Many health care providers are uncomfortable having conversations with patients about their sexual identity or sexual behaviors. Avoiding this discomfort is causing a serious threat to the mental and physical health of Americans, particularly those in the lesbian, gay, bisexual, transgender, questioning, or intersex (LGBTQI) community. The health-related disparities among LGBTQI patients range from bullying and physical assault to refusal of health care and housing. Many individuals choose not to seek health care due of fear of being judged, marginalized, or abused. This article focuses on the many disparities faced by the LGBTQI community and describes how simple changes in the practices of health care providers can potentially improve their health outcomes.
Background: Balance deficits underlie a number of disorders and can exacerbate the primary condition if not addressed. Limits of stability, usually evaluated via force plates, can provide valuable information about balance and associated insufficiencies. A portable instrumented mat used clinically to measure gait characteristics has recently shown potential for limits of stability assessment. The mat also affords the ability to measure proactive control of limits of stability and quantitative information specific to stepping when limits of stability are exceeded. This study examined concurrent validity between the Bertec BalanceCheck Force Plate, an established instrument for measuring limits of stability, and the ProtoKinetics Zeno Walkway. Methods: A total of 51 adults (mean age 25.5 [standard deviation: 7.5] years; 72.5% female) without known disabilities leaned as far as possible in anterior, posterior, rightward and leftward directions while standing in narrow and natural stances on the force plate and walkway. Results: Pearson correlations for the force plate and walkway showed significant positive agreement for all directions tested in the narrow (r range = 0.657–0.878) and natural stances (r range: 0.928–0.936). Conclusions: Findings lend evidence of instrument interchangeability when measuring limits of stability. The results demonstrate evidence of concurrent and construct validity in support of the use of the Zeno Walkway as a measure of limits of stability.
Over the last several years, there has been a surge of readily available curricular resources for global health (GH) educators that theoretically has enabled them to overcome the barrier of needing to create new content for their programs. Despite this increase in available resources, integrating GH education into the already busy schedule of residency is a common challenge to the growing number of GH track directors. In this perspectives piece, GH educators from multiple institutions will share a novel model for packaging, administering, and monitoring GH educational curricula. This model transposes traditional GH learning objectives into self-paced, longitudinal maps of opportunities suitable for the time-intensive demands of residency, with flexibility for individual learning preferences and built-in tracking mechanisms.
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