ABSTRACT This project examined 55 picture books featuring transgender, gender expansive or genderqueer protagonists or narrators published between 2008 and 2018. The purpose of the study was to determine how this genre of children’s literature supports and challenges four gender assumptions: the gender binary, gender essentialism, sex/gender congruency and gender stability. Additionally, this critical analysis explored misgendering within this genre and themes of social rejection and acceptance. Protagonists and narrators were permitted a degree of gender nonconformity, however, the majority of picture books missed opportunities for a more complete exploration of gender possibilities. 相似文献
Background: Gait disorders are common in Parkinson’s disease patients who respond poorly to dopaminergic treatment. Blockade of adenosine A2A receptors is expected to improve gait disorders. Istradefylline is a first-in-class selective adenosine A2A receptor antagonist with benefits for motor complications associated with Parkinson’s disease.
Research design and methods: This multicenter, open-label, single-group, prospective interventional study evaluated changes in total gait-related scores of the Part II/III Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) and Freezing of Gait Questionnaire (FOG-Q) in 31 Parkinson’s disease patients treated with istradefylline. Gait analysis by portable gait rhythmogram was performed.
Results: MDS-UPDRS Part III gait-related total scores significantly decreased at Weeks 4–12 from baseline with significant improvements in gait, freezing of gait, and postural stability. Significant decreases in MDS-UPDRS Part II total scores and individual item scores at Week 12 indicated improved daily living activities. At Week 12, there were significant improvements in FOG-Q, new FOG-Q, and overall movement per 48 h measured by portable gait rhythmogram. Adverse events occurred in 7/31 patients.
Conclusions: Istradefylline improved gait disorders in Parkinson’s disease patients complicated with freezing of gait, improving their quality of life. No unexpected adverse drug reactions were identified.
目的对比动力髋螺钉(dynamic hip screw,DHS)治疗和股骨近端抗旋髓内钉(proximal femoral nail anti-rotation,PFNA)固定治疗老年股骨粗隆间骨折疗效。方法纳入本院收治的45例采用PFNA固定治疗的老年股骨粗隆间骨折患者作为研究组,研究时间为2017年11月-2018年11月;回顾性分析2016年11月-2017年11月在我院采用DHS治疗的45例老年股骨粗隆间骨折患者的临床资料,作为对照组。记录两组的相关手术指标,观察手术并发症情况。结果研究组的手术时间和骨折愈合时间均短于对照组,术中出血量明显少于对照组,术后疼痛VAS评分均明显低于对照组(P<0.05)。对照组的并发症发生率高于研究组(P<0.05)。结论PFNA固定治疗比DHS治疗老年股骨粗隆间骨折更加安全有效,值得临床借鉴和应用。 相似文献
Endolymphatic hydrops features excess endolymph in the membranous labyrinth, and is a marker of Menière's disease. Between the early 1980s and late 2000s, MRI in Menière's disease aimed purely to rule out tumor or malformation as differential diagnoses for the pressure disorder. Progress in high-resolution MRI, however, now enables excess endolymph to be visualized in the membranous labyrinth, differentiating saccule and utricle in Menière's disease and in other clinical presentations such as cochleovestibular schwannoma. More recently, non-visibility of the saccule was demonstrated in a subgroup of Menière's disease patients, and utricle atelectasis in case of uni- or bilateral vestibular areflexia. Endolymph quantification remains highly controversial in terms of grading approach, but a simple semiology based on excess or deficient visualization of endolymph according to the compartment sheds light on the pathophysiological mechanisms of cochleovestibular disorder and may in future allow effective monitoring of medical and surgical treatment. 相似文献
BackgroundThe aim of this study was to compare the radiographic and functional results between fixation and non-fixation in the Cotton osteotomy for the treatment of adult acquired flatfoot.MethodsA retrospective, case-controlled study of consecutive stage IIB posterior tibial tendon dysfunction (PTTD) patients treated with the same bony reconstructive surgery including cotton osteotomy between 2013 and 2017. Meary’s angle, the medial arch sag angle (MASA), and medial cuneiform cobb angle (MCCA) were evaluated pre-operation, at first weight bearing after surgery, and 12 months post operation.ResultsForty feet were included in the study. The cotton osteotomy utilized screw fixation (n = 20) or non-fixation technique (n = 20). No significant differences between groups were found in pre-operative and follow-up radiographic parameters, union rate, and functional results.ConclusionThe non-fixation with press fit technique is a reliable procedure for Cotton osteotomy and as effective as screw fixation.Level of evidenceLevel III, case control study 相似文献
There are well-established relationships between health and homelessness, and shelters can facilitate the transmission of diseases and contribute to their prevention. Adequate environmental health conditions and hygiene behaviors in homeless shelters are fundamental to the health of their clients, a marginalized population. We report the status of environmental health conditions and hygiene behaviors in homeless shelters and associated health outcomes; interventions to improve these conditions, behaviors, and outcomes; and obstacles to improvement.
Methods
PubMed, Web of Science, Scopus, and EBSCOhost were searched for peer-reviewed studies, and additional sources for grey literature. Studies were included if they reported primary data on one or more environmental health condition or hygiene behavior in homeless shelters.
Results
Twenty-eight studies were included in the review. Insufficient ventilation systems, unhygienic bedding, and overcrowding were the most documented environmental health and hygiene deficiencies in homeless shelters, and tuberculosis infections and skin diseases were the most documented associated health outcomes among clients. Studies frequently recommended or described implementation of behavioral and administrative controls, ventilation system improvements, and ultraviolet germicidal irradiation fixtures.
Discussion
Most studies addressed airborne transmission of tuberculosis and were conducted in high-income countries, revealing an imbalance in the literature. Insufficient resources and the transience of clients are barriers to improving hygiene behaviors and environmental conditions in homeless shelters. Further investment and research into ensuring adequate hygiene and environmental health in this setting can protect and promote the health and well-being of people experiencing homelessness. 相似文献