scholarly journals Totalistic Programs for Youth

2019 ◽  
Vol 3 (2) ◽  
pp. 44-71 ◽  
Author(s):  
Mark M Chatfield
Keyword(s):  
Residential Treatment ◽  
House Of Representatives ◽  
The United States ◽  
Regulatory Oversight ◽  
Safety Standards ◽  
Thought Reform ◽  
Outdoor Programs ◽  
Harm Prevention

Recent annual estimates suggest that in the United States, approximately 57,000 young people are placed by their parents into some type of residential treatment program. Parent – pay programs are exempt from federal safety standards and some states provide little or no regulatory oversight. Federal investigations revealed a nationwide pattern of institutional abuse across multiple facilities, and some professionals have noted ‘cruel and dangerous uses of thought reform techniques’ within such programs (U.S. House of Representatives 2007, 76). This article summarizes qualitative research based on interviews with 30 adults who lived for an average of 20 months within a ‘highly totalistic’ youth program. The concept of totalistic treatment was operationalized and measured with seven key identifiers found in the literature. Twenty – five different programs of four general types were represented: therapeutic boarding schools, residential treatment centers, wilderness/outdoor programs, and intensive outpatient programs. To organize qualitative findings, three themes explaining the experiences, immediate effects, and long – term impacts of treatment help to reveal implicit meanings woven throughout the interviews. By understanding a wider range of experiences associated with totalistic programs, efforts to improve quality of care and strategies to prevent harm may be improved. Harm prevention efforts would benefit from the analytical perspectives found in theories of coercive persuasion and thought reform.  

scholarly journals Assessment and management of disease burden and quality of life in patients with hereditary angioedema: a consensus report

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Konrad Bork ◽  
John T. Anderson ◽  
Teresa Caballero ◽  
Timothy Craig ◽  
Douglas T. Johnston ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hereditary Angioedema ◽  
Clinical Management ◽  
Disease Burden ◽  
The United States ◽  
Consensus Meeting ◽  
Consensus Statements ◽  
Consensus Report

Abstract Background Hereditary angioedema (HAE) is a rare disease characterized by unpredictable, potentially life-threatening attacks, resulting in significant physical and emotional burdens for patients and families. To optimize care for patients with HAE, an individualized management plan should be considered in partnership with the physician, requiring comprehensive assessment of the patient’s frequency and severity of attacks, disease burden, and therapeutic control. Although several guidelines and consensus papers have been published concerning the diagnosis and treatment of HAE, there has been limited specific clinical guidance on the assessment of disease burden and quality of life (QoL) in this patient population. Practical guidance is critical in supporting effective long-term clinical management of HAE and improving patient outcomes. The objective of this review is to provide evidence-based guidelines for an individualized assessment of disease burden and QoL in patients with HAE. Methods A consensus meeting was held on February 29, 2020, consisting of 9 HAE experts from the United States and Europe with extensive clinical experience in the treatment of HAE. Consensus statements were developed based on a preliminary literature review and discussions from the consensus meeting. Results Final statements reflect the consensus of the expert panel and include the assessment of attack severity, evaluation of disease burden, and long-term clinical management of HAE caused by C1-esterase inhibitor deficiency. Patient-reported outcome measures for assessing HAE attack severity and frequency are available and valuable tools; however, attack frequency and severity are insufficient markers of disease severity unless they are evaluated in the broader context of the effect on an individual patient’s QoL. QoL assessments should be individualized for each patient and minimally, they should address the interference of HAE with work, school, social, family, and physical activity, along with access to and burden of HAE treatment. Advances in HAE therapies offer the opportunity for comprehensive, individualized treatment plans, allowing patients to achieve minimal attack burden with reduced disease and treatment burden. Conclusion This consensus report builds on existing guidelines by expanding the assessment of disease burden and QoL measures for patients with HAE.

