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Background One of the greatest challenges of gender affirmation for some trans and gender diverse (TGD) people is that one or more of their voice, speech and communication are not congruent with their gender identity or the way they want to present themselves to other people. Speech training is often an intervention of choice to develop a more gender congruent communication and frequently focuses on those aspects which are the most salient in gender perception. According to the systematic review of Leung et al. (2018), intonation is a prosodic component that contributes to gender perception. However, it is not clear to what extent changes in intonation patterns increase the congruence between a person’s speech and their gender identity or preferred gender presentation, and empirical evidence of intonation training is lacking. The aim of this study was to investigate the effectiveness of intonation training on vocal characteristics in gender diverse people using a randomized sham-controlled trial. Methods Currently, fourteen trans women with a desire for speech feminization and 4 non-binary persons with an aim for speech masculinization were included. The participants were randomly allocated to the experimental or control group. The experimental group received 4 weeks of intonation training (4 one-hour sessions) aiming to achieve more gender congruent intonation patterns. The content of the intonation training was selected based on a pilot study conducted by our research group (Papeleu et al., 2022). The control group received 4 weeks of intonation training after 4 weeks of sham training. Based on their group allocation, participants were recorded 3 or 4 times, in between the training blocks: pre, after training 1 (experimental and control group), after training 2 (only control group), and follow-up (after 4 weeks of no intervention). Speech samples included a sustained vowel, continuous speech during reading, spontaneous speech and a standardized intonation protocol published by Leyns et al. (2022). These samples were analyzed using Praat software. Four acoustic intonation parameters (i.e. general intonation shift, final intonation shift, general fundamental frequency (fo) range and fo variation index) as well as, fundamental frequency (fo), intensity, voice range profile (VRP), vowel formant frequencies (F1-2-3-4-5 of /a/-/i/-/u/), aerodynamic measures and vocal quality (AVQI and DSI) were measured. A linear mixed model will be used to compare the acoustic voice measurements between the groups and between measurements at pre, post 1, post 2 and post 3. Results It should be noted that data collection is ongoing and therefore additional analyses will be conducted once data collection is complete. The results will be ready to present at the conference in April. Conclusions This research is likely to lead to new insights for gender affirming speech training and to have an impact on evidence-based practice in speech training for gender diverse people.

AimsTo identify the experiences of nursing in high secure forensic mental health settings that may affect staff recruitment and retention.BackgroundRecruitment and retention of Registered Nurses is a vital international concern in the field of mental health. The high secure forensic setting presents unique challenges for the nurse. Studies of nurse's experiences in this setting have not previously been reviewed in the context of workforce sustainability pressures.DesignAn integrative review (Whittemore and Knapfl, 2005).Data sourcesA systematic search of data sources: MEDLINE (PubMed), PsycINFO, EMBASE, CINAHL, International Bibliography of the Social Sciences, Applied Social Sciences Index and Abstracts (ASSIA), Social Services Abstracts, ProQuest Social Sciences Premium collection (IBSS, PAIS, and Sociological Abstracts), and Web of Science from inception to December 2019.Review methodsData extraction, quality appraisal, and convergent qualitative synthesis.ResultsFifteen papers were selected for inclusion in the review, describing 13 studies. Six studies were quantitative, all cross-sectional surveys. There were seven qualitative studies, using a variety of methodologies. Four themes were identified: engagement with the patient group, the ward social environment, impact on the nurse, and implications for practice.ConclusionWhen policymakers address workforce shortages in high secure forensic nursing they must take account of the unique features of the setting and patient group. Nurses must be adequately prepared and supported to function in an ethically and emotionally challenging environment.ImpactThis study identified factors affecting workforce pressures in the speciality of forensic mental health nursing. Findings are of interest to national nursing policymakers and workforce leads in mental health service provider organizations, seeking to promote forensic nursing as a career option and retain nursing staff.

Service-learning is a rich context for developing reflection skills, promoting learning and personal/professional development. This service-learning project required students to partner with a professional who serves clients in a group setting and plan one group meeting/session. This poster describes reflection assignments and completed projects, and highlights learning promoted through reflection. Previously presented at the Engagement Scholarship Consortium (2013)

Antipsychotic medication is effective in reducing psychotic symptoms but use isassociat-ed with weight gain. Weight gain is associated with an increased risk of a number of life threatening health conditions. Multi-component lifestyle interventions are the recom-mended non-pharmacological way of tacking weight gain and its consequences. This review summarises the evidence for the effectiveness of multicomponent lifestyle intervention in reducing weight and waist circumference in adults taking antipsychotics. The re-view of eight studies found that such approaches are effective, however multiple factors affect success, for example tailoring of information to the cognitive abilities of participants and the use of individual combined with groupapproaches. Eight studies were reviewed. There were some unexpected results within studies, where some control groups lost weight or decreased waist circumference as well as intervention groups. Reasons for significant weight change in control groups was attributed to possible access to weight loss activities outside of the intervention programmes. Adherence to intervention pro-grammes was also important for success. Nurses who support antipsychotic users to lose weight should promote multicomponent approaches that are tailored to the specific needs of this group.

