Combined hysterectomy and mastectomy surgery for transgender patients in an integrated health care setting

Background: Hysterectomy and mastectomy surgery for gender affirmation have traditionally been performed as separate surgeries. Our institution offers these surgeries as a single combined procedure, typically with same-day discharge. Decreasing the number of times patients need to have surgery may reduce barriers to care by limiting surgical and hospital stay events. Our primary objective was to describe the perioperative experience of transgender patients who underwent combined hysterectomy and mastectomy surgery.

Methods: This retrospective case series assessed patients who underwent combined hysterectomy and mastectomy surgery between 2013 and 2015 in an integrated health care setting in the United States. Chart reviews were performed for outcomes of interest, which included operative and postoperative complications.

Results: We identified 25 patients who underwent a combined hysterectomy and mastectomy for the indication of gender transition. Preoperative patient characteristics included a median age of 31, with a median BMI of 25. Ninety-two percent of the patients were on testosterone therapy at the time of surgery. A total of 76% and 24% of patients had laparoscopic and vaginal hysterectomies, respectively. Intraoperatively, the average blood loss was 104 mL, and there were no complications. Eighty percent of patients were discharged on the same day. Postoperatively, 92% of patients experienced no major complications. One patient received a uterine artery embolization and blood transfusion for postoperative intraabdominal bleeding, and one patient presented 9 weeks after surgery with partial vaginal cuff dehiscence requiring a cuff revision. There were no re-admissions within six months of surgery. There were no major mastectomy-related complications.

Conclusions: Combined surgeries are feasible and reduce the number of surgical events and hospital stays. There were no complications that could be attributed to undergoing two procedures as a single incident.     

The effects of implementation intention strategies on prospective memory cue encoding

Implementation intentions, which include a structured verbal statement and mental imagery, improve prospective memory performance (i.e. remembering to execute delayed intentions). To investigate whether, and how, implementation intention strategies affect encoding processes we had participants complete a thought probe procedure immediately after forming the intention to remember to press Q when seeing fruit words. In Experiment 1, an implementation intention verbal statement (relative to control statement) significantly increased generation of high typicality exemplars (apple, banana, orange). In Experiment 2, an implementation intention imagery procedure (relative to control imagery) produced similar outcomes. In Experiment 3, combining the statement and imagery components of the implementation intention (relative to control statement and imagery) demonstrated even more potent effects (e.g. three-fold increase in fruit exemplars generated). In Experiment 4, we tested whether the control statement versus control imagery procedure differentially affected encoding, but these control procedures showed no significant differences. An interesting, unanticipated finding was that there was significantly less mind wandering in the implementation intention conditions relative to the control conditions. The current experiments provide novel information on the processes operating during intention encoding, and support the classic view that implementation intentions increase the encoding of specific retrieval cues.     

The ethics of trauma: re-traumatization in society's approach to the traumatized subject

The paper starts from a question about the subconscious needs and anxieties which may underlie society's current responses to trauma. In particular, the author argues that the interest in the trauma of torture and man-made violence is a reaction to the increasingly dehumanizing and death-denying culture we live in. After proposing that the various categories of societal responses-the author focuses on evaluation, treatment, and advocacy-to traumatized subjects hide defenses of denial, distortion, refusal, with respect to the challenge of mortality, meaning-making, and mourning, the author then makes the thesis that they can derail and corrupt the project of post-traumatic repair. The paper proceeds with an examination of the ethics and politics that are implicit in contemporary North American society's current approach to trauma. The central argument is that the current approach may contain a collective acting out that often ends up being re-traumatizing to the traumatized subjects.     

Regional differences in the listener's phonemic inventory affect semantic processing: A mismatch negativity (MMN) study

Using the mismatch negativity (MMN) response, we examined how Standard French and Southern French speakers access the meaning of words ending in /e/ or /ε/ vowels which are contrastive in Standard French but not in Southern French. In Standard French speakers, there was a significant difference in the amplitude of the brain response after the deviant-minus-standard subtraction between the frontocentral (FC) and right lateral (RL) recording sites for the final-/ε/ word but not the final-/e/ word. In contrast, the difference in the amplitude of the brain response between the FC and RL recording sites did not significantly vary as a function of the word’s final vowel in Southern French speakers. Our findings provide evidence that access to lexical meaning in spoken word recognition depends on the speaker’s native regional accent.     

