Independently planned parenthood: Sexual identity and evaluations of single-parenthood-by-choice.

Parenthood is usually viewed as happening within the institution of marriage. Single parenthood has a negative connotation and is typically associated with divorce, separation, or widowhood. However, independently planned parenthood, or single-parenthood-by-choice, is intrinsically different in that independently planned parents actively plan to pursue parenthood without a romantic partner, sexual partner, or other coparenting unit. This study examined attitudes toward independently planned parenthood and willingness to consider independently planned parenthood as a function of gender and sexual identity. Participants included 631 cisgender young adults (201 lesbian/gay, 430 heterosexual) living in the United States. Women had more positive attitudes toward independently planned parenthood than men, and lesbian and gay people had more positive attitudes toward independently planned parenthood than heterosexual people. Gay men were more willing to consider becoming parents independently than heterosexual men, but there were no significant differences between lesbian and heterosexual women. In all, independently planned parents are an underrecognized population within single parenthood. These parents challenge the patriarchal and heteronormative norms surrounding parenthood and may suffer social backlash and stigmatization because of their decision to pursue parenthood alone. However, this study finds that monosexual women and gay men may be more welcoming of this nontraditional family structure than heterosexual men. This research acts as a foundation to continue to explore issues of independently planned parenthood. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

United States Normative Attitudes for Pursuing Parenthood as a Function of Gender, Sexual Orientation, and Age.

Decisions about whether or not to become a parent are significant parts of normative human development. Many studies have shown that married different-sex couples are expected to become parents, and that many social pressures enforce this norm. For same-sex couples, however, much less is known about social norms surrounding parenthood within marriage. This study examined injunctive norms and descriptive norms for the pursuit of parenthood as a function of age, gender, and sexual orientation. Participants in an internet survey included 1020 (522 heterosexual, 498 lesbian/gay) cisgender people from across the United States Findings showed that norms, especially descriptive norms, for the pursuit of parenthood for heterosexual people were much stronger than those for lesbian women and gay men, and that norms for lesbian women were stronger than those for gay men. These differences were more pronounced for older, heterosexual, and male participants. However, lesbian and gay participants, especially gay men, reported that lesbian and gay people ought to become parents to the same extent as heterosexual people. Overall, the results indicated that, regardless of sexual orientation, adults report that lesbian and gay married people ought to become parents, but that they expect only a minority of these couples will pursue parenthood. This research provided a glimpse into how Americans are envisioning family formation among same-sex couples today.

33% hydrogen peroxide as a Neoadjuvant treatment in the surgical excision of non-melanoma skin cancers: a case series.

BACKGROUND: Hydrogen peroxide (H2O2) is a product of respiration in mitochondria and an important oxidizing agent in biological systems. Previous investigations have shown the efficacy of H2O2 in treating skin conditions such as seborrheic keratosis and actinic keratosis. In an area like the face, reconstruction of excision defects and ultimately aesthetic outcomes are of utmost importance. Hydrogen peroxide may represent a simple yet effective method at shrinking non-melanoma skin cancers (NMSC) of the head and neck before they are excised. METHODS: Eleven consecutive patients presenting to our cutaneous malignancy clinic had their skin lesions evaluated by the senior author for participation in the study. Lesion length and width was measured. Hydrogen peroxide formulated at a concentration of 33% was rubbed into the lesion until blanching was observed. Lesions were re-measured at follow up. Excisional biopsy was then performed and histopathological diagnosis was obtained. Statistical analyses compared pre- and post-treatment lesion dimensions. RESULTS: Seventeen biopsy-proven NMSC lesions were included in this investigation. Statistically significant reductions in the length (p < 0.001) and width (p < 0.001) were observed with H2O2 treatment. For some lesions, H2O2 was the sole treatment required, with post-treatment biopsy demonstrating no evidence of malignancy. Patients endured minimal discomfort during treatment and no long-term side effects were observed. Follow up at 6 months revealed no recurrences. CONCLUSIONS: We have demonstrated a significant reduction in the size of multiple lesions after application of 33% hydrogen peroxide, simplifying definitive excision and reconstruction. Hydrogen peroxide demonstrated an ability to successfully treat non-melanoma skin cancers as well.

Desire for Parenthood in Context of Other Life Aspirations Among Lesbian, Gay, and Heterosexual Young Adults.

