Documenting research with transgender, gender non-binary, and other gender diverse (trans) people: an evidence map and ethical analysis

This work critically examines and documents the approaches researchers have taken to studying transgender, gender non-binary, and other gender diverse (trans) individuals and communities. It applies systematic review methods, including evidence mapping, to demonstrate new ways of studying researchers and research ethics. This dissertation documents trans research across a broad range of fields and identifies evidence gaps and opportunities for more responsible research with trans individuals and communities. Incorporating mixed methods design, the study includes a systematic evidence map of 690 trans-focused empirical studies published in English in peer-reviewed journals between 2010 and 2014, an ethical analysis examining research challenges and recommendations for positive change, and a cross-sectional study investigating the relative risk of clinical photographs of trans people published in peer-reviewed journal articles appearing openly on the internet. It presents a detailed ethnographic content analysis of key ethical challenges related to research focus and study design, data collection and reporting, data analysis, and publishing practices. Recommendations to researchers, research ethics committees, and publishers highlight the need for vigilance with respect to study design (particularly, attention to how and why we divide people into gender categories and the implications of those choices) and publishing practices (emphasising public engagement, open science, and the potential of critical data studies to increase access to research that includes trans people). This study is innovative, the first of its kind to draw attention to trans people as research subjects, and the first to examine trans research ethics using systematic review methodologies. The Global Trans Research Evidence Map is also unique, incorporating qualitative, quantitative, mixed methods, and clinical research from multiple fields of investigation. This study, by providing critical insights into how to engage in inclusive, respectful, and responsible research with trans individuals and communities, has broader implications for the ethics of research with marginalized communities and for innovations in methods to examine research ethics

An Investigation Of Organizational Information Security Risk Analysis

Despite a growing number and variety of information security threats, many organizations continue to neglect implementing information security policies and procedures.  The likelihood that an organization’s information systems can fall victim to these threats is known as information systems risk (Straub & Welke, 1998).  To combat these threats, an organization must undergo a rigorous process of self-analysis. To better understand the current state of this information security risk analysis (ISRA) process, this study deployed a questionnaire using both open-ended and closed ended questions administered to a group of information security professionals (N=32).  The qualitative and quantitative results of this study show that organizations are beginning to conduct regularly scheduled ISRA processes.  However, the results also show that organizations still have room for improvement to create idyllic ISRA processes.&nbsp

Condoms and Contradictions: Assessing Sexual Health Knowledge in Lesbian, Gay, Bisexual, Trans, and Queer Youth Labelled with Intellectual Disabilities

Background: Accessible, culturally relevant data collection tools to assess the sexual health knowledge of lesbian, gay, bisexual, trans, queer and questioning (LGBTQ) young people labelled with intellectual disabilities are sparse. Materials and Methods: Using community-based participatory research (CBPR) we piloted a variety of interactive activities designed to assess the sexual health knowledge and decision making skills of LGBTQ young people with intellectual disabilities. Results: Posters created by youth participants suggested substantial sexual health knowledge and empowerment, while individual knowledge assessment scores indicated a range in understanding of risks and strategies to avoid pregnancy, HIV and herpes. Conclusions: These findings reinforce the importance of using multiple strategies to assess sexual knowledge with this population. Creative evaluation strategies catering to the cultural specificities, sexual experiences, and cognitive abilities of diverse youth help to clarify gaps in knowledge and areas for renewed attention. Keywords: HIV/AIDS; community-based participatory research; intellectual disabilities; lesbian, gay, bisexual, and trans (LGBT); sexual health Les outils de collecte des données, accessibles et culturellement appropriés, afin d’évaluer les connaissances sur la santé sexuelle des jeunes LGBT (Lesbiennes, Gais, Bisexuel-les et Trans) ayant des handicaps intellectuels sont rares. Nous avons pilotés une variété d’activités interactives ayant pour but l’évaluation des connaissances en santé sexuelle et des compétences pour la prise de décision de jeunes LGBT ayant des handicaps intellectuels. Les affiches créées par les jeunes participants indiquent une responsabilisation et une connaissance approfondie de la santé sexuelle. Les résultats des évaluations de la connaissance en santé sexuelle indiquent une bonne compréhension des risques et des stratégies pour éviter la grossesse, Le VIH et l’herpès. Les résultats obtenus renforcent l’importance d’utiliser diverses stratégies pour évaluer la connaissance en santé sexuelle de cette population. Des stratégies d’évaluation créatives qui adressent les spécificités culturelles, les expériences sexuelles et les habilités cognitives de différents jeunes aident à clarifier les lacunes en connaissance et les domaines qui nécessitent une attention accrue. Mots-clés: VIH/SIDA; recherche participative axée sur la communauté; handicaps intellectuels; (LGBT) lesbiennes, gais, bisexuel-les et trans; santé sexuell

