聴覚ブレインコンピュータインターフェイスにおける畳み込みニューラルネットワークを用いた事象関連電位の同定

国立大学法人長岡技術科学大

Financial planning for retirement: Spousal communication and collaboration

Numerous investigations can be found in the retirement planning literature. However, no studies have appeared that have examined how married individuals communicate and collaborate with one another when making decisions about the future. In this dissertation, three different established areas of literature are combined to assess how married individuals make their financial plans for retirement. Some 682 married individuals completed a questionnaire about how they make retirement decisions with their spouses. Of particular interest were differences between couples who collaborate with one another, and those in which one spouse severs as the primary planner. The findings from the investigation were illuminating. The tendency to collaborate was more often seen among respondents who had been married longer, had higher incomes, were good communicators, and who had shared goals and values. Findings also revealed that couples who collaborate are more likely to experience positive communication patterns, exhibited increased levels of task involvement, and perceive a more positive future for themselves in retirement. This investigation is significant because it is a multidisciplinary first step toward understanding marital decision making patterns in this important real-world domain

Curbing the Hepatitis B Epidemic in Asian American Communities: Engaging Local Hospitals

Background. In the United States, more than 50% of the 1.2 million living with hepatitis B infection are Asian Americans (Centers for Disease Control and Prevention [CDC], 2013). In the city of San Francisco, Asian Americans make up 33% of the population and the city itself has the highest rate of liver cancer in the nation (United States Census Bureau, 2010, California Cancer Registry, 2011). In 2007, to address the risk of hepatitis B and liver cancer, the San Francisco Hep B Free Campaign (SFHBF) drew together a comprehensive coalition of key leaders and organizations from media, health care, government, community and business sectors within and beyond the Asian American community. Methods. Based on 13 key informant interviews with stakeholders, this paper explores how SFHBF incorporated local city hospitals as coalition partners to increase knowledge and screening of hepatitis B among Asian Americans throughout San Francisco. Results. Key findings include the various steps needed to involve hospitals including 1) Identify mission and key stakeholders, 2) Create collaborations among hospitals; 3) Identify benefits to hospitals. Implications. This research makes a unique contribution to the literature on engaging hospitals in community health partnerships. The findings have implications for other public health initiatives that are seeking to engage and involve hospitals as partners and collaborators

Rural Primary Care Providers’ Experiences and Knowledge Regarding LGBTQ Health in a Midwestern State

PurposeHealth disparities among LGBTQ people have been documented across various settings and recent research has indicated that many disparities are heightened in the context of rurality. Among these disparities is the decreased rate of primary care utilization by rural LGBTQ individuals. Understanding and addressing provider knowledge and attitudes related to LGBTQ health provides a relevant avenue for addressing underutilization.MethodsThe study presented was a mail‐out survey regarding rural primary care providers’ knowledge and experiences regarding LGBTQ health. Publicly available records were compiled to recruit a total sample of 113 primary care providers, at a response rate of 19.8%.FindingsA majority of respondents reported experience providing care to LGBTQ patients, while only slightly over half had received LGBTQ health education. Data analyses revealed significant associations between reported experiences and patient characteristics including religion, religiousness, age, length of time practicing in current provider role, and gender identity. Provider knowledge of LGBTQ health varied greatly across the items assessed. Provider profession (physician, nurse practitioner, physician assistant) and length of current county residence were significantly predictive of LGBTQ knowledge scores.ConclusionResults provide insight into rural health care for LGBTQ people. Preeminent findings were: (1) an existing need for LGBTQ health education, (2) variation in knowledge across content areas, and (3) association between knowledge, profession, and length of current county residence. Promotion of rural LGBTQ health may benefit by addressing identified gaps in current care.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149681/1/jrh12322.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149681/2/jrh12322_am.pd

Percepções de enfermeiros acerca da população LGBT+ e os seus entrelaces com a Atenção Primária à Saúde

