INTRODUCTION There are several techniques for creation of a neovagina in male-to-female reassignment surgery. Although vaginoplasty with the sigmoid colon is not a common procedure, it is becoming more common. Perforation of the recto-sigmoid neovagina after sex reassignment surgery is very rare. We hereby report a case of perforation of the neovagina that presented as acute peritonitis, with a...

BACKGROUND We prospectively studied outcomes of sex reassignment, potential differences between subgroups of transsexuals, and predictors of treatment course and outcome. METHOD Altogether 325 consecutive adolescent and adult applicants for sex reassignment participated: 222 started hormone treatment, 103 did not; 188 completed and 34 dropped out of treatment. Only data of the 162 adults were...

The health impact attributable to climate change has been identified as one of the priority areas for impact assessment. The main goal of this paper is to estimate the monetary value of one key health effect, which is premature mortality. Specifically, our goal is to derive the value of a statistical life from people's willingness to pay for avoiding the risk of dying in one post-transition cou...

In this chapter, I summarize the use of interventions used by leaders in cultural change. First, I examine the use of interactive and meaningful interventions. Then, I look at structural and learning interventions. Power and conflict interventions are also elucidated. I then consider the relationship between interventions and change strategies. Finally, I discuss possibilities to combine interv...

BACKGROUND While there is evidence to suggest that teaching practices in clinical education should include activities that more accurately reflect the real world, many educators base their teaching on transmission models that encourage the rote learning of knowledge and technical skills. Technology-mediated instruction may facilitate the development of professional attributes that go beyond "ha...

This article examines age variations in support for climate change policies in a sample of over 14,000 respondents to a 1999 Eurobarometer survey. There is a steady decline with age in whether respondents are willing to incur higher gasoline taxes to protect the environment and in the amount of gasoline taxes they are willing to pay. This relationship remains even controlling for demographic ch...

The paper describes a series of perceptual experiments in which the prosodic parameters F0, energy, voicing and timing of utterances were systematically altered and the resulting speech resynthesised for a group of listeners. Using the linear-prediction source/filter model of production composite neutral spectral models were composed from the speech of two or more speakers. Listener responses o...

Note: We discuss the use of gonadotropin-releasing hormone analogs for puberty suppression in adolescents who have gender dysphoria, but this is not a U.S. Food and Drug Administration-approved use of these drugs. AUTHOR DISCLOSURE Drs Lopez, Stewart, and Jacobson-Dickman have disclosed no financial relationships relevant to this article. This commentary does contain a discussion of an unapprov...

In this paper we introduce Clima Futura, a game about climate change. The primary aim of Clima Futura is to gain experience with the parameters affecting climate change and to give access to climate change related research in a playful manner. The concept for the game has been developed as a submission for the yearly Dutch contest for the communication of science. In this paper we will give an ...