Home About us Contact
|
Home About us Contact | ||
|
|
||
Health Challenges (health + challenge)
Kinds of Health Challenges Selected AbstractsDelinquent Youths' Risky Behavior Presents Public Health Challenge for Their CommunitiesPERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH, Issue 3 2007D. Hollander No abstract is available for this article. [source] Neurological Disorders: Public Health ChallengesJOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 1 2008Gideon Vardi M.D. [source] Early cannabis use and DSM-IV nicotine dependence: a twin studyADDICTION, Issue 11 2008Arpana Agrawal ABSTRACT Background Evidence suggests that cannabis users are at increased risk for cigarette smoking,if so, this may potentially be the single most alarming public health challenge posed by cannabis use. We examine whether cannabis use prior to age 17 years is associated with an increased likelihood of DSM-IV nicotine dependence and the extent to which genetic and environmental factors contribute to this association. Methods A population-based cohort of 24,36-year-old Australian male and female twins (n = 6257, 286 and 229 discordant pairs) was used. The co-twin,control method, with twin pairs discordant for early cannabis use, was used to examine whether, after controlling for genetic and familial environmental background, there was evidence for an additional influence of early cannabis use on DSM-IV nicotine dependence. Bivariate genetic models were fitted to the full data set to quantify the genetic correlation between early cannabis use and nicotine dependence. Results The early cannabis-using twin was about twice as likely to report nicotine dependence, when compared to their co-twin who had experimented with cigarettes but had never used cannabis. Even when analyses were restricted to cannabis users, earlier age cannabis use onset conferred greater risk (1.7) for nicotine dependence than did later onset. This association was governed largely by common genetic liability to early cannabis use and nicotine dependence, as demonstrated by genetic correlations of 0.41,0.52. Conclusions Early-onset cannabis users are at increased risk for nicotine dependence, but this risk is attributable largely to common genetic vulnerability. There is no evidence for a causal relationship between cannabis use and nicotine dependence. [source] Obesity,hypertension: an ongoing pandemicINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 2 2007E. A. Francischetti Summary Considerable evidence has suggested that excessive weight gain is the most common cause of arterial hypertension. This association has been observed in several populations, in different regions of the world. Obesity,hypertension, a term that underscores the link between these two deleterious conditions, is an important public health challenge, because of its high frequency and concomitant risk of cardiovascular and kidney diseases. The obesity,hypertension pandemic imposes a considerable economic burden on societies, directly reflecting on healthcare system costs. Increased renal sodium reabsorption and blood volume expansion are central features in the development of obesity,hypertension. Overweight is also associated with increased sympathetic activity. Leptin, a protein expressed in and secreted by adipocytes, is the main factor linking obesity, increased sympathetic nervous system activity and hypertension. The renin,angiotensin,aldosterone system has also been causally implicated in obesity,hypertension, because angiotensinogen is expressed in and secreted by adipose tissue. Hypoadiponectinemia, high circulating levels of free fatty acids and increased vascular production of endothelin-1 (ET-1) have been reported as potential mechanisms for obesity,hypertension. Lifestyle changes are effective in obesity,hypertension control, though pharmacological treatment is frequently necessary. Despite the consistency of the mechanistic approach in explaining the causal relation between hypertension and obesity, there is yet no evidence that one class of drug is superior to the others in controlling obesity,hypertension. In this review, we present the current knowledge and research in obesity,hypertension, exploring the epidemiologic evidence of the association, its probable pathophysiological mechanisms and treatment issues. [source] Access to essential drugs in Guyana: a public health challenge,,INTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT, Issue 1 2010Enrique Seoane-Vazquez Abstract Guyana's pharmaceutical sector faces major challenges that limit access to essential drugs. This study analyzes Guyana's drug policy and regulation, public financing, and drug procurement and delivery. The study also identifies main barriers to drug access and proposes alternatives to strengthen the country's public health functions. Data were collected from the country's regulatory agencies, public procurement agency, pharmacies, wholesalers, and pharmaceutical companies. The information was supplemented with interviews with a convenient sample of Guyanese health authorities and stakeholders. Data were also compiled from scientific databases, and web pages of the country's Ministries of Health, Commerce and Finance, the Bureau of Statistics, and international organizations. Major barriers to drug access include: (1) lack of national drug policy and regulation, and limited role of the regulatory authority; (2) inefficient drug selection and irrational drug use; (3) insufficient financial resources and lack of drug pricing policy; (4) inefficient planning and managing public supply system; (5) deficient epidemiological and information systems; and (6) inadequate