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The human major histocompatibility complex (MHC) is a ~4 Mb genomic segment on Chromosome 6 that plays a pivotal role in the immune response. Despite its importance in various traits and diseases, its complex nature makes it challenging to accurately characterize on a routine basis. We present a novel approach allowing targeted sequencing and de novo haplotypic assembly of the MHC region in heterozygous samples, using long-read sequencing technologies. Our approach is validated using two reference samples, two family trios, and an African-American sample. We achieved excellent coverage (96.6%–99.9% with at least 30x depth) and high accuracy (99.89%–99.99%) for the different haplotypes. This methodology offers a reliable and cost-effective method for sequencing and fully characterizing the MHC without the need for whole-genome sequencing, facilitating broader studies on this important genomic segment and having significant implications in immunology, genetics, and medicine.

Purpose:

Sexual misconduct by physicians is a consequential violation of patient trust. The purpose of this study was to determine the frequency and patterns of sexual misconduct by physicians certified by the American Board of Family Medicine (ABFM).

Background:

Certain health-related risk factors require legal interventions. Medical-legal partnerships (MLPs) are collaborations between clinics and lawyers that address these health-harming legal needs (HHLNs) and have been shown to improve health and reduce utilization.

COPD and asthma are two of the most common chronic lung diseases, affecting over 545 million people globally and 34 million in the United States. Annual health care costs related to chronic lung disease are estimated at €380 billion in the European Union, and $24–$50 billion in the United States averaging to $4,000 in out-of-pocket costs per person in the U.S. A full-text literature search was conducted for English publications between January 1, 2005–March 18, 2024. It returned over 5,000 publications that were further narrowed using key search words, resulting in 172 peer-reviewed articles. Using their experience and subject expertise, the authors further narrowed the peer-reviewed articles to 55 that were in their opinion relevant. Also, 38 recently published industry reports and news articles specific to downstream effects of inhaler market changes and the future impact were included. The literature suggests that individuals with chronic lung disease face increased challenges with access to inhaled medication due to rising medication costs, discontinuation of branded medications, introduction of generic medications not covered by insurance, exclusionary preferred drug list tactics that force health care providers into non-medical switching of medication or devices, and ongoing medication shortages. Providers experience ongoing hurdles in prescribing appropriate inhaled medications for individuals with chronic lung disease, including increased time and costs spent on administrative tasks due to inhaler denials, a loss of patient trust, and limits on their ability to prescribe appropriate inhaled medication for individuals with chronic lung disease.

During B-cell development, cells progress through multiple developmental stages, with the pro-B-cell stage defining commitment to the B-cell lineage. YY1 is a ubiquitous transcription factor that is capable of both activation and repression functions. We found here that knockout of YY1 at the pro-B-cell stage eliminates B lineage commitment. YY1 knockout pro-B cells can generate T lineage cells in vitro using the OP9-DL4 feeder system and in vivo after injection into sublethally irradiated Rag1^–/– mice. These T lineage-like cells lose their B lineage transcript profile and gain a T-cell lineage profile. Single-cell RNA-seq experiments showed that as YY1 knockout pro-B cells transition into T lineage cells in vitro, various cell clusters adopt transcript profiles representing a multiplicity of hematopoietic lineages, indicating unusual lineage plasticity. In addition, YY1 KO pro-B cells in vivo can give rise to other hematopoietic lineages in vivo. Evaluation of RNA-seq, scRNA-seq, ChIP-seq, and scATAC-seq data indicates that YY1 controls numerous chromatin-modifying proteins leading to increased accessibility of alternative lineage genes in YY1 knockout pro-B cells. Given the ubiquitous nature of YY1 and its dual activation and repression functions, YY1 may regulate commitment in multiple cell lineages.

ABSTRACTIntroduction:Family Planning 2020 (FP2020) was established in 2012 with the goal of expanding contraceptive access. By 2020, 46 countries had made commitments to FP2020. A sustained focus on adolescents and youth (AY) began in 2016. During the commitment formulation process, substantial support was offered to countries to develop AY commitments based on sound data, research evidence, and programmatic experience. This study assesses how country commitments under FP2020 and FP2030 have evolved over time with respect to improving attention to and focus on the needs of adolescents and youth sexual and reproductive health (AYSRH).Methods:We analyzed the content of FP2020 and FP2030 country commitments focusing on AY (aged 10–24 years) using a scoring guideline we developed to measure the AY commitments in terms of completeness, clarity, and quality.Results:This analysis shows that FP2030 commitments better articulate strategies and activities to reach AY with contraceptive information and services when compared to FP2020 commitments.Conclusion:FP2030 commitments are stronger in some areas on AYSRH, such as commitment to establish national or local policies, strategies, and guidance for AY programming, specifying the target audience of the AY commitment, and partnering with AY or youth-led organizations in commitments. However, more work remains to be done by countries to dedicate a budget for achieving AY objectives, including measurable targets for monitoring progress, identifying and addressing the root causes that impact AY access to and use of contraception, including child marriage and gender-based violence, and reducing financial barriers to access contraception.

