Helpful Source Of Information Research Articles

Social Media and Website Use: The Experiences of Parents and Carers Accessing Care at the Oxford Craniofacial Unit.

Historically, medical professionals have been the providers of specialist information about rare medical conditions. Now, increasingly, patients and the public are using the internet to access and generate information about medical diagnoses. The global nature of the internet allows patients to connect across geographical borders, and to obtain and share information that would have been previously inaccessible to them. This research investigated the use of website and social media by parents of children with craniosynostosis. A cross-sectional survey-based design was employed. Participants were parents of children with craniosynostosis attending multidisciplinary craniofacial clinics within the Oxford Craniofacial Unit. A questionnaire was administered which assessed social media and website use adapted from the questionnaire created by Khouri and colleagues (2016) and Huggons and colleagues (2019). The surveys were administered over an 18-month period (November 2020 to May 2022). The final sample comprised 82 parents [70 mothers; 10 fathers; 1 sister/carer and 1 parent (mother/father unspecified)]. The children were aged 11 months-16 years of age (average age 6y and 3mo). Children had a variety of diagnoses: 31 sagittal, 19 metopic, 14 syndromic craniosynostosis, 8 unicoronal, 6 multisuture, 3 bicoronal, and 1 unilambdoid.Results showed that 93% (n=76/82) of parents used the internet to find out more about craniosynostosis, with 72% (n=59/82) of parents specifically using social media to find out more about craniosynostosis. The social media platforms used included: Facebook 64% (n=53/82), Instagram 24% (n=20/82), Blogs 12% (n=10/82), Twitter 4% (n= 4/82), Tik Tok 2% (n=2/82), and Snapchat 0.01% (n=1/82).Parents reported that Facebook was the most helpful source of information about craniosynostosis (52%; n=43/82). Parents indicated the key timepoints they used social media included: when their child received a diagnosis (70%; n=58/82), before their child's surgery (34%; n=28/82), before their first craniofacial clinic appointment (83%; n=25/30), and when child was older (17%; n=14/84). Forty percent (n=33/82) of parents said that a diagnosis of craniosynostosis made no difference to their social media use, whereas 34% (n=28/82) of parents used social media more, and 20% (n=16/82) used it less. Results highlight that parents use social media and other websites to access information relating to craniosynostosis. Future research should examine whether parental use of social media changes across their child's lifespan and evaluate the quality of this information.

Cadmium-induced Sertoli Cell Injury Through p38-MAPK and Related Signaling Proteins-A Study by RNA Sequencing.

Environmental toxicants, such as cadmium, found in foods, water, and consumer products are known to induce male reproductive dysfunction. However, the underlying molecular mechanism(s) by which cadmium-induced Sertoli cell injury as manifested by a disruption of the blood-testis barrier (BTB) remains unknown. Interestingly, one of the primary targets of cadmium toxicity in the testis is the cytoskeletons of the Sertoli cells, which, in turn, impedes cell junctions in the seminiferous epithelium. In order to expand these earlier observations and to provide a roadmap for future studies, we embarked a study using RNA sequencing to identify the pertinent genes involved in cadmium-induced Sertoli cell injury. Using bioinformatics analyses, multiple gene sets that regulated actin and microtubule (MT) cytoskeletons were identified along with components of the mitogen-activated protein kinase (MAPK) signaling protein and several signaling pathways. More important, we have also discovered that while the gene expression of p38-MAPK (also JNK or c-Jun) was considerably up- or downregulated during cadmium-induced Sertoli cell injury, the activated (phosphorylated) form was upregulated. Importantly, doramapimod (also known as BIRB 796), a specific p38-MARK inhibitor, that was shown to selectively block cadmium-induced p-p38 MAPK activation via phosphorylation in Sertoli cells, was indeed capable of blocking cadmium-induced Sertoli cell injury including disruption of the Sertoli cell-permeability barrier function, disruptive distribution of BTB-associated proteins, and disruptive organization of the actin and MT cytoskeletons. These data provide a helpful source of information for investigators to probe the role of signaling proteins and/or their signaling cascades, besides MAPKs, that likely utilized by cadmium to induce reproductive dysfunction.

