HIV Organ Policy Equity Act Research Articles

Living in the Telling

Stories provide listeners or readers a doorway to understand the storyteller’s context and live in the telling. We, as Māori Indigenous scholars (doctoral students, researchers, and academics), bring together our stories, in the forms of creative nonfiction and poetry located in Aotearoa New Zealand and Te Whenua Moemoeā Australia, to tell the ways we navigate colonial spaces while also imagining our desired future. Centring Indigenous storytelling methods and sensory ethnography, we bring together the interrelatedness that situates our stories across time and place. The next wave of Indigenous researchers will be stepping into these spaces that we now walk, so it is timely and crucial that we find creative ways to provide clearer direction for them. We tell our stories in this paper as an act of hope that our stories might spark a fire in the reader’s heart to also tell theirs.

From Confusion to Hope: Lament and Hope in the Faith of Late Adolescence and Early Adulthood

Abstract Young people in late adolescence or emerging adulthood may re-examine their childhood Christian faith. Christian commitments in a pluralistic context can come to be regarded as one possible set of commitments among many options. Articulating clear claims about Christianity will be part of an approach to the faith nurture of young people. Yet Christian faith is also, fundamentally, an act of hope in Christ. A practice of hope, specifically among those beginning to question Christian commitments, can be the activity of lament. The Christian practice of lament addresses God amid the sorrows and confusions of this world. Christian lament is offered to God in the hope that he might respond. Ministering persons may participate in lament with young people, bringing to bear their own sense of Christian hope, and inviting young people to choose this hope as well.

Imagining the impossible: An act of radical hope

Even the most determined optimists among us cannot deny we are living in dark times, with raging wars and the effects of climate change upon us. A pandemic has left us feeling uncertain about our futures, polarization has pressured social discourse. Our assumptions of the future are being challenged: even what we took for granted now seems uncertain. And instead of asking: how did we get here? We are left with the question: what made us think we would never get here? If the unimaginable suddenly becomes a reality, then what is left to imagine? Is it still worth being hopeful? It appears that we are not only suffering from the poverty of imagination, but also from the poverty of hope. But what if imagination and hope are inherently connected? In this essay we propose that we cannot be hopeful without rethinking our images of the future, in which imagining the impossible turns out to become a necessity: a radical act of hope.

Pilgrimage, Precarity, and Pandemics

Pilgrimage, Precarity, and Pandemics

Ivo van Hove and Almodóvar: Remixing The Human Voice

Ivo van Hove and Almodóvar: Remixing <i>The Human Voice</i>

634. Implementation of a medical education intervention to improve acceptance of HIV-positive donors for transplant at a tertiary care hospital

Abstract Background The HIV Organ Policy Equity Act (HOPE Act) was enacted in the US on November 21, 2013. HIV patients have a higher waitlist mortality and decreased access to transplant compared to HIV negative controls. The HIV Organ Policy Equity Act (HOPE Act) was a major step towards increasing the donor pool, but utilization of organs through the act has been less than initially anticipated.. Our own institution performed only one HIV D+/R+ transplant in the first four years of the trial despite a significant number of HIV+ patients on the waitlist. TableFigure summarizing perceived barriers and targeted interventions. Rate of HOPE transplants impacted positively by intervention Rate of HOPE transplants impacted positively by intervention Methods Monthly multidisciplinary meetings were set up. The agenda included discussing all offers, risks/benefits in a standardized format. Didactic sessions were conducted to address identified barriers to accepting HIV+ organs (Figure 1). HOPE consultants from experienced larger-volume centers were invited as guests. Results In the 15 months since this intervention was implemented, there have been 7 HIV D+/R+ transplants including a heart-kidney transplant. While the overall rate of transplant didn't change in a statistically significant way pre and post intervention for patients the rate of HOPE transplants increased significantly (Figure 2). Conclusion Making organs from HIV-positive donors available for donation does not mean they will be used. Intensive provider education can improve organ acceptance rates and help fulfill the promise of the HOPE act. Disclosures Vagish Hemmige, MD, Merck: Grant/Research Support.

