A qualitative exploration of positive body image experiences among nonbinary individuals.

One group whose positive body image experiences remain under-explored is individuals who identify as nonbinary, gender fluid, and/or genderqueer (including other nonbinary identities). Thus, we sought to answer the questions: What does it look like to have a positive body image for a nonbinary person? and How do nonbinary persons form and maintain a positive body image? To answer these questions, we conducted in-depth, semi-structured interviews with 15 nonbinary individuals who were assessed as having positive body image using the Body Appreciation Scale-2 (Tylka & Wood-Barcalow, 2015a). Data were analyzed using reflexive thematic analysis. Four themes were identified as characterizing the core features of positive body image among nonbinary persons: body appreciation, body- and self-acceptance, bodily appearance embodied their authentic self, and holding flexible ideals for ways of being. Six themes were identified as related to on-going processes that explain how body image is formed and maintained among nonbinary persons: reframing negative body image information, staging resistance, experiencing representation, receiving and giving social support, practicing self-compassion and self-care, and using dress to create a satisfying presentation of self. In keeping with the tenets of queer theory, findings reflected how gender identity set a context for participants' positive body image experiences.

Art, Media, and Fashion: Negotiating Queerness and Catholicism Through Depictions of Saint Sebastian, From the 15th Century to the Present.

Queerness and Catholicism have historically been at odds with one another. The Church's condemnation of queer individuals was pervasive globally for centuries, yet one way queerness and Catholicism converge is via Saint Sebastian depictions. The purpose of this research is to examine how and why Sebastian, a Catholic saint, has come to serve as an icon for the queer community as well as how dress has been used in depicting shifting representations of the Saint from the 15th to 21st centuries. Drawing upon the historic method, we critically analyze the meanings present in imagery of Saint Sebastian. Through our study of portrayals of the Saint, several key themes have emerged. Several of these contemporary artworks incorporated written language that reifies sainthood and associated suffering. Furthermore, many artworks' overall composition surrounding Saint Sebastian reinforced sainthood through contextual visual elements. Ambivalence in depictions of Saint Sebastian's fleshy body was apparent, with an emphasis on depicting Sebastian within the context of his executions. A gap in time periods and differing artwork styles was observed, with many of our examples being either from the Renaissance or post 1960s. Finally, many of the contemporary artworks surveyed included overt signifiers of queerness, with minimal references to subtle queerness.

Apparel Consumption and Embodied Experiences of Gay Men and Transgender Women in India: Variety and Ambivalence, Fit Issues, LGBT-Fashion Brands, and Affordability.

The purpose of this study was to explore Indian LGBT individuals' apparel consumption practices and embodied experiences related to fashion, style, and the body. Specifically, our research questions were these: What are Indian LGBT individuals' experiences like when navigating the fashion system, and how do they experience their own embodiment in what they wear and how they appear? A qualitative, phenomenological approach was used to answer the research questions. Three gay men and seven transgender women responded to a solicitation for participation and completed a semistructured interview. In our data analysis, we established four themes that relate to two larger areas of emphasis: embodiment and the fashion system. Regarding embodiment, participants related many experiences with their bodies, including (a) variety and ambivalence with bodily practices and (b) difficulty with clothing fit. The other themes centered around knowledge and desires related to the fashion system. Within the fashion system, participants expressed (a) fashion brand awareness and a need for LGBT-centered brands and (b) affordability as a barrier to clothing purchase. Overall, the essence of fashioning one's body as a transgender woman or gay man in India is that, while there has been a significant amount of gender oppression in India, these participants were interested in and desired gender-neutral or LGBT-focused brands.

Effect of Opioid Prescribing Education for Obstetrics and Gynecology Residents in a Safety-Net Hospital.

