Video gaming and gender dysphoria: some case study evidence

Video gaming has become an established area of psychological research over the last two decades. Over the past few years there has been increasing research into online gender swapping, showing that for many groups or individuals it can have positive psychological benefits (e.g., as a way to explore gender roles and boundaries in a safe environment). To date, no research has ever examined online gender swapping among individuals with gender dysphoria – people with acknowledged gender-identity issues. Using four case studies, this exploratory study examined the role of gaming in the life of individuals seeking treatment for gender dysphoria. The main objectives were to use exemplar case studies to highlight that gaming – in some circumstances – appears to be a functional way of dealing with gender identity issues, and that gender swapping in gaming may help such individuals to come to terms with their gender dysphoria. Recommendations for further research are suggested along with the limitations of the data collected. Durant les últimes dues dècades, els videojocs han anat ocupant un camp establert de la investigació psicològica. En els últims anys hi ha hagut un augment de la investigació sobre el canvi de gènere online, mostrant que per a molts grups o individus això pot tenir beneficis psicològics (per exemple, com una manera d’explorar les funcions i els límits de gènere en un entorn segur). Fins a la data, cap investigació ha examinat el canvi de gènere online en els individus amb disfòria de gènere - persones amb problemes d’identitat de gènere. Utilitzant quatre estudis de cas, aquest estudi exploratori va examinar el paper del joc en la vida dels individus que busquen tractament per disfòria de gènere. Els objectius principals eren d’usar estudis de casos exemplar per mostrar que jugar jocs online pot ser - en algunes circumstàncies - una manera funcional de tractar amb problemes d’identitat de gènere, i que el canvi de gènere en els jocs poden ajudar aquests ndividus a millorar la disfòria de gènere. Es discuteixen les limitacions de les dades recollides i es suggereixen recomanacions per a futures investigacions

The human development index adjusted for efficient resource utilization

The human development index (HDI) developed by the United Nations Development Programme is computed as the average of three equally weighted outcome measures: life expectancy (LI), educational attainment (EI) and income (WI). However, this computational process is independent of the resources being devoted by each country to the achievement of the three outcome levels. Hence, it is conceivable that two different countries may consume vastly different amount of resources in achieving the same outcome, say, LI. However, this difference in the efficiency of resource utilization is not reflected in the HDI. The purpose of this paper is to address this efficiency issue

Responses of track and field coaches to athletes with eating problems

This study aimed to explore how track and field coaches respond to athletes with eating problems. Eleven experienced coaches participated in semi-structured interviews exploring their responses to, and challenges faced when, working with athletes with eating problems. The analysis revealed three themes relating to the strategies employed by coaches. The first theme indicated a supportive approach, where coaches were proactive in seeking support and in reducing training at the early stages of an eating problem. The second theme outlined an avoidant approach, characterized by coach reluctance to be involved in managing eating problems, and a lack of confidence in their knowledge of eating disorders. The third theme involved a confrontational approach, where coaches employed strict rules and engaged in coercion to persuade athletes to seek treatment. All of the coaches reported facing challenges in persuading athletes to seek treatment and were frustrated by the lack of available support. The study highlights the importance of providing resources and support services where coaches can seek advice. Coach-education packages can utilize the findings to highlight the strengths and limitations of different coach strategies, and to reinforce the importance of their role in identification and intervention when eating problems in athletes are suspected

Una evaluación crítica del potencial de supervivencia de las sociedades laborales

This paper presents a critical evaluation of the economic survival of labour-managed firms (LMF) compared to that of conventional companies, paying particular attention to their different forms of capital ownership. There are many arguments both ways; some argue that LMFs enjoy a higher likelihood of survival, since they offer greater employment stability and their workers enjoy more incentives as they are involved in the decision-making process. The counterarguments claim that LMFs are less efficient, due largely to the free-rider problem, serious agent-principal problems, a higher degree of risk aversion on the part of their worker-owners and degeneration due to rent-seeking behaviour, which reduces their likelihood of survival. The results of this evaluation point to the divergence between most of the predictions of economic theory and the successful development of LMFs in Spain.Labour-managed firms, forms of capital ownership, economic performance, survival prospects.

MotivATE: A Pretreatment Web-Based Program to Improve Attendance at UK Outpatient Services Among Adults With Eating Disorders.

BACKGROUND: In the UK, eating disorders affect upward of 725,000 people per year, and early assessment and treatment are important for patient outcomes. Around a third of adult outpatients in the UK who are referred to specialist eating disorder services do not attend, which could be related to patient factors related to ambivalence, fear, and a lack of confidence about change. This lack of engagement has a negative impact on the quality of life of patients and has implications for service costs. OBJECTIVE: To describe the development of a Web-based program ("MotivATE") designed for delivery at the point of referral to an eating disorder service, with the aim of increasing service attendance. METHODS: We used intervention mapping and a person-based approach to design the MotivATE program and conducted a needs assessment to determine the current impact of service nonattendance on patients (via a review of the qualitative evidence) and services (through a service provision survey to understand current issues in UK services). Following the needs assessment, we followed the five steps of program development outlined by Bartholomew et al (1998): (1) creating a matrix of proximal program objectives; (2) selecting theory-based intervention methods and strategies; (3) designing and organizing the program; (4) specifying adoption and implementation plans; and (5) generating program evaluation plans. RESULTS: The needs assessment identified current nonattendance rates of 10%-32%. We defined the objective of MotivATE as increasing attendance rates at an eating disorder service and considered four key determinants of poor attendance: patient ambivalence about change, low patient self-efficacy, recognition of the need to change, and expectations about assessment. We chose aspects of motivational interviewing, self-determination theory, and the use of patient stories as the most appropriate ways to enable change. Think-aloud piloting with people with lived experience of an eating disorder resulted in positive feedback on the MotivATE program. Participants related well to the stories used. Nonetheless, because of feedback, we further modified the program in line with patients' stage of change and addressed issues with the language used. A consultation with service staff meant that we could make clear implementation plans. Finally, a randomized controlled trial is currently underway to evaluate the MotivATE program. CONCLUSIONS: Using intervention mapping, we have developed a novel pretreatment Web-based program that is acceptable to people with eating disorders. To our knowledge, this is the first such program. The model of development described here could be a useful template for designing further programs for other difficult-to-engage populations

