Health care and social service providers' observations on the intersection of HIV/AIDS and violence among their clients and patients - DiStefano, A.S.; Cayetano, R.T. (Qualitative Health Research, 2011)
Associations between HIV/AIDS and several forms of violence have been demonstrated in recent research. We conducted qualitative interviews with 30 providers who offered services related to HIV/AIDS or violence to identify specific manifestations of HIV/AIDS-violence intersections, factors that explain why HIV/AIDS and violence intersect in client/patient populations, and the theoretical salience of providers' narratives. Providers confirmed links between HIV/AIDS and violent victimization, and yielded new insights into crossover risk between HIV/AIDS and suicidality, nonsuicidal self-harm, and witnessing and perpetrating violence. We also isolated 20 explanatory factors, including substance use, poor mental health, sex work/trading sex, and sexual orientation/gender identity. Narratives were consistent with syndemics theory, indicating that HIV/AIDS and violence fueled each other's occurrence and magnified the health-related burden on affected client/patient populations, often under conditions of health and social disparity. Providers contribute a novel perspective on our understanding of HIV/AIDS-violence syndemics that shows promise in informing future interventions and practice. © The Author(s) 2011.
Keywords: health care professionals; HIV/AIDS; interviews; social services; violence

Sexual identity, sex of sexual contacts, and health-risk behaviors among students in grades 9-12 - Youth risk behavior surveillance, selected sites, United States, 2001-2009 - Kann, L.; Olsen, E.O.; McManus, T.; Kinchen, S.; Chyen, D.; Harris, W.A.; Wechsler, H. (Morbidity and Mortality Weekly Report, 2011)
Problem: Sexual minority youths are youths who identify themselves as gay or lesbian, bisexual, or unsure of their sexual identity or youths who have only had sexual contact with persons of the same sex or with both sexes. Population-based data on the health-risk behaviors practiced by sexual minority youths are needed at the state and local levels to most effectively monitor and ensure the effectiveness of public health interventions designed to address the needs of this population. Reporting Period Covered: January 2001-June 2009 Description of the System: The Youth Risk Behavior Surveillance System (YRBSS) monitors priority health-risk behaviors (behaviors that contribute to unintentional injuries, behaviors that contribute to violence, behaviors related to attempted suicide, tobacco use, alcohol use, other drug use, sexual behaviors, dietary behaviors, physical activity and sedentary behaviors, and weight management) and the prevalence of obesity and asthma among youths and young adults. YRBSS includes state and local school-based Youth Risk Behavior Surveys (YRBSs) conducted by state and local education and health agencies. This report summarizes results from YRBSs conducted during 2001-2009 in seven states and six large urban school districts that included questions on sexual identity (i.e., heterosexual, gay or lesbian, bisexual, or unsure), sex of sexual contacts (i.e., same sex only, opposite sex only, or both sexes), or both of these variables. The surveys were conducted among large population-based samples of public school students in grades 9-12. Results: Across the nine sites that assessed sexual identity, the prevalence among gay or lesbian students was higher than the prevalence among heterosexual students for a median of 63.8% of all the risk behaviors measured, and the prevalence among bisexual students was higher than the prevalence among heterosexual students for a median of 76.0% of all the risk behaviors measured. In addition, the prevalence among gay or lesbian students was more likely to be higher than (rather than equal to or lower than) the prevalence among heterosexual students for behaviors in seven of the 10 risk behavior categories (behaviors that contribute to violence, behaviors related to attempted suicide, tobacco use, alcohol use, other drug use, sexual behaviors, and weight management). Similarly, the prevalence among bisexual students was more likely to be higher than (rather than equal to or lower than) the prevalence among heterosexual students for behaviors in eight of the 10 risk behavior categories (behaviors that contribute to unintentional injuries, behaviors that contribute to violence, behaviors related to attempted suicide, tobacco use, alcohol use, other drug use, sexual behaviors, and weight management). Across the 12 sites that assessed sex of sexual contacts, the prevalence among students who had sexual contact with both sexes was higher than the prevalence among students who only had sexual contact with the opposite sex for a median of 71.1% of all the risk behaviors measured, and the prevalence among students who only had sexual contact with the same sex was higher than the prevalence among students who only had sexual contact with the opposite sex for a median of 29.7% of all the risk behaviors measured. Furthermore, the prevalence among students who had sexual contact with both sexes was more likely to be higher than (rather than equal to or lower than) the prevalence among students who only had sexual contact with the opposite sex for behaviors in six of the 10 risk behavior categories (behaviors that contribute to violence, behaviors related to attempted suicide, tobacco use, alcohol use, other drug use, and weight management). The prevalence among students who only had sexual contact with the same sex was more likely to be higher than (rather than equal to or lower than) the prevalence among students who only had sexual contact with the opposite sex for behaviors in two risk behavior categories (behaviors related to attempted suicide and weight management). Interpretation: Sexual minority students, particularly gay, lesbian, and bisexual students and students who had sexual contact with both sexes, are more likely to engage in health-risk behaviors than other students. Public Health Action: Effective state and local public health and school health policies and practices should be developed to help reduce the prevalence of health-risk behaviors and improve health outcomes among sexual minority youths. In addition, more state and local surveys designed to monitor health-risk behaviors and selected health outcomes among population-based samples of students in grades 9-12 should include questions on sexual identity and sex of sexual contacts.

Interpersonal trauma and discriminatory events as predictors of suicidal and nonsuicidal self-injury in gay, lesbian, bisexual, and transgender persons - House, A.S.; Van Horn, E.; Coppeans, C.; Stepleman, L.M. (European Physical Education Review, 2011)
Recent research suggests that gay, lesbian, bisexual, and transgender (GLBT) persons are at greater risk for mental health problems, including suicidal and nonsuicidal self-injury, than heterosexuals. However, few studies have investigated factors that may be linked to this increased risk. This study investigated interpersonal violence, victimization, and discriminatory events as possible predictors of suicidal and nonsuicidal self-injury in a sample of sexual minorities (i.e., a GLBT sample). Participants were 1,126 self-identified gay, lesbian, bisexual, and/or transgender (GLBT) individuals who responded to an Internet-based survey. Results indicated that both experiences of interpersonal trauma and sexual discrimination were associated with increased likelihoods of engaging in suicidal and nonsuicidal self-injury. In addition, participants at the greatest risk were those experiencing high levels of both interpersonal trauma and sexual discrimination. Clinical implications of these results are discussed. © The Author(s) 2011.
Keywords: interpersonal trauma; self-injury; sexual discrimination; sexual minority; suicidal behavior

Offsetting Risks: High School Gay-Straight Alliances and Lesbian, Gay, Bisexual, and Transgender (LGBT) Youth - Heck, N.C.; Flentje, A.; Cochran, B.N. (School Psychology Quarterly, 2011)
Lesbian, gay, bisexual, and transgender (LGBT) youth are at risk for engaging in negative health behaviors and for experiencing at-school victimization. Specific benefits of attending a high school with a gay-straight alliance (GSA), including lower levels of suicidality, have been published; however, it is unclear whether GSAs are related to lower levels of problematic substance use, depressive symptoms, and psychological distress. Using a sample of 145 LGBT youth recruited from college and university organizations for LGBT students, we examined whether attending a high school with a GSA was related to more positive school experiences and mental health outcomes for LGBT youth. The results indicate that youth who attended a high school with a GSA report significantly more favorable outcomes related to school experiences, alcohol use, and psychological distress. The implications of the findings are discussed as they relate to school psychologists. Important limitations of this study are reviewed. © 2011 American Psychological Association.
Keywords: Alcohol; Gay-straight alliance; High school; LGBT; Sexual minority youth

Sexual orientation and mortality among US men aged 17 to 59 years: Results from the National Health and Nutrition Examination Survey III - Cochran, S.D.; Mays, V.M. (American Journal of Public Health, 2011)
Objectives: We investigated associations between minority sexual orientation and mortality among US men. Methods: We used data from a retrospective cohort of 5574 men aged 17 to 59 years, first interviewed in the National Health and Nutrition Examination Survey III (NHANES III; 1988-1994) and then followed for mortality status up to 18 years later. We classified men into 3 groups: those reporting (1) any same-sex sexual partners (men who have sex with men [MSM]; n=85), (2) only female sexual partners (n=5292), and (3) no sexual partners (n=197). Groups were then compared for all-cause mortality, HIV-related mortality, suicide-related mortality, and non-HIV-related mortality. Results: Compared with heterosexual men, MSM evidenced greater all-cause mortality. Approximately 13% of MSM died from HIV-related causes compared with 0.1% of men reporting only female partners. However, mortality risk from non-HIV-related causes, including suicide, was not elevated among MSM. Conclusions: In the United States, the HIV epidemic continues to be the major contributing factor for premature death rates among MSM. Cohorts such as the NHANES III offer a unique opportunity to track the effects of the HIV epidemic on this population.

Increased risk of suicide attempts among black and Latino lesbians, gay men, and bisexuals - O'Donnell, S.; Meyer, I.H.; Schwartz, S. (American Journal of Public Health, 2011)
Members of racial/ethnic minority groups have a lower lifetime prevalence than have Whites of mental disorders, a risk factor for suicide attempts; paradoxically, however, lesbian, gay, and bisexual (LGB) ethnic minority youths may be at increased risk for suicide attempts relative to White LGB youths. We found that the increased risk of suicide attempts among racial/ethnic minority LGB respondents in our sample relative to White respondents was not explained by excess youth onset of depression and substance abuse or by a higher susceptibility to suicide in the racial/ethnic minority LGB group.

Sexual revictimization and mental health: A comparison of lesbians, gay men, and heterosexual women - Balsam, K.F.; Lehavot, K.; Beadnell, B. (Journal of Interpersonal Violence, 2011)
Childhood sexual abuse (CSA) has several deleterious effects on health and well-being, including increased risk for rape in adulthood. Such revictimization experiences are linked to negative mental health outcomes. The vast majority of literature on prevalence and impact of sexual revictimization has focused on heterosexual women. In an effort to extend this research to lesbians and gay men, who are known to face higher rates of both CSA and adult rape, we conducted a study (N = 871) comparing adult lesbians, gay men, and heterosexual women on prevalence and mental health correlates of sexual revictimization. Results indicated that CSA is associated with elevated rates of adult rape for all three groups. In addition, revictimization showed comparable associations with mental health variables for all three groups. Participants with both CSA and adult rape had higher levels of psychological distress, suicidality, alcohol use, and self-harm behaviors relative to those with only one type of victimization and those with no victimization, and those with any victimization were more likely to report recent use of drugs compared to those with no victimization. © The Author(s) 2011.
Keywords: gay; lesbian; revictimization; sexual abuse

Is sex worth dying for? Sentimental-homicidal-suicidal violence in theological discourse of sexuality - Rees, G. (Journal of Religious Ethics, 2011)
In theological discourse of sexuality, queer theory has often been regarded as an extension of the project of gay and lesbian liberation, when it actually challenges an organizing value of the entire discourse, because it challenges any ascription of ultimate value to "sex," an imaginative formation of power relations. Rather than appeal to God to authorize the privileged status of sex, queer commentary suggests that theological writers should refuse assertions of the absolute importance of any particular formation of human imagination as a basis of relation between self and God. The goal is to recognize the violence - symbolized and real - that enforces the worth of certain imaginations of intelligibly sexed personal identity and stunts the formation of alternative imaginations of intelligible personal identity. Critical account of this violence as sentimental-homicidal-suicidal opens space to confess a theological discourse of personal identities that is entirely beyond sex. © 2011 Journal of Religious Ethics, Inc.
Keywords: literature; queer theory; sexuality; theology; violence

Valerie Solanas and the queer performativity of madness - Rowe, D.D.; Chávez, K.R. (Cultural Studies - Critical Methodologies, 2011)
Accusations of madness have long been hurled at queer and feminist bodies, and typically when people are deemed mad, they are granted little agency. This article attempts to read madness as potentially agentic when it manifests as what we call a "queer performativity of madness." Using the writing of and rhetoric surrounding Valerie Solanas, the infamous radical feminist known for shooting Andy Warhol, we develop the notion of a queer performativity of madness and show how historical figures like Solanas read against the binary oppositions that often create our understanding of sexuality, reason, and politics. Though madness does not always supply agency, we suggest that rethinking madness offers fruitful resources for feminist and queer theory. © 2011 SAGE Publications.
Keywords: Agency; Binary oppositions; Foucault; Politics of knowing; Unreason

Community a factor in suicide attempts by lesbian, gay, and bisexual teens - Voelker, R. (JAMA - Journal of the American Medical Association, 2011)

The social environment and suicide attempts in lesbian, gay, and bisexual youth - Hatzenbuehler, M.L. (Pediatrics, 2011)
OBJECTIVE: To determine whether the social environment surrounding lesbian, gay, and bisexual youth may contribute to their higher rates of suicide attempts, controlling for individual-level risk factors. METHODS: A total of 31 852 11th grade students (1413 [4.4%] lesbian, gay, and bisexual individuals) in Oregon completed the Oregon Healthy Teens survey in 2006 -2008. We created a composite index of the social environment in 34 counties, including (1) the proportion of same-sex couples, (2) the proportion of registered Democrats, (3) the presence of gay-straight alliances in schools, and (4) school policies (nondiscrimination and antibullying) that specifically protected lesbian, gay, and bisexual students. RESULTS: Lesbian, gay, and bisexual youth were significantly more likely to attempt suicide in the previous 12 months, compared with heterosexuals (21.5% vs 4.2%). Among lesbian, gay, and bisexual youth, the risk of attempting suicide was 20% greater in unsupportive environments compared to supportive environments. A more supportive social environment was significantly associated with fewer suicide attempts, controlling for sociodemographic variables and multiple risk factors for suicide attempts, including depressive symptoms, binge drinking, peer victimization, and physical abuse by an adult (odds ratio: 0.97 [95% confidence interval: 0.96-0.99]). CONCLUSIONS: This study documents an association between an objective measure of the social environment and suicide attempts among lesbian, gay, and bisexual youth. The social environment appears to confer risk for suicide attempts over and above individual-level risk factors. These results have important implications for the development of policies and interventions to reduce sexual orientation-related disparities in suicide attempts. Copyright © 2011 by the American Academy of Pediatrics.
Keywords: Disparities; Sexual orientation; Social determinants of health; Suicide attempts

Lesbian, Gay, Bisexual, and Transgender Adolescent School Victimization: Implications for Young Adult Health and Adjustment - Russell, S.T.; Ryan, C.; Toomey, R.B.; Diaz, R.M.; Sanchez, J. (Journal of School Health, 2011)
BACKGROUND: Adolescent school victimization due to lesbian, gay, bisexual, or transgender (LGBT) status is commonplace, and is associated with compromised health and adjustment. Few studies have examined the long-term implications of LGBT school victimization for young adult adjustment. We examine the association between reports of LGBT school victimization and young adult psychosocial health and risk behavior. METHODS: The young adult survey from the Family Acceptance Project included 245 LGBT young adults between the ages of 21 and 25 years, with an equal proportion of Latino and non-Latino White respondents. A 10-item retrospective scale assessed school victimization due to actual or perceived LGBT identity between the ages of 13 and 19 years. Multiple regression was used to test the association between LGBT school victimization and young adult depression, suicidal ideation, life satisfaction, self-esteem, and social integration, while controlling for background characteristics. Logistic regression was used to examine young adult suicide attempts, clinical levels of depression, heavy drinking and substance use problems, sexually transmitted disease (STD) diagnoses, and self-reported HIV risk. RESULTS: Lesbian, gay, bisexual, and transgender-related school victimization is strongly linked to young adult mental health and risk for STDs and HIV; there is no strong association with substance use or abuse. Elevated levels of depression and suicidal ideation among males can be explained by their high rates of LGBT school victimization. CONCLUSIONS: Reducing LGBT-related school victimization will likely result in significant long-term health gains and will reduce health disparities for LGBT people. Reducing the dramatic disparities for LGBT youth should be educational and public health priorities. © 2011, American School Health Association.
Keywords: Adolescents; HIV; LGBT; Mental health; Risk behavior; Sexual orientation; STDs; Victimization; Young adulthood

Sexual minority youth, social connection and resilience: From personal struggle to collective identity - DiFulvio, G.T. (Social Science and Medicine, 2011)
Sexual minority youth are at increased risk for negative health outcomes including substance abuse, depression, anxiety, and suicide. Researchers suggest that sexual orientation victimization is a predictor of such outcomes. Social connectedness-or the importance of belonging where youth perceive they are cared for and empowered within a given context-has been associated with positive youth outcomes. This qualitative study utilized life story methodology. Life stories are considered to be important expressions of one's identity and are shaped by personal, social, and cultural contexts. Twenty-two interviews were conducted with 15 young people ranging in age from 14 to 22 years. Two focus groups with youth were also conducted. Youth were recruited from rural and urban communities in Massachusetts. This study contributes to the literature on resilience by including the voices of sexual minority youth and explores the meaning of social connection in their lives. Youth discuss the ways in which individual connection and group affiliation served to affirm one's identity, and provided a forum for moving personal struggle to collective action. The findings suggest the need to reconceptualize consequences of disconnection (such as depression or suicide) from individual pathology and attend to these consequences as a response to discrimination and stigma. Implications for these findings and areas for future research are discussed. © 2011 Elsevier Ltd.
Keywords: Discrimination; Marginalized groups; Resilience; Sexual minority; Social connection; USA; Youth

Sexual attraction, depression, self-harm, suicidality and help-seeking behaviour in New Zealand secondary school students - Lucassen, M.F.G.; Merry, S.N.; Robinson, E.M.; Denny, S.; Clark, T.; Ameratunga, S.; Crengle, S.; Rossen, F.V. (Australian and New Zealand Journal of Psychiatry, 2011)
Objective: To describe the sexual attractions of New Zealand secondary school students and investigate the associations between sexual attraction and self-reported depression, self-harm, suicidality and help-seeking behaviour. Method: Multiple logistic regression was used to examine the associations between sexual attraction and depressive symptoms, suicidality, self-harming and help-seeking behaviours in a nationally representative secondary school health and well-being survey, undertaken in 2007. Results: Of the students surveyed, 92% were attracted to the opposite sex, 1% to the same sex, 3% to both sexes, 2% were not sure and 2% were attracted to neither sex. Students who were attracted to the same or to both sexes consistently had higher prevalence estimates of depression (p = < 0.0001), suicidality (p = < 0.0001) and self-harming (p = < 0.0001). Odds ratios were highest for students who reported they were attracted to both sexes for depressive symptoms (OR 3.7, 95%CI 2.84.7), self-harm (OR 5.8, 95%CI 4.47.6) and attempted suicide (OR 7.0, 95%CI 5.29.4). Students not exclusively attracted to the opposite sex were more likely to report having seen a health professional for an emotional worry and were more likely to have difficulty accessing help for emotional concerns. Conclusions: The study findings highlight significant mental health disparities faced by students attracted to the same or both sexes, with those attracted to both sexes appearing particularly vulnerable. There is a vital need to ensure primary care and mental health services have the capacity and capability to screen and provide appropriate responsive care for youth who are attracted to the same or both sexes. © 2011 The Royal Australian and New Zealand College of Psychiatrists.
Keywords: Adolescent; deliberate self-harm; depression; sexuality; suicide

How depressed and suicidal sexual minority adolescents understand the causes of their distress - Diamond, G.M.; Shilo, G.; Jurgensen, E.; D'Augelli, A.; Samarova, V.; White, K. (Journal of Gay and Lesbian Mental Health, 2011)
This study examined how lesbian, gay, and bisexual (LGB) adolescents reporting clinically significant depressive and suicidal symptoms understand the causes of their psychological distress. The role of the quality of the adolescent-parent relationship as a risk or protective factor was explored. Ten qualitative interviews were analyzed using the Consensual Qualitative Research method. Results showed that adolescents viewed family rejection of sexual orientation, extra-familial LGB related victimization, and non-LGB related negative family life events as the most common causes of their psychological distress. Most of the adolescents also reported experiencing support from at least one family member, and half reported experiencing significant extra-familial (e.g., peers, school counselor) support. Almost all of the adolescents reported wishing that their relationships with their parents were closer and characterized by more acceptance, as well as a willingness to participate in family therapy to improve their relationships with their parents. Clinical implications are discussed. © Taylor & Francis Group, LLC.
Keywords: Adolescent; Bisexual; Depression; Family therapy; Gay; Lesbian; Parents; Suicide

A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormones - Asscheman, H.; Giltay, E.J.; Megens, J.A.J.; De Ronde, W.; Van Trotsenburg, M.A.A.; Gooren, L.J.G. (European Journal of Endocrinology, 2011)
Objective: Adverse effects of long-term cross-sex hormone administration to transsexuals are not well documented. We assessed mortality rates in transsexual subjects receiving long-term cross-sex hormones. Design: A cohort study with a median follow-up of 18.5 years at a university gender clinic. Methods: Mortality data and the standardized mortality rate were compared with the general population in 966 male-to-female (MtF) and 365 female-to-male (FtM) transsexuals, who started cross-sex hormones before July 1, 1997. Follow-up was at least 1 year. MtF transsexuals received treatment with different high-dose estrogen regimens and cyproterone acetate 100 mg/day. FtM transsexuals received parenteral/oral testosterone esters or testosterone gel. After surgical sex reassignment, hormonal treatment was continued with lower doses. Results: In the MtF group, total mortality was 51% higher than in the general population, mainly from increased mortality rates due to suicide, acquired immunodeficiency syndrome, cardiovascular disease, drug abuse, and unknown cause. No increase was observed in total cancer mortality, but lung and hematological cancer mortality rates were elevated. Current, but not past ethinyl estradiol use was associated with an independent threefold increased risk of cardiovascular death. In FtM transsexuals, total mortality and cause-specific mortality were not significantly different from those of the general population. Conclusions: The increased mortality in hormone-treated MtF transsexuals was mainly due to nonhormone-related causes, but ethinyl estradiol may increase the risk of cardiovascular death. In the FtM transsexuals, use of testosterone in doses used for hypogonadal men seemed safe. © 2011 European Society of Endocrinology.

A Review of the Evidence on the Effects of Intimate Partner Violence on Men - Randle, A.A.; Graham, C.A. (Psychology of Men and Masculinity, 2011)
This review examines the empirical evidence on the effects of intimate partner violence (IPV) in men. The main theoretical frameworks used in this area are outlined, and methodological issues are discussed. Studies examining posttraumatic stress (PTS) symptoms, depression, and suicidal ideation in men who have experienced IPV are reviewed. The limited research on the effects of IPV in same-sex couples is considered. Outcomes suggest that men can experience significant psychological symptoms as a consequence of IPV; associations among IPV and PTS, depression, and suicide have been documented. Recommendations for future research on the effects of IPV in male victims are provided, including the need to focus on externalizing, in addition to internalizing, symptomatology; the development of gender-appropriate measures of violent behavior; and the comparison of male IPV and non-IPV samples. In-depth qualitative research and studies focusing on psychological abuse experienced by men would also be valuable. © 2011 American Psychological Association.
Keywords: Intimate partner violence; Male violence

Is there a right not to know one's sex? The ethics of 'gender verification' in women's sports competition - Wiesemann, C. (Journal of Medical Ethics, 2011)
The paper discusses the current medical practice of 'gender verification' in sports from an ethical point of view. It takes the recent public discussion about 800 m runner Caster Semenya as a starting point. At the World Championships in Athletics 2009 in Berlin, Germany, Semenya was challenged by competitors as being a so called 'sex impostor'. A medical examination to verify her sex ensued. The author analyses whether athletes like Semenya could claim a right not to know that is generally acknowledged in human genetics and enforced by international and national genetic privacy laws. The relevance of this right for genetic diagnosis in sports is discussed. To this end, the interests of the athlete concerned and of third parties are balanced according to the expected benefits and harms.Harm is documented in a number of cases and includes unjustified disqualification, severe sex and gender identity crisis, demeaning reactions, social isolation, depression and suicide. Benefits are dubious as most cases of intersex are considered irrelevant for sports competition. It has to be concluded that the benefits to be gained from 'gender verification' in sports via genetic testing do not outweigh the grave individual disadvantages. The current practice of athletic associations to largely ignore the right of competitors not to know does not comply with prevailing ethical provisions on the protection of sensitive personal data. Therefore, genetic 'gender verification' in sports should be abolished.

Adolescent health screening practices by physicians in Jamaica - Harrison, A.; Pierre, R.; Gordon-Strachan, G.; Campbell-Forrester, S.; Leslie, K. (Revista Panamericana de Salud Publica/Pan American Journal of Public Health, 2011)
Objective. To review Jamaican physicians' adolescent health screening practices by determining their frequency in areas of biomedical, psychological, social, and educational health; the factors that influence these practices; and physicians' perceived level of self-efficacy and their awareness of screening tools and guidelines. Methods. A questionnaire was mailed to general practitioners, family medicine specialists, and pediatricians in Jamaica. The primary outcome variable was the frequency of physician screening for a range of biomedical, psychosocial, and educational developmental issues in the majority (≥ 50%) of adolescent patients. Bivariate analyses were performed to determine differences between professional groups. Results. The response rate was 32.3% (n = 213), with 209 responders being suitable for further analysis. The sample comprised 48.8% general practitioners, 33.0% family medicine specialists, and 18.2% pediatricians. Physicians more often screened for biomedical risks than for psychosocial risks, with very low frequencies of screening for psychosocial issues such as mood, suicidal ideation, sexual orientation, and safety concerns. Physicians reported high levels of confidence in discussing most psychosocial issues with adolescent patients. Time limitation and an insufficient knowledge base were the main factors identified as influencing screening practices. Conclusions. The data suggest unsatisfactory frequency of adolescent health screening by Jamaican physicians, in particular for psychosocial factors. The primary factors identified by physicians as influencing their screening practices have potential for improvement through continued medical education.
Keywords: Adolescent health; Jamaica; Physician's practice patterns

Long-term follow-up of transsexual persons undergoing sex reassignment surgery: Cohort study in Sweden - Dhejne, C.; Lichtenstein, P.; Boman, M.; Johansson, A.L.V.; Långström, N.; Landén, M. (PLoS ONE, 2011)
Context: The treatment for transsexualism is sex reassignment, including hormonal treatment and surgery aimed at making the person's body as congruent with the opposite sex as possible. There is a dearth of long term, follow-up studies after sex reassignment. Objective: To estimate mortality, morbidity, and criminal rate after surgical sex reassignment of transsexual persons. Design: A population-based matched cohort study. Setting: Sweden, 1973-2003. Participants: All 324 sex-reassigned persons (191 male-to-females, 133 female-to-males) in Sweden, 1973-2003. Random population controls (10:1) were matched by birth year and birth sex or reassigned (final) sex, respectively. Main Outcome Measures: Hazard ratios (HR) with 95% confidence intervals (CI) for mortality and psychiatric morbidity were obtained with Cox regression models, which were adjusted for immigrant status and psychiatric morbidity prior to sex reassignment (adjusted HR [aHR]). Results: The overall mortality for sex-reassigned persons was higher during follow-up (aHR 2.8; 95% CI 1.8-4.3) than for controls of the same birth sex, particularly death from suicide (aHR 19.1; 95% CI 5.8-62.9). Sex-reassigned persons also had an increased risk for suicide attempts (aHR 4.9; 95% CI 2.9-8.5) and psychiatric inpatient care (aHR 2.8; 95% CI 2.0-3.9). Comparisons with controls matched on reassigned sex yielded similar results. Female-to-males, but not male-to-females, had a higher risk for criminal convictions than their respective birth sex controls. Conclusions: Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism, and should inspire improved psychiatric and somatic care after sex reassignment for this patient group. © 2011 Dhejne et al.

Artists' rifles and artistic licence: Edward Dent's war - Arrandale, K. (First World War Studies, 2011)
In the years before 1914, Edward Dent had devoted his youth to establishing music as an academic subject, and the performing arts and literature as essential elements of ordinary life. He built up a creative nexus in pre-war Cambridge, and the young men in his circle, many of them homosexual, began to take the unprecedented step of becoming professional musicians and artists. When the first crop of his carefully nurtured and highly talented students went off to war he was at first devastated. But his practical side took over, and he spent the rest of the war engaged in writing and translating for the pacifist Cambridge Magazine. In an atmosphere of increased stifling of any form of dissent, he built up a new circle of like-minded young men, mostly through a vast correspondence, which became a kind of forum for ideas kept alive in the direst circumstances. When the war ended, Dent and his circle were able to carry on where they had left off, establishing theatre, music and opera for all. This paper focuses on how music in particular was kept alive through Dent himself, and his correspondence with Arthur and Kennard Bliss, Denis Browne, Ralph Vaughan Williams, Clive Carey, Rupert Brooke and J.B. Trend. © 2011 Taylor & Francis.
Keywords: Arthur Bliss; Clive Carey; Denis Browne; Homosexuality; J.B. Trend; Kennard Bliss; Pacifism; Ralph Vaughan Williams; Rupert Brooke

Context of sexual risk behaviour among abused ethnic minority adolescent women - Champion, J.D. (International Nursing Review, 2011)
Background: Evidence suggests that multiple influences on sexual behaviour of adolescents exist, ranging from relationships with significant others including sexual or physical abuse and childhood molestation to substances used prior to sex and environmental circumstances such as sex work. Purpose: This study aims to describe associations between childhood molestation and sexual risk behaviour. Method: African American and Mexican American adolescent women aged 14-18 years (n=562) with sexually transmitted infection (STI) or abuse histories and enrolled in a randomized controlled trial of behavioural interventions were interviewed via self-report concerning sexual risk behaviour, abuse and childhood molestation at study entry. Results: Sexual (59%), physical (77%) and psychological (82%) abuse and childhood molestation (25%) were self-reported without differences by ethnicity. Adolescents reporting childhood molestation experienced more forms of sexual, physical and psychological abuse than others and higher incidences of STI. Fewer attended school; however, more had arrests, convictions, incarcerations and probations. Stressors including depression, running away, thoughts of death and suicide were highest for those reporting childhood molestation. Those reporting childhood molestation engaged in higher sexual risk behaviours than adolescents experiencing other forms of sexual or physical abuse (lifetime partners, bisexual relationships, anal and group sex, sex with friends with benefits, sex for money, concurrent partners, drug use including multiple substances, alcohol use and alcohol problems). These adolescents reported 'getting high' and having sex when out of control as reasons for sex with multiple partners. Conclusion: Interventions for abused adolescent women necessitate a focus on associations between childhood molestation and a multiplicity of sexual risk behaviours for prevention of abuse, substance use and sex work, STI/human immunodeficiency virus (HIV) and sequelae. © 2011 The Author. International Nursing Review © 2011 International Council of Nurses.
Keywords: Abuse; Adolescent women; Childhood molestation; Drug use; Sexual risk behaviours; STI/HIV

Mental health of the non-heterosexual population of England - Chakraborty, A.; McManus, S.; Brugha, T.S.; Bebbington, P.; King, M. (British Journal of Psychiatry, 2011)
Background: There has been little research into the prevalence of mental health problems in lesbian, gay and bisexual (LGB) people in the UK with most work conducted in the USA. Aims: To relate the prevalence of mental disorder, self-harm and suicide attempts to sexual orientation in England, and to test whether psychiatric problems were associated with discrimination on grounds of sexuality. Method: The Adult Psychiatric Morbidity Survey 2007 (n = 7403) was representative of the population living in private UK households. Standardised questions provided demographic information. Neurotic symptoms, common mental disorders, probable psychosis, suicidality, alcohol and drug dependence and service utilisation were assessed. In addition, detailed information was obtained about aspects of sexual identity and perceived discrimination on these grounds. Results: Self-reported identification as non-heterosexual (determined by both orientation and sexual partnership, separately) was associated with unhappiness, neurotic disorders overall, depressive episodes, generalised anxiety disorder, obsessive-compulsive disorder, phobic disorder, probable psychosis, suicidal thoughts and acts, self-harm and alcohol and drug dependence. Mental health-related general practitioner consultations and community care service use over the previous year were also elevated. In the non-heterosexual group, discrimination on the grounds of sexual orientation predicted certain neurotic disorder outcomes, even after adjustment for potentially confounding demographic variables. Conclusions: This study corroborates international findings that people of non-heterosexual orientation report elevated levels of mental health problems and service usage, and it lends further support to the suggestion that perceived discrimination may act as a social stressor in the genesis of mental health problems in this population.

