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Douglass, Alan B., Wendy B. Barr, Joe M. Skariah, Kelly J. Hill, Yadira Acevedo, Roger Garvin, and Sasha Savage. "Financing the Fourth Year: Experiences of Required 4-Year Family Medicine Residency Programs." Family Medicine 53, no. 3 (March 4, 2021): 195–99. http://dx.doi.org/10.22454/fammed.2021.249809.
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Abstract: The optimal length of family medicine training has been debated since the specialty’s inception. Currently there are four residency programs in the United States that require 4 years of training for all residents through participation in the Accreditation Council for Graduate Medical Education Length of Training Pilot. Financing the additional year of training has been perceived as a barrier to broader dissemination of this educational innovation. Utilizing varied approaches, the family medicine residency programs at Middlesex Health, Greater Lawrence Health Center, Oregon Health and Science University, and MidMichigan Medical Center all demonstrated successful implementation of a required 4-year curricular model. Total resident complement increased in all programs, and the number of residents per class increased in half of the programs. All programs maintained or improved their contribution margins to their sponsoring institutions through additional revenue generation from sources including endowment funding, family medicine center professional fees, institutional collaborations, and Health Resources and Services Administration Teaching Health Center funding. Operating expense per resident remained stable or decreased. These findings demonstrate that extension of training in family medicine to 4 years is financially feasible, and can be funded through a variety of models.
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Cinelli, Bethann, Mary Rose-Colley, and David M. Hayes. "Health Promotion Efforts in Pennsylvania Schools." American Journal of Health Promotion 2, no. 4 (March 1988): 36–44. http://dx.doi.org/10.4278/0890-1171-2.4.36.
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The purpose of this study was to investigate and describe health promotion efforts within Pennsylvania public schools. A questionnaire was designed which addressed the following areas: demographics, health issues and concerns, health promotion programming, and variables pertinent to describe districts without programs. The sample consisted of 275 superintendents of public school districts, 41 of which indicated the existence of a health promotion program in their district. Superintendents of districts with health promotion programs indicated the following: the most frequently offered programs were physical fitness activities, stress management and weight reduction; programs were most frequently offered during the after school hours; many programs were not open to family and community; and the administration of the programs was most frequently the responsibility of a school administrator. The remaining 234 school districts did not have health promotion programs. The reasons cited by the superintendents included limited financial resources, an uninterested faculty and staff, and lack of school board support.
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Iliopoulou, L., V. Koutras, K. Komninou, E. Fidi, S. Gonta, and V. Basogianni. "The management of relapse in an outpatient program for heroin user by administration of naltrexone." European Psychiatry 26, S2 (March 2011): 55. http://dx.doi.org/10.1016/s0924-9338(11)71766-7.
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IntroductionThe Counseling Center for Combating Drug Abuse offers an outpatient drug psychotherapeutic program, on an individual basis. Naltrexone is prescribed to selected heroin addicted users as part of this program.ObjectivesRelapse is one of the most challenging problems.AimsDetection of factors which engage in the therapeutic process and hinder successful therapy leads to a better design of the therapeutic plan.MethodsAdministration of naltrexone aims at retention in therapy and avoidance of relapse. The program's design focuses on the right selection of users, and the therapist's suitability. Family or people in the user's environment engage actively in the observation of ingestion. Naltrexone administration continues for several months after stabilization and at least until user changes his attitude towards drug use. Relapse is considered as a stage of the withdrawal procedure. Manipulation focuses on user's rehabilitation in therapy. Therapist, user and family concentrate on factors which fostered relapse (parallel drug use, association with active users, co-morbidity, personal and family difficulties), and set new goals.ResultsDevelopment of a therapeutic alliance between therapist and addicted patient is one of the stronger predictors of treatment retention and success. Effective manipulation of the factors which foster relapse may lead to successful therapy.ConclusionsRelapse must be seen not as a failure, but as a demanding stage of the procedure. Goal readjustment, and focusing on previously unresolved problems, may lead to an ultimate successful therapeutic outcome, and develop trust in naltrexone programs which are considered as particularly effective in open withdrawal programs.
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Pauwels, Judith, and Amanda Weidner. "The Cost of Family Medicine Residency Training:." Family Medicine 50, no. 2 (February 2, 2018): 123–27. http://dx.doi.org/10.22454/fammed.2018.844856.
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Background and Objectives: Numerous organizations are calling for the expansion of graduate medical education (GME) positions nationally. Developing new residency programs and expanding existing programs can only happen if financial resources are available to pay for the expenses of training beyond what can be generated in direct clinical income by the residents and faculty in the program. The goal of this study was to evaluate trended data regarding the finances of family medicine residency programs to identify what financial resources are needed to sustain graduate medical education programs. Methods: A group of family medicine residency programs have shared their financial data since 2002 through a biennial survey of program revenues, expenses, and staffing. Data sets over 12 years were collected and analyzed, and results compared to analyze trends. Results: Overall expenses increased 70.4% during this period. Centers for Medicare and Medicaid Services (CMS) GME revenue per resident increased by 15.7% for those programs receiving these monies. Overall, total revenue per resident, including clinical revenues, state funding, and any other revenue stream, increased 44.5% from 2006 to 2016. The median cost per resident among these programs, excluding federal GME funds, is currently $179,353; this amount has increased over the 12 years by 93.7%. Conclusions: For this study group of family medicine programs, data suggests a cost per resident per year, excluding federal and state GME funding streams, of about $180,000. This excess expense compared to revenue must be met by other agencies, whether from CMS, the Health Resources and Services Administration (HRSA), state expenditures or other sources, through stable long-term commitments to these funding mechanisms to ensure program viability for these essential family medicine programs in the future.
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Lopreite, Debora. "Gender Policies in Argentina after Neoliberalism." Latin American Perspectives 42, no. 1 (June 26, 2013): 64–73. http://dx.doi.org/10.1177/0094582x13492709.
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After a decade of neoliberalism under the social-conservative administration of Carlos Menem (1989–1999), with its negative effects on women’s rights, the 2001–2002 economic crises created new opportunities for women. The Menem administration initiated a gender-equality agenda with its quota for women candidates for the Congress and its adoption of the UN Convention on the Elimination of All Forms of Discrimination against Women, but it clashed with women’s groups on reproductive rights. While the two Kirchner administrations (2003–present) established programs for sexual health and responsible procreation, they reverted to maternalism in their programs for social assistance for poor mothers and family support. The Consejo Nacional de la Mujer (National Women’s Council), created during the Menem administration, took on more responsibility for delivering social assistance but abandoned its original gender-equality mandate. Luego de una década de neoliberalismo bajo la administración conservadora-social de Carlos Menem (1989–1999), con sus efectos negativos sobre los derechos de las mujeres, las crisis económicas de 2001–2002 crearon nuevas oportunidades para las mujeres. La administración Menem inició una agenda de igualdad de género con la adopción de la cuota para candidatas mujeres para el Congreso y la adopción del Convención sobre la Eliminación de Todas las Formas de Discriminación contra la Mujer de la ONU, pero chocó con los grupos de mujeres sobre derechos reproductivos. Aunque las dos administraciones Kirchner (2003 al presente) establecieron programas para la salud sexual y la procreación responsable, volvieron al maternalismo en sus programas de asistencia social para mujeres pobres y el apoyo familiar. El Consejo Nacional de la Mujer, creado durante la administración Menem, se comprometió más en la entrega de asistencia social pero abandonó su mandato original de igualdad de género.
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Kalinyak, Christopher M., Faye A. Gary, Cheryl M. Killion, and M. Jane Suresky. "An Overview of Quality Programs that Support Transition-Aged Youth." Journal of Youth Development 11, no. 1 (December 15, 2016): 98–115. http://dx.doi.org/10.5195/jyd.2016.437.
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This article provides a concise overview of several programs that deliver services to transition-aged youth, ages 14–29. Included are family support, the Assisting Unaccompanied Children and Youth program, the Substance Abuse and Mental Health Services Administration services, the wraparound approach, intensive home-based treatment, multisystemic therapy, foster care, independent living, mentoring, the Steps to Success program, the Jump on Board for Success program, the Options program, the Positive Action program, the Transition to Success model, and the Transition to Independence Program. Primary focus is placed upon the usefulness of each of the programs in facilitating successful outcomes for transition-aged youth.
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Ofei-Dodoo, Samuel, Paul Callaway, and Kendra Engels. "Prevalence and Etiology of Burnout in a Community-Based Graduate Medical Education System: A Mixed-Methods Study." Family Medicine 51, no. 9 (October 4, 2019): 766–71. http://dx.doi.org/10.22454/fammed.2019.431489.
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Background and Objectives: Burnout rates among American physicians and trainees are high. The objectives of this study were: (1) to compare burnout rates among residents and faculty members of the graduate medical education (GME) programs sponsored by the University of Kansas School of Medicine-Wichita (KUSM-W) to previously published data, and (2) to evaluate the physicians’ feedback on perceived causes and activities to promote wellness. Methods: Between April and May 2017, we surveyed 439 residents and core faculty members from 13 residency programs sponsored by the KUSM-W. The survey included the Abbreviated Maslach Burnout Inventory, two open-ended questions, and demographic questions. The authors used Kruskal-Wallis and Fisher exact tests to analyze the quantitative data, and an immersion-crystallization approach to analyze the open-ended data. Results: Forty-three percent of all respondents met the criteria for burnout, and the overall response rate was 50%. When compared with core faculty members, rates of burnout among residents were higher (51% vs 31%, P<.05). The immersion-crystallization approach revealed five interconnected themes as possible causes of burnout among physicians: work-life imbalance, system issues, poor morale, difficult patient populations, and unrealistic expectations. Promotion of healthy and mindfulness activities; enhanced program leadership; and administration, program, and system modification were identified as activities/resources that can promote wellness among physicians. Conclusions: The findings show that burnout is prevalent among physicians within GME. Wellness and burnout prevention should be addressed at the beginning of medical training and longitudinally. Potential intervention should include activities that allow physicians to thrive in the health care environment.
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Surani, Vincencius, Dewi Elizadiani Suza, and Mula Tarigan. "The impact of family intervention programs on the caregiver burden of hemodialysis patients." Kontakt 23, no. 2 (May 5, 2021): 138–45. http://dx.doi.org/10.32725/kont.2021.017.
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Lucas, Kimberley D., Joseph Bick, and Janet C. Mohle-Boetani. "California’s Prisoner Protections for Family and Community Health Act." Public Health Reports 135, no. 1_suppl (July 2020): 50S—56S. http://dx.doi.org/10.1177/0033354920920629.