CONGENITAL ZIKA VIRUS SYNDROME-RELATED ANOMALIES DETECTED OVER THE SEVEN-YEAR HISTORY OF THE EPIDEMIC: A LITERATURE REVIEW

Background: In 2015, an alarming increase in microcephaly was recorded in Brazil, being associated to Zika virus (ZV) epidemic. The teratogenic effects of ZV, however, are not restricted to microcephaly only. Aim: To describe the body structures affected by the teratogenic potential of Zika virus congenital syndrome (ZVCS), in order to provide an overview of the anomalies detected and make this knowledge available to health professionals and to the scientific community. Methods: A narrative review was carried out between June 2020 and January 2022 in Portal de Periódicos CAPES, MEDLINE, Scopus, LILACS and SciELO databases. Scientific publications that addressed fetal organic structures that were affected by the teratogenic effects of ZVCS were included. Results: Thirty-two studies were included in this review and identified anomalies in cranium, orofacial structures, nervous system, joints, visual pathway and thoracic viscera. Conclusion: The teratogenic effects of ZVCS affect a broad spectrum of body structures. The children affected by ZVCS still require multidisciplinary health approach, so the present study is a helpful source of information for such professionals.

Pharmacognostical Standardization, Phytochemical Characteristics of Stem-bark of Zanthoxylum alatum Roxb

Pharmacognosy Research,2022,14,3,316-320.DOI:10.5530/pres.14.3.46Published:July 2022Type:Original ArticleAuthors:Nishant Kumar, Pooja Puri, Navdeep Kaur, Jasreen Uppal, Apporva Chawla, Monika, and Prince Ahad Mir Author(s) affiliations:Nishant Kumar1, Pooja Puri2, Navdeep Kaur3, Jasreen Uppal1, Apporva Chawla1, Monika3, Prince Ahad Mir1,* 1Khalsa College of Pharmacy, GT Road, Amritsar, Punjab, INDIA. 2Pharmacy Officer, Community Health Center (Punjab Govt.), Kairon, Punjab, INDIA. 3Amritsar College of Pharmacy, Amritsar-Jalandhar GT Road, Manawal, Amritsar, Punjab, INDIA. 4University Institute of Pharmaceutical Sciences and Research, BFUHS, Faridkot, Punjab, INDIA. Abstract:Background: Zanthoxylum alatum Roxb (ZA) also known as ‘Indian Prickly Ash’ is a member of the Rutaceae family. It is native to the Himalayas, Jammu and Kashmir, Andhra Pradesh, and various other parts of India and is an important medicinal plant species. The stem bark of the plant is known to be a particularly rich source of medicinal compounds, and it is frequently utilized as an anti-diabetic, antioxidant, and anti-inflammatory agent. Despite the high therapeutic efficacy of bark, nothing is known about the requirements for its standardization. Since the quality control and standardization qualities of the product must be thoroughly documented, of the stem bark of Zanthoxylum alatum Roxb was produced as a result of the current research, which may be seen here. As part of this research, the stem bark of Z. alatum was harvested, dried in the shade, and then pulverised. The establishment of pharmacognostical standards was accomplished via the use of techniques such as microand macroscopy, physicochemical parameters, extractive values, and fluorescence analysis. Results: There were numerous distinguishing traits in the stem bark of Z. alatum Roxb that were discovered using macroscopic, microscopic, and physical-chemical criteria. Conclusion: This is the first research to provide a comprehensive pharmacognostic profile of the stem bark of Z. alatum Roxb, and it will be a helpful source of information in the development of pharmacognostic criteria for identification, purity, quality, and categorization of Z. alatum Roxb stem bark. Keywords:Indian Prickly Ash, Microscopical features, Phytochemical screening., Standardization, Zanthoxylum alatumView:PDF (235.01 KB)

Hepatitis C Elimination During a Global Pandemic: A Case Study of Resilience in Action.

