Mazzoni Center

Therapeutic strategies for prostate cancer (PCa) have been evolving dramatically worldwide. The current article reports on the evolution of surgical management strategies for PCa in Italy. The data from two independent Italian multicenter projects, the MIRROR-SIU/LUNA (started in 2007, holding data of 890 patients) and the Pros-IT-CNR project (started in 2014, with data of 692 patients), were compared. Differences in patients' characteristics were evaluated. Multivariable logistic regression models were used to identify characteristics associated with robot-assisted (RA) procedure, nerve sparing (NS) approach, and lymph node dissection (LND). The two cohorts did not differ in terms of age and prostate-specific antigen (PSA) levels at biopsy. Patients enrolled in the Pros-IT-CNR project more frequently were submitted to RA (58.8% vs 27.6%, p < 0.001) and NS prostatectomy (58.4% vs. 52.9%, p = 0.04), but received LND less frequently (47.7% vs. 76.7%, p < 0.001), as compared to the MIRROR-SIU/LUNA patients. At multivariate logistic models, Lower Gleason Scores (GS) and PSA levels were significantly associated with RA prostatectomy in both cohorts. As for the MIRROR-SIU/LUNA data, clinical T-stage was a predictor for NS (OR = 0.07 for T3, T4) and LND (OR = 2.41 for T2) procedures. As for Pros-IT CNR data, GS ≥ (4 + 3) and positive cancer cores ≥ 50% were decisive factors both for NS (OR 0.29 and 0.30) and LND (OR 7.53 and 2.31) strategies. PCa management has changed over the last decade in Italian centers: RA and NS procedures without LND have become the methods of choice to treat newly medium-high risk diagnosed PCa.

Research on the experiences of trans youth has generally emphasized their disparate risk for negative educational, housing, and health outcomes. While drawing attention to very real vulnerabilities, these depictions can represent trans youth as one-dimensional passive victims. Some recent research draws on resiliency theory and offers a strengths-based perspective highlighting the strategies trans youth employ and the resources they draw upon in the face of challenging circumstances. In this study, we look to the concept of situated agency as a way to understand how risk and resilience simultaneously characterize the high school experiences of trans youth. Through hearing their own accounts of daily life in a large urban public school district, we seek to understand their attitudes, behavior, and choices as strategies for coping, surviving and resisting the bureaucratic structures that create conflict by upholding traditional binary gender norms. In so doing, we seek to redirect the spotlight on the practices and systems that constrain trans youth agency—rather than the trans youth, themselves—as the most appropriate focus for intervention.

Transgender individuals are disproportionately affected by negative mental and sexual health outcomes. School nurses have prime opportunities to combat these outcomes through affirming nursing care, especially when transgender students are socially transitioning. Examples of affirming practice include recognizing students' gender-affirming names, using their pronouns, ensuring safe locker rooms, advocating for student's clothing choices, stopping bullying and harassment, and refraining from making assumptions about their transgender students' sexual orientation. Through inclusive care directly provided to transgender children, school nurses can also be instrumental in ushering an affirming environment for all.

Adipose tissue alterations (ATAs) were clinically assessed in 2258 HIV-1-infected outpatients consecutively observed in 6 Italian clinical centers and were found to be present in 29.5% of the men and 41.9% of the women. A logistic regression model including age, HIV disease Centers for Disease Control stage, CD4 cell counts, HIV RNA load, the duration of antiretroviral therapy, the number of drugs taken, and the use of d4T showed that men had a 0.47 adjusted risk of presenting with ATAs (95% CI: 0.38-0.58, P < 0.0001). The risks of having ATAs (except circumscribed lipomas) in any body region, presenting with fat accumulation, or being affected by combined forms of ATA were also lower in men, whereas the risk of developing pure lipoatrophy was similar in the 2 genders. Our results indicate that women are at higher risk of developing antiretroviral treatment-related ATAs and show a particular and complex ATA pattern.

One may be a general classroom music teacher in an elementary school, a high school orchestra director, or perform a combination of musical duties at a variety of grade levels. But despite the wide spectrum of specialties, all public school music teachers must be prepared educationally in the same manner, must compete in the same relative job market, and enjoy the same advantages and disadvantages of the ca-