infrastructures and human resources shortage. Improving drug access in Guyana requires the strengthening of the country's public health functions and the implementation of a national drug policy and pricing policy, streamlining the drug financing, procurement, and planning and managing drug supply; and adequate infrastructures and human resources. Copyright © 2008 John Wiley & Sons, Ltd. [source] Revising the Cannabis Use Disorders Identification Test (CUDIT) by means of Item Response TheoryINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2010Beatrice Annaheim Abstract Cannabis use among adolescents and young adults has become a major public health challenge. Several European countries are currently developing short screening instruments to identify ,problematic' forms of cannabis use in general population surveys. One such instrument is the Cannabis Use Disorders Identification Test (CUDIT), a 10-item questionnaire based on the Alcohol Use Disorders Identification Test. Previous research found that some CUDIT items did not perform well psychometrically. In the interests of improving the psychometric properties of the CUDIT, this study replaces the poorly performing items with new items that specifically address cannabis use. Analyses are based on a sub-sample of 558 recent cannabis users from a representative population sample of 5722 individuals (aged 13,32) who were surveyed in the 2007 Swiss Cannabis Monitoring Study. Four new items were added to the original CUDIT. Psychometric properties of all 14 items, as well as the dimensionality of the supplemented CUDIT were then examined using Item Response Theory. Results indicate the unidimensionality of CUDIT and an improvement in its psychometric performance when three original items (usual hours being stoned; injuries; guilt) are replaced by new ones (motives for using cannabis; missing out leisure time activities; difficulties at work/school). However, improvements were limited to cannabis users with a high problem score. For epidemiological purposes, any further revision of CUDIT should therefore include a greater number of ,easier' items. Copyright © 2010 John Wiley & Sons, Ltd. [source] Occurrence and management of acute respiratory illnesses in early childhoodJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 3 2007Merci MH Kusel Aim: Acute respiratory illnesses (ARI) impose massive economic burden on health services. The growing costs, limited benefits of pharmacotherapeutic agents, and alarming rise in antibiotic resistance poses a major health challenge. Analysis of the nature and burden of ARI through well-designed epidemiologic studies will help in the development of a uniform public health approach to identify methods to reduce disease transmission and maximise prevention strategies. The aim of this study was to analyse the nature and magnitude of the burden of ARI encountered by a cohort of children in the first 5 years of life. Methods: This community-based prospective study of ARI followed a cohort of children from birth until 5 years of age. Information on all episodes of ARI encountered, and their management, was collected through daily symptom diary and fortnightly telephone calls. Results: Four episodes of ARI/year were reported in the first 2 years and 2,3 episodes/year between 2 and 5 years. The majority were upper respiratory infections. 53% had at least one lower respiratory infection in the first year. For the majority, symptoms lasted 1,2 weeks. 53% were treated with antitussives or cough mixtures, 44% with paracetamol and 23% with antibiotics. A total of 46% of the episodes presented to a family physician, with younger children and those with lower respiratory infection more likely to seek attention. Conclusion: ARI are common in childhood and although symptoms may last for 4 weeks, the majority resolve spontaneously. Use of medication does not appear to significantly alter the course or duration of symptoms of ARI. [source] Nutritional status in pregnant adolescents: a systematic review of biochemical markersMATERNAL & CHILD NUTRITION, Issue 2 2007Victoria Hall Moran Abstract Adolescent pregnancy is a major public health challenge for many industrialized countries and is associated with significant medical, nutritional, social and economic risk for mothers and their infants. Despite this, relatively little is known about the nutritional status of this population. The aim of this paper was to conduct a systematic review of the current evidence relating to the biochemical markers of nutritional status of pregnant adolescents living in industrialized countries. Six papers were identified that fulfilled the inclusion criteria, the majority of which were conducted in the United States. The studies were of variable quality and most failed to control for potential confounders which may have strongly influenced the findings. Due to limited research, conclusions cannot be drawn about the zinc and calcium status of pregnant adolescents, and data on folate and vitamin B12 status appeared conflicting. There was some consensus among studies, however, to suggest that indicators of anaemia and iron status were compromised in pregnant adolescents, particularly during the third trimester of pregnancy. Chronological age did not appear to influence nutritional status, although there was some evidence to suggest that increasing gynaecologic age may positively influence plasma ferritin levels. Current research is limited by sampling and measurement bias, and research is urgently required to address these limitations. Further consideration should also be made of the influence of the role of socio-economic support on pregnant