Until the COVID-19 pandemic, San Francisco's hepatitis C virus (HCV) elimination initiative, End Hep C SF, was expanding and refining HCV testing and treatment strategies citywide, making progress toward local HCV elimination goals. Although a shelter-in-place health order issued in March 2020 categorized HCV testing as an "essential service," most HCV testing and treatment immediately stopped until COVID-19-safe protocols could be implemented. During the 14 months of pandemic-related organizational closures, End Hep C SF transitioned to a 100% virtual model, maintaining regularly scheduled meetings. Community-based HCV antibody testing decreased 80% from February to April 2020, and HCV treatment initiation also decreased, although both services started to rebound in mid-to-late 2020, partially as a result of End Hep C SF collaborations. End Hep C SF service providers, clinicians, and advocates reported that the continuous communication and common agenda of End Hep C SF-2 principles of the collective impact initiative-served as a familiar touchpoint and helpful source of information during this isolating and uncertain time. Ultimately, End Hep C SF allowed us to continue HCV elimination strategies through 6 lessons learned: maintaining HCV treatment access through telehealth and mobile services; leveraging research studies that provided HCV testing and treatment; offering HCV screening and linkage to care in tandem with COVID-19-related initiatives; being flexible and inventive, such as administering HCV treatment to residents of shelter-in-place hotels; establishing a data dashboard to track HCV testing and treatment; and relying on partnerships to solve problems and avoid burnout.

OP056: ScreenPlus pilot newborn screening: recruitment and engagement findings from the first 300 consented infants

OP056: ScreenPlus pilot newborn screening: recruitment and engagement findings from the first 300 consented infants

Injury and death associated with jumping castles: A public health issue.

A recent tragedy in Davenport, Tasmania, Australia, resulted in the death of six young school children and serious injury to three others when the jumping castle on which they were playing was lifted from the ground in a gust of wind. It became airborne to a maximum height of 10 m and travelled 50 m before becoming lodged in a tree. This incident highlights potential serious health consequences associated with jumping or bouncy castles or inflatable bouncers. Previous studies suggest that one child presents every 46 min to a US emergency department with an injury sustained on a jumping castle.1 We conducted a literature search of MEDLINE and EMBASE for journal articles and used Google to identify news articles on jumping castle-related injuries and deaths. We identified 10 relevant full text journal articles from the USA and Europe, comprising five cohort studies and five case series/reports including 131 164 children/adolescents and 65 429 injuries directly related to jumping castles (Table 1). Olsen2 prospectively identified 112 amusement-park injuries of which 78 occurred on jumping castles over a 7-month period: most were sprains, mainly ankle (37%), fractures (29%), contusions of the back and extremities (18%) and wounds (10%).2 A study reported 49 fractures among children and adolescents playing on jumping castles who presented to a hospital emergency department (ED), only two of whom (aged 4 and 10) required surgery.3 A study using a hospital ED database identified 521 children injured on inflatable bouncers between 2002 and 2013.4 Almost half had fractures (n = 246, 47%), the upper extremity being the most common site (80.5%). These were followed by sprains (31.3%), contusion/abrasion (5.8%), concussion (4.6%), joint dislocation (3.8%), laceration (1.7%) and multiple injuries (0.4%). There was a substantial increase in injuries over time from 1.4 per 1000 in 2002 to 24.4 per 1000 in 2013.4 A prospective study identified 114 children injured on jumping castles who presented to the ED with fractures of the upper limb (humerus, distal radius), ankle sprains and vertebral fractures. Almost 90% of injuries were unwitnessed, parents being alerted by a crying child.5 The largest study, from the USA, used a national database to identify 64 657 injuries due to inflatable bouncers over a 20-year period.1 As reported for other studies, the most common injuries were fractures (27.5%), sprains (27.3%), soft-tissue injuries (18.0%), concussion (7.0%) and lacerations (6.4%). In this large study, an increasing number of injuries were observed over time, the increase being most rapid in recent years.5 We also identified news articles from web-based sources reporting 484 injuries and 28 deaths since 2000, with a trend for increasing numbers over time (Fig. 1). The news media is a helpful source of information: deaths were reported in news items but not in the medical literature. Most reported deaths were associated with jumping castles/inflatable bouncers being lifted off the ground by strong gusts of wind. The median wind speed was 43 km/h (range 8–137 km/h). Some bouncers were not anchored to the ground. Causes of death were not provided. The only Australian report, in 2001, described that 15 children were injured and a 7-year old girl died when a dust devil (‘Willy-Willy’, whirlwind, dust storm) lifted a jumping castle. The USA has the largest number of accidents related to jumping castles (53%), followed by China (11%), the UK (10%) and Australia (8%). Of the 28 reported child deaths related to jumping castle accidents, 29% occurred in China, 11% in the USA and 7% in the UK. This information highlights the potential dangers of inflatable bouncers for children and adolescents. Injury prevention requires adult supervision by centre staff and parents, limiting the numbers of children on the device, and securing the device to the ground. The Australian Standard for owning and operating commercial jumping castles (3533.1.2009) states that the device should be securely anchored and should not be used in inclement weather when wind gusts exceed 40 km/h. However, many reported deaths have occurred when a jumping castle was lifted off the ground by a dust devil, which is extremely unpredictable. Once airborne, jumping castles are often unstoppable and some have travelled up to 1.6 km from their origin. Some countries have banned the use of inflatable devices. Perhaps Australia should follow? APSU activities are supported by the Australian Government Department of Health; the University of Sydney, Faculty of Medicine and Health, Discipline of Child and Adolescent Health; the Children's Hospital at Westmead; and the Royal Australasian College of Physicians. EJ Elliott is supported by an NHMRC-MRFF Next Generation Fellowship (#1135959).