ABSTRACTPolitics is one of the critical factors that influence health policy agendas. However, scholarly efforts, especially in low- and middle-income countries, rarely focus on how politics influence health policy agenda-setting. We conducted a qualitative document review to examine the factors that led to developing the free primary health care policy for maternal health in Papua New Guinea. We also discuss mechanisms through which national politics, as an overriding factor, influenced the development of the policy. The review draws on Kingdon’s multiple-stream model for agenda-setting and incorporates theoretical insights from Fox and Reich’s framework for analyzing the politics of health reform for universal health coverage in low- and middle-income countries.

Previous studies demonstrated that sigma receptor (R) antagonists alone fail to alter cocaine self-administration despite blocking various other effects of cocaine. However, R antagonists when combined with dopamine transporter (DAT) inhibitors substantially decrease cocaine self-administration. To better understand the effects of this combination, the present study examined the effects of R antagonist and DAT inhibitor combinations in male rats discriminating cocaine (10 mg/kg, i.p.) from saline injections. The DAT inhibitors alone [(–)-2-β-carbomethoxy-3-β-(4-fluorophenyl)tropane 1,5-naphthalenedisulfonate monohydrate (WIN 35,428) and methylphenidate] at low (0.1-mg/kg) doses that were minimally active failed to shift the dose-effect function for discriminative-stimulus effects of cocaine to the left more than 2-fold. At 0.32 mg/kg the DAT inhibitors alone shifted the cocaine dose-effect function leftward 24- or 6.6-fold, respectively. The R antagonists (BD1008, BD1047, and BD1063) failed to fully substitute for cocaine, although BD1008 and BD1047 substituted partially. At 10 mg/kg, BD1008, BD1047, or BD1063 alone shifted the cocaine dose-effect function leftward less than 6.0-fold. In combination with 0.1 mg/kg WIN 35,428, the 10 mg/kg doses of R antagonists shifted the cocaine dose-effect function from 12.3- to 36.7-fold leftward, and with 0.32 mg/kg WIN 35,428 from 14.3- to 440-fold leftward. In combination with 0.1 mg/kg methylphenidate, those R antagonist doses shifted the cocaine dose-effect function from 5.5- to 55.0-fold leftward, and with 0.32 mg/kg methylphenidate from 10.5- to 48.1-fold leftward. The present results suggest that dual DAT/R inhibition produces agonist-like subjective effects that may promote decreases in self-administration obtained in previous studies.

Our knowledge of the roles of individual cytochrome P450 (P450) enzymes in drug metabolism has developed considerably in the past 30 years, and this base has been of considerable use in avoiding serious issues with drug interactions and issues due to variations. Some newer approaches are being considered for "phenotyping" metabolism reactions with new drug candidates. Endogenous biomarkers are being used for noninvasive estimation of levels of individual P450 enzymes. There is also the matter of some remaining "orphan" P450s, which have yet to be assigned reactions. Practical problems that continue in drug development include predicting drug-drug interactions, predicting the effects of polymorphic and other P450 variations, and evaluating interspecies differences in drug metabolism, particularly in the context of "metabolism in safety testing" regulatory issues ["disproportionate (human) metabolites"].

BACKGROUND AND PURPOSE:

Intracranial vessel wall imaging is technically challenging to implement, given the simultaneous requirements of high spatial resolution, excellent blood and CSF signal suppression, and clinically acceptable gradient times. Herein, we present our preliminary findings on the evaluation of a deep learning–optimized sequence using T1-weighted imaging.

