Working with Transgender Adolescents: Essential Guidelines and Applications

2021 ◽  
Vol 11 ◽  
Author(s):  
Kevin Chou ◽  
Brandon Johnson
Keyword(s):  
Clinical Practice ◽  
Current Literature ◽  
Gender Dysphoria ◽  
Evidence Base ◽  
Medical Intervention ◽  
Professional Organizations ◽  
Comprehensive Treatment ◽  
Endocrine Society ◽  
Medical Interventions ◽  
The World

Background: There has been a rise in the numbers of adolescents identifying as transgender and seeking medical treatment for gender dysphoria. While gender clinics are developing across the country, not all transgender adolescents have access to these centers. There is, therefore, an increased need for other clinicians to be aware of interventions and guidelines to help transgender youth and their families. Objective: The aim of this article is to provide an overview of current literature and guidelines for treating transgender adolescents with gender dysphoria. Methods: Using keywords “gender”, “gender dysphoria”, “transgender”, “trans*”, “adolescent trans*”, the authors searched PubMed to gather current literature on treating transgender adolescents. Additionally, sources from primary transgender resources online were obtained, including current endocrine and psychological guidelines. Results: This article discusses important gender concepts that are relevant to treating all transgender individuals. It describes models of engagement with transgender adolescents seeking treatment, including assenting and consenting to medical intervention. Finally, we discuss the assessment of transgender adolescents’ needs and present an overview of the various guidelines outlining both non-medical and medical interventions targeted to treat gender dysphoria in this population. Conclusions: Knowledge of treating adolescents with gender dysphoria is imperative as gender dysphoria presents more commonly in practice. Multidisciplinary collaboration is required to provide comprehensive treatment to this population. Guidelines from professional organizations such as the World Professional Association for Transgender Health and the Endocrine Society provide instructions for clinical practice while the evidence base in this field continues to expand.

scholarly journals Cuffed vs Uncuffed Endotracheal Tubes for Pediatric Patients: A Review

2021 ◽  
Vol 4 (1) ◽  
pp. 50-53
Author(s):  
Yim A ◽  
Doctor J ◽  
Aribindi S ◽  
Ranasinghe L
Keyword(s):  
Clinical Practice ◽  
Endotracheal Tube ◽  
Current Literature ◽  
Pediatric Patients ◽  
Review Article ◽  
Endotracheal Tubes ◽  
Key Points ◽  
Economical Benefit ◽  
The World ◽  
Superior Type

The use of uncuffed endotracheal tubes (ETT) in patients younger than 8 years old has been in practice for the last 60 years. In the last decade, there has been a change in clinical practice with a transition to cuffed ETT use, and there continues to be debate between cuffed vs uncuffed ETT use. This narrative review article aims to review the current literature on the topic and highlight some key points in the argument of cuffed vs uncuffed ETT use in pediatric patients. Cuffed ETTs are increasingly being used with several studies over the last 20 years demonstrating its benefits. Studies have claimed cuffed ETT has a clinical, environmental, and economical benefit over uncuffed ETT. Despite shortcomings of various studies and no definitive conclusion of a superior type of endotracheal tube, cuffed ETTs are here to stay in the world of anesthesia.

Meaning of innovative technologies for improvement of results in treating burned patients

2020 ◽  
pp. 44-47
Author(s):  
A. A. Alekseev ◽  
A. E. Bobrovnikov ◽  
V. V. Bogdanov
Keyword(s):  
Clinical Practice ◽  
Medical Care ◽  
Clinical Effectiveness ◽  
High Tech ◽  
Comprehensive Treatment ◽  
Case Histories ◽  
Innovative Technologies ◽  
Treatment Technologies ◽  
Burn Disease ◽  
Complications And Mortality

In order to include innovative technologies in clinical recommendations, confirmation of their clinical effectiveness in comprehensive treatment of burned patients is necessary. 1,696 case histories of patients with burns were audited, which are divided into two groups depending on peculiarities of treatment. The use of innovative treatment technologies for burned patients has reduced the incidence of burn disease complications and mortality. Introduction of innovative technologies in treating burned patients into broad clinical practice improves results of provision of specialized, high-tech medical care for victims of burns.

The Co-Occurrence of Autism and Gender Diversity

2020 ◽  
pp. 197-211
Author(s):  
Jill C. Fodstad ◽  
Rebecca Elias ◽  
Shivali Sarawgi
Keyword(s):  
Gender Dysphoria ◽  
Gender Diversity ◽  
Gender Nonconforming ◽  
Medical Interventions ◽  
Gender Diverse ◽  
Nonbinary Gender ◽  
Psychiatric Conditions ◽  
The Common ◽  
And Gender

Gender diversity refers to gender expressions and/or gender identity experiences that vary from the common experiences of gender. Gender-diverse people may be gender nonconforming, gender nonbinary, gender fluid, gender exploring, transgender, and so forth. Some gender-diverse individuals experience gender dysphoria and/or gender incongruence and may require gender-affirming supports, including gender-affirming medical interventions. The co-occurrence of autism and gender diversity has been highlighted in a series of studies internationally as well as through rich community expressions. Studies in gender-referred individuals reveal high rates of autism traits as well as high rates of existing autism diagnoses. Studies in autistic populations reveal greater gender diversity characteristics. The long-term course of gender diversity in autistic individuals is poorly understood. Clinical guidelines have been developed for adolescents with the co-occurrence, but much work remains: No gender-related measures have been developed and tested for use in neurodiverse populations, no programs exist to support gender-diverse neurodiverse adults, and little is known about co-occurring mental health profiles, risks, or protective factors for people with the co-occurrence. The inclusion of this chapter on co-occurring autism and gender diversity within a book on “co-occurring psychiatric conditions” is problematic, because gender diversity is not a “psychiatric condition,” but instead a form of human diversity. The diagnosis of Gender Dysphoria is useful only insomuch as it allows individuals to obtain necessary gender-related supports. The authors’ choice to include this chapter in this book reflects a compromise, motivated by the need for educating both autism and gender specialists in this common co-occurrence.