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In 2014, California passed Assembly Bill 966, which required condom access for persons incarcerated in all 35 California state prisons (33 men’s and 2 women’s prisons). The California Correctional Health Care Services and the Sexually Transmitted Disease Control Branch and the Office of AIDS of the California Department of Public Health collaborated in a prison administration–led multidisciplinary implementation workgroup. Our workgroup, representing public health, correctional health, legal and legislative affairs, labor relations, and prison staff members, participated in 4 planning meetings during May–September 2015. We surveyed prison staff members and incarcerated men to identify and address potential challenges; conceptualized a tamper-resistant condom dispenser; developed educational materials, frequently asked questions for staff members, and fact sheets for the public; and conducted forums for custody and medical staff members at each prison. Key lessons learned included the need for high-level custody support, engagement of labor unions early in the decision-making process, and flexibility within defined parameters for sites to determine best practices given their unique institutional population, culture, and physical layout. Condom access was initiated at 4 prisons in July 2015 and expanded incrementally to the remaining 29 men’s prisons through July 2016. A total of 243 563 condoms were accessed in the men’s prisons, for an average of 354 condoms per 1000 population per month. The start-up dispenser cost was $69 825 (735 dispensers at $95 each). We estimated an annual condom cost of $0.60 per person. Although staff members and incarcerated men expressed concern that this legislation would condone sex and provide repositories for contraband, no serious adverse incidents involving condoms were reported. California demonstrated that condom access is a safe, low-cost intervention with high uptake for a large correctional system and provided a replicable implementation model for other states. Prison condom programs have the potential to decrease transmission of sexually transmitted infections (STIs) among incarcerated persons and their communities, which are often disproportionately affected by STIs, HIV, and other chronic diseases.
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Burgdorf, Julia, Alicia Arbaje, and Jennifer L. Wolff. "Older Adult Factors Associated With Identified Need for Family Caregiver Assistance During Home Health Care." Home Health Care Management & Practice 32, no. 2 (September 17, 2019): 67–75. http://dx.doi.org/10.1177/1084822319876608.
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Family caregivers make important contributions to home health care for older adults, but knowledge of the specific roles they assume is lacking. We analyzed data from 1,758 community-dwelling Medicare beneficiaries aged 65+ receiving Medicare-funded home health care between 2011 and 2016, using linked National Health and Aging Trends Study and Outcomes and Assessment Information Set data. Most (86.7%) beneficiaries receiving home health care had an identified need for family caregiver assistance, and nearly 6 in 10 (57.9%) had identified need for caregiver assistance with five or more tasks. After examining significant associations between older adult characteristics and identified needs for caregiver assistance with specific tasks, we identified three profiles of older adults who demonstrate similar patterns of identified need for family caregiver assistance during home health. These profiles include: (1) older adults with greater functional impairment who more often had identified need for assistance with Instrumental Activities of Daily Living, advocacy, or Activities of Daily Living; (2) older adults with cognitive impairment who more often had identified need for assistance with medication administration or supervision; and (3) older adults with greater clinical severity who more often had identified need for assistance with medical procedures and equipment. Findings support calls to develop training interventions and strengthen the partnership between home health providers and family caregivers. These three profiles present a potential framework for the development of family caregiver training programs.
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Normajatun, Normajatun, Sitna Hajar Malawat, and Fika Fibriyanita. "IMPLEMENTASI KEBIJAKAN PROGRAM KAMPUNG KELUARGA BERENCANA - KAMPUNG BAIMAN (KKB-KB) DI KOTA BANJARMASIN." AS-SIYASAH: Jurnal Ilmu Sosial Dan Ilmu Politik 3, no. 2 (July 23, 2019): 47. http://dx.doi.org/10.31602/as.v3i2.2084.
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Developing countries are always experiencing the main problem of development, where one of the points of development problems concerning the problem of a large population with a low quality of life Banjarmasin city government has a policy. namely Kampung Keluarga Berencana - Kampung Baiman (KKB-KB). The KKB-KB program not only prioritizes family planning programs but all sectors, such as health development, population administration and residential development. The KKB-KB program is expected to improve the quality of life of the community. This study uses a qualitative approach to collect data and analyze data then interpreted.
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McFadden, Emily Jean, and Jill Worrall. "Toward a global perspective of family continuity: The effects of international exchange on child welfare practice programs and policy." Children Australia 24, no. 4 (1999): 89–92. http://dx.doi.org/10.1017/s1035077200009433.
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The International Foster Care Organisation (IFCO) has been a significant vehicle of change within the steadily evolving field of foster care. In two decades of international transfer of knowledge, the organization has examined critical and controversial issues such as the colonization of indigenous people, the insensitivity of ‘Westernized’ systems of care to the kinship networks of children of color, and the needs of families stricken by poverty, dysfunction or oppression. Concurrently, the exchange of knowledge and skill on case planning, dynamics of change, legal issues, foster parent training; and systems of administration led to greater understanding between people working in foster care systems of different countries. IFCO became a moving and reconstituting global village of committed individuals, families, groups and organizations that transcended national boundaries.
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Dinakar, R. "Effectiveness of Work Life Balance (WLB) on Job Satisfaction of Employees working in Banks." International Journal of Management and Humanities 5, no. 7 (March 30, 2021): 22–26. http://dx.doi.org/10.35940/ijmh.g1256.035721.
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The passage of new private banks improves operational effectiveness and intensity in the Indian financial system. The new private area banks have presented state-of-theart and inventive administrations and products to catch the high market share of the overall banking industry. This progression the working example of the employees in the financial sector. The findings of the study shows that equilibrium work life balance, responsibility, Institutional help, and monetary help are determinants of the WLB of representatives in new private area banks. The outcomes demonstrate that there is a critical distinction between the financial status of employees and determinants of WLB in new private area banks. The outcomes likewise suggest that WLB, Organizational help, monetary help, and responsibility are fundamentally and emphatically affecting the work fulfillment of representatives in new private area banks. The new private area banks should offer work-family uphold programs in particular youngster care uphold and adaptable working timings to diminish employee pressure and encourage to the administration of family and work viably. Moreover, new private banks should actualize arrangements of anticipation of lewd behavior, yearly health checkups, and sick leaves successfully so that employees can satisfy with their roles and in turn increase the productiveness of their operations.
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Pringle, Janice L., Alicia Kowalchuk, Jessica Adams Meyers, and J. Paul Seale. "Equipping Residents to Address Alcohol and Drug Abuse: The National SBIRT Residency Training Project." Journal of Graduate Medical Education 4, no. 1 (March 1, 2012): 58–63. http://dx.doi.org/10.4300/jgme-d-11-00019.1.
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Abstract Background The Screening, Brief Intervention and Referral to Treatment (SBIRT) service for unhealthy alcohol use has been shown to be one of the most cost-effective medical preventive services and has been associated with long-term reductions in alcohol use and health care utilization. Recent studies also indicate that SBIRT reduces illicit drug use. In 2008 and 2009, the Substance Abuse Mental Health Service Administration funded 17 grantees to develop and implement medical residency training programs that teach residents how to provide SBIRT services for individuals with alcohol and drug misuse conditions. This paper presents the curricular activities associated with this initiative. Methods We used an online survey delivery application (Qualtrics) to e-mail a survey instrument developed by the project directors of 4 SBIRT residency programs to each residency grantee's director. The survey included both quantitative and qualitative data. Results All 17 (100%) grantees responded. Respondents encompassed residency programs in emergency medicine, family medicine, pediatrics, obstetrics-gynecology, psychiatry, surgery, and preventive medicine. Thirteen of 17 (76%) grantee programs used both online and in-person approaches to deliver the curriculum. All 17 grantees incorporated motivational interviewing and validated screening instruments in the curriculum. As of June 2011, 2867 residents had been trained, and project directors reported all residents were incorporating SBIRT into their practices. Consistently mentioned challenges in implementing an SBIRT curriculum included finding time in residents' schedules for the modules and the need for trained faculty to verify resident competence. Conclusions The SBIRT initiative has resulted in rapid development of educational programs and a cohort of residents who utilize SBIRT in practice. Skills verification, program dissemination, and sustainability after grant funding ends remain ongoing challenges.
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Frois, Christian, Thomas O’Connell, Jacqueline Pesa, and John Fastenau. "The Impact of Medicaid Preferred Drug Lists on Utilization and Costs of Antipsychotic Medication." Journal of Health Economics and Outcomes Research 1, no. 1 (May 24, 2013): 54–61. http://dx.doi.org/10.36469/9853.
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Background: Few studies have attempted to assess the effectiveness of formulary management in reducing the antipsychotic costs and utilization across U.S. state Medicaid programs, despite concerns about the potential impact of such formulary management on Medicaid patient health outcomes. Objectives: Compare antipsychotic utilization and total costs across Medicaid states with preferred drug list (PDL) programs vs. states without PDLs in place. Methods: The following data from 48 Medicaid fee-for-service (FFS) programs were collected for calendar year 2010: antipsychotic prescription use (IMS Health); formulary management (MediMedia, Medicaid FFS programs’ websites), and patient enrollment (MediMedia). For each program, the total antipsychotic cost per capita was estimated by multiplying antipsychotic utilization by list price (First DataBank), then dividing by program enrollment. To control for differences in the prevalence of antipsychotic use among Medicaid patients across states, cost estimates were adjusted using state-level mental-health illness prevalence data (Kaiser Family Foundation, Substance Abuse and Mental Health Services Administration [SAMHSA], and Thomson Healthcare). Volume-based market share of branded antipsychotics was also calculated to compare branded vs. generic antipsychotic use across states. Significance of difference between the means of PDL and non-PDL states was tested using a two-sided, two sample t-test, assuming unequal variances between samples. Results: Among the 48 states studied, 33 (68.8%) used PDLs as a means to limit access to branded antipsychotic medications, including those states with the largest populations with a mental-health illness (e.g. New York, California, Texas). In our analyses, the average difference in antipsychotic costs per capita between PDL and non-PDL states was less than $0.6M or 1.5% (p=0.95). The average difference in antipsychotic utilization per capita was less than 2.8% (p=0.91) and in branded antipsychotic market share was 0.7% (p=0.59). Conclusions: Although a majority of Medicaid states use PDLs to manage antipsychotic utilization, this analysis found no evidence of significant advantages for these Medicaid programs in terms of lowering percapita antipsychotic costs or increasing generic utilization.
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King, Diane K., Lucía L. Neander, Alexandra E. Edwards, Jodi D. Barnett, Amanda L. Zold, and Bridget L. Hanson. "Fit and Feasibility: Adapting a Standardized Curriculum to Prepare Future Health Professionals to Address Alcohol Misuse." Pedagogy in Health Promotion 5, no. 2 (August 1, 2018): 107–16. http://dx.doi.org/10.1177/2373379918785924.
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Standardized screening, brief intervention, and referral to treatment (SBIRT) is effective when used by health care professionals to assess, educate, and intervene to address risky alcohol use. To accelerate SBIRT training within academic settings, the Substance Abuse and Mental Health Services Administration funded implementation of its SBIRT curriculum to promote its use by future health care professionals. We report on how SBIRT content was implemented within nursing, social work, psychology, and family medicine residency programs at a state university. The reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) evaluation framework was used to compare delivery of SBIRT curriculum across health professions. Survey data measured changes in student knowledge, confidence, and responsibility to use SBIRT for alcohol and drugs, pre- and post-SBIRT training. Twelve months postgraduation follow-up surveys examined maintenance of outcomes and SBIRT use in practice. Observational data explored fidelity and adaptations made to curriculum content and delivery logistics. Results indicated that instructor adoption, fidelity, and format varied across health professional training programs, with adaptations made to improve fit, role alignment, and cultural relevance. Despite variation in curriculum delivery, students demonstrated significant gains in knowledge and confidence, ( p < .001). Key implementation and maintenance challenges included time constraints, instructor buy-in, competing accreditation requirements, and costs for using the university simulation laboratory to practice SBIRT. Strengths supporting maintenance included flexibility to adapt curriculum, department champions, and electronic resources to support curriculum delivery. Results suggest that adaptations maximizing the feasibility and fit of SBIRT within existing courses enhanced its adoption and maintenance potential without sacrificing effectiveness.
