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PubMed2001

Addressing lesbian, gay, bisexual, and transgender issues from the inside: one federal agency's approach.

The mission of the Substance Abuse and Mental Health Services Administration (SAMHSA) is to protect and serve underserved and vulnerable populations. Congress established SAMHSA under Public Law 102-321 on October 1, 1992, to strengthen the nation's health care capacity to provide prevention, diagnosis, and treatment services for substance abuse and mental illnesses. SAMHSA works in partnership with states, communities, and private organizations to address the needs of people with substance abuse and mental illnesses as well as the community risk factors that contribute to these illnesses. As part of its efforts to address the unique needs of special populations, SAMHSA has reached out to the lesbian, gay, bisexual, and transgender (LGBT) community. SAMHSA and its centers (Center for Substance Abuse Treatment, Center for Substance Abuse Prevention, and Center for Mental Health Services) have made a concerted effort, through both policy and programs, to develop services responsive to this community.

Community Health Planning↗
PubMed2002

Moving forward: addressing the health of Asian American and Pacific Islander women.

Little is known about the health of Asian American and Pacific Islander (AAPI) women, a rapidly growing population marked by diverse sociodemographic characteristics, health needs, and access to and use of health services. This commentary provides broad recommendations for research, program development, and policy development based on the first-ever White House Initiative report on AAPIs. These recommendations address the issues of data, access, civil rights, community capacity, and the need to recognize ethnic subgroups among the AAPI population. Reflecting on the events of the past year, the recommendations provide direction for public health to address the health and well-being of AAPI women.

Asian↗
PubMed2005

Addressing complex health issues: developing contextual knowing through sequenced writing and presentations.

When students discuss possible solutions for health problems they tend to form quick opinions, rush to conclusions, and suggest answers that do not address all the factors or stakeholders involved. Therefore, teaching the complexity of community health issues can be challenging. A series of learning activities applying Baxter-Magolda's model of four stages of college students' intellectual development is used to help students address complex health problems. Two written assignments and two presentations involving role playing are sequenced throughout the semester. This project has been well received by students and other faculty.

Community Health Services↗
PubMed1995

Changing paradigms in animal agriculture: addressing animal issues in Washington by a professional society.

This article discusses key points that we believe are important as we consider how a professional society in Washington could address animal issues with a changing paradigm as expressed by the public. In summary, our professional perspectives need to change as much as or more than society does. We must understand the advocacy groups and where they are coming from. We have to provide relevant messages to the diverse audiences that play an important role in the public policy process. We have to be clear about our goals and objectives as professionals so as to be more effective as we participate with others in trying to achieve stated goals. We need to understand the broad view of the role of science that exists today, particularly focusing on accountability and relevance of our work to assure the public that their funds are well spent. We need to ensure that all the questions are addressed so that society will maintain trust and respect for the role of science in society.

Animal Husbandry↗
PubMed2006

Personal empowerment program: addressing health concerns in people with schizophrenia.

Three staff nurses in the Outpatient Schizophrenia Service of the Foothills Medical Centre in Calgary, Alberta, Canada, became concerned about the weight gain of their patients. Patients and their family members were also concerned and asking for help. Before integrating a program to address these concerns, staff first had to demonstrate that a program of this nature would be beneficial for clinic patients. Of the 75 clients screened, many presented with problems in the areas of weight, blood pressure, and fasting blood sugar and lipid levels. Although not a research study, an 8-month pilot project was implemented to address these concerns. It was hypothesized that integrating all dimensions of wellness in patient programming would have a positive effect on various defined indicators (e.g., weight, body mass index, blood pressure, and fasting blood sugar and lipid levels). Screening tests before, during, and after the 8-month project provided the physical outcome measurements. Social and psychological outcomes were described through observation and group member feedback. The positive results are significant in terms of empowering patients in the long-term management of their health.

Adult↗
PubMedDate not supplied

Evaluation of United States Department of Agriculture-sponsored consumer materials addressing food security.

