RESUMO
BACKGROUND: Vulvodynia and pudendal neuralgia comprise significant contributors to vulvar-related pain and its impact on daily life. AIM: A retrospective clinical audit was conducted at the Women's Health & Research Institute of Australia, Sydney, to determine the pattern of use and the efficacy of the application of topical amitriptyline 0.5% plus oestriol 0.03% in organogel (AOO), to the vulvar vestibule in reducing the impact of pain on daily life. MATERIALS AND METHODS: There were 1174 patients who received a script from May 2017 until February 2020: 1054 patients agreed to be contacted and had a valid email address. RESULTS: There were 376 (35.7%) patients who replied. Pain with intercourse was the main indication for use. Treatment was rated effective by 51.2% (95% CI: 35.4-66.8%) of patients less than 30 years of age, 66.7% (95% CI: 57.3-74.9%) of patients 30-50 years of age, and 58.3% (95% CI: 50.9-65.4%) in patients over 50. Stinging at the site of application was the most commonly reported side effect. CONCLUSION: Topical AOO is an effective and well-tolerated treatment for vulvar pain.
Assuntos
Dispareunia , Neuralgia do Pudendo , Vulvodinia , Idoso , Amitriptilina , Austrália , Auditoria Clínica , Dispareunia/tratamento farmacológico , Estriol , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Vulvodinia/tratamento farmacológicoRESUMO
Racial and ethnic discrimination persist in science, technology, engineering and mathematics fields, including ecology, evolution and conservation biology (EECB) and related disciplines. Marginalization and oppression as a result of institutional and structural racism continue to create barriers to inclusion for Black people, Indigenous people and people of colour (BIPOC), and remnants of historic racist policies and pseudoscientific theories continue to plague these fields. Many academic EECB departments seek concrete ways to improve the climate and implement anti-racist policies in their teaching, training and research activities. We present a toolkit of evidence-based interventions for academic EECB departments to foster anti-racism in three areas: in the classroom; within research laboratories; and department wide. To spark restorative discussion and action in these areas, we summarize EECB's racist and ethnocentric histories, as well as current systemic problems that marginalize non-white groups. Finally, we present ways that EECB departments can collectively address shortcomings in equity and inclusion by implementing anti-racism, and provide a positive model for other departments and disciplines.
Assuntos
Racismo , Negro ou Afro-Americano , Ecologia , Engenharia , Humanos , Grupos PopulacionaisRESUMO
Cognitive impairments can increase significantly a person's level of risk for becoming or remaining homeless. Five topics are explored that address these impairments in preventing homelessness: (1) the nature and estimated prevalence of cognitive impairments among people who are homeless, especially those with vulnerabilities like mental illness or substance abuse; (2) the multiple origins of these impairments; (3) how these impairments impact services for people at risk for homelessness; (4) good practice approaches to handling cognitive impairments in homeless shelters, supported housing programs, and other service systems for people at risk for homelessness; and, (5) important research and practice issues requiring further action.
Assuntos
Transtornos Cognitivos/prevenção & controle , Pessoas Mal Alojadas/psicologia , Pesquisa , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Estados UnidosRESUMO
Effective discharge planning can contribute significantly to preventing homelessness. As part of a larger continuum of care, this process can help people reach goals of stable housing, recovery, and increased quality of life in the community. Discharge planning identifies and organizes services a person with mental illness, substance abuse, and other vulnerabilities needs when leaving an institutional or custodial setting and returning to the community. A three-component model is presented, relating discharge planning to institutional assessment and treatment, and to community services. Service challenges, innovative programs (based on a state-by-state analysis), and recommendations for enhancing discharge planning also are discussed.