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LGBTQ+ (lesbian, gay, bisexual, transgender, queer, plus) people, compared to their heterosexual and/or cisgender (non-transgender) counterparts, are more likely to be discriminated against based on their gender or sexual identities. Drawing on data from The OutLook Study in Waterloo Region, Ontario, Canada this paper examines discrimination and social support among high school and post-secondary students, and how they are related to self-esteem. We found that transgender students in high school reported significantly higher levels of direct transphobia and of victimization compared to transgender post-secondary students. We found indirect homophobia and indirect transphobia had a significant adverse relationship to self-esteem. Further, social support from friends was related to higher self-esteem for cisgender LGBQ students, but not for transgender students. These findings have the potential to inform school-based policies and mental health interventions in support of improved wellbeing for LGBTQ+ students.

This study adapted a participatory action research (PAR) approach as part of student-staff collaboration aimed at co-producing a research-engaged pedagogy to provide vocational students with access to curricular opportunities to develop their academic capabilities. This article focuses on the co-creation process between seven multidisciplinary higher education (HE) students at different stages in their studies and two academic support staff. The participants immersed themselves in a double-loop inquiry process, researching student perceptions of belonging in their institution to co-produce knowledge to develop a research-based pedagogy. Working with the concept of epistemic injustice, we consider how participation in the inquiry influenced the student participants' sense of credibility as knowers and producers of knowledge. Attention is paid to how the cycle of shared reflection and adaptation inherent in the PAR approach re-characterised power relationships between staff and students. We discuss how moments of discomforting disequilibrium were catalytic in the redistribution of power across the group. We maintain that adapting a PAR approach aimed at contributing to the Scholarship of Teaching and Learning (SoTL), provides students with opportunities to develop their epistemic confidence. However, for this to happen, students and staff must be willing to work with disequilibrium which emerges as student-staff power dynamics are challenged.

Pre-exposure prophylaxis (PrEP) is an effective HIV-prevention tool for gay, bisexual, and other men who have sex with men (GBMSM), a group known to be disproportionately affected by HIV/AIDS. We [...]

Climate change and sea level rise degrade the environment, infrastructure, and private property along US coastlines. The magnitude of these harms will only accelerate unless the United States improves its coastal protection scheme. Informed by approaches in Israel, the United Kingdom, and China, this Note offers a dynamic solution to coastline protection by way of a federal Rolling Coastal Conservation Easements Act. The act would authorize states to develop and implement rolling easements on private coastal properties. This flexible scheme would include compensation for those landowners who grant easements to their localities, while giving private property owners the option to deny the government's easement. This market-driven program gives states the notice, information, and transparency capacities to implement more meaningful and broad-reaching coastline protections by way of these rolling coastal conservation easements., TABLE OF CONTENTS I. INTRODUCTION 714 II. THE CURRENT STATE OF CLIMATE CHANGE AND SEA LEVEL RISE 717 III. REGULATORY TAKINGS AND COASTLINE PROTECTION IN THE UNITED STATES 720 A. [...]

It is well-known that trans and non-binary individuals experience worse health outcomes due to experiences of violence and discrimination. For this reason, accessible healthcare for trans and non-binary people is crucial. There is a lack of Canadian literature on the experiences of non-binary people within the healthcare system. This study sought to understand barriers to healthcare among non-binary people living in a mid-sized urban/rural region of Canada. Interviews were conducted between November 2019 to March 2020 with 12 non-binary individuals assigned female at birth, living in Waterloo Region, Ontario, Canada, as a part of a larger qualitative study exploring experiences within the community, healthcare and employment. Three broad themes were developed: erasure, barriers to access to healthcare, and assessing whether (or not) to come out. Sub-themes included institutional erasure, informational erasure, general healthcare barriers, medical transition healthcare barriers, anticipated discrimination, and assessing safety. Policy and institutional changes are needed to increase the safety and accessibility of healthcare services to non-binary individuals. [ABSTRACT FROM AUTHOR]

HIV testing and diagnosis are the gateway into treatment and eventual viral suppression. With gay, bisexual, and other men who have sex with men (GBMSM) persistently over-representing new HIV diagnoses in Canada, combined with the evolving nature of community social connection, an exploration of factors associated with recent HIV testing is warranted. As most studies of GBMSM rely on samples obtained from larger metropolitan regions, examining HIV testing from an under-researched region is necessary. With data collected from an online survey of LGBTQ+ persons 16 or older living, working, or residing in the Region of Waterloo, Ontario, Canada, we used multinomial logistic regression to explore socio-demographic, behavioural, and psychosocial factors associated with recent HIV testing for GBMSM. In the final multivariate multinomial logistic regression model: sense of belonging was associated with more recently testing, as was having an increasing proportion of LGBT friends, app use to find sex partners in the past 12 months, access to the local AIDS service organization, and general sense of belonging to local community, among other. This analysis highlights the continued importance of enabling and need factors when accessing testing, and suggests areas for further testing promotion in physical and virtual spaces frequented by GBMSM. [ABSTRACT FROM AUTHOR]

This study adapted a participatory action research (PAR) approach as part of student-staff collaboration aimed at co-producing a research-engaged pedagogy to provide vocational students with access to curricular opportunities to develop their academic capabilities. This article focuses on the co-creation process between seven multidisciplinary higher education (HE) students at different stages in their studies and two academic support staff. The participants immersed themselves in a double-loop inquiry process, researching student perceptions of belonging in their institution to co-produce knowledge to develop a research-based pedagogy. Working with the concept of epistemic injustice, we consider how participation in the inquiry influenced the student participants' sense of credibility as knowers and producers of knowledge. Attention is paid to how the cycle of shared reflection and adaptation inherent in the PAR approach re-characterised power relationships between staff and students. We discuss how moments of discomforting disequilibrium were catalytic in the redistribution of power across the group. We maintain that adapting a PAR approach aimed at contributing to the Scholarship of Teaching and Learning (SoTL), provides students with opportunities to develop their epistemic confidence. However, for this to happen, students and staff must be willing to work with disequilibrium which emerges as student-staff power dynamics are challenged. [ABSTRACT FROM AUTHOR]

Background: End-of-life care requires support for people to die where they feel safe and well-cared for. End-of-life care may require funding to support dying outside of hospital. In England, funding is procured through Continuing Healthcare Fast-Track funding, requiring assessment to determine eligibility. Anecdotal evidence suggested that Fast-Track funding applications were deferred where clinicians thought this inappropriate due to limited life-expectancy., Aim: To evaluate overall survival after Fast-Track funding application., Design: Prospective evaluation of Fast-Track funding application outcomes and survival., Setting/participants: All people in 2021 who had a Fast-Track funding application from a medium-sized district general hospital in Southwest England., Results: 439 people were referred for Fast-Track funding with a median age of 80 years (range 31-100 years). 413/439 (94.1%) died during follow-up, with a median survival of 15 days (range 0-436 days). Median survival for people with Fast-Track funding approved or deferred was 18 days and 25 days, respectively (p=0.0013). 129 people (29.4%) died before discharge (median survival 4 days) and only 7.5% were still alive 90 days after referral for Fast-Track funding., Conclusions: Fast-Track funding applications were deferred for those with very limited life-expectancy, with minimal clinical difference in survival (7 days) compared with those who had applications approved. This is likely to delay discharge to the preferred place of death and reduce quality of end-of-life care. A blanket acceptance of Fast-Track funding applications, with review for those still alive after 60 days, may improve end-of-life care and be more efficient for the healthcare system., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)