scholarly journals Sex differences in the management of persons with dementia following a subnational primary care policy intervention

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Nadia Sourial ◽  
Geneviève Arsenault-Lapierre ◽  
Eva Margo-Dermer ◽  
Mary Henein ◽  
Isabelle Vedel
Keyword(s):  
Quality Of Care ◽  
Secondary Analysis ◽  
Retrospective Chart Review ◽  
Dementia Care ◽  
Cognitive Testing ◽  
Future Research ◽  
Sex And Gender ◽  
Care Needs ◽  
And Gender

Abstract Background The influence of sex and gender on the risk of dementia, its clinical presentation and progression is increasingly being recognized. However, current dementia strategies have not explicitly considered sex and gender differences in the management of dementia to ensure equitable care. The objective of this study was to examine the moderating effect of sex on the quality of care following the implementation of the Quebec Alzheimer Plan (QAP). Methods We conducted a secondary analysis of the evaluation of the QAP consisting of a retrospective chart review of 945 independent, randomly-selected patient charts of males and females 75+ years old with dementia and a visit to one of 13 participating Family Medicine Groups before (October 2011–July 2013) and after (October 2014 – July 2015). The quality of dementia care score, based on Canadian and international recommendations and consensus guidelines, consisted of documented assessments in 10 domains. We used a mixed linear regression model to measure the interaction between sex and the implementation of the QAP on the quality of dementia care score, adjusting for age and number of medications. Results We found that improvements in the quality of dementia care following the QAP were larger for men than women (mean difference = 4.97; 95%CI: 0.08, 9.85). We found that men had a larger improvement in four indicators (driving assessments, dementia medication management, Alzheimer Society referrals, and functional status evaluation), while women had a smaller improvement in three (home care needs, behavioural and psychological symptoms of dementia, and weight). Men were prescribed fewer anticholinergics post-QAP, while women were prescribed more. Cognitive testing improved in men but decreased for women following the QAP; the opposite was observed for caregiver needs. Conclusion While the overall quality of care improved after the implementation of the QAP, this study reveals differences in dementia management between men and women. While we identified areas of inequalities in the care received, it is unclear whether this represents inequities in access to care and health outcomes. Future research should focus on better understanding sex and gender-specific needs in dementia to bridge this gap and better inform dementia strategies.

scholarly journals Sex-Gender Awareness in Diabetes

Diabetology ◽  
2021 ◽  
Vol 2 (2) ◽  
pp. 117-122
Author(s):  
Giancarlo Tonolo
Keyword(s):  
Type 2 Diabetes ◽  
Gender Differences ◽  
Type 1 Diabetes ◽  
Quality Of Care ◽  
Sex And Gender ◽  
And Gender ◽  
The Individual

Sex and gender can affect incidence, prevalence, symptoms, course and response to drug therapy in many illnesses, being sex (the biological side) and gender (the social-cultural one), variously interconnected. Indeed, women have greater longevity; however, this is accompanied by worse health than men, particularly when obesity is present. Sex-gender differences are fundamental also in both type 1 and type 2 diabetes. Just for example in the prediabetes situation impaired fasting glucose (expression of increased insulin resistance) is more common in men, while impaired glucose tolerance (expression of beta cell deficiency) is more common in female, indicating a possible different genesis of type 2 diabetes in the two sexes. In type 1 diabetes male and female are equivalent as incidence of the disease since puberty, while estrogens act as protective and reduce the incidence of type 1 diabetes in female after puberty. Considering macrovascular complications, diabetic women have a 3.5 fold higher increased cardiovascular risk than non diabetic women, against an observed increase of “only” 2.1 fold in male. Thus it is clear, although not fully explained, that sex-gender differences do exist in diabetes. Another less studied aspect is that also physician gender influences quality of care in patients with type 2 diabetes, female physicians providing an overall better quality of care, especially in risk management. The goal of this short commentary is to open the special issue of Diabetology: “Gender Difference in Diabetes” leaving to the individual articles to deepen differences in genesis, psychologists aspects and complications of the disease.

Self-Compassion and Quality of Life in Adults Who Stutter

2020 ◽  
Vol 29 (4) ◽  
pp. 2097-2108
Author(s):  
Robyn L. Croft ◽  
Courtney T. Byrd
Keyword(s):  
Quality Of Life ◽  
Social Connectedness ◽  
The Self ◽  
Future Research ◽  
Self Compassion ◽  
Adults Who Stutter ◽  
And Gender ◽  
Relationship Of ◽  
The Impact

