Exploring Reflections, Motivations, and Experiential Outcomes of First Same-Sex/Gender Sexual Experiences among Lesbian, Gay, Bisexual, and Other Sexual Minority Individuals.

First sex is an important event in an individual's sexual development. Previous literature has, however, primarily investigated first heterosexual sex, overlooking important contextual factors specific to same-sex/gender sexual experiences. Seventeen in-depth semi-structured interviews were conducted with lesbian, gay, bisexual, and other sexual minority (LGB+) individuals, ages 18-23 years. Four themes emerged from thematic analysis of reported thoughts, affect, and behavior. First, participants reported difficulty defining sex between same-sex/gender partners, especially women who reported that this undermined their personal relationships and identity. Second, participants met partners through several means; however, it was almost exclusively men who reported meeting their first partners online. Third, motivations for first same sex/gender sex included affirmation of personal sexual identity, sexual exploration, social expectation, and spontaneity. Fourth, participants felt underprepared for their first same-sex/gender sex, noting that their earlier sex and relationship education had not included information on same-sex/gender sex or LGB+ identities. Consequently, participants reported relying on experienced partners and seeking information on the internet, including pornography and social media. Greater cultural representation and more comprehensive sex education that recognizes sexual diversity is needed to better prepare LGB+ young people for early sexual encounters.

High-throughput discovery of organic cages and catenanes using computational screening fused with robotic synthesis.

Supramolecular synthesis is a powerful strategy for assembling complex molecules, but to do this by targeted design is challenging. This is because multicomponent assembly reactions have the potential to form a wide variety of products. High-throughput screening can explore a broad synthetic space, but this is inefficient and inelegant when applied blindly. Here we fuse computation with robotic synthesis to create a hybrid discovery workflow for discovering new organic cage molecules, and by extension, other supramolecular systems. A total of 78 precursor combinations were investigated by computation and experiment, leading to 33 cages that were formed cleanly in one-pot syntheses. Comparison of calculations with experimental outcomes across this broad library shows that computation has the power to focus experiments, for example by identifying linkers that are less likely to be reliable for cage formation. Screening also led to the unplanned discovery of a new cage topology-doubly bridged, triply interlocked cage catenanes.

Minerals in the gut: scoping a Cambrian digestive system.

The Sirius Passet Lagerstätte of North Greenland contains the first exceptionally preserved mat-ground community of the Cambrian, dominated, in terms of abundance, by trilobites but particularly characterized by iconic arthropods and lobopods, some also occurring in the Burgess shale. High-resolution photography, scanning electron imaging and elemental mapping have been carried out on a variety of specimens of the non-mineralized arthropod Campanamuta mantonae (Budd 2011 J. Syst. Palaeontol.9, 217-260 (doi:10.1080/14772019.2010.492644)) which has three-dimensional gut and muscle preservation. Results show that the guts contain a high concentration of calcium phosphate (approximating to the mineral francolite), whereas the adjacent muscles are silicified. This indicates a unique, tissue-specific taphonomy for this Cambrian taxon. We hypothesize that the precipitation of calcium phosphate in the guts occurs rapidly after death by 'crystal seed' processes in suboxic, slightly acidic conditions; critically, the gut wall remained intact during precipitation. We postulate that the calcium phosphate was derived from ingested cellular material. Silicification of the muscles followed as the localized water chemistry became saturated in silica, high in Fe2+, and low in oxygen and sulfate. We document here the unique occurrence of two distinct but mechanistically similar taphonomic pathways within a diverse suite of possibilities in an Early Cambrian Lagerstätte.

[Pediatric management by mobile intensive care units in the northern French Alps emergency network]. / Activité pédiatrique des SMUR du réseau nord-alpin des urgences.

INTRODUCTION: The northern French Alps emergency network (RENAU) manages emergent care and patient treatment pathways in a three-county area in the French Alps. The aim of the study was to describe the pediatric activity in mobile intensive care units (MICUs). METHOD: This retrospective observational study was conducted from 1 January to 31 December 2012. Data were obtained from patients' medical records in seven representative MICUs of the RENAU. Consecutive patients between 1 month and 18 years of age were enrolled. RESULTS: During the study period, MICUs carried out 11,951 primary transports and 3087 secondary transfers. A total of 1325 patients were enrolled: 1087 primary transports and 238 secondary transfers. In primary interventions, 531 (48.9%) patients were managed for a trauma, 118 (11%) children were discharged and stayed home, 427 (39.9%) underwent an intravenous cannulation and 27 (2.5%) on-scene intubation. A pediatrician was in charge of 64 (26.9%) secondary transfers. Among 1649 (18%) mountain rescues, 296 (18.7%) involved a child. CONCLUSION: Emergency physicians in MICUs are involved with children's prehospital care and need dedicated materiel and special training.

An audit of partner notification for syphilis and HIV.

