Using Family and Ecological Systems Approaches to Conceptualize Family- and Community-Based Experiences of Transgender and/or Nonbinary Youth From the Trans Teen and Family Narratives Project.

The current study used family and ecological systems approaches to understand transgender and/or nonbinary (TNB) youths' experiences of their gender identity within family and community contexts. A sample of 33 TNB youth, ages 13-17 years (M = 15.18, SD = 1.24), were recruited from community-based venues in the New England region of the United States to participate in the Trans Teen and Family Narratives Project, a longitudinal community-based mixed methods study. TNB youth in the sample identified as trans girls (n = 12), trans boys (n = 17), and nonbinary (n = 3 assigned female at birth; n = 1 assigned male at birth). Race/ethnicity of the sample was 73% White and 15% mixed race/ethnicity. All participants completed a one-time, in-person semi-structured qualitative interview at baseline about their family and community-based experiences related to their TNB identity. Interviews were audio-recorded and professionally transcribed. Interview transcripts were coded and analyzed using immersion/crystallization and thematic analysis approaches. Eight themes were developed, which correspond to different levels of the ecological systems model: individual-level (identity processes, emotions/coping), family-level (general family experiences, family support), community-level (general community experiences; community support; lesbian, gay, bisexual, transgender, queer (LGBTQ) community), and societal/institutional-level (external forces). Findings emphasize the importance of using family and ecological systems approaches to understanding the family- and community-based experiences of TNB youth and have implications for improving clinical practice with TNB youth and families.

Helping young women go red: Harnessing the power of personal and digital information to prevent heart disease.

OBJECTIVE: Cardiovascular disease (CVD) is the leading cause of death for American women, yet young women are rarely the target population of CVD prevention campaigns. This study investigated young women's exposure to CVD information. METHODS: We surveyed 331 females ages 15-24 years to determine 1) whether participants felt informed about heart disease or stroke, 2) their exposure to heart disease information sources over the past year, and 3) whether they had ever discussed CVD-related topics with healthcare providers. RESULTS: Over half of participants reported feeling not informed about heart disease (52%) or stroke (59%). Participants were more likely to report feeling informed if they were exposed to information from websites or social media, or if they had ever discussed family history of heart disease, personal risk for heart disease, or high blood pressure with their healthcare provider. CONCLUSIONS: Most young women did not feel informed about CVD. Exposure to specific information sources and discussions with healthcare providers may help improve this. PRACTICE IMPLICATIONS: Public health campaigns should promote cardiovascular health through websites and social media popular amongst young women. Healthcare providers should discuss CVD risk factor modification with young patients in order to promote cardiovascular health across the life course.

Dexmedetomidine Dosing to Prevent Pediatric Emergence Delirium.

Because of the high incidence and untoward effects of emergence delirium in the pediatric population, investigating pharmacologic measures for preventing this phenomenon is important to the anesthesia provider. Dexmedetomidine, a highly selective α2 agonist, has been shown to prevent emergence delirium in the perioperative setting; however, recommendations for best practice regarding use of this medication are not widely available. Barriers to the use of dexmedetomidine may include side effects such as bradycardia and delayed emergence, as well as limited evidence for the best practice of timing, method, and dosing of dexmedetomidine. This review of the evidence included 2,142 study participants ranging in age from 1 to 15 years. The findings suggest that administering an intravenous bolus dose of 0.5 µg/kg of body weight in the intraoperative phase demonstrated a significant reduction in the incidence of emergence delirium with minimal side effects. Administration of dexmedetomidine immediately following induction of anesthesia revealed benefit in these patients without a delay in emergence from anesthesia. Along with the benefit of preventing emergence delirium in pediatric patients, the evidence also suggests that dexmedetomidine may lower volatile-agent and analgesic requirements.

Young Women's Perceptions of Heart Disease Risk.

PURPOSE: Heart disease is the number one cause of death in women. Little is known about how adolescent and young adult women perceive their risk of heart disease. METHODS: We conducted eight online, semistructured focus groups with 35 young women aged 15-24 years recruited from two primary care practices in Boston, MA. Focus group discussion topics built upon data from a larger sample of women who completed the American Heart Association Women's Health Study survey. Topics included health concerns salient to young women, perceived susceptibility to heart disease, and barriers to heart-healthy behaviors. We used qualitative coding and thematic analyses to synthesize data. RESULTS: Participants were surprised to learn that heart disease is the leading cause of death in women. Young women discussed age ("I feel like those are things I associate with older people like 40"), gender ("I usually hear more about men suffering from heart problems than women"), and social norms ("we're so pressured just to grow up and [be] more focused on pregnancies or depression or our weight") as reasons for their low perceived risk for heart disease. Participants noted several barriers to adopting heart-healthy behaviors including stress, lack of time, and low perceived risk. "We just don't have time to worry about hearts. Especially if our hearts aren't bothering us to begin with and we can't see it." CONCLUSIONS: Perceptions of age, gender, and social norms contribute to low heart disease awareness among young women, which in turn may limit heart-healthy behaviors.

Will Teens Go Red? Low Cardiovascular Disease Awareness Among Young Women.

Background The American Heart Association Go Red for Women campaign has improved awareness of cardiovascular disease ( CVD ) among adult women aged 25 years and older. Little is known about awareness among younger women. Methods and Results We assessed awareness of CVD and prevention efforts among 331 young women aged 15 to 24 years using the American Heart Association National Women's Health Study survey. We compared responses from this cohort to the 2012 American Heart Association online survey of 1227 women aged 25 years and older. Only 33 (10.0%) young women correctly identified CVD as the leading cause of death in women. This was significantly lower than awareness among all adult women in 2012 (785 [64.0%]) and among women aged 25 to 34 years (90 of 168 [53.6%]) ( P<0.01 for both). Many young women in the current study (144 [43.5%]) said they were not at all informed about CVD ; most worried little (130 [39.2%]) or not at all (126 [38%]) about CVD . Young women did report engaging in behaviors known to reduce risk of CVD , although not considering oneself at risk was cited as the number one barrier to engaging in prevention behaviors. Conclusions Young women are largely unaware of CVD as the leading cause of death for women. Given that most young women are not worried about CVD and their 10-year risk for CVD events is low, campaigns to promote heart-healthy behaviors among younger women should underscore the benefits of these preventive behaviors to current health in addition to reductions in lifetime risk of CVD .