This book examines a range of current health care issues affecting Asian Americans and explores ways to improve the quality of their health care. The author covers a variety of topics, including sociocultural approaches to health, illness, and health care; clients' experiences in accessing health care services; the important role of alternative practices in primary health care; and limitations on the professional development and practice of Asian health care providers. The book concludes with a look at challenges, implications, and research directions for Asian American health care improvement
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The Aquino administration through the Human Development and Poverty Reduction Cluster (HDPRC) and Good Governance and Anti-Corruption Cluster (GGACC) launched the bottom-up budgeting (BUB) exercise in 2012. The strategy hopes to empower civil society organizations (CSOs) and citizens' groups to engage local government and national government agencies and make them more responsive to people's needs. The program is desirable not only because of the additional funds it provides, but because it promotes transparency in governance. Furthermore, the BUB not only improves CSO-LGU relations, but also gives CSOs a sense of empowerment and heightens their political efficacy. Since the first round, the BUB process has improved significantly in terms of the level of CSO participation, clarity of guidelines, and the process as a whole. It has made planning and budgeting more inclusive and reflective of the local needs from the grassroots level. Despite these improvements, some issues and concerns still need to be addressed in terms of CSO engagement, process facilitation, social preparation, project identification and prioritization, subproject implementation, and service delivery. This paper assesses the FY 2015 planning process as well as the FY 2013 subproject implementation in three municipalities in Agusan del Norte, and explores areas for further improvement in the implementation of the subsequent rounds of the BUB.
Objective: To provide an overview of the previous study findings on tobacco use patterns and deleterious consequences on the health and economy in China, the largest producer and consumer of tobacco products in the world. Data Sources: Medline literature searches, books, and reports from 1982 to 2002. Data Synthesis: Seven categories were examined (prevalence patterns of smoking, its correlations with age and gender, smoking initiation, risk factors, health and economic consequences, knowledge of and attitudes towards tobacco among smokers and non-smokers, and suggestions on tobacco control efforts). Conclusions: The results consistently indicated high prevalence rates in China, which varied significantly with gender, age, and region. The health and ensuing economic consequences of tobacco use are enormous. The authors urge the Chinese governmental authorities that investment in tobacco control is a wise and profitable venture to counteract the effects of tobacco before a highly probable health catastrophe occurs.
Abstract Background Black Americans have long been considered a hard-to-reach population for research studies, whether quantitative surveys or for clinical research. Studies have explored multiple rationales for why Blacks are hard to reach, and the explanations have included historical mistrust, the need to assess the benefits from participating in research, and the expense of spending time participating in research, among others. What has not been explored is the continuous merging of all individuals who identify as Black, particularly when exploring reasonings for a lower interest in participating in research. This paper addresses this issue by investigating the participation rate of individuals identifying as Black in New York City in a study exploring dietary practices as a predictor of colorectal cancer screening behavior. Participants were asked to self-report screening behavior, intent to screen, and dietary and other lifestyle practices. In this analysis, we discuss the unique experience encountered in recruiting Black American participants to participate in this study, particularly amid a worldwide pandemic of COVID-19.
Methods The methodology for this study included a systematic review of the literature, a two-part recruitment process, and data analysis. The first part of the recruitment process involved registering individuals who were interested in participating in the study and consented to be contacted and reminded to come to the location where they were recruited on a scheduled date to complete the actual survey. With this part of the recruitment process, we engaged with n = 488 Black men and women between November 2019 and February 2020. The second part of the recruitment process utilized availability sampling outside of NYC subway stations and other high traffic areas as well as large community events. We engaged with n = 319 individuals. Total engagement with n = 807 individuals yielded a sample size for the survey of 504 completed surveys.
Results Of the total engaged (n = 807), 14% declined to participate due to a lack of time, 11% chose not to participate in the study because the incentive was not enough to compensate for their time 0.02% declined due to not trusting institutions conducting research, and 0.03% did not feel comfortable understanding the questions due to a language barrier. We had a sample size of (n = 504) of the total 807 individuals engaged.
Conclusions Recruiting Black Americans into our colorectal cancer study did not prove to be challenging with the two-tiered model of recruitment that involved consistent engagement and having the primary researcher lead this recruitment process. Extracting within race differences is critical in demystifying the conclusion of numerous studies that African Americans specifically are hesitant to participate due to historical mistrust related to tragedies such as the Tuskegee Experiment and numerous other occurrences of African Americans being treated as guinea pigs for the advancement of research. This data contributes knowledge to this field regarding understanding recruitment challenges in the Black population, but further work needs to be conducted. Mistrust in this study primarily came from the individuals engaged in Caribbean neighborhoods, where many expressed more comfort with home remedies and bush doctors when asked about colorectal cancer screening and declined to participate. Innovative communication, qualitative research, and recruitment strategies tailored to the Caribbean population are needed in future studies to address this recruitment challenge that we experienced.
