The Intersection of Childcare and Health Among Women at a U.S. Safety-Net Health System During the COVID-19 Pandemic: A Qualitative Study.

Introduction: Lack of childcare has been linked to missed health care appointments for adult women, especially for lower-income women. The COVID-19 pandemic created additional stressors for many low-income families that already struggled to meet childcare and health care needs. By exploring the experiences of women who were referred for childcare services at a U.S. safety-net health system, we aimed to understand the challenges women faced in managing their health and childcare needs during the COVID-19 pandemic. Methods: We conducted semistructured interviews with participants in Dallas County, TX between August 2021 and February 2022. All participants were referred from women's health clinics at the county's safety-net hospital system to an on-site drop-off childcare center by hospital staff who identified lack of childcare as a barrier to health care access. Participants were the primary caregiver for at least one child ≤age 13. Interviews were conducted in English or Spanish. We analyzed data using thematic content analysis. Results: We interviewed 22 participants (mean age 34); participants were adult women, had on average 3 children, and primarily identified as Hispanic or African American. Three interrelated themes emerged: disruptions in access, competing priorities, and exacerbated psychological distress. Conclusions: Findings demonstrate how low-income women with young children in a safety-net health system struggle to address their own health needs amid childcare and other household demands. Our study advances our understanding of childcare as a social domain of health, a necessary step to inform how we build structural support systems and drive policy interventions.

Innovation in Sexuality and Relationship Education in Child Welfare: Shifting Toward a Focus on Ongoing Conversations, Connection, and Consent.

Youth in foster care experience disproportionate rates of abusive relationships, teen pregnancy, and sexually transmitted infections (STIs). Extant research points to the need for interventions at multiple levels of the social ecology, however, there is a lack of evidence to guide the development of coordinated interventions for youth, foster parents, and child welfare professionals. The Texas Foster Youth Health Initiative (TFYHI) convened a multidisciplinary learning community to build a foundation for intervention development. The intentional learning and innovation process engaged several groups of stakeholders: young adults with lived experience (n = 41), foster parents (n = 14), and child welfare professionals (n = 52). Interviews, community listening sessions, and reflection exercises were designed to capture tacit and experiential knowledge and explore challenges and desired outcomes from different perspectives. Based on a thematic analysis of stakeholder perspectives, we identified overarching needs to normalize conversations about sexuality and relationships and shift away from risk-based and stigmatizing approaches. We also identified key strategies for designing coordinated interventions targeting youth, foster parents, and child welfare professionals: (1) Reflect on values about sexuality and relationships. (2) Validate youths' need for connection. (3) Focus on strengthening youth-adult relationships and ongoing conversations. (4) Build healthy relationship skills including communication about consent, condom use, and contraception. (5) Identify teachable moments and model problem solving. (6) Use interactive approaches for sharing health information and empower youth to choose methods that fit their needs.

Family planning science and practice lessons from the 2018 International Conference on Family Planning.

Background Since 2009, the International Conference on Family Planning (ICFP) has served as an opportunity for the global reproductive health community to share FP advances and practice lessons in the areas of research, programming, and advocacy. The purpose of this paper was to synthesize the key results and findings presented by members of the FP community at the 2018 ICFP Conference. Methods More than 700 abstracts from all 15 conference tracks were reviewed and 64 abstracts total were selected for this paper based on the novelty and urgency of the findings. The content analysis of conference abstracts were grouped into six final thematic areas. Results 1 ) Investing in family planning for a lifetime of returns. FP continues to face a shortage of funding. Domestically based and locally owned funding models provide alternative financing solutions. 2) Addressing inequities in family planning for key populations. Various populations still face challenges in accessing FP. Youth-inclusive and user-centered programming show promise in addressing such challenges. 3) Reproductive justice, Unsafe abortions tend to be more common among younger, poor, uneducated and rural women. Legislation is still needed to facilitate a culture of safe abortions. 4) Couple dynamics and decision-making. Couples who share equitable responsibility in decision-making processes are more likely to use contraceptives; couple disagreement influences women's decisions to covertly use FP. 5) Male involvement in  programming. Male champions can successfully promote uptake of FP. Gender-transformative programming promotes gender equity and impacts behavior change. 6) Breakthroughs in novel contraceptives and systems improvement in family planning. Recent advances include user-centered contraceptive technologies that allow for self-administration and information systems which optimize supply chain management. Conclusion The research, advocacy, and programmatic abstracts at ICFP 2018 highlighted research advances, showcased implementation science wins, and provided evidence of critical knowledge gaps in global FP access and use.

PRUNE2 is a human prostate cancer suppressor regulated by the intronic long noncoding RNA PCA3.

Prostate cancer antigen 3 (PCA3) is the most specific prostate cancer biomarker but its function remains unknown. Here we identify PRUNE2, a target protein-coding gene variant, which harbors the PCA3 locus, thereby classifying PCA3 as an antisense intronic long noncoding (lnc)RNA. We show that PCA3 controls PRUNE2 levels via a unique regulatory mechanism involving formation of a PRUNE2/PCA3 double-stranded RNA that undergoes adenosine deaminase acting on RNA (ADAR)-dependent adenosine-to-inosine RNA editing. PRUNE2 expression or silencing in prostate cancer cells decreased and increased cell proliferation, respectively. Moreover, PRUNE2 and PCA3 elicited opposite effects on tumor growth in immunodeficient tumor-bearing mice. Coregulation and RNA editing of PRUNE2 and PCA3 were confirmed in human prostate cancer specimens, supporting the medical relevance of our findings. These results establish PCA3 as a dominant-negative oncogene and PRUNE2 as an unrecognized tumor suppressor gene in human prostate cancer, and their regulatory axis represents a unique molecular target for diagnostic and therapeutic intervention.

Ligand-directed profiling of organelles with internalizing phage libraries.

Phage display is a resourceful tool to, in an unbiased manner, discover and characterize functional protein-protein interactions, create vaccines, and engineer peptides, antibodies, and other proteins as targeted diagnostic and/or therapeutic agents. Recently, our group has developed a new class of internalizing phage (iPhage) for ligand-directed targeting of organelles and to identify molecular pathways within live cells. This unique technology is suitable for applications ranging from fundamental cell biology to drug development. This unit describes the methods for generating and screening the iPhage display system, and explains how to select and validate candidate internalizing homing peptide.

Targeting mammalian organelles with internalizing phage (iPhage) libraries.

Techniques that are largely used for protein interaction studies and the discovery of intracellular receptors, such as affinity-capture complex purification and the yeast two-hybrid system, may produce inaccurate data sets owing to protein insolubility, transient or weak protein interactions or irrelevant intracellular context. A versatile tool for overcoming these limitations, as well as for potentially creating vaccines and engineering peptides and antibodies as targeted diagnostic and therapeutic agents, is the phage-display technique. We have recently developed a new technology for screening internalizing phage (iPhage) vectors and libraries using a ligand/receptor-independent mechanism to penetrate eukaryotic cells. iPhage particles provide a unique discovery platform for combinatorial intracellular targeting of organelle ligands along with their corresponding receptors and for fingerprinting functional protein domains in living cells. Here we explain the design, cloning, construction and production of iPhage-based vectors and libraries, along with basic ligand-receptor identification and validation methodologies for organelle receptors. An iPhage library screening can be performed in ∼8 weeks.