PURPOSE: Food insecurity in the United States is a major public health issue. The main objective of this study was to evaluate the availability and quality of printed materials addressing food security targeted to special populations by the United States Department of Agriculture (USDA). DESIGN: Nutrition education resources addressing food security available from USDA websites were selected for analysis. SETTING: Not applicable. PARTICIPANTS: The review team consisted of project staff (n = 6), two of who were fluent in Spanish. METHOD: Selection criteria were established to identify the food-security materials, and a group of reviewers assessed the quality of each publication both quantitatively and qualitatively. A consensus meeting among the reviewers was held to make final determinations of the quality of the materials. The quantitative data analysis consisted of basic descriptive statistics. RESULTS: Among the 27 materials initially identified, 20 were either irrelevant or of low relevance to food security. Moreover, very few of them were intended for minority populations. The quality of most of the materials ranged from "average" to "good." Some of the major weaknesses include readability level, lack of cultural relevance, and inadequate coverage of food insecurity. CONCLUSION: Very few materials on food insecurity are of high quality. In the development of such materials, emphasis should be given to the readability level, content, and cultural relevance.

Access to Information↗
PubMed1999

Addressing spiritual concerns of patients: family physicians' attitudes and practices.

BACKGROUND: Our goals were to assess family physicians' spiritual well-being, identify their perceived barriers to discussing spiritual issues with patients, and determine how often they have these discussions. METHODS: We mailed a questionnaire to 231 Missouri family physicians (80 residents, 43 faculty, and 108 community physicians). The questionnaire included the Ellison Spiritual Well-being Scale (ESWS), as well as questions about physicians' attitudes toward spirituality and the barriers to and frequency of discussions of spiritual issues with patients. RESULTS: The response rate was 74%. The mean ESWS score indicated that the physician respondents had a high level of spiritual well-being. Nearly all respondents (96%) considered spiritual well-being an important health component, 86% supported referral of hospitalized patients with spiritual questions to chaplains, and 58% believed physicians should address patients' spiritual concerns. Fear of dying was the spiritual issue most commonly discussed, and less than 20% of physicians reported discussing other spiritual topics in more than 10% of patient encounters. Barriers to addressing spiritual issues included lack of time (71%), inadequate training for taking spiritual histories (59%), and difficulty identifying patients who want to discuss spiritual issues (56%). CONCLUSIONS: Family physicians in this survey had high spiritual well-being scores. Most believed spiritual well-being is an important factor in health. Despite this belief, however, most reported infrequent discussions of spiritual issues with patients and infrequent referrals of hospitalized patients to chaplains. Lack of time and training were key barriers to spiritual assessment.

Attitude of Health Personnel↗
PubMed1998

Health promotion partnerships: service and education addressing the health needs of vulnerable groups.

This paper describes partnerships between service and education that can assist in meeting the health care needs of vulnerable population groups. Baccalaureate nursing students learn about population-based nursing practice as a means of addressing health needs. Each semester, groups of 8-10 senior students work with a community agency serving a population at risk. Students assess health needs and plan, implement, and evaluate a health promotion intervention with the population and the agency. Emphasis is placed on designing culturally appropriate interventions that are accomplished in partnership with the agency and population. Projects which illustrate the generalizability of this approach will be discussed. Such experiences reduce barriers that separate education from practice. Community agencies benefit as health needs that might not otherwise be met are addressed.

Alaska↗
PubMedDate not supplied

Rural system addresses social, economic needs. Cooperation, education, and advocacy revitalize a region's healthcare delivery.

In recent years leaders at Presentation Health System (PHS), Sioux Falls, SD, have expanded their mission to help strengthen local communities economically and socially. PHS now offers support to rural leaders in business, politics, and healthcare through its Center for Rural Health and Economic Development. In addition, educational outreach coordinators have created programs that address the needs of the entire rural community. To establish an effective network of services in the region, two of the system's tertiary care hospitals are collaborating to provide emergency helicopter service. These larger facilities also extend outreach services to rural hospitals and clinics. PHS assists rural hospitals in grant writing and in adapting to changing government reimbursement rules. In addition, the healthcare system coordinates a group purchasing program and a debt collection agency. An important voice for its region's healthcare needs, PHS has worked with the state of South Dakota to address problems and concerns about emergency medical services. The system also publishes Report, a quarterly newsletter that keeps rural residents abreast of healthcare issues affecting them. Two years ago, PHS's Center for Rural Health and Economic Development sponsored its first Invitational Rural Health Leadership Conference. These annual conferences bring together leaders to examine ways to improve rural healthcare delivery by strengthening the social and economic fabric of rural communities.

