Crisis Intervention Teams and People with Mental Illness: Exploring the Factors that Influence the Use of Force

ERIC Educational Resources Information Center

Morabito, Melissa S.; Kerr, Amy N.; Watson, Amy; Draine, Jeffrey; Ottati, Victor; Angell, Beth

2012-01-01

The Crisis Intervention Team (CIT) program was first developed to reduce violence in encounters between the police and people with mental illness as well as provide improved access to mental health services. Although there is overwhelming popular support for this intervention, scant empirical evidence of its effectiveness is…

Mental Health Nurse Incentive Program: facilitating physical health care for people with mental illness?

PubMed

Happell, Brenda; Platania-Phung, Chris; Scott, David

2013-10-01

People with serious mental illness have increased rates of physical ill-health and reduced contact with primary care services. In Australia, the Mental Health Nurse Incentive Program (MHNIP) was developed to facilitate access to mental health services. However, as a primary care service, the contribution to physical health care is worthy of consideration. Thirty-eight nurses who were part of the MHNIP participated in a national survey of nurses working in mental health about physical health care. The survey invited nurses to report their views on the physical health of consumers and the regularity of physical health care they provide. Physical health-care provision in collaboration with general practitioners (GPs) and other health-care professionals was reported as common. The findings suggest that the MHNIP provides integrated care, where nurses and GPs work in collaboration, allowing enough time to discuss physical health or share physical health activities. Consumers of this service appeared to have good access to physical and mental health services, and nurses had access to primary care professionals to discuss consumers' physical health and develop their clinical skills in the physical domain. The MHNIP has an important role in addressing physical health concerns, in addition to the mental health issues of people accessing this service. © 2012 The Authors; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

Extending the P4P agenda, part 2: how Medicare can reduce waste and improve the care of the chronically ill.

PubMed

Wennberg, John E; Fisher, Elliott S; Skinner, Jonathan S; Bronner, Kristen K

2007-01-01

The care of Americans with severe chronic illnesses is disorganized, unnecessarily costly, and undisciplined by sound clinical science. The federal government should invest in a crash program to improve the scientific basis of managing chronic illness, and the Centers for Medicare and Medicaid Services (CMS) should extend its pay-for-performance (P4P) agenda to ensure that within ten years all Americans with severe chronic illnesses have access to accountable health care organizations providing evidence-based prospective care. This paper recommends a strategy for achieving this goal.

Community-Based Palliative Care and Advance Care Planning Documentation: Evidence from a Multispecialty Group.

PubMed

Tai-Seale, Ming; Yang, Yan; Dillon, Ellis; Tapper, Sharon; Lai, Steve; Yu, Peter; Allore, Heather; Ritchie, Christine

2018-02-01

With the growing public demand for access to critical health data across care settings, it is essential that advance care planning (ACP) information be included in the electronic health record (EHR) so that multiple clinicians can access it and understand individuals' preferences for end-of-life care. Community-based palliative care programs often incorporate ACP services. This study examined whether a community-based palliative care program is associated with digitally extractable ACP documentation in the EHR. Observational study using propensity score-weighted generalized estimation equations to examine patterns of digitally extractable ACP documentation. Palo Alto Medical Foundation (PAMF), a multispecialty ambulatory healthcare system in northern California. Individuals aged 65 and older with serious illnesses between January 1, 2013, and December 31, 2014 (N = 3,444). Community-based palliative care program in PAMF. Digitally extractable ACP in EHR. We found that only 14% (n = 483) of individuals with serious illnesses had digitally extractable ACP in electronic health records. Of the 6% of individuals receiving palliative care, 65% had ACP, versus 11% of those not receiving palliative care. Study results showed a strong positive association between palliative care and ACP. Only a small percentage of individuals with serious illnesses had ACP documentation in the EHR. Individuals with serious illnesses infrequently used palliative care delivered by board-certified palliative care specialists. Palliative care service use was associated with higher rates of ACP after controlling for organizational and individual characteristics using a propensity score weighting method. Scalable interventions targeted at non-palliative care clinicians for universal access to ACP are needed. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Researching a Best-Practice End-of-Life Care Model for Canada

ERIC Educational Resources Information Center

Wilson, Donna M.; Birch, Stephen; Sheps, Sam; Thomas, Roger; Justice, Christopher; MacLeod, Rod

2008-01-01

The vast majority of the 220,000 Canadians who die each year, principally of old age and progressive ill health, do not have access to specialized hospice or palliative care. Hospice and palliative care programs are unevenly distributed across Canada, with existing programs limited in capacity and services varying considerably across programs.…

Healthy Amistad: improving the health of people with severe mental illness.

PubMed

Martin, Maurice Bud; Martin, Sarah L

2014-10-01

Here, we report evaluation results of implementing a health promotion program for individuals with serious mental illnesses. Healthy Amistad aimed to address four behaviors: physical inactivity, nutrition choices, smoking, and seeking access to health care. The evaluation employed a mixed-method study design to assess changes in the health of individuals in the program. Process measures assessed the implementation of the program. A pre-post examination was used to compare data associated with behaviors. Data sources included the 2008 and 2009 annual surveys, clinical data, interviews for staff, interviews with members, and an on-site observation. Participants were staff and members of Amistad. Those involved with the Peer Patient Navigator lost weight; new physically active activities were being offered. A new salad bar and healthier menu was offered in the Amistad cafeteria. Interviews revealed that 11 members lost a total of 150 pounds. The percentage reporting visits to an emergency room more than once in the last 6 months decreased from 58% to 37%, the percentage calling the crisis line less often increased from 75% to 86%, and the percentage reporting that they had become more satisfied with their life since joining Amistad improved from 76% to 88%. Individuals with serious mental illnesses are benefiting from programs that focus on the mitigation of disease states manifested from issues with physical inactivity, nutrition, smoking, and health access. Evaluation of the Healthy Amistad program has shown a positive influence.

Outreach: the western New York Hospital Library Services Program, 1985-1989.

PubMed Central

Birkinbine, L A; Bertuca, C A

1991-01-01

The Hospital Library Services Program (HLSP) in western New York, during the period covered by its first five-year plan, 1984-1989, is recounted and described. This ongoing program is funded annually by a New York State grant and hospital participation fees. It is designed to support access to biomedical information for health care professionals through a grant program for hospitals with staffed libraries and a circuit program for hospitals without library staffing or without libraries. Hospitals participating in the grant program contribute funds and receive grants for collection development. Hospitals participating in the circuit program pay a participation fee and receive regularly scheduled, documented, circuit librarian visits; a collection development grant; and a grant for contract library services. The program contracts with the State University of New York at Buffalo's (UB) Health Sciences Library to provide computerized literature searches; interlibrary loan (ILL) of journal articles, books, and audiovisuals; and ILL referrals. PMID:1958912

Do microfinance programs help families insure consumption against illness?

PubMed

Gertler, Paul; Levine, David I; Moretti, Enrico

2009-03-01

Families in developing countries face enormous financial risks from major illness both in terms of the cost of medical care and the loss in income associated with reduced labor supply and productivity. We test whether access to microfinancial savings and lending institutions helps Indonesian families smooth consumption after declines in adult health. In general, results support the importance of these institutions in helping families to self-insure consumption against health shocks.

A Common Programming Language for the Department of Defense--Background and Technical Requirements

DTIC Science & Technology

1976-06-01

Method Findings I. Introduction A. The Problem 1. Software Costs 2. Programming Language 3. Lack of Comrr.onality 4. Common Language 5...accessible soft- ware tools and aids. There are a number of widely held perceptions about the ill effects of the lack of programming language ...cost- effective (at lea~t during development) than de- velopi~g a new programming language specialized to the project. On the other hand,

Effectiveness and Usability of a Web-Based Mindfulness Intervention for Families Living with Mental Illness.

PubMed

Stjernswärd, Sigrid; Hansson, Lars

2017-01-01

Families living with mental illness express needs of support and experiences of burden that may affect their own health detrimentally and hence also their ability to support the patient. Mindfulness-based interventions have shown beneficial health effects in both clinical and healthy populations. The aim of the current study was to explore the effectiveness and usability of a web-based mindfulness program for families living with mental illness, which was first tested in a feasibility study. The study was designed as a randomized controlled trial with an experiment group and a wait-list control group with assessments on primary and secondary outcomes at baseline, post-intervention, and at a 3-month follow-up. Significant positive improvements in mindfulness and self-compassion, and significant decreases in perceived stress and in certain dimensions of caregiver burden were found, with good program usability. Easily accessible mindfulness-based interventions may be useful in addressing caregivers' needs of support and in preventing further ill health in caregivers. Further studies are needed, among others, to further customize interventions and to investigate the cost-effectiveness of such programs.

Interlibrary loan in primary access libraries: challenging the traditional view.

PubMed

Dudden, R F; Coldren, S; Condon, J E; Katsh, S; Reiter, C M; Roth, P L

2000-10-01

Primary access libraries serve as the foundation of the National Network of Libraries of Medicine (NN/LM) interlibrary loan (ILL) hierarchy, yet few published reports directly address the important role these libraries play in the ILL system. This may reflect the traditional view that small, primary access libraries are largely users of ILL, rather than important contributors to the effectiveness and efficiency of the national ILL system. This study was undertaken to test several commonly held beliefs regarding ILL system use by primary access libraries. Three hypotheses were developed. HI: Colorado and Wyoming primary access libraries comply with the recommended ILL guideline of adhering to a hierarchical structure, emphasizing local borrowing. H2: The closures of two Colorado Council of Medical Librarians (CCML) primary access libraries in 1996 resulted in twenty-three Colorado primary access libraries' borrowing more from their state resource library in 1997. H3: The number of subscriptions held by Colorado and Wyoming primary access libraries is positively correlated with the number of items they loan and negatively correlated with the number of items they borrow. The hypotheses were tested using the 1992 and 1997 DOCLINE and OCLC data of fifty-four health sciences libraries, including fifty primary access libraries, two state resource libraries, and two general academic libraries in Colorado and Wyoming. The ILL data were obtained electronically and analyzed using Microsoft Word 98, Microsoft Excel 98, and JMP 3.2.2. CCML primary access libraries comply with the recommended guideline to emphasize local borrowing by supplying each other with the majority of their ILLs, instead of overburdening libraries located at higher levels in the ILL hierarchy (H1). The closures of two CCML primary access libraries appear to have affected the entire ILL system, resulting in a greater volume of ILL activity for the state resource library and other DOCLINE libraries higher up in the ILL hierarchy and highlighting the contribution made by CCML primary access libraries (H2). CCML primary access libraries borrow and lend in amounts that are proportional to their collection size, rather than overtaxing libraries at higher levels in the ILL hierarchy with large numbers of requests (H3). The main limitations of this study were the small sample size and the use of data collected for another purpose, the CCML ILL survey. The findings suggest that there is little evidence to support several commonly held beliefs regarding ILL system use by primary access libraries. In addition to validating the important contributions made by primary access libraries to the national ILL system, baseline data that can be used to benchmark current practice performance are provided.

Interlibrary loan in primary access libraries: challenging the traditional view

PubMed Central

Dudden, Rosalind Farnam; Coldren, Sue; Condon, Joyce Elizabeth; Katsh, Sara; Reiter, Catherine Morton; Roth, Pamela Lynn

2000-01-01

Introduction: Primary access libraries serve as the foundation of the National Network of Libraries of Medicine (NN/LM) interlibrary loan (ILL) hierarchy, yet few published reports directly address the important role these libraries play in the ILL system. This may reflect the traditional view that small, primary access libraries are largely users of ILL, rather than important contributors to the effectiveness and efficiency of the national ILL system. Objective: This study was undertaken to test several commonly held beliefs regarding ILL system use by primary access libraries. Hypotheses: Three hypotheses were developed. H1: Colorado and Wyoming primary access libraries comply with the recommended ILL guideline of adhering to a hierarchical structure, emphasizing local borrowing. H2: The closures of two Colorado Council of Medical Librarians (CCML) primary access libraries in 1996 resulted in twenty-three Colorado primary access libraries' borrowing more from their state resource library in 1997. H3: The number of subscriptions held by Colorado and Wyoming primary access libraries is positively correlated with the number of items they loan and negatively correlated with the number of items they borrow. Methods: The hypotheses were tested using the 1992 and 1997 DOCLINE and OCLC data of fifty-four health sciences libraries, including fifty primary access libraries, two state resource libraries, and two general academic libraries in Colorado and Wyoming. The ILL data were obtained electronically and analyzed using Microsoft Word 98, Microsoft Excel 98, and JMP 3.2.2. Results: CCML primary access libraries comply with the recommended guideline to emphasize local borrowing by supplying each other with the majority of their ILLs, instead of overburdening libraries located at higher levels in the ILL hierarchy (H1). The closures of two CCML primary access libraries appear to have affected the entire ILL system, resulting in a greater volume of ILL activity for the state resource library and other DOCLINE libraries higher up in the ILL hierarchy and highlighting the contribution made by CCML primary access libraries (H2). CCML primary access libraries borrow and lend in amounts that are proportional to their collection size, rather than overtaxing libraries at higher levels in the ILL hierarchy with large numbers of requests (H3). Limitations: The main limitations of this study were the small sample size and the use of data collected for another purpose, the CCML ILL survey. Conclusions: The findings suggest that there is little evidence to support several commonly held beliefs regarding ILL system use by primary access libraries. In addition to validating the important contributions made by primary access libraries to the national ILL system, baseline data that can be used to benchmark current practice performance are provided. PMID:11055297

Targeted population health management can help a hospital grow market share.

PubMed

Olson, Gary; Talbert, Pearson

2012-06-01

In 2005, St. Luke's Hospital in Chesterfield, Mo., launched the "Passport to Wellness" program to help employers reduce preventable illnesses by providing access to screenings, health education, health coaching, disease management, and healthy lifestyle programs. The program was designed to influence consumer choice of hospitals and physicians and influence health insurance purchasing decisions. St. Luke's program also met goals created by local businesses, including identifying health risks of each employer's workforce and reducing health-related costs.

Access to Investigational Drugs: FDA Expanded Access Programs or “Right‐to‐Try” Legislation?

PubMed Central

Berglund, Jelena P.; Weatherwax, Kevin; Gerber, David E.; Adamo, Joan E.

2015-01-01

Abstract Purpose The Food and Drug Administration Expanded Access (EA) program and “Right‐to‐Try” legislation aim to provide seriously ill patients who have no other comparable treatment options to gain access to investigational drugs and biological agents. Physicians and institutions need to understand these programs to respond to questions and requests for access. Methods FDA EA programs and state and federal legislative efforts to provide investigational products to patients by circumventing FDA regulations were summarized and compared. Results The FDA EA program includes Single Patient‐Investigational New Drug (SP‐IND), Emergency SP‐IND, Intermediate Sized Population IND, and Treatment IND. Approval rates for all categories exceed 99%. Approval requires FDA and Institutional Review Board (IRB) approval, and cooperation of the pharmaceutical partner is essential. “Right‐to‐Try” legislation bypasses some of these steps, but provides no regulatory or safety oversight. Conclusion The FDA EA program is a reasonable option for patients for whom all other therapeutic interventions have failed. The SP‐IND not only provides patient access to new drugs, but also maintains a balance between immediacy and necessary patient protection. Rather than circumventing existing FDA regulations through proposed legislation, it seems more judicious to provide the knowledge and means to meet the EA requirements. PMID:25588691

Access to Investigational Drugs: FDA Expanded Access Programs or "Right-to-Try" Legislation?

PubMed

Holbein, M E Blair; Berglund, Jelena P; Weatherwax, Kevin; Gerber, David E; Adamo, Joan E

2015-10-01

The Food and Drug Administration Expanded Access (EA) program and "Right-to-Try" legislation aim to provide seriously ill patients who have no other comparable treatment options to gain access to investigational drugs and biological agents. Physicians and institutions need to understand these programs to respond to questions and requests for access. FDA EA programs and state and federal legislative efforts to provide investigational products to patients by circumventing FDA regulations were summarized and compared. The FDA EA program includes Single Patient-Investigational New Drug (SP-IND), Emergency SP-IND, Intermediate Sized Population IND, and Treatment IND. Approval rates for all categories exceed 99%. Approval requires FDA and Institutional Review Board (IRB) approval, and cooperation of the pharmaceutical partner is essential. "Right-to-Try" legislation bypasses some of these steps, but provides no regulatory or safety oversight. The FDA EA program is a reasonable option for patients for whom all other therapeutic interventions have failed. The SP-IND not only provides patient access to new drugs, but also maintains a balance between immediacy and necessary patient protection. Rather than circumventing existing FDA regulations through proposed legislation, it seems more judicious to provide the knowledge and means to meet the EA requirements. © 2015 Wiley Periodicals, Inc.

High-Intensity Telemedicine Decreases Emergency Department Use by Senior Living Community Residents.

PubMed

Shah, Manish N; Wasserman, Erin B; Wang, Hongyue; Gillespie, Suzanne M; Noyes, Katia; Wood, Nancy E; Nelson, Dallas; Dozier, Ann; McConnochie, Kenneth M

2016-03-01

The failure to provide timely acute illness care can lead to adverse consequences or emergency department (ED) use. We evaluated the effect on ED use of a high-intensity telemedicine program that provides acute illness care for senior living community (SLC) residents. We performed a prospective cohort study over 3.5 years. Six SLCs cared for by a primary care geriatrics practice were intervention facilities, with the remaining 16 being controls. Consenting patients at intervention facilities could access telemedicine for acute illness care. Patients were provided patient-to-provider, real-time, or store-and-forward high-intensity telemedicine (i.e., technician-assisted with resources beyond simple videoconferencing) to diagnose and treat acute illnesses. The primary outcome was the rate of ED use. We enrolled 494 of 705 (70.1%) subjects/proxies in the intervention group; 1,058 subjects served as controls. Control and intervention subjects visited the ED 2,238 and 725 times, respectively, with 47.3% of control and 43.4% of intervention group visits resulting in discharge home. Among intervention subjects, ED use decreased at an annualized rate of 18% (rate ratio [RR]=0.82; 95% confidence interval [CI], 0.70-0.95), whereas in the control group there was no statistically significant change in ED use (RR=1.01; 95% CI, 0.95-1.07; p=0.009 for group-by-time interaction). Primary care use and mortality were not significantly different. High-intensity telemedicine significantly reduced ED use among SLC residents without increasing other utilization or mortality. This alternative to traditional acute illness care can enhance access to acute illness care and should be integrated into population health programs.

Critical care medicine training and certification for emergency physicians.

PubMed

Huang, David T; Osborn, Tiffany M; Gunnerson, Kyle J; Gunn, Scott R; Trzeciak, Stephen; Kimball, Edward; Fink, Mitchell P; Angus, Derek C; Dellinger, R Phillip; Rivers, Emanuel P

2005-09-01

Demand for critical care services is increasing. Unless the supply of intensivists increases, critically ill patients will not have access to intensivists. Recent critical care society recommendations include increased graduate medical education support and expansion of the J-1 visa waiver program for foreign medical graduates. This article proposes additional recommendations, based on strengthening the relationship between emergency medicine and critical care medicine. Demand for critical care services is increasing. Unless the supply of intensivists increases, critically ill patients will not have access to intensivists. Recent critical care society recommendations include increased graduate medical education support and expansion of the J-1 visa waiver program for foreign medical graduates. This article proposes additional recommendations, based on strengthening the relationship between emergency medicine (EM) and critical care medicine (CCM). Critical care is a continuum that includes prehospital, emergency department (ED), and intensive care unit (ICU) care teams. Both EM and CCM require expertise in treating life-threatening acute illness, with many critically ill patients often presenting first to the ED. Increased patient volumes and acuity have resulted in longer ED lengths of stay and more critical care delivery in the ED. However, the majority of CCM fellowships do not accept EM residents, and those who successfully complete a fellowship do not have access to a U.S. certification exam in CCM. Despite these barriers, interest in CCM training among EM physicians is increasing. Dual EM/CCM-trained physicians not only will help alleviate the intensivist shortage but also will strengthen critical care delivery in the ED and facilitate coordination at the ED-ICU interface. We therefore propose that all accreditation bodies work cooperatively to create a route to CCM certification for emergency physicians who complete a critical care fellowship.

Swedish District Nurses' experiences on the use of information and communication technology for supporting people with serious chronic illness living at home--a case study.

PubMed

Nilsson, Carina; Skär, Lisa; Söderberg, Siv

2010-06-01

The aim of this case study was to describe two District Nurses' (DN) experiences of using information and communication technology (ICT) to communicate with chronically ill people in their homes. An electronic messaging program via computers and mobile phones with an Internet connection was used, enabling DNs and the ill people to exchange messages to and from anywhere. The program comprised different virtual rooms, and communication was via text messages. The DNs in this study used the program two to four times each week from November 2003 to March 2004. Semi-structured interviews were performed before, during and after the implementation of the new technology and were analysed using thematic content analysis. The results showed that the DNs felt that the technology increased accessibility to nursing care through a more direct communication with the ill person meaning that a more trusting relationship could be created. The DNs also experienced that the use of ICT saved working time. This study indicates that the use of ICT for communication allowed the DN to better support a chronically ill person at home leading to improved home nursing care. This method of communication cannot replace physical presence, but can be seen as a complement to nursing care at home.

How does outcome-based funding affect service delivery? An analysis of consequences within employment services for people living with serious mental illness.

PubMed

Gewurtz, Rebecca E; Cott, Cheryl; Rush, Brian; Kirsh, Bonnie

2015-01-01

This paper explores the impact of outcome-based funding on service delivery within employment services for people with serious mental illness. It draws on a case study of a policy change in the provincial disability support program in Ontario, Canada where funding for employment programs and services was changed from a fee-for-service to an outcome-based model. The findings highlight that the financial imperative for programs to meet employment targets in order to secure their funding has shifted the focus away from the provision of pre-employment supports to job development and job placements. However, there remains little attention to job matching and career development, and there is concern about access to services among those with complex barriers to employment. There is a need to reconcile tensions between the goals of outcome-based funding and on-the-ground service delivery to promote ongoing innovation in employment services for people with serious mental illness.

Federal Policies and Programs to Expand Employment Services Among Individuals with Serious Mental Illnesses.

PubMed

Karakus, Mustafa; Riley, Jarnee; Goldman, Howard

2017-05-01

Previous studies suggest that providing employment services to individuals with serious mental illnesses can help them obtain competitive, real-world employment. However, these services are still not easily accessible to this population. This paper provides a brief summary of recent federal initiatives that may influence widespread implementation of employment services. While there is an increasing recognition of the need to remove barriers and provide supported employment services to individuals with mental illnesses, a wide-spread coordination across Federal polices, financing and regulatory changes are necessary to promote measurable and lasting effects on the broad availability of employment services among this population.

42 CFR 51.44 - [Reserved

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false [Reserved] 51.44 Section 51.44 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS REQUIREMENTS APPLICABLE TO THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Access to Records, Facilities and Individuals...

Association of mandated language access programming and quality of care provided by mental health agencies.

PubMed

McClellan, Sean R; Snowden, Lonnie

2015-01-01

This study examined the association between language access programming and quality of psychiatric care received by persons with limited English proficiency (LEP). In 1999, the California Department of Mental Health required county Medicaid agencies to implement a "threshold language access policy" to meet the state's Title VI obligations. This policy required Medi-Cal agencies to provide language access programming, including access to interpreters and translated written material, to speakers of languages other than English if the language was spoken by at least 3,000, or 5%, of the county's Medicaid population. Using a longitudinal study design with a nonequivalent control group, this study examined the quality of care provided to Spanish speakers with LEP and a severe mental illness before and after implementation of mandatory language access programming. Quality was measured by receipt of at least two follow-up medication visits within 90 days or three visits within 180 days of an initial medication visit over a period of 38 quarter-years. On average, only 40% of Spanish-speaking clients received at least three medication follow-up visits within 180 days. In multivariate analyses, language access programming was not associated with receipt of at least two medication follow-up visits within 90 days or at least three visits within 180 days. This study found no evidence that language access programming led to increased rates of follow-up medication visits for clients with LEP.

mobile Digital Access to a Web-enhanced Network (mDAWN): Assessing the Feasibility of Mobile Health Tools for Self-Management of Type-2 Diabetes.

PubMed

Ho, Kendall; Newton, Lana; Boothe, Allison; Novak-Lauscher, Helen

2015-01-01

The mobile Digital Access to a Web-enhanced Network (mDAWN) program was implemented as an online, mobile self-management system to support patients with type-2 diabetes and their informal caregivers. Patients used wireless physiological sensors, received text messages, and had access to a secure web platform with health resources and semi-facilitated discussion forum. Outcomes were evaluated using (1) pre and post self-reported health behavior measures, (2) physiological outcomes, (3) program cost, and (4) in-depth participant interviews. The group had significantly decreased health distress, HbA1c levels, and systolic blood pressure. Participants largely saw the mDAWN as providing good value for the costs involved and found the program to be empowering in gaining control over their diabetes. mHealth programs have the potential to improve clinical outcomes through cost effective patient-led care for chronic illness. Further evaluation needs to examine integration of similar mHealth programs into the patient-physician relationship.

