...indications that stereotyping, prejudices, and uncertainty on the behalf of healthcare providers can all contribute to unequal treatment. The situations in which many clinical encounters take place - written off as high time pressure, cognitive complexity, and pressures for cost containment, may perhaps increase the chance that these practices will consequently result in care poorly matched to minority patients’ needs. Minorities can experience a range of other barriers to accessing care, even when insured at the same level as Caucasians; which may include language barriers, geographical areas, and cultural familiarities. Furthermore, financial and institutional arrangements of health systems, as well as the legal, regulatory, and political atmosphere in which they function, may have unequal and negative effects on minorities’ capability to reach quality care. A widespread, multi-level strategy is desired to reduce these disparities. Healthcare providers, their patients, payors, health plan purchasers, and society as a whole should be made aware of the healthcare gap between racial and ethnic groups in the United States. Health systems should base decisions about resource allocation on published clinical guidelines, insure that physician financial incentives do not...
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...named the Social Cognitive Theory. That framework is currently the dominant version used in health behaviour and health promotion; however, it is still often referred to as Social Learning Theory. The impetus for this special issue on HIV came from a discussion a few years ago during which we established a shared interest in a revival of the sort of scholarly innovation that characterized the early years of the HIV epidemic. As far back as the early 1980s, social theorists, cultural, critics, artists and others created a vibrant body of work on HIV/AIDS. Working from various theoretical and disciplinary sites they steadfastly emphasized the ‘social’ for understanding the significance of AIDS and opened up new avenues for critiquing and re-imagining scientific, cultural and social responses to infectious disease. At its best, this work served also as an impetus for queer theory, various feminist critiques and a range of research under the rubric of science, medicine and technology studies. The contributions made by this early work and its effects on public discourse on HIV/AIDS were multiple. Among the more groundbreaking contributions worth underscoring here were analyses that destabilized the neutrality of scientific knowledge and practice, emphasizing the malleability and culture-bound nature of its disease definitions (Martin, 1994) as well as...
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...10 Combination HIV Prevention: Tailoring and Coordinating Biomedical, Behavioural and Structural Strategies to Reduce New HIV Infections A UNAIDS Discussion Paper UNAIDS – JC2007 (English original, September 2010) © Joint United Nations Programme on HIV/AIDS (UNAIDS) 2010. All rights reserved. Publications produced by UNAIDS can be obtained from the UNAIDS Content Management Team. Requests for permission to reproduce or translate UNAIDS publications—whether for sale or for noncommercial distribution— should also be addressed to the Content Management Team at the address below, or by fax, at +41 22 791 4835, or e-mail: publicationpermissions@unaids.org. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of UNAIDS concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by UNAIDS in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by UNAIDS to verify the information contained in this publication. However, the published material is being distributed without warranty of any...
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...Trainers span my medical academic career, which began when I was an undergraduate student of Nutrition at Hunter College in New York City. My exposure to the realities of the medical system as it relates to blacks and other minorities continued through my experiences at the Ryan White Clinic for HIV (Fulton County Government) in Atlanta Georgia and subsequently at my current home base Rainbow Preventive Services founded in September of 2007. During that time span from my undergraduate years to the present, I have not only witnessed some dramatic events and developments regarding the delivery of health care to the nation’s medically neediest populations, I have also been privileged to play a role in them. Examples are my developing a Lactation Education program at Broward County Community College, teaching Nutrition as Adjunct Faculty in Miami Dade Community College – Wolfson Campus and as a Trained Trainer for Bright from the Start Georgia Child Care Trainer and Reviewer. Ultimately founded Rainbow Preventive Services (RPS Inc.) to be located in downtown Atlanta in the near future. www.rps-agency.com. This agency is dedicated to decreasing healthcare disparities by preventing HIV incidence and prevalence, by educating high risk populations at large, healthcare professionals about cultural competency and the need for cultural sensitivity in treating a diverse population. As I developed interest in the provision of a more humane type of healthcare delivery and the elimination...
