The Game of Queer Family Life: Exploring 2SLGBTQI+ Parents' Experiences of Cisheteronormativity, Racism, and Colonialism Through Digital Storytelling in Ontario, Canada

In this article we describe and analyze five videos created through an arts-informed research project, Precarious Inclusion: Studying Ontarian 2SLGBTQI+ parents' experiences childrearing in a post-legal parity framework. Precarious Inclusion used interviews and digital storytelling to investigate Ontario 2SLGBTQI+ parents' current experiences of inclusion and exclusion when navigating institutional and social interactions in everyday life in a post-legal parity context. The study centrally explored how intersecting identities with regards to sexuality, gender, geography, disability, class, race, Indigeneity, and ethnicity intersect with structural forces to influence 2SLGBTQI+ parents' inclusion and exclusion experiences. We examine research creation activities that supported 2SLGBTQI+ parents in making short videos about their experiences of parenting. Our analysis of the five videos created by Indigenous, racialized, trans, nonbinary, Two-Spirit, and disabled parents show how consistent experiences of exclusion mark 2SLGBTQI+ parents' everyday lives. We deepen theorizations of the material and psychological impacts of exclusion for 2SLGBTQI+ families through foregrounding three themes: 1) the operations of racism, white supremacy, and colonialism in makers' lives; 2) misrecognition and its psychic effects of bifurcation and disjuncture; and 3) love, joy, and multi-species kinship as powerful sites of healing and belonging. We further demonstrate how parents used their videos as self-advocacy for resisting precarious inclusion.

A Structural Analysis of Gender-Based Violence and Depression in the Lives of Sexual Minority Women and Trans People

This article explores structural mechanisms that are the context for violence and depression in the lives of sexual minority women and trans people in Ontario, Canada. The article draws on interviews with 14 people who reported experiences of depression in the previous year, foregrounding three representative narratives. Narrative and case study analysis reveal that violence is a repeated and cumulative experience over lifetimes, occurring across different interpersonal contexts and institutional encounters. A common theme across the narratives is that experiences of violence are connected to a broader context in which structural arrangements, cultural norms, and institutional processes create conditions where marginalized people are put in harm's way, perpetrators are empowered, and justice and access to help are elusive. As the violence experienced by these sexual minority women and trans people is rooted in structural and cultural oppression represented in poverty, racism, misogyny, homophobia, and transphobia, the prevention of violence and its consequences for these and other marginalized populations requires systemic transformation of the structures and systems that currently allow and perpetuate harm.

Navigating return to sex: A qualitative Reddit analysis of parents' perceptions about the timing of resuming sex after a birth

OBJECTIVE

Given the many transitions that occur in the postpartum period as men and women navigate the return to sex after a birth, this study aimed to explore parents' experiences of resuming sexual activity.

METHODS

This was a qualitative study that used posts from both men and women from the online public forum Reddit. Data were analysed using constructivist grounded theory.

RESULTS

This study found that the discourse surrounding sexual activity in the postpartum period was dominated by an understanding that medical guidelines prohibited sex prior to six weeks after giving birth. Although some parents disagreed, many Reddit users perceived a high degree of risk in resuming sex prior to six weeks and medical expertise was highly valued as parents negotiated the return to sex. While Reddit users were largely in agreement that penetrative vaginal sex prior to six weeks was a risky activity, there was less consensus as to the risk involved in other sexual activities.

CONCLUSION

This study recommends that medical practitioners initiate conversations with men and women about returning to sexual activity after a birth, and that these conversations should consider parents' emotional well-being as they resume sex. Further research is needed to establish evidence-based and comprehensive guidelines to facilitate these conversations.

In spite of the system: A qualitatively-driven mixed methods analysis of the mental health services experiences of LGBTQ people living in poverty in Ontario, Canada

Lesbian, gay, bisexual, trans, and/or queer (LGBTQ) people face barriers to accessing mental health care; however, we know little about service experiences of low income LGBTQ people. In this qualitatively-driven mixed methods study, over 700 women and/or trans people completed an internet survey, of whom 12 LGBTQ individuals living in poverty participated in interviews. Low income LGBTQ respondents saw more mental health professionals and had more unmet need for care than all other LGBTQ/income groups. Narrative analysis illustrated the work required to take care of oneself in the context of extreme financial constraints. These findings highlight the mechanisms through which inadequate public sector mental health services can serve to reproduce and sustain both poverty and health inequities.

