title: Primary care access and foregone care: A survey of transgender adolescents and young adults

authors: Clark, Drew B. A.

subjects: Science & technology

abstract: Objective. To examine the issues of primary care access and foregone health care among transgender adolescents and young adults. 
Methods. This cross-sectional analysis of data from the Canadian Trans Youth Health Survey was conducted online during 2013–2014. Participants included 923 youth aged 14–25 (323 adolescents aged 14–18 and 600 young adults aged 19–25). Main outcome measures were self-reported general and mental health status, comfort discussing transgender identity and health care needs with general practitioners, and types of and reasons for self-identified foregone health care. 
Results. Most youth reported poor/fair general and mental health status. Comfort with a family doctor was positively correlated with both general health (r(528) = 21, P < 0.001) and mental health (r(450) = 26, P < 0.001) status, as was having a doctor who was aware of one’s transgender status. 47.2% (n = 219) of young adults reported foregoing needed health care. Among adolescents, levels of comfort with family doctor were negatively correlated with foregone mental health care in the previous 12 months (F₃,₁₆₆ = 3.829, P = 0.011), but not correlated with foregone physical health care (F₃,₁₆₅ = 0.506, P = 0.679). Reasons for missing needed care spanned the dimensions of health care access, ranging from cost barriers to previous negative experiences with health care providers, and concerns that a doctor would be uneducated about transgender people. Conclusion. General practitioners can play a key role in improving the health of transgender youth by demonstrating understanding of the health care needs of transgender youth and competence in gender-affirming care, and by ensuring that their practices are accessible to all transgender youth in need of care.

text: Primary care access and foregone care: A survey of transgender adolescents and young adults Objective. To examine the issues of primary care access and foregone health care among transgender adolescents and young adults. 
Methods. This cross-sectional analysis of data from the Canadian Trans Youth Health Survey was conducted online during 2013–2014. Participants included 923 youth aged 14–25 (323 adolescents aged 14–18 and 600 young adults aged 19–25). Main outcome measures were self-reported general and mental health status, comfort discussing transgender identity and health care needs with general practitioners, and types of and reasons for self-identified foregone health care. 
Results. Most youth reported poor/fair general and mental health status. Comfort with a family doctor was positively correlated with both general health (r(528) = 21, P < 0.001) and mental health (r(450) = 26, P < 0.001) status, as was having a doctor who was aware of one’s transgender status. 47.2% (n = 219) of young adults reported foregoing needed health care. Among adolescents, levels of comfort with family doctor were negatively correlated with foregone mental health care in the previous 12 months (F₃,₁₆₆ = 3.829, P = 0.011), but not correlated with foregone physical health care (F₃,₁₆₅ = 0.506, P = 0.679). Reasons for missing needed care spanned the dimensions of health care access, ranging from cost barriers to previous negative experiences with health care providers, and concerns that a doctor would be uneducated about transgender people. Conclusion. General practitioners can play a key role in improving the health of transgender youth by demonstrating understanding of the health care needs of transgender youth and competence in gender-affirming care, and by ensuring that their practices are accessible to all transgender youth in need of care.

year: 2018

title: Diffuse flow environments within basalt- and sediment-based hydrothermal vent ecosystems harbor specialized microbial communities

authors: Campbell, Barbara J.

subjects: 16S rRNA

abstract: Hydrothermal vents differ both in surface input and subsurface geochemistry. The effects of these differences on their microbial communities are not clear. Here, we investigated both alpha and beta diversity of diffuse flow-associated microbial communities emanating from vents at a basalt-based hydrothermal system along the East Pacific Rise (EPR) and a sediment-based hydrothermal system, Guaymas Basin. Both Bacteria and Archaea were targeted using high throughput 16S rRNA gene pyrosequencing analyses. A unique aspect of this study was the use of a universal set of 16S rRNA gene primers to characterize total and diffuse flow-specific microbial communities from varied deep-sea hydrothermal environments. Both surrounding seawater and diffuse flow water samples contained large numbers of Marine Group I (MGI) Thaumarchaea and Gammaproteobacteria taxa previously observed in deep-sea systems. However, these taxa were geographically distinct and segregated according to type of spreading center. Diffuse flow microbial community profiles were highly differentiated. In particular, EPR dominant diffuse flow taxa were most closely associated with chemolithoautotrophs, and off axis water was dominated by heterotrophic-related taxa, whereas the opposite was true for Guaymas Basin. The diversity and richness of diffuse flow-specific microbial communities were strongly correlated to the relative abundance of Epsilonproteobacteria, proximity to macrofauna, and hydrothermal system type. Archaeal diversity was higher than or equivalent to bacterial diversity in about one third of the samples. Most diffuse flow-specific communities were dominated by OTUs associated with Epsilonproteobacteria, but many of the Guaymas Basin diffuse flow samples were dominated by either OTUs within the Planctomycetes or hyperthermophilic Archaea. This study emphasizes the unique microbial communities associated with geochemically and geographically distinct hydrothermal diffuse flow environments.