Partner notification (PN) is a vital tool used by genitourinary (GU) medicine services in the public health control of sexually transmitted infections. We audited our PN outcomes for syphilis and HIV, over an 18-month period, at the Edinburgh GUM clinic. Follow-up information on testing was only available for 58% of traceable syphilis contacts and 59% of traceable HIV contacts, though substantially larger percentages in each case, respectively 78% and 90%, were informed regarding their risk of exposure. Furthermore, the department achieved screening verification in 78% of identifiable syphilis contacts and 94% of identifiable HIV partners.

Baroreceptor sensitivity after Valsalva maneuver in women with chronic obstructive pulmonary disease.

PURPOSE: Reduced baroreceptor sensitivity (BRS) results in changes in autonomic modulation. Patients with chronic obstructive pulmonary disease (COPD) may have altered BRS. Therefore, we compared BRS between COPD patients and normal controls. METHODS: We compared 14 COPD patients [mean (±SD) age, 62 ± 8 years] to 14 healthy controls [mean (±SD) age, 59 ± 6 years] for the loss of BRS. All patients received ß(2)-agonist therapy but were free from any other type of medication that would interfere with autonomic responses, all controls were free from cardiopulmonary disease, and none was taking medications. All participants were female, post-menopausal, had no known cardiac disease and were ex-smokers. Reduced baroreceptor sensitivity was determined using the slope of the magnitude of R-R widening over the increase in systolic blood pressure following Valsalva maneuver. RESULTS: The mean BRS in controls versus COPD patients showed a mean value of 6.15 ± 2.26 versus 1.91 ± 2.92 ms/mmHg (p < 0.001). CONCLUSIONS: These findings are consistent with other abnormalities of autonomic disruption as previously reported, and demonstrate a severe blunting of the baroreceptor response in individuals with COPD. The cause of this altered BRS response in COPD is not fully clear, we postulate that air trapping with persistent elevation of intrathoracic pressure may lead to a subsequent blunting of the sensitivity of the baroreceptors.

Environmental education in Tobago's primary schools: a case study of coral reef education

Environmental education is a relatively new area on the primary school curriculum of Trinidad and Tobago. Because of the close relationship between human activities and the degradation of the natural environment in Tobago, environmental education will become increasingly important to the preservation and conservation of the island's fragile natural resources. Current teaching methods rely heavily on text books and utilise a lecture style that does not promote student interaction. Unfortunately, these methods are not very conducive to environmental education. As such, this paper examines a pilot program in which staff from the Buccoo Reef Trust taught students from 15 primary schools about coral reefs using interactive tools and hands-on methods as described in People & Corals: an Education Package for Primary Schools (People & Corals). The pilot program ran over an eight week period with prepared lessons being taught every two weeks and student evaluations taking place once before the first lesson and once after the last lesson. The lessons were supplemented with a field trip to a coral reef ecosystem. Despite several challenges that were faced in the implementation process, the overall outcome of the pilot program was successful. Teachers and students reacted positively to the information that was being shared, thereby reinforcing the effectiveness of using a dynamic, active method of teaching to advance environmental education

No evidence to support CTLA-4 as a susceptibility gene in MS families: the Canadian Collaborative Study.

Two polymorphisms of the CTLA-4 gene were genotyped in 232 sibling pairs affected with multiple sclerosis (MS) from 185 families. The CTLA-4 polymorphisms genotyped were a 3' untranslated (AT)(n) microsatellite and an alanine/threonine RFLP of exon 1. There was no evidence observed for linkage by either identity-by-descent (ibd) or identity-by-state (ibs) methods. A transmission disequilibrium test (TDT) was performed and no preferential transmission of alleles was observed. Upon stratification of patients, there was no preferential transmission observed based upon gender, by presence or absence of HLA*DRB1*15, by ethnicity or by clinical course of the disease. CTLA-4 does not appear to be a major MS susceptibility locus in Canadian multiplex families.

Sex differences in emigration and mortality affect optimal management of deer populations.

Populations of red deer that are limited by food, like those of many other ungulates, commonly include more females than males. We assessed the contribution of variation in sex- and age-specific rates of mortality and emigration to density-dependent changes in the adult sex ratio, using long-term observations and demographic experiments involving the red deer population on Rum, Scotland. We incorporated these effects in a stochastic model of local populations under different management regimes to show here that, when female numbers are allowed to increase to more than 60% of the ecological carrying capacity, the sustainable annual harvest of males from local deer populations will fall. Because males are typically culled by fee-paying hunters and generate more income than females, income will decrease as the male harvest falls. Because numbers of female deer throughout much of the Highlands probably exceed the threshold at which male density starts to be affected, many managers might be able to raise income from local deer populations by reducing female numbers, with potential benefits to the vegetation of Scottish Highland environments.

