted with one another in predicting risks of POP. Complex interaction patterns in high- and moderate-risk subgroups, the importance of a machine-learning approach to sustainable human resource management in industry 4.0, and the limitations and future research are discussed.

Hogy minden falat számítson: étrendi ajánlás az amerikaiaknak

Az 1980-ban megjelent első kiadás óta az Amerikaiaknak szóló étrendi ajánlások (Dietary Guidelines for Americans) tudományosan megalapozott tanácsokat adnak arra vonatkozóan, hogy mit kell enni és inni az egészség megőrzése, a krónikus betegségek kockázatának csökkentése és a tápanyagszükséglet kielégítése érdekében. Az étrendi ajánlások közzétételét az 1990. évi Nemzeti Táplálkozásfigyelő és Kapcsolódó Kutatási Törvény (National Nutrition Monitoring and Related Research Act) írja elő, amely kimondja, hogy az Egyesült Államok Mezőgazdasági Minisztériuma (U. S. Departments of Agriculture, USDA) és az Egészségügyi és Humán Szolgáltatások Minisztériuma (Health and Human Services, HHS) legalább öt évente közösen tegyen közzé egy jelentést, amely táplálkozási és étrendi információkat, ajánlásokat tartalmaz a lakosság számára. A törvény (Public Law 101-445, 7 United States Code 5341 et seq.) előírja, hogy az étrendi ajánlásoknak a jelenlegi tudományos és orvosi ismereteken kell alapulniuk. Az étrendi ajánlások 2020-2025-ös kiadása a 2015-ös kiadásra épül, a 2020-as étrendi ajánlások tanácsadó bizottságának tudományos jelentésén (Scientific Report of the 2020 Dietary Guidelines Advisory Committee) alapuló felülvizsgálatokkal, valamint a szövetségi ügynökségek és a lakossági észrevételek figyelembevételével.

Drug importation: limitations of current proposals and opportunities for improvement

Drug importation is a policy proposal to help alleviate rising pharmaceutical prices. Restrictions on drug importation stem from the Federal Food, Drug, and Cosmetic Act but authorization of importation can be made by the Health and Human Services (HHS) Secretary. During the Trump administration a number of states passed laws to develop a drug importation programs, however, none have been authorized by HHS. Limitations of these importation programs include sole reliance on Canada, exclusion of high-cost drugs like biologics, and persistent legal hazard of the Personal Importation Program. Potential revisions to current law include expansion of countries approved for importation, inclusion of biologics, and codifying protection for personal importation. Drug importation policies are not a panacea to address rising pharmaceutical prices but may blunt prices while more permanent solutions are pursued.