Racial and Ethnic Disparities in the Treatment of Chronic Pain

Pain Medicine ◽  
2020 ◽  
Author(s):  
Mary E Morales ◽  
R Jason Yong
Keyword(s):  
Chronic Pain ◽  
Racial Differences ◽  
Current Literature ◽  
Ethnic Disparities ◽  
The United States ◽  
Cross Sectional ◽  
Effective Interventions ◽  
Sociodemographic Profile

Abstract Objective To summarize the current literature on disparities in the treatment of chronic pain. Methods We focused on studies conducted in the United States and published from 2000 and onward. Studies of cross-sectional, longitudinal, and interventional designs were included. Results A review of the current literature revealed that an adverse association between non-White race and treatment of chronic pain is well supported. Studies have also shown that racial differences exist in the long-term monitoring for opioid misuse among patients suffering from chronic pain. In addition, a patient’s sociodemographic profile appears to influence the relationship between chronic pain and quality of life. Results from interventional studies were mixed. Conclusions Disparities exist within the treatment of chronic pain. Currently, it is unclear how to best combat these disparities. Further work is needed to understand why disparities exist and to identify points in patients’ treatment when they are most vulnerable to unequal care. Such work will help guide the development and implementation of effective interventions.

scholarly journals Understanding contributors to quality of care in long-term care and changes under COVID-19

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 960-960
Author(s):  
Sara Luck ◽  
Katie Aubrecht
Keyword(s):  
Quality Of Care ◽  
Long Term Care ◽  
The United States ◽  
Control Measures ◽  
Qualitative Description ◽  
Care Staff ◽  
Term Care ◽  
The Impact

Abstract Nursing home facilities are responsible for providing care for some of the most vulnerable groups in society, including the elderly and those with chronic medical conditions. In times of crisis, such as COVID-19 or other pandemics, the delivery of ‘regular’ care can be significantly impacted. In relation to COVID-19, there is an insufficient supply of personal protective equipment (PPE) to care for residents, as PPE not only protects care staff but also residents. Nursing homes across the United States and Canada have also taken protective measures to maximize the safety of residents by banning visitors, stopping all group activities, and increasing infection control measures. This presentation shares a research protocol and early findings from a study investigating the impact of COVID-19 on quality of care in residential long-term care (LTC) in the Canadian province of New Brunswick. This study used a qualitative description design to explore what contributes to quality of care for residents living in long-term care, and how this could change in times of crisis from the perspective of long-term care staff. Interviews were conducted with a broad range of staff at one LTC home. A semi-structured interview guide and approach to thematic analysis was framed by a social ecological perspective, making it possible to include the individual and proximal social influences as well as community, organizations, and policy influencers. Insights gained will improve the understanding of quality of care, as well as potential barriers and facilitators to care during times of crisis.

scholarly journals FEDERAL POLICY SUPPORTS AND GAPS IN ADDRESSING RACIAL-ETHNIC HEALTH DISPARITIES IN U.S. LONG-TERM CARE FACILITIES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S161-S161
Author(s):  
Rebecca L Mauldin ◽  
Kathy Lee ◽  
Antwan Williams
Keyword(s):  
Long Term Care ◽  
Federal Policy ◽  
Care Facility ◽  
Well Being ◽  
The United States ◽  
Term Care ◽  
Long Term Care Facility ◽  
Care Facilities

Abstract Older adults from racial and ethnic minority groups face health inequities in long-term care facilities such as nursing homes and assisted living facilities just as they do in the United States as a whole. In spite of federal policy to support minority health and ensure the well-being of long-term care facility residents, disparities persist in residents’ quality of care and quality of life. This poster presents current federal policy in the United States to reduce racial and ethnic health disparities and to support long-term care facility residents’ health and well-being. It includes legislation enacted by the Patient Protection and Affordable Care Act of 2010 (ACA), regulations of the U.S. Department of Health and Human Services (DHHS) for health care facilities receiving Medicare or Medicare funds, and policies of the Long-term Care Ombudsman Program. Recommendations to address threats to or gaps in these policies include monitoring congressional efforts to revise portions of the ACA, revising DHHS requirements for long-term care facilities staff training and oversight, and amending requirements for the Long-term Care Ombudsman Program to mandate collection, analysis, and reporting of resident complaint data by race and ethnicity.