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...for the clinic and the patients, Rebecca will use the Informed Decisions Toolbox (IDT) (Arroyo et al, 2007). Following is a case study of Rebecca’s decision making process. The IDT will be defined and Rebecca will follow the steps to make an informed decision. Her decision to focus the clinic’s efforts on early intervention, preventive medicine, STD/HIV prevention, and case management will be explained. Why the Four A’s tool is determined to be the most effective in making the decision will be addressed (Arroyo et al, 2007). Finally, the use of the toolbox and the affect on the clinic’s accountability, knowledge transfer, and becoming a questioning organization will be studied. The Informed Decisions Toolbox (IDT) The Informed Decisions Toolbox (IDT) is a set of tools that can be useful to healthcare managers when making decisions. The toolbox consists of six steps that can lead to a well-informed decision: Step 1: Framing the question Step 2: Finding sources of information Step 3: Assessing the accuracy of the evidence Step 4: Assessing the applicability of the evidence Step 5: Assessing the "actionability" of the evidence Step 6: Determining if the information is adequate (Arroyo et al, 2007) Step 1: Framing the Question First, Rebecca must formulate a question. “A well-defined question will explicitly state the intervention, the outcome of interest, the type of setting, the time frame, and the population” (Arroyo et al, 2007, para. 12). The intervention is the...
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...is often incorrectly regarded as a subset of the medical profession; in reality, the profession of Nursing is a unique, distinct science with its own knowledge base and skillset. In accordance with the requirements of a scientific profession, there is a need for scholarly inquiry and nursing research in order to maintain autonomy and distinction of the Nursing perspective separate from other disciplines. An editorial published in the Journal of Nursing Scholarship noted that “the distinguishing feature of a profession is how its practitioners use knowledge to make a difference” (Hegyvary, 2007). The evidence generated by Nursing scholars influences global health initiatives and policy worldwide. The need for field wide scholarly inquiry, the application of rigorous scientific standards to research, and the importance of stringent ethical and legal protection for research subjects has been the subject of numerous articles, books, and papers. The Nursing Profession has a responsibility to engage in scholarly research for many reasons that will be discussed in depth within this paper. Importance of Nursing Research to the Nursing Profession As noted in the introduction, in order to maintain its status as a unique, autonomous profession, Nursing as a field must continually refine and expand its scientific knowledge base. The AACN position statement summarizes the importance of research to the profession by stating “The essence of a discipline is its body of scientific knowledge...
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...of this Family of Islands recognize that the preservation of their Freedom will be guaranteed by a national commitment to Self-discipline, Industry, Loyalty, Unity and an abiding respect for Christian values and the Rule of Law”. (Bahamas Government) This shows that due to religious principles, and other aspects of culture the reasons that cause Bahamians to develop homophobic outlooks are, their beliefs that homosexuals bring a higher rate of diseases in the Bahamas, secondly, the fact that it is violating natural law and lastly the aspects of social morality. These points will be constricted to the views of the Bahamian society Firstly, the rapid spread of pandemic illnesses can be the biggest fear amongst heterosexuals, especially AIDS/HIV transmission, despite the fact these sicknesses aren’t limited to the lesbian, gay, bi-sexual,...
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...Research Proposal on HIV Posted at: February 9, 2010 under: Sample Research Proposals by admin @ 7:04 am Problem Twenty years ago, the subject of HIV (human immunodeficiency virus), which has been found to be the cause of AIDS (acquired immunodeficiency syndrome), would not have been the topic of a major and serious worldwide catastrophe. Twenty years ago, people were not phased by the effects that would be caused by this ever so populating disease, and no one would have ever realized that this disease would not be curable or helped without expensive medicine. Like a simple exponential growth equation, the AIDS virus has increased victim numbers by about forty million all over the world. AIDS has also shown that it is not discriminating; it has infected all races and all heritages. The AIDS crisis extends far beyond its death toll, because more than seventy percent of the thirty-six million people with HIV/AIDS live in sub-Saharan Africa. Last year alone, the disease killed 1.5 million people in Africa. One third of these victims are between the ages of ten and twenty-four. The disease has been described as a development crisis; it is profoundly disrupting the economic and social bases of families and entire nations at a rate of infection at 16,000 per day. Without immediate action, AIDS will surpass the effect of the Black Plague that killed forty million people in the late fourteenth century. It is estimated that only ten percent of the death that this disease...