Predator, Pet Lesbian, or Just The Nanny? LGBTQ Parents of Children With Disabilities Describe Categorization

How are lesbian/gay/bisexual/trans/queer (LGBTQ) parents of children with disabilities categorized by service providers, and how do parents anticipate, interpret, and respond to such categorizations? This intersectional study investigated the experiences of LGBTQ parents of children with disabilities with service providers in Toronto, Canada. Parents described pressures to "fit" into providers' limited understanding of family. Some parents described facing overt discrimination, including one parent who was seen as a possible sexual predator. Some described being perceived as representatives of "diversity" for organizations, or "pet lesbians" in the words of one couple. Others described being misread as a non-parent, as in "just the nanny," particularly in conjunction with their racial minority status. Parents described how their experiences of being "outside the mainstream" helped them challenge systems and normative beliefs. Findings suggest that a context of scarce disability resources shapes parents' experiences of how LGBTQ identity comes to matter.

Depression and discrimination in the lives of women, transgender and gender liminal people in Ontario, Canada

This article uses an intersectionality lens to explore how experiences of race, gender, sexuality, class and their intersections are associated with depression and unmet need for mental healthcare in a population of 704 women and transgender/gender liminal people from Ontario, Canada. A survey collecting demographic information, information about mental health and use of mental healthcare services, and data for the Everyday Discrimination Scale and the PHQ-9 Questionnaire for Depression was completed by 704 people via Internet or pen-and-paper between June 2011 and June 2012. Bivariate and regression analyses were conducted to assess group differences in depression and discrimination experiences, and predictors of depression and unmet need for mental healthcare services. Analyses revealed that race, gender, class and sexuality all corresponded to significant differences in exposure to discrimination, experiences of depression and unmet needs for mental healthcare. Use of interaction terms to model intersecting identities and exclusion contributed to explained variance in both outcome variables. Everyday discrimination was the strongest predictor of both depression and unmet need for mental healthcare. The results suggest lower income and intersections of race with other marginalised identities are associated with more depression and unmet need for mental healthcare; however, discrimination is the factor that contributes the most to those vulnerabilities. Future research can build on intersectionality theory by foregrounding the role of structural inequities and discrimination in promoting poor mental health and barriers to healthcare.

A mark that is no mark? Queer women and violence in HIV discourse

Lesbian, bisexual and queer women are invisible and ignored in HIV discourse, as epidemiological classifications result in their institutionalised exclusion from risk categories. Simultaneously, these women live with HIV, often in situations of societal exclusion and under threat of violence. In this paper, we consider the connections between discourse and violence to examine how both are reproduced through, applied to and dependent upon people. The ways lesbian, bisexual and queer women do (or do not) appear in HIV discourse tells us much about how people and categories operate in the global pandemic. The fault-lines of lesbian, bisexual and queer women's constrained visibility in HIV discourse can be seen in situations where they are exposed to HIV transmission through homophobic sexual assault. In dominant HIV discursive practices, such homophobic assault leaves Judith Butler's 'mark that is no mark', recording neither its violence nor its 'non-heterosexuality'. Structural violence theory offers a means to understand direct and indirect violence as it pertains to HIV and lesbian, bisexual and queer women. We call for forms of modified structural violence theory that better attend to the ways in which discourse connects with material realities. Our theoretical and epidemiological lens must be broadened to examine how anti-lesbian, bisexual and queer-women bias affects transnational understandings of human worth.

Stressing Reproduction: Reading Into Parents of Disabled Children

<p>What does is mean to be the parent of a disabled child? This article explores assumptions which permeate the author's encounter with of a prominent Canadian newspaper text on "stress". Through a hermeneutic phenomenological method, the author opens up broader cultural meanings that contribute to and rely upon the category of "parents of disabled children". In particular, the author explores the prescriptions presented on disability, race, class, gender, nationality, and sexuality which emerge in the reading process. Additionally, the author considers how medico-scientific authority is asserted in this textual encounter, and examines the historical grounding of such interpretive moves.</p> <p>&nbsp;</p> <p>Keywords</p> <p>stress, parents, mothers, fathers, history, disability, gender, nation, race, class, sexuality, reproduction, children</p>

