Chapter 5 Visible, valued and included

This co-created chapter explores the involvement of the authors in the development of the Irish LGBTI+ National Youth Strategy 2018-2020: LGBTI+ young people: visible, valued and included. More specifically, it provides rich insights of two youth co-authors’ experience of participating on the Youth Advisory Group for the Strategy. Their reflective commentary draws on previously undocumented learning and provides examples of the innovative initiatives which sought to ensure LGBTI+ youth were also visible, valued and included in the policy-making process. By placing LGBTI+ young people front and centre, the potential for holistic and lived experience to inform strategic planning was enhanced, reflecting the breadth and diversity of this experience. The development of the Strategy showcases the potential of creative policy-making processes underpinned by child-centred, rights-based approaches. While collaboration in policy-making with young people is essential, the complexities and challenges of participation highlight the need for consideration of the practicalities of implementing meaningful participatory processes. The importance of interpersonal and institutional allyship are discussed throughout the chapter, with the youth co-authors providing real-world examples. The chapter concludes with an appeal to strengthen dialogue and feedback, enhancing the influence of seldom-heard youth on policy-making. In this way, participation ensures policy-making speaks directly to young people’s interests and concerns

LGBT+ Youth Perspectives on Sexual Orientation and Gender Identity Questions in the Growing Up in Ireland Survey: A Qualitative Study

The increasing importance of identifying lesbian, gay, bisexual and transgender (LGBT+) populations is a key driver in changes to demographic data collection in representative surveys of youth. While such population-based data are rare, Growing Up in Ireland (GUI), an Irish, government-funded, longitudinal survey, includes sexual orientation and gender identity (SOGI) measurements. This qualitative study responds to a query from the GUI study team and aims to identify how best to collect SOGI data in future waves of GUI. A university Human Research Ethics Committee granted approval for online consultations with LGBT+ youth (n = 6) with experiential expertise in policy making. The research is underpinned by rights-based public patient involvement (PPI) with recorded discussions, which were transcribed and imported into NVivo 12, generating the theme “recognition in research, policy and society”. This co-created article, with the LGBT+ young PPI Panel members, commends the inclusion of SOGI data in GUI and recommends changes in question placement and phrasing. Aligning with best practice, the PPI members provide a template for wording on consecutive sex and gender questions, expanded sexual orientation identity categories and maintaining the existing well-phrased transgender question from GUI. This offers potential to improve the quality of the SOGI data collected and the experience of those completing the questionnaire. These findings extend beyond GUI, with relevance for surveys with youth populations. This paper underscores the potential and benefits of participatory approaches to research with youth and views their role beyond simply as sources of data

Chapter 5 Visible, valued and included

This co-created chapter explores the involvement of the authors in the development of the Irish LGBTI+ National Youth Strategy 2018-2020: LGBTI+ young people: visible, valued and included. More specifically, it provides rich insights of two youth co-authors’ experience of participating on the Youth Advisory Group for the Strategy. Their reflective commentary draws on previously undocumented learning and provides examples of the innovative initiatives which sought to ensure LGBTI+ youth were also visible, valued and included in the policy-making process. By placing LGBTI+ young people front and centre, the potential for holistic and lived experience to inform strategic planning was enhanced, reflecting the breadth and diversity of this experience. The development of the Strategy showcases the potential of creative policy-making processes underpinned by child-centred, rights-based approaches. While collaboration in policy-making with young people is essential, the complexities and challenges of participation highlight the need for consideration of the practicalities of implementing meaningful participatory processes. The importance of interpersonal and institutional allyship are discussed throughout the chapter, with the youth co-authors providing real-world examples. The chapter concludes with an appeal to strengthen dialogue and feedback, enhancing the influence of seldom-heard youth on policy-making. In this way, participation ensures policy-making speaks directly to young people’s interests and concerns

Beyond ‘Voice’ to ‘Learning with’: A Multiple Streams Policy Analysis and Qualitative Exploration Problematizing Representations of Young LGBT+ Identities

