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Homelessness among older people in Canada is both a growing concern, and an emerging field of study. This article reports thematic results of qualitative interviews with 40 people aged 46 to 75, carried out as part of a mixed-methods study of older people who are homeless in Montreal, Quebec, Canada. Our participants included people with histories of homelessness (= 14) and persons new to homelessness in later life (= 26). Interviews focused on experiences at the intersections of aging and homelessness including social relationships, the challenges of living on the streets and in shelters in later life, and the future. This article outlines the 5 main themes that capture the experience of homelessness for our participants: age exacerbates worries; exclusion and isolation; managing significant challenges; shifting needs and realities; and resilience, strength, and hope. Together, these findings underscore the need for specific programs geared to the unique needs of older people who are homeless.  相似文献   
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This study examined the effect of Testofen, a specialised Trigonella foenum-graecum seed extract on the symptoms of possible androgen deficiency, sexual function and serum androgen concentrations in healthy aging males. This was a double-blind, randomised, placebo-controlled trial involving 120 healthy men aged between 43 and 70 years of age. The active treatment was standardised Trigonella foenum-graecum seed extract at a dose of 600?mg/day for 12 weeks. The primary outcome measure was the change in the Aging Male Symptom questionnaire (AMS), a measure of possible androgen deficiency symptoms; secondary outcome measures were sexual function and serum testosterone. There was a significant decrease in AMS score over time and between the active and placebo groups. Sexual function improved, including number of morning erections and frequency of sexual activity. Both total serum testosterone and free testosterone increased compared to placebo after 12 weeks of active treatment. Trigonella foenum-graecum seed extract is a safe and effective treatment for reducing symptoms of possible androgen deficiency, improves sexual function and increases serum testosterone in healthy middle-aged and older men.  相似文献   
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The refusal of psychotropic medication is a challenge faced by many healthcare providers when treating patients with mental illness. Controversy surrounds medication refusal because some mental health professionals believe that psychiatric patients should be forced to take medications for the safety of the general public, while patients are often acutely aware of potential lifelong adverse side effects and are sometimes reluctant to comply. The proposed alternative to this problem begins with developing the patient-provider relationship through a patient-centered approach. This approach emphasizes the individual needs of patients and creates opportunities for input from patients about their care, which helps form relationships of mutual trust and respect between patients and providers. This article explores the literature to: (1) understand some of the challenges and controversies involved in patient medication refusal from a clinical and societal level; (2) identify some issues in a patient-centered approach; and (3) make some brief clinical and policy recommendations that might help to bring about an increase in the use of patient-centered care. Hopefully, as efforts are made toward a patient-centered approach, increased psychotropic medication adherence and decreased medication coercion will result as providers listen and act upon the needs of their patients.  相似文献   
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ABSTRACT

This article engages with the understudied phenomenon of the ‘disinterested, denouncing’ diaspora state (Levitt, P., and N. G. Schiller. 2004. “Conceptualizing Simultaneity: A Transnational Social Field Perspective on Society.” International Migration Review 38 (3): 1002–1039. doi:10.1111/j.1747-7379.2004.tb00227.x) or ‘indifferent’ diaspora state (Ragazzi, F. 2009. “Governing Diasporas.” International Political Sociology 3 (4): 378–397. doi:10.1111/j.1749-5687.2009.00082.x). Focusing on U.S. citizens abroad, the article argues that there is negative diasporic outreach on the part of the state – ‘disinterested’ from the state's perspective, but ‘denouncing’ from that of the diaspora. Negative diasporic outreach is exemplified by the 2010 FATCA legislation, which sought to root out tax evaders resident in the U.S., but has, instead, affected millions of American emigrants through increased financial control and the repercussions of those policies, and has resulted in sharply higher citizenship renunciation figures. Impact on an American diaspora was not considered in the law's proposal, debate and passage into law. Second, the article argues that this negative diasporic outreach, in combination with the continued facilitation of the right to vote, is a reflection of the inclusion of these American emigrants in the American state, but their simultaneous exclusion from the American nation.  相似文献   
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ABSTRACT

Many who move countries today do so for work, and labour mobility – both temporary and permanent – is the mechanism by which countless people (both movers and stayers) come into contact with cultural difference. The domain of mobile labour is thus an important context through which to consider the transformative possibilities of encounters with racial and cultural difference. Situated within debates on everyday multi-culture and vernacular cosmopolitanisms, this essay considers the question of intercultural encounter at work in relation to the layered histories of race and variegated citizenships of mobile labour in Singapore. Exploring the micro-nature of cosmopolitan practices, the paper considers under what labour conditions might an outward-looking cosmopolitan sensibility and a convivial openness to otherness emerge among migrant workers, as against a set of survival-based intercultural capacities. I reflect specifically upon two cases of ‘incongruous encounter’ in workplaces reliant on precariously employed migrant labour: a mainland Chinese man and a Filipina woman who, because of Singapore’s racialised system of work visas, find themselves working in South Asian restaurants in Singapore’s Little India. They both engage ‘cosmopolitan practices’, yet their sensibilities differ sharply. Their stories highlight how, in a place like Singapore, the ‘encounter’ needs to be understood within a regime of mobile labour, situated racial hierarchies, and a highly stratified system of work visas. I further suggest that situational factors such as the nature of work including its spatial and temporal qualities, the mixture of co-workers, and recognition relations with superiors all mattered in framing the affective atmospheres of encounter. In a context of forced encounter, I argue that learnt capacities to function and interact across difference should not necessarily be romanticised as a cosmopolitan sensibility.  相似文献   
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OBJECTIVE: Maryland became the first state to pass a vaccination law requiring college and university students living on campus to obtain a meningococcal vaccination or to sign a waiver refusing vaccination because college students are at increased risk for disease. The authors sought to identify how Maryland colleges addressed the law and determine whether schools were in full compliance. PARTICIPANTS: The authors surveyed 32 college/university administrators via a self-administered questionnaire. METHODS: The authors calculated vaccination and waiver rates and assessed compliance with the law overall and with specific law components. RESULTS: Among 28 participating schools, annual vaccination rates and waiver rates among students during 2000-2004 ranged from 66%-76% and 12%-17%, respectively. Two (7%) schools were compliant with all components of the law. CONCLUSIONS: Mandatory vaccination laws do not ensure compliance at the college and university level. Mandatory reporting, increased education, and collaboration between colleges and universities and public health agencies are needed.  相似文献   
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Urban Ecosystems - Communication systems rely upon specific social contexts and environments that permit effective transmission, and thus, are particularly vulnerable to disruption by anthropogenic...  相似文献   
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Scholars, educators, regulators, pundits, and other observers are advocating for regulation and oversight of direct-to-consumer (DTC) genomic testing. As a result, the technology has been subject of highly visible public and regulatory controversy. In this article, we explore the nature and the shape of the sentiment of public discourse about the DTC company, 23andMe. We conduct a quantitative content analysis and qualitative framing analysis on Tweets. We find that the discourse surrounding DTC genomics and 23andMe is largely positive. We also identify a number of frames users deploy to debate, discuss, and share their experiences with DTC genomics and 23andMe. We argue that these frames create meaning around this emerging technology for its users.  相似文献   
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