Future national surveys are likely to observe higher numbers of transgender people. The large variety in questions used to ask about transgender identity may account for residual heterogeneity in our models. Public health implications. Under- or nonrepresentation of transgender individuals in population surveys is a barrier to understanding social determinants and health disparities faced by this population. We recommend using standardized questions to identify respondents with transgender and nonbinary gender identities, which will allow a more accurate population size estimate.

Research on brain areas involved in experiencing emotion and physical pain is abundant; however, psychological pain has received little attention in studies of the brain. The purpose of this systematic review was to provide an overview of studies on brain function related to psychological pain. The review was limited to studies in which participants experienced actual psychological pain or recalled a significant autobiographical event that may be assumed to have involved psychological pain. Based on results of the studies (N = 18), a tentative neural network for psychological pain is proposed that includes the thalamus, anterior and posterior cingulate cortex, the prefrontal cortex, cerebellum, and parahippocampal gyrus. Results indicated that grief may be a more accurate exemplar of psychological pain than recalled sadness, with indications of greater arousal during psychological pain. The proposed neural network for psychological pain overlaps to some extent with brain regions involved in physical pain, but results suggest a markedly reduced role for the insula, caudate, and putamen during psychological pain. Psychological pain is well known for its association with depression and as a precursor of suicidal behavior. Thus, identification of brain areas involved in psychological pain may help guide development of interventions to decrease mortality and morbidity.

No abstract

Aims and objectives. The purpose of this study is to develop -from the patients' perspective -a tentative theoretical model explaining the effectiveness of inpatient nursing care of adolescents diagnosed with anorexia nervosa. Background. The continuous and direct involvement of nurses with patients is likely to play a significant role in the recovery process of patients with anorexia nervosa. However, only limited evidence is available on what patients with anorexia nervosa themselves consider important and effective in terms of nursing care. Design. The design of this study was qualitative. Methods. A grounded theory approach was applied where 13 adolescents with anorexia nervosa were interviewed to generate data for the model. Results. Participants stated that nurses contributed significantly to their recovery from anorexia nervosa. Three recurring themes emerged from the data: (1) normalisation, (2) structure and (3) responsibility. The focus of nursing care with respect to these themes shifted during the phases of recovery. Conclusions. Based on patients' experiences a theoretical model is developed describing effective nursing care of adolescents diagnosed with anorexia nervosa. Patients identified the key components of this model as essential to their weight recovery. Relevance to clinical practice. The model may be used to improve the quality of nursing care of adolescents diagnosed with anorexia nervosa through analysis of current practice with respect to the key components of our model. Interventions that are based on these components closely follow the patients' needs.