text: Diffuse flow environments within basalt- and sediment-based hydrothermal vent ecosystems harbor specialized microbial communities Hydrothermal vents differ both in surface input and subsurface geochemistry. The effects of these differences on their microbial communities are not clear. Here, we investigated both alpha and beta diversity of diffuse flow-associated microbial communities emanating from vents at a basalt-based hydrothermal system along the East Pacific Rise (EPR) and a sediment-based hydrothermal system, Guaymas Basin. Both Bacteria and Archaea were targeted using high throughput 16S rRNA gene pyrosequencing analyses. A unique aspect of this study was the use of a universal set of 16S rRNA gene primers to characterize total and diffuse flow-specific microbial communities from varied deep-sea hydrothermal environments. Both surrounding seawater and diffuse flow water samples contained large numbers of Marine Group I (MGI) Thaumarchaea and Gammaproteobacteria taxa previously observed in deep-sea systems. However, these taxa were geographically distinct and segregated according to type of spreading center. Diffuse flow microbial community profiles were highly differentiated. In particular, EPR dominant diffuse flow taxa were most closely associated with chemolithoautotrophs, and off axis water was dominated by heterotrophic-related taxa, whereas the opposite was true for Guaymas Basin. The diversity and richness of diffuse flow-specific microbial communities were strongly correlated to the relative abundance of Epsilonproteobacteria, proximity to macrofauna, and hydrothermal system type. Archaeal diversity was higher than or equivalent to bacterial diversity in about one third of the samples. Most diffuse flow-specific communities were dominated by OTUs associated with Epsilonproteobacteria, but many of the Guaymas Basin diffuse flow samples were dominated by either OTUs within the Planctomycetes or hyperthermophilic Archaea. This study emphasizes the unique microbial communities associated with geochemically and geographically distinct hydrothermal diffuse flow environments.

year: 2013

title: Ecological modelling of water quality management options in Lake Waahi to support Hauanga Kai species: Technical Report

authors: Allan, Mathew Grant

abstract: This report describes a numerical modelling approach for Lake Waahi to assess the effects of various future scenarios on water quality attributes known to affect the appearance of the lake’s multiple hauanga kai species across differing spatial scales. Hauanga kai refers to customary gathering and use of naturally occurring and cultivated foods. Numerical models were used to support shared learning and development of future scenarios in response to different management options and environmental pressures. The shallow lakes of the Waikato region have been particularly impacted by anthropogenic eutrophication. This is due to the fact that many of these lakes have already undergone a degree of natural eutrophication due to their geomorphic properties, such as their low elevation and shallow depth. The main contributing factors to water quality decline in shallow Waikato lakes have been identified as: high external nutrient and sediment loads, internal loading exacerbated by high sediment resuspension and bioturbation from pest fish (carp), reduced water depth due to installation of water control structures, reduction in wetland filtering potential due to draining, and stock access to wetlands. A 1-D hydrodynamics model, the General Ocean Turbulence Model was coupled to a complex ecological model (PClake) via the Framework for Aquatic Biogeochemical Models (FABM). FABM is an open source FORTAN-based code that facilitates the coupling of hydrodynamic and ecological models. FABM-PCLake is a redesigned PCLake. The consensus from the model simulations carried out in the study suggests that, for Lake Waahi to undergo restoration whereby the lake is restored to clear-water stable state, both external load needs to be reduced significantly by greater than 50%, along with changes in lake ecological structure, resulting from re-establishment of macrophytes aided by the control of carp biomass. These finding supports the general view within the literature that for lake restoration success, external load reduction (catchment load) is critical. Finally, if the ultimate goal of lake restoration in Lake Waahi is to address the decline in tuna (shortfin eel - Anguilla australis) biomass, a return to a clear-water stable state should facilitate improvement in tuna habitat and provide the conditions for development of a healthy eel population. Coupled modelling approaches will provide a more complete picture of potential responses of Hauanga kai species to land and lake management scenarios.

text: Ecological modelling of water quality management options in Lake Waahi to support Hauanga Kai species: Technical Report This report describes a numerical modelling approach for Lake Waahi to assess the effects of various future scenarios on water quality attributes known to affect the appearance of the lake’s multiple hauanga kai species across differing spatial scales. Hauanga kai refers to customary gathering and use of naturally occurring and cultivated foods. Numerical models were used to support shared learning and development of future scenarios in response to different management options and environmental pressures. The shallow lakes of the Waikato region have been particularly impacted by anthropogenic eutrophication. This is due to the fact that many of these lakes have already undergone a degree of natural eutrophication due to their geomorphic properties, such as their low elevation and shallow depth. The main contributing factors to water quality decline in shallow Waikato lakes have been identified as: high external nutrient and sediment loads, internal loading exacerbated by high sediment resuspension and bioturbation from pest fish (carp), reduced water depth due to installation of water control structures, reduction in wetland filtering potential due to draining, and stock access to wetlands. A 1-D hydrodynamics model, the General Ocean Turbulence Model was coupled to a complex ecological model (PClake) via the Framework for Aquatic Biogeochemical Models (FABM). FABM is an open source FORTAN-based code that facilitates the coupling of hydrodynamic and ecological models. FABM-PCLake is a redesigned PCLake. The consensus from the model simulations carried out in the study suggests that, for Lake Waahi to undergo restoration whereby the lake is restored to clear-water stable state, both external load needs to be reduced significantly by greater than 50%, along with changes in lake ecological structure, resulting from re-establishment of macrophytes aided by the control of carp biomass. These finding supports the general view within the literature that for lake restoration success, external load reduction (catchment load) is critical. Finally, if the ultimate goal of lake restoration in Lake Waahi is to address the decline in tuna (shortfin eel - Anguilla australis) biomass, a return to a clear-water stable state should facilitate improvement in tuna habitat and provide the conditions for development of a healthy eel population. Coupled modelling approaches will provide a more complete picture of potential responses of Hauanga kai species to land and lake management scenarios.

year: 2018