CONTEXT: The number of deaths due to opioid overdose has steadily increased in the United States since the early 2000s. The US opioid epidemic calls for an urgent need to evaluate physician prescribing habits. OBJECTIVE: To educate obstetrics and gynecology residents about opioid abuse, the quantity typically prescribed postoperatively, and strategies to decrease adverse outcomes. METHODS: Obstetrics and gynecology residents at an urban safety-net hospital were given a preintervention evaluation to understand their opioid prescribing patterns and use of resources like prescription drug monitoring programs and opioid risk tool. Residents then attended a didactic session reviewing rates of adverse outcomes from overprescribing, resources to reduce adverse outcomes, and the number of opioids considered appropriate postoperatively. Residents completed an immediate postintervention evaluation to reevaluate prescribing patterns. RESULTS: Pre- and postintervention evaluations were completed by 13 residents. In the preintervention evaluation, all participants reported that they would prescribe at least 30 opioid pills for patients after cesarean delivery, but in the postintervention evaluation, none reported that they would prescribe more than 20 opioid pills (P=<.0001). Similar but less distinct shifts can be seen in laparoscopic hysterectomy and the use of preoperative gabapentinoids (ie, gabapentin and pregabalin). Before the intervention, 7 residents (54%) reported that they currently prescribed 20 opioid pills or more for patients after laparoscopic hysterectomy, whereas after the intervention, 1 resident (7.7%) reported that he or she would prescribe more than 20 opioid pills in (P=.0382). Before the intervention, 2 residents (15.4%) reported that they would consider gabapentinoids compared with 13 residents (100%) after the intervention. CONCLUSION: Focused opioid education can reduce the intended number of opioid pills prescribed in a postoperative setting. This study highlights the effect that educational curricula can have on physician prescribing patterns to help mitigate the current epidemic and help optimize stepwise multimodal analgesia to avoid overprescribing opioids.

"Male Hair Cannot Extend Below Plane of the Shoulder" and "No Cross Dressing": Critical Queer Analysis of High School Dress Codes in the United States.

In this study, we questioned how high school dress codes outlined in official handbooks were written or presented in regard to the gender binary, either/or perspective. We critically analyzed how or if they allowed for flexibility in expression of gender and sexual identity and if they supported, encouraged, or affirmed a variety of expressions, in particular transgender and gender non-conforming expressions, throughout the text or images. The content analysis method was used to analyze 735 handbooks from the 2016 to 2017 school year. Three themes emerged from the data: (1) support of fluid gender expression, yet not overt support; (2) passive marginalization of gender non-conforming or transgender identities or expressions; and (3) active marginalization of gender non-conforming or transgender identities or expressions. The "LGBTQ+ Dress Code Analysis Tool" was developed for policy makers to use to analyze their dress codes.

Is this what a lesbian looks like? Lesbian fashion and the fashionable lesbian in the United States press, 1960s to 2010s.

We explored articulations of lesbian styles, fashions, and ways of dressing in mainstream fashion and media outlets within the United States during the twentieth and twenty-first centuries. Based upon our findings, we propose that there was trending ambivalence and multiple assemblages across space and time where the mainstream media did not necessarily perpetuate a single stereotypical or essentialist way of conceptualizing fashionable lesbians or lesbian fashions. However, we also noted across time a divide between representations of celebrity lesbians and the contemporary lived experience of ordinary lesbians. Though the press acknowledged this divide on occasion, they also established, circulated, and reinforced this difference. According to the press, while lesbians have been 'chic' since the 1990s-whether they embraced a butch or femme esthetic-the best way to be lesbian was to be rich, white, and fashionably dressed.

LGBTQ Women, Appearance Negotiations, and Workplace Dress Codes.

The purpose of this study was to explore LGBTQ women's experiences with unwritten or formal dress codes at work. I asked: What are LGBTQ women's experiences in the workplace with appearance management, and what are LGBTQ women's experiences navigating the written and unwritten dress codes in the workplace? To answer the research question, interviews were conducted with 24 self-identifying LGBTQ women. Six key themes emerged from the data. Themes included (1) expressed sexual identity in appearance, (2) unwritten dress codes in work environments did not always allow for expression of sexual identity in appearance, (3) motivations for pressure or desire to conceal expression of sexual identity in appearance at work, (4) negotiations of revealing or concealing sexual identity in appearance in the workplace impacted levels of comfort and confidence, (5) verbal and nonverbal negative experiences related to appearance at work, and (6) received compliments about appearance at work.

Socializing girls whose bodies may not align with contemporary ideals of thinness: An interpretive study of US mothers' accounts.

