Gender detransition is an emerging yet poorly understood phenomenon in our society. In the absence of research, clinicians and researchers have applied the concept of detransition differently, ...leading to inconsistencies in its use. The article suggests a typology of gender detransition based on the cessation or the continuation of a transgender identity to address this issue. Implications of this typology for healthcare providers are discussed, emphasizing the increasing necessity of developing clinical guidelines for detransitioners. Finally, the article reflects on the possibilities of preventing detransition, which underlines the challenges that clinicians face when treating individuals with gender dysphoria.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
The international university context is generating multiple dynamics of innovation. A relevant issue is the creation of inclusive campuses. This text studies keys to spatial planning on the urban and ...architectural scales and offers functional recommendations to create campuses that promote wellbeing and cognitive accessibility for people with intellectual disabilities. The goal is to inspire inclusive environments, promote an appropriation of the space, and reinforce a sense of belonging, emphasizing aspects such as the psychological and emotional perception of university environments. Based on this exploration, the text discusses a set of planning guidelines and architectural typologies with an inclusive scope. It begins by studying paradigms taken from the historical university legacy: the cloister and the campus. After this, the article focuses on aspects that inspire the integral planning of campuses to reinforce social inclusion: communities of learning, typologies of spatial composition, the human scale, edges, nature, the aesthetic component, and functional strategies. The text finishes by presenting a range of conclusions on how to supply those criteria and types so that campuses can be planned with higher quality with the goal of transforming them into inclusive environments, providing guidelines that can optimize them for all kinds of users.
V mednarodnem univerzitetnem okolju se ustvarjajo različne inovacije, med drugim tudi na področju oblikovanja vključujočih kampusov. V članku avtor proučuje ključne dejavnike prostorskega načrtovanja ...na urbanistični in arhitekturni ravni ter predstavi funkcionalna priporočila za oblikovanje kampusov, ki podpirajo dobro počutje in omogočajo kognitivni dostop osebam z intelektualno oviranostjo. Cilj je spodbuditi razvoj vključujočih okolij in okrepiti občutek pripadnosti kraju, pri čemer je poudarek na psihološkem in čustvenem zaznavanju univerzitetnega okolja. Avtor proučuje niz vključujočih načrtovalskih smernic in arhitekturnih tipologij, pri čemer se najprej osredotoči na dve zgodovinski univerzitetni prostorski paradigmi: križni hodnik in kampus. Nato proučuje rešitve, ki so lahko zgled za celostno načrtovanje kampusov in krepitev socialne vključenosti: učne skupnosti, razne tipologije prostorske kompozicije, človeško merilo, robove, naravo, estetiko in funkcionalne strategije. Na koncu predstavi, kako se lahko zadosti opisanim merilom, na podlagi česar se lahko kampusi bolj kakovostno načrtujejo in preobrazijo v vključujoča okolja, ob tem pa ponudi napotke za njihove izboljšave in prilagoditve najrazličnejšim uporabnikom.
Covid-19 and Kidney Transplantation Akalin, Enver; Azzi, Yorg; Bartash, Rachel ...
The New England journal of medicine,
06/2020, Letnik:
382, Številka:
25
Journal Article
Recenzirano
Odprti dostop
A cohort of 36 consecutive kidney-transplant recipients had less fever, lower CD3, CD4, and CD8 cell counts, more rapid clinical deterioration, and a higher mortality than the general population of ...patients with Covid-19.
Purpose
This study aims to investigate the influence of supply chain (SC) complexity on the effectiveness of resilience capabilities in mitigating SC disruptions. Hypotheses about direct and ...moderating influences of complexity on resilience capabilities and performance change after disruption are built and quantitatively tested.
Design/methodology/approach
Partial least square-based structural equation modelling with formative constructs was used as an overall approach. Secondary data on SC disruptions, related performance change and resilience practices were collected from multiple sources through a predefined procedure. The collected data were systematically encoded prior to performing statistical analysis.
Findings
SC structural complexity is found to have a significant positive relation with performance improvement after disruption, along with resilience capability; it also positively moderates the resilience–performance link.
Research limitations/implications
The SC complexity factors the authors considered in this study do not include dynamic forms because of the nature of data collected. Future research may attempt to include and test whether the results of this study also hold when additional complexity parameters are taken into account.
Practical implications
Managers are often trying to reduce SC complexity. This study implies that some level of complexity is beneficial also for a better recovery of operational performance affected because of disruption. Resilience capabilities become more effective when leveraged on complexity in the SC.
Originality/value
This is the first study to empirically investigate the influence of SC complexity on the resilience–performance link.