Genetic susceptibility to MS: a second stage analysis in Canadian MS families.

Four published genome screens have identified a number of markers with increased sharing in multiple sclerosis (MS) families, although none has reached statistical significance. One hundred and five markers previously identified as showing increased sharing in Canadian, British, Finnish, and American genome screens were genotyped in 219 sibling pairs ascertained from the database of the Canadian Collaborative Project on Genetic Susceptibility to MS (CCPGSMS). No markers examined met criteria for significant linkage. Markers located at 5p14 and 17q22 were analyzed in a total of 333 sibling pairs and attained mlod scores of 2.27 and 1.14, respectively. The known HLA Class II DRB1 association with MS was confirmed (P<0.0001). Significant transmission disequilibrium was also observed for D17S789 at 17q22 (P=0.0015). This study highlights the difficulty of searching for genes with only mild-to-moderate effects on susceptibility, although large effects of specific loci may still be present in individual families. Future progress in the genetics of this complex trait may be helped by (1) focussing on more ethnically homogeneous samples, (2) using an increased number of MS families, and (3) using transmission disequilibrium analysis in candidate regions rather than the affected relative pair linkage analysis.

Growth patterns in euconodont crown enamel: implications for life history and mode-of-life reconstruction in the earliest vertebrates.

Euconodonts were the first vertebrates to produce a mineralized skeleton. It is concluded that the minor increments in the crown enamels of Protopanderodus varicostatus and Drepanodus robustus are probable homologues of the cross striations in hominoid enamel, although they are much more variable in thickness and represent daily to weekly growth. Major increments are superficially similar to lines of Retzuis, but represent a check in growth that is likely to have occurred at monthly intervals. Periods of above- and below-average growth are likely to have been seasonally moderated. The growth of P. varicostatus' elements are characterized by two distinct phases: the production of a triangular, asymmetrical juvenile 'proto-element' followed, in a second phase, by the development of the curved and twisted geometry of the adult element. These fundamentally different morphologies imply that juvenile and adult animals had different modes of life and/or feeding strategies. In these animals the growth of the elements was indeterminate. The growth model for euconodonts is clearly different from that of hominoid teeth as the enamel organ must have reformed repeatedly throughout life.

Future directions.

Despite progress in promotion and support of breastfeeding over the past decade, the HIV pandemic necessitates new actions based on human rights, such as voluntary and confidential testing and counseling, offering HIV-positive women objective information on the risks and costs of all infant feeding options, and providing appropriate support for their decisions. Implementation of the Baby-Friendly Hospital Initiative and the International Code of Marketing are essential components of a rights-based policy response to HIV and will lessen spillover of replacement feeding among HIV-negative women. Protective effects of nevirapine and exclusive breastfeeding, as well as the listed additional topics, require further research. We have yet to make exclusive breastfeeding easy and common when mothers choose to breastfeed.

The impact of managed care on nurses' workplace learning and teaching.

This paper examines the impact of managed care on the informal learning process for nurses in a major US-based health organisation. Through the analysis of focus group data we report the nurses' view of the effect recent changes have had on the nurse/patient/care relationship. Managed care, our research indicates, has transformed the learning milieus for nurses with two effects. First, nurses have seen their need for informal learning increase while the time and context for that learning has diminished. Second, the process of teaching patients and families has also been adversely affected even as managed care creates the need for more patient education. We report the analysis of the data collected at group interviews involving nurses working in both hospital and community settings of a leading US-based HMO. All interviews took place during September of 1997 at various sites in California. This study is part of a larger Social Science Research Council of Canada funded investigation into managed care in the US and Canada.

Changes in work practice after a respiratory health survey among welders in New Zealand.

AIMS: To assess changes in work practice among eight New Zealand engineering sites, following a study of occupational respiratory symptoms in welders two years previously. METHODS: In 1996, we found that an acute decrease in lung function was more common in welders working without local exhaust ventilation. Findings were reported back to management, study participants and the media. Two years later we re-visited the eight welding sites. RESULTS: Of the eight engineering sites, two had local exhaust ventilation present in both Study 1 and Study 2, one site had installed local exhaust ventilation in part of the site since Study 1 and one site had moved to larger premises. The remaining four sites had no exhaust ventilation or change to the workplace between studies. Five welders (12.8%) used respiratory protection in both Study 1 and Study 2, seven welders (18%) used respiratory protection in Study 1 but not Study 2, four welders (10.3%) did not have respiratory protection in Study 1 but did in Study 2 and nine welders (23.1%) did not use respiratory protection at all in Study 1 or Study 2. CONCLUSION: Further effort is required to ensure that such studies lead to significant improvements in the work environment.

Six new species of Lepidapedon Stafford, 1904 (Digenea: Lepocreadiidae) from deep-sea macrourid fishes from the Gulf of Mexico and Caribbean Sea, with revised keys to the species of the genus.

