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1.
Lesbian, gay, bisexual, transgender, and queer/questioning people in the United States experience multiple health disparities related to sexual and reproductive health. Attempts to address these disparities have focused on sexual orientation and gender identity rather than on the specific aspects of sexuality that may be more relevant to an individual’s health outcomes. This focus is also incongruent with a holistic approach to health and wellness interventions. We propose an adaptation of sexual configurations theory, a psychological theory with which to accurately describe different aspects of sexuality, to better position nurses to address these important disparity issues. We position sexual configurations theory within a contextual framework that incorporates aspects of trauma theory as a new way to evaluate individual sexuality in a holistic nursing context. 相似文献
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Cline Catteau Denise Faulks Bruno Pereira Martine Hennequin 《Special care in dentistry》2019,39(1):10-19
This study aimed to investigate the effectiveness of an oral health promotion intervention implemented in special care establishments by dentists trained online. Twenty‐six dentists intervening in 27 French special care establishments undertook a standardised oral health promotion intervention, including a conference presentation for care staff and hands‐on toothbrushing workshops. Oral hygiene status of the residents was performed at baseline and at 6 months, and were compared using the McNemar test. Mixed logistic regression was performed to identify the factors associated with an improvement of dental plaque removal. The oral health intervention was completed by 890 residents: 445 children, 373 adults and 72 elderly adults. At baseline, dental plaque was observed for 79.8% of the 797 dentate residents. Among the 691 dentate residents included in the final analysis, dental plaque removal was improved for 34%. Improvement in dental plaque removal was recorded more often for the group of 13 to 20‐year‐old residents (OR = 1.97; 95% CI = 1.15–3.38). The results indicate that this programme failed to significantly improve the dental plaque removal of the residents. More research is needed to understand the limiting factors of such interventions. 相似文献
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《Archives of physical medicine and rehabilitation》2019,100(11):2032-2038
ObjectiveTo explore attitudes and practices of physicians relating to accessible medical diagnostic equipment in serving patients with mobility disability.DesignOpen-ended individual telephone interviews, which reached data saturation. Interview recordings were transcribed verbatim for qualitative conventional content analysis.SettingMassachusetts, the United States, October 2017-January 2018.ParticipantsPracticing physicians from 5 clinical specialties (N=20).InterventionsNot applicable.Main Outcome MeasuresCommon themes concerning physical accessibility.ResultsMean ± SD time in practice was 27.5±12.5 years; 14 practices had height-adjustable examination tables; and 7 had wheelchair-accessible weight scales. The analysis identified 6 broad themes: height-adjustable examination tables have advantages; height-adjustable examination tables have drawbacks; transferring patients onto examination tables is challenging; rationale for examining patients in their wheelchairs; perceptions of wheelchair-accessible weight scales; and barriers and facilitators to improving physical accessibility. Major barriers identified by participants included costs of equipment, limited space, and inadequate payment for extra time required to care for persons with disability. Even physicians with accessible examination tables sometimes examined patients seated in their wheelchairs.ConclusionsEven if physicians have accessible equipment, they do not always use it in examining patients with disability. Future efforts will need to consider ways to eliminate these access barriers in clinical practice. Given small sample size, results are not generalizable to physicians nationwide and globally. 相似文献
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Jaymie R. Meliker Caterina Vacchi-Suzzi James Harrington Keith Levine Li-Yung Lui Douglas C. Bauer Eric Orwoll Deborah M. Kado 《International journal of hygiene and environmental health》2019,222(2):230-234
Objectives
There is growing evidence that urine cadmium is a temporally stable biomarker indicative of long-term cadmium exposure; however questions remain with regard to generalizability to older persons, the impact of changes in smoking behavior, and the degree of temporal stability when repeat sample collection spans years instead of weeks or months.Methods
Using archived samples from cohorts of older men (Osteoporotic Fractures in Men (MrOS-US)) and women (Study of Osteoporotic Fractures (SOF)) (mean age?=?80?at study visit 2), we analyzed two morning urine samples each from 39 men and 18 women with a diverse self-reported smoking history. For MrOS, samples were collected approximately 6 years apart, and 4 years apart for SOF. Intra-class correlations were computed to assess temporal stability, and adjusted for age and body mass index.Results
The median creatinine-adjusted urinary cadmium levels (0.39?μg/g for men, 0.89?μg/g for women) were similar to levels expected for these age/sex groups in the US according to the National Health and Nutrition Examination Survey. The overall intra-class correlation was high (ICC?=?0.85; 95% CI: 0.76–0.91) and similar between cohorts (MrOS: ICC?=?0.74; 95% CI: 0.58–0.86; SOF: ICC?=?0.81; 95% CI: 0.59–0.93), but slightly lower among those who stopped smoking between visits of sample collection (ICC?=?0.64; 95% CI: 0.31–0.87) or among former smokers who quit prior to the first sample collection (ICC?=?0.68; 95% CI: 0.25–0.93).Conclusions
We report good-to-excellent reproducibility of urine cadmium using morning urine samples collected 4–6 years apart from older men and women, but slightly lower correlations among those with a history of smoking. Single measures of urine cadmium are a reliable biomarker in older men and women. 相似文献9.
《Journal of the American Medical Directors Association》2020,21(9):1309-1315.e4
ObjectiveFrailty is a multifactorial syndrome characterized by social, physical, and psychological stressors. Network analysis is a graphical statistical technique that can contribute to the understanding of this complex, multifactorial phenomenon. The aim of this study was to investigate the relationships between social, physical, and psychological factors and frailty in older persons.DesignA cross-sectional study.Settings and ParticipantsA total of 2588 community-dwelling older persons from the FIBRA (Frailty in Brazilian Older Persons) 2008 to 2009 study.MeasuresParticipants were assessed for sociodemographic variables, physical and mental health, and the frailty phenotype. Partial correlation network analysis with the Graphical Least Absolute Shrinkage and Selection Operator (glasso) estimator was performed to determine the relationships between social, physical, and psychological factors and frailty.ResultsMean participant age was 72.31 years, 7.0% were frail, and 50.6% were prefrail. In the network structure, frailty correlated most strongly with physical and psychological factors such as diabetes and depression and exhibited greater proximity to physical factors such as disability, urinary incontinence, and cardiovascular risk as measured by waist-to-hip ratio.Conclusions and ImplicationsThe analytical strategy used can provide information for specific subpopulations of interest and here confirmed that frailty is not uniformly determined but associated with different psychological and physical health factors, thereby allowing better understanding and management of this condition. 相似文献
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利用上海市调研数据,以60岁及以上老人为研究对象,基于SERVQUAL模型和有序多分类逻辑回归方法分析我国老年长期护理服务质量及其影响因素。研究发现:老人对长期护理服务质量评价不高,且常用临床护理服务质量略低于基本生活照料服务质量。供给方因素中护理机构基础设施、管理水平、护理人员专业水平对长期护理服务质量的提升具有正向激励作用。需求方因素中老人养老金水平对长期护理服务质量的提高具有显著正向激励,而老人的失能程度对服务质量具有显著负向影响,且与男性老人相比,女性老人对长期护理服务质量评价显著更高。研究结果为精确地评估我国老年长期护理服务质量提供了科学依据,对提升失能老人的生活质量,促进我国长期护理服务产业的发展具有重要的政策启示。 相似文献