Purpose The purpose of this study was to identify levels of self-compassion in adults who do and do not stutter and to determine whether self-compassion predicts the impact of stuttering on quality of life in adults who stutter. Method Participants included 140 adults who do and do not stutter matched for age and gender. All participants completed the Self-Compassion Scale. Adults who stutter also completed the Overall Assessment of the Speaker's Experience of Stuttering. Data were analyzed for self-compassion differences between and within adults who do and do not stutter and to predict self-compassion on quality of life in adults who stutter. Results Adults who do and do not stutter exhibited no significant differences in total self-compassion, regardless of participant gender. A simple linear regression of the total self-compassion score and total Overall Assessment of the Speaker's Experience of Stuttering score showed a significant, negative linear relationship of self-compassion predicting the impact of stuttering on quality of life. Conclusions Data suggest that higher levels of self-kindness, mindfulness, and social connectedness (i.e., self-compassion) are related to reduced negative reactions to stuttering, an increased participation in daily communication situations, and an improved overall quality of life. Future research should replicate current findings and identify moderators of the self-compassion–quality of life relationship.

scholarly journals Elucidating the Relationship Between Insomnia, Sex, and Cardiovascular Disease

2020 ◽  
Vol 4 ◽  
pp. 247028972098001
Author(s):  
Rebecca Leeds ◽  
Ari Shechter ◽  
Carmela Alcantara ◽  
Brooke Aggarwal ◽  
John Usseglio ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Sex Differences ◽  
Cardiovascular Health ◽  
Future Research ◽  
Sex And Gender ◽  
Men And Women ◽  
Sex Research ◽  
And Gender ◽  
The Relationship ◽  
Cvd Mortality

Sex differences in cardiovascular disease (CVD) mortality have been attributed to differences in pathophysiology between men and women and to disparities in CVD management that disproportionately affect women compared to men. Similarly, there has been investigation of differences in the prevalence and presentation of insomnia attributable to sex. Few studies have examined how sex and insomnia interact to influence CVD outcomes, however. In this review, we summarize the literature on sex-specific differences in the prevalence and presentation of insomnia as well as existing research regarding the relationship between insomnia and CVD outcomes as it pertains to sex. Research to date indicate that women are more likely to have insomnia than men, and there appear to be differential associations in the relation between insomnia and CVD by sex. We posit potential mechanisms of the relationship between sex, insomnia and CVD, discuss gaps in the existing literature, and provide commentary on future research needed in this area. Unraveling the complex relations between sex, insomnia, and CVD may help to explain sex-specific differences in CVD, and identify sex-specific strategies for promotion of cardiovascular health. Throughout this review, terms “men” and “women” are used as they are in the source literature, which does not differentiate between sex and gender. The implications of this are also discussed.

Disability and quality of life in patients with low back pain: Focus on sex and gender: A cross-sectional study

2021 ◽  
pp. 1-8
Author(s):  
Yen-Mou Lu ◽  
Chung-Hwan Chen ◽  
Yi-Jing Lue
Keyword(s):  
Quality Of Life ◽  
Low Back Pain ◽  
Back Pain ◽  
Gender Identity ◽  
Gender Role ◽  
Low Back ◽  
Sex And Gender ◽  
Cross Sectional ◽  
And Gender

BACKGROUND: Sex and gender affect responses to pain, but little is known about disability and quality of life. OBJECTIVES: To investigate the effects of sex and gender on disability and health-related quality of life (HRQOL) in patients with low back pain. METHODS: Ninety-three patients with low back pain were included in this cross-sectional survey study. Disability, HRQOL and gender identity were respectively assessed with the Oswestry Disability Index, Short Form-36 and Bem Sex Role Inventory. The participants were classified into four gender role orientations (masculinity, femininity, androgyny and undifferentiated). One-way analysis of variance was used to analyze both the sex and the gender role orientation. RESULTS: Females had higher disability than males (p< 0.05), but in gender identity, no significant difference was found. Seven domains of HRQOL were lower than the healthy norms. Males experienced greater impacts than females on vitality and mental health (p< 0.05). For gender identity, five domains of HRQOL had significant differences (p< 0.05). Masculinity orientation had the least impact on four domains (p< 0.05), while undifferentiated orientation had the largest impact on all domains. CONCLUSION: Sex and gender effects can be used to analyze disability and HRQOL in patients with low back pain. Females have higher disability, while HRQOL is greatly influenced by different gender role orientations.

scholarly journals Young GI Societies in Europe: 2019 update

2020 ◽  
Vol 8 (2) ◽  
pp. 227-232 ◽  
Author(s):  
Henriette Heinrich ◽  
Iago Rodríguez-Lago ◽  
Radislav Nakov ◽  
Vita Skuja ◽  
Pilar Acedo ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Health Inequalities ◽  
The State ◽  
Future Research ◽  
Web Based ◽  
Research Education ◽  
Excellent Quality ◽  
Further Development ◽  
The Way