Species of the genus Lepidapecon are divided into various groups and subgroups based on vitelline distribution relative to the acetabulum and anterior extent of the excretory vesicle. Members of this genus predominantly parasitise gadiform fishes and are commonly collected from relatively deep waters. A recent study of deep-sea helminths from macrourids of the Gulf of Mexico and Caribbean Sea revealed six new species of this genus. L. mexicanensis n. sp., of the elongatum group, elongatum subgroup, differs from other species in this subgroup in proportions (as % of body length), lacking confluent vitelline fields between both the ovary and anterior testis and the testes, and in having a smaller egg and body size. L. nezumiatis n. sp., of the elongatum group, desclersae oesophagus than prepharynx. L. caribbaei n. sp. and L. longivesicula n. sp., of the garrardi group, congeri sub-subgroup, differs from both L. filiformis and L. desclersae in having intermediate egg and body sizes, and a longer group, differ from L. congeri in having a sucker-ratio of 1: < 1. L. caribbaei n. sp. and L. longivesicula n. sp. differ from each other in that L. caribbaei n. sp. has numerous long, barb-like, deeply imbedded spines, a less elongate body, an infundibuliform oral sucker, a similar-sized oesophagus and prepharynx, and a caecal bifurcation which is closer to the acetabulum than oral sucker, while L. longivesicula n. sp. has shorter, serrate or plate-like, lightly imbedded, widely to sporadically spaced spines, a more elongate body, a spherical to subspherical oral sucker, a longer oesophagus than prepharynx, and a caecal bifurcation which is closer to the oral sucker than acetabulum. L. desotoensis n. sp., of the rachion group, rachion subgroup, is distinct from both L. luteum and L. abyssensis in having a smaller size, lacking cervical glands or pharyngeal gland cells, and possessing dark-staining particles in the mesenchyme, while it differs from L. abyssensis specifically in having a much longer oesophagus than prepharynx, lateral vitelline fields that are not confluent intertesticularly, and wider eggs. L. zaniophori n. sp., also of the rachion subgroup, differs from both L. cascadensis and L. genge in having a smaller egg size, a shorter prepharynx and oesophagus than pharynx, and vitelline fields that are intertesticular but only slightly encroach between the ovary and anterior testis. L. sammari and L. spiniferi are designated as incertae sedis, and L. quiloni and L. stromateusi are designated as species inquirendae. New parasite keys and host records for Coelorinchus coelorhincus. C. caribbaeus and Nezumia cyrano are offered. Support is given to Lepidapedon probably being the dominant digenean genus in deep water.

In vitro and in vivo characterization of conantokin-R, a selective NMDA receptor antagonist isolated from the venom of the fish-hunting snail Conus radiatus.

The purification, characterization, and synthesis of conantokin-R (Con-R), an N-methyl-D-aspartate (NMDA) receptor peptide antagonist from the venom of Conus radiatus, are described. With the use of well defined animal seizure models, Con-R was found to possess an anticonvulsant profile superior to that of ifenprodil and dizocilpine (MK-801). With voltage-clamp recording of Xenopus oocytes expressing heteromeric NMDA receptors from cloned NR1 and NR2 subunit RNAs, Con-R exhibited the following order of preference for NR2 subunits: NR2B approximately NR2A > NR2C >> NR2D. Con-R was without effect on oocytes expressing the alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA) receptor subunit GluR1 or the kainate receptor subunit GluR6. In mouse cortical neurons voltage-clamped at -60 mV, Con-R application produced a slowly developing block of inward currents evoked by 10 microM NMDA and 1 microM glycine (IC(50) = 350 nM). At 3 microM, Con-R did not affect gamma-aminobutyric acid- or kainate-evoked currents. Con-R prevented sound-induced tonic extension seizures in the Frings audiogenic seizure-susceptible mice at i.c.v. doses below toxic levels. It was also effective at nontoxic doses in CF#1 mice against tonic extension seizures induced by threshold (15 mA) and maximal (50 mA) stimulation, and it partially blocked clonic seizures induced by s.c. pentylenetetrazol. In contrast, MK-801 and ifenprodil were effective only at doses approaching (audiogenic seizures) or exceeding (electrical and pentylenetetrazol seizures) those required to produce significant behavioral impairment. These results indicate that the subtype selectivity and other properties of Con-R afford a distinct advantage over the noncompetitive NMDA antagonists MK-801 and ifenprodil. Con-R is a useful new pharmacological agent for differentiation between the anticonvulsant and toxic effects of NMDA antagonists.

Potent immunosuppressive C32-O-arylethyl ether derivatives of ascomycin with reduced toxicity.

The synthesis of C32-O-arylethyl ether derivatives of ascomycin that possess equivalent immunosuppressant activity but reduced toxicity, compared to FK-506, is described.