Background: The Dietary Guidelines for Americans 2010 recommend that Americans age two years and older consume seafood, especially fish high in omega-3 polyunsaturated fatty acids, at least twice a week. Although fish is of particular importance during childhood to support proper brain and eye development, it is under-consumed in the US pediatric population. This study examined if substituting salmon for chicken would increase preschooler’s fish consumption. Methods: Two-to-five years old children (n = 45) were served eight lunches (four pairs of comparable chicken versus salmon dishes) twice, totaling sixteen lunches over a period of three months to test the hypothesis that children will consume fish at least once a week, thus increasing docosahexaenoic acid (DHA) intake. The plate waste method was used to collect intake data and consumption of total energy and DHA intake in the chicken and the fish dishes were compared using contrasts within a mixed effect ANOVA (significance at P < 0.05). Results: Dietary intake estimates showed that there were no significant differences in energy intake when the chicken and fish dishes looked similar (macaroni-and-cheese and wraps), but when the fish dishes looked new (nuggets and dumplings), energy intake on fish days was lower than on the chicken day. DHA intake increased significantly on all days the fish was served. Conclusions: This pilot study indicates that fish intake can meet recommendations if salmon is incorporated into familiar dishes such as salad wraps or macaroni-and-cheese, in the childcare setting. Although fish is more expensive, childcare centers may serve this highly nutritious protein once a week without experiencing undue amounts of food wastes if incorporated into well-accepted main dishes. Further studies in larger and more diverse samples of children, different experimental dishes, and longer exposure periods may elucidate additional venues to increase children’s diet quality by increasing consumption of fatty fish.

This article presents the findings of a survey of 225 UK registered mental health nurses. The aim of the study was to measure the subjective wellbeing of a group of UK mental health nurses using three survey measures, and to identify whether certain demographic and workplace factors correlated with subjective wellbeing measure scores. An online survey incorporating the subjective wellbeing questions used by the Office for National Statistics, the Satisfaction with Life Scale and the Warwick Edinburgh Mental Wellbeing Scale was administered to members of two professional bodies for mental health nurses. There was good consistency between the three subjective wellbeing measures, each demonstrating that UK mental health nurses had a relatively low subjective wellbeing. Apart from the Office for National Statistics question, ‘Overall, to what extent do you feel the things you do in your life are worthwhile?’, demographic and workplace factors did not correlate with subjective wellbeing measure scores, although the characteristics of being male, living alone and being aged 40 to 49 were associated with lower mean scores on all three measures. The findings of the exploratory study suggest that a similar study should be undertaken with a larger representative population of mental health nurses, and that qualitative research should be undertaken to explore why and how UK mental health nurses have relatively low subjective wellbeing. The limitations of this study, namely the response rate and sample representativeness mean that the results of this study must be tested in further research on the mental health nurse population.

The conference presentation will focus on a discussion of the results of this study, following a thematic thread from the survey to the interview findings.Background: The study of subjective wellbeing(SWB), or happiness, has gained inter- national research prominence in recent years with it being seen increasingly as a marker of national prosperity (Dolan, Layard & Metcalfe, 2011). This is the first published study of UK mental health nurses using validated SWB measures.Aims: The aim of the study was to measure the SWB of UK mental health nurses, and to identify how nurses with high SWB looked after their own mental health.Methods: This was a mixed methods study. Data was collected between November 2012 and February 2014. In part one a national sample of 237 UK mental health nurses took part in an online survey using three different measures of SWB, including the Warwick Edinburgh Mental Wellbeing Scale (Tennant et al, 2007). In part two a purposive sample of 27 mental health nurses with high SWB were interviewed regarding their mental health and happiness.Results: Study participants had a relatively low SWB compared to national population samples, Happy mental health nurses associated certain activities and attitudes with their SWB. It was associated with spending time in nature, taking exercise, listening to and playing music and practicing mindfulness, reality acceptance, valuing the self and seeking out pleasurable experiences.Discussion: This study has implications for occupational health and human resources policy within healthcare organisations. The findings should inform the content of staff ‘happiness strategies’ and occupational health promotion activities.Conclusion: This is the first study looking specifically as SWB in UK mental health nurses. It provides new insights into how mental health nurses perceive their own happiness, and what can be done to maintain and enhance it.