BackgroundLong-term health conditions are major challenges for care systems. Social prescribing link workers have been introduced via primary care networks (PCNs) across England since 2019 to address the wider determinants of health by connecting individuals to activities, groups, or services within their local community.AimTo assess whether the rollout of social prescribing link workers was in areas with the highest need.Design and settingA retrospective study of social prescribing link workers in England from 2019 to 2023.MethodWorkforce, population, survey, and area-level data at the PCN-level from April 2020 to October 2023 were combined. Population need before the rollout of link workers was measured using reported lack of support from local services in the 2019 General Practice Patient Survey. To assess if rollout reflected need, linear regression was used to relate provision of link workers (measured by full-time equivalent [FTE] per 10 000 patients) in each quarter to population need for support.ResultsPopulations in urban, more deprived areas and with higher proportions of people from minority ethnic groups had the highest reported lack of support. Geographically these were in the North West and London. Initially, there was no association between need and provision; then from July 2022, this became negative and significant. By October 2023, a 10-percentage point higher need for support was associated with a 0.035 (95% confidence interval = −0.634 to −0.066) lower FTE per 10 000 patients.ConclusionRollout of link workers has not been sufficiently targeted at areas with the highest need. Future deployments should be targeted at those areas.

BackgroundIncident benzodiazepine prescriptions in primary care for anxiety decreased between 2003 and 2018. However, from 2008, incident prescribing of benzodiazepines for anxiety increased among those aged 18–34 years. There are increasing concerns around prescribing of benzodiazepines. Further, although guidelines state benzodiazepines should only be prescribed short term, in 2017, 44% of incident prescriptions were prescribed for longer than the recommended duration of 2–4 weeks.AimTo understand when and why GPs prescribe benzodiazepines for anxiety in young adults.Design and settingA qualitative study was undertaken using in-depth interviews with 17 GPs from 10 general practices in South West England.MethodInterviews were conducted by telephone or videocall. A topic guide was used to ensure consistency across interviews. Interviews were audio-recorded, transcribed verbatim, and data analysed using reflexive thematic analysis.ResultsGPs described caution in prescribing benzodiazepines for anxiety in young adults, but thought they had an important role in acute situations. GPs described caution in prescribing duration, but some thought longer-term prescriptions could be appropriate. In light of these views, some GPs questioned whether primary care needs to revisit how clinicians are using benzodiazepines. GPs perceived that some young adults requested benzodiazepines and suggested this might be because they wanted quick symptom relief. GPs noted that refusing to prescribe felt uncomfortable and that the number of young adults presenting to general practice, already dependent on benzodiazepines, had increased.ConclusionPatient-driven factors for prescribing benzodiazepines suggest there are current unmet treatment needs among young adults with anxiety. Given increases in prescribing in this age group, it may be timely to revisit the role of benzodiazepines in the management of people with anxiety in primary care.

BackgroundBetween 2003 and 2018, incident prescriptions of beta-blockers for anxiety increased substantially, particularly for young adults. National Institute for Health and Care Excellence guidance for anxiety does not recommend beta-blockers, probably due to a lack of evidence to support such use. Recent reports have highlighted the potential risks of beta-blockers.AimTo understand when and why GPs prescribe beta-blockers for people with anxiety.Design and settingIn-depth interviews with 17 GPs in Bristol and the surrounding areas.MethodInterviews were held by telephone or video call. A topic guide was used to ensure consistency across interviews. Interviews were audio-recorded, transcribed verbatim, and analysed thematically.ResultsMany GPs viewed beta-blockers as ‘low risk’, particularly for young adults. Some GPs viewed beta-blockers as an alternative to benzodiazepines, acting quickly and not leading to dependence. GPs reflected that some patients appeared to want an ‘immediate fix’ to their symptoms, which GPs thought beta-blockers could potentially offer. This is salient in light of substantial waiting lists for talking therapies and delays in antidepressants taking effect. GPs described how some patients seemed more willing to try beta-blockers than antidepressants, as patients did not perceive them as ‘mental health drugs’ and therefore viewed them as potentially more acceptable and less stigmatising. Further, GPs viewed beta-blockers as ‘patient-led’, with patients managing their own dose and frequency, without GP input.ConclusionMany GPs believe that beta-blockers have a role to play in the management of anxiety. Given recent increases in the prescribing of these drugs in primary care, there is a need to assess their safety and effectiveness as a treatment for people with anxiety disorders.