Objetivo: este estudo busca investigar as demandas de saúde da população Lésbica, Gay, Bissexual e Trans (LGBT+), a partir das percepções de enfermeiros atuantes na Atenção Primária em Saúde. Método: estudo qualitativo, de cunho descritivo, realizado por meio de entrevistas semiestruturadas com 31 enfermeiros atuantes na Atenção Primária à Saúde, de um município da região central do estado do Rio Grande do Sul, Brasil. Resultados: para os enfermeiros, os problemas de saúde mais enfrentados pelo público LGBT+ estaria vinculado à saúde mental, violência ou ainda, às Infecções Sexualmente Transmissíveis (IST). Foi possível ainda, destacar a perpetuação de discursos cis-heteronormativos e que fortalecem o estigma de anormalidade associado a este público, já que para alguns profissionais a procura pela APS ocorreria por questões pontuais, como por exemplo, realização de testes rápidos. Conclusão: os achados deste estudo reiteram a necessidade de discussões nos meios acadêmicos e nos serviços de saúde, a fim de efetuar mudanças que possam melhorar a qualidade de vida desta população

Illness perceptions and explanatory models of viral hepatitis B & C among immigrants and refugees: a narrative systematic review.

© 2015 Owiti et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.BACKGROUND: Hepatitis B and C (HBV, HCV) infections are associated with high morbidity and mortality. Many countries with traditionally low prevalence (such as UK) are now planning interventions (screening, vaccination, and treatment) of high-risk immigrants from countries with high prevalence. This review aimed to synthesise the evidence on immigrants' knowledge of HBV and HCV that might influence the uptake of clinical interventions. The review was also used to inform the design and successful delivery of a randomised controlled trial of targeted screening and treatment. METHODS: Five databases (PubMed, CINHAL, SOCIOFILE, PsycINFO & Web of Science) were systematically searched, supplemented by reference tracking, searches of selected journals, and of relevant websites. We aimed to identify qualitative and quantitative studies that investigated knowledge of HBV and HCV among immigrants from high endemic areas to low endemic areas. Evidence, extracted according to a conceptual framework of Kleinman's explanatory model, was subjected to narrative synthesis. We adapted the PEN-3 model to categorise and analyse themes, and recommend strategies for interventions to influence help-seeking behaviour. RESULTS: We identified 51 publications including quantitative (n = 39), qualitative (n = 11), and mixed methods (n = 1) designs. Most of the quantitative studies included small samples and had heterogeneous methods and outcomes. The studies mainly concentrated on hepatitis B and ethnic groups of South East Asian immigrants residing in USA, Canada, and Australia. Many immigrants lacked adequate knowledge of aetiology, symptoms, transmission risk factors, prevention strategies, and treatment, of hepatitis HBV and HCV. Ethnicity, gender, better education, higher income, and English proficiency influenced variations in levels and forms of knowledge. CONCLUSION: Immigrants are vulnerable to HBV and HCV, and risk life-threatening complications from these infections because of poor knowledge and help-seeking behaviour. Primary studies in this area are extremely diverse and of variable quality precluding meta-analysis. Further research is needed outside North America and Australia

Exploring the lived experience of gay men with prostate cancer: A phenomenological study

Purpose: Gay men with prostate cancer are an ‘invisible species’ in the research literature despite concerns that the impact of treatment may be more profound and in some ways unique compared to heterosexual men. The aim of this research is to explore the lived experience of gay men with prostate cancer. Method: In-depth interviews were recorded and transcribed verbatim from a purposive sample of eight gay men treated for prostate cancer in Ireland. A qualitative methodological approach employing Giorgi's descriptive phenomenological method was used to collect and analyse data. Findings: Three key aspects emerged representing the essence of the participants lived experience; The experience of diagnosis, treatment decision making, and the impact of treatment, with sub-themes of shock of diagnosis, the generalist nature of information, sexual side effects and incontinence, and masculinity and gay identity. Secondly, the experience of the healthcare service with sub-themes of sexual orientation disclosure and communication with the healthcare team; and thirdly, sources of support and means of coping which included significant others, family & friends, cancer support groups, and gay resources and support services. Conclusion: Gay men with prostate cancer have unmet information and supportive care needs throughout their prostate cancer journey, especially related to the impact of sexual dysfunction and associated rehabilitation, negatively impacting their quality of life. Issues associated with heteronormativity, minority stress, and stigma may influence how gay men interact with the health service, or how they perceive the delivery of care. Healthcare education providers should update prostate cancer education programmes accordingly

