Trends in Bullying Victimization and Social Unsafety for Sexually and Gender Diverse Students.

Research has documented trends in bullying victimization for sexually diverse adolescents in the US, but trends regarding school social unsafety are understudied and there is a dearth of research examining these trends for gender diverse adolescents. This study aimed to identify disparities in bullying victimization and feelings of social unsafety in schools for sexually and gender diverse adolescents. Data stem from the 2014 (N = 15,800; M age = 14.17, SD = 1.50), 2016 (N = 22,310; M age = 14.17, SD = 1.49), and 2018 (N = 10,493; M age = 14.02, SD = 1.52) survey cycles of the Social Safety Monitor, a Dutch cross-sectional school-based study. Findings indicate that sexual orientation disparities remained relatively small, but stable over time, while gender diverse adolescents remained more likely to be victimized and feel unsafe in school, with larger disparities overall. Monitoring these trends is highly relevant, especially considering recent negative developments regarding societal acceptance of sexual and gender diversity.

Core content for venous and Lymphatic Medicine: 2022 revision.

The core content for a medical specialty outlines the scope of the discipline as well as the categories of knowledge considered essential to practice in the field. It provides a template for the development of curricula for medical school, graduate, and postgraduate education, as well as for creating certification standards. Venous and Lymphatic Medicine (VLM) is a specialty that has benefitted from contributions from specialists from several medical disciplines. Optimally, the societies, boards, and residency review committees representing these disciplines would uniformly recognize the scope of VLM to develop education and assessment standards to allow training and identification of qualified practitioners. In order to inform the standard setting bodies and other stakeholders of the current scope of VLM, a task force of VLM experts from cardiology, dermatology, emergency medicine, general surgery, interventional radiology, vascular medicine, and vascular surgery was formed to revise a 2014 consensus document defining the core content of the specialty of VLM.

Key predictors and burden of meticillin-resistant Staphylococcus aureus infection in comparison with meticillin-susceptible S. aureus infection in an Australian hospital setting.

BACKGROUND: Staphylococcus aureus is associated with significant mortality and increased burden on the healthcare system. Relatively few reliable estimates are available regarding the impact of meticillin-resistant S. aureus (MRSA) infection compared with meticillin-susceptible S. aureus (MSSA) infection. AIMS: To compare patients with MRSA infection and MSSA infection to identify differences in inpatient mortality, length of stay and costs of hospital services, and identify predictors of MRSA as a cause of S. aureus infection. METHODS: An analytical, retrospective, longitudinal study using non-identifiable linked data on adults admitted to hospitals of a health district in Australia with a diagnosis of S. aureus infection over a 10-year period. The main outcome measure was 30-day inpatient mortality. Secondary endpoints included total overnight stays, all-cause inpatient mortality, and hospitalization costs within 1 year of index admission. FINDINGS: Inpatient mortality at 30, 100 and 365 days was estimated to be significantly greater for patients with MRSA infection. The mean additional cost of MRSA infection when controlling for additional factors was $5988 and 4 nights of additional hospital stay per patient within 1 year of index admission. Key predictors of MRSA infection were: date of index admission; higher comorbidity score; greater socio-economic disadvantage; admission to hospital other than via the emergency department; older age; and prior admission to hospital within 28 days of index admission. CONCLUSIONS: MRSA infection is associated with increased inpatient mortality, costs and hospital length of stay compared with MSSA infection. Efforts are required to alleviate the additional burden of MRSA infection on patients and healthcare systems.

Associations of Relationship Experiences, Dating Violence, Sexual Harassment, and Assault With Alcohol Use Among Sexual and Gender Minority Adolescents.

