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41.
Mary C. Politi Melissa A. Clark Gene Armstrong Kelly A. McGarry Christopher N. Sciamanna 《Journal of general internal medicine》2009,24(4):511-516
BACKGROUND Although past studies have highlighted the importance of patient–provider communication about sexual health and intimate relationships
(SHIR), much of the research has focused on young women’s or married women’s experiences when discussing SHIR with their providers.
OBJECTIVE To describe experiences of unmarried, middle-aged and older women in communicating about SHIR with their health care providers.
DESIGN AND PARTICIPANTS Qualitative interviews were conducted with 40 unmarried women aged 40–75 years. We compared the responses of 19 sexual minority
(lesbian and bisexual) women and 21 heterosexual women.
RESULTS Women varied in their definitions of intimate relationships. Not all women thought providers should ask about SHIR unless
questions were directly related to a health problem, and most were not satisfied with questions about SHIR on medical intake
forms. However, the themes women considered to be important in communication about SHIR were remarkably consistent across
subgroups (e.g. previously married or never married; sexual minority or heterosexual). Sexual minority women were more hesitant
to share information about SHIR because they had had prior negative experiences when disclosing their sexual orientation or
perceived that clinicians were not informed about relevant issues.
CONCLUSIONS Some women felt that providers should ask about SHIR only if questions relate to an associated health problem (e.g. sexually
transmitted infection). When providers do ask questions about SHIR, they should do so in ways that can be answered by all
women regardless of partnering status, and follow questions with non-judgmental discussions.
Support for this research was provided by the National Cancer Institute, K07-CA87070, to Melissa A. Clark, PhD and the National
Cancer Institute 2 R25 CA087972-06A2 to The Miriam Hospital. 相似文献
42.
Background
HIV/AIDS has been described as the fourth largest cause of death globally and leading cause of death in Africa. HIV/AIDS has been a devastating inferno for nearly 30 years, and has particularly impacted countries in sub-Saharan Africa. In most African countries, it has been reported that the HIV infection amongst the military has been shown to be about 2 to 5 times higher than their civilian counterparts.Objective
To address the knowledge level of HIV/AIDS and risk-related behaviours in military personnel, a well-described high risk groups for HIV/AIDS.Methods
A cross-sectional study among army personnel in 82 Division Nigerian Army Headquarters Enugu, which has a population of about 1777. A random sampling in all the departments of 82 Division Nigerian Army Headquarters was done using the ballot method to select the respondents. Approval for the study was obtained from the General Officer in Command (GOC) of the 82 Division Nigerian Army Headquarters Enugu.Results
There were no significant differences between the risk related behavior variables when comparisons were made between those under 30 years, and those 30 years and above. Furthermore, more respondents under 30 years (48.0%) did not seek medical treatment when infected with another STI before having sex again as against 45% of those above 30 years. Most of the respondents (9.1%) under the age of 30 years believed that HIV/AIDS could be contracted through mosquito bites as against 2.8% of those above 30 years.Conclusion
The knowledge level of HIV/AIDS among the army personnel was high, though misconceptions about transmission modes like getting HIV through the bites of mosquitoes and casual body contacts were noted, especially among those under 30 years of age. 相似文献43.
Given the ample evidence delirium in hospitalized older adults is underdiagnosed and not recognized by nurses up to 85% of the time, interventions are needed at the point of care to assist nurses in recognizing delirium. In this qualitative study, factors that might influence the implementation of a point-of-care screening tool for delirium were examined. 相似文献
44.
Sciamanna G Hollis R Ball C Martella G Tassone A Marshall A Parsons D Li X Yokoi F Zhang L Li Y Pisani A Standaert DG 《Neurobiology of disease》2012,47(3):416-427
DYT1 dystonia, a common and severe primary dystonia, is caused by a 3-bp deletion in TOR1A which encodes torsinA, a protein found in the endoplasmic reticulum. Several cellular functions are altered by the mutant protein, but at a systems level the link between these and the symptoms of the disease is unclear. The most effective known therapy for DYT1 dystonia is the use of anticholinergic drugs. Previous studies have revealed that in mice, transgenic expression of human mutant torsinA under a non-selective promoter leads to abnormal function of striatal cholinergic neurons. To investigate what pathological role torsinA plays in cholinergic neurons, we created a mouse model in which the Dyt1 gene, the mouse homolog of TOR1A, is selectively deleted in cholinergic neurons (ChKO animals). These animals do not have overt dystonia, but do have subtle motor abnormalities. There is no change in the number or size of striatal cholinergic cells or striatal acetylcholine content, uptake, synthesis, or release in ChKO mice. There are, however, striking functional abnormalities of striatal cholinergic cells, with paradoxical excitation in response to D2 receptor activation and loss of muscarinic M2/M4 receptor inhibitory function. These effects are specific for cholinergic interneurons, as recordings from nigral dopaminergic neurons revealed normal responses. Amphetamine stimulated dopamine release was also unaltered. These results demonstrate a cell-autonomous effect of Dyt1 deletion on striatal cholinergic function. Therapies directed at modifying the function of cholinergic neurons may prove useful in the treatment of the human disorder. 相似文献
45.
Grundmann K Glöckle N Martella G Sciamanna G Hauser TK Yu L Castaneda S Pichler B Fehrenbacher B Schaller M Nuscher B Haass C Hettich J Yue Z Nguyen HP Pisani A Riess O Ott T 《Neurobiology of disease》2012,47(1):61-74
A mutation in the coding region of the Tor1A gene, resulting in a deletion of a glutamic acid residue in the torsinA protein (?ETorA), is the major cause of the inherited autosomal-dominant early onset torsion dystonia (DYT1). The pathophysiological consequences of this amino acid loss are still not understood. Currently available animal models for DYT1 dystonia provided important insights into the disease; however, they differ with respect to key features of torsinA associated pathology. We developed transgenic rat models harboring the full length human mutant and wildtype Tor1A gene. A complex phenotyping approach including classical behavioral tests, electrophysiology and neuropathology revealed a progressive neurological phenotype in ?ETorA expressing rats. Furthermore, we were able to replicate key pathological features of torsinA associated pathology in a second species, such as nuclear envelope pathology, behavioral abnormalities and plasticity changes. We therefore suggest that this rat model represents an appropriate new model suitable to further investigate the pathophysiology of ?ETorA and to test for therapeutic approaches. 相似文献
46.
Christopher N. Sciamanna Michaela Kiernan Barbara J. Rolls Jarol Boan Heather Stuckey Donna Kephart Carla K. Miller Gordon Jensen Terry J. Hartmann Eric Loken Kevin O. Hwang Ronald J. Williams Melissa A. Clark Jane R. Schubart Arthur M. Nezu Erik Lehman Cheryl Dellasega 《American journal of preventive medicine》2011,41(2):159-166
47.
目的:通过分析精神分裂症患者中枢多巴胺代谢产物-血浆高香草酸浓度(pHVA)与临床指征的关系,进一步探讨多巴胺神经递质及其药物治疗在精神分裂症的作用。方法在46例长期药物治疗、58例未治疗精神分裂症患者中,采用高液相色谱连接电化学分析仪测定PHVA;测前评定阳性症状量表(SAPS)和阴性症状量表(SANS)。结果(1)与62例健康对照组比,治疗组PH-VA显著减低,未治疗组显著增高,以阴性症状组为 相似文献
48.
Transcranial magnetic stimulation does not improve mild cognitive impairment in Parkinson's disease
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49.
50.
T Ibrahim B Bloch CN Esler KR Abrams WM Harper 《Annals of the Royal College of Surgeons of England》2010,92(3):231-235