adolescents' nutritional status. The achievement of improved nutrition in pregnancy among adolescents requires multidisciplinary collaborations of adolescent healthcare providers, academics, professional organizations, policymakers, industry and service users. Only once this is achieved can adolescent nutrition, and adolescent nutrition in pregnancy, be significantly and sustainably optimized. [source] Genetic and Environmental Contributions to Racial Disparities in Preterm BirthMOUNT SINAI JOURNAL OF MEDICINE: A JOURNAL OF PERSONALIZED AND TRANSLATIONAL MEDICINE, Issue 2 2010Siobhan M. Dolan MD Abstract The preterm birth rate exceeds 12% in the United States, and preterm birth continues to be a clinical and public health challenge globally. Even though preterm birth is a major contributor to infant mortality and lifelong morbidity, there are few effective strategies to predict preterm birth and few clinical interventions to prevent it. Genomic research approaches that identify risk factors at the intersection of genetics and the environment will likely provide insights. Both genetic and environmental factors are known to contribute to the racial disparity seen in preterm birth. Through the identification of relevant gene-environment interactions that contribute to preterm birth and may underlie the racial disparity in preterm birth, research that will translate to clinical practice and ultimately prevent a number of preterm births is possible. Mt Sinai J Med 77:160,165, 2010. © 2010 Mount Sinai School of Medicine [source] Menstrual disorders and their adverse symptoms at work: An emerging occupational health issue in the nursing professionNURSING & HEALTH SCIENCES, Issue 3 2008Derek R. SmithArticle first published online: 4 AUG 200 Abstract Menstrual disorders and their adverse symptoms represent an important health issue for many women of child-bearing age. Aside from a deleterious effect on the individual's private life, menstrual disorders are being increasingly recognized as having significant implications at work. This is particularly relevant in occupations such as nursing, where the majority of staff is female. Various investigations have identified the prevalence, distribution, and risk factors associated with menstrual disorders, both in the general community and within the nursing profession. Overall, it is clear that menstrual disorders and their adverse symptoms represent an important occupational health challenge for modern nursing. Future interventions specifically aimed at reducing the work-related burden of these issues should be urgently considered. A more dedicated commitment from higher management regarding the overall health of nurses at work is also required. [source] Genetic Counseling and the Advanced Practice Oncology Nursing Role in a Hereditary Cancer Prevention Clinic: Hereditary Breast Cancer Focus (Part I)THE BREAST JOURNAL, Issue 2009Carrie L. Snyder MSN Abstract:, Interest in hereditary breast cancer has increased rapidly among all health care providers as well as the laity. A major problem for health care providers, however, is the time and skill required for gathering family history, interpreting the pedigree, and providing genetic counseling for the high-risk patient so that BRCA testing, when indicated, can be pursued and screening and prevention strategies employed by the patient. The fields of hereditary cancer and molecular biology have developed at a rate that makes it difficult for physicians to keep up with this explosive knowledge. Therefore, "Who is going to take care of all of these crucial matters for patient benefit?" is a germane question. Our experience has confirmed that the advanced practice oncology nurse who is interested in cancer genetics can become skilled at providing this service to the patient and his/her family. This study portrays the role of such an oncology nurse in meeting this important public health challenge, with special attention devoted to the logistics of this role in the rapidly emerging field of hereditary breast cancer. [source] Powerlessness, marginalized identity, and silencing of health concerns: Voiced realities of women living with a mental health diagnosisINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 3 2009Susan Van Den Tillaart ABSTRACT Using a feminist qualitative approach, this study substantiated many earlier research findings that document how women with a mental health diagnosis experience unequal access to comprehensive health care compared to the general population. Accounts of this disparity are documented in the literature, yet the literature has failed to record or attend to the voices of those living with mental health challenges. In this paper, women living with a mental health diagnosis describe their experiences as they interface with the health-care system. The participating women's stories clearly relate the organizational and interpersonal challenges commonly faced when they seek health-care services. The stories include experiences of marginalized identity, powerlessness, and silencing of voiced health concerns. The women tell of encountered gaps in access to health care and incomplete health assessment, screening, and treatment. It becomes clear that personal and societal stigmatization related to the mental health diagnosis plays a significant role in these isolating and unsatisfactory experiences. Lastly, the women offer beginning ideas for change by suggesting starting points to eliminate the institutional and interpersonal obstacles or barriers to their wellness. The concerns raised demand attention, reconsideration, and change by those in the health-care system responsible for policy and