Oral Poliovirus Vaccine Evolution and Insights Relevant to Modeling the Risks of Circulating Vaccine‐Derived Polioviruses (cVDPVs)

The live, attenuated oral poliovirus vaccine (OPV) provides a powerful tool for controlling and stopping the transmission of wild polioviruses (WPVs), although the risks of vaccine‐associated paralytic polio (VAPP) and circulating vaccine‐derived poliovirus (cVDPV) outbreaks exist as long as OPV remains in use. Understanding the dynamics of cVDPV emergence and outbreaks as a function of population immunity and other risk factors may help to improve risk management and the development of strategies to respond to possible outbreaks. We performed a comprehensive review of the literature related to the process of OPV evolution and information available from actual experiences with cVDPV outbreaks. Only a relatively small fraction of poliovirus infections cause symptoms, which makes direct observation of the trajectory of OPV evolution within a population impractical and leads to significant uncertainty. Despite a large global surveillance system, the existing genetic sequence data largely provide information about transmitted virulent polioviruses that caused acute flaccid paralysis, and essentially no data track the changes that occur in OPV sequences as the viruses transmit largely asymptomatically through real populations with suboptimal immunity. We updated estimates of cVDPV risks based on actual experiences and identified the many limitations in the existing data on poliovirus transmission and immunity and OPV virus evolution that complicate modeling. Modelers should explore the space of potential model formulations and inputs consistent with the available evidence and future studies should seek to improve our understanding of the OPV virus evolution process to provide better information for policymakers working to manage cVDPV risks.     

ON THE BEHRENS–FISHER PROBLEM1

In this article the Behrens-Fisher problem is reformulated in terms of a structural model of inference. For this version of the problem a solution is obtained which is valid for arbitrary absolutely continuous error distributions. These results are further discussed for the standard normal distribution and for some other special cases with not normally distributed populations.     

Gendered policies and practices that increase older men's risk of elder mistreatment

We aim to detail some of the ways that social policy and gendered practices put older men at risk of elder mistreatment. Research on the abuse and neglect that older adults experience has often focused on the characteristics of the victims and the dynamics within families, emphasizing factors such as the likelihood of an intergenerational cycle of violence, substance abuse and dependency, and older men's financial status as key risks in elder abuse. The effect on men from this type of analysis is that elder mistreatment remains an individual or family problem rather than being viewed as a larger societal concern. This article challenges the individualistic focus by outlining the importance of societal forces affecting older men's risk of mistreatment.     

“They Kill People Over Nothing”: An Exploratory Study of Latina Immigrant Trauma

Abstract

This article presents findings from an exploratory, mixed methods study to: (1) Ascertain whether Latina immigrant clients of a healthcare clinic for uninsured patients suffer a higher rate of PTSD compared to the citizen population at large and (2) Explore whether factors unique to immigrants, such as surviving human smuggling, would predict PTSD. Two validated instruments were deployed with clients who agreed to be screened (n?=?62). Ten percent of U.S. women are expected to develop PTSD in a lifetime, a total tripled by immigrant women in this study. Women who scored high on the PTSD CheckList for Civilians (PCL-C) reported victimization from sexual assault, robberies and loss of friend/family member to violence, though no single assault predicted PTSD. Qualitative data, however, revealed that violence in countries of origin influenced decisions to immigrate. Among the avenues for future research identified by this study are (1) exploration of methods for linking Latina immigrants to mental health services, (2) determining the effects of smuggling violence on immigrants, and (3) Evaluate additive effects of multiple traumas.