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Here's a few that might answer the question...Stress relief from laughter? Yes, no jokeWhen it comes to relieving stress, more giggles and guffaws are just what the doctor ordered. Here's why.http://www.mayoclinic.com/health/stress-relief/SR00034Stress management: Prevent stress setbackshttp://www.mayoclinic.com/health/stress-management/SR00038/NSECTIONGROUP=2The following came from PubMed (http://www.ncbi.nlm.nih.gov/pubmed), a database of medical articles by the US federal govtI used the subject heading -->Laughter-TherapyThere were about 50 or so articles....few seemed to be scientific studies...here's a few of them-------Heart Lung. 2011 Jul-Aug;40(4):310-9. (This journal is not freely available online..ask a librarian at your local public or academic library how you might access the full text of this article)Effects of humor and laughter on psychological functioning, quality of life, health status, and pulmonary functioning among patients with chronic obstructive pulmonary disease: a preliminary investigation.Lebowitz KR, Suh S, Diaz PT, Emery CF.SourceDepartment of Psychiatry, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.AbstractOBJECTIVE:Previous research indicates the beneficial effects of humor among healthy adults. Little is known about the physical and psychological effects of sense of humor and laughter among patients with chronic obstructive pulmonary disease (COPD).METHODS:Patients with COPD (n = 46; mean age ± SD, 66.9 ± 9.9 years) completed assessments of sense of humor, depression, anxiety, quality of life, and recent illness. A subset of patients (n = 22) completed a laughter induction study and were randomly assigned to view either a humorous or a neutral video. Pulmonary function, mood state, and dyspnea were assessed before and after the video.RESULTS:Sense of humor was associated with fewer symptoms of depression and anxiety and an enhanced quality of life. However, the induction of laughter led to lung hyperinflation.CONCLUSION:Sense of humor among patients with COPD is associated with positive psychological functioning and enhanced quality of life, but laughing aloud may cause acute deterioration in pulmonary function secondary to worsened hyperinflation.---Geriatr Gerontol Int. 2011 Jul;11(3):267-74. doi: 10.1111/j.1447-0594.2010.00680.x. Epub 2011 Jan 17.Effects of laughter therapy on depression, cognition and sleep among the community-dwelling elderly.Ko HJ, Youn CH.SourceDepartment of Family Medicine, Kyungpook National University Hospital, Daegu, Korea.AbstractAIM:To investigate the effects of laughter therapy on depression, cognitive function, quality of life, and sleep of the elderly in a community.METHODS:Between July and September 2007, the total study sample consisted of 109 subjects aged over 65 divided into two groups; 48 subjects in the laughter therapygroup and 61 subjects in the control group. The subjects in the laughter therapy group underwent laughter therapy four times over 1 month. We compared Geriatric Depression Scale (GDS), Mini-Mental State Examination (MMSE), Short-Form Health Survey-36 (SF-36), Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) between the two groups before and after laughter therapy.RESULTS:There were no significant differences in baseline characteristics between the two groups. Before laughter therapy, the GDS scores were 7.98 ± 3.58 and 8.08 ± 3.96; the MMSE scores were 23.81 ± 3.90 and 22.74 ± 4.00; total scores of SF-36 were 54.77 ± 17.63 and 52.54 ± 21.31; the ISI scores were 8.00 ± 6.29 and 8.36 ± 6.38; the PSQI scores were 6.98 ± 3.41 and 7.38 ± 3.70 in laughter therapy group and control groups, respectively. After laughter therapy, the GDS scores were 6.94 ± 3.19 (P=0.027) and 8.43 ± 3.44 (P=0.422); the MMSE scores were 24.63 ± 3.53 (P=0.168) and 23.70 ± 3.85 (P=0.068); total scores of SF-36 were 52.24 ± 17.63 (P=0.347) and 50.32 ± 19.66 (P=0.392); the ISI scores were 7.58 ± 5.38 (P=0.327) and 9.31 ± 6.35 (P=0.019); the PSQI scores were 6.04 ± 2.35 (P=0.019) and 7.30 ± 3.74 (P=0.847) in both groups, respectively.CONCLUSION:Laughter therapy is considered to be useful, cost-effective and easily-accessible intervention that has positive effects on depression, insomnia, and sleep quality in the elderly.