Effects of superoxide on nitric oxide-dependent N-nitrosation reactions

Recent studies have demonstrated that nitric oxide (NO) in the presence of superoxide (O2-) may mediate mutagenesis via the N-nitrosation of DNA bases followed by nitrosative deamination to yield their hydroxylated derivatives. We have found that phorbol myristate acetate (PMA)-activated extravasated rat neutrophils (PMNs) will N-nitrosate 2,3-diaminonaphthalene (DAN) to yield its highly fluorescent nitrosation product 2,3-naphthotriazole (triazole) via the L-arginine dependent formation of NO. Addition of SOD enhanced triazole formation suggesting that O2- production may inhibit the N-nitrosating activity and thus the mutagenic activity of inflammatory PMNs. The objective of this study was to assess the role of superoxide as a modulator of NO-dependent N-nitrosation reactions using PMA-activated PMNs as well as a chemically defined-system that generates both NO and superoxide. We found that PMA-activation of PMNs reduced found that PMA-activation of PMNs reduced the amount of N-nitrosation of DAN by approximately 64% when compared to non-stimulated cells (450 vs. 1250 nM). Addition of SOD but not inactivated SOD or catalase to PMA-activated PMNs enhanced the formation of triazole by approximately 4-fold (1950 nM). In addition, we found that the NO-releasing spermine/NO adduct (Sp/NO; 50 microM) which produces approximately 1.0 nmol NO/min generated approximately 8000 nM of triazole whereas the combination of Sp/NO and a superoxide generator (hypoxanthine/xanthine oxidase) that produces approximately 1.0 nmol O2-/min reduced triazole formation by 90% (790 nM). Addition of SOD but not catalase restored the N-nitrosating activity. We conclude that equimolar fluxes of superoxide react rapidly with NO to generate products that have only limited ability to N-nitrosate aromatic amino compounds and thus may have limited ability to promote mutagenesis via the nitrosative deamination of DNA bases.

A review of the management of a major incident involving predominantly paediatric casualties

On 27 September 1993 a double-decker bus full of secondary school children was involved in a collision with a lorry. A total of 58 people were injured, including two fatalities. All except two of the casualties were children. Forty-two casualties, including all of the seriously injured, were taken to the Accident & Emergency Department at York District Hospital. Fifteen casualties were admitted, the majority with closed head injuries. Most of the injuries were of a minor nature, predominantly soft-tissue damage and superficial lacerations. This paper reviews these injuries and the implementation of the hospital major accident (MAJAX) plan. It identifies specific problems encountered with this incident. It also describes the measures taken retrospectively to upgrade the MAJAX plan. It highlights the difficulties encountered by medical staff called to the incident who were unfamiliar with managing injuries and describes retrospective attempts to improve the awareness of trauma management skills.

Undergraduate medical student education: the case for a national curriculum

Thirty-eight teaching hospital affiliated accident and emergency departments were surveyed by post to try to find if there had been any change in undergraduate medical student teaching over the past 10 years. Twenty-six departments replied. The results showed that although there has been an improvement in the teaching of A&E medicine to undergraduates in the past few years there are still some medical schools where an A&E attachment is not mandatory. In those departments providing teaching, there is wide variation in course duration and content.

Femoral shortening in correction of congenital knee flexion deformity with popliteal webbing

Severe knee flexion deformity with popliteal webbing or pterygium is considered to be uncorrectable. The soft tissues and, in particular, the main nerves and vessels are short relative to the bone. Femoral shortening was used in correction of such a deformity in a child with arthrogryposis. The operative procedure is described. Femoral shortening should be considered as an aid to correction of any severe knee flexion deformity.

The use of histoacryl tissue adhesive for the primary closure of scalp wounds

A prospective evaluation of Histoacryl tissue adhesive for the repair of simple scalp wounds is described. Fifty wounds were repaired using the adhesive and, on examination 5 days later, 49 wounds were fully healed, the remaining wound having only a small area of dehiscence. The advantage of this method of wound repair is discussed.

Familial multiple jejunal atresia with malrotation

Two siblings with multiple jejunal atresia and malrotation of the midgut are reported. In the first, incomplete rotation of the gut was associated with two jejunal atresias and an intraluminal diaphragm. In the second, there was complete failure of rotation of the gut with two jejunal atresias, one of which had a V-shaped mesenteric defect. I am unaware of any previous reports of familial multi level small intestinal atresias with malrotation. Possible reasons for this association are discussed.

