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A piece of Puerto Princesa

Eating a plateful of timolok worms may have been one of the highlights for John Ryan Mendoza when he visited Puerto Princesa, but as he discovered, there’s always more to discover in this part of Palawan.

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“Do they taste like what a worm would taste like in your head before you ate it?” said the Facebook message that my Canadian friend sent me after leaving an appalled comment on a photo of me biting a tamilok.

“They tasted familiar, like oysters, but still very different,” I replied, amused.

The tamilok, a wood worm that thrives in coconut tree trunks, is a local delicacy in the island province of Palawan. My transgender travel buddy and I just found them in a menu at Kinabuch’s Grill on the second night of our promo flight getaway. At 130 pesos, we had a full plate of skinned worms with a small saucer of vinegar. The tamiloks only got to the side of my friend’s face for the photo, so I had the whole squirmy plate to myself. They tasted like very, very long oysters. After dipping it in vinegar, I had to slurp a whole juicy one in order to chew it. I finished most of the plate. I just hesitated at the thought that my stomach wouldn’t be so happy about it and may just end up in toilet confinement rather than the Palawan outdoors the next day. I turned out fine and I definitely would have them again, cooked next time. Puerto Princesa, Palawan’s capital city, offered so much more aside from these quirky tamiloks.

Ka Lui’s cake
We started this Puerto Princesa trip with a dinner reservation at Ka Lui’s Seafood House. We had to go on barefoot to get inside so we had to leave our footwear in numbered drawers at the entrance. The place had a native Filipino ambience and was packed. We were ushered to a low candlelit table for two and were crouched comfortably. We ordered the Ka Lui’s special for the day. At 485 pesos, we had full course meal of veggies, prawns, fried fish in mango sauce, grilled fish, and a young coconut with tropical fruits. The whole night, my transgender friend couldn’t help but notice the good-looking waiters that served the customers. Then we had a surprise for the night- a not just phallic, but really penile cake was served for a birthday celebrant in the next table. My friend guessed right, Ka Lui is proudly a successful gay businessman according to locals. With this gay vibe, I would definitely come back here with friends and have that cake.

Ice cold island tour
On the second day, as Typhoon Gener was raging over most of Luzon, a morning text brought bad news. Our subterranean river trip was cancelled due to the reported dangerous river currents from the local coast guard. Unfazed, we proceeded with the Honda Bay island tour.

At 200 pesos, we rode a tricycle to the boat terminal where we started to pay the various fees and taxes for the tour. We were about to pay 1,300 pesos for just the two of us, when luckily a young (het) couple was also there looking to share a boat with others. There were four islands and one reef that were lined up for the tour. Entrance fees for Pandan and Cowrie islands, 100 and 75 pesos respectively, were paid there at the terminal. All other entrance fees that charged 50 pesos were to be paid once getting there.

We first stopped at Luli island. It was just a sand bar where a highly stilted house and some small cottages stood. The boat man told us that the whole sand bar submerges during high tide. That’s why it’s called “Luli” (lulubog-lilitaw). We just spent a brief time exploring the quite dense mangrove growth and proceeded to our next stop. We then arrived at Pambato reef, where we donned our rented snorkeling gear and footwear. We all rented the equipment at 150 pesos each at the shops near the main highway and then just realized that we can rent them even cheaper at 100 pesos at the boat terminal. Oh well, next time. There was so much colourful fish and corals too see but there was just one problem-the water was too murky. Being in a low pressure area was starting to take its toll on our tour. On a sunny day, I’m pretty sure how much more amazing this underwater world would be.

Next stop-Starfish island. It was starting to rain when we disembarked from the boat and four starfishes welcomed us at the shore. After going around for the camera poses and jump-shots, we realized that those were the only starfishes we ever saw. Maybe we weren’t looking well enough, but I was starting to suspect the starfish welcome was staged. It was starting to get really cold so we all took refuge in the warm seawater. We all wouldn’t recommend swimming here, snorkelling I guess, for the beach was too rocky, unless you are into pain.

It was on our transit to Pandan island when the torrential rain poured. The island was so shrouded in thick white mists that our boatman got disoriented – just freaky. After around 30 minutes, we arrived at the more developed island all drenched and freezing. Cottages for rent at 300 pesos were at the beachfront and a food and drinks counter was at the interior. We took shelter at a tent beside the food place and had our lunch of grilled squid and pork at 180 pesos per plate. The island was just surrounded with snorkelling spots. After our cold meal, we finally dipped into the soothing warm waters. This time, we brought a feast for the fishes – breadcrumbs. One doesn’t need a life vest anymore since the spots you can feed the fish and find corals were very shallow. Just stay clear from the black gardens of sea urchins and occasional camouflaged stone fishes. They all sting pretty bad.

