Incidence, Risk Factors and Management of Postoperative Complications in Horizontal Strabismus Surgery.

OBJECTIVE: To report the incidence, risk factors and management of postoperative complications after horizontal strabismus surgery. DESIGN: Retrospective Cohort study. PARTICIPANTS: The study assessed 1,273 patients with 1,035 cases of exotropia and 238 cases of esotropia, with a minimum 18-month follow-up. METHODS: Retrospective review of strabismus operation patients' medical records included baseline demographics, age at surgery, pre/postoperative visual acuity, and deviation. Complications were categorized as surgical site (infection, scarring, cyst, granuloma, ischemia) and strabismus-related (recurrence, diplopia), with analysis of incidence, risk factors, and management. RESULTS: Among surgical site complications, the incidence of infection, pyogenic granuloma, and anterior segment ischemia were similar between the exotropia (0.3%, 0.3%, 0.2%) and esotropia (0.8%, 0%, 0.4%) groups (p = .221, 0.406, 0.515). In contrast, the esotropia group presented a higher risk of conjunctival inclusion cyst and conjunctival scar than the exotropia group, with incidences of 5.0% vs 2.2% and 6.3% vs 1.3%, respectively (p = .004, <0.001). Regarding strabismus complications, the incidence of early recurrence was not significant between the two groups, with 10.0% in the exotropia group and 10.5% in the esotropia group (p = .553). Older age and poor initial visual acuity were associated with early recurrence (p < .001). The esotropia group had a higher risk of persistent diplopia than the exotropia group, with incidences of 4.2% vs 2.0%, respectively (p = .003). CONCLUSION: Esotropia carries a higher risk of conjunctival inclusion cysts, conjunctival scarring, and persistent diplopia compared to the exotropia group, while both groups exhibit similar rates of early recurrence and other surgical site complications.

A Minority Stress Response Model of Health Behaviors in Gay and Bisexual Men: Results from a Taiwanese Sample.

Purpose: Health disparities among sexual minority men remain and continue to demand novel interventions. Other than risk reduction, a promising approach is to identify pathways to health-promoting behaviors. In this study, depressive symptoms, internalized homophobia, and sense of community connectedness were hypothesized to result from the experience of harassment and rejection, and in turn either promote or inhibit an individual's tendency toward health-promoting behaviors. We accounted for subgroup differences by examining the hypothesized model in gay and bisexual men separately. Methods: This was a cross-sectional survey study. One thousand three hundred eighty-one gay (81.5%) and bisexual (18.5%) Taiwanese men 18-49 years of age (mean = 26.56, standard deviation = 6) were recruited through a social media advertisement and completed an online survey. Structural equation modeling was employed to simultaneously examine multiple hypothesized paths. Results: Harassment and rejection were associated with greater depressive symptoms, internalized homophobia, and sense of community connectedness, which in turn yielded direct or indirect associations with health-promoting behavior among gay men. For bisexual men, depressive symptoms remained an important mechanism linking harassment and rejection and health-promoting behavior, whereas the roles of internalized homophobia and sense of community connectedness appeared less obvious. Conclusion: These findings cast new light on the behavioral implications of minority stress and elucidate the possible underlying mechanisms. The study suggests that more effort should be invested to understand and promote the drivers of health-promoting behavior to reduce health disparities in this population.

Filial piety, internalized homonegativity, and depressive symptoms among Taiwanese gay and bisexual men: A mediation analysis.

A theme emerging from the current literature is that Chinese gay and bisexual men are likely to struggle to accept themselves because of the cultural emphasis on filial piety. However, our understanding of this culturally particular process remains partial because most research has operationalized filial piety as either a component of Chinese values or an aggregate construct itself. To pinpoint this mechanism, this study deconstructed filial piety into pragmatic obligations and compassionate reverence to test a mediation model in which internalized homonegativity served as a mediator between filial piety and depressive symptoms among Taiwanese gay and bisexual men. With the aid of Facebook advertisements, a total of 1,381 respondents (Mean age = 26.56, SD = 6) were recruited to complete a web-based survey comprising the Contemporary Filial Piety Scale, the Chinese Internalized Homophobia Scale, and the Patient Health Quesionanire-9. Structural equation modeling was performed to test the mediation paths. Results showed that pragmatic obligations are directly and negatively associated with depressive symptoms without yielding significant correlation with internalized homonegativity. A full mediation path was found in that compassionate reverence is positively correlated with internalized homonegativity and in turn associated with higher depressive symptoms. Whereas filial piety still assumes salience among Taiwanese gay and bisexual men, this study provides novel evidence for the intricate effect of the value of filial piety on Taiwanese gay and bisexual men's self-acceptance and mental health. The results highlight the importance of a relational and cultural focus to address mental health disparities among sexual minorities. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

"Fewer but not weaker": Understanding the intersectional identities among Chinese immigrant young gay men in Toronto.

Sexual minorities of color in North America are frequently defined as a "double minority" group. Intersectionality theory has inspired investigations into how different forms of marginalization intersect to shape the lives of people with multiple minority statuses. In this constructivist grounded theory study, 18 Chinese immigrant gay men between 18 and 28 years of age participated in a semistructured individual interview to narrate their lived experiences in relation to their intersectional identities. All interviews were transcribed verbatim and analyzed through a constant comparative method. Several themes emerged from the data. First, study participants perceived their sexual identity as either compatible with or irrelevant to their cultural identity and did not experience negotiating conflicts between their sexual and cultural identities. Second, the intersectionality was context-specific. Study participants experienced a certain form of marginalization in the contexts of disclosing their gay identity and finding a dating partner within a gay community. Third, participants considered the label double minority oversimplified and derogatory. They emphasized that their daily lives were in a complex power structure that was constituted by more than two identity categories. The marginalization based on their ethnic and sexual identities weighed differently and should not be understood as simple math. Last, despite carrying the status of minority, these gay men indicated that their intersectional identities served as a source of social support. This study contributes to the knowledge base around intersectionality by uncovering its qualitative nuance and bringing to light its contextual specificity. Practice, policy, and research implications are provided. (PsycINFO Database Record (c) 2019 APA, all rights reserved).