"It's Like the Pieces of a Puzzle That You Know": Research Interviews With People Who Inject Drugs Using the VidaviewTM Life Story Board

Bei dem Life Story Board (LSB) handelt es sich um ein visuelles Tool, das in therapeutischen Kontexten zum Einsatz kommt, um die Lebenswelt zu ko-konsturieren, die die persönlichen, relationalen und zeitlichen Aspekte individueller gelebter Erfahrung umfasst. In unserer Studie zu Drogennutzung und Schadensreduzierung interviewten wir Menschen, die Drogen injizieren unter Einsatz des LSB, um herauszufinden, ob sich hieraus Potenziale für eine verbesserte qualitative Forschung ergeben könnten. In unserem Forschungsteam arbeiteten neben Akademiker*innen auch frühere oder aktuelle Drogenkonsument*innen mit. Interviews wurden von jeweils zwei Personen geführt: eine agierte als Interviewer*in, die andere war für das LSB zuständig.Entlang der Ergebnisse war nachvollziehbar, dass Interviewende und Interviewte in unterschiedlicher Weise mit dem LSB interagierten: Während die Interviewer*innen es nutzten, um sich im Leitfaden zu orientieren, half es den Befragten, die eigene Lebensgeschichte mittels einer Vielzahl an emotionalen und kognitiven Äußerungen zu validieren oder zu unterstreichen. Das LSB erlaubte, sich an spezifische Situationen oder Vorfälle zu erinnern, Perspektiven hinzuzugewinnen und der eigenen Geschichte zusätzlichen Sinn zu verleihen. Insoweit arbeiteten Interviewte und Interviewende unter jeweils unterschiedlichen Vorzeichen mittels des LSB gemeinsam an einer (Re-)Präsentation der jeweiligen Lebensgeschichte.The Life Story Board (LSB) is a visual tool used in therapeutic circumstances to co-construct a lifescape that represents the personal, relational and temporal aspects of a person's lived experiences. We conducted a study of the drug use and harm reduction experiences of people who inject drugs through research interviews using the LSB to determine whether it has the potential to enhance qualitative research. Our team included community researchers who were current or former drug users and academic researchers. Interviews were conducted by two community researchers: an interviewer and a storyboarder who populated the LSB.Results showed that interviewers and participants interacted with the LSB in different ways. The board functioned to situate the interviewers in the interview schedule, whereas participants often used the board as a way to validate or reinforce their life story. Participants expressed a variety of emotional and cognitive responses to the board. Overall, the LSB helped participants focus on their life story to recall specific occasions or incidents and enabled them to gain perspective and make greater sense of their lives. Both participants and interviewers engaged with the LSB in nuanced ways that enabled them to work together to represent the participant's life story

Capacity building and mentorship among pan-Canadian early career researchers in community-based primary health care