Hearing young voices is of paramount importance, particularly as some voices are seldom-heard, including those of lesbian, gay, bisexual and transgender (LGBT+) youth. Recent research highlighting mental health disparities for these populations led to the formation of the Irish LGBTI+ National Youth Strategy, which prioritized youth participation through a Youth Advisory Group (YAG). A policy analysis of the initiation of the Strategy outlines the convergence of problems, policies and politics using a Multiple Streams Approach (MSA), with quantitative literature suggesting substantial vulnerabilities. This is enhanced through qualitative exploration of the views of six youth co-authors, with experiential expertise, and as YAG members. A university ethics committee granted approval for online recorded consultations via group, pair and individual interviews. The theme of ‘seen and heard’ highlighted unprompted discussions on discursive assumptions representing young LGBT+ identities almost solely in relation to mental health risk. These rich narratives problematize the (in)visibility and silence in representations of the diversity of LGBT+ youth identities, which may inadvertently reinforce stigma. This underscores the need for comprehensive and inclusive school curricula. While MSA may explain prioritization for policy initiation, participation potentially disrupts unintended negative consequences. This article concludes by emphasizing how ‘learning with’ LGBT+ young people can ensure research, policy and practice speaks directly to youth interests and concerns

Status and Trends of Coral Reefs of the Pacific

This document is part of the status report series of the Global Coral Reef Monitoring Network (GCRMN) founded in 1995 as part of the International Coral Reef Initiative (ICRI) to document the ecological conditions of coral reefs, to strengthen monitoring efforts, and to link existing organisations and people working with coral reefs around the world

Clinical discriminators between acute brain hemorrhage and infarction: a practical score for early patient identification Características clínicas diferenciais entre hemorragia e infarto cerebral: uma escala prática para identificação precoce do paciente

New treatments for acute stroke require a rapid triage system, which minimizes treatment delays and maximizes selection of eligible patients. Our aim was to create a score for assessing the probability of brain hemorrhage among patients with acute stroke based upon clinical information. Of 1805 patients in the Stroke Data Bank, 1273 had infarction (INF) and 237 had parenchymatous hemorrhage (HEM) verified by CT. INF and HEM discriminators were determined by logistic regression and used to create a score. ROC curve was used to choose the cut-point for predicting HEM (score <= 2), with sensitivity of 76% and specificity of 83%. External validation was done using the NOMASS cohort. Although the use of a practical score by emergency personnel cannot replace the gold-standard brain image differentiation of HEM from INF for thrombolytic therapy, this score can help to select patients for stroke trials and pre-hospital treatments, alert CT scan technicians, and warn stroke teams of incoming patients to reduce treatment delays.<br>Novas perspectivas no tratamento do acidente vascular cerebral (AVC) requerem um método de triagem rápido para seleção dos pacientes. Nosso objetivo foi criar uma escala com informações clínicas simples para diferenciar hematoma intra-parenquimatoso (HEM) entre os pacientes com AVC. Estudamos 1.273 pacientes com AVC isquêmico (INF) e 237 com HEM do Stroke Data Bank. Variáveis independentes para o diagnóstico de INF e HEM foram determinadas pela análise de regressão logística e utilizadas para criar uma escala. Através da curva ROC foi escolhido o nível de corte para discriminar HEM (<= 2 ), com sensibilidade de 76%, especificidade de 83%. Foi realizada validação externa utilizando os pacientes do estudo NOMASS. Embora o uso de uma escala de fácil aplicação pelas equipes de emergência não possa substituir os métodos de imagem na diferenciação entre INF e HEM para a indicação de trombolítico, a escala proposta pode ser útil para selecionar pacientes para estudos clínicos e tratamento pré-hospitalar, alertar técnicos de tomografia e as equipes médicas sobre a chegada de pacientes, contribuindo para reduzir atrasos cruciais no tratamento

Factors and Mechanisms for Pharmacokinetic Differences between Pediatric Population and Adults

Many physiologic differences between children and adults may result in age-related changes in pharmacokinetics and pharmacodynamics. Factors such as gastric pH and emptying time, intestinal transit time, immaturity of secretion and activity of bile and pancreatic fluid among other factors determine the oral bioavailability of pediatric and adult populations. Anatomical, physiological and biochemical characteristics in children also affect the bioavailability of other routes of administration. Key factors explaining differences in drug distribution between the pediatric population and adults are membrane permeability, plasma protein binding and total body water. As far as drug metabolism is concerned, important differences have been found in the pediatric population compared with adults both for phase I and phase II metabolic enzymes. Immaturity of glomerular filtration, renal tubular secretion and tubular reabsorption at birth and their maturation determine the different excretion of drugs in the pediatric population compared to adults