The association between relationship markers of sexual orientation and suicide: Denmark, 1990-2001 - Mathy, R.M.; Cochran, S.D.; Olsen, J.; Mays, V.M. (Social Psychiatry and Psychiatric Epidemiology, 2011)
Objective: Minority sexual orientation has been repeatedly linked to elevated rates of suicide attempts. Whether this translates into greater risk for suicide mortality is unclear. We investigated sexual orientation-related differences in suicide mortality in Denmark during the initial 12-year period following legalization of same-sex registered domestic partnerships (RDPs). Method: Using data from death certificates issued between 1990 and 2001 and population estimates from the Danish census, we estimated suicide mortality risk among individuals classified into one of three marital/cohabitation statuses: current/formerly in same-sex RDPs; current/formerly heterosexually married; or never married/registered. Results: Risk for suicide mortality was associated with this proxy indicator of sexual orientation, but only significantly among men. The estimated age-adjusted suicide mortality risk for RDP men was nearly eight times greater than for men with positive histories of heterosexual marriage and nearly twice as high for men who had never married. Conclusions: Suicide risk appears greatly elevated for men in same-sex partnerships in Denmark. To what extent this is true for similar gay and bisexual men who are not in such relationships is unknown, but these findings call for targeted suicide prevention programs aimed at reducing suicide risk among gay and bisexual men. © 2009 The Author(s).
Keywords: Gay; Homosexuality; Lesbian; Mortality; Suicide

Sexual orientation and its relation to mental disorders and suicide attempts: Findings from a nationally representative sample - Bolton, S.-L.; Sareen, J. (Canadian Journal of Psychiatry, 2011)
Objective: To compare the rates of all Axis I and II mental disorders and suicide attempts in sexual orientation minorities with rates in heterosexuals using a nationally representative sample. Method: Data used were from the National Epidemiologic Survey on Alcohol and Related Conditions Wave 2 (n = 34 653, response rate = 70.2%). Cross-tabulations and multivariate logistic regression analyses were performed to determine differences in rates of mental disorders and suicide attempts by sexual orientation. All analyses were stratified by sex. Results: Compared with their heterosexual counterparts, lesbians and bisexual women demonstrated a 3-fold increased likelihood of substance use disorders, and gay and bisexual men showed twice the rate of anxiety disorders and schizophrenia and (or) psychotic illness, even after accounting for mental disorder comorbidity. Suicide attempts were independently associated with bisexuality, with odds 3 times higher than in heterosexuals. Conclusion: Findings from our study emphasize the fact that sexual orientation minorities are vulnerable to poor mental health outcomes, including suicide attempts. Clinicians need to be aware of these specific negative mental health consequences when assessing sexual orientation minorities.
Keywords: Attempts; Gay; Lesbian; Mental disorders; National Epidemiologic Survey on Alcohol and Related Conditions; Sexual minorities; Suicide

Preventing bullycides: the school nurse's role in breaking the link between victimization of sexual minority youth and suicide. - Reynolds, D.V. (NASN school nurse (Print), 2011)

The perception of young lesbians and gays regarding the attitude of their parents with respect to their homosexuality - Charbonnier, É.; Graziani, P. (Canadian Journal of Community Mental Health, 2011)
The aim of this study is to better comprehend vulnerability factors for young gays and lesbians and the connection between these factors and their parents' attitudes about their homosexuality. The research was carried out in France with 82 young gays and lesbians. In this group, 66[%] stated that they have had suicidal thoughts and 31[%] reported having attempted suicide. These results illustrate the vulnerability of this community. Furthermore, perceiving paternal attitudes as rejecting was correlated with the presence of suicidal ideation and at least one suicide attempt. In the same way, when maternal reactions were perceived as negative, they were correlated with difficulty in social interactions and a strong level of worry. Parents' attitudes towards homosexuality constitute a key element in the high level of distress and suicide risk among young gays and lesbians.

Comparing health and mental health needs, service use, and barriers to services among sexual minority youths and their peers - Williams, K.A.; Chapman, M.V. (Health and Social Work, 2011)
Using a representative national sample (N = 20,745), this article explores health and mental health needs, service use, and barriers to services among sexual minority youths (SMYs) and heterosexual peers. SMYs were defined by ever having a same-sex romantic attraction or having a recent same-sex romantic relationship or sexual partner. SMYs accounted for 7.5 percent of the sample. Data were analyzed to ascertain prevalence of risks and explore group differences. Compared with peers, SMY self-reports indicated higher prevalence rates on all indicators of health and mental health need. SMYs reported more sexual activity, more sexually transmitted disease diagnoses, a higher perceived risk for HIV/AIDS, and more forgone medical care than peers. Also compared with peers, SMYs reported higher levels of anxiety, depression, suicidality, and physical and sexual victimization and higher rates of unmet mental health need. SMYs also reported greater concerns about confidentiality and were less likely to use school-based services. The majority of SMYs reported same-sex attraction only. Social work and other helping professionals should incorporate same-sex attraction questions into assessment protocols to target services for this population. School-and office-based providers must consider whether their services are welcoming and offer sufficient assurances of confidentiality to facilitate access by SMYs.
Keywords: Health; LGB youths; Mental health need; Service use; Sexual minority

Transgender patients sidelined by attitudes and labelling - Bateman, C. (South African Medical Journal, 2011)

Sexual attraction status and adolescent suicide proneness: The roles of hopelessness, depression, and social support - Langhinrichsen-Rohling, J.; Lamis, D.A.; Malone, P.S. (Journal of Homosexuality, 2011)
This study explored the relationship between sexual attraction status (same-sex, both-sex, and opposite-sex) and suicidal behavior in a diverse sample of adolescents (N = 1,533 youth). Adolescents with attractions to both sexes reported greater suicide proneness, recent and lifetime suicidal ideation, and past suicide attempts than those with exclusively opposite-sex attractions; individuals reporting same-sex attractions generally demonstrated moderate elevations on these variables. As hypothesized, both hopelessness and depression mediated the relationship between sexual attraction status and suicide proneness. Social support moderated the mediating effect of depression but not hopelessness in the sexual attraction status-suicide proneness link. Targeting the distress that can be associated with experiencing same-sex or both-sex attractions may enhance suicide prevention efforts, particularly in U.S. youth with reduced social support. © Taylor & Francis Group, LLC.
Keywords: Adolescents; Depression; Homosexuality; Hopelessness; Social support; Suicidal behavior

Introduction to special issue on suicide, mental health, and youth development - Eliason, M. (Journal of Homosexuality, 2011)

Examining victimization and psychological distress in transgender college students - Effrig, J.C.; Bieschke, K.J.; Locke, B.D. (Journal of College Counseling, 2011)
Treatment-seeking and non-treatment-seeking transgender college students were examined with regard to victimization and psychological distress. Findings showed that transgender college students had elevated rates of distress as compared with college students who identified as men or women. Results indicated that treatment-seeking and non-treatment-seeking transgender college students did not significantly differ with regard to psychological distress or experiences of victimization, with the exception of rates of suicidal ideation. © 2011 by the American Counseling Association. All rights reserved.

Daughters of the new revolutionary war: Representations of confederate women and gun culture in the confederate press, 1861-1864 - Cronin Lamonica, M.M. (American Journalism, 2011)
This research examines how Southern editors at twenty newspapers across the length of the Confederacy represented news stories ofwomen soldiers and militia members. Although some editors cast a wary eye at women who cross-dressed and went off to battle, this article argues that the promotion ofthese women soldiers provided a unique opportunity for editors who sought to use their publications to promote Confederate nationalist beliefs. Women soldiers were held up as exemplars ofthose beliefs. Stories of women soldiers also served two other important purposes: Editors used such stories to boost morale, showing that even women wouldfight to help their husbands, brothers, and fathers build a new nation. Such stories also were used to shame men not in service to don uniforms and undertake their civic duty for the good ofthe South. © 2011, American Journalism Historians Association.

Obsessive compulsive disorder with psychosis NOS, in an asexual male: A diagnostic challenge - Smigas, T.; Nevue, J.; Gadit, A.M. (BMJ Case Reports, 2011)
A 28-year-old asexual Malaysian male presented for emergency assessment with suicidal thoughts, paranoid delusions and increasing time spent on ritualistic behaviours that included hand washing, door checking and religious chanting. His obsessions were primarily related to counting, perfectionism, contamination and chanting. The patient found himself compelled to complete numerous rituals including chanting religiously to 1000, having to restart in the event of an error during such and also described delusions of being followed by a woman who was analysing his life pattern in order to steal from him. He then started to proclaim himself to be Buddha as he believed this would keep his dead grandmother away from him, thus avoiding supposed persecution from her. Following optimisation of both escitalpram and olanzapine, a slight reduction in the patient's ritualistic behaviour and psychotic phenomenon were witnessed. Copyright 2011 BMJ Publishing Group. All rights reserved.

Gender differences in the pattern of organophosphorus poisoning in a tribal distict of Andhra Pradesh - Bashir, M.S.M.; Khade, A.; Bhagat, S.; Irfanuddin, M. (Indian Journal of Forensic Medicine and Toxicology, 2011)
Gender differences in the pattern of organophosphorus poisoning in a tribal distict of andhra Pradesh Msm bashir, a khade,s bhagat, m irfanuddin Objectives Retrospective study for gender differences in the pattern of organophosphorus (OP) poisoning in Adilabad, a tribal district of Andhra Pradesh was carried out to know the present status. Materials and methods Data was collected from the records of OP poisoning patients admitted in RIMS Adilabad, a government medical college, for the period of 1st May 2005 to 30th April 2010. Gender differences were seen for death, hospital stay, time of consumption and age. Results 70% males and 30% females were involved with peak cases during 2009-10. Death rate was 16 to 20% in male with majority of cases during monsoon season while in female it was less than 15% without seasonal variations. Mean hospital stay was almost similar in both genders. Time of consumption was evening and night hours in male and afternoon in female. Male from 3rd decade onwards and female in their 2nd and 3rd decade were commonly involved. Conclusion Better policies to reduce the impact of monsoon failure and overall development of female are needed.
Keywords: Death; Op poisoning; Suicide

Health behaviors in the development and maintenance process of homosexual identity - Patthum, T.; Kessomboon, P.; Sinsuphan, N.; Ratanasiri, A. (Journal of the Medical Association of Thailand, 2010)
Background: Health behaviors of men who have sex with men (MSM) affect their health status in many aspects. Rate of HIV infection among Thai male prostitutes in 2005 was 15.4%. Among these, 28.3% were MSM. Thirty percent of youth suicides were conducted by gays and lesbians. Objective: To explore the health behaviors related to the development and maintenance process of men who have sex with men. Material and Method: This was a qualitative study. The study population was MSM in Mukdahan province. The subjects were recruited gradually, by snowball sampling, until the required data were saturated. In-depth interviews and participant observations were performed over a period of 17 months. A triangulation technique was applied to check reliability of the data. Data were analyzed by content analysis and compared with the Troiden's stages of development and maintenance process of homosexual identity. Results: Eleven Thai MSM were recruited and followed up. Health behaviors of them were different according to the stages of development and maintenance process regarding Troiden's theory. Physical, psychological, social and sexual aspects of health behaviors were identified in various stages. It was found that many factors affect health behaviors of MSM. These include health promoting and undermining factors. Conclusion: Health behaviors of MSM varied in each stage of development and maintenance of homosexual identity. Health promotion campaigns and policies for MSM should be designed accordingly.
Keywords: Development and maintenance process; Health behavior; Homosexual identity; Men who have sex with men; MSM

Group differences in risk across three domains using an expanded measure of sexual orientation - Loosier, P.S.; Dittus, P.J. (Journal of Primary Prevention, 2010)
The purpose of this study was to highlight associations between sexual orientation and risk outcomes in late adolescence and early adulthood using an expanded measure of sexual orientation. Recent data indicate higher levels of risk behavior in a newly identified population, mostly heterosexuals, as compared to heterosexuals. Comparisons among groups using an expanded measure of sexual orientation such as this, however, often do not include all possible groups or may restrict comparisons between groups. Data were derived from the National Longitudinal Study of Adolescent Health (Add Health); participants identified as heterosexual, mostly heterosexual, bisexual, mostly gay, or gay. Main risk outcomes were parental mistreatment, home displacement, thoughts of suicide, depressive symptoms, frequency of drinking, and delinquency. A priori planned comparisons examined differences between: (a) heterosexual vs. mostly heterosexual, (b) gay vs. mostly gay, (c) mostly heterosexual vs. bisexual, (d) mostly gay vs. bisexual, (e) mostly heterosexual vs. mostly gay, (f) heterosexual vs. gay, (g) heterosexual vs. bisexual, and (h) gay vs. bisexual. Mostly heterosexual youth were at significantly greater risk than heterosexual youth on all outcomes but did not differ from bisexual or mostly gay youth. Heterosexuals were at lower risk as compared to mostly heterosexuals and bisexuals. This study provides further evidence of differential risk associations for sexual minorities. © 2010 Springer Science+Business Media, LLC (outside the USA).
Keywords: Adolescence; Bisexual; Externalizing behaviors; Heterosexual; Homosexual; Internalizing behaviors; Sexual minority

Mental health disorders, psychological distress, and suicidality in a diverse sample of lesbian, gay, bisexual, and transgender youths - Mustanski, B.S.; Garofalo, R.; Emerson, E.M. (American Journal of Public Health, 2010)
Objectives. We examined associations of race/ethnicity, gender, and sexual orientation withmental disorders among lesbian, gay, bisexual and transgender (LGBT) youths. Methods. We assessed mental disorders by administering a structured diagnostic interview to a community sample of 246 LGBT youths aged 16 to 20 years. Participants also completed the Brief Symptom Inventory 18 (BSI 18). Results. One third of participants met criteria for any mental disorder, 17% for conduct disorder, 15% for major depression, and 9% for posttraumatic stress disorder. Anorexia and bulimia were rare. Lifetime suicide attempts were frequent (31%) but less so in the prior 12 months (7%). Few racial/ethnic and gender differences were statistically signi?cant. Bisexually identi?ed youths had lower prevalences of every diagnosis. The BSI 18 had high negative predictive power (90%) and low positive predictive power (25%) for major depression. Conclusions. LGBT youths had higher prevalences of mental disorder diagnoses than youths in national samples, but were similar to representative samples of urban, racial/ethnic minority youths. Suicide behaviors were similar to those among representative youth samples in the same geographic area. Questionnaires measuring psychological distress may overestimate depression prevalence among this population.

The relation between sexual orientation and suicide attempts in Austria - Plöderl, M.; Kralovec, K.; Fartacek, R. (Archives of Sexual Behavior, 2010)
Previous studies indicate that homosexual or bisexual individuals are at a higher risk of attempting suicide compared to heterosexuals. To overcome biases in these studies, more rigorous definitions of "suicide attempts" and the assessment of multiple dimensions of sexual orientation are needed. In addition, studies from the German speaking region are sparse, especially those not recruiting participants from the gay or lesbian communities. We solicited self-reported suicide attempts among 1,382 Austrian adults recruited through structured snowball sampling from students' social networks. Suicide attempts were more frequently reported by those participants with homosexual or bisexual fantasies, partner preference, behavior, and self-identification, compared to their heterosexually classified counterparts. This was true for any dimension of sexual orientation and for suicide attempts with intent to die or suicide attempts that required medical treatment. Our Austrian study confirmed existing evidence that homosexual and bisexual individuals are at an increased risk for attempting suicide. This should be considered in suicide preventive efforts. © Springer Science+Business Media, LLC 2010.
Keywords: Homosexuality; Sexual orientation; Suicide attempts

Family acceptance in adolescence and the health of LGBT young adults - Ryan, C.; Russell, S.T.; Huebner, D.; Diaz, R.; Sanchez, J. (Journal of Child and Adolescent Psychiatric Nursing, 2010)
Issue: The role of family acceptance as a protective factor for lesbian, gay, bisexual, and transgender (LGBT) adolescents and young adults has not been established. Methods: A quantitative measure with items derived from prior qualitative work retrospectively assessed family accepting behaviors in response to LGBT adolescents' sexual orientation and gender expression and their relationship to mental health, substance abuse, and sexual risk in young adults (N = 245). Findings: Family acceptance predicts greater self-esteem, social support, and general health status; it also protects against depression, substance abuse, and suicidal ideation and behaviors. Conclusions: Family acceptance of LGBT adolescents is associated with positive young adult mental and physical health. Interventions that promote parental and caregiver acceptance of LGBT adolescents are needed to reduce health disparities. © 2010 Wiley Periodicals, Inc.
Keywords: Gender identity; Homosexuality; LGBT adolescent; Protective factors; Sexual orientation; Transgender

A systematic review of parental influences on the health and well-being of lesbian, gay, and bisexual youth: Time for a new public health research and practice agenda - Bouris, A.; Guilamo-Ramos, V.; Pickard, A.; Shiu, C.; Loosier, P.S.; Dittus, P.; Gloppen, K.; Michael Waldmiller, J. (Journal of Primary Prevention, 2010)
Relatively little is known about how parents influence the health and well-being of lesbian, gay, and bisexual (LGB) adolescents and young adults. This gap has led to a paucity of parent-based interventions for LGB young people. A systematic literature review on parental influences on the health of LGB youth was conducted to better understand how to develop a focused program of applied public health research. Five specific areas of health among LGB young people aged 10-24 years old were examined: (a) sexual behavior; (b) substance use; (c) violence and victimization; (d) mental health; and (e) suicide. A total of 31 quantitative articles were reviewed, the majority of which were cross-sectional and relied on convenience samples. Results indicated a trend to focus on negative, and not positive, parental influences. Other gaps included a dearth of research on sexual behavior, substance use, and violence/ victimization; limited research on ethnic minority youth and on parental influences identified as important in the broader prevention science literature; and no studies reporting parent perspectives. The review highlights the need for future research on how parents can be supported to promote the health of LGB youth. Recommendations for strengthening the research base are provided. © 2010 Springer Science+Business Media, LLC.
Keywords: Adolescents; Bisexual; Gay; Health risk behavior; Lesbian; Mental health; Parental influences; Same-sex attraction; Sexual behavior; Substance use; Suicide; Victimization; Violence; Young adults

We are Marshall Bloom: Sexuality, suicide, and the collective memory of the Sixties - Slonecker, B. (Sixties, 2010)
This essay examines the collective memory of Liberation News Service co-founder Marshall Bloom. A minor yet influential figure in the constellation of American New Leftists, Bloom played active roles in the civil rights, antiwar, and student movements, the underground media, and the communal counterculture. In the 40 years since Bloom's 1969 suicide, commentators have attached a medley of meanings to his life and death, casting him as a misguided counterculture narcissist, a Movement martyr, a closeted homosexual, and a revolutionary organic farmer. This essay explores these representations of Bloom to illustrate how they constitute a collective memory that is as variable as Bloom and the Sixties were complex. © 2010 Taylor & Francis.
Keywords: communal counterculture; gay liberation; Liberation News Service; Marshall Bloom; memory; Montague Farm; organic farming; suicide; the Sixties and memory

Domestic violence screening: Prevalence and outcomes in a canadian HIV population - Siemieniuk, R.A.C.; Krentz, H.B.; Gish, J.A.; Gill, M.J. (AIDS Patient Care and STDs, 2010)
There is a strong association between domestic violence victimization and HIV infection. This may lead to poor health outcomes including mental health disorders and reduced access to care. A standardized domestic violence screening interview was incorporated into ongoing care in the large and diverse population living with HIV in Southern Alberta, Canada. Results from May through December 2009 are reported, including the prevalence and outcomes of abuse. Thirty-four percent of 853 patients screened reported abuse. Of these, 16% reported abuse in their current relationship, 58% in a previous relationship, and 57% reported a history of childhood abuse. High-risk groups for abuse included females (43%), gay/bisexual males (35%), and Aboriginals (61%). We found an association between a history of domestic violence and delayed access to care (p<0.05), missed appointments (p<0.001), and an increased use of clinic resources such as social work (p<0.0001) and psychiatry (p<0.001). Mental health conditions prior to HIV diagnosis, including depression (p<0.0001), suicidal ideation (p<0.0001), and anxiety disorder (p<0.0001) were associated with abuse at any time, while a history of adjustment disorder was associated with childhood abuse (p<0.05). A simple domestic violence screening tool was helpful for identifying patients experiencing abuse in our diverse HIV-infected population. This high prevalence of domestic violence among our HIV patients was associated with poor outcomes and an increased use of medical resources. HIV caregivers should be aware of domestic violence in order to optimize care and refer patients to appropriate support professionals as needed. © Copyright 2010, Mary Ann Liebert, Inc.

The cause of P. I. Tchaikovsky's (1840 - 1893) death: Cholera, suicide, or both? - Kornhauser, P. (AMHA - Acta Medico-Historica Adriatica, 2010)
The death of P. I. Tchaikovsky (1840-1893) excites imagination even today. According to the »official scenario«, Tchaikovsky had suffered from abdominal colic before being infected with cholera. On 2 November 1893, he drank a glass of unboiled water. A few hours later, he had diarrhoea and started vomiting. The following day anuria occured. He lost consciousness and died on 6 November (or on 25 Oktober according to the Russian Julian calendar). Soon after composer's death, rumors of forced suicide began to circulate. Based on the opinion of the musicologist Alexandra Orlova, the main reason for the composer's tragic fate lies in his homosexual inclination. The author of this article, after examining various sources and arguments, concludes that P. I. Tchaikovsky died of cholera.
Keywords: Cause of death; History of medicine 19th century; Musicians; P. I. Tchaikovsky; Pathografy; Russia

A population-based study of sexual orientation identity and gender differences in adult health - Conron, K.J.; Mimiaga, M.J.; Landers, S.J. (American Journal of Public Health, 2010)
Objectives. We provide estimates of several leading US adult health indicators by sexual orientation identity and gender to fill gaps in the current literature. Methods. We aggregated data from the 2001-2008 Massachusetts Behavioral Risk Factor Surveillance surveys (N = 67359) to examine patterns in self-reported health by sexual orientation identity and gender, using multivariable logistic regression. Results. Compared with heterosexuals, sexual minorities (i.e., gays/lesbians, 2% of sample; bisexuals, 1%) were more likely to report activity limitation, tension or worry, smoking, drug use, asthma, lifetime sexual victimization, and HIV testing, but did not differ on 3-year Papanicolaou tests, lifetime mammography, diabetes, or heart disease. Compared with heterosexuals, bisexuals reported more barriers to health care, current sadness, past-year suicidal ideation, and cardiovascular disease risk. Gay men were less likely to be overweight or obese and to obtain prostate-specific antigen tests, and lesbians were more likely to be obese and to report multiple risks for cardiovascular disease. Binge drinking and lifetime physical intimate partner victimization were more common among bisexual women. Conclusions. Sexual orientation disparities in chronic disease risk, victimization, health care access, mental health, and smoking merit increased attention. More research on heterogeneity in health and health determinants among sexual minorities is needed.

Psychiatric comorbidity among patients with gender identity disorder - Hoshiai, M.; Matsumoto, Y.; Sato, T.; Ohnishi, M.; Okabe, N.; Kishimoto, Y.; Terada, S.; Kuroda, S. (Psychiatry and Clinical Neurosciences, 2010)
Aims: Psychiatric comorbidity and mental instability seem to be important unfavorable prognostic factors for long-term psychosocial adjustment in gender identity disorder (GID). However, psychiatric comorbidity in patients with GID has rarely been assessed. In this study, we investigated the psychiatric comorbidity and life events of patients with GID in Japan. Methods: A total of 603 consecutive patients were evaluated independently by at least two senior psychiatrists at the GID clinic using clinical information and results of examinations. Results: Using DSM-IV criteria, 579 patients (96.0%) were diagnosed with GID. Among the GID patients, 349 (60.3%) were the female-to-male (FTM) type, and 230 (39.7%) were the male-to-female (MTF) type. Current psychiatric comorbidity was 19.1% (44/230) among MTF patients and 12.0% (42/349) among FTM patients. The lifetime positive history of suicidal ideation and self mutilation was 76.1% and 31.7% among MTF patients, and 71.9% and 32.7% among FTM patients. Among current psychiatric diagnoses, adjustment disorder (6.7%, 38/579) and anxiety disorder (3.6%, 21/579) were relatively frequent. Mood disorder was the third most frequent (1.4%, 8/579). Conclusions: Comparison with previous reports on the psychiatric comorbidity among GID patients revealed that the majority of GID patients had no psychiatric comorbidity. GID is a diagnostic entity in its own right, not necessarily associated with severe comorbid psychological findings. © 2010 Japanese Society of Psychiatry and Neurology.
Keywords: female-to-male type; gender; gender identity disorder; male-to-female type; psychiatric comorbidity

Now, he's not alive - Teman, E.D. (Qualitative Inquiry, 2010)
Through a mini-educational ethnography of a queer cultural center at a midsized, Western U.S. university, I explored the center's cultural importance on the college campus and in its surrounding community. During the course of this study, one of my gay male participants, an undergraduate student leader of the center, committed suicide. While interviewing several participants (three gay males and one lesbian), I inquired into their feelings about suicide in the gay community in general and into the suicide of the center's leader in particular. The words of four of my participants are captured in this poem. © The Author(s) 2010.
Keywords: cultural center; educational ethnography; gay; GLBT; research poetry; suicide; university

Suicide patterns and association with predictors among rhode island public high school students: A latent class analysis - Jiang, Y.; Perry, D.K.; Hesser, J.E. (American Journal of Public Health, 2010)
Objectives. We analyzed Rhode Island's 2007 Youth Risk Behavior Survey (YRBS) data to investigate suicide patterns and their association with suicide risk predictors among public high school students. Methods. We used latent class regression analysis of Rhode Island's 2007 YRBS data (from a random sample of 2210 public high school students) to model latent classes of suicide risk and identify predictors of latent class membership. Results. Four latent classes of suicide risk were modeled and predictors were associated with each: class 1 (emotionally healthy, 74%); class 2 (considered and planned suicide, 14%) was associated with being female, having low grades, being gay/lesbian/bisexual/ unsure, feeling unsafe at school, having experienced forced sexual intercourse, and self-perceived overweight; class 3 (attempted suicide, 6%) was associated with speaking a language other than English at home, being gay/lesbian/bisexual/ unsure, feeling unsafe at school, and forced sexual intercourse; and class 4 (planned and attempted suicide, 6%) was associated with the previously mentioned predictors and with being in 9th or 10th grade and currently smoking. Conclusions. A single model characterized and quantified 4 patterns of suicide risk among adolescents and identified predictors for 3 at-risk classes. Interventions for high-risk youths may help prevent adolescent suicides.

Chronic oral treatment with isotretinoin alters measures of activity but not anxiety in male and female rats - Ferguson, S.A.; Berry, K.J. (Neurotoxicology and Teratology, 2010)
Use of the anti-acne drug, Accutane® (ACC) (isotretinoin, 13-cis-retinoic acid), has been associated with neuropsychiatric events ranging from depression in animal models to depression and suicide ideation in humans. Our studies, however, have consistently indicated few effects on measures of depression in male and female rats. Still, the comorbidity of depression and anxiety suggests that anxiety assessments in ACC-treated rats could be informative. Such assessments must be balanced with measures of activity since drug-induced activity alterations may impact the expression of anxiety-like behaviors. Here, Sprague-Dawley rats (n=15/sex/dose) were gavaged daily with 0 (soy oil), 7.5, or 30. mg/kg/day ACC beginning on postnatal day (PND) 59. Blood ACC levels similar to humans taking recommended ACC doses are produced by 7.5. mg/kg/day. Short-term activity was assessed in open fields prior to ACC treatment (PND 51) and again at PNDs 129 and 164 and in a complex environment at PNDs 66 and PND 184. Long-term residential activity was measured in running wheels (PNDs 85-92) and figure 8 mazes (PNDs 99-106). Anxiety-like behavior was assessed via elevated plus maze (EPM) activity on PND 98 and in a black/white apparatus on PND 125. The typical sex differences in most behaviors were exhibited (i.e., increased EPM open arm entries and overall activity in most measures in females); however, there were no significant effects of ACC treatment on open field activity, complex environment activity, residential running wheel activity, or EPM activity. Residential figure 8 maze activity indicated that male and female rats treated with 30. mg/kg/day were less active on all nights (p<0.05) and females treated with 7.5 or 30. mg/kg/day were less active than same-sex controls on most days (p<0.05). Similarly, rats of both sexes treated with 30. mg/kg/day were significantly less active in the black/white apparatus (p<0.05), entering the darkened area less frequently (p<0.05), although duration in the darkened area did not differ. These data indicate that at blood levels typically achieved by humans (i.e., the 7.5. mg/kg group), there are no significant anxiogenic effects associated with ACC treatment. At higher ACC levels, there are mild effects on activity but these appear to be apparatus- and/or age-specific. © 2010.
Keywords: 13-cis-retinoic acid; Accutane; Activity; Anxiety; Isotretinoin; Rat

The contribution of school to the feeling of acceptance and the risk of suicide attempts among Austrian gay and bisexual males - Plöderl, M.; Faistauer, G.; Fartacek, R. (Journal of Homosexuality, 2010)
School-related factors contributing to the suicidality of lesbian, gay, and bisexual individuals are understudied, especially in Germanspeaking Europe. Among our Web-based sample of 468 Austrian gay or bisexual adults, 18% attempted suicide and about one half of them reported that hard times at school related to one's homosexuality partly or mainly caused the attempt. Such suicide attempts were associated with a lack of acceptance at school and harassment experiences. In contrast to suicide attempts, acceptance at school was significantly associated with protective factors such as teachers intervening against homophobia or presence of openly homosexual teachers or peers. These findings may be important for consideration in school-based suicide prevention programs. © Taylor & Francis Group, LLC.
Keywords: Adolescents; Bisexual; Gay; Homosexuality; School; Sexual orientation; Suicidality; Suicide; Suicide attempt

Barriers to optimal care between physicians and lesbian, gay, bisexual, transgender, and questioning adolescent patients - Kitts, R.L. (Journal of Homosexuality, 2010)
The objective of this article was to identify barriers to optimal care between physicians and LGBTQ (lesbian, gay, bisexual, transgender, and questioning) adolescents. To this end, 464 anonymous, self-administered surveys were distributed in 2003 to residents and attending physicians in pediatrics, internal medicine, obstetrics-gynecology, psychiatry, emergency medicine, and family practice at Upstate Medical University. The survey included questions pertaining to practice, knowledge, and attitude pertaining to lesbian, gay, transgender, or questioning (LGBTQ) adolescents. One hundred eight four surveys were returned. The majority of physicians would not regularly discuss sexual orientation, sexual attraction, or gender identity while taking a sexual history from a sexually active adolescent. As well, the majority of physicians would not ask patients about sexual orientation if an adolescent presented with depression, suicidal thoughts, or had attempted suicide. If an adolescent stated that he or she was not sexually active, 41% of physicians reported that they would not ask additional sexual health-related questions. Only 57% agreed to an association between being a LGBTQ adolescent and suicide. The majority of physicians did not believe that they had all the skills they needed to address issues of sexual orientation with adolescents, and that sexual orientation should be addressed more often with these patients and in the course of training. This study concludes that barriers in providing optimal care for LGBTQ adolescents can be found with regard to practice, knowledge, and attitude regardless of medical field and other demographics collected. Opportunities exist to enhance care for LGBTQ adolescents.
Keywords: Attitude; Bisexual; Gay; Knowledge; Lesbian; Physician; Practice; Sexual orientation; Transgender adolescents

Exploration of the resilience construct in posttraumatic stress disorder severity and functional correlates in military combat veterans who have served since September 11, 2001 - Green, K.T.; Calhoun, P.S.; Dennis, M.F.; Beckham, J.C.; Miller-Mumford, M.; Fernandez, A.; Taber, K.H.; Yoash-Gantz, R.E.; Moore, S.D.; Tupler, L.A. (Journal of Clinical Psychiatry, 2010)
Objective: This study evaluated the relationship between resilience and psychological functioning in military veterans deployed to a region of military conflict in support of Operation Enduring Freedom or Operation Iraqi Freedom. Method: 497 military veterans completed a structured psychiatric interview and questionnaires measuring psychological symptoms, resiliency, and trauma exposure. The study had 2 primary aims: (1) to examine whether the association between trauma exposure and PTSD was moderated by resilience and (2) to examine whether resilience was uniquely associated with functional outcomes after accounting for PTSD. Measures included the Structured Clinical Interview for DSM-IV-TR Axis I Disorders (for PTSD diagnosis), the Connor-Davidson Resilience Scale, and the Traumatic Life Events Questionnaire. Data were collected between June 2005 and February 2009. Results: Evaluating the association of resilience and trauma exposure with PTSD revealed main effects for combat exposure, lifetime trauma exposure, and resilience. Additionally, there was a significant (P < .05) interaction between combat exposure and resilience such that higher levels of resilience were particularly protective among individuals with high combat exposure. After controlling for age, gender, minority status, trauma exposure, and PTSD diagnosis, resilience was uniquely associated with decreased suicidality, reduced alcohol problems, lower depressive symptom severity, and fewer current health complaints and lifetime and past-year medical problems. Conclusions: These results suggest that resilience is a construct that may play a unique role in the occurrence of PTSD and severity of other functional correlates among deployed veterans. Future studies in this area would benefit from a prospective design, the evaluation of other possible protective processes (eg, social support), and specific examination of particular aspects of resilience and how resilience may be increased. © Copyright 2010 Physicians Postgraduate Press, Inc.

