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Background: While research on trans People of Color's experiences has been increasing in recent years, this intersectional work has often not included a focus on the specificities of multiracial and multiethnic trans experiences. Aims: This study explores shifts in racial identity by multiracial/multiethnic trans people as they transition gender and the ways Whiteness and nationalist ideology shape their racialized gender experiences. Methods: This paper is based on six in-depth, semi-structured interviewswith self-identifiedmultiracial, multiethnic, andmulti-heritage trans people in the USA. Data collection centered participants' experiences of self-identification and interactionswith others (e.g., family, acquaintances, and strangers). Results: As participants transitioned gender and were acknowledged by others in their gender identity, shifts in their embodiment were used by others to ascribe a new racialized gender. This often resulted in participants reflecting on their sense of self and racialized gender identities in new ways. Discussion: Multiracial and multiethnic transgender people's experiences in transitioning race confirm the importance of intersectional analysis, reveal the intersectional fluidity of social categories, explicate how social understandings of one category (e.g., race) influence another category (e.g., gender), demonstrate that the meanings associated with racialized gender are based in relations of power, and show that, in transgender studies particularly, we must attend to the ways that the concept of transition implicates not only gender, but also other categories such as race and nationality. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this paper was to determine the extent to which dry needling is instructed in entry-level education programs for physical therapists. Methods: Program directors from 226 entry-level education programs recognized by the Commission on Accreditation in Physical Therapy Education were recruited via e-mail to participate in an anonymous 35-item electronic survey during the 2017-2018 academic year. The survey evaluated dry needling curricula, faculty qualifications, attitudes and experience, and programs' future plans for teaching dry needling. Results: A total of 75 programs responded to the survey (response rate = 33.1%). Forty (53.3%) had integrated dry needling theory and psychomotor training into their programs and 8 (10.6%) planned to include such content in their curriculum in the future. Of the 40 respondents, 28 indicated that dry needling education was integrated into a required course, 4 indicated that dry needling was an elective course, and 8 did not specify how dry needling education was integrated. Faculty teaching dry needling appear to be well qualified, with the majority having 5-10 years of experience using dry needling in clinical practice. The primary reason for programs not teaching dry needling is that it was not considered an entry-level skill. Discussion: There appeared to be variability in how dry needling was integrated into the curricula, as well as in the depth and breadth of instruction. Our research may serve as a baseline for faculty to assess existing dry needling curricula and as a guide for developing curricula in new or existing physical therapy programs. [ABSTRACT FROM AUTHOR]

Objective: This study aims to identify facilitators and barriers of Human Papillomavirus (HPV) vaccine acceptance, initiation, and completion among LGBTQ (lesbian, gay, bisexual, trans, and queer) individuals. Method: A systematic review of qualitative and quantitative studies on HPV vaccine acceptance, initiation, and completion from 2006 to June 15, 2020 was performed in each database. Results: Twenty-six studies focusing on HPV vaccination among LGBTQ individuals were reviewed. Conclusions: Knowledge of HPV vaccine and healthcare providers' recommendations were identified as facilitators to receive HPV vaccinate, while high co-pay cost and concerns of the effectiveness and safety were identified as barriers. [ABSTRACT FROM AUTHOR]

Attitudes have been widely studied as predictors of a number of social and health behaviors. However, attitudes predicting sleep outcomes have only recently been examined, despite sleep being conceptualized as an important health behavior. Prior research has demonstrated that attitudes toward sleep are associated with sleep hygiene, sleep duration and quality (Peach & Gaultney, 2017; Peach, Gaultney, Ruggiero, 2018). Sleep attitudes interact with varying demographic identities, such as age, gender, race, and perceived socioeconomic status (SES) (Ruggiero, Peach, & Gaultney, 2019). The present study hypothesized that (1) sleep attitudes would be indirectly associated with sleep outcomes (duration and quality) via sleep hygiene, and, (2) this indirect effect would be modified by specific demographic variables (age, gender, race, and perceived SES; moderated mediation). One hundred and seventy-two adults from the United States completed an anonymous survey on sleep characteristics and health. Results confirmed the first hypothesis, indicating that sleep attitudes were significantly and indirectly associated with both sleep duration and sleep quality via sleep hygiene. Additionally, gender and SES further modified these significant indirect effects, meaning hypothesis two was partially supported. Results are discussed in terms of their implications for the importance and variability of sleep attitudes, and future research directions are considered. [ABSTRACT FROM AUTHOR]

Objective: The article studied the knowledge and practice patterns of primary care providers and internal medicine residents in their initial evaluation of thyroid nodules and determined whether their practice is in accordance with published guidelines by the American Thyroid Association and American Association of Clinical Endocrinologists. Method: A survey was distributed to primary care physicians (PCPs) and internal medicine residents at a community hospital in Baltimore and a chart review was conducted at the Diabetes and Endocrine Center in the same hospital. Results: A total of 47 physicians (70%) responded to the survey, 16 PCPs and 33 residents. Most responders (96%) will always obtain a TSH, and of these, 21% of PCP and 25% of residents will obtain a TSH without any other laboratory work-up. Fifty percent of the physicians (PCP, 75%; resident, 39%) will always obtain a thyroid ultrasound (p=0.043). Most physicians (97%) will refer for a fine-needle aspiration (FNA) biopsy of a nodule >1 cm. Sixty-two percent of the physicians will not put a euthyroid patient on levothyroxine suppression therapy. Many physicians (48%) are not aware of the AACE and ATA thyroid nodule guidelines. Most physicians (65%) have not read the guidelines. Of the 113 charts reviewed, TSH was obtained alone in 40% and with other laboratory tests in 74%. Thyroid ultrasound was done in 67%. Only one patient was on levothyroxine for levothyroxine suppression therapy. Discussion: Although many physicians were not aware of the guidelines, and a small number of physicians have read them, many PCP and residents responded in concordance with the guidelines in obtaining TSH, an ultrasound, performing FNA biopsy, and not providing levothyroxine suppressive therapy in euthyroid patients. No differences were found between the responses of PCP and residents except for obtaining an ultrasound. Chart review data also showed that majority of tests ordered for non-toxic thyroid nodule evaluation were in agreement with the guidelines. Limitations include lowsurvey response rate among PCPs and that results are from one community hospital. Conclusion: Our findings from the survey and chart review conclude that majority of primary care physicians were initiating the appropriate work up of thyroid nodules prior to referral to a specialist. [ABSTRACT FROM AUTHOR]