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Students in high school or secondary school face challenges that too often lead them to drop out of school. Administrators and staff in many of these schools have attempted to address this challenge by adopting a framework of Positive Behavior Interventions and Supports (PBIS) that offers graduated tiers of intervention suited to students' needs. One such intervention that has been used in some parts of the US, was developed by the School of Life Foundation (SOLF). The intervention consists of a life-skills curriculum that supports students by addressing factors related to increased probability of dropping out of school. This article provides a case report, from the United States, of the SOLF intervention in the context of a PBIS framework.

BackgroundInformation regarding the impact of substance use on the timing of entry into HIV care is lacking. Better understanding of this relationship can help guide approaches and policies to improve HIV testing and linkage.MethodsWe examined the effect of specific substances on stage of HIV disease at entry into care in over 5000 persons with HIV (PWH) newly enrolling in care. Substance use was obtained from the AUDIT-C and ASSIST instruments. We examined the association between early entry into care and substance use (high-risk alcohol, methamphetamine, cocaine/crack, illicit opioids, marijuana) using logistic and relative risk regression models adjusting for demographic factors, mental health symptoms and diagnoses, and clinical site.ResultsWe found that current methamphetamine use, past and current cocaine and marijuana use was associated with earlier entry into care compared with individuals who reported no use of these substances.ConclusionEarly entry into care among those with substance use suggests that HIV testing may be differentially offered to people with known HIV risk factors, and that individuals with substances use disorders may be more likely to be tested and linked to care due to increased interactions with the healthcare system.

BackgroundIt is unknown whether gaining inpatient health care coverage had an effect on hospitalization rates among persons with HIV (PWH) after implementation of the Affordable Care Act in 2014.MethodsHospitalization data from 2015 were obtained for 1634 adults receiving longitudinal HIV care at 3 US HIV clinics within the HIV Research Network. All patients were engaged in care and previously uninsured and supported by the Ryan White HIV/AIDS Program in 2013. We evaluated whether PWH who transitioned to either Medicaid or private insurance in 2014 tended to have a change in hospitalization rate compared with PWH who remained uncovered and Ryan White HIV/AIDS Program supported. Analyses were performed by negative binomial regression with robust standard errors, adjusting for gender, race/ethnicity, age, HIV risk factor, CD4 count, viral load, clinic site, and 2013 hospitalization rate.ResultsAmong PWH without inpatient health care coverage in 2013, transitioning to Medicaid [adjusted incidence rate ratio 1.26, (0.71, 2.23)] or to private insurance [0.48 (0.18, 1.28)] in 2014 was not associated with 2015 hospitalization rates, after accounting for demographics, HIV characteristics, and prior hospitalization rates. The factors significantly associated with higher hospitalization rates include age 55-64, CD4 400 copies/mL, and 2013 hospitalization rate.ConclusionsAcquiring inpatient coverage was not associated with a change in hospitalization rates. These results provide some evidence to allay the concern that acquiring inpatient coverage would lead to increased inpatient utilization.

BackgroundThe clinical management of low-level viremia (LLV) remains unclear. The objective of this study was to investigate the association of blips and LLV with virologic failure.MethodsWe enlisted patients who newly enrolled into the HIV Research Network between 2005 and 2015, had HIV-1 RNA more than 200 copies/ml, and were either antiretroviral therapy (ART)-naive or ART-experienced and not on ART. Patients were included who achieved virologic suppression (≤50 on two consecutive viral loads) and had at least two viral loads following suppression. Blips and LLV (≥2 consecutive >51 copies/ml) were categorized separately into three categories: no blips/LLV, 51-200, 201-500. Cox proportional hazards regression was used to assess association between rates of blips/LLV and virologic failure (two consecutive >500).ResultsThe 2795 patients were mostly male (75.4%), black (50.3%), and MSM (52.9%). Median age was 38 years old (interquartile range 29-48). Most patients (88.8%) were ART-naive at study entry. Overall, 283 (10.1%) patients experienced virologic failure. A total of 152 (5.4%) patients experienced LLV to 51-200 and 110 (3.9%) patients experienced LLV to 201-500. Both LLV 51-200 [adjusted hazard ratio (aHR) 1.83 (1.10,3.04)] and LLV 201-500 [aHR 4.26 (2.65,6.86)] were associated with virologic failure. In sensitivity analysis excluding ART-experienced patients, the association between LLV 51 and 200 and virologic failure was not statistically significant.ConclusionLLV between 201 and 500 was associated with virologic failure, as was LLV between 51 and 200, particularly among ART-experienced patients. Patients with LLV below the current Department of Health and Human Services threshold for virologic failure (persistent viremia ≥200) may require more intensive monitoring because of increased risk for virologic failure.