BackgroundThere has been significant investment in pharmacists working in UK general practice to improve the effective and safe use of medicines. However, evidence of how to optimise collaboration between GPs and pharmacists in the context of polypharmacy (multiple medication) is lacking.AimTo explore GP and pharmacist views and experiences of in-person, interprofessional collaborative discussions (IPCDs) as part of a complex intervention to optimise medication use for patients with polypharmacy in general practice.Design and settingA mixed-method process evaluation embedded within the Improving Medicines use in People with Polypharmacy in Primary Care (IMPPP) trial conducted in Bristol and the West Midlands, between February 2021 and September 2023.MethodAudio-recordings of IPCDs between GPs and pharmacists, along with individual semi-structured interviews to explore their reflections on these discussions, were used. All recordings were transcribed verbatim and analysed thematically.ResultsA total of 14 practices took part in the process evaluation from February 2022 to September 2023; 17 IPCD meetings were audio-recorded, discussing 30 patients (range 1–6 patients per meeting). In all, six GPs and 13 pharmacists were interviewed. The IPCD was highly valued by GPs and pharmacists who described benefits, including: strengthening their working relationship; gaining in confidence to manage more complex patients; and learning from each other. It was often challenging, however, to find time for the IPCDs.ConclusionThe model of IPCD used in this study provided protected time for GPs and pharmacists to work together to deliver whole-patient care, with both professions finding this beneficial. Protected time for interprofessional liaison and collaboration, and structured interventions may facilitate improved patient care.

PURPOSE

HIV pre-exposure prophylaxis (PrEP) may increase rates of bacterial sexually transmitted infections (STIs) among gay, bisexual, and other men who have sex with men (GBM) through risk compensation (eg, an increase in condomless sex or number of partners); however, longitudinal studies exploring the time-dependent nature of PrEP uptake and bacterial STIs are limited. We used marginal structural models to estimate the effect of PrEP uptake on STI incidence.

PURPOSE

The impact of digital health on medically underserved patients is unclear. This study aimed to determine the early impact of a digital innovation to grow quality care through an interprofessional care team (DIG IT) on the blood pressure (BP) and 10-year atherosclerotic cardiovascular disease (ASCVD) risk score of medically underserved patients.

BACKGROUND

For many patients with post–COVID-19 condition (long COVID), primary care is the first point of interaction with the health care system. In principle, primary care is well situated to manage long COVID. Beyond expressions of disempowerment, however, the patient’s perspective regarding the quality of long COVID care is lacking. Therefore, this study aimed to analyze the expectations and experiences of primary care patients seeking treatment for long COVID.

Video game workers face challenges from employers in their efforts to unionize in Canada.

The post Dual boss battle: video game workers face-off multiple employers at once appeared first on rabble.ca.

Shetland Library and the National Library of Scotland have been praised for "providing optimist for the future."

Relatives of Lyle and Erik Menendez spoke in an interview Wednesday about their long-running fears that the brothers had been abused for years before they killed their parents.

After a press conference in which they’d called for the imprisoned siblings’ freedom, the family members told Chris Cuomo on NewsNation about how their suspicions only deepened as time passed.

“Over the years we really did know that there was abuse at gut-level. But as time goes on and we all talked to each other more and more, it validates the fears and the gut-level reactions that we had,” the brothers’ cousin Karen VanderMolen-Copley told Cuomo. “That solidified the knowledge that the sexual abuse actually did occur, because that’s not something you want to believe, and then once you talk to each other it becomes more and more obvious.”

Read more at The Daily Beast.

Hori's latest addition to its controller lineup, the "Horipad Wireless for Steam," is now available for preorder on Amazon. After already releasing in Japan at the end of October, now the gamepad is coming to the US.

Read more

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JUDY WOODRUFF: The hashtag #MeToo has millions of women sharing stories of abuse, shining a spotlight on a troubling reality in our society.

It was first used in 2007, but when actor Alyssa Milano tweeted it Sunday night to talk about sexual harassment and assault in the wake of the Harvey Weinstein story, it went viral. The hashtag was tweeted nearly a million times in just 48 hours. Facebook reported 45 percent of its users have friends who posted #MeToo, as women wrote about their experiences about the workplace and culture, and what should change.

We explore some of those issues with Fatima Goss Graves. She’s president of the National Women’s Law Center. Lisa Senecal wrote about her own experience for the online news site Daily Beast. She’s with the Vermont Commission on Women. And Melissa Silverstein is the founder of the blog and Web site Women and Hollywood.

Thank you all for joining us.

Lisa Senecal, I’m going to start with you.

You have had a personal experience with sexual harassment. That’s in part what has drawn you to this #MeToo campaign movement.

Just tell us briefly about what happened.

LISA SENECAL, Member, Vermont Commission on Women: Sure.

Like most women, I have had a number of experiences with sexual harassment, beginning with my first job, when I was 15 years old. And it’s really been a threat off and on throughout my entire professional career.

The most egregious offense was an actual assault that occurred with a male executive. Unfortunately, because of an NDA — and we can go into the evils of nondisclosures another time — but because of that, there isn’t a lot that I’m able to say about the specific event.

