For transgender individuals, gender-affirming surgery can lead to long-term mental health benefits, according to new research published in the American Journal of Psychiatry. The study found that among transgender individuals with gender incongruence, undergoing gender-affirming surgery was significantly associated with a decrease in mental health treatment over time.

Researchers Richard Branstrom, Ph.D., and John E. Pachankis, Ph.D., with the Yale School of Public Health, New Haven, Connecticut, used the Swedish Total Population Register to identify more than 2.500 individuals who received a diagnosis of gender incongruence (i.e., transsexualism or gender identity disorder) between 2005 and 2015. Among individuals with gender incongruence, just more than 70% had received hormone treatment and nearly half (48%) had undergone gender-affirming surgical treatment during the 10-year follow-up period. Nearly all (97%) of those who had undergone surgery also received hormone treatment. Less than one-third had received neither treatment.

They analyzed mental health treatment in 2015 in relation to the length of time since gender-affirming hormone and surgical treatment, including distinguishing the potentially interrelated effects of the two treatments. The mental health measures included health care visits for mood and anxiety disorder, antidepressant and anti-anxiety prescriptions, and hospitalization after a suicide attempt.

Increased time since last gender-affirming surgery was associated with reduced likelihood of use of mental health treatment. The study found the odds of receiving mental health treatment were reduced by 8% for every year since receiving gender-affirming surgery over the 10-year follow-up period. They did not find the same association for hormone treatment.

The study also found that compared with the general population, transgender individuals with a gender incongruence were

• about six times as likely to have had a mood or anxiety disorder health care visit;
• more than three times as likely to have received prescriptions for antidepressants and anti-anxiety medication; and
• more than six times as likely to have been hospitalized after a suicide attempt.

Despite the reduced mental health treatment use after gender-affirming surgery, treatment use among transgender individuals continued to exceed that of the general population.

The authors conclude that “in this first total population study of transgender individuals with a gender incongruence diagnosis, the longitudinal association between gender-affirming surgery and reduced likelihood of mental health treatment lends support to the decision to provide gender-affirming surgeries to transgender individuals who seek them.”

Not all fats are equal in how they affect our skin, according to a new study in the Journal of Investigative Dermatology, published by Elsevier. The investigators found that different ketogenic diets impacted skin inflammation differently in psoriasiform-like skin inflammation in mice. Ketogenic diets heavy in medium-chain triglycerides (MCTs) such as coconut, especially in combination with omega-3 fatty acids from fish oil and plant sources like nuts and seeds, exacerbated psoriasis.

‘This study leads to a broader understanding of possible effects of ketogenic diets with a very high fat content on skin inflammation and underlines the importance of the composition of fatty acids in the diet,” explained co-lead investigator, Barbara Kofler, PhD, Research Program for Receptor Biochemistry and Tumor Metabolism, Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria. “We found that a well-balanced ketogenic diet, limited primarily to long-chain triglycerides (LCTs) like olive oil, soybean oil, fish, nuts, avocado, and meats, does not exacerbate skin inflammation. However, ketogenic diets containing high amounts of MCTs especially in combination with omega-3 fatty acids, should be used with caution since they may aggravate preexisting skin inflammatory conditions.”

Ketogenic diets are increasingly popular because of their promise to treat a number of diseases and promote weight loss. They are currently being evaluated as a potential therapy in a variety of diseases and have been suggested to act as an anti-inflammatory in certain conditions. Dietary products containing coconut oil (high in MCTs) or fish oil (high in omega-3 fatty acids), consumed as part of a ketogenic diet, are marketed and used by the general population because of their reported health promoting effects.

Previous studies have indicated that high-fat diets with a substantial amount of carbohydrates promote the progression of psoriasiform-like skin inflammation and development of spontaneous dermatitis in mice. The investigators therefore hypothesized that high-fat ketogenic diets would dampen psoriasiform-like skin inflammation progression and that partial supplementation of LCT with MCT and/or omega-3 fatty acids would further enhance these effects. Although the study did not confirm that hypothesis, it showed that an LCT-based ketogenic diet does not worsen skin inflammation.

Co-lead investigator Roland Lang, PhD, Department of Dermatology, Paracelsus Medical University, Salzburg, Austria, elaborated on the study’s results, “Ketogenic diets supplemented with MCTs not only induce the expression of pro-inflammatory cytokines, but also lead to an accumulation of neutrophils in the skin resulting in a worse clinical appearance of the skin of the mice. Neutrophils are of particular interest since they are known to express a receptor for MCTs and therefore a ketogenic diet containing MCTs may have an impact on other neutrophil-mediated diseases not limited to the skin.”