Sexual and gender minority (SGM) adolescents report higher rates of dating violence victimization compared with their heterosexual and cisgender peers. Research on dating violence often neglects diversity in sexual and gender identities and is limited to experiences in relationships. Further, given that dating violence and alcohol use are comorbid, research on experiences of dating violence could provide insights into alcohol use disparities among SGM adolescents. We aimed to map patterns of relationship experiences, sexual and physical dating violence, and sexual and physical assault and explored differences in these experiences among SGM adolescents. Further, we examined how these patterns explained alcohol use. We used a U.S. non-probability national web-based survey administered to 13-17-year-old SGM adolescents (N = 12,534). Using latent class analyses, four patterns were identified: low relationship experience, dating violence and harassment and assault (72.0%), intermediate dating experiences, sexual harassment, and assault and low levels of dating violence (13.1%), high dating experiences, dating violence, and sexual assault (8.6%), and high dating experiences, dating violence, and sexual harassment and assault (6.3%). Compared to lesbian and gay adolescents, bisexual adolescents reported more experiences with dating, dating violence, and sexual assault, whereas heterosexual adolescents reported fewer experiences with dating, dating violence, and sexual harassment and assault. Compared to cisgender boys, cisgender girls, transgender boys, and non-binary/assigned male at birth adolescents were more likely to experience dating violence inside and outside of relationship contexts. Experiences of dating, dating violence, and sexual harassment and assault were associated with both drinking frequency and heavy episodic drinking. Together, the findings emphasize the relevance of relationship experiences when studying dating violence and how dating violence and sexual harassment and assault might explain disparities in alcohol use.

The 2016 ENFSI Fingerprint Working Group testing programme.

In 2016, the Fingerprint Working Group (EFP-WG) of the European Network of Forensic Science Institutes (ENFSI), officially established an advisory group with the task of organising proficiency tests (PTs), as well as collaborative exercises (CEs) as a way of raising standards within the fingerprint profession. This article will provide an overview of the Visualisation collaborative exercise and the Comparison proficiency test, which were carried out in 2016. Both the exercise and the test were organised and co-funded by the Prevention of and Fight against Crime Programme of the European Union [1-3], Direct Grant "Towards the Vision for European Forensic Science 2020 (TVEFS-2020)" HOME/2013/ISEC/MO/ENFSI/4000005962, work package T3 "Proficiency Tests and Collaborative Exercises for the Fingerprint Domain". The characteristics of the testing programme are summarised, followed by an overview of the knowledge that has been gained, including lessons learnt.

Exploring lesbian, gay and bisexual patients' accounts of their experiences of cancer care in the UK.

Despite greater recognition of rights and responsibilities around the care of cancer patients who identify as lesbian, gay or bisexual (LGB) within healthcare systems in the United Kingdom, recent quantitative evidence suggests that they experience poorer care than heterosexual counterparts and qualitative findings are limited. Therefore, in the present study, we present an analysis of the accounts of fifteen British LGB cancer patients (diagnosed with different forms of the disease) of the care received. Data were collected through in-depth individual interviews and analysed using thematic analysis. Three of the emerging themes are discussed. These include an examination of what we conceptualise as the 'awkward choreography around disclosure' opportunities and dilemmas for LGB patients, we describe 'making sense of sub-optimal care' which included instances of overt discrimination but was more frequently manifested through micro-aggressions and heteronormative systems and practices, and explore accounts of 'alienation from usual psychosocial cancer support'. We employ Meyer's Minority Stress Theory (2003) as a lens to interrogate the data and explore the ways in which actual or anticipated prejudice affected their experiences of treatment and support. We close with recommendations to enhance LGB-affirmative cancer care including enhanced training of healthcare professionals and explicit articulation of institutional commitment to LGB equality.

Bone health and SATB2-associated syndrome.

SATB2-associated syndrome (SAS) is a rare disorder caused by alterations in the special AT-rich sequence-binding protein 2 (SATB2). Skeletal abnormalities such as tibial bowing, osteomalacia, osteopenia or osteoporosis have been reported suggesting a higher frequency of skeletal complications in SAS. The optimal timing, necessity, and methodology for routine assessment of bone health in individuals with SAS, however, remain unclear. We report molecular and phenotypic features of 7 individuals with SAS documented to have low bone mineral density (BMD) ascertained by dual-energy X-ray absorptiometry (DXA), often preceded by tibial bowing. The lowest BMD Z-scores ranged -2.3 to -5.6. In 4 individuals, total alkaline phosphatase levels were elevated (2 with elevated bone fraction) around the time of low BMD documentation. A clinically significant fracture history and a diagnosis of pediatric osteoporosis were present in 4 individuals. Pamidronate treatment in 2 children improved BMD. In conclusion, low BMD, fractures, and tibial bowing are relatively common skeletal complications in individuals with SAS. DXA is a useful tool when evaluating a child with SAS suspected to have low BMD and the results might alter clinical management.