A Comprehensive Review of Spirit Drink Safety Standards and Regulations from an International Perspective

2017 ◽  
Vol 80 (3) ◽  
pp. 431-442 ◽  
Author(s):  
Xiao-Na Pang ◽  
Zhao-Jie Li ◽  
Jing-Yu Chen ◽  
Li-Juan Gao ◽  
Bei-Zhong Han
Keyword(s):  
Maximum Level ◽  
The United States ◽  
International Perspective ◽  
Control Measures ◽  
Alcoholic Beverages ◽  
Hydrocyanic Acid ◽  
The European Union ◽  
Safety Standards ◽  
Standards And Regulations

ABSTRACT Standards and regulations related to spirit drinks have been established by different countries and international organizations to ensure the safety and quality of spirits. Here, we introduce the principles of food safety and quality standards for alcoholic beverages and then compare the key indicators used in the distinct standards of the Codex Alimentarius Commission, the European Union, the People's Republic of China, the United States, Canada, and Australia. We also discuss in detail the “maximum level” of the following main contaminants of spirit drinks: methanol, higher alcohols, ethyl carbamate, hydrocyanic acid, heavy metals, mycotoxins, phthalates, and aldehydes. Furthermore, the control measures used for potential hazards are introduced. Harmonization of the current requirements based on comprehensive scope analysis and the risk assessment approach will enhance both the trade and quality of distilled spirits. This review article provides valuable information that will enable producers, traders, governments, and researchers to increase their knowledge of spirit drink safety requirements, control measures, and research trends.

Recruiting Racially Minoritized Students to Optometry School

The Advisor ◽  
2021 ◽  
Vol 41 (4) ◽  
Author(s):  
Christian Alberto ◽  
Guilherme Albieri
Keyword(s):  
Best Practices ◽  
Career Paths ◽  
Health Professions ◽  
Quality Of Healthcare ◽  
The United States ◽  
Cultural Wealth ◽  
Professional Career ◽  
Admissions Process

Abstract Enrollment inequities among racially minoritized (RM) students is an ongoing challenge facing health professions programs in the United States, including optometry schools. Consideration of RM students’ representation in health professions programs is essential for long-term improvement in access to and quality of healthcare for RM patients. Prehealth and undergraduate advisors assist students in navigating graduate and professional career paths. Data collected by ASCO on the nationwide matriculation survey reveal prehealth advisors rank third most important in navigating the admissions process for optometry after practicing optometrists and admissions representatives. Prehealth advisors, therefore, are central to generating the optometry school pipeline, inclusive of students from RM backgrounds. This article therefore explores the question “How can prehealth advisors help attract their RM students to optometry?” by approaching best practices in prehealth advising utilizing Yosso’s (2005) Community Cultural Wealth theoretical framework. The recommendations offered in response to the question center on the lived experiences of RM students and identify/acknowledge the strengths inherent among recruiting them to optometry school. The empowering nature of the approach has positive implications on strengthening aspiration, application, and enrollment in optometry schools or health professions broadly.

The Car and the City

2018 ◽  
Author(s):  
David Blanke
Keyword(s):  
The United States ◽  
Urban Transit ◽  
Cultural Attitudes ◽  
Congested Traffic ◽  
Private And Public ◽  
Recent Phase ◽  
Ease Of Access ◽  
The City

The relationship between the car and the city remains complex and involves numerous private and public forces, innovations in technology, global economic fluctuations, and shifting cultural attitudes that only rarely consider the efficiency of the automobile as a long-term solution to urban transit. The advantages of privacy, speed, ease of access, and personal enjoyment that led many to first embrace the automobile were soon shared and accentuated by transit planners as the surest means to realize the long-held ideals of urban beautification, efficiency, and accessible suburbanization. The remarkable gains in productivity provided by industrial capitalism brought these dreams within reach and individual car ownership became the norm for most American families by the middle of the 20th century. Ironically, the success in creating such a “car country” produced the conditions that again congested traffic, raised questions about the quality of urban (and now suburban) living, and further distanced the nation from alternative transit options. The “hidden costs” of postwar automotive dependency in the United States became more apparent in the late 1960s, leading to federal legislation compelling manufacturers and transit professionals to address the long-standing inefficiencies of the car. This most recent phase coincides with a broader reappraisal of life in the city and a growing recognition of the material limits to mass automobility.

