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Background: Many different clinical specialists provide care to patients with Turner syndrome (TS), who have highly variable clinical manifestations. Therefore, a national TS registry is essential to inform a cohesive approach to healthcare and research. In 2015, the Turner Syndrome Society of the United States (TSSUS) created the Turner Syndrome Research Registry (TSRR) to engage directly with community participants who voluntarily provide longitudinal data about their experiences with TS. TSRR projects are collaborative partnerships between people with TS, TSSUS, and researchers. Results: To ensure that registry workflows conform to the data privacy choices of participants, TSSUS collaborated with UTHealth Houston in 2021 to create a new version of the TSRR that completely separates participant health data (stored at UTHealth) and personal identifiers (maintained at TSSUS). We developed an innovative Visual Basic (VB) script that, when embedded into Microsoft Outlook, redirects REDCap surveys through TSSUS to participants by matching registry IDs to participant email addresses. Additionally, the utilization of REDCap allows for portability of data as it is an open source platform. Conclusion: In this report, we will highlight three recent changes that more closely align the TSRR with this mission: a unique and equal collaborative partnership between UTHealth and TSSUS, an open-source platform, REDCap, that ensures data portability and compatibility across institutions, and an innovative survey routing system that retains participant confidentiality without sacrificing REDCap survey distribution capabilities to connect researchers with thousands of participants. [ABSTRACT FROM AUTHOR]

The article presents the discussion on experiencing mental illness just like inpatient medical hospitalization serving the most acutely ill. Topics include mental health systems optimally including a care continuum for meeting people's needs in the most accessible and least restrictive environment; and inaccessible treatment results in homelessness or involvement with the criminal justice system.

In recent years, large-scale protests have forced several incumbent governments in former Soviet countries from power. Scholarly examinations of these events have lacked a cohesive explanation of the reasons for the success of certain movements and the failure of others. This study uses prior research on the dynamics of protest to formulate a game-theoretic model for why protest takes place and how its eventual outcome comes about. The model is tested through logistic regression analyses of monthly protest data. The statistical analysis shows that elections, prior protests and government transgressions increase the likelihood of anti-government protests. [ABSTRACT FROM AUTHOR]

Objective: To assess the efficacy, tolerability, and acceptance of a vaginal ring delivering the equivalent of 50 or 100 microg per day of estradiol (E2), compared with placebo, for relief of moderate to severe vasomotor symptoms and urogenital symptoms in postmenopausal women.Methods: Women with moderate to severe vasomotor symptoms (seven or more per day or 56 per week average) received 13 weeks of treatment with a vaginal ring delivering 50 microg per day E2 (n = 113) or 100 microg per day E2 (n = 112), or a placebo vaginal ring (n = 108). Severity of vasomotor symptoms was assessed by a daily diary card and the Greene Climacteric Scale. Urogenital signs and symptoms were evaluated via patient and physician assessment and vaginal cytology. Participant satisfaction with the vaginal ring was evaluated via questionnaire.Results: Vasomotor symptoms significantly improved in both treatment groups, compared with placebo (P <.05). There was a trend toward greater improvement in patient assessment of urogenital signs with active rings compared with placebo. For women with vaginal atrophy at baseline (n = 60), the maturation index improved significantly in both treatment groups compared with placebo. Total Greene Climacteric Scale scores significantly improved for both E2 vaginal ring groups (P <.05) compared with placebo. The vaginal rings were well tolerated. Most adverse events were mild or moderate and consistent with estrogen therapy.Conclusion: A novel vaginal ring delivering the equivalent of 50 or 100 microg per day of E2 significantly reduced the number and severity of vasomotor symptoms and improved urogenital symptoms, compared with placebo. The E2 vaginal ring was well tolerated. [ABSTRACT FROM AUTHOR]

In 2000, 22 states had tuberculosis (TB) incidence rates less than or equal to the Advisory Council for the Elimination of Tuberculosis (ACET) year-2000 interim objective of 3.5 cases/100,000 population, which is defined as low incidence. These states reported 1,949 TB cases, 11.9% of the national total of 16,377 cases in 2000. Health departments in low-incidence states, and in low-incidence regions within states with higher rates, need distinctive strategies, based on their specific epidemiologic characteristics, for maintaining skills and resources for finding increasingly rare TB cases, containing outbreaks, and ending transmission. Capacity for all the essential components of a TB prevention and control program must be retained at local, state, and national levels; failure to do so increases the risk of a new TB resurgence. In low-incidence areas, especially important are an adequate public health infrastructure and creative integration of resources, some of which until now have not played a role in TB control. Operational research is needed for determining the most efficient control measures. Eventually, with continued success in eliminating TB, low incidence will be attainable in all states, and the nation will profit from the lessons learned in the current low-incidence states. [ABSTRACT FROM AUTHOR]