40 results on '"Dorsen C"'
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2. Review: antibiotics are effective for acute purulent rhinitis but are associated with increased gastrointestinal side effects
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Dorsen, C., primary
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- 2007
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3. Dear editor.
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Dorsen C, Andrist LC, Beal MW, Cappiello J, Engstrom J, Koeniger-Donohue R, Likis FE, Simmonds KE, Singer J, Taylor D, Hellerman S, Howse R, Kline AM, and White C
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- 2006
4. Motivation for Physical Activity in Low-Income Adults: An Integrative Literature Review.
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Turner AR, Coats H, Cook P, Dorsen C, and Jankowski C
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Aim: To explore, review and assess the literature on motivation for physical activity in low-income adults to inform future research and clinical interventions., Design: An integrative review of the literature on motivation for physical activity in low-income adults., Methods: Whittemore and Knaul's five-stage methodological approach for integrative reviews was utilised. Studies written in English that focused primarily on low-income adults discussed physical activity and included a component of motivation or drive were included. The Johns Hopkins Evidence Level and Quality Guide was used to assess the quality of the studies., Data Sources: PubMed, CINAHL, PsycINFO, SPORTDiscuss and Google Scholar from 1 January 2018 - 23 August 2024., Results: A total of 20 studies met the inclusion criteria. Three main categories of factors impacting physical activity in low-income adults were identified: (1) motivators for physical activity, (2) barriers for physical activity (3) and items that were both a motivator and a barrier. Despite the key role nurses play in promoting health and wellness, studies conducted by nurses or employing nursing interventions were notably absent., Conclusion: This integrative literature review highlights the need for more information about what motivates low-income adults to be more physically active., Implications for the Profession: Understanding the experience of low-income adults with physical activity is integral to meeting their needs and facilitating increased physical activity. Future research should utilise nursing theories and interventions to improve physical activity levels among low-income adults., Impact: This study addressed physical inactivity in low-income adults. More information is needed about motivation for physical activity. This information will impact researchers and clinicians., Reporting Method: The search strategy and reporting method were consistent with PRISMA guidelines., Patient or Public Contribution: No Patient or Public Contribution., (© 2024 John Wiley & Sons Ltd.)
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- 2024
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5. Preparedness of Practicing Nurses in the Care of Sexual and Gender Diverse People in the United States: A Scoping Review.
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Bower KM, Dorsen C, Hughes T, Moore SE, Coleman CL, Smith SK, Zerwic J, Newman L, Brown C, and Sherman ADF
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Background: Sexual and gender diverse (SGD) people in the United States (US) experience health inequities due to societal stigma and marginalisation. The nursing workforce must provide evidence-based affirming, inclusive and culturally responsive care for SGD people to meet individual and community health needs and eliminate disparities., Aims: The purpose of this scoping review was to synthesise what is known about (1) nurses' knowledge, skills and attitudes related to caring for SGD people in the US and (2) the existence, development and evaluation of SGD-related educational offerings available to practicing nurses in the US to develop the knowledge and skills needed to promote the health and wellbeing of SGD individuals, families and communities., Methods: This review followed the scoping review methodology and PRISMA for Scoping Reviews (PRISMA-ScR)., Data Sources: In conjunction with a health librarian, an electronic literature search was conducted using PubMed, LGBT Health, CINAHL, ERIC and Health Source-Nursing., Results: Thirty-two studies were included in this review, including quantitative and qualitative studies that sought to understand the knowledge, attitudes and clinical experiences of nurses related to the care of SGD people; studies that tested educational interventions and studies that identified educational barriers and facilitators. Major gaps in education, practice and research, as well as methodological limitations of existing studies, were noted., Conclusion: Nurses would benefit from expanded access to effective standardised foundational SGD-related health continuing education to help prepare them to care for diverse patient populations. Equity, inclusivity and dignity are key values of the nursing profession. It is imperative that nurses have the knowledge and skills to apply these values consistently in day-to-day professional practice across populations and settings., Impact: There is an urgent need to develop standardised, easily accessible evidence-based educational content to address nurses' knowledge of and attitudes towards caring for SGD people., Reporting Method: This study adhered to the PRISMA-ScR reporting guidelines., Patient or Public Contribution: There was no patient or public contribution to this study., (© 2024 John Wiley & Sons Ltd.)
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- 2024
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6. Urban Green Space and Perinatal Health Inequities in the United States: A Literature Review.
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Aktan N, Blumenfeld J, Schafer R, Dorsen C, and Nocella J
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Access to urban green space has been linked to positive health outcomes including enhanced perinatal health. The purpose of this article was to review, summarize, and synthesize what is known about the relationship between urban green space and perinatal health and outline implications for practice, policy, education, and research. Nineteen articles were included in this state-of-the-science review. Overall, it was found that limited access to green space is significantly related to adverse birth outcomes. These findings present an important opportunity for childbirth educators and other clinicians involved in the provision of prenatal and reproductive health care. Through education and intervention, poor perinatal outcomes may be mitigated. Clinical screening and education about the importance of access to and use of urban green space during pregnancy should be an essential component of preconception counseling and antenatal screening for at-risk populations. Policy makers should be made aware of these findings so that impactful change can be made in order to reduce disparities and promote health equity., Competing Interests: The authors have no relevant financial interest or affiliations with any commercial interests related to the subjects discussed within this article., (© Copyright 2024 Lamaze International.)
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- 2024
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7. Effects of Behavioral Intervention Components for African American/Black and Latino Persons Living with HIV with Non-suppressed Viral Load Levels: Results of an Optimization Trial.
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Cleland CM, Gwadz M, Collins LM, Wilton L, Leonard NR, Ritchie AS, Martinez BY, Silverman E, Sherpa D, and Dorsen C
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- Humans, Hispanic or Latino, Quality of Life, Viral Load, Black or African American, HIV Infections therapy
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There is an urgent need for efficient behavioral interventions to increase rates of HIV viral suppression for populations with serious barriers to engagement along the HIV care continuum. We carried out an optimization trial to test the effects of five behavioral intervention components designed to address barriers to HIV care continuum engagement for African American/Black and Latino persons living with HIV (PLWH) with non-suppressed HIV viral load levels: motivational interviewing sessions (MI), focused support groups (SG), peer mentorship (PM), pre-adherence skill building (SB), and navigation with two levels, short (NS) and long (NL). The primary outcome was HIV viral suppression (VS) and absolute viral load (VL) and health-related quality of life were secondary outcomes. Participants were 512 African American/Black and Latino PLWH poorly engaged in HIV care and with detectable HIV viral load levels in New York City, recruited mainly through peer referral. Overall, VS increased to 37%, or 45% in a sensitivity analysis. MI and SG seemed to have antagonistic effects on VS (z = - 1.90; p = 0.057); the probability of VS was highest when either MI or SG was assigned, but not both. MI (Mean Difference = 0.030; 95% CI 0.007-0.053; t(440) = 2.60; p = 0.010) and SB (Mean Difference = 0.030; 95% CI 0.007-0.053; t(439) = 2.54; p = 0.012) improved health-related quality of life. This is the first optimization trial in the field of HIV treatment. The study yields a number of insights into approaches to improve HIV viral suppression in PLWH with serious barriers to engagement along the HIV care continuum, including chronic poverty, and underscores challenges inherent in doing so., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2023
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8. A systematic review of U.S. nursing faculty's knowledge, awareness, inclusion, and perceived importance of sexual and gender minority-related content in nursing curricula.