The 2015 ENFSI Fingerprint Working Group testing programme.

As early as 2004, the Fingerprint Working Group (EFP-WG) of the European Network of Forensic Science Institutes (ENFSI) has organised proficiency tests (PT's), as well as collaborative exercises (CE's), as a way of raising standards within the fingerprint profession. This article provides an overview of the three collaborative exercises carried out in 2015. The characteristics of the testing programme are summarised, followed by an overview of the knowledge that has been gained, including depicting what lessons have been learnt.

ENFSI collaborative testing programme for fingermarks: Past experiences and future perspectives.

As early as 2004 the Fingerprint Working Group of the European Network of Forensic Science Institutes (ENFSI) has organised proficiency tests (PT's) as well as collaborative exercises (CE's) as a way of raising standards within the fingerprint profession. Participation in PT's and CE's is a key element in the ISO/IEC accreditation process as they enable laboratories to monitor the quality of their analytical results. On the basis of the European Council Framework Decision 2009/905/JHA, of 30 November 2009, on Accreditation of forensic service providers carrying out laboratory activities[1], from November 15th of 2015, only accredited laboratories are allowed to exchange fingerprint data with other EU countries. This article will provide an overview of the ENFSI collaborative tests for fingermarks in the fields of visualisation, imaging and individualisation. The characteristics of the testing programme are summarised, followed by an overview of the knowledge that has been gained, including lessons learnt. It is hoped that this reflective process can outline the critical issues that should be addressed as well as highlight future opportunities in relation to Monopoly Project 2013, "Proficiency Tests and Collaborative Exercises for the Fingerprint Domain".

Cancer survivorship monitoring systems for the collection of patient-reported outcomes: a systematic narrative review of international approaches.

PURPOSE: This systematic narrative review describes and compares the development and operational approaches of monitoring systems without a clinical care component that collect patient-reported outcome (PRO) data from cancer survivors. METHODS: Searches were conducted using Medline, PubMed, PsycINFO, the Cochrane Library, CINAHL, Scopus, Joanna Briggs Institute EBP Database and Google Scholar (Advanced). Sources of grey literature and websites of relevant organisations were also searched for relevant published and unpublished material. Articles were included if they described the development (including piloting) of monitoring systems with ongoing recruitment that collect PRO at more than one time point, from 6 months post-diagnosis onward. RESULTS: The initial searches returned 7290 unique citations. After screening titles and abstracts, 39 full-text articles were retrieved for more detailed examination. Eleven articles were included in the review, representing seven international monitoring systems. Systems varied in their scope, implementation process, governance and administration, recruitment and data collection, consent rates, PRO collection, use of PRO and translation strategies. CONCLUSIONS: The most suitable approach for setting-up and implementing a monitoring system for ongoing surveillance will differ depending on the unique requirements, aims and level of resourcing available within a particular context. Better specification and consideration of how PRO data will be used, for what purpose, and by whom, is required to inform effective translational strategies to improve outcomes for cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS: The findings from this review may inform the future development of survivorship monitoring systems in varied environments, which in turn may improve practices that lead to better outcomes for survivors.

Genotype and phenotype in 12 additional individuals with SATB2-associated syndrome.

SATB2-associated syndrome (SAS) is a multisystemic disorder caused by alterations of the SATB2 gene. We describe the phenotype and genotype of 12 individuals with 10 unique (de novo in 11 of 11 tested) pathogenic variants (1 splice site, 5 frameshift, 3 nonsense, and 2 missense) in SATB2 and review all cases reported in the published literature caused by point alterations thus far. In the cohort here described, developmental delay (DD) with severe speech compromise, facial dysmorphism, and dental anomalies were present in all cases. We also present the third case of tibial bowing in an individual who, just as in the previous 2 individuals in the literature, also had a truncating pathogenic variant of SATB2. We explore early genotype-phenotype correlations and reaffirm the main clinical features of this recognizable syndrome: universal DD with severe speech impediment, mild facial dysmorphism, and high frequency of craniofacial anomalies, behavioral issues, and brain neuroradiographic changes. As the recently proposed surveillance guidelines for individuals with SAS are adopted by providers, further delineation of the frequency and impact of other phenotypic traits will become available. Similarly, as new cases of SAS are identified, further exploration of genotype-phenotype correlations will be possible.