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...THE DOCTOR WILL SUE YOU NOW by Ben Goldacre The shocking and previously unpublishable new chapter from his book Bad Science. This is an extract from BAD SCIENCE by Ben Goldacre Published by Harper Perennial 2009. You are free to copy it, paste it, bake it, reprint it, read it aloud, as long as you don’t change it – including this bit – so that people know that they can find more ideas for free at www.badscience.net ISBN 978-0-00-728487-0 This work is licenced under the Creative Commons Attribution-Non-Commercial-No Derivative Works 3.0 Unported License. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/3.0/ The Doctor Will Sue You Now This chapter did not appear in the original edition of this book, because for fifteen months leading up to September 2008 the vitamin-pill entrepreneur Matthias Rath was suing me personally, and the Guardian, for libel. This strategy brought only mixed success. For all that nutritionists may fantasise in public that any critic is somehow a pawn of big pharma, in private they would do well to remember that, like many my age who work in the public sector, I don’t own a flat. The Guardian generously paid for the lawyers, and in September 2008 Rath dropped his case, which had cost in excess of £500,000 to defend. Rath has paid £220,000 already, and the rest will hopefully follow. Nobody will ever repay me for the endless meetings, the time off work, or the days spent poring over tables filled...
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...organization. Health care administrators require assistance in making the right decision, and they face many barriers when making a decision. As technology changes, so does the process of decision-making. Budget Cuts and Medicaid Patients As a manager for Hillsborough county clinic in Florida that services the population who utilizes Medicaid just received a budget cut by 15%. The manager is responsible for deciding what clinical services to cut or introduced new services to lower the budget. A management meeting is held to determine which services will be eliminated, kept or add new services to replace olds services to lower the budgeted amount. During the meeting research is compiled out of evidence-based decision-making practices, and the staff is involved in the decision-making process as well. The Informed Decision Toolbox or IDT was developed to assist with decision-making processes. Rundall wrote in order for managers to overcome barriers they must follow six key steps, “ (1) framing the management question, (2) finding sources of information, (3) assessing the accuracy of the information, (4) assessing the applicability of the information, (5) assessing the...
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... including opportunistic infections and tumors that do not usually affect people who have working immune systems. HIV is transmitted primarily via unprotected sexual intercourse, contaminated blood transfusions, hypodermic needles, and from mother to child during pregnancy, delivery, or breastfeeding. Prevention of HIV infection, primarily through safe sex and needle-exchange programs, is a key strategy to control the spread of the disease. There is no cure or vaccine; however, antiretroviral treatment can slow the course of the disease and may lead to a near-normal life expectancy. While antiretroviral treatment reduces the risk of death and complications from the disease, these medications are expensive and may be associated with side effects. Genetic research indicates that HIV originated in west-central Africa during the early twentieth century. AIDS was first recognized by the Centers for Disease Control and Prevention in 1981 and its cause—HIV infection—was identified in the early part of the decade. Since its discovery, AIDS has caused nearly 30 million deaths . As of 2010, approximately 34 million people are living with HIV globally. Signs and symptoms There are three main stages of HIV infection: acute infection, clinical latency and AIDS. Acute infection The initial period following the contraction of HIV is called acute HIV, primary HIV or acute retroviral syndrome. Clinical...
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...HIV/AIDS Affect on the African American Community Nicole Donald Capella University HIV/AIDS Affect on the African American Community HIV/AIDS is prevalent in the African American community. African Americans are among the highest risk group for contracting HIV/AIDS. HIV/AIDS has been an issue in the African-American community for a number of years. This learner will provide a general overview on the ethnic population under study but will have a particular focus on black heterosexual men for the purpose contributing to the much lacking knowledge base on this particular population subset. Problem Statement The topic of HIV/AIDS is relevant to mental health counseling because this disease can have a devastating effect on the psyche of any human being suffering with this illness. Many minority teens and adults have a passive attitude when it comes to HIV/AIDS, and when confronted with the issue, they need to have access to the proper channels for information and support. Over 33 million people worldwide are living with HIV infection, and approximately 56,000 new HIV infections are reported every year in the United States alone (Kamen, et al., 2012). Black heterosexual men (BHM) are seldom mentioned in HIV prevention research, policy, and interventions, despite evidence that heterosexual contact is becoming the leading exposure category for BHM (Bowleg & Raj, 2012). It is important to identify the risk factors and treatments available for African Americans with HIV/AIDS...