Aim: To describe activities and outcomes of a cross-team capacity building strategy that took place over a five-year funding period within the broader context of 12 community-based primary health care (CBPHC) teams. Background: In 2013, the Canadian Institutes of Health Research funded 12 CBPHC Teams (12-Teams) to conduct innovative cross-jurisdictional research to improve the delivery of high-quality CBPHC to Canadians. This signature initiative also aimed to enhance CBPHC research capacity among an interdisciplinary group of trainees, facilitated by a collaboration between a capacity building committee led by senior researchers and a trainee-led working group. Methods: After the committee and working group were established, capacity building activities were organized based on needs and interests identified by trainees of the CBPHC Teams. This paper presents a summary of the activities accomplished, as well as the outcomes reported through an online semistructured survey completed by the trainees toward the end of the five-year funding period. This survey was designed to capture the capacity building and mentorship activities that trainees either had experienced or would like to experience in the future. Descriptive and thematic analyses were conducted based on survey responses, and these findings were compared with the existing core competencies in the literature. Findings: Since 2013, nine webinars and three online workshops were hosted by trainees and senior researchers, respectively. Many of the CBPHC Teams provided exposure for trainees to innovative methods, CBPHC content, and showcased trainee research. A total of 27 trainees from 10 of the 12-Teams responded to the survey (41.5%). Trainees identified key areas of benefit from their involvement in this initiative: skills training, networking opportunities, and academic productivity. Trainees identified gaps in research and professional skill development, indicating areas for further improvement in capacity building programs, particularly for trainees to play a more active role in their education and preparation

Primary health care engagement among marginalized people who use drugs in Ottawa, Canada

Introduction Engagement in primary health care may be lower among marginalized people who use drugs (PWUD) compared to the general population, despite having greater mental and physical healthcare needs as evidenced by higher co-morbidity, and more frequent use of emergency department care. Objectives and Approach We investigated which socio-structural factors were related to primary care engagement among PWUD using rich survey data from the Participatory Research in Ottawa: Understanding Drugs cohort study; these data were deterministically linked to several robust provincial-level health administrative databases held at the Institute for Clinical Evaluative Sciences. We defined primary care engagement over the 2 years prior to survey completion (March-December 2013) as: not engaged (<3 outpatient visits to the same family physician) versus engaged in care (3+ outpatient visits to the same family physician). Multi-variable logistic regression was used to identify factors associated with primary health care engagement. Results Among 663 participants, characteristics include: mean age of 41.4 years, 75.6% male, 66.7% in the lowest two income quintiles, and 51.1% with 6+ co-morbidities. 372 (56%) were engaged in primary care, with a mean of 15.97 visits per year (SD=20.18). Engagement was significantly associated with the following factors: receiving drug benefits from either the Ontario Disability Support Program (adjusted odds ratio [AOR] 4.48; 95% confidence interval [95%CI] 2.64 to 7.60) or Ontario Works (AOR 3.41; 95%CI 1.96 to 5.91), having ever taken methadone (AOR 3.05; 95%CI 1.92 to 4.87), mental health co-morbidity (AOR 2.93; 95%CI 1.97 to 4.36), engaging in sex work in the last 12 months (AOR 2.05; 95%CI 1.01 to 4.13), and having stable housing (AOR 1.98; 95%CI 1.30 to 3.01). Conclusion/Implications Nearly half of PWUD are not engaged in primary care, representing missed opportunities to improve health. Engagement in primary care may reflect both an increased need for health care, such as mental health disability, and increased access to primary care through other health and social services, such as housing support

Characteristics of Patients with Oseltamivir-Resistant Pandemic (H1N1) 2009, United States

During April 2009–June 2010, thirty-seven (0.5%) of 6,740 pandemic (H1N1) 2009 viruses submitted to a US surveillance system were oseltamivir resistant. Most patients with oseltamivir-resistant infections were severely immunocompromised (76%) and had received oseltamivir before specimen collection (89%). No evidence was found for community circulation of resistant viruses; only 4 (unlinked) patients had no oseltamivir exposure