From the New Editorial Team of “Third Space”

From the New Editorial Team of “Third Space”

SEL, Mindfulness, and the Art of General Music Education

General music education, if practiced with intentionality, has the potential to be a passionate act of hope with tremendous implications for the academic, social, and emotional needs of students. General music specialists have the capacity to expose students to the very best parts of life itself: joy, playfulness, respect, gratitude, creativity, persistence, resilience, curiosity, and so much more. The general music teacher is well positioned to help students develop relationships with long-held human insights and best practices in living an art filled, meaningful life. A few key skills students can learn in the general music classroom include cooperation, communication, positive peer interactions, recognition and support of the rights of others, dependability, responsibility, focus of personal attention, impulse control, delayed gratification, and acceptance of consequences. All 21st-century life skills that are integral to education and human development.

My Old Kentucky Home: The Astonishing Life and Reckoning of an Iconic American Song by Emily Bingham

Reviewed by: My Old Kentucky Home: The Astonishing Life and Reckoning of an Iconic American Song by Emily Bingham Craig Thompson Friend (bio) My Old Kentucky Home: The Astonishing Life and Reckoning of an Iconic American Song. By Emily Bingham. (New York: Alfred A. Knopf, 2022. Pp. xx, 329. $30.00 cloth; $14.99 ebook) If the singing of “My Old Kentucky Home” at the Kentucky Derby or a University of Kentucky football game or other public events has ever brought goosebumps or a tear to your eye, read this book. It is a book about how our ancestors crafted and used historical memory, whether in the form of a song, a lost cause, a historic site, or an absolute belief in American progress that allows us to continue to sing a song about enslavement because such horrors are in the past. It is also a book about reckoning as “an act of hope,” as Emily Bingham concludes in her exceptional study of one of the most iconic songs in United States history (p. 229). We live in an age of reckoning, wrestling with legacies of colonialism, capitalism, imperialism, and probably most importantly, our ancestors’ inability (or refusal) to acknowledge and solve the inequalities those legacies created in a nation founded on the premise of equality. We have witnessed much of this reckoning in public ways: the dismantling of Confederate monuments, the removal of enslavers’ statues and names from federal institutions, and the publication of The 1619 Project (2019). Not just the public, but historians, too, have questioned how history-making, as an endeavor, contributed to myths that caused, and continue to cause, more harm than good. In Creating a Confederate Kentucky (2010), Anne Marshall visited the monument mania that overtook Kentuckians in the late nineteenth century as they crafted a memory of the Civil War that did not fit their realities, making Kentucky “southern” in the process. Now, we have Bingham’s study of “My Old Kentucky Home”—a song written to make a quick dime through white performers in [End Page 197] blackface as they mocked Black Americans and altered to appeal to more genteel audiences so that they would buy the sheet music. It was employed to create nostalgia around a lost cause that few Kentuckians had experienced, was sung by Black performers who knew success relied on concession, became part of a canon of “exotic” southern fare with the rise of Hollywood movies, found itself attached to a historic site that had no connection to it or its author, and became so sentimentalized that the commonwealth uncritically adopted it as its state song. Her study is so thorough that it is difficult to imagine what Bingham might have overlooked in the research, and her writing is simultaneously inspiring and provocative. As a Kentuckian, Bingham lived with and relished the sentimentality of “My Old Kentucky Home.” This book is more than a history of the song, however. It is a memoir of her journey toward enlightenment about the song, and why, although it still holds a place in her memories, it can no longer hold a place in her heart. Bingham draws her own ancestors—people who enslaved others, who perpetuated racial segregation and oppression, who bought into the mythology of the Old Kentucky home—into the story, and with good reason. The history of a song is more than a dispassionate objective narrative, it is the story of how each person hears and remembers that song. Although some readers may bristle at the myth-busting, Bingham offers readers the opportunity to weigh for themselves the harsh realities of history and the sentimental comforts of a fabricated past. Ultimately, that is Bingham’s purpose, to empower Kentuckians, particularly Black Kentuckians, to reconsider “My Old Kentucky Home” in their history and mythology. “I don’t believe it can be wrong to love a song,” she contemplates, “but I do believe we commit wrongs when we do not understand what we claim to love” (p. 229). [End Page 198] Craig Thompson Friend CRAIG THOMPSON FRIEND teaches history and public history at North Carolina State University. He is co-author of The New History of Kentucky, 2d. ed. (2018) and...

