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Article ; Online: Pathways to Care for Adolescents Attending a First Hormone Appointment at Canadian Gender Affirming Medical Clinics: A Cross-Sectional Analysis From the Trans Youth CAN! Study.

Lawson, Margaret L / Gotovac, Sandra / Couch, Bob / Gale, Lorraine / Vandermorris, Ashley / Ghosh, Shuvo / Bauer, Greta R

The Journal of adolescent health : official publication of the Society for Adolescent Medicine

2023 Volume 74, Issue 1, Page(s) 140–147

Abstract: Purpose: Limited research has examined adolescents' pathways to gender-affirming medical care.: Methods: Enrollment in Trans Youth CAN! was at an initial appointment for hormone suppression or gender-affirming hormones, if pubertal or postpubertal, ... ...

Abstract	Purpose: Limited research has examined adolescents' pathways to gender-affirming medical care. Methods: Enrollment in Trans Youth CAN! was at an initial appointment for hormone suppression or gender-affirming hormones, if pubertal or postpubertal, and < 16 years old. Adolescent/parent surveys and clinical records were obtained for 174 adolescents and 160 matched parents at 10 medical clinics across Canada. Results: Participants' mean age was 14.3 years, 95% confidence interval (CI) [14.1-14.6]; 126 (75.8%) identified as boys, 32 (15.9%) girls, and 14 (8.3%) nonbinary. Average wait time after referral was 269 days (95% CI [244, 294]). Adolescents reported 13.5 months seeking gender-affirming medical care, longer than reported by their parents (p = .0001). Family physicians or pediatricians provided 68% of referrals. Prior to clinic, adolescents saw an average of 2.7 (maximum eight) different types of providers (95% CI [2.4, 2.9]). Indigenous background and greater number of types of providers seen were associated with longer time seeking care. The majority of adolescents had ever engaged in self-harm (67.6%), with 58.1% ever seriously considering suicide and 36.0% attempting. Previous self-harm and suicidal thoughts were associated with longer wait times and older age. Seventeen point seven percent of parents/caregivers reported their adolescents had participated in conversion therapy or that parents had considered it. Discussion: The majority of participants were referred by family physicians or pediatricians, seeing multiple types of providers regarding their gender prior to referral. Adolescents experienced significant wait times. Indigenous adolescents reported longer times seeking care. Adolescents with longer wait times were more likely to have ever engaged in self-harm or had suicidal ideation.
MeSH term(s)	Male ; Female ; Humans ; Adolescent ; Transgender Persons ; Cross-Sectional Studies ; Canada ; Gender Identity ; Hormones
Chemical Substances	Hormones
Language	English
Publishing date	2023-10-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1063374-1
ISSN	1879-1972 ; 1054-139X
ISSN (online)	1879-1972
ISSN	1054-139X
DOI	10.1016/j.jadohealth.2023.07.021
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Article ; Online: Words with weight: The construction of obesity in eating disorders research.

Gotovac, Sandra / LaMarre, Andrea / Lafreniere, Kathryn

Health (London, England : 1997)

2018 Volume 24, Issue 2, Page(s) 113–131

Abstract: In current public health discourse, obesity is conceptualized as a disease epidemic, with treatment being weight loss. The pursuit of weight loss as a treatment for the "disease" of obesity is in direct contradiction to the history of research in eating ... ...