Ziel dieser Arbeit war es mittels Fluoreszenz-in-situ-Hybridisierungs (FISH)-Technik wiederkehrende chromosomale Aberrationen in Genorten für den JAK/STAT-Signalweg (IL6ST, JAK2, STAT2, STAT6, STAT3/5A/5B) und Komponenten der Zentrosomenaktivität (PLK1, STK15) im klassischen Hodgkin-Lymphom (cHL) zu identifizieren. Zunächst mussten neue Interphase-FISH-Assays validiert werden, mit denen numerische und strukturelle Veränderungen der genannten Genloci nachgewiesen werden können. Es wurden 36 cHL-Primärfälle und 4 cHL-Zelllinien mit den FISH-Assays hybridisiert. Zusätzlich wurden Tissue Microarrays (TMA) von 33 cHL-Primärfällen mit dem JAK2-Assay untersucht. Von 36 hybridisierten Fällen waren 21 auswertbar. Amplifikationen und Zugewinne von JAK2 wurden in je 4 Fällen (19%) gefunden. Untermauert werden diese Ergebnisse durch die TMA-Analysen für das JAK2-Gen. Hier zeigten 12 Fälle (57%) Zugewinne oder Amplifikationen. Interessanterweise traten in 4 der cHL-Fälle (19%) JAK2-Verluste auf. In 4 Fällen (19%) zeigten sich Zugewinne oder Amplifikationen der Genloci STAT2 und STAT6. Die Genloci IL6ST, STAT3/5A/5B, PLK1 und STK15 wiesen keine signifikanten Veränderungen auf. Wiederkehrende chromosomale Bruchpunkte der untersuchten Loci wurden nicht entdeckt. Die Ergebnisse dieser Arbeit bestätigen, dass Zugewinne von JAK2 die häufigsten genomischen Veränderungen der JAK/STAT-Signaltransduktionskaskade im cHL darstellen. Außerdem konnten erstmals wiederkehrende Zugewinne von STAT2 und STAT6 beschrieben werden. Ein Zusammenhang zwischen Veränderungen der Zentrosomen-Gene PLK1 und STK15 und im cHL gefundenen Auffälligkeiten der Zentrosomen und der Zellstruktur sind dagegen unwahrscheinlich.

The cleaner wrasse Labroides dimidiatus occupies fixed ‘cleaning stations’ on coral reefs, which ‘client’ reef fish visit repeatedly to have parasites removed. Conflict arises because cleaners prefer to cheat by feeding on client mucus instead of parasites. Clients can prevent L. dimidiatus from always cheating using control mechanisms such as chasing and partner switching, which depend on repeated interactions. These control mechanisms would be undermined in the absence of frequent repeated interactions, if cleaners roved over large areas. Roving behaviour has been anecdotally described for the closely related cleaner wrasse Labroides bicolor. Here we report field data comparing these two species in Moorea, French Polynesia. Our results confirmed that L. bicolor home ranges are much larger than L. dimidiatus home ranges, and showed that cleaning interactions occurred all over the L. bicolor home range: home range of cleaning interactions increased with total home range size. Moreover, we found that cleaner initiation of interactions increased with home range size in L. bicolor, which would give L. bicolor with large home ranges additional leverage to increase cheating. In line with these results, we found that client jolt rate (used as a measure of cheating) was higher among clients of cleaners with large home ranges. Our results emphasise the importance of game structure and control over initiating interactions as parameters in determining the nature of interactions in mutualisms.

This technical report summarizes new and existing data to address the question, “Does Head Start work for Indiana children, families, and communities?” Data sources consulted in this study include the state Head Start Program Information Report, local Indiana Head Start and Early Head Start Programs, existing national studies of Head Start and Early Head Start, and local and national data available on children’s development in early care and education programs for low-income families. This report concludes that Indiana’s Early Head Start and Head Start programs are indeed providing substantial benefits to children, families, and communities. The report summarizes the outcomes on each of these levels, and provides recommendations for policy and future research.

This study explores the subjective wellbeing and subjective experience of mental health problems in UK mental health nurses using a mixed methods approach. It aimed to understand the relationships between mental health nurses' own mental health and their subjective wellbeing, and to explore the ways in which mental health nurses managed their own mental health and wellbeing and how they negotiated for and use their experiences both within and outside of their work.\ud \ud The mixed methods design had two phases. In phase one an online survey was sent to mental health nurses via their national professional bodies, the Royal College of Nursing and the Mental Health Nurses Association. The survey comprised three measures of subjective wellbeing, questions about personal and familial mental health history and questions about the impact of these experiences on mental health nursing work. 237 survey responses were included in the final statistical analysis. In the second phase 27 semi structured interviews were undertaken with a purposive sample of survey respondents who had both subjective experience of mental health problems and high subjective wellbeing.\ud \ud A major finding of the study was that mental health nurses critically appraised their experience of delivering and receiving mental health care from the expert perspectives of both being a nurse and having their own experience of mental ill health.\ud \ud Personal experience of mental illness was found to influence nursing practice in a number of ways: first, through overt disclosure and negotiation of professional boundaries; second, through the ‘use of the self as a tool’, the emotional labour of nursing; third, through the formation and development of professional nursing identity. This was in the context of a broader canvas of life experiences which participants considered to influence the development of their nursing identity, the use of self and self disclosure in their work.\ud \ud Mental health nurses in this study had a relatively low subjective wellbeing. Low subjective wellbeing was associated with having current mental health problems, and with having past experience of mental health problem. Personal experience of living with someone with mental health problems was associated with relatively higher subjective wellbeing.\ud \ud This study has implications for occupational health and human resources policy within healthcare organisations. The findings suggest that mental health nurses who present to primary care or occupational health services should be offered care and treatment commensurate with their expertise and experience. Employers’ ‘staff happiness strategies’ and occupational health promotion activities should address work life balance and what nurses could do outside of their work to be well, as well as addressing the effects that team and management changes have on staff wellbeing.