Investigation on two methods of in vitro micropropagation of Eucalyptus maculata - Assareh, M.H.; Sedaghati, M.; Kiarostami, K.; Zare, A.G.; Rezaii, M.B. (Acta Horticulturae, 2010)
Eucalyptus genus is one of the fast growing trees and adapted to climate conditions of Iran, and it has a special role in agro-forestry, industrial and medical consumptions. E. maculata is the most important species among eucalyptuses from some chemistry components and medical applications point of view. Asexual propagation by conventional methods has many problems and sexual propagation is not suitable because the species is a cross-pollinated plant and wide range of genetic variability exists in nature. Compared with the conventional method of tissue culture, woody plant propagatin by the new method of tissue culture (photoautotrophic conditions), has many advantages. This investigation was carried out to determine the best method of mass propagation for E. maculata, using photoautotrophic method and conventional micropropagation.
Keywords: Eucalyptus maculata; Micropropagation; Photoautotrophic; Shooting and rooting

The cultural theory and model of suicide - Chu, J.P.; Goldblum, P.; Floyd, R.; Bongar, B. (Applied and Preventive Psychology, 2010)
A growing body of research has demonstrated important variations in the prevalence, nature, and correlates of suicide across ethnic and sexual minority groups. Despite these developments, existing clinical and research approaches to suicide assessment and prevention have not incorporated cultural variations in any systematic way. In addition, theoretical models of suicide have been largely devoid of cultural influence. The current report presents a comprehensive analysis of literature describing the relationship between cultural factors and suicide in three major ethnic groups (African Americans, Asian Americans, and Latinos) and LGBTQ. 11" LGBTQ" populations are also referred to as " sexual minorities." LGBTQ is an abbreviation for lesbian, gay, bisexual, and transgender or transsexual individuals, and people questioning their sexual orientation. sexual minority groups. We utilized an inductive approach to synthesize this variegated body of research into four factors that account for 95% of existing culturally specific risk data: cultural sanctions, idioms of distress, minority stress, and social discord. These four cultural factors are then integrated into a theoretical framework: the Cultural Model of Suicide. Three theoretical principles emerge: (1) culture affects the types of stressors that lead to suicide; (2) cultural meanings associated with stressors and suicide affect the development of suicidal tendencies, one's threshold of tolerance for psychological pain, and subsequent suicidal acts; and (3) culture affects how suicidal thoughts, intent, plans, and attempts are expressed. The Cultural Model of Suicide provides an empirically guided cohesive approach that can inform culturally competent suicide assessment and prevention efforts in future research and clinical practice. Including both ethnic and sexual minorities in our investigations ensures advancement along a multiple identities perspective. © 2011 Elsevier Ltd.
Keywords: African American; Asian American; Culture; Ethnicity; Latino; LGBTQ; Sexual orientation; Suicide; Theory

Mental Health Pathways From Interpersonal Violence to Health-Related Outcomes in HIV-Positive Sexual Minority Men - Pantalone, D.W.; Hessler, D.M.; Simoni, J.M. (Journal of Consulting and Clinical Psychology, 2010)
Objective: We examined mental health pathways between interpersonal violence (IPV) and health-related outcomes in HIV-positive sexual minority men engaged with medical care. Method: HIV-positive gay and bisexual men (N = 178) were recruited for this cross-sectional study from 2 public HIV primary care clinics that treated outpatients in an urban setting. Participants (M age = 44.1 years, 36% non-White) filled out a computer-assisted survey and had health-related data extracted from their electronic medical records. We used structural equation modeling to test associations among the latent factors of adult abuse and partner violence (each comprising indicators of physical, sexual, and psychological abuse) and the measured variables: viral load, health-related quality of life (HRQOL), HIV medication adherence, and emergency room (ER) visits. Mediation was tested for the latent construct mental health problems, comprising depression, anxiety, symptomatology of posttraumatic stress disorder, and suicidal ideation. Results: The final model demonstrated acceptable fit, χ2 (123) = 157.05, p = .02, CFI = .95, TLI = .94, RMSEA = .04, SRMR = .06, accounting for significant portions of the variance in viral load (13%), HRQOL (41%), adherence (7%), and ER visits (9%), as well as the latent variable mental health problems (24%). Only 1 direct link emerged: a positive association between adult abuse and ER visits. Conclusions: Findings indicate a significant role of IPV and mental health problems in the health of people living with HIV/AIDS. HIV care providers should assess for IPV history and mental health problems in all patients and refer for evidence-based psychosocial treatments that include a focus on health behaviors. © 2010 American Psychological Association.
Keywords: HIV/AIDS; interpersonal violence; men who have sex with men; mental health

Suicidal ideation among young French adults: Association with occupation, family, sexual activity, personal background and drug use - Legleye, S.; Beck, F.; Peretti-Watel, P.; Chau, N.; Firdion, J.M. (Journal of Affective Disorders, 2010)
Background: To assess associations among young adults between suicidal ideation in the previous year and adverse childhood events, occupation, education, tobacco use, alcohol abuse, cannabis use in the previous month, illicit drug use, sexual orientation and activity, depression, physical violence in the previous year, and lifetime forced sexual intercourse. Methods: A subsample of 4075 French adults aged 18-30 years was drawn from a random national telephone survey in 2005. Major depressive episode and alcohol abuse were assessed using CIDI-SF and AUDIT-C (score above 4). Data were analysed with logistic regressions. Results: Suicidal ideation affected 5.7% of men and 4.9% of women. Among men depression had the highest adjusted odds ratio (ORa = 8.06, 5.07-12.79), followed by homosexual intercourse (3.37, 1.62-7.04), absence of sexual activity (2.83, 1.80-4.44); ORa between 1.6 and 2.0 were observed for living alone, daily tobacco smoking, being unemployed, serious health event concerning the father, age 26-30 and bad relationships between parents. Among women, depression had the highest ORa (7.60, 4.70-12.29), followed by lifetime experience of forced sexual intercourse (5.37, 2.89-9.96), having consumed illicit drugs other than cannabis (4.01, 1.48-10.89); ORa between 1.7 and 2.5 were observed for living alone, being unemployed, bad relationship between parents and age 26-30. Limitations: Cross-sectional survey, sexual orientation inferred from sexual activity. Conclusion: Suicide prevention should integrate the fact that besides depression, unemployment, family history, age, and sexual activity and orientation are specific risk factors among men, whereas illicit drug use, violence and forced sexual intercourse are more important among women. © 2009 Elsevier B.V. All rights reserved.
Keywords: Family environment; Gender; Mental health; Occupation; Sexual activity; Substance use; Suicidal ideation

Adolescent Suicide and Health Risk Behaviors. Rhode Island's 2007 Youth Risk Behavior Survey - Jiang, Y.; Perry, D.K.; Hesser, J.E. (American Journal of Preventive Medicine, 2010)
Background: Suicide is the third-leading cause of death among high school students in the U.S. Purpose: This study examined the relationships among indicators of depressed mood, suicidal thoughts, suicide attempts, and demographics and risk behaviors in Rhode Island high school students. Methods: Data from Rhode Island's 2007 Youth Risk Behavior Survey were utilized for this study. The statewide sample contained 2210 randomly selected public high school students. Data were analyzed in 2008 to model for each of five depressed mood/suicide indicators using multivariable logistic regression. Results: By examining depressed mood and suicide indicators through a multivariable approach, the strongest predictors were identified, for multiple as well as specific suicide indicators. These predictors included being female, having low grades, speaking a language other than English at home, being lesbian/gay/bisexual/unsure of sexual orientation, not going to school as a result of feeling unsafe, having been a victim of forced sexual intercourse, being a current cigarette smoker, and having a self-perception of being overweight. Conclusions: The strength of associations between three factors (immigrant status, feeling unsafe, and having forced sex) and suicide indicators adds new information about potential predictors of suicidal behavior in adolescents. © 2010 American Journal of Preventive Medicine.

Oedipus at Colonus - Harris, J.C. (Archives of General Psychiatry, 2010)

Genetic and environmental influences on risk of death due to infections assessed in Danish twins, 1943-2001 - Obel, N.; Christensen, K.; Petersen, I.; Sørensen, T.I.A.; Skytthe, A. (American Journal of Epidemiology, 2010)
Genetic differences have been proposed to play a strong role in risk of death from infectious diseases. The study base of 44,005 included all same-sex twin pairs born in 1870-2001, with both twins alive on January 1, 1943, or those born thereafter. Cause of death was obtained from the Danish Cause of Death Register and was available for 18,359 deaths. The authors classified death due to infections by 3 definitions (narrow, broader, and broadest) and calculated concordance rates for same-sex monozygotic and dizygotic twin pairs. Heritability was estimated by using structural equation models. When the 3 definitions were applied, 211 (1.1%), 1,089 (5.9%), and 2,907 (15.8%) deaths, respectively, were due to infections. The probandwise concordance rates for monozygotic twin pairs were consistently higher than for dizygotic twin pairs regardless of the definition (9% vs. 0% (P = 0.04), 10% vs. 3% (P < 0.01), and 19% vs. 15% (P = 0.07), respectively). For the broader and broadest definitions, heritability was 40% (95% confidence interval: 12, 50) and 19% (95% confidence interval: 3, 35), respectively. The concordance rates were generally low, and, although a genetic influence on the risk of death from infectious diseases could be demonstrated, the absolute effect of the genetic component on mortality was small. © The Author 2010.
Keywords: cause of death; genetics; infection; twins

Sexual Orientation, Parental Support, and Health During the Transition to Young Adulthood - Needham, B.L.; Austin, E.L. (Journal of Youth and Adolescence, 2010)
Some recent studies suggest that sexual minorities may have worse health-related outcomes during adolescence because they report lower levels of family connectedness, a key protective resource. Using data from wave 3 of the National Longitudinal Study of Adolescent Health (n = 11,153; 50.6% female; mean age = 21.8 years), this study extends prior research on adolescents to young adults. We examine whether lesbian, gay, and bisexual (LGB) young adults report lower levels of parental support than their heterosexual peers and whether differences in parental support help explain why LGB young adults tend to have worse health-related outcomes. We find that lesbian and bisexual women report lower levels of parental support than heterosexual women and that gay men report lower levels of parental support than bisexual and heterosexual men. Compared to heterosexual women, lesbian and bisexual women have higher odds of suicidal thoughts and recent drug use; bisexual women also have higher odds of elevated depressive symptomatology and heavy drinking. Gay men have higher odds of suicidal thoughts than heterosexual men. With the exception of heavy drinking, parental support either partially or fully mediates each of the observed associations. Even though the transition from adolescence to young adulthood is characterized by increased independence from parents, parental support remains an important correlate of health-related outcomes during this stage of life. Sexual minorities report lower levels of parental support during young adulthood, which helps explain why they have worse health-related outcomes. Interventions designed to strengthen relationships between LGB young adults and their parents could lead to a reduction in health disparities related to sexual orientation. © 2010 Springer Science+Business Media, LLC.
Keywords: Health behavior; Mental health; Parental support; Sexual orientation

Homotolerance and heterosexuality as Norwegian values - RØthing, A.; Svendsen, S.H.B. (Journal of LGBT Youth, 2010)
In recent years, equality between homosexual and heterosexual relationships has increasingly been presented as a marker for Norwegian values. Norwegian schooling encourages tolerance toward homosexuals, and the state shows active interest in counteracting bullying against LGBT (lesbian, gay, bisexual, and transgender) youth by supporting research and prevention programs. Recent studies concerning LGBT youth in Norway do indicate, however, that young Norwegians in general find it difficult to imagine themselves living a nonheterosexual life. Suicide is still considered a "reasonable" reaction to having to face a future as a homosexual. How can this be understood? Our analyses of teaching and textbooks in Norwegian schools points to three approaches to understanding young peoples' reluctance to imagining themselves as nonheterosexual: the double message of homotolerance, the selfevidence of heterosexuality, and the absence of nonheterosexual futurescapes. © Taylor & Francis Group, LLC.
Keywords: Bullying; Heterosexual; Homosexual; Lgbt; Norway; Schooling; Sexuality

Mental health needs of sexual minorities in Jamaica - White, Y.R.G.; Barnaby, L.; Swaby, A.; Sandfort, T. (International Journal of Sexual Health, 2010)
This study examined the prevalence of Axis I disorders and associated risk factors in a sample of sexual minority men and women in Jamaica, a country that is widely known for its high societal rejection of homosexuality. Poor relationships with family, negative or abusive experiences related to one's sexual orientation, and greater openness about one's sexual orientation were independent risk factors for Axis I disorders. Prevention of mental disorders in sexual minorities in Jamaica should focus on rebuilding family support and promoting social acceptance of sexual minorities. © Taylor & Francis Group, LLC.
Keywords: Depression; Jamaica; LGBT; Mental health; Minority; Stress; Suicide

Coming out to talk about suicide: Gay men and suicidality - McAndrew, S.; Warne, T. (International Journal of Mental Health Nursing, 2010)
International studies report increased rates of mental health problems and subsequent suicidality among homosexual populations. While international health-care policy is concerned with reducing suicide among young people, important research findings relating to gay people and suicidality remain unacknowledged in the Suicide Prevention Strategy for England. This qualitative study, utilizing single case studies, was used to gain an in-depth understanding of the life experiences contributing to the suicidality of four gay men. The methodology was psychoanalytically informed, using free association narrative interviewing. The initial data analysis involved interpretation of each of the case studies and a subsequent analysis exploring the shared experiences found in each of the individual narratives. Thematically, these are described as 'knowing and not knowing', 'the centrality of the father-son relationship', 'the loneliness of outsiderness', 'leading a double life', and 'crime and punishment'. The significance of the life experiences these themes illustrate reveal why some gay men might not only experience long-term mental health problems, but also engage in suicidality. Individually and collectively, the analyses provide important insights for mental health nurses becoming more attuned to provide sensitive mental health care to those who have a gay sexual orientation. © 2010 The Authors. Journal compilation © 2010 Australian College of Mental Health Nurses Inc.
Keywords: Bricolage; Free association narrative interviewing; Gay men; Suicidality

A choice between fun or health Relationships between nightlife substance use, happiness, and mental well-being - Sumnall, H.; Bellis, M.A.; Hughes, K.; Calafat, A.; Juan, M.; Mendes, F. (Journal of Substance Use, 2010)
Objective: To examine the substance use behaviours of young adults in Europe and to explore the association with self reported indices of mental well being, and the relative value of health. Method: 1341 1635-year-olds, representing youth and young adults who routinely engage in nightlife, were surveyed in nine European cities. Participants self-completed questionnaires, designed to gather demographic, social, and behavioural data on historic and current substance use, risk behaviours, and mental well being. Results: Controlling for inter-country differences, we found that early initiation and frequency of use of a range of substances was associated with poorer life satisfaction, suicidal ideation, and hopelessness. Younger, more frequent substance users placed greater value on having fun than maintaining long-term health. Bihomosexual participants were more likely to report hopelessness, suicidal thoughts, dissatisfaction with life, and preferring fun to health. Younger cocaine initiates were more likely to report considering suicide in the last 12 months than older initiates. Conclusions: These findings confirm the importance of early intervention for young substance users. Whilst our study does not make assumptions on causality, identification of substance use in nightclub attendees may be a good marker of comorbid disorders. It is important to recognize that negative mental states may also partly be a product of lifestyle and socioeconomic factors. Prevention and harm reduction interventions should recognize that the most at risk young people may discount future health gains from reducing their substance use. © 2010 Informa UK Ltd.
Keywords: Europe; Fun and hedonism; Substance use prevalence; Suicide risk factor; Well being

Suicidal Ideation and Attempt Among Adolescents Reporting "Unsure" Sexual Identity or Heterosexual Identity Plus Same-Sex Attraction or Behavior: Forgotten Groups? - Zhao, Y.; Montoro, R.; Igartua, K.; Thombs, B.D. (Journal of the American Academy of Child and Adolescent Psychiatry, 2010)
Objective: To compare risk of suicide ideation and attempts in adolescents with 1) gay, lesbian, or bisexual (GLB) identity, 2) "unsure" identity, or 3) heterosexual identity with same-sex attraction/fantasy or behavior, to heterosexual identity without same-sex attraction/fantasy or behavior. Method: A total of 1,856 students 14 years of age and older from 14 public and private high schools in Montréal, Québec, were surveyed anonymously. The survey included items assessing sexual orientation, health risk behaviors, and suicidal ideation and attempts. Multiple logistic regression models were used to assess risk factors for suicidal ideation and attempts. Results: In all, 58 (3.1%) adolescents self-identified as GLB, 59 (3.2%) as unsure, and 115 (6.2%) as heterosexual with same-sex attraction/fantasy or behavior. Compared with heterosexually identified youth without same-sex attraction/fantasy or behavior (N = 1,624; 87.5%), in multivariable analyses, 12-month suicidal ideation was significantly higher for both GLB (odds ratio [OR] = 2.31, 95% confidence interval [CI] = 1.22-4.37) and unsure youth (OR = 2.64, 95% CI = 1.38-5.08). Twelve-month suicide attempts were significantly elevated for GLB youth (OR = 2.23, 95% CI = 1.15-4.35) and high, although not statistically significant, for unsure youth (OR = 1.61, 95% CI = 0.77-3.36). Heterosexual identity with same-sex attraction/fantasy or behavior was not significantly associated with increased suicidal ideation (OR = 1.26, 95% CI = 0.76-2.08) or attempts (OR = 1.03, 95% CI = 0.55-1.91) in multivariable analyses. Conclusion: Compared with heterosexual youth without same-sex attraction/fantasy or behavior, adolescents with GLB and unsure identities were at greater risk of suicidality. However, youth who reported same-sex attraction or behavior but a heterosexual identity were not at elevated risk. © 2010 American Academy of Child and Adolescent Psychiatry.
Keywords: Adolescence; Sexual identity; Suicidality

Alcohol and drug use and related consequences among gay, lesbian and bisexual college students: Role of experiencing violence, feeling safe on campus, and perceived stress - Reed, E.; Prado, G.; Matsumoto, A.; Amaro, H. (Addictive Behaviors, 2010)
Objective: To examine differences between gay, lesbian, and bisexual (GLB) and non-GLB university students in alcohol and other drug use (AOD) and related consequences as well as the relevance of violence, perceived safety, and stress to any such differences in AOD use and related concerns. Methods: A random representative sample of university students (n = 988) were recruited via email for an online survey. Linear regression models assessed associations between identifying as GLB and AOD use and related consequences. Results: Regression models (adjusted for gender) indicated that, in comparison to heterosexual students, GLB students were more likely to report recent illicit drug use (AOR = 2.0; 95% CI: 1.1-3.9), more frequent negative AOD consequences (β = 5.5, SE = 1.4, p < 0.0001), and having seriously thought about/attempted suicide due to AOD use in the past year (AOR = 6.6; 95% CI: 3.0-14.3). Study findings also suggested that violence, safety, and stress variables partially contribute to AOD use and related concerns among GLB students. Conclusions: Findings highlight the need for future efforts to investigate and address mechanisms, including aspects of campus life, which contribute to AOD related risks among GLB students. © 2009 Elsevier Ltd. All rights reserved.
Keywords: Alcohol use; Campus environment; College students; Drug use; GLBT; Stress; Substance use; Victimization

Adolescent same-sex attraction and mental health: The role of stress and support - Teasdale, B.; Bradley-Engen, M.S. (Journal of Homosexuality, 2010)
This study draws on the social stress model from the sociology of mental health to examine the impact of same-sex attraction on depressed mood and suicidal tendencies. Specifically, we hypothesize that across multiple contexts, adolescents with same-sex attractions are likely to experience more social stress and less social support than heterosexual adolescents. In turn, these experiences increase the likelihood of negative mental health outcomes. Using data from the National Longitudinal Study of Adolescent Health (n = 11,911), we find that adolescents with same-sex attraction are more likely than their heterosexual counterparts to report depressed mood and suicidal tendencies. Moreover, stress and social support were found to mediate a substantial part of the relationship between same-sex attraction and depressed mood. In addition, stress and social support mediated about one third of the relationship between same-sex attraction and suicidal tendencies. These findings give strong support for the social stress model. We conclude with a discussion of the role that alienation plays in same-sex-attracted adolescent mental health. © Taylor & Francis Group, LLC.
Keywords: Alienation; Mepressed mood; Same-sex attraction; Social stress model; Suicidal tendencies

Suicide in HIV-infected individuals and the general population in Switzerland, 1988-2008 - Keiser, O.; Spoerri, A.; Brinkhof, M.W.G.; Hasse, B.; Gayet-Ageron, A.; Tissot, F.; Christen, A.; Battegay, M.; Schmid, P.; Bernasconi, E.; Egger, M. (American Journal of Psychiatry, 2010)
Objective: High rates of suicide have been described in HIV-infected patients, but it is unclear to what extent the introduction of highly active antiretroviral therapy (HAART) has affected suicide rates. The authors examined time trends and predictors of suicide in the pre-HAART (1988-1995) and HAART (1996-2008) eras in HIV-infected patients and the general population in Switzerland. Method: The authors analyzed data from the Swiss HIV Cohort Study and the Swiss National Cohort, a longitudinal study of mortality in the Swiss general population. The authors calculated standardized mortality ratios comparing HIV-infected patients with the general population and used Poisson regression to identify risk factors for suicide. Results: From 1988 to 2008, 15,275 patients were followed in the Swiss HIV Cohort Study for a median duration of 4.7 years. Of these, 150 died by suicide (rate 158.4 per 100,000 person-years). In men, standardized mortality ratios declined from 13.7 (95% CI=11.0-17.0) in the pre-HAART era to 3.5 (95% CI=2.5-4.8) in the late HAART era. In women, ratios declined from 11.6 (95% CI=6.4-20.9) to 5.7 (95% CI=3.2-10.3). In both periods, suicide rates tended to be higher in older patients, in men, in injection drug users, and in patients with advanced clinical stage of HIV illness. An increase in CD4 cell counts was associated with a reduced risk of suicide. Conclusions: Suicide rates decreased significantly with the introduction of HAART, but they remain above the rate observed in the general population, and risk factors for suicide remain similar. HIV-infected patients remain an important target group for suicide prevention.

Suicide risk among transgender individuals - Maguen, S.; Shipherd, J.C. (Psychology and Sexuality, 2010)
We examined the frequency and predictors of suicide attempts among gender minority individuals (N = 153) who were recruited at a transgender conference. Eighteen percent of the participants reported a past suicide attempt, with trans men reporting the highest rate of suicide attempts (41%), followed by trans women (20%). Factors associated with having a past suicide attempt included female sex assigned at birth, psychiatric hospitalisations, and having experienced transgender-related violence. Implications of these data are considered in the context of intervention development for this at-risk group. © 2010 Taylor & Francis.
Keywords: Risk factors; Suicide; Transgender

Correlates of cutting behavior among sexual minority youths and young adults - Walls, N.E.; Laser, J.; Nickels, S.J.; Wisneski, H. (Social Work Research, 2010)
Using secondary analyses of data from a sample of 265 sexual minority youths, the authors examined correlates of cutting behavior to determine whether patterns are similar to those found in studies of self-injury with community samples of predominately heterosexual youths. The sample consisted of youths who received services at an urban social service agency serving the sexual minority community; youths from the region attending social events, who located the survey through the Internet, or who were referred from other youth-serving agencies; and youths from out of state who found the survey through the Internet or were referred by youth-serving agencies. Prevalence of cutting was higher than that found in community-based samples of similar age groups. However, similar patterns of risk were found with regard to peer victimization, homelessness, suicidality, and depression. Female and transgender respondents were more likely to have engaged in cutting behavior than were male respondents. No significant race-based differences emerged. Both age and having knowledge of a supportive adult were associated with decreased likelihood of cutting. Additional findings link higher levels of "outness," higher occurrence of suicidality among social network, and higher rates of smoking to increased likelihood of cutting. Implications for practice and future research are discussed. © 2010 National Association of Social Workers.
Keywords: Cutting; Gay; Lesbian; Nonsuicidal self-injury; Transgender

Pilots of the future: Suicide prevention and the internet - Boyce, N. (The Lancet, 2010)

Sexually transmitted disease (STD) diagnoses and mental health disparities among women who have sex with women screened at an Urban Community Health Center, Boston, MA, 2007 - Reisner, S.L.; Mimiaga, M.J.; Case, P.; Grasso, C.; O'Brien, C.T.; Harigopal, P.; Skeer, M.; Mayer, K.H. (Sexually Transmitted Diseases, 2010)
BACKGROUND: A growing body of research documents mental health disparities among women who have sex with women (WSW) compared with women who have sex with men only (WSM). However, there remains a dearth of research exploring these indicators alongside sexually transmitted diseases (STDs) and WSW sexual health. METHODS: A retrospective chart review was conducted of all female patients (n = 368) screened for STDs between July 2007 and December 2007 at an urban community health center in Boston, MA. Deidentified electronic medical record data (e.g., demographics, psychosocial, sexual health) were analyzed and linked to STD positivity. Women who did not have sexual behavior documented in their medical chart (n = 58) were excluded from this analysis. Bivariate and multivariable logistic regression procedures examined sexual and psychosocial health indicators, including sexual preference. RESULTS: Twenty-seven percent of participants were WSW (17% WSW only and 10% WSW/M). Overall, 5% of WSW were diagnosed with a new STD (human papillomavirus, anogenital warts, genital herpes, pelvic inflammatory disease) and 17% had a history of a prior STD. In multivariable models adjusting for demographics, WSW were disproportionately more likely to have mental health and psychosocial issues noted in their medical records, including: a clinical diagnosis of depression, anxiety, and posttraumatic stress disorder, history of suicide attempts, and inpatient psychiatric/mental health treatment. However, WSW were significantly less likely than WSM to engage in "high risk" HIV/STD sexual behavior. In a final multivariable model, same sex behavior was not associated with a different likelihood of being diagnosed with an STD, compared with opposite sex behavior. However, WSW diagnosed with STDs were at increased odds of having bipolar disorder and utilizing outpatient mental health counseling services compared with WSW without STDs. WSW with a history of STDs were at increased odds of having attempted suicide in the past, utilizing both outpatient and inpatient mental health treatment services, and having a history of injection drug use compared with WSW without a history of STDs. CONCLUSIONS: WSW with STDs may have presenting psychosocial problems. Further research is warranted to better understand the relationship between sexual behavior and health, as well as to guide the development of interventions to ameliorate health disparities among WSW, particularly in the psychosocial domain. Copyright © 2009 American Sexually Transmitted Diseases Association All rights reserved.