practice. [source] Improving geriatric mental health nursing care: Making a case for going beyond psychotropic medicationsINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 1 2003Philippe Voyer ABSTRACT Providing high-quality mental health nursing care should be an important and continuous preoccupation in the gerontological nursing field. As the proportion of elderly people in our society is growing, the emphasis on high-quality care will receive increasing attention from administrators, politicians, organized groups, researchers and clinical nurses. Recent findings illustrate unequivocally the important contribution of nurses to achieving the goal of high-quality geriatric care. However, the quality of care for the elderly with psychological difficulties has not been addressed. The objective of this article is to illustrate that while nurses can accomplish much to improve the well-being and mental health of the elderly, their skills are often underutilized. Psychotropic drugs are often the first-line interventions used by health-care professionals to treat mental health concerns of elderly persons. Alternative therapies that could be implemented and evaluated, such as psychological counselling, supportive counselling, education and life review, are infrequently used. Nevertheless, current scientific data suggest that it would be very advantageous if nurses were to play a dominant role in the care of elderly people who are depressed or experiencing sleep pattern disturbances. The same can be said about elderly chronic users of benzodiazepines, as well as those with cognitive impairment. Evidence for the use of psychotropic medications as a viable treatment option for the elderly both in the community and in the long-term care setting who are experiencing mental health challenges is examined. Alternative non-pharmacological approaches that nurses can use to augment care are also briefly discussed. [source] Association Between Dietary Quality of Rural Older Adults and Self-Reported Food Avoidance and Food Modification Due to Oral Health ProblemsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2010Margaret R. Savoca PhD OBJECTIVES: To quantify the association between food avoidance and modification due to oral health problems, to examine the association between food practices and dietary quality, and to determine foods associated with these self-management behaviors. DESIGN: Cross-sectional. SETTING: Rural North Carolina. PARTICIPANTS: Six hundred thirty-five community-dwelling adults aged 60 and older. MEASUREMENTS: Demographic and food frequency data and oral health assessments were obtained during home visits. Avoidance (0, 1,2 foods, 3,14 foods) and modification (0,3 foods, 4,5 foods) due to oral health problems were assessed for foods representing oral health challenges. Food frequency data were converted into Healthy Eating Index-2005 (HEI-2005) scores. Linear regression models tested the significance of associations between HEI-2005 measures and food avoidance and modification. RESULTS: Thirty-five percent of participants avoided three to 14 foods, and 28% modified four to five foods. After adjusting for age, sex, ethnicity, poverty, education, and tooth loss, total HEI-2005 score was lower (P<.001) for persons avoiding more foods and higher for persons modifying more foods (P<.001). Those avoiding three to 14 foods consumed more saturated fat and energy from solid fat and added sugar and less nonhydrogenated fat than those avoiding fewer than three foods. Those who modified four to five foods consumed less saturated fat and solid fat and added sugar but more total grains than those modifying fewer than four foods. CONCLUSION: Food avoidance and modification due to oral health problems are associated with significant differences in dietary quality. Approaches to minimize food avoidance and promote food modification by persons having eating difficulties due to oral health conditions are needed. [source] An Analysis of the Distribution and Social Antecedents of Restrictive Behavioural Practices in a Community Day Service for Adults with Intellectual DisabilitiesJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 2 2009Lori L. Finn Background, Community service providers strive to reduce the use of restrictive behavioural procedures, but little is known about their use in community services. Therefore, this study analysed the distribution among service users and antecedents to the use of restrictive procedures. Materials, The authors analysed records of the use of restrictive behavioural procedures for 81 adults with intellectual disabilities, behavioural and mental health challenges who attended a community day programme. The authors obtained data from one quarter in each of three consecutive years. The authors analysed the frequency of restrictive procedures by individual and the frequency of antecedents to the use of restrictive procedures. Results, A small proportion of service users accounted for all use of restrictive procedures. This was true for all three data sets. We coded antecedents to the use of restrictive procedures reliably. The most common antecedents were transitions and seatwork. Conclusion, Restrictive behavioural procedures are concentrated among a small proportion of service users and occasions. Efforts to reduce the use of restrictive procedures should first identify these service users and occasions and then focus efforts to reduce restrictive procedures there. Information concerning the antecedents of restrictive behavioural procedures may be useful as part of a descriptive assessment to design individual interventions to reduce restrictive procedures. [source] Hypertension