Proceedings of the Working Group Session on Fertility Preservation for Individuals with Gender and Sex Diversity

Children and adolescents with gender and sex diversity include (1) gender-nonconforming and transgender individuals for whom gender identity or expression are incongruent with birth-assigned sex (heretofore, transgender) and (2) individuals who have differences in sex development (DSD). Although these are largely disparate groups, there is overlap in the medical expertise necessary to care for individuals with both gender and sex diversity. In addition, both groups face potential infertility or sterility as a result of desired medical and surgical therapies. The Ann and Robert H. Lurie Children's Hospital of Chicago (Lurie Children's) gender and sex development program (GSDP) provides specialized multidisciplinary care for both transgender and DSD patients. In response to patient concerns that recommended medical treatments have the potential to affect fertility, the Lurie Children's GSDP team partnered with experts from the Oncofertility Consortium at Northwestern University to expand fertility preservation options to gender and sex diverse youth. This article summarizes the results of a meeting of experts across this field at the annual Oncofertility Consortium conference with thoughts on next steps toward a unified protocol for this patient group.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140296/1/trgh.2016.0008.pd

An empirical assessment of student outcome and classroom interactions during two phases of a sociocultural teacher training program

This study empirically assessed student outcome and change in classroom interactions during two phases of a sociocultural teacher-training project implemented in a Mexican primary school. Phase 1 (preintervention) analyzed the prevalence of interpersonal (interactive) events versus noninterpersonal (passive) events using coded video recordings of several hours of normal classroom routines from four classrooms. The influence of the grade and sex of the students was also explored. Results indicated significantly greater prevalence of most passive events assessed than that of interactive events, irrespective of the grade and sex of the students. The yearlong teacher-training project was implemented in Phase 2. Experiment 1 assessed student outcome in reading comprehension and writing skills by comparing scores on yearend summaries of narrative and expository texts of intervention (experimental) school students with those of students in a control school. The effect of the variables of grade, sex of teacher, and sex of students on student outcome was also explored in the analyses between schools and in separate experimental-school analyses. Results indicated that, across both text types, students in the experimental school performed significantly better than those in the control school when assessed by grade. Experimental school scores were also influenced by the exploratory variables, with girls of female, particularly 2nd-grade, teachers performing significantly better across tests than other groups of girls or boys. Finally, Experiment 2 assessed the ongoing success (or failure) of the participating experimental school teachers to adopt basic sociocultural techniques in their classrooms, as determined by increasing interactive and decreasing passive events over the course of the intervention. Again, coded video recordings of normal classroom routines, taken three times during the year, were used and the effect of the variables of grade, sex of students, and sex of teacher was explored. Results were mixed for each event examined, with female teachers, particularly those in the second grade, showing the most success. Sex of students was not a notable influence in these analyses

An empirical assessment of student outcome and classroom interactions during two phases of a sociocultural teacher training program

This study empirically assessed student outcome and change in classroom interactions during two phases of a sociocultural teacher-training project implemented in a Mexican primary school. Phase 1 (preintervention) analyzed the prevalence of interpersonal (interactive) events versus noninterpersonal (passive) events using coded video recordings of several hours of normal classroom routines from four classrooms. The influence of the grade and sex of the students was also explored. Results indicated significantly greater prevalence of most passive events assessed than that of interactive events, irrespective of the grade and sex of the students. The yearlong teacher-training project was implemented in Phase 2. Experiment 1 assessed student outcome in reading comprehension and writing skills by comparing scores on yearend summaries of narrative and expository texts of intervention (experimental) school students with those of students in a control school. The effect of the variables of grade, sex of teacher, and sex of students on student outcome was also explored in the analyses between schools and in separate experimental-school analyses. Results indicated that, across both text types, students in the experimental school performed significantly better than those in the control school when assessed by grade. Experimental school scores were also influenced by the exploratory variables, with girls of female, particularly 2nd-grade, teachers performing significantly better across tests than other groups of girls or boys. Finally, Experiment 2 assessed the ongoing success (or failure) of the participating experimental school teachers to adopt basic sociocultural techniques in their classrooms, as determined by increasing interactive and decreasing passive events over the course of the intervention. Again, coded video recordings of normal classroom routines, taken three times during the year, were used and the effect of the variables of grade, sex of students, and sex of teacher was explored. Results were mixed for each event examined, with female teachers, particularly those in the second grade, showing the most success. Sex of students was not a notable influence in these analyses

COVID-19: ICU delirium management during SARS-CoV-2 pandemic

The novel coronavirus, SARS-CoV-2-causing Coronavirus Disease 19 (COVID-19), emerged as a public health threat in December 2019 and was declared a pandemic by the World Health Organization in March 2020. Delirium, a dangerous untoward prognostic development, serves as a barometer of systemic injury in critical illness. The early reports of 25% encephalopathy from China are likely a gross underestimation, which we know occurs whenever delirium is not monitored with a valid tool. Indeed, patients with COVID-19 are at accelerated risk for delirium due to at least seven factors including (1) direct central nervous system (CNS) invasion, (2) induction of CNS inflammatory mediators, (3) secondary effect of other organ system failure, (4) effect of sedative strategies, (5) prolonged mechanical ventilation time, (6) immobilization, and (7) other needed but unfortunate environmental factors including social isolation and quarantine without family. Given early insights into the pathobiology of the virus, as well as the emerging interventions utilized to treat the critically ill patients, delirium prevention and management will prove exceedingly challenging, especially in the intensive care unit (ICU). The main focus during the COVID-19 pandemic lies within organizational issues, i.e., lack of ventilators, shortage of personal protection equipment, resource allocation, prioritization of limited mechanical ventilation options, and end-of-life care. However, the standard of care for ICU patients, including delirium management, must remain the highest quality possible with an eye towards long-term survival and minimization of issues related to post-intensive care syndrome (PICS). This article discusses how ICU professionals (e.g., physicians, nurses, physiotherapists, pharmacologists) can use our knowledge and resources to limit the burden of delirium on patients by reducing modifiable risk factors despite the imposed heavy workload and difficult clinical challenges posed by the pandemic