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Judge, Katherine, and Sam Fazio. "Development of an Innovative Financial Literacy and Preparedness Program for Family Caregivers." Innovation in Aging 4, Supplement_1 (December 1, 2020): 357. http://dx.doi.org/10.1093/geroni/igaa057.1148.
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Abstract Informal caregivers provide the bulk of daily care and assistance to older adults needing help. Tasks range from assisting with transportation, coordinating care and appointments, household tasks, emotional and social support, and personal care. Caregivers also assist with financial care-related issues. This assistance ranges from helping pay bills, making health-care decisions, to paying out-of-pocket care expenses. Research on financial care-related issues greatly lags behind other areas of caregiving. Additionally, few programs have been developed that specifically address these financial issues and how best to provide timely and personalized information for families. The following poster will present an innovative program that addresses these gaps within the literature and fills the void facing families in navigating key financial care-related decisions. Funded by the Administration on Community Living, the evidence-informed program was developed based on findings from a comprehensive literature review, an environmental scan, market analysis, and feedback from focus groups. The program includes educational information, skills-training, and resources for caregivers across the following content areas: Introduction to Costs of Caregiving, Benefits of Early Planning, Avoiding Financial Abuse and Fraud, Conversations about Finances, Assessing Financial Needs, Creating Action Plans, and Finding Financial Support. The program also addresses specific financial needs facing caregivers of individuals with Alzheimer’s disease and related dementias. Discussion will highlight key aspects of the program, including the standardized yet flexible and tailored approach for addressing families’ specific financial care-related needs, along with next steps in program implementation and evaluation.
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Deyo-Svendsen, Mark, Matthew Cabrera Svendsen, James Walker, Andrea Hodges, Rachel Oldfather, and Meghna P. Mansukhani. "Medication-Assisted Treatment for Opioid Use Disorder in a Rural Family Medicine Practice." Journal of Primary Care & Community Health 11 (January 2020): 215013272093172. http://dx.doi.org/10.1177/2150132720931720.
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Opioid use disorder (OUD) is a cause of significant morbidity and mortality in the United States. Although efforts are being made to limit access to prescription opioids, the use of heroin and synthetic opioids as well as death due to opioid overdose has increased. Medication-assisted treatment (MAT) is the pairing of psychosocial intervention with a Food and Drug Administration (FDA)–approved medication (methadone, buprenorphine plus naltrexone) to treat OUD. MAT has resulted in reductions in overdose deaths, criminal activity, and infectious disease transmission. Access to MAT in rural areas is limited by shortages of addiction medicine-trained providers, lack of access to comprehensive addiction programs, transportation, and cost-related issues. Rural physicians express concern about lack of mentorship and drug diversion as reasons to avoid MAT. The prescribing of MAT with buprenorphine requires a Drug Enforcement Agency (DEA) waiver that can easily be obtained by Family Medicine providers. MAT can be incorporated into the outpatient practice, where patient follow-up rates and number needed to treat to effect change are similar to that of other chronic medical conditions. We describe a case of opioid overdose and a suggested protocol for the induction of MAT with buprenorphine/naloxone (Suboxone) for OUD in a rural family medicine outpatient practice. Treatment access is facilitated by utilizing the protocol, allowing office staff work to the extent allowed by their licensure, promoting teamwork and minimizing physician time commitment. We conclude that improved access to MAT can be accomplished in a rural family medicine outpatient clinic by staff that support and mentor one another through use of a MAT protocol.
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Wanti, Linda Perdana, and Eka Tripustikasari. "Pelatihan Komputer Dasar Bagi Kader PKK dan Posyandu Di Desa Patikraja." Madani : Indonesian Journal of Civil Society 1, no. 1 (August 31, 2019): 17–23. http://dx.doi.org/10.35970/madani.v1i1.22.
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Empowerment of Family Welfare or often abbreviated as PKK is a movement that has been built from the center to the village and its existence and benefits have been felt by the community. This PKK activity is reflected in the 10 PKK Principal Programs, one of which is focused on health and attention specifically aimed at maternal and child health. So that an Integrated Service Post (Posyandu) was formed consisting of trained Posyandu cadres. These trained Posyandu cadres are not only seen from the way they handle maternal and child health but also must be supported by their ability to use computers in the process of recording and data collection. However, not all PKK and Posyandu Cadres, especially in villages, are adept at using computers, for example, PKK Cadres and Patikraja Village Posyandu. In fact, many cadres are new to computers and cannot use standard programs such as Microsoft PowerPoint and Microsoft Word. The goal of this community service program is to improve the capabilities and competencies of PKK Cadres and Patikraja Village Posyandu in operating computers to support good and smooth performance in terms of administration and data collection. Based on the results of the evaluation it was seen that PKK cadres and the Patikraja Village Posyandu attended the training with great enthusiasm and they were able to practice the material very well.
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Sparks, Shirley N., and Rosemary Tisch. "A Family-Centered Program to Break the Cycle of Addiction." Families in Society: The Journal of Contemporary Social Services 99, no. 2 (April 2018): 100–109. http://dx.doi.org/10.1177/1044389418767841.
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Celebrating Families!™ (CF!) is a manualized family-centered program focused on the goal of breaking the cycle of generational substance use disorders (SUDs). It is one of the few evidence-based family-focused practices listed on Substance Abuse and Mental Health Services Administration’s National Registry of Evidence-Based Programs and Practices. Compared to another evidence-based program, Strengthening Families, CF! showed significant impact on family organization, positive parenting, parent involvement, and alcohol and drug use reduction. CF! is shown to be successful in unifying families from family dependency courts and as a prevention program for SUDs when offered by community social service agencies. A preliminary efficacy study illustrates changes within participating families consistent with the goal. The study’s purpose was to test the hypothesis that a family skills program such as CF! changed behavior by reducing risk factors and increasing protective factors. Data from 20 cycles of the program revealed that parents ( N = 263), referred from family drug court, expressed significant behavior changes toward their children in ways that increased protective factors after the 16-week program, and youth ( N = 106) showed better understanding of SUDs. Results suggest that this family skills program can be an intervention program for families at-risk for perpetuating the cycle of addiction, as well as prevention of family violence, abuse, and neglect. Agencies that serve families at risk can use the program to prevent costly foster care placements and SUDs by providing such programs.
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Mujiati, Mujiati, Sugiharti Sugiharti, Siti Masitoh, and Eva Laelasari. "KESIAPAN MANAJEMEN PUSKESMAS DALAM MENJALANKAN PROGRAM INDONESIA SEHAT DENGAN PENDEKATAN KELUARGA (PIS-PK) DI INDONESIA." JURNAL EKOLOGI KESEHATAN 19, no. 2 (September 23, 2020): 119–33. http://dx.doi.org/10.22435/jek.v19i2.2931.
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ABSTRACT
Indonesian Health Program with Family Approach (PIS-PK) is one of the health development priority programs by visiting family to increase target coverage and access to health services. This research was conducted by quantitative approach through interview using a structured questionnaire to Head of PHC or Head of Administration Division or PIS-PK officer) or PHC officer who understand about PIS-PK in 9699 PHC in 34 provinces. Data were analyzed descriptively. The results showed that PHC that had been trained in PIS-PK was better prepared in management compared to PHC that had not been trained. PHC that had been trained by PIS-PK were better prepared in availability of human resources, budget, RUK and RPK, availability of PIS-PK instruments, presence of socialization, availability of computers with internet access, monthly and quarterly administration has been carried out, and presence evaluation. PHC are expected to prepare these aspects so that they can be prepared management to carry out PIS-PK. It is expected that District/ city health offices able to carry out routine monitoring and evaluation, supervision and technical assistance to the PHC.
Keywords: Readiness; Primary health care’s management; Indonesian Health Program with Family Approach
ABSTRAK
Program Indonesia Sehat dengan Pendekatan Keluarga (PIS-PK) merupakan salah satu program prioritas pembangunan kesehatan yang dilaksanakan oleh Puskesmas dengan cara mendatangi keluarga untuk meningkatkan jangkauan sasaran dan akses pelayanan kesehatan. Program PIS-PK dilaksanakan secara bertahap sejak tahun 2016, oleh karena itu perlu dilakukan analisis tentang kesiapan manajemen Puskesmas dalam menjalankan PIS-PK. Analisis dilakukan dengan menggunakan data laporan Riset Ketenagaan Kesehatan (Risnakes) 2017 terpublikasi. Data Risnakes dikumpulkan dengan pendekatan kuantitatif melalui wawancara menggunakan kuesioner terstruktur pada Kepala Puskesmas, Kepala Bagian Tata Usaha atau Penanggungjawab PIS-PK atau petugas puskesmas yang memahami tentang PIS-PK di 9.697 Puskesmas di 34 provinsi. Hasil analisis menunjukkan Puskesmas yang sudah melaksanakan pelatihan PIS-PK (78,8%) lebih siap secara manajemen dibanding dengan Puskesmas yang belum melaksanakan pelatihan PIS-PK (49,9%). Kesiapan dalam pelaksanaan PIS-PK karena puskesmas lebih siap dalam aspek ketersediaan SDM, anggaran, telah disusunnya RUK dan RPK, ketersediaan instrumen PIS-PK, adanya sosialisasi, ketersediaan komputer dengan akses internet, telah dilakukannya lokmin bulanan dan triwulanan, serta adanya evaluasi kehadiran. Puskesmas diharapkan dapat menyiapkan aspek-aspek tersebut agar siap secara manajemen untuk menjalankan PIS-PK. Diharapkan Dinas Kesehatan Kabupaten/Kota dapat melakukan monitoring, evaluasi, supervisi dan bimbingan teknis program secara rutin kepada puskesmas.
Kata kunci: Manajemen puskesmas, pelatihan, PIS-PK
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Mengistu, Getachew, Muluken Azage, and Hordofa Gutema. "Iron Deficiency Anemia among In-School Adolescent Girls in Rural Area of Bahir Dar City Administration, North West Ethiopia." Anemia 2019 (March 21, 2019): 1–8. http://dx.doi.org/10.1155/2019/1097547.
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Background. Anemia is a major public health problem worldwide. Adolescent girls are the most vulnerable group of population due to different reasons. The aim of this study was to assess the prevalence of anemia and associated factors among school adolescent girls in rural towns of Bahir Dar City Administration, North West Ethiopia. Methods. A cross-sectional study was conducted from March 5 to April 15, 2017, on 443 randomly selected school adolescent girls. Data were collected using pretested structured questionnaire and anthropometric measurements. Blood sample was also collected to assess the hemoglobin (Hgb) value of study participants. SPSS version 20 was used to analyze data. Descriptive statistics were used to describe data. Bivariate and multivariable logistic regression models were used to identify the associated factors with the outcome variable. Crude and adjusted odds ratios with 95% confidence interval (CI) were calculated to identify the variables significantly associated with the outcome variable. Result. The prevalence of anemia was 11.1%. Household family size [AOR=3.2, 95%CI (1.29-7.89)], average household monthly income <500 ETB [AOR=10; 95%CI (2.49-41.26)], 501-1000 ETB [AOR=6, 95%CI (2.54-14.33)], history of intestinal parasitic infection [AOR=2.7; 95% CI (1.19-6.21)], duration of menstruation flow [AOR=2.4; 95%CI (1.08- 5.44)], and BMI for age [AOR-3.2; 95% CI (1.43-7.05)] were the predictors of anemia. Conclusion and Recommendation. Anemia was a mild public health problem among school adolescent girls in the study area. Household monthly income, family size, intestinal parasite infections, duration of menstruation, and BMI for age are predictors of anemia. Thus, intervention strategies should focus on prevention and early treatment of intestinal parasite, nutritional education, screening, and iron supplementation programs to prevent anemia among school adolescent girls.