A collaboration of student nurse coaches and students with mental illnesses in a college preparation project.

PubMed

Hsieh, Nancye L

2010-01-01

With refined diagnostic tools, earlier recognition, new pharmacological and other treatment modalities, individuals living with mental illnesses are able to experience considerable recovery. Some individuals require support and guidance to build confidence and to manage in everyday situations. Previous to their illness, many had been functioning and able to meet their needs in most aspects of their lives, including academics, but, following illness, lacked confidence or skill to continue their education. This pilot program was designed to socialize students with a mental illness to life at college. To develop the pilot concept, college departments including nursing faculty and community mental health personnel collaborated together. Potential students attended informational sessions where those interested, applied for entry into the pilot. Each student was paired with a coach, a third year nursing student, with whom they established and evaluated goals geared towards registering independently in a college course the following semester. Evaluation of the program was measured in terms of attendance, registration in a college course for the following semester or job readiness, and focus group evaluation sessions. By the end of the semester, 12 of the 13 students completed the program. With support and guidance of their coaches, students gained confidence, developed a social support network and learned skills needed to be able to navigate the college system. This type of college preparation program is effective in assisting students with mental illness to access college courses and it is recommended that there be further similar programs offered as an orientation at the college level for students with mental illness in preparation for their registration and attendance at college. To minimize cost factors and gain administrative support, practitioners wishing to replicate this study would do well to consider sources of funding, as well as resource personal or volunteers in order to keep costs to a minimum.

29 CFR 1952.175 - Changes to approved plans.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., California's Small Employer Voluntary Compliance Program, implemented on March 1, 1981, was approved by the... on January 1, 1977, was approved by the Assistant Secretary on March 6, 1978. (b) On January 1, 1978... employee access to the employer's log and summary of occupational injuries and illnesses. (d) In accordance...

29 CFR 1952.175 - Changes to approved plans.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., California's Small Employer Voluntary Compliance Program, implemented on March 1, 1981, was approved by the... on January 1, 1977, was approved by the Assistant Secretary on March 6, 1978. (b) On January 1, 1978... employee access to the employer's log and summary of occupational injuries and illnesses. (d) In accordance...

New Jersey's Medicaid waiver for acquired immunodeficiency syndrome

PubMed Central

Merzel, Cheryl; Crystal, Stephen; Sambamoorthi, Usha; Karus, Daniel; Kurland, Carol

1992-01-01

This article contains data from a study of New Jersey's home and community-based Medicaid waiver program for persons with symptomatic human immunodeficiency virus illness. Major findings include lower hospital costs and utilization for waiver participants compared with general Medicaid acquired immunodeficiency syndrome admissions in New Jersey. Average program expenditures were $2,400 per person per month. Based on study findings, it is evident that the waiver program is an important means of providing financial benefits and access to services and that comprehensive case management is a critical factor in assuring program quality. PMID:10120180

A pilot randomized controlled trial of a depression and disease management program delivered by phone.

PubMed

Aburizik, Arwa; Dindo, Lilian; Kaboli, Peter; Charlton, Mary; Dawn, Klein; Turvey, Carolyn

2013-11-01

Depression in medically ill patients occurs at twice the rate found in the general population. Though pharmacologic and psychotherapeutic interventions for depression are effective, response to treatment and access to care are barriers for this population. A multidimensional telehealth intervention was designed to focus on these barriers by delivering a phone based intervention that addressed managing one's illness and coping emotionally. Veterans with diabetes, hypertension, or chronic pain and depressive symptoms were randomized to one of three conditions: Usual Care (n=23), Illness Management Only (n=31), or Combined Psychotherapy and Illness Management (n=29). Those randomized to the Combined or Illness Management Only intervention group received 10 phone visits. Veterans in the Combined group received all aspects of the illness management program plus a manualized depression intervention. Subjects completed assessments at baseline, week 5, and 10 to test the main hypothesis that veterans in the Combined condition would have a greater decline in depressive symptoms. The Combined intervention yielded a significant decline in depressive symptoms when compared with Usual Care. However, the there was no significant difference between the Combined and Illness Management Only groups. This is a pilot study with a small sample size relative to a standard randomized controlled trial in psychotherapy. This telephone-based intervention succeeded in reducing depressive symptoms in veterans with chronic illness. It adds to the building evidence base for providing phone-delivered mental health services. © 2013 Elsevier B.V. All rights reserved.

A Multimodal Mindfulness Training to Address Mental Health Symptoms in Providers Who Care for and Interact With Children in Relation to End-of-Life Care.

PubMed

O'Mahony, Sean; Gerhart, James; Abrams, Ira; Greene, Michelle; McFadden, Rory; Tamizuddin, Sara; Levy, Mitchell M

2017-11-01

Medical providers may face unique emotional challenges when confronted with the suffering of chronically ill, dying, and bereaved children. This study assessed the preliminary outcomes of participation in a group-based multimodal mindfulness training pilot designed to reduce symptoms of burnout and mental health symptoms in providers who interact with children in the context of end-of-life care. A total of 13 medical providers who care for children facing life-threatening illness or bereaved children participated in a 9-session multimodal mindfulness session. Mental health symptoms and burnout were assessed prior to the program, at the program midpoint, and at the conclusion of the program. Participation in the pilot was associated with significant reductions in depressive and posttraumatic stress disorder (PTSD) symptoms among providers ( P < .05). Mindfulness-based programs may help providers recognize and address symptoms of depression and PTSD. Additional research is needed to enhance access and uptake of programming among larger groups of participants.

Pediatric Critical Care Telemedicine Program: A Single Institution Review.

PubMed

Hernandez, Maria; Hojman, Nayla; Sadorra, Candace; Dharmar, Madan; Nesbitt, Thomas S; Litman, Rebecca; Marcin, James P

2016-01-01

Rural and community emergency departments (EDs) often receive and treat critically ill children despite limited access to pediatric expertise. Increasingly, pediatric critical care programs at children's hospitals are using telemedicine to provide consultations to these EDs with the goal of increasing the quality of care. We conducted a retrospective review of a pediatric critical care telemedicine program at a single university children's hospital. Between the years 2000 and 2014, we reviewed all telemedicine consultations provided to children in rural and community EDs, classified the visits using a comprehensive evidence-based set of chief complaints, and reported the consultations' impact on patient disposition. We also reviewed the total number of pediatric ED visits to calculate the relative frequency with which telemedicine consultations were provided. During the study period, there were 308 consultations provided to acutely ill and/or injured children for a variety of chief complaints, most commonly for respiratory illnesses, acute injury, and neurological conditions. Since inception, the number of consultations has been increasing, as has the number of participating EDs (n = 18). Telemedicine consultations were conducted on 8.6% of seriously ill children, the majority of which resulted in admission to the receiving hospital (n = 150, 49%), with a minority of patients requiring transport to the university children's hospital (n = 103, 33%). This single institutional, university children's hospital-based review demonstrates that a pediatric critical care telemedicine program used to provide consultations to seriously ill children in rural and community EDs is feasible, sustainable, and used relatively infrequently, most typically for the sickest pediatric patients.

Paid sick days and stay-at-home behavior for influenza

PubMed Central

Piper, Kaitlin; Youk, Ada; James, A. Everette

2017-01-01

Access to paid sick days (PSD) differs by workplace size, race/ethnicity, gender, and income in the United States. It is not known to what extent decisions to stay home from work when sick with infectious illnesses such as influenza depend on PSD access, and whether access impacts certain demographic groups more than others. We examined demographic and workplace characteristics (including access to PSD) associated with employees’ decisions to stay home from work for their own or a child’s illness. Linking the 2009 Medical Expenditure Panel Survey (MEPS) consolidated data file to the medical conditions file, we used multivariate Poisson regression models with robust variance estimates to identify factors associated with missed work for an employee’s own or a child’s illness/injury, influenza-like-illness (ILI), and influenza. Controlling for gender, race/ethnicity, education, and income, access to PSD was associated with a higher probability of staying home for an employee’s own illness/injury, ILI, or influenza, and for a child’s illness/injury. Hispanic ethnicity was associated with a lower prevalence of staying home for the employee’s own or a child’s illness compared to non-Hispanic Whites. Access to PSD was associated with a significantly greater increase in the probability of staying home among Hispanics than among non-Hispanic Whites. Women had a significantly higher probability of staying home for their child’s illness compared to men, suggesting that women remain the primary caregivers for ill children. Our results indicate that PSD access is important to encourage employees to stay home from work when sick with ILI or influenza. Also, PSD access may be important to enable stay-at-home behavior among Hispanics. We conclude that access to PSD is likely to reduce the spread of disease in workplaces by increasing the rate at which sick employees stay home from work, and reduce the economic burden of staying home on minorities, women, and families. PMID:28151940

Paid sick days and stay-at-home behavior for influenza.

PubMed

Piper, Kaitlin; Youk, Ada; James, A Everette; Kumar, Supriya

2017-01-01

Access to paid sick days (PSD) differs by workplace size, race/ethnicity, gender, and income in the United States. It is not known to what extent decisions to stay home from work when sick with infectious illnesses such as influenza depend on PSD access, and whether access impacts certain demographic groups more than others. We examined demographic and workplace characteristics (including access to PSD) associated with employees' decisions to stay home from work for their own or a child's illness. Linking the 2009 Medical Expenditure Panel Survey (MEPS) consolidated data file to the medical conditions file, we used multivariate Poisson regression models with robust variance estimates to identify factors associated with missed work for an employee's own or a child's illness/injury, influenza-like-illness (ILI), and influenza. Controlling for gender, race/ethnicity, education, and income, access to PSD was associated with a higher probability of staying home for an employee's own illness/injury, ILI, or influenza, and for a child's illness/injury. Hispanic ethnicity was associated with a lower prevalence of staying home for the employee's own or a child's illness compared to non-Hispanic Whites. Access to PSD was associated with a significantly greater increase in the probability of staying home among Hispanics than among non-Hispanic Whites. Women had a significantly higher probability of staying home for their child's illness compared to men, suggesting that women remain the primary caregivers for ill children. Our results indicate that PSD access is important to encourage employees to stay home from work when sick with ILI or influenza. Also, PSD access may be important to enable stay-at-home behavior among Hispanics. We conclude that access to PSD is likely to reduce the spread of disease in workplaces by increasing the rate at which sick employees stay home from work, and reduce the economic burden of staying home on minorities, women, and families.

Through the Looking Glass: Estimating Effects of Medical Homes for People with Severe Mental Illness.

PubMed

Domino, Marisa Elena; Kilany, Mona; Wells, Rebecca; Morrissey, Joseph P

2017-10-01

To examine whether medical homes have heterogeneous effects in different subpopulations, leveraging the interpretations from a variety of statistical techniques. Secondary claims data from the NC Medicaid program for 2004-2007. The sample included all adults with diagnoses of schizophrenia, bipolar disorder, or major depression who were not dually enrolled in Medicare or in a nursing facility. We modeled a number of monthly service use, adherence, and expenditure outcomes using fixed effects, generalized estimating equation with and without inverse probability of treatment weights, and instrumental variables analyses. Data were received from the Carolina Cost and Quality Initiative. The four estimation techniques consistently revealed generally positive associations between medical homes and access to primary care, specialty mental health care, greater medication adherence, slightly lower emergency room use, and greater expenditures. These findings were consistent across all three major severe mental illness diagnostic groups. Some heterogeneity in effects were noted, especially in preventive screening. Expanding access to primary care-based medical homes for people with severe mental illness may not save money for insurance providers, due to greater access for important outpatient services with little cost offset. Health services research examining more of the treatment heterogeneity may contribute to more realistic projections about medical homes outcomes. © Health Research and Educational Trust.

Managed care and the delivery of primary care to the elderly and the chronically ill.

PubMed Central

Wholey, D R; Burns, L R; Lavizzo-Mourey, R

1998-01-01

OBJECTIVE: To analyze primary care staffing in HMOs and to review the literature on primary care organization and performance in managed care organizations, with an emphasis on the delivery of primary care to the elderly and chronically ill. DATA SOURCES/STUDY SETTING: Analysis of primary care staffing: InterStudy HMO census data on primary care (n = 1,956) and specialist (n = 1,777) physician staffing levels from 1991 through 1995. Primary care organization and performance for the chronically ill and elderly were analyzed using a review of published research. STUDY DESIGN: For the staffing-level models, the number of primary care and specialist physicians per 100,000 enrollees was regressed on HMO characteristics (HMO type [group, staff, network, mixed], HMO enrollment, federal qualification, profit status, national affiliation) and community characteristics (per capita income, population density, service area size, HMO competition). For the review of organization and performance, literature published was summarized in a tabular format. PRINCIPAL FINDINGS: The analysis of physician staffing shows that group and staff HMOs have fewer primary care and specialist physicians per 100,000 enrollees than do network and mixed HMOs, which have fewer than IPAs. Larger HMOs use fewer physicians per 100,000 enrollees than smaller HMOs. Federally qualified HMOs have fewer primary care and specialist physicians per 100,000 enrollees. For-profit, nationally affiliated, and Blue Cross HMOs have more primary care and specialist physicians than do local HMOs. HMOs in areas with high per capita income have more PCPs per 100,000 and a greater proportion of PCPs in the panel. HMO penetration decreases the use of specialists, but the number of HMOs increases the use of primary care and specialist physicians in highly competitive markets. Under very competitive conditions, HMOs appear to compete by increasing access to both PCPs and specialists, with a greater emphasis on access to specialists. The review of research on HMO performance suggests that access to PCPs is better in MCOs. But access to specialists and hospitals is lower and more difficult in MCOs than FFS. Data do not suggest that processes of care, given access, are different in MCOs and FFS. MCO enrollees are more satisfied with financial aspects of a health plan and less satisfied with other aspects of health plan organization. There are potential problems with outcomes, with some studies finding greater declines among the chronically ill in MCOs than FFS. We found a variety of innovative care programs for the elderly, based on two fundamentally different approaches: organization around primary care or organizing around specialty care. Differences between the performance of the two approaches cannot be evaluated because of the small amount of research done. It is difficult to say how well particular programs perform and if they can be replicated. The innovative programs described in the literature tend to be benchmark programs developed by HMOs with a strong positive reputation. PMID:9618674

Managed care and the delivery of primary care to the elderly and the chronically ill.

PubMed

Wholey, D R; Burns, L R; Lavizzo-Mourey, R

1998-06-01

To analyze primary care staffing in HMOs and to review the literature on primary care organization and performance in managed care organizations, with an emphasis on the delivery of primary care to the elderly and chronically ill. Analysis of primary care staffing: InterStudy HMO census data on primary care (n = 1,956) and specialist (n = 1,777) physician staffing levels from 1991 through 1995. Primary care organization and performance for the chronically ill and elderly were analyzed using a review of published research. For the staffing-level models, the number of primary care and specialist physicians per 100,000 enrollees was regressed on HMO characteristics (HMO type [group, staff, network, mixed], HMO enrollment, federal qualification, profit status, national affiliation) and community characteristics (per capita income, population density, service area size, HMO competition). For the review of organization and performance, literature published was summarized in a tabular format. The analysis of physician staffing shows that group and staff HMOs have fewer primary care and specialist physicians per 100,000 enrollees than do network and mixed HMOs, which have fewer than IPAs. Larger HMOs use fewer physicians per 100,000 enrollees than smaller HMOs. Federally qualified HMOs have fewer primary care and specialist physicians per 100,000 enrollees. For-profit, nationally affiliated, and Blue Cross HMOs have more primary care and specialist physicians than do local HMOs. HMOs in areas with high per capita income have more PCPs per 100,000 and a greater proportion of PCPs in the panel. HMO penetration decreases the use of specialists, but the number of HMOs increases the use of primary care and specialist physicians in highly competitive markets. Under very competitive conditions, HMOs appear to compete by increasing access to both PCPs and specialists, with a greater emphasis on access to specialists. The review of research on HMO performance suggests that access to PCPs is better in MCOs. But access to specialists and hospitals is lower and more difficult in MCOs than FFS. Data do not suggest that processes of care, given access, are different in MCOs and FFS. MCO enrollees are more satisfied with financial aspects of a health plan and less satisfied with other aspects of health plan organization. There are potential problems with outcomes, with some studies finding greater declines among the chronically ill in MCOs than FFS. We found a variety of innovative care programs for the elderly, based on two fundamentally different approaches: organization around primary care or organizing around specialty care. Differences between the performance of the two approaches cannot be evaluated because of the small amount of research done. It is difficult to say how well particular programs perform and if they can be replicated. The innovative programs described in the literature tend to be benchmark programs developed by HMOs with a strong positive reputation.

Terminal illness and access to Phase 1 experimental agents, surgeries and devices: reviewing the ethical arguments.

PubMed

Schüklenk, Udo; Lowry, Christopher

2009-01-01

The advent of AIDS brought about a group of patients unwilling to accept crucial aspects of the methodological standards for clinical research investigating Phase 1 drugs, surgeries or devices. Their arguments against placebo controls in trials, which depended--at the time--on the terminal status of patient volunteers led to a renewed discussion of the ethics of denying patients with catastrophic illnesses access to last-chance experimental drugs, surgeries or devices. Existing ethics and health policy literature on the topic of access to experimental drugs. The positions of those arguing for or against free access to experimental drugs for terminally ill patients are irreconcilable. At stake are questions about the kinds of personal sacrifices society can reasonably expect patients in clinical trials to make to ensure statistically predictive results. These would benefit by necessity a much larger number of current and future patients--the conflict is about individual versus public interests. It is also about the question of whether or not the state can legitimately prevent patients with terminal illnesses from unfettered access to experimental drugs, surgeries or devices in order to motivate them to participate in clinical trials. We review the ethical arguments for and against the provision of access to Phase 1 agents for terminally ill patients. Finding a compromise between providing free or no access to Phase 1 drugs for terminally ill patients. We ought to investigate means to increase access to experimental drugs for terminally ill patients without sacrificing necessary clinical trials' sounds scientific methods.

Severity of illness and ambulatory care-sensitive conditions.

PubMed

Yuen, Elaine J

2004-09-01

This study describes how severity of illness may refine the definition of ambulatory care-sensitive conditions, or ACSCs. Hospital discharge abstract data from Philadelphia were combined with census data to develop population-based adjusted rates of hospitalization for diabetes and asthma, two ACSCs. By stratifying ACSC hospitalization by severity of illness, variations were observed by age, race, and gender. Minority groups may be at higher risk for less access to outpatient primary care and were observed to have higher rates of more severely ill, Stage 3 hospitalization. Geographic map displays indicated wide ranges of age-sex-adjusted rates for high-severity hospitalization in the five-county Philadelphia region. This refined ACSC measure may help to identify specific groups and clinical conditions within a population to assist health care planners estimate health care resources such as facilities, manpower, and programs, as well as to evaluate their outcomes.

Individual Placement And Support Services Boost Employment For People With Serious Mental Illnesses, But Funding Is Lacking.

PubMed

Drake, Robert E; Bond, Gary R; Goldman, Howard H; Hogan, Michael F; Karakus, Mustafa

2016-06-01

The majority of people with serious mental illnesses want to work. Individual placement and support services, an evidence-based supported employment intervention, enables about 60 percent of people with serious mental illnesses who receive the services to gain competitive employment and improve their lives, but the approach does not lead to fewer people on government-funded disability rolls. Yet individual placement and support employment services are still unavailable to a large majority of people with serious mental illnesses in the United States. Disability policies and lack of a simple funding mechanism remain the chief barriers. A recent federal emphasis on early-intervention programs may increase access to employment services for people with early psychosis, but whether these interventions will prevent disability over time is unknown. Project HOPE—The People-to-People Health Foundation, Inc.

Is the Partners in Recovery program connecting with the intended population of people living with severe and persistent mental illness? What are their prioritised needs?

PubMed

Hancock, Nicola; Smith-Merry, Jennifer; Gillespie, James A; Yen, Ivy

2017-10-01

Objective The Partners in Recovery (PIR) program is an Australian government initiative designed to make the mental health and social care sectors work in more coordinated ways to meet the needs of those with severe and complex mental illness. Herein we reflect on demographic data collected during evaluation of PIR implementation in two Western Sydney sites. The aims of the present study were to: (1) explore whether two Sydney-based PIR programs had recruited their intended population, namely people living with severe and persistent mental illness; and (2) learn more about this relatively unknown population and their self-identified need priorities. Methods Routinely collected initial client assessment data were analysed descriptively. Results The data suggest that the two programs are engaging the intended population. The highest unmet needs identified included psychological distress, lack of daytime activities and company, poor physical health and inadequate accommodation. Some groups remain hard to connect, including people from Aboriginal and other culturally diverse communities. Conclusions The data confirm that the PIR program, at least in the two regions evaluated, is mostly reaching its intended audience. Some data were being collected inconsistently, limiting the usefulness of the data and the ability to build on PIR findings to develop ongoing support for this population. What is known about the topic? PIR is a unique national program funded to engage with and address the needs of Australians living with severe and persistent mental illness by facilitating service access. What does this paper add? This paper reports on recruitment of people living with severe and persistent mental illness, their need priorities and data collection. These are three central elements to successful roll-out of the much anticipated mental health component of the National Disability Insurance Scheme, as well as ongoing PIR operation. What are the implications for practitioners? Active recruitment, exploration of self-reported need priorities and routine outcome measurement are essential yet challenging work practices when working with people living with severe and persistent mental illness.

Barriers to involvement in physical activities of persons with mental illness.

PubMed

Shor, Ron; Shalev, Anat

2016-03-01

Participating in physical activities could be essential for reducing the multiple risk factors for health problems that persons with severe mental illness (SMI) may suffer. However, people with SMI are significantly less active than the general population. To develop knowledge about factors related to the perceived barriers hindering this population's participation in physical activities and the benefits this participation would have, a study was conducted in Israel with 86 people with mental illness living in community mental health facilities prior to their participation in a health promotion program. A mixed method was implemented and included: a scale designed to measure participants' perceptions of the barriers to and benefits of involvement in physical activities; instruments focusing on bio-psycho-social factors that may affect the level of barriers experienced; and personal interviews. The findings revealed high ranking for accessibility barriers hindering the participation in physical activities. Bio-psycho-social factors stemming from the participants' mental health, such as level of depression, were correlated with higher ranking of accessibility barriers. Bio-psycho-social factors reflecting positive mental health and health, such as positive appraisal of body weight, were correlated with lower ranking of accessibility barriers. Other barriers may include organizational and broader systemic barriers in the mental health facilities where the participants reside. These findings illuminate the need to consider the unique challenges that persons with mental illness may face in any attempt to advance their involvement in physical activity. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Exploring opportunities to support mental health care using social media: A survey of social media users with mental illness.

PubMed

Naslund, John A; Aschbrenner, Kelly A; McHugo, Gregory J; Unützer, Jürgen; Marsch, Lisa A; Bartels, Stephen J

2017-10-20

Social media holds promise for expanding the reach of mental health services, especially for young people who frequently use these popular platforms. We surveyed social media users who self-identified as having a mental illness to learn about their use of social media for mental health and to identify opportunities to augment existing mental health services. We asked 240 Twitter users who self-identified in their profile as having a mental illness to participate in an online survey. The survey was in English and inquired about participants' mental health condition, use of social media for mental health and interest in accessing mental health programs delivered through social media. Respondents from 10 countries completed 135 surveys. Most respondents were from the United States (54%), Canada (22%) and the United Kingdom (17%) and reported a psychiatric diagnosis of either schizophrenia spectrum disorder (27%), bipolar disorder (25%), major depressive disorder (16%) or depression (20%). Young adults age ≤35 (46%) were more likely to use Instagram (P = .002), Snapchat (P < .001) and their mobile phone for accessing social media (P < .001) compared to adults age 36 and older (53%). Most participants (85%) expressed interest in mental health programs delivered through social media, especially to promote overall health and wellbeing (72%) and for coping with mental health symptoms (90%). This exploratory study demonstrates the feasibility of reaching social media users with mental illness and can inform efforts to leverage social media to make evidence-based mental health services more widely available to those in need. © 2017 John Wiley & Sons Australia, Ltd.

Does SCHIP Spell Better Dental Care Access for Children? An Early Look at New Initiatives. Occasional Paper Number 50. Assessing the New Federalism: An Urban Institute Program To Assess Changing Social Policies.

