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Journal of Medical Ethics Dec 2022While fertility preservation is recommended practice for paediatric oncology patients, it is increasingly being considered for transgender children and young people in...
BACKGROUND
While fertility preservation is recommended practice for paediatric oncology patients, it is increasingly being considered for transgender children and young people in paediatric care. This raises ethical issues for clinicians, particularly around consent and shared decision-making in this new area of healthcare.
METHODS
A systematic review of normative literature was conducted across four databases in June 2020 to capture ethical considerations related to fertility counselling and preservation in paediatric transgender healthcare. The text of included publications was analysed inductively, guided by the Qualitative Analysis Guide of Leuven.
RESULTS
Twenty-four publications were identified for inclusion. Four key ethical considerations emerged from this literature: access to fertility preservation, conscientious objection, decision-making capacity of children and young people, and shared decision-making.
CONCLUSION
In the identified literature, there is consensus that transgender children and young people should not be refused access to fertility preservation services solely due to their gender identity, and that clinicians with conscientious objections to fertility preservation for this group have an obligation to refer on to willing providers. Factors that create ethical complexity in this area of paediatric care include the child's age, mental health, and parents' views.
Topics: Child; Humans; Female; Male; Adolescent; Fertility Preservation; Transgender Persons; Decision Making; Gender Identity; Delivery of Health Care
PubMed: 34980674
DOI: 10.1136/medethics-2021-107702 -
Ear, Nose, & Throat Journal Dec 2021Saccharin test (ST) is a convenient method to assess the efficiency of mucociliary clearance, the primary defense mechanism of the upper airways' tract. The study...
OBJECTIVES
Saccharin test (ST) is a convenient method to assess the efficiency of mucociliary clearance, the primary defense mechanism of the upper airways' tract. The study objectives are to: (1) substantiate its short- (3 days) and long-term (30 days) repeatability; (2) assess its tolerability; (3) conduct a systematic literature review and to compare our results with the existing evidence.
METHODS
Twenty-nine healthy subjects were enrolled in an observational prospective study to perform an ST on three separate visits (at baseline; at follow-up visits at day 3 and at day 30). Transit times were recorded and self-reported nasal and general symptoms noted. A systematic review of the literature was conducted to compare our results with the existing literature.
RESULTS
The mean values (±SD) of ST transit time (STTT) were 7.085 (±2.19), 7.788 (±2.11), and 7.790 (±2.06) minutes at baseline, day 3, and day 30, respectively. Significant linear regression analysis was observed between day 3 and baseline ( = .193; = .019) and day 30 and baseline ( = .182 = .024). Significant agreement for the intrasession repeatability was observed with an ICC = .354 ( = .001). Outcomes' comparisons between baseline vs day 3 ( = .197) and baseline vs day 30 ( = .173) were not statistically significant. ST was well tolerated. Concordance with existing literature's data and high level of STTT repeatability were confirmed by the qualitative analysis.
CONCLUSION
STTT reproducibility was good both in the short- and long-term. ST tolerability was very good. Our study data are consistent with the existing literature, indicating ST as a sound methodology for detection of early respiratory health changes and for specific regulatory application in respiratory research.
PubMed: 34915769
DOI: 10.1177/01455613211064044 -
American Journal of Men's Health 2021The social construct of masculinity evolves in response to changes in society and culture. Orthodox masculinity is mostly considered to be hegemonic and is evidenced by...
The social construct of masculinity evolves in response to changes in society and culture. Orthodox masculinity is mostly considered to be hegemonic and is evidenced by the dominance of men over women and other, less powerful men. Contemporary shifts in masculinity have seen an emergence of new masculinities that challenge traditional male stereotypes. This systematic review aims to review and synthesize the existing empirical research on contemporary masculinities and to conceptualize how they are understood and interpreted by men themselves. A literature search was undertaken on 10 databases using terms regularly used to identify various contemporary masculinities. Analysis of the 33 included studies identified four key elements that are evident in men's descriptions of contemporary masculinity. These four elements, (a) Inclusivity, (b) Emotional Intimacy, (c) Physicality, and (d) Resistance, are consistent with the literature describing contemporary masculinities, including Hybrid Masculinities and Inclusive Masculinity Theory. The synthesized findings indicate that young, middle-class, heterosexual men in Western cultures, while still demonstrating some traditional masculinity norms, appear to be adopting some aspects of contemporary masculinities. The theories of hybrid and inclusive masculinity suggest these types of masculinities have several benefits for both men and society in general.