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Moore SE, Coleman CL, Hughes TL, Dorsen C, Smith SK, Bower KM, Clochesy JM, Clark K, and Sherman ADF
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- Humans, Cross-Sectional Studies, Gender Identity, Curriculum, Faculty, Nursing, Sexual and Gender Minorities
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Background: In the US, sexual and gender minority (SGM) individuals continue to experience health inequities, and nursing curricula content and nursing faculty with SGM health expertise in the US remain limited. Addressing health disparities begins with the preparation of future nurses-US nursing faculty must be supported to meet these growing needs., Purpose: To describe, appraise, and synthesize research from 2000-2020 on US nursing faculty knowledge, awareness, inclusion, and perceived importance of SGM health content., Methods: Following PRISMA 2020 guidelines, we registered a systematic review and appraisal protocol in PROSPERO, and then executed the protocol and synthesized the literature., Discussion: We found an empirical evidence base surrounding US nursing faculty and SGM health much more limited than expected. Only four cross-sectional, descriptive empirical articles fit the a priori inclusion criteria. The studies were of moderate quality at best and often relied on unvalidated or older measures. In general, the studies focused on examining characteristics of nursing programs, faculty comfort with content, faculty perceptions of content importance, and hours dedicated to content., Conclusion: Since the close of the review, new commentaries and editorials expanding the call for change in the US were published-the time for commentary has passed. It remains unclear whether US nursing faculty are adequately prepared to educate future nurses about SGM health issues-and an unprepared healthcare workforce is yet another barrier to SGM health equity. The evidence base supporting US nursing faculty development desperately needs more studies using rigorous methodologies., (Copyright © 2023 Elsevier Inc. All rights reserved.)
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- 2023
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9. Nursing pre-licensure and graduate education for LGBTQ health: A systematic review.
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Sherman ADF, Smith SK, Moore SE, Coleman CL, Hughes TL, Dorsen C, Balthazar MS, Klepper M, Mukerjee R, and Bower KM
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- Female, Humans, Sexual Behavior, Education, Graduate, Education, Nursing, Sexual and Gender Minorities, Students, Nursing
- Abstract
Background: Lesbian, gay, bisexual, transgender, and queer plus (LGBTQ) people experience discrimination and health disparities compared to heterosexual cisgender people. Clinicians report discomfort and insufficient preparation for providing care to LGBTQ people and nursing has been slow to integrate LGBTQ health into curricula., Purpose: Conduct a systematic review to examine and critically appraise peer-reviewed literature on nursing student knowledge, skills, and attitudes (KSAs) regarding LGBTQ health and the development/evaluation of LGBTQ health content in nursing curricula., Methods: A systematic review was conducted (N = 1275 articles from PubMed, LGBT Health, CINAHL, ERIC, and Health Source-Nursing/Academic Edition)., Findings: Twenty articles met inclusion criteria. Twelve studies described curricular interventions; however, there were few validated tools to evaluate content coverage or KSAs. Four themes emerged specific to LGBTQ health content inclusion., Discussion: While an emerging science of LGBTQ nursing education has been identified, more work is needed to build and evaluate a comprehensive curricular approach for full programmatic integration of LGBTQ health., Conclusion: As nursing programs build LGBTQ content into nursing curricula, care must be taken to integrate this content fully with the depth of curricular content in population health, social determinants of health, social justice, intersectionality, cultural competence, and political advocacy., Tweetable Abstract: Greater integration of LGBTQ health content into nursing education should be a priority for nursing education., (Copyright © 2022 Elsevier Inc. All rights reserved.)
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- 2023
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10. Correction: Advancing behavioral interventions for African American/Black and Latino persons living with HIV using a new conceptual model that integrates critical race theory, harm reduction, and self-determination theory: a qualitative exploratory study.
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Gwadz M, Cluesman SR, Freeman R, Collins LM, Dorsen C, Hawkins RL, Cleland CM, Wilton L, Ritchie AS, Torbjornsen K, Leonard NR, Martinez BY, Silverman E, Israel K, and Kutnick A
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- 2022
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11. Advancing behavioral interventions for African American/Black and Latino persons living with HIV using a new conceptual model that integrates critical race theory, harm reduction, and self-determination theory: a qualitative exploratory study.
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Gwadz M, Cluesman SR, Freeman R, Collins LM, Dorsen C, Hawkins RL, Cleland CM, Wilton L, Ritchie AS, Torbjornsen K, Leonard NR, Martinez BY, Silverman E, Israel K, and Kutnick A
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- Female, Harm Reduction, Hispanic or Latino, Humans, Male, Middle Aged, Personal Autonomy, United States, Black or African American, HIV Infections drug therapy
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Background: Rates of participation in HIV care, medication uptake, and viral suppression are improving among persons living with HIV (PLWH) in the United States. Yet, disparities among African American/Black and Latino PLWH are persistent, signaling the need for new conceptual approaches. To address gaps in services and research (e.g., insufficient attention to structural/systemic factors, inadequate harm reduction services and autonomy support) and improve behavioral interventions, we integrated critical race theory, harm reduction, and self-determination theory into a new conceptual model, then used the model to develop a set of six intervention components which were tested in a larger study. The present qualitative study explores participants' perspectives on the study's acceptability, feasibility, and impact, and the conceptual model's contribution to these experiences., Methods: Participants in the larger study were African American/Black and Latino PLWH poorly engaged in HIV care and with non-suppressed HIV viral load in New York City (N = 512). We randomly selected N = 46 for in-depth semi-structured interviews on their experiences with and perspectives on the study. Interviews were audio-recorded and professionally transcribed verbatim, and data were analyzed using directed qualitative content analysis., Results: On average, participants were 49 years old (SD = 9) and had lived with HIV for 19 years (SD = 7). Most were male (78%) and African American/Black (76%). All had taken HIV medication previously. Challenging life contexts were the norm, including poverty, poor quality/unstable housing, trauma histories exacerbated by current trauma, health comorbidities, and substance use. Participants found the study highly acceptable. We organized results into four themes focused on participants' experiences of: 1) being understood as a whole person and in their structural/systemic context; 2) trustworthiness and trust; 3) opportunities for self-reflection; and 4) support of personal autonomy. The salience of nonjudgment was prominent in each theme. Themes reflected grounding in the conceptual model. Participants reported these characteristics were lacking in HIV care settings., Conclusions: The new conceptual model emphasizes the salience of systemic/structural and social factors that drive health behavior and the resultant interventions foster trust, self-reflection, engagement, and behavior change. The model has potential to enhance intervention acceptability, feasibility, and effectiveness with African American/Black and Latino PLWH., (© 2022. The Author(s).)