A67 ABC, EASY AS 123, SIMPLE AS GLUTEN-FREE? KNOWLEDGE AND ADHERENCE IN ADOLESCENTS WITH CELIAC DISEASE

BackgroundResearch shows that adolescents with celiac disease (CeD) are at great risk for non-adherence to the gluten-free diet (GFD), and that knowledge of the GFD may play a role in adherence.AimsThe primary objective of this study was to examine the relationship between patient knowledge and adherence to the GFD in a local population of adolescents with CeD. Secondary objectives were to identify information sources used to learn about the GFD, and compare adolescent and parent knowledge of the GFD.MethodsAdolescents with CeD (12–17 years) were recruited at pediatric gastroenterology clinics in Calgary, Alberta. Preliminary data was collected October 2020 to August 2021. Both the adolescent and a parent were asked to complete a 5 minute online survey received via email. Survey measures included a validated adherence scale (Biagi score) and a unique knowledge assessment (GFD-Q), adapted from a previously published questionnaire. GFD-Q scores were categorized as “sufficient knowledge” based on correctly identifying 3/3 gluten-containing foods, at least 4/7 of gluten-free foods, and at least 4/7 foods that may contain gluten. Respondents submitted demographic and clinical information, as well as reviewed information sources used to learn about the GFD.ResultsInitial data were reviewed for 25 participant pairs (adolescent with respective parent), with a planned sample size of 40 participant pairs. Most adolescents (96%) reported adherence to the GFD (Biagi score of 3 or 4). Eleven (44%) adolescents had sufficient knowledge of the GFD. About 90% of adolescents correctly identified which foods to question, however, 20% did not correctly identify a gluten-containing food (namely malt), and 36% did not identify most gluten-free foods (such as maltodextrin and balsamic vinegar). Parents scored higher on the GFD-Q with 17/25 (68%) demonstrating sufficient knowledge. Interestingly, of the 11 adolescents with sufficient knowledge, 10/11 (91%) respective parents also had sufficient knowledge. Most adolescents and parents identified the gastroenterologist, another individual with CeD, and Google as helpful information sources. Adolescents also indicated their parents were a helpful information source.ConclusionsWhile the study is still enrolling to reach sample size, we acknowledge that most adolescents in our study report being adherent to the GFD. However, their reported knowledge is variable, especially in knowing which foods are safe to eat. Thus, education should also focus as much on which foods to avoid, as well as safe foods to consume. Parent knowledge of the GFD may have a role in adolescent knowledge. At study completion, descriptive statistics will be used to examine participant characteristics and identify trends to assist in the development of future health education for adolescents with CeD.Funding AgenciesCanadian Celiac Association - James A.Campbell Research Fund

A Comparison and Evaluation of International Guidelines on the Treatment of Severe SARS-CoV-2 Infection.