ERIC Educational Resources Information Center

Almeida, Ruth; Hill, Ian; Kenney, Genevieve

Dental disease is one of the most prevalent illnesses facing children in the United States today. Eighty percent of untreated dental disease in permanent teeth is found in roughly 25 percent of 5- to 17-year old children, most of whom come from low-income and other vulnerable populations. The State Children's Health Insurance Program (SCHIP)…

The utility of outpatient commitment: acute medical care access and protecting health.

PubMed

Segal, Steven P; Hayes, Stephania L; Rimes, Lachlan

2018-06-01

This study considers whether, in an easy access single-payer health care system, patients placed on outpatient commitment-community treatment orders (CTOs) in Victoria Australia-are more likely to access acute medical care addressing physical illness than voluntary patients with and without severe mental illness. For years 2000 to 2010, the study compared acute medical care access of 27,585  severely mentally ill psychiatrically hospitalized patients (11,424 with and 16,161 without CTO exposure) and 12,229 never psychiatrically hospitalized outpatients (individuals with less morbidity risk as they were not considered to have severe mental illness). Logistic regression was used to determine the influence of the CTO on the likelihood of receiving a diagnosis of physical illness requiring acute care. Validating their shared and elevated morbidity risk, 53% of each hospitalized cohort accessed acute care compared to 32% of outpatients during the decade. While not under mental health system supervision, however, the likelihood that a CTO patient would receive a physical illness diagnosis was 31% lower than for non-CTO patients, and no different from lower morbidity-risk outpatients without severe mental illness. While, under mental health system supervision, the likelihood that CTO patients would receive a physical illness diagnosis was 40% greater than non-CTO patients and 5.02 times more likely than outpatients were. Each CTO episode was associated with a 4.6% increase in the likelihood of a member of the CTO group receiving a diagnosis. Mental health system involvement and CTO supervision appeared to facilitate access to physical health care in acute care settings for patients with severe mental illness, a group that has, in the past, been subject to excess morbidity and mortality.

Exploring the relationship between food access and foodborne illness by using spatial analysis.

PubMed

Newbold, Bruce; Watson, Susannah; Mackay, Kevin; Isaacs, Sandy

2013-09-01

There is some evidence that neighborhood deprivation increases residents' risk of foodborne illnesses. Because urban areas with the least available access to adequate amounts of nutritious or affordable food options (or "food deserts") also tend to be the most deprived areas within a city, it is hypothesized that food access and foodborne illness risk are linked. However, the complexity of tracking numbers and sources of gastrointestinal (GI) illnesses often leads researchers to speculate about reasons for disproportionate rates of pathogen outbreaks among demographic groups. This study explores the suitability of existing data to examine associations between food deserts and the spatial distribution of GI illnesses in Hamilton, Ontario, Canada. A spatial analysis by using GIS software methodology was used to identify and map food retail outlets and accessibility, as well as GI illness outbreaks and sales of antidiarrhea, antinausea, and rehydration products (used as a proxy for GI cases) within the city, based on available data. Statistical analysis of the maps shows no statistical relationship between location, access to food outlets, and rates of GI illness. The analysis points to shortfalls and gaps in the existing data, which leaves us unable to draw conclusions either supporting or refuting our hypothesis. This article includes recommendations to improve the current system of illness reporting and to continue to refine the definition and process of mapping food access issues. A more comprehensive set of data would enable municipalities to more easily identify groups most at risk, depending on exposures and the type of pathogen, and reduce the occurrence of foodborne disease.

Health care access and health care workforce for immigrant workers in the agriculture, forestry, and fisheries sector in the southeastern US.

PubMed

Frank, Arthur L; Liebman, Amy K; Ryder, Bobbi; Weir, Maria; Arcury, Thomas A

2013-08-01

The Agriculture, Forestry, and Fishery (AgFF) Sector workforce in the US is comprised primarily of Latino immigrants. Health care access for these workers is limited and increases health disparities. This article addresses health care access for immigrant workers in the AgFF Sector, and the workforce providing care to these workers. Immigrant workers bear a disproportionate burden of poverty and ill health and additionally face significant occupational hazards. AgFF laborers largely are uninsured, ineligible for benefits, and unable to afford health services. The new Affordable Care Act will likely not benefit such individuals. Community and Migrant Health Centers (C/MHCs) are the frontline of health care access for immigrant AgFF workers. C/MHCs offer discounted health services that are tailored to meet the special needs of their underserved clientele. C/MHCs struggle, however, with a shortage of primary care providers and staff prepared to treat occupational illness and injury among AgFF workers. A number of programs across the US aim to increase the number of primary care physicians and care givers trained in occupational health at C/MHCs. While such programs are beneficial, substantial action is needed at the national level to strengthen and expand the C/MHC system and to establish widely Medical Home models and Accountable Care Organizations. System-wide policy changes alone have the potential to reduce and eliminate the rampant health disparities experienced by the immigrant workers who sustain the vital Agricultural, Forestry, and Fishery sector in the US. Copyright © 2013 Wiley Periodicals, Inc.

Access to healthcare for the most vulnerable migrants: a humanitarian crisis.

PubMed

Pottie, Kevin; Martin, Jorge Pedro; Cornish, Stephen; Biorklund, Linn Maria; Gayton, Ivan; Doerner, Frank; Schneider, Fabien

2015-01-01

A series of Médecins Sans Frontières projects for irregular migrants over the past decade have consistently documented high rates of 14 physical and sexual trauma, extortion and mental illness amidst severe healthcare, food, and housing limitations. Complex interventions were needed to begin to address illness and barriers to healthcare and to help restore dignity to the most vulnerable women, children and men. Promising interventions included mobile clinics, use of cultural mediators, coordination with migrant-friendly entities and NGOs and integrating advocacy programs and mental health care with medical services. Ongoing interventions, research and coordination are needed to address this neglected humanitarian crisis.

Persisting Barriers to Employment for Recently Housed Adults with Mental Illness Who Were Homeless.

PubMed

Poremski, Daniel; Woodhall-Melnik, Julia; Lemieux, Ashley J; Stergiopoulos, Vicky

2016-02-01

Adults with mental illness who are homeless experience multiple barriers to employment, contributing to difficulties securing and maintaining housing. Housing First programs provide quick, low-barrier access to housing and support services for this population, but their success in improving employment outcomes has been limited. Supported employment interventions may augment Housing First programs and address barriers to employment for homeless adults with mental illness. The present paper presents data from qualitative interviews to shed light on the persisting barriers to employment among people formerly homeless. Once housed, barriers to employment persisted, including the following: (1) worries about disclosing sensitive information, (2) fluctuating motivation, (3) continued substance use, and (4) fears about re-experiencing homelessness-related trauma. Nevertheless, participants reported that their experiences of homelessness helped them develop interpersonal strength and resilience. Discussing barriers with an employment specialist helps participants develop strategies to overcome them, but employment specialists must be sensitive to specific homelessness-related experiences that may not be immediately evident. Supported housing was insufficient to help people return to employment. Supported employment may help people return to work by addressing persisting barriers.

Mobile Health for All: Public-Private Partnerships Can Create a New Mental Health Landscape

PubMed Central

2016-01-01

Research has already demonstrated that different mHealth approaches are feasible, acceptable, and clinically promising for people with mental health problems. With a robust evidence base just over the horizon, now is the time for policy makers, researchers, and the private sector to partner in preparation for the near future. The Lifeline Assistance Program is a useful model to draw from. Created in 1985 by the U.S. Federal Communications Commission (FCC), Lifeline is a nationwide program designed to help eligible low-income individuals obtain home phone and landline services so they can pursue employment, reach help in case of emergency, and access social services and healthcare. In 2005, recognizing the broad shift towards mobile technology and mobile-cellular infrastructure, the FCC expanded the program to include mobile phones and data plans. The FCC provides a base level of federal support, but individual states are responsible for regional implementation, including engagement of commercial mobile phone carriers. Given the high rates of disability and poverty among people with severe mental illness, many are eligible to benefit from Lifeline and research has shown that a large proportion does in fact use this program to obtain a mobile phone and data plan. In the singular area of mobile phone use, the gap between people with severe mental illness and the general population in the U.S. is vanishing. Strategic multi-partner programs will be able to grant access to mHealth for mental health programs to those who will not be able to afford them—arguably, the people who need them the most. Mobile technology manufacturing costs are dropping. Soon all mobile phones in the marketplace, including the more inexpensive devices that are made available through subsidy programs, will have “smart” capabilities (ie, internet connectivity and the capacity to host apps). Programs like Lifeline could be expanded to include mHealth resources that capitalize on “smart” functions, such as secure/encrypted clinical texting programs and mental health monitoring and illness-management apps. Mobile phone hardware and software development companies could be engaged to add mHealth programs as a standard component in the suite of tools that come installed on their mobile phones; thus, in addition to navigation apps, media players, and games, the new Android or iPhone could come with guided relaxation videos, medication reminder systems, and evidence-based self-monitoring and self-management tools. Telecommunication companies could be encouraged to offer mHealth options with their data plans. Operating system updates pushed out by the mobile carrier companies could come with optional mHealth applications for those who elect to download them. In the same manner in which the Lifeline Assistance Program has helped increase access to fundamental opportunities to so many low-income individuals, innovative multi-partner programs have the potential to put mHealth for mental health resources in the hands of millions in the years ahead. PMID:27268283

Mobile Health for All: Public-Private Partnerships Can Create a New Mental Health Landscape.

PubMed

Ben-Zeev, Dror

2016-06-06

Research has already demonstrated that different mHealth approaches are feasible, acceptable, and clinically promising for people with mental health problems. With a robust evidence base just over the horizon, now is the time for policy makers, researchers, and the private sector to partner in preparation for the near future. The Lifeline Assistance Program is a useful model to draw from. Created in 1985 by the U.S. Federal Communications Commission (FCC), Lifeline is a nationwide program designed to help eligible low-income individuals obtain home phone and landline services so they can pursue employment, reach help in case of emergency, and access social services and healthcare. In 2005, recognizing the broad shift towards mobile technology and mobile-cellular infrastructure, the FCC expanded the program to include mobile phones and data plans. The FCC provides a base level of federal support, but individual states are responsible for regional implementation, including engagement of commercial mobile phone carriers. Given the high rates of disability and poverty among people with severe mental illness, many are eligible to benefit from Lifeline and research has shown that a large proportion does in fact use this program to obtain a mobile phone and data plan. In the singular area of mobile phone use, the gap between people with severe mental illness and the general population in the U.S. is vanishing. Strategic multi-partner programs will be able to grant access to mHealth for mental health programs to those who will not be able to afford them-arguably, the people who need them the most. Mobile technology manufacturing costs are dropping. Soon all mobile phones in the marketplace, including the more inexpensive devices that are made available through subsidy programs, will have "smart" capabilities (ie, internet connectivity and the capacity to host apps). Programs like Lifeline could be expanded to include mHealth resources that capitalize on "smart" functions, such as secure/encrypted clinical texting programs and mental health monitoring and illness-management apps. Mobile phone hardware and software development companies could be engaged to add mHealth programs as a standard component in the suite of tools that come installed on their mobile phones; thus, in addition to navigation apps, media players, and games, the new Android or iPhone could come with guided relaxation videos, medication reminder systems, and evidence-based self-monitoring and self-management tools. Telecommunication companies could be encouraged to offer mHealth options with their data plans. Operating system updates pushed out by the mobile carrier companies could come with optional mHealth applications for those who elect to download them. In the same manner in which the Lifeline Assistance Program has helped increase access to fundamental opportunities to so many low-income individuals, innovative multi-partner programs have the potential to put mHealth for mental health resources in the hands of millions in the years ahead.

Illness, death, and macronutrients: adequacy of rural Mozambican household production of macronutrients in the face of HIV/AIDS.

PubMed

Donovan, Cynthia; Massingue, Jaquelino

2007-06-01

As the public sector and civil society develop intervention programs to deal with the HIV/ AIDS epidemic, there has been an increasing emphasis on the relationship between nutrition and the disease. Drug interventions may be ineffective, and the progression from HIV infection to full-blown AIDS may be accelerated without adequate nutrition. Mozambique is still fighting an increasing prevalence rate of HIV including in rural areas. Rural households in Mozambique rely heavily on their own agricultural production for the basic macronutrients. To evaluate the extent to which household agricultural production of basic staples meets overall household needs for major macronutrients, comparing households affected and not directly affected by HIV/ AIDS and other major illnesses over two time periods. Methods. This research analyzes nationally representative panel data from rural household surveys conducted in 2002 and 2005 to evaluate whether households that have suffered the chronic illness or illness-related death of prime-age adult members (15 to 49 years of age) are more vulnerable to macronutrient gaps. Households in the South and in the North with a male illness or death in 2002 produced significantly less macronutrients from crops in 2005 than nonaffected households. These households also had significantly lower income per adult equivalent. Mortality or illness from HIV/AIDS affects the ability of agricultural households dependent on own-food production to produce macronutrients. Interventions to improve access to food may be needed for affected households, particularly in light of their inability to recover over time. More analysis is needed to understand income sources, crop diversification, and access to macronutrients through the market.

Expanding Access: An Evaluation of ReadCube Access as an ILL Alternative.

PubMed

Grabowsky, Adelia

2016-01-01

ReadCube Access is a patron-driven, document delivery system that provides immediate access to articles from journals owned by Nature Publishing Group. The purpose of this study was to evaluate the use of ReadCube Access as an interlibrary loan (ILL) alternative for nonsubscribed Nature journals at Auburn University, a research university with a School of Pharmacy and a School of Veterinary Medicine. An analysis of ten months' usage and costs are presented along with the results of a user satisfaction survey. Auburn University Libraries found ReadCube to be an acceptable alternative to ILL for unsubscribed Nature journals and at current levels of use and cost, consider ReadCube to be financially sustainable.

Information needs, care difficulties, and coping strategies in families of people with mental illness

PubMed Central

Sabanciogullari, Selma; Tel, Havva

2015-01-01

Objective: To determine information needs, care difficulties, and coping mechanisms of family members of people with mental illness. Methods: In this descriptive cross-sectional study, the study sample consisted of the families of 134 patients who were treated in the Psychiatric Unit of Cumhuriyet University Training and Research Hospital in Sivas, Turkey between January and May 2011. Data was collected by a questionnaire and analysed descriptively, and by chi-square testing. Results: It was determined that 79.1% of family members were knowledgeable of the patients’ illness. It was found that they experienced difficulties in communicating with the patient, and in ensuring drug compliance and anger management and that they used psychological and social coping strategies. Conclusion: Our results indicate that access to medical information on its own is not sufficient for carers of people with mental illness, and the necessity of developing positive attitudes when dealing with the illness and its symptoms. We recommend that nurses and other health professionals offer long term support and consultation programs to family members. PMID:25864067

Aid to people with disabilities: Medicaid's growing role.

PubMed

Carbaugh, Alicia L; Elias, Risa; Rowland, Diane

2006-01-01

Medicaid is the nation's largest health care program providing assistance with health and long-term care services for millions of low-income Americans, including people with chronic illness and severe disabilities. This article traces the evolution of Medicaid's now-substantial role for people with disabilities; assesses Medicaid's contributions over the last four decades to improving health insurance coverage, access to care, and the delivery of care; and examines the program's future challenges as a source of assistance to children and adults with disabilities. Medicaid has shown that it is an important source of health insurance coverage for this population, people for whom private coverage is often unavailable or unaffordable, substantially expanding coverage and helping to reduce the disparities in access to care between the low-income population and the privately insured.

Clinical and financial considerations for implementing an ICU telemedicine program.

PubMed

Kruklitis, Robert J; Tracy, Joseph A; McCambridge, Matthew M

2014-06-01

As the population in the United States increases and ages, the need to provide high-quality, safe, and cost-effective care to the most critically ill patients will be of great importance. With the projected shortage of intensivists, innovative changes to improve efficiency and increase productivity will be necessary. Telemedicine programs in the ICUs (tele-ICUs) are a successful strategy to improve intensivist access to critically ill patients. Although significant capital and maintenance costs are associated with tele-ICUs, these costs can be offset by indirect financial benefits, such as decreased length of stay. To achieve the positive clinical outcomes desired, tele-ICUs must be carefully designed and implemented. In this article, we discuss the clinical benefits of tele-ICUs. We review the financial considerations, including direct and indirect reimbursement and development and maintenance costs. Finally, we review design and implementation considerations for tele-ICUs.

Applying comparative effectiveness research to public and population health initiatives.

PubMed

Teutsch, Steven M; Fielding, Jonathan E

2011-02-01

Comparative effectiveness research to date has focused primarily on the diagnosis and treatment of diseases and injuries in individuals. Yet the greatest drivers of people's overall health are found in their social and physical environments. We recommend that the comparative effectiveness research agenda focus on the public health issues responsible for the greatest overall illness and death levels, such as programs to increase high school graduation rates, which are strongly associated with improvements in long-term illness and death rates. In so doing, the agenda should spotlight efforts to address widely recognized social and environmental determinants of health, such as improving access to early childhood development programs and education, as well as interventions aimed at affecting climate change and addressing behavioral risk factors such as smoking. We also urge federal health agencies to invest in further development of methods to compare public health interventions and to use those methods to conduct the studies.

One-year housing arrangements among homeless adults with serious mental illness in the ACCESS program.

PubMed

Mares, Alvin S; Rosenheck, Robert A

2004-05-01

This study examined the various living arrangements among formerly homeless adults with mental illness 12 months after they entered case management. The study surveyed 5,325 clients who received intensive case management services in the Access to Community Care and Effective Services and Supports (ACCESS) program. Living arrangements 12 months after program entry were classified into six types on the basis of residential setting, the presence of others in the home, and stability (living in the same place for 60 days). Differences in perceived housing quality, unmet housing needs, and overall satisfaction were compared across living arrangements by using analysis of covariance. One year after entering case management, 37 percent of clients had been independently housed during the previous 60 days (29 percent lived alone in their own place and 8 percent lived with others in their own place), 52 percent had been dependently housed during the previous 60 days (11 percent lived in someone else's place, 10 percent lived in an institution, and 31 percent lived in multiple places), and 11 percent had literally been homeless during the previous 60 days. Clients with less severe mental health and addiction problems at baseline and those in communities that had higher social capital and more affordable housing were more likely to become independently housed, to show greater clinical improvement, and to have greater access to housing services. After the analysis adjusted for potentially confounding factors, independently housed clients were more satisfied with life overall. However, no significant association was found between specific living arrangements and either perceived housing quality or perceived unmet needs for housing. Living independently was positively associated with satisfaction of life overall, but it was not associated with the perception that the quality of housing was better or that there was less of a need for permanent housing.

Access to and Use of the Internet by Veterans with Serious Mental Illness.

PubMed

Record, Elizabeth J; Medoff, Deborah R; Dixon, Lisa B; Klingaman, Elizabeth A; Park, Stephanie G; Hack, Samantha; Brown, Clayton H; Fang, Li Juan; Kreyenbuhl, Julie

2016-02-01

This study evaluated internet use among 239 veterans with serious mental illness who completed questionnaires assessing demographics and internet use in 2010-2011. The majority of individuals (70 %) reported having accessed the internet and among those, 79 % had accessed it within the previous 30 days. Those who were younger and more educated were more likely to have accessed the internet, as were those with a schizophrenia spectrum disorder, bipolar disorder, or major depressive disorder, compared to individuals with PTSD. Veterans with serious mental illness commonly use the internet, including to obtain health information, though use varies across demographic characteristics and clinical diagnosis.

Access to and Use of the Internet by Veterans with Serious Mental Illness

PubMed Central

Record, Elizabeth J.; Medoff, Deborah R.; Dixon, Lisa B.; Klingaman, Elizabeth A.; Park, Stephanie G.; Hack, Samantha; Brown, Clayton H.; Fang, Li Juan; Kreyenbuhl, Julie

2017-01-01

This study evaluated internet use among 239 veterans with serious mental illness who completed questionnaires assessing demographics and internet use in 2010-2011. The majority of individuals (70%) reported having accessed the internet and among those, 79% had accessed it within the previous 30 days. Those who were younger and more educated were more likely to have accessed the internet, as were those with a schizophrenia spectrum disorder, bipolar disorder, or major depressive disorder, compared to individuals with PTSD. Veterans with serious mental illness commonly use the internet, including to obtain health information, though use varies across demographic characteristics and clinical diagnosis. PMID:25821927

Increasing physical activity for veterans in the Mental Health Intensive Case Management Program: A community-based intervention.

PubMed

Harrold, S Akeya; Libet, Julian; Pope, Charlene; Lauerer, Joy A; Johnson, Emily; Edlund, Barbara J

2018-04-01

Individuals with severe mental illness (SMI), experience increased mortality-20 years greater disparity for men and 15 years greater disparity for women-compared to the general population (Thornicroft G. Physical health disparities and mental illness: The scandal of premature mortality. Br J Psychiatr. 2011;199:441-442). Numerous factors contribute to premature mortality in persons with SMI, including suicide and accidental death (Richardson RC, Faulkner G, McDevitt J, Skrinar GS, Hutchinson D, Piette JD. Integrating physical activity into mental health services for persons with serious mental illness. Psychiatr Serv. 2005;56(3):324-331; Thornicroft G. Physical health disparities and mental illness: The scandal of premature mortality. Br J Psychiatr. 2011;199:441-442), but research has shown that adverse health behaviors-including smoking, low rate of physical activity, poor diet, and high alcohol consumption-also significantly contribute to premature deaths (Jones J. Life expectancy in mental illness. Psychiatry Services. 2010. Retrieved from http://psychcentral.com/news/2010/07/13/life-expectancy-in-mental-illness). This quality improvement (QI) project sought to improve health and wellness for veterans in the Mental Health Intensive Case Management Program (MHICM), which is a community-based intensive program for veterans with SMI at risk for decompensation and frequent hospitalizations. At the time of this QI project, the program had 69 veterans who were assessed and treated weekly in their homes. The project introduced a pedometer steps intervention adapted from the VA MOVE! Program-a physical activity and weight management program-with the addition of personalized assistance from trained mental health professionals in the veteran's home environment. Because a large percentage of the veterans in the MHICM program had high blood pressure and increased weight, these outcomes were the focus of this project. Through mental health case management involvement and the comfort of their familiar living environment, veterans were assisted to meet their physical and mental health goals with a program that could easily be integrated into their daily lives. Healthy People 2020 developed goals to improve levels of physical activity and has ranked physical activity as a leading health indicator (US DHHS. Office of Disease Prevention and Health Promotion. Physical activity topic overview. In Healthy People 2020. 2016. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/physical-activity). Individuals with SMI are significantly less active than the general population (Shor and Shalev, 2014). It is sometimes difficult for the average individual to obtain the recommended 10,000 steps and even more difficult for those with SMI. Lifestyle modifications, in particular diet and exercise, are recommended for improvement of chronic disease outcomes (US Preventive Services Counseling Task Force, 2016). The health benefits of physical activity for people with SMI are mixed (Pearsall R, Smith D, Pelosi A, Geddes J. Exercise therapy in adults with serious mental illness: A systematic review and meta-analysis. BMC Psychiatr. 2014;14:117). Some studies found significant physical health benefits, while others did not. However, according to a review by Soundy et al., physical exercise is shown to not only have physical benefits but also psychosocial benefits. One of the barriers that hinder participation in physical activities is accessibility (Shor and Shalev, 2014). Integrating a more personalized supported, and in-home pedometer program into mental healthcare should ensure better access to interventions that could possibly reverse the causes of premature death. The program was offered to 69 veterans in the MHICM. Forty-nine agreed to start the program and 20 declined. Twenty-five clients actually started the program with 17 veterans completing it. Preimplementation data included collecting blood pressure and weight measures for all veterans in the MHICM program. Additionally, a focus group was held with case managers to obtain a group perspective on motivating veterans to participate in this program. Further, a teaching session was held to review pedometers use, the client video, the client booklet, methods for getting veterans started, and the progression of the walking intervention. The pedometer physical activity intervention continued for 2 months. At the end of the 2 months, aggregate de-identified data on number of steps, blood pressure, and weight were collected. At the end of the program, the data were reviewed, synthesized, and analyzed, being careful to account for potentially intervening conditions and other chronic illnesses. The postimplementation data revealed that the mean weight decreased by 9 lbs. The percentage of controlled blood pressure increased from 60 to 84, while the percentage of uncontrolled blood pressure decreased from 40 to 16. Implementation of a multiple component personalized exercise intervention program for veterans with SMI contributed to reduction in weight and blood pressure. © 2017 Wiley Periodicals, Inc.

Using Technology to Improve Access to Mental Health Services.

PubMed

Cortelyou-Ward, Kendall; Rotarius, Timothy; Honrado, Jed C

Mental ill-health is a public health threat that is prevalent throughout the United States. Tens of millions of Americans have been diagnosed along the continuum of mental ill-health, and many more millions of family members and friends are indirectly affected by the pervasiveness of mental ill-health. Issues such as access and the societal stigma related to mental health issues serve as deterrents to patients receiving their necessary care. However, technological advances have shown the potential to increase access to mental health services for many patients.

