Examining the Second-Order Factor Structure of the Gender Minority Stress and Resilience Scale.

The gender minority stress and resilience (GMSR) theory and associated measure are widely utilized in research investigating the stress, resilience, and psychological health experiences of gender nonconforming (GNC) individuals. GMSR theory specifies that distal stress and proximal stress experiences adversely affect the psychological health of GNC individuals, while resilience factors help buffer against these deleterious impacts. Moreover, GMSR theory clearly specifies a second-order factor structure such that distal stress experiences are comprised of gender-based victimization, rejection, discrimination, and non-affirmation; proximal stress experiences are comprised of internalized transphobia, negative expectations for the future, and gender identity nondisclosure; and pride and community connectedness constitute resilience factors. However, despite widespread use of the GMSR measure, including validating its use among Italian, Spanish, and adolescent GNC individuals, all research to date has only queried the first-order factor structure of the measure. The present study therefore evaluated the second-order factor structure of the GMSR measure among a sample of 234 GNC college students. Results suggested that the second-order factor structure provided a reasonable fit to the data but did not fit the data exceptionally well. Moreover, results suggested that the first-order factor structure with correlated factors provided a better fit to the data than did the second-order model. Thus, while this study found support for the second-order factor structure, it appears that the first-order structure may be better suited for research use. Secondarily, the GMSR measure appears valid for use among GNC undergraduates. Additional research is needed to further validate the measure's second-order factor structure, and future research should consider trimming redundant items from the GMSR to address known fit issues.

Transvesical NOTES: survival study in porcine model.

BACKGROUND AND OBJECTIVES: The optimal access route and method for natural orifice transluminal endoscopic surgery (NOTES) has not been established. A transvesical approach, with its low rate of peritoneal contamination, is an effective clean portal of entry, but a safe urinary bladder closure has been a challenge. We developed a new technique for a safe, pure transvesical NOTES approach. METHODS: Four female piglets were used in the study. With the pigs under anesthesia, a flexible cystoscope (15Fr) was used to make an endoscopic cystotomy; diagnostic peritoneoscopy of the abdominal quadrants was done with biopsies and hemostasis. At the end, a Vicryl loop was pushed to close the bladder incision while the incision edges were pulled inwards. The pigs were euthanized after 2 wk, and necropsies were performed. RESULTS: No bowel injury was noted in any of the 4 pigs. Satisfactory bladder closure was done in 2 pigs, while a partial closure was achieved in 1 case. In the postoperative period, the pigs showed no signs of pain or distress, voided normally, and had a good appetite. On necropsy, we noted healed cystotomy incisions, no intraabdominal adhesions, and no adhesions at the site. CONCLUSION: Our new technique for endoscopic cystotomy overcomes previously reported risks for bowel injuries. Using this route gives good spatial orientation and access to all quadrants, including the pelvis. Biopsies with good hemostasis can be easily achieved. Lack of intraperitoneal changes postoperatively indicate that this procedure may be safe for humans.

Topical gentamicin does not provide any additional anastomotic strength when combined with fibrin glue.

BACKGROUND: We evaluated the effect of a combination of fibrin sealant and topical gentamicin on a colonic anastomosis in a rat model. METHODS: Partial anastomosis in the transverse colon was performed in 70 male Sprague-Dawley rats aged 6 to 10 weeks using 5 interrupted sutures. The rats were divided into 4 groups (control, gentamicin, fibrin glue, and combination). On postoperative days 3 and 5, the rats in each group were killed, anastomotic bursting pressures scores and bowel loop adhesions were determined, and histologic examination was performed. RESULTS: No significant difference was noted in the bursting pressures, adhesions, inflammatory infiltrates, fibroblasts, or neoangiogenesis between the fibrin-glue only and the combination groups for both the day 3 and day 5 subgroups. CONCLUSIONS: The combination of topical gentamicin and fibrin glue had little effect because the combination did not provide additional anastomotic strength or decrease the number of adhesions when compared with fibrin glue alone.

Protective effect of methylprednisolone on warm ischemia-reperfusion injury in a cholestatic rat liver.