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- 2022
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12. How can the nursing profession help reduce sexual and gender minority related health disparities: Recommendations from the National Nursing LGBTQ Health Summit.
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Hughes TL, Jackman K, Dorsen C, Arslanian-Engoren C, Ghazal L, Christenberry-Deceased T, Lance Coleman C, Mackin M, Moore SE, Mukerjee R, Sherman A, Smith S, and Walker R
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- Curriculum, Female, Gender Identity, Humans, Sexual Behavior, United States, Sexual and Gender Minorities, Transgender Persons
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Background: Lesbian, gay, bisexual, transgender and queer (LGBTQ) people, also commonly referred to as sexual and gender minorities (SGMs), live in every part of the United States and encompass all races and/or ethnicities, religions, and social classes. Major reports from various sources document higher rates of health issues (e.g., substance abuse, depression, suicidality, cardiovascular disease) among SGMs than heterosexuals. Chronic stress related to marginalization and discrimination is a key contributor to these disparities. The nursing profession has paid relatively little attention to SGM health issues., Purpose and Methods: To address these gaps, the first National Nursing LGBTQ Health Summit brought together nursing deans, leaders of national nursing organizations, and other participants from across the United States., Findings: Participants agreed that increasing SGM-specific content in nursing curricula, practice guidelines, faculty development, and research is necessary to improve the health of SGM people., Discussion: The Summit ended with a call to action for the nursing profession to prioritize SGM health through innovations in education, research, and practice., (Copyright © 2022 Elsevier Inc. All rights reserved.)
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- 2022
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13. A population-based study of the intersection of sexual identity and race/ethnicity on physiological risk factors for CVD among U.S. adults (ages 18-59).
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Caceres BA, Ancheta AJ, Dorsen C, Newlin-Lew K, Edmondson D, and Hughes TL
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- Adolescent, Adult, Ethnicity, Female, Humans, Male, Middle Aged, Nutrition Surveys, Risk Factors, Young Adult, Cardiovascular Diseases, Sexual and Gender Minorities
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Objectives: Sexual minorities face significant psychosocial stressors (such as discrimination and violence) that impact their health. Several studies indicate that sexual minority women (SMW) and bisexual men may be at highest risk for cardiovascular disease (CVD), but limited research has examined physiological CVD risk or racial/ethnic differences. This study sought to examine racial/ethnic differences in physiological risk factors for CVD among sexual minority and heterosexual adults. Design : We analyzed data from the National Health and Nutrition Examination Survey (2001-2016) using sex-stratified multiple linear regression models to estimate differences in physiological CVD risk. We compared sexual minorities (gay/lesbian, bisexual, 'not sure') to heterosexual participants first without regard to race/ethnicity. Then we compared sexual minorities by race/ethnicity to White heterosexual participants. Results: The sample included 22,305 participants (ages 18-59). Lesbian women had higher body mass index (BMI) but lower total cholesterol than heterosexual women. Bisexual women had higher systolic blood pressure (SBP). Gay men had lower BMI and glycosylated hemoglobin (HbA1c) relative to heterosexual men. White and Black lesbian women and bisexual women of all races/ethnicities had higher BMI than White heterosexual women; Black bisexual women had higher SBP and HbA1c. Black sexual minority men had higher HbA1c relative to White heterosexual men. Latino 'not sure' men also had higher SBP, HbA1c, and total cholesterol than White heterosexual men. Conclusions: Given evidence of higher CVD risk in sexual minority people of color relative to White heterosexuals, there is a need for health promotion initiatives to address these disparities. Additional research that incorporates longitudinal designs and examines the influence of psychosocial stressors on CVD risk in sexual minorities is recommended. Findings have implications for clinical and policy efforts to promote the cardiovascular health of sexual minorities.
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- 2022
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14. Trees as a social determinant of health.
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Dorsen C and Aktan N
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- Humans, Social Determinants of Health, Trees
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- 2022
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15. Time to Reflect and Take Action on Health Disparities and Health Inequities.
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Salmond S and Dorsen C
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- Female, Gender Identity, Healthcare Disparities, Humans, Male, United States, COVID-19, Health Inequities
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The United States healthcare system underperforms in healthcare access, quality, and cost resulting in some of the poorest health outcomes among comparable countries, despite spending more of its gross national product on healthcare than any other country in the world. Within the United States, there are significant healthcare disparities based on race, ethnicity, socioeconomic status, education level, sexual orientation, gender identity, and geographic location. COVID-19 has illuminated the racial disparities in health outcomes. This article provides an overview of some of the main concepts related to health disparities generally, and in orthopaedics specifically. It provides an introduction to health equity terminology, issues of bias and equity, and potential interventions to achieve equity and social justice by addressing commonly asked questions and then introduces the reader to persistent orthopaedic health disparities specific to total hip and total knee arthroplasty., (Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the National Association of Orthopaedic Nurses.)
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- 2022
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16. Why Should Nurses Care About the Supreme Court?
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Dorsen C, Harney H, and LeDuc C
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- Community Health Nursing legislation & jurisprudence, Humans, United States, Legislation, Nursing, Nursing Staff legislation & jurisprudence, Nursing, Supervisory legislation & jurisprudence, Supreme Court Decisions
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Many cases have direct and indirect bearing on health care policy and public health., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2021
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17. An Integrative Review of Experiences Parenting Transgender and Gender Diverse Children.
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Warner A, Dorsen C, Navarra AD, and Cohen S
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- Child, Gender Identity, Humans, Parenting, Parents, United States, Substance-Related Disorders, Transgender Persons
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Transgender and gender diverse (TGD) children face increased behavioral health risks including suicidal behaviors and substance abuse. Parental affirmation is associated with behavioral health outcomes similar to non-TGD peers. This integrative review synthesizes and appraises evidence regarding experiences of parenting a TGD child in the United States or Canada from 2008 to 2018. Most parents across these 15 studies described affirming their child's gender at time of interview. Parents reported initial interpersonal processes (emotions, concerns, beliefs), sought education (frequently online), and described interactions with family members and professionals that were not always affirming. Parents accessed support groups but described their own well-being as a low priority relative to the child's needs. Parents' own needs for well-being may affect the process of parenting a TGD child and should be explored. Future research should address the experiences of non-parent family members and participants from more diverse backgrounds. Nursing education must consistently address gender affirming care.
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- 2021
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18. African American/Black and Latino Adults with Detectable HIV Viral Load Evidence Substantial Risk for Polysubstance Substance Use and Co-occurring Problems: A Latent Class Analysis.