But the issue of sexual harassment and finally having this come to the fore, so many women are already familiar with it from being on the receiving end. And I think, especially with the #MeToo campaign, it’s been really wonderful and an eye-opening experience for men to realize just how pervasive an issue this is.

JUDY WOODRUFF: So, in your experience, it was a business setting.

Melissa Silverstein, you have been writing about women in Hollywood for 10 years. Of course, that’s where the Harvey Weinstein story came from.

If it’s been going on in Hollywood forever, why hasn’t it been talked about more before now?

MELISSA SILVERSTEIN, Founder, Women and Hollywood: Well, I think there was a culture of silence created around this man and also within this industry.

People were afraid. People are afraid for their jobs. It’s a very relational industry, where if someone is going to blacklist you, you are not going to get your next job.

So I think the way that a person was able to conduct himself for 30 years like this was to build a culture of fear, to make people sign nondisclosure agreements, and to get them to shut up.

JUDY WOODRUFF: Fatima Goss Graves, here with me in Washington with the National Women’s Law Center, we have been talking about Hollywood.

We have talking about the business workplace. Is there any field of work where this isn’t going on?

FATIMA GOSS GRAVES, President, National Women’s Law Center: Right.

The issue of harassment and assault, it’s a Hollywood problem, but really it’s an everywhere problem. It infects industries across the board, whether you’re high-wage jobs, low-wage jobs, male-dominated fields, but also female-dominated fields.

Restaurants are some of the areas where you have some of the highest rates of EEOC charges. And that’s not a male-dominated field.

JUDY WOODRUFF: EEOC, the Equal Employment Opportunity Commission.

Lisa Senecal, some people are saying that they’re uncomfortable with this #MeToo campaign movement because they’re saying, once again, women are being asked to go public with what happened to them, but there is no promise that there is going to be anything done about it. How do you see this?

LISA SENECAL: I don’t necessarily believe that women are being asked to come forward.

I think this is an opportunity to come forward, if that’s something that women want to do, but there’s no obligation to do it. And there’s been a lot of support for letting women know that if this isn’t something you’re comfortable with at this time, no one is obligated to tell their story, and no one is allowed to force you to tell your story before you’re ready.

But the stories are important. Without them, the degree to which this happens across all industries, across genders as well — we know that this happens to men. This happens to the transgender.

It’s not specific to women, although it affects us most frequently. Until we have a critical mass of women who are able to get the men in their lives, the men that they work with to understand how pervasive a problem it is, and then can get men to begin to act on this, because this isn’t a women’s issue.

This is a violence issue, and an issue of power and who has the power. So until the people who still primarily do hold the power, which is primarily men and primarily white men, until they’re going to begin to act, then the problems are going to persist.

JUDY WOODRUFF: Melissa Silverstein, how do you see that? What is it going to take for this to be a change?

MELISSA SILVERSTEIN: The fact that we’re having a global conversation about sexual harassment — I have been doing media for the last week all over the world.

People are really enthralled by this and want to see change. This is a global issue. And, also, Hollywood is a global industry. Seventy cents of every dollar of Hollywood studio movies are made outside the United States.

So what people are looking for is Hollywood to step up. And, today, we had a leader in Hollywood, Kathleen Kennedy, to say we need to have a commission, cross-industry commission, of people who are going to look into this and put a stop to it once and for all.

JUDY WOODRUFF: And pick up on that, Fatima Goss Graves. Just across the board, what is it going to take?

FATIMA GOSS GRAVES: Right.

We know that there are things that would make a difference here. If employers had processes that their employees actually use, you wouldn’t have harassment in the shadows. Right now, most people don’t report harassment to anyone. And it’s because they think their employers won’t do anything, or, worse, that they would experience retaliation.

JUDY WOODRUFF: And that’s — because that’s been what happened.

FATIMA GOSS GRAVES: And that is. They’re right to believe that they will experience retaliation, because they do. They’re shamed. They’re blamed.

But employees could make a difference. Right? They can be — take it seriously and communicate that to their workplace. They can also have the right policies that are in place. And, finally, they could, when someone comes forward, be really clear that they take it seriously and that they will not tolerate retaliation.

Those are things that aren’t happening among employers frequently enough.

JUDY WOODRUFF: Lisa Senecal, as somebody who had it happen to you in a business environment, what changes need to be made in the workplace? What has to happen?

LISA SENECAL: Well, I agree completely with what was just said.

Too often, the workplace education that goes on is incredibly insufficient. It’s more of companies wanting to be able to check the box and say that they did their sexual harassment training. And it isn’t truly something within the culture of companies that they believe that this is a problem and that it is a right of all people working at that company not to be harassed.

