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What Are Puberty Blockers? What Are the Benefits and Risks for Transgender Children?

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Puberty blockers are drugs that stop the body from producing estrogen and testosterone. In the clinic, they’re called gonadotropin-releasing hormone agonists (GnRHa).

If teens take these medications during puberty, the physical changes related to puberty are prevented. If these medications are stopped, the physical changes return.

Puberty blockers were used since the starting of the 80s in the treatment of precocious puberty in young children.

Since the Nineteen Nineties.Puberty blockers have also been utilized in transgender adolescents to stop the unwanted development of male or female physical changes that occur during puberty.

What advantages do transgender teens receive?

Many transgender children describe the anxiety about the undesirable physical changes that may occur during puberty, especially as puberty approaches.

For presumed females at birth, these undesirable changes include breast development and early periods. For presumed males at birth, these undesirable changes may include the development of a deeper voice, an Adam’s apple, facial hair, and a masculine construct.

Many of those physical changes are irreversible and cause not only Gender dysphoria but additionally misgendering. This is when transgender persons are mistakenly assigned the gender they were assigned at birth. Misgendering generally is a significant and lifelong the source of suffering.

Some transgender people will seek surgery to handle these unwanted irreversible changes. This may include chest masculinization, facial feminization, voice changes, or Adam’s apple reduction.

For young transgender people and their families, the most blatant advantages of using puberty blockers are: avoid unwanted changes that occur with puberty. It can even reduce misgendering and prevent the need for future surgeries.

Puberty blocking drugs may reduce misgendering.
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Several studies have evaluated the potential advantages of puberty blockers. Systematic review 2024 studies have provided consistent evidence that they’re effective in inhibiting puberty.

The study, which the review authors described as highest quality significantly improved psychological outcomes. Puberty blockers reduced suicidal thoughts and actions in transgender adolescents compared with those that didn’t use treatment.

When must you start using puberty blockers?

Puberty blockers can only be began once puberty has began. The age at which this happens varies greatly between individuals. To avoid unwanted physical changes, puberty blockers should ideally be began in early or middle adolescence.

However, many transgender adolescents were began on puberty blockers at the end of puberty and even after it had ended.

IN EnglandFor example, at the least 12 months of treatment with puberty blockers was previously mandatory for any transgender teen under 18 who wanted access to estrogen or testosterone. As a result, many young people began using puberty blockers long after puberty had ended.

One potential problem with starting puberty blockers after early or mid-puberty is that unwanted physical changes have already occurred, so no further profit must be expected from this treatment.

The last systematic review of puberty blockers noted that while many studies found improvements in psychological well-being, others found no difference. One possible explanation is that none of those studies considered the stage of adolescence at which treatment began.

Especially, a more recent study conducted at Harvard University evaluation was restricted to puberty blocker treatment in early and middle adolescence. Treatment was found to be related to significant reductions in anxiety, depression, and suicidal ideation.

Risk of Puberty Blockers for Transgender Teens

Puberty blockers are generally well tolerated. However, like every medical intervention, they can even cause undesirable effectsThis includes decreased bone density and fertility, and changes in adult growth.

When they begin after early or middle puberty, they usually tend to cause menopause-like unwanted effects, corresponding to hot flashes. This is as a result of a decrease in sex hormone production.

The girl looks warmly at her father
Puberty blocking drugs are generally well tolerated but can have potential unwanted effects.
Alena Ozerova/Shutterstock

There are also potential long-term effects of puberty blockers which are still being researched.

The brain matures significantly during adolescence. However, it’s unclear what effect puberty blockers can have on cognitive development. While the use of puberty blockers in early adolescence has not shown influence cognitive functioning, research on transgender teenagers are in progress.

Where are the randomized controlled trials of puberty blockers?

Randomized controlled trials are widely considered the gold standard for testing the effectiveness of medical interventions.

To date, there have been no randomized controlled trials of puberty blockers in transgender teens, leading some to call the treatment experimental. However, carrying out such hormonal intervention trials in transgender youth is problematic because it might be unethical to withhold treatment for research purposes.