Despite recent socially positive progression in the view and treatment of lesbian, gay, bisexual, and transgender (LGBT) individuals in the USA, the LGBT population continues to face complicated circumstances and significant hindrances in many societal institutions. One of the most challenging and complex arena is the educational system (Biegel 2010). The present qualitative study explored the thoughts, feelings, and experiences of LGBT-identified school psychologists. Based on data gathered via interviews with LGBT-identified school psychologists and analyzed using the consensual qualitative research (CQR) method, several themes emerged: impact on professional role, the presence of heterosexism in schools, the role of relationships, individual resiliency, and advocacy. These insights help to better understand the successes, challenges, and potential negative outcomes LGBT school psychologists face on the job and how these issues can affect the students they serve. Finally, the implications for policy development, education, and training are outlined.

Analysis of Gury's sources for his two principles governing the indirect voluntary both illuminates its historical development and raises questions about its meaning. The historical review reveals not only that Gury relied far more on later theologians than on Thomas Aquinas in formulating his principles, but also that two critical changes in the understanding of the indirect voluntary have created a deceptive appearance of historical continuity regarding double-effect reasoning., MORE THAN A CENTURY AFTER Catholic ethicists first began to debate its effectiveness, the principle of double effect continues to be a bone of contention in moral theology, with periodic [...]

Early Modern theologians Francisco de Vitoria and Leonardus Lessius analyzed the nature and limits of the obligation to preserve one's life through the use of food. Vitoria described the ethical foundations of and the circumstances that might limit such an obligation, while Lessius argued for a virtuous approach to nutrition that eschewed both indifference and excessive concern. Their analyses raise significant questions for contemporary moral theology concerning the scope and difficulties of nutritional ethics., ROMAN CATHOLIC MORAL THEOLOGIANS commonly acknowledge that their 16th- and 17th-century predecessors devoted significant attention to the ethics of preserving human life, and that these early modern analyses eventually gave [...]

Contemporary historians of Western lynching point out that the influential frontier justice interpretation has many weaknesses, especially its inattention to the role of race and ethnicity. Selected Jesuit incidental references both reflect the influence of this paradigm and support its contemporary critique by identifying frontier lynching as an Anglo-American practice. [ABSTRACT FROM AUTHOR]

A HISTORY OF MORAL THEOLOGY IN THE TWENTIETH CENTURY: FROM CONFESSING SINS TO LIBERATING CONSCIENCES. By James F. Keenan, S.J. New York: Continuum, 2010. Pp. viii + 248. $85; $29.95. [...]

The Teachings of Modern Roman Catholicism on Law, Politics, & Human Nature. Edited by John Witte, Jr. and Frank S. Alexander; introduction by Russell Hittinger. New York: Columbia University Press, [...]

Persons with HIV (PWH) are aging. The impact of aging on healthcare utilization is unknown. The objective of this study was to evaluate hospitalization rates and reasons stratified by age among PWH in longitudinal HIV care. Hospitalization data from 2014–2015 was obtained on all adults receiving HIV care at 14 diverse sites within the HIV Research Network in the United States. Modified clinical classification software from the Agency for Healthcare Research and Quality assigned primary ICD-9 codes into diagnostic categories. Analysis performed with multivariate negative binomial regression. Among 20,608 subjects during 2014–2015, all cause hospitalization rate was 201/1000PY. Non-AIDS defining infection (non-ADI) was the leading cause for admission (44.2/1000PY), followed by cardiovascular disease (CVD) (21.2/1000PY). In multivariate analysis of all-cause admissions, the incidence rate ratio (aIRR) increased with older age (age 18–29 reference): age 30–39 aIRR 1.09 (0.90,1.32), age 40–49 1.38 (1.16,1.63), age 50–59 1.58 (1.33,1.87), and age ≥ 60 2.14 (1.77,2.59). Hospitalization rates increased significantly with age for CVD, endocrine, renal, pulmonary, and oncology. All cause hospitalization rates increased with older age, especially among non-communicable diseases (NCDs), while non-ADIs remained the leading cause for hospitalization. HIV providers should be comfortable screening for and treating NCDs. [ABSTRACT FROM AUTHOR]

Vainglory: The Forgotten Vice. By Rebecca Konyndyk DeYoung. Grand Rapids, Ml: Eerdmans, 2014. Pp. x + 157. $14. In her aptly titled work, philosopher DeYoung draws upon Aquinas, Augustine, and [...]