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Ashley Lacombe-Duncan PhD MSW Hannah Kia PhD MSW Carmen H. Logie PhD MSW Kieran P. Todd BA Yasmeen Persad Gabrielle Leblanc Kelendria Nation Ayden I. Scheim PhD Tara Lyons PhD Chavisa Horemans MES BFA Mona Loutfy MD FRCPC MPH 《Health & social care in the community》2021,29(5):e33-e46
Transgender (trans) women experience barriers to access to HIV care, which result in their lower engagement in HIV prevention, treatment and support relative to cisgender people living with HIV. Studies of trans women's barriers to HIV care have predominantly focused on perspectives of trans women, while barriers are most often described at provider, organisation and/or systems levels. Comparing perspectives of trans women and service providers may promote a shared vision for achieving health equity. Thus, this qualitative study utilised focus groups and semi-structured interviews conducted 2018–2019 to understand barriers and facilitators to HIV care from the perspectives of trans women (n = 26) and service providers (n = 10). Barriers endorsed by both groups included: (a) anticipated and enacted stigma and discrimination in the provision of direct care, (b) lack of provider knowledge of HIV care needs for trans women, (c) absence of trans-specific services/organisations and (d) cisnormativity in sexual healthcare. Facilitators included: (a) provision of trans-positive trauma-informed care, (b) autonomy and choice for trans women in selecting sexual health services and (c) models for trans-affirming systems change. Each theme had significant overlap, yet nuanced perspective, between trans women and service providers. Specific recommendations to improve HIV care access for trans women are discussed. These recommendations can be used by administrators and service providers alike to work collaboratively with trans women to reduce barriers and facilitators to HIV care and ultimately to achieve health equity for trans women. 相似文献
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Effectiveness of the STOPP/START (Screening Tool of Older Persons' potentially inappropriate Prescriptions/Screening Tool to Alert doctors to the Right Treatment) criteria: systematic review and meta‐analysis of randomized controlled studies 下载免费PDF全文
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Lisa N. Houston MPH Mary Warner MMSC PA-C Robin L. Corelli Pharmd Christine M. Fenlon BFA Karen Suchanek Hudmon DRPH 《Journal of cancer education》2009,24(2):107-113
Background. Few health degree programs incorporate sufficient tobacco cessation education in core curricula. Methods. A national survey of 132 PA programs assessed the extent to which tobacco is addressed, educational methods, perceived importance and adequacy of tobacco education, and perceived barriers to enhancing tobacco-related content. Results. Surveys (n=99; 75%) revealed a median of 150 minutes of tobacco education throughout the degree program. Key barriers to enhancing training are lack of curriculum time and lack of access to comprehensive, evidence-based resources. Two-thirds expressed interest in participating in a nationwide effort to enhance tobacco cessation training. Conclusions. Similar to other disciplines, enhanced tobacco education is needed in PA programs to adequately prepare graduates to address the primary known cause of preventable death in the United States. 相似文献
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Keith R. Berend MD Michael J. Morris MD Michael D. Skeels DO Adolph V. Lombardi Jr MD FACS Joanne B. Adams BFA 《Clinical orthopaedics and related research》2011,469(1):168-173
Background
The complication risk of staged versus simultaneous total knee arthroplasty continues to be debated in the literature. Previous reports suggest unicompartmental knee arthroplasty provides a more rapid functional recovery than total knee arthroplasty. However, little data exist on whether simultaneous unicompartmental knee arthroplasty can be performed without increasing the perioperative risk compared with staged unicompartmental knee arthroplasty. 相似文献6.
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Prospective,randomized comparison of 3‐dimensional computed tomography guidance versus TEE data for left atrial appendage occlusion (PRO3DLAAO) 下载免费PDF全文
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Ge Zhao MD PhD Phillip C. Hochwalt MD Marcia L. Usui BS Robert A. Underwood BFA Pradeep K. Singh MD Garth A. James PhD Philip S. Stewart PhD Philip Fleckman MD John E. Olerud MD 《Wound repair and regeneration》2010,18(5):467-477
Chronic wounds are a major clinical problem that lead to considerable morbidity and mortality. We hypothesized that an important factor in the failure of chronic wounds to heal was the presence of microbial biofilm resistant to antibiotics and protected from host defenses. A major difficulty in studying chronic wounds is the absence of suitable animal models. The goal of this study was to create a reproducible chronic wound model in diabetic mice by the application of bacterial biofilm. Six‐millimeter punch biopsy wounds were created on the dorsal surface of diabetic (db/db) mice, subsequently challenged with Pseudomonas aeruginosa (PAO1) biofilms 2 days postwounding, and covered with semiocclusive dressings for 2 weeks. Most of the control wounds were epithelialized by 28 days postwounding. In contrast, none of biofilm‐challenged wounds were closed. Histological analysis showed extensive inflammatory cell infiltration, tissue necrosis, and epidermal hyperplasia adjacent to challenged wounds—all indicators of an inflammatory nonhealing wound. Quantitative cultures and transmission electron microscopy demonstrated that the majority of bacteria were in the scab above the wound bed rather than in the wound tissue. The model was reproducible, allowed localized cutaneous wound infections without high mortality, and demonstrated delayed wound healing following a biofilm challenge. This model may provide an approach to study the role of microbial biofilms in chronic wounds as well as the effect of specific biofilm therapy on wound healing. 相似文献
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Christopher H. Allan MD ; Philip Fleckman MD ; Russell J. Fernandes PhD ; Barbara Hager BS ; Jennifer James BS BIOE ; Zudtky WisecarverBS ChE ; F. Kyle Satterstrom AB ; Alicia Gutierrez BS ; Anthony Norman BS ; Anna Pirrone BS ; Robert A. Underwood BFA ; Brian P. Rubin MD PhD ; Miqin Zhang PhD ; Hassna R. Ramay MS ; John M. Clark MD PhD 《Wound repair and regeneration》2006,14(4):398-404