Experience of emotional stress and resilience in street-involved youth: the need for early mental health intervention.

PubMed

McCay, Elizabeth

2011-01-01

Mental illness left untreated in adolescence and young adulthood can readily become a chronic illness in adulthood, seriously hampering the capacity of individuals to become healthy contributing members of society. Mental health challenges are of paramount importance to the health and well-being of Canadian adolescents and young adults, with 18% of Canadian youth, ages 15-24, reporting a mental illness (Leitch 2007). However, it is unlikely that this statistic accounts for those invisible youth (Rachlis et al. 2009) who are disconnected from families and caregivers, bereft of stable housing and familial support - in other words, youth who are street-involved. Mental health risk is amplified in street-involved youth and, as such, must be recognized as a priority for policy development that commits to accessible mental health programming, in order to realize the potential of these vulnerable youth.

Making drugs accessible.

PubMed

1999-01-01

Making drugs accessible for common HIV-associated illnesses in West Africa is discussed. HIV-positive people in Ouagadougou, Burkina Faso, could not afford drugs for treating their illnesses; thus, volunteers from La Bergerie-FUC, a Christian organization, have established a day care center for HIV-positive people. A French church supplies the drugs; oral rehydration salts are provided through the Ministry of Health. Since the organization did not have enough drugs to meet the needs of all its patients, two strategies were developed to improve its drug supply. The first strategy was to raise money to buy drugs through the support of a local NGO, the Initiative Privee et Communautaire de lutte contre le SIDA (IPC). IPC initially refused to support them, but, eventually agreed to fund drug purchasing as a pilot project. The second strategy was to look at ways of reducing the cost of drugs, which resulted in a list of essential drugs for HIV-associated infections. The list was approved by Care and Support Committee of the national AIDS program for use by other organizations. The organizations have created a national network to improve the delivery of community-based care and support services in Burkina Faso. Recently, the national AIDS program has asked this network to help them change the national essential drugs list to include essential drugs for treating common HIV-associated infections.

Supporting patients with mental illness: Deconstructing barriers to community pharmacist access.

PubMed

Calogero, Samantha; Caley, Charles F

To discuss the barriers faced by individuals with mental health conditions attempting to access their community pharmacists and to propose solutions toward deconstructing those barriers. Given the prevalence of mental illness and the frequency at which psychotropic medications are dispensed, community pharmacists have a daily opportunity to engage patients with mental illness and be active participants in community-based mental health care. Yet multiple barriers affect patient access to community pharmacists. Some barriers, such as heavy dispensing workload, can be considered as "external" to the pharmacist. Other barriers, such as negative attitudes about mental illness, are considered to be "internal." Research about mental illness stigma in pharmacy often reports that community pharmacists are uncomfortable with, or have little time for, mental health patients. Patients also report experiencing stigma from pharmacists and pharmacy staff. Expanded efforts are needed by the pharmacy profession to deconstruct barriers that patients with mental illness are faced with in community pharmacy, especially related to stigma. Specifically, these efforts should include critically evaluating and addressing the quality of didactic and experiential opportunities in psychiatric pharmacotherapy for pharmacy students, transforming the physical layout of community pharmacies to offer true counseling privacy, educating community pharmacists and pharmacy staff about mental illness, and educating patients about what to expect from community pharmacists. There are opportunities for community pharmacy to improve its impact on mental health treatment outcomes by resolving mental illness stigma and other barriers that prevent patients with mental illness from accessing their community pharmacist. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Injury and Illness Epidemiology at a Summer Sport-Camp Program, 2008 Through 2011

PubMed Central

Oller, Daria M.; Buckley, W. E.; Sebastianelli, Wayne J.; Vairo, Giampietro L.

2015-01-01

Context: University-sponsored summer sport camps often employ athletic trainers; however, there is a dearth of epidemiologic studies describing the injury and illness experience of sport-camp participants to guide clinicians. Objective: To describe the injury and illness experience of youth participants at a university-sponsored summer sport-camp program during a 4-year period. Design: Descriptive epidemiology study. Setting: A National Collegiate Athletic Association Division I university that sponsored 76 to 81 camps for 28 sports each summer. Patients or Other Participants: A total of 44 499 camp participants enrolled during the 4 years. Male and female participants ranged in age from 10 to 17 years and in athletic skill from novice to elite. Main Outcome Measure(s): Data from handwritten injury and illness log books, maintained by sports health care personnel, were accessed retrospectively, entered into an electronic spreadsheet, and coded. Data were applied to the National Athletic Injury/Illness Reporting System. Participant−personnel contacts, defined as any instance when a participant sought health care services from personnel, were calculated per 100 participants. Injury and illness rates were calculated per 10 000 exposures, measured in participant-days. The distribution of injury and illness conditions and affected body regions were calculated. Results: There were 11 735 contacts, for an overall rate of 26 per 100 participants, and 4949 injuries and illnesses, for a rate of 1 per 10 000 participant-days. Participants at single-sex camps were less likely to sustain injuries and illnesses than participants at coeducational camps (rate ratio [RR] = 0.49; 95% confidence interval = 0.45, 0. 35; P < .001, and RR = 0.47; 95% confidence interval = 0.43, 0.51; P < .001, respectively). The lower extremity was injured most frequently (27.9%). Most injury and illness conditions were dermatologic (37.1%). Conclusions: The contact and injury and illness differences observed among sports and between sexes demonstrated potential differences in the sports health care needs of camp participants. These data can be used to make evidence-based clinical decisions, such as determining injury-prevention strategies and sports health care staffing needs. PMID:25611314

Injury and illness epidemiology at a summer sport-camp program, 2008 through 2011.

PubMed

Oller, Daria M; Buckley, W E; Sebastianelli, Wayne J; Vairo, Giampietro L

2015-03-01

University-sponsored summer sport camps often employ athletic trainers; however, there is a dearth of epidemiologic studies describing the injury and illness experience of sport-camp participants to guide clinicians. To describe the injury and illness experience of youth participants at a university-sponsored summer sport-camp program during a 4-year period. Descriptive epidemiology study. A National Collegiate Athletic Association Division I university that sponsored 76 to 81 camps for 28 sports each summer. A total of 44, 499 camp participants enrolled during the 4 years. Male and female participants ranged in age from 10 to 17 years and in athletic skill from novice to elite. Data from handwritten injury and illness log books, maintained by sports health care personnel, were accessed retrospectively, entered into an electronic spreadsheet, and coded. Data were applied to the National Athletic Injury/Illness Reporting System. Participant-personnel contacts, defined as any instance when a participant sought health care services from personnel, were calculated per 100 participants. Injury and illness rates were calculated per 10 ,000 exposures, measured in participant-days. The distribution of injury and illness conditions and affected body regions were calculated. There were 11 ,735 contacts, for an overall rate of 26 per 100 participants, and 4949 injuries and illnesses, for a rate of 1 per 10, 000 participant-days. Participants at single-sex camps were less likely to sustain injuries and illnesses than participants at coeducational camps (rate ratio [RR] = 0.49; 95% confidence interval = 0.45, 0. 35; P < .001, and RR = 0.47; 95% confidence interval = 0.43, 0.51; P < .001, respectively). The lower extremity was injured most frequently (27.9%). Most injury and illness conditions were dermatologic (37.1%). The contact and injury and illness differences observed among sports and between sexes demonstrated potential differences in the sports health care needs of camp participants. These data can be used to make evidence-based clinical decisions, such as determining injury-prevention strategies and sports health care staffing needs.

Evaluation of an Evidence-Based Tobacco Treatment Curriculum for Psychiatry Residency Training Programs

PubMed Central

Prochaska, Judith J.; Fromont, Sebastien C.; Leek, Desiree; Hudmon, Karen Suchanek; Louie, Alan K.; Jacobs, Marc H.; Hall, Sharon M.

2009-01-01

Objective Smokers with mental illness and addictive disorders account for nearly one in two cigarettes sold in the United States and are at high risk for smoking-related deaths and disability. Psychiatry residency programs provide a unique arena for disseminating tobacco treatment guidelines, influencing professional norms, and increasing access to tobacco cessation services among smokers with mental illness. The current study evaluated the Rx for Change in Psychiatry curriculum, developed for psychiatry residency programs and focused on identifying and treating tobacco dependence among individuals with mental illness. Methods The 4-hour curriculum emphasized evidence-based, patient-oriented cessation treatments relevant for all tobacco users, including those not yet ready to quit. The curriculum was informed by comprehensive literature review, consultation with an expert advisory group, faculty interviews, and a focus group with psychiatry residents. This study reports on evaluation of the curriculum in 2005–2006, using a quasi-experimental design, with 55 residents in three psychiatry residency training programs in Northern California. Results The curriculum was associated with improvements in psychiatry residents’ knowledge, attitudes, confidence, and counseling behaviors for treating tobacco use among their patients, with initial changes from pre- to posttraining sustained at 3-months’ follow-up. Residents’ self-reported changes in treating patients’ tobacco use were substantiated through systematic chart review. Conclusion The evidence-based Rx for Change in Psychiatry curriculum is offered as a model tobacco treatment curriculum that can be implemented in psychiatry residency training programs and disseminated widely, thereby effectively reaching a vulnerable and costly population of smokers. PMID:19190293

Using systems of care to reduce incarceration of youth with serious mental illness.

PubMed

Erickson, Chris D

2012-06-01

Youth with serious mental illness come into contact with juvenile justice more than 3 times as often as other youth, obliging communities to expend substantial resources on adjudicating and incarcerating many who, with proper treatment, could remain in the community for a fraction of the cost. Incarceration is relatively ineffective at remediating behaviors associated with untreated serious mental illness and may worsen some youths' symptoms and long-term prognoses. Systems of care represent a useful model for creating systems change to reduce incarceration of these youth. This paper identifies the systemic factors that contribute to the inappropriate incarceration of youth with serious mental illness, including those who have committed non-violent offenses or were detained due to lack of available treatment. It describes the progress of on-going efforts to address this problem including wraparound and diversion programs and others utilizing elements of systems of care. The utility of systems of care principles for increasing access to community-based mental health care for youth with serious mental illness is illustrated and a number of recommendations for developing collaborations with juvenile justice to further reduce the inappropriate incarceration of these youth are offered.

A scoping review of weight bias by community pharmacists towards people with obesity and mental illness.

PubMed

Murphy, Andrea L; Gardner, David M

2016-07-01

Community pharmacists are accessible health care professionals who are increasingly offering weight management programs. People living with serious mental illness have markedly higher rates of obesity and associated illness outcomes than the general population, providing pharmacists who are interested in offering weight management services with an identifiable patient subgroup with increased health needs. Issues with stigma within obesity and mental illness care are prevalent and can lead to inequities and reduced quality of care. We conducted a scoping review to map and characterize the available information from published and grey literature sources regarding community pharmacists and weight bias towards obese people with lived experience of mental illness. A staged approach to the scoping review was used. Six articles and 6 websites were abstracted after we removed duplicates and applied our inclusion and exclusion criteria. The published studies that we found indicated that pharmacists and pharmacy students do demonstrate implicit and explicit weight bias. Very limited research is available regarding weight bias in pharmacists and stigma towards people with obesity, and we found no information on these phenomena relating to people with lived experience of mental illness. Investigations are needed to characterize the extent and nature of anti-fat bias and attitudes by pharmacists and the consequences of these attitudes for patient care.

Enhancing work-focused supports for people with severe mental illnesses in australia.

PubMed

Contreras, Natalia; Rossell, Susan L; Castle, David J; Fossey, Ellie; Morgan, Dea; Crosse, Caroline; Harvey, Carol

2012-01-01

Persons with severe mental illness (SMI) have reduced workforce participation, which leads to significant economic and social disadvantage. This theoretical review introduces the strategies that have been implemented to address this issue. These include Individual Placement and Support (IPS) services, the most widely researched form of supported employment, to which cognitive remediation has more recently been recognised in the USA, as an intervention to improve employment outcomes by addressing the cognitive impairments often experienced by people with SMI. The authors review the international literature and discuss specifically the Australian context. They suggest that Australia is in a prime position to engage clients in such a dual intervention, having had recent success with increasing access to supported employment programs and workforce reentry, through implementation of the Health Optimisation Program for Employment (HOPE). Such programs assist with gaining and maintaining employment. However, they do not address the cognitive issues that often prevent persons with SMI from effectively participating in work. Thus, optimising current interventions, with work-focused cognitive skills development is critical to enhancing employment rates that remain low for persons with SMI.

Participants' Voices From Within a Healthy Lifestyle Group.

PubMed

Park, Tanya; Foster, Kim; Usher, Kim

2017-02-01

Weight gain is a serious health concern. People with mental illnesses are at increased risk of weight gain. The primary treatment is lifestyle changes such as increasing physical activity and dietary changes. This qualitative study explored the experience of people with schizophrenia who participated in a healthy lifestyle program. Four themes were identified. The findings indicate that benefits of the program were more than physical health improvements and included regular access to a health professional, gaining social relationships, and a sense of belonging. Future recommendations include retaining a group structure in lifestyle interventions to facilitate these additional benefits.

Going "social" to access experimental and potentially life-saving treatment: an assessment of the policy and online patient advocacy environment for expanded access.

PubMed

Mackey, Tim K; Schoenfeld, Virginia J

2016-02-02

Social media is fundamentally altering how we access health information and make decisions about medical treatment, including for terminally ill patients. This specifically includes the growing phenomenon of patients who use online petitions and social media campaigns in an attempt to gain access to experimental drugs through expanded access pathways. Importantly, controversy surrounding expanded access and "compassionate use" involves several disparate stakeholders, including patients, manufacturers, policymakers, and regulatory agencies-all with competing interests and priorities, leading to confusion, frustration, and ultimately advocacy. In order to explore this issue in detail, this correspondence article first conducts a literature review to describe how the expanded access policy and regulatory environment in the United States has evolved over time and how it currently impacts access to experimental drugs. We then conducted structured web searches to identify patient use of online petitions and social media campaigns aimed at compelling access to experimental drugs. This was carried out in order to characterize the types of communication strategies utilized, the diseases and drugs subject to expanded access petitions, and the prevalent themes associated with this form of "digital" patient advocacy. We find that patients and their families experience mixed results, but still gravitate towards the use of online campaigns out of desperation, lack of reliable information about treatment access options, and in direct response to limitations of the current fragmented structure of expanded access regulation and policy currently in place. In response, we discuss potential policy reforms to improve expanded access processes, including advocating greater transparency for expanded access programs, exploring use of targeted economic incentives for manufacturers, and developing systems to facilitate patient information about existing treatment options. This includes leveraging recent legislative attention to reform expanded access through the CURE Act Provisions contained in the proposed U.S. 21st Century Cures Act. While expanded access may not be the best option for the majority of individuals, terminally ill patients and their families nevertheless deserve better processes, policies, and availability to potentially life-changing information, before they decide to pursue an online campaign in the desperate hope of gaining access to experimental drugs.

An Evaluation of the Latent Tuberculosis Control Program in the United States Military at Accession

DTIC Science & Technology

2010-10-15

and costs associated with lost productivity. Cost-of-illness estimates for the health outcomes will be obtained from the TRICARE management agency...National Collaborating Centre for Chronic Conditions. Tuberculosis: national clinical guidelines for diagnosis, management , prevention, and control...N, Ranganathan SC. A three- way comparison of tuberculin skin testing, QuantiFERON-TB gold and T-SPOT.TB in children. PLoS ONE. 2008;3(7):e2624

A case series of patients using medicinal marihuana for management of chronic pain under the Canadian Marihuana Medical Access Regulations.

PubMed

Lynch, Mary E; Young, Judee; Clark, Alexander J

2006-11-01

The Canadian Marihuana Medical Access Regulations (MMAR) program allows Health Canada to grant access to marihuana for medical use to those who are suffering from grave and debilitating illnesses. This is a report on a case series of 30 patients followed at a tertiary care pain management center in Nova Scotia who have used medicinal marihuana for 1-5 years under the MMAR program. Patients completed a follow-up questionnaire containing demographic and dosing information, a series of 11-point numerical symptom relief rating scales, a side effect checklist, and a subjective measure of improvement in function. Doses of marihuana ranged from less than 1 to 5g per day via the smoked or oral route of administration. Ninety-three percent of patients reported moderate or greater pain relief. Side effects were reported by 76% of patients, the most common of which were increased appetite and a sense of well-being, weight gain, and slowed thoughts. Limitations of the study include self-selection bias, small size, and lack of a control group. The need for further study using controlled trials is discussed along with an overview of the MMAR program.

Illness identity as an important component of candidacy: Contrasting experiences of help-seeking and access to care in cancer and heart disease.

PubMed

Macdonald, Sara; Blane, David; Browne, Susan; Conway, Ellie; Macleod, Una; May, Carl; Mair, Frances

2016-11-01

How and when we use health services or healthcare provision has dominated exploration of and debates around healthcare access. Levels of utilisation are assumed as a proxy for access. Yet, focusing on utilisation conceals an important aspect of the access conundrum: the relationships that patients and potential patients have with the healthcare system and the professionals within those systems. Candidacy has been proposed as an antidote to traditional utilisation models. The Candidacy construct offers the ability to include patient-professional aspects alongside utilisation and thus promotes a deeper understanding of access. Originally applied to healthcare access for vulnerable populations, additional socio-demographic factors, including age and ethnicity, have also been shown to influence the Candidacy process. Here we propose a further extension of the Candidacy construct and illustrate the importance of illness identities when accessing healthcare. Drawing on a secondary data analysis of three data sets of qualitative interviews from colorectal cancer and heart failure patients we found that though similar access issues are apparent pre-diagnosis, diagnosis marks a critical juncture in the experience of access. Cancer patients describe a person-centred responsive healthcare system where their patienthood requires only modest assertion. Cancer speaks for itself. In marked contrast heart failure patients, describe struggling within a seemingly impermeable system to understand their illness, its implications and their own legitimacy as patients. Our work highlights the pressing need for healthcare professionals, systems and policies to promote a person centred approach, which is responsive and timely, regardless of illness category. To achieve this, attitudes regarding the importance or priority afforded to different categories of illness need to be tackled as they directly influence ideas of Candidacy and consequently access and experiences of care. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evaluation of the novel respiratory virus surveillance program: Pediatric Early Warning Sentinel Surveillance (PEWSS).

PubMed

Armour, Patricia A; Nguyen, Linh M; Lutman, Michelle L; Middaugh, John P

2013-01-01

Infections caused by respiratory viruses are associated with recurrent epidemics and widespread morbidity and mortality. Routine surveillance of these pathogens is necessary to determine virus activity, monitor for changes in circulating strains, and plan for public health preparedness. The Southern Nevada Health District in Las Vegas, Nevada, recruited five pediatric medical practices to serve as sentinel sites for the Pediatric Early Warning Sentinel Surveillance (PEWSS) program. Sentinel staff collected specimens throughout the year from ill children who met the influenza-like illness case definition and submitted specimens to the Southern Nevada Public Health Laboratory for molecular testing for influenza and six non-influenza viruses. Laboratory results were analyzed and reported to the medical and general communities in weekly bulletins year-round. PEWSS data were also used to establish viral respiratory seasonal baselines and in influenza vaccination campaigns. The surveillance program was evaluated using the Centers for Disease Control and Prevention's (CDC's) Updated Guidelines for Evaluating Public Health Surveillance Systems. PEWSS met three of six program usefulness criteria and seven of nine surveillance system attributes, which exceeded the CDC Guidelines evaluation criteria for a useful and complete public health surveillance program. We found that PEWSS is a useful and complete public health surveillance system that is simple, flexible, accessible, and stable.

Evaluation of the Novel Respiratory Virus Surveillance Program: Pediatric Early Warning Sentinel Surveillance (PEWSS)

PubMed Central

Nguyen, Linh M.; Lutman, Michelle L.; Middaugh, John P.

2013-01-01

Objectives Infections caused by respiratory viruses are associated with recurrent epidemics and widespread morbidity and mortality. Routine surveillance of these pathogens is necessary to determine virus activity, monitor for changes in circulating strains, and plan for public health preparedness. The Southern Nevada Health District in Las Vegas, Nevada, recruited five pediatric medical practices to serve as sentinel sites for the Pediatric Early Warning Sentinel Surveillance (PEWSS) program. Methods Sentinel staff collected specimens throughout the year from ill children who met the influenza-like illness case definition and submitted specimens to the Southern Nevada Public Health Laboratory for molecular testing for influenza and six non-influenza viruses. Results Laboratory results were analyzed and reported to the medical and general communities in weekly bulletins year-round. PEWSS data were also used to establish viral respiratory seasonal baselines and in influenza vaccination campaigns. The surveillance program was evaluated using the Centers for Disease Control and Prevention's (CDC's) Updated Guidelines for Evaluating Public Health Surveillance Systems. PEWSS met three of six program usefulness criteria and seven of nine surveillance system attributes, which exceeded the CDC Guidelines evaluation criteria for a useful and complete public health surveillance program. Conclusion We found that PEWSS is a useful and complete public health surveillance system that is simple, flexible, accessible, and stable. PMID:23997308

The ROC program: accelerated restoration of competency in a jail setting.

PubMed

Rice, Kevin; Jennings, Jerry L

2014-01-01

In 29 months of operation, the restoration of competency (ROC) program provided treatment services to 192 incompetent to stand trial patients in a jail setting. The ROC restored competency for 55% of the patients in an average of 57 days compared to the state hospital average of 180 days. The average cost of treatment/restoration per admission was $15,568 compared to the state hospital average of $81,000. The ROC model accelerates needed treatment for mentally ill defendants, cuts demand for costly state hospital forensic beds, and assists jails in better managing inmates with severe psychiatric disorders--yielding major cost savings and improved care. In addition to preventing readmissions and negative behavioral episodes, the ROC improved the broader forensic system by eliminating the state hospital waiting list, accelerating access to psychiatric services, promoting local access for lawyers and family, and gaining stakeholder satisfaction.

Eisenhower and Suez: An Appraisal of Presidential Leadership

DTIC Science & Technology

1992-06-05

anything in all my public life that we were right, my colleagues and I, in the judgments and decisions we took, and that history will prove it.൩ When...alliance. Britain’s conservative press revealed the extent of ill will and bitterness caused by the crisis. Nevertheless, the tabloids recognized that...FUNDING NUMBERS U.S. Naval War College PROGRAM PROJECT TASK WORK UNIT Newport, R.I. 02841-5010 ELEMENT NO. NO NO ACCESSION NO 11 TITLE (Include Security

Position of the American Dietetic Association, American Society for Nutrition, and Society for Nutrition Education: Food and nutrition programs for community-residing older adults.

PubMed

Kamp, Barbara J; Wellman, Nancy S; Russell, Carlene

2010-03-01

Given the federal cost-containment policy to rebalance long-term care away from nursing homes to home- and community-based services, it is the position of the American Dietetic Association, the American Society for Nutrition, and the Society for Nutrition Education that all older adults should have access to food and nutrition programs that ensure the availability of safe, adequate food to promote optimal nutritional status. Appropriate food and nutrition programs include adequately funded food assistance and meal programs, nutrition education, screening, assessment, counseling, therapy, monitoring, evaluation, and outcomes documentation to ensure more healthful aging. The growing number of older adults, the health care focus on prevention, and the global economic situation accentuate the fundamental need for these programs. Yet far too often food and nutrition programs are disregarded or taken for granted. Growing older generally increases nutritional risk. Illnesses and chronic diseases; physical, cognitive, and social challenges; racial, ethnic, and linguistic differences; and low socioeconomic status can further complicate a situation. The beneficial effects of nutrition for health promotion, risk reduction, and disease management need emphasis. Although many older adults are enjoying longer and more healthful lives in their own homes, others, especially those with health disparities and poor nutritional status, would benefit from greater access to food and nutrition programs and services. Food and nutrition practitioners can play a major role in promoting universal access and integrating food and nutrition programs and nutrition services into home- and community-based services.

"Helping my neighbour is like giving a loan…" -the role of social relations in chronic illness in rural Uganda.

PubMed

Amurwon, Jovita; Hajdu, Flora; Yiga, Dominic Bukenya; Seeley, Janet

2017-11-09

Understanding individuals' experience of accessing care and tending to various other needs during chronic illness in a rural context is important for health systems aiming to increase access to healthcare and protect poor populations from unreasonable financial hardship. This study explored the impact on households of access to free healthcare and how they managed to meet needs during chronic illness. Rich data from the life stories of individuals from 22 households in rural south-western Uganda collected in 2009 were analysed. The data revealed that individuals and households depend heavily on their social relations in order to meet their needs during illness, including accessing the free healthcare and maintaining vital livelihood activities. The life stories illustrated ways in which households draw upon social relations to achieve the broader social protection necessary to prevent expenses becoming catastrophic, but also demonstrated the uncertainty in relying solely on informal relations. Improving access to healthcare in a rural context greatly depends on broader social protection. Thus, the informal social protection that already exists in the form of strong reciprocal social relations must be acknowledged, supported and included in health policy planning.