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Cleland CM, Gwadz M, Collins LM, Wilton L, Sherpa D, Dorsen C, Leonard NR, Cluesman SR, Martinez BY, Ritchie AS, and Ayvazyan M
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- Adult, Black or African American, Cross-Sectional Studies, Hispanic or Latino, Humans, Latent Class Analysis, New York City epidemiology, United States epidemiology, Viral Load, HIV Infections complications, HIV Infections drug therapy, HIV Infections epidemiology, Substance-Related Disorders complications, Substance-Related Disorders epidemiology
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Substance use problems are highly prevalent among persons living with (PLWH) in the United States and serve as serious barriers to engagement in HIV care. Yet, in contrast to studies of single substances, little is known about patterns of polysubstance use in this population. Moreover, other risk factors (e.g., financial hardship, incarceration, homelessness, and mental health distress) are also prevalent and complicate HIV management. The present study drew on a cross-sectional survey with African American/Black and Latino (AABL) adult PLWH from low socioeconomic status backgrounds in New York City who were insufficiently engaged in HIV care and evidenced detectable HIV viral load (N = 512). We used latent class analysis (LCA) to explore patterns of polysubstance use and their relationships to financial hardship, incarceration, homelessness, and mental health. LCA yielded three substance use classes: Class 1, a high polysubstance use/high-risk substance use class (9%); Class 2, a polysubstance use/moderate substance use risk class (18%); and Class 3, a moderate polysubstance use/moderate-to-low-risk substance use class (74%). Mental health symptoms were prevalent in all classes, but Class 1 had greater mental health distress than the other two classes. Current homelessness was more prevalent in Classes 1 and 2. We cannot end the HIV epidemic without engaging and treating AABL PLWH who have serious barriers to engagement along the HIV care continuum, and who evidence polysubstance use along with co-occurring risk factors. Clinical settings can develop outreach and engagement approaches to bring this subpopulation of PLWH into care settings, and further, specialized services are needed to successfully screen, treat, and retain them.
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- 2021
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19. Stronger together: The case for multidisciplinary tenure track faculty in academic nursing.
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Tubbs-Cooley HL, Lavin R, Lyndon A, Anderson J, Baernholdt M, Berry P, Bosse JD, Mahoney AD, Gibbs KD, Donald EE, Donevant S, Dorsen C, Fauer A, French R, Gilmore-Bykovskyi A, Greene M, Morse BL, Patil CL, Rainbow J, Ruppar TM, Trotter TL, Umberfield EE, Walker RK, Wright ML, and Friese CR
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- Humans, Career Mobility, Faculty, Nursing
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- 2021
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20. Black and Latino Persons Living with HIV Evidence Risk and Resilience in the Context of COVID-19: A Mixed-Methods Study of the Early Phase of the Pandemic.
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Gwadz M, Campos S, Freeman R, Cleland CM, Wilton L, Sherpa D, Ritchie AS, Hawkins RL, Allen JY, Martinez BY, Dorsen C, Collins LM, Hroncich T, Cluesman SR, and Leonard NR
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- Black or African American, Hispanic or Latino, Humans, Male, New York City epidemiology, Pandemics prevention & control, SARS-CoV-2, COVID-19, HIV Infections drug therapy, HIV Infections epidemiology, HIV Infections prevention & control
- Abstract
The COVID-19 pandemic has great potential to disrupt the lives of persons living with HIV (PLWH). The present convergent parallel design mixed-methods study explored the early effects of COVID-19 on African American/Black or Latino (AABL) long-term survivors of HIV in a pandemic epicenter, New York City. A total of 96 AABL PLWH were recruited from a larger study of PLWH with non-suppressed HIV viral load. They engaged in structured assessments focused on knowledge, testing, trust in information sources, and potential emotional, social, and behavioral impacts. Twenty-six of these participants were randomly selected for in-depth semi-structured interviews. Participants were mostly men (64%), African American/Black (75%), and had lived with HIV for 17 years, on average (SD=9 years). Quantitative results revealed high levels of concern about and the adoption of recommended COVID-19 prevention recommendations. HIV care visits were commonly canceled but, overall, engagement in HIV care and antiretroviral therapy use were not seriously disrupted. Trust in local sources of information was higher than trust in various federal sources. Qualitative findings complemented and enriched quantitative results and provided a multifaceted description of both risk factors (e.g., phones/internet access were inadequate for some forms of telehealth) and resilience (e.g., "hustling" for food supplies). Participants drew a direct line between structural racism and the disproportional adverse effects of COVID-19 on communities of color, and their knowledge gleaned from the HIV pandemic was applied to COVID-19. Implications for future crisis preparedness are provided, including how the National HIV/AIDS Strategy can serve as a model to prevent COVID-19 from becoming another pandemic of the poor.
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- 2021
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21. Understanding long-term HIV survivorship among African American/Black and Latinx persons living with HIV in the United States: a qualitative exploration through the lens of symbolic violence.
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Freeman R, Gwadz M, Wilton L, Collins LM, Dorsen C, Hawkins RL, Silverman E, Martinez BY, Leonard NR, Applegate A, and Cluesman S
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- Aged, Ethnicity psychology, Female, HIV Infections ethnology, Humans, Male, Middle Aged, New York City, Qualitative Research, Social Class, Social Isolation, United States, Violence, Black or African American psychology, Emotions, HIV Infections psychology, Hispanic or Latino psychology, Poverty, Social Stigma, Survivorship
- Abstract
Background: Persons living with HIV (PLWH) are living longer, although racial/ethnic and socioeconomic status (SES) disparities persist. Yet, little is known about the experience of living with and managing HIV over decades. The present study took a qualitative approach and used the lens of symbolic violence, a type of internalized, non-physical violence manifested in the power differential between social groups. We focused on adult African American/Black and Latinx (AABL) PLWH from low-SES backgrounds., Methods: Data were drawn from two studies with AABL PLWH in New York City (N = 59). After providing signed informed consent, participants engaged in in-depth semi-structured interviews on aspects of HIV management. Interviews were audio-recorded and professionally transcribed verbatim, and data were analyzed using directed qualitative content analysis., Results: Participants in the two studies were comparable on sociodemographic and background characteristics. They had lived with HIV for 20 years, on average (range 3-33 years). All were from low-SES backgrounds and most were African American/Black and men. Participants experienced a convergence of multiple social exclusions, harms, and stigmas, consistent with symbolic violence, which contributed to disengagement from HIV care and discontinuation of HIV medications. We organized results into five sub-themes: (1) participants were "ground down" over time by material, social, and emotional challenges and this diminished self-worth and, at times, the will to live; (2) social isolation and self-isolation, based in part on feeling devalued and dehumanized, served as stigma-avoidance strategies and mechanisms of social exclusion; (3) stigmatizing aspects of patient-provider interactions, both experienced and anticipated, along with (4) restricted autonomy in HIV care and other settings (e.g., parole) reduced engagement; and (5) poor HIV management was internalized as a personal failure. Importantly, resilience was evident throughout the five sub-themes., Conclusions: Symbolic violence is a useful framework for understanding long-term HIV management and survivorship among AABL PLWH from low-SES backgrounds. Indeed, forms of symbolic violence are internalized over time (e.g., experiencing devaluation, dehumanization, loss of self-worth, and anticipated stigma), thereby impeding successful HIV management, in part because avoiding HIV care and discontinuing HIV medications are primary coping strategies. Results have implications for interventions in community and health care settings.