ABSTRACTBackground: The first dose of home IV antibiotic therapy is traditionally administered under a physician's supervision because of concerns about unpredictable immediate allergic reactions. In some jurisdictions, patients also have the added expense of purchasing epinephrine kits.Objective: To evaluate the standard of care and to develop evidence-based guidelines for patients receiving IV antibiotics at home.Methods: Information was gathered through a literature review, analysis of reports retrieved from the Canadian Adverse Drug Reaction Information System (CADRIS) database, a survey of the policies of Ontario Community Care Access Centres (CCACs), and opinion polls of pharmacists interested in parenteral antibiotic therapy and of infectious disease physicians.Results: A literature search did not yield any reports on the incidence of adverse drug reactions with the first dose of IV antibiotics. About half of anaphylactic reactions reported to CADRIS during the past 8 years in which an IV antibiotic was the suspected drug occurred with initiation of therapy. Of the 29 CCACs that responded to the survey (67% response rate), 21 (72%) allowed the first dose of IV therapy to be given at home. Most of the specialists surveyed have protocols regarding home IV antibiotic therapy. In most cases, patients were not required to purchase epinephrine.Conclusions: In certain situations, it should be possible to initiate home IV therapy with antibiotics under the supervision of a nurse, but in other situations (e.g., allergy to medications, patient preference), such therapy should be started under the supervision of a physician. A decision algorithm was developed.RÉSUMÉHistorique : La dose initiale d'antibiotique dans le cadre d'une antibiothérapie intraveineuse (IV) à domicile est habituellement administrée sous la supervision d'un médecin, à cause des risques de réactions allergiques immédiates imprévisibles. Dans certaines régions, les patients doivent en plus acheter des trousses d'épinéphrine.Objectif : Évaluer le traitement standard et élaborer des lignes directrices fondées sur des données probantes à l'intention des patients sous antibiothérapie IV à domicile.Méthodes : On a procédé à la collecte d'information à partir de l'examen de la littérature, de l'analyse de rapports tirés du système canadien d'information sur les effets indésirables des médicaments (Canadian Adverse Drug Reaction Information System—CADRIS), des résultats d'un sondage sur les politiques des Centres d'accès aux soins communautaires de l'Ontario (CASC), et de sondages d'opinion auprès de pharmaciens intéressés par l'antibiothérapie parentérale et de médecins infectiologues.Résultats : La recherche dans la littérature n'a pas permis de dégager de rapports sur l'incidence des effets indésirables suivant la dose initiale d'antibiotiques IV. Près de la moitié des réactions anaphylactiques consignées dans CADRIS au cours des 8 dernières années, dont on soupçonnait un antibiotique IV d'en être responsable, sont survenues au début du traitement. Des 29 (67 %) CASC qui ont répondu au sondage, 21 (72 %) ont permis l'administration à domicile de la dose initiale d'antibiotique IV. La majorité des spécialistes sondés avaient des protocoles d'antibiothérapie à domicile. Dans la plupart des cas, les patients n'avaient pas à acheter d'épinéphrine.Conclusions : Dans certaines situations, il devrait être possible d'amorcer l'antibiothérapie IV à domicile sous la supervision d'une infirmière, mais dans d'autres cas (p. ex, allergie médicamenteuse, préférence du patient), l'antibiothérapie devrait être amorcée sous la supervision d'un médecin. Un algorithme de décision a été élaboré.
Purpose This study aims to explore barriers and pathways to a whole-institution governance of sustainability within the working structures of universities.
Design/methodology/approach This paper draws on multi-year interviews and hierarchical structure analysis of ten universities in Canada, the USA, Australia, Hong Kong, South Africa, Brazil, the UK and The Netherlands. The paper addresses existing literature that championed further integration between the two organizational sides of universities (academic and operations) and suggests approaches for better embedding sustainability into four primary domains of activity (education, research, campus operations and community engagement).
Findings This research found that effective sustainability governance needs to recognise and reconcile distinct cultures, diverging accountability structures and contrasting manifestations of central-coordination and distributed-agency approaches characteristic of the university's operational and academic activities. The positionality of actors appointed to lead institution-wide embedding influenced which domain received most attention. The paper concludes that a whole-institution approach would require significant tailoring and adjustments on both the operational and academic sides to be successful.
Originality/value Based on a review of sustainability activities at ten universities around the world, this paper provides a detailed analysis of the governance implications of integrating sustainability into the four domains of university activity. It discusses how best to work across the operational/academic divide and suggests principles for adopting a whole institution approach to sustainability.
BACKGROUND:We describe reach, partnerships, products, benefits, and lessons learned of the 25 Community Network Programs (CNPs) that applied community-based participatory research (CBPR) to reduce cancer health disparities. METHODS:Quantitative and qualitative data were abstracted from CNP final reports. Qualitative data were grouped by theme. RESULTS:Together, the 25 CNPs worked with more than 2,000 academic, clinical, community, government, faith-based, and other partners. They completed 211 needs assessments, leveraged funds for 328 research and service projects, trained 719 new investigators, educated almost 55,000 community members, and published 991 articles. Qualitative data illustrated how use of CBPR improved research methods and participation; improved knowledge, interventions, and outcomes; and built community capacity. Lessons learned related to the need for time to nurture partnerships and the need to attend to community demand for sustained improvements in cancer services. IMPLICATIONS:Findings demonstrate the value of government-supported, community-academic, CBPR partnerships in cancer prevention and control research.
BackgroundWe describe reach, partnerships, products, benefits, and lessons learned of the 25 Community Network Programs (CNPs) that applied community-based participatory research (CBPR) to reduce cancer health disparities.MethodsQuantitative and qualitative data were abstracted from CNP final reports. Qualitative data were grouped by theme.ResultsTogether, the 25 CNPs worked with more than 2,000 academic, clinical, community, government, faith-based, and other partners. They completed 211 needs assessments, leveraged funds for 328 research and service projects, trained 719 new investigators, educated almost 55,000 community members, and published 991 articles. Qualitative data illustrated how use of CBPR improved research methods and participation; improved knowledge, interventions, and outcomes; and built community capacity. Lessons learned related to the need for time to nurture partnerships and the need to attend to community demand for sustained improvements in cancer services.ImplicationsFindings demonstrate the value of government-supported, community-academic, CBPR partnerships in cancer prevention and control research.