The weather was getting worse but we were all still resolute to get our money’s worth. After another chilly and wavy trip, Cowrie island proved to be worth it. It had the finest sand and the most pristine waters among all the other islands. This last stop’s warmer water was just perfect for languid swimming after enduring all that cold. We finally sailed back to the terminal and then all parted at our respective hotels after sharing again, a tricycle. Just one classic – share a boat/tricycle, win a friend – day.

Wet City Tour
On our third day, the morning text message made us abandon all hope we had for the underground river tour. The typhoon raged on and the underground river currents could kill, the travel agent told us. We were just left with the city tour option. Our friendly driver agreed to tour us for the whole day at 500 pesos. We first drove to Palawan governor-owned Rancho Sta. Monica, popularly known as Mitra’s Ranch. Located at a hilltop, it had a magnificent view of Puerto Princesa and offered various activities such as horseback riding, trampoline jumping, and ziplining. My friend opted to pay 500 pesos for ziplining. The ranch’s zipline had 3 lines where you can transfer from one line to another thru towers as high as the tree tops. The first zip line is 300 meters long while the 2nd and 3rd zip lines are 150 meters long each. The male zipline staffs were so accommodating to my friend that they agreed to take photos of all her zipline moments and even invited her to a drinking session sometime after work. Maybe it’s just my friend’s charm or just this place’s really friendly locals.

Then we proceeded to Baker’s Hill. It is a bakery/restaurant with a mini park with fun statues, exotic birds, and beautiful landscapes. No wonder, it is a pretty famous dating spot for locals. The Hopia Ube and Hopia Baboy are the bakery’s famous delicacies.

The non-stop cam-whoring at the mini park eventually starved us so we went the nearby Dampa sa Mansion Restaurant for lunch. You get to choose the fresh seafood from the display and just buy the amount you need. You then have them cooked the way you want at 100 pesos. We were awful at estimating the amount of seafood we want and ended up paying much for the food we can’t all consume. We just got them packed for the next day. The place had a nice open space and you can just enjoy the fresh air while dining. Except for really rainy days when mists of water would just spray on your entire table if you are near the peripheries, which was unfortunately our case.

The rains were hard again and the driver updated us of the situation of the other usual city tour spots. On that day, butterflies were a no-show in the butterfly garden, and getting to the crocodile farm or the Palawan Wildlife Rescue and Conservation Center was impossible due to the flood-damaged bridge. We just moved to our next stop – the Binuatan Creations. Binuatan Creations had this weaving workshop where the staff assists you in making handloom woven mats using the indigenous plant fibers of Palawan drawn from the buntal, coconut, buri, cogon grass, pandan, and pineapple. Their products are world-class exports and you can buy these native products at the source. The bags are really good and cheap. Impulsive, broke, and thick-faced, I bought four and had my friend swipe her credit card for me. Once the buying starts, the shopping mode is on for both of us. We then rode to the newly opened LRC 908 Market Mall, where there was an assortment of local handcrafts, pearl accessories, and lots of pasalubong items.

It was a Sunday and my friend wanted to hear mass at the Immaculate Conception cathedral. The driver then brought us to the Baywalk, which was just very near the cathedral. The Baywalk is a famous place to enjoy the view of the Puerto Princesa Bay to stroll, bike (available for rent), and to try street food. After the usual photos, we were then finally transported to the cathedral. I had an hour to wait for my friend so I just killed time at Plaza Cuartel, which was just a few steps from the cathedral entrance.

Plaza Cuartel looks like a plain city park with concrete pavements, tall trees, water fountains, and benches. With the clinging couples at every corner, I now get why the driver said it is known to be a “lover’s park” for local teenagers. Yet I realized after some reading of inscribed texts at the monument, the ruins of an old garrison and tunnels are proof of its brutal history. This plaza is the site of Palawan Massacre. In the tunnels, 150 American prisoners of war were kept during World War II. It was on December 14, 1944, the Japanese decided to burn them all alive. Many died and only eleven prisoners survived and escaped the mass execution. Then it rained on me at this quite dark conclusion for the city tour.