BACKGROUND: Cholestasis has been identified as a risk factor for oxidative stress, and it potentially enhances after ischemic-reperfusion injury. The aim of this study was to evaluate the role of methylprednisolone on warm ischemia-reperfusion injury in the presence of cholestasis. METHODS: A reversible cholestatic rat model was created. After 7 days, rats received 30 mg/kg of intravenous methylprednisolone 2 hours before ischemia, followed by 30 minutes of ischemia. Rats were euthanized 24 hours after ischemia. Serum aspartate aminotransferase and interleukin-6 were measured, and the liver was harvested for histology and myeloperoxidase estimation. RESULTS: Methylprednisolone had a protective effect, with a statistically significant decrease in aspartate aminotransferase (P=.01) and a trend toward decreased levels of interleukin-6 (P=.07). Histology showed a significant difference in architectural distortion (P=.01), cytoplasmic vacuolation (P=.01), and nodular hepatocellular necrosis (P=.04). CONCLUSIONS: Methylprednisolone attenuated the ischemic-reperfusion injury in the presence of cholestasis and can be considered for clinical use in the presence of cholestasis.

Veteran interest in family involvement in PTSD treatment.

[Correction Notice: An erratum for this article was reported in Vol 7(3) of Psychological Services (see record 2010-17074-004). The copyright for the article was listed incorrectly. This article is in the Public Domain. The online version has been corrected.] The present study examined interest in family involvement in treatment and preferences concerning the focus of family oriented treatment for veterans (N = 114) participating in an outpatient Veterans Affairs outpatient posttraumatic stress disorder (PTSD) program. Most veterans viewed PTSD as a source of family stress (86%) and expressed interest in greater family involvement in their treatment (79%). These results suggest the need to consider increasing family participation in the clinical care of individuals with PTSD and to develop specialized family educational and support services for this population. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Emotion regulation among individuals classified with and without generalized anxiety disorder.

Generalized anxiety disorder (GAD) has been conceptualized as being characterized by the experience of intense emotion, limited understanding of the emotional experience, poor ability to adaptively modulate emotions, and an aversive response to emotions [Mennin, D. S., Turk, C. L., Heimberg, R. G., & Carmin, C. N. (2004). Focusing on the regulation of emotion: a new direction for conceptualizing and treating generalized anxiety disorder. In: M. A. Reinecke, & D. A. Clark (Eds.), Cognitive therapy over the lifespan: theory, research and practice (pp. 60-89). New York: Wiley]. In order to test aspects of this model, participants completed daily diaries and a questionnaire measuring emotion regulation strategies. As hypothesized, relative to controls, individuals classified as having GAD reported more intense daily emotional experiences. Contrary to predictions and previous research, those with GAD did not show poor emotion differentiation and used several emotion regulation strategies more often than control participants. The implications for both the emotion dysregulation model and treatment of GAD are discussed.

Completion hysterectomy after radiation therapy for bulky cervical cancer stages IB, IIA, and IIB: complications and survival rates.

OBJECTIVE: The purpose of this study was to assess survival and morbidity when completion hysterectomy follows radiation for bulky cervical cancer. STUDY DESIGN: This was a retrospective observational descriptive review that assessed the survival and morbidity of patients with bulky cervical cancer that was treated with radiation followed by completion hysterectomy between 1993 and 2002. Chemotherapy, external beam radiation, and brachytherapy data were collected. RESULTS: Fifty-five cases were reviewed. Fifty-three patients received brachytherapy. Twenty-nine patients underwent sensitizing chemotherapy. All patients had hysterectomies. There were 12 early postoperative complications (21.8%) and 10 late complications (19.6%). Eleven patients are dead of disease (21.6%); 3 patients are alive with disease (5.9%), and 37 patients are free of disease (72.5%). Four patients were lost to follow-up. Seven patients who are free of disease had residual cancer in the specimen at hysterectomy. CONCLUSION: Complications of combined therapy were comparable to radiation or radical hysterectomy alone. In cases in which an incomplete response to radiation and chemotherapy leaves potential residual carcinoma, adjuvant hysterectomy may be a reasonable treatment option.