Parental acceptance and illegal drug use among Gay, Lesbian, and Bisexual adolescents: Results from a national survey - Padilla, Y.C.; Crisp, C.; Rew, D.L. (Social Work, 2010)
Although gay, lesbian, and bisexual (GLB) adolescents face many of the same developmental challenges as do heterosexual adolescents, they must also deal with the stress of being part of a stigmatized group. The purpose of this study was to examine the extent to which family support and involvement with the queer community may buffer the effects of life stress on substance use among GLB youths. Drawing on a large national online survey, the authors examined drug use in 1,906 GLB youths 12 to 17 years of age. Overall, 20 percent of the youths reported using illegal substances in the past 30 days. Results from multivariate analyses revealed that stress, as measured by suicidal ideation, significantly increased the risk of drug use. A positive reaction from the mother to the youth's coming out served as a significant protective factor, whereas involvement in a queer youth group had no effect. The authors found evidence that, for GLB adolescents, parental acceptance of sexual identity is an important aspect of a strong family relationship and, thus, has important ramifications for their healthy development. Implications of the findings for social work practice are discussed. © 2010 National Association of Social Workers.
Keywords: Adolescent; Family support; Gay; Illegal drug use; Lesbian

Men's sexual orientation and health in Canada - Brennan, D.J.; Ross, L.E.; Dobinson, C.; Veldhuizen, S.; Steele, L.S. (Canadian Journal of Public Health, 2010)
Objectives: Previous large-scale population studies have reported that gay and bisexual men may be at increased risk for health disparities. This study was conducted to determine whether health status and health risk behaviours of Canadian men vary based on sexual orientation identity. Methods: Utilizing the Canadian Community Health Survey data (Cycle 2.1, 2003; n=49,901), we conducted multivariable logistic regression to assess the independent effects of sexual orientation on health status and health risk behaviours. For all multivariate models, we calculated odds ratios, p-values, standard errors, and 95% confidence intervals (CIs) using the bootstrap re-sampling procedure recommended by Statistics Canada. Results: When compared to heterosexual men, gay and bisexual men did not report more respiratory conditions; had lower rates of obesity and overweight BMI; and reported more mood/anxiety disorders, and a history of lifetime suicidality. Gay and bisexual men did not report higher rates of daily smoking or risky drinking, however, gay men reported an almost six-fold increase in STD diagnoses when compared to heterosexual men. Conclusion: This study represents the largest-known population-based data analysis on health risks and behaviours among men of varying sexual orientations. These findings raise important concerns regarding the impact of sexual orientation on mental and sexual health. Limitations of this data set, including those associated with measurement of sexual orientation, are discussed. Further research is required to understand the mechanisms that influence these health resiliencies and disparities. © Canadian Public Health Association, 2010.
Keywords: Bisexual men; Gay men; General population sample; Health behaviors; Health disparities; Homosexuality; Sexual identity

Harmful alcohol consumption and patterns of substance use in HIV-infected patients receiving antiretrovirals (ANRS-EN12-VESPA Study): Relevance for clinical management and intervention - Michel, L.; Carrieri, M.P.; Fugon, L.; Roux, P.; Aubin, H.-J.; Lert, F.; Obadia, Y.; Spire, B. (AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, 2010)
Alcohol abuse affects secondary prevention and disease progression in HIV-infected patients, and adherence and response to treatment in those chronically treated. The objective of this study was to estimate the prevalence of harmful alcohol consumption (HAC) using various indicators and identify which groups of patients may require specific targeted interventions for HAC risk reduction. A cross-sectional survey, based on a random sample representative of people living with HIV/AIDS (PLWHA) was carried out in 102 French hospital departments delivering HIV care. As alcohol abuse is particularly detrimental to patients receiving highly active antiretroviral therapy (HAART), we focused only on those individuals receiving HAART with complete alcohol assessment (CAGE, AUDIT-C, regular binge drinking, N=2340). Collected information included medical and socio-demographic data, HIV risk behaviors, adherence to treatment and substance and alcohol use, together with depression, anxiety, and experience of attempted suicide or sex work. HAC prevalence was evaluated as follows: 12% (CAGE score 2), 27% (AUDIT-C), and 9% (regular binge drinking). Three groups were at higher risk of HAC: men who have sex with men using stimulants, polydrug users, and to a lesser degree, ex-drug users. Innovative intervention strategies to reduce HAC and improve HIV prevention and HAART adherence in various PLWHA populations need urgent testing and implementation. Such interventions for alcohol risk reduction remain central to promoting improved HIV prevention and assuring HAART effectiveness in these populations. © 2010 Taylor and Francis.
Keywords: adherence; alcohol abuse; antiretroviral therapy; HIV; unsafe sex

70 U.S. veterans with gender identity disturbances: A descriptive study - McDuffie, E.; Brown, G.R. (International Journal of Transgenderism, 2010)
This study describes the largest population of veterans referred for a gender identity disorder (GID) evaluation. Most were self-referred, others were referred by their commanding officer. A search of the English language literature revealed no similar studies on veterans other than a pilot project by the second author. Methods: Retrospective descriptive data were obtained from chart reviews of 70 U.S. veterans who were evaluated by the second author for gender disturbances over a 20-year period (1987 to 2007). The modal veteran with gender identity disturbance was a natal male (91%) identifying as female, >40 years old, Caucasian, employed, with more than 12 years of education. Fifty-seven percent were parents with a history of sexual involvement with opposite sex individuals. Histories of autogynephilia were not elicited in vets interviewed since 1997. Classic "flight into hypermasculinity" was described by a majority of the natal male vets as a retrospective understanding of why they joined the military. Psychiatric comorbidities (43%) included post traumatic stress disorder (PTSD), depression, schizophrenia (N = 1), substance use disorders (17%), dissociative identity disorder (N = 1), and personality disorders (11%). Ninety-three percent met criteria for diagnosis of GID or GID not otherwise specified; suicidal ideation was reported by 61% with one or more suicide attempts by 11% of 56 responding; and 4% reported genital self-harm. Although 11% expressed active thoughts of surgical self-treatment, most expressed a desire for physician-performed sex reassignment surgery (SRS). Cross-dressing behaviors were common, and currently reported arousal with cross-dressing was reported by 13%, 63% of whom were not diagnosed with GID. Conclusion: Veterans often reported that they joined the military in an attempt to purge their transgender feelings, believing the military environment would "make men" of them. Most were discharged before completing a 20-year career. More than half received health care at veterans affairs medical centers, often due to medical or psychiatric disabilities incurred during service. Comorbid Axis I diagnoses were common, as were suicidal thoughts and behaviors.
Keywords: Gender identity; Military; Transsexual; Veteran

Sexual orientation and gender identity in youth suicide victims: An exploratory study - Renaud, J.; Berlim, M.T.; Begolli, M.; McGirr, A.; Turecki, G. (Canadian Journal of Psychiatry, 2010)
Objective: Our study was designed to explore additional outcome variables of a suicide case - control study to determine the association between sexual orientation and gender identity in suicide completion in children and adolescents. Method: Fifty-five child and adolescent suicide victims and 55 community control subjects were assessed using semi-structured, proxy-based interviews and questionnaires regarding sexual orientation and gender issues, psychopathological diagnoses, and service use. Results: In our sample, no significant differences between suicide victims and control subjects were found regarding same-sex sexual orientation nor intimidation related to same-sex sexual orientation. Suicide victims with same-sex sexual orientation were more likely than suicide victims without same-sex sexual orientation, to meet criteria for anxiety disorders. Within the month preceding their deaths, these youth were more likely to have consulted a health professional, a psychiatrist, as well as having been hospitalized, and were more likely to have consulted a psychiatrist in the last year. Conclusions: In our sample, same-sex sexual orientation and gender identity issues do not appear to be more prevalent among youth who die by suicide, compared with youth recruited from the general population, nor for same-sex sexual-related intimidation. While exhibiting comparable levels of general psychopathological diagnoses associated with suicide, suicide victims with same-sex sexual orientation were more likely to meet criteria for anxiety disorders and to have consulted mental health professionals before their deaths.
Keywords: Adolescents; Children; Gender identity; Same-sex sexual orientation; Suicide

Psychiatric impact of gender-related abuse across the life course of male-to-female transgender persons - Nuttbrock, L.; Hwahng, S.; Bockting, W.; Rosenblum, A.; Mason, M.; MacRi, M.; Becker, J. (Journal of Sex Research, 2010)
The psychiatric impact of interpersonal abuse associated with an atypical presentation of gender was examined across the life course of 571 male-to-female (MTF) transgender persons from the New York City Metropolitan Area. Gender-related abuse (psychological and physical), suicidality, and Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision) major depression were retrospectively measured across five stages of the life course using the Life Chart Interview. Among younger respondents (current age of 19-39), the impact of both types of abuse on major depression was extremely strong during adolescence and then markedly declined during later stages of life. Among older respondents (current age of 40-59), the impact of both types of abuse on major depression was strong during adolescence and then marginally declined during later stages of life. The effects of both types of abuse on suicidality were weaker but more consistently observed across the life course among both the younger and older respondents. Gender-related abuse is a major mental health problem among MTF transgender persons, particularly during adolescence. As these individuals mature, however, the consequences of this abuse appear less severe, which may represent the development of moderately effective mechanisms for coping with this abuse.

Psychiatric adverse events in randomized, double-blind, placebo-controlled clinical trials of varenicline: A pooled analysis - Tonstad, S.; Davies, S.; Flammer, M.; Russ, C.; Hughes, J. (Drug Safety, 2010)
Background: Varenicline (Chantix®, Champix®) has shown efficacy and tolerability as an aid to smoking cessation. In postmarketing surveillance, neuropsychiatric symptoms have appeared; however, their incidence and causal relationship to varenicline is not known. Objective: We assessed the incidence and relative risk (RR) of psychiatric disorders in ten randomized, double-blind, placebo-controlled trials of varenicline for smoking cessation. Methods: All smoking cessation phase II, III and IV randomized controlled clinical trials of varenicline versus placebo completed as of 31 December 2008, on file with the manufacturer (Pfizer, Inc.), were included. All studies have been published. All 3091 participants who received at least one dose of varenicline and all 2005 participants who received placebo were included in this analysis. These were men and women smoking ≥10 cigarettes/day, aged 18-75 years and without current psychiatric disease who received varenicline or placebo for 6 (one study), 12 (eight studies) or 52 (one study) weeks. Adverse events were recorded at each study visit and classified according to standard Medical Dictionary for Regulatory Activities (MedDRA) terms (version 11.0). Results: The incidence of psychiatric disorders other than solely sleep disorders and disturbances was 10.7% in subjects treated with varenicline and 9.7% in subjects treated with placebo, with an RR of 1.02 (95% CI 0.86, 1.22). The RRs (95% CI) versus placebo of psychiatric adverse events with an incidence ≥1% in the varenicline group were 0.86 (0.67, 1.12) for anxiety disorders and symptoms, 0.76 (0.42, 1.39) for changes in physical activity, 1.42 (0.96, 2.08) for depressed mood disorders and disturbances, 1.21 (0.79, 1.83) for mood disorders and disturbances not elsewhere classified and 1.70 (1.50, 1.92) for sleep disorders and disturbances. There were no cases of suicidal ideation or behaviour in varenicline-treated subjects in the ten placebo-controlled studies analysed. However, among three trials that were excluded from the analysis because of their open-label design, two cases of suicidal ideation and one completed suicide were reported in patients who had been treated with varenicline. With the exception of sleep disorders and disturbances, there was no evidence of dose-responsivity. Conclusions: There was no significant increase in overall psychiatric disorders, other than sleep disorders and disturbances, in varenicline-treated subjects in this sample of smokers without current psychiatric disorders. Ongoing studies are testing the use of varenicline in psychiatric patients. © 2010 Adis Data Information BV. All rights reserved.

Use of school-based health centres for mental health support in Cape Breton, Nova Scotia - Szumilas, M.; Kutcher, S.; LeBlanc, J.C.; Langille, D.B. (Canadian Journal of Psychiatry, 2010)
Objective: To determine whether students with self-reported needs for mental health support used school-based health centres (SBHCs) for this purpose. Method: A secondary analysis was conducted on self-reported data collected from 1629 high school students from Cape Breton, Nova Scotia. Descriptive statistics and logistic regression analyses were employed to determine the influence of sex, grade, sexual orientation, socioeconomic status (SES), school performance, social involvement, and health risk-taking behaviours on need for mental health support and use of SBHC for that purpose. Results: One-half of surveyed students reported needs for mental health support. Risk for depression was the most commonly reported indicator of need. Only 13% of students visited a SBHC nurse for mental health support, and 4 times as many females than males used the SBHC for this purpose (20.4%, compared with 5.3%, P < 0.001). There was a significantly increased likelihood of use of SBHC for mental health support, given the presence of a greater number of need factors. Multivariate logistic regression determined that female sex (OR 5.57, 95% CI 3.07 to 10.09), lower SES factor (OR 1.19, 95% CI 1.11 to 1.28), sexual health risk-taking behaviours (OR 1.72, 95% CI 1.28 to 2.31), and suicidal behaviour (OR 1.83, 95% CI 1.48 to 2.27) were significantly associated with the use of SBHCs for mental health support. Conclusions: Substantial need for mental health support and significant unmet need were observed. In particular, male students underused the services relative to their self-reported need. Implications for SBHCs and directions for future research are discussed.
Keywords: Adolescence; Mental health services; School health

Desire for non-mutilative disability in a nonhomosexual, male-to-female transsexual - Kolla, N.J.; Zucker, K.J. (Archives of Sexual Behavior, 2009)
In adults, the desire for a healthy limb amputation has been reported in both the lay press and the scientific literature. While the etiology of this condition is currently unknown, prevailing theories have tended to conceptualize the phenomenon as paraphilic in origin. In this report, we present the case of a 25-year-old, nonhomosexual male-to-female transsexual who manifested an intense desire to be afflicted with a nonmutilative neurological disability (multiple sclerosis). The patient categorically denied sexual attraction towards the thought of being an amputee or physically disabled. Hypotheses are proposed for the development of this condition with special emphasis accorded to the significance of the preferred target disability. © 2009 Springer Science+Business Media, LLC.
Keywords: Apotemnophilia; Disability; Gender identity disorder; Multiple sclerosis; Transsexualism

Eligibility and readiness criteria for sex reassignment surgery: Recommendations for revision of the WPATH standards of care - De Cuypere, G.; Vercruysse Jr., H. (International Journal of Transgenderism, 2009)
In a review of the literature on follow-up studies of sex reassignment surgery (SRS) with regard to regret, suicide, and prognosis, this article evaluates the eligibility and readiness criteria of the WPATH Standards of CareSixth Version. Because the literature shows a lack of high-quality follow-up studies on large numbers of operated transsexuals, it offers no evidence-based research above evidence Level B or Level C. Nevertheless, our review allows us to conclude that most of the eligibility criteria are evidence-based. Although psychiatric co-morbidity is consistently mentioned in the literature as a negative predictive factor, it is barely addressed in the eligibility and readiness criteria for SRS. Therefore this paper suggests some changes and a shift in emphasis in the eligibility and readiness criteria of the Standards of Care.
Keywords: Eligibility criteria; Follow-up study; Gender identity disorder; Sex reassignment surgery; Transsexual; WPATH standards of care

Women's sexual orientation and health: Results from a Canadian population-based survey - Steele, L.S.; Ross, L.E.; Dobinson, C.; Veldhuizen, S.; Tinmouth, J.M. (Women and Health, 2009)
The current study sought to determine whether health status and health risk behaviors of Canadian women varied based on sexual identity. This was a cross-sectional analysis of data from the Canadian Community Health Survey: cycle 2.1, a national population-based survey designed to gather health data on a representative sample of over 135,000 Canadians including 354 lesbian respondents, 424 bisexual women respondents, and 60,937 heterosexual women respondents. Sexual orientation was associated with disparities in health status and health risk behaviors for lesbian and bisexual women in Canada. Bisexual women were more likely than lesbians or heterosexual women to report poor or fair mental and physical health, mood or anxiety disorders, lifetime STD diagnosis, and, most markedly, life-time suicidality. Lesbians and bisexual women were also more likely to report daily smoking and risky drinking than heterosexual women. In sum, sexual orientation was associated with health status in Canada. Bisexual women, in particular, reported poorer health outcomes than lesbian or heterosexual women, indicating this group may be an appropriate target for specific health promotion interventions.
Keywords: Bisexual women; Health status; Lesbian; Mental health; Risk behaviors; Sexual orientation; Women's health

Lifetime risk factors for HIV/sexually transmitted infections among male-to-female transgender persons - Nuttbrock, L.; Hwahng, S.; Bockting, W.; Rosenblum, A.; Mason, M.; MacRi, M.; Becker, J. (Journal of Acquired Immune Deficiency Syndromes, 2009)
OBJECTIVES:: To describe and evaluate risk factors for HIV/sexually transmitted infections (STIs) among male-to-female (MTF) transgender persons. METHODS:: Using the life chart interview, potential lifetime risk factors for HIV/STIs among MTFs were measured and evaluated in conjunction with lifetime exposures for HIV, syphilis, hepatitis B, and hepatitis C. The participants were 517 MTFs between the ages of 19 and 59 years from the New York metropolitan area. RESULTS:: HIV/STIs were low among white Americans and very high among Hispanics and African Americans. In the latter groups, HIV and hepatitis B were associated with an androphilic sexual orientation, lifetime number of commercial sex partners (sex work), and the social expression of transgender identity; syphilis was associated with lifetime number of casual sex partners; and hepatitis C was associated with injection drug use, unemployment, and social expression of transgender identity. In multivariate models, the social expression of transgender identity was the strongest and most consistent predictor of HIV/STIs. Consistent with their lower levels of infections, white Americans reported significantly lower levels of the risk factors found to be predictive of HIV/STI among Hispanics and African Americans. CONCLUSIONS:: HIV/STI prevention in this population should be targeted at Hispanic and African Americans. Prevention programs should incorporate multiple components designed to address the diverse issues confronting ethnic minority transgender persons, with an emphasis on the social expression of transgender identity. Copyright © 2009 by Lippincott Williams & Wilkins.
Keywords: Life chart interview; Major depression; Male-to-female transgender persons; Suicidality

Childhood sexual abuse and the sociocultural context of sexual risk among adult Latino gay and bisexual men - Arreola, S.G.; Neilands, T.B.; Díaz, R. (American Journal of Public Health, 2009)
Objectives. We sought to examine the relationships among childhood sexual abuse, social discrimination, psychological distress, and HIV-risk among Latino gay and bisexual men in the United States. Methods. Data were from a probability sample of 912 men from Miami, FL; Los Angeles, CA; and New York, NY. We used logistic regression and path analyses to examine direct and indirect effects of childhood sexual abuse on psychological distress and sexual risk behavior. Results. We found a 15.8% (95% confidence interval=12.3%, 19.2%) prevalence of childhood sexual abuse. Not having sex before age 16 years and having consensual sex before age 16 years did not differ from each other in predicting any of the outcomes of interest. Forced sex was associated with a significantly increased risk for all outcomes. A path analyses yielded direct effects of childhood sexual abuse and exposure to homophobia during childhood and during adulthood on psychological distress and indirect effects on risky sexual behavior. Conclusions. HIV-risk patterns among Latino gay and bisexual men are related to childhood sexual abuse and a social context of discrimination, which combined lead to symptoms of psychological distress and participation in risky sexual situations that increase risky sexual behaviors associated with HIV acquisition.

Age of Minority Sexual Orientation Development and Risk of Childhood Maltreatment and Suicide Attempts in Women - Corliss, H.L.; Cochran, S.D.; Mays, V.M.; Greenland, S.; Seeman, T.E. (American Journal of Orthopsychiatry, 2009)
Women with minority sexual orientations (e.g., lesbian, bisexual) are more likely than heterosexual women to report histories of childhood maltreatment and attempted suicide; however, the importance of the timing of minority sexual orientation development in contributing to this increased risk is uncertain. This study investigated relationships between self-reported ages of achieving minority sexual orientation development milestones (first awareness of same-gender attractions, disclosure of a minority sexual orientation to another person, and same-gender sexual contact), and childhood maltreatment and suicide attempt experiences in a sample of 2, 001 women recruited from multiple-community sources. Younger age of minority sexual orientation development milestones was positively linked to self-reported recall of childhood maltreatment experiences, and to a childhood suicide attempt. After adjusting for differences in maltreatment, the odds of suicide attempt attributable to younger age of sexual orientation development milestones was reduced by 50 to 65%, suggesting that maltreatment may account for about half of the elevated risk for childhood suicide attempts among women with early minority sexual orientation development. Implications for services, interventions, and further research to address maltreatment disparities for sexual minorities are discussed. © 2009 American Orthopsychiatric Association.
Keywords: Childhood maltreatment; Racial/ethnic minority; Sexual orientation; Suicide attempt; Victimization

Clinical case rounds in child and adolescent psychiatry: Erotomania in an adolescent male with concomitant gender identity issues - Ritchie, B. (Journal of the Canadian Academy of Child and Adolescent Psychiatry, 2009)
Keywords: Adolescent; Erotomania; Stalking

Addressing key theoretical approaches to gay male sexual identity: Issues and insights for practitioners of mental health - Casey, M. (Critical Public Health, 2009)
This article seeks to draw attention to understandings of sexual identity and practice beyond essentialist notions of sexuality for mental health professionals working with gay men. A number of key studies and articles are explored in the article, which offer both historical and contemporary discussions of sexuality in mental health research and the social sciences. Initially, the article examines the important changes in approaches to and understandings of homosexuality and gay male identity by mental health professionals. In so doing, it considers the strengths and limits of recent studies by Diaz et al. (2001) and Sandfort et al. (2006) into mental health and homosexuality. The article then goes on to highlight approaches to gay male identity within the social sciences, focusing, in particular, on the work of Richardson (1987) and the value of social constructionist approaches to sexuality for therapists and practitioners. Work by Gray (2000) is then drawn upon which he examines the worth and value of using social constructionist accounts of sexuality in therapeutic practice. The aim of the article is to draw attention to the limits of essentialist notions of sexuality and the potential value of social constructionist accounts of sexual identity for those working with gay men and their mental health needs. © 2009 Taylor & Francis.
Keywords: Essentialism; Gay; Health behaviour; Homosexuality; Mental health; Sexuality; Social constructionism; Sociology of health

Suicide in teens and young adults in the United States - Baron, D.; Paglia, C.; Thorkelson, G.; Namdari, M. (Quaderni Italiani di Psichiatria, 2009)
Introduction: Physicians choose a career in medicine to help people live longer, healthier lives. When individuals attempt to, or succeed in, ending their lives, it is very stressful for their families, friends, and care providers. This is particularly true when adolescents choose to end their young lives. Aim of this paper: This paper will provide an overview of adolescent suicide in the United States. Special emphasis will be placed on reviewing the epidemiology of adolescent suicide, known risk factors and suggestions for early intervention. The authors review the extant literature, including the Columbia Suicide Assessment Scale (C-CASA), and highlight areas in need of additional research. © 2009 Elsevier Srl. All rights reserved.
Keywords: Adolescent; Bullying; Depression; Epigenetics; Impulsive-aggression; Suicide

Impact of Sexual Harassment Victimization by Peers on Subsequent Adolescent Victimization and Adjustment: A Longitudinal Study - Chiodo, D.; Wolfe, D.A.; Crooks, C.; Hughes, R.; Jaffe, P. (Journal of Adolescent Health, 2009)
Purpose: To examine gender differences in prevalence and types of sexual harassment victimization experienced in grade 9 and how it contributes to relationship victimization and psychological adjustment 2.5 years later. Methods: A total of 1734 students from 23 schools completed self-report surveys at entry to grade 9 and end of grade 11. Self-report data were collected on victimization experiences (sexual harassment, physical dating violence, peer violence, and relational victimization) and adjustment (emotional distress, problem substance use, self-harm, suicidal thoughts, maladaptive dieting, feeling unsafe at school, and perpetration of violent delinquency). Separate analyses by sex were prespecified. Results: Sexual harassment victimization was common among boys (42.4%) and girls (44.1%) in grade 9, with girls reporting more sexual jokes, comments, and unwanted touch than among boys, and with boys reporting more homosexual slurs or receiving unwanted sexual content. For girls, sexual harassment victimization in grade 9 was associated with elevated risk of self-harm, suicidal thoughts, maladaptive dieting, early dating, substance use, and feeling unsafe at school. A similar pattern of risk was found for boys, with the exception of dieting and self-harm behaviors. Adjusted odds ratios (AOR) indicated these students were significantly more likely than nonharassed students to report victimization by peers and dating partners 2.5 years later (AOR for boys and girls, respectively; all p < .01), including sexual harassment (AOR: 2.45; 2.9), physical dating violence (AOR: 2.02; 3.73), and physical peer violence (AOR: 2.75; 2.79). Gr 9 sexual harassment also contributed significantly to emotional distress (AOR: 2.09; 2.24), problem substance use (AOR: 1.79; 2.04), and violent delinquency perpetration (AOR: 2.1; 3.34) 2.5 years later (boys and girls, respectively; all p < .01). Conclusions: Sexual harassment at the beginning of high school is a strong predictor of future victimization by peers and dating partners for both girls and boys, and warrants greater prevention and intervention efforts. © 2009 Society for Adolescent Medicine.
Keywords: Sexual harassment; Victimization; Youth

Association of adolescent catatonia with increased mortality and morbidity: Evidence from a prospective follow-up study - Cornic, F.; Consoli, A.; Tanguy, M.-L.; Bonnot, O.; Périsse, D.; Tordjman, S.; Laurent, C.; Cohen, D. (Schizophrenia Research, 2009)
This paper examined outcomes among youth with catatonic syndrome and determined whether the characteristics suggesting the relevance of chronic catatonic schizophrenia (CCS) at index episode remained stable at follow-up. From 1993 to 2004, 35 individuals aged 12 to 18 years were prospectively admitted for management of catatonic syndrome and followed up after discharge. Mean duration from discharge to follow-up was 3.9 years (range 1-10). Four patients were lost to follow-up. Among the remaining 31 subjects (mean age = 19.5 years, range 15-26), life-time diagnosis using the Diagnostic Interview for Genetic Studies was unchanged in 28 patients, and included schizophrenia (all subtypes; N = 20), major depressive episode (N = 5), bipolar disorder type I (N = 4) and brief psychotic episode (N = 2). Mortality (all-cause Standardized Mortality Ratio = 6266; 95% CI = 1181-18,547) and morbidity were severe, with 3 deaths (including 2 suicides), 6 patients presenting with a causal organic condition and 14 subjects needing continuous psychiatric care. All males in the study (N = 8) who had chronic catatonic schizophrenia at the index episode still had chronic catatonic signs at follow-up. Catatonia is one of the most severe psychiatric syndromes in adolescents. It is associated with a 60-fold increased risk of premature death, including suicide, when compared to the general population of same sex and age. This increased risk of premature death remains higher than the one measured in former adolescent psychiatric patients (all-cause SMR = 221; 95% CI = 156-303; Engqvist and Rydelius, 2006), or in schizophrenia irrespective to age and subtype (all-cause SMR = 157; 95% CI = 153-160; Harris and Barraclough, 1998). © 2009 Elsevier B.V. All rights reserved.
Keywords: Adolescent; Catatonia; Follow-up; Schizophrenia; Standardized mortality ratio

Emotional distress among lgbt youth: The influence of perceived discrimination based on sexual orientation - Almeida, J.; Johnson, R.M.; Corliss, H.L.; Molnar, B.E.; Azrael, D. (Journal of Youth and Adolescence, 2009)
The authors evaluated emotional distress among 9th-12th grade students, and examined whether the association between being lesbian, gay, bisexual, and/or transgendered (i.e., "LGBT") and emotional distress was mediated by perceptions of having been treated badly or discriminated against because others thought they were gay or lesbian. Data come from a school-based survey in Boston, Massachusetts (n = 1,032); 10% were LGBT, 58% were female, and ages ranged from 13 to 19 years. About 45% were Black, 31% were Hispanic, and 14% were White. LGBT youth scored significantly higher on the scale of depressive symptomatology. They were also more likely than heterosexual, non-transgendered youth to report suicidal ideation (30% vs. 6%, p < 0.0001) and self-harm (21% vs. 6%, p < 0.0001). Mediation analyses showed that perceived discrimination accounted for increased depressive symptomatology among LGBT males and females, and accounted for an elevated risk of self-harm and suicidal ideation among LGBT males. Perceived discrimination is a likely contributor to emotional distress among LGBT youth. © 2009 Springer Science+Business Media, LLC.
Keywords: Depression; Emotional distress; LGBT; Self-harm; Suicide

Connecting the invisible dots: Reaching lesbian, gay, and bisexual adolescents and young adults at risk for suicide through online social networks - Silenzio, V.M.B.; Duberstein, P.R.; Tang, W.; Lu, N.; Tu, X.; Homan, C.M. (Social Science and Medicine, 2009)
Young lesbian, gay, and bisexual (young LGB) individuals report higher rates of suicide ideation and attempts from their late teens through early twenties. Their high rate of Internet use suggests that online social networks offer a novel opportunity to reach them. This study explores online social networks as a venue for prevention research targeting young LGB. An automated data collection program was used to map the social connections between LGB self-identified individuals between 16 and 24 years old participating in an online social network. We then completed a descriptive analysis of the structural characteristics known to affect diffusion within such networks. Finally, we conducted Monte Carlo simulations of peer-driven diffusion of a hypothetical preventive intervention within the observed network under varying starting conditions. We mapped a network of 100,014 young LGB. The mean age was 20.4 years. The mean nodal degree was 137.5, representing an exponential degree distribution ranging from 1 through 4309. Monte Carlo simulations revealed that a peer-driven preventive intervention ultimately reached final sample sizes of up to 18,409 individuals. The network's structure is consistent with other social networks in terms of the underlying degree distribution. Such networks are typically formed dynamically through a process of preferential attachment. This implies that some individuals could be more important to target to facilitate the diffusion of interventions. However, in terms of determining the success of an intervention targeting this population, our simulation results suggest that varying the number of peers that can be recruited is more important than increasing the number of randomly-selected starting individuals. This has implications for intervention design. Given the potential to access this previously isolated population, this novel approach represents a promising new frontier in suicide prevention and other research areas. © 2009 Elsevier Ltd. All rights reserved.
Keywords: Adolescent suicide; Adult suicide; Algorithms; Bisexual; Gay; Human sexuality; Internet; Lesbian; Network analysis

LGB and questioning students in schools: The moderating effects of homophobic bullying and school climate on negative outcomes - Birkett, M.; Espelage, D.L.; Koenig, B. (Journal of Youth and Adolescence, 2009)
Lesbian, gay, and bisexual students (LGB) and those questioning their sexual orientation are often at great risk for negative outcomes like depression, suicidality, drug use, and school difficulties (Elliot and Kilpatrick, How to Stop Bullying, A KIDSCAPE Guide to Training, 1994; Mufoz-Plaza et al., High Sch J 85:52-63, 2002; Treadway and Yoakam, J School Health 62(7):352-357, 1992). This study examined how school contextual factors such as homophobic victimization and school climate influence negative outcomes in LGB and questioning middle school students. Participants were 7,376 7th and 8th grade students from a large Midwestern county (50.7% Female, 72.7% White, 7.7% Biracial, 6.9% Black, 5.2% Asian, 3.7% Hispanic, and 2.2% reported "other"). LGB and sexually questioning youth were more likely to report high levels of bullying, homophobic victimization, and various negative outcomes than heterosexual youth. Students who were questioning their sexual orientation reported the most bullying, the most homophobic victimization, the most drug use, the most feelings of depression and suicidality, and more truancy than either heterosexual or LGB students. A positive school climate and a lack of homophobic victimization moderated the differences among sexual orientation status and outcomes. Results indicate that schools have the ability to lessen negative outcomes for LGB and sexually questioning students through creating positive climates and reducing homophobic teasing. © 2009 Springer Science+Business Media, LLC.
Keywords: Bullying; Homophobia; Homosexuality; Middle school students; Moderators; School climate; Victimization

Psychosocial and psychiatric factors associated with adolescent suicide: A case-control psychological autopsy study - Portzky, G.; Audenaert, K.; van Heeringen, K. (Journal of Adolescence, 2009)
This study aimed at the investigation of psychosocial and psychiatric risk factors of adolescent suicide by means of a case-control psychological autopsy study. Relatives and other informants of 19 suicide victims and 19 matched psychiatric controls were interviewed by means of a semi-structured interview schedule. Psychiatric controls included adolescents, individually matched according to gender, age and time between interview and suicide/admission, who had been admitted to a Psychiatric Department with suicidal ideation or attempted suicide at admission. Results showed that suicide victims had been exposed more frequently to suicidal behaviour by friends and through media and experienced more relational problems in the past year. Suicidal communication was less frequently reported in suicide victims than in controls and when communication did occur, it was less often directed towards parents. Treatment of psychiatric disorders was significantly less found in suicide victims. Psychiatric control patients were more likely to have comorbidity of psychiatric disorder, conduct disorder, delinquency or academic difficulties. This study showed significant differences between young suicide victims and psychiatric controls for life events, exposure, communication and treatment. These results also suggest that more symptoms and more externalizing behaviour can be observed in psychiatric control patients which could indicate more warning signals of possible psychiatric problems for the environment, which could result in more help-seeking behaviour and treatment. © 2008 The Association for Professionals in Services for Adolescents.
Keywords: Adolescents; Psychological autopsy; Risk factors; Suicide

Predicting deliberate self-harm in adolescents: A six month prospective study - O'Connor, R.C.; Rasmussen, S.; Hawton, K. (Suicide and Life-Threatening Behavior, 2009)
Few studies have investigated the extent to which psychosocial/ psychological factors are associated with the prediction of deliberate self-harm (DSH) among adolescents. In this study, 737 pupils aged 15-16 years completed a lifestyle and coping survey at time one and 500 were followed up six months later. Six point two percent of the respondents (n = 31) reported an act of DSH between Time 1 and Time 2. In multivariate analyses, worries about sexual orientation, history of sexual abuse, family DSH, anxiety, and self-esteem were associated with repeat DSH during the course of the study, but history of sexual abuse was the only factor predictive of first-time DSH. The findings suggest that school-based programs focused on how young people cope with psychosocial stressors may offer promise. © 2009 The American Association of Suicidology.

Walker, uncle will, and i: A homophobe and two queens - Percy, W.A., III; Flax-Clarke, A.; Gannett, L. (Southern Communication Journal, 2009)
The noted novelist Walker Percy (1916–1990) endured the suicides of his grandfather, father, and mother during his childhood. His cousin William Alexander Percy (1885–1942) adopted Walker and his two brothers following those tragedies. “Uncle Will” took great interest in the education of his adoptive sons. Walker in particular benefited from this; later in life, Walker and his good boyhood friend, Shelby Foote, who himself was to gain fame as a Civil War historian, speculated that Will Percy's influence played a major role in the incubation of their literary careers. There is an irony in this. Will Percy, a World War I combat hero, published poet of stature, world traveler, member of the Uranian movement, and author of the classic Southern memoir Lanterns on the Levee (1941), led a piquantly gay life. To present-day sensibilities, Will Percy's poetry and his memoir emanate a palpable queerness. Yet, Walker Percy denied his benefactor's homosexuality and indeed, with his brothers, took exhaustive steps to try to conceal that reality. Walker also became a celebrated moralist who expressed a decided aversion to homosexuality. This aspect of the family history exemplifies deletion of queer history in the particular historical context of hereditary Southern gentry with a literary bent in the mid- to late twentieth century. © 2009 Taylor & Francis Group, LLC. All right reserved.

