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While evidence supports the need for increased provider education on gender-affirming care, few medical curricula address the healthcare needs of transgender and non-binary (TGNB) patients. To bridge this knowledge gap, we developed an online learning module to educate medical students (MS) in the care of this underserved population. The module included topics such as TGNB health disparities, gender dysphoria, and gender-affirming therapy. We hypothesized that learners would possess greater knowledge and self-efficacy following completion of the module. A cohort of 272 first- (MS1) and second-year medical students (MS2) from a single institution received protected time during their academic training to complete the mandatory online module (total duration: 60 minutes). Of those, 90 learners consented to participate in our IRB approved study and completed pre- and post-module surveys. Surveys assessed the impact of the educational module on self-reported knowledge and self-efficacy pertaining to learning objectives. Most participants self-identified as cisgender (97%), while 40% of those who chose to answer reported being part of LGBTQIA+ community. Baseline knowledge scores ranged from 7 (not knowledgeable) to 35 (knowledgeable). Following completion of the module, the median knowledge score significantly increased by 9 points (23 to 32; p Our data showed that an online educational module on gender-affirming care was successful in increasing knowledge and self-efficacy in surveyed MS1 and MS2 at our institution. Education of healthcare providers is a key step towards improving care for TGNB patients. Therefore, more institutions should adopt formal curricula for MS on gender-affirming care to mitigate health disparities in this vulnerable population. Similar modules could be adapted to educate already practicing clinicians and support staff to ensure a more gender-inclusive healthcare environment. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.

Background Apoplexy of benign neurenteric cysts can present with acute onset of a severe headache. Pituitary dysfunction, such as hypothyroidism and diabetes insipidus, can occur after transsphenoidal resection of these cysts. Clinical Case A 14-year-old male presented to the ED with acute onset of a severe headache, nausea and emesis. He denied recent vision changes, weight changes, temperature intolerance, diarrhea, constipation, skin changes, polyuria, or polydipsia. He reported starting puberty by 13 years of age. He was treated with Zofran, Tylenol, and Dexamethasone which led to headache resolution. His MRI showed a trans-sellar structure measuring 12 by 16 mm and demonstrating internal intrinsic T1 hyper-intensity, deep T2 hypo-intensity, and mildly thickened peripheral enhancement. The lesion abuts the undersurface of the optic chiasm and the stalk enhances normally. The neurohypophysis is not well identified. The optic nerves are unremarkable, and the optic chasm is slightly bowed superiorly. His initial labs were significant for: Na 136 mmol/L, K 4 mmol/L, TSH 1.15 uIU/mL, FT4 0.81 ng/dL, IGF-1 286 ng/mL, cortisol Conclusion This case demonstrates that neurenteric cyst apoplexy can occur in teenagers who present with the acute onset of a severe headache with associated nausea and emesis. This case demonstrates the importance of thoroughly investigating the patient's pituitary function at baseline and post-operatively since pituitary deficiencies, such as DI, can occur. Presentation: No date and time listed

Tricyclic antidepressants (TCAs) were originally designed and marketed for treating depression, but over time they have been applied to a variety of conditions, mostly off-label. TCAs can serve as first-line or augmenting drugs for neuropathic pain, headache, migraine, gastrointestinal syndromes, fibromyalgia, pelvic pain, insomnia, and psychiatric conditions other than depression. This article reviews pharmacology, dosing, and safety considerations for these uses.

In this research, a series of case studies of heroic era (1898 to 1917) Antarctic exploration parties which included sledge dogs were examined. Eight expedition parties were investigated with a focus that accorded the sledge dogs status as actual, and reciprocating, historical actors alongside the men. The findings illuminate the seemingly contradictory roles of the sledge dogs; as expendable commodities, co-workers, shipmates and companions. Polar exploration is shown to provide an exceptional circumstance in which to examine the complexity of trans-species emotional relationships. The research contributes to the growing field of animal-human histories, and to polar historiography.