Using video ratings to assess multitasking performance in a naturalistic paradigm.

BACKGROUND: Multitasking measures, in which a series of tasks must be completed within a naturalistic setting not fully under the experimenter's control, have been shown to be more sensitive than traditional measures in detecting organisational problems in people with difficulties in executive functioning. There are a number of drawbacks to such tasks however. They can take considerable time to administer and are demanding in terms of examiners noting and recording all relevant aspects of performance. This potentially leaves them more open to subtle bias. One method that could offset these limitations is to video record performance. OBJECTIVES: The practicality and outcome of using video ratings to accurately score performance off-line is investigated here. METHODS: Nineteen participants completed a Multiple Errands Task (MET) while wearing a body-worn camera. Their performance was scored "live" and by an independent rater who had only access to video footage of the task. RESULTS: Significant relationships were seen on all variables of the MET between the live and video ratings. The inter-rater reliability of the measure appears strong. CONCLUSION: We provide initial support for the use of a video rater when assessing performance on an MET.

Intensive working memory training: a single case experimental design in a patient following hypoxic brain damage.

BACKGROUND: Recent reports suggest that intensive, progressive training on working memory tasks can lead to generalized cognitive gains. CASE STUDY: A patient, following hypoxic brain damage, showed significant difficulties in working memory and time-perception. This study examined the impact and specificity of any benefits resulting from automated working memory training (AWMT) in comparison with the effects of an equivalent programme that emphasized automated novel problem-solving (APST) which served as an active control. Following initial assessment, the patient trained for 4 weeks (20 days), 20-30 minutes a day on the APST tasks before repeating key outcome measures. He then trained for an identical period on AWMT. RESULTS: There were no cognitive gains apparent following APST. Furthermore, there were no disproportionate gains on digit span following AWMT. AWMT was, however, associated with improvement in time-perception that had previously been resistant to rehabilitation. In line with previous reports, AWMT was also followed by gains on a measure of planning. CONCLUSION: The results provide encouraging evidence that AWMT may have generalized benefits in the context of impaired WM capacity following brain injury.

Minimally invasive therapy for fetal sacrococcygeal teratoma: case series and systematic review of the literature.

OBJECTIVE: Large solid sacrococcygeal teratomas (SCT) can cause high-output cardiac failure and fetal or neonatal death. The aim of this study was to describe the outcomes of minimally invasive antenatal procedures for the treatment of fetal SCT. METHODS: A case review was performed of five fetuses with a large SCT treated antenatally using minimally invasive techniques, and a systematic literature review on fetal therapy for solid SCTs was carried out. RESULTS: Five women were referred between 17 + 5 and 26 + 4 weeks' gestation for a large fetal SCT with evidence of fetal cardiac failure. Vascular flow to the tumors was interrupted by fetoscopic laser ablation (n = 1), radiofrequency ablation (RFA; n = 2) or interstitial laser ablation ± vascular coiling (n = 2). There were two intrauterine fetal deaths. The other three cases resulted in preterm labor within 10 days of surgery. One neonate died. Two survived without procedure-related complications but had long-term morbidity related to prematurity. The systematic literature review revealed 16 SCTs treated minimally invasively for (early) hydrops. Including our cases, six of 20 hydropic fetuses survived after minimally invasive therapy (30%). Survival after RFA or interstitial laser ablation was 45% (5/11). Of 12 fetuses treated for SCT without obvious hydrops and for which perinatal survival data were available, eight (67%) survived. Mean gestational age at delivery after minimally invasive therapy was 29.7 ± 4.0 weeks. Survival after open fetal surgery in hydropic fetuses was 6/11 (55%), with a mean gestational age at delivery of 29.8 ± 2.9 weeks. CONCLUSIONS: Fetal therapy can potentially improve perinatal outcomes for hydropic fetuses with a solid SCT, but is often complicated by intrauterine death and preterm birth.