Identification and characterization of integron mediated antibiotic resistance in pentachlorophenol degrading bacterium isolated from the chemostat - SHARMA, A.; THAKUR, I.S. (Journal of Environmental Sciences, 2009)
A bacterial consortium was developed by continuous enrichment of microbial population isolated from sediment core of pulp and paper mill effluent in mineral salts medium (MSM) supplemented with pentachlorophenol (PCP) as sole source of carbon and energy in the chemostat. The consortia contained three bacterial strains. They were identified as Escherichia coli, Pseudomonas aeruginosa and Acinetobacter sp. by 16S rRNA gene sequence analysis. Acinetobacter sp. readily degraded PCP through the formation of tetrachloro-p-hydroquinone (TecH), 2-chloro-1,4-benzenediol and products of ortho ring cleavage detected by gas chromatograph/mass spectrometer (GC-MS). Out of the three acclimated PCP degrading bacterial strains only one strain, Acinetobacter sp. showed the presence of integron gene cassette as a marker of its stability and antibiotic resistance. The strain possessed a 4.17 kb amplicon with 22 ORF's. The plasmid isolated from the Acinetobacter sp. was subjected to shotgun cloning through restriction digestion by BamHI, HindIII and SalI, ligated to pUC19 vector and transformed into E. coli XLBlue1α, and finally selected on MSM containing PCP as sole source of carbon and energy with ampicillin as antibiotic marker. DNA sequence analysis of recombinant clones indicated homology with integron gene cassette and multiple antibiotic resistance genes. © 2009 The Research Centre for Eco-Environmental Sciences, Chinese Academy of Sciences.
Keywords: Acinetobacter sp.; antibiotic resistance gene; chemostat; integron gene cassette; pentachlorophenol; recombinant clone

Childhood gender nonconformity and harassment as predictors of suicidality among gay, lesbian, bisexual, and heterosexual Austrians - Plöderl, M.; Fartacek, R. (Archives of Sexual Behavior, 2009)
The role of childhood gender role nonconformity (CGNC) and childhood harassment (CH) in explaining suicidality (suicide ideation, aborted suicide attempts, and suicide attempts) was examined in a sample of 142 lesbian, gay, and bisexual (LGB) adults and 148 heterosexual adults in Austria. Current and previous suicidality, CGNC, and CH were significantly greater in LGB participants compared to heterosexual participants. After controlling for CGNC, the effect of sexual orientation on CH diminished. CGNC correlated significantly with current suicidality in the LGB but not in the heterosexual group, and only non-significant correlations were found for CGNC with previous suicidality. Controlling for CH and CGNC diminished the effect of sexual orientation on current suicidality. Bayesian multivariate analysis indicated that current suicidality, but not previous suicidality, depended directly on CGNC. CH and CGNC are likely implicated in the elevated levels of current suicidality among adult LGB participants. As for previous suicidality, the negative impact of CGNC on suicidality might be overshadowed by stress issues affecting sexual minorities around coming out. The association of CGNC with current suicidality suggests an enduring effect of CGNC on the mental health and suicide risk of LGB individuals. © 2007 Springer Science+Business Media, LLC.
Keywords: Child abuse; Gender role nonconformity; Homosexuality; Sexual orientation; Suicide

Where risks and protective factors operate differently: Homeless sexual minority youth and suicide attempts - Walls, N.E.; Potter, C.; Van Leeuwen, J. (Child and Adolescent Social Work Journal, 2009)
Using a sample of 628 homeless youth and young adults from eight US cities, this study examines whether the relationship between having been in custody of social services and suicide attempts, and the relationship between engaging in survival sex and suicide attempts differ based on sexual orientation. Findings suggest that being in custody of social services is associated with a significant increase in likelihood of suicide attempts for heterosexual youth, it does not, however, significantly change the already increased risk of suicide attempts for sexual minority youth. Engaging in survival sex appears to be associated with increased risks of suicide attempts for both heterosexual and sexual minority youth, but the increase in likelihood is much stronger for heterosexual youth than for sexual minority youth. Implications for practice and future research are discussed. © 2009 Springer Science+Business Media, LLC.
Keywords: Bisexual; Child welfare; Gay; Homeless youth; Lesbian; Sexual minority; Social services custody; Suicide; Survival sex

Sociodemographic, clinical, and psychiatric characteristics of transsexuals from Spain - Gómez-Gil, E.; Trilla, A.; Salamero, M.; Godás, T.; Valdés, M. (Archives of Sexual Behavior, 2009)
The aim of this study was to examine the characteristics of transsexuals from Spain. A total of 252 consecutive applicants for sex reassignment were evaluated using a standardized semistructured clinical interview and the Mini International Neuropsychiatric Interview (Spanish Version 5.0.0) to record demographic, clinical, and psychiatric data. Transsexualism was diagnosed in 230 patients, with a male to female (MF)/female to male (FM) ratio of 2.2:1. Transsexual patients frequently had low employment status, lived with their parents, and mainly had a sexual orientation toward same-sex partners. The most frequent psychiatric diagnoses were adjustment disorder and social phobia in both groups, and alcohol and substance-related disorders in the MF group. MF transsexuals were older than FM transexuals when requesting sex reassignment, but did not differ in age when starting hormonal therapy (often on their own); fewer MFs were in employment requiring high educational qualification, more were non-Spanish natives, and more had previous and current histories of alcohol and substance abuse or dependence. The basic characteristics of transsexuals from Spain were similar to those of other European countries, except for the higher proportion of patients living with their parents and the higher proportion of MFs who reported same-sex sexual orientation compared with previous studies. © 2008 Springer Science+Business Media, LLC.
Keywords: Gender identity disorder; Psychiatric comorbidity; Sexual orientation; Spain; Transsexualism

Accidental death due to complete autoerotic asphyxia associated with transvestic fetishism and anal self-stimulation - Case report - Atanasijević, T.; Jovanović, A.A.; Nikolić, S.; Popović, V.; Jašović-Gašić, M. (Psychiatria Danubina, 2009)
A case is reported of a 36-year-old male, found dead in his locked room, lying on a bed, dressed in his mother's clothes, with a plastic bag over his head, hands tied and with a barrel wooden cork in his rectum. Two pornographic magazines were found on a chair near the bed, so that the deceased could see them well. Asphyxia was controlled with a complex apparatus which consisted of two elastic luggage rack straps, the first surrounding his waist, perineum, and buttocks, and the second the back of his body, and neck. According to the psychological autopsy based on a structured interview (SCID-I, SCID-II) with his father, the deceased was single, unemployed and with a part college education. He had grown up in a poor family with a reserved father and dominant mother, and was indicative of fulfilling DSM-IV diagnostic criteria for alcohol dependence, paraphilia involving hypoxyphilia with transvestic fetishism and anal masturbation and a borderline personality disorder. There was no evidence of previous psychiatric treatment. The Circumstances subscale of Beck's Suicidal Intent Scale (SIS-CS) pointed at the lack of final acts (thoughts or plans) in anticipation of death, and absence of a suicide note or overt communication of suicidal intent before death. Integration of the crime scene data with those of the forensic medicine and psychological autopsy enabled identification of the event as an accidental death, caused by neck strangulation, suffocation by a plastic bag, and vagal stimulation due to a foreign body in the rectum. © Medicinska naklada.
Keywords: Anal self-stimulation; Autoerotic asphyxia; Forensic autopsy; Forensic science; Psychological autopsy

Are gay men in worse mental health than heterosexual men? The role of age, shame and guilt, and coming-out - Bybee, J.A.; Sullivan, E.L.; Zielonka, E.; Moes, E. (Journal of Adult Development, 2009)
Previous studies reporting that gay individuals are in worse mental health than heterosexuals have typically employed young or mixed-age samples, ignoring the role of age. Mental health problems may show greater age-related improvement among gay than heterosexual men as indicated by the findings of the present study. In this study, the following indices of mental health are examined, and found to be comparable, among 86 heterosexual and 81 gay men aged 18-48: depression, suicidality, anger, anxiety, negative self-esteem, emotional instability, and lack of emotional responsiveness. Most indices show age-related effects among gay men, with less severe symptoms reported by older individuals. Among heterosexual men, effects of age are less widespread, although older men do report fewer symptoms of anger. Chronic shame and chronic guilt are related to mental health problems and a lessening in shame accounted, in part, for the age-related decline in depression among gay men. Different approaches to disclosing/concealing sexual identity are also linked with shame, guilt, and mental health among gay men. © Springer Science+Business Media, LLC 2009.
Keywords: Adult development; Guilt; Men; Mental health; Shame

Predictors of non-suicidal self-injury versus attempted suicide: Similar or different? - Wichstrøm, L. (Archives of Suicide Research, 2009)
A nationally representative sample of Norwegian high school students (ages 14 to 19, N = 2,924) completed self-reports in school about non-suicidal self-injury (NSSI), suicide attempt (SA), and risk and protective factors. They were re-examined 5 years later. In all 2.2% reported NSSI with no SA during the follow-up period and 3.2% reported SA. Several risk and protective factors were common to NSSI and SA: previous SA, young age, debut of sexual intercourse before the age of 15, and nonheterosexual sexual interest. However, other risk and protective factors were unique to NSSI or SA: Previous NSSI increased the risk for future NSSI whereas satisfaction with social support protected against later NSSI. Suicidal ideation increased the risk for SA whereas attachment to parents protected against it. NSSI did not increase the risk of future SA. NSSI and SA may be thus conceived of as only partly overlapping phenomena, and not necessarily just representing different degrees of suicidality. © International Academy for Suicide Research.
Keywords: Adolescent; High school students; Prospective; Self-harm; Self-injury; Suicide attempts

Psychosocial Concerns of Sexual Minority Youth: Complexity and Caution in Group Differences - Poteat, V.P.; Aragon, S.R.; Espelage, D.L.; Koenig, B.W. (Journal of Consulting and Clinical Psychology, 2009)
This investigation tested a large adolescent sample (n = 14,439) for significant group differences on psychosocial concerns on the basis of intersecting identities of sexual orientation (lesbian, gay, bisexual, questioning/less certain, heterosexual), race (Whites, racial minorities), and gender (boys, girls). A significant 2-way interaction between sexual orientation and gender was identified on victimization. Boys reported higher victimization than did girls among heterosexual and questioning/less certain students. Furthermore, significant 3-way interactions between sexual orientation, race, and gender were identified for substance use and depressed/suicidal thoughts. Questioning/less certain youth generally reported the highest levels of victimization, substance abuse, and suicidal thoughts. However, results suggest that, on the basis of small effect sizes for most comparisons, significant differences should be interpreted with caution. Results indicate the need to consider the diversity of subgroups within the sexual minority youth community and that intervention efforts might be more effective if tailored to the unique needs of specific subgroups. © 2009 American Psychological Association.
Keywords: adolescents; racial minorities; sexual orientation; substance use; victimization

Correlates of serious suicidal ideation and attempts in female adult sexual assault survivors - Ullman, S.E.; Najdowski, C.J. (Suicide and Life-Threatening Behavior, 2009)
Relations between (a) serious suicidal ideation and attempts and (b) demographics, trauma history, assault characteristics, post-assault outcomes, and psychosocial variables were examined among female adult sexual assault survivors. Younger, minority, and bisexual survivors reported greater ideation. More traumas, drug use, and assault disclosure related to greater attempts, whereas perceived control over recovery was related to fewer attempts. Child sexual abuse and some assault characteristics predicted suicidal behavior. Depression was related to suicidal behavior until psychosocial variables were accounted for. Specifically, using substances to cope and self-blame predicted greater ideation, whereas receiving aid/information support was related to less ideation. Implications for research and treatment are discussed. © 2009 The American Association of Suicidology.

HIV prevalence and risk behaviour among men who have sex with men in Vientiane Capital, Lao People's Democratic Republic, 2007 - Sheridan, S.; Phimphachanh, C.; Chanlivong, N.; Manivong, S.; Khamsyvolsvong, S.; Lattanavong, P.; Sisouk, T.; Toledo, C.; Scherzer, M.; Toole, M.; Griensven, F.V. (AIDS, 2009)
Background: Men who have sex with men are at high risk for HIV infection. Here we report the results of the first assessment of HIV prevalence and risk behaviour in this group in Vientiane, Lao People's Democratic Republic. Methods: Between August and September 2007, 540 men were enrolled from venues around Vientiane, using venue-day-time sampling. Men of Lao nationality, 15 years and over, reporting oral or anal sex with a man in the previous 6 months were eligible for participation. Demographic and socio-behavioural information was self-collected using hand-held computers. Oral fluid was tested for HIV infection. Logistic regression was used to evaluate risk factors for prevalent HIV infection. Results: The median age of participants was 21 years; the HIV prevalence was 5.6%. Of participants, 39.6% reported exclusive attraction to men and 57.6% reported sex with women. Of those who reported having regular and nonregular sexual partner(s) in the past 3 months, consistent condom use with these partners was 14.4 and 24.2%, respectively. A total of 42.2% self-reported any sexually transmitted infection symptoms and 6.3% had previously been tested for HIV. Suicidal ideation was reported by 17.0%, which was the only variable significantly and independently associated with HIV infection in multivariate analysis. Conclusion: Although the HIV prevalence is low compared with neighbouring countries in the region, men who have sex with men in Lao People's Democratic Republic are at high behavioural risk for HIV infection. To prevent a larger HIV epidemic occurrence and transmission into the broader community, higher coverage of HIV prevention interventions is required. © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Keywords: AIDS; Asia; HIV; Homosexual men; Lao people's democratic republic

Out yonder: Sexual-minority adolescents in rural communities in British Columbia - Poon, C.S.; Saewyc, E.M. (American Journal of Public Health, 2009)
Objectives. We compared sexual-minority adolescents living in rural communities with their peers in urban areas in British Columbia, exploring differences in emotional health, victimization experiences, sexual behaviors, and substance use. Methods. We analyzed a population-based sample of self-identified lesbian, gay, or bisexual respondents from the British Columbia Adolescent Health Survey of 2003 (weighted n=6905). We tested rural-urban differences separately by gender with the χ2 test and logistic regressions. Results. We found many similarities and several differences. Rural sexual-minority adolescent boys were more likely than were their urban peers to report suicidal behaviors and pregnancy involvement. Rural sexual-minority adolescents, especially girls, were more likely to report various types of substance use. Rural status was associated with a lower risk of dating violence and higher risk of early sexual debut for sexual-minority girls and a higher risk of dating violence and lower risk of early sexual debut for sexual-minority boys. Conclusions. Location should be a demographic consideration in monitoring the health of sexual-minority adolescents. Lesbian, gay, and bisexual adolescents in rural communities may need additional support and services as they navigate adolescence.

Mental health in sexual minorities: Recent indicators, trends, and their relationships to place in North America and Europe - Lewis, N.M. (Health and Place, 2009)
This meta-analysis featuring 12 national adult studies and 16 state/regional youth studies of sexuality and mental health finds that sexual minorities-as a likely consequence of place-contingent minority stress-experience mental health outcomes such as depression, anxiety, and suicide ideation much more frequently than their heterosexual counterparts. By interrogating the geographic variations in the findings, such as high rates of poor mental health outcomes in the United Kingdom, large gay-heterosexual disparities in the Netherlands, and lower and improving rates of both outcomes and risk factors in Vermont and British Columbia, this study asserts that policy regimes, health programming, and the ways in which sexual minorities are constructed in places all contribute to their mental health. © 2009 Elsevier Ltd. All rights reserved.
Keywords: Gay; Mental health; Meta-analysis; Place determinants; Queer; Sexuality

Family rejection as a predictor of negative health outcomes in white and latino lesbian, gay, and bisexual young adults - Ryan, C.; Huebner, D.; Diaz, R.M.; Sanchez, J. (Pediatrics, 2009)
OBJECTIVE. We examined specific family rejecting reactions to sexual orientation and gender expression during adolescence as predictors of current health problems in a sample of lesbian, gay, and bisexual young adults. METHODS. On the basis of previously collected in-depth interviews, we developed quantitative scales to assess retrospectively in young adults the frequency of parental and caregiver reactions to a lesbian, gay, or bisexual sexual orientation during adolescence. Our survey instrument also included measures of 9 negative health indicators, including mental health, substance abuse, and sexual risk. The survey was administered to a sample of 224 white and Latino self-identified lesbian, gay, and bisexual young adults, aged 21 to 25, recruited through diverse venues and organizations. Participants completed self-report questionnaires by using either computer-assisted or pencil-and-paper surveys. RESULTS.Higher rates of family rejection were significantly associated with poorer health outcomes. On the basis of odds ratios, lesbian, gay, and bisexual young adults who reported higher levels of family rejection during adolescence were 8.4 times more likely to report having attempted suicide, 5.9 times more likely to report high levels of depression, 3.4 times more likely to use illegal drugs, and 3.4 times more likely to report having engaged in unprotected sexual intercourse compared with peers from families that reported no or low levels of family rejection. Latino men reported the highest number of negative family reactions to their sexual orientation in adolescence. CONCLUSIONS. This study establishes a clear link between specific parental and caregiver rejecting behaviors and negative health problems in young lesbian, gay, and bisexual adults. Providers who serve this population should assess and help educate families about the impact of rejecting behaviors. Counseling families, providing anticipatory guidance, and referring families for counseling and support can help make a critical difference in helping decrease risk and increasing well-being for lesbian, gay, and bisexual youth. Copyright © 2009 by the American Academy of Pediatrics.
Keywords: Gay youth; Homosexuality; LGB adolescents; Risk factors; Sexual orientation

A report from a single institute's 14-year experience in treatment of male-to-female transsexuals - Imbimbo, C.; Verze, P.; Palmieri, A.; Longo, N.; Fusco, F.; Arcaniolo, D.; Mirone, V. (Journal of Sexual Medicine, 2009)
Introduction: Gender identity disorder or transsexualism is a complex clinical condition, and prevailing social context strongly impacts the form of its manifestations. Sex reassignment surgery (SRS) is the crucial step of a long and complex therapeutic process starting with preliminary psychiatric evaluation and culminating in definitive gender identity conversion. Aim: The aim of our study is to arrive at a clinical and psychosocial profile of male-to-female transsexuals in Italy through analysis of their personal and clinical experience and evaluation of their postsurgical satisfaction levels SRS. Methods: From January 1992 to September 2006, 163 male patients who had undergone gender-transforming surgery at our institution were requested to complete a patient satisfaction questionnaire. Main Outcome Measures: The questionnaire consisted of 38 questions covering nine main topics: general data, employment status, family status, personal relationships, social and cultural aspects, presurgical preparation, surgical procedure, and postsurgical sex life and overall satisfaction. Results: Average age was 31 years old. Seventy-two percent had a high educational level, and 63% were steadily employed. Half of the patients had contemplated suicide at some time in their lives before surgery and 4% had actually attempted suicide. Family and colleague emotional support levels were satisfactory. All patients had been adequately informed of surgical procedure beforehand. Eighty-nine percent engaged in postsurgical sexual activities. Seventy-five percent had a more satisfactory sex life after SRS, with main complications being pain during intercourse and lack of lubrication. Seventy-eight percent were satisfied with their neovagina's esthetic appearance, whereas only 56% were satisfied with depth. Almost all of the patients were satisfied with their new sexual status and expressed no regrets. Conclusions: Our patients' high level of satisfaction was due to a combination of a well-conducted preoperative preparation program, competent surgical skills, and consistent postoperative follow-up. © 2009 International Society for Sexual Medicine.
Keywords: Gender identity disorders; Male to female transsexualism; Patient's satisfaction questionnaire; Sex reassignment surgery; Transsexual; Vaginoplasty

Self-harm in adolescents: Self-report survey in schools in Scotland - O'Connor, R.C.; Rasmussen, S.; Miles, J.; Hawton, K. (British Journal of Psychiatry, 2009)
Background: The suicide rate in Scotland is twice as high as that in England. However, the prevalence of self-harm is unknown. Aims: To determine the prevalence of self-harm in adolescents in Scotland and the factors associated with it. Method: A total of 2008 pupils aged 15-16 years completed an anonymous lifestyle and coping survey, information was obtained on demographic characteristics, lifestyle, life events and problems, social influences, psychological variables and self-harm. Results: Self-harm was reported by 13.8% of the respondents. The majority (71%) of those who had self-harmed had done so in the past 12 months and girls were approximately 3.4 times more likely to report self-harm than boys. In multivariate analyses, smoking, bullying, worries about sexual orientation, self-harm by family and anxiety were associated with self-harm in both genders. In addition, drug use, physical abuse, serious boy/girlfriend problems, self-harm by friends and low levels of optimism were also associated with self-harm in girls. Conclusions: Despite markedly different national suicide rates, the prevalence of self-harm in Scotland is similar to that in England with girls at least three times more likely to report self-harm than boys. The findings suggest a role for emotional literacy programmes in schools and highlight the importance of promoting positive mental health among adolescents.

Analysis of behavior-related adverse experiences in clinical trials of montelukast - Philip, G.; Hustad, C.M.; Malice, M.-P.; Noonan, G.; Ezekowitz, A.; Reiss, T.F.; Knorr, B. (Journal of Allergy and Clinical Immunology, 2009)
Background: Frequencies of behavior-related adverse experiences (BRAEs) in controlled clinical studies of leukotriene modifier drugs have not been summarized. Objective: We sought to compare the frequency of BRAEs in patients receiving montelukast or placebo in a retrospective analysis of Merck clinical trial data. Methods: An adverse experience database was constructed to include all double-blind, placebo-controlled trials of montelukast meeting prespecified criteria. BRAEs (described using the Medical Dictionary for Regulatory Activities controlled vocabulary dictionary) were prespecified to include any term in the Psychiatric Disorders System Organ Class, selected terms related to general disorders, and terms related to akathisia. Frequencies of BRAEs (overall, leading to study discontinuation, and/or serious) were summarized. Analyses estimated the odds ratios (ORs) for montelukast versus placebo based on the frequency of patients with BRAEs in each study. Results: In total 35 adult and 11 pediatric placebo-controlled trials were included; 11,673 patients received montelukast, 8,827 received placebo, and 4,724 received active control. The frequency of patients with 1 or more BRAEs was 2.73% and 2.27% in the montelukast and placebo groups, respectively; the OR for montelukast versus placebo was 1.12 (95% CI, 0.93-1.36). The frequency of patients with a BRAE leading to study discontinuation was 0.07% and 0.11% in the montelukast and placebo groups, respectively (OR, 0.52; 95% CI, 0.17-1.51). The frequency of patients with a BRAE considered serious was 0.03% in both treatment groups. Conclusion: Reports of BRAEs were infrequent in clinical trials of montelukast. Those leading to study discontinuation or considered serious were rare. Frequencies were similar regardless of treatment group. © 2009 American Academy of Allergy, Asthma & Immunology.
Keywords: adverse experiences; allergic rhinitis; asthma; behavior; clinical trial; Montelukast; placebo; psychiatric

Your teen's sexual orientation: What parents should know (Paediatrics and Child Health, 2008)

Childhood sexual experiences and adult health sequelae among gay and bisexual men: Defining childhood sexual abuse - Arreola, S.; Neilands, T.; Pollack, L.; Paul, J.; Catania, J. (Journal of Sex Research, 2008)
Gay and bisexual men carry the burden of HIV infections in the United States and have high rates of childhood sexual abuse that predict HIV and other health outcomes. This study examined differential effects of forced, consensual, and no childhood sexual experiences (CSE) on health outcomes among a probability sample of adult men who have sex with men (MSM). The forced sex group had the highest levels of psychological distress, substance use, and HIV risk. There were no differences in rates of depression and suicidal ideation between the consensual- and no-sex groups. The consensual- and forced-sex groups had higher rates of substance use and transmission risk than the no-sex group. The forced-sex group, however, had significantly higher rates of frequent drug use and high-risk sex than the consensual group. Findings suggest that forced CSEs result in a higher-risk profile than consensual or no childhood sexual experiences, the kind of risk pattern differs between forced and consensual childhood sexual experiences, and the underlying mechanisms that maintain risk patterns may vary. It is important to clarify risk patterns and mechanisms that maintain them differentially for forced and consensual sex groups so that interventions may be tailored to the specific trajectories related to each experience.

Stigma management? The links between enacted stigma and teen pregnancy trends among gay, lesbian, and bisexual students in British Columbia - Saewyc, E.M.; Poon, C.S.; Homma, Y.; Skay, C.L. (Canadian Journal of Human Sexuality, 2008)
Over the past decade, several large-scale school-based studies of adolescents in Canada and the U.S. have documented health disparities for lesbian, gay and bisexual teens compared to their heterosexual peers, such as higher rates of suicide attempts, homelessness, and substance use. Many of these disparities have been linked to "enacted stigma," or the higher rates of harassment, discrimination, and sexual or physical violence that sexual minority youth experience at home, at school, and in the community. An unexpected health disparity for lesbian, gay and bisexual youth is their significantly higher risk of teen pregnancy involvement (between two and seven times the rate of their heterosexual peers), especially in light of declining trends in teen pregnancy across North America since the early 1990s. What is behind this higher risk? Is it getting better or worse? Using the province-wide cluster-stratified British Columbia Adolescent Health Surveys from 1992, 1998, and 2003, this paper explores the trends in pregnancy involvement, related sexual behaviours, and exposure to forms of enacted stigma that may help explain this particular health disparity for gay, lesbian and bisexual youth in Canada.

Adjustment among mothers reporting same-gender sexual partners: A study of a representative population sample from Quebec province (Canada) - Julien, D.; Jouvin, E.; Jodoin, E.; L'Archevêque, A.; Chartrand, E. (Archives of Sexual Behavior, 2008)
We examined the well-being of mothers and non-mothers reporting exclusive opposite-gender sexual partners (OG), same-gender sexual partners (SG), or both (BI) in a representative sample of 20,773 participants (11,034 women) 15-years-old or older from the population of Quebec province in Canada. Participants completed a self-administered questionnaire and SG and BI women (n = 179) were matched to a sample of OG women (n = 179) based on age, income, geographical area, and children (having at least one 18-year-old or younger biological or adopted child at home). We assessed social milieu variables, risk factors for health disorders, mental health, and quality of mothers' relationship with children. The findings indicated a sexual orientation main effect: Mothers and non-mothers in the SG and BI group, as compared to their OG controls, were significantly less likely to live in a couple relationship, had significantly lower levels of social support, higher prevalence of early negative life events, substance abuse, suicide ideation, and higher levels of psychological distress. There were no Sexual Orientation X Parenthood status effects. The results further indicated that sexual orientation did not account for unique variance in women's psychological distress beyond that afforded by their social milieu, health risk factors, and parenthood status. No significant differences were found for the quality of mothers' relationship with children. SG-BI and OG mothers with low levels of social integration were significantly more likely to report problems with children than parents with high levels of social integration. We need to understand how marginal sexualities and their associated social stigma, as risk indicators for mothers, interact with other factors to impact family life, parenting skills, and children's adjustment. © 2007 Springer Science+Business Media, LLC.
Keywords: Community studies; Mothers; Parenting; Population-based studies; Sexual minority; Sexual orientation

Making sense of suicide: A discourse analysis of young people's talk about suicidal subjecthood - Roen, K.; Scourfield, J.; McDermott, E. (Social Science and Medicine, 2008)
Though there is a substantial body of literature on youth suicide, relatively few studies provide a detailed analysis of young people's own understandings of suicidal behaviour. The present research pays particular attention to how young people make sense of suicide, in the understanding that suicide only becomes possible insofar as it is imaginable. Interviews and focus groups (including 69 participants in total) with people aged 16-24 years provide the empirical material for this study. Research participants were recruited across a range of ethnic groups and sexual orientations, and drawn from rural and urban areas in the North of England and South Wales. Four frameworks for understanding youth suicide are discussed in this paper. These frameworks of understanding variously (i) cast suicidal subjects as Other, (ii) highlight suicide as something that is accessible to young people, (iii) demonstrate the desire to rationalise suicidal behaviour, and (iv) define suicidal subjects in terms of their relationships with others. The interwoven meanings that run through these four frameworks, and their connection with existing literature, are discussed and the implications for suicide prevention are indicated. © 2008 Elsevier Ltd. All rights reserved.
Keywords: Discourse analysis; Suicidal subjects; UK; Youth suicide

Clinical characteristics, psychiatric comorbidities and sociodemographic profile of transsexual patients from an outpatient clinic in brazil - Lobato, M.I.; Koff, W.J.; Schestatsky, S.S.; Chaves, C.P.D.V.; Petry, A.; Crestana, T.; Amaral, J.T.; Onofrio, F.D.Q.; Salvador, J.; Silveira, E.; Henriques, A.A. (International Journal of Transgenderism, 2008)
Objective: To provide a description of our transsexual population. Method: This descriptive observational study included 138 patients with a diagnosis of Trans-sexualism in Brazil, between March 1998 and September 2005. Demographic, clinical and psychiatry data were collected. Results: Age ranged from 16 to 54 years; 88.4% were male. The prevalence of sexually transmitted diseases was 19.5%, and 17.6% were HIV-positive. Hormone therapy was reported by 91.2%, and 47.4% referred drug and alcohol use; 14.2%, attempted suicide; and 12.5%, history of sexual abuse. Self-mutilation was reported by 5.2%s. Fifty-nine patients (42.7%) had at least one currently psychiatric comorbidity (axis I or II). Conclusions: Mental health professionals have a central role in coordinating the multidisciplinary care of transsexuals. © 2008 by The Haworth Press.
Keywords: Mental health; Multidisciplinary care; Psychiatric comorbidity; Sexual and gender disorders; Transsexualism

Trained table based recognition & classification (TTRC) approach in human motion reconstruction & analysis. - Yasin, H.; Khan, S.A. (Proceedings - 4th IEEE International Conference on Emerging Technologies 2008, ICET 2008, 2008)
In this paper, first we discuss human motion analysis using the temporal template methodology. This methodology deals with the creation of Motion History Images (MHIs). Hu Moment Invariants are calculated from MHIs, for feature description. Two types of training datasets based on Hu Moment Invariants, have been developed. One training dataset is of 105x7 elements and other consists of 200x7 elements. Secondly a new simple approach for motion recognition and classification called Trained Table based Recognition & Classification (TTRC) has been proposed. In TTRC approach, instead of using the training datasets, a simple data table has been trained. The training process comprises of the behavioral study of seven q" values of Hu Moment Invariants. We make performance evaluation of TTRC with other classification techniques using these training datasets in the context of accuracy, success rate, time & speed and memory capacity. The classifiers used in this paper are KNearest Neighbor (KNN) and Fuzzy K-Nearest Neighbor (FKNN) classifiers with values of K = 1,3,5, Mahalanobis Distance (MD) classifier, Linear Bayes Gaussian (LBG) classifier, Quadratic Bayes Gaussian (QBG) classifier. Five different types of motions are selected for this research which are: Bending, Gun Shot, Jumping, Kicking and Punching.

Avoiding shame: Young LGBT people, homophobia and self-destructive behaviours - McDermott, E.; Roen, K.; Scourfield, J. (Culture, Health and Sexuality, 2008)
This paper reports on findings from qualitative research conducted in the UK that sought to explore the connections between sexual identities and self-destructive behaviours in young people. International evidence demonstrates that there are elevated rates of suicide and alcohol abuse amongst lesbian, gay, bisexual and transgender (LGBT) youth. Rarely included in this body of research are investigations into young LGBT people's views and experiences of self-destructive behaviours. Data from interviews and focus groups with young LGBT participants suggest a strong link between homophobia and self-destructive behaviours. Utilising a discourse analytic approach, we argue that homophobia works to punish at a deep individual level and requires young LGBT people to manage being positioned, because of their sexual desire or gendered ways of being, as abnormal, dirty and disgusting. At the centre of the complex and multiple ways in which young LGBT people negotiate homophobia are 'modalities of shame-avoidance' such as: the routinization and minimizing of homophobia; maintaining individual 'adult' responsibility; and constructing 'proud' identities. The paper argues that these strategies of shame-avoidance suggest young LGBT people manage homophobia individually, without expectation of support and, as such, may make them vulnerable to self-destructive behaviours.
Keywords: Homophobia; Sexuality; Shame; Suicide; Youth

The facts about violence against historically disadvantaged persons - McLeod-Bryant, S.; Robinson, G.E.; Benton, B.T.; Srinivasaraghavan, J.; Bialer, P.A. (Psychiatric Times, 2008)
The disadvantaged racial/ethnic and sexual orientation minorities and women have disproportionately experienced suicide and homicide in the United States. The complex history of each group, its language, attitudes, values, and behaviors, which interact with those of the majority culture, produce unique patterns of violence. Regardless of a victim's background, a psychiatric approach that begins with an assessment of the cultural identity of the victim gives each victim the best chance of becoming a survivor. This approach recognizes the assets available in the victim's community of support and provides a safe haven for learning adaptive and proactive behaviors. Finally, psychiatrists are encouraged to advocate for broader social changes that will prevent future victimization and provide greater opportunities for recovery.