Mice used in the study were fed an extremely high-fat (77 percent) ketogenic diet, which is uncommon except for patients following a strict regime for medical conditions like drug-resistant epilepsy. “I think most people following a ketogenic diet don’t need to worry about unwanted skin inflammation side effects. However, patients with psoriasis should not consider a ketogenic diet an adjuvant therapeutic option, noted Dr. Kofler.”

Drinking small amounts of alcohol frequently is linked with a higher likelihood of atrial fibrillation than binge drinking, according to research published today in EP Europace, a journal of the European Society of Cardiology (ESC) (1).

‘Recommendations about alcohol consumption have focused on reducing the absolute amount rather than the frequency,’ said study author Dr. Jong-Il Choi, of Korea University College of Medicine and Korea University Anam Hospital, Seoul, Republic of Korea. ‘Our study suggests that drinking less often may also be important to protect against atrial fibrillation.’

Atrial fibrillation is the most common heart rhythm disorder and raises the risk of stroke by five-fold (^2). Symptoms include palpitations, racing or irregular pulse, shortness of breath, tiredness, chest pain and dizziness (^3).

A prior meta-analysis found a linear correlation between alcohol and atrial fibrillation: risk increased by 8% for every 12 g of alcohol (one drink) consumed per week (^4). But it was not clear which is more important: the total amount of alcohol or the number of drinking sessions.

This study examined the relative importance of frequent drinking versus binge drinking for new-onset atrial fibrillation. The analysis included 9,776,956 individuals without atrial fibrillation who underwent a national health check-up in 2009 which included a questionnaire about alcohol consumption. Participants were followed-up until 2017 for the occurrence of atrial fibrillation.

The number of drinking sessions per week was the strongest risk factor for new-onset atrial fibrillation. Compared with drinking twice per week (reference group), drinking every day was the riskiest, with a hazard ratio (HR) of 1.412, while drinking once a week was the least risky (HR 0.933). Binge drinking did not show any clear link with new-onset atrial fibrillation.

‘Our study suggests that frequent drinking is more dangerous than infrequent binge drinking with regard to atrial fibrillation,’ said Choi. ‘The number of drinking sessions was related to atrial fibrillation onset regardless of age and sex. Repeated episodes of atrial fibrillation triggered by alcohol may lead to overt disease. In addition, drinking can provoke sleep disturbance which is a known risk factor for atrial fibrillation.’

In keeping with other studies, weekly alcohol consumption was related to atrial fibrillation. There was a 2% increase in the risk of new-onset atrial fibrillation for each gram of alcohol consumed per week. Compared to mild drinkers, those who drank no alcohol, moderate, or high amounts had 8.6%, 7.7%, and 21.5% elevated risks respectively.

Choi said the protective effect of mild drinking needs to be confirmed. ‘It is not clear if this is a true benefit or a confounding effect of unmeasured variables,’ he said.

He concluded: ‘Atrial fibrillation is a disease with multiple dreadful complications and significantly impaired quality of life. Preventing atrial fibrillation itself, rather than its complications, should be our first priority. Alcohol consumption is probably the most easily modifiable risk factor. To prevent new-onset atrial fibrillation, both the frequency and weekly amount of alcohol consumption should be reduced.’

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REFERENCES

1. Kim YG, Han KD, Choi JI, et al. Frequent drinking is a more important risk factor for new-onset atrial fibrillation than binge drinking: a nationwide population-based study. Europace. 2019. doi:10.1093/europace/euz256.
2. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016;37:2893-2962. doi:10.1093/eurheartj/ehw210.
3. Learn to recognise signs and symptoms of atrial fibrillation: https://www.afibmatters.org/en_GB/Signs-and-symptoms.
4. Larsson SC, Drca N, Wolk A. “Alcohol consumption and risk of atrial fibrillation: a prospective study and dose-response meta-analysis.” J Am Coll Cardiol. 2014;64:281-289. doi:10.1016/j.jacc.2014.03.048.

It turns out being Sugar Daddy isn’t a one-size-fits-all gig. While it occasionally lives up to the stereotype of a wealthy, middle-aged man lavishing gifts and money on a young woman in return for her companionship, there’s more to it… a least in the U.S.