Abstract	In current public health discourse, obesity is conceptualized as a disease epidemic, with treatment being weight loss. The pursuit of weight loss as a treatment for the "disease" of obesity is in direct contradiction to the history of research in eating disorders, which has demonstrated the risks for the development of eating disorders. In this study, we critically examined the eating disorder literature to explore this contradiction. We analyzed 30 of the top-cited articles in the eating disorder literature between 1994 and 2011, asking: how is the concept of obesity examined in eating disorder research? We identified tensions related to body mass index and the perceived associated risks of lower or higher body mass index, assumptions of the "causes" of fatness (i.e. overeating and inactivity), and the anti-diet voice challenging the prescription of dieting for those in fat bodies. In our analysis, we highlight the problematics of, for instance, prescribing a body mass index range of 20-24 in eating disorder recovery, how many studies in eating disorders do not problematize the presumption that a higher body mass index is necessarily associated with ill health, and a lack of cultural sensitivity and acknowledgment of intersectional spaces of belonging. We discuss these themes in the context of biomedical discourses of obesity contributing to the cultural thin ideal. We argue that biomedical discourses on obesity contribute to the thin ideal nuanced against discourses of healthism that permeate our society. Rather than an ideal of emaciation, it is an ideal of a healthy, productive person, often constructed as morally superior. The moral panic around obesity is evident throughout the eating disorder literature, which is a concern given that we would hope that the aim of eating disorder treatment would be to promote wellness for all-not only those who are thin.
MeSH term(s)	Biomedical Research ; Body Image ; Body Mass Index ; Feeding Behavior ; Feeding and Eating Disorders ; Humans ; Obesity/psychology ; Weight Loss
Language	English
Publishing date	2018-07-11
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1338717-0
ISSN	1461-7196 ; 1363-4593
ISSN (online)	1461-7196
ISSN	1363-4593
DOI	10.1177/1363459318785706
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Article ; Online: Experiences and Stressors of Parents of Trans and Gender-Diverse Youth in Clinical Care from Trans Youth CAN!

Pullen Sansfaçon, Annie / Temple Newhook, Julia / Douglas, Laura / Gotovac, Sandra / Raiche, Joe / Speechley, Kathy Nixon / Lawson, Margaret L / Bauer, Greta R

Health & social work

2022 Volume 47, Issue 2, Page(s) 92–101

Abstract: Parents of trans and gender-diverse youth can experience challenges navigating gender-affirming (GA) care such as stigma, transphobia, and lack of support. There is little information available about stressors, worries, and positive feelings of parents ... ...

Abstract	Parents of trans and gender-diverse youth can experience challenges navigating gender-affirming (GA) care such as stigma, transphobia, and lack of support. There is little information available about stressors, worries, and positive feelings of parents as they try to support their youth accessing GA care. This article presents baseline survey data on experiences and stressors of 160 parents/caregivers in the Trans Youth CAN! cohort study, which examined medical, social, and family outcomes in youth age 16 years or younger considering puberty blockers or GA hormones. Data were collected at 10 Canadian gender clinics. Authors report on participating parents' characteristics, levels of support toward youth, stressors, worries, concerns, and positive feelings related to youth's gender. Most parent participants were White (85.1 percent), female (85.1 percent), birth or adoptive parents (96.1 percent), and reported strong support for youth's gender. Participants' concerns included their youth facing rejection (81.9 percent), generalized transphobia (74.6 percent), or encountering violence (76.4 percent). Parents also reported positive feelings about seeing their youth grow more confident. Most parental worries and stressors were situated outside the family, reflecting the systemic discrimination faced by youth and their families. Social workers could address these by developing systems-focused interventions and by further taking into account intersectional health disparities.
MeSH term(s)	Adolescent ; Canada ; Cohort Studies ; Female ; Gender Identity ; Humans ; Parents ; Transgender Persons
Language	English
Publishing date	2022-03-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	448861-1
ISSN	1545-6854 ; 0360-7283
ISSN (online)	1545-6854
ISSN	0360-7283
DOI	10.1093/hsw/hlac003
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Article: Perceptions of sexual assault victims/survivors: the influence of sexual history and body weight.

Gotovac, Sandra / Towson, Shelagh

Violence and victims

2015 Volume 30, Issue 1, Page(s) 66–80

Abstract: The intersection between a woman's body weight and sexual history and the victim blaming attitudes of future health care providers was investigated. University undergraduate students (N = 91) enrolled in programs associated with the provision of health ... ...

