A Call for Updates to Hormone Therapy Guidelines for Gender-Diverse Adults Assigned Male at Birth.

Gender-affirming hormone therapy for assigned male at birth (AMAB) individuals with gender incongruence typically consists of estradiol with or without an anti-androgen to achieve physical changes and psychological benefits. However, prescribed hormone regimens vary considerably, and high-quality research in this area is extremely limited. Additional evidence-based research evaluating patient-reported outcome measures (PROMs) is needed to fill current knowledge gaps and create a personalized therapeutic approach for AMAB individuals.

Priorities for efficacy trials of gender-affirming hormone therapy with estrogen: collaborative design and results of a community survey.

Purpose: Treatment guidelines for gender-affirming hormone therapy with estrogen (GAHT-E) recommend specific dosing regimens based on limited data. Well-controlled efficacy trials are essential to tailoring treatment to patient goals as the guidelines recommend. The goal of this study was to take a foundational step toward designing community-centered effectiveness trials for gender-diverse individuals seeking GAHT-E.

Health insurance, labor market shocks, and mental health during the first year of the COVID-19 crisis.

We use the Census Household Pulse Survey (HPS) to examine employment and earnings loss, health insurance, and hardships related to physical and mental health and health care, as well as food insecurity and difficulty meeting expenses, during the first year of the COVID-19 pandemic. Pandemic job loss is strongly associated with uninsurance in the HPS. Moreover, among those who were not employed due to a pandemic economic reason such as a business closure, we find substantial regression-adjusted differences in hardship by insurance status, especially in the domains of mental health, mental health care and financial difficulties (food insufficiency and difficulty paying usual expenses).

On the Importance and Intrinsic Difficulties of Incorporating Health Insurance Benefits in Absolute Poverty Trends.

Context: US government poverty measures do not include health insurance in the threshold or health insurance benefits in resources. Yet the 2019 Economic Report of the President presented long-term trends using the full-income poverty measure (FPM), which includes health insurance benefits as resources. A 2021 technical advisory report recommended statistical agencies produce absolute poverty trends with and without health insurance.

School Disengagement, School-Age Births and High School Graduation: Evidence From Linked Administrative Records.

Background: Failure to complete secondary education often results from a process of educational disengagement. Studies of teen childbearing and high school completion have not adequately accounted for the role of school disengagement prior to conception and may overestimate causal impacts of teen childbearing.

Methods: We link New York City birth and school records to study a cohort of 22,484 Black and Latina public school students.

Improving estimates of Medicaid's effect on poverty: Measures and counterfactuals.

Objective: To re-evaluate the effect of Medicaid on poverty using a poverty measure that accounts for health insurance needs and benefits and an evaluation approach that reflects disparities in access to alternative coverage.

Data Sources: The Current Population Survey (CPS) for calendar year 2015.

Study Design: We estimate the effect of losing Medicaid on poverty, combining two previous approaches: (1) A propensity impact, which simulates a no-Medicaid counterfactual incorporating changes to health insurance and medical out-of-pocket spending, using the Supplemental Poverty Measure (SPM).

Longitudinal Patterns of School Disengagement before Conception among New York City Teen Mothers.

Background: School-based pregnancy prevention programs should optimally be offered while students are still engaged in school since early disengagement is strongly associated with risk of a teen birth.

Methods: We used linked New York City birth and enrollment data (2005-2013), a sample of 6,809 teen mothers (mean age conception = 16.2 years).

Ethics of organ procurement from the unrepresented patient population.

The shortage of organs for transplantation by its nature prompts ethical dilemmas. For example, although there is an imperative to save human life and reduce suffering by maximising the supply of vital organs, there is an equally important obligation to ensure that the process by which we increase the supply respects the rights of all stakeholders. In a relatively unexamined practice in the USA, organs are procured from unrepresented decedents without their express consent.

Estimating the educational consequences of teenage childbearing: Identification, heterogeneous effects and the value of biological relationship information.

Understanding the contribution of childbearing to social disadvantages of teenage mothers requires estimates that control for unobservables and generalize to teenage mothers. Sibling-differences and Instrumental Variables (IV) are common approaches to this end. Using the "Add Health" data, which oversampled siblings, and building on IV specifications from a widely-cited study, we compare various estimates of the consequences of teenage childbearing for schooling attainment.

Depression in Nonclassical Hypogonadism in Young Men.

The specific objective of this study was to test the clinically derived hypothesis associating a high prevalence of depression in young men with nonclassical hypogonadism. We studied the entire population of men aged 18 to 40 years who had an outpatient visit at an academic health system in the years 2013 to 2015. The study group comprised 186 patients with a diagnosis of eugonadotropic hypogonadism and a testosterone value below 10.

Estimating The Effects Of Health Insurance And Other Social Programs On Poverty Under The Affordable Care Act.

The effects of health insurance on poverty have been difficult to ascertain because US poverty measures have not taken into account the need for health care and the value of health benefits. We developed the first US poverty measure to include the need for health insurance and to count health insurance benefits as resources available to meet that need-in other words, a health-inclusive poverty measure. We estimated the direct effects of health insurance benefits on health-inclusive poverty for people younger than age sixty-five, comparing the impacts of different health insurance programs and of nonhealth means-tested cash and in-kind benefits, refundable tax credits, and nonhealth social insurance programs.