In pediatric care, data from randomized controlled trials are sometimes lacking. more broadlySimilar research gaps apply to the use of puberty blockers in early puberty.

However, the politicization of transgender youth has meant that the use of puberty blockers in transgender adolescents has been judged by a unique standard.

How are puberty blockers accessed in several clinical situations?

IN United KingdomPuberty blockers will now only be available available for transgender teens through the National Health Service (NHS) as a part of a research effort, following the recommendations of the Cass Review, which checked out gender identity services available to children and young people through the NHS.

One of the primary criticisms of the review was that it didn’t consider the likely harms of denying hormone therapy to transgender teenagers.

In Australia, health experts also caution against comparing our healthcare system to the NHS and indicate that a lot of the recommendations in the review are consistent with practices currently utilized in Australian specialist gender equality services.

Puberty blockers in Australia can be found to transgender adolescents as a part of a comprehensive, team-based approach to gender-affirming care. This emphasizes holistic, individualized care that takes under consideration the young person’s stage of puberty while balancing potential advantages and risks.

This article was originally published on : theconversation.com
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Health and Wellness

Do You Wake Up With A Bang? It Could Be “Exploding Head Syndrome”

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Have you ever fallen asleep after which been jolted away from bed by the sound of a bomb exploding in your head? If so, you might have probably experienced exploding head syndrome, a mysterious and poorly understood sleep problem. Exploding head syndrome (EHS) belongs to a family of sleep disorders referred to as parasomnias. Other parasomnias include sleep paralysis and hypnotic jerks – the explanation for the unpleasant feeling of falling that we sometimes experience when falling asleep.

EHS has been known to healthcare employees for no less than 1876and apparently a French philosopher and scientist René Descartes I even have experienced this. Despite this, we all know surprisingly little about this condition.

A typical episode is characterised by the experience of a sudden loud noise or a way of explosion inside the top that happens throughout the transition from wakefulness to sleep. Sounds heard during EHS are variableand include perceptions of gunshots, slamming doors, or unspecified screams. Importantly, the sounds which can be heard are all the time temporary (a number of seconds or less), very loud, and with none obvious external source within the environment.

Next to the sounds, some people experience accompanied by temporary visual hallucinations, akin to shiny flashes. Others have also reported a sense of intense heat or a sensation of an electrical charge flowing through the upper body.

It is difficult to accurately estimate how many individuals experience EHS. One reason is just the dearth of accessible data. Only a number of studies have attempted to look at the prevalence of EHS in the final population.

One early study found that 11% of healthy adults experienced EHS, while one other test in undergraduate students, 17% of participants were found to have experienced multiple episodes of their lives. In my very own, newer study, also with undergraduate students, my colleagues and I discovered that one third in our sample experienced no less than one episode of EHS of their lifetime, with roughly 6% experiencing no less than one episode per thirty days.

These studies show that EHS is a comparatively common experience, no less than in young adults. However, it appears to be less common than other parasomnias, akin to hypnotic jerks, which occur in 70% of individuals.

Triggers

The exact explanation for EHS is unknown. While many theories have been recommend concerning the root explanation for EHS, hottest implies natural brain processes that occur throughout the transition from wakefulness to sleep. On a typical night, as we transition from wakefulness to sleep, activity within the reticular structure of the brain is reduced.

This reticular formation is a set of brain structures positioned primarily within the brain stem and hypothalamus that acts as an “on-off” switch for the brain. As reticular activity slows within the transition to sleep, our sensory cortex, which controls vision, sound, and motor movement, begins turn off.

It has been proposed that the experience of EHS is brought on by a disruption of this normal shutdown process, which ends up in a delayed and disjoint increase within the activation of sensory neural networks within the absence of any external stimuli. These temporary increases in activation are then perceived because the loud, nonspecific sounds that characterize EHS.

Although the precise neural basis of EHS stays speculative, we’re starting to learn more about other aspects that make an episode of EHS more likely. In one among the primary studies to take a look at the aspects involved, my colleagues and I discovered that well-being variables, akin to life stress, were related to experiencing EHS. This association was mediated by insomnia symptoms. In other words, life stress was indirectly related to EHS, but was not directly associated by first disrupting normal sleep patterns.