Complexity is regarded a major impediment to Supply Chain (SC) performance. However, very few studies aid SC managers adopt adequate practices in response to structural and dynamic complexity. This ...study offers a comprehensive review of the practices that four manufacturing companies employ in their SC function to manage the structural and dynamic complexity of their product portfolio, internal SC, and supplier and customer bases. Moreover, leveraging the results of the inductive in-depth case studies, a classification of complexity management practices consisting of four clusters is advanced: variety reducing, confinement and decoupling, coordination and collaboration and decision support and knowledge generation. Each cluster's distinctive logic and limitations are discussed and propositions on their managerial scope are introduced, therefore providing managers with relevant insights to design effective complexity management approaches in their organisations.
Research suggests that transgender and non-binary (TGNB) individuals experience lower levels of psychological well-being than the general population. Although practice recommendations and guidelines ...exist, there is a paucity of studies evaluating the effects of psychological interventions on this group. This systematic review aimed to synthesize and analyze existing empirical affirmative psychological interventions for TGNB individuals to assess their efficacy. Eight databases (PubMed, Web of Science, PsycINFO, Scopus, LILACS, Cochrane, ProQuest, Google Scholar) were searched from January 2010 to June 2022 to identify relevant studies. Included studies needed to be randomized controlled trials, quasi-experimental, or uncontrolled pre-post. Twenty-two articles were included, of which eight had TGNB participants only, two had mixed samples with separated outcome data for TGNB participants, and 12 had mixed samples with no disaggregated data. Experimental designs, participant samples, assessed variables, and type of interventions varied widely across studies, thus preventing comparisons. Overall results suggest improvements in psychological distress, depression, anxiety, suicidality, substance-related risk behaviors, coping skills/emotion regulation, stress appraisal, self-esteem, self-acceptance, social support, minority stress, resilience, hope, positive identity, and identity acceptance, although conclusions are limited by moderate-to-high risk of bias. Future research should implement more consistent and rigorous methodological designs to assess and compare intervention efficacy.
•Transgender and non-binary individuals show low levels of psychological well-being.•Studies gauging the effects of psychological treatments for this group are scarce.•Results suggest improvements in mental health and gender minority stress variables.•The quality of evidence was moderate-to-low, so more rigorous research is needed.
This paper explores the interplay between structural and dynamic complexity factors, uncovering the mechanisms that underpin it. Four in-depth inductive case studies, which comprised semi-structured ...interviews with senior operations and SC managers as well as the use of companies' official documents and other secondary data, were carried out. The study offers a deep understanding and provides rich empirical descriptions of the interplay between structural and dynamic complexity factors. A general framework to represent different aspects of this interplay is also introduced, i.e. the House of Supply Chain Complexity diagram; as a practical tool for mapping the complexity factors and inferring the prevailing interplay mechanisms in specific cases. The results show four interplay mechanisms between structural and dynamic complexity factors: silo-thinking, localism, limited adaptability and increased uncertainty. Testable propositions are presented with relevant insights on the interplay between a wide range of structural and dynamic complexity factors. Research implications relate to: (i) a general framework usable to further investigate interplay mechanisms at factors level and in different SC contexts and (ii) theory building on the suggested interplay mechanisms. We contribute to enhance contingency research claiming for the importance of considering the cumulative effect of contingency factors on SC performance. The results also suggest that managers can accommodate the mechanisms of silo-thinking and increased uncertainty by information sharing and organizational means, but the interplay mechanisms of localism and limited adaptability appear to be more related to the physical structure of SC elements and thus mainly manageable by reducing complexity, i.e. reducing the factors involved in the interplay.
The coronavirus pandemic has significantly impacted solid organ transplantation (SOT). Early in the outbreak period, transplant societies recommended suspending living kidney transplant programs in ...communities with widespread transmission to avoid exposing recipients to increased risk of immunosuppression, while recommendations were made to reserve deceased-donor kidney transplantation for likely life-saving indications. SOT recipients may be at high risk from COVID-19 disease due to chronic immunosuppressive treatment and other medical comorbidities. Mortality rates reported between 13 to over 30% in SOT recipients. In addition to high rates of complications and mortality attributable to COVID-19 infections, the pandemic has also led to additional complexities in transplantation including new questions regarding screening of donors and recipients, decision making to accept a patient for kidney transplant or wait after pandemic. The clinical implications of COVID-19 infection may also differ depending on the type of the transplanted organ and recipient comorbidities which further impacts decisions on continuing transplantation during the pandemic. Transplant activity during a pandemic should be tailored with careful selection of both donors and recipients. Furthermore, while tremendous strides have been made in treatment strategies and vaccinations, the impact of these in transplant recipients may be attenuated in the setting of their immunosuppression. In this review, we aim to summarize several aspects of COVID-19 in transplantation, including the immune response to SARS-CoV-2, SARS-CoV-2 diagnostics, clinical outcomes in SOT recipients and end stage kidney disease patients, transplant activity during the pandemic and treatment options for COVID-19 disease.
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