Parent–child relationship quality and infantile amnesia in adults

The first years of life are typically shrouded by infantile amnesia, but there is enormous variability between adults in how early and how much they can remember from this period. This study examined one possible factor affecting this variability: whether the perceived quality of parent–child relationships is associated with the number of early memories young adults can retrieve, and their age at the time of their first memory. We found such associations but they were qualified by parent gender. Mother–child relationships that were more affectively intense (greater social support but also more negative interchanges) were associated with recalling more early memories, although paternal companionship was most associated with how early an individual's first memory was. Affective tone of retrieved memories was also assessed, and a greater proportion of affectively positive memories (as well as fewer affectively neutral memories for males) was associated with high parental involvement in children's lives.     

Acquiring Non-Object Terms: The Case for Time Words

We address the issue of children's understanding of abstract words with two studies on preschoolers' knowledge of the time-duration words minutes, hours, days, and years. The first study examines 4- and 5-year-olds' ability to answer questions about durations of common phenomena with duration terms. The second study examines 4- to 6-year-olds' comprehension of duration terms with a forced-choice pointing task. Both show that preschoolers' knowledge of such words is incomplete, but that it adheres to the pattern proposed in previous work with toddlers for abstract words. More specifically, children form lexical domains for such words even before they know their individual meanings, thereby allowing the children to often respond appropriately but not usually correctly to questions about abstract dimensions like time.     

L’accès aux médicaments : quelles contributions des règles sur les brevets de l’Accord de partenariat transpacifique global et progressiste ?

Enhanced protection for patents in free trade agreements would undermine access to medicines and show difficulties for developing countries with respect to public health issue. In the context of the Comprehensive and Progressive Trans-Pacific Partnership Agreement, however, after the withdrawal of the United States, the legal regime applicable to patents seems less rigid and, therefore, more favorable to access to medicines. This results, on the one hand, from certain flexibilities contained in this agreement itself; and on the other hand, the suspension of some material and procedural obligations. This article aims to analyze these two sides to justify the contribution of this agreement to ensure access to medicines.     

Constructing Finite Least Kripke Models for Positive Logic Programs in Serial Regular Grammar Logics

A serial context-free grammar logic is a normal multimodal logicL characterized by the seriality axioms and a set of inclusionaxioms of the form _ts1..._sk. Such an inclusion axiom correspondsto the grammar rule t s₁... s_k. Thus the inclusion axioms ofL capture a context-free grammar . If for every modal index t, the set of words derivable fromt using is a regular language, then L is a serial regular grammar logic. In this paper, we present an algorithm that, given a positivemultimodal logic program P and a set of finite automata specifyinga serial regular grammar logic L, constructs a finite leastL-model of P. (A model M is less than or equal to model M' iffor every positive formula , if M then M' .) A least L-modelM of P has the property that for every positive formula , P iff M . The algorithm runs in exponential time and returnsa model with size 2^O(n³). We give examples of P and L, for bothof the case when L is fixed or P is fixed, such that every finiteleast L-model of P must have size 2⁽ⁿ⁾. We also prove that ifG is a context-free grammar and L is the serial grammar logiccorresponding to G then there exists a finite least L-modelof _s p iff the set of words derivable from s using G is a regularlanguage.     

Consumer ethnocentrism,cultural sensitivity,and intention to purchase local products—evidence from Vietnam

• This study empirically investigates the impacts of consumer ethnocentrism and cultural sensitivity on both imported product judgment and intention to purchase local products in the context of a developing country—Vietnam. Structural equation modeling was used to test these impacts, utilizing a sample of 549 consumers. The results show that consumer ethnocentrism is negatively related to imported product judgment and positively related to intention to purchase local products. In addition, cultural sensitivity has a positive relationship with imported product judgment but not with consumer ethnocentrism. The results also indicate that the impacts of consumer ethnocentrism on imported product judgment and on intention to purchase local products are not different in terms of product categories, gender, income, and education levels. However, differences exist between younger and older consumers.

Copyright © 2008 John Wiley & Sons, Ltd.