We sought to understand how mothers of young adolescent girls who are perceived as overweight or at risk for becoming so and whose body mass indices are at the 70th percentile or higher socialize their daughters about body, weight, eating, and health. In-depth interviews were conducted with 13 US mothers, and data were analyzed using constant comparison processes. Findings revealed that mothers adopted a variety of strategies - including teaching, modeling, managing, avoiding, and comforting - to achieve varied socialization goals for their daughters. Specifically, mothers sought to help their daughters to accept the self, reject the hegemonic ideal, maintain "healthful" eating, avoid overeating/monitor the self for over-eating, engage in regular physical activity, and/or navigate stigmatizing social situations. Mothers' sometimes experienced ambivalence or uncertainty as they socialized their daughters about the body, suggesting that they may benefit from professional counseling designed to resolve this tension/hesitancy.

Grommets and glue guns: standardization of a pfannenstiel model for low-fidelity obstetrics-gynecology education.

OBJECTIVE: To validate standardized instructions for the creation, implementation, and performance assessment of a low-fidelity model for Pfannenstiel incision. STUDY DESIGN: The Pfannenstiel model used at the University of Florida-Jacksonville was broken down into composite steps and constructed by obstetrics-gynecology faculty from across the country. The model was then utilized at participants' home institutions and evaluated with respect to realism of the model, ability to replicate the simulation, appropriateness of the skills checklists, and perceived utility of a publication of similarly catalogued simulation modules for use in obstetrics-gynecology training programs. RESULTS: The model was correctly constructed by 94.7% (18 of 19) participants and 72.2% (13 of 18) completed a post construction/post simulation survey indicating a high degree of perceived educational utility, feasibility of construction, and desire for additional catalogued modules. CONCLUSIONS: A low-fidelity simulation model was developed, successfully reproduced using inexpensive materials, and implemented across multiple training programs. This model can serve as a template for developing, standardizing and cataloging other low-fidelity simulations for use in resident education. As discussions among medical educators continue regarding further restrictions on duty hours, it is highly likely that more programs will be looking for guidance in establishing quick, inexpensive, and reliable means of developing and assessing surgical skills in their learners. Furthermore, the Accreditation Council for Graduate Medical Education (ACGME) has well-defined goals of programs developing better and more reproducible tools for all of their assessments. For programs with limited resources, preparing and disseminating reproducible, validated tools could be invaluable in complying with future ACGME mandates.

Ca2+-mediated ascorbate release from coronary artery endothelial cells.

1.--The addition of Ca(2+) ionophore A23187 or ATP to freshly isolated or cultured pig coronary artery endothelial cells (PCEC) potentiated the release of ascorbate (Asc). Cultured PCEC were used to characterize the Ca(2+)-mediated release. An increase in Ca(2+)-mediated Asc release was observed from PCEC preincubated with Asc, Asc-2-phosphate or dehydroascorbic acid (DHAA). 2.--The effects of various ATP analogs and inhibition by suramin were consistent with the ATP-induced release being mediated by P2Y2-like receptors. 3.--ATP-stimulated Asc release was Ca(2+)-mediated because (a) ATP analogs that increased Asc release also elevated cytosolic [Ca(2+)], (b) Ca(2+) ionophore A23187 and cyclopiazonic acid stimulated the Asc release, (c) removing extracellular Ca(2+) and chelating intracellular Ca(2+)inhibited the ATP-induced release, and (d) inositol-selective phospholipase C inhibitor U73122 also inhibited this release. 4.--Accumulation of Asc by PCEC was examined at Asc concentrations of 10 microM (Na(+)-Asc symporter not saturated) and 5 mM (Na(+)-Asc symporter saturated). At 10 microM Asc, A23187 and ATP caused an inhibition of Asc accumulation but at 5 mM Asc, both the agents caused a stimulation. Substituting gluconate for chloride did not affect the basal Asc uptake but it abolished the effects of A23187. 5.--PCEC but not pig coronary artery smooth muscle cells show a Ca(2+)- mediated Asc release pathway that may be activated by agents such as ATP.

Ascorbate uptake in pig coronary artery endothelial cells.

