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In multivariable analyses, voice was linked to all forms of SRH communication in Kinshasa and Cuenca with adjusted odds ratios ranging from 1.6 to 2.2, but not in Shanghai. In Cuenca, decision-making was associated with a 50% and 60% increase in odds of communication about pregnancy and contraception, respectively. In Kinshasa, a stronger association between voice and pregnancy discussions was observed for girls than boys. CONCLUSIONS Developmental characteristics and voice were linked to communication about SRH among young adolescents across two contexts. Results suggest agency may play a role in shaping antecedents, like communication, to sexual behaviors. PURPOSE Untreated major depression can lead to various negative health and social consequences among adolescents. This study aimed to examine national patterns, temporal trends, and factors related to U.S. adolescents' mental health service use for 12-month major depression across service settings. METHODS Data on adolescents aged 12-17 years who received treatment for their 12-month major depression were drawn from the National Survey on Drug Use and Health, 2011-2018. Patterns, trends, and factors related to adolescents' service use in specialty mental health, educational, and general medical settings and multiple settings were examined using bivariate and multivariate logistic regression. RESULTS Across the survey years, service use in specialty mental health settings was the most common, followed by educational and general medical settings. A significant increase was observed in adolescents' specialty mental health service use (p less then .001) over time, whereas the rates of service use in educational and general medical settings remained stable. Approximately 40% of adolescents who were treated for 12-month depression received services in multiple settings each year, with no significant change over time. Among multisetting service users, combined service use in specialty mental health and educational settings was the most common. Adolescents' age, race, gender, insurance status, family income, and school experiences significantly influenced their service use across settings. CONCLUSIONS Continued efforts are needed to improve service provision for adolescents with depression, especially in educational and general medical settings. Strengthened funding and policy support are warranted to expand safety-net mental health services for uninsured, low-income, and racial/ethnic minority adolescents. INTRODUCTION The NHS breast screening programme only employs female mammographers to carry out breast screening. The screening service is experiencing a shortage of staff and introducing male mammographers into the service is a potential solution. This research aimed to determine if the introduction of male mammographers would impact acceptance rates of the offer of screening, how women feel about the potential change and what the impact would be at a programme level. METHODS The research was conducted in 3 stages. selleck compound Initially 24 face-to-face interviews were conducted with women aged 45-70 and 19 interviews over the telephone with stakeholders; these interviews explored what women's reaction would be to the introduction of male mammographers. These interviews informed the content of a questionnaire that was completed online by 1000 women aged 50-71. It explored what women would do if offered a test with a male mammographer and how they felt about the potential change. RESULTS Over half, 53.4% stated they would attend a routine mammogram if the mammographer was male, 15.3% said they would attend if a female chaperone was present, and 31.3% stated they would refuse to attend. The face-to-face interviews suggested women view routine breast screening differently to other healthcare interactions because it is an optional service and not a treatment. As a result, participants had higher expectations both in terms of expecting a choice over the gender of the mammographer and a need to feel comfortable. CONCLUSION AND IMPLICATIONS FOR PRACTICE The findings indicate that the percentage of eligible women attending breast screening may decrease if male mammographers were introduced. This impact of introducing male mammographers would need to be carefully weighed up against the potential gains in workforce numbers in opening up mammography to male practitioners. BACKGROUND Primary Bone Lymphoma can be challenging to interpret even for the experienced reviewer. This case demonstrates the subtle multimodality appearances encountered. CASE SUMMARY a gentleman in his late 70s with one week history of groin pain underwent plain radiography and subsequent further imaging. Only following biopsy was the diagnosis of primary bone lymphoma made for which the patient has received successful treatment. CONCLUSION This case demonstrates the difficulties in identifying lymphoma when seen within the musculoskeletal system. It also provides opportunity to reflect on the importance of initial imaging, good quality history and understanding of differentials. Combination of corticosteroids (CS) with cyclosporin A (CsA) is widely used in the treatment of autoimmune diseases, autoinflammatory diseases and transplantation rejection. However, some patients fail to respond or develop resistance to the combination regimen. In Vogt-Koyanagi-Harada (VKH) disease model, we performed RNA sequencing (RNA-seq) based transcriptomics, isobaric tags for relative and absolute quantification (iTRAQ) based proteomics and assays in vitro to screen and validate potential resistant molecules. We found that a total of 1697 differentially expressed genes (DEGs) and 21 differentially expressed proteins (DEPs) in CD4+ T cells between CsA & CS-resistant and -sensitive VKH patients. Ribosomal Protein S4, Y-Linked 1 (RPS4Y1) was verified to regulate the resistance of CD4+ T cells from male VKH patients to CsA & CS. Importantly, we showed that chlorambucil (CLB) could reverse the resistance by RPS4Y1 suppression. Taken together, we identify RPS4Y1 as an important CsA & CS resistance gene in VKH disease. Researchers should consider validating the resistant effect of RPS4Y1 in other autoimmune diseases or organ transplantation.

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