When the SARS-CoV-2 pandemic began, no uniform treatment and care strategies for critically ill COVID-19 patients were yet available. National and international treatment recommendations were formulated under time pressure, initially on the basis of indirect evidence from the treatment of similar diseases. In this article, we give an overview of the content, currency, and methodological quality of the existing national and international guidelines, with special attention to the care of critically ill patients. Guidelines were identified by a comprehensive search, the included guidelines were assessed in standardized fashion with the AGREE II guideline assessment instrument and according to the AMWF rulebook criteria, and the core recommendations of the included and methodologically high-quality guidelines were compared. Nine of the 97 guidelines that were identified fulfilled the content criteria for inclusion, and 6 of these fulfilled the qualitative criteria; these 6 guidelines still differed, however, in the topics to which they devoted the most attention, as well as in their methodological quality and currency. The treatment strategies for patients with severe respiratory failure (lung-protective ventilation strategies and rescue measures) deviated little from established standards. Uniform recommendations were made, among other things, for the administration of dexamethasone, which was recommended in all of the guidelines for patients requiring oxygen treatment, as well as for antithrombotic drug prophylaxis and for the prone positioning of ventilated patients. Many recommendations were based on insufficient evidence, and some were contradictory, e.g., those regarding antibiotic treatment or the choice between high-flow oxygen administration via nasal canula (HFNC) and noninvasive ventilation (NIV). The consultation of multiple high-quality international guidelines and guideline recommendations shared in online portals such as MagicApp are helpful sources of information for clinicians. In view of the continuing lack of strong evidence, further research on intensive care treatments is needed (aspects of ventilation, positioning therapy, and the role of extracorporeal membrane oxygenation [ECMO]).

A Longitudinal Observation of the Influence of Michigan Sports Concussion Law on Parents' Knowledge and Perception of Sport-Related Concussion.

INTRODUCTIONIn 2013, Michigan enacted legislation requiring parents and athletes to receive educational material concerning sport-related concussion (SRC). The aim of this study was to examine trends in concussion knowledge of parents from one community following implementation of Michigan’s Sports Concussion Laws (MSCL).METHODSA convenience sample of parents of students from a suburban school district were surveyed via district email at one year and five years post MSCL implementation. Results were compared to an equivalent 33-item survey obtained prior to the law. Individual questions were compared between the three surveys using Chi-square analysis with statistical significance observed at p < 0.05.RESULTSA total of 381 responses were obtained from the one-year post-MSCL (1yMSCL) and 178 in the five-year post-MSCL (5yMSCL) survey. Awareness of district policy regarding concussion was significantly higher after implementation of the MSCL (i.e., 77% at 1yMSCL and 71% at 5yMSCL) compared to prior 18% pre-MSCL (p < 0.0001). Respondents to the 5yMSCL survey were also significantly more aware of medical guidelines surrounding “return to play” after SRC compared to 1yMSCL (84.8% v 78.7%, p = 0.01). At 5yMSCL, significantly more respondents agreed that head injuries could cause more brain damage to children than adults (86.5% v 78.7% at 1yMSCL, p = 0.03). Finally, most parents at both survey periods rated the concussion educational material as the most helpful information source regarding SRC.CONCLUSIONSBased on these results, parental knowledge awareness appears to have increased concerning awareness of medical guidelines for SRC and potential brain damage risks to children after enactment of the MSCL.

A Longitudinal Observation of the Influence of Michigan Sports Concussion Law on Parents Knowledge and Perception of Sport-Related Concussion