An early male adolescent with externalizing behaviors, school failure, and a colostomy. - Sedberry, D.; Tarbell, S.; Stein, M.T. (Journal of developmental and behavioral pediatrics : JDBP, 2008)
CASE: Jeff is a 14 (1/2) years old ninth grader who presents with his mother, father, and step-father because he is failing in school. Jeff was born with an imperforate anus, and he had several surgical procedures in the first few years of life. He has a colostomy, but it is not clear how well he cares for it independently. Jeff's parents state that there other concern is that to prepare for school each morning or for other activities, they literally remind him of each step. Jeff has been active and disruptive since preschool, but is also described as "charming." School work and peer relations improved following a diagnosis of attention-deficit hyperactivity disorder (ADHD) in the second grade and treatment with a long-acting stimulant medication. An Independent Education Plan (IEP) in second grade included achievement tests that demonstrated above grade level scores. Jeff continued to have problems with written expression, but did quite well in verbal expression. By seventh grade, Jeff complained to his parents that he "wasn't fun to be around," and refused to take medication for ADHD. He increasingly refused to do most of his homework or class work. Grades were approaching failing levels in the eighth grade when he was suspended twice for impulsive behaviors-drawing a picture of a gun pointed at another student, and signing a petition stating that a classmate was gay. After his second suspension, he was sent to a continuation school, where he resisted doing the required work, failed each subject, and socialized with peers. Jeff is failing in ninth grade although his teachers describe him as respectful in the classroom. His parents divorced when Jeff was a preschooler, and they do not agree on how to manage Jeff. Jeff's father has not supported medication for the treatment of ADHD. The parents tried numerous strategies to help Jeff, including improving organizational skills, offering rewards and punishments and counseling; they have participated in parenting classes. The parents acknowledge that Jeff always tries to negotiate with them and they often give in. There is no known substance abuse or illegal behavior, although he has demonstrated destructiveness and stealing at home. Jeff's mother remarried a year ago, and her husband backed her in setting more strict limits for Jeff; at Jeff's request, he is currently living with his father most of the time.

Suicidality and self-harm among sexual minorities in Japan - DiStefano, A.S. (Qualitative Health Research, 2008)
In this study, I used ethnographic methods to examine suicidality and nonsuicidal self-harm among gay, lesbian, bisexual, and transgender persons in Japan. Participants (N = 84) indicated that suicidality and self-harm are serious problems among sexual minorities and tend to be driven by (a) a homophobic/transphobic environment and the negative consequences of sexual minorities either disclosing their true selves or remaining hidden and silent within such an environment; (b) various antecedents to poor mental health; and (c) factors not directly related to being a sexual minority, particularly unemployment and debt in the context of a protracted national economic decline in Japan prior to the study period of 2003-2004. Participants also perceived a potentially higher risk for suicidality and self-harm among sexual minority adolescents and persons in their early 20s; those who work in the entertainment, bar, or sex industries; and survivors of violence perpetrated by intimate partners or family members. © 2008 Sage Publications.
Keywords: Asia; Bisexuals; Ethnography; Gays and lesbians; General; Japan; Japanese; Minorities; Qualitative methods; Sexuality; Transsexuals; Violence; Vulnerable populations

Suicide and reputation damage - Pridmore, S.; McArthur, M. (Australasian Psychiatry, 2008)
Aim: This paper uses the public record to explore the relationship between reputation damage and suicide. Method: The public record of the last 20 years was examined for examples of individuals without evidence of mental disorder who suffered actual or threatened reputation damage and suicided shortly thereafter. Results: Fifteen individual cases were identified; 18 additional cases, less comprehensively detailed, were mentioned in reports of The Wood Royal Commission and Operation Auxin. All cases were male. Of the 15 individual cases, the average age was 55 years, with a range of 40 to 76 years. The available details of the 18 additional cases were consistent with these findings. Conclusion: Middle-aged males without clear evidence of mental disorder, who suffer actual or threatened reputation damage, may be at increased risk of suicide. Naming and shaming needs to be conducted with caution.
Keywords: Reputation; Sociology; Suicide; Suicide prevention

Suicide attempts among people living with HIV in France - Preau, M.; Bouhnik, A.-D.; Peretti-Watel, P.; Obadia, Y.; Spire, B.; Afsa, C.; Bonnet, A.; Bouhnik, A.D.; Di Paola, V.; Dray-Spira, R.; Fagnani, J.; Fernandez, L.; et al. (AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, 2008)
This study examined the prevalence and characteristics of attempted suicide among a representative sample of French Human Immunodeficiency virus (HIV) infected individuals. In 2003, a face-to-face survey was conducted among people living with HIV/AIDS (PLWHA) selected in a random, stratified sample of French hospital departments. Among solicited individuals, 2,932 agreed to participate and were asked if they had ever AS. Among the respondents, 23% had AS. Female gender, younger age, native French citizenship, reporting household financial difficulties, having been HIV-contaminated through homosexual contact or through injection drug use and suffering from lipodystrophy-related symptoms were all independently associated with AS. HIV-discrimination and the lack of social support from family remained independently associated with AS. Our findings indicate a high level of AS among PLWHA and emphasize the multiple roles of factors associated with living with HIV, together with sociodemographic factors. The results enable the possibility for vulnerable groups to be targeted for specific future interventions in order to prevent attempted suicide. © 2008 Taylor & Francis.
Keywords: Discrimination; Lipodystrophy; Side-effects; Suicide attempt

Moment invariants based human mistrustful & suspicious motion detection, recognition & classification - Yasin, H.; Khan, S.A. (Proceedings - UKSim 10th International Conference on Computer Modelling and Simulation, EUROSIM/UKSim2008, 2008)
In this paper, we present human mistrustful motion detection & classification using Hu Moment Invariants feature descriptions. A new method for recognition & classification that is Moment Invariant based Classifier (MIBC) has been proposed. The basis of the MIBC is the different seven φ values of Hu Moment Invariants itself and the Euclidean Distance measure between these φ values of all image frames of each type of motion. These values of Moment Invariants and Euclidean Distances are compared with other values and Euclidean Distances of all image frames of different or same type of motion. The performance of MIBC is evaluated with other types of methodologies & classifiers like Mahalanobis Distance (MD) classifier, Linear Bayes Gaussian (LBG) classifier, Quadratic Bayes Gaussian (QBG) classifier and Fuzzy K-Nearest Neighbor (FKNN) classifier using temporal template motion detection technique. The performance evaluation is done in the context of accuracy, time and speed. Experiments are conducted on five types of suspicious motions: Bending down, Gun Shot, Jumping up, Kicking front and Punching forward. © 2008 IEEE.

Suicidal ideation in UK HIV clinic attenders - Sherr, L.; Lampe, F.; Fisher, M.; Arthur, G.; Anderson, J.; Zetler, S.; Johnson, M.; Edwards, S.; Harding, R. (AIDS, 2008)
Background:: HIV has been associated with elevated suicidal ideation. Although new treatments have changed prognosis, they also bring new challenges. This study measured suicidal ideation in HIV clinic attenders in the United Kingdom (London/Southeast) and explored associated factors. Method:: All 1006 attenders at five HIV clinics were approached, of which 903 met inclusion criteria and 778 participated (86% response). Participants provided detailed information on suicidal ideation, demographics, treatment, adherence, symptoms (psychological and physical on Memorial Symptom Assessment Schedule), quality of life (EuroQol) information, HIV disclosure, clinical variables, sexual risk behaviour and treatment optimism. Results:: There was a 31% prevalence of suicidal ideation. Factors associated with suicidal ideation were being a heterosexual man, black ethnicity, unemployment, lack of disclosure of HIV status, having stopped antiretroviral treatment (compared to treatment or treatment naive), physical symptoms, psychological symptoms and poorer quality of life. There was no association with sexual risk behaviour. Sex/sexuality and ethnicity were independently associated with suicidal ideation: the odds of suicidal ideation increased almost two-fold for heterosexual men compared with gay men or women and for black respondents compared with White or Asian respondents. Lack of disclosure was independently associated with a two-fold increase in odds of suicidal ideation. Elevated physical and psychological symptoms were strong independent predictors of suicidal ideation. Independent predictors of suicidal ideation were very similar among the subgroup of 492 patients on antiretroviral treatment. Conclusion:: Despite advances in treatment, suicidal ideation rates among HIV-positive clinic attenders are high. Emotional support and attention to mental health provision and social context are strongly endorsed. © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Keywords: Adherence; HIV; Psychological burden; Suicidal ideation

Homophobic teasing, psychological outcomes, and sexual orientation among high school students: What influence do parents and schools have? - Espelage, D.L.; Aragon, S.R.; Birkett, M.; Koenig, B.W. (School Psychology Review, 2008)
Homophobic teasing is often long-term, systematic, and perpetrated by groups of students (Rivers, 2001); it places targets at risk for greater suicidal ideation, depression, and isolation (Elliot & Kilpatrick, 1994). This study fills a gap in the literature by examining buffering influences of positive parental relations and positive school climate on mental health outcomes for high school students who are questioning their sexual orientation. Participants were 13,921 high school students from a Midwestern U.S. public school district. Students completed a survey consisting of a wide range of questions related to their school experiences (bullying, homophobia, school climate), parental support, mood, and drug-alcohol use. Students were categorized into three groups: (a) youth who identified as heterosexual, (b) youth who questioned their sexual orientation, and (c) youth who identified as lesbian, gay, or bisexual (LGB). As hypothesized, sexual minority youth were more likely to report high levels of depression-suicide feelings and alcohol-marijuana use; students who were questioning their sexual orientation reported more teasing, greater drug use, and more feelings of depression and suicide than either heterosexual or LGB students. Sexually questioning students who experienced homophobic teasing were also more likely than LGB students to use drugs-alcohol and rate their school climate as negative. Finally, positive school climate and parental support protected LGB and questioning students against depression and drug use. Copyright 2008 by the National Association of School Psychologists.

Well-being among same-sex- and opposite-sex-attracted youth at school - Rivers, I.; Noret, N. (School Psychology Review, 2008)
In this study, 53 students who reported being solely or primarily attracted to members of the same sex were matched with 53 peers who reported being attracted solely to members of the opposite sex on various demographic factors as well as exposure to bullying at school. Data relating to tobacco and alcohol use, drug use, health risk behaviors, concerns and sources of social support, interpersonal sensitivity, depression, anxiety, hostility, suicide ideation, loneliness, and concentration were analyzed. Results indicated that same-sex-attracted students reported drinking alcohol alone more than opposite-sex-attracted peers; however, they were no more likely to engage in health-risk behaviors, or use Class 1 and 2 drugs. They were more likely to report being worried about being lesbian or gay, and were more likely to seek support from a member of school staff than opposite-sex-attracted peers. In terms of psychological well-being, same-sex-attracted students scored significantly higher on a hostility subscale when compared to opposite-sex-attracted peers and were more likely to report feeling lonely. These results suggest that the management of reactive aggression or hostility toward others may be a key determinant of healthy gay, lesbian, and bisexual development. Copyright 2008 by the National Association of School Psychologists.

Gynecologic Care of the Female-to-Male Transgender Man - Dutton, L.; Koenig, K.; Fennie, K. (Journal of Midwifery and Women's Health, 2008)
Transgender men are a vulnerable population whose health care needs have been difficult to identify because of limited research and an inability to identify the population. Limited evidence suggests that transgender men are at increased risk of having polycystic ovarian syndrome, contracting HIV, experiencing violence, and committing suicide. This qualitative study, conducted through face-to-face interviews of a convenient sample, was a three-part interview containing a demographic and health questionnaire, the Norbeck Social Support Questionnaire, as well as the Health Care Relationship Trust Scale. Audio recordings and written notes were reviewed and common themes were identified via content analysis. Six self-identified transgender men between the ages of 19 and 45 years were enrolled in the study. Participants were at varying degrees of social and medical transition. Four major themes were identified: 1) receiving gynecologic care was perceived to be important; 2) breasts caused the most gender identity conflict; 3) transgender men struggle with revealing their gender identity to health care providers; and 4) the male/female boxes on health intake forms, as well as pronoun usage by medical staff, were barriers to receiving health care. This gynecologic health care needs assessment of transgender men begins to characterize the barriers transgender men face when seeking health care. © 2008 American College of Nurse-Midwives.
Keywords: cultural competency; gynecology; Pap smear; primary care; transgender; transsexual

An exploratory study of correlates, onset, and offset of non-suicidal self-injury - Deliberto, T.L.; Nock, M.K. (Archives of Suicide Research, 2008)
The study of non-suicidal self-injury (NSSI) has focused largely on identifying diagnostic correlates and the functions of this behavior; however, little is known about the broader range of factors related to NSSI. We examined a wide array of factors hypothesized to correlate with non-suicidal self-injury (NSSI) and provided a qualitative analysis of adolescents' self-reported motivations for starting and stopping this behavior. Participants were 64 adolescents with a history of NSSI and 30 comparison adolescents without such a history matched on age, sex, and ethnicity recruited from the community and assessed during one laboratory visit. The presence of NSSI was associated with a family history of suicidal ideation, violence, and drug and alcohol abuse, but not with more general forms of psychopathology. NSSI also was associated with the presence of in utero complications, the occurrence of non-injurious repetitive behaviors during childhood, and endorsement of a homosexual or bisexual orientation. Self-injurers reported getting the idea to self-injure from peers (38%) more often than any other source, and most (78%) reported at least one reason for wanting to stop self-injury. Less than half were currently receiving treatment. This exploratory study provides new information about the correlates of NSSI that has implications for research and clinical work in this area. Copyright © International Academy for Suicide Research.
Keywords: Correlates; Onset; Self-harm; Self-injury; Self-mutilation; Treatment

From my cold, dead hands: Democratic consequences of sacred rhetoric - Marietta, M. (Journal of Politics, 2008)
Political rhetoric often appeals to sacred values, or nonnegotiable convictions grounded in transcendent authority rather than reasoned consequences. Sacred convictions are treated as absolutes that resist normal value tradeoffs and cast doubt on the moral standing of citizens who violate them. This study examines the political meaning of this form of persuasion in political domains such as guns, gay marriage, the death penalty, and the environment. Experimental evidence suggests that the distinctive effects of sacred appeals are on citizens' political reasoning and motivation rather than on their expressed opinions. Sacred rhetoric is not more effective in changing minds, but in shifting the nature of public discourse and increasing levels of political intensity. The democratic consequences of sacred rhetoric include greater citizen participation but lesser prospects for meaningful deliberation, a contradictory influence on the health of American democracy. © 2008 Southern Political Science Association 2008.

ON COURAGE - Jacobs, T.J. (Psychoanalytic Psychology, 2008)
In this clinical vignette, the author describes an individual who, in his opinion, manifested unusual courage, both in making extremely difficult life decisions and in facing his own fatal illness. © 2008 American Psychological Association.
Keywords: church; courage; homosexuality; religion; suicide

Proteomic profile of dormant Trichophyton Rubrum conidia - Leng, W.; Liu, T.; Li, R.; Yang, J.; Wei, C.; Zhang, W.; Jin, Q. (BMC Genomics, 2008)
Background: Trichophyton rubrum is the most common dermatophyte causing fungal skin infections in humans. Asexual sporulation is an important means of propagation for T. rubrum, and conidia produced by this way are thought to be the primary cause of human infections. Despite their importance in pathogenesis, the conidia of T. rubrum remain understudied. We intend to intensively investigate the proteome of dormant T. rubrum conidia to characterize its molecular and cellular features and to enhance the development of novel therapeutic strategies. Results: The proteome of T. rubrum conidia was analyzed by combining shotgun proteomics with sample prefractionation and multiple enzyme digestion. In total, 1026 proteins were identified. All identified proteins were compared to those in the NCBI non-redundant protein database, the eukaryotic orthologous groups database, and the gene ontology database to obtain functional annotation information. Functional classification revealed that the identified proteins covered nearly all major biological processes. Some proteins were spore specific and related to the survival and dispersal of T. rubrum conidia, and many proteins were important to conidial germination and response to environmental conditions. Conclusion: Our results suggest that the proteome of T. rubrum conidia is considerably complex, and that the maintenance of conidial dormancy is an intricate and elaborate process. This data set provides the first global framework for the dormant T. rubrum conidia proteome and is a stepping stone on the way to further study of the molecular mechanisms of T. rubrum conidial germination and the maintenance of conidial dormancy. © 2008 Leng et al; licensee BioMed Central Ltd.

Suicide protective and risk factors for sexual minority youth: Applying the cumulative factor model - Rutter, P.A. (Journal of LGBT Issues in Counseling, 2008)
This report explores suicide protective and risk factors for lesbian, gay and bisexual (LGB) youth and offers a Cumulative Factor Model constructed from these factors. Numerous studies to date have concluded that a youth's sexual minority identity is a key risk factor for suicide. Few studies however have explored the internal and external protective factors that may cumulate to increase or reduce suicidal ideation and risk among this LGB population. Counseling implications for both assessment and intervention strategies are discussed in light of this cumulative factor approach to understand and potentially stem LGB youth suicide. © 2008 by The Haworth Press. All rights reserved.
Keywords: Bisexual; Gay; Lesbian; Sexual minority; Suicide protective factors; Suicide risk factors; Youth

Lifetime prevalence of mental disorders and suicide attempts in diverse lesbian, gay, and bisexual populations - Meyer, I.H.; Dietrich, J.; Schwartz, S. (American Journal of Public Health, 2008)
Past studies have reported little about variability in mental disorders among lesbians, gay men, and bisexual individuals. We assessed the prevalence of psychiatric disorders in 388 lesbian, gay, and bisexual Black, Latino, and White individuals. Black lesbians, gay men, and bisexual individuals had lower prevalence of all disorders than did Latino and White individuals; younger cohorts had fewer mood disorders than did older cohorts; bisexual persons had more substance use disorders than did gay men and lesbians; and Latino respondents attempted suicide more often than did White respondents.

Clustering of adolescent dating violence, peer violence, and suicidal behavior - Bossarte, R.M.; Simon, T.R.; Swahn, M.H. (Journal of Interpersonal Violence, 2008)
To understand the co-occurrence of multiple types of violence, the authors developed a behavioral typology based on self-reports of suicidal behaviors, physical violence, and psychological abuse. Using a sample of dating adolescents from a high-risk school district, they identified five clusters of behaviors among the 1,653 students who reported being abusive or violent in the past year. Victimization and perpetration with same-sex peers and dating partners clustered together among the students who reported the highest levels of abusive (n = 357) or violent behavior (n = 146). These students also reported high levels of suicidal behavior. There were few significant demographic differences across clusters. The implications of the results for the need to design and evaluate efforts to prevent multiple types of violence are discussed. © 2008 Sage Publications.
Keywords: Adolescence; Overlap; Prevention; Suicide; Typologies; Violence

Risk for reassault in abusive female same-sex relationships - Glass, N.; Perrin, N.; Hanson, G.; Bloom, T.; Gardner, E.; Campbell, J.C. (American Journal of Public Health, 2008)
Objectives. We revised the Danger Assessment to predict reassault in abusive female same-sex relationships. Methods. We used focus groups and interviews to evaluate the assessment tool and identify new risk factors and telephone interviews at baseline and at 1-month follow-up to evaluate the revised assessment. Results. The new assessment tool comprised 8 original and 10 new items. Predictors included increase in physical violence (relative risk ratio [RRR]=1.95; 95% confidence interval [CI]=0.84, 4.54), constant jealousy or possessiveness of abuser (RRR=4.07; 95% CI=0.61, 27.00), cohabitation (RRR=1.96; 95% CI=0.54, 7.12), threats or use of gun by abuser (RRR=1.93; 95% CI=0.79, 4.75), alcoholism or problem drinking of abuser (RRR=1.47; 95% CI=0.79, 2.71), illegal drug use or abuse of prescription medications by abuser (RRR=1.33; 95% CI=0.72, 2.46), stalking by abuser (RRR=1.39; 95% CI=0.70, 2.76), failure of individuals to take victim seriously when she sought help (RRR=1.66; 95% CI=0.90, 3.05), victim's fear of reinforcing negative stereotypes (RRR=1.42; 95% CI=0.73, 2.77), and secrecy of abuse (RRR=1.72; 95% CI=0.74, 3.99). Both unweighted (P<.005) and weighted (P<.004) versions of the revised assessment were significant predictors of reassault. Conclusions. The revised Danger Assessment accurately assesses risk of reassault in abusive female relationships.

Attempted suicide and associated risk factors among youth in urban Japan - Hidaka, Y.; Operario, D.; Takenaka, M.; Omori, S.; Ichikawa, S.; Shirasaka, T. (Social Psychiatry and Psychiatric Epidemiology, 2008)
Background: Suicide is a major social and health issue in Japan. We assessed prevalence of attempted suicide and explored individual, interpersonal, behavioral, and psychological risk factors associated with attempted suicide in a general community sample of youth in a metropolitan Japanese city. Method: Survey of 2,095 participants age between 15 and 24 who were recruited using street-intercept techniques. Results: Overall, 6% of males and 11% of females reported a prior suicide attempt. For males, attempted suicide was independently associated with experience of school bullying, being homosexual or bisexual, history of drug use, experience of unwanted sex, history of a diagnosed sexually transmitted infection, and low self-esteem. For females, attempted suicide was independently associated with being younger (ages 15-19 compared to 20-24), experience of school bullying, history of drug use, and history of smoking. Conclusion: Prevention intervention programs for youth in Japan are necessary to achieve national aims to reduce attempted suicides and suicide mortality. © Springer-Verlag 2008.
Keywords: Japan; Mental health; Suicide; Youth

Lesbian, gay, bisexual and transgender young people's experiences of distress: Resilience, ambivalence and self-destructive behaviour - Scourfield, J.; Roen, K.; McDermott, L. (Health and Social Care in the Community, 2008)
The research presented in this paper set out to explore the cultural context of youth suicide and more specifically any connections between sexual identity and self-destructive behaviour, in the light of international evidence about the disproportionate risk of suicidal thoughts and suicide attempts in lesbian, gay, bisexual and transgender (LGBT) young people. The empirical basis for the paper is qualitative research that was carried out in the North West of England and South Wales. Focus groups and interviews were conducted with a total of 69 young people, with a purposive sample to reflect diversity of sexual identity, social class and regional and rural-urban location. The paper presents a thematic analysis of the data specifically relating to the experiences of LGBT young people. A range of strategies that LGBT young people employ in the face of distress are described. These are categorised as resilience, ambivalence and self-destructive behaviour (including self-harm and suicide). The potential implications for health and social care of these strategies include the need for ecological approaches and for sexual cultural competence in practitioners, as well as prioritisation of LGBT risk within suicide prevention policies. © 2008 Blackwell Publishing Ltd.
Keywords: Qualitative research; Sexuality; Suicide and self-destructive behaviour; Young people

Correlates of substance use among homeless youths in eight cities - Salomonsen-Sautel, S.; Van Leeuwen III, J.M.; Gilroy, C.; Boyle, S.; Malberg, D.; Hopfer, C. (American Journal on Addictions, 2008)
Homeless youths (N = 684) in eight cities participated in this study to understand the rates and correlates of substance use. Rates of lifetime and recent substance use ranged from 66% to 90%. Variability in lifetime and recent substance use was partially explained by being white (ages 14-17); ever attempting suicide (ages 14-17); not being African American (lifetime substance use) or Hispanic (ages 18-24); being male (ages 18-24); identifying as lesbian, gay, or bisexual (ages 18-24); using substances with a parent; beginning substance use at a young age; and having a family history of a substance problem. Copyright © American Academy of Addiction Psychiatry.

Remarks by Mary McAleese, President of Ireland: Made at the International Association of Suicide Prevention XXIV Biennial Conference, August 31, 2007, Irish National Events Centre, Killarney, Co. Kerry, Ireland - Connolly, J. (Crisis, 2008)
Reducing suicide rates requires a collective, concerted effort from all groups in society: health, social services, other professionals, communities and community leaders, voluntary and statutory agencies and organizations, parents, friends, neighbors, and individuals. It also requires the careful nurturing of a culture in which people in psychological distress don't hesitate to seek help from family, friends, health professionals and community leaders, a culture that recognizes the signs and signals of distress and is willing to help, and that focuses early in life on developing good coping skills and avoiding harmful practices; in short, a sensitive culture that cherishes human courtesy and takes responsibility for our own mental health and the mental health of others. Suicide occurs in many diverse contexts but there are recurring patterns and elements that research is revealing to us. The more we are learning, the better we are able to devise strategies and take action. We already know, for example, that alcohol abuse plays a very significant role in suicide and features prominently in youth suicide. Research has also established that cannabis increases the risk of depression and psychosis and that it reduces normal inhibitions against suicide. Since marijuana is the illegal drug most used by those under25 years of age, a critical factor in suicide prevention must be to inform young people as to its danger and counter the erroneous impression that it is a benign substance. We know that bullying sometimes features in the story of suicide. Our young people need to know just how damaging, just how unacceptable, bullying is. Education and access to support structures - whether at work, school, or home - are an essential part of protecting the victim of bullying not just from the bully but from their own downward spiral into suicidal thoughts. A less discussed but nonetheless important issue worth raising is the issue of dealing with sexual identity. Although Ireland is making considerable progress in developing a culture of genuine equality, recognition, and acceptance of gay men and women, there is still an undercurrent of both bias and hostility which young gay people must find deeply hurtful and inhibiting. For them, homosexuality is a discovery, not a decision, and for many it is a discovery which is made against a backdrop where, within their immediate circle of family and friends as well as the wider society, they have long encountered antigay attitudes which will do little to help them deal openly and healthily with their own sexuality. © 2008 Hogrefe & Huber Publishers.

Suicidal ideation and attempts in north american school-based surveys: Are bisexual youth at increasing risk? - Saewyc, E.M.; Skay, C.L.; Hynds, P.; Pettingell, S.; Bearinger, L.H.; Resnick, M.D.; Reis, E. (Journal of LGBT Health Research, 2008)
This study explored the prevalence, disparity, and cohort trends in suicidality among bisexual teens vs. heterosexual and gay/lesbian peers in 9 population-based high school surveys in Canada and the U.S. Multivariate logistic regressions were used to calculate age-adjusted odds ratios separately by gender; 95% confidence intervals tested cohort trends where surveys were repeated over multiple years. Results showed remarkable consistency: bisexual youth reported higher odds of recent suicidal ideation and attempts vs. heterosexual peers, with increasing odds in most surveys over the past decade. Results compared to gay and lesbian peers were mixed, with varying gender differences in prevalence and disparity trends in the different regions. © 2007 by The Haworth Press. All rights reserved.
Keywords: Bisexual gay lesbian adolescents; Health disparities; Population surveys; School-based surveys; Sexual orientation; Suicide attempts

Meeting the needs of GLB youth in residential care settings: A framework for assessing the unique needs of a vulnerable population - Block, R.G.; Matthews, J.D. (Residential Treatment for Children and Youth, 2008)
This article explores uses for strengths-based assessment of gay, lesbian and bisexual youth in residential care. Gay, lesbian and bisexual (GLB) youth face unique challenges such as stigma management and disclosure. In addition, GLB youth are also at increased risk for drug use, suicide and unprotected sex. Consequently, the needs of GLB youth differ upon entering residential care. Using the strengths perspective offers a variety of techniques and strategies for advancing efficacy and efficiency of assessment for GLB youth entering residential care. Applying the strengths perspective to the assessment process seeks to increase the level of empowerment experienced by the youth, enhance rapport building between client and clinician and providing an introduction into residential care that is client-centered and client driven. The pivotal nature of assessment in serving and treating youth in residential care make it a natural target for improved service delivery to GLB youth. Because of this population's experiences with stigma, oppression, internalization of hatred and resultant damage to self-esteem, working from a strengths perspective is especially relevant to clinicians and other service providers. Strategies for the process of the assessment, as well as the content of the assessment based on the strengths perspective speak to feelings of loneliness and isolation, and the need to manage disclosure, which are common experiences for GLB youth. In this exploration of application of the strengths perspective in assessment of GLB youth entering residential care, recommendations for both assessment process and content are made. A case example illustrating the use and application of these recommendations is also presented. © 2006 by The Haworth Press, All rights reserved.
Keywords: Assessment; Gay; Lesbian bisexual; Residential treatment; Strengths perspective; Youth

Bridging the divide:Integrating lesbian identityand orthodox judaism - Glassgold, J.M. (Women and Therapy, 2008)
Women who consider themselves traditional or conservative in the context of religious practice often experience tremendous conflicts regarding the integration of same-sex emotional and sexual feelings with their religion and spirituality. Current religious teachings about homosexuality make this combination difficult as only heterosexual sexuality within marriage is permitted in most orthodox faiths. Further, the way that spirituality and sexuality are conceptualized as opposing dichotomous categories (e.g., body vs. soul) presents women with a framework where integration does not seem possible. Observant women who come to psychotherapy often experience tremendous distress, guilt, depression, and even suicidality due to the conflict between their sexual feelings and religious doctrine. Relieving the distress, and resolving the conflicts while honoring the emotional complexity of sexual feelings, spirituality, and religious orthodoxy can present tremendous dilemmas for the practitioner as well as the client. Using the example of psychotherapy of an Orthodox Jewish woman who integrated same-sex desire into her life, this article describes psychotherapy process and alternative ways of viewing spirituality and sexuality that permit possible resolutions for clients.
Keywords: Judaism; Lesbian; Orthodoxy; Psychotherapy; Spirituality

Suicidal ideation and attempts among sexual minority youths receiving social services - Walls, N.E.; Freedenthal, S.; Wisneski, H. (Social Work, 2008)
The increased risk of suicidal ideation and attempts among sexual minority youths have been documented in studies using both convenience samples and representative community samples. However, as most youths do not access social services, these studies do not necessarily represent the sexual minority youths that community-based social workers may encounter in their day-to-day practice. As such, the present study on risk and protective factors related to suicidality surveyed 182 sexual minority youths (14 to 21 years of age) who sought assistance at a community-based social services agency in Denver. Similar to existing literature, the findings suggest that risk factors related to suicidality include hopelessness, methamphetamine use, homelessness, and in-school victimization. However, unlike studies of the general youth population, this study found that African American and male sexual minority youths were not at a lower risk of suicidality than sexual minority youths who were, respectively, white or female. In addition, our findings suggest that the presence of gay-straight alliances in schools may function as a protective resource for sexual minority youths. Implications for social work practice are discussed. © 2008 National Association of Social Workers.
Keywords: Gay; Gay-straight alliance; Lesbian; Suicide; Youths

Adolescent sexual orientation - Baltzer, F.; Elliott, A.; Katzman, D.; Pinzon, J.; Sankaran, K.; Taddeo, D.; Findlay, S.M.; Harvey, J.; Kaufman, M. (Paediatrics and Child Health, 2008)

Sexuality in patients with spinal cord injuries due to attempted suicide - Lombardi, G.; Mondaini, N.; Iazzetta, P.; MacChiarella, A.; Popolo, G.D. (Spinal Cord, 2008)
Objective: To evaluate the specific characteristics of sexuality in spinal cord injury (SCI) patients resulting from attempted suicide pre- and post-SCI. Methods: From March 1998 to March 2005, n=27 were compared with a SCI group with similar characteristics. In March 2006, all patients completed a final sexual check-up. Using our database we reviewed their sexuality path. Results: Suicide group (SG): Examination of personal/clinical history revealed in three how sexuality represented a possible co-factor for suicidal tendencies: one female reported a history of sexual abuse, two were homosexual (one gay and one lesbian). Five reported sexual dysfunctions. Nine females consistently showed via the Female Sexual Function Index (FSFI) at least one sexual disorder in all follow-ups; six females were in a stable relationship pre-SCI, seven during the final check-up; eight males in the SG presented erectile dysfunction using the International Index of Erectile Function (IIEF5); and eight were in a stable relationship pre-SCI and seven during the final visit. Control group (CG): Pre-SCI only one male presented erectile dysfunction. Seven females consistently showed sexual disorders. 11 females and 11 males were in stable relationships pre-SCI, respectively, 10 and 11 at the final check-up. In women the overall sexual satisfaction is statistically significant, correlated to the duration of the relationship P<0.05. Nine patients showed erectile dysfunction in the final follow-up. Conclusions: The SG showed a higher percentage of sexual dysfunction pre-SCI compared with CG, and they presented constant difficulty in establishing a stable relationship causing both an obstacle in the initial sexual rehabilitation and in achieving a satisfactory overall sexual life. © 2008 International Spinal Cord Society All rights reserved.
Keywords: Attempted suicide; Mental disorders; Sexual dysfunctions; Sexuality; Spinal cord injury

Ten years of lesbian health survey research in the UK West Midlands - Meads, C.; Buckley, E.; Sanderson, P. (BMC Public Health, 2007)
Background. Very little is known about the physical health needs of lesbian and bisexual women in the UK; most research has looked at mental or sexual health only. This article reports the results of four surveys carried out in the West Midlands between 1995 and 2005. Methods. The first two surveys were conducted in 1995-6 by a volunteer group, with participants from a lesbian health conference (n = 69) and in a convenience sample from a wide range of relevant groups and venues (n = 354). The second two surveys were commissioned by the West Midlands South Strategic Health Authority in partnership with the Gay Men's Health Network and were conducted in 2002 (n = 449) and 2005 (n = 166) and again used convenience sampling methods including the internet. Results. The mean age of respondents varied between 29-33 years and 5-7% were from a non-white ethnic background. The smoking rates varied from 42% o 55%, being twice the West Midlands regional average of 21% for women aged 16 or more. Similarly, problems with alcohol were reported in 25-37% of respondents, higher than the West Midlands regional average of 7% for women aged 16+. The prevalence of any mental health problem varied between 31-35% and any suicide attempt between 20-31%. Only 29-45% had revealed their sexual orientation to their GP and of these, approximately 50% had experienced a positive reaction. Conclusion. The results suggest health needs that current UK health services may not be meeting. There is a need to identify and target specific health measures for lesbians and bisexual women in order to ensure improved physical and mental health in the longer term. © 2007 Meads et al; licensee BioMed Central Ltd.