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- 2020
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22. Designing a Program to Serve Older Adult LGBTQ+ Populations in Home Healthcare.
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Alvarado LA, Dorsen C, Jere C, Woerner L, Jones E, and Miner SM
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- Aged, Female, Humans, Male, New York, Prejudice, Program Development, Program Evaluation, Vulnerable Populations, Home Care Services organization & administration, Sexual and Gender Minorities
- Abstract
When compared with their heterosexual cisgender (nontransgender) counterparts, LGBTQ+ older adults are more likely to delay or not seek medical care, often due to fear of real or perceived discrimination from healthcare providers. HCR Home care is a home healthcare agency in Upstate New York that has been delivering high-quality in-home healthcare services for over 40 years. We recognized that we had a unique opportunity to address the vulnerabilities of older adults in the LGBTQ+ community and to better meet their health needs as they age in place. We developed a five-step process to implement a program to better serve the home healthcare needs of the LGBTQ+ population in our community. The goal of this initiative is to provide ongoing community education on home healthcare, awareness of the social and health issues surrounding LGBTQ+ older adults, and ultimately to improve care and decrease health disparities. This article describes the five-step process, the challenges, successes, and implications for the future. Ensuring there are healthcare solutions available for vulnerable and marginalized individuals is key to changing the way home healthcare is structured and improving quality of life and health outcomes for all.
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- 2020
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23. Dysbiosis of the Gut Microbiome: A Concept Analysis.
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Perez NB, Dorsen C, and Squires A
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- Humans, Concept Formation, Dysbiosis physiopathology, Gastrointestinal Microbiome
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Background: Gut microbes influence the development several chronic conditions marking them as targets for holistic care, prevention strategies, and potential treatments. Microbiome studies are relatively new to health research and present unfamiliar terms to clinicians and researchers. "Dysbiosis" often refers to an alteration in the gut microbiome, but conceptual clarification is rarely provided. Purpose: The purpose of this study is to refine a conceptual definition of dysbiosis based on a review of nursing literature. Method: A Rodgerian approach to concept analysis was used. CINAHL, PubMed, and Web of Science were queried using "dysbiosis" through December 2018. Each article was analyzed with regard to the antecedents, attributes, and consequences of dysbiosis. Essential elements were tabulated and compared across studies to determine recurring themes and notable outliers. Findings: Analysis revealed several important antecedences, attributes, and consequences of dysbiosis. The findings also elucidated notable gaps and highlighted the co-evolving nature of the proposed definition with advances in microbiome research. Conclusion: This article adds a proposed definition of dysbiosis, offering a contribution of conceptual clarity upon which to enhance dialogue and build research. The definition emphasizes risk factors and consequences of dysbiosis as implications for holistic nursing practice.
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- 2020
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24. Provider and LGBT Individuals' Perspectives on LGBT Issues in Long-Term Care: A Systematic Review.
- Author
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Caceres BA, Travers J, Primiano JE, Luscombe RE, and Dorsen C
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Attitude of Health Personnel, Female, Humans, Long-Term Care, Male, Middle Aged, Young Adult, Health Personnel psychology, Residential Facilities, Sexual and Gender Minorities psychology
- Abstract
Background and Objectives: Discrimination toward the lesbian, gay, bisexual and transgender (LGBT) population has raised concerns about the type of long-term services and supports (LTSS) that will be available to them as they age. To understand the unique needs of aging LGBT populations, we sought to synthesize and critique the evidence related to LTSS providers and LGBT individuals' perspectives of LGBT issues in LTSS in the United States., Research Design and Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, a systematic review of the literature was conducted. The Crowe Critical Appraisal Tool was used to appraise the quality of the included studies., Results: Nineteen studies met inclusion criteria. Seven studies that examined the perspectives of LTSS providers identified two themes, including that they lack knowledge and training on LGBT health issues and generally report negative attitudes toward same-sex relations among older adults. In addition, 12 studies that examined the perspectives of LGBT individuals found that they (i) are concerned about LTSS planning, (ii) fear discrimination from providers in LTSS, and (iii) identify several strategies for improving care of LGBT older adults receiving LTSS., Discussion and Implications: This systematic review highlights the importance for LTSS providers to receive training in LGBT health and be reflective of potential biases toward the LGBT population. LGBT individuals identified concerns related to LTSS planning and fear of discrimination from LTSS providers. LGBT individuals also identified a need for increased training of providers to improve the care of LGBT older adults in LTSS., (© The Author(s) 2019. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Published
- 2020
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25. Ceremonial "plant medicine" use and its relationship to recreational drug use: an exploratory study.
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Dorsen C, Palamar J, and Shedlin MG
- Abstract
Background: The ceremonial use of psychoactive/hallucinogenic plant based drugs, such as ayahuasca, psilocybin and others, is a growing trend in the United States (US) and globally. To date, there has been little research documenting how many people are using psychoactive substances in this context, who the users are, what benefits/risks exist in the use of these drugs and the relationship between ceremonial drug use and recreational drug use.In this paper we describe a cohort of plant medicine facilitators in the US and explore how they differentiate plant medicine use from recreational drug use., Methods: Using modified ethnography, individual interviews were conducted in 2016 with 15 participants who are currently facilitating plant medicine ceremonies in the US. Descriptive content analysis was performed to discover themes and to inform a larger mixed-method study., Results: Ceremonial drug use was seen by participants as a natural healing and treatment modality used in the context of community and ritual. Three main themes were identified relating to participants' differentiation between ceremonial plant medicine use and recreational drug use: 1) participants see a clear delineation between plant medicine use and recreational drug use; 2) plant medicine is seen as a potential treatment for addiction, but concerns exist regarding potential interference with recovery; and 3) plant medicine use may influence recreational use., Conclusions: More research is needed on who is using plant medicine, motivators for use, perceived and real risks and benefits of plant medicine use and harm reduction techniques regarding safe ingestion.
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- 2019
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26. Prevalence of Obesity, Prediabetes, and Diabetes in Sexual Minority Women of Diverse Races/Ethnicities: Findings From the 2014-2015 BRFSS Surveys.