Catholicism↗
PubMedDate not supplied

Continuing to care in changing times. Keynote address.

While oral presentations do not always translate well into print, the enthusiastic response of the audience to Bill Tietjen's keynote address to the 14th Discharge Planning Symposium, Oct. 23, 1993, prompted DPU to put this editorial maxim to the test. Considering the relevance of the symposium's theme to the upheavals that health care reform will invariably impose, we offer Tietjen's keynote address here, in a somewhat shortened version to accommodate the print medium.

Congresses as Topic↗
PubMed1988

Pastoral care must address spiritual needs of the elderly.

For the immediate future, the attention and resources of healthcare will be focused on the increasing number of elderly individuals. But the American population is ill-prepared to handle the psychosocial aspects of this enormous population shift. Too often this country's mind-set toward the elderly is exemplified by its stereotypes. The ramifications of these biases are ethical, political, social, religious, and economic. Pastoral care should identify and create avenues to address the spiritual needs of the elderly, which can be categorized under three major areas: 1. The need to find a meaning and purpose to life 2. The need to feel a sense of belonging and love 3. The need to find reconciliation with God and the human community One tool to address these needs is the "life review", whose fundamental operational principle is that memory confers identity. The pastoral care professional identifies, interprets, and probes the remembrances and reminiscences of the elderly to help them find understanding and hope in the waning days of life.

Aged↗
PubMed1988

Addressing operational issues in medical practice development.

Even after a buyer for a medical practice has been found by a hospital's medical practice development team, potential problems could arise. Financing arrangements have been taken care of by the development team, but legal, operational, and additional financial issues still remain and must be addressed before the acquisition is finalized. In this final article of a two-part series on medical practice development, the operational issues of buying a physician practice are discussed. Acquisition of a medical practice and the transfer of patient loyalty can contain problem areas that must be addressed before the transition is initiated.

Decision Making↗
PubMed1998

Human rights approaches to an expanded response to address women's vulnerability to HIV/AIDS.

Research from around the world has revealed how gender-related sociocultural norms and economic realities contribute to women's vulnerability to HIV infection, and how gender-related discrimination contributes to their vulnerability to the impact of AIDS. As the global response to the epidemic enters its second decade, the need for an expanded response to address the societal determinants of women's vulnerability to HIV/AIDS is widely accepted. However, public health has been ill-equipped to address the broader context of vulnerability. This paper analyzes the research on gender and vulnerability, including five key policy and programmatic responses that have emerged from the research, through the lens of human rights. Each recommendation will be presented in terms of the promotion and protection of enumerated rights under four human rights treaties, the realization of which can support the objectives of an expanded response to reduce women's vulnerability to HIV and the impact of AIDS.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

The role of the health sector in addressing poverty.

PURPOSE: To explore Canadian health sector initiatives addressing poverty. METHODS: Information about 224 health sector initiatives addressing poverty was collected from Health Canada, provincial/territorial health ministries, and health regions. RESULTS: Health Canada, 12 provincial/territorial health ministries, and at least one third of health regions have been undertaking poverty-related initiatives. Almost two thirds (64.7%) of initiatives focused on the consequences of poverty. Much less frequent were initiatives that aim to: raise awareness about poverty; prevent people from becoming poor; enhance skills and education of people in poverty; and alter social and economic conditions contributing to poverty. DISCUSSION AND CONCLUSIONS: While strategies that focus on the consequences of poverty likely enhance the health of Canadians in poverty, these strategies do little to reduce poverty rates. Efforts to improve the health of both individual Canadians in poverty and society as a whole will be limited until the health sector uses more strategies that challenge fundamental structural conditions contributing to poverty.

Canada↗
PubMedDate not supplied

A participatory research approach to address data needs in tobacco use among Native Hawaiians.