---Adv Mind Body Med. 2007 Winter;22(3-4):8-12.Humor, as an adjunct therapy in cardiac rehabilitation, attenuates catecholamines and myocardial infarction recurrence.Tan SA, Tan LG, Lukman ST, Berk LS.SourceSection of Endocrinology, Loma Linda University, Loma Linda, California, USA.AbstractBACKGROUND:Catecholamines, especially epinephrine, are implicated in causing arrhythmias, hypertension, and recurrence of myocardial infarction (MI). Diminishing or blocking the effect of catecholamines is useful in cardiac rehabilitation. We have shown previously that a single 1-hour viewing of a humorous video attenuates epinephrine production.DESIGN:We hypothesized that daily participation in viewing humor would diminish catecholamine production and improve cardiac rehabilitation.METHODS:Forty-eight diabetic patients who had recently experienced an MI were divided into 2 matched groups and followed for 1 year in their cardiac rehabilitation programs. The experimental humor group was asked to view self-selected humor for 30 minutes daily as an adjunct to the standard cardiac therapy. Blood pressure, urinary and plasma epinephrine and norepinephrine levels, and 24-hour Holter recording were monitored monthly in both experimental humor and control groups.RESULTS:The patients in the humor group had fewer episodes of arrhythmias, lower blood pressure, lower urinary and plasma epinephrine and norepinephrine levels, less use of nitroglycerin for angina, and a markedly lower incidence of recurrent MI (2/24) than did the control group (10/24).CONCLUSION:Humor appears to attenuate catecholamines and MI recurrence and thus may be an effective adjunct in post-MI care.

No.That is why they just elected London Breed as mayor.She recognizes that a large part of the “homeless problem” we have here has to do with mental illness, not housing.Chief among her short-term goals is addressing the city’s homeless population, particularly those struggling with mental health problems and drug addiction.She has made this a primary talking point since she was elected. She often goes against the status quo.Contrary to popular belief, she knows that the majority of homeless in San Francisco did in fact live here prior to their current state.69% of surveyed homeless residents were living in the City when they became homeless. Only 10% came from outside the state.However she does recognize that part of the problem does have to do with housing, but that simply providing more housing will not fix the problem.I will ensure that our City has the resources and effective policies in place to keep our residents housed, help those currently struggling with homelessness into housing, and provide the supportive services all of our residents need.Office of the MayorSF Mayor-elect London Breed says she wants to move quickly, look to futureIf you have ever volunteered at a homeless shelter, as I have, you would see, as London Breed has, that the people who end up homeless include families (with kids), and that fixing the issue is nowhere near as simple as some people think it is.Her plan, and ability to carry that out might not be perfect but it will not be based on the methods used up until now that have not worked out.A Bold Approach to Homelessness – London Breed – Medium

There have been. The problem is getting all or at least a representative sample of post-op patients to respond 5 or more years after the surgery. This problem plagues all types of follow up surveys, not just surveys on sex-reassignment surgery.The most trustworthy surveys follow up on patients from specific clinics. That way researchers have access to all their information, like their age, type of surgery, when it was performed and so on. The best-done survey (the first listed below) began with the intent to follow patients. That gave researchers a fairly uniform group (called a cohort) who were treated by the same clinic and the same group of doctors in the same time period. They began with a pre-op battery of quality of life surveys and followed up at 1, 3 and 5 years. By the fifth year, only 43 out of 190 responded.Reasons for loss to follow-up included deceased, moved abroad, and moving without forwarding address and no registration in the Swedish residential register.[1](There is an even bigger problem keeping track of research subjects for long-term studies in the US. We have no central database of addresses or medical records. Researchers only have so much time and money available to find people who have scattered or died.)Most surveys are done after the fact. In order to get a meaningful number of participants, researchers will get the records from a number of clinics that span a number of years with a variety of doctors and approaches. So right off the bat, the group isn’t even relatively uniform.The researchers will divide up the survey results by years after surgery, but the later years (as above) get underrepresented. The early years are when people with successful surgeries are most likely to feel good about them. Even if they aren’t perfectly