Measuring a New Stress Domain: Validation of the Couple-Level Minority Stress Scale

Existing social stress frameworks largely conceive of stress as emanating from individual experience. Recent theory and research concerning minority stress have focused on same-sex couples' experiences of both eventful and chronic stressors associated with being in a stigmatized relationship, including having ongoing or episodic fears of discrimination, and experiencing actual acts of discrimination. Such couple-level minority stressors represent a novel domain of social stress affecting minority populations that is only beginning to become a focus in empirical investigations testing minority stress theory. This article presents the results of psychometric analyses of dyadic data from 106 same-sex couples from across the U.S., introducing the Couple-Level Minority Stress (CLMS) scale featuring eight new couple-level minority stress factors: (1) Couple-Level Stigma; (2) Couple-Level Discrimination; (3) Seeking Safety as a Couple; (4) Perceived Unequal Relationship Recognition; (5) Couple-Level Visibility; (6) Managing Stereotypes about Same-Sex Couples; (7) Lack of Integration with Families of Origin; and (8) Lack of Social Support for Couples. The CLMS demonstrated a clear factor structure with satisfactory model-data fit and subscale reliabilities. The CLMS also exhibited validity as a correlate of one indicator of relationship quality (relationship satisfaction) and three indicators of mental health (nonspecific psychological distress, depressive symptomatology, and problematic drinking) when controlling for individual-level minority stressors and has great potential to extend and enrich minority stress research, particularly studies that deepen understandings of longstanding health inequities based on sexual orientation

Recovery of a US Endangered Fish

BACKGROUND: More fish have been afforded US Endangered Species Act protection than any other vertebrate taxonomic group, and none has been designated as recovered. Shortnose sturgeon (Acipenser brevirostrum) occupy large rivers and estuaries along the Atlantic coast of North America, and the species has been protected by the US Endangered Species Act since its enactment. METHODOLOGY/PRINCIPAL FINDINGS: Data on the shortnose sturgeon in the Hudson River (New York to Albany, NY, USA) were obtained from a 1970s population study, a population and fish distribution study we conducted in the late 1990s, and a fish monitoring program during the 1980s and 1990s. Population estimates indicate a late 1990s abundance of about 60,000 fish, dominated by adults. The Hudson River population has increased by more than 400% since the 1970s, appears healthy, and has attributes typical for a long-lived species. Our population estimates exceed the government and scientific population recovery criteria by more than 500%, we found a positive trend in population abundance, and key habitats have remained intact despite heavy human river use. CONCLUSIONS/SIGNIFICANCE: Scientists and legislators have called for changes in the US Endangered Species Act, the Act is being debated in the US Congress, and the Act has been characterized as failing to recover species. Recovery of the Hudson River population of shortnose sturgeon suggests the combination of species and habitat protection with patience can yield successful species recovery, even near one of the world's largest human population centers

Complications related to deep venous thrombosis prophylaxis in trauma: a systematic review of the literature

Deep venous thrombosis prophylaxis is essential to the appropriate management of multisystem trauma patients. Without thromboprophylaxis, the rate of venous thrombosis and subsequent pulmonary embolism is substantial. Three prophylactic modalities are common: pharmacologic anticoagulation, mechanical compression devices, and inferior vena cava filtration. A systematic review was completed using PRISMA guidelines to evaluate the potential complications of DVT prophylactic options. Level one evidence currently supports the use of low molecular weight heparins for thromboprophylaxis in the trauma patient. Unfortunately, multiple techniques are not infrequently required for complex multisystem trauma patients. Each modality has potential complications. The risks of heparin include bleeding and heparin induced thrombocytopenia. Mechanical compression devices can result in local soft tissue injury, bleeding and patient non-compliance. Inferior vena cava filters migrate, cause inferior vena cava occlusion, and penetrate the vessel wall. While the use of these techniques can be life saving, they must be appropriately utilized

Endocrinologic, neurologic, and visual morbidity after treatment for craniopharyngioma

Craniopharyngiomas are locally aggressive tumors which typically are focused in the sellar and suprasellar region near a number of critical neural and vascular structures mediating endocrinologic, behavioral, and visual functions. The present study aims to summarize and compare the published literature regarding morbidity resulting from treatment of craniopharyngioma. We performed a comprehensive search of the published English language literature to identify studies publishing outcome data of patients undergoing surgery for craniopharyngioma. Comparisons of the rates of endocrine, vascular, neurological, and visual complications were performed using Pearson’s chi-squared test, and covariates of interest were fitted into a multivariate logistic regression model. In our data set, 540 patients underwent surgical resection of their tumor. 138 patients received biopsy alone followed by some form of radiotherapy. Mean overall follow-up for all patients in these studies was 54 ± 1.8 months. The overall rate of new endocrinopathy for all patients undergoing surgical resection of their mass was 37% (95% CI = 33–41). Patients receiving GTR had over 2.5 times the rate of developing at least one endocrinopathy compared to patients receiving STR alone or STR + XRT (52 vs. 19 vs. 20%, χ2P < 0.00001). On multivariate analysis, GTR conferred a significant increase in the risk of endocrinopathy compared to STR + XRT (OR = 3.45, 95% CI = 2.05–5.81, P < 0.00001), after controlling for study size and the presence of significant hypothalamic involvement. There was a statistical trend towards worse visual outcomes in patients receiving XRT after STR compared to GTR or STR alone (GTR = 3.5% vs. STR 2.1% vs. STR + XRT 6.4%, P = 0.11). Given the difficulty in obtaining class 1 data regarding the treatment of this tumor, this study can serve as an estimate of expected outcomes for these patients, and guide decision making until these data are available

Satisfaction with Open Sexual Agreements in Australian Gay Men's Relationships: the Role of Perceived Discrepancies in Benefit

This study investigated whether satisfaction with open sexual agreements in gay men’s relationships was associated with perceptions of discrepancies in the benefit experienced from those agreements. Three types of perceived discrepancy between the self and the relationship partner were examined: frequency of casual sex, attractiveness of casual partners, and “overall” benefit. Results from a survey conducted in 2010 of 685 Australian gay men in relationships with open agreements showed that men perceiving discrepancies in benefit, particularly those representing “under-benefit”, were less satisfied with their agreement than were men perceiving equal benefit. These results supported hypotheses derived from equity theory and provide insight into factors associated with gay men’s satisfaction with open agreements. These findings also have important practical implications. Professionals counselling gay men or couples experiencing low satisfaction with open agreements may consider raising issues of unequal benefit and work with their clients towards achieving equality

Between and Within Couple-Level Factors Associated with Gay Male Couples’ Investment in a Sexual Agreement

Sexual agreements are common among gay male couples, and between one-third and two-thirds of gay men acquire HIV while in a same-sex relationship. Studies have assessed whether agreements could be used for HIV prevention yet additional research is needed. By using dyadic data collected from 361 U.S. gay male couples, the present cross-sectional study sought to assess whether certain between and within couple-level relationship characteristics predict a partner's value in, commitment to, and satisfaction with an agreement. On average, couples with higher levels of constructive communication and relationship satisfaction and commitment were associated with partners who had higher levels of investment in the agreement. Within the couple, differences in commitment and investment of the relationship were also found to be negatively associated with partners’ investment toward an agreement. Implications are discussed for how sexual agreements may be used to develop new HIV prevention efforts for gay male couples