Research has established that sexual minority young adults generally report fewer desires and fewer expectations for parenthood than do their heterosexual peers. Little is known, however, about other desires and expectations. Is parenthood the only domain in which lesbian and gay individuals report fewer desires and expectations than their heterosexual peers? Or do lower aspirations among lesbian and gay adults about parenthood also occur in other domains, such as marriage and work? In this study, we explored a variety of desires and expectations for the future among lesbian, gay, and heterosexual young adults. Participants for this internet survey were recruited via social media, and included 368 childless cisgender young adults (211 lesbian or gay and 157 heterosexual) living in the United States. There were three main findings. First, while lesbian/gay individuals were less likely than heterosexual participants to express desire for parenthood, desires in the other future domains did not vary across sexual orientation. Lesbian/gay participants were as likely as heterosexual individuals to desire marriage, friendships, and community connections, as well as career and economic success. Results for expectations were, however, very different. Lesbian/gay participants were less likely than heterosexual individuals to expect that they would marry, become parents, feel connected to a community, achieve meaningful careers, live in their ideal housing, or that they would attain financial stability. Thus, although desires were largely unrelated to sexual orientation, many expectations were strongly linked to it. Lesbian and gay individuals were also far more likely than their heterosexual peers to desire future goals that they did not expect to achieve. Overall, for lesbian/gay young adults, low parenthood aspirations were part of a general pattern of low expectations (though not reduced desires) across a number of life domains.

Sexual minority women's attitudes toward infants, children, and parenthood.

Little is known about the experiences of lesbian and bisexual women with infants or children or about their views on trade-offs required by parenthood. In this study, we examined how reactions to experiences with infants/children, perceived trade-offs of parenthood, and self-reported nurturance vary as a function of women's sexual orientation. Two hundred cisgender childless women (53 lesbian, 57 plurisexual, 90 heterosexual) from the United States, recruited via social media, participated in this study. Results showed that lesbian women reported more negative attitudes toward infants/children and parenthood than did heterosexual women. Self-reported nurturance did not differ as a function of sexual orientation. Overall, lesbian women reported that they had less favorable experiences with infants and/or children and that they anticipated more social and economic costs involved with parenthood than did heterosexual women. Lesbian women also reported lower aspirations for parenthood than heterosexual women, and this was largely accounted for by differences in perceptions of the trade-offs involved with parenthood. Plurisexual women did not differ from lesbian or heterosexual women on any outcome. These results contribute to our understanding of why lesbian women are, on average, less likely than heterosexual women to aspire to parenthood.

Predictors of parenting intentions among childless lesbian, gay, and heterosexual adults.

Disparities in the intention to parent have been found for lesbian and gay individuals compared with heterosexual individuals, but little is known about what social contexts predict these differences. Qualities of family relationships, friendships, and romantic relationships may all play a role, but these have not been studied as a function of sexual orientation. Using a large national sample of adults in the United States, this study explored intentions for parenthood, ideal family size, and predictors of parenting intentions as a function of gender and sexual orientation. Results showed that fewer lesbian and gay than heterosexual individuals intended to become parents. In addition, among those who intended parenthood, lesbian and gay individuals reported smaller intended family sizes than did their heterosexual peers. Sociocontextual and demographic variables predicted parenting intentions similarly among all participants, regardless of sexual orientation. However, dissimilarities in the levels of these predictors explained some of the disparity in parenting intentions between lesbian/gay and heterosexual participants. Much remains to be learned about the role of sexual orientation in family formation processes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Antagonists of Wnt/ß-catenin signalling in the periodontitis associated with type 2 diabetes and smoking.

AIM: This study evaluated the levels of sclerostin (SOST) and Dickkopf (DKK)-1 in the chronic periodontitis (CP) associated with type 2 diabetes (DM) and/or smoking. Relationships between SOST, DDK1, RANKL, OPG, IL-1ß, IL-6 and TNF-α, and pathogens were assessed. MATERIAL AND METHODS: The study population included non-diabetic non-smokers (control), non-smokers with DM (DM group), non-diabetic smokers (S group) and smokers with DM (SDM group), all with CP. Serum and gingival levels of SOST, DKK1, RANKL, OPG, IL-1ß, IL-6 and TNF-α were evaluated by multiplex immunoassay. Gene expressions of these biomarkers and subgingival levels of pathogens were assessed by qPCR. RESULTS: Gingival protein and/or mRNA levels of DKK1 and SOST were higher in subjects with DM and/or smoking than in controls (p < .05). Serum levels of SOST were higher in the DM group than in controls (p < .05). DKK1 positively correlated with SOST in the DM, SDM and control groups (p < .05) at mRNA levels. DKK-1 and SOST correlated with pathogens, especially in both groups with DM. CONCLUSIONS: SOST and DKK1 were upregulated in patients with CP presenting DM and/or smoking. DM, alone or with smoking, particularly influenced the correlations of SOST and DKK1 with each other and with the other biomarkers mostly at mRNA levels, as well as with periodontal pathogens.