Badjao at the Seafront
After the mass, we were both ready for our fourth leg of seafood pig-out. At 60 pesos, we got a tricycle to transport us from the cathedral to Badjao Seafront Restaurant. It’s a popular place and is expectedly crowded so we had to reserve a table earlier that day. When we arrived, the winds were strong and it was already quite dark. We had to pass through a hallway with wafting white curtains and can see that the restaurant is built on top of a mangrove forest. The place had large open windows, some of which were unfortunately covered then due to the winds. On nicer weather, I’m sure it has a beautiful sea-view. Named after the Badjaos, the restaurant is adorned with textiles that are associated with the seafaring tribes in the south. We agreed to just have modest dinner since we quite overspent for lunch. The mixed seafood dish was expectedly good. All our neighbouring tables had crabs, shrimps, and all the fish Palawan can offer, and all looked satisfied. This place lives up to its fame.

Big Brother and Garcellano
The fourth day was my friend’s last day and we figured to just enjoy our remaining hours at the House of Big Brother. For 1,000 pesos per night, our “housemate” room had two couple wide beds, a hot/cold shower, wide screened flat screen TV with cable and a kitchenette equipped with modern fire-less induction cooker, electric kettle, automatic rice cooker, refrigerator, microwave oven, cooking and dining utensils. Cooking skills would be very much handy and economical along with Palawan’s bountiful seafood and vegetables that are just waiting in the city markets. Big Brother offers quite a good deal for a larger group and a longer stay.

I still had one more night in the city so I had to check-in into another place by noon time and I fortunately discovered the cheapest place ever- the Garcellano Tourist Inn. It is only 250 pesos per night. Don’t expect Big Brother’s extra amenities, for this place only has fan rooms with private toilet and bath. They have bigger rooms for larger groups but the rates still remain less than 500 pesos. If most of the day you would just be enjoying the outdoors, this place gives you just the comfortable basics for your stay.

Vietnam in Palawan: Chaolong
On this mission-less day, we finally tried Chaolong for lunch. We have been seeing many of outlets around the city. We discovered from the stories of our tricycle driver/tourist guide that this ubiquitous Vietnamese dish came along after the fall of South Vietnam in 1975. At this time, Vietnamese migrants first began arriving in boats in the Philippines. A refugee camp was setup by the United Nations in Palawan. The still existing small community of the refugees, called Viet Ville, is about 13 kilometers up the road from Puerto Princessa.

To be more factual, Puerto Princesa’s chao long should be qualified, the Vietnamese chao long, is “scrummy” rice porridge (the chao) laden with innards (the long). Puerto Princesa’s chao long is flat, thin rice noodles in a sweet-savory broth with your chosen meats (beefbones, beef , pork), served with the indispensable plate containing raw bean sprouts, shoots of basil and mint, and a piece of kalamansi.

We had a taste of this dish at Bona’s Chaolong House and Restaurant, where prices are really cheap. I ordered the Beef Bones with Noodles Special (55 pesos) and French Bread with Cheese (25 pesos). I liked it a lot that I had Chaolong again for breakfast the next day.

Walking along Rizal Avenue
When my friend had to go to the airport for her flight, we just decided to walk from the House of Big Brother. Google maps advised us it was just near, and it was. When we arrived, we both gave tricycle drivers 50 pesos to get us to our accommodation. We realized it was too much. The regular fare which was eight or ten pesos was enough.

I was then alone. I decided to just walk again from the airport and along the stretch of Rizal avenue, one of city’s main streets. The air was so non-Manila. Even while strolling along a street with so many vehicles, the air was clean. Puerto Princesa lives up to being the cleanest and most environment-friendly city in the Philippines. This main road is sprawled with hotels, motorbike rentals, handicraft stores, travel agencies, restaurants, and bars. These are proudly good indicators of an ever booming tourism industry.

It was already night-time when I reached the Baywalk. Locals and tourists just leisurely hang out while viewing the quiet bay. The vibe has been peaceful not only here but throughout the areas I have been so far in the city. Locals and official reports verify that Puerto Princesa is still the most peaceful among the urban centers in the country. Puerto Princesa Mayor Edward Hagedorn had reported that the city has the lowest crime rate and highest crime solution efficiency compared to other urban centers in the country. With strong political will, significant impacts like this are truly achievable.

