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Objective: Gender nonconformity refers to individuals whose gender identity, roles, or expressions do not adhere to societal standards and norms. Affirmative care is an approach to healthcare delivery in which organizations, programs, and providers recognize, validate, and support the identity stated or expressed by the individuals served. This study examined the effects of nonsurgical interventions performed by dermatologists, specifically botulinum toxins (BoNTA) and dermal filler injections, on the physical and mental health of Filipino gender nonconforming individuals. Methods: Six gender nonconforming patients received filler and BoNTA injections to enhance their desired facial features. The patients were interviewed before and three months after the treatment session. Baseline and three months posttreatment photos were used to examine treatment results, including the facial width-to-height ratio (FWHR). Three months after treatment, the patients answered a five-question Likert-scale satisfaction survey. Results: Patients reported high satisfaction with the treatment outcomes (median=5) and agreed that the treatment met their expectations (median=5). They reported improved fine lines and wrinkles (median=5) and increased self-confidence (median=5). All participants strongly recommended the treatment to others (median=5). Changes in FWHR varied among participants who requested a feminine appearance, except for one participant who sought a masculine appearance and whose FWHR increased. Conclusion: Sensitivity, openness, and knowledge regarding the facial aspirations and treatment preferences of gender nonconforming patients can improve outcomes and increase patient satisfaction in this patient population.

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This paper outlines the psychosocial impacts of the COVID-19 pandemic as reported by 145 licensed mental health providers in the Philippines in an online survey. Respondents perceived an increase in observed mental health disorders in their beneficiaries and an overall decrease in stigma associated with receiving mental health care services during the pandemic. Respondents further identified specific stigma-related help-seeking barriers during the pandemic. Positive impacts of telehealth and importance of increased public education of mental health were highlighted, with implications for improving the landscape of mental health care for Philippines post-pandemic.

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@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Medication errors are preventable events that can cause or lead to inappropriate drug use. Knowing the prevalence and types of errors can help us institute corrective measures and avoid adverse drug events.<br /><strong>OBJECTIVE:</strong> This study determined the prevalence of medication errors and its specific types in the four main service wards of a tertiary government training medical center.<br /><strong>METHODS:</strong> This is a retrospective, descriptive chart review study. From the master list of admissions, systematic sampling was done to retrieve the required number of charts. Relevant pages such as order sheets, nurses' notes, therapeutic sheets were photographed. For prolonged admissions, only the first 7 days were reviewed. Each chart was evaluated by two people who then met and agreed on the errors identified.<br /><strong>RESULTS:</strong> The overall prevalence of medication errors is 97.8%. Pediatrics had the most (63.3/chart), followed by Medicine, OB-Gynecology, and Surgery (7.3/chart). The most common type of errors identified were prescribing, followed by compliance, then administration errors.<br /><strong>CONCLUSION:</strong> Medication errors are present in the four main wards in our hospital. We recommend orientation of all incoming first year residents on proper ordering and prescribing of drugs, as well as a prospective observational study to determine true prevalence of all types of medication errors.</p>

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Over half of human genome contains retroelements, including retrotransposons, retroviruses, and other elements. Human endogenous retroviruses (HERVs) comprise about 8% of human genome. The products of 2 of 16 identified genes of HERV-W seem to play a pivotal role in the placentation. These 2 genes are HERV-W env glycoprotein (syncytin-1) and HERV-FRD env glycoprotein (syncytin-2). It has been shown previously that syncytin-1 mediates cell-cell fusions of cytotrophoblasts into syncytiotrophoblasts. In addition, HERV-W env contains an immunosuppressive region that may prevent rejection of a semiallogenic fetus from the mother's immune system. We analyzed 40 full-term placental tissues to localize the expression of syncytin-1-ISR by immunohistochemical staining and by reverse trancscriptase (RT) in situ polymerase chain reaction (PCR). Both the immunostaining and in situ RT-PCR showed strong expression of syncytin-1 in the syncytiotrophoblast layer from the full-term placental tissues. To further analyze the mechanism of early embryo HERV-W env activation, we utilized a HTR-8/SVneo cell line developed from first trimester human trophoblasts and subjected them to various physiologic concentrations of maternal hormones. Quantitative RT-PCR analyses demonstrated that exposure to progesterone significantly upregulated the HERV-W env expression, whereas several other hormones apparently played lesser roles. In conclusion, our findings suggest that expression of syncytin-1 (HERV-W env) in utero is expressed exclusively in the syncytiotrophoblast layer and is upregulated by progesterone.

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The adolescent with same-sex attraction in the twenty-first century straddles ambivalent cultural and religious attitudes regarding gay, lesbian, bisexual, or transgender (GLBT) issues; rapid technologic advances that provide easy access to information on sex and sex partners; and the clinician's sensitivity about GLBT issues and his or her awareness of how adolescents can use technology for sex-seeking behavior. It is necessary to deconstruct these factors into defined frameworks. Three checklists, the Clinician's Framework Guide Questions for the GLBT Adolescent, Clinician Reaction to GLBT Issues Checklist, and Global GLBT Checklist for Biopsychosocial Risk Factors, may aid the clinician in acquiring an appreciation of the global dynamics between the gay adolescent, the clinician, and the impact of current social realities.

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