Topics: Female; Heterosexuality; Humans; Male; Masculinity; Men; Sexual Behavior; Sexual Partners
PubMed: 34844458
DOI: 10.1177/15579883211061009 -
The Lancet. Public Health Dec 2021Transgender and gender non-conforming (TGNC) individuals are at a high risk of adverse mental health outcomes due to minority stress-the stress faced by individuals...
Transgender and gender non-conforming (TGNC) individuals are at a high risk of adverse mental health outcomes due to minority stress-the stress faced by individuals categorised as stigmatised social minority groups. This systematic review sought to summarise the key mental health findings of the research on TGNC individuals in mainland China. We also aimed to consolidate research on the topic, identify specific mental health disparities, and offer new perspectives for future research to inform both policy and clinical practice. An extensive search of the literature, published in English and Chinese, was done between Jan 1, 1990, and Aug 1, 2021, using PubMed, PsycINFO, Scopus, Wanfang (in Chinese), and CNKI (in Chinese). Overall, two qualitative and 28 quantitative articles were identified. The quantitative findings showed a high prevalence of mental health problems, such as depression, anxiety, substance use disorders, and stress-related issues, and greater disparities in psychological wellbeing. High prevalence is also reported in suicidality and self-harm behaviours in this group. Across the two qualitative studies, attributable factors included gender-related discrimination, barriers to accessing health services, low social support, decreased knowledge and awareness of HIV prevention, and demographic characteristics-such as marital status, educational level, and gender identity. This Review also found little evidence of gender-affirming care and mental health interventions in mainland China. Following from these results, the next step is to integrate multi-level, social-psychological interventions with education to reduce cultural stereotypes and transphobia in mainland China. Political and social implications are also discussed to inform a standard set of guidelines for transgender-inclusive health-care services, including advocating for funding to create these special care programmes and services.
Topics: Anxiety; China; Depression; Female; Gender Identity; Humans; Male; Mental Health; Self Concept; Self-Injurious Behavior; Sexual and Gender Minorities; Social Stigma; Stereotyping; Stress, Psychological; Suicidal Ideation; Transgender Persons
PubMed: 34838199
DOI: 10.1016/S2468-2667(21)00236-X -
Antioxidants (Basel, Switzerland) Oct 2021Chronic obstructive pulmonary disease (COPD) is a progressive disease that is characterized by a state of persistent inflammation and oxidative stress. The presence of... (Review)
Review
Chronic obstructive pulmonary disease (COPD) is a progressive disease that is characterized by a state of persistent inflammation and oxidative stress. The presence of oxidative stress in COPD is the result of an imbalance between pro-oxidant and antioxidant mechanisms. The aim of this review was to investigate a possible association between glutathione peroxidase (GPx), a key component of antioxidant defense mechanisms, and COPD. A systematic search for relevant studies was conducted in the electronic databases PubMed, Web of Science, Scopus, and Google Scholar, from inception to June 2021. Standardized mean differences (SMDs) were used to express the differences in GPx concentrations between COPD patients and non-COPD subjects. Twenty-four studies were identified. In 15 studies assessing whole blood/erythrocytes (GPx isoform 1), the pooled results showed that GPx concentrations were significantly lower in patients with COPD (SMD = -1.91, 95% CI -2.55 to -1.28, < 0.001; moderate certainty of evidence). By contrast, in 10 studies assessing serum/plasma (GPx isoform 3), the pooled results showed that GPx concentrations were not significantly different between the two groups (very low certainty of evidence). The concentration of GPx-1, but not GPx-3, is significantly lower in COPD patients, suggesting an impairment of antioxidant defense mechanisms in this group.
PubMed: 34829616
DOI: 10.3390/antiox10111745 -
Euro Surveillance : Bulletin Europeen... Nov 2021BackgroundIn Europe, HIV disproportionately affects men who have sex with men (MSM), people who inject drugs (PWID), prisoners, sex workers, and transgender people....