Acquisition of endemic Pseudomonas aeruginosa on an intensive therapy unit

During a 9-month period, patients, staff and environment were monitored in order to trace the source of endemic Pseudomonas aeruginosa on our intensive therapy unit (ITU). Of 81 patients studied, 14 (17%) acquired 15 different pyocin types while on the ITU. The most frequent site of colonization was the rectum (11 patients). Rectal strains subsequently appeared in urine (two patients), wound (one) and sputum (four) of six patients. Three episodes of cross-infection (wound (two), urine (one] occurred without development of rectal colonization. Strains isolated from the environment and staff were not implicated. While gastrointestinal carriage of P. aeruginosa may not be detected on admission to the ITU, excessive use of antibiotics may be responsible for apparent acquisition of the organism followed by endogenous transfer of the rectal strains to other sites of the body.

A comparison of triclosan and chlorhexidine preparations with 60 per cent isopropyl alcohol for hygienic hand disinfection

Four detergent preparations containing triclosan; two alcoholic products, containing triclosan and chlorhexidine respectively, and a detergent preparation containing chlorhexidine were compared with 60 per cent isopropyl alcohol following a single hand wash using Escherichia coli as the test organism. In vitro tests indicated that all had a high activity against hospital pathogens. The triclosan-containing preparations exhibited a significant pathogens. The triclosan-containing preparations exhibited a significant residual activity. Experiments in volunteers showed that 0.5 per cent alcoholic triclosan was significantly more effective than all other preparations tested. All the detergent preparations had an effect similar to that of 60 per cent isopropyl alcohol. None of the seven products evaluated was significantly less bactericidal than 60 per cent isopropyl alcohol.

Comparative epidemiology of gentamicin-resistant enterobacteria: persistence of carriage and infection

During a two-year period from January 1979, 260 patients have been involved in an outbreak of carriage and infection due to gentamicin-resistant enterobacteria. We have examined the duration of carriage of such enterobacteria and have compared the carriage of Klebsiella with that of other resistant enterobacteria. Carriage of gentamicin-resistant enterobacteria occurred most frequently and was least sporadic in the intestinal tract. Vaginal carriage was observed in 49 out of 68 patients tested and occurred more frequently in older patients. Oral carriage was noted in 36% of patients but was more sporadic than intestinal carriage. Rates of oral carriage were greater among moribund patients. Carriage at skin sites was related to their proximity to the perineum. Intestinal carriage of gentamicin-resistant Escherichia coli and Klebsiellae but not Klebsiella oxytoca nor Citrobacter persisted for long periods (half lives of 140 and 100 days respectively). Cessation of carriage of gentamicin-resistant Klebsiellae was due to loss of both the organism and its plasmid rather than a shedding of the plasmid. Chronic bacteriuria with gentamicin-resistant E coli and Klebsiellae (half life 180 days) but not Klebsiella oxytoca nor Citrobacter persisted for long periods.

Variation in skin and environmental survival of hospital gentamicin-resistant enterobacteria

During a period when 245 patients were infected by or harboured gentamicin-resistant enterobacteria, random sampling showed hand carriage in 33% of affected patients but in only 5% of attendant staff. Only klebsiellae were isolated from the latter. Recovery was commoner from the hands of bed-ridden patients or faecal carriers and significantly more frequent for klebsiellae (37%) and enterobacter (33%) than citrobacter (5.6%) and E. coli (5.0%). Similarly, survival on forearms of volunteers was much longer for klebsiellae and enterobacter than for citrobacter or E. coli (means respectively were 70, 45, 10 and 13 min), and on dry surfaces (means respectively were 28, 26, 3 and 7 h). Klebsiellae were isolated from 17 of the 56 dry environmental surfaces sampled. The presence of plasmid resistance determinants had no effect on survival times, either on the skin or following drying onto formica surfaces. On dry surfaces 9.5% of E. coli but only 1.3% of klebsiellae lost resistance to gentamicin. These findings accord well with recent experience in which gentamicin-resistant klebsiellae have been involved to a much greater extent than other resistant enterobacteria in hospital infection.