So, until it starts to be taken more seriously, and when a woman or anyone comes forward with an accusation, it does have to be taken so much more seriously. And the knee-jerk response, as was in my case, cannot be to shame the woman, can’t be to blame her for somehow bringing this on herself, and putting women back in a position of being victimized a second time because they’re not taken seriously when they come forward.

JUDY WOODRUFF: Melissa Silverstein, yes, go ahead.

MELISSA SILVERSTEIN: I just wanted to add, one of the things that’s so fundamental about this is how this — how it’s so normalized for all of us to go through this kind of harassment, especially in Hollywood, and how people kind of laugh off, oh, you know, that’s locker room talk, or, you know, this is the movie business, get used to it.

And what we need to do is really pierce that veil of the normalization of this kind of conduct, because it starts with, you know, the comments, and then it can escalate very quickly.

So we really need to just change people’s attitudes and get rid of the toxic masculinity. Hollywood has no much institutionalized sexism that sometimes I feel like we need to just start over, if possible.

JUDY WOODRUFF: Joining us also is Leigh Gilmore, a professor at Wellesley College who’s written a book about why — titled “Why We Doubt What Women Say About Their Lives.”

Leigh Gilmore, why don’t women — why haven’t women been believed and taken seriously on this, and could we now be at a moment when they are?

LEIGH GILMORE, Wellesley College: It’s good to be with you, Judy.

I think we have a persistent and a pervasive culture of doubting what women say, especially when they’re bringing forward accounts of harm into the public sphere. So we have these pre-made default cultural narratives of women’s unreliability. We have he said/she said, which is a false equivalence narrative.

We have that notion that nobody knows what really happened. We have that notion that you can’t really trust what women say. None of these are based in fact, but they are part of a kind of cloud that enables us to doubt any woman before she speaks up.

And it’s quite intimidating. And so, if we’re at a point of change, we really are at a moment where I think we have a new level of visibility, and we have the opportunity to amplify the voices of women who are speaking out.

So, insofar as we have that opportunity, there is a form of solidarity, and more women speaking can lead to change.

JUDY WOODRUFF: Fatima Goss Graves, as somebody who works on these issues from a legal standpoint, are we, could we be at a watershed point, or is it just a whole lot more complicated?

FATIMA GOSS GRAVES: Well, the culture change typically has to go together with both the enforcement of the laws and the policy change.

And so we’re at a tipping point, surely, on culture change. But I will tell you, you know, the National Women’s Law Center runs a hot line. And over the last two weeks, we have had double the intake on harassment.

And we have a new network called the Legal Network for Gender Equity, so we’re — attorneys are joining with us and will be ready to take these cases. But those people who are making these calls and contacting us, I think that that shows that you have people who are ready to come forward on social media, and there is power there, but it seems like there are people who are ready to come forward in other ways, too.

JUDY WOODRUFF: I want to quickly go around and ask each one of you about the role of men in all of this.

Lisa Senecal?

LISA SENECAL: Oh, I think it’s critical for men as allies to be coming forward and supporting women who do come forward.

Men also need to be willing to call out other men, whether that’s one-on-one, whether it’s in a group setting within a company, or socially. If a man hears, sees someone doing something inappropriate, they need to have the courage to stand up, even in front of other men, and say, it’s not OK, it’s inappropriate behavior, and it’s not going to be tolerated.

And until it’s also men joining in, women can’t do this by themselves. There is an organization, A Call to Men, that I’m a big fan of. And one of their mantras is, if women could have stopped abuse and assault, they would have done it already.

And that’s completely true. It’s not something that women are going to be able to do alone. It shouldn’t be looked at as only a women’s issue. And until people look at this on a larger scale and understand that this affects the bottom line of companies, it affects productivity, it affects, you know, absenteeism, just across the board, this is not a women’s issue.

It is a human issue.

JUDY WOODRUFF: Right.

Melissa Silverstein, what about that?

And we should point out that men are themselves the victims of sexual harassment and abuse at times.

MELISSA SILVERSTEIN: I feel that this is on men.

The men are most of the perpetrators. They’re also the collaborators. And, at The Weinstein Company, their board was all men, and they were all complicit in creating an environment that allowed this to thrive.

In Hollywood, there’s not a single woman, even the people at the tippy-top of the industry, who don’t report to men. This is also about getting more women into leadership positions and getting the men — and holding the men accountable.

