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: Morphological evolution of creek networks in 10 restored coastal wetlands in the UK

authors: Chirol, Clementine

subjects: Science & Technology

abstract: Coastal wetlands provide crucial ecosystem services including flood protection and carbon storage, but are being lost rapidly worldwide to the combined effects of sea-level rise, erosion and coastal urbanisation. Managed Realignment (MR) aims to mitigate for these losses by restoring reclaimed land to tidal influence. Data of creek evolution is critical to assess the performance of design strategies and improve design and implementation practices. This data descriptor provides a dataset of the horizontal morphological evolution of creek systems from various initial conditions in 10 MR schemes across the UK. Using a semi-automated workflow, morphological creek parameters were extracted from 52 lidar datasets at 1 m horizontal resolution spanning 2 to 20 years post-breach. This constitutes the most comprehensive systematic monitoring of MR creek morphology to date. The dataset will assist future MR design and provide baseline morphological information for ecological and biogeochemical surveying.

text: Morphological evolution of creek networks in 10 restored coastal wetlands in the UK Coastal wetlands provide crucial ecosystem services including flood protection and carbon storage, but are being lost rapidly worldwide to the combined effects of sea-level rise, erosion and coastal urbanisation. Managed Realignment (MR) aims to mitigate for these losses by restoring reclaimed land to tidal influence. Data of creek evolution is critical to assess the performance of design strategies and improve design and implementation practices. This data descriptor provides a dataset of the horizontal morphological evolution of creek systems from various initial conditions in 10 MR schemes across the UK. Using a semi-automated workflow, morphological creek parameters were extracted from 52 lidar datasets at 1 m horizontal resolution spanning 2 to 20 years post-breach. This constitutes the most comprehensive systematic monitoring of MR creek morphology to date. The dataset will assist future MR design and provide baseline morphological information for ecological and biogeochemical surveying.

year: 2022

title: Governance of water based on responsible use – an elegant solution?‎

authors: Te Aho, Linda

abstract: The inspiration for this chapter is a proposal said to represent "a paradigm shift" for the governance of freshwater, articulated by Sir Edward Taihakurei Durie in 2014. ² Arising out of challenges to a government plan to sell its shares in powergenerating companies,³ the Durie proposal has at its heart a possibility for reconciling Maori rights and interests and wider general interests in freshwater. It is based on the assumption that Maori and the general public have a legitimate interest in the natural water regimes of the country. However, the source of the interest is not the same. The Maori interest is proprietary and is sourced in their status as the indigenous first peoples of the land who were guaranteed continuation of their tino rangatiratanga in respect of their lands and waters in Te Tiriti o Waitangi.⁴ The public interest is sourced in the British laws that superimposed Maori laws through processes of colonisation. The heart of the Durie proposal is that those utilising water for commercial purposes should be charged and that an independent commission would be responsible for overseeing charging and revenue collection and disbursement. A proportion of the funds would be allocated to Maori authorities in recognition of the Maori interest. Whether in public or Maori hands, the funds should be applied to the maintenance or improvement of the natural water bodies of the area or the assurance of water supplies to all homes. In short, the proposal focuses upon responsibility.

text: Governance of water based on responsible use – an elegant solution?‎ The inspiration for this chapter is a proposal said to represent "a paradigm shift" for the governance of freshwater, articulated by Sir Edward Taihakurei Durie in 2014. ² Arising out of challenges to a government plan to sell its shares in powergenerating companies,³ the Durie proposal has at its heart a possibility for reconciling Maori rights and interests and wider general interests in freshwater. It is based on the assumption that Maori and the general public have a legitimate interest in the natural water regimes of the country. However, the source of the interest is not the same. The Maori interest is proprietary and is sourced in their status as the indigenous first peoples of the land who were guaranteed continuation of their tino rangatiratanga in respect of their lands and waters in Te Tiriti o Waitangi.⁴ The public interest is sourced in the British laws that superimposed Maori laws through processes of colonisation. The heart of the Durie proposal is that those utilising water for commercial purposes should be charged and that an independent commission would be responsible for overseeing charging and revenue collection and disbursement. A proportion of the funds would be allocated to Maori authorities in recognition of the Maori interest. Whether in public or Maori hands, the funds should be applied to the maintenance or improvement of the natural water bodies of the area or the assurance of water supplies to all homes. In short, the proposal focuses upon responsibility.

year: 2019