Teachers must address both children’s academic and social needs to maintain a supportive and optimal learning environment. In order to successfully create and maintain an optimal learning environment, teachers’ influence on children’s peer relations in the classroom must be intentional. This can be accomplished by addressing how psychological research on children’s peer relations can be explicitly applied to the classroom context. This review addresses contemporary research in children’s peer relations during the elementary school years with a primary focus on how teachers can intentionally influence children’s peer acceptance in classroom settings. Teachers should intentionally shape children’s peer relations in their elementary classrooms through increasing their attunement to peer group affiliations, using classroom management strategies that foster intended classroom norms, and using classroom spatial arrangements effectively.

The purpose of this article is to describe a substantive theory that details how adolescents manage living with a parent experiencing chronic noncancer pain (CNCP).Grounded theory methods were used to recruit 30 young adults, ages 18 through 21 years, from community settings.During open-ended interviews, participants were asked to look back on their adolescence and talk about how they managed living with parental chronic pain. Interview transcripts and field notes were analyzed using constant comparative methods.Participants who lived with heavily shrouded parents (a) endured hardships; (b) distanced themselves; (c) lamented losses; and (d) held back on revealing their authentic selves. Those who lived with minimally shrouded parents (a) received nurturance and parenting; (b) empathized with their parents' pain situations; (c) lamented losses; and (d) revealed to their parents how parental pain affected them. Participants who connected with significant others "filled the gaps" created by parental pain disability, while those who did not connect with significant others "cooped up" their thoughts, feelings, and needs.Findings shed light on psychosocial processes and behavior within families experiencing CNCP and serve as the basis for the development of personalized family interventions.Nursing interventions should focus on helping adolescents and parents build interpersonal relationship and communication skills. Aggressive diagnosis and treatment of mood disturbance in the parent with CNCP should be part of a holistic treatment plan.

This introduction is a critical response to claims made about the demise and revival of the sub-discipline of kinship studies. Contemporary calls to a reclaimed and revitalised area rest, ironically, on a misplaced concentration on the preoccupations of dominant cultures, one of the grounds used to discard kinship in the past. It is argued that many of the issues debated up to the 1970s in the domain of kinship involve more general problems such as arguments about structure and process, gender and biology and the way in which indigenous categories are to be apprehended and accommodated in a genuinely comparative discipline. The case is also made that kinship's demise is largely an Anglocentric phenomenon and that the continuing importance of many of the issues debated in the past, such as the relationship between people and land and its local ideological representations and global consequences, make knowledge of kinship's more exotic manifestations vital to contemporary graduates. The final section introduces the papers in the volume, each of which addresses, in a contemporary and critical way, an area that was important to previous kinship debates and remains of interest in the present.

Arrowtooth flounder soluble protein powder (AFSP) and arrowtooth flounder insoluble protein powder (AFISP) were evaluated for their functional, nutritional, and rheological properties. AFSP and AFISP contained 80% and 79% protein and 5.9% and 14.9% fat, respectively. Yield of AFSP (8.6%) was less than AFISP (13.1%). AFSP and AFISP had desirable essential amino acid and mineral contents. Emulsion stability of AFSP was greater than AFISP. Fat and water absorptions (mL/g protein) were 5.2 and 1.8 for AFSP, respectively, and 3.3 and 4.2 for AFISP Mayonnaises made from AFSP had greater emulsion stability than mayonnaise made from AFISP. Mayonnaises from both AFSP and AFISP possessed pseudoplastic and viscoelastic characteristics.

In comparative political theory in Anthropology, Pacific leadership has had a prominent place, with a long history of debate about typologies and forms. In this paper I eschew such approaches in favour of a demonstration of the complexity of interactions fostered in local communities by interpretations of a protean ‘tradition’, refracted by a history of encounters with modernity and its social imaginary at a particular historical moment. The narratives of three local leaders in Vanuatu's recent history, provide a context for evaluating the relative merits of such typologies when the grounds of leadership itself are contested.