The men in this industry need to step up. They need to say, we want to be — we want to create this industry in a way that women can thrive and don’t have to experience this anymore.

JUDY WOODRUFF: Leigh Gilmore?

LEIGH GILMORE: We’re talking about awareness and accountability.

So, as wonderful as it is to have increased visibility, and it enables us to connect the dots and to see the long histories of sexual abuse, harassment and discrimination, we need new levels of accountability.

I will echo the notion that Harvey Weinstein’s board certainly knew about these accusations. There’s a DA who failed to charge him. We have ample examples of failures.

And what we really need to do is to correct those. The role of men is certainly important here. Minimally, they can show up and be witnesses.

JUDY WOODRUFF: And, finally, Fatima Goss Graves, the role of men and how we prevent this.

FATIMA GOSS GRAVES: We have had a little bit of conversation about men as survivors, but the conversation we haven’t really had is about what happens when men are abusers or enablers or allow this to happen in the workplaces, in schools, or in women’s everyday lives?

And so now we have an opportunity culturally for that conversation. That culture is going to have to hit where policy-makers are. It’s going to have to hit where employers are in order to make a real difference.

JUDY WOODRUFF: Well, it’s clear that everyone is hoping this is a watershed moment, that things will change as a result of what’s happened here. But we will see.

And we appreciate all of you joining us in this conversation, Fatima Goss Graves here with me in Washington, Lisa Senecal, Melissa Silverstein, and Leigh Gilmore.

We thank you all.

FATIMA GOSS GRAVES: Thank you.

MELISSA SILVERSTEIN: Thank you.

The post As survivors say #MeToo, what will it take to stop widespread sexual harassment? appeared first on PBS NewsHour.

In America, there’s a significant kind of public insistence that one’s “freedom” is fundamentally tied to one’s wealth.

Much of the country views America through an aspirational and transformative lens, a colorblind and bias-free utopia, wherein wealth conveys equality and acts as a panacea for social and racial ills. Once an individual achieves massive financial success, or so the message goes, he or she will “transcend” the scourge of economic and racial inequality, truly becoming “free.”

Working in parallel with this reverence for this colorblind version of the “American Dream” is the belief that economic privilege mandates patriotic gratitude. Across industries and disciplines, Americans are told to love their nation uncritically, be thankful that they are exceptional enough to live in a country that allows citizens the opportunity to reach astronomical heights of economic prosperity.

For the nation’s black citizens, there’s often an additional racialized presumption lurking under the surface of these concepts: the notion that black success and wealth demands public silence on systemic issues of inequality and oppression.

These are durable and fragile ideologies that prop up the concept of the American Dream – durable because they are encoded in the very fabric of American culture (most Americans, including African Americans, have readily embraced these ideologies as assumed facts); yet fragile because it’s all too easy to see that one’s economic privilege is a lousy barrier against both individual and systemic discrimination and oppression.

Consequently, black people have also been among the most vocal challengers of these ideologies, as we’ve seen most recently with the Colin Kaepernick and the NFL #TakeAKnee demonstrations. In a show of solidary with the free agent quarterback, professional football players – the vast majority of whom are black – have been kneeling during the National Anthem as a means of protesting racial injustice and police brutality.

WATCH: NFL players team up in defiance and solidarity

Over the past few weeks, the president of the United States has brought renewed attention to the inherent tensions that define the ideologies of the “American Dream” through his repeated public criticisms of these kneeling NFL players.

“If a player wants the privilege of making millions of dollars in the NFL, or other leagues,” Trump recently tweeted, he or she should not be allowed to kneel. Labeling the protestors actions “disrespectful” to the country, flag and anthem, President Donald Trump has called for players to be fired, encouraged a boycott of the NFL, insisted that the league pass a rule mandating that players stand for the anthem and derided the protestors as “sons of bitches.”

In a dramatic ploy more befitting of a scripted reality television show, the president gloated that he had instructed Vice President Mike Pence to walk out of an Indianapolis Colts game the moment any player kneeled. This was an orchestrated show of power and outrage, designed to send a flamboyant political message given that Trump and Pence knew in advance that on that particular day, the Colts were playing the San Francisco 49ers – the team that currently has the most protestors. The NFL’s announcement this week that the league has no plans to penalize protesting players is the most recent event to provoke the president’s fury; taking to social media during the early morning, he once again equated kneeling with “total disrespect” for our country.

As many have pointed out, the president’s moralizing outrage toward the NFL players is selective and deeply flawed – his apparent patriotic loyalty hasn’t stopped the billionaire politician from criticizing the removal of Confederate statues, or attacking a Gold Star family, or mocking Sen. John McCain’s military service.