Associations Between Neighborhood Social Capital, Health Literacy, and Self-Rated Health Among People With Chronic Illness.

PubMed

Waverijn, Geeke; Heijmans, Monique; Spreeuwenberg, Peter; Groenewegen, Peter P

2016-01-01

Health literacy skills are important for health and self-management for people with chronic illness. Neighborhood social capital can provide resources, such as access to information and informal social control over unhealthy behavior. The benefit of these resources, and the access people have to these resources, might depend on levels of health literacy. We investigated whether neighborhood social capital is differentially related to the health of people with chronic illness according to health literacy skills. This study focused on health literacy skills in 4 domains related to the ability to access and understand health information and to the ability to perform self-management. We found a significant positive interaction between social capital and health literacy skills for accessing and understanding health information. This suggests that health literacy enhances people's ability to gain access to and use neighborhood resources to benefit health. There was no interaction effect between social capital and health literacy skills in the other 2 domains. More research is needed to investigate how people with chronic illness can benefit from knowledge, support, and other social resources for health and self-management also whether they have limited health literacy skills.

The Stigma of Mental Illness

ERIC Educational Resources Information Center

Overton, Stacy L.; Medina, Sondra L.

2008-01-01

Stigma surrounding major mental illness creates many barriers. People who experience mental illness face discrimination and prejudice when renting homes, applying for jobs, and accessing mental health services. The authors review the current literature regarding stigma and mental illness. They define stigma and review theories that explain its…

Loan Stars: ILL Comes of Age.

ERIC Educational Resources Information Center

Jackson, Mary E.

1998-01-01

Assesses the changes in interlibrary loan (ILL) practices, and points the way to an ideal future. Discusses patron-initiated document request systems; library-mediated ordering systems; document delivery suppliers; accessing electronic resources; ILL management software; paying ILL invoices; new electronic delivery options; and results of a…

Scientific, legal, and ethical challenges of end-of-life organ procurement in emergency medicine.

PubMed

Rady, Mohamed Y; Verheijde, Joseph L; McGregor, Joan L

2010-09-01

We review (1) scientific evidence questioning the validity of declaring death and procuring organs in heart-beating (i.e., neurological standard of death) and non-heart-beating (i.e., circulatory-respiratory standard of death) donation; (2) consequences of collaborative programs realigning hospital policies to maximize access of procurement coordinators to critically and terminally ill patients as potential donors on arrival in emergency departments; and (3) ethical and legal ramifications of current practices of organ procurement on patients and their families. Relevant publications in peer-reviewed journals and government websites. Scientific evidence undermines the biological criteria of death that underpin the definition of death in heart-beating (i.e., neurological standard) and non-heart-beating (i.e., circulatory-respiratory standard) donation. Philosophical reinterpretation of the neurological and circulatory-respiratory standards in the death statute, to avoid the appearance of organ procurement as an active life-ending intervention, lacks public and medical consensus. Collaborative programs bundle procurement coordinators together with hospital staff for a team-huddle and implement a quality improvement tool for a Rapid Assessment of Hospital Procurement Barriers in Donation. Procurement coordinators have access to critically ill patients during the course of medical treatment with no donation consent and with family or surrogates unaware of their roles. How these programs affect the medical care of these patients has not been studied. Policies enforcing end-of-life organ procurement can have unintended consequences: (1) erosion of care in the patient's best interests, (2) lack of transparency, and (3) ethical and legal ramifications of flawed standards of declaring death. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Three Nontraditional Approaches to Improving the Capacity, Accessibility, and Quality of Mental Health Services: An Overview.

PubMed

Grant, Kiran L; Simmons, Magenta Bender; Davey, Christopher G

2018-05-01

To provide evidence for wider use of peer workers and other nonprofessionals, the authors examined three approaches to mental health service provision-peer support worker (PSW) programs, task shifting, and mental health first-aid and community advocacy organizations-summarizing their effectiveness, identifying similarities and differences, and highlighting opportunities for integration. Relevant articles obtained from PubMed, MEDLINE, and Google Scholar searches are discussed. Studies indicate that PSWs can achieve outcomes equal to or better than those achieved by nonpeer mental health professionals. PSWs can be particularly effective in reducing hospital admissions and inpatient days and engaging severely ill patients. When certain care tasks are given to individuals with less training than professionals (task shifting), these staff members can provide psychoeducation, engage service users in treatment, and help them achieve symptom reduction and manage risk of relapse. Mental health first-aid and community organizations can reduce stigma, increase awareness of mental health issues, and encourage help seeking. Most PSW programs have reported implementation challenges, whereas such challenges are fewer in task-shifting programs and minimal in mental health first-aid. Despite challenges in scaling and integrating these approaches into larger systems, they hold promise for improving access to and quality of care. Research is needed on how these approaches can be combined to expand a community's capacity to provide care. Because of the serious shortage of mental health providers globally and the rising prevalence of mental illness, utilizing nontraditional providers may be the only solution in both low- and high-resource settings, at least in the short term.

Access to dental care and dental ill-health of people with serious mental illness: views of nurses working in mental health settings in Australia.

PubMed

Happell, Brenda; Platania-Phung, Chris; Scott, David; Hanley, Christine

2015-01-01

People with serious mental illness experience higher rates of oral and dental health problems than the wider population. Little is known about how dental health is viewed or addressed by nurses working with mental health consumers. This paper presents the views of nurses regarding the nature and severity of dental health problems of consumers with serious mental illness, and how often they provide advice on dental health. Mental health sector nurses (n=643) completed an online survey, including questions on dental and oral health issues of people with serious mental illness. The majority of nurses considered the oral and dental conditions of people with serious mental illness to be worse than the wider community. When compared with a range of significant physical health issues (e.g. cardiovascular disease), many nurses emphasised that dental and oral problems are one of the most salient health issues facing people with serious mental illness, their level of access to dental care services is severely inadequate and they suffer significantly worse dental health outcomes as a result. This study highlights the need for reforms to increase access to dental and oral health care for mental health consumers.

Factors influencing physical activity and rehabilitation in survivors of critical illness: a systematic review of quantitative and qualitative studies.

PubMed

Parry, Selina M; Knight, Laura D; Connolly, Bronwen; Baldwin, Claire; Puthucheary, Zudin; Morris, Peter; Mortimore, Jessica; Hart, Nicholas; Denehy, Linda; Granger, Catherine L

2017-04-01

To identify, evaluate and synthesise studies examining the barriers and enablers for survivors of critical illness to participate in physical activity in the ICU and post-ICU settings from the perspective of patients, caregivers and healthcare providers. Systematic review of articles using five electronic databases: MEDLINE, CINAHL, EMBASE, Cochrane Library, Scopus. Quantitative and qualitative studies that were published in English in a peer-reviewed journal and assessed barriers or enablers for survivors of critical illness to perform physical activity were included. Prospero ID: CRD42016035454. Eighty-nine papers were included. Five major themes and 28 sub-themes were identified, encompassing: (1) patient physical and psychological capability to perform physical activity, including delirium, sedation, illness severity, comorbidities, weakness, anxiety, confidence and motivation; (2) safety influences, including physiological stability and concern for lines, e.g. risk of dislodgement; (3) culture and team influences, including leadership, interprofessional communication, administrative buy-in, clinician expertise and knowledge; (4) motivation and beliefs regarding the benefits/risks; and (5) environmental influences, including funding, access to rehabilitation programs, staffing and equipment. The main barriers identified were patient physical and psychological capability to perform physical activity, safety concerns, lack of leadership and ICU culture of mobility, lack of interprofessional communication, expertise and knowledge, and lack of staffing/equipment and funding to provide rehabilitation programs. Barriers and enablers are multidimensional and span diverse factors. The majority of these barriers are modifiable and can be targeted in future clinical practice.

Awareness and use of California's Paid Family Leave Insurance among parents of chronically ill children.

PubMed

Schuster, Mark A; Chung, Paul J; Elliott, Marc N; Garfield, Craig F; Vestal, Katherine D; Klein, David J

2008-09-03

In 2004, California's Paid Family Leave Insurance Program (PFLI) became the first state program to provide paid leave to care for an ill family member. To assess awareness and use of the program by employed parents of children with special health care needs, a population likely to need leave. Telephone interviews with successive cohorts of employed parents before (November 21, 2003-January 31, 2004; n = 754) and after (November 18, 2005-January 31, 2006; n = 766) PFLI began, randomly sampled from 2 children's hospitals, one in California (with PFLI) and the other in Illinois (without PFLI). Response rates were 82% before and 81% after (California), and 80% before and 74% after (Illinois). Taking leave, length of leave, unmet need for leave, and awareness and use of PFLI. Similar percentages of parents at the California site reported taking at least 1 day of leave to care for their ill child before (295 [81%]) and after (327 [79%]) PFLI, taking at least 4 weeks before (64 [21%]) and after (74 [19%]) PFLI, and at least once in the past year not missing work despite believing their child's illness necessitated it before (152 [41%]) and after (156 [41%]) PFLI. Relative to Illinois, parents at the California site reported no change from before to after PFLI in taking at least 1 day of leave (difference of differences, -3%; 95% confidence interval [CI], -13% to 7%); taking at least 4 weeks of leave (1%; 95% CI, -9% to 10%); or not missing work, despite believing their child's illness necessitated it (-1%; 95% CI, -13% to 10%). Only 77 parents (18%) had heard of PFLI approximately 18 months after the program began, and only 20 (5%) had used it. Even among parents without other access to paid leave, awareness and use of PFLI were minimal. Parents of children with special health care needs receiving care at a California hospital were generally unaware of PFLI and rarely used it. Among parents of children with special health care needs, taking leave in California did not increase after PFLI implementation compared with Illinois.

29 CFR 1904.35 - Employee involvement.

Code of Federal Regulations, 2012 CFR

2012-07-01

... RECORDING AND REPORTING OCCUPATIONAL INJURIES AND ILLNESSES Other OSHA Injury and Illness Recordkeeping... he or she is to report an injury or illness to you. (2) You must provide limited access to your injury and illness records for your employees and their representatives. (b) Implementation—(1) What must...

29 CFR 1904.35 - Employee involvement.

Code of Federal Regulations, 2014 CFR

2014-07-01

... RECORDING AND REPORTING OCCUPATIONAL INJURIES AND ILLNESSES Other OSHA Injury and Illness Recordkeeping... he or she is to report an injury or illness to you. (2) You must provide limited access to your injury and illness records for your employees and their representatives. (b) Implementation—(1) What must...

29 CFR 1904.35 - Employee involvement.

Code of Federal Regulations, 2013 CFR

2013-07-01

... RECORDING AND REPORTING OCCUPATIONAL INJURIES AND ILLNESSES Other OSHA Injury and Illness Recordkeeping... he or she is to report an injury or illness to you. (2) You must provide limited access to your injury and illness records for your employees and their representatives. (b) Implementation—(1) What must...

Disabilities in the workplace: recruitment, accommodation, and retention.

PubMed

Davis, Linda

2005-07-01

Who has never had a need for accommodation to perform a job because of age-related changes, gender issues related to family care, religious practices, health status, or disability? Who has never had the benefit of universal accommodations designed to provide access for individuals with disabilities, such as using the handicap button to open a door when one's arms are loaded? All of society has had the benefit of inclusion of individuals with disabilities within the work force. Occupational health nurses are essential to accommodating new employees with disabilities, assisting ill or injured employees in returning to work, and changing attitudes toward disabled workers. Additionally, nurses have the skills and knowledge for leading and managing newly emerging disease management programs for workers with disabilities caused by chronic illness.

Mental Health: Overcoming the Stigma of Mental Illness

MedlinePlus

... difference. StigmaFree me. National Alliance on Mental Illness. https://www.nami.org/Get-Involved/Take-the-stigmafree- ... it a problem? National Alliance on Mental Illness. https://www.nami.org/stigmafree. Accessed April 25, 2017. ...

Racial disparities in prescription drug use for mental illness among population in US.

PubMed

Han, Euna; Liu, Gordon G

2005-09-01

Racial minorities are a rapidly growing portion of the US population. Research suggests that racial minorities are more vulnerable to mental illness due to risk factors, such as higher rates of poverty. Given that the burden of mental illnesses is significant, equal likelihood of mental health services utilization is important to reduce such burden. Racial minorities have been known to use mental health services less than Whites. However, it is unclear whether racial disparity in prescription drug use for mental illnesses exists in a nationally representative sample. For a valid estimation of prescription drug use patterns, the characteristic in the distribution of prescription drug use should be accounted for in the estimation model. This study is intended to document whether there was a disparity in psychiatric drug use in both extensive and intensive margins between Whites and three racial minorities: Blacks, Hispanics, and Asian-Indians. The study looked at several specified mental illnesses, controlling for underlying health status and other confounding factors. Secondary data analysis was conducted using the multiyear Medical Expenditure Panel Survey (MEPS), a nationally representative panel sample from 1996 through 2000. This analysis provides estimates of the actual expenditure on prescription drug use for people with specified mental illnesses for this study, based on comparison of Whites and other racial minorities. We derived the estimates from the two-part model, a framework that adjusts the likelihood of using prescription drugs for the specified mental illnesses while estimating the total actual expenditures on prescription drugs among the users. This study found that Blacks, Hispanics, and Asian-Indians were less likely than Whites to use prescription drugs by 8.3, 6.1 and 23.6 percentage points, respectively, holding other factors constant in the sample, with at least one of the specified mental illnesses. The expenditure on prescription drugs for the specified mental illnesses differs between each of racial minorities (Blacks, Hispanics, and Asian-Indians) and Whites even after adjusting for the different likelihood of using those prescription drugs. Blacks, Hispanics, and Asian-Indians with the specified mental illnesses were estimated to spend 606.53 US dollars, 9.83 US dollars and 179.60 US dollars less per year, respectively, on their actual prescription drugs than Whites. This study concludes that three racial minorities: Blacks, Hispanics, and Asian-Indians, with the specified mental illnesses are less likely to use psychiatric drugs than Whites. Among users, racial minorities use less psychiatric drugs than Whites in terms of actual spending on those drugs. There is a need to focus on a program to reach out to racial minorities with a diagnosis of mental illnesses, and this program should consider the cultural specificity of each minority group regarding mental illnesses. In the development of mental health policy, it is crucial to understand the underlying non-socioeconomic factors which may significantly determine the access to mental health service. Also, education programs or other outreach programs for racial minorities are necessary to understand the different distribution of mental health services for racial minorities. Future research should examine the causes for racial disparity in the use of prescription drugs for mental illness both in the extensive and intensive margins. An in-depth analysis is needed to map out the attributes for the observed disparity between Whites and racial minorities in mental health service use.

Use of information and communication technologies among individuals with and without serious mental illness.

PubMed

Abu Rahal, Ziyad; Vadas, Limor; Manor, Iris; Bloch, Boaz; Avital, Avi

2018-08-01

Growing interest surrounds the use ofinformation and communication technologies (ICTs) for mental-health-related purposes, yet little is known about rates of ICT use among the psychiatric population and those with severe mental illness. This study examines ICT accessibility among the psychiatric population, focusing on serious and non-serious mental illness (SMI and non-SMI). Patients (N = 427) from all service branches of the Psychiatry Department at Emek Medical Centerwere recruited orally or through advertisement. Responders completed a self-report survey regarding accessibility and use of ICTs (i.e., computer, internet, Facebook, mobile phone, smartphone). Results revealed that 59.3% of respondents used computers, 77.3% used the internet, 92.7% owned a mobile phone, 67.9% owned a smartphone, and 63% used Facebook. Over half of participants who used ICTs reported doing so at least once per day. SMI and non-SMI respondents differed significantly in their use and access to a computer, the internet, Facebook, and smartphones. Results suggest that mental illness is not a barrier to using and accessing technology; however, when differentiating between SMI and non-SMI, illness severity is a barrier to potential ICT utilization. These results may encourage policy makers to design ICTs that suit the needs of individuals with SMI. Copyright © 2018 Elsevier B.V. All rights reserved.

A theory-informed approach to mental health care capacity building for pharmacists.

PubMed

Murphy, Andrea L; Gardner, David M; Kutcher, Stan P; Martin-Misener, Ruth

2014-01-01

Pharmacists are knowledgeable, accessible health care professionals who can provide services that improve outcomes in mental health care. Various challenges and opportunities can exist in pharmacy practice to hinder or support pharmacists' efforts. We used a theory-informed approach to development and implementation of a capacity-building program to enhance pharmacists' roles in mental health care. Theories and frameworks including the Consolidated Framework for Implementation Research, the Theoretical Domains Framework, and the Behaviour Change Wheel were used to inform the conceptualization, development, and implementation of a capacity-building program to enhance pharmacists' roles in mental health care. The More Than Meds program was developed and implemented through an iterative process. The main program components included: an education and training day; use of a train-the-trainer approach from partnerships with pharmacists and people with lived experience of mental illness; development of a community of practice through email communications, a website, and a newsletter; and use of educational outreach delivered by pharmacists. Theories and frameworks used throughout the program's development and implementation facilitated a means to conceptualize the component parts of the program as well as its overall presence as a whole from inception through evolution in implementation. Using theoretical foundations for the program enabled critical consideration and understanding of issues related to trialability and adaptability of the program. Theory was essential to the underlying development and implementation of a capacity-building program for enhancing services by pharmacists for people with lived experience of mental illness. Lessons learned from the development and implementation of this program are informing current research and evolution of the program.

Automating Document Delivery: A Conference Report.

ERIC Educational Resources Information Center

Ensor, Pat

1992-01-01

Describes presentations made at a forum on automation, interlibrary loan (ILL), and document delivery sponsored by the Houston Area Library Consortium. Highlights include access versus ownership; software for ILL; fee-based services; automated management systems for ILL; and electronic mail and online systems for end-user-generated ILL requests.…

Beyond Social Media: A Cross-Sectional Survey of Other Internet and Mobile Phone Applications in a Community Psychiatry Population.

PubMed

Colder Carras, Michelle; Mojtabai, Ramin; Cullen, Bernadette

2018-03-01

Popular media applications have been shown to benefit people with severe mental illness by facilitating communication and social support, helping patients cope with or manage symptoms, and providing a way to monitor or predict mental health states. Although many studies of technology use by individuals with severe mental illness have focused primarily on use of social media, this study provides additional information about use of Internet applications such as blogs, wikis (websites that allow collaborative editing of content and structure by users), video games, and Skype by a community psychiatry population. All English-speaking patients attending an outpatient program during a 4-week period in 2011 (N=274) were surveyed about their technology use and demographic information; 189 patients provided demographic data and comprised the sample. Among Internet users (n=112), rates of use of message boards, wikis, Skype, role-playing games, and blogs ranged from 26.8% to 34.8%. Among mobile phone users (n=162), 41.4% used their phones to access the Internet and 25.3% used Twitter on their phones. In multivariate analysis, patients who had attended or completed college had much greater odds of accessing the Internet on mobile phones. Older patients were much less likely to access the Internet or use Twitter. Our findings indicate that use of several popular forms of media is not uncommon in a community psychiatry population, but that rates of use differ on the basis of age and education. As the digital divide between people with severe mental illness and the general population is lessening, further research is needed to determine how to best leverage various types of media to support mental health recovery and complement clinical care.

Limited interface between physiotherapy primary care and people with severe mental illness: a qualitative study.

PubMed

Lee, Samantha; Waters, Flavie; Briffa, Kathy; Fary, Robyn E

2017-07-01

How do mental health professionals perceive the role of physiotherapists in the care of people with severe and persistent mental illness, and what factors do they perceive as influencing access to physiotherapy services? How do people with severe and persistent mental illness understand the potential role of physiotherapy in their healthcare, and what factors do they perceive as influencing access to physiotherapy services? Qualitative study. Twenty-four mental health professionals and 35 people with severe and persistent mental illness. Interview schedules were developed to explore participants' understanding of physiotherapy, as well as barriers and enablers to service access. Focus groups and interviews were conducted for each group of participants. Transcripts were analysed using an inductive approach to derive key themes. Both the mental health professionals and the people with severe and persistent mental illness expressed a limited understanding of the role and relevance of physiotherapy for physical health in mental healthcare. Common barriers to service access were cost, transport and lack of motivation. Likewise, enablers of reduced cost, provision of transport and education about physiotherapy to improve their understanding were identified. The health system structure and perceived lack of mental health knowledge by physiotherapists influenced referrals from mental health professionals. Consequently, education in mental health for physiotherapists and integration of the service within mental health were identified as potential enablers to physiotherapy access. Limited understanding about physiotherapy and its relevance to physical health in mental healthcare among mental health professionals and people with severe and persistent mental illness was found to be a key factor influencing service access. Limited physiotherapy presence and advocacy within mental health were also highlighted. There is a need for greater understanding about physiotherapy among stakeholders, and for physiotherapists to be well equipped with skills and knowledge in mental health to facilitate greater involvement. [Lee S, Waters F, Briffa K, Fary RE (2017) Limited interface between physiotherapy primary care and people with severe mental illness: a qualitative study. Journal of Physiotherapy 63: 168-174]. Copyright © 2017. Published by Elsevier B.V.

Housing and Food Insecurity, Care Access, and Health Status Among the Chronically Ill: An Analysis of the Behavioral Risk Factor Surveillance System.

PubMed

Charkhchi, Paniz; Fazeli Dehkordy, Soudabeh; Carlos, Ruth C

2018-05-01

The proportion of the United States population with chronic illness continues to rise. Understanding the determinants of quality of care-particularly social determinants-is critical to the provision of care in this population. To estimate the prevalence of housing and food insecurity among persons with common chronic conditions and to assess the independent effects of chronic illness and sociodemographic characteristics on (1) housing and food insecurity, and (2) health care access hardship and health status. Cross-sectional study. We used data from the 11 states and one territory that completed the social context module of the 2015 Behavioral Risk Factor Surveillance System (BRFSS). We estimated the prevalence of housing and food insecurity among patients with cancer, stroke, cardiovascular disease, and chronic lung disease. Logistic regression models were used to assess the independent effects of housing and food insecurity, chronic conditions, and demographics on health care access and health status. Among the chronically ill, 36.71% (95% CI: 35.54-37.88) experienced housing insecurity and 30.60% (95% CI: 29.49-31.71) experienced food insecurity. Cardiovascular and lung disease increased the likelihood of housing (OR 1.69, 95% CI: 1.07-2.66 and OR 1.71, 95% CI: 1.12-2.60, respectively) and food insecurity (OR 1.75, 95% CI: 1.12-2.73 and OR 1.78, 95% CI: 1.20-2.63, respectively). Housing and food insecurity significantly increased the risk of health care access hardship. Being insured or having an income level above 200% of the federal poverty level significantly reduced the likelihood of access hardship, while female gender significantly increased the likelihood. Chronic illness independently affects housing and food insecurity. In turn, food and housing anxiety leads to reduced access to care, likely due to cost concerns, and correlates with poorer health. A more complete understanding of the pathways by which chronic illness influences social determinants and clinical outcomes is needed.

Cultural and linguistic barriers to mental health service access: the deaf consumer's perspective.

PubMed

Steinberg, A G; Sullivan, V J; Loew, R C

1998-07-01

The authors investigated knowledge, attitudes, and beliefs about mental illness and providers held by a group of deaf adults. The American Sign Language interviews of 54 deaf adults were analyzed. Recurrent themes included mistrust of providers, communication difficulty as a primary cause of mental health problems, profound concern with communication in therapy, and widespread ignorance about how to obtain services. Deaf consumers' views need due consideration in service delivery planning. Outreach regarding existing programs is essential.

Crisis-Affected Populations and Tuberculosis.

PubMed

Zenner, Dominik

2017-01-01

By definition, humanitarian crises can severely affect human health, directly through violence or indirectly through breakdown of infrastructure or lack of provision for basic human needs, such as safe shelter, food, clean water, and suitable clothing. After the initial phase, these indirect effects are the most important determinants of morbidity and mortality in humanitarian emergencies, and infectious diseases are among the most significant causes of ill health. Tuberculosis (TB) incidence in humanitarian emergencies varies depending on a number of factors, including the country background epidemiology, but will be elevated compared with precrisis levels. TB morbidity and mortality are associated with access to appropriate care and medications, and will also be elevated due to barriers to access to diagnosis and appropriate treatment, including robust TB drug supplies. While reestablishment of TB control is challenging in the early phases, successful treatment programs have been previously established, and the WHO has issued guidance on establishing such successful programs. Such programs should be closely linked to other health programs and established in close collaboration with the country's national treatment program. Individuals who flee the emergency also have a higher TB risk and can face difficulties accessing care en route to or upon arrival in host countries. These barriers, often associated with treatment delays and worse outcomes, can be the result of uncertainties around legal status, other practical challenges, or lack of health care worker awareness. It is important to recognize and mitigate these barriers with an increasing number of tools now available and described.