Recent writing on the ethnogeography of Vanuatu has identified mobility and primordial connection as two counterpoised aspects of connection to place that have a long history in the archipelago. These themes are taken up in this paper in the specific case of north Ambrym, an island community in north-central Vanuatu in which the accidental geography of active volcanoes has fostered an equally active interest in making connections outside the island. In the post-contact period, Ambrymese were more mobile than many of their neighbours, as they recruited vigorously in a labour trade taking them to distant destinations and facilitating a fragmentation of the local population, already decimated by introduced disease. In addition, conversion of a large proportion of the population to Christianity brought local movement. The named domains, with their primordial connections to ancient sites replete with cosmo-mythic significance, were reconstituted as villages of one denomination or another, containing members of many different origin sites. Cash-cropping became characteristic of coastal, Christian settlements whose residents saw themselves as opposed to their ‘heathen’ neighbours. For the bush-folk, kastom was both symbolic of their identification with the past and their justification for exclusive access to its popular manifestations in the artefact trade, in the present. In the pre-Independence 1970s, local politics and pressure on productive resources including kastom, forced a radical re-emphasis on primordial connection at the expense of the more ‘rhizomatic’ attachments inside and outside domains, the boundaries of districts and even the island itself that had been, until then, more characteristic of Ambrymese place-making.

Chronic non-cancer pain (CNCP) is a prevalent occurrence and is experienced by adults in their child-rearing years. Communication within the family about parental illness can be formidable, and family members are often uninformed about illness details. To date, there is no research exploring how children and adolescents understand parental chronic pain, a very complex phenomenon, and its related disability. The aim of this study was to develop a substantive theory that describes how adolescents manage the experience of living with a parent suffering with CNCP and environmental factors that help or hinder this process. Grounded theory was used, the focus of which was adolescents' processes of dealing with parental illness in the interpersonal and environmental contexts of their daily lives. A sample of 30 young adults was recruited in northeastern Ohio using theoretical sampling. During open-ended interviews, participants were asked to look back on their adolescence and talk about how they managed living with parental chronic pain. Interview transcripts and field notes were analyzed using constant comparative methods. Six ways of understanding parental chronic pain emerged from the data: noticing something is different, wrestling with not knowing, searching for answers, questioning the validity of pain, developing insight into the complexity of pain, and learning important life lessons. Findings shed light on how adolescents understand and attach meaning and significance to parental chronic pain and disability and serve as the basis for the development of personalized family interventions.

The goals of this program were to discover and implement a redox shuttle that is compatible with large format lithium ion cells utilizing LiNi{sub 1/3}Mn{sub 1/3}Co{sub 1/3}O{sub 2} (NMC) cathode material and to understand the mechanism of redox shuttle action. Many redox shuttles, both commercially available and experimental, were tested and much fundamental information regarding the mechanism of redox shuttle action was discovered. In particular, studies surrounding the mechanism of the reduction of the oxidized redox shuttle at the carbon anode surface were particularly revealing. The initial redox shuttle candidate, namely 2-(pentafluorophenyl)-tetrafluoro-1,3,2-benzodioxaborole (BDB) supplied by Argonne National Laboratory (ANL, Lemont, Illinois), did not effectively protect cells containing NMC cathodes from overcharge. The ANL-RS2 redox shuttle molecule, namely 1,4-bis(2-methoxyethoxy)-2,5-di-tert-butyl-benzene, which is a derivative of the commercially successful redox shuttle 2,5-di-tert-butyl-1,4-dimethoxybenzene (DDB, 3M, St. Paul, Minnesota), is an effective redox shuttle for cells employing LiFePO{sub 4} (LFP) cathode material. The main advantage of ANL-RS2 over DDB is its larger solubility in electrolyte; however, ANL-RS2 is not as stable as DDB. This shuttle also may be effectively used to rebalance cells in strings that utilize LFP cathodes. The shuttle is compatible with both LTO and graphite anode materials although the cell with graphitemore » degrades faster than the cell with LTO, possibly because of a reaction with the SEI layer. The degradation products of redox shuttle ANL-RS2 were positively identified. Commercially available redox shuttles Li{sub 2}B{sub 12}F{sub 12} (Air Products, Allentown, Pennsylvania and Showa Denko, Japan) and DDB were evaluated and were found to be stable and effective redox shuttles at low C-rates. The Li{sub 2}B{sub 12}F{sub 12} is suitable for lithium ion cells utilizing a high voltage cathode (potential that is higher than NMC) and the DDB is useful for lithium ion cells with LFP cathodes (potential that is lower than NMC). A 4.5 V class redox shuttle provided by Argonne National Laboratory was evaluated which provides a few cycles of overcharge protection for lithium ion cells containing NMC cathodes but it is not stable enough for consideration. Thus, a redox shuttle with an appropriate redox potential and sufficient chemical and electrochemical stability for commercial use in larger format lithium ion cells with NMC cathodes was not found. Molecular imprinting of the redox shuttle molecule during solid electrolyte interphase (SEI) layer formation likely contributes to the successful reduction of oxidized redox shuttle species at carbon anodes. This helps to understand how a carbon anode covered with an SEI layer, that is supposed to be electrically insulating, can reduce the oxidized form of a redox shuttle.« less