- Author
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Newlin Lew K, Dorsen C, Melkus GD, and Maclean M
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- Adolescent, Adult, Black or African American statistics & numerical data, Aged, Behavioral Risk Factor Surveillance System, Diabetes Mellitus ethnology, Female, Health Services Accessibility statistics & numerical data, Hispanic or Latino statistics & numerical data, Humans, Middle Aged, Obesity ethnology, Prediabetic State ethnology, Prevalence, United States epidemiology, White People statistics & numerical data, Young Adult, Diabetes Mellitus epidemiology, Ethnicity statistics & numerical data, Obesity epidemiology, Prediabetic State epidemiology, Racial Groups statistics & numerical data, Sexual and Gender Minorities statistics & numerical data
- Abstract
Purpose The purpose of this study is to assess the weighted prevalence and odds ratios of obesity, prediabetes, and diabetes by (1) female sexual orientation (lesbian, bisexual, and straight) with racial/ethnic (Hispanic, non-Hispanic black, and non-Hispanic white) groups combined and (2) across and within racial/ethnic groups by sexual orientation. Methods A secondary analysis of pooled 2014-2015 Behavioral Risk Factor Surveillance System data from 28 states (N = 136 878) was conducted. Rao-Scott chi-square test statistics were computed and logistic regression models were developed to assess weighted prevalence and odds ratios of obesity, prediabetes, and diabetes with adjustments for demographics (age, income, and education), depression, and health care access factors. Results With racial/ethnic groups combined, lesbian and bisexual women, relative to straight women, had a significantly increased likelihood for obesity when controlling for demographics. Bisexual women were found to have significantly reduced odds for diabetes, compared with straight women, with adjustments for demographics, depression, and health care access factors. Compared with their non-Hispanic white counterparts, Hispanic lesbian women had significantly increased odds for obesity and diabetes, while non-Hispanic black bisexual women had a significantly greater likelihood for obesity, holding demographics, depression, and health care access factors constant. Non-Hispanic white lesbian women had an increased likelihood for obesity relative to their straight, ethnic/racial counterparts. Prediabetes subsample analysis revealed the prevalence was low across all female sexual orientation groups. Conclusion Sexual minority women, particularly those of color, may be at increased risk for obesity and diabetes. Research is needed to confirm the findings.
- Published
- 2018
- Full Text
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27. Sexual Orientation Differences in Modifiable Risk Factors for Cardiovascular Disease and Cardiovascular Disease Diagnoses in Men.
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Caceres BA, Brody AA, Halkitis PN, Dorsen C, Yu G, and Chyun DA
- Subjects
- Adolescent, Adult, Cross-Sectional Studies, Humans, Male, Middle Aged, Nutrition Surveys, Risk Factors, United States epidemiology, Young Adult, Bisexuality statistics & numerical data, Cardiovascular Diseases diagnosis, Cardiovascular Diseases epidemiology, Health Status Disparities, Heterosexuality statistics & numerical data, Homosexuality, Male statistics & numerical data
- Abstract
Purpose: Despite higher rates of modifiable risk factors for cardiovascular disease (CVD) in gay and bisexual men, few studies have examined sexual orientation differences in CVD among men. The purpose of this study was to examine sexual orientation differences in modifiable risk factors for CVD and CVD diagnoses in men., Methods: A secondary analysis of the National Health and Nutrition Examination Survey (2001-2012) was conducted. Multiple imputation was performed for missing values. Differences across four distinct groups were analyzed: gay-identified men, bisexual-identified men, heterosexual-identified men who have sex with men (MSM), and heterosexual-identified men who denied same-sex behavior (categorized as exclusively heterosexual). Multiple logistic regression models were run with exclusively heterosexual men as the reference group., Results: The analytic sample consisted of 7731 men. No differences between heterosexual-identified MSM and exclusively heterosexual men were observed. Few differences in health behaviors were noted, except that, compared to exclusively heterosexual men, gay-identified men reported lower binge drinking (adjusted odds ratio [AOR] 0.58, 95% confidence interval [CI] = 0.37-0.85). Bisexual-identified men had higher rates of mental distress (AOR 2.39, 95% CI = 1.46-3.90), obesity (AOR 1.69, 95% CI = 1.02-2.72), elevated blood pressure (AOR 2.30, 95% CI = 1.43-3.70), and glycosylated hemoglobin (AOR 3.01, 95% CI = 1.38-6.59) relative to exclusively heterosexual men., Conclusions: Gay-identified and heterosexual-identified MSM demonstrated similar CVD risk to exclusively heterosexual men, whereas bisexual-identified men had elevations in several risk factors. Future directions for sexual minority health research in this area and the need for CVD and mental health screenings, particularly in bisexual-identified men, are highlighted.
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- 2018
- Full Text
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28. Cardiovascular Disease Risk in Sexual Minority Women (18-59 Years Old): Findings from the National Health and Nutrition Examination Survey (2001-2012).
- Author
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Caceres BA, Brody AA, Halkitis PN, Dorsen C, Yu G, and Chyun DA
- Subjects
- Adult, Cardiovascular Diseases epidemiology, Female, Health Surveys, Humans, Middle Aged, Prevalence, Risk Factors, Self Report, Socioeconomic Factors, United States, Young Adult, Bisexuality statistics & numerical data, Cardiovascular Diseases prevention & control, Health Behavior, Homosexuality, Female statistics & numerical data, Minority Groups statistics & numerical data
- Abstract
Objective: Sexual minority women (lesbian and bisexual) experience significant stigma, which may increase their cardiovascular disease (CVD) risk. The purpose of this study was to examine the prevalence of modifiable risk factors for CVD (including mental distress, health behaviors, blood pressure, glycosylated hemoglobin, and total cholesterol) and CVD in sexual minority women compared with their heterosexual peers., Materials and Methods: A secondary analysis of the National Health and Nutrition Examination Survey (2001-2012) was conducted. Multiple imputation with chained equations was performed. Logistic regression models adjusted for relevant covariates were run. Self-report (medical history and medication use) and biomarkers for hypertension, diabetes, and high total cholesterol were examined., Results: The final analytic sample consisted of 7,503 that included 346 sexual minority women (4.6%). Sexual minority women were more likely to be younger, single, have a lower income, and lack health insurance. After covariate adjustment, sexual minority women exhibited excess CVD risk related to higher rates of frequent mental distress (adjusted odds ratio [AOR], 2.05; 95% confidence interval [CI], 1.45-2.88), current tobacco use (AOR, 2.11; 95% CI, 1.53-2.91), and binge drinking (AOR, 1.66; 95% CI, 1.17-2.34). Sexual minority women were more likely to be obese (AOR, 1.61; 95% CI, 1.23-2.33) and have glycosylated hemoglobin consistent with prediabetes (AOR, 1.56; 95% CI, 1.04-2.34). No differences were observed for other outcomes., Conclusions: Sexual minority women demonstrated increased modifiable risk factors for CVD, but no difference in CVD diagnoses. Several emerging areas of research are highlighted, in particular, the need for CVD prevention efforts that target modifiable CVD risk in sexual minority women., (Copyright © 2018 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF
29. Prevalence of Obesity, Prediabetes, and Diabetes in Sexual Minority Men: Results From the 2014 Behavioral Risk Factor Surveillance System.
