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to develop a more standardized definition of VL and a better assessment tool for VL symptoms. Polland A, Duong V, Furuya R, et al. Description of Vaginal Laxity and Prolapse and Correlation With Sexual Function (DeVeLoPS). Sex Med 2021;XXXXXXXX.

To examine the association of housing and neighborhood conditions with sleep among disadvantaged older adults.

We used data from 136 low-income, predominantly Black older adults with disabilities. Predictors were indices of interior housing conditions (eg, pests, tripping hazards); exterior housing conditions (eg, broken windows); and neighborhood disorder (eg, litter, vacant buildings). Outcomes were actigraphic total sleep time (TST), wake after sleep onset (WASO), and sleep efficiency (SE).

In models adjusted for age, sex, education, living arrangement, comorbidities, and physical performance, each additional exterior housing problem was associated with 20.9-minutes less TST (95% confidence interval [CI] -39.2, -2.6), 8.6-minutes more WASO (95% CI 0.7, 16.5), and 2.3% lower SE (95% CI -4.2, -0.4). The associations of interior housing conditions and neighborhood disorder with the sleep parameters were of smaller magnitude and not statistically significant.

Future studies should examine the effects of housing repair on sleep health.

Future studies should examine the effects of housing repair on sleep health.

Reduction of explicit and implicit bias in healthcare providers is a critical issue faced by our society in moving toward more equitable and culturally appropriate health and rehabilitation care. Because resources for OT and PT services are limited and shortages in these professions exist, direct care provision by occupational and physical therapist assistants (OTA/PTA) is on the rise and valued in comprehensive rehabilitation practice. It is important to consider attitudes and biases of OTA/PTA, as they are directly involved in provision of rehabilitation services for people with disabilities.

This study examined the explicit and implicit disability attitudes of a large cross-section of OTA/PTA.

Secondary data analysis was completed using data from 6113 OTA/PTA from the Project Implicit Disability Attitudes Implicit Association Test. Implicit attitudes were calculated and OTA/PTA explicit and implicit disability attitudes were compared. Results were further categorized using an adapted version of Son Hing etal.'s two-dimensional model of prejudice.

Findings revealed the majority of OTA/PTA reported having no explicit preference for people with disabilities or nondisabled people. However, the majority of OTA/PTA were aversive ableists, indicating low explicit and high implicit bias.

Though explicit bias is lower in OTA/PTA, implicit bias is strong, indicating that people with disabilities face bias that may influence clinical interactions, and may be reproduced in professional education, practice, and policy. Concrete action must be taken to recognize and address disability bias to reduce health disparities in people with disabilities.

Though explicit bias is lower in OTA/PTA, implicit bias is strong, indicating that people with disabilities face bias that may influence clinical interactions, and may be reproduced in professional education, practice, and policy. Concrete action must be taken to recognize and address disability bias to reduce health disparities in people with disabilities.

Insufficient social support is associated with increased mortality among older adults. Lung cancer is primarily a disease of older adults and is the leading cause of all cancer deaths. We assessed the association of social support with outcomes among older adults with lung cancer.

Adults age 65 and older with lung cancer with a completed geriatric assessment (GA) were assessed. Emotional social support (ES) and tangible (material, instrumental) support (TS) measures and patient characteristics were obtained from the GA. The electronic health record was used to extract clinical variables. Simple linear regression models evaluated the association between social support scales with patient and clinical factors.

79 adults were assessed. selleck inhibitor White race was positively associated with ES score (p=.04), while higher BMI (p=.03), depression (p=.03) and anxiety (p=.02) were associated with worse ES. Higher BMI was associated with higher/better TS score (p=.02) while living alone was associated with lower/worse TS score (p=.03). Completion of platinum-based doublet chemotherapy with immunotherapy as planned was associated with higher ES scores (p=.02) and higher TS scores (p=.02). Disease progression was associated with lower ES scores (p=.03).

Social support may influence clinical outcomes in older adults with lung cancer. As lung cancer often portends to poor prognosis, social support may be an important prognostic indicator.

Social support may influence clinical outcomes in older adults with lung cancer. As lung cancer often portends to poor prognosis, social support may be an important prognostic indicator.

The epidemiology of chronic kidney disease remains poorly described in France despite its burden. The objective of our study was to provide an estimate of the prevalence of chronic kidney disease stades3-5 (without replacement therapy) in France.

The data come from the Esteban study carried out in France between 2014 and 2016 on a representative sample of the French population. This study included 3,021adults between 18 and 74years old. Of these, 2422adults (80.2%) had serum creatinine assay and were included in this analysis. Renal function was estimated by calculating glomerular filtration rate using the Chronic kidney disease epidemiology collaboration (CKD-Epi) and European Kidney function consortium (EKFC) equations.