in Women: The Women Take Heart ProjectJOURNAL OF CLINICAL HYPERTENSION, Issue 1 2003Alice A. Furumoto-Dawson PhD Hypertension is an important, modifiable risk for cardiovascular disease. The Women Take Heart study, a prospective, community-based cohort study of risk factors for heart disease, provides an opportunity to examine prevalence, awareness, and control of hypertension specifically in women. In 1992, 5932 women, age 35 and older (mean age, 52.9; 86% white, 9% African American, 5% other) and free of active heart disease symptoms for 3 months, were recruited through Chicago area public announcements, and their baseline examination data analyzed. Overall, 47.6% were hypertensive (systolic blood pressure 140 mm Hg or diastolic blood pressure 90 mm Hg, or self-report). Only 17.3% reported being hypertensive; in 63.2% of all hypertensive women, the hypertension was undetected or unacknowledged. Blood pressure was controlled to <140/90 mm Hg in 24.1% of self-reported hypertensives. Results from this study and national surveys indicate that hypertension detection and control remain major public health challenges in preventing cardiovascular disease in older women. [source] A longitudinal study of mental health consumer/survivor initiatives: Part 3,A qualitative study of impacts of participation on new membersJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 3 2006Joanna Ochocka This article examines the outcomes of participation in mental health Consumer/Survivor Initiatives (CSIs) and identifies helpful qualities of CSIs through a longitudinal, qualitative study that involved in-depth interviews of people who experienced severe mental health challenges in Ontario, Canada. We used a nonequivalent control group design in which we compared active participants in CSIs ( n = 15) with nonactive participants ( n = 12) at baseline and at 9- and 18-month follow-up intervals. Compared with non-CSI participants, CSI participants reported more stable mental health, enhanced social support, sustained work, stable income, and participation in education and training at 9- and 18-month interviews. The helpful qualities of CSIs that participants reported were (1) safe environments that provide a positive, welcoming place to go; (2) social arenas that provide opportunities to meet and talk with peers; (3) an alternative worldview that provides opportunities for members to participate and contribute; and (4) effective facilitators of community integration that provide opportunities to connect members to the community at large. The findings are discussed in terms of previous research in self-help and consumer-run organizations in mental health. © 2006 Wiley Periodicals, Inc. [source] Risk-Taking Behaviors in Early Adolescent Minority Women: Implications for Research and PracticeJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 4 2002FAAN, Willa M. Doswell RN Adolescence is a time of biologic, intellectual, and psychosocial transition for young women. For an African American or Hispanic girl, the challenge of being female is compounded by the challenge of being a member of a minority group. In this article, the authors present the reproductive health challenges faced by African American and Hispanic girls and suggest research-based programs and nursing practice interventions to address these challenges. [source] Connecting with the larger purpose of our workJOURNAL OF PHARMACEUTICAL SCIENCES, Issue 3 2008Gary M. Cohen Abstract Organizations and people that are able to connect their daily work with a larger overall purpose will be rewarded with higher levels of fulfillment, accomplishment, employee engagement, and job satisfaction. Those who work in the field of the life sciences have a direct opportunity to achieve positive impact on the human condition. For BD (Becton, Dickinson and Co.), this opportunity has manifested itself through medical technology advances that have contributed to human health for over a century. These competencies are currently being applied to help address some of the most important health challenges facing the developing world, such as pandemic disease, child health, and the need to establish sufficient and sustainable access to health and laboratory services. This work is being pursued through commercial activity, technical training and support, public-private sector collaboration, philanthropy, and volunteerism. © 2008 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci 97:1041,1046, 2008 [source] Factors associated with trauma and posttraumatic stress disorder among homeless youth in three U.S. cities: The importance of transience,JOURNAL OF TRAUMATIC STRESS, Issue 1 2010Kimberly Bender Homeless youth experience disproportionately high rates of trauma and posttraumatic stress disorder (PTSD). This study examined correlates of trauma and PTSD among homeless youth with a focus on the impact of homeless culture, substance addiction, and mental health challenges. Homeless youth (N = 146) from Los Angeles, California, Denver, Colorado, and St. Louis, Missouri, were recruited from organizations providing services to homeless youth using comparable methods. Results indicate that 57% of respondents had experienced a traumatic event and 24% met criteria for PTSD. A multinomial logistic regression model revealed greater transience, alcohol addiction, mania, and lower self-efficacy predicted PTSD whereas trauma exposure was associated with alcohol addiction only. Findings have implications for screening and intervening with traumatized homeless youth across service settings. [source] The Public Health Nursing Practice Manual: A Tool for Public Health NursesPUBLIC HEALTH