Wellness Centre: An Evidence-Guided Approach to Delivering Culturally Relevant Community Psychogeriatric Services for Chinese Elders

PubMed Central

Chan, Kar C.; Sadavoy, Joel

2012-01-01

Ethnic elders are commonly reluctant to access mental health services and their mental health problems are often overlooked and detected late in the course of illness. Prior studies identified major barriers to ethnic seniors accessing appropriate mental health care demonstrating that language and cultural beliefs cannot be ignored if effective mental health services are to be provided to patients from diverse cultural groups. These are particularly important when care is needed by less acculturated immigrant ethnic seniors for whom language barriers are often greatest. Differences in conceptions of mental distress affect ethnic seniors' choice of help-seeking and often discourage or divert aged persons from utilizing mainstream conventional psychiatric care. Despite the extensive need for appropriate service models for ethnic populations, there have been limited data and models to illustrate how these programs can be systematically and effectively integrated within the mainstream mental health service framework. This paper describes an innovative, mainstream, community-based psychogeriatric service delivery model developed for Chinese seniors in Toronto, Canada, aiming at improving their access to care and enhancing earlier mental health problem detection. The important concepts and strategies of designing and operating a culturally acceptable program are illustrated supported by program data and the challenges analyzed. PMID:23762771

29 CFR 1904.35 - Employee involvement.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR RECORDING AND REPORTING OCCUPATIONAL INJURIES AND ILLNESSES Other OSHA Injury and Illness Recordkeeping... employees and their representatives access to the OSHA injury and illness records? Yes, your employees...

29 CFR 1904.35 - Employee involvement.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR RECORDING AND REPORTING OCCUPATIONAL INJURIES AND ILLNESSES Other OSHA Injury and Illness Recordkeeping... employees and their representatives access to the OSHA injury and illness records? Yes, your employees...

Reference as an Access Service: Collaboration between Reference and Interlibrary Loan Departments

ERIC Educational Resources Information Center

Kern, M. Kathleen; Weible, Cherie L.

2005-01-01

Academic libraries increasingly rely on Interlibrary Loan (ILL) departments to obtain research materials. This adds to the workload of ILL at a time when many libraries are experiencing budget cuts and dwindling staff. Collaboration between ILL and Reference can assist ILL by providing searching expertise. Collaboration is facilitated by the…

Using Research Evidence to Reframe the Policy Debate Around Mental Illness and Guns: Process and Recommendations

PubMed Central

Frattaroli, Shannon; Appelbaum, Paul S.; Bonnie, Richard J.; Grilley, Anna; Horwitz, Joshua; Swanson, Jeffrey W.; Webster, Daniel W.

2014-01-01

Recent mass shootings have prompted a national dialogue around mental illness and gun policy. To advance an evidence-informed policy agenda on this controversial issue, we formed a consortium of national gun violence prevention and mental health experts. The consortium agreed on a guiding principle for future policy recommendations: restricting firearm access on the basis of certain dangerous behaviors is supported by the evidence; restricting access on the basis of mental illness diagnoses is not. We describe the group’s process and recommendations. PMID:25211757

Using research evidence to reframe the policy debate around mental illness and guns: process and recommendations.

PubMed

McGinty, Emma E; Frattaroli, Shannon; Appelbaum, Paul S; Bonnie, Richard J; Grilley, Anna; Horwitz, Joshua; Swanson, Jeffrey W; Webster, Daniel W

2014-11-01

Recent mass shootings have prompted a national dialogue around mental illness and gun policy. To advance an evidence-informed policy agenda on this controversial issue, we formed a consortium of national gun violence prevention and mental health experts. The consortium agreed on a guiding principle for future policy recommendations: restricting firearm access on the basis of certain dangerous behaviors is supported by the evidence; restricting access on the basis of mental illness diagnoses is not. We describe the group's process and recommendations.

Position of the American Dietetic Association, American Society for Nutrition, and Society for Nutrition Education: food and nutrition programs for community-residing older adults.

PubMed

Kamp, Barbara J; Wellman, Nancy S; Russell, Carlene

2010-01-01

Given the federal cost-containment policy to rebalance long-term care away from nursing homes to home- and community-based services, it is the position of the American Dietetic Association, the American Society for Nutrition, and the Society for Nutrition Education that all older adults should have access to food and nutrition programs that ensure the availability of safe, adequate food to promote optimal nutritional status. Appropriate food and nutrition programs include adequately funded food assistance and meal programs, nutrition education, screening, assessment, counseling, therapy, monitoring, evaluation, and outcomes documentation to ensure more healthful aging. The growing number of older adults, the health care focus on prevention, and the global economic situation accentuate the fundamental need for these programs. Yet far too often food and nutrition programs are disregarded or taken for granted. Growing older generally increases nutritional risk. Illnesses and chronic diseases; physical, cognitive, and social challenges; racial, ethnic, and linguistic differences; and low socioeconomic status can further complicate a situation. The beneficial effects of nutrition for health promotion, risk reduction, and disease management need emphasis. Although many older adults are enjoying longer and more healthful lives in their own homes, others, especially those with health disparities and poor nutritional status, would benefit from greater access to food and nutrition programs and services. Food and nutrition practitioners can play a major role in promoting universal access and integrating food and nutrition programs and nutrition services into home- and community-based services. Copyright 2010 The American Dietetic Association, the American Society for Nutrition, and the Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

Primary care access for mental illness in Australia: Patterns of access to general practice from 2006 to 2016.

PubMed

Farrer, Louise M; Walker, Jennie; Harrison, Christopher; Banfield, Michelle

2018-01-01

General practice has an important role within the Australian healthcare system to provide access to care and effective management of chronic health conditions. However, people with serious mental illness experience challenges associated with service access. The current paper seeks to examine drivers of access to general practice for people with common and serious mental disorders, compared with people who access care for type II diabetes, a common physical health problem managed in general practice. The Bettering the Evaluation and Care of Health (BEACH) programme provides the most comprehensive and objective measurement of general practitioner activity in Australia. Using BEACH data, this study compared general practice encounters for depression, anxiety, bipolar disorder, schizophrenia, and type II diabetes during a 10-year period between 2006 and 2016. Analysis revealed more frequent encounters for depression compared to anxiety, and a higher representation of women in encounters for bipolar disorder compared to men. The relationship between number of encounters and patient age was strongly associated with the life course and mortality characteristics associated with each disorder. The findings highlight specific challenges associated with access to primary care for people with serious mental illness, and suggest areas of focus to improve the ability of these patients to access and navigate the health system.

[Publicly funded programs of psychotherapy in Australia and England].

PubMed

Vasiliadis, Helen-Maria; Dezetter, Anne

Quebec's HealthCommissioner on the performance of the health system clearly highlighted gaps in the collaboration between primary care physicians and mental health specialists, decreased accessibility and inequity in access to effective mental health services such as psychotherapy.Objectives The aim of this article was to describe the implementation of two publicly funded programs of psychotherapy in Australia and England with similar gatekeeper systems to the one in Quebec.Findings Following the Access to Allied Psychological Services (ATAPS) program introduced in Australia in 2003, one of the most important initiatives from the Council of Australian Governments' National Action Plan on Mental Health 2006-2011 was the Better Access Initiative which commenced in 2006. The plan included AUD1.2 billion in funding for integrating and improving the mental health care system. The purpose of Better Access was to improve the treatment and management of mental illnesses and increasing community access to mental health professionals and providing more affordable mental health care. GPs were encouraged to work more closely with mental health professionals. Under this program, these professionals are able to provide mental health services on a fee-for-service basis subsidized through Medicare. Access to psychological therapies is provided through private providers, rather than through fund holding arrangements. As of 2009 in Australia, 2 million people (1 in 11) had received over 11.2 million subsidized mental health services. A recent study showed clinical improvements in patients with depression associated with Better Access, concluding that the program is meeting previously unmet mental health needs.In the case of England, the IAPT - Improving Access to psychological Therapies-program enabled primary care trusts (PCTs) to implement evidence-based psychological therapies as recommended by National Institute for Health and Clinical Excellence for people suffering from depression and anxiety. In October 2007, the Secretary of State for Health announced additional funds totalling £173 million between 2008 and 2011 that would be used to deliver a major training program that would build a skilled workforce of qualified psychological therapists in 4 therapy areas for adults and children: cognitive behaviour therapy; psychodynamic psychoanalytic therapy; systemic and family therapy; humanistic therapy. The main goals of the program were to have: (i) 3,600 newly trained therapists with an appropriate skill mix and supervision arrangements; (ii) 900,000 more people treated; (iii) 50% of people who leave treatment are recovered; (iv) 25,000 fewer people on sick pay and benefits.Conclusion To date, the results in both countries have shown clinical improvements in symptoms associated with depression and anxiety for people entering the programs and at a population level, decreasing the unmet mental health needs of the population by allowing self-referrals to the program, and therefore rendering access to services to populations otherwise not reached.

76 FR 30695 - Energy Employees Occupational Illness Compensation Program Act of 2000; Revision to the List of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-26

... DEPARTMENT OF ENERGY Energy Employees Occupational Illness Compensation Program Act of 2000... publishes or revises a list of facilities covered under the Energy Employees Occupational Illness... establishes a program to provide compensation to certain employees who develop illnesses as a result of their...

78 FR 9678 - Energy Employees Occupational Illness Compensation Program Act of 2000; Revision to the List of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-11

... DEPARTMENT OF ENERGY Energy Employees Occupational Illness Compensation Program Act of 2000... publishes revisions to its list of facilities covered under the Energy Employees Occupational Illness... establishes a program to provide compensation to certain employees who develop illnesses as a result of their...

20 CFR 30.100 - In general, how does an employee file an initial claim for benefits?

Code of Federal Regulations, 2013 CFR

2013-04-01

... PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS... employee may not want to claim for an occupational illness or a covered illness for which a payment has...

Access to Safe Water and Personal Hygiene Practices in the Kulandia Refugee Camp (Jerusalem).

PubMed

Issa, Mohamad; McHenry, Michael; Issa, Abdul Aziz; Blackwood, R Alexander

2015-12-22

Diarrheal illness, frequently associated with fecal-oral transmission, is one of the leading causes of death worldwide. It is commonly preventable through the implementation of safe water practices. This experiment concerns how to best implement safe water practices in a quasi-permanent refugee camp setting with limited ability for structural changes. Specifically, we explore how health promotion activities that help identify target groups for hygiene interventions can play a role in disease prevention. An anonymous survey was conducted at the United Nations Relief and Works Agency Health Clinic in the Kulandia refugee camp to assess the safe water and personal hygiene practices. Demographic and social characteristics, accessible water and personal hygiene characteristics, and gastrointestinal (GI) burden for individuals and their households were assessed. A total of 96 individuals were enrolled; 62 females and 34 males. Approximately 58% of the sample had soap available and washed hands before and after eating and when preparing food. Piped water was the main source of drinking water (62%), while 31% of our sample utilized tanker-trucks. 93% of participants had access to toilet facilities, with 86% of these facilities being private households. 55% practice extra water hygiene measures on their household drinking water source. 51.3% considered vendor cleanliness when they were buying food. 51% had received formal health education. 68.8% had been taught by their parents, but only 55.2% were teaching their children and 15.6% had consistent access to a health professional for hygiene inquiries. Individual variables and hygiene practices associated with lower rates of diarrheal illnesses included having water piped into the home, proper hand washing, adequate soap availability, proper consideration of vendor cleanliness, higher income, levels of education, health hygiene education, and having access to healthcare professions to discuss hygiene related matters. This is the first study to assess the water and personal hygiene practices at the Kulandia refugee ramp. This study demonstrates that hygiene education and better practices are closely associated with the rate at which individuals and households suffer from diarrheal illnesses within the Kulandia refugee camp. There are significant hygiene deficits in the camp, which likely result from a lack of formal hygiene education and a lack of awareness concerning the connection between diarrheal illness and hygiene. With respect to practices, our results elucidate several areas where basic, communal programming - including lessons on appropriate hand washing and food preparation - will likely improve hygiene practices and decrease overall GI burden.

Access to Mobile Communication Technology and Willingness to Participate in Automated Telemedicine Calls Among Chronically Ill Patients in Honduras

PubMed Central

Mendoza-Avelares, Milton O.; Milton, Evan C.; Lange, Ilta; Fajardo, Roosevelt

2010-01-01

Abstract Objectives: Patients in underdeveloped countries may be left behind by advances in telehealthcare. We surveyed chronically ill patients with low incomes in Honduras to measure their use of mobile technologies and willingness to participate in mobile disease management support. Materials and Methods: 624 chronically ill primary care patients in Honduras were surveyed. We examined variation in telephone access across groups defined by patients' sociodemographic characteristics, diagnoses, and access to care. Logistic regression was used to identify independent correlates of patients' interest in automated telephonic support for disease management. Results: Participants had limited education (mean 4.8 years), and 65% were unemployed. Eighty-four percent had telephone access, and 78% had cell phones. Most respondents had voicemail (61%) and text messaging (58%). Mobile technologies were particularly common among patients who had to forego clinic visits and medications due to cost concerns (each p < 0.05). Most patients (>80%) reported that they would be willing to receive automated calls focused on appointment reminders, medication adherence, health status monitoring, and self-care education. Patients were more likely to be willing to participate in automated telemedicine services if they had to cancel a clinic appointment due to transportation problems or forego medication due to cost pressures. Conclusions: Even in this poor region of Honduras, most chronically ill patients have access to mobile technology, and most are willing to participate in automated telephone disease management support. Given barriers to in-person care, new models of mobile healthcare should be developed for chronically ill patients in developing countries. PMID:21062234

42 CFR 51.21 - Contracts for program operations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... APPLICABLE TO THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Program Administration... with mental illness provided that: (1) Any organization that will operate the full program meets the... to and conduct full investigations on behalf of individuals with mental illness; and (ix) Assurances...

Intergenerational equity and environmental restoration cleanup levels.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hocking, E. K.; Environmental Assessment

2001-01-01

The United States Department of Energy environmental restoration program faces difficult decisions about the levels of cleanup to be achieved at its many contaminated sites and has acknowledged the need for considering intergenerational equity in its decision making. Intergenerational equity refers to the fairness of access to resources across generations. Environmental restoration cleanup levels can have unintended and unfair consequences for future generations access to resources. The potentially higher costs associated with using low, non-risk-based cleanup levels for remediation may divert funding from other activities that could have a greater beneficial impact on future generations. Low, non-risk-based cleanup levels couldmore » also result in more damage to the nation's resources than would occur if a higher cleanup level were used. The loss or impairment of these resources could have an inequitable effect on future generations. However, intergenerational inequity could arise if sites are not completely restored and if access to and use of natural and cultural resources are unfairly limited as a result of residual contamination. In addition to concerns about creating possible intergenerational inequities related to selected cleanup levels, the tremendous uncertainties associated with sites and their restoration can lead site planners to rely on stewardship by default. An ill-conceived stewardship program can contribute to intergenerational inequity by limiting access to resources while passing on risks to future generations and not preparing them for those risks. This paper presents a basic model and process for designing stewardship programs that can achieve equity among generations.« less

The SMILES program: a group program for children with mentally ill parents or siblings.

PubMed

Pitman, Erica; Matthey, Stephen

2004-07-01

The Simplifying Mental Illness + Life Enhancement Skills program, for children with a mentally ill parent or sibling, is a 3-day program that aims to increase children's knowledge of mental illness and to better equip them with life skills considered beneficial for coping in their family. Self-report data from 25 children who attended 3 of these programs, in Canada and Australia, indicate that these aims were achieved. Their parents also report benefits for their children.

Mental Illness in Blacks: An Overview, and Treatment Approaches

PubMed Central

Davis, Elizabeth B.

1979-01-01

Provisions for inner city mental health services must recognize the association between poverty, discrimination, and related social and physical conditions and disproportionately high rates of severe mental disorder—a transcultural phenomenon. Program emphasis should therefore be on the prevention, early recognition, prompt and effective treatment and rehabilitative care of psychosis. The total spectrum of psychiatric services is required for this, and thus an opportunity is afforded for necessary training and research. Poverty has negative impact on general health and cognitive development as well as on self-esteem, self-care, and the ability to utilize medical and health services. This contributes to a vicious, intergenerational poverty cycle. Primary prevention of mental illness, where possible, depends at present on socioeconomic change. Secondary prevention, ie, timely, appropriate treatment, is effective, but requires patient access to and acceptance of all indicated modalities of care. PMID:537113

Supported employment for persons with serious mental illness: current status and future directions.

PubMed

Mueser, K T; McGurk, S R

2014-06-01

The individual placement and supported (IPS) model of supported employment is the most empirically validated model of vocational rehabilitation for persons with schizophrenia or another serious mental illness. Over 18 randomized controlled trials have been conducted throughout the world demonstrating the effectiveness of supported employment at improving competitive work compared to other vocational programs: IPS supported employment is defined by the following principles: 1) inclusion of all clients who want to work; 2) integration of vocational and clinical services; 3) focus on competitive employment; 4) rapid job search and no required prevocational skills training; 5) job development by the employment specialist; 6) attention to client preferences about desired work and disclosure of mental illness to prospective employers; 7) benefits counseling; and 8) follow-along supports after a job is obtained. Supported employment has been successfully implemented in a wide range of cultural and clinical populations, although challenges to implementation are also encountered. Common challenges are related to problems such as the failure to access technical assistance, system issues, negative beliefs and attitudes of providers, funding restrictions, and poor leadership. These challenges can be overcome by tapping expertise in IPS supported employment, including standardized and tested models of training and consultation. Efforts are underway to increase the efficiency of training methods for supported employment and the overall program, and to improve its effectiveness for those clients who do not benefit. Progress in IPS supported employment offers people with a serious mental illness realistic hope for achieving their work goals, and taking greater control over their lives. Copyright © 2014. Published by Elsevier Masson SAS.

Older Patients' Perspectives on Quality of Serious Illness Care in Primary Care.

PubMed

Abu Al Hamayel, Nebras; Isenberg, Sarina R; Hannum, Susan M; Sixon, Joshua; Smith, Katherine Clegg; Dy, Sydney M

2018-01-01

Despite increased focus on measuring and improving quality of serious illness care, there has been little emphasis on the primary care context or incorporation of the patient perspective. To explore older patients' perspectives on the quality of serious illness care in primary care. Qualitative interview study. Twenty patients aged 60 or older who were at risk for or living with serious illness and who had participated in the clinic's quality improvement initiative. We used a semistructured, open-ended guide focusing on how older patients perceived quality of serious illness care, particularly in primary care. We transcribed interviews verbatim and inductively identified codes. We identified emergent themes using a thematic and constant comparative method. We identified 5 key themes: (1) the importance of patient-centered communication, (2) coordination of care, (3) the shared decision-making process, (4) clinician competence, and (5) access to care. Communication was an overarching theme that facilitated coordination of care between patients and their clinicians, empowered patients for shared decision-making, related to clinicians' perceived competence, and enabled access to primary and specialty care. Although access to care is not traditionally considered an aspect of quality, patients considered this integral to the quality of care they received. Patients perceived serious illness care as a key aspect of quality in primary care. Efforts to improve quality measurement and implementation of quality improvement initiatives in serious illness care should consider these aspects of care that patients deem important, particularly communication as an overarching priority.

The Port Arthur massacre and the National Firearms Agreement: 20 years on, what are the lessons?

PubMed

Dudley, Michael J; Rosen, Alan; Alpers, Philip A; Peters, Rebecca

2016-06-06

The 20th anniversary of the National Firearms Agreement (NFA) offers lessons for mental health and public health. Along with similar international legislation, the NFA exemplifies how firearms regulation can prevent firearm mortality and injuries. The gun lobby claims that mental illness underpins gun violence and should be a key site for intervention. A modest but significant link exists between mental disorders and community violence. However, the vast majority of mentally ill individuals are not violent. Despite media portrayals of their dangerousness, they are more likely to be victims of violence and of suicide. Most violent individuals do not have mental illness, and most mass murderers do not have identifiable severe mental illness. Many have maladaptive personality configurations. Gun availability and gun ownership, not severe mental illness, determines most gun homicides. Following recent gun massacres in the United States, there have been calls for better resourcing of mental health services to help identify and respond to those at risk and to regulate firearms access. Screening mentally ill populations for violence risk is misguided. However, clinicians can play a key role in working with legal authorities to monitor and assist regulation of firearm access, especially among high risk populations. Clinician involvement must be complemented by wider gun control measures. The gun lobby's turning the firearms availability debate into a question about whether people with mental illness histories should access such weapons is a calculated appeal to prejudice.

"Helpful People in Touch" Consumer Led Self Help Programs for People with Multiple Disorders, Mental Illness, Drug Addiction, and Alcoholism (MIDAA).

ERIC Educational Resources Information Center

Sciacca, Kathleen

This paper describes the consumer program, "Helpful People in Touch," a self-help treatment program for people with the multiple disorders of mental illness, drug addiction, and/or alcoholism. First, the terms, "Mentally Ill Chemical Abusers and Addicted" (MICAA) and "Chemical Abusing Mentally Ill" (CAMI) are defined…

Chronically ill Canadians' experiences of being unattached to a family doctor: a qualitative study of marginalized patients in British Columbia.

PubMed

Crooks, Valorie A; Agarwal, Gina; Harrison, Angela

2012-07-16

Unattached patients do not have a regular primary care provider. Initiatives are being developed to increase attachment rates across Canada. Most existing attention paid to patient unattachment has focused on quantifying the problem and health system costs. Our purpose is to qualitatively identify the implications of chronically ill patients' experiences of unattachment for health policy and planning to provide policy-relevant insights for Canadian attachment initiatives. Three focus groups were conducted with marginalized chronically ill individuals residing in a mid-sized city in British Columbia who are unattached to a family doctor. We use the term marginalized as a descriptor to acknowledge that by virtue of their low socio-economic status and lack of attachment the participants are marginalized in Canada's health care system Focus groups were structured as an open conversation organized around a series of probing questions. They were digitally recorded and transcribed verbatim. Thematic analysis was employed. Twenty-six individuals participated in the focus groups. The most common chronic illnesses reported were active drug addiction or recovery (and their associated symptoms), depression, arthritis, and hepatitis C. Participants identified life transitions as being the root cause for not having a family doctor. There was a strong sense that unsuccessful attempts to get a family doctor reflected that they were undesirable patients. Participants wanted to experience having a trusting relationship with a regular family doctor as they believed it would encourage greater honesty and transparency. One of the main health concerns regarding lack of access to a regular family doctor is that participants lacked access to preventative care. Participants were also concerned about having a discontinuous medical record due to unattachment. Participants perceived that there are many benefits to be had by having attachment to a regular family doctor and that experiencing unattachment challenged their health and access to health care. We encourage more research to be done on the lived experience of unattachment in order to provide on-the-ground insights that policy-makers require in order to develop responsive, patient-centred supports and programs.

Management of demand in the NHS, including the effects of queues and pensioners.

PubMed

Groocock, J

1999-01-01

Discusses the methods used in the NHS to bring demand into balance with supply. People with minor illnesses try self-treatments and alternative medicine. Systematic programs to identify ill people are applied to only a few illnesses. Waiting lists for elective surgery cause some richer people to take their demand to private hospitals. An analysis of such waiting lists shows that, other than this, queues are not a method of rationing but are just the effect of bad management of the actual methods, which are then discussed. The same methods are used to ration access to specialist physicians. Providing extra resources would eliminate queues only if another condition was satisfied. It is argued that providing fully adequate medical care for patients of working age, although expensive, might produce a net economic gain, whereas all care for pensioners, including medical care, gives a net economic loss. Therefore it may not be sensible for people to have inadequate medical care for the first 65 years of their lives just because it is economically impracticable for them to have fully adequate medical care when they are pensioners.

Awareness and Use of California's Paid Family Leave Insurance Among Parents of Chronically Ill Children

PubMed Central

Schuster, Mark A.; Chung, Paul J.; Elliott, Marc N.; Garfield, Craig F.; Vestal, Katherine D.; Klein, David J.