happy, they’ll attribute it to adjusting to the change. It isn’t until after 3 years or so that if they’re still unhappy that they’re better able to see that their hopes for the surgery didn’t come about. At the least, they’ll feel embarrassed and more likely depressed if they blame themselves or feel hopeless. Those are the ones least likely to be motivated to participate in a survey. And obviously, a survey can’t get the opinions of the ones who have died or, worse, committed suicide.There are huge problems with online surveys. One, it’s impossible to post surveys in places that will reach everyone who had surgery. You might think trans groups would be a good place, but they’re the least likely places to find people who regret their surgery. Once people feel disconnected from their experience as trans people, they drop out of trans groups.Two, when people can opt-out of participating in a survey, researchers only get the opinions of those who have a strong desire to express their opinion. If the survey doesn’t get to the people who regret the surgery, the online survey will only gather data from those who are happy.Three, though there are various ways to prevent people from taking a survey more than once, it can still be a problem.Here are the surveys that popped up for me. The first lists several more in the last paragraph of the Introduction (sources 10–17).This survey, though well set up, couldn’t reach 77% of the participants by year 5.What happened to the 147 who didn’t respond? Did they move? Were they too busy or too bored with the survey? Did they die? Did they die a natural death, from complications of the surgery, from suicide unrelated to transitioning, from suicide because the surgery didn’t solve their problems? We don’t know.Year 5 showed a decline in quality of life. But what does that mean? That those who were not wildly happy or wildly unhappy didn’t feel like filling out the survey? That those who were dissatisfied were more likely to answer? (As a personal observation, people who feel they’ve been wronged (by a botched or inadequate surgery for instance) are more likely to respond to a survey than those who blame themselves for a choice they regret.)For such a well-done survey, it has a bad title. It sounds like an overall positive, but their results showed a decline by year 5.Quality of life improves early after gender reassignment surgery in transgender womenMethodsWe performed a prospective cohort study on individuals with a diagnosis of gender dysphoria (F64.0 in ICD-10) undergoing male-to-female gender reassignment surgery at Karolinska University Hospital between 2003 and 2015. All patients presenting at the clinic were invited to participate. No exclusion criterion was applied. Patients who denied participation at first visit were not asked again to participate. The quality of life questionnaire was distributed to patients pre-operatively, as well as 1, 3, and 5 years post-operatively.ResultsOf 190 individuals included in the study, a majority completed the SF-36 on at least two occasions, and 17 completed the questionnaire on all four measure points. One hundred forty-six individuals completed the questionnaire pre-operatively, 108 at year 1, 64 at year 3, and 43 at year 5. Reasons for loss to follow-up included deceased, moved abroad, and moving without forwarding address and no registration in the Swedish residential register. The mean age of the participants was 36 years (range 19 to 76 years).ConclusionsTo our knowledge, this is the largest prospective study to follow a group of transgender patients with regards to QoL over continuous temporal measure points. Our results show that transgender women generally have a lower QoL compared to the general population. GRS leads to an improvement in general well-being as a trend but over the long-term, QoL decreases slightly in line with that of the comparison group.DiscussionThe finding that quality of life seems to decrease with time, although statistically non-significant, is interesting and underlines the need of prospective studies with long follow-up time. The reasons could be disappointment in long-term effects of surgical treatment, or simply reflect an improvement by treatment from baseline quality of life not sufficient to reach the level of the general population. Another reason could be that only those dissatisfied with treatment, or suffering from complications, completed the follow-up questionnaires at 3 and 5 years and that the results from these measure points do not reflect the true mean of the population under study.This study had less than half the patients respond. Presumably, the data breaks the results down by years after surgery and what percent responded, but the summary doesn’t.It also only followed MtF and not FtM.Satisfaction With Male-to-Female Gender Reassignment Surgery: Results of a Retrospective AnalysisMethods254 consecutive patients who had undergone male-to-female gender reassignment surgery at Essen University Hospital’s Department of Urology retrospectively filled out a questionnaire about their subjective postoperative satisfaction.Results119 (46.9%) of the patients filled out and returned the questionnaires, at a mean of 5.05 years after surgery (standard deviation 1.61 years, range 1–7 years). 