OBJECTIVES: This case study describes the first phase of collaboration among three entities: 1) Papa Ola Lokahi (POL) a community-based consortium that focuses on Native Hawaiian health concerns, 2) the Hawaii State Department of Health's Tobacco Prevention and Control Program (TPCP) and, 3) five community-based, Native Hawaiian Health Care Systems (NHHCS) that provide health promotion and screening services to Native Hawaiians statewide. METHODS: We utilized a participatory action research approach to address the need for ethnic-specific information on smoking attitudes and behaviors. Collaboratively, each party provided resources and/or skills, which produced outcomes relevant and meaningful to each. FINDINGS: This collaborative process resulted in 1) a user-friendly survey tool that gathered data of interest to all three groups; 2) a positive experience in data collection; 3) community-specific results with direct application to the NHHCS; 4) well-formatted reports that made them easy for each NHHCS to present the findings to their staff and participants; and 5) an expanded community capacity for future health promotion action. CONCLUSIONS: This modest achievement represents the first phase of a participatory research process that promotes and supports the needs and efforts of Native Hawaiian communities to actively identify, address and resolve their concerns about tobacco use.

Female↗
PubMedDate not supplied

Using a stages of readiness model to address community capacity on tobacco control in the Asian American and Pacific Islander community.

OBJECTIVES: This paper describes the Asian Pacific Partners for Empowerment and Leadership (APPEAL) Stages of Community Readiness Model, a framework for assessing and evaluating tobacco control in the diverse Asian American and PaCific Islander (AAPI) communities. METHODS: This model extends the work of existing community capacity models by applying a "stage of readiness" continuum of the five stages of pre-contemplation, contemplation, preparation, action and maintenance in terms of developing, launching and sustaining AAPI tobacco control efforts. FINDINGS: The APPEAL Model allows communities to diagnose, then address their unique needs through appropriate technical assistance, training and resources. The APPEAL Model benefits both communities and funders through its ability to better understand their readiness to conduct tobacco control and have realistic expectations on the outcomes of those efforts. CONCLUSIONS: This paper describes the elements of the Readiness model for AAPIS, particularly those addressing research and data issues, current applications of the model in specific AAPI ethnic communities, and the lessons learned thus far regarding the model's applicability to, and support of, the development of AAPI tobacco control efforts nationally.

Asian↗
PubMed2002

Generating addressable protein microarrays with PROfusion covalent mRNA-protein fusion technology.

An mRNA-protein fusion consists of a polypeptide covalently linked to its corresponding mRNA. These species, prepared individually or en masse by in vitro translation with a modified mRNA conjugate (the PROfusion process), link phenotype to genotype and enable powerful directed evolution schemes. We have exploited the informational content of the nucleic acid component of the mRNA-protein fusion to create an addressable protein microarray that self-assembles via hybridization to surface-bound DNA capture probes. The nucleic acid component not only directs the mRNA-protein fusion to the proper coordinate of the microarray, but also positions the protein in a uniform orientation. We demonstrate the feasibility of this protein chip concept with several mRNA-protein fusions, each possessing a unique peptide epitope sequence. These addressable proteins could be visualized on the microarray both by autoradiography and highly specific monoclonal antibody binding. The anchoring of the protein to the chip surface is surprisingly robust, and the system is sensitive enough to detect sub-attomole quantities of displayed protein without signal amplification. Such protein arrays should be useful for functional screening in massively parallel formats, as well as other applications involving immobilized peptides and proteins.

DNA Primers↗
PubMed2003

Addressing immunization barriers, benefits, and risks.

Immunization rates in the United States still fall short of the Healthy People 2010 goals for children and adults. To improve rates of immunization, physicians need to understand and address barriers to immunization, including fragmented health-care delivery, missed opportunities to vaccinate, and the patient's fear of adverse reactions. This article addresses these issues and suggests strategies by which rates can be improved, such as patient reminders, standing orders, and assessment of and feedback on practitioner performance. Additionally, it provides suggestions to help physicians better communicate vaccine risks and benefits to their patients, potentially affecting an individual's acceptance of those risks. It describes the appropriate use of materials such as the Vaccine Information Statements. Physicians should also be prepared to answer patients' questions about alleged or controversial vaccine adverse events.

Chickenpox↗