Book Review: Inviting Educational Leadership

Inviting Educational Leadership: Fulfilling Potentialand Applying Ethics to the Education Process is written by John M. Novak. “S chools can either be part of the solution or partof the problem.” If schools are to be a part of the former, then theyneed to be unconditionally invitational. Invitational Education isthe theory that informs his book Inviting Educational Leadership:Fulfilling Potential and Applying Ethics to the Education Process.If educational leadership is to be truly successful, leadership willacknowledge that there are specific invitational ideals required asfounding principles. There are five core invitational principleswhich underscore the notion that education is fundamentally animaginative act of hope aimed at inviting all stakeholders to continuouslysavour, understand, and better their expectations.

Reflections of a Public Loony

Reflections of a Public Loony Sandy Jeffs (bio) I have been a public loony for over thirty years. In an act of reclaiming my life from the catastrophe of schizophrenia, sharing my story with audiences empowered me to write my own narrative and to eventually see my life through a lens of hope. This act of hope was important because when I was diagnosed in 1976, hope was the first casualty of what was then considered a virtual death-sentence. The magnitude of such an existential crisis cannot be understated. For those of us who carried this diagnosis, we were condemned to a life of irretrievable madness from which we would never recover. That was the messaging we got from clinicians. But in the 1970s psychiatry was under attack in a world that was in a state of flux. The anti-authoritarian 1960s and 70s were heady times for social activism. The Civil Rights movement was in full swing in the USA while the Feminist and Gay Liberation movements across the world were gathering steam. And the antipsychiatry crusade was making waves in the world’s universities where sociology departments and intellectuals were enthusiastic followers of R.D. Laing, Cooper, Thomas S. Szasz, Erving Goffman, and Michel Foucault. Mad people, too, were emboldened by antipsychiatry which offered a robust critique of psychiatry and madhouses in which they were confined. These were characterised as oppressive, dehumanising institutions that represented all that was bad in a world ruled by capitalism. Schizophrenics were portrayed as victims who needed to be rescued from the clutches of psychopathic psychiatrists while tyrannical madhouses were seen as instruments of oppression. Placards from the mass demonstrations in Paris in 1968 proclaimed: Schizophrenics are the Proletariat! Maverick psychiatrist and the darling of the antipsychiatry movement, R.D. Laing, wrote seminal texts in which he describes schizophrenia as a sane response to an insane world. He offers a positive spin on a diagnosis that had such a negative clinical profile. In The Politics of Experience Laing writes that ‘if the human race survives, future men will … look back on our enlightened epoch as a veritable age of Darkness … they will see what we call ‘schizophrenia’ as one of the forms in which, often through quite ordinary people, the light began to break through the cracks in our all-too-closed minds’.1 He goes on further to say ‘madness need not be all breakdown, it may also be break-through’.2 Schizophrenia, according to Laing, was [End Page 174] more like an awakening, a window into higher consciousness which at the time was what a lot of hippie and counter-culture young folks were searching for, often through the agency of recreational drugs. As a young student at La Trobe University in the 1970s which, ironically, was built on land excised from the large acreage on which three psychiatric institutions were built, including Larundel Psychiatric Hospital, I came across antipsychiatry in my sociology and history studies. Sociology was a forceful, unforgiving opponent of psychiatry, and it was where I was made aware of the infamous Rosenhan experiment that was seminal in the growing chorus against psychiatry. Psychologist by training, David Rosenhan set out to prove that clinicians could not distinguish the mad from the sane and to discredit the ‘pseudo-science’ of psychiatry. He sent students posing as voice-hearers into psychiatric hospitals. On presentation they were admitted into a ward and assessed by psychiatrists. They then acted normally and said they were no longer hearing voices. They weren’t believed and were forced to take medication. When they were finally discharged, all but one of the fake patients left with the diagnosis of ‘schizophrenia in remission’.3 It caused a storm in the academic world and an even bigger storm for psychiatry which had been embarrassed by the revelations that the veracity of psychiatric diagnoses was very shaky if not completely spurious. The case against psychiatry was mounting as was the case against the big stand-alone psychiatric hospitals. It was in the midst of this milieu that I began my career as a ‘psych patient’. Influenced by my studies, and by charismatic lecturers, I took on board the...

The &lt;em&gt;Journal of Limnology&lt;/em&gt;'s 80&lt;sup&gt;th&lt;/sup&gt; anniversary

Celebrating an anniversary is, at the same time, appreciation of past well-being and hope for a favourable future. However, celebrating the birthday of a scientific journal is not just an act of hope in the future, but rather an act of faith in research and in science as tools for the advancement of the human species....