The means glomerular filtration rate in our population were respectively 97.5 and 89.0mL/min/1.73m

with the CKD-EPI and EKFC equations. The prevalence of chronic renal failure, defined by a glomerular filtration rate less than 60mL/min/1.73m

was 1.5% with the CKD-EPI formula and 2.1% with the EKFC formula in adults aged 18 to 74years. The prevalence was higher in women than in men and increased with age, reaching 6.5% and 9.9% in 65-74years with the CKD-EPI and EKFC equations, respectively. After extrapolation to the French population, the number of adults with chronic kidney disease stades3-5 without renal replacement therapy was around 1.6million.

In France, the prevalence of chronic kidney disease stades3-5 without renal replacement therapy was between 1.5 and 2.1% of the adult population aged18 to74.

In France, the prevalence of chronic kidney disease stades 3-5 without renal replacement therapy was between 1.5 and 2.1% of the adult population aged 18 to 74.Bullous pemphigoid is an autoimmune bullous cutaneous disease. We report the case of a 60 year-old male patient whose kidney allograft failed and was on hemodialysis for the previous 16 months. After tapering immunosuppressive medication, he presented simultaneous bullous eruption and kidney allograft intolerance syndrome. Investigation showed a positive BP180 anti-basement membrane zone antibody and skin biopsy was consistent with bullous pemphigoid. The patient was treated with corticotherapy and bullous pemphigoid resolved. The development of new onset diabetes and concerns over long term immunosuppression, halted the decision to continue corticotherapy and the patient underwent graft nephrectomy, with resolution of the kidney allograft intolerance syndrome without recurrence of the bullous disease. The occurrence of bullous pemphigoid in patients with failed renal allograft is rare, with only eleven cases reported in literature. This case illustrates how graft nephrectomy can provide a definitive cure to bullous pemphigoid in this setting.

How does use of a levonorgestrel-releasing intrauterine system (LNG-IUS) in infertile women with endometrial hyperplasia without atypia affect endometrial hyperplasia regression and pregnancy rates compared with oral medroxyprogesterone acetate (MPA)?

This prospective cohort study included 215 infertile women with an indication for assisted reproductive technology (ART) and a diagnosis of endometrial hyperplasia without atypia. Endometrial hyperplasia was diagnosed by hysteroscopic endometrial biopsy. At the time of first- and second-line treatment, patients were offered therapy with either oral MPA 10mg daily or LNG-IUS. Follow-up biopsies were scheduled after 90 days' treatment. After endometrial hyperplasia regression, patients were admitted to IVF/intracytoplasmic sperm injection (ICSI) cycles.

Baseline characteristics and confounders including age at diagnosis, body mass index and duration of infertility did not differ between LNG-IUS users and control participants and were accounted for using propnot jeopardize the chances of pregnancy in women seeking fertility treatment.Triple negative breast cancer (TNBC) represents 15% to 20% of all primary breast cancers and is the most aggressive subtype of breast cancer. There has been rapid progress in targeted therapy and biomarker development to identify the optimal treatments for TNBC. To update recent developments, this article comprehensively reviews molecular classification and biomarkers of TNBC and targeted therapy developments in immunotherapy, PARP and AKT pathway inhibitors, antibody-drug conjugates and androgen receptor blockade. The treatment of TNBC has dramatically evolved beyond basic cytotoxic chemotherapy into an expanding domain of targeted therapies tailored to the heterogeneity of this complex and aggressive disease. Progress will continue through the sustained and devoted efforts of our investigators and the patients who dedicatedly enroll in clinical trials. Through a daring persistence to challenge the status quo we now have the opportunity to offer our patients with TNBC a new sense of hope.

In 2018, a Department of Veterans Affairs (VA) primary care service and a school of pharmacy collaborated to offer introductory pharmacy practice experiences (IPPEs) in population health. Working remotely from the VA facility, students spent 2 hours per week using information from VA clinical dashboards and electronic health records (EHRs) to perform population health activities. Beginning August 2020, women's health initiatives were incorporated.

The objective was to evaluate student learning and productivity in an established remote population health IPPE that included women's health initiatives during a coronavirus disease (COVID-19)-related university closure.

During 2 IPPE semesters, activities of second-year student pharmacists were tracked. The course is typically conducted remotely at the university; however, owing to COVID-19 restrictions, students completed the course from their homes. Students were granted remote access privileges to VA's EHR and precepted by VA clinical pharmacists using Mic

Incorporating women's health initiatives into a remote population health IPPE assisted the VA facility with population health activities and increased students' perceived skill.

Incorporating women's health initiatives into a remote population health IPPE assisted the VA facility with population health activities and increased students' perceived skill.

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