Ethical Considerations in the Conduct of Electronic Surveillance Research

2006 ◽  
Vol 34 (3) ◽  
pp. 611-619 ◽  
Author(s):  
Ashok J. Bharucha ◽  
Alex John London ◽  
David Barnard ◽  
Howard Wactlar ◽  
Mary Amanda Dew ◽  
...  
Keyword(s):  
Assisted Living ◽  
Long Term Care ◽  
The United States ◽  
Assisted Living Facilities ◽  
Ethical Considerations ◽  
Term Care ◽  
Baby Boomer Generation ◽  
Demographic Shifts

Nearly 2.5 million Americans currently reside in nursing homes and assisted living facilities in the United States, accounting for approximately five percent of persons sixty-five and older. The aging of the “Baby Boomer” generation is expected to lead to an exponential growth in the need for some form of long-term care (LTC) for this segment of the population within the next twenty-five years. In light of these sobering demographic shifts, there is an urgency to address the profound concerns that exist about the quality-of-care (QoC) and quality-of-life (QoL) of this frailest segment of our population.

Short- and Long-term Cardiovascular Complications of Cancer Treatment: Overview for the Practicing Oncologist

2012 ◽  
pp. 553-554
Author(s):  
Chetan Shenoy ◽  
Gretchen Kimmick
Keyword(s):  
Quality Of Life ◽  
Cancer Treatment ◽  
The United States ◽  
Cardiovascular Complications ◽  
Complex Interaction ◽  
Comorbid Illness ◽  
Increase Risk ◽  
Short And Long Term

Overview: As new therapies improve survival from cancer, attention to comorbid illness and complications of therapy—both short- and long-term—become much more important to improving not only quality of life but also overall survival. Recognized for its importance as the leading cause of death in the United States, heart disease often coexists with cancer, and cancer treatment may increase risk and/or severity. In addition, there are well-recognized cardiovascular toxicities of cancer treatment, including not only cardiomyopathy, but also hypertension, hypercholesterolemia, and others. Oncologists and cardiologists are working closely to learn more about the complex interaction and to improve management and outcome for patients.

Pediatric Cancer Survivorship: Research and Clinical Care

2006 ◽  
Vol 24 (32) ◽  
pp. 5160-5165 ◽  
Author(s):  
Anna T. Meadows
Keyword(s):  
Pediatric Cancer ◽  
Late Effects ◽  
Clinical Care ◽  
Survival Rates ◽  
The United States ◽  
Term Survival ◽  
Pediatric Cancer Survivors ◽  
Effects Of Aging

Regardless of how one defines survivorship, more than 10 million individuals in the United States have been treated for a malignant disease; about 250,000 were younger than 21 years of age at diagnosis. Thirty years ago, pediatric oncologists recognized that children with cancer might be cured by adding chemotherapy to surgery and radiation. Studies were then begun of complications that could reduce survival or the quality of survival, and that might be associated with previous therapy. The complications were termed late effects, and studies focused on patients who were likely to be cured, or less likely to succumb to the original cancer than they were to experience disabilities. Clinical trials tested whether changes in therapy to reduce complications could maintain the same excellent survival rates. During the last 20 years, articles detailing late effects and the relationship between therapy and outcome have been published. This article reviews the progress made in understanding the outcomes reported and the efforts made to improve the quality of long-term survival for children and adolescents. Several questions remain regarding the long-term complications of therapy. Clinicians need more data regarding the effects of aging to guide them in managing former patients. Caregivers and pediatric cancer survivors who are now adults seek the optimal venue in which to receive care as independent adults. In addition, medical oncologists need to determine whether the models for research and clinical care of survivors created in pediatric oncology can be applied to survivors of adult-onset cancer.

Sign in / Sign up

Export Citation Format

Share Document