Barriers experienced by organ procurement organizations in implementing the HOPE act and HIV-positive organ donation

In the seven years since the HIV Organ Policy Equity (HOPE) Act made HIV-positive organ donation to HIV-positive recipients legally permissible in the United States, there have been fewer HIV-positive organ donations than expected. Organ procurement organizations (OPOs) play a key role in the transplant system and barriers at OPOs may be partly responsible for the relatively low number of HIV-positive donors. To understand potential OPO barriers, we conducted semi-structured interviews with 20 OPO staff members. Interviews were recorded, transcribed, and analyzed using a conventional content analytic approach with two coders. OPO staff had high levels of knowledge about HOPE. Many had evaluated referrals of HIV-positive donors and approached families for authorization. Barriers to HIV-positive organ recovery identified included obtaining authorization for donation, potentially disclosing HIV status to next-of-kin, and fear of HIV infection among those engaged in organ recovery. Strategies to overcome these barriers include providing continuing education about the specific tasks required to procure organs from HIV-positive donors, implementing targeted interventions to reduce fear of infection, and developing partnerships with HIV advocacy and care organizations. Given the central role OPOs play, HIV-positive donations are unlikely to occur in significant numbers unless these barriers can be overcome.

Retrospective-prospective study of safety and efficacy of sofosbuvir-based direct-acting antivirals in HIV/HCV-coinfected participants with decompensated liver disease pre- or post-liver transplant.

Direct-acting antiviral (DAA) therapy has transformed the management of human immunodeficiency virus (HIV) and hepatitis C (HCV) coinfected patients with advanced liver disease. STOP-Coinfection was a multicenter prospective and retrospective, open-label study using sofosbuvir-based DAA therapy to treat HIV/HCV-coinfected participants pre- or post-liver transplant (LT). Sixty-eight participants with end-stage liver disease (Child-Turcotte-Pugh score ≥7 and Model for End-Stage Liver Disease score 6-29) were enrolled, 26 had hepatocellular carcinoma. Forty-two participants were treated pre-LT and 26 post-LT. All participants completed therapy without need for dose reduction or transfusion; eight required two or more courses of therapy. Ninety-three percent achieved a sustained virologic response and DAA therapy was well tolerated. Despite HCV cure, 12 end-stage liver disease participants required subsequent LT, 7 for decompensated liver disease. Thirteen participants died, 10 with decompensated liver disease pre-LT and three post-LT. Overall, transplant free survival was 42.8% at 4years and post-LT survival was 87.9% at 5years. We conclude that sofosbuvir-based DAA therapy is safe and highly effective in HCV-HIV patients with decompensated liver disease and post-LT, with post-LT survival rates comparable to other indications. This removes one of the last barriers to liver transplantation in this challenging cohort of recipients.

Because the Poet

The transdisciplinary dialogue, the rebellious attitude, and the sublimation of dissidence by experimenting new forms as an act of hope are the key features of the relationship between Pier Paolo Pasolini and Patti Smith, who saluted the Italian writer as one of her greatest teachers throughout her entire career, along with Blake, Rimbaud and the Beats. From the poetry of Babel to the lyrics of Easter, passing through the photographic series Pasolini es vie, the eclectic American artist has never ceased to appraise the literary works and movies of this author as a constant source of inspiration, creating a bond that became very important to the audience but was never properly explored by the critics. In terms of reception, one should not forget that this original relationship also led many (especially outside Italy) to discover the figure of Pasolini. This article seeks to investigate Patti Smith’s Pasolini and the works that influenced her most, revealing through an intertextual and interdiscursive approach how the poet contributed to shape the imaginary and spiritual vision of one among the most important lyrical voices in the world today.