Introduction: In 2013, Michigan enacted legislation requiring parents and athletes to receive educational material on Sport-Related Concussion (SRC). The aim of this study was to follow trends in concussion knowledge of parents from one community following implementation of Michigan’s Sports Concussion Laws (MSCL). Methods: Parents of students from a suburban school district were surveyed via district email at 1 year and 5 years post-implementation of MSCL. Results were compared to a survey obtained prior to the law. Individual questions were compared between the three surveys by Chi-square analysis with significance at p&lt;0.05. Results: A total of 381 responses were obtained in the 1-year post-MSCL (1yMSCL) and 178 in the 5 year post-MSCL (5yMSCL) survey. Awareness of district policy regarding concussion was much higher after implementation of the law (77% at 1yMSCL and 71% at 5yMSCL) compared to prior (18% pre-MSCL, p&lt;0.0001). As the law matured, parental knowledge improved. Respondents to the 5yMSCL survey were more aware of medical guidelines surrounding “return to play” after SRC compared to 1yMSCL (84.8% v 78.7%, p=0.01). At 5yMSCL, more respondents agreed that head injury can cause more brain damage to children than adults (86.5% v 78.7% at 1yMSCL, p=0.03). Lastly, parents continued to rate the concussion educational material as the most helpful information source on SRC. Conclusion: Since implementation of MSCL, parental knowledge increased in awareness of medical guidelines for SRC and potential brain damage risks to children. This increase may be in part from maturation of policy changes from MSCL.

The Prevalence of Using Pornography for Information About How to Have Sex: Findings from a Nationally Representative Survey of U.S. Adolescents and Young Adults.

We analyzed cross-sectional data collected from a U.S. nationally representative survey of individuals ages 14-24years old on what sources of information from the past year they considered to be the most helpful about how to have sex (n = 600 adolescents ages 14-17years old, and n = 666 young adults ages 18-24years old). Among the 324 adolescents who indicated that they had been helped by at least one source of information, helpful information was most likely to have come from parents (31.0%) and friends (21.6%). Only 8.4% of adolescents said pornography was helpful. However, for those in the 18-24-year-old age group, pornography was the most commonly endorsed helpful source (24.5%), as compared to other possible options such as sexual partners, friends, media, and health care professionals. Multivariable regression analyses revealed that indicating that pornography was the most helpful source of information about how to have sex, compared to the other sources, was inversely associated with being female (OR = 0.32, p = .001), inversely associated with identifying as bisexual compared to heterosexual (OR = 0.15, p = .038), positively associated with being Black compared to being white non-Hispanic (OR = 4.26, p = .021), inversely associated with reporting a household income of either $25K to $49,999 (OR = 0.31, p = .010) or $50K to $74,999 (OR = 0.36, p = .019) compared to more than $75K, and positively associated with having masturbated (OR = 13.20, p = .005). Subsequent research should investigate the role of pornography in both adolescent and adult sexual development, including why one-quarter of U.S. young adults say that pornography is a helpful source of information about how to have sex and what they think that they are learning from it.

Synthesis, structural diversity, and applications of mesoionic 1,2,3-triazol-5-ylidene metal complexes, an update (2017–2020)

Over the last one and half decades, mesoionic 1,2,3-triazoly-5-ylidenes (tzNHCs) have been extensively used as ligand precursors for the synthesis of various transition metal complexes. Thus, the current progress of mesoionic 1,2,3-triazoly-5-ylidene metal complexes is of great importance in synthetic organometallic and organic chemistry. This review describes recent progress made in the rapidly developing field of mesoionic 1,2,3-triazol-5-ylidene metal complexes (metals: silver, gold, rhodium, ruthenium, iridium, palladium, osmium, molybdenum, and iron). In particular with their design, synthesis, characterization, reactivity and their catalytic, photophysical, and medicinal applications. We believe, this review will become a helpful source of information for every synthetic chemist in the field. In summary, it covers the reported literature from 2017 to 2020.

Association of Media Coverage of Transgender and Gender Diverse Issues With Rates of Referral of Transgender Children and Adolescents to Specialist Gender Clinics in the UK and Australia