Ima’s Gulay Bar
It was my last dinner at this peaceful green city so I searched for the nearest vegetarian restaurant. Just a few blocks from where I was staying, I finally found Ima’s Gulay Bar. Quaint and somewhat intimate were my impressions of the place when I got in the wooden cottage. Their menu declared that they served delectable continental vegetarian dishes. I then automatically looked for entries that were unfamiliar. I ordered the spicy okra and mango pasta (70 pesos) and a smoothie called Ima’s blend (80 pesos). The restaurant had a good wifi connection so my partner and I had a “vegetarian dinner date” via Skype. He was also having his veggie bolognaise. With good vegetarian food, affordable prices, quiet ambience, and a free and fast wifi connection, Ima’s Gulay Bay is my instant favorite. I came back the next day for lunch and stayed there to do some writing until I had to leave for the airport.

I was welcomed back in Manila by the remaining wrath of Typhoon Gener. In the taxi on my way home, the strong wind howled, the heavy rain fell, and flood and traffic was everywhere. I just happily thought to myself that I have had a piece of Puerto Princesa and still has that sweet promise to return.

A registered nurse, John Ryan (or call him "Rye") Mendoza hails from Cagayan de Oro City in Mindanao (where, no, it isn't always as "bloody", as the mainstream media claims it to be, he noted). He first moved to Metro Manila in 2010 (supposedly just to finish a health social science degree), but fell in love not necessarily with the (err, smoggy) place, but it's hustle and bustle. He now divides his time in Mindanao (where he still serves under-represented Indigenous Peoples), and elsewhere (Metro Manila included) to help push for equal rights for LGBT Filipinos. And, yes, he parties, too (see, activists need not be boring! - Ed).

Health & Wellness

Sexual minority men who smoke report worse mental health, more frequent substance use

LGBTQ+ people are more likely to smoke than their cisgender and heterosexual peers to cope with an anti-LGBTQ+ society, inadequate health care access and decades of targeted tobacco marketing. Those social stressors drive the health disparities they face, which are compounded by a lack of LGBTQ-affirming healthcare providers, research shows.

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Cigarette smoking is associated with frequent substance use and poor behavioral and physical health in sexual and gender minority populations, according to Rutgers researchers.

The study, published in the journal Annals of Behavioral Medicine, examined tobacco use by sexual minority men and transgender women to better understand the relationships between smoking, substance use and mental, psychosocial and general health.

The researchers, who are part of the Rutgers School of Public Health’s Center for Health, Identity, Behavior and Prevention Studies, surveyed 665 racially, ethnically and socioeconomically diverse sexual minority men and transgender women, 70 percent of whom reported smoking cigarettes.

They found that smoking was associated with participants’ race/ethnicity, marijuana and alcohol use and mental health. Current smokers were more likely to be white and reported more days of marijuana use in the past month. The study also found that current smoking was associated with more severe anxiety symptoms and more frequent alcohol use.

“Evidence also tells us that smoking is associated with worse mental health and increased substance use, but we don’t know how these conditions are related to each other, exacerbating and mutually reinforcing their effects,” said Perry N. Halkitis, dean of the Rutgers School of Public Health and the study’s senior author.

LGBTQ+ people are more likely to smoke than their cisgender and heterosexual peers to cope with an anti-LGBTQ+ society, inadequate health care access and decades of targeted tobacco marketing. Those social stressors drive the health disparities they face, which are compounded by a lack of LGBTQ-affirming healthcare providers, research shows.

“Our findings underscore the importance of holistic approaches to tobacco treatment that account for psychosocial drivers of substance use and that address the complex relationships between mental health and use of substances like alcohol, tobacco and marijuana,” said Caleb LoSchiavo, a doctoral student at the Rutgers School of Public Health and the study’s first author.

The study recommends further research examining the social determinants of disparities in substance use among marginalized populations and how interpersonal and systemic stressors contribute to poorer physical and mental health for minority populations.

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Technology

Why you should switch to IPTV

If you want to cut your bills in half, or more than in half, you need to switch to IPTV. For a fraction of the price of cable, you can access the same channels using your WiFi connection – the same as you would when watching on your computer.

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Your TV is an important part of your life – even if you wouldn’t like to admit it. More and more, we  use our TVs to watch movies, shows, news and even play video games.

IMAGE SOURCE: PEXELS.COM

During the COVID-19 pandemic, with movie theaters closed, we all snuggled down and watched Netflix to pass the time in quarantine. It’s pretty difficult to imagine our lives without TV. The downside, however, is that we spend an increasing amount on TV per month – with subscriptions, rentals and cable, it gets pretty pricey.