„…rozmawiałem z Bogiem (uśmiechacie się! tylko z nim mogę jeszcze rozmawiać!)”. Modlitewne lamentacje w pamiętniku Karola Rotgebera z getta warszawskiego

A merchant and dental technician, Karol Rotgeber wrote his Warsaw ghetto memoir while hiding on the ‘Aryan’ side between April and June 1943. The fragments of the memoir presented here were selected mostly to show the thread of religious meditations which intertwines with a narration about the fate of the author, his family, and the Warsaw ghetto community.Two different discourse orders clash in Rotgeber’s text: the diarist narration and theprayer-lamentation dimension. They co-exist. They do not merge or overlap, but intertwine with each other. There is no transition between them. The diarist narration is suddenly interrupted with an ejaculatory prayer, a supplication, a complaint, a call for help and revenge,a confession of faith, or an act of hope. And then, equally suddenly and without a warning, Rotgeber resumes his previous thread, comes back to the everyday life in the ghetto, a list of tortures and persecutions, to the concrete and the topography, and his private life.

Organs from deceased donors with false-positive HIV screening tests: An unexpected benefit of the HOPE act.

Organs from deceased donors with suspected false-positive HIV screening tests were generally discarded due to the chance that the test was truly positive. However, the HIV Organ Policy Equity (HOPE) Act now facilitates use of such organs for transplantation to HIV-infected (HIV+) individuals. In the HOPE in Action trial, donors without a known HIV infection who unexpectedly tested positive for anti-HIV antibody (Ab) or HIV nucleic acid test (NAT) were classified as suspected false-positive donors. Between March 2016 and March 2018, 10 suspected false-positive donors had organs recovered for transplant for 21 HIV+recipients (14 single-kidney, 1 double-kidney, 5 liver, 1 simultaneous liver-kidney). Median donor age was 24years; cause of death was trauma (n = 5), stroke (n =4), and anoxia (n = 1); three donors were labeled Public Health Service increased infectious risk. Median kidney donor profile index was 30.5 (IQR 22-58). Eight donors were HIV Ab+/NAT-; two were HIV Ab-/NAT+. All 10 suspected false-positive donors were confirmed to be HIV-noninfected. Given the false-positive rates of approved assays used to screen>20000 deceased donors annually, we estimate 50-100 HIV false-positive donors per year. Organ transplantation from suspected HIV false-positive donors is an unexpected benefit of the HOPE Act that provides another novel organ source.

The HOPE Act and HIV-Positive Organ Donors

The HIV Organ Policy Equity (HOPE) Act, enacted in 2013, authorizes organ donation from HIV-positive donors to HIV-positive recipients in the context

Singing as Un Saber del Sur, or Another Way of Knowing

In this article, I show how one song, “El Espíritu de Dios,” can be a source of knowledge and an act of epistemic disobedience, even amid the increasingly complex dynamics of the “coloniality of music.” When it is sung in embodied ways from below, it affirms knowledge as something that emerges out of the oral tradition arising from the heart of a community's life and experience. It is understood to belong to the community, in this case multiple local Latin American communities. This embodied, oral, communal singing challenges prevailing Eurocentric norms that emphasize written texts, individual ownership, and rationalist intellectualism, represented in Euro-North-Atlantic epistemologies of the Enlightenment. When it is sung as a fully embodied holistic human expression, it instead actualizes an act of hope, another way of knowing, un saber del sur (knowledge from the South), which defies forces that oppress and the pervasiveness of coloniality. Who we are and who we want to become as active agents of a liberative praxis proclaiming what is and what ought to be, the already and not yet of the Reign of God, emerges. Understanding the dynamics of (de)coloniality in hymns and songs involves affirming songs like “El Espíritu de Dios,” which express an-other way of knowing and singing and a decolonial mode for doing theology.

Summits Where Souls Gather

Rituals have played a vital role in the wake of the earthquake, tsunami, and nuclear disasters that struck northeastern Japan on 11 March 2011 (subsequently referred to as “3.11”). Rituals have enabled survivors to differentiate social order from the immediate chaos of disaster, to mourn, to overcome grief, and to exorcise the spirits of the disaster dead. Yet, much remains to be learned about the transformative potential of ritual after 3.11. The significance of pilgrimage, for instance, which is a prominent aspect of religious practice in Japan, has received minimal attention. In this article, I draw on ethnographic fieldwork carried out in Dewa Sanzan, a sacred mountain range in Yamagata Prefecture, to discuss mountain pilgrimage for post-disaster memorialization. I argue that the event of 3.11 expanded the ontological meaning of the summit of Gassan 月山 (Mount Moon), thought to be an axis between the world of the living and that of the ancestral dead. Pilgrimage to the peak of Gassan has become a path of remembrance and overcoming, a formula for posthumous care, and an act of hope in post-disaster Japan.