Is EHS dangerous?

Despite its provocative name, EHS is harmless. However, it is crucial to differentiate an episode of EHS from other conditions, particularly from various forms of headaches. EHS episodes are very temporary (a number of seconds) and frequently don’t involve any pain. If there’s pain, it’s mild and transient. In contrast, many headaches last more and involve much higher levels of pain.

This doesn’t mean that EHS can’t be a terrifying experience. last examination Of the greater than 3,000 participants who experienced EHS, we found that 45% of respondents reported moderate to severe levels of fear related to their EHS. A quarter of participants also reported high levels of stress in response to experiencing EHS, with increased levels of stress being related to more frequent episodes.

Unfortunately, no systematic studies have been conducted to research potential treatments and coping strategies for people combating EHS-related distress. In our studyparticipants reported that changing sleeping position to avoid sleeping on their backs, adjusting sleep patterns, and using mindfulness techniques were effective strategies to stop EHS. Whether any of those techniques will prove effective in clinical trials stays to be tested.

Encouragingly, just learning that EHS is a typical and harmless condition can go a good distance. patient case studyreassurance and education concerning the experience have been reported to stop episodes from occurring. At least for now, the very best advice appears to be to try to grasp that these experiences are natural and don’t indicate that anything is unsuitable. Simple techniques, akin to improving sleep habits, can go a good distance toward stopping stressful episodes from occurring.

This article was originally published on : theconversation.com
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Health and Wellness

NYFW Celebrity Look Of The Day: Day 1, Ciara – Essence

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Getty photos

Ciara’s talent for fashion is difficult to disregard. Her music has all the time been a staple of the band, however it can be unfair to forget that she’s a fashion lover. On the primary day of New York Fashion Week, the singer rocked a method we’ve never seen on her dancer’s body before.

She selected a totally engrossing, oversized Willy Chavarria ensemble in a plaid that blended effortlessly as a substitute of clashing. Her puffy pants moved rhythmically as she entered the show. Her top and trench coat blended together, almost as one, single top in the event you didn’t look closely enough. Her turtleneck shirt had an asymmetrical detail at the underside, a creative silhouette that added to her already detailed look. Layered cross necklaces in gold with encrusted diamonds dangled from the highest, sparkling in the sunshine from every angle.

NYFW Celebrity Look Of The Day: Day 1, Ciara
Gilbert Carrasquillo/GC Images

Her trench coat gracefully touched the ground, as she opted for white boots as a substitute of heels. Nevertheless, the look was elegant.

She added a couple of gold rings that appeared to cover each finger to the max, matching her large necklaces. To complete her look, she added dark aviator sunglasses that accentuated the form of her face and added an effortlessly cool element to her already trendy outfit.

As New York Fashion Week continues to unfold, we won’t wait to see more looks from Ciara and other stars in the approaching days.

NYFW Celebrity Look Of The Day: Day 1, Ciara
Gilbert Carrasquillo/GC Images

This article was originally published on : www.essence.com
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Health and Wellness

Some Doctors Use AI to Write Medical Documents. What You Need to Know

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Imagine this. You finally mustered up the courage to go to your loved ones doctor for an embarrassing problem. You sit down. Your family doctor says:

before we start, I take advantage of a pc to log my visits. This is AI – it is going to write a summary of notes and a letter to the specialist. Is this OK?

Wait – AI writes our medical records? Why would we wish that?

Documentation is important for protected and effective healthcare. Physicians must keep good records to keep your registrationHealth services must provide good record keeping systems for accreditationRecords are also legal documents: they could be essential within the event of an insurance claim or legal motion.

But writing things down (or dictating notes or letters) takes time. During visits, doctors can divide their attention between good recordkeeping and good patient communication. Sometimes doctors have to work on records after hours, at the top of an already long day.

So it’s understandable excitementfrom every kind of healthcare professionals about “ambient artificial intelligence” or “digital scribes.”

Who are digital scribes?