Background One of the aims of the Young Talent Group (YTG) is to make United European Gastroenterology (UEG) more attractive to young fellows interested in gastroenterology (GI), and to actively involve them in UEG activities and the activities of their respective national societies. In 2017, we conducted a survey among the Friends of the UEG YTG with the aim of identifying the state of organization and needs of Young GI Sections (YGISs) throughout Europe, highlighting areas for further development and improvement. Aims The aim of the current web-based survey was to assess the progress of YGISs over 1 year, and persisting hurdles in forming and running a YGIS. Results Overall, 38 of 42 Friends answered the survey (91%). The number of YGISs has increased significantly from 12 in 2017 to 25 in 2019. Young gastroenterologists remained supported, but not influenced, by national societies. Results of the survey suggest that a lack of dedicated and motivated fellows has replaced a lack of funding as the most prevalent hurdle in forming these types of sections. Conclusion Our survey shows that the development of YGISs has improved markedly within the last 2 years. However, several limitations, like underrepresentation in subcommittees of national societies, remain and need to be addressed in order to involve young gastroenterologists in their respective national societies and within UEG, to pave the way for future research, education and excellent quality of care, and reduce health inequalities across Europe.

scholarly journals Opportunities for Outpatient Pharmacy Services for Patients with Cystic Fibrosis: Perceptions of Healthcare Team Members

Pharmacy ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. 34 ◽  
Author(s):  
Olufunmilola Abraham ◽  
Ashley Morris
Keyword(s):  
Cystic Fibrosis ◽  
Quality Of Care ◽  
Systems Engineering ◽  
Insurance Coverage ◽  
Multidisciplinary Care ◽  
Care Team ◽  
Healthcare Team ◽  
Care Needs ◽  
Treatment Regimens

Cystic fibrosis (CF) is one of the most common life-threatening, genetic conditions. People with CF follow complex, time-consuming treatment regimens to manage their chronic condition. Due to the complexity of the disease, multidisciplinary care from CF Foundation (CFF)-accredited centers is recommended for people with CF. These centers include several types of healthcare professionals specializing in CF; however, pharmacists are not required members. The purpose of this study was to identify the outpatient care needs of people living with CF that pharmacists could address to improve their quality of care. Healthcare members from a CFF accredited center and pharmacists were recruited to participate in semi-structured, audio-recorded interviews. Prevalent codes were identified and data analysis was conducted, guided by the systems engineering initiative for patient safety (SEIPS) model. The objective was to understand the medication and pharmacy-related needs of patients with CF and care team perspectives on pharmacists providing support for these patients. From the themes that emerged, pharmacists can provide support for people living with CF (medication burden, medication access, medication education) and the CF care team (drug monitoring and adherence, prior authorizations and insurance coverage, refill history). Pharmacists are well-positioned to address these difficulties to improve quality of care for people living with cystic fibrosis.

Safety Culture, Patient Safety, and Quality of Care Outcomes: A Literature Review

2017 ◽  
Vol 41 (2) ◽  
pp. 279-304 ◽  
Author(s):  
Seung Eun Lee ◽  
Linda D. Scott ◽  
V. Susan Dahinten ◽  
Catherine Vincent ◽  
Karen Dunn Lopez ◽  
...  
Keyword(s):  
Patient Safety ◽  
Quality Of Care ◽  
Literature Review ◽  
Safety Culture ◽  
Theoretical Framework ◽  
Future Research ◽  
Units Of Analysis ◽  
Care Outcomes ◽  
Collection Methods

This integrative literature review was conducted to examine the relationships between safety culture and patient safety and quality of care outcomes in hospital settings and to identify directions for future research. Using a search of six electronic databases, 17 studies that met the study criteria were selected for review. This review revealed semantic inconsistencies, infrequent use of a theory or theoretical framework, limited discussions of validity of instruments used, and significant methodological variations. Most notably, this review identified a large array of nonsignificant and inconsistent relationships between safety culture and patient safety and quality of care outcomes. To improve understanding of the relationships, investigators should consider using a theoretical framework and valid measures of the key concepts. Researchers should also give more attention to selecting appropriate sampling and data collection methods, units of analysis, levels of data measurement and aggregation, and statistical analyses.

Radical Cystectomy and Surgical Quality of Care

2005 ◽  
Vol 3 (1) ◽  
pp. 37-42 ◽  
Author(s):  
Brent K. Hollenbeck ◽  
James E. Montie ◽  
John T. Wei
Keyword(s):  
Bladder Cancer ◽  
Quality Of Care ◽  
Conceptual Model ◽  
Recent Work ◽  
Radical Cystectomy ◽  
Future Research ◽  
Surgical Quality

Defining surgical quality is an imperative and substantial undertaking before its measurement and ultimate improvement. This article defines quality of care and a rationale for its measurement. In the context of radical cystectomy for bladder cancer, we describe a conceptual model for measuring quality of care. Finally, we provide a framework for future research by presenting an overview of recent work pertaining to cystectomy and quality of care.

Sign in / Sign up

Export Citation Format

Share Document