The A-rich RNA sequences of HIV-1 pol are important for the synthesis of viral cDNA

The bias of A-rich codons in HIV-1 pol is thought to be a record of hypermutations in viral genomes that lack biological functions. Bioinformatic analysis predicted that A-rich sequences are generally associated with minimal local RNA structures. Using codon modifications to reduce the amount of A-rich sequences within HIV-1 genomes, we have reduced the flexibility of RNA sequences in pol to analyze the functional significance of these A-rich ‘structurally poor’ RNA elements in HIV-1 pol. Our data showed that codon modification of HIV-1 sequences led to a suppression of virus infectivity by 5–100-fold, and this defect does not correlate with, viral entry, viral protein expression levels, viral protein profiles or virion packaging of genomic RNA. Codon modification of HIV-1 pol correlated with an enhanced dimer stability of the viral RNA genome, which was associated with a reduction of viral cDNA synthesis both during HIV-1 infection and in a cell free reverse transcription assay. Our data provided direct evidence that the HIV-1 A-rich pol sequence is not merely an evolutionary artifact of enzyme-induced hypermutations, and that HIV-1 has adapted to rely on A-rich RNA sequences to support the synthesis of viral cDNA during reverse transcription, highlighting the utility of using ‘structurally poor’ RNA domains in regulating biological process

Alcohol and cannabis use as risk factors for injury – a case-crossover analysis in a Swiss hospital emergency department

BACKGROUND: There is sufficient and consistent evidence that alcohol use is a causal risk factor for injury. For cannabis use, however, there is conflicting evidence; a detrimental dose-response effect of cannabis use on psychomotor and other relevant skills has been found in experimental laboratory studies, while a protective effect of cannabis use has also been found in epidemiological studies. METHODS: Implementation of a case-crossover design study, with a representative sample of injured patients (N = 486; 332 men; 154 women) from the Emergency Department (ED) of the Lausanne University Hospital, which received treatment for different categories of injuries of varying aetiology. RESULTS: Alcohol use in the six hours prior to injury was associated with a relative risk of 3.00 (C.I.: 1.78, 5.04) compared with no alcohol use, a dose-response relationship also was found. Cannabis use was inversely related to risk of injury (RR: 0.33; C.I.: 0.12, 0.92), also in a dose-response like manner. However, the sample size for people who had used cannabis was small. Simultaneous use of alcohol and cannabis did not show significantly elevated risk. CONCLUSION: The most surprising result of our study was the inverse relationship between cannabis use and injury. Possible explanations and underlying mechanisms, such as use in safer environments or more compensatory behavior among cannabis users, were discussed

The causes and consequences of inbreeding avoidance and tolerance in cooperatively breeding vertebrates

Cooperative breeders provide a particularly interesting scenario for studying inbreeding. Such populations are viscous due to delayed dispersal and short dispersal distances, resulting in the build-up of relatives in the local population. This leads to a high risk of inbreeding, and consequently of inbreeding depression. This has driven the evolution of an array of inbreeding avoidance mechanisms resulting in a relatively low level of close inbreeding in the majority of cooperative breeders. However, there are a number of species where inbreeding occurs relatively frequently. The presence of regular inbreeding (in cases where inbreeding is not a result of recent population declines), suggests that inbreeding tolerance and even preference can evolve under some circumstances. Both inbreeding and inbreeding avoidance mechanisms have enormous downstream fitness consequences for cooperative breeding species. For example, they can influence reproductive dynamics leading to a monopolisation of breeding opportunities by dominant individuals. Inbreeding and its avoidance are also likely to impact on the evolution of cooperative breeding itself through influencing levels of relatedness between potential cooperators. Finally, in some cooperative breeders, a high degree of inbreeding avoidance can be detrimental to population viability, and hence is of particular concern to conservationists. In this review, I discuss these issues in detail and also briefly consider recent advances in the methods available for the study of inbreeding in natural populations