The significance of breastfeeding on sleep patterns during the first 48 hours postpartum for first time mothers.

Postpartum women sleep less during the early days following delivery. Long-term sleep disturbance and fatigue can have significant implications for physical and mental health, relationships, employment and parental competence. Most studies focus on the quality and quantity of maternal sleep between weeks one and six postpartum. We explored sleep patterns and reasons for wakefulness of first-time mothers immediately following delivery. Thirty first-time mothers completed a postnatal sleep questionnaire, detailing their total sleep time (TST), the reasons for being awake and their level of fatigue. The logs were completed in real time during the first 48 h postpartum, while they were still in a hospital environment. The data collected from the mothers in the study indicated that the mean TST in the first 48 h was 9.7 h. Of the factors explored only breastfeeding influenced the TST. Breastfeeding women slept on average 2.6 h longer than women who bottle-fed (p = .042). Impact statement What is already known on this subject: Childbearing affects women's sleep in many ways. Hormonal changes during pregnancy and postpartum as well as physiological and anatomical alterations, and the process of adaptation to the new parent's responsibilities contribute to changes in sleep architecture. Since first study of sleep and pregnancy published in 1968 there have been very few publications addressing maternal sleep postpartum. Most studies which have focussed on quality of maternal sleep in the first 6-months postpartum period describe the relationships between poor maternal sleep and postpartum depression and other mental health outcomes. What the results of this study add: We explored sleep patterns and reasons for wakefulness of first-time mothers immediately following delivery while they remained in the hospital environment. We found that environmental factors such as background noise, shared rooms, type of delivery, feeding and worrying about the neonate did not influence the total sleep time, however, the main outcome of our study is that breastfeeding promotes maternal sleep. What the implications are of these findings for clinical practice and/or further research: We believe that this study would be of interest to many obstetricians, general practitioners, nurses and midwives as well as to the general public. Appropriate counselling of patients early in postnatal period can improve their sleep patterns and reduce the risk of depression and other abnormal physical, psychological and social outcomes.

The Doyle-Saleh blink reflex.

OBJECTIVES: When performing septoplasty or septorhinoplasty, we have observed that patients blink on injection of local anaesthetic (lidocaine 1 per cent with adrenaline 1:80 000) into the nasal mucosa of the anterior septum or vestibular skin, despite appropriate general anaesthesia. This study sought to quantify this phenomenon by conducting a prospective audit of all patients undergoing septoplasty or septorhinoplasty. METHODS: Patients were observed for a blink reflex at the time of local anaesthetic infiltration into the nasal vestibule. Also measured at this point were propofol target-controlled infusion levels, remifentanil rate, bispectral index, blood pressure, heart rate, pupil size and position, and patient movement. RESULTS: There were 15 blink reflexes in the 30 patients observed. The average bispectral index value was 32.75 (range, 22-50) in the blink group and 26.77 (range, 18-49) in the non-blink group. No patients moved on local anaesthetic injection. CONCLUSION: The blink reflex appears to occur in 50 per cent of patients, despite a deep level of anaesthesia. Without an understanding and appreciation of the blink reflex, this event may result in a request to deepen anaesthesia, but this is not necessary and surgery can proceed safely.

A paired comparison analysis of third-party rater thyroidectomy scar preference.

OBJECTIVE: To determine the length and position of a thyroidectomy scar that is cosmetically most appealing to naïve raters. METHODS: Images of thyroidectomy scars were reproduced on male and female necks using digital imaging software. Surgical variables studied were scar position and length. Fifteen raters were presented with 56 scar pairings and asked to identify which was preferred cosmetically. Twenty duplicate pairings were included to assess rater reliability. Analysis of variance was used to determine preference. RESULTS: Raters preferred low, short scars, followed by high, short scars, with long scars in either position being less desirable (p < 0.05). Twelve of 15 raters had acceptable intra-rater and inter-rater reliability. CONCLUSION: Naïve raters preferred low, short scars over the alternatives. High, short scars were the next most favourably rated. If other factors influencing incision choice are considered equal, surgeons should consider these preferences in scar position and length when planning their thyroidectomy approach.

Governing Principles of Alginate Microparticle Synthesis with Centrifugal Forces.