Mindfulness-based cancer stress management: impact of a mindfulness-based programme on psychological distress and quality of life.

Within the area of cancer care, mindfulness-based therapeutic interventions have been found to be efficacious in reducing psychological distress related to a cancer diagnosis; however, the impact of mindfulness-based interventions on quality of life is unclear. This study explores the impact of a Mindfulness-Based Cancer Stress Management programme on psychological distress and quality of life. Research methodology included a single-group quasi-experimental study of 26 participants experiencing distress related to a cancer diagnosis, including carers, who completed an MBCSM programme and all assessments. Participants completed the Functional Assessment of Cancer Therapy - General version 4 (FACT-G) and its associated spirituality index (FACIT-Sp-Ex), Hospital Anxiety and Depression Scale (HADS), Freiburg Mindfulness Inventory (FMI), and the Distress Thermometer at baseline, post-intervention, and three months after programme completion. Significant improvements were observed on all measures (ranges: P ≤ 0.001 to 0.008, r = -0.53 to -0.79) following the intervention, which were maintained at 3-month follow-up. Mindfulness was significantly correlated with all main outcome measures at post-intervention (range: r = -0.41 to 0.67) and 3-month follow-up (range: r = -0.49 to 0.73), providing evidence for the internal validity of the study. Our findings indicate that the MBCSM programme is effective in reducing psychological distress and improving quality of life, including spiritual well-being.

Adverse health effects of spousal violence among women attending Saudi Arabian primary health-care clinics.

This study aimed to investigate the frequency of spousal violence among Saudi women and document the related health effects and injuries, as well as their attitudes to gender and violence. Structured interviews were conducted with 200 ever-married women recruited from primary-care centres in Jeddah. Nearly half of the surveyed women (44.5%) reported ever experiencing physical violence from their spouse. Although 37 women (18.5%) had received violence-related injuries, only 6.5% had reported these injuries to a health-care provider. Victims of spousal violence had poor perceptions of their overall health, and reported pain or discomfort, antidepressant use and suicidal thoughts. Women mostly disagreed with the presented justifications for wife-beating. However, the association between gender attitudes and spousal violence was not significant. The results of this study support calls for integration of education about partner violence into health-care curricula to enhance the access and quality of services.

Adverse health effects of spousal violence among women attending Saudi Arabian primary health-care clinics

This study aimed to investigate the frequency of spousal violence among Saudi women and document the related health effects and injuries, as well as their attitudes to gender and violence. Structured interviews were conducted with 200 ever-married women recruited from primary-care centres in Jeddah. Nearly half of the surveyed women [44.5%] reported ever experiencing physical violence from their spouse.Although 37 women [18.5%] had received violence-related injuries, only 6.5% had reported these injuries to a health-care provider. Victims of spousal violence had poor perceptions of their overall health,and reported pain or discomfort, antidepressant use and suicidal thoughts.Women mostly disagreed with the presented justifications for wife- beating.However,the association between gender attitudes and spousal violence was not significant. The results of this study support calls for integration of education about partner violence into health-care curricula to enhance the access and quality of services

La présente étude visait à examiner la fréquence de la violence physique infligée par les conjoints à des femmes saoudiennes et de documenter les effets sur la santé et les traumatismes qui y sont liés,ainsi que leurs attitudes vis-à-vis du sexisme et de la violence. Des entretiens structurés ont été menés auprès de 200 femmes ayant déjà été mariées, recrutées dans des centres de soins de santé primaires à Djedda. Près de la moitié des femmes ayant participé à l'enquête [44,5 %] ont déclaré avoir déjà été victimes de violence conjugale. Pourtant, si 37 femmes [18,5 %] ont présenté des traumatismes liés à la violence physique infligée par leur conjoint, seules 6,5 % avaient consulté un prestataire de soins de santé pour ce motif. Les victimes de violence conjugale avaient une perception médiocre de leur état de santé en général et affirmaient souffrir de douleur et de gêne, consommer des antidépresseurs et avoir des idées suicidaires. Les femmes interrogées étaient le plus souvent en désaccord avec les justifications proposées pour la violence conjugale. Toutefois, l'association entre les attitudes sexistes et la violence conjugale n'était pas significative. Les résultats de cette étude confirment la nécessité d'inclure une formation sur la violence conjugale dans les programmes d'études sur les soins de santé afin d'accroître l'accès aux services et leur qualité

Short communication: Varying dietary dry matter concentration through water addition: effect on nutrient intake and sorting of dairy cows in late lactation.