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Maiocco, Gina, Billie Vance, and Toni Dichiacchio. "Readiness of Non-Veteran Health Administration Advanced Practice Registered Nurses to Care for Those Who Have Served: A Multimethod Descriptive Study." Policy, Politics, & Nursing Practice 21, no. 2 (May 2020): 82–94. http://dx.doi.org/10.1177/1527154420923749.
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Federal, state, and educational policy, as well as public and professional initiatives, should influence how care is delivered to veterans from non-Veteran Health Administration (VHA) advanced practice registered nurses (APRNs) located in civilian health care facilities. Due to the MISSION Act, more veterans are receiving care outside the VHA, but little is known about the readiness of APRNs to address the needs of this population. This mixed-methods study describes the perceptions of 340 non-VHA APRNs concerning practice, clinical needs, and challenges they face while delivering care to veterans. Survey results show only 8% of APRNs consistently asked about military service; less than 1% asked if the patient has a family member with military history; and only 25% applied research by inquiring into military history when patients presented with conditions like chronic pain, interpersonal violence, or insomnia. Technology use via mobile application was minimally reported (<1%). “Missing in Action,” the overarching theme from qualitative data, included three subthemes: (a) absence facilitated collaboration with VHA, (b) concerns regarding personal competency in the care of the military person, and (c) lack of recognition of the significance of the need to know about military status. Practice implications proffered include implementation of mandatory inquiry into military service and enactment of APRN veteran-centric nursing competencies. Education actions involve updating graduate nursing programs to include veteran health content and increased policy awareness. Future research should encompass replication of this study in specific APRN roles and consist of ongoing evaluation of veteran care by the civilian sector as the MISSION Act is implemented.
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Camlibel, Durmus Alper, and Salih Hakan Can. "Social stressors, personality and coping behaviors associated with male inmate violence." Journal of Criminological Research, Policy and Practice 7, no. 3 (August 27, 2021): 251–69. http://dx.doi.org/10.1108/jcrpp-10-2020-0066.
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Purpose The purpose of this study was to expand available knowledge on predictors of male inmate violence by examining a large set of variables offered by the importation, deprivation and threat appraisal and coping theories. Design/methodology/approach A total of 465 male inmates from five medium-security prisons in Wisconsin completed surveys to report demographics, violence, personality, social stressors and healthy coping behaviors to help manage risk by identifying key factors. Findings Inmates reported more violence with the “imported” characteristics of younger age, less incarceration, no college experience and personality patterns of impulsiveness, hostility and internal locus of control. More violence was reported by inmates with social stressors experienced from family and correctional staff. Additionally, less violence was reported by inmates with more healthy coping behaviors of exercise and social support, especially from family and other inmates. Research limitations/implications One must remain uncertain about whether similar patterns of demographics, personality, social stressors and coping behaviors associated with inmate violence would be found in other US prisons. Future research can determine whether similar predictors of violence are found for women inmates and the consideration of ethnicity should be warranted when examining predictors of inmate violence. Practical implications Prison administrators can develop new programs to reduce social stressors and increase healthy coping behaviors found by this study to be significantly associated with reduced violence, exercise and social support from other inmates and family. Social implications This research recommends that educating and training correctional staff for a trauma-informed care approach is an integral part of lessening the effects of “pains of imprisonment” on inmate violence and healing the effects of trauma. Originality/value To the best of the authors’ knowledge, this study provides the first direct comparison of social stressors from other inmates, correctional staff or family members outside the prison as possible predictors of male inmate violence.
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Syriopoulou-Delli, Christine K., Stavroula A. Polychronopoulou, Gerasimos A. Kolaitis, and Alexandros-Stamatios G. Antoniou. "Review of Interventions for Inclusion of Children With ASD and Anxiety in Education." Journal of Educational and Developmental Psychology 10, no. 1 (January 5, 2020): 1. http://dx.doi.org/10.5539/jedp.v10n1p1.
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BACKGROUND: Anxiety is one of the most common accompanying symptoms in people with autism spectrum disorder (ASD), and may compound the difficulties they experience in social inclusion.
OBJECTIVE: Review of methods and programs that have been developed for the management of anxiety symptoms in individuals with ASD, to help them cope with their social environment, and in particular, school.
METHODS: A search for papers published from the 1980s to 2017 was made in PubMed and in the official websites of the US Food and Drug Administration (FDA), the American Association of Anxiety and Depression, UCLA PEERS, Sutherland House School and Autism Speaks, and in the US National Institute of Health (NIH) publications. In addition, other resources were found in the library of the University of Macedonia and the Greek National Research Foundation.
RESULTS: The search revealed papers on anxiety in ASD and its treatment, and three reports of training programs that had been developed specifically for enhancement of the inclusion of people with ASD and anxiety. The papers were reviewed with a view to identifying the components that decrease anxiety and have long-term effects in curtailing social exclusion. Programs incorporating a variety of methods, including intervention in the school curriculum, development of CBT and other psycho-social approaches and promotion of family support, can all increase awareness of anxiety stimuli and lead to successful and sustained management of anxiety symptoms and enhanced social inclusion. Assessment of anxiety in children and young people with ASD is imperative, and efficacy of the intervention needs to be evaluated using evidence-based measurement.
CONCLUSION: Intervention programs based on recognition and management of anxiety symptoms can increase the possibilities for adaptation and social inclusion of children and young people with ASD. Evaluation of the efficacy of interventions is an area that requires attention.
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Braun, Barbara I., Hasina Hafiz, Shweta Singh, and Mushira M. Khan. "Health Care Worker Violent Deaths in the Workplace: A Summary of Cases From the National Violent Death Reporting System." Workplace Health & Safety 69, no. 9 (May 4, 2021): 435–41. http://dx.doi.org/10.1177/21650799211003824.
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Background: Violent workplace deaths among health care workers (HCWs) remain understudied in the extant literature despite the potential for serious long-term implications for staff and patient safety. This descriptive study summarized the number and types of HCWs who experienced violent deaths while at work, including the location in which the fatal injury occurred. Methods: Cases were identified from the Centers for Disease Control and Prevention’s National Violent Death Reporting System between 2003 and 2016. Coded variables included type of HCW injured, type of facility, and location within the facility and perpetrator type among homicides. Frequencies were calculated using Excel. Findings: Among 61 HCW deaths, 32 (52%) were suicides and 21 (34%) were homicides; eight (13%) were of undetermined intent. The occupations of victims included physicians (28%), followed by nurses (21%), administration/support operations (21%), security and support services (16%), and therapists and technicians (13%). Most deaths occurred in hospitals (46%) and nonresidential treatment services (20%). Within facility, locations included offices/clinics (20%) and wards/units (18%). Among homicide perpetrators, both Type II (perpetrator was client/patient/family member) and Type IV (personal relationship to perpetrator) were equally common (33%). Conclusion/ Applications to Practice: Suicide was more common than homicide among HCW fatal injuries. Workplace violence prevention programs may want to consider both types of injuries. Although fatal HCW injuries are rare, planning for all types of violent deaths could help minimize consequences for staff, patients, and visitors.
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Tran, Bach Xuan, Phung Quoc Tat Than, Tung Thanh Tran, Cuong Tat Nguyen, and Carl A. Latkin. "Changing Sources of Stigma against Patients with HIV/AIDS in the Rapid Expansion of Antiretroviral Treatment Services in Vietnam." BioMed Research International 2019 (January 21, 2019): 1–9. http://dx.doi.org/10.1155/2019/4208638.
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Stigmatization against HIV/AIDS greatly hinders efforts to increase the accessibility and utilization of HIV/AIDS services to meet the 90-90-90 goal. This study assessed the stigmatization and discrimination experienced by people living with HIV (PLWH) across multiple social settings such as family, community, and healthcare facilities in Vietnam. A total of 1,016 patients (63.8% males, mean age = 35.4) participated in a cross-sectional study using a culturally tailored HIV stigma measure in three HIV-epidemic-concentrated cities in Vietnam. Zero-inflated Poisson models were used to examine factors associated with the number of types of stigma that patients experienced. 86.2% PLWH reported experiencing stigma against HIV/AIDS, more frequently from their community (62.8%) and family (30.2%) than from health care facilities (8%). The level of stigma from community reported by PLWH is associated with socioeconomic status (e.g., income, occupation). The poor and middle economic classes and unemployed patients reported more stigmatization and discrimination from the community. Across all settings, PLWH experienced fewer stigmatization over the course of ART indicating the benefits of rapidly expanded ART programs. PLWH reported more stigmatization and discrimination at the provincial level of the health administration. Those with the history of drug injection reported significantly less stigmatization from healthcare setting. More culturally tailored interventions to reduce stigmatization overall to improve the quality of life and health outcomes of PLWH should be warranted to achieve the 90-90-90 goal. Improving HIV-related knowledge of the general population and providing opportunities for PLWH to be reintegrated into should be considered. Using mass media with positive messages and images would also foster positive attitudes towards HIV/AIDS among the population and could potentially change social values. Continuous training of health staffs’ attitude could minimize the occurrence of stigmatization and discrimination at healthcare facilities.
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Emery-Tiburcio, Erin, and Rani Snyder. "Engaging and Educating Older Adults and Caregivers in Age-Friendly Healthcare." Innovation in Aging 4, Supplement_1 (December 1, 2020): 686. http://dx.doi.org/10.1093/geroni/igaa057.2397.
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Abstract As the Age-Friendly Health System initiative moves across the US and around the world, not only do health system staff require education about the 4Ms, but older adults, caregivers, and families need education. Engaging and empowering the community about the 4Ms can improve communication, clarify and improve adherence to treatment plans, and improve patient satisfaction. Many methods for engaging the community in age-friendly care are currently in development. Initiated by Health Resources and Services Administration (HRSA)-funded Geriatric Workforce Enhancement Programs (GWEPs), Community Catalyst is leading the co-design of Age-Friendly Health System materials with older adults and caregivers. Testing these materials across the country in diverse populations of older adults and caregivers will yield open-source documents for local adaptation. Rush University Medical Center is testing a method for identifying, engaging, educating, and providing health services for family caregivers of older adults. This unique program integrates with the Age-Friendly Health System efforts in addressing all 4Ms for caregivers. The Bronx Health Corps (BHC) was created by the New York University Hartford Institute of Geriatric Nursing to educate older adults in the community about health and health behaviors. BHC developed a method for engaging and educating older adults that is replicable in other communities. Baylor College of Medicine adapted and tested the Patient Priorities Care model to educate primary care providers about how to engage older adults in conversations about What Matters to them. Central to the Age-Friendly movement, John A. Hartford Foundation leadership will discuss the implications of this important work.
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Chaves, André Preissler Loureiro, and Roni Bitencourt da Silva. "Environmental diagnosis of hazardous household wastes and the family health strategy as liaison for implementation of a management program in the South of Brazil." Cadernos Saúde Coletiva 23, no. 2 (June 2015): 109–17. http://dx.doi.org/10.1590/1414-462x201500020056.