A controlled synthesis of polymeric particles is becoming increasingly important because of emerging applications ranging from medical diagnostics to self-assembly. Centrifugal synthesis of hydrogel microparticles is a promising method, combining rapid particle synthesis and the ease of manufacturing with readily available laboratory equipment. This method utilizes centrifugal forces to extrude an aqueous polymer solution, sodium alginate (NaALG) through a nozzle. The extruded solution forms droplets that quickly cross-link upon contact with aqueous calcium chloride (CaCl2) solution to form hydrogel particles. The size distribution of hydrogel particles is dictated by the pinch-off behavior of the extruded solution through a balance of inertial, viscous, and surface tension stresses. We identify the parameters dictating the particle size and provide a numerical correlation predicting the average particle size. Furthermore, we create a phase map identifying different pinch-off regimes (dripping without satellites, dripping with satellites, and jetting), explaining the corresponding particle size distributions, and present scaling arguments predicting the transition between regimes. By shedding light on the underlying physics, this study enables the rational design and operation of particle synthesis by centrifugal forces.

Mechanical signatures of microbial biofilms in micropillar-embedded growth chambers.

Biofilms are surface-attached communities of microorganisms embedded in an extracellular matrix and are essential for the cycling of organic matter in natural and engineered environments. They are also the leading cause of many infections, for example, those associated with chronic wounds and implanted medical devices. The extracellular matrix is a key biofilm component that determines its architecture and defines its physical properties. Herein, we used growth chambers embedded with micropillars to study the net mechanical forces (differential pressure) exerted during biofilm formation in situ. Pressure from the biofilm is transferred to the micropillars via the extracellular matrix, and reduction of major matrix components decreases the magnitude of micropillar deflections. The spatial arrangement of micropillar deflections caused by pressure differences in the different biofilm strains may potentially be used as mechanical signatures for biofilm characterization. Hence, we submit that micropillar-embedded growth chambers provide insights into the mechanical properties and dynamics of the biofilm and its matrix.

Urbanization and non-communicable disease in Southeast Asia: a review of current evidence.

OBJECTIVE: Non-communicable diseases (NCDs) have been highlighted as a major public health issue in the Southeast (SE) Asian region. One of the major socio-environmental factors that are considered to be associated with such a rise in NCDs is urbanization. Urbanization is associated with behavioural changes such as eating an unhealthy diet, and a decrease in physical activities, which may result in associated obesity. The SE Asian region also has a substantive burden of infectious disease such as HIV and malaria, which may modify associations between urbanization and development of NCDs. STUDY DESIGN: A systematic review was conducted until April 2013. METHODS: Using four databases: EMBASE, PubMed, GlobalHealth and DigitalJournal, the systematic review pools existing evidence on urban-rural gradients in NCD prevalence/incidence. RESULTS: The study found that in SE Asia, urban exposure was positively associated with coronary heart disease, diabetes and respiratory diseases in children. Urban exposure was negatively associated with rheumatic heart diseases. The stages of economic development may also modify the association between urbanization and NCDs such as diabetes. CONCLUSION: There was pronounced heterogeneity between associations. It is recommended that future studies examine the major constituents of NCDs separately and also focus on the interplay between lifestyle and infectious risk factors for NCDs. Prospective studies are needed to understand the diverse causal pathways between urbanization and NCDs in SE Asia.

Maternal depression, antidepressant prescriptions, and congenital anomaly risk in offspring: a population-based cohort study.

OBJECTIVE: To estimate risks of major congenital anomaly (MCA) among children of mothers prescribed antidepressants during early pregnancy or diagnosed with depression but without antidepressant prescriptions. DESIGN: Population-based cohort study. SETTING: Linked UK maternal-child primary care records. POPULATION: A total of 349,127 singletons liveborn between 1990 and 2009. METHODS: Odds ratios adjusted for maternal sociodemographics and comorbidities (aORs) were calculated for MCAs, comparing women with first-trimester selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants (TCAs) and women with diagnosed but unmedicated depression, or women without diagnosed depression. MAIN OUTCOME MEASURES: Fourteen system-specific MCA groups classified according to the European Surveillance of Congenital Anomalies and five specific heart anomaly groups. RESULTS: Absolute risks of MCA were 2.7% (95% confidence interval, 95% CI, 2.6-2.8%) in children of mothers without diagnosed depression, 2.8% (95% CI 2.5-3.2%) in children of mothers with unmedicated depression, and 2.7% (95% CI 2.2-3.2%) and 3.1% (95% CI 2.2-4.1%) in children of mothers with SSRIs or TCAs, respectively. Compared with women without depression, MCA overall was not associated with unmedicated depression (aOR 1.07, 95% CI 0.96-1.18), SSRIs (aOR 1.01, 95% CI 0.88-1.17), or TCAs (aOR 1.09, 95% CI 0.87-1.38). Paroxetine was associated with increased heart anomalies (absolute risk 1.4% in the exposed group compared with 0.8% in women without depression; aOR 1.78, 95% CI 1.09-2.88), which decreased marginally when compared with women with diagnosed but unmedicated depression (aOR 1.67, 95% CI 1.00-2.80). CONCLUSIONS: Overall MCA risk did not increase with maternal depression or with antidepressant prescriptions. Paroxetine was associated with increases of heart anomalies, although this could represent a chance finding from a large number of comparisons undertaken.