Abstract	The intersection between a woman's body weight and sexual history and the victim blaming attitudes of future health care providers was investigated. University undergraduate students (N = 91) enrolled in programs associated with the provision of health care read 1 of 4 patient files of a woman reporting a rape as well as 2 distracter files. Results showed that, for overweight rape victims/survivors, study participants' antifat attitudes were correlated with victim blaming attitudes. Male participants held the attacker significantly less responsible than did female participants if the victim/survivor had several previous sexual partners. Findings suggest that body weight should be considered as a contributing factor in attitudes toward rape victims/survivors, and the gender of the health care provider can be a factor in the post-assault treatment of overweight rape victims/survivors.
MeSH term(s)	Adult ; Attitude to Health ; Body Weight ; Canada ; Crime Victims/psychology ; Female ; Humans ; Judgment ; Male ; Middle Aged ; Obesity/psychology ; Public Opinion ; Rape/psychology ; Social Perception ; Students/statistics & numerical data ; Universities ; Young Adult
Language	English
Publishing date	2015-03-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	639280-5
ISSN	1945-7073 ; 0886-6708
ISSN (online)	1945-7073
ISSN	0886-6708
DOI	10.1891/0886-6708.vv-d-12-00168
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Article: Visual-Based Person Detection for Search-and-Rescue with UAS: Humans vs. Machine Learning Algorithm

Gotovac, Sven / Zelenika, Danijel / Marušić, Željko / Božić-Štulić, Dunja

Remote Sensing. 2020 Oct. 10, v. 12, no. 20

2020

Abstract: Unmanned Aircraft Systems (UASs) have been recognized as an important resource in search-and-rescue (SAR) missions and, as such, have been used by the Croatian Mountain Search and Rescue (CMRS) service for over seven years. The UAS scans and photographs ... ...

Abstract	Unmanned Aircraft Systems (UASs) have been recognized as an important resource in search-and-rescue (SAR) missions and, as such, have been used by the Croatian Mountain Search and Rescue (CMRS) service for over seven years. The UAS scans and photographs the terrain. The high-resolution images are afterwards analyzed by SAR members to detect missing persons or to find some usable trace. It is a drawn out, tiresome process prone to human error. To facilitate and speed up mission image processing and increase detection accuracy, we have developed several image-processing algorithms. The latest are convolutional neural network (CNN)-based. CNNs were trained on a specially developed image database, named HERIDAL. Although these algorithms achieve excellent recall, the efficiency of the algorithm in actual SAR missions and its comparison with expert detection must be investigated. A series of mission simulations are planned and recorded for this purpose. They are processed and labelled by a developed algorithm. A web application was developed by which experts analyzed raw and processed mission images. The algorithm achieved better recall compared to an expert, but the experts achieved better accuracy when they analyzed images that were already processed and labelled.
Keywords	Internet ; accuracy ; algorithms ; artificial intelligence ; databases ; detection ; experts ; humans ; image analysis ; landscapes ; photographs ; remote sensing ; unmanned aerial vehicles
Language	English
Dates of publication	2020-1010
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
Note	NAL-light
ZDB-ID	2513863-7
ISSN	2072-4292
ISSN	2072-4292
DOI	10.3390/rs12203295
Database	NAL-Catalogue (AGRICOLA)

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Article: Evaluating Training Programs for Primary Care Providers in Child/Adolescent Mental Health in Canada: A Systematic Review.

Gotovac, Sandra / Espinet, Stacey / Naqvi, Reza / Lingard, Lorelei / Steele, Margaret

Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent

2018 Volume 27, Issue 2, Page(s) 99–111

Abstract: Introduction: The need for child/adolescent mental health care in Canada is growing. Primary care can play a key role in filling this gap, yet most providers feel they do not have adequate training. This paper reviews the Canadian literature on capacity ...

Abstract	Introduction: The need for child/adolescent mental health care in Canada is growing. Primary care can play a key role in filling this gap, yet most providers feel they do not have adequate training. This paper reviews the Canadian literature on capacity building programs in child and adolescent psychiatry for primary care providers, to examine how these programs are being implemented and evaluated to contribute to evidence-based initiatives. Methods: A systematic literature review of peer-reviewed published articles of capacity building initiatives in child/adolescent mental health care for primary care practitioners that have been implemented in Canada. Results: Sixteen articles were identified that met inclusion criteria. Analysis revealed that capacity building initiatives in Canada are varied but rigorous evaluation methodology is lacking. Primary care providers welcome efforts to increase mental health care capacity and were satisfied with the implementation of most programs. Discussion: Objective conclusions regarding the effectiveness of these programs to increase mental health care capacity is challenging given the evaluation methodology of these studies. Conclusion: Rigorous evaluation methods are needed to make evidence-based decisions on ways forward to be able to build child/adolescent mental health care capacity in primary care. Outcome measures need to move beyond self-report to more objective measures, and should expand the measurement of patient outcomes to ensure that these initiative are indeed leading to improved care for families.
Language	English
Publishing date	2018-04-01
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2381637-5
ISSN	2293-6122 ; 1719-8429
ISSN (online)	2293-6122
ISSN	1719-8429
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: A Study Protocol for the "Practitioner Training in Child and Adolescent Psychiatry" Cluster-randomized Pilot Study.