Drawing from 48 in-depth interviews, sociologist Maren Scull, PhD, assistant professor at University of Colorado Denver, has identified seven types of these “sugar” relationships:

1. sugar prostitution
2. compensated dating
3. compensated companionship
4. sugar dating
5. sugar friendships
6. sugar friendships with benefits, and
7. pragmatic love

The results of her study were published in Sociological Perspectives.

“Whenever I read an article about Sugar Daddies or Sugar Babies, I often saw the same sensationalistic slant: the women are desperate, starved college students engaging in prostitution,” said Scull. “As someone who studies deviance, I knew there were more important nuances to these relationships.”

Modern sugaring

Sugar relationships are based on companionships, intimacy or other forms of attention in exchange for personal benefit (financial support, material goods, professional advancement). These kinds of agreements are hardly new–in the 1750s, Geishas were seen as socially respected entertainers even though they were paid to amuse men, usually without sex. During the first two World Wars, soldiers paid women to join them for a night out of dinner and dancing.

But the bulk of modern-day research focuses on transactional and survival sex in sub-Saharan Africa, and compensated dating in East and Southeast Asia. There was a black hole of research in the US.

To understand how “sugaring” works, Scull spoke with 48 women about their experiences as Sugar Babies. She explored the kind of activities the women were involved in, whether sex was involved and whether their lives were intertwined with their benefactors.

She found that 40% of the women had never had sex with their benefactors and the ones that did often had genuine, authentic connections with the men. She also found that most forms of sugaring aren’t a play-for-pay arrangement.

“I didn’t have the intent of creating a typology, but there was so much variety that I knew I had to highlight the different nuances and forms that sugar relationships can take,” said Scull.

The 7 types of sugar relationships

Scull labeled the first “sugar prostitution,” a form of sugaring absent emotion and purely the exchange of gifts for sex. “Compensated dating,” popular in Asia, involves a monetary or material compensation for grabbing a coffee, a meal or attending a specific event together. “Compensated companionship” involves wider scope of activities and often involve the woman becoming more intertwined in the man’s life. Neither compensated dating nor compensated companionship involves anything sexual for most people.

“Sugar dating,” the most common form of sugaring, combines the intertwined life of companionship with sex. In this case, most women receive an allowance on a weekly, monthly or as-needed basis. The sums could range from $200 to several thousands of dollars a month.

“Sugar friendships are a mutually beneficial relationships with someone the women consider a friend. In fact, these benefactors are often a part of the women’s lives already or soon become a part of it. “Sugar friendships with sexual benefits” is more unstructured. In some cases, benefactors pay for all living expenses for the women, including rent, cell phone bills, clothing, cars and vacations.

Finally, Scull found that some of these relationships involved two people who hoped to end up together, with the woman taken care of for the rest of her life, in a category she named “pragmatic love.”

“When we lump sugar relationships together as prostitution, it deviantizes and criminalizes these relationships,” said Scull. “We were missing how they are often organic and involve genuine, emotional connection. Many of the women didn’t intend on having a benefactor. They just happened to meet someone at work or during a catering gig who wanted to take care of them. These relationships can last decades.”

Caring for your hair is a constant battle, particularly if you are suffering from hair loss. But with a number of procedures such as hair transplants to help resolve the issue, the Turkey hair transplant cost is more than affordable for any price range to help those that are suffering. However, it is important to ensure that you are caring for your hair before it gets to this stage.

In this article, we will be looking into five things you are doing wrong when caring for your hair.

Brushing Wet Hair

One of the biggest mistakes you can make is brushing your hair when it is wet. This not only causes it to tangle but it can lead to the hair falling out or breaking halfway down the length. When drying your hair, use a wide-tooth comb or a wet brush as this will help to detangle the hair and prevent breakages over time. Though you may still experience the typical 100 hairs falling out per day, this will be significantly less by using a wide-tooth comb.

Skipping Heat Protection

Another major mistake that you can make is skipping heat protection. This will not only cause damage to the hair, but it can lead to the hair being damaged in the follicle when drying out the hair. By applying this to the roots of the hair as well as the lengths, this will help to resolve issues such as split ends and breakage due to excessive heat. Though this isn’t always accessible, it is important to ensure that it is not forgotten about as this can bring about lasting damage as a result.

Using Too Many Products

If you are using a number of products such as dry shampoo and hair gel, this can all build up on the scalp, causing the root to be starved of oxygen. By reducing the number of products that you use as well as deep cleaning the scalp regularly, you can ensure that your hair is healthy all year round. With a number of hair products on the market that are not damaging to the scalp or the lengths, you can style your hair without concern of any lasting damage.