Understanding thermal adaptation of enzymes through the multistate rational design and stability prediction of 100 adenylate kinases.

Careful balance between structural stability and flexibility is a hallmark of enzymatic function, and temperature can affect both properties. Canonical (fixed-backbone) enzyme design strategies currently do not consider the role of these properties. Herein, we describe the rational design of 100 temperature-adapted adenylate kinase enzymes using a multistate design strategy that incorporates the impact of conformational changes to backbone structure and stability, in addition to experimental analysis of thermostability and function. Comparison of the experimental temperature of maximum activity to the melting temperature across all 100 variants reveals a strong correlation between these two parameters. In turn, experimental stability data were used to produce accurate predictions of thermostability, providing the requisite complement for de novo temperature-adapted enzyme design. In principle, this level of design-based analysis can be applied to any protein, paving the way toward identifying and understanding the hallmarks of the thermodynamic and structural limits of function.

Improving levels of evidence in studies published in spinal journals from 1983 to 2011.

INTRODUCTION: The evidence basis for spinal surgical practice is closely related to the quality of clinical studies published. In the hierarchy of study designs, the quality of evidence from a randomised controlled trial (RCT) and meta-analysis are considered better than other types of prospective and retrospective study designs. We assessed the level of evidence in studies published from 1983 to 2011 in 4 journals, publishing predominantly on spine related topics. METHODS: Computerised search of the Medline database was undertaken to evaluate the articles published in 4 'spinal' journals (Spine, European Spine Journal, Journal of Spinal Disorders and Techniques and Spinal Cord) from 1983 to 2011. The numbers of RCTs, meta-analyses and other clinical trials (non-RCT) over the time periods 1983-7, 1988-92, 1993-7, 1998-2002, 2003-7 and 2008-11 were compared. RESULTS: From a total number of 21775 articles evaluated, there were 888 (4.1%) RCTs, 93 (0.4%) meta-analyses and 1355 (6.2%) other clinical trials. Overall, comparing the time periods 1983-7 with 2008-11, there were increases in the proportion of RCTs (1.6% to 5.1%), meta-analysis (0% to 0.6%) and other clinical trials (0.9% to 6.3%) and a decrease in the proportion of other articles published (97.6% to 88.1%). These changes appear to have plateaued after 2003-7. CONCLUSIONS: Although RCTs, meta-analysis and other clinical trials form a small proportion of the studies published in leading 'spinal' journals, there have been an encouraging increase in their proportion over the years. This is comparable with other larger surgical specialities and provides a better evidence basis for clinical practice in spinal disorders.

Enhancing the conceptual clarity and utility of the international classification of functioning, disability & health: the potential of a new graphic representation.

PURPOSE: To present a new graphic representation of the international classification of functioning, disability and health (ICF), entitled the ICF-conceptual revision (ICF-CR). The ICF-CR aims to be clearer and more usable tool than the ICF graphic currently used by starting to address criticisms of the ICF raised in the literature, with a focus on positioning quality of life (QoL) in relation to the ICF's other components. METHOD: This is a conceptual paper based on a review of criticisms of the ICF and related literature published on human functioning. RESULTS: In addition to criticisms of the current graphic, four criticisms of the ICF are discussed in relation to the development of the ICF-CR, including: the lack of development of biopsychosocial theory, the lack of clarity between activities and participation, the language used, and the absence of QoL. General systems theory is used to help construct the new graphic in addressing these criticisms and to position QoL. CONCLUSIONS: The ICF-CR is designed to be a more responsive graphic of human functioning; one which enhances the clarity of principles integral to the ICF, including biopsychosocial theory and universalism. It is hoped the ICF-CR will promote continued discussion toward the goal of enhancing the ICF, both visually and conceptually.