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AbstractDespite the serious threat to public health that it represents, hazardous household waste (HHW) is not perceived as dangerous by a majority of the population. Existing waste management systems contribute to this misperception, by underestimating the importance of these residues. This, in practice, reflects the lack of knowledge of citizens about the risks and about their responsibility. This study aimed to identify the major HHW generated and disposal practices of the population of São Luís District and know the HHW management situation of the municipality of Canoas, Brazil. We conducted a neighborhood survey, identifying the generation and destination of 15 types of HHW. The situation of the management of this waste was obtained through consultations with the City of Canoas, where we observed little effective action to correct mismanagement. With the aim of improving the current administration, this paper proposes the use of the Family Health Strategy as a liaison for implementation of an appropriate hazardous household waste management program. The role of Community Health Workers restates the important potential for the integration of environmental education and preventive action.
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Jan, Chyi-Feng Jeff, Che-Jui Jerry Chang, Shinn-Jang Hwang, Tzeng-Ji Chen, Hsiao-Yu Yang, Yu-Chun Chen, Cheng-Kuo Huang, and Tai-Yuan Chiu. "Impact of team-based community healthcare on preventable hospitalisation: a population-based cohort study in Taiwan." BMJ Open 11, no. 2 (February 2021): e039986. http://dx.doi.org/10.1136/bmjopen-2020-039986.
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ObjectivesThe objective of this study was to explore the impact of Taiwan’s Family Practice Integrated Care Project (FPICP) on hospitalisation.DesignA population-based cohort study compared the hospitalisation rates for ambulatory care sensitive conditions (ACSCs) among FPICP participating and non-participating patients during 2011–2015.SettingThe study accessed the FPICP reimbursement database of Taiwan’s National Health Insurance (NHI) administration containing all NHI administration-selected patients for FPICP enrolment.ParticipantsThe NHI administration-selected candidates from 2011 to 2015 became FPICP participants if their primary care physicians joined the project, otherwise they became non-participants.InterventionsThe intervention of interest was enrolment in the FPICP or not. The follow-up time interval for calculating the rate of hospitalisation was the year in which the patient was selected for FPICP enrolment or not.Primary outcome measuresThe study’s primary outcome measures were hospitalisation rates for ACSC, including asthma/chronic obstructive pulmonary disease (COPD), diabetes or its complications and heart failure. Logistic regression was used to calculate the ORs concerning the influence of FPICP participation on the rate of hospitalisation for ACSC.ResultsThe enrolled population for data analysis was between 3.94 and 5.34 million from 2011 to 2015. Compared to non-participants, FPICP participants had lower hospitalisation for COPD/asthma (28.6‰–35.9‰ vs 37.9‰–42.3‰) and for diabetes or its complications (10.8‰–14.9‰ vs 12.7‰–18.1‰) but not for congestive heart failure. After adjusting for age, sex and level of comorbidities by logistic regression, participation in the FPICP was associated with lower hospitalisation for COPD/asthma (OR 0.91, 95% CI 0.87 to 0.94 in 2015) and for diabetes or its complications (OR 0.87, 95% CI 0.83 to 0.92 in 2015).ConclusionParticipation in the FPICP is an independent protective factor for preventable ACSC hospitalisation. Team-based community healthcare programs such as the FPICP can strengthen primary healthcare capacity.
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Drummond, Adriano. "O perfil e a funcionalidade de idosos inscritos no programa saúde da família." Revista Eletronica Gestão & Saúde 2, no. 1 (October 10, 2011): 148. http://dx.doi.org/10.18673/gs.v2i1.23118.
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O presente ensaio tem como objetivo fornecer breves informações sobre aspectos do envelhecimento acerca de sua influência sobre a capacidade funcional, não só quanto aos fatores intrínsecos, como as respostas fisiológicas e doenças, mas quanto aos fatores extrínsecos, como a diversidade socioeconômica e demográfica. E ainda dialogar quanto à necessidade de investigação do perfil de idosos inscritos em Programas Saúde da Família, como na região administrativa do Paranoá, Distrito Federal.Palavras chave: gerontologia, envelhecimento, idoso, perfil sócio-demográfico ABSTRACTThis essay aims to provide brief information about aspects of aging on their influence on functional capacity, not only on the intrinsic factors, such as physiological and disease, but as to extrinsic factors such as socioeconomic and demographic diversity. And talk about the need to investigate the profile of seniors enrolled in Family Health Programs, as in the administrative region of Paranoá, Distrito Federal.Keywords: gerontology, aging, elderly, socio-demographic profile RESUMEN Este ensayo tiene como objetivo proporcionar una breve información sobre los aspectos del envejecimiento de su influencia en la capacidad funcional, no sólo en los factores intrínsecos, como fisiológicos y enfermedades, pero en cuanto a factores extrínsecos tales como la diversidad socioeconómica y demográfica. Y si hablamos de la necesidad de investigar el perfil de los adultos mayores inscritos en los programas de salud de la familia, como en la región administrativa de Paranoá, Distrito Federal.Palabras clave: gerontología, el envejecimiento, las personas mayores, perfil sociodemográfico
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Sim, Wan Hua, Anthony F. Jorm, Katherine A. Lawrence, and Marie B. H. Yap. "Development and evaluation of the Parenting to Reduce Child Anxiety and Depression Scale (PaRCADS): assessment of parental concordance with guidelines for the prevention of child anxiety and depression." PeerJ 7 (May 30, 2019): e6865. http://dx.doi.org/10.7717/peerj.6865.
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Background Involving parents in the prevention of mental health problems in children is prudent given their fundamental role in supporting their child’s development. However, few measures encapsulate the range of risk and protective factors for child anxiety and depression that parents can potentially modify. The Parenting to Reduce Child Anxiety and Depression Scale (PaRCADS) was developed as a criterion-referenced measure to assess parenting against a set of evidence-based parenting guidelines for the prevention of child anxiety and depressive disorders. Methods In Study 1, 355 parents of children 8–11 years old across Australia completed the PaRCADS and measures of parenting, general family functioning, child anxiety and depressive symptoms, and parent and child health-related quality of life. Their children completed measures of parenting, anxiety and depressive symptoms, and health-related quality of life. In Study 2, six subject-experts independently evaluated the PaRCADS items for item-objective congruence and item-relevance. Item analysis was conducted by examining item-total point-biserial correlation, difficulty index, B-index, and expert-rated content validity indices. Reliability (or dependability) was assessed by agreement coefficients for single administration. Construct validity was examined by correlational analyses with other measures. Results Four items were removed to yield a 79-item, 10-subscale PaRCADS. Reliability estimates for the subscale and total score range from .74 to .94. Convergent validity was indicated by moderate to strong correlations with other parenting and family functioning measures, and discriminant validity was supported by small to moderate correlations with a measure of parents’ health-related quality of life. Higher scores on the PaRCADS were associated with fewer anxiety and depressive symptoms and better health-related quality of life in the child. PaRCADS total score was associated with parental age, parent reported child’s history of mental health diagnosis and child’s current mental health problem. Discussion Results showed that the PaRCADS demonstrates adequate psychometric properties that provide initial support for its use as a measure of parenting risk and protective factors for child anxiety and depression. The scale may be used for intervention and evaluative purposes in preventive programs and research.
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Endee, Lisa, Russell Rozensky, and Stephen Smith. "301 Evaluation of Fatigue and Healthy Lifestyle Practices among New York State Law Enforcement Professionals." Sleep 44, Supplement_2 (May 1, 2021): A120. http://dx.doi.org/10.1093/sleep/zsab072.300.
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Abstract Introduction An important risk factor for drowsy driving is shift work, and law enforcement, an occupation known for its atypical work schedules, is a highly vulnerable occupation. A connection between fatigue and unintentional injuries among police officers has been observed (Vila, 2006), but data supporting the connection is limited. Understanding how sleep and lifestyle practices impact this population’s driving performance and job safety is critical to officer safety. Methods An online survey was disseminated to New York State law enforcement agencies by the Governor’s Traffic Safety Committee to assess sleep health and lifestyle practices among law enforcement personnel. Statistical analysis included data cleaning, basic and advanced statistical testing. Results 7,366 survey invitations were distributed, 1,171 were returned (15.9% response rate), and after data cleaning, 1,038 surveys were included in the analysis. Respondents reported from various state, county, and local agencies, holding titles from Police Officer to Senior Management. More than 30% of officers reported driving 5 hours or more during their shift, with 12% driving greater than 7 hours. 65% of respondents reported having experienced drowsy driving. Although, 34% reported never having received education about drowsy driving. On work days, only 40% of respondents obtain 7 hours of sleep or more. On days off, 23.6% reported sleeping 6 hours or less. Work, stress, and family responsibilities were reported as having a significant impact on sleep. Almost 87% reported at least one medical issue. Daytime sleepiness (47.4%), fatigue (42.6%), and poor memory (26.8%) were reported daily. Only 23.8% and 29.3% of respondents received education on sleep or heart health, respectively. The majority (81.7%) reported they would consider education in a variety of health-related programs. Conclusion Our findings indicate that poor sleep (60%), high stress (22.7%), and anxiety (16.8%) are a concern amongst officers. Poor cardiovascular health was also noted, based on reports of obesity (34.1%), high blood pressure (23.5%), and high cholesterol (22.4%). This research supports the need for prioritizing health education programs within law enforcement agencies. Support (if any) Funded by The National Highway Traffic Safety Administration with a grant from The New York State Governor’s Traffic Safety Committee.
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Fyffe, Denise C., Joyce Williams, Paul Tobin, and Carol Gibson-Gill. "Spinal Cord Injury Veterans’ Disability Benefits, Outcomes, and Health Care Utilization Patterns: Protocol for a Qualitative Study." JMIR Research Protocols 8, no. 10 (October 4, 2019): e14039. http://dx.doi.org/10.2196/14039.
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Background An estimated 42,000 people currently living with chronic spinal cord injury (SCI) are veterans. SCI was a common combat-related injury in the World Wars and Vietnam era and now affects more than 11% of military personnel injured in Operation Iraqi Freedom and Operation Enduring Freedom. The Veterans Benefits Administration primarily offers financial compensation for disabilities sustained or re-aggravated during military service, called service-connected disability compensation. With the overwhelming cost of living with an SCI, this monthly financial compensation can provide service-connected veterans and their families with access to additional supportive resources (eg, assistive devices and personal aide) and maintain their quality of life (QOL). Little is known about personal, health, functional, and QOL outcomes associated with service-connected and nonservice-connected status for veterans living with an SCI. Objective The aim of this study is to compare the ways in which Veterans Affairs’ (VA) service-connected and nonservice-connected status may be associated with health and functional outcomes, choice of health care provider, and overall QOL for veterans living with an SCI and their caregivers. Methods This cross-sectional qualitative study will gather data using retrospective chart reviews, semistructured interviews, and focus groups. After obtaining institutional review board (IRB) approval, purposeful sampling techniques will be used to recruit and enroll the following key stakeholders: veterans living with an SCI, family caregivers, and SCI health care providers. Concurrent data collection will take place at 2 sites: Veterans Administration New Jersey Healthcare System and Northern New Jersey Spinal Cord Injury System. Results This study was funded in July 2015. IRB approval was obtained by November 2016 at both sites. Enrollment and data collection for phase 1 to phase 4 are complete. A total of 69 veterans, 18 caregivers, and 19 SCI clinicians enrolled in the study. Data analyses for these phases are underway. In phase 5, the follow-up focus group activities are scheduled. The final results are expected by the end of 2019. Conclusions The factors that contribute to veterans living with SCI seeking and not seeking VA disability compensation benefits are not well understood in rehabilitation research. Triangulation of these data sources will allow us to compare, contrast, and integrate the results, which can be used to develop clinical guidelines, caregiver training, and patient education programs. International Registered Report Identifier (IRRID) DERR1-10.2196/14039
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Capurso, Silva, Ljubica Paradžik, and Matija Čale Mratović. "Cyberbullying among children and adolescents – an overview on epidemiological studies and effective preventive programs." Kriminologija & socijalna integracija 25, no. 1 (May 10, 2017): 127–37. http://dx.doi.org/10.31299/ksi.25.1.5.
