Innovating resilience promotion: Integrating cultural practices, social ecologies and development-sensitive conceptual strategies for advancing child well-being.

This chapter's goal is to interrogate the intersectional significance of race and socioeconomic status for children of varied statuses of human vulnerability. It provides a context-connected, culture acknowledging, systems model and identity formation perspective. This strategy is ideal for delineating behavioral consistencies (and interpreting inconsistencies). When operationalized with programming opportunities, it accommodates the nation's diversity and aids the interpretation of findings. This chapter is divided into several sections: First, it interrogates critical insights afforded by a "resiliency-vulnerability" approach; second, it draws attention to the roles of culture, culturally competent practices, and justice-informed contexts for children's perception-based "meaning making" as each-increasingly with age-navigates multiple social ecologies. Third, it shifts to and emphasizes the intersectionally relevant factors of race (e.g., identifiability and skin color stereotyping) and socioeconomic status (i.e., both low resourced and privileging situations); and following a synthesis of the previous sections-as Section 4-it then frames the cumulative and integrated conceptual strategy (phenomenological variant of ecological systems theory: PVEST). In Section 5, the chapter presents theory-focused exemplars to illustrate the theory's efficacy, which are followed by results of two recent preliminary application projects. Salient is that the two projects presenting preliminary findings add to and afford important child development insights salient as strategies for neutralizing intersectionality effects and maximizing resiliency outcomes. To sum, synthesizing several decades of scholarship, theorizing, contemporary research and programming application efforts, the handbook chapter concludes with suggested strategies for creating more informed policies and practices relevant to all children's overall resiliency, healthy development and well-being.

Early experience with the use of hepatitis C antibody-positive, nucleic acid testing-negative donors in lung transplantation.

Historically, potential lung donors who have detectable antibodies to hepatitis C virus have been declined by most centers due to concern for possible disease transmission. We sought to evaluate hepatitis C viral transmission rates from donors who were known to be HCV Ab positive but HCV NAT negative. We performed a single-center retrospective review of a prospectively collected database for lung transplant recipients at our center including HCV Ab+NAT- donors (approved January 2017). Donor and recipient demographic data were compiled, and records were queried to ascertain rate of seroconversion. During the study period (1/1/17 to 8/9/17), a total of 64 recipients underwent lung transplantation. Thirteen (20%) donors were HCV Ab+NAT-. All recipients of HCV Ab+NAT- grafts were HCV Ab- at the time of transplant. Recipients of grafts from HCV Ab+NAT- donors underwent protocol NAT at 2 and 12 months and all are NAT- to date. One recipient developed reactive HCV Ab at 6 months post-transplant. Follow-up NAT showed HCV RNA to be undetectable. To date, use of HCV Ab+NAT- donors in lung transplantation has yielded favorable outcomes, with evidence of one transient seroconversion suggesting this practice may increase access to life-saving transplantation to those in need.

Employment and the sexual and reproductive behavior of female adolescents.

CONTEXT: Women's employment opportunities may reduce the risk of early intercourse and pregnancy, but some evidence has linked adolescent employment and problem behaviors with early intercourse. METHODS: Hazard regression analyses of data from the National Longitudinal Survey of Youth were used to examine the relationship between employment and the risk of first intercourse before age 20 among women who were aged 14-16 in 1979. The relationship between employment and the risk of a first, nonmarital pregnancy among sexually experienced young women was also assessed. RESULTS: Current employment and cumulative months of past employment are associated with increased hazards of first intercourse (hazard ratios, 1.20 and 1.01, respectively); this association is particularly strong for white young women. Adolescents who work more than 120 hours a month are significantly more likely than nonworking adolescents to experience first intercourse (1.4). Although current employment has no effect on the likelihood of a first, nonmarital pregnancy among white adolescents, it is associated with an increased risk of pregnancy among blacks and with a reduced risk of pregnancy among Hispanics. CONCLUSIONS: Program planners and policymakers should be aware of the potential association between adolescent employment, particularly intense employment, and the likelihood of initiating intercourse and experiencing pregnancy, even if causality is still unclear.