- Author
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Newlin Lew K, Dorsen C, and Long T
- Subjects
- Adolescent, Adult, Aged, Humans, Logistic Models, Male, Middle Aged, Odds Ratio, Prevalence, United States epidemiology, Young Adult, Behavioral Risk Factor Surveillance System, Diabetes Mellitus epidemiology, Obesity epidemiology, Prediabetic State epidemiology, Sexual and Gender Minorities statistics & numerical data
- Abstract
Purpose The purpose of this study is to assess the prevalence and related odds ratios for obesity, prediabetes, and diabetes in sexual minority men (SMM) in relation to straight men. Methods A secondary analysis of 2014 Behavioral Risk Factor Surveillance System data from 19 states (n = 53 542) was conducted. Weighted means and standard errors were computed to estimate prevalence rates of obesity, prediabetes, and diabetes across male sexual orientation groups, respectively. Unadjusted and adjusted (demographics, depression, and health care access factors) weighted logistic regression models were developed. Results Obesity prevalence was lower in gay men relative to straight men with logistic regression modeling indicating gay men were significantly less likely to be obese, relative to their straight counterparts, in the unadjusted and adjusted models. In terms of prediabetes, rates were low across all sexual orientation groups with no significant differences observed. Yet bisexual men, relative to straight men, had higher rates of diabetes with significantly increased odds for the disease in both the unadjusted and adjusted models. Conclusion Findings indicate gay men have reduced risk for obesity while bisexual men may have increased diabetes burden. Across all male sexual orientation groups, prediabetes prevalence was low, suggesting the need for more aggressive prediabetes screening. Additional research is necessary to confirm the findings.
- Published
- 2018
- Full Text
- View/download PDF
30. Pelvic pain in transgender men taking testosterone: Assessing the risk of ovarian cancer.
- Author
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Harris M, Kondel L, and Dorsen C
- Subjects
- Female, Humans, Male, Practice Guidelines as Topic, Review Literature as Topic, Risk Assessment, Ovarian Neoplasms nursing, Pelvic Pain nursing, Testosterone administration & dosage, Transgender Persons
- Abstract
Some guidelines on care for transgender men taking testosterone recommend oophorectomy to prevent ovarian cancer, while others recommend following guidelines for females. A review of the literature finds no strong evidence that transgender men are at increased risk for ovarian cancer. In transgender men taking testosterone without other risk factors, oophorectomy to prevent cancer is unnecessary.
- Published
- 2017
- Full Text
- View/download PDF
31. Open arms, conflicted hearts: nurse-practitioner's attitudes towards working with lesbian, gay and bisexual patients.
- Author
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Dorsen C and Van Devanter N
- Subjects
- Adult, Female, Humans, Male, Middle Aged, Attitude of Health Personnel, Nurse Practitioners psychology, Sexuality
- Abstract
Aims and Objectives: To explore nurse-practitioner's attitudes towards working with lesbian, gay and bisexual patients., Background: Literature suggests that lesbians, gay men and bisexuals have significant health disparities compared to heterosexuals. Although the reasons are multifactorial, research suggests that attitudes of healthcare providers (HCPs) may be a contributing factor in both accessing and receiving care. There is currently no literature exploring the attitudes of the approximately 300,000 nurse-practitioners in the United States. Thus, nurse-practitioners strengths and challenges in providing care to sexual minorities are unknown., Design: As part of a larger study, Corbin & Strauss' grounded theory methodology was used to explore the attitudes towards lesbian, gay and bisexual patients among primary care nurse-practitioners in NYC., Methods: Data were collected via individual semi-structured interviews with nurse-practitioners currently in practice in primary or outpatient care in NYC (n = 19). Data were evaluated using the three-step constant comparison method., Results: Nurse-practitioners in this study had varied, often overlapping and sometimes conflicting, attitudes about working with lesbian, gay and bisexual patients. The main theme identified was 'open arms, conflicted hearts' with three major subthemes - feeling at home, struggling to maintain professionalism and finding comfort under the umbrella of diversity., Conclusions: Nurse-practitioner participants in this study had varied attitudes about working with lesbian, gay and bisexual patients, ranging from open, confident and comfortable to ambivalent, cautious and unsure about working with lesbian, gay and bisexual patients generally and specifically regarding the health needs of this population., Relevance to Clinical Practice: This study highlights the inadequate didactic and clinical preparation most nurse-practitioners feel they have to care for lesbian, gay and bisexual patients. There is a need for increased education for registered nurses and nurse-practitioners regarding lesbian, gay and bisexual culture, their unique healthcare needs, as well as the role of stigma and marginalisation in caring for vulnerable populations., (© 2016 John Wiley & Sons Ltd.)
- Published
- 2016
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32. Improving Heart Failure Self-care Through a Community-Based Skill-Building Intervention: A Study Protocol.
- Author
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Dickson VV, Melkus GD, Dorsen C, Katz S, and Riegel B
- Subjects
- Aged, Feasibility Studies, Female, Humans, Independent Living, Male, Heart Failure therapy, Patient Education as Topic, Self Care
- Abstract
Background: Self-care is the cornerstone of heart failure (HF) management. Numerous approaches to improving HF self-care, which involves adherence to the treatment plan, routine symptom monitoring, and the response to symptoms when they occur, have been developed with little impact on HF outcomes. On the basis of HF practice recommendations that patients receive education and counseling that emphasizes self-care and targets skill building of critical target behaviors, we are conducting a clinical trial designed to improve self-care among community-dwelling older adults using an innovative group-based, skill-building approach led by a trained health educator., Objective: This article describes the study design and research methods used to implement and evaluate the intervention., Methods: The study uses a staggered randomized controlled design to assess feasibility of providing an HF self-care intervention in a community group setting to improve HF self-care, knowledge, and health-related quality of life at 1 and 3 months. A community engagement approach is used to partner with the community throughout all phases of the project. Seventy-five older adults with HF are randomly assigned to the intervention consisting of six to eight 60-minute sessions held in community senior centers or to the wait-list control group. Focus groups are used to elicit feedback on the participants' experience in the program., Results: Preliminary study participation data (n=60; women, 48%; black, 27%; Hispanic, 32%; mean [SD] age, 70 [10] years) and focus group feedback suggest that the delivery approach is feasible and acceptable, and the participants are very satisfied with the program., Conclusions: Implementation of a community-based HF self-care intervention delivered in partnership with established community-based centers is an innovative approach to intervention. If efficacy is demonstrated, this intervention has far-reaching implications for helping the growing population of HF patients in ethnically diverse communities.