90.2% said their expectations for life as a woman were fulfilled postoperatively. 85.4% saw themselves as women. 61.2% were satisfied, and 26.2% very satisfied, with their outward appearance as a woman; 37.6% were satisfied, and 34.4% very satisfied, with the functional outcome. 65.7% said they were satisfied with their life as it is now.This one only had 37% respond. The data may break them down by MtF and FtM but the summary doesn’t.Surgical Satisfaction, Quality of Life, and Their Association After Gender-Affirming Surgery: A Follow-up StudyWe assessed the outcomes of gender-affirming surgery (GAS, or sex-reassignment surgery) 4 to 6 years after first clinical contact, and the associations between postoperative (dis)satisfaction and quality of life (QoL). Our multicenter, cross-sectional follow-up study involved persons diagnosed with gender dysphoria (DSM-IV-TR) who applied for medical interventions from 2007 until 2009. Of 546 eligible persons, 201 (37%) responded, of whom 136 had undergone GAS (genital, chest, facial, vocal cord and/or thyroid cartilage surgery).Main outcome measures were procedure performed, self-reported complications, and satisfaction with surgical outcomes (standardized questionnaires), QoL (Satisfaction With Life Scale, Subjective Happiness Scale, Cantril Ladder), gender dysphoria (Utrecht Gender Dysphoria Scale), and psychological symptoms (Symptom Checklist-90).Postoperative satisfaction was 94% to 100%, depending on the type of surgery performed. Eight (6%) of the participants reported dissatisfaction and/or regret, which was associated with preoperative psychological symptoms or self-reported surgical complications (OR = 6.07). Satisfied respondents’ QoL scores were similar to reference values; dissatisfied or regretful respondents’ scores were lower. Therefore, dissatisfaction after GAS may be viewed as indicator of unfavorable psychological and QoL outcomes.This wasn’t a survey but an analysis of records. Sweden keeps good records of addresses, hospitalizations, and causes of death. They matched the records of SRS patients with people matched by age, sex and target sex. It isn’t clear from the wording, but the chart shows that death rates for SRS patients increased a bit initially then were similar to the control group. Until year 10. Then deaths began increasing fairly, especially suicide. Was it because they had surgery? Because surgery didn’t fix the problems in their life? Or because their gender dysphoria was strong? Since it couldn’t study the mental health of the people in the study, that question remains unanswered.Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in SwedenParticipantsAll 324 sex-reassigned persons (191 male-to-females, 133 female-to-males) in Sweden, 1973–2003. Random population controls (10∶1) were matched by birth year and birth sex or reassigned (final) sex, respectively.Main Outcome MeasuresHazard ratios (HR) with 95% confidence intervals (CI) for mortality and psychiatric morbidity were obtained with Cox regression models, which were adjusted for immigrant status and psychiatric morbidity prior to sex reassignment (adjusted HR [aHR]).ResultsThe overall mortality for sex-reassigned persons was higher during follow-up (aHR 2.8; 95% CI 1.8–4.3) than for controls of the same birth sex, particularly death from suicide (aHR 19.1; 95% CI 5.8–62.9). Sex-reassigned persons also had an increased risk for suicide attempts (aHR 4.9; 95% CI 2.9–8.5) and psychiatric inpatient care (aHR 2.8; 95% CI 2.0–3.9). Comparisons with controls matched on reassigned sex yielded similar results. Female-to-males, but not male-to-females, had a higher risk for criminal convictions than their respective birth sex controls.ConclusionsPersons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism, and should inspire improved psychiatric and somatic care after sex reassignment for this patient group.Image source: Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in SwedenFootnotes[1] Quality of life improves early after gender reassignment surgery in transgender women