2016-01-01

Context In 2004, California's Paid Family Leave Insurance Program (PFLI) became the first state program to provide paid leave to care for an ill family member. Objective To assess awareness and use of the program by employed parents of children with special health care needs, a population likely to need leave. Design, Setting, and Participants Telephone interviews with successive cohorts of employed parents before (November 21, 2003-January 31, 2004; n=754) and after (November 18, 2005-January 31, 2006; n=766) PFLI began, randomly sampled from 2 children's hospitals, one in California (with PFLI) and the other in Illinois (without PFLI). Response rates were 82% before and 81% after (California), and 80% before and 74% after (Illinois). Main Outcome Measures Taking leave, length of leave, unmet need for leave, and awareness and use of PFLI. Results Similar percentages of parents at the California site reported taking at least 1 day of leave to care for their ill child before (295 [81%]) and after (327 [79%]) PFLI, taking at least 4 weeks before (64 [21%]) and after (74 [19%]) PFLI, and at least once in the past year not missing work despite believing their child's illness necessitated it before (152 [41%]) and after (156 [41%]) PFLI. Relative to Illinois, parents at the California site reported no change from before to after PFLI in taking at least 1 day of leave (difference of differences, −3%; 95% confidence interval [CI], −13% to 7%); taking at least 4 weeks of leave (1%; 95% CI, −9% to 10%); or not missing work, despite believing their child's illness necessitated it (−1%; 95% CI, −13% to 10%). Only 77 parents (18%) had heard of PFLI approximately 18 months after the program began, and only 20 (5%) had used it. Even among parents without other access to paid leave, awareness and use of PFLI were minimal. Conclusions Parents of children with special health care needs receiving care at a California hospital were generally unaware of PFLI and rarely used it. Among parents of children with special health care needs, taking leave in California did not increase after PFLI implementation compared with Illinois. PMID:18768416

Urban Telemedicine Enables Equity in Access to Acute Illness Care.

PubMed

Ronis, Sarah D; McConnochie, Kenneth M; Wang, Hongyue; Wood, Nancy E

2017-02-01

Children with care for acute illness available through the Health-e-Access telemedicine model at childcare and schools were previously found to have 22% less emergency department (ED) use than counterparts without this service, but they also had 24% greater acute care use overall. We assessed the hypothesis that increased utilization reflected improved access among impoverished inner-city children to a level experienced by more affluent suburban children. This observational study compared utilization among children without and with telemedicine access, beginning in 1993, ending in 2007, and based on 84,287 child-months of billing claims-based observation. Health-e-Access Telemedicine was initiated in stepwise manner over 187 study-months among 74 access sites (childcare, schools, community centers), beginning in month 105. Children dwelled in inner city, rest-of-city Rochester, NY, or in surrounding suburbs. Rate of total acute care visits (office, ED, telemedicine) was measured as visits per 100 child-years. Observed utilization rates were adjusted in multivariate analysis for age, sex, insurance type, and season of year. When both suburban and inner-city children lacked telemedicine access, overall acute illness visits were 75% greater among suburban than inner-city children (suburban:inner-city rate ratio 1.75, p < 0.0001). After telemedicine became available to inner-city children, their overall acute visits approximated those of suburban children (suburban:inner-city rate ratio 0.80, p = 0.07), whereas acute visits among suburban children remained at least (worst-case comparison) 56% greater than inner-city children without telemedicine (rate ratio 1.56, p < 0.0001). At baseline, overall acute illness utilization of suburban children exceeded that of inner-city children. Overall utilization for inner-city children increased with telemedicine to that of suburban children at baseline. Without telemedicine, however, inner-city use remained substantially less than for suburban counterparts. Health-e-Access Telemedicine redressed socioeconomic disparities in acute care access in the Rochester area, thus contributing to a more equitable community.

A Platform for Crowdsourced Foodborne Illness Surveillance: Description of Users and Reports

PubMed Central

2017-01-01

Background Underreporting of foodborne illness makes foodborne disease burden estimation, timely outbreak detection, and evaluation of policies toward improving food safety challenging. Objective The objective of this study was to present and evaluate Iwaspoisoned.com, an openly accessible Internet-based crowdsourcing platform that was launched in 2009 for the surveillance of foodborne illness. The goal of this system is to collect data that can be used to augment traditional approaches to foodborne disease surveillance. Methods Individuals affected by a foodborne illness can use this system to report their symptoms and the suspected location (eg, restaurant, hotel, hospital) of infection. We present descriptive statistics of users and businesses and highlight three instances where reports of foodborne illness were submitted before the outbreaks were officially confirmed by the local departments of health. Results More than 49,000 reports of suspected foodborne illness have been submitted on Iwaspoisoned.com since its inception by individuals from 89 countries and every state in the United States. Approximately 95.51% (42,139/44,119) of complaints implicated restaurants as the source of illness. Furthermore, an estimated 67.55% (3118/4616) of users who responded to a demographic survey were between the ages of 18 and 34, and 60.14% (2776/4616) of the respondents were female. The platform is also currently used by health departments in 90% (45/50) of states in the US to supplement existing programs on foodborne illness reporting. Conclusions Crowdsourced disease surveillance through systems such as Iwaspoisoned.com uses the influence and familiarity of social media to create an infrastructure for easy reporting and surveillance of suspected foodborne illness events. If combined with traditional surveillance approaches, these systems have the potential to lessen the problem of foodborne illness underreporting and aid in early detection and monitoring of foodborne disease outbreaks. PMID:28679492

A Platform for Crowdsourced Foodborne Illness Surveillance: Description of Users and Reports.

PubMed

Quade, Patrick; Nsoesie, Elaine Okanyene

2017-07-05

Underreporting of foodborne illness makes foodborne disease burden estimation, timely outbreak detection, and evaluation of policies toward improving food safety challenging. The objective of this study was to present and evaluate Iwaspoisoned.com, an openly accessible Internet-based crowdsourcing platform that was launched in 2009 for the surveillance of foodborne illness. The goal of this system is to collect data that can be used to augment traditional approaches to foodborne disease surveillance. Individuals affected by a foodborne illness can use this system to report their symptoms and the suspected location (eg, restaurant, hotel, hospital) of infection. We present descriptive statistics of users and businesses and highlight three instances where reports of foodborne illness were submitted before the outbreaks were officially confirmed by the local departments of health. More than 49,000 reports of suspected foodborne illness have been submitted on Iwaspoisoned.com since its inception by individuals from 89 countries and every state in the United States. Approximately 95.51% (42,139/44,119) of complaints implicated restaurants as the source of illness. Furthermore, an estimated 67.55% (3118/4616) of users who responded to a demographic survey were between the ages of 18 and 34, and 60.14% (2776/4616) of the respondents were female. The platform is also currently used by health departments in 90% (45/50) of states in the US to supplement existing programs on foodborne illness reporting. Crowdsourced disease surveillance through systems such as Iwaspoisoned.com uses the influence and familiarity of social media to create an infrastructure for easy reporting and surveillance of suspected foodborne illness events. If combined with traditional surveillance approaches, these systems have the potential to lessen the problem of foodborne illness underreporting and aid in early detection and monitoring of foodborne disease outbreaks. ©Patrick Quade, Elaine Okanyene Nsoesie. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 05.07.2017.

20 CFR 30.3 - What do these regulations contain?

Code of Federal Regulations, 2014 CFR

2014-04-01

... EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED General Provisions Introduction... criteria for occupational illnesses and covered illnesses compensable under Parts B and E of EEOICPA...

20 CFR 30.3 - What do these regulations contain?

Code of Federal Regulations, 2010 CFR

2010-04-01

... EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED General Provisions Introduction... criteria for occupational illnesses and covered illnesses compensable under Parts B and E of EEOICPA...

20 CFR 30.3 - What do these regulations contain?

Code of Federal Regulations, 2013 CFR

2013-04-01

... EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED General Provisions Introduction... criteria for occupational illnesses and covered illnesses compensable under Parts B and E of EEOICPA...

20 CFR 30.3 - What do these regulations contain?

Code of Federal Regulations, 2011 CFR

2011-04-01

... EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED General Provisions Introduction... criteria for occupational illnesses and covered illnesses compensable under Parts B and E of EEOICPA...

20 CFR 30.3 - What do these regulations contain?

Code of Federal Regulations, 2012 CFR

2012-04-01

... EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED General Provisions Introduction... criteria for occupational illnesses and covered illnesses compensable under Parts B and E of EEOICPA...

20 CFR 30.232 - How does a claimant establish that the employee has been diagnosed with a covered illness, or...

Code of Federal Regulations, 2011 CFR

2011-04-01

... employee has been diagnosed with a covered illness, or sustained an injury, illness, impairment or disease as a consequence of a covered illness? 30.232 Section 30.232 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF...

Evidence-based psychosocial practices and recovery from schizophrenia.

PubMed

Shean, Glenn D

2009-01-01

Pessimistic views about the course and outcome of schizophrenia have been replaced by a more hopeful perspective that emphasizes on providing opportunities for recovery. Recovery, from a provider perspective, means that priority is placed on providing access to treatments and community services that have been proven effective in both decreasing symptoms and assisting individuals to lead maximally productive and personally meaningful lives. In 2004, the Schizophrenia Patient Outcomes Research Team (PORT) published a consensus list of evidence-based practices (EBPs) that includes six psychosocial treatments. These psychosocial interventions in combination with access to pharmacotherapy are important components of comprehensive treatment programs for the seriously mentally ill. This paper summarizes and updates the research basis for the PORT psychosocial EBPs and discusses several additional issues and research topics to be considered in the future.

Systematic review of positive youth development programs for adolescents with chronic illness.

PubMed

Maslow, Gary R; Chung, Richard J

2013-05-01

The Positive Youth Development (PYD) framework has been successfully used to support at-risk youth. However, its effectiveness in fostering positive outcomes for adolescents with chronic illness has not been established. We performed a systematic review of PYD-consistent programs for adolescents with chronic illness. Data sources included PubMed, CINAHL, and PsychINFO. Guided by an analytic framework, we searched for studies of PYD-consistent programs serving adolescents and young adults aged 13 through 24 with chronic illness. References were screened iteratively with increasing depth until a focused cohort was obtained and reviewed in full. The authors separately reviewed the studies using structured analysis forms. Relevant study details were abstracted during the review process. Fifteen studies describing 14 programs were included in the analysis. Three comprehensive programs included all 3 core components of a PYD program, including opportunities for youth leadership, skill building, and sustained connections between youth and adults. Four programs were primarily mentoring programs, and 7 others focused on youth leadership. Programs served youth with a variety of chronic illnesses. The quality and type of evaluation varied considerably, with most reporting psychosocial outcomes but only a few including medical outcomes. The PYD-consistent programs identified in this review can serve as models for the development of youth development programs for adolescents with chronic illness. Additional study is needed to evaluate such programs rigorously with respect to both psychosocial and health-related outcomes. PYD-consistent programs have the potential to reach youth with chronic illness and promote positive adult outcomes broadly.

Impact of Illness Management and Recovery Programs on Hospital and Emergency Room Use by Medicaid Enrollees

PubMed Central

Salyers, Michelle P.; Rollins, Angela L.; Clendenning, Daniel; McGuire, Alan B.; Kim, Edward

2011-01-01

Objective Illness management and recovery is a structured program that helps consumers with severe mental illness learn effective ways to manage illness and pursue recovery goals. This study examined the impact of the program on health service utilization. Methods This was a retrospective cohort study of five assertive community treatment (ACT) teams in Indiana that implemented illness management and recovery. With Medicaid claims data from July 1, 2003, to June 30, 2008, panel data were created with person-months as the level of analysis, resulting in 14,261 observations, for a total of 498 unique individuals. Zero-inflated negative binomial regression models were used to predict hospitalization days and emergency room visits, including covariates of demographic characteristics, employment status, psychiatric diagnosis, and concurrent substance use disorder. The main predictor variables of interest were receipt of illness management and recovery services, dropout from the program, and program graduation status. Results Consumers who received some illness management and recovery services had fewer hospitalization days than those receiving only ACT. Graduates had fewer emergency room visits than did ACT-only consumers. Conclusions This is the first study to examine the impact of illness management and recovery on service utilization. Controlling for a number of background variables, the study showed that illness management and recovery programs were associated with reduced inpatient hospitalization and emergency room use over and above ACT. PMID:21532077

Access to primary and specialized somatic health care for persons with severe mental illness: a qualitative study of perceived barriers and facilitators in Swedish health care.

PubMed

Björk Brämberg, Elisabeth; Torgerson, Jarl; Norman Kjellström, Anna; Welin, Peder; Rusner, Marie

2018-01-09

Persons with severe mental illness (e.g. schizophrenia, bipolar disorder) have a high prevalence of somatic conditions compared to the general population. Mortality data in the Nordic countries reveal that these persons die 15-20 years earlier than the general population. Some factors explaining this high prevalence may be related to the individuals in question; others arise from the health care system's difficulty in offering somatic health care to these patient groups. The aim of the present study was therefore to explore the experiences and views of patients, relatives and clinicians regarding individual and organizational factors which facilitate or hinder access to somatic health care for persons with severe mental illness. Flexible qualitative design. Data was collected by means of semi-structured individual interviews with patients with severe mental illness, relatives and clinicians representing primary and specialized health care. In all, 50 participants participated. The main barrier to accessing somatic care is the gap between the organization of the health care system and the patients' individual health care needs. This is observed at both individual and organizational level. The health care system seems unable to support patients with severe mental illness and their psychiatric-somatic comorbidity. The main facilitators are the links between severe mental illness patients and medical departments. These links take the form of functions (i.e. systems which ensure that patients receive regular reminders), or persons (i.e. professional contacts who facilitate patients' access the health care). Health care services for patients with severe mental illness need reorganization. Organizational structures and systems that facilitate cooperation between different departments must be put in place, along with training for health care professionals about somatic disease among psychiatric patients. The links between individual and organizational levels could be strengthened by introducing professional contacts, such as liaison physicians and case managers. This is also important to reduce stress and responsibility among relatives.

Establishing Core Mental Health Workforce Attributes for the Effective Mental Health Care of People with an Intellectual Disability and Co-Occurring Mental Ill Health

ERIC Educational Resources Information Center

Weise, Janelle; Fisher, Karen R.; Trollor, Julian N.

2017-01-01

Background: People with intellectual disability experience high rates of mental ill health but multiple barriers to access to quality mental health care. One significant barrier to access is a generalist mental health workforce that lacks capacity, and consensus on what constitutes core workforce competencies in this area. As such, the first step…

Using Geospatial Research Methods to Examine Resource Accessibility and Availability as it Relates to Community Participation of Individuals with Serious Mental Illnesses.

PubMed

Townley, Greg; Brusilovskiy, Eugene; Snethen, Gretchen; Salzer, Mark S

2018-03-01

Greater community participation among individuals with serious mental illnesses is associated with better psychosocial and health outcomes. Typically, studies examining community participation have utilized self-report measures and been conducted in limited settings. The introduction of methodological advances to examining community participation of individuals with serious mental illnesses has the potential to advance the science of community mental health research and invigorate the work of community psychologists in this area. This study employed an innovative geospatial approach to examine the relationship between community participation and resource accessibility (i.e., proximity) and availability (i.e., concentration) among 294 individuals utilizing community mental health services throughout the United States. Findings suggest small but significant associations between community participation and the accessibility and availability of resources needed for participation. Furthermore, findings demonstrate the importance of car access for individuals residing in both urban and non-urban settings. The methods and results presented in this study have implications for community mental health research and services and provide an illustration of ways that geospatial methodologies can be used to investigate environmental factors that impact community inclusion and participation of individuals with serious mental illnesses. © Society for Community Research and Action 2017.

Effects of contact-based mental illness stigma reduction programs: age, gender, and Asian, Latino, and White American differences.

PubMed

Wong, Eunice C; Collins, Rebecca L; Cerully, Jennifer L; Yu, Jennifer W; Seelam, Rachana

2018-03-01

Mental illness stigma disproportionately affects help seeking among youth, men, and ethnic minorities. As part of a comprehensive statewide initiative to reduce mental illness stigma and discrimination in California, a broad set of contact-based educational programs were widely disseminated. This study examined whether the effects of contact-based educational programs varied depending on the age, gender, and race-ethnicity of participants. Participants (N = 4122) attended a contact-based educational program that was delivered as part of the statewide initiative to reduce mental illness stigma and discrimination. Self-administered surveys assessing beliefs, attitudes, and intentions toward mental illnesses and treatment were conducted immediately before and after participation in contact-based educational programs. Participant age, gender, and race-ethnicity significantly moderated pre-post changes in mental illness stigma. Although all groups exhibited significant pre-post changes across most of the stigma domains assessed, young adults, females, and Asian and Latino American participants reported larger improvements compared to older adults, males, and Whites, respectively. Findings suggest that contact-based educational programs can achieve immediate reductions in mental illness stigma across a variety of sociodemographic groups and may particularly benefit young adults and racial-ethnic minorities. Further research is needed to assess whether contact-based educational programs can sustain longer-term changes and aid in the reduction of disparities in mental illness stigma and treatment.

Contingent workers: Workers' compensation data analysis strategies and limitations.

PubMed

Foley, Michael; Ruser, John; Shor, Glenn; Shuford, Harry; Sygnatur, Eric

2014-07-01

The growth of the contingent workforce presents many challenges in the occupational safety and health arena. State and federal laws impose obligations and rights on employees and employers, but contingent work raises issues regarding responsibilities to maintain a safe workplace and difficulties in collecting and reporting data on injuries and illnesses. Contingent work may involve uncertainty about the length of employment, control over the labor process, degree of regulatory, or statutory protections, and access to benefits under workers' compensation. The paper highlights differences in regulatory protections and benefits among various types of contingent workers and how these different arrangements affect safety incentives. It discusses challenges caused by contingent work for accurate data reporting in existing injury and illness surveillance and benefit programs, differences between categories of contingent work in their coverage in various data sources, and opportunities for overcoming obstacles to effectively using workers' compensation data. © 2014 Wiley Periodicals, Inc.

20 CFR 30.11 - Who maintains custody and control of claim records?

Code of Federal Regulations, 2014 CFR

2014-04-01

... LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED General... Occupational Illness Compensation Program Act File). This system of records is maintained by and under the...

20 CFR 30.11 - Who maintains custody and control of claim records?

Code of Federal Regulations, 2013 CFR

2013-04-01

... LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED General... Occupational Illness Compensation Program Act File). This system of records is maintained by and under the...

20 CFR 30.11 - Who maintains custody and control of claim records?

Code of Federal Regulations, 2011 CFR

2011-04-01

... LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED General... Occupational Illness Compensation Program Act File). This system of records is maintained by and under the...

20 CFR 30.11 - Who maintains custody and control of claim records?

Code of Federal Regulations, 2012 CFR

2012-04-01

... LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED General... Occupational Illness Compensation Program Act File). This system of records is maintained by and under the...

20 CFR 30.11 - Who maintains custody and control of claim records?

Code of Federal Regulations, 2010 CFR

2010-04-01

... LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED General... Occupational Illness Compensation Program Act File). This system of records is maintained by and under the...

20 CFR 30.101 - In general, how is a survivor's claim filed?

Code of Federal Regulations, 2013 CFR

2013-04-01

... LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Filing... who sustained an occupational illness or a covered illness must file a claim for compensation in...

Barriers to Access to Palliative Care

PubMed Central

Hawley, Pippa

2017-01-01

Despite significant advances in understanding the benefits of early integration of palliative care with disease management, many people living with a chronic life-threatening illness either do not receive any palliative care service or receive services only in the last phase of their illness. In this article, I explore some of the reasons for failure to provide palliative care services and recommend some strategies to overcome these barriers, emphasizing the importance of describing palliative care accurately. I provide language which I hope will help health care professionals of all disciplines explain what palliative care has to offer and ensure wider access to palliative care, early in the course of their illness. PMID:28469439

The community case management program: for 12 years, caring at its best.

PubMed

Luzinski, Cyndy Hunt; Stockbridge, Eleanor; Craighead, Janet; Bayliss, Deborah; Schmidt, Marie; Seideman, Janice

2008-01-01

One of the most complex issues currently under debate in this country is how best to provide health care for our society. Since 1995, Poudre Valley Hospital in Fort Collins, Colorado, has been effectively addressing one facet of this national crisis by providing services to a population of primarily elderly, chronically ill individuals perpetually caught in the gaps between acute and end-of-life services. Community case managers link program participants with appropriate health care services and providers that enhance physiological and functional status, identify resources that enrich quality of life, and encourage relationships and skills which foster self-efficacy. By emphasizing timely access to health-maximizing services, this program documented an impressive 81% reduction in financial losses to the organization during 2006 for emergency and inpatient services provided to a specific sample from this population.

Human rights violations among economically disadvantaged women with mental illness: An Indian perspective

PubMed Central

Poreddi, Vijayalakshmi; Ramachandra; Thimmaiah, Rohini; Math, Suresh Bada

2015-01-01

Background: Globally women confront manifold violations of human rights and women with poverty and mental illness are doubly disadvantaged. Aim: The aim was to examine the influence of poverty in meeting human rights needs among recovered women with mental illness at family and community level. Materials and Methods: This was a descriptive study carried out among randomly selected (n = 100) recovered women with mental illness at a tertiary care center. Data were collected through face-to-face interview using structured needs assessment questionnaire. Results: Our findings revealed that below poverty line (BPL) participants were not satisfied in meeting their physical needs such as “access to safe drinking water” (χ2 = 8.994, P < 0.02), “served in the same utensils” (χ2 = 13.648, P < 0.00), had adequate food (χ2 = 11.025, P < 0.02), and allowed to use toilet facilities (χ2 = 13.565, P < 0.00). The human rights needs in emotional dimension, that is, afraid of family members (χ2 = 8.233, P < 0.04) and hurt by bad words (χ2 = 9.014, P < 0.02) were rated higher in above poverty line (APL) participants. Similarly, 88.9% of women from APL group expressed that they were discriminated and exploited by the community members (χ2 = 17.490, P < 0.00). More than three-fourths of BPL participants (76.1%) believed that there were wondering homeless mentally ill in their community (χ2 = 11.848, P < 0.01). Conclusion: There is an urgent need to implement social welfare programs to provide employment opportunities, disability allowance, housing and other social security for women with mental illness. Further, mental health professionals play an essential role in educating the family and public regarding human rights of people with mental illness. PMID:26124524

Human rights violations among economically disadvantaged women with mental illness: An Indian perspective.

PubMed

Poreddi, Vijayalakshmi; Ramachandra; Thimmaiah, Rohini; Math, Suresh Bada

2015-01-01

Globally women confront manifold violations of human rights and women with poverty and mental illness are doubly disadvantaged. The aim was to examine the influence of poverty in meeting human rights needs among recovered women with mental illness at family and community level. This was a descriptive study carried out among randomly selected (n = 100) recovered women with mental illness at a tertiary care center. Data were collected through face-to-face interview using structured needs assessment questionnaire. Our findings revealed that below poverty line (BPL) participants were not satisfied in meeting their physical needs such as "access to safe drinking water" (χ(2) = 8.994, P < 0.02), "served in the same utensils" (χ(2) = 13.648, P < 0.00), had adequate food (χ(2) = 11.025, P < 0.02), and allowed to use toilet facilities (χ(2) = 13.565, P < 0.00). The human rights needs in emotional dimension, that is, afraid of family members (χ(2) = 8.233, P < 0.04) and hurt by bad words (χ(2) = 9.014, P < 0.02) were rated higher in above poverty line (APL) participants. Similarly, 88.9% of women from APL group expressed that they were discriminated and exploited by the community members (χ(2) = 17.490, P < 0.00). More than three-fourths of BPL participants (76.1%) believed that there were wondering homeless mentally ill in their community (χ(2) = 11.848, P < 0.01). There is an urgent need to implement social welfare programs to provide employment opportunities, disability allowance, housing and other social security for women with mental illness. Further, mental health professionals play an essential role in educating the family and public regarding human rights of people with mental illness.

20 CFR 30.0 - What are the provisions of EEOICPA, in general?

Code of Federal Regulations, 2013 CFR

2013-04-01

... ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED General Provisions... Illness Compensation Program Act of 2000, as amended (EEOICPA or Act), 42 U.S.C. 7384 et seq., provides...

20 CFR 30.0 - What are the provisions of EEOICPA, in general?

Code of Federal Regulations, 2012 CFR

2012-04-01

... LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED General... Occupational Illness Compensation Program Act of 2000, as amended (EEOICPA or Act), 42 U.S.C. 7384 et seq...

20 CFR 30.0 - What are the provisions of EEOICPA, in general?

Code of Federal Regulations, 2014 CFR

2014-04-01

... ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED General Provisions... Illness Compensation Program Act of 2000, as amended (EEOICPA or Act), 42 U.S.C. 7384 et seq., provides...

20 CFR 30.0 - What are the provisions of EEOICPA, in general?

Code of Federal Regulations, 2011 CFR

2011-04-01

... LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED General... Occupational Illness Compensation Program Act of 2000, as amended (EEOICPA or Act), 42 U.S.C. 7384 et seq...