The effects of educational curricula and training on LGBT specific health issues for healthcare students and professionals: a mixed-methods systematic review

Introduction: Poor access of lesbian, gay, bisexual and transgender (LGBT) people to healthcare providers with clinical and cultural competency contributes to health inequalities between heterosexual/cisgender and LGBT people. This systematic review assesses the effect of educational curricula and training for healthcare students and professionals on LGBT healthcare issues. Methods: Systematic review; the search terms, strategy and process as well as eligibility criteria were predefined and registered prospectively on PROSPERO. A systematic search of electronic databases was undertaken. Screening for eligible studies and data extraction were done in duplicate. All the eligible studies were assessed for risk of bias. The outcome of interest was a change in participants’ knowledge, attitude and or practice. Results: Out of 1171 papers identified, 16 publications reporting 15 studies were included in the review. Three were non-randomized controlled studies and 12 had a pre/post-design; two had qualitative components. Bias was reported in the selection of participants and confounding. Risk reported was moderate/mild. Most studies were from the USA, the topics revolved around key terms and terminology, stigma and discrimination, sexuality and sexual dysfunction, sexual history taking, LGBT-specific health and health disparities. Time allotted for training ranged from 1 to 42 hours, the involvement of LGBT people was minimal. The only intervention in sub-Saharan Africa focused exclusively on men who have sex with men. All the studies reported statistically significant improvement in knowledge, attitude and/or practice post-training. Two main themes were identified from the qualitative studies: the process of changing values and attitudes to be more LGBT inclusive, and the constraints to the application of new values in practice.Conclusions: Training of healthcare providers will provide information and improve skills of healthcare providers which may lead to improved quality of healthcare for LGBT people. This review reports short-term improvement in knowledge, attitudes and practice of healthcare students and professionals with regards to sexual and LGBT-specific healthcare. However, a unified conceptual model for training in-terms of duration, content and training methodology was lacking

The inclusion of LGBT+ health issues within undergraduate healthcare education and professional training programmes: A systematic review

BACKGROUND: An inclusive health curriculum within undergraduate and continuing professional development programmes (CPD) should include issues related to people whom identify as LGBT+. OBJECTIVES: The aim of this systematic review was to examine the education and training requirements of undergraduate students and health professionals regarding the inclusion of LGBT+ health issues. DESIGN: A systematic review of the available published empirical studies. DATA SOURCES: A systematic literature search was undertaken of the following databases: CINAHL, PubMed, PsycINFO, Embase and Sociological Abstracts. All papers reviewed were from the years 2007 to 2017 and written in English. REVIEW METHODS: Three research questions informing the literature review were: (i) What are the education and training requirements of undergraduate students and health professionals regarding the health needs of LGBT+ people? (ii) What are the approaches utilized in the education and training of undergraduate students and health professionals regarding the health needs of LGBT+ people? (iii) What are the best practice examples of the education and training of undergraduate students and health professionals? Following the application of definitive criteria, 22 papers were included in the review. Quality appraisal and data extraction was undertaken by the two authors. RESULTS: The 22 papers were reviewed in detail in the final data analysis and synthesis where four main themes were identified: (1) Cultural competence and inclusivity. (2) Existing knowledge of LGBT+ health-related issues. (3) Curriculum developments and outcomes. (4) Evidence of best practice in education delivery. CONCLUSION: The review highlights the importance of the inclusion of LGBT+ health-related issues within the health curriculum and continuing professional development programmes and the implications for education and training, clinical practice and research