Specialist gender clinics worldwide have witnessed an increase in referrals of transgender and gender diverse (TGD) children and adolescents, but the underlying factors associated with this increase are unknown. To determine whether increases in TGD young people presenting to specialist gender clinics are associated with related media coverage. This cross-sectional study was conducted at 2 publicly funded, pediatric specialist gender services, one located in the UK and the other in Australia. Participants were all children and adolescents aged 0 to 18 years, referred between January 1, 2009, and December 31, 2016, to their respective gender services in the UK and Australia. Data analysis was performed in April 2019. Media coverage of TGD issues. Referral rates from each gender service were compared with local TGD-related media coverage during the study period. Referral data for 5242 TGD young people were obtained (4684 in the UK, of whom 1847 [39.4%] were assigned male at birth and 2837 [60.6%] were assigned female at birth; 558 in Australia, of whom 250 [44.8%] were assigned male at birth and 308 [55.2%] were assigned female at birth), and a total of 2614 news items were identified (UK, 2194; Australia, 420). The annual number of TGD young people referred to both specialist gender clinics was positively correlated with the number of TGD-related local media stories appearing each year (Spearman r = 1.0; P < .001). Moreover, weekly referral rates in both the UK for week 1 (β̂ = 0.16; 95% CI, 0.03-0.29; P = .01) and Australia for week 2 (β̂ = 0.12; 95% CI, 0.04-0.20; P = .003) showed evidence of association with the number of TGD-related media items appearing within the local media. There was no evidence of association between referrals and media items appearing 3 weeks beforehand. Media predominantly focused on TGD issues showed some association with increased referral rates. Specifically, TGD-focused stories showed evidence of association with referral numbers at week 1 (β̂ = 0.16; 95% CI, 0.04-0.28; P = .007) and week 2 (β̂ = 0.23; 95% CI, 0.11-0.35; P < .001) in Australia and with referral numbers at week 1 (β̂ = 0.22; 95% CI, 0.01-0.44; P = .04) in the UK. No evidence of association was found between media peripherally related to TGD issues and referral rates. This study found evidence of an association between increasing media coverage of TGD-related topics and increasing numbers of young people presenting to gender clinics. It is possible that media coverage acts as a precipitant for young people to seek treatment at specialist gender services, which is consistent with clinical experiences in which TGD young people commonly identify the media as a helpful source of information and a trigger to seek assistance.

Still–Gennari Olefination and its Applications in Organic Synthesis

AbstractThe Still–Gennari olefination is a widely applied modification of the Horner–Wadsworth–Emmons reaction, allowing access to Z‐olefins by carbonyl group transformation. Its synthetic utility is undoubtedly of great significance for organic chemistry, as can be illustrated by the number of citations of the original report by W. C. Still and C. Gennari which up to date has been cited over 1000 times. In 2008 Nobel prize winner Ei‐ichi Negishi indicated the Still–Gennari olefination as one of the crucial methods for tolefin synthesis, complementary to palladium‐catalyzed alkenylations. Surprisingly, so far there is no review concerning this popular and valuable transformation. Therefore, we aim to comprehensively systematize achievements in this field and to present the scope of applications of the Still–Gennari olefination along with recent examples in the total synthesis of biologically active compounds. Our review is intended to be of interest for the general chemical community as well as to be a helpful source of information for synthetic organic chemists.magnified image

College-attending young men’s sexual and reproductive health knowledge, attitudes and practices

Objective Male involvement in contraceptive practice remains low. Family planning and pediatric health associations have recommended an emphasis on long-acting reversible contraceptives (LARC) in clinical counseling with adolescents and young adults, raising concerns about the resulting adverse impact on sexually transmitted infection (STI) rates. Participants: College-attending men responded to an internet based questionnaire (n=31) and a phone-based qualitative interview (n=25). Methods: Our survey solicited attitudes toward and knowledge of contraceptive methods and assessed communication practices with sexual partners regarding use of contraception and disease prevention. Results: Knowledge about female methods of contraception was low, with a comparatively high level of knowledge about Plan B. Parents and health care providers were cited as the most helpful sources of information. Conversations about protection with sexual partners were reported by most men, due mainly to fear of unplanned pregnancy, not STI. Conclusion: Addressing couple communication and dual protection among college-attending men needs greater emphasis.

Gaps in Knowledge and Understanding of Patients With Metastatic Breast Cancer in Mexico.