NURSING, Issue 2 2004M.S.N./ M.P.H., Sharon D. Sakamoto R.N. Abstract Public health nursing is recognized as an important and critical component of the public health workforce, and today, it makes up the largest single category of public health professionals, according to the U.S. Department of Health and Human Services. Preparation of generalist public health nurses with the knowledge base, skills, and training to effectively respond to public health challenges is essential. The County of Los Angeles Department of Health Services, Public Health Nursing Section, in response to this need, implemented the Public Health Nursing Practice Manual to provide public health nurses with interventions and guidelines to articulate their role and practice as outlined by the framework of the Public Health Nursing Practice Model developed by Los Angeles County. Identification and development of new methods to support the practice of nursing is imperative in facilitating a more sophisticated and expanded level of practice, as well as providing a means of improving, protecting, and enhancing the quality of health for all people. The Public Health Nursing Practice Manual is an effective tool to monitor performance improvement and provide standardization of the generalist public health nurse practicing in Los Angeles County. [source] Climate Change and Emergency Medicine: Impacts and OpportunitiesACADEMIC EMERGENCY MEDICINE, Issue 8 2009Jeremy J. Hess MD Abstract There is scientific consensus that the climate is changing, that human activity plays a major role, and that the changes will continue through this century. Expert consensus holds that significant health effects are very likely. Public health and health care systems must understand these impacts to properly pursue preparedness and prevention activities. All of medicine will very likely be affected, and certain medical specialties are likely to be more significantly burdened based on their clinical activity, ease of public access, public health roles, and energy use profiles. These specialties have been called on to consider the likely impacts on their patients and practice and to prepare their practitioners. Emergency medicine (EM), with its focus on urgent and emergent ambulatory care, role as a safety-net provider, urban concentration, and broad-based clinical mission, will very likely experience a significant rise in demand for its services over and above current annual increases. Clinically, EM will see amplification of weather-related disease patterns and shifts in disease distribution. In EM's prehospital care and disaster response activities, both emergency medical services (EMS) activity and disaster medical assistance team (DMAT) deployment activities will likely increase. EM's public health roles, including disaster preparedness, emergency department (ED)-based surveillance, and safety-net care, are likely to face increasing demands, along with pressures to improve fuel efficiency and reduce greenhouse gas emissions. Finally, EM's roles in ED and hospital management, particularly related to building and purchasing, are likely to be impacted by efforts to reduce greenhouse gas emissions and enhance energy efficiency. Climate change thus presents multiple clinical and public health challenges to EM, but also creates numerous opportunities for research, education, and leadership on an emerging health issue of global scope. [source] Growing old and getting sick: Maintaining a positive spirit at the end of lifeAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 3 2007David M. Clarke Abstract End of life throws up significant mental health challenges. A high proportion of people in the terminal stages of illness experience depressive symptoms. This paper integrates a theory of hierarchy of human needs and empirical research describing experiences of grief and depression in terminal illness, to develop a model of care aimed at reducing depression and suffering. This care attends to physical, psychological, social and spiritual aspects, taking into account the concerns of patients and their families. Professional help can be offered to patients to restore dignity and hope, strengthen their ways of coping, and encourage social connections. To offer this, a well-resourced and coordinated, multidisciplinary and skilled workforce is needed. [source] Development of an English as a second language curriculum for hepatitis B virus testing in Chinese Americans,CANCER, Issue S12 2005Gloria D. Coronado Ph.D. Abstract Chinese Americans are at disproportionately high risk of liver cancer. A major risk factor for liver cancer in Asia is infection with hepatitis B virus (HBV): Approximately 80% of liver cancers are linked to HBV, and chronic carriers of HBV are > 100 times more likely to develop liver cancer compared with noncarriers. However, many adults, particularly those who have immigrated to the U.S., remain untested and therefore unvaccinated or unmonitored for the disease. Chinese Americans are mostly foreign born, and more recent arrivals face multiple social and health challenges. Many require special attention from public health professionals because of low levels of acculturation and difficulties learning English. It has long been established that an English as a Second Language (ESL) curriculum can teach immigrant adults and their family's important life skills, such as job training and citizenship. The authors report on their plans to develop and pilot test a culturally appropriate curriculum that will motivate Chinese ESL students to obtain a blood test for the detection of the HBV. Cancer 2005. © 2005 American Cancer Society. [source] | |||||||||||||