What Is IPTV?

IPTV stands for Internet Protocol Television and is a service which uses the internet, rather than satellite or cable, to access TV. IPTV is streamed through the Internet, but don’t be fooled, it does not just include TV which is usually online like Amazon Prime. IPTV includes all TV channels which you would be accessing through cable or satellite – it is simply a different way of accessing the same things. IPTV is accessible through WiFi and can be used by anyone with a strong broadband connection.

Why Choose IPTV?

IPTV has basically no cons – it’s all pros. This service is fast, simple, and crucially, cost-effective.

  • The Pricing

If you want to cut your bills in half, or more than in half, you need to switch to IPTV. For a fraction of the price of cable, you can access the same channels using your WiFi connection – the same as you would when watching on your computer. The pricing of IPTV is unparalleled next to the traditional modes of TV watching. 

  • The Convenience and Reliability

With a good WiFi provider,  you are all set. It really is as simple as that. Instead of paying for high speed internet and cable television, you can combine the two. Plus, there will be barely any glitching. It is smooth, simple and highly convenient.

  • The Expansive Channel Selection Perfect For Families

Unlike with cable, IPTV has thousands of channels available so it is perfect for the whole family. If you want a great selection of kids shows, adult series and movies, this is the perfect package.

How To Switch To IPTV

If you want to make the switch to IPTV, you need to notify your cable provider once you find the right IPTV package for you. You can shop for IPTV packages on comparison sites and find the right selection for you.

In addition, it’s important to make sure you have the Best Device for IPTV which can stream it in high definition. Also, you need to ensure your WiFi is high speed, to avoid any buffering when your IPTV is installed!

The decision has never been easier – switch to IPTV today and find an amazing selection of channels for the lowest price ever.

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Health & Wellness

Love hormone also forms important link between stress and digestive problems

Oxytocin, an anti-stress hormone, is released from the hypothalamus in the brain which acts to counteract the effects of stress. For a long time, the actions of oxytocin were believed to occur due to its release into the blood with only minor effects on the nerves within the brain that regulate gastrointestinal functions.

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New research published in The Journal of Physiology shows that oxytocin, known as the love hormone, plays an important role in stress’ disruption of digestion such as bloating, discomfort, nausea and diarrhea.  

Stress disrupts gastrointestinal functions and causes a delay in gastric emptying (how quickly food leaves the stomach). This delay in gastric emptying causes bloating, discomfort, and nausea and accelerates colon transit, which causes diarrhea.  

Oxytocin, an anti-stress hormone, is released from the hypothalamus in the brain which acts to counteract the effects of stress. For a long time, the actions of oxytocin were believed to occur due to its release into the blood with only minor effects on the nerves within the brain that regulate gastrointestinal functions.  

The study used new ways to manipulate the neurons and nerves (neurocircuits) that oxytocin released from the hypothalamus acts upon and measured the effects on the response of gastric emptying to stress. They have shown that, contrary to previous assumptions, these oxytocin circuits play a major role in the response of the stomach to stress.  

Activation of these oxytocin circuits reversed the delay in gastric emptying that occurs normally in response to stress, by increasing muscle contractions (motility) of the stomach, while inhibition of these neurocircuits prevented adaptation to stress.  

The new research, conducted at Penn State University- College of Medicine and was sponsored by a grant from the National Institute of Health, USA, employed cutting-edge tools that allow selective manipulation of the circuits that receive hypothalamic oxytocin inputs together with simultaneous measurements of gastric emptying and motility in response to stress.  

The authors used a rat model of different types of stress – acute stress, appropriate adaptation to stress, and inappropriate adaptation to stress. The authors infected the neurons controlling the oxytocin nerves and neurocircuits with novel viruses that allowed them to be activated or inhibited and measured muscle activity in the stomach, as well as gastric emptying (the time for food to leave the stomach).  

The researchers have shown that these oxytocin neural circuits play a major role in the gastric response to stress loads. Indeed, their activation reversed the delayed gastric emptying observed following acute or chronic responses to stress, thus increasing both gastric tone and motility. Conversely, inhibition of these neurocircuits prevented adaptation to stress thus delaying gastric emptying and decreasing gastric tone.   