This is not an old-fashioned transcription program: you dictate a letter, and this system transcribes it word by word.

Digital scribes are different. They use AI – large language models with generative capabilities – similar to ChatGPT (or sometimes GPT4 myself).

The app silently records a conversation between a health care provider and a patient (using a phone, tablet, or computer microphone, or a dedicated sensitive microphone). AI converts the recording right into a word-by-word transcription.

The AI ​​system then uses the transcript and directions received to write clinical notes and/or letters for other clinicians, ready for the clinician to review.

Most clinicians know little about these technologies: they’re experts of their specialty, not in AI. Marketing materials promise to “let AI take care of your clinical notes so you can spend more time with your patients.”

Put yourself within the clinician’s shoes. You can say, “Yes, please!”

Some doctors would welcome the chance to reduce their workload.
Stephen Barnes/Shutterstock

How are they regulated?

Lately, Australian Medical Practice Regulatory Agency published a code of practice for the usage of digital scribes. Royal Australian College of General Practitioners an information card was published. Both warn physicians that they continue to be accountable for the content of their medical records.

Some AI applications are regulated as medical devicesbut many digital scribes usually are not. Therefore, it is commonly up to health care providers or physicians to determine whether scribes are protected and effective.

What does the research say to date?

Real-world data and evidence on the effectiveness of digital writers could be very limited.

In a big California hospital system, researchers tracked the work of 9,000 physicians for ten weeks. within the digital scribe pilot test.

Some doctors liked the scribe: their working hours were reduced, they communicated higher with patients. Others didn’t even start using the scribe.

And the person taking the notes made mistakes – for instance, writing down the incorrect diagnosis or writing down that a test was done when it must have been done.

So what should we do with digital writers?

This Recommendations the primary Australian National Citizens’ Jury on AI in Healthcare show what Australians expect from AI in healthcare and supply start line.

Building on these recommendations, listed below are some things to be mindful about digital scribes the following time you go to the clinic or emergency room:

1) You must be informed if a digital scribe is used.

2) Only healthcare-grade typescripts must be used in healthcare. Ordinary, publicly available generative AI tools (comparable to ChatGPT or Google Gemini) shouldn’t be utilized in clinical care.

3) You should have the ability to give or refuse consentto use a digital scribe. You must have all relevant risks explained to you and have the ability to freely agree or decline.

4) Those who create digital records for clinical purposes must meet strict privacy standards. You have the precise to privacy and confidentiality in healthcare. The entire record of a visit can contain way more detail than a clinical note. So ask:

  • Are your meeting transcripts and summaries processed in Australia or one other country?
  • How are they protected and secured (e.g. are they encrypted)?
  • Who has access to them?
  • How are they used (e.g. are they used to train AI systems)?
  • Does the scribe have access to other data out of your record to make the summary? If so, is that data ever shared?
A doctor takes notes on a piece of paper in the hallway of the clinic.
Physicians must comply with privacy standards.
PeopleImages.com – Yuri A/Shutterstock

Is human supervision enough?

Generative AI systems could make mistakes, get confused, or misunderstand the accents of some patients. But they often communicate these errors in a way that sounds very convincing. This signifies that close human review is important.

Doctors are told by tech and insurance firms that they need to check every summary or letter (and they need to). But that is not It’s that straightforward. Busy clinicians can turn into overly depending on a scribe and easily accept summaries. Tired or inexperienced clinicians might imagine their memory have to be incorrect and the AI ​​have to be right (referred to as automation bias).

Some people have suggested these scribes must also have the ability to create patient summaries. We don’t own our own medical records, but we normally have the precise to access them. Knowing that a digital scribe is in use can increase consumers’ motivation to review what’s of their medical records.

Doctors have all the time written notes about our embarrassing problems and have all the time been accountable for those notes. Privacy, security, confidentiality and quality of those records have all the time been essential.

Perhaps at some point, digital scribes will mean higher records and higher interactions with our clinicians. But without delay, we want good evidence that these tools can work in real-world clinics without compromising quality, safety, or ethics.

This article was originally published on : theconversation.com
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