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Bullying is defined as repeated aggressive behavior (Kowalski & Limber, 2007; Olweus, 1993, and as such has been recognized as a significant social issue. Furthermore, we know that the incidence of bullying behaviors increases with the students’ age (Cassidy, Jackson & Brown, 2009; Green-Forde, 2014; Kowalski & Limber, 2007). Cyber bullying, electronic/ online bullying, or online social cruelty is, according to Kowalski & Limber (2007), a relatively new kind of bullying through email, instant messaging, chat room exchanges, digital messages etc. (Kowalski et al, 2012). The goal of this paper is to give an overview of epidemiological studies and effective cyberbullying prevention aimed at children and adolescents. Some authors state that a student is cyberbullied if it happens two or three times a month, while others suggest that a frequency of once or twice a month is sufficient for the existence of the phenomenon (Olweus, 2012a; Hinduja & Patchin, 2012; Menesini, 2012; Kowalski & Limber, 2007). This difference between these threshold is what accounts for the discrepancies found in the data and results of various studies. Thus, we may talk about 4,5% to 24% of cyberbullied children, as in various international studies. Croatian data are similar, with 4,9 % to 29% of cyberbullied students, depending of the definition (Child Protection Center Zagreb, 2013; Zadravec et al., 2014.; Pregrad et al., 2011). The physical and psychological health, and academic performance in the context of bullying and cyberbullying are sometimes similar (Kowalski & Limber, 2013). Social cognitive theory and media effects model are a theoretical framework used to identify main categories which could explain cyberbullying, noting the following: individual factors, family, school, peers and media (Felson, 1996). Cyberbullying behaviors are connected to perception problems, hyperactivity, anger, aggression, problems of behavior control, low sociability, feeling of revenge and feeling unsecure at school (Sourander et al., 2010; Nixon, 2014). School-based intervention/ prevention programs for traditional bullying are often successful and could be used in modified forms for cyberbullying prevention programs (Ttofi & Farrington, 2011 in Slonje, Smith & Frisen, 2013). In Croatia, several preventive programs are being implemented, aimed at bullying in schools, designed for implementation in local communities and financed by local governments or the national administration (Zadravec et al., 2014). These cyberbullying programs are still not, though they should be, part of some broader anti-bullying programs. The aim of conducting effective preventive programs, including cyberbullying interventions, is to decrease bullying and cyberbullying in schools and improve the school climate. The goal is also to reduce students’ hyperactivity, anger, aggression and problems of behavior control and initiate better self-efficacy.
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Jorghi, Herlysse Jorghi, Praba Ginandjar, Nissa Kusariana, and Lintang Dian Saraswati. "Peran Tenaga Pelaksana Eliminasi dalam Pelaksanaan Program Pemberian Obat Secara Massal (POPM) Filariasis di Kota Pekalongan." MEDIA KESEHATAN MASYARAKAT INDONESIA 19, no. 1 (January 5, 2020): 14–18. http://dx.doi.org/10.14710/mkmi.19.1.14-18.
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Latar belakang: Penyakit Filariasis merupakan penyakit yang disebabkan oleh cacing filaria. Kota Pekalonganmerupakan kota dengan endemis filariasis dan telah dilakukan Program Pemberian Obat secara Massal (POPM) sejak tahun 2011 hingga 2015, Namun, hasil Survei Darah Jari (SDJ) menunjukkan nilai Mikrofilaria Rate di Kota Pekalongan masih > 1%. Penelitian ini bertujuan untuk menggambarkan peran Tenaga Pelaksana Eliminasi (TPE) filariasis dan hambatan yang ditemui pada pelaksanaan POPM di Kota Pekalongan.Metode: Penelitian ini merupakan penelitian cross sectiona. Jumlah sampel 95 orang petugas TPE dengan menggunakan simple ramdom sampling. Pengumpulan data dengan wawancara menggunakan kuesioner. Hasil: Hasil penelitian menunjukkan bahwa EP dalam memilih anggota keluarga target yang akan dirawat adalah optimal (63,2%). EP dalam membantu puskesmas menentukan dosis dan pemberian obat-obatan untuk masing-masing keluarga yang dibantu (52,6%). EP dalam merekam keluarga yang dibantu yang minum obat pada kartu sudah optimal (55,8%). EP dalam memantau dan mencatat reaksi perawatan yang mungkin timbul dan melaporkan kepada petugas kesehatan adalah optimal (61,1%).Simpulan: Peran tenaga pelaksana eliminasi TPE di Kota Pekalongan dalam menyeleksi anggota keluarga binaan yang akan diobati, dalam membantu puskesmas menentukan dosis dan pemberian obat pada setiap keluarga binaan, dalam pencatatan keluarga binaan yang meminum obat pada kartu, dan dalam pengawasan dan pencatatan reaksi pengobatan yang mungkin timbul serta pelaporan kepada petugas kesehatan sudah optimalKata kunci: Filariasis, Tenaga Pelaksana EliminasiABSTRACT Title: The role of Elimination Personnel (EP) implementing filariasis MDA in Pekalongan City Background: Filariasis is a disease caused by filarial worms, Pekalongan City has carried out filariasis MDA (Mass Drug Administration) since 2011-2015. However, the results of the Finger Blood Survey (SDJ) showed that the microfilaria rate was > 1%. This study aims to describe the role of Elimination Personnel (EP) and the obstacles faced in implementing filariasis MDA in Pekalongan City.Method: This study used a cross sectional research method. Sampling in this study used simple random side, total 95 respondents. Data obtained by structure interviews using questionnaires.Result: The results showed that EP in selecting the target family members to be treated is optimal (63.2%). EP in helping puskesmas determine the dosage and administration of medicines for each of the assisted families (52.6%). EP in recording the assisted families who drank the medicine on the card was optimal (55.8%). EP in monitoring and recording treatment reactions that may arise and reporting to health workers was optimal (61.1%).Conclusion: The roles of TPE elimination workers of Pekalongan City were optimum, such as selecting family member who will be treated, helping Puskesmas in deciding the dosage and giving the medicine to every treated family, record of treated family who take the medicine in the given card, and in the supervision and record of medical reaction that might happen and reporting it to health workers.Keywords: Filariasis, Elimination Personnel
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Grzelak, Lech, Anna Wiśniewska, and Robert Ślusarz. "Ocena satysfakcji rodziców z leczenia ludzkim rekombinowanym hormonem wzrostu dzieci z somatotropinową niedoczynnością przysadki." Innowacje w Pielęgniarstwie 5, no. 4 (December 30, 2020): 38–53. http://dx.doi.org/10.21784/iwp.2020.021.
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Introduction. Short stature is a term for a child's height below two standard deviations from the norms adopted for sex and age. In Poland, treatment with recombinant growth hormone of somatotropin hypopituitarism is reimbursed under the National Health Fund drug programs. Administration of growth hormone in the form of daily injections is cumbersome and requires the in-volvement of the whole family in the treatment process. The multidirectional action of GH improves the quality of life of small patients. Aim. The aim of the study is to analyze parents' satisfaction with growth hor-mone treatment in children with somatotropin hypopituitarism. Materiał and methods. The study involved 69 parents of children with so-matotropin hypopituitarism treated with growth hormone at the Department of Pediatrics, Endocrinology, Diabetology and Pediatric Neurology at the Chil-dren"s Hospital in Torun. The research used the own questionnaire and KID-SCREEN questionnaire for parents. Results. Parents of children with somatotropin hypopituitarism are satisfied with the treatment with recombinant growth hormone and evaluate the treat-ment positively. During growth hormone therapy, they highly estimate the quality of their children’s lives. There is a correlation between parents' as-sessment of growth hormone therapy and the change in their children's quality of life. Conclusions. Satisfaction with treatment recombinant growth hormone de-pends on the duration of treatment, achieved growth results and the child's age.
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Sadock, B. "When Your Patient Dies by Suicide; Aftermath and Implications." European Psychiatry 41, S1 (April 2017): S42. http://dx.doi.org/10.1016/j.eurpsy.2017.01.187.
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Over fifty percent of psychiatrists will have at least one patient die by suicide while in treatment and some will have more than one patient suicide during the course of their career. The impact of patient suicide on the personal and professional lives of those psychiatrists can be profound. Personally, many suffer a grief reaction than can progress to depression in some cases. Almost all experience a sense of shock upon first learning of the event. Feelings of guilt are also common. Professionally, many fear disapproval from peers and may never again treat a suicidal patient. Some psychiatrists leave the field completely or go into administration so that they never have to treat patients again.Surveys of training programs have found that most provide training in the assessment of suicide risk and in the management of the suicidal patient but there is minimal training in how to deal with the aftermath of a patient suicide. There is a need to teach and to help practicing psychiatrists, at whatever stage in their career, cope with the stress that occurs when one of their patients dies by suicide during the course of therapy. Important issues are how and when to contact family members and other survivors, whether or not to attend a funeral or memorial service and what and what not to do regarding discussing the case with others. The risk of litigation also is influenced by how psychiatrists behave after patient suicide occurs. The case of Ernest Hemingway is used as an example to illustrate some of these concepts.Disclosure of interestThe author declares that he has no competing interest.
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Abdala, Ingrid Gomes, Sheila Giardini Murta, Jordana Calil Lopes de Menezes, Larissa de Almeida Nobre-Sandoval, Maria do Socorro Mendes Gomes, Karina Damous Duailibe, and Danielle Aranha Farias. "Barriers and Facilitators in the Strengthening Families Program (SFP 10–14) Implementation Process in Northeast Brazil: A Retrospective Qualitative Study." International Journal of Environmental Research and Public Health 17, no. 19 (September 24, 2020): 6979. http://dx.doi.org/10.3390/ijerph17196979.
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This study analyzed contextual barriers and facilitators in the implementation of Strengthening Families Program (SFP 10–14), Brazilian version, a family-based preventive program focused on the prevention of risk behaviors for adolescent health. SFP 10–14 was implemented between 2016 and 2017 for socioeconomically vulnerable families in four Northeast Brazilian states as a tool of the National Drug Policy. A retrospective qualitative study was carried out in which 26 implementation agents participated. Data from 16 individual interviews and two group interviews were analyzed through content analysis. The most recurrent barriers were the group facilitators’ working conditions, weak municipal administration, precarious infrastructure, inadequate group facilitator training methodologies, low adherence of managers and professionals, and funding scarcity. The conditions highlighted as favorable to the implementation were proper intersectoral coordination, engagement of involved actors, awareness of public agency administrators, municipal management efficacy, and efficient family recruitment strategies. Favorable political contexts, engagement of implementation agents, and intersectoral implementation strategies were identified as central to the success of the implementation of SFP 10–14, especially in the adoption of the intervention, community mobilization, and intervention delivery stages. Further studies should combine contexts, mechanisms, and results for a broad understanding of the effectiveness of this intervention in the public sector.