Global Competitiveness and Canadian Sectoral/Regional Labour Productivity Differences

This paper evaluates the extent to which the decrease in total factor productivity growth that is alleged to have occurred in the last few years is also reflected in corresponding decreases in labour productivity growth, among key provinces and sectors of the Canadian economy. The analysis is based upon non-parametric productivity comparisons, for the 1984-1998 period. Data envelopment analysis is the methodological tool selected for the measurement of total factor productivity and hence of operational effectiveness to assess the extent to which sectoral productivity differences across Canadian regions represents a barometer of global competitiveness. The evidence indicates that labour productivity is growing. Factors associated with economies of scale appear to be the main source of inefficiency, as expected in a spatial setting. These inefficiencies are reflected mostly in increasing returns to scale, which enhances the competitiveness potential of the regions' economic base and of the industries in their midst

A complete tool set for molecular QTL discovery and analysis

Population scale studies combining genetic information with molecular phenotypes (for example, gene expression) have become a standard to dissect the effects of genetic variants onto organismal phenotypes. These kinds of data sets require powerful, fast and versatile methods able to discover molecular Quantitative Trait Loci (molQTL). Here we propose such a solution, QTLtools, a modular framework that contains multiple new and well-established methods to prepare the data, to discover proximal and distal molQTLs and, finally, to integrate them with GWAS variants and functional annotations of the genome. We demonstrate its utility by performing a complete expression QTL study in a few easy-to-perform steps. QTLtools is open source and available at https://qtltools.github.io/qtltools/.</p

Treatment outcome of patients with comorbid type 1 diabetes and eating disorders

Background: Co-morbidity between Type 1 Diabetes Mellitus (T1DM) and eating disorders (ED) has been previously described; however the effect of this illness on the outcomes for conventional ED treatments has not been previously investigated. This study aims to compare clinical, psychopathological and personality features between two samples of ED individuals: those with comorbid T1DM and those without (No-DM); and to identify differences in treatment outcomes between the groups. Methods: This study compares treatment outcome, dropouts, ED psychopathology and personality characteristics for 20 individuals with ED and T1DM and 20 ED patients without diabetes, matched for diagnostic and treatment type. Results: The study found higher dropout rates from therapy in individuals with T1DM and worse treatment outcome in spite of having no significant differences in eating disorder psychopathology, although individuals with T1DM report misusing insulin. Conclusions: The low levels of motivation to change, and insulin abuse in T1DM patients, may suggest that treatment for patients with ED and T1DM should consider the individual's personality and role of insulin abuse when determining the appropriate intervention

Gender incongruence of adolescence and adulthood: acceptability and clinical utility of the World Health Organization’s proposed ICD-11 criteria

The World Health Organization (WHO) is currently updating the tenth version of their diagnostic tool, the International Classification of Diseases (ICD, WHO, 1992). Changes have been proposed for the diagnosis of Transsexualism (ICD-10) with regard to terminology, placement and content. The aim of this study was to gather the opinions of transgender individuals (and their relatives/partners) and clinicians in the Netherlands, Flanders (Belgium) and the United Kingdom regarding the proposed changes and the clinical applicability and utility of the ICD-11 criteria of ‘Gender Incongruence of Adolescence and Adulthood’ (GIAA). A total of 628 participants were included in the study: 284 from the Netherlands (45.2%), 8 from Flanders (Belgium) (1.3%), and 336 (53.5%) from the UK. Most participants were transgender people (or their partners/relatives) (n = 522), 89 participants were healthcare providers (HCPs) and 17 were both healthcare providers and (partners/relatives of) transgender people. Participants completed an online survey developed for this study. Most participants were in favor of the proposed diagnostic term of ‘Gender Incongruence’ and thought that this was an improvement on the ICD-10 diagnostic term of ‘Transsexualism’. Placement in a separate chapter dealing with Sexual- and Gender-related Health or as a Z-code was preferred by many and only a small number of participants stated that this diagnosis should be excluded from the ICD-11. In the UK, most transgender participants thought there should be a diagnosis related to being trans. However, if it were to be removed from the chapter on “psychiatric disorders”, many transgender respondents indicated that they would prefer it to be removed from the ICD in its entirety. There were no large differences between the responses of the transgender participants (or their partners and relatives) and HCPs. HCPs were generally positive about the GIAA diagnosis; most thought the diagnosis was clearly defined and easy to use in their practice or work. The duration of gender incongruence (several months) was seen by many as too short and required a clearer definition. If the new diagnostic term of GIAA is retained, it should not be stigmatizing to individuals. Moving this diagnosis away from the mental and behavioral chapter was generally supported. Access to healthcare was one area where retaining a diagnosis seemed to be of benefit