Leakage current analysis of nitride based optoelectronics by emission microscopy inspection - Chiou, Y.-Z.; Ko, T.-K.; Wang, C.-K.; Lin, T.-K.; Lin, K.-W. (Asia-Pacific Microwave Conference Proceedings, APMC, 2007)
GaN MSM photodetectors (PDs) and p-i-n photodetectors (PDs) with E-gun SiO2 passivation and Plasma Enhanced Chemical Vapor Deposited (PECVD) SiO2 passivation were fabricated and characterized. Inductance Couple Plasma (ICP) etching would cause significant damage on GaN MSM photodetectors. The damage was proved to induce leakage current via the surface of device by using emission microscopy inspection. However, the surface damage can be partially recovered by E-gun SiO2 passivation. As for the passivation for p-i-n photodetectors, the effect is not significant in the reduction of dark current due to smaller etched area as compare to the whole area of p-i-n PDs.
Keywords: Emission microscopy; ICP etching; MSM; P-i-n; Photodetectors

Drinking patterns, problems, and motivations among collegiate bisexual women - Bostwick, W.B.; McCabe, S.E.; Horn, S.; Hughes, T.; Johnson, T.; Ramirez Valles, J. (Journal of American College Health, 2007)
Objective and Participants: The authors compared the drinking behaviors, motivations, and problems of collegiate bisexual women with those of heterosexual women (N = 2,788; n = 86 bisexual women). Methods: Data came from the 2003 Student Life Survey, a random population-based survey at a large midwestern university. The authors explored the hypothesis that bisexual women would be more likely than heterosexual women to report drinking motivations related to stress and coping as a result of sexual identity stigma. Results: They found that bisexual women drank significantly less than did heterosexual women. There were few differences between the 2 groups in drinking motivations and problems. Bisexual women reported a comparable number of problems related to their drinking but were significantly more likely to report contemplating suicide after drinking than were heterosexual women. Conclusions: More research is needed to understand the finding that despite lower levels of alcohol consumption, bisexual women reported a comparable number of drinking problems. College health educators and health care providers need to be aware of findings related to heightened suicidal risk among bisexual women. Copyright © 2007 Heldref Publications.
Keywords: Bisexual women; College health; Drinking motivations; Drinking problems

Transgender youth and life-threatening behaviors - Grossman, A.H.; D'Augelli, A.R. (Suicide and Life-Threatening Behavior, 2007)
Sexual minority status is a key risk factor for suicide among lesbian, gay, and bisexual youth; however, it has not been studied among transgender youth. Fifty-five transgender youth reported on their life-threatening behaviors. Nearly half of the sample reported having seriously thought about taking their lives and one quarter reported suicide attempts. Factors significantly related to having made a suicide attempt included suicidal ideation related to transgender identity; experiences of past parental verbal and physical abuse; and lower body esteem, especially weight satisfaction and thoughts of how others evaluate the youths' bodies. Sexual minority status is a key risk factor for life-threatening behaviors among transgender youth. © 2007 The American Association of Suicidology.

Mental Health and Substance Use Disorders Among Latino and Asian American Lesbian, Gay, and Bisexual Adults - Cochran, S.D.; Mays, V.M.; Alegria, M.; Ortega, A.N.; Takeuchi, D. (Journal of Consulting and Clinical Psychology, 2007)
Growing evidence suggests that lesbian, gay, and bisexual adults may be at elevated risk for mental health and substance use disorders, possibly due to anti-gay stigma. Little of this work has examined putative excess morbidity among ethnic/racial minorities resulting from the experience of multiple sources of discrimination. The authors report findings from the National Latino and Asian American Survey (NLAAS), a national household probability psychiatric survey of 4,488 Latino and Asian American adults. Approximately 4.8% of persons interviewed identified as lesbian, gay, bisexual, and/or reported recent same-gender sexual experiences. Although few sexual orientation-related differences were observed, among men, gay/bisexual men were more likely than heterosexual men to report a recent suicide attempt. Among women, lesbian/bisexual women were more likely than heterosexual women to evidence positive 1-year and lifetime histories of depressive disorders. These findings suggest a small elevation in psychiatric morbidity risk among Latino and Asian American individuals with a minority sexual orientation. However, the level of morbidity among sexual orientation minorities in the NLAAS appears similar to or lower than that observed in population-based studies of lesbian, gay, and bisexual adults. © 2007 American Psychological Association.
Keywords: Asian American; bisexual; gay; Latino; psychiatric epidemiology

Successive switching of antiretroviral therapy is associated with high psychological and physical burden - Sherr, L.; Lampe, F.; Norwood, S.; Leake-Date, H.; Fisher, M.; Edwards, S.; Arthur, G.; Anderson, J.; Zetler, S.; Johnson, M.; Harding, R. (International Journal of STD and AIDS, 2007)
HIV treatment and management is constantly evolving. This is as a result of more treatment options coming on stream, tolerance changes and progress in treatment management. HIV infection today, in resource-rich countries and in the presence of combination therapies, is experienced as lifelong treatment punctuated by adjustments to antiretroviral therapy (ART) regimens. People who are diagnosed as HIV positive face a number of challenges and changes around the decision to commence treatment, responses to treatment and changes in treatment regimens. This study was set up to examine the experience of switching treatments and the impact of such switches on psychological parameters. The method used was a cross-sectional questionnaire study. A group of 779 HIV-positive clinic attendees at four clinics in London and South East England participated in the study (86% response rate). They provided detail of their treatment switching experiences as well as demographic details, risk and optimism evaluations, quality of life, symptom burden, adherence and disclosure information. The sample (n = 779) comprised 183 (24%) females, 76 (10%) heterosexual males and 497 gay males (66%). Self-reported ethnicity was 67% white, 25% black, 3% Asian and 5% mixed/other ethnicity. One hundred and fifty-five (21%) were ART-naïve and 624 (79%) were ARTexperienced; 161 (22%) were receiving their first regimen, 135 (18%) had experienced one regimen switch, 196 (26%) had multiple switches and 99 (13.3%) had stopped treatment. Treatment naïve, non-switchers and single switchers generally reported lower symptom burden and higher quality of life. Multiple switchers reported higher physical symptom burden and higher global symptom distress scores. Those who had stopped treatment had significantly lower quality-of-life scores than all other groups. Suicidal ideation was high across the groups and nearly a fifth of all respondents had not disclosed their HIV status to anyone. Reported adherence was suboptimal - 79% of subjects were at least 95% adherent on self-report measures of doses taken over the preceding week. In conclusion, nearly half this clinic sample will have switched treatments. A holistic approach is needed to understand the psychological effects of such switches if lifelong treatment is to be maintained and those on antiretroviral treatment are to attain good quality of life and minimize symptom burden.

Young adult suicide and sexual orientation: What should counselors know? - Rutter, P.A. (Journal of LGBT Issues in Counseling, 2007)
The current project focused on the suicidal ideation and risk potential of young adults (N = 312) and explored scores on self-report measures of suicidal ideation inclusive of various sexual orientations. Results suggest that the Lesbian, Gay, and Bisexual (LGB) youth surveyed (N = 73) differ in their display of suicide risk with significantly higher Beck Hopelessness Scale (BHS) and Suicide Probability Scale (SPS) scores. Social support served as a mitigating factor relating significantly to lower levels of hopelessness and suicidal ideation, especially among those LGB participants. The SPS held a significant relationship to suicide attempt in the past year, while the BHS held a significant relationship to suicide attempt in the past six months. Implications for counselors serving young adults are addressed, including specific suggestions to enhance counselor education and supervision related to suicide assessment and LGB counselor competency. © 2006 by The Haworth Press, Inc. All rights reserved.
Keywords: Assessment; Counseling; LGB; Sexual orientation; Suicide risk

Dating violence, sexual assault, and suicide attempts among urban teenagers - Olshen, E.; McVeigh, K.H.; Wunsch-Hitzig, R.A.; Rickert, V.I. (Archives of Pediatrics and Adolescent Medicine, 2007)
Objective: To evaluate the relationship between dating violence, sexual assault, and suicide attempts among urban adolescents. Design: Secondary analysis of the 2005 New York City Youth Risk Behavior Survey. Setting: Eighty-seven New York City public high schools. Participants: Representative population-based sample of 8080 students, 14 years and older. Main Exposures: Dating violence in the past year and lifetime history of sexual assault. Outcome Measure: One or more suicide attempts in the past year. Results: Respondents were 50.0% female and primarily black (36.0%) or Hispanic (40.1%). In the past year, 11.7% of females and 7.2% of males reported 1 or more suicide attempts. Lifetime history of sexual assault was reported by 9.6% of females and 5.4% of males. Dating violence in the past year was reported by 10.6% of females and 9.5% of males. In multivariate models, controlling for persistent sadness, sexual orientation, and significant risk behaviors, recent dating violence (odds ratio, 1.61; 95% confidence interval, 1.05-2.47) was associated with suicide attempts in adolescent girls, while lifetime history of sexual assault (odds ratio, 3.86; 95% confidence interval, 2.11-7.06) was associated with suicide attempts in adolescent boys. Conclusions: In this population of urban youth, recent dating violence among females and lifetime history of sexual assault among males were significantly associated with suicide attempts. Clinicians and educators should be trained to routinely screen adolescents for violence victimization and should have a low threshold for referring these at-risk teenagers for mental health services. ©2007 American Medical Association. All rights reserved.

Suicide among Asian Americans: What do we know? What do we need to know? - Leong, F.T.L.; Leach, M.M.; Yeh, C.; Chou, E. (Death Studies, 2007)
The current review begins with an acknowledgment of the diversity within the Asian American population as well as the scarcity of information on suicide among this particular racial/ethnic minority group. In analyzing what is known and what still needs to be learned about suicide among Asian Americans, the current article provides a critical review of significant factors such as age, gender, religious and spirituality issues, acculturation, social support, familial dynamics, social integration as well as gay/lesbian/bisexual orientations. In examining these factors, recommendations related to interventions and the existing research gaps are also discussed.

The Health and Health Behaviors of Young Men Who Have Sex with Men - Kipke, M.D.; Kubicek, K.; Weiss, G.; Wong, C.; Lopez, D.; Iverson, E.; Ford, W. (Journal of Adolescent Health, 2007)
Purpose: To describe the range of health and mental health problems for which young men who have sex with men (YMSM) may be at risk. Methods: An audio-computer-assisted survey was administered to a large, ethnically diverse sample of 526 YMSM (aged 18-24 years) recruited from bars, clubs, and other social venues using a venue-based probability sampling method. Results: Subjects reported a range of health and mental health problems, and involvement in health-compromising behaviors, such as overweight/obesity, depression, and suicidal thoughts/attempts, and many were found to have high rates of sexually transmitted infections. Moreover, many reported not having insurance coverage and/or limited access to care. Conclusions: Many of the health concerns and risks reported by these young men are preventable and can be addressed by any number of sectors, including health care and social service providers, religious organizations, schools, and employers. © 2007 Society for Adolescent Medicine.

After Our Bodies Ourselves - Monder, B.R. (Psychoanalytic Psychology, 2007)
The panel "After Our Bodies Ourselves," organized by Section III (Women, Gender, and Psychoanalysis), focused on the trajectory that feminism took since the publication in the early 1970s of Our Bodies Ourselves. Each of the five panelists had her own approach to the broad topic. Papers covered a historical overview of some of the societal changes affecting women in the past few decades in the United States; the psychodynamic impact of elective body-altering surgeries on adult women and adolescent girls; an introduction to a new construct - object orientation - and its implications in the rethinking of the construct of gender; and a case study about a woman with a snake phobia. © 2007 APA, all rights reserved.
Keywords: Cosmetic surgery; Eating disorder; Feminism; Gastric bypass; Object orientation; Psychodynamic impact; Snake phobia; Societal changes

Youth homelessness and social stigma - Kidd, S.A. (Journal of Youth and Adolescence, 2007)
Building upon previous exploratory qualitative research (Kidd SA (2003) Child Adol Social Work J 20(4):235-261), this paper examines the mental health implications of social stigma as it is experienced by homeless youth. Surveys conducted with 208 youths on the streets and in agencies in New York City and Toronto revealed significant associations between perceived stigma due to homeless status and sexual orientation, pan handling and sex trade involvement, and amount of time homeless. Higher perceived stigma was also related to low self esteem, loneliness, feeling trapped, and suicidal ideation, with guilt/self-blame due to homeless status having the strongest impact on mental health variables. © Springer Science+Business Media, LLC 2007.
Keywords: Social stigma; Street youth; Suicidality; Youth homelessness

Approaches for improving crop resistance to soilborne fungal diseases through biotechnology using Sclerotinia sclerotiorum as a case study - Dickman, M. (Australasian Plant Pathology, 2007)
Genetic engineering of crop plants with enhanced disease resistance has offered considerable promise and experimental power, however, with varying degrees of success. Traditional breeding has been very successful, though not in all cases. While the technology for gene manipulation in virtually any crop plant has been available for several years, field success has been hampered by our overall lack of understanding of the essential determinants mediating disease. Two key questions regarding molecular breeding will be addressed: (i) what genes or conceptual approaches can be used that have a realistic chance to be effective? and (ii) can we extrapolate useful information from model plants? Arabidopsis has served as an invaluable model system in many aspects of plant biology, including plant pathology and plant stress physiology, with many insights viewed to be directly applicable to crop plants. In addition, Arabidopsis has several experimental advantages: the genome has been sequenced, microarray chips are available, and there are a multitude of well characterised mutants. In addition, reverse genetics will continue as a powerful tool to examine gene function in Arabidopsis. The pros and cons of Arabidopsis application will be discussed. Sclerotinia sclerotiorum will serve as an example for approaches to disease control for soilborne fungal pathogens. The idea of interfering with fungal compatibility determinants coupled with biotechnology approaches will be described. S. sclerotiorum is an extremely broad host range, economically important, necrotrophic fungal plant pathogen. Diseases caused in economically important plants by S. sclerotiorum occur worldwide, cause considerable damage, have proven difficult to control (culturally or chemically) and host resistance to this fungus has been inadequate. A primary determinant contributing to the pathogenic success of this fungus is the ability to form sclerotia. The sclerotium of S. sclerotiorum is a multicellular, highly pigmented, rigid, asexual, resting or overwintering structure composed of condensed vegetative hyphal cells, which become interwoven and aggregate together, and it is capable of surviving years in soil. The importance of sclerotia for the pathogenic success of this fungus is underscored by the fact that sclerotia are the primary survival structures of this fungus upon which all other developmental phases of the fungus depend. Thus, sclerotia are an attractive target for intervention with the persistence of this pathogen. Effective pathogenesis by this fungus requires the secretion of oxalic acid, a primary pathogenicity determinant. Since this necrotrophic fungus requires host cell death for pathogenic success, we examined whether or not modulation of programmed cell death would impact the plant response to this aggressive pathogen. In animals, programmed cell death or its morphological equivalent, apoptosis, is genetically controlled cellular suicide. Multicellular organisms eliminate redundant, damaged or aged cells by this gene-directed cell death process. It is a complex process that is essential for development, maintenance of cellular homeostasis and for defence against environmental insults such as pathogen attack. Taking a trans-kingdom approach, transgenic crop plants that express animal anti-apoptotic genes have been generated. These genes all suppress apoptotic death in animal cells. We have shown that expression of these genes in tobacco and tomato abrogate disease development in plants infected with S. sclerotiorum. Plants with null mutations in these transgenes did not protect against pathogens. These data suggest that disease development requires host cell death pathways, thus differing from traditional concepts associated with necrotrophy. Transgenic plants also displayed tolerance or resistance to several abiotic stresses (heat, cold, salt and drought). Functional plant homologues of these mammalian genes are being identified. Taken together, our data suggest that modulation of host cell death is crucial in dictating the outcome of several fungal-plant interactions. The complete genome of S. sclerotiorum has been sequenced. The assembled sequence encodes a 39 Mb genome size with >8 fold coverage. The generation of an optical map and our collaboration with the 'Botrytis community' is expected to yield new insight into fungal biology via comparative genomics. © Australasian Plant Pathology Society 2007.
Keywords: Fungal signalling; Reactive oxygen species

Risk comparison among youth who report sex with same-sex versus both-sex partners - Moon, M.W.; Fornili, K.; O'Briant, A.L. (Youth and Society, 2007)
This article examines risk behavior among youth attending support groups for sexual minority youth in Richmond, Virginia, using a structured survey, with particular attention to partner selection and its relationship to risk. Within this generally high-risk group, youth reporting sex partners of both sexes had significantly higher risk profiles, including histories of drug use, suicide attempts, sexual victimization, and having run away from or been removed from the home, than those reporting only same-sex partners. © 2007 Sage Publications.
Keywords: Adolescents; Sexual minority youth; Substance use; Suicide

Suicide attempts among Norwegian gay, lesbian and bisexual youths: General and specific risk factors - Hegna, K.; Wichstrøm, L. (Acta Sociologica, 2007)
The aim of the study was to identify the specific factors that affect the risk of attempted suicide in Norwegian gay, lesbian and bisexual (GLB) youths beyond the effect of general risk factors presumed to be of importance irrespective of sexual orientation. The national non-probability sample included 407 GLB youths aged between 16 and 25 years of age, among whom 26 per cent of both genders reported a previous suicide attempt. General risk factors for attempted suicide among GLB youths were: lack of parental contact, internalizing problems (depression/anxiety), low self-esteem, regular smoking and victimization. The following risk factors specific for GLB youths increased the risk of attempted suicide even when controlling for general risk factors: currently being in a steady heterosexual relationship, early heterosexual debut (<16), young age of coming out (<15), infrequent contact with heterosexual friends and openness to all heterosexual friends. For practitioners engaged in social work among young people in general or GLB youths in particular, these results show that while coming out is a vital aspect of sexual identity formation that enhances psychological well-being and should be celebrated, in another sense it is a serious stressor with potentially negative consequences unless a strong social support network is there to be relied upon. Copyright © 2007 Nordic Sociological Association and SAGE.
Keywords: Adolescence; Identity; Risk factors; Sexual orientation; Suicidal behaviour; Young adult

Crystal methamphetamine: A source of added sexual risk for Hispanic men who have sex with men? - Fernández, M.I.; Bowen, G.S.; Warren, J.C.; Ibañez, G.E.; Hernandez, N.; Harper, G.W.; Prado, G. (Drug and Alcohol Dependence, 2007)
Objectives: To determine whether use of crystal methamphetamine increases HIV risk behaviors beyond the risk associated with use of other recreational drugs among Hispanic men who have sex with men (HMSM). Design: We compared the sexual behaviors and psychosocial characteristics of non-recreational drug users (non-users), recreational drug users who did not use crystal (non-crystal drug users), and recreational drug users who used crystal (crystal users). Methods: We recruited 294 HMSM from Internet and 272 from community venues. Eligible men completed an ACASI to assess socio-demographic factors, drug use, sexual behaviors and psychosocial factors and received $50. Results: In the multivariate model, crystal users were more likely than non-crystal drug users to have lower Hispanicism, higher attachment to the gay community, and history of suicide attempts. Crystal users were not significantly different from non-crystal drug users in number of sex partners; however, differences in unprotected receptive anal sex approached significance. Conclusions: The additional risk of crystal above that of other recreational drugs needs to be disentangled from those associated with poly-drug use. Our data suggest that it may depend on how one defines risky sexual behavior and is influenced by psychological, physiologic and social factors. © 2006 Elsevier Ireland Ltd. All rights reserved.
Keywords: Crystal methamphetamine; Drugs; Hispanic MSM; HIV; Sexual risk

Sexual orientation and risk factors for suicidal ideation and suicide attempts among adolescents and young adults - Silenzio, V.M.B.; Pena, J.B.; Duberstein, P.R.; Cerel, J.; Knox, K.L. (American Journal of Public Health, 2007)
Same-gender sexual orientation has been repeatedly shown to exert an independent influence on suicidal ideation and suicide attempts, suggesting that risk factors and markers may differ in relative importance between lesbian, gay, and bisexual individuals and others. Analyses of recent data from the National Longitudinal Study of Adolescent Health revealed that lesbian, gay, and bisexual respondents reported higher rates of suicidal ideation and suicide attempts than did heterosexual respondents and that drug use and depression were associated with adverse outcomes among heterosexual respondents but not among lesbian, gay, and bi-sexual respondents.

Lesbian studies and activism in India - Vanita, R. (Journal of Lesbian Studies, 2007)
This essay surveys public debates and writings about lesbianism and the history of activism around lesbian issues in twentieth-century India. Weddings between women and joint suicides by female couples over the last twenty-five years are among the under-researched, but increasingly reported, phenomena that suggest future directions that activism and the study of lesbianism in India may take. © by The Haworth Press, Inc. All rights reserved.
Keywords: Feminist academics; Fire; India; Lesbians; LGBT movements; Same-sex weddings and suicides; Suniti Namjoshi; Women's movements

Self-reported suicide attempts and associated risk and protective factors among secondary school students in New Zealand. - Fleming, T.M.; Merry, S.N.; Robinson, E.M.; Denny, S.J.; Watson, P.D. (The Australian and New Zealand journal of psychiatry, 2007)
OBJECTIVE: To examine associations between individual, family, school and community characteristics and rates of suicide attempts in a national population sample of New Zealand secondary school students. METHOD: A total of 9570 randomly selected 9- to 13-year-old students from 114 schools were surveyed, using the New Zealand Adolescent Health Survey. This is a 523-item anonymous self-report comprehensive questionnaire delivered by Multi-Media Computer-Assisted Self-Interviewing. Multivariate analyses were used to examine correlates of self-reported suicide attempts within the last 12 months. RESULTS: In total, 739 participants (4.7% of males and 10.5% of females) reported having made a suicide attempt within the last 12 months. Depressive symptoms, alcohol abuse, -having a friend or family member attempt suicide, family violence and non-heterosexual attractions were independently associated with increased rates of suicide attempts while parents caring, other family members caring, teachers being fair and feeling safe at school were independently associated with decreased rates of suicide attempts. Caring friendships, attending worship frequently, possible sexual abuse and anxiety symptoms were not independently associated with suicide attempts. Risk and protective factors operated in the same way for male and female students and for those with and without other suicide predictors. CONCLUSIONS: New Zealand secondary school students, particularly female students, report high rates of suicide attempts. Risk of suicide attempts is lower in students reporting caring home and fair, safe school environments and this effect remains once depression is taken into account. This study confirms the importance of depression, substance use, problem behaviour, negative life events, exposure to suicide behaviour by others and the significance of sexual orientation in suicidal behaviour among school students and provides evidence of the importance of the family and school environments in reducing risk among this group.

Health priorities and perceived health determinants among South Australians attending GLBTI festival events - Rogers, G.D. (Health Promotion Journal of Australia, 2007)
Issue addressed: Health differentials related to the social position of people whose sexual attraction or gender identity differs from that of the majority may be the 'forgotten inequity' in contemporary Australian discourses on health inequalities and social inclusion. What sexually- and gender-diverse communities see as health priorities and the social determinants of their health have been little studied in Australia. This survey explored the experience and opinions of a convenience sample of gay, lesbian, bisexual, trangender and intersex (GLBTI) people in South Australia. Method: A pencil and paper survey was administered to people attending events associated with the Feast GLBTI festival in Adelaide in 2004 and good participation rates were obtained. Two hundred and fifty-three people completed the survey, of which 122 identified as female, 124 as male and seven as other genders. Results: Depression, HIV, suicide, family relationship problems and alcohol problems were seen as the most important health issues for these communities, while discrimination under the law and in daily life were rated the most important health determinants. Conclusions: GLBTI South Australians surveyed identified priority health issues for their communities and identified legal and personal discrimination as significant determinants of their health.
Keywords: Bisexuality; Gender Identity; Health priorities; Homosexuality; Socio-economic factors

Family and Community Influences on the Social and Sexual Lives of Latino Gay Men - Guarnero, P.A. (Journal of Transcultural Nursing, 2007)
The purpose of this study was to explore the effect of family and community on the social and sexual lives of a group of Latino gay men living in a metropolitan area. A secondary analysis of four focus groups with 28 Latino gay men was conducted. Families had a difficult time acknowledging and supporting participants’ homosexuality. Participants experienced racism, discrimination, and physical and verbal abuse as a result of their ethnicity and homosexuality. These negative effects contributed to their marginalization and made them vulnerable to depression and suicide. Health care professionals should be aware of the effect of family and culture on the social and sexual lives of Latino gay men so that they can intervene and direct the client to the services needed to manage depression, suicidal ideation, and high-risk sexual behavior. © 2007, Sage Publications. All rights reserved.
Keywords: community; family; gay men; Latino

Representations of “the other side” in nadine gordimer’s the house gun - Stobie, C. (Scrutiny2, 2007)
In this article I examine ways in which Nadine Gordimer renders, in The house gun, a zone of alterity typified in the novel as the ‘Other Side! The author represents such alterity, seen mainly as racial and cultural, as alien, even while her purpose is to illustrate the necessity for change in a new post-apartheid political dispensation. Further, her focus on the other Other Side, that of sexuality, is also riven with contradictions, particularly in her representation of the scandalous middle ground of bisexuality, which is paired with criminality in the form of murder. I examine the complex effects of these contradictions, particularly in the light of the ending of the novel. I argue that the figure of the bisexual in this representative text, one among many in this period which employs to significant effect a bisexual character, carries the burden of social anxieties and hopes about this interstitial phase in our collective history. © Taylor & Francis Group, LLC.

Highlights of the 2006 Institute on Psychiatric Services - Jackson, D.S.; Gartner, C. (Psychiatric Services, 2007)

Direct organogenesis in nodal explants of mangabeira (Hancornia speciosa Gomes) - Soares, F.P.; Paiva, R.; De Alvarenga, A.A.; Nogueira, R.C.; Emrich, E.B.; Martinotto, C. (Ciencia e Agrotecnologia, 2007)
The mangabeira presents potential for fruit and rubber production. Since the seeds are recalcitrant which makes difficult its propagation, new approaches are needed in order to obtain plants through asexual methods. In this context, the process of in vitro culture presents as an alternative for the mangabeira propagation. The objective of the present work was to establish a micropropagation methodology of mangabeira through direct organogenesis. To obtain shoots, nodal segments collected from in vitro germinated seedlings were inoculated in WPM medium supplemented with different concentrations of BAP (0.0; 1.0; 2.0; 3.0; 4.0 e 5.0 mg L−1). For root induction, shoots were inoculated in WPM medium supplemented with 0.1% activated charcoal and different concentrations of NAA (0.0; 1.0; 2.0 e 3.0 mg L−1) or IBA (0.0; 1.0; 2.0; 3.0 e 4.0 mg L−1). The inoculated shoots were maintained in for 15 days a growth room after which were transferred to a free grow regulator WPM medium. The concentrations of 5.0 mg L−1 and 3.0 mg L−1 BAP were the most eficient for shoots and buds induction, respectively. Higher shoot length was observed in medium suplemented with 1.0 mg L−1 or 2,0 mg L−1 BAP. The higher callus formation occurred in medium suplemented with 4.0 mg L−1 BAP. The use of NAA was not efficient, in all tested concentrations, to induce in vitro root formation in shoots. In presence of 3.0 mg L−1 IBA, 20% of the shoots developed roots. © 2007, Federal University of Lavras. All rights reserved.
Keywords: Micropropagation; Rooting; Shooting

GaN membrane MSM ultraviolet photodetectors - Muller, A.; Konstantinidis, G.; Kostopoulos, A.; Dragoman, M.; Neculoiu, D.; Androulidaki, M.; Kayambaki, M.; Vasilache, D.; Buiculescu, C.; Petrini, I. (Proceedings of SPIE - The International Society for Optical Engineering, 2007)
GaN exhibits unique physical properties, which make this material very attractive for wide range of applications and among them ultraviolet detection. For the first time a MSM type UV photodetector structure was manufactured on a 2.2 μm. thick GaN membrane obtained using micromachining techniques. The low unintentionally doped GaN layer structure was grown by MOCVD on high resistivity (p>10kΩcm) 〈111〉 oriented silicon wafers, 500μm thick. The epitaxially grown layers include a thin AlN layer in order to reduce the stress in the GaN layer and avoid cracking. Conventional contact lithography, e-gun Ni/Au (10nm /200nm) evaporation and lift-off techniques were used to define the interdigitated Schottky metalization on the top of the wafer. Ten digits with a width of 1μm and a length of 100μm were defined for each electrode. The distance between the digits was also 1μm. After the backside lapping of the wafer to a thickness of approximately 150μm, a 400nm thick Al layer was patterned and deposited on the backside, to be used as mask for the selective reactive ion etching of silicon. The backside mask, for the membrane formation, was patterned using double side alignment techniques and silicon was etched down to the 2.2μm thin GaN layer using SF6 plasma. A very low dark current (30pA at 3V) was obtained. Optical responsivity measurements were performed at 1.5V. A maximum responsivity of 18mAA/W was obtained at a wavelength of 370nm. This value is very good and can be further improved using transparent contacts for the interdigitated structure.
Keywords: GaN membrane; MSM devices; UV photodetector

A general review of recent reports on homosexuality and lesbianism - Hughes, J.R. (Sexuality and Disability, 2006)
This review deals with the most recent reports on male homosexuality (H) and lesbianism (L). The reviewer checked the most recent 1000 articles in the Internet's Medline to report the major new findings in H and L. First discussed is the presumed etiology or cause, including the "maternal immunization hypothesis" and the evidence for both genetic and environmental factors. Next the prevalence in various countries is reported. The related diseases include HIV+, syphilis and other venereal diseases. Factors like drug involvement, unprotected anal sex, casual partners are included, as is suicidal ideation, violence, child molestation and changes in sexual orientation over time. The goal of this review is to make available to all readers the most recent reports on H and L so that pre-existing problems and any new disorders that have arisen can be better understood and that attempts at their solution can be pursued. © 2006 Springer Science+Business Media, LLC.
Keywords: Bisexual; Casual sex; HIV+; Homosexuality; Lesbianism; Unprotected sex; Venereal disease

Follow-up of sex reassignment surgery in transsexuals: A Brazilian cohort - Lobato, M.I.I.; Koff, W.J.; Manenti, C.; Seger, D.D.F.; Salvador, J.; Da Graça Borges Fortes, M.; Petry, A.R.; Silveira, E.; Henriques, A.A. (Archives of Sexual Behavior, 2006)
This study examined the impact of sex reassignment surgery on the satisfaction with sexual experience, partnerships, and relationship with family members in a cohort of Brazilian transsexual patients. A group of 19 patients who received sex reassignment between 2000 and 2004 (18 male-to-female, 1 female-to-male) after a two-year evaluation by a multidisciplinary team, and who agreed to participate in the study, completed a written questionnaire. Mean age at entry into the program was 31.21±8.57 years and mean schooling was 9.2±1.4 years. None of the patients reported regret for having undergone the surgery. Sexual experience was considered to have improved by 83.3% of the patients, and became more frequent for 64.7% of the patients. For 83.3% of the patients, sex was considered to be pleasurable with the neovagina/neopenis. In addition, 64.7% reported that initiating and maintaining a relationship had become easier. The number of patients with a partner increased from 52.6% to 73.7%. Family relationships improved in 26.3% of the cases, whereas 73.7% of the patients did not report a difference. None of the patients reported worse relationships with family members after sex reassignment. In conclusion, the overall impact of sex reassignment surgery on this cohort of patients was positive. © 2006 Springer Science+Business Media, Inc.
Keywords: Brazil; Gender identity disorder; Sex reassignment surgery; Sexuality; Transsexualism

Suicidality among Gay, Lesbian and Bisexual Youth: The Role of Protective Factors - Eisenberg, M.E.; Resnick, M.D. (Journal of Adolescent Health, 2006)
Purpose: Many reports have indicated that gay, lesbian and bisexual (GLB) youth are particularly vulnerable to poor outcomes, including suicide. Certain protective factors are likely to reduce this risk. The present study examines four protective factors (family connectedness, teacher caring, other adult caring, and school safety) and their association with suicidal ideation and attempts among adolescents with same-gender experience. Methods: Data come from the 2004 Minnesota Student Survey of 9th and 12th grade students; 21,927 sexually active youth were grouped according to the gender of their sex partner(s) into GLB and non-GLB groups. Four protective factors and suicidal ideation and attempts were compared across groups. Logistic regression was used to examine the influence of protective factors on suicide, and predicted probabilities of suicidal ideation and attempts were estimated using general linear modeling. Results: There were 2,255 respondents who reported same-gender experience. Over half of GLB students had thought about suicide and 37.4% reported a suicide attempt. GLB youth reported significantly lower levels of each protective factor than their non-GLB peers. Family connectedness, adult caring, and school safety were significantly protective against suicidal ideation and attempts. Risk associated with a GLB sexual orientation is largely mediated through protective factors. Conclusions: Sexual orientation alone accounts for only a small portion of variability in suicidal ideation and attempts. If protective factors were enhanced among GLB youth, suicide in this population is expected to be considerably lower. Protective factors examined here are amenable to change and should be targeted in interventions. © 2006 Society for Adolescent Medicine.
Keywords: Protective factors; Resiliency; Sexual orientation; Suicide

Attempted suicide, psychological health and exposure to harassment among Japanese homosexual, bisexual or other men questioning their sexual orientation recruited via the internet - Hidaka, Y.; Operario, D. (Journal of Epidemiology and Community Health, 2006)
Objective: To investigate the rates of attempted suicide and its association with psychological distress, experiences of bullying and verbal harassment, and demographic characteristics among Japanese homosexual, bisexual or other men questioning their sexual orientation. Design: A cross-sectional design using Japanese participants recruited through the internet. Results: Of the 1025 respondents, 154 (15%) of the men reported a history of attempted suicide, 716 (70%) showed high levels of anxiety and 133 (13%) showed high levels of depression. 851 (83%) experienced school bullying and 615 (60%) were verbally harassed because of being perceived by others as homosexual. Independent correlates of attempted suicide were psychological distress, history of being verbally harassed, history of sex with a woman, history of meeting a male through the internet, disclosing sexual orientation to six or more friends and not having a university degree. Conclusions: Mental health services and prevention programmes are needed to deal with the psychological consequences of social stigma for Japanese men who are homosexual, bisexual or questioning their sexual orientation.