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- 2015
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33. Haber et al. respond.
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Haber J, Hartnett E, Allen K, Hallas D, Dorsen C, Lange-Kessler J, Lloyd M, Thomas E, and Wholihan D
- Subjects
- Humans, Dental Health Services standards, Health Personnel education, Health Services Accessibility standards, Interprofessional Relations, Oral Health education
- Published
- 2015
- Full Text
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34. Putting the mouth back in the head: HEENT to HEENOT.
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Haber J, Hartnett E, Allen K, Hallas D, Dorsen C, Lange-Kessler J, Lloyd M, Thomas E, and Wholihan D
- Subjects
- Clinical Competence standards, Comorbidity, Curriculum, Dental Health Services organization & administration, Education, Dental standards, Education, Dental trends, Education, Nursing standards, Education, Nursing trends, Health Personnel standards, Humans, Interdisciplinary Studies standards, Interdisciplinary Studies trends, Interinstitutional Relations, Models, Educational, New York, Oral Health standards, Organizational Innovation, Schools, Dental organization & administration, Schools, Dental trends, Schools, Nursing organization & administration, Schools, Nursing trends, Workforce, Dental Health Services standards, Health Personnel education, Health Services Accessibility standards, Interprofessional Relations, Oral Health education
- Abstract
Improving oral health is a leading population health goal; however, curricula preparing health professionals have a dearth of oral health content and clinical experiences. We detail an educational and clinical innovation transitioning the traditional head, ears, eyes, nose, and throat (HEENT) examination to the addition of the teeth, gums, mucosa, tongue, and palate examination (HEENOT) for assessment, diagnosis, and treatment of oral-systemic health. Many New York University nursing, dental, and medical faculty and students have been exposed to interprofessional oral health HEENOT classroom, simulation, and clinical experiences. This was associated with increased dental-primary care referrals. This innovation has potential to build interprofessional oral health workforce capacity that addresses a significant public health issue, increases oral health care access, and improves oral-systemic health across the lifespan.
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- 2015
- Full Text
- View/download PDF
35. Cardiac biomarkers in persons with HIV infection: a review of the literature.
- Author
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Chandler C and Dorsen C
- Subjects
- Anti-HIV Agents adverse effects, Anti-HIV Agents therapeutic use, C-Reactive Protein analysis, Cardiovascular Diseases etiology, Cardiovascular Diseases virology, HIV Infections blood, HIV Infections drug therapy, Humans, Risk Factors, Biomarkers blood, HIV Infections complications
- Published
- 2014
- Full Text
- View/download PDF
36. An integrative review of nurse attitudes towards lesbian, gay, bisexual, and transgender patients.
- Author
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Dorsen C
- Subjects
- Female, Humans, Male, Attitude of Health Personnel, Bisexuality psychology, Homosexuality, Female psychology, Homosexuality, Male psychology, Nursing Staff psychology, Transgender Persons psychology
- Abstract
A growing body of literature suggests that lesbian, gay, bisexual, and transgender (LGBT) persons have significant health disparities as compared to heterosexuals. Although the reasons for this are complex and multifactorial, one area of research has examined the real or perceived negative attitudes of health-care providers. This integrative review critically appraises and synthesizes data from 17 articles regarding nurses' attitudes towards LGBT patients. Every study analyzed showed some evidence of negative attitudes. However, the literature revealed major limitations, including a paucity of well-designed studies; a dearth of qualitative studies; inconsistent use of validated, reliable instruments; and a lack of measures examining attitudes towards lesbian, bisexual, and transgender persons. Increased knowledge in this area could lead to interventions to improve nurses' cultural competency; resource allocation to nursing research, education, and services related to LGBT health; and inclusion of more LGBT content in nursing curricula.
- Published
- 2012
37. Barriers to volunteer enrollment in HIV preventive vaccine clinical research trials: a review of the literature.
- Author
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Hurley-Rosenblatt A and Dorsen C
- Subjects
- Humans, AIDS Vaccines therapeutic use, HIV Infections prevention & control, Patient Selection
- Published
- 2011
- Full Text
- View/download PDF
38. Vulnerability in homeless adolescents: concept analysis.
- Author
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Dorsen C
- Subjects
- Adolescent, Adolescent Behavior, Adult, Child, Developed Countries, Family Conflict, Female, Healthcare Disparities, Homeless Youth statistics & numerical data, Humans, Male, Risk Factors, Risk-Taking, Socioeconomic Factors, Young Adult, Concept Formation, Health Status Disparities, Homeless Youth psychology, Nursing Theory, Vulnerable Populations
- Abstract
Aim: This paper is a report of an analysis of the concept of vulnerability in homeless adolescents., Background: Caring for vulnerable populations and reduction of health inequities are top international healthcare priorities. Homeless adolescents experience health disparities as compared to their housed counterparts and are among the most vulnerable of all populations. Understanding the concept of vulnerability as it relates to the homeless adolescent population will assist nurses in addressing the health and social concerns of this population., Data Sources: The PubMed, Medline, Cochrane and CINAHL electronic databases were used to search for research papers published between 1980 and 2009. The keywords 'vulnerable', 'vulnerability' and 'homeless', 'adolescent', 'street' and 'youth' were used. Twenty-three papers from multiple disciplines were reviewed in an effort to arrive at a global definition of homeless adolescents' vulnerability., Method: Rodgers' evolutionary method of concept analysis was used for the analysis., Results: Based on this analysis, vulnerability in homeless adolescents is defined as the constellation of past, present and future risk, perceived or real, because of the common human experience of risk, the increased vulnerability of the adolescent period, the consequences of family disruption, and the increased risks of life on the street., Conclusion: There was agreement in the literature regarding the antecedents, attributes, consequences and surrogate terms of the concept. However, differentiation between the concepts of risk and vulnerability, as suggested by seminal nurse researchers, was not supported. More research is needed into self-perceptions of vulnerability and vulnerability in subgroups of homeless adolescents., (© 2010 Blackwell Publishing Ltd.)
- Published
- 2010
- Full Text
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39. The oral-systemic connection in primary care.
- Author
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Haber J, Strasser S, Lloyd M, Dorsen C, Knapp R, Auerhahn C, Kennedy R, Alfano MC, and Fulmer T
- Subjects
- Adult, Health Promotion, Humans, Male, Nurse Practitioners, Oral Hygiene, Surveys and Questionnaires, Dentistry, Health Services Needs and Demand, Interprofessional Relations, Nursing, Primary Health Care methods
- Published
- 2009
- Full Text
- View/download PDF
40. 1996 Fuld Scholar winning essay. Advocating for ourselves: the emerging role of nurses as patient advocates within multidisciplinary health care teams.
- Author
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Dorsen C
- Subjects
- Humans, Job Description, Nurses psychology, Oncology Nursing, Patient Advocacy, Patient Care Team
- Published
- 1997
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