Espinet, Stacey D / Gotovac, Sandra / Knight, Sommer / Zwarenstein, Merrick / Lingard, Lorelei / Steele, Margaret

Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent

2018 Volume 27, Issue 4, Page(s) 236–244

Abstract: Background: Primary care providers (PCPs) are increasingly called upon to assist in meeting the growing demand for paediatric mental health care in Canada, yet they report inadequate training and confidence to do so. The Practitioner Training in Child ... ...

Abstract	Background: Primary care providers (PCPs) are increasingly called upon to assist in meeting the growing demand for paediatric mental health care in Canada, yet they report inadequate training and confidence to do so. The Practitioner Training in Child and Adolescent Psychiatry (PTCAP) program was designed to fill this gap by teaching PCPs the skills needed to provide frontline care themselves, particularly in rural/remote regions where specialist resources are limited. This innovative educational intervention may improve paediatric mental health care capacity, but a pilot study is needed. Methods: We designed a cluster randomized, controlled pilot of PTCAP. Random assignment to intervention or control (treatment-as-usual) will occur at the practice level. Participating PCPs (N=61) at sites randomized to intervention will receive eight hours of training in the use of practice guidelines and brief counseling techniques (i.e., common skills/elements) for addressing diagnosable conditions and more general, transdiagnostic concerns. Mental health care capacity at one-week post-intervention will be the primary outcome, assessed through self-report questionnaires of mental health care confidence, and through a more objective, observational assessment of trained skills. We will also examine retention of these skills at one-month follow-up. We expect use of trained common skills/elements to be associated with better child mental health outcomes on the Strengths and Difficulties Questionnaire (N = 250). Discussion: As one of the first RCTs of its kind in Canada, this study will provide unique, preliminary evidence in regards to the feasibility and efficacy of the PTCAP intervention for enhancing rural, paediatric mental health care capacity.
Language	English
Publishing date	2018-11-01
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2381637-5
ISSN	2293-6122 ; 1719-8429
ISSN (online)	2293-6122
ISSN	1719-8429
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Primary Care Practitioner Training in Child and Adolescent Psychiatry (PTCAP): A Cluster-Randomized Trial.

Espinet, Stacey D / Gotovac, Sandra / Knight, Sommer / Wissow, Larry / Zwarenstein, Merrick / Lingard, Lorelei / Steele, Margaret

Canadian journal of psychiatry. Revue canadienne de psychiatrie

2019 Volume 65, Issue 5, Page(s) 319–329

Abstract: Objectives: Rural primary care practitioners (PCPs) have a pivotal role to play in frontline pediatric mental health care, given limited options for referral and consultation. Yet they report a lack of adequate training and confidence to provide this ... ...