BackgroundIn Europe, HIV disproportionately affects men who have sex with men (MSM), people who inject drugs (PWID), prisoners, sex workers, and transgender people. Epidemiological data are primarily available from national HIV case surveillance systems that rarely capture information on sex work, gender identity or imprisonment. Surveillance of HIV prevalence in key populations often occurs as independent studies with no established mechanism for collating such information at the European level.AimWe assessed HIV prevalence in MSM, PWID, prisoners, sex workers, and transgender people in the 30 European Union/European Economic Area countries and the United Kingdom.MethodsWe conducted a systematic literature review of peer-reviewed studies published during 2009-19, by searching PubMed, Embase and the Cochrane Library. Data are presented in forest plots by country, as simple prevalence or pooled across multiple studies.ResultsEighty-seven country- and population-specific studies were identified from 23 countries. The highest number of studies, and the largest variation in HIV prevalence, were identified for MSM, ranging from 2.4-29.0% (19 countries) and PWID, from 0.0-59.5% (13 countries). Prevalence ranged from 0.0-15.6% in prisoners (nine countries), 1.1-8.5% in sex workers (five countries) and was 10.9% in transgender people (one country). Individuals belonging to several key population groups had higher prevalence.ConclusionThis review demonstrates that HIV prevalence is highly diverse across population groups and countries. People belonging to multiple key population groups are particularly vulnerable; however, more studies are needed, particularly for sex workers, transgender people and people with multiple risks.
Topics: Europe; Female; Gender Identity; HIV Infections; HIV Seroprevalence; Homosexuality, Male; Humans; Male; Population Groups; Prevalence; Seroepidemiologic Studies; Sex Workers; Sexual and Gender Minorities
PubMed: 34823636
DOI: 10.2807/1560-7917.ES.2021.26.47.2100044 -
Biology of Sex Differences Nov 2021Despite growing recognition of the importance of sex and gender considerations in health research, they are rarely integrated into research design and reporting. We... (Review)
Review
BACKGROUND
Despite growing recognition of the importance of sex and gender considerations in health research, they are rarely integrated into research design and reporting. We sought to assess the integration of sex, as a biological attribute, and gender, as a socially constructed identity, in published reporting guidelines.
METHODS
We conducted a systematic review of published reporting guidelines listed on the EQUATOR website ( www.equator-nework.org ) from inception until December 2018. We selected all reporting guidelines (original and extensions) listed in the EQUATOR library. We used EndNote Citation Software to build a database of the statements of each guideline identified as a "full bibliographic reference" and retrieved the full texts. Reviewers independently extracted the data on use of sex and gender terms from the checklist/abstract/main text of guidelines. Data were analyzed using descriptive statistics and narrative synthesis.
RESULTS
A total of 407 reporting guidelines were included; they were published between 1995 and 2018. Of the 407 guidelines, 235 (57.7%) mentioned at least one of the sex- and gender-related words. In the checklist of the reporting guidelines (n = 363), "sex" and "gender" were mentioned in 50 (13.8%) and 40 (11%), respectively. Only one reporting guideline met our criteria (nonbinary, appropriate categorization, and non-interchangeability) for correct use of sex and gender concepts. Trends in the use of "sex" and "gender" in the checklists showed that the use of "sex" only started in 2003, while "gender" has been in use since 1996.
CONCLUSIONS
We assessed the integration of sex and gender in reporting guidelines based on the use of sex- and gender-related words. Our findings showed a low use and integration of sex and gender concepts and their incorrect use. Authors of reporting guidelines should reduce this gap for a better use of research knowledge. Trial registration PROSPERO no. CRD42019136491.
Topics: Biomedical Research; Checklist; Female; Gender Identity; Humans; Male
PubMed: 34801060
DOI: 10.1186/s13293-021-00404-0 -
Revista Medica de Chile Jul 2021Students belonging to sexual and gender diversity experience chronic stress due to stigmatization and discrimination.
BACKGROUND
Students belonging to sexual and gender diversity experience chronic stress due to stigmatization and discrimination.
AIM
To identify the experiences of lesbian, gay, bisexual, transgender/transsexual, and queer (LGBTQ+) medical students.
MATERIAL AND METHODS
Systematic literature review using the PRISMA protocol in PubMed, ERIC, EMBASE, and LILACS databases. Articles published in Spanish or English were considered. Three authors independently reviewed and synthesized information from the selected articles, according to the PRISMA criteria.