scholarly journals Validity of the Gender Dysphoria diagnosis and incidence trends in Sweden: a nationwide register study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Malin Indremo ◽  
Richard White ◽  
Thomas Frisell ◽  
Sven Cnattingius ◽  
Alkistis Skalkidou ◽  
...  
Keyword(s):  
Gender Dysphoria ◽  
Age Groups ◽  
Medical Intervention ◽  
Future Research ◽  
Advantages And Disadvantages ◽  
Incidence Trends ◽  
Interaction Terms ◽  
Definition Of ◽  
The Individual ◽  
Nationwide Register Study

AbstractThe aim of this study was to examine the validity of the Gender Dysphoria (GD) diagnoses in the Swedish National Patient Register (NPR), to discuss different register-based definitions of GD and to investigate incidence trends. We collected data on all individuals with registered GD diagnoses between 2001 and 2016 as well as data on the coverage in the NPR. We regarded gender confirming medical intervention (GCMI) as one proxy for a clinically valid diagnosis and calculated the positive predictive value (PPV) for receiving GCMI for increasing number of registered GD diagnoses. We assessed crude and coverage-adjusted time trends of GD during 2004–2015 with a Poisson regression, using assigned sex and age as interaction terms. The PPV for receiving GCMI was 68% for ≥ 1 and 79% for ≥ 4 GD-diagnoses. The incidence of GD was on average 35% higher with the definition of ≥ 1 compared to the definition of ≥ 4 diagnoses. The incidence of GD, defined as ≥ 4 diagnoses increased significantly during the study period and mostly in the age categories 10–17 and 18–30 years, even after adjusting for register coverage. We concluded that the validity of a single ICD code denoting clinical GD in the Swedish NPR can be questioned. For future research, we propose to carefully weight the advantages and disadvantages of different register-based definitions according to the individual study’s needs, the time periods involved and the age-groups under study.

scholarly journals Nursing Teleconsultation for the Outpatient Management of Patients with Cardiovascular Disease during COVID-19 Pandemic

2021 ◽  
Vol 18 (4) ◽  
pp. 2087
Author(s):  
Vincenzo Russo ◽  
Roberta Cassini ◽  
Valentina Caso ◽  
Chiara Donno ◽  
Annunziata Laezza ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Continuity Of Care ◽  
Medical Intervention ◽  
Lipid Lowering ◽  
Outpatient Management ◽  
Medical Interventions ◽  
Artery Disease ◽  
Clinical Conditions ◽  
Mean Time

Introduction: During the COVID-19 outbreak, non-urgent clinic visits or cardiac interventional procedures were postponed to a later date, and the implementation of telemedicine has guaranteed continuity of care for patients with chronic diseases. The aim of our study was to describe the medical interventions following nursing teleconsultation for the outpatient management of patients with cardiovascular diseases during the COVID-19 pandemic. Materials and Methods: All patients who did not attend the follow-up visit from 4 to 15 April 2020 at our institution and who were re-scheduled due to the COVID-19 lockdown were selected to be enrolled in the study. Each patient was followed by a semi-structured telephonic interview performed by a nurse. The outcomes of our study were to assess the patients’ adherence to nursing teleconsultation and the usefulness of nursing teleconsultation to detect clinical conditions in need of medical intervention. Results: In total, 203 patients (81%) underwent nursing teleconsultation in a mean time of 7 ± 3 days from the outpatient visit lost due to the COVID-19 lockdown. Furthermore, 53 patients (26%) showed poor adherence to nursing teleconsultation. Among the 150 patients (mean age 67 ± 10 years; 68% male) who completed the telephonic interview, the nursing teleconsultation revealed the need of medical intervention in 69 patients (46%), who were more likely at very high cardiovascular risk (77% vs. 48%; p < 0.0003) and who showed a higher prevalence of dyslipidemia (97% vs. 64%; p < 0.0001) and coronary artery disease (75% vs. 48%, p < 0.0008) compared to those not in need of any intervention. The up-titration of the lipid-lowering drugs (n: 32, 74%) was the most frequent medical intervention following the nursing teleconsultation. The mean time between the nursing teleconsultation and the date of the rescheduled in-person follow-up visit was 164 ± 36 days. Conclusions: Nursing teleconsultation is a simple and well-tolerated strategy that ensures the continuity of care and outpatient management for patients with cardiovascular diseases during the COVID-19 pandemic.

scholarly journals Benefits and Limitations of Non-Transgenic Micronutrient Biofortification Approaches

Agronomy ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 464
Author(s):  
Edward Marques ◽  
Heather M. Darby ◽  
Jana Kraft
Keyword(s):  
Current Literature ◽  
The State ◽  
World Health ◽  
Micronutrient Deficiencies ◽  
Conventional Breeding ◽  
The World ◽  
Primary Focus

Increasing the amount of micronutrients in diets across the world is crucial to improving world health. Numerous methods can accomplish this such as the biofortification of food through biotechnology, conventional breeding, and agronomic approaches. Of these, biofortification methods, conventional breeding, and agronomic approaches are currently globally accepted and, therefore, should be the primary focus of research efforts. This review synthesizes the current literature regarding the state of biofortified foods through conventional breeding and agronomic approaches for crops. Additionally, the benefits and limitations for all described approaches are discussed, allowing us to identify key areas of research that are still required to increase the efficacy of these methods. The information provided here should provide a basal knowledge for global efforts that are combating micronutrient deficiencies.

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