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...Courtesy of L E K A R SPECIAL EDITION Authors: Marino, Paul L. Title: ICU Book, The, 3rd Edition Copyright ©2007 Lippincott Williams & Wilkins ISBN: 0-7817-4802-X Authors Dedication Quote Preface to Third Edition Preface to First Edition Acknowledgments Table of Contents Section I - Basic Science Review Basic Science Review Chapter 1 - Circulatory Blood Flow Chapter 2 - Oxygen and Carbon Dioxide Transport Section II - Preventive Practices in the Critically Ill Preventive Practices in the Critically Ill Chapter 3 - Infection Control in the ICU Chapter 4 - Alimentary Prophylaxis Chapter 5 - Venous Thromboembolism Section III - Vascular Access Vascular Access Chapter 6 - Establishing Venous Access Chapter 7 - The Indwelling Vascular Catheter Section IV - Hemodynamic Monitoring Hemodynamic Monitoring Chapter 8 - Arterial Blood Pressure Chapter 9 - The Pulmonary Artery Catheter Chapter 10 - Central Venous Pressure and Wedge Pressure Chapter 11 - Tissue Oxygenation Section V - Disorders of Circulatory Flow Disorders of Circulatory Flow Chapter 12 - Hemorrhage and Hypovolemia Chapter 13 - Colloid and Crystalloid Resuscitation Chapter 14 - Acute Heart Failure Syndromes Chapter 15 - Cardiac Arrest Chapter 16 - Hemodynamic Drug Infusions Section VI - Critical Care Cardiology Critical Care Cardiology Chapter 17 - Early Management of Acute Coronary Syndromes Chapter 18 - Tachyarrhythmias Section VII - Acute Respiratory Failure Acute Respiratory Failure Chapter 19 - Hypoxemia...
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...Causation of diseases 8 Achievements in Epidemiology 9 Small pox 9 Methyl Mercury Poisoning 10 Rheumatic Fever and Rheumatic Heart Disease 11 Iodine Deficiency Disease 11 Tobacco use, Asbestos and Lung Cancer 12 Hip Fractures 12 HIV/AIDS 13 Global AIDS epidemic 1990–2003 13 SARS 14 Conclusion 15 Bibliography 16 Introduction This essay provides a brief summary of what epidemiology is, what it is used for and discusses the major successes epidemiologist have contributed towards control and eradication of major epidemics. The discussion will also touch on the historical context and development of the emergency of epidemiology as a science and art, and give example of some of the people that greatly contributed to the achievement scored in epidemiology studies and applications. The Historical Context Epidemiology originated from the Hippocrates` observation more than 200 years ago who identified environmental factors to have an influence on the occurrence of diseases. It was until the nineteenth century when the distribution of the disease specific in human population group was measured to a large extent as beginnings of epidemiology and road to the most spectacular achievement. The other aspect practice that became common in the late nineteenth and early twentieth century’s was the comparing of rates of the disease...
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...Evaluation of Interventions to Decrease the HIV/STI Risk Behaviors of African American Youth: Can We Control Future Trends? Beatrice Simiyu Capstone Project Dr. Bruce Johnson Abstract As a result of the need to recognize successful human immunodeficiency virus (HIV) and sexually transmitted infections (STI) interventions tailored for African American youth, a literature review of six HIV/STI randomized controlled trials interventions targeting African American youth conducted in the United States were evaluated. A comparative analysis was used; the settings, procedures and outcomes of the different interventions targeting African American youth were compared, contrasted and combined to ultimately identify trends that are likely to initiate and possibly sustain change in HIV/STI risk behaviors among African American youth who are a vulnerable group. Variables were evaluated by the various intervention impacts on reducing sexual risk behaviors by an indication of a delay in first sexual intercourse, a decline in the number of sex partners and frequency of sex, and increase in condom use and a reduction in positive STI outcomes. Outcomes were used to facilitate identification of public health strategies that might be most beneficial in targeting African American youth and pinpoint what manner current public health strategies neglects to focus on their needs. The research and practice implications of the findings imply that enhancing future HIV/STI targeting African American youth...
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