These data indicate that oxytocin influences directly the neural pathways involved in the stress response and plays a major role in the gastric response to stressors. ​ 

The ability to respond appropriately to stress is important for normal physiology functions. Inappropriate responses to stress, or the inability to adapt to stress, triggers and worsens the symptoms of many gastrointestinal disorders including delayed gastric emptying and accelerated colon transit.  

Previous studies have shown that the nerves and neurocircuits that regulate the function of gastric muscle and emptying respond to stress by changing their activity and responses.  

In order to identify targets for more effective treatments of disordered gastric responses to stress, it is important to first understand how stress normally affects the functions of the stomach. Their study provided new information about the role that oxytocin plays in controlling these nerves and circuits during stress and may identify new targets for drug development. 

Commenting on the study R Alberto Travagli said: “Women are more vulnerable to stress and stress-related pathologies, such as anxiety and depression, and report a higher prevalence in gastrointestinal disorders. Our previous studies showed that vagal neural circuits are organized differently in males versus females. We are now finalizing a series of studies that investigate the role and the mechanisms through which oxytocin modulates gastric functions in stressed females. This will help to develop targeted therapies to provide relief for women with gastrointestinal disorders.”

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Lifestyle & Culture

Bringing your employer to rights over workplace health and safety

As LGBTQIA people often find barriers to gainful employment and legal recourse, they will find workplace conditions even more unsafe than the average person. However, legal protections are changing, and workers can now bring their rights against their employers.

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Workplaces in the Philippines are often not safe to work in. A study conducted in 2016 by the British Medical Journal found that workplace injury was prevalent nationally in the Philippines, rather than just being outlying incidents and errors on a small scale.

As LGBTQIA people often find barriers to gainful employment and legal recourse, they will find workplace conditions even more unsafe than the average person. However, legal protections are changing, and workers can now bring their rights against their employers.

How the law has changed

A big turning point in workplace health and safety protections came up in 2018, and is now starting to be implemented. As highlighted by the WHO, the Occupational Safety And Health Standards Act brings with it a raft of protections to help the workplace be far safer. What comes hand in hand with this is an enriched legal environment.

American legal experts JJS Justice note that government protections are only as good as their enforcement, and it’s the job of national attorneys to ensure people are well represented. Increasingly, this is becoming a reality for Filipinos – even for the historically under-represented LGBTQIA community.

Improved legal environment

Legal representation is slowly becoming a good news story for LGBTQIA people in the Philippines. 2017 saw the meteoric rise of Geraldine Roman, and her trendsetting has seen a far greater level of protection afforded, legally speaking, to those who could not access legal help due to societal pressure.

Legal advocates and help are starting to take the issues presented by LGBTQIA people in the Philippines seriously, even if the government and administration do not. International trends are starting to indicate that the country is taking this, and workplace protections, seriously.

International recognition

It can sometimes be a good yardstick as to the quality of a country’s legal protections to see how the international community perceive them. The Philippines recently received the Safe Travels stamp from a major international tourism body in recognition of improved safety standards all over the country. With international bodies likely to only recognize international levels of good work being done, this is encouraging in the overall push for better workplace standards.

Keeping this push going is important to improving working lives for everyone. This includes LGBTQIA people, who have historically faced discrimination in employment. As one workplace improves, so do all – and that’s a good thing.

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Health & Wellness

Notable percentage of trans men who have sex with men never got tested for HIV, bacterial and viral STIs

When considering screening for HIV and sexually transmitted infections (STIs), transgender men who have sex with men (TMSM) represent an understudied population. A study found that a notable percentage of TMSM had never tested for HIV and bacterial and viral STIs.

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When considering screening for HIV and sexually transmitted infections (STIs), transgender men who have sex with men (TMSM) represent an understudied population. A study found that a notable percentage of TMSM had never tested for HIV and bacterial and viral STIs.

In “Sociodemographic and behavioural factors associated with testing for HIV and STIs in a US nationwide sample of transgender men who have sex with men” – done by Nadav Antebi-Gruszka, Ali J. Talan, Sari L. Reisner and Jonathon Rendina, and published in BMJ Journals – researchers tried to examine HIV and STI testing prevalence among TMSM along with the factors associated with testing in a diverse sample of TMSM. They used data from a cross-sectional online convenience sample of 192 TMSM, analyzed using multivariable binary logistic regression models to examine the association between sociodemographic and behavioral factors and lifetime testing for HIV, bacterial STIs and viral STIs, as well as past year testing for HIV.