The objective of this study was to determine if feed sorting can be reduced and if nutrient consumption can be limited in late-lactation cows through water addition to a nutrient-dense total mixed ration (TMR) with a dry matter (DM) content greater than 60%. Twelve lactating Holstein cows (214.8±28.5 d in milk) were exposed to 2 diets in a crossover design with 28-d periods. Diets had the same ingredient composition and differed only in DM percentage, which was reduced by the addition of water. Treatment diets were (1) dry TMR (61.7% DM) and (2) wet TMR (51.9% DM). Dry matter intake and milk production (4% fat-corrected milk; FCM) were recorded for the last 14 d of each treatment period. For the final 4 d of each period, fresh feed and orts were sampled for particle size analysis and subsequent calculation of sorting activity (expressed as a percentage of predicted intake). Adding water to the diet tended to decrease the amount of DM in the fine particle fraction, increase starch concentration in the longer ration particles, and reduce starch concentration in the shortest ration particles. All cows sorted against long ration particles; the extent of this sorting did not differ between the dry and wet treatments (72.9 vs. 77.6%). There tended to be more sorting for fine ration particles on the dry diet compared with the wet (106.3 vs. 104.0%). Water addition had no effect on production, with similar DMI (27.9 vs. 26.5 kg/d), 4% FCM (28.7 vs. 27.6 kg/d), and efficiency of production (0.98 vs. 1.00 kg of 4% FCM/kg of DMI) between the dry and wet treatments. Adding water to a TMR with greater than 60% DM containing primarily haylage and corn silage forage sources may change ration particle DM distribution and particle starch content, possibly contributing to less sorting for the smallest ration particles. This research does not provide evidence that water addition to such a TMR can effectively limit DMI in late-lactation cows and, thus, improve efficiency of milk production.

Norovirus in the hospital setting: virus introduction and spread within the hospital environment.

Norovirus (NoV) strains were collected over a four-month period during 2009-2010 from hospitalised patients with symptoms of gastroenteritis. These were characterised in order to estimate how many strains were introduced into the hospital from the community. In addition, environmental swabbing was performed after clinical cleaning of bays or wards accommodating infected patients. This was performed in order to assess the efficiency of cleaning and identify any NoV contamination in the environment. A total of eight distinct genetic clusters of NoV GII-4 genotype were identified during the four-month period, with some wards experiencing multiple outbreaks with different GII-4 strains during the season. NoV was detected from 31.4% of environmental swabs post cleaning. Notes trolleys, computer keyboards, soap and alcohol dispensers, blood pressure equipment, pulse oximeters and tympanic thermometers were identified as NoV reservoirs but contamination was also found on surfaces around the bedside environment, and furniture, fixtures and fittings associated with toilets and shower rooms. The combination of detailed virus characterisation and environmental swabbing is a powerful tool for infection control audits to determine the size and scope of an outbreak and to monitor the efficiency of clinical cleaning.

Isotropic-to-nematic transition in confined liquid crystals: an essentially nonuniversal phenomenon.

Computer simulations are presented of the isotropic-to-nematic transition in a liquid crystal confined between two parallel plates a distance H apart. The plates are neutral and do not impose any anchoring on the particles. Depending on the shape of the pair potential acting between the particles, we find that the transition either changes from first order to continuous at a critical film thickness H=H(x) , or that the transition remains first order irrespective of H . This demonstrates that the isotropic-to-nematic transition in confined geometry is not characterized by any universality class, but rather that its fate is determined by microscopic details. The resulting capillary phase diagrams can thus assume two topologies: one where the isotropic and nematic branches of the binodal meet at H=H(x), and one where they remain separated. For values of H where the transition is strongly first order the shift Deltaepsilon of the transition temperature is in excellent agreement with the Kelvin equation. Not only is the relation Deltaepsilon proportional, variant 1/H recovered but also the prefactor of the shift is in quantitative agreement with the independently measured bulk latent heat and interfacial tension.