There is paucity of data regarding the knowledge and understanding of patients with metastatic breast cancer (MBC) about their disease stage and treatment goals. This study assessed these patients’ awareness of MBC incurability, topics reviewed with their oncologist, perceptions of having enough knowledge to participate in treatment decision-making, most helpful information source, and satisfaction with the information they received. For this purpose, 185 patients with MBC who attended follow-up medical appointments at a Mexican referral cancer center completed a survey designed by the Metastatic Breast Cancer Alliance. Clinical data were obtained from medical records. Descriptive statistics were applied, and associations between qualitative and quantitative variables were assessed with χ2 and Mann-Whitney U tests, respectively. Half (52%) of the patients were aware that their disease was incurable, while 31% were not sure, and 17% thought it was curable. Forty percent found it difficult to talk about treatments because they did not understand the options that were available to them. The medical staff was the most helpful information source for 74% of participants, and 64% scored their satisfaction with information ≥9 of 10. A significant association was found between higher satisfaction and knowing that MBC is incurable, as well as being older than 40 years. These results illustrate the significant lack of understanding patients with MBC have regarding their cancer, even when reporting high satisfaction with the provided information, and identify a critical need for improved patient education to enhance their comprehension and promote their participation in decision-making processes, treatment adherence, and, ultimately, outcomes.

Gaps in metastatic breast cancer patient knowledge and understanding in Mexico.

1090 Background: Among patients with metastatic breast cancer (MBC), there is paucity of data regarding knowledge and understanding about disease stage and goals of treatment. The limited evidence shows that up to 40% of MBC patients ignore their stage and reports inadequate educational resources and support. Aim: To assess MBC patients’ knowledge of their disease and satisfaction with the medical information received. Methods: 185 patients diagnosed with MBC who attended follow-up medical appointments at INCan from June to December 2018 were asked to complete a survey to assess their knowledge on MBC curability, subtype, topics reviewed with the oncologist, need of additional information regarding MBC and satisfaction with the quality of the information they received. Clinical data was obtained from the medical records. Descriptive statistics were applied, and the association between qualitative and quantitative variables was assessed with the Chi square test and the Mann Whitney U test, respectively. This study was supported by the SPARC mBC Challenge. Results: Only 52% of patients knew that their disease is not curable, while 31% were not sure and 17% thought it was curable. 82% ignored their MBC subtype and 81% reported to want more information about their cancer. 64% scored their satisfaction with the provided information ≥9 (out of 10), and 74% stated that their most helpful source of information was the medical staff. A statistically significant association was found between the perception of the impossibility of curing MBC and better patient satisfaction (p = 0.038). Likewise, better patients’ satisfaction was associated with older age (p = 0.002), longer time since initial diagnosis (p = 0.018) and since diagnosis of MBC (p = 0.014). Conclusions: Our results dramatically illustrate the lack of understanding patients have regarding their cancer, even when reporting high satisfaction with the received information, and identify a critical need for improvement of healthcare providers’ communication skills. Directed efforts should be implemented to enhance patients’ comprehension to promote their participation in decision-making processes, adherence and, ultimately, outcomes.

The importance of digitalisation in urology

The Internet has shaped and changed society like no other technology. Culturally, the emergence of the Internet is being described as having the same impact on society as the invention of printing. In 2018, more than 4 billion people had access to the Internet. Among all Internet users, approximately 80 % search the Internet for health-related information, with cancer being the most frequently searched condition. Patients rate the Internet as the second most helpful source of information, outranked only by consultation with a medical doctor. There are more than 2.6 billion active social media users. Among urological residents, 97 % use social media on a regular basis. Digitalisation has the potential to strengthen patients' health literacy and optimise patient care, especially in the oncologic field. In summary, digitalisation bears an enormous potential for the field of urology.

The Support for New Mums Project: A protocol for a pilot randomized controlled trial designed to test a postnatal psychoeducation smartphone application.

To report a pilot trial protocol for testing the effectiveness of the Support for New Mums smartphone application in a cohort of first-time mothers. A pilot/feasibility randomized controlled trial using a two-group pre-test and repeated post-test design. This protocol follows the Standard Protocol Items: Recommendations for Intervention Trials (SPIRIT) guidelines. The Intervention group will receive access to the smartphone application for 6weeks post birth. Both Intervention and control groups will receive standardized institutional postnatal care services. Trial funding was gained from respective grant sponsors in May and November 2016. The Support for New Mums smartphone application could be a novel method for addressing the gap in provision of postpartum care services providing psychoeducation and improving maternal parental self-efficacy for Australian childbearing women. Australian New Zealand Clinical Trials Registry ACTRN12618001580268.