Including health insurance in poverty measurement: The impact of Massachusetts health reform on poverty.

We develop and implement what we believe is the first conceptually valid health-inclusive poverty measure (HIPM) - a measure that includes health care or insurance in the poverty needs threshold and health insurance benefits in family resources - and we discuss its limitations. Building on the Census Bureau's Supplemental Poverty Measure, we construct a pilot HIPM for the under-65 population under ACA-like health reform in Massachusetts. This pilot demonstrates the practicality, face validity and value of a HIPM.

Multifactorial hypercalcemia and literature review on primary hyperparathyroidism associated with lymphoma.

The most common cause of hypercalcemia in hospitalized patients is malignancy. Primary hyperparathyroidism most commonly causes hypercalcemia in the outpatient setting. These two account for over 90% of all cases of hypercalcemia.

Does Child Care Quality Mediate Associations Between Type of Care and Development?

Studies document that, on average, children cared for in centers, as compared to homes, have higher cognitive test scores but worse socioemotional and health outcomes. The authors assessed whether the quality of care received explains these associations. They considered multiple domains of child development-cognitive, socioemotional, and health-and examined whether mediation is greater when quality measures are better aligned with outcome domains.

New evidence on the validity of the Arnett Caregiver Interaction Scale: Results from the Early Childhood Longitudinal Study-Birth Cohort.

The Arnett Caregiver Interaction Scale (CIS) has been widely used in research studies to measure the quality of caregiver-child interactions. The scale was modeled on a well-established theory of parenting, but there are few psychometric studies of its validity. We applied factor analyses and item response theory methods to assess the psychometric properties of the Arnett CIS in a national sample of toddlers in home-based care and preschoolers in center-based care from the Early Childhood Longitudinal Study-Birth Cohort.

A pregnant dilemma: primary hyperparathyroidism due to parathyromatosis in pregnancy.

Objective: To describe an exceedingly rare case of parathyromatosis in pregnancy and the limited medical treatment options available for such cases that are refractory to surgery.

Methods: Case presentation and description of clinical course with brief review of the literature.

Results: A 21-year-old woman with a history of 3.

The Child and Adult Care Food Program and the Nutrition of Preschoolers.

Children spend a considerable amount of time in preschools and child care centers. As a result, these settings may have an influence on their diet, weight, and food security, and are potentially important contexts for interventions to address nutritional health. The Child and Adult Care Food Program (CACFP) is one such intervention.

Variants identified in a GWAS meta-analysis for blood lipids are associated with the lipid response to fenofibrate.

A recent large-scale meta-analysis of genome-wide studies has identified 95 loci, 59 of them novel, as statistically significant predictors of blood lipid traits; we tested whether the same loci explain the observed heterogeneity in response to lipid-lowering therapy with fenofibrate. Using data from the Genetics of Lipid Lowering Drugs and Diet Network (GOLDN, n = 861) we fit linear mixed models with the genetic markers as predictors and high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, total cholesterol, and triglyceride concentrations as outcomes. For all four traits, we analyzed both baseline levels and changes in response to treatment with fenofibrate.

An assessment of the validity of the ECERS-R with implications for measures of child care quality and relations to child development.

The Early Childhood Environment Rating Scale-Revised (ECERS-R) is widely used to associate child care quality with child development, but its validity for this purpose is not well established. We examined the validity of the ECERS-R using the multidimensional Rasch partial credit model (PCM), factor analyses, and regression analyses with data from the Early Childhood Longitudinal Study Birth Cohort. The PCM identified rating category disordering, indicating previously unrecognized problems with the scale's response process validity.

Improving communication when seeking informed consent: a randomised controlled study of a computer-based method for providing information to prospective clinical trial participants.

Objective: To assess the efficacy, with respect to participant understanding of information, of a computer-based approach to communication about complex, technical issues that commonly arise when seeking informed consent for clinical research trials.

Design, Setting And Participants: An open, randomised controlled study of 60 patients with diabetes mellitus, aged 27-70 years, recruited between August 2006 and October 2007 from the Department of Diabetes and Endocrinology at the Alfred Hospital and Baker IDI Heart and Diabetes Institute, Melbourne.

Intervention: Participants were asked to read information about a mock study via a computer-based presentation (n = 30) or a conventional paper-based information statement (n = 30).

Factors related to declining luteal function in women during the menopausal transition.

Context: Reproductive hormones are incompletely characterized during the menopause transition (MT).

Hypothesis: Increased anovulation and decreased progesterone accompany progress through the MT.

Design: The Daily Hormone Study (DHS) of the Study of Women's Health Across the Nation (SWAN) included 848 women aged 43-53 yr at baseline who collected daily urine for one cycle or up to 50 d annually for 3 yr.

The effects of maternal employment on child injuries and infectious disease.

This article presents estimates of effects of maternal paid work and nonmaternal child care on injuries and infectious disease for children aged 12 to 36 months. Mother-child fixed-effects estimates are obtained by using data from the NICHD Study of Early Child Care. Estimates indicate that maternal employment itself has no statistically significant adverse effects on the incidence of infectious disease and injury.