The researchers found that more than two-thirds of TMSM reported lifetime testing for HIV (71.4%), bacterial STIs (66.7%), and viral STIs (70.8%), and 60.9% had received HIV testing in the past year. Engaging in condomless anal sex with a casual partner whose HIV status is different or unknown and having fewer than two casual partners in the past six months were related to lower odds of lifetime HIV, bacterial STI, viral STI and past year HIV testing.

Being younger in age was related to lower probability of testing for HIV, bacterial STIs and viral STIs.

The domiciles of the TMSM also affected their health-seeking behaviors. In this study, those residing in the South of the US were less likely to be tested for HIV and viral STIs in their lifetime, and for HIV in the past year.

Finally, lower odds of lifetime testing for viral STIs was found among TMSM who reported no drug use in the past six months.

According to the researchers, these findings indicate that a notable percentage of TMSM had never tested for HIV and bacterial and viral STIs, though at rates only somewhat lower than among cisgender MSM despite similar patterns of risk behavior.

They recommend for “efforts to increase HIV/STI testing among TMSM, especially among those who engage in condomless anal sex.”

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Health & Wellness

People with anorexia and body dysmorphic disorder show brain similarities, differences

Eating disorders and body dysmorphic disorder are more than simply choosing to eat or not eat or not liking how you look. These are brain abnormalities, and how we treat those brain abnormalities could be with psychotherapy, or psychiatric medications, but brain changes need to happen in order to address these disorders.

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A new UCLA study shows partially overlapping patterns of brain function in people with anorexia nervosa and those with body dysmorphic disorder, a related psychiatric condition characterized by misperception that particular physical characteristics are defective.

The study, published in the peer-reviewed journal Brain Imaging and Behavior, found that abnormalities in brain function are related to severity of symptoms in both disorders, and may be useful in developing new treatment methods.

The results reinforce the understanding that eating disorders and body dysmorphic disorder are more than simply choosing to eat or not eat or not liking how you look. “These are brain abnormalities, and how we treat those brain abnormalities could be with psychotherapy, or psychiatric medications, but brain changes need to happen in order to address these disorders,” says Dr. Wesley Kerr, neurology resident and biostatistics researcher at UCLA.

For the study, the researchers recruited 64 female participants: 20 with anorexia nervosa, 23 with body dysmorphic disorder, and 21 healthy controls. Patients with anorexia nervosa have a distorted body image and an intense fear of gaining weight, leading them to eat very little. Body dysmorphic disorder (BDD) is characterized by obsessions with a particular body part or a perceived flaw rather than with weight.

Eating disorders and body dysmorphic disorder are more than simply choosing to eat or not eat or not liking how you look.

Participants were shown images of male and female bodies while researchers observed their brain activity via MRI. Three types of images were used: normal photos, “low spatial frequency” (LSF) images, which had details blurred out, and “high spatial frequency” (HSF) images, in which the edges and details were accentuated.

Functional MRI is a brain imaging technique that detects the blood flow within the brain, allowing researchers to see which parts of the brain are active while a person is doing various tasks. It can also be used to understand what brain regions’ activities are in sync with each other; that is, “connected.”

Each of the women performed a “matching” task while inside the MRI scanner. On the top of the screen, the person would see an image of a body, and would have to choose the matching body from two images shown on the bottom of the screen.

While viewing the images that differed from those of healthy individuals, people with anorexia nervosa and those with BDD showed patterns of activity and connectivity in visual and parietal brain networks. These abnormalities in activity were different in BDD and anorexia nervosa, whereas the connectivity abnormalities were largely similar. The more severe the symptoms, the more pronounced the pattern of brain activity and connectivity when the images were viewed, particularly for the LSF images. Further, connectivity and activity abnormalities were associated with how the participants judged the appearance and body weight of the individuals in the photos.

What the researchers saw indicated that while the brains of patients with anorexia nervosa and those with BDD abnormally process images with high, low, or normal levels of detail, the abnormalities for low level of detail, that is “low spatial frequency” images, have the most direct relationships to symptom severity and body perception. The results may help researchers understand the underlying neurobiology that leads to the characteristic body image distortions in both cases.

“This gives us a clearer picture of neurological basis for what is one disorder, what is the other, and what characteristics they share,” said Dr. Jamie Feusner, senior author and professor of psychiatry and biobehavioral sciences at the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA.

A next step for the research will be to see whether, with existing psychotherapy and medication treatments, the brain activity in patients begins to normalize, or else changes in a different way to compensate for underlying abnormalities.

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