There is a scarcity of research on the impact of trauma team member communication on performance. Anecdotal evidence tells of "talking to the air"--asking for tasks to be completed by no one in particular. Human factors techniques were used to analyze the communication patterns in trauma team performance. Video of trauma cases were observed and analyzed. Proposed solutions will be simulated in a state of the art simulation center.

The Trobriand Islands. Despite Malinowski's several works on the Trobriands it is difficult to isolate the data on particular institutions. As Fortes noted, the facts concerning local organisation, kinship, and political structure are given piecemeal "where they are needed as the indispensable bones and joints on which to hang the flesh and blood of his descriptions" (Fortes, 1957: 164). Nor is there always consistency in the accounts. Although I designated the Trobriand parish as monocarpellary, it is not always so. Malinowski does not indicate specifically the proportion of villages associated with a single sub-clan as against those containing more than one {vide Coral Gardens, p. 346). Nevertheless, it would appear that most marriages are extra parish, indicating that monocarpellary parishes probably predominate (Malinowski, 1927: 11: 45). Sons therefore must move from one community to another. The fact that parishes are not necessarily monocarpellary does not alter the designation of Trobriand society as Type A. The important point is that the in-group is dispersed, as Malinowski's description of a garden team shows (a village community "exploit jointly their garden lands ..." (ibid): 69). "There is a permanent core, which is formed by the sub-clan ... On the other hand, the non-citizen residents change . . . The citizens may marry women from a great many other sub-clans. The offspring of such unions belong to an ever shifting variety of alien kinship groups". (Malinowski 1935: 357) The difference between in-group and out-group is marked. All the members of the matrilineal sub-clan are of the same body and constitute the in-group. All others, including a person's father and spouse, are members of the outgroup, categorised as tomakava (strangers) (ibid: 47). But, as previously noted, the members of both groups necessarily live together in the same parish. Conflict frequently takes place within the parish. Almost all disease, death, and misfortune are attributed to the machinations of sorcerers or witches (Malinowski, 1922: 76-78). Malinowski's cursory treatment of this subject has occasioned valid criticism (see Nadel, 1957a: 194-5). He made no attempt to place the phenomena in context except in a tendentious account of the way in which sorcery allegedly supports law and order. The dubious validity of the conclusion in Crime and Custom may be

A NTHROPOLOGISTS have recently made amends for their earlier lack of ?\. attention to sorcery and witchcraft by producing considerable literature on the subject.1 The institutions have received most attention in Africa, and in consequence theoretical propositions have been largely based on data from that region. No comprehensive account of the Melanesian phenomena has been published, but even a cursory appraisal of regional studies suggests that there are significant differences between these institutions in the Pacific and Africa. My aim here is to present a theoretical framework suited to the Melanesian data. I propose a hypothesis concerning the relation between sorcery and witchcraft and certain other social variables, and in the final section of the paper I test the hypothesis in a survey of the available ethnography for that region.2 My reasons for proposing this particular framework will be made clear perhaps by a brief examination of some of the major theories that have been utilised by anthropologists in explaining sorcery and witchcraft phenomena.