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Kananga, A. Mubeneshayi. "Coordination of Care Within a Mobile Palliative Care Team and Organization of a Continuing Education Program for Health Professionals in Palliative Care." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 62s. http://dx.doi.org/10.1200/jgo.18.36800.
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Background: In DR Congo (DRC), many cancer patients in the terminal phase of their condition have minimal access to palliative care. There is a combined effect of poverty, the deterioration of the health system and the absence of a well-defined national policy on palliative care. Patients are for the most part abandoned to the care of inexperienced family members. Founded in 2009, Palliafamilli aims to improve the quality of life of patients requiring palliative care in the DRC by providing visits and care for patients, by striving to increase access to palliative care in the region and by informing, raising awareness and mobilizing key national stakeholders. In September 2018, Palliafamilli will launch a mobile palliative care team (MPCT) in partnership with the general hospital of Ndjili in Kinshasa. The MPCT is an interdisciplinary team consisting of physicians, nurses, a psychologist and a project manager; all experienced in accompaniment, symptom management and palliative emergency. It has a consultancy role for professionals, patients and their caregivers. Aim: Through a African Cancer Fellowship award, I will visit a mobile team of palliative care from CHRU Besançon, France, for one month in May 2018 to gain experience in designing and implementing best practices for a mobile palliative care team. Methods: I will work closely with the mobile palliative care team of the Besançon Regional Hospital Center to gain experience regarding the coordination and care administration of palliative care within a mobile team. I will also learn about the different programs of continuing education for health professionals, make comparisons and adapt the programs to the reality of DR Congo. Results: With a view to promoting access to palliative care patients, I intend to learn from the host organization the best practices that they apply to overcome communication difficulties with the patient and their relatives which can constitute delays to access to adequate care. This delay is more marked for patients suffering from cancer because the evolution of their pathology is unpredictable. The main barriers are the insufficient knowledge of patients' needs and the opportunities offered by palliative care. Upon my return, I will adapt the best practices learned in France to the DRC context during the launch of the new mobile palliative care team. Conclusion: In Congo, a cross-cutting approach is required to provide patients with palliative care and pain relief, as resources are limited, many people are in need of care, and there are few nurses and doctors empowered to provide care. An effective approach is to involve community or volunteer caregivers supervised by health professionals, and Palliafamilli is successful due in its multidisciplinary and multisectoral approach, with adaptation to cultural, social and economic specificities and its integration with existing health systems, focusing on primary health care and community and home care.
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Icardi, Giancarlo, Claudio Costantino, Marcello Guido, Antonella Zizza, Vincenzo Restivo, Daniela Amicizia, Federico Tassinari, et al. "Burden and Prevention of HPV. Knowledge, Practices and Attitude Assessment Among Pre-Adolescents and their Parents in Italy." Current Pharmaceutical Design 26, no. 3 (March 18, 2020): 326–42. http://dx.doi.org/10.2174/1381612826666200114100553.
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Despite infections due to HPV nowadays represent the most common sexually transmitted diseases worldwide with recognized effective and safe preventive strategies, knowledge, attitudes; however, awareness on HPV is considerably low. The present study has two main objectives: 1. To conduct a literature review to analyze the evolution of preventive tools, the complexity of the vaccine choice process, and the challenges posed by HPV vaccine hesitancy and refusal among pre-adolescents and their parents; 2. To assess knowledge, practices and attitudes toward HPV infection and vaccination in a sample of Italian pre-adolescents and their parents. The observational study was carried out through the use of two anonymous and self-administered pre- and postintervention questionnaires dedicated to the target populations. Between the administrations of the pre- and postintervention questionnaires, an educational intervention on HPV infection and related diseases, and prevention strategies was conducted. All participants demonstrated suboptimal knowledge and positive attitudes in the preintervention questionnaire. Higher levels of knowledge and attitudes were observed among pre-adolescents thatused social networks and had heard of sexually transmitted diseases at home/school/physician and from parents and also who had heard of HPV from General Practitioners, Gynecologists, family members and newspapers. A significant increase in HPV vaccination awareness was observed among pre-adolescents after the educational sessions. Health education programs aimed at increasing knowledge, attitudes and awareness on HPV are needed to implement the outcomes of HPV immunization programs, especially if supported by the physicians involved in counselling and recommendation processes.
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Ceballos-Gurrola, Oswaldo, Raul Lomas-Acosta, Marco Antonio Enríquez-Martínez, Erik Ramírez, Rosa Elena Medina-Rodríguez, María Cristina Enríquez-Reyna, and Armando Cocca. "Impacto de un programa de salud sobre perfil metabólico y autoconcepto en adolescentes con obesidad (Impact of a health program on metabolic profile and self-concept in adolescents with obesity)." Retos, no. 38 (March 4, 2020): 452–58. http://dx.doi.org/10.47197/retos.v38i38.77003.
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Se analizó el impacto de un programa de salud para adolescentes con problema de obesidad. La intervención duró 14 semanas, consistió en tres condiciones (control, experimental y experimental con fototerapia) y los indicadores fueron medidas del perfil metabólico y cinco dimensiones del autoconcepto (Inventario de autoconcepto forma AF-5). Diseño cuasi-experimental con mediciones pre-post. La condición de control únicamente fue evaluada en dos ocasiones. Un grupo experimental recibió orientación nutricional y realizó actividad física (bicomponente). El segundo grupo experimental recibió, además, sesiones de fototerapia. Se analizaron las diferencias basales (pretest) encontrando diferencias entre las tres condiciones en triglicéridos y autoconcepto familiar. Los resultados finales indicaron que la administración de orientación nutricional, actividad física y fototerapia se relacionó con mejoras en el pliegue tricipital, triglicéridos y glicemia (p < .05). La administración de cualquiera de las condiciones experimentales, incluyeran o no fototerapia, se correspondía con mejor autoconcepto social respecto del grupo de control. Se concluye que la participación en un programa de salud que incluye orientación nutricional y actividad física puede producir en corto plazo cambios en la distribución de la adiposidad y el autoconcepto social en adolescentes con obesidad.Abstract. The impact of a health program for adolescents with obesity problem was analyzed. The intervention lasted 14 weeks, consisted of three conditions (control, experimental, and experimental with phototherapy) and the indicators were measures of the metabolic profile and five dimensions of the Self-concept Inventory Form. A quasi-experimental design with pre-post measurements was applied. Control condition was only evaluated twice. An experimental group received nutritional guidance and performed physical activity. The second experimental group additionally received phototherapy sessions. Baseline differences (pretest) were analyzed, finding differences between the three conditions in triglycerides and family self-concept. Final results indicated that nutritional guidance, physical activity and phototherapy were related to improvements in the tricipital fold, triglycerides and glycemia (p < .05). The administration of any of the experimental conditions, with or without phototherapy, corresponded with better social self-concept with respect to the control group. Participation in a health program that includes nutritional guidance and physical activity can produce changes in the distribution of adiposity and social self-concept in adolescents with obesity in the short term.
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Kerwin, Donald, and Mike Nicholson. "The Effects of Immigration Enforcement on Faith-Based Organizations: An Analysis of the FEER Survey." Journal on Migration and Human Security 7, no. 2 (June 2019): 42–51. http://dx.doi.org/10.1177/2331502419854103.
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Executive Summary The effects of US immigration enforcement policies on immigrants, US families, and communities have been well documented. Less attention, however, has been paid to their impact on faith-based organizations (FBOs). Faith communities provide a spiritual home, and extensive legal, resettlement, social, health, and educational services, for refugees and immigrants. This report presents the findings of the FEER (Federal Enforcement Effect Research) Survey, which explored the effects of US immigration enforcement policies on immigrant-serving Catholic institutions.1 Many of these institutions arose in response to the needs of previous generations of immigrants and their children (Kerwin and George 2014, 14, 74–75). Most strongly identify with immigrants and have long served as crucial intermediaries between immigrant communities and the broader society (Campos 2014, 149–51).2 During its first two years, the Trump administration has consistently characterized immigrants as criminals, security risks, and an economic burden. Among its policy initiatives, the administration has supported major cuts in family-based immigration, attempted to terminate the Deferred Action for Childhood Arrivals (DACA) program, reduced refugee admissions to historic lows, instituted admission bars on Muslim-majority countries, attempted to strip Temporary Protection Status (TPS) from all but a fraction of its beneficiaries, erected major new barriers to asylum, and proposed new rules regarding the public charge grounds of inadmissibility that would make it more difficult for poor and working-class persons to obtain permanent residence. US immigration enforcement policies have separated children from their parents, criminally prosecuted asylum seekers, expanded detention, increased arrests of noncitizens without criminal records, and militarized the US–Mexico border. These policies have failed to stem the flow of migrants and asylum seekers: instead, these flows have increased dramatically in recent months. These policies have succeeded, however, in devastating children, instilling fear in immigrant communities, blocking access to the US asylum system, and undermining immigrant integration (Kerwin 2018).3 The Federal Enforcement Effect Research (FEER) Survey points to a paradox. On one hand, US enforcement policies have increased the demand for services such as legal screening, representation, naturalization, assistance to unaccompanied minors, and support to the US families of detainees and deportees. Many Catholic institutions have expanded their services to accommodate the increased demand for their services. On the other hand, their work with immigrants has been impeded by federal immigration policies that effectively prevent immigrants from driving, attending gatherings, applying for benefits, and accessing services due to fear that these activities might lead to their deportation or the deportation of a family member. Among other top-line findings, 59 percent of 133 FEER respondents reported that “fear of apprehension or deportation” negatively affected immigrants’ access to their services, and 57 percent of 127 respondents reported that immigrant enforcement very negatively or negatively affected the participation of immigrants in their programs and ministries.
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Oteshova, Almagul, Natalia Prodanova, Aigul Niyazbayeva, Natalia Savina, and Vadim Dikikh. "MODERN PROBLEMS AND ASSESSMENT OF THE EFFECTIVENESS OF THE STATE SOCIAL POLICY AND SOCIAL SECURITY OF THE POPULATION." Humanities & Social Sciences Reviews 8, no. 4 (October 4, 2020): 1482–93. http://dx.doi.org/10.18510/hssr.2020.84136.
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Purpose of the study: This article aims to analyze the theoretical and practical issues of public administration in the social sphere in a market economy; to consider the implementation of social programs of the Republic of Kazakhstan. Recommendations were also made to assess areas for improving the social system. Special attention is paid to the analysis of political activities and policies in all spheres of society.
Methodology: The study was based on the analysis of the development of social sectors in a market economy and evaluated the directions for improving the system of social sectors in a market economy. General scientific methods of cognition-dialectical, analysis, synthesis, system and functional approaches, generalization, comparison, analogy; methods of empirical research have been employed for this study.
Main Findings: In the article were studied and suggested ways to support the poor and low-income segments of the population, help them find employment in society, reduce the level of crime in society, develop social spheres (education, health, science, culture, residential homes, etc.), and ensure the country's environmental security.
Applications of this study: The results of the study can be used by public authorities in the development and implementation of policies in the field of social protection and income regulation, population and development, gender, and family policy.
Novelty/Originality of this study: The study includes the development of theoretical foundations of social protection of the population, taking into account the current rules of economic social dynamics; the development of a model for the implementation of social protection of the population related to the justification of parameters of its demographic effectiveness and the justification of new directions and practical recommendations in the development of methodological approaches for the development of social protection of young families.