Not Washing Thoroughly Enough

Though we all shampoo and condition often, could it be the case that we are not cleaning our scalp thoroughly? As product can build up on the scalp, this can lead to the hair falling out or becoming weaker over time. Therefore, investing in products such as a scalp cleansing brush can help to remove dirt and grime from the follicle without causing damage to the hair. In addition to this, it also helps to increase blood flow to the scalp to promote the growth of healthy hair.

You Are Using the Wrong Products

Every hair type is completely different and therefore the products that you are using have to cater to this. Whether you have oily hair, dry hair or hair that is prone to breakage, there are a number of products that are specifically designed to keep your hair looking great all year round. But by using the wrong products, you could be inflicting more damage as a result.

With this in mind, there are a number of ways that you can limit the damage done to your hair whilst keeping your hair as healthy as possible throughout the course of both autumn and winter.

A study from Nationwide Children’s Hospital and the Central Ohio Poison Center found rates of suicide attempts by self-poisoning among youth and adolescents are higher in rural communities, higher during the academic school year and involve common medications found in many households.

The study, published online in Clinical Toxicology, expands on previous research that evaluated the incidence and outcomes from intentional suspected-suicide self-poisoning in children and young adults ages 10 to 24 years old from 2000-2018. In that 19-year time frame, there were more than 1.6 million intentional suspected-suicide self-poisoning cases in youth and young adults reported to US poison centers. The majority of cases were female (71%), and involved a pharmaceutical (92%).

“While most of these cases involved medications, with adolescents, any available medication can be a potential hazard,” said Henry Spiller, MS, D.ABAT, director of the Central Ohio Poison Center at Nationwide Children’s, and co-author of the study. “It’s not so much a matter of substance type, but rather a matter of access to the substance. Any type of medication can be misused and abused in ways that can unfortunately lead to very severe outcomes, including death.”

The two most common substance groups in all age groups were over-the-counter (OTC) analgesics – such as acetaminophen, ibuprofen and aspirin – followed by antidepressants. In youth and adolescents 10-12 and 13-15 years old, ADHD medications were common, and had the highest risk of serious medical outcomes. Opiates only accounted for 7% of cases with serious medical outcomes.

“Because medications are so readily available in homes, many families do not take precautions to store them safely. Our findings suggest this is a big problem,” said John Ackerman, PhD, clinical psychologist and suicide prevention coordinator for the Center for Suicide Prevention and Research at Nationwide Children’s, and co-author of the study. “Medications can be part of effective treatment, but they require an extra layer of care. The answer is not to stop prescribing medications to those who stand to benefit, but rather to emphasize the practice of safe storage and vigilance when administering any kind of medicine, especially when children and teens live in the home.”

The study also found that places with a lower population per square mile (rural areas) had a greater number of reported cases with all outcomes and serious medical outcomes. Results also revealed there was a significant decrease in the number of cases in school-aged individuals during non-school months of June through August (27.5% decrease in 10-12-year-olds; 27.3% decrease in 13-15-year-olds; and 18.3% decrease in 16-18-year-olds), compared with school months September through May.

This issue is worth highlighting for the LGBTQIA community because 50.8% of transmasculine adolescents between the ages of 11 and 19 have attempted suicide at least once, while 41.8% of nonbinary adolescents – those who don’t identify as exclusively male or exclusively female – have attempted suicide.

Nationwide Children’s Big Lots Behavioral Health experts recommend that parents check in with their children regularly, and ask them directly how they are doing and if they have ever had thoughts about ending their life. These direct questions are even more critical if warning signs of suicide are observed. Medications should be stored up, away and out of sight, preferably in a locked cabinet. Administration of medicine should always be supervised.

“It should concern us that youth in rural areas are about twice as likely as those living in urban areas to die by suicide. Although we are in dire need of more research to help us understand what places some people at more risk than others, available evidence indicates that include increased social isolation, stigma, access to lethal means and lack of appropriate mental health resources may play a role in this disparity,” said Ackerman. “It is vital that parents, teachers and other trusted adults start conversations about mental health early, and pay even closer attention during the school year, as rates of anxiety and depression are shown to increase during that time. Warning signs can often be detected and support is available for young people in crisis.”

Dr. Ackerman recommends parents start now to increase the dialogue and have important conversations as a family.