RESULTS
Fifteen studies met the inclusion criteria. Forty-three experiences were reported, which were finally classified into four categories: i) Relationship between peers in the educational context (23%), ii) Relationship between students and teachers in the educational context (23%), iii) Relationship with the educational institution (34%), and iv) Curriculum and training experience (19%). The relationship with the educational institution was identified as the most relevant category. Students with a strong sense of belonging to their institution were more likely to be persistent and make an effort in learning. The second most relevant experiences, mainly negative, derive from interactions with peers and teachers.
CONCLUSIONS
LGBTQ+ medical students still experience more discrimination than inclusion during their training. Therefore, medical schools should render medical education a more inclusive space for the LGBTQ+ population.
Topics: Female; Gender Identity; Homosexuality, Female; Humans; Sexual Behavior; Sexual and Gender Minorities; Students, Medical
PubMed: 34751308
DOI: 10.4067/s0034-98872021000701058 -
Obesity (Silver Spring, Md.) Dec 2021Weight stigma is associated with impaired health, attributed in part to reductions in health-promoting behaviors. This review analyzed evidence of the association... (Review)
Review
OBJECTIVE
Weight stigma is associated with impaired health, attributed in part to reductions in health-promoting behaviors. This review analyzed evidence of the association between weight stigma and physical activity (PA) in adults and youth.
METHODS
Three databases were searched for terms related to weight stigma and PA. Eligible studies reported the quantitative association between at least one measure of weight stigma and one behavioral measure of PA.
RESULTS
A total of 38 studies met eligibility criteria. Of the 29 studies of adults, 3 used objective PA measures, and 79% used an observational, cross-sectional design. Findings of the relationship between weight stigma and PA were mixed. Everyday weight discrimination and internalizing weight stigma were associated with reduced PA in most studies. Several studies found indirect, and not direct, effects of weight stigma on PA when analyses included other individual-level factors. In the nine studies of youth, two used objective PA measures, all were observational, and only one study was longitudinal. Most youth studies found a relationship between weight-based teasing and reduced PA.
CONCLUSIONS
Weight teasing, everyday discrimination, and internalization were associated with reduced PA. However, associations were inconsistent and often indirect. Future studies should include objective PA measures with larger samples and longitudinal assessments.
Topics: Adolescent; Adult; Cross-Sectional Studies; Databases, Factual; Defense Mechanisms; Exercise; Humans; Social Stigma; Weight Prejudice
PubMed: 34747131
DOI: 10.1002/oby.23274 -
International Journal of Molecular... Sep 2021Agriculture in the 21st century is facing multiple challenges, such as those related to soil fertility, climatic fluctuations, environmental degradation, urbanization,...
Agriculture in the 21st century is facing multiple challenges, such as those related to soil fertility, climatic fluctuations, environmental degradation, urbanization, and the increase in food demand for the increasing world population. In the meanwhile, the scientific community is facing key challenges in increasing crop production from the existing land base. In this regard, traditional farming has witnessed enhanced per acre crop yields due to irregular and injudicious use of agrochemicals, including pesticides and synthetic fertilizers, but at a substantial environmental cost. Another major concern in modern agriculture is that crop pests are developing pesticide resistance. Therefore, the future of sustainable crop production requires the use of alternative strategies that can enhance crop yields in an environmentally sound manner. The application of rhizobacteria, specifically, plant growth-promoting rhizobacteria (PGPR), as an alternative to chemical pesticides has gained much attention from the scientific community. These rhizobacteria harbor a number of mechanisms through which they promote plant growth, control plant pests, and induce resistance to various abiotic stresses. This review presents a comprehensive overview of the mechanisms of rhizobacteria involved in plant growth promotion, biocontrol of pests, and bioremediation of contaminated soils. It also focuses on the effects of PGPR inoculation on plant growth survival under environmental stress. Furthermore, the pros and cons of rhizobacterial application along with future directions for the sustainable use of rhizobacteria in agriculture are discussed in depth.
Topics: Bacteria; Biodegradation, Environmental; Crop Production; Crops, Agricultural; Plant Development; Plant Roots; Rhizosphere; Soil Microbiology; Stress, Physiological
PubMed: 34638870
DOI: 10.3390/ijms221910529