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Gherbon, Adriana, Romulus Timar, Mirela Frandes, Marioara Nicula, Dorel Dronca, and Mirela Ahmadi. "Prevalence Of Alcohol Consumption In First-Year Romanian Medical Students And Its Association With Cardiovascular Risk Factors." European Scientific Journal, ESJ 17, no. 21 (June 30, 2021): 337. http://dx.doi.org/10.19044/esj.2021.v17n21p337.
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Alcohol is the third risk factor for premature disease and death for the general population of the European Union (EU) after smoking and high blood pressure. In the case of young people, they consume alcohol based on the desire to explore, sometimes associating it with recreational drugs use, thus increasing the risk of negative consequences. The objective of this study was to assess the prevalence of alcohol consumption and its association with other cardiovascular risk factors in first-year medical students. The studied lot consisted of 434 first-year medical students, 30.18% boys, and 69.82% girls, with the mean age of 19.48 ± 0.53 years. The methods included the administration of a questionnaire (CORT 2004 questionnaire on health risk behaviors in first-year medical students) for assessing both alcohol consumption and stress state, as well as blood pressure determination, and anthropometric parameters. The prevalence of alcohol consumption among first-year medical students was 22.58%, with a net prevalence of male gender (57.25% M versus 7.59% F) (p <0.001, X2 = 129.02). The main reasons for alcohol consumption were the festive and official occasions and the desire to integrate into the group. People with whom they prefer to drink alcohol were friends, colleagues, and family. The age at which most people began to consume alcohol was 13-14 years old, and the favorite drink was beer among boys and wine among the girls. Regarding the cardiovascular risk factors, positive correlations were obtained between alcohol and smoking, increased consumption of bread, sedentary lifestyle, and increased body mass index. Students need to be educated from the first year of study on the long-term consequences of alcohol consumption related to the development of the cardiovascular disease, and further studies are needed to see if educational programs really reduce the prevalence of alcohol consumption.
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Kharde, Sangeeta N., and Ashakumari H. Rajaput. "Effectiveness of Planned Teaching Program (PTP) on Knowledge of Sex Education among Adolescent Girls." Journal of South Asian Federation of Obstetrics and Gynaecology 2, no. 1 (2010): 85–88. http://dx.doi.org/10.5005/jp-journals-10006-1071.
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ABSTRACT Adolescent is the second decade of life, marking the transistion from childhood to adulthood. These are the formative years when maximum amount of physical, psychological and behavioral changes takes place. A study was undertaken to evaluate the effectiveness of PTP on knowledge of sex education among adolescent girls was the main objective of the present study. Objectives • To assess the knowledge of adolescent girls on selected aspects of sex. • To prepare and conduct planned teaching program on selected aspects of sex education among adolescent girls. • To evaluate the effectiveness of planned teaching program. • To find out the association between pretest knowledge scores and selected demographic variables. Methods The research approach for the study was that of an evaluative one with one group pretest post-test design. The sample size considered for the study was 65 adolescent girls. The sampling technique used for the study was simple random sampling which is a type of probability sampling. The tool used for gathering relevant data was a structured questionnaire on knowledge of sex education. Results The results revealed that, majority of the girls 25 (38.46%) belonged to a age group of 17 years while minimum 5 (7.69%) belonged to a age group of 19 years. Majority girls 34 (52.30%) belonged to PUC II year. Majority of girls 51(78.46%) belonged to Hindu religion and majority girls mothers educational status 27 (41.53%) was secondary school where majority of girls father educational status 21(41.53%) was graduation. Most of the mothers 42 (64.6%) were working and majority of the girls 36 (55.38%) and 37 (56.92%) belonged to nuclear family and rural area. Majority of girls 61(93.4%) were unmarried and 27 (41.53%) gained information from internet and 28 (43.07%) family income was 4001 to 6000. In pretest majority of the girls 40 (61.53%) had average knowledge, 14 (21.53%) had good knowledge, and 11(16.92%) had poor knowledge, whereas in post-test 62 (95.38%) of girls had good knowledge and 3 (4.61%) had average knowledge. The calculated paired ‘t’ value (t = 26.38) is greater than tabulated ‘t’ value (t = 1.960). Conclusion There was evident increase in the knowledge scores in all the areas included in the study after administration of PTP. Thus, it was proved that PTP was effective teaching method for creating awareness on importance of sex education and STI, STD and HIV/ AIDS transmission and focusing the reproductive health hazards like preventing sexual violence among youths.
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Shiroma, Paulo R., Tina Velasquez, Timothy J. Usset, John H. Wilhelm, Paul Thuras, and Eric Baltutis. "Antidepressant Effect of the VA Weight Management Program (MOVE) Among Veterans With Severe Obesity." Military Medicine 185, no. 5-6 (February 20, 2020): e586-e591. http://dx.doi.org/10.1093/milmed/usz475.
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Abstract Introduction Obesity is prevalent among users of Veteran’s Health Administration services, where it is comorbid with depression, post-traumatic stress disorder, type 2 diabetes, cardiovascular disease, colon, and breast cancer. Among obese subjects, severe obesity represents a subpopulation with the highest risk of depression. We investigate the antidepressant effect of a local VA weight management program (Managing Overweight Veterans Everywhere – MOVE) among depressed veterans with severe obesity. Material and Methods In a 10-week prospective pilot study, 14 clinically depressed veterans with severe obesity were recruited from: (1) the 2-week residential based intense MOVE program (IMP) (N = 7) and (2) the 10-week educational module of self-management MOVE program (SMP) (N = 7). Subjects had a Beck Depression Inventory, 2nd edition (BDI-II) score > 12 and BMI > 40 or BMI > 35 with associated to comorbid conditions. Concurrent treatment for depression such as medications or psychotherapy was excluded. The primary efficacy endpoint was the change in BDI-II score form baseline to week 10. Analysis consisted of linear mixed model with baseline BDI-II score as a covariate, and level of MOVE intervention (IMP vs. SMP), time, and time by treatment interaction as fixed effects, and random patient effect. Pearson’s correlation examined the relationships between clinical and demographic variables and change in severity of depression by BDI-II scores. Secondary outcomes include weight loss and energy expenditure. Results The sample was composed by 14 subjects (IMP = 7; SMP = 7) mostly unemployed (N = 9), married (N = 10), mid-aged (mean = 58.2, SD = 8.4), Caucasian (N = 13), male (N = 12), with recurrent depression (N = 11), and a mean overall duration of current depressive episode of 13.5 months (SD = 10.2). Out of 14 participants; seven had a family history of mood disorder, two had previous psychiatric hospitalization, three had a previous suicidal attempt, and eight had a history of substance use disorder. There was a significant decrease in severity of depression among all 14 (F3,36.77 = 5.28; P < 0.01); antidepressant effect favored the IMP compared to SMP at day 12 (F1,15.10 = 9.37, P = 0.01) and week 6 (F2,27.34 = 4.26, P = 0.03), but effect fell short of significance at week 10. The change in severity of depression measured by BDI-II score significantly correlated with total weight loss (r = −0.60; P = 0.04) and daily energy expenditure at 12 days (r = −0.67; P = 0.01), week 6 (r = −0.59; P = 0.03), and week 10 (r = −0.71; P = 0.01). Conclusions Depressed veterans with severe obesity improved their depressive symptoms by participating in the MOVE program. Veterans in the IMP had greater but short-term antidepressant effect as compared to educational intervention for obesity. Future studies with larger sample size may elucidate the underlying mechanisms of weight reduction to improve depression and, more importantly, sustain response among veterans with severe obesity.
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Grace, Elizabeth S., Elizabeth J. Korinek, Lindsay B. Weitzel, and Dennis K. Wentz. "Physicians Reentering Clinical Practice: Characteristics and Clinical Abilities." Journal of Medical Regulation 97, no. 1 (March 1, 2011): 16–23. http://dx.doi.org/10.30770/2572-1852-97.1.16.
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INTRODUCTION: Limited information exists to describe physicians who return to practice after absences from patient care. The Center for Personalized Education for Physicians (CPEP) is an independent, not-for-profit organization that provides clinical competency assessment and educational programs for physicians, including those reentering practice. This article studies the medical licensure status, performance and correlates between physician characteristics and performance on initial assessment. METHODS: Sixty-two physicians who left practice voluntarily and without discipline or sanction and who were returning to practice in the same discipline as their previous practice participated in the CPEP reentry program. Physicians completed an objective clinical skills assessment including clinical interviews by specialty-matched board-certified physicians, simulated patient encounters, a documentation exercise and a cognitive function screen. Physicians were rated from 1 (no or limited educational needs) to 4 (global, pervasive deficits). Performance scores were compared based on select physician characteristics. RESULTS: Twenty-five (40.3 percent) participants were female; participants' average age was 53.7 years (female 48.1 years; male 57.5 years). Physicians left practice for family issues (30.6 percent), health issues (27.4 percent), retirement or nonmedical career change (17.7 percent), and change to medical administration (14.5 percent). Females were more likely than males to have left practice for child rearing (P < 0.0001). Approximately one-quarter (24.2 percent) of participants achieved a performance rating of 1 (best-performing group); 35.5 percent achieved a rating of 2; 33 percent achieved a rating of 3; 6.5 percent achieved a rating of 4 (worst-performing group). Years out of practice and increasing physician age predicted poorer performance (P = 0.0403, P = 0.0440). A large proportion of physicians presenting without an active license achieved active licensure; how many of these physicians actually returned to practice is not known. DISCUSSION: Physicians who leave practice are a heterogeneous group. Most participants' performance warranted some formal education; few demonstrated global educational needs. The data from this study justify mandates that physicians demonstrate competence through an objective testing process prior to returning to practice. Emerging patterns regarding the performance of the reentering physician may help guide future policy.
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Marrs, Joel C. "Family medicine pharmacy residency programs." American Journal of Health-System Pharmacy 63, no. 19 (October 1, 2006): 1803–5. http://dx.doi.org/10.2146/ajhp060201.
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Fitria Budi Utami. "The Implementation of Eating Healthy Program in Early Childhood." JPUD - Jurnal Pendidikan Usia Dini 14, no. 1 (April 30, 2020): 125–40. http://dx.doi.org/10.21009/141.09.
Full textAbstract:
Eating habits develop during the first years of a child's life, children learn what, when, and how much to eat through direct experience with food and by observing the eating habits of others. The aim of this study is to get a clear picture of the Eating program Healthy, starting from the planning, implementation, supervision, and evaluation as a case study of nutrition education; to get information about the advantages, disadvantages and effects of implementing a healthy eating program for children. This research was conducted through a case study with qualitative data analysed using Miles and Huberman techniques. Sample of children in Ananda Islāmic School Kindergarten. The results showed the Healthy Eating program could be implemented well, the diet was quite varied and could be considered a healthy and nutritious food. The visible impact is the emotion of pleasure experienced by children, children become fond of eating vegetables, and make children disciplined and responsible. Inadequate results were found due to the limitations of an adequate kitchen for cooking healthy food, such as cooking activities still carried out by the cook himself at the Foundation's house which is located not far from the school place; use of melamine and plastic cutlery for food; the spoon and fork used already uses aluminium material but still does not match its size; does not involve nutritionists.
Keywords: Early Childhood, Eating Healthy Program
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