The NFL players and their defenders have repeatedly stated that the protests are intended to highlight racial inequality and oppression. They’ve also explained that their decision to kneel emerged from a desire to protest peacefully and respectfully after a sustained conversation with military veterans.

Trump has chosen to ignore these rationales and the structural issues of inequality that motivate the protests and instead, advance a narrative exclusively concerned with overt displays of American patriotism and the “privilege” of the NFL players. As one of president’s advisors explained, by aggressively targeting the NFL players, Trump believes that he is “winning the cultural war,” having made black “millionaire sport athletes his new [Hillary Clinton].”

READ MORE: As ‘America’s sport,’ the NFL cannot escape politics

It’s a cynical statement, revealing the president’s perception of the jingoism of his base of supporters who envision him as a crusader for American values and symbols.

In casting the black protestors as the antithesis of all of this, Trump has marked the players as unpatriotic elites and enemies of the nation. For a president who has consistently fumbled his way through domestic and foreign policy since he was elected, a culture war between “hard-working” and “virtuous” working-class and middle-class white Americans and rich, ungrateful black football players is a welcome public distraction.

Trump’s attacks on the NFL protestors are rooted in those competing tensions inherent to the American Dream: that wealth equals freedom; that economic privilege demands patriotic gratitude; and most importantly, that black people’s individual economic prosperity invalidates their concerns about systemic injustice and requires their silence on racial oppression.

Among the protestors’ detractors, this has become a common line of attack, a means of disparaging the black NFL players’ activism by pointing to their apparent wealth. The fact that systemic racism is demonstrably real and that individual prosperity does not make one immune to racial discrimination appears to be lost on the protestors’ critics.

Theirs is a grievance that suggests that black athletes should be grateful to live in this country; that racism can’t exist in America since black professional athletes are allowed to play and sign contracts for considerable sums of money; that black players owe the nation their silence since America “gave” them opportunity and access; that black athletes have no moral authority on issues of race and inequality because of their individual success; and that black athletes’ success was never theirs to earn, but instead, was given to them and can just as easily be taken away.

This culture war being waged over black athletes is not new. Black athletes – and entertainers – have long been hyper-aware of their peculiar place in American society as individuals beloved for their athletic and artistic talents, yet reviled the moment they use their public platform to protest systemic racial inequality. The parallels between the #TakeAKnee protests and the protests of Muhammad Ali or John Carlos and Tommie Smith are readily apparent; so too are there important similarities to the case of Paul Robeson.

An outspoken civil rights activist, collegiate and professional football player, lawyer, opera singer and actor, Robeson had his passport revoked in 1950 because of his political activism and speech – actions that all but destroyed his career. The star athlete and entertainer, “who had exemplified American upward mobility” quickly “became public enemy number one” as institutions cancelled his concerts, the public called for his death and anti-Robeson mobs burned effigies of him.

During a 1956 congressional hearing, the chairman of the House Committee on Un-American Activities beat a familiar refrain with Robeson, challenging the entertainer’s accusations of American racism and racial oppression. He saw no sign of prejudice, he argued, since Robeson was privileged, having gone to elite universities and playing collegiate and professional football.

READ MORE: Poll: Americans divided on NFL protests

Black athletes, even the silent ones, largely understand that their economic privilege doesn’t insulate them from the realities of racial discrimination. They also understand that their wealth and success is precarious and is often dependent not only upon their athletic performance, but also upon them remaining silent on issues of racial injustice, especially those that appear to question the “American Dream” or implicate the American public by association.

It should come as no surprise then that Colin Kaepernick, whose protests turned him into a national pariah despite his on-the-field talents, has filed a grievance against the NFL, accusing the league and its teams of blackballing him because of his political beliefs. “Principled and peaceful political protest,” Kaepernick’s lawyers argued in a statement, “should not be punished and athletes should not be denied employment based on partisan political provocation by the Executive Branch of our government.” Whether the ostracized Kaepernick will win his grievance is unknown, but it is certainly telling that he and his lawyers have rooted their claims in contested definitions of freedom and the precarious economic privilege of outspoken NFL players.

For the loudest and most vocal critics of black protestors, in particular, outspokenness is tantamount to treason, grounds for the harshest of punishments. Perhaps they would benefit from a close reading of James Baldwin, who once argued: “I love America more than any other country in this world, and, exactly for this reason, I insist on the right to criticize her perpetually.”

The post Column: For black athletes, wealth doesn’t equal freedom appeared first on PBS NewsHour.

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