Abstract	Objectives: Rural primary care practitioners (PCPs) have a pivotal role to play in frontline pediatric mental health care, given limited options for referral and consultation. Yet they report a lack of adequate training and confidence to provide this care. The aim of this study was to test the effectiveness of the Practitioner Training in Child and Adolescent Psychiatry (PTCAP) program, which was designed to enhance PCPs' pediatric mental health care confidence. The program includes brief therapeutic skills and practice guidelines PCPs can use to address both subthreshold concerns and diagnosable conditions, themselves. Methods: The study design was a pilot, cluster-randomized, multicenter trial. Practices were randomly assigned to intervention ( Results: Findings were a statistically significant difference in the primary outcomes. Compared to the control group, the intervention group indicated significantly greater confidence in managing Conclusion: PTCAP enhances PCPs' child/youth mental health care confidence in managing both general and diagnosable concerns. However, an 8-hr session focused on applying brief therapeutic skills was insufficient to significantly change attitudes and knowledge. Formal testing of PTCAP may be warranted, perhaps using more intensive training and including outcome assessments capable of determining whether increased PCP confidence translates to more effective management and better patient outcomes.
MeSH term(s)	Adolescent ; Adolescent Psychiatry ; Attention Deficit Disorder with Hyperactivity ; Child ; Family ; Humans ; Primary Health Care ; Referral and Consultation
Language	English
Publishing date	2019-12-09
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	304227-3
ISSN	1497-0015 ; 0008-4824 ; 0706-7437
ISSN (online)	1497-0015
ISSN	0008-4824 ; 0706-7437
DOI	10.1177/0706743719890161
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Zs.A 110: Show issues

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Article ; Online: Transgender Youth Referred to Clinics for Gender-Affirming Medical Care in Canada.

Bauer, Greta R / Pacaud, Danièle / Couch, Robert / Metzger, Daniel L / Gale, Lorraine / Gotovac, Sandra / Mokashi, Arati / Feder, Stephen / Raiche, Joe / Speechley, Kathy Nixon / Temple Newhook, Julia / Ghosh, Shuvo / Sansfaçon, Annie Pullen / Susset, Françoise / Lawson, Margaret L

Pediatrics

2021 Volume 148, Issue 5

Abstract: Background and objectives: Referrals of transgender and gender-diverse (trans) youth to medical clinics for gender-affirming care have increased. We described characteristics of trans youth in Canada at first referral visit.: Methods: Baseline ... ...

Abstract	Background and objectives: Referrals of transgender and gender-diverse (trans) youth to medical clinics for gender-affirming care have increased. We described characteristics of trans youth in Canada at first referral visit. Methods: Baseline clinical and survey data (2017-2019) were collected for Trans Youth CAN!, a 10-clinic prospective cohort of Results: Of youth, 137 were transmasculine (assigned female) and 37 transfeminine (assigned male); 69.0% were aged 14 to 15, 18.8% Indigenous, 6.6% visible minorities, 25.7% from immigrant families, and 27.1% low income. Most (66.0%) were gender-aware before age 12. Only 58.1% of transfeminine youth lived in their gender full-time versus 90.1% of transmasculine ( Conclusions: Trans youth in Canada attending clinics for hormonal suppression or gender-affirming hormones were generally healthy but with depression, anxiety, and support needs.
MeSH term(s)	Adolescent ; Awareness ; Canada ; Child ; Depression/diagnosis ; Estrogens/therapeutic use ; Female ; Gender Dysphoria/drug therapy ; Gender Dysphoria/psychology ; Gender Identity ; Health Status ; Hormone Antagonists/therapeutic use ; Humans ; Indigenous Peoples/statistics & numerical data ; Leuprolide/therapeutic use ; Male ; Poverty/statistics & numerical data ; Prospective Studies ; Referral and Consultation ; Social Environment ; Suicidal Ideation ; Suicide, Attempted/statistics & numerical data ; Testosterone/therapeutic use ; Transgender Persons/psychology ; Transgender Persons/statistics & numerical data
Chemical Substances	Estrogens ; Hormone Antagonists ; Testosterone (3XMK78S47O) ; Leuprolide (EFY6W0M8TG)
Language	English
Publishing date	2021-10-07
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	207677-9
ISSN	1098-4275 ; 0031-4005
ISSN (online)	1098-4275
ISSN	0031-4005
DOI	10.1542/peds.2020-047266
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Zs.MO 357: Show issues

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Book ; Thesis: Geschalteter Reluktanzmotor für Positionierantriebe

Gotovac, Sven

1994

Author's details	von Sven Gotovac
Language	Undetermined
Size	II, 133 S, graph. Darst
Document type	Book ; Thesis
Thesis / German Habilitation thesis	@Berlin, Techn. Univ., Diss. : 1994
Database	Library catalogue of the German National Library of Science and Technology (TIB), Hannover

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