Although smooth muscle and endothelial cells in pig coronary artery are morphologically and functionally distinct, ascorbate uptake has been characterized only in smooth muscle cells. Ascorbate transporters in kidney and intestinal epithelial cells differ from those in smooth muscle. We examined ascorbate transport and mRNA expression of sodium-dependent vitamin C transporters (SVCT) by RT-PCR in the pig coronary artery endothelial cell cultures. When 14C-ascorbate uptake in endothelial cells was examined as 14C or by HPLC, the two values did not differ from each other. 14C-ascorbate uptake was Na(+)-dependent, stereoselective for L-ascorbate and inhibited by sulfinpyrazone. The kinetic characteristics of the uptake were: Km = 27 +/- 3 microM (Hill coefficient = 1) for ascorbate and Km = 73 +/- 14 mM (Hill coefficient = 2) for Na+. Surprisingly, endothelial cells had similar kinetic parameters as smooth muscle cells, except for a slightly lower uptake velocity in endothelial cells. Comparison with the smooth muscle showed that both tissue types expressed mRNA for SVCT2. Endothelial cells differ from epithelial cells which express mainly SVCT1 but resemble smooth muscle cells in this respect.

Effects of peroxynitrite on pig coronary artery smooth muscle.

We examined the effects of peroxynitrite pretreatment of pig coronary arteries on their sarcoplasmic reticulum (SR) Ca(2+) pump function. Pretreating rings from de-endothelialized arteries with peroxynitrite, followed by a wash to remove this agent, led to a decrease in the force of contraction produced in response to the SR Ca(2+) pump inhibitor cyclopiazonic acid (CPA, IC(50) = 87 +/- 6 microM). Inclusion of catalase and superoxide dismutase with the peroxynitrite did not alter its effect indicating that the inhibition was produced by peroxynitrite. Contractions produced by 30 mM KCl were not affected by up to 250 microM peroxynitrite. Smooth muscle cells cultured from this artery gave a transient increase in cytosolic Ca(2+) in response to CPA. Treating the cells with peroxynitrite inhibited this increase. Treating the SR-enriched isolated subcellular membrane fraction with peroxynitrite produced an inhibition of the ATP-dependent azide-insensitive oxalate-stimulated Ca(2+) uptake. Thus, peroxynitrite damages the SR Ca(2+)pump in the coronary artery, and this inhibition appears to lead to an inability of the arteries to respond to CPA. Thus, peroxynitrite produced from superoxide and NO in the arteries may compromise regulation of coronary tone which requires mobilization of Ca(2+) from the SR.

Peroxynitrite and nitric oxide differ in their effects on pig coronary artery smooth muscle.

Peroxynitrite generated in arteries from superoxide and nitric oxide (NO) may damage their function. Here, we compare the effects of peroxynitrite and peroxynitrite/NO-generating agents SIN-1 (3-morpholinosydnonimine hydrochloride), SNAP (S-nitroso-N-acetyl-penicillamine), SNP (sodium nitroprusside), and NONOate (spermine NONOate) on pig coronary artery. Deendothelialized artery rings were pretreated with these agents and then washed before examining their contractility. Pretreatment with all agents (200 microM) results in a decrease in the force of contraction in response to the sarco(endo)plasmic Ca(2+) (SERCA) pump inhibitor cyclopiazonic acid (CPA): SNAP > NONOate > or = peroxynitrite > or = SIN-1 > SNP. Pretreatment with SNAP, NONOate, or SIN-1 also inhibits the force of contraction produced with 30 mM KCl, with SNAP being the most potent. Including catalase plus superoxide dismutase (SOD) during the preincubation has no effect. Including an NO scavenger [2-(4-carboxyphenyl)-4,4,5,5-tetramethylimidazoline-1-oxyl-3-oxide] or a guanylate cyclase inhibitor (1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one) partially protects against SNAP. Pretreatment of cultured cells with peroxynitrite, but not with SNAP, inhibits the Ca(2+) transients produced in response to CPA. Pretreating isolated membrane vesicles with peroxynitrite inhibits the Ca(2+) uptake due to the SERCA pump, with all the other agents being less effective. Thus peroxynitrite and NO both inhibit the CPA-induced contractions in deendothelialized artery rings, peroxynitrite by damage to the SERCA pump and NO possibly by a step downstream from the increase in cytosolic Ca(2+).