Background In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov ( NCT04381936 ). Findings Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001). Interpretation In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding UK Research and Innovation (Medical Research Council) and National Institute of Health Research.

ࡗ Family Relationships of Lesbians and Gay MenThe family lives of lesbian and gay people have been a source of controversy during the past decade. Despite prejudice and discrimination, lesbians and gay men have often succeeded in creating and sustaining family relationships. Research on same-gender couple relationships, parent-child relationships, and other family relationships is reviewed here. In general, the picture of lesbian and gay relationships emerging from this body of work is one of positive adjustment, even in the face of stressful conditions. Research is also beginning to address questions about individual differences among the family relationships of lesbians and gay men. Future work in this area has the potential to affect lesbian and gay lives, influence developmental and family theory, and inform public policies in the decade ahead.The family lives of lesbian and gay people have been a subject of controversy during the past decade. Because of the stigma attached to nonheterosexual identities, those who declare lesbian or gay identities often do so at the risk of relationships in families of origin. In the United States, as in most other nations, the law does not recognize marriages between same-gender partners, nor-in many jurisdictions-does it protect relationships between lesbian or gay parents and their children. Despite such obstacles, however, lesbian and gay people have often succeeded in creating and sustaining meaningful family relationships.

This study examined associations among family type (same-sex vs. opposite-sex parents); family and relationship variables; and the psychosocial adjustment, school outcomes, and romantic attractions and behaviors of adolescents. Participants included 44 12-to 18-year-old adolescents parented by same-sex couples and 44 same-aged adolescents parented by opposite-sex couples, matched on demographic characteristics and drawn from a national sample. Normative analyses indicated that, on measures of psychosocial adjustment and school outcomes, adolescents were functioning well, and their adjustment was not generally associated with family type. Assessments of romantic relationships and sexual behavior were not associated with family type. Regardless of family type, adolescents whose parents described closer relationships with them reported better school adjustment.

Parenthood is one of the most universal and highly valued experiences of American adults. However, lesbian and gay adults in the United States are much less likely than heterosexual adults to be parents. Our goal was to explore the reasons why this is the case. Using nationally representative data from the 2002 National Survey of Family Growth (NSFG), we studied parenting intentions, desires, and attitudes of childless lesbian, gay, and heterosexual individuals 15 to 44 years of age. We found that gay men and lesbian women were less likely than matched heterosexual peers to express desire for parenthood. Moreover, gay men who expressed desire to become parents were less likely than heterosexual men to express the intention to become parents; this was not true for women. Despite being less likely to express parenting desires, gay and lesbian participants endorsed the value of parenthood just as strongly as did heterosexual participants. By exploring the psychology of family formation as a function of sexual orientation, these results inform ongoing debates about sexual orientation and parenthood.

Using a prospective longitudinal design, rejection by peers, aggressive behavior, and social withdrawal were examined among a representative community sample of 107 maltreated children and an equal number of non-maltreated children. Results revealed that chronic maltreatment was associated with heightened risk of rejection by peers. Chronically maltreated children were more likely to be rejected by peers repeatedly across multiple years from childhood to early adolescence. Maltreatment chronicity was also associated with higher levels of children's aggressive behavior, as reported by peers, teachers, and children themselves. Aggressive behavior accounted in large part for the association between chronic maltreatment and rejection by peers. Socially withdrawn behavior was associated with peer rejection, but did not account for the association between chronic maltreatment and peer rejection. These results held for both girls and boys, followed from childhood through early adolescence. Moreover, the links among chronic maltreatment, aggressive behavior, and peer rejection were already established by early school age. Implications of these results for developmental theory and intervention are discussed.