Bullying and homophobia in UK schools: A perspective on factors affecting resilience and recovery - Rivers, I.; Cowie, H. (Journal of Gay and Lesbian Issues in Education, 2006)
This article reports the results of a three-year study focusing on the experiences of a sample of lesbian, gay, and bisexual (LGB) people in the United Kingdom who were victimized by their peers at school. Data collected from 190 LGBs suggested that experiences of victimization at school were both long-term and systematic, and were perpetrated by groups rather than by individuals. Subsequently, data collected from a sub-sample of 119 participants indicated that over 50 percent had contemplated self-harm or suicide at the time they were being harassed, and that 40 percent had engaged in such behavior at least once. As adults, participants were found to exhibit symptoms associated with negative affect when contrasted with heterosexual and non-victimized LGB peers. Seventeen percent exhibited symptoms associated with PTSD. However, the results also demonstrated that the majority of participants did not differ significantly from comparison groups in terms of self-esteem, and they had a positive attitude towards their sexual orientation. These findings are discussed with reference to the current literature about the development of resilience following exposure to violence and trauma. Copyright © by The Haworth Press, Inc. All rights reserved.
Keywords: Bullying; Harassment; Higher education; Homophobia; Mental health; Post-traumatic stress; Resilience; Secondary education; Self-esteem; Sexual orientation; Suicide; United Kingdom; Victimization

Attempted suicide among transgender persons: The influence of gender-based discrimination and victimization - Clements-Nolle, K.; Marx, R.; Katz, M. (Journal of Homosexuality, 2006)
To determine the independent predictors of attempted suicide among transgender persons we interviewed 392 male-to-female (MTF) and 123 female-to-male (FTM) individuals. Participants were recruited through targeted sampling, respondent-driven sampling, and agency referrals in San Francisco. The prevalence of attempted suicide was 32% (95% CI = 28% to 36%). In multivariate logistic regression analysis younger age (<25 years), depression, a history of substance abuse treatment, a history of forced sex, gender-based discrimination, and gender-based victimization were independently associated with attempted suicide. Suicide prevention interventions for transgender persons are urgently needed, particularly for young people. Medical, mental health, and social service providers should address depression, substance abuse, and forced sex in an attempt to reduce suicidal behaviors among transgender persons. In addition, increasing societal acceptance of the transgender community and decreasing gender-based prejudice may help prevent suicide in this highly stigmatized population. © 2006 by The Haworth Press, Inc. All rights reserved.
Keywords: Discrimination; Independent risk factors; Stigmatization; Suicide; Transgender; Transsexual; Victimization

From "male bonding rituals" to "suicide tuesday": A qualitative study of issues faced by gay male ecstasy (MDMA) users - Klitzman, R. (Journal of Homosexuality, 2006)
Use of MDMA and other club drugs has increased among gay men, but questions remain concerning the use, context, and popularity of these drugs; and views of their side effects. We interviewed in-depth 12 gay MDMA users in New York. MDMA had specific appeals to gay men, who often described isolation and stigmatization. Users underwent a period of initiation and social networks often became comprised of greater numbers of other users. Club environments fostered drug use and vice versa. Awareness of potential adverse effects varied and was minimized. Appropriate educational and prevention programs are needed to address these issues, and must take into account the specific contexts of these gay men's lives. © 2006 by The Haworth Press, Inc. All rights reserved.
Keywords: Club drugs; Crystal methamphetamine; Drug abuse; Ethnographic; Homosexuality; MDMA; Prevention; Risk behavior; Side effects; Substance use

Sexual violence among two populations of men at high risk of HIV infection - Braitstein, P.; Asselin, J.J.; Schilder, A.; Miller, M.-L.; Laliberté, N.; Schechter, M.T.; Hogg, R.S. (AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, 2006)
This study sought to compare the prevalence of, and relationship between, age at first experience of sexual violence and HIV and other health risk behaviors in two populations of men at high risk of HIV infection. Data were drawn from two cohorts: Vanguard, a prospective study of young men who have sex with men (MSM), and VIDUS, the Vancouver Injection Drug Users Study. Controlling for fixed sociodemographics, multivariate logistic regression was used to assess the relationship between age at first sexual violence (vs. never experiencing it) and several health risk behaviors. There were 140/498 (28%) MSM from Vanguard and 173/932 (19%) injection drug users (IDU) from VIDUS who reported having experienced sexual violence. Among VIDUS men, 130/852 (15%) IDU-only and 43/80 (54%) who were both IDU and MSM reported a history of sexual violence. The prevalence of child sexual abuse was 13% in Vanguard MSM, and 11% among VIDUS IDU-only, but 26% among VIDUS MSM/IDU. The median age of onset was significantly lower among VIDUS IDU-only compared to the two other groups. Experiencing sexual violence first in childhood was strongly related to ever being in the sex trade in both IDU and MSM. MSM in Vanguard who experienced sexual violence in childhood were more likely to have attempted suicide, and have a diagnosed mood disorder. Non-MSM IDU in VIDUS who experienced sexual violence in childhood were more likely to have a diagnosed mental illness, to binge on alcohol, and to have ever accidentally overdosed. In conclusion, men who have ever had sex with men appear to have a higher lifetime prevalence of sexual violence, compared to non-MSM injection drug users. Sexual violence is differentially associated with different health risk behaviors, depending on the age at first occurrence and the primary HIV risk factor (i.e. MSM vs. IDU). © 2006 Taylor & Francis.

A National Needs Assessment of Nurses Providing Health Care to Adolescents - Saewyc, E.M.; Bearinger, L.H.; McMahon, G.; Evans, T. (Journal of Professional Nursing, 2006)
Nurses, as the largest group of health providers in the United States, and by virtue of their scope of practice, are in an important position to promote the health of adolescents. A national survey of nurse members of the American Public Health Association, the National Association of Pediatric Nurse Associates and Practitioners, and the National Association of School Nurses was conducted in 1997 (n = 520) and was compared with findings from a parallel survey conducted in 1985 that assessed perceived competence in addressing common adolescent health issues, relevance of those issues to nurses' practice, and leadership skills. Findings provided a hopeful yet cautious picture of nurses' competencies. Strong increases in the proportion of nurses who felt equipped to address common health problems of youth suggest improved adolescent health education among nurses. Yet, at least 25% of nurses indicated a low level of knowledge in half of the adolescent health areas, and, like 1985's nurses, most nurses in 1997 did not feel competent to address the needs of gay, lesbian, and bisexual youth. Several priority areas in Healthy People 2010 were considered by 25% or more of the nurses to be irrelevant to their practice, including smoking cessation, suicide, violence, and pregnancy. The task remains to assure that all nurses who work with adolescents are equipped to respond to their diverse and unique health needs. © 2006.
Keywords: Adolescent health; Continuing education; Leadership; Nursing competency; Nursing education

Perceptions of lesbian, gay and bisexual people of primary healthcare services - Neville, S.; Henrickson, M. (Journal of Advanced Nursing, 2006)
Aim. This paper reports a study exploring people's perceptions of disclosure about lesbian, gay and bisexual identity to their primary healthcare providers. Background. Disclosure of sexual identity to healthcare professionals is integral to attending to the health needs of lesbian, gay and bisexual populations, as non-disclosure has been shown to have a negative impact on the health of these people. For example, an increased incidence of suicide, depression and other mental health problems have been reported. Method. From April to July 2004, a national survey of lesbian, gay and bisexual persons was carried out in New Zealand. Participants were recruited through mainstream and lesbian, gay and bisexual media and venues, and 2269 people completed the questionnaire, either electronically or via hard copy. The 133-item instrument included a range of closed-response questions in a variety of domains of interest. Results. In this paper, we report results from the health and well-being domain. More women than men identified that the practitioner's attitude toward their non-heterosexual identity was important when choosing a primary healthcare provider. Statistically significantly more women than men reported that their healthcare provider usually or always presumed that they were heterosexual and in addition more women had disclosed their sexual identity to their healthcare provider. Conclusion. Nurses need to reconsider their approach to all users of healthcare services by not assuming everyone is heterosexual, integrating questions about sexual identity into health interviews and ensuring that all other aspects of the assessment process are appropriate and safe for lesbian, gay and bisexual people. © 2006 The Authors.
Keywords: Attitudes; Bisexual; Gay; Homosexual; Lesbian; Nursing; Primary health care; Survey

The prevalence of suicidal behaviours in a group of HIV-positive men - Shelton, A.J.; Atkinson, J.; Risser, J.M.H.; McCurdy, S.A.; Useche, B.; Padgett, P.M. (AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, 2006)
We studied a convenience sample of 54 HIV-positive men, recruited from HIV/AIDS community based service organizations. Data were collected on HIV risk factors and suicidal behaviours. Fifty-nine percent of the sample reported ever thinking about suicide, and 50% of those individuals reported attempting suicide at some point in their lives. Suicide ideation and attempts were more common among white participants. Suicidal behaviours were prevalent in this sample suggesting a need for mental health and suicide interventions targeted for this population. © 2006 Taylor & Francis.

Sex, gender role orientation, gender role attitudes and suicidal thoughts in three generations: A general population study - Hunt, K.; Sweeting, H.; Keoghan, M.; Platt, S. (Social Psychiatry and Psychiatric Epidemiology, 2006)
Background: Suicide and other suicidal behaviours are markedly (though differently) patterned by gender. The increase in young male suicide rates in many countries has heightened interest in whether suicidal behaviours and ideation (thoughts) are related to masculinity. Relatively little research has explored the relationship between gender role attitudes and orientation and suicidal behaviours and ideation. Most research in this area has been conducted with young people. Objective: We investigated whether gender role orientation (masculinity and femininity scores) and gender role attitudes were related to the reporting of serious suicidal thoughts in three generations (early adulthood, and early and late middle age) in a community sample. Methods: Subjects (653 men and women aged around 23 years, 754 aged around 43 years, 722 aged around 63 years) completed home interviews with nurses as part of an ongoing longitudinal community-based study of social factors and health. These included measures of suicidal ideation (thoughts), attitudes to traditional gender roles, and a validated measure of gender role orientation (masculinity and femininity scores). Results: The prevalence of serious suicidal thoughts was higher in early adulthood (10% men, 15% women) than in early (4% men, 8% women) and late (6% men, 5% women) middle age. In early adulthood only sex was significantly related to suicidal thoughts, with women at higher risk (adjusted OR 1.74, 95% CI 1.01-3.00). In early middle age masculinity scores were negatively related to suicidal thoughts (adjusted OR for each unit increase in score 0.65: 95% CI 0.46-0.93), and more traditional views on gender roles were positively associated with suicidal thoughts (adjusted OR 1.48: 95% CI 1.07-2.04). In late middle age trends were in the same direction as in early middle age, but were not statistically significant. Femininity scores were unrelated to serious suicidal thoughts at any age. Conclusion: The high rates of suicidal thoughts amongst men and women in early adulthood point to the importance of understanding mental health problems at this age. The results raise a number of questions and suggest that suicide researchers should pay more attention to gender roles and attitudes in older adults. © Steinkopff Verlag Darmstadt 2006.
Keywords: Gender; Gender role attitudes; Masculinity; Suicidal ideation

Mental health issues: A comparison of lesbian, bisexual and heterosexual women - Koh, A.S.; Ross, L.K. (Journal of Homosexuality, 2006)
This study examines mental health issues among women of different sexual orientations. An anonymous survey was administered at 33 health care sites across the United States; the sample (N = 1304) included lesbians (n = 524), bisexual (n = 143) and heterosexual women (n = 637). Not only did sexual orientation influence the probability of experiencing emotional stress, but also whether a bisexual woman or lesbian had disclosed her sexual orientation (was "out") impacted the likelihood of having or having had mental health problems. Bisexual women and lesbians experienced more emotional stress as teenagers than did heterosexual women. Bisexual women were more than twice as likely to have had an eating disorder compared to lesbians. If a bisexual woman reported being out she was twice as likely to have had an eating disorder compared to a heterosexual woman. Lesbians who were not out and bisexual women who were out were 2-2.5 times more likely to experience suicidal ideation in the past 12 months. Lesbians and bisexual women who were not out were more likely to have had a suicide attempt compared to heterosexual women. Lesbians used psychotherapy for depression more commonly than did heterosexual or bisexual women. This is one of the few studies that compares lesbians, bisexual and heterosexual women. The implications of these findings are discussed. © 2006 by The Haworth Press, Inc. All rights reserved.
Keywords: Bisexual women; Eating disorders; Lesbian; Mental health; Methodology; Sexual orientation; Sexual orientation disclosure; Suicidality

Factors associated with 'feeling suicidal': The role of sexual identity - Abelson, J.; Lambevski, S.; Crawford, J.; Bartos, M.; Kippax, S. (Journal of Homosexuality, 2006)
This paper examines factors associated with feeling suicidal in a large sample of urban men in Sydney and Melbourne, aged 18-50, including heterosexual, gay and bisexual men, HIV antibody positive and HIV antibody negative. As in previous research, sexuality (being homosexual or bisexual) was found to be a major predictor of suicidality. The research went some way towards explaining the close relationship between feeling suicidal and sexual orientation. Sexuality interacts with feeling bad in that, once men feel moderately bad/depressed, they are more likely to feel suicidal if they are homosexual or bisexual than if they are heterosexual. In addition, the research found that experience of verbal abuse and physical assault (harassment) increased feeling suicidal for both heterosexual and gay/bisexual men, not just for homosexual men as suggested by previous research, and that social isolation in the form of living alone is a further risk factor. Seeking counseling help and taking sexual risks were also independently associated with feeling suicidal. These actions may result from feeling suicidal rather than the reverse, and their association with feeling suicidal warrants further research. Many of the 46 independent variables examined in the research, including HIV antibody status and closeness to the HIV/ AIDS epidemic, were related to feeling suicidal only through their association with being gay/bisexual. Celibacy and general risk taking were not related to feeling suicidal in this study. © 2006 by The Haworth Press, Inc. All rights reserved.
Keywords: Counseling; Feeling suicidal; Harassment; HIV/AIDS; Men's sexuality; Sexual risk taking; Social isolation; Suicidality

Familial and sociopsychopathological risk factors for suicide attempt in bulimic and in depressed women: Prospective study - Nickel, M.K.; Simek, M.; Lojewski, N.; Muehlbacher, M.; Fartacek, R.; Kettler, C.; Bachler, E.; Egger, C.; Rother, N.; Buschmann, W.; Gil, F.P.; Kaplan, P.; et al. (International Journal of Eating Disorders, 2006)
Objective: This study was carried out to examine sociopsychopathological predictors of prospective observed suicide attempts in bulimic women purging type without comorbid major depression (BNG) at the time of study entry and in woman with major depression without comorbid eating disorder at the time of study entry (MDG). Method: Data from 28 BNG (age 23.5 ± 3.6) and 126 MDG women (age 33.4 ± 5.1) who had attempted suicide during 12 months' monitoring were compared. Results: A univariate comparison of the two groups revealed various differences. Analysis of risk factors for suicide attempts using stepwise logistic regression was conducted separately for each group. The derived logistic models showed that patients from the BNG group had a history of higher incidence of sexual abuse in childhood, as well as abuse of laxatives and illicit drugs; they also lacked orientation in life, felt lonely despite family and friends, tended to direct their anger outward, and were unable to relax. Conclusion: Sociopsychopathological risk factors for suicide attempts in the BNG and MDG appear to vary. © 2006 by Wiley Periodicals, Inc.
Keywords: Aggression; Bulimia nervosa; Family history; Major depression; Risk factors; Suicide

Suicidality and sexual orientation: Differences between men and women in a general population-based sample from The Netherlands - De Graaf, R.; Sandfort, T.G.M.; Ten Have, M. (Archives of Sexual Behavior, 2006)
Homosexuality has been shown to be associated with suicidality and mental disorders. It is unclear whether homosexuality is related to suicidality, independently of mental disorders. This study assessed differences in lifetime symptoms of suicidality (death ideation, death wishes, suicide contemplation, and deliberate self-harm) between homosexual and heterosexual men and women, controlling for lifetime psychiatric morbidity. Interaction effects of age and the role of perceived discrimination were also examined. Data were collected on a representative sample of the Dutch population aged 18-64 years. Classification as heterosexual or homosexual was based upon reported sexual behavior in the preceding year. Of those sexually active, 2.8% of 2,878 men and 1.4% of 3,120 women had had same-sex partners. Homosexual men differed from their heterosexual counterparts on all four suicide symptoms (OR ranging from 2.58 to 10.23, with higher ORs for more severe symptoms), and on the sum total of the four symptoms; homosexual women only differed from heterosexual women on suicide contemplation (OR=2.12). Controlling for psychiatric morbidity decreased the ORs, but among men all associations were still significant; the significance for suicide contemplation among women disappeared. Younger homosexuals were not at lower risk for suicidality than older homosexuals in comparison with their heterosexual counterparts. Among homosexual men, perceived discrimination was associated with suicidality. This study suggests that even in a country with a comparatively tolerant climate regarding homosexuality, homosexual men were at much higher risk for suicidality than heterosexual men. This relationship could not only be attributed to their higher psychiatric morbidity. In women, there was no such clear relationship. © 2006 Springer Science+Business Media, Inc.
Keywords: Epidemiology; General population study; Homosexuality; Mental disorders; Suicidality

Self-injurious behaviors in a college population - Whitlock, J.; Eckenrode, J.; Silverman, D. (Pediatrics, 2006)
OBJECTIVE. The goal was to assess the prevalence, forms, demographic and mental health correlates of self-injurious behaviors in a representative college sample. METHODS. A random sample of undergraduate and graduate students at 2 northeastern US universities were invited to participate in an Internet-based survey in the spring of 2005. Thirty-seven percent of the 8300 invited participants responded. RESULTS. The lifetime prevalence rate of having ≥1 self-injurious behavior incident was 17.0%. Seventy-five percent of those students engaged in self-injurious behaviors more than once. Thirty-six percent reported that no one knew about their self-injurious behaviors and only 3.29% indicated that a physician knew. Compared with non-self-injurers, those with repeat self-injurious behavior incidents were more likely to be female, bisexual or questioning their sexual orientation. They were less likely to be Asian/Asian American and >24 years of age. When controlling for demographic characteristics, those with repeat self-injurious behavior incidents were more likely to report a history of emotional abuse or sexual abuse, ever having considered or attempted suicide, elevated levels of psychological distress, and ≥1 characteristic of an eating disorder. A dose-response gradient was evident in each of these areas when single-incident self-injurious behaviors were compared with repeat-incident self-injurious behaviors. CONCLUSIONS. A substantial number of college students reported self-injurious behaviors in their lifetimes. Many of the behaviors occurred among individuals who had never been in therapy for any reason and who only rarely disclosed their self-injurious behaviors to anyone. Single self-injurious behavior incidents were correlated with a history of abuse and comorbid adverse health conditions but less strongly than were repeat self-injurious behavior incidents. The reticence of these clients to seek help or advice renders it critical that medical and mental health providers find effective strategies for detecting and addressing self-injurious behaviors. Copyright © 2006 by the American Academy of Pediatrics.
Keywords: Mental health; Self-injury; Young adults

Understanding the needs of lesbian, gay, bisexual, and transgender people living with mental illness - Huygen, C. (MedGenMed Medscape General Medicine, 2006)

The impact of gender-role nonconforming behavior, bullying, and social support on suicidality among gay male youth - Friedman, M.S.; Koeske, G.F.; Silvestre, A.J.; Korr, W.S.; Sites, E.W. (Journal of Adolescent Health, 2006)
This study hypothesized that gender-role nonconformity is associated with suicidality, and bullying mediates this relationship. Gay males retrospectively answered questions pertaining to elementary, middle, and high school. Support for the hypotheses was found. Results can help screen gay youth for suicidality and support the need for policies prohibiting harassment based on sexual orientation. © 2006 Society for Adolescent Medicine.
Keywords: Attempted suicide; Bullying; Gender roles; Homosexuality; Sex roles; Sexual orientation; Social support; Suicide; Victimization

Predictors of suicidal ideation among high school students by gender in South Korea - Park, H.S.; Schepp, K.G.; Jang, E.H.; Koo, H.Y. (Journal of School Health, 2006)
The purpose of this study was to examine the evidence to determine if there are gender differences in suicidal ideation of adolescents. This study examined the main effect of risk factors from 5 domains and protective factors from 1 domain in relation to suicidal ideation by gender and identified the most important predictors of suicidal ideation for males (N = 654) and females (N = 658). This study was a cross-sectional survey, and data were collected through self-report questionnaires. In the univariate analysis, especially, risk factors from behavioral variables and psychosocial-environmental variables appeared to be gender skewed. For males, all behavioral variables were predictive of suicidal ideation. For the females, unlike the males, Wang-tta or victim of bullying behavior and sexual orientation as behavioral variables were predictive of suicidal ideation. For males, parental divorce and parental alcohol abuse as psychosocial-environmental variables were predictive of suicidal ideation. For the females, again unlike for the males, all the psychosocial-environmental variables were not predictive of suicidal ideation. The most important predictors of suicidal ideation for males as a result of the multivariate analysis were history of suicidal attempt, depression, hostility, smoking, parental alcohol abuse, communication with friends, and self-esteem. The most important predictors of suicidal ideation for females as a result of the multivariate analysis were depression, hostility, sexual orientation, and self-esteem. These results would indicate that an effective suicide screening and prevention program for adolescents should consider gender differences. © 2006, American School Health Association.

Mental health problems and use of services of lesbians: Results of the Boston lesbian health project II - Roberts, S.J.; Grindel, C.G.; Patsdaughter, C.A.; Reardon, K.; Tarmina, M.S. (Journal of Gay and Lesbian Social Services, 2006)
The Boston Health Project II, replicating a national survey of lesbians completed in 1987, found few differences from previous data regarding mental health problems and service use among lesbians. Respondents expressed positive feelings about being lesbian but reported money and work to be major problems. Surveyed lesbians used therapy at high rates, with depression and relationship problems being common reasons for seeking care. Most respondents were satisfied with their therapy experiences; female and lesbian therapists received the highest ratings. Depression, anxiety/panic disorders, and alcohol use continued to be concerns, alongwith suicide attempts and eating disorders among adolescents. Findings confirm that mental health needs exist for lesbians and challenge social service workers to make these services available. © 2004 by The Haworth Press, Inc. All rights reserved.
Keywords: Alcohol use; Lesbians; Mental health; Mental health services; Women

Violence against women and suicide risk: The neglected impact of same-sex sexual behaviour - Lhomond, B.; Saurel-Cubizolles, M.-J. (Social Science and Medicine, 2006)
We used data from the National Survey on Violence against Women in France carried out in 2000 on a representative sample of 6970 women to compare the social characteristics of women who had sex with women (WSW) and women who had sex only with men (WSM). The WSW were more likely to be of a high socio-economic level and living in large cities. They were more frequently unmarried, without children, and had a more diverse sexual life, generally beginning younger, with more partners, mainly men. They were also more likely to use tobacco, alcohol and drugs. WSW reported more physical violence in the recent past and more suicide attempts than WSM, despite a lack of difference in psychological distress and stress. These results, in a field little studied in France, are consistent with international findings attesting to the difficulties faced by women in situations involving autonomy and marginality.
Keywords: France; Homosexuality; Same-sex sexual behaviour; Suicide; Violence; Women

Shotgun identification of proteins from uredospores of the bean rust Uromyces appendiculatus - Cooper, B.; Garrett, W.M.; Campbell, K.B. (Proteomics, 2006)
We are interested in learning more about the proteome of Uromyces appendiculatus, the fungus that causes common bean rust. Knowledge of the proteins that differentiate life-cycle stages and distinguish infectious bodies such as uredospores, germlings, appressoria, and haustoria may be used to define host-pathogen interactions or serve as targets for chemical inhibition of the fungus. We have used 2-D nanoflowLC-MS/MS to identify more than 400 proteins from asexual uredospores. A majority of the proteins appear to have roles in protein folding or protein catabolism. We present a model by which an abundance of heat shock proteins and translation elongation factors may enhance a spore's ability to survive environmental stresses and rapidly initiate protein production upon germination. © 2006 Wiley-VCH Verlag GmbH & Co. KGaA.
Keywords: MudPIT; Proteome; Rust; Spore; Uromyces appendiculatus

Progressive symptoms and signs following institution of highly active antiretroviral therapy and subsequent antituberculosis therapy: Immune reconstitution syndrome or infection? - Miller, R.F.; Shahmanesh, M.; Talbot, M.D.; Wiselka, M.J.; Shaw, P.J.; Bacon, C.; Robertson, C.M. (Sexually Transmitted Infections, 2006)
A 36 year old man presented with weight loss, cough, fever, and exertional dyspnoea shortly after a diagnosis of HIV infection. Symptoms and initial radiological abnormalities worsened after highly active antiretroviral therapy was started. An eventual diagnosis was established but multiple problems occurred throughout the treatment period. Differentiation between immune reconstitution inflammatory syndrome and an infective cause was problematic.

A segment of the apospory-specific genomic region is highly microsyntenic not only between the apomicts Pennisetum squamulatum and buffelgrass, but also with a rice chromosome 11 centromeric-proximal genomic region - Gualtieri, G.; Conner, J.A.; Morishige, D.T.; Moore, L.D.; Mullet, J.E.; Ozias-Akins, P. (Plant Physiology, 2006)
Bacterial artificial chromosome (BAC) clones from apomicts Pennisetum squamulatum and buffelgrass (Cenchrus ciliaris), isolated with the apospory-specific genomic region (ASGR) marker ugt197, were assembled into contigs that were extended by chromosome walking. Gene-like sequences from contigs were identified by shotgun sequencing and BLAST searches, and used to isolate orthologous rice contigs. Additional gene-like sequences in the apomicts' contigs were identified by bioinformatics using fully sequenced BACs from orthologous rice contigs as templates, as well as by interspecies, whole-contig cross-hybridizations. Hierarchical contig orthology was rapidly assessed by constructing detailed long-range contig molecular maps showing the distribution of gene-like sequences and markers, and searching for microsyntenic patterns of sequence identity and spatial distribution within and across species contigs. We found microsynteny between P. squamulatum and buffelgrass contigs. Importantly, this approach also enabled us to isolate from within the rice (Oryza sativa) genome contig Rice A, which shows the highest microsynteny and is most orthologous to the ugt197-containing C1C buffelgrass contig. Contig Rice A belongs to the rice genome database contig 77 (according to the current September 12, 2003, rice fingerprint contig build) that maps proximal to the chromosome 11 centromere, a feature that interestingly correlates with the mapping of ASGR-linked BACs proximal to the centromere or centromere-like sequences. Thus, relatedness between these two orthologous contigs is supported both by their molecular microstructure and by their centromeric-proximal location. Our discoveries promote the use of a microsynteny-based positional-cloning approach using the rice genome as a template to aid in constructing the ASGR toward the isolation of genes underlying apospory. © 2006 American Society of Plant Biologists.

Homophobia and psychotic crimes of violence - Murphy, D. (Journal of Forensic Psychiatry and Psychology, 2006)
Irrationally negative attitudes towards homosexual people, known as homophobia, may cause assaults by mentally ill men. A qualitative study is presented in which homophobic motives are examined in detail. Five hospital in-patients were selected. All suffered from paranoid psychosis in which a homophobic theme was prominent. All had attacked with the intention to kill. Two of the victims died. The case records were studied and each patient participated in a semi-structured interview, which was audio-taped. Transcripts were made and studied using discourse analysis with an emphasis on the narrative of events leading to the crime. These cases are used as a basis for suggesting that it may be useful to categorize homophobic violence into three broad categories: non-psychotic violence, violence arising during typical psychotic illness, and violence arising during atypical or brief psychosis. The study describes and compares features of these homophobic states. Non-psychotic homophobia is an attitude often shared with others. It may lead to severe violence, often premeditated, and may influence the development of psychotic ideas. In those with typical psychotic states, abnormal ideas, often bizarre, of a homophobic nature may arise and can be described in the same way as other abnormal ideas in mental illness. In those with atypical psychosis, both the psychosis and the accompanying homophobic violence may be a reaction to a humiliating failure of gender self-esteem, which can be described as severe internalized homophobia. This may generate extreme and unbearable states of mind leading to both suicide and homicide. Inner conflicts about sexual functioning, associated with shame and rage, lead to paranoid attacks. Distinction between different forms of homophobia may be important in providing advice to courts and in planning therapy. © 2006 Taylor & Francis.
Keywords: Homicidal assault; Homophobia; Internalized homophobia; Psychosis