20 CFR 30.0 - What are the provisions of EEOICPA, in general?

Code of Federal Regulations, 2010 CFR

2010-04-01

... LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED General... Occupational Illness Compensation Program Act of 2000, as amended (EEOICPA or Act), 42 U.S.C. 7384 et seq...

75 FR 10504 - Division of Energy Employees Occupational Illness Compensation Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-08

... Occupational Illness Compensation Proposed Collection; Comment Request ACTION: Notice. SUMMARY: The Department... concerning the proposed collection: Energy Employees Occupational Illness Compensation Program Act Forms... Occupational Illness Compensation Program Act of 2000, as amended (EEOICPA or Act), 42 U.S.C. 7384 et seq. The...

75 FR 45608 - Energy Employees Occupational Illness Compensation Program Act of 2000; Corrected Revision to...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-03

... DEPARTMENT OF ENERGY Energy Employees Occupational Illness Compensation Program Act of 2000...'') periodically publishes or revises a list of facilities covered under the Energy Employees Occupational Illness... to provide compensation to certain employees who develop illnesses as a result of their employment...

Medicaid programme changes and the chronically ill: early results from a prospective cohort study of the Oregon Health Plan.

PubMed

Solotaroff, Rachel; Devoe, Jennifer; Wright, Bill J; Smiths, Jeanene; Boone, Janne; Edlund, Tina; Carlson, Matthew J

2005-09-01

To describe the impacts of recent Oregon Health Plan (OHP) policy changes on individuals living with chronic illness in Oregon. A mail survey was conducted of 1374 OHP beneficiaries who were directly affected by the new policies. The analyses reported in this article represent baseline findings from the first of three survey waves in an ongoing prospective cohort study. A significant association was found between Medicaid policy changes and high rates of disenrolment from the OHP. Compared to the non-chronically ill, the chronically ill were more likely to report inability to pay for medications, higher medical debt, more unmet health needs, and poorer health status. Among the chronically ill, those who lost insurance reported decreased access to and utilization of healthcare, more medical debt, and more restriction of medications. As policy-makers restructure public programmes to accommodate tight budgets and rising healthcare costs, people with chronic illness can easily be overlooked. Chronically ill individuals face disproportionate financial and health burdens. Small cost-saving policy changes can lead to widespread disenrolment that cascades into reduced access to healthcare services, altered utilization patterns, and financial strain.

Factors associated with receipt of pension and compensation benefits for homeless veterans in the VBA/VHA Homeless Outreach Initiative.

PubMed

Chen, Joyce H; Rosenheck, Robert A; Greenberg, Greg A; Seibyl, Catherine

2007-03-01

Public support payments may facilitate exit from homelessness for persons with mental illness. We examined data from 10,641 homeless veterans contacted from October 1, 1995 to September 30, 2002 in a collaborative outreach program designed to facilitate access to Department of Veterans Affairs (VA) disability benefits. Those who were awarded benefits (22% of contacted veterans) were more likely to report disability, poor to fair self-rated health, and were more likely to have used VA services in the past. Thus, this program achieved only modest success and was most successful with veterans who were already receiving VA services and who might have received benefits even without the outreach effort.

Reducing the stigma of mental illness.

PubMed

Stuart, H

2016-01-01

This paper presents a narrative review of anti-stigma programming using examples from different countries to understand and describe current best practices in the field. Results highlight the importance of targeting the behavioural outcomes of the stigmatization process (discrimination and social inequity), which is consistent with rights-based or social justice models that emphasize social and economic equity for people with disabilities (such as equitable access to services, education, work, etc.). They also call into question large public education approaches in favour of more targeted contact-based interventions. Finally, to add to the research base on best practices, anti-stigma programs are encouraged to create alliances with university researchers in order to critically evaluate their activities and build better, evidence informed practices.

76 FR 12080 - TRICARE Access to Care Demonstration Project

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-04

... DEPARTMENT OF DEFENSE Office of the Secretary TRICARE Access to Care Demonstration Project AGENCY..., Section 1092, entitled Department of Defense TRICARE Access to Care Demonstration Project. The demonstration project is intended to improve access to urgent care including minor illness or injury for Coast...

Reporting of Foodborne Illness by U.S. Consumers and Healthcare Professionals

PubMed Central

Arendt, Susan; Rajagopal, Lakshman; Strohbehn, Catherine; Stokes, Nathan; Meyer, Janell; Mandernach, Steven

2013-01-01

During 2009–2010, a total of 1,527 foodborne disease outbreaks were reported by the Centers for Disease Control and Prevention (CDC) (2013). However, in a 2011 CDC report, Scallan et al. estimated about 48 million people contract a foodborne illness annually in the United States. Public health officials are concerned with this under-reporting; thus, the purpose of this study was to identify why consumers and healthcare professionals don’t report foodborne illness. Focus groups were conducted with 35 consumers who reported a previous experience with foodborne illness and with 16 healthcare professionals. Also, interviews with other healthcare professionals with responsibility of diagnosing foodborne illness were conducted. Not knowing who to contact, being too ill, being unsure of the cause, and believing reporting would not be beneficial were all identified by consumers as reasons for not reporting foodborne illness. Healthcare professionals that participated in the focus groups indicated the amount of time between patients’ consumption of food and seeking treatment and lack of knowledge were barriers to diagnosing foodborne illness. Issues related to stool samples such as knowledge, access and cost were noted by both groups. Results suggest that barriers identified could be overcome with targeted education and improved access and information about the reporting process. PMID:23965924

Reporting of foodborne illness by U.S. consumers and healthcare professionals.

PubMed

Arendt, Susan; Rajagopal, Lakshman; Strohbehn, Catherine; Stokes, Nathan; Meyer, Janell; Mandernach, Steven

2013-08-19

During 2009-2010, a total of 1,527 foodborne disease outbreaks were reported by the Centers for Disease Control and Prevention (CDC) (2013). However, in a 2011 CDC report, Scallan et al. estimated about 48 million people contract a foodborne illness annually in the United States. Public health officials are concerned with this under-reporting; thus, the purpose of this study was to identify why consumers and healthcare professionals don't report foodborne illness. Focus groups were conducted with 35 consumers who reported a previous experience with foodborne illness and with 16 healthcare professionals. Also, interviews with other healthcare professionals with responsibility of diagnosing foodborne illness were conducted. Not knowing who to contact, being too ill, being unsure of the cause, and believing reporting would not be beneficial were all identified by consumers as reasons for not reporting foodborne illness. Healthcare professionals that participated in the focus groups indicated the amount of time between patients' consumption of food and seeking treatment and lack of knowledge were barriers to diagnosing foodborne illness. Issues related to stool samples such as knowledge, access and cost were noted by both groups. Results suggest that barriers identified could be overcome with targeted education and improved access and information about the reporting process.

Randomized Trial of Supported Employment Integrated With Assertive Community Treatment for Rural Adults With Severe Mental Illness

PubMed Central

Gold, Paul B; Meisler, Neil; Santos, Alberto B; Carnemolla, Mark A; Williams, Olivia H; Keleher, Jennie

2006-01-01

Urban-based randomized clinical trials of integrated supported employment (SE) and mental health services in the United States on average have doubled the employment rates of adults with severe mental illness (SMI) compared to traditional vocational rehabilitation. However, studies have not yet explored if the service integrative functions of SE will be effective in coordinating rural-based services that are limited, loosely linked, and geographically dispersed. In addition, SE's ability to replicate the work outcomes of urban programs in rural economies with scarce and less diverse job opportunities remains unknown. In a rural South Carolina county, we designed and implemented a program blending Assertive Community Treatment (ACT) with an SE model, Individual Placement and Support (IPS). The ACT-IPS program operated with ACT and IPS subteams that tightly integrated vocational with mental health services within each self-contained team. In a 24-month randomized clinical trial, we compared ACT-IPS to a traditional program providing parallel vocational and mental health services on competitive work outcomes for adults with SMI (N = 143; 69% schizophrenia, 77% African American). More ACT-IPS participants held competitive jobs (64 versus 26%; p < .001, effect size [ES] = 0.38) and earned more income (median [Mdn] = $549, interquartile range [IQR] = $0–$5,145, versus Mdn = $0, IQR = $0–$40; p < .001, ES = 0.70) than comparison participants. The competitive work outcomes of this rural ACT-IPS program closely resemble those of urban SE programs. However, achieving economic self-sufficiently and developing careers probably require increasing access to higher education and jobs imparting marketable technical skills. PMID:16177278

Lives in isolation: stories and struggles of low-income African American women with panic disorder.

PubMed

Johnson, Michael; Mills, Terry L; Deleon, Jessica M; Hartzema, Abraham G; Haddad, Judella

2009-01-01

Research evidence points to the existence of racial-ethnic disparities in both access to and quality of mental health services for African Americans with panic disorder. Current panic disorder evaluation and treatment paradigms are not responsive to the needs of many African Americans. The primary individual, social, and health-care system factors that limit African Americans' access to care and response to treatment are not well understood. Low-income African American women with panic disorder participated in a series of focus-group sessions designed to elicit (1) their perspectives regarding access and treatment barriers and (2) their recommendations for designing a culturally consistent panic treatment program. Fear of confiding to others about panic symptoms, fear of social stigma, and lack of information about panic disorder were major individual barriers. Within their social networks, stigmatizing attitudes toward mental illness and the mentally ill, discouragement about the use of psychiatric medication, and perceptions that symptoms were the result of personal or spiritual weakness had all interfered with the participants' treatment seeking efforts and contributed to a common experience of severe social isolation. None of the focus-group members had developed fully effective therapeutic relationships with either medical or mental health providers. They described an unmet need for more interactive and culturally authentic relationships with treatment providers. Although the focus-group sessions were not intended to be therapeutic, the women reported that participation in the meetings had been an emotionally powerful and beneficial experience. They expressed a strong preference for the utilization of female-only, panic disorder peer-support groups as an initial step in the treatment/recovery process. Peer-support groups for low-income African American women with panic disorder could address many of the identified access and treatment barriers.

20 CFR 30.609 - Is a settlement or judgment received as a result of allegations of medical malpractice in...

Code of Federal Regulations, 2010 CFR

2010-04-01

... result of allegations of medical malpractice in treating an illness covered by EEOICPA a recovery that... PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS...

20 CFR 30.609 - Is a settlement or judgment received as a result of allegations of medical malpractice in...

Code of Federal Regulations, 2013 CFR

2013-04-01

... result of allegations of medical malpractice in treating an illness covered by EEOICPA a recovery that... PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS...

20 CFR 30.609 - Is a settlement or judgment received as a result of allegations of medical malpractice in...

Code of Federal Regulations, 2014 CFR

2014-04-01

... result of allegations of medical malpractice in treating an illness covered by EEOICPA a recovery that... PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS...

20 CFR 30.609 - Is a settlement or judgment received as a result of allegations of medical malpractice in...

Code of Federal Regulations, 2012 CFR

2012-04-01

... result of allegations of medical malpractice in treating an illness covered by EEOICPA a recovery that... PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS...

20 CFR 30.609 - Is a settlement or judgment received as a result of allegations of medical malpractice in...

Code of Federal Regulations, 2011 CFR

2011-04-01

... result of allegations of medical malpractice in treating an illness covered by EEOICPA a recovery that... PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS...

Primary health care, mental health, and the dietitian's role.

PubMed

Davison, Karen

2006-01-01

Individuals with mental illness are at nutritional risk because of health, social, and economic factors. To address this problem, the Canadian Collaborative Mental Health Initiative (CCMHI) and Dietitians of Canada (DC) commissioned the development of a toolkit that outlines the role of the registered dietitian (RD) and advocates for RDs in primary health care (PHC) mental health programs. The development of the toolkit followed a four-stage process: a comprehensive literature review, a focus group discussion with a national working group, interviews with consumers about RD services, and evaluation of the toolkit. The costs of mental illness in Canada are at least US dollars 6.85 billion per year. Currently, little evidence exists on how RD services can reduce these expenses. The focus group identified accessibility as the predominant issue facing individuals with mental illness. To explain consumer experiences with RD services, a three-tier theory based on in-depth interviews was developed. Consumer experiences with RDs occur in five categories: financial concerns, perception of service, status of mental illness, engagement, and self-esteem (tier 1). These are further influenced by five individual and contextual factors, e.g., social environment, the mental illness (tier 2), which are weighed as benefits and barriers instrumental in determining actions (tier 3). The evaluation of the final draft of the RD toolkit confirmed that it reflected the visions of PHC. The toolkit is intended to act as a blueprint for action. Dietitians are encouraged to use its contents to advocate for positions in mental health PHC settings.

20 CFR 30.205 - What are the criteria for eligibility for benefits relating to beryllium illnesses covered under...

Code of Federal Regulations, 2013 CFR

2013-04-01

... benefits relating to beryllium illnesses covered under Part B of EEOICPA? 30.205 Section 30.205 Employees... ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Eligibility Criteria Eligibility Criteria for Claims...

20 CFR 30.205 - What are the criteria for eligibility for benefits relating to beryllium illnesses covered under...

Code of Federal Regulations, 2014 CFR

2014-04-01

... benefits relating to beryllium illnesses covered under Part B of EEOICPA? 30.205 Section 30.205 Employees... ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Eligibility Criteria Eligibility Criteria for Claims...

20 CFR 30.205 - What are the criteria for eligibility for benefits relating to beryllium illnesses covered under...

Code of Federal Regulations, 2010 CFR

2010-04-01

... benefits relating to beryllium illnesses covered under Part B of EEOICPA? 30.205 Section 30.205 Employees... ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Eligibility Criteria Eligibility Criteria for Claims...

20 CFR 30.205 - What are the criteria for eligibility for benefits relating to beryllium illnesses covered under...

Code of Federal Regulations, 2011 CFR

2011-04-01

... benefits relating to beryllium illnesses covered under Part B of EEOICPA? 30.205 Section 30.205 Employees... ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Eligibility Criteria Eligibility Criteria for Claims...

20 CFR 30.205 - What are the criteria for eligibility for benefits relating to beryllium illnesses covered under...

Code of Federal Regulations, 2012 CFR

2012-04-01

... benefits relating to beryllium illnesses covered under Part B of EEOICPA? 30.205 Section 30.205 Employees... ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Eligibility Criteria Eligibility Criteria for Claims...

Empowerment of women and mental health promotion: a qualitative study in rural Maharashtra, India

PubMed Central

Kermode, Michelle; Herrman, Helen; Arole, Rajanikant; White, Joshua; Premkumar, Ramaswamy; Patel, Vikram

2007-01-01

Background The global burden of mental illness is high and opportunities for promoting mental health are neglected in most parts of the world. Many people affected by mental illness live in developing countries, where treatment and care options are limited. In this context, primary health care (PHC) programs can indirectly promote mental health by addressing its determinants i.e. by enhancing social unity, minimising discrimination and generating income opportunities. The objectives of this study were to: 1. Describe concepts of mental health and beliefs about determinants of mental health and illness among women involved with a PHC project in rural Maharashtra, India; 2. Identify perceived mental health problems in this community, specifically depression, suicide and violence, their perceived causes, and existing and potential community strategies to respond to them and; 3. Investigate the impact of the PHC program on individual and community factors associated with mental health Method We undertook qualitative in-depth interviews with 32 women associated with the PHC project regarding: their concepts of mental health and its determinants; suicide, depression and violence; and the perceived impact of the PHC project on the determinants of mental health. The interviews were taped, transcribed, translated and thematically analysed. Results Mental health and illness were understood by these women to be the product of cultural and socio-economic factors. Mental health was commonly conceptualised as an absence of stress and the commonest stressors were conflict with husbands and mother-in-laws, domestic violence and poverty. Links between empowerment of women through income generation and education, reduction of discrimination based on caste and sex, and promotion of individual and community mental health were recognised. However, mental health problems such as suicide and violence were well-described by participants. Conclusion While it is essential that affordable, accessible, appropriate treatments and systems of referral and care are available for people with mental illness in developing country settings, the promotion of mental health by addressing its determinants is another potential strategy for reducing the burden of mental illness for individuals and communities in these settings. PMID:17761003

Empowerment of women and mental health promotion: a qualitative study in rural Maharashtra, India.

PubMed

Kermode, Michelle; Herrman, Helen; Arole, Rajanikant; White, Joshua; Premkumar, Ramaswamy; Patel, Vikram

2007-08-31

The global burden of mental illness is high and opportunities for promoting mental health are neglected in most parts of the world. Many people affected by mental illness live in developing countries, where treatment and care options are limited. In this context, primary health care (PHC) programs can indirectly promote mental health by addressing its determinants i.e. by enhancing social unity, minimising discrimination and generating income opportunities. The objectives of this study were to: 1. Describe concepts of mental health and beliefs about determinants of mental health and illness among women involved with a PHC project in rural Maharashtra, India; 2. Identify perceived mental health problems in this community, specifically depression, suicide and violence, their perceived causes, and existing and potential community strategies to respond to them and; 3. Investigate the impact of the PHC program on individual and community factors associated with mental health We undertook qualitative in-depth interviews with 32 women associated with the PHC project regarding: their concepts of mental health and its determinants; suicide, depression and violence; and the perceived impact of the PHC project on the determinants of mental health. The interviews were taped, transcribed, translated and thematically analysed. Mental health and illness were understood by these women to be the product of cultural and socio-economic factors. Mental health was commonly conceptualised as an absence of stress and the commonest stressors were conflict with husbands and mother-in-laws, domestic violence and poverty. Links between empowerment of women through income generation and education, reduction of discrimination based on caste and sex, and promotion of individual and community mental health were recognised. However, mental health problems such as suicide and violence were well-described by participants. While it is essential that affordable, accessible, appropriate treatments and systems of referral and care are available for people with mental illness in developing country settings, the promotion of mental health by addressing its determinants is another potential strategy for reducing the burden of mental illness for individuals and communities in these settings.

Mental Illness and Firearms: Legal Context and Clinical Approaches.

PubMed

Pinals, Debra A; Anacker, Lisa

2016-12-01

Gun violence and mental illness is a major area of media attention, especially because highly publicized mass shootings seem to have become more commonly reported in the press. Gun access also is undergoing a highly politicized debate in the United States. It is important for mental health practitioners to understand the background and context of laws related to firearms access, and to understand data related to risk of suicide and violence toward others caused by gun violence among persons with mental illness. In addition, clinically driven risk assessments with specific inquiry related to firearms can be important for identifying individuals for whom firearm-focused clinical risk mitigation may be warranted. Copyright © 2016 Elsevier Inc. All rights reserved.

Talking about Mental Illness: A Guide for Developing an Awareness Program for Youth. Community Guide.

ERIC Educational Resources Information Center

2001

This guide contains all of the information, support and tools that community members need to implement "Talking About Mental Illness" in their community--an awareness program proven to be effective in bringing about positive change in young people's knowledge about mental illness, and in reducing stigma that surrounds mental illness. The…

20 CFR 30.606 - Under what circumstances must a recovery of money or other property in connection with an illness...

Code of Federal Regulations, 2010 CFR

2010-04-01

... money or other property in connection with an illness for which benefits are payable under EEOICPA be..., DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED...

20 CFR 30.2 - In general, how have the tasks associated with the administration of EEOICPA claims process been...

Code of Federal Regulations, 2012 CFR

2012-04-01

... OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS... illnesses under Part B of the Act and covered illnesses under Part E of the Act. In addition, OWCP provides...

20 CFR 30.230 - What are the criteria necessary to establish that an employee contracted a covered illness under...

Code of Federal Regulations, 2014 CFR

2014-04-01

... that an employee contracted a covered illness under Part E of EEOICPA? 30.230 Section 30.230 Employees... ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Eligibility Criteria Eligibility Criteria for Other...

20 CFR 30.2 - In general, how have the tasks associated with the administration of EEOICPA claims process been...

Code of Federal Regulations, 2010 CFR

2010-04-01

... OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS... illnesses under Part B of the Act and covered illnesses under Part E of the Act. In addition, OWCP provides...

20 CFR 30.606 - Under what circumstances must a recovery of money or other property in connection with an illness...

Code of Federal Regulations, 2014 CFR

2014-04-01

... money or other property in connection with an illness for which benefits are payable under EEOICPA be..., DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED...

20 CFR 30.2 - In general, how have the tasks associated with the administration of EEOICPA claims process been...

Code of Federal Regulations, 2013 CFR

2013-04-01

... OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS... illnesses under Part B of the Act and covered illnesses under Part E of the Act. In addition, OWCP provides...

20 CFR 30.230 - What are the criteria necessary to establish that an employee contracted a covered illness under...

Code of Federal Regulations, 2013 CFR

2013-04-01

... that an employee contracted a covered illness under Part E of EEOICPA? 30.230 Section 30.230 Employees... ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Eligibility Criteria Eligibility Criteria for Other...

20 CFR 30.230 - What are the criteria necessary to establish that an employee contracted a covered illness under...

Code of Federal Regulations, 2011 CFR

2011-04-01

... that an employee contracted a covered illness under Part E of EEOICPA? 30.230 Section 30.230 Employees... ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Eligibility Criteria Eligibility Criteria for Other...

20 CFR 30.606 - Under what circumstances must a recovery of money or other property in connection with an illness...

Code of Federal Regulations, 2011 CFR

2011-04-01

... money or other property in connection with an illness for which benefits are payable under EEOICPA be..., DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED...

20 CFR 30.2 - In general, how have the tasks associated with the administration of EEOICPA claims process been...

Code of Federal Regulations, 2011 CFR

2011-04-01

... OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS... illnesses under Part B of the Act and covered illnesses under Part E of the Act. In addition, OWCP provides...

20 CFR 30.606 - Under what circumstances must a recovery of money or other property in connection with an illness...

Code of Federal Regulations, 2013 CFR

2013-04-01

... money or other property in connection with an illness for which benefits are payable under EEOICPA be..., DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED...

20 CFR 30.230 - What are the criteria necessary to establish that an employee contracted a covered illness under...

Code of Federal Regulations, 2010 CFR

2010-04-01

... that an employee contracted a covered illness under Part E of EEOICPA? 30.230 Section 30.230 Employees... ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Eligibility Criteria Eligibility Criteria for Other...

20 CFR 30.2 - In general, how have the tasks associated with the administration of EEOICPA claims process been...

Code of Federal Regulations, 2014 CFR

2014-04-01

... OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS... illnesses under Part B of the Act and covered illnesses under Part E of the Act. In addition, OWCP provides...

20 CFR 30.230 - What are the criteria necessary to establish that an employee contracted a covered illness under...

Code of Federal Regulations, 2012 CFR

2012-04-01

... that an employee contracted a covered illness under Part E of EEOICPA? 30.230 Section 30.230 Employees... ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Eligibility Criteria Eligibility Criteria for Other...

20 CFR 30.606 - Under what circumstances must a recovery of money or other property in connection with an illness...

Code of Federal Regulations, 2012 CFR

2012-04-01

... money or other property in connection with an illness for which benefits are payable under EEOICPA be..., DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED...

Vulnerability and access to care for South Asian Sikh and Muslim patients with life limiting illness in Scotland: prospective longitudinal qualitative study

PubMed Central

Worth, Allison; Irshad, Tasneem; Bhopal, Raj; Brown, Duncan; Lawton, Julia; Grant, Elizabeth; Murray, Scott; Kendall, Marilyn; Adam, James; Gardee, Rafik

2009-01-01

Objectives To examine the care experiences of South Asian Sikh and Muslim patients in Scotland with life limiting illness and their families and to understand the reasons for any difficulties with access to services and how these might be overcome. Design Prospective, longitudinal, qualitative design using in-depth interviews. Setting Central Scotland. Participants 25 purposively selected South Asian Sikh and Muslim patients, 18 family carers, and 20 key health professionals. Results 92 interviews took place. Most services struggled to deliver responsive, culturally appropriate care. Barriers to accessing effective end of life care included resource constrained services; institutional and, occasionally, personal racial and religious discrimination; limited awareness and understanding among South Asian people of the role of hospices; and difficulty discussing death. The most vulnerable patients, including recent migrants and those with poor English language skills, with no family advocate, and dying of non-malignant diseases were at particularly high risk of inadequate care. Conclusions Despite a robust Scottish diversity policy, services for South Asian Sikh and Muslim patients with life limiting illness were wanting in many key areas. Active case management of the most vulnerable patients and carers, and “real time” support, from where professionals can obtain advice specific to an individual patient and family, are the approaches most likely to instigate noticeable improvements in access to high quality end of life care. Improving access to palliative care for all, particularly those with non-malignant illnesses, as well as focusing on the specific needs of ethnic minority groups, is required. PMID:19190015

From homeless to housed: caring for people in transition.

PubMed

Drury, Lin J

2008-01-01

This ethnographic study was conducted to determine what homeless people experience during the transition from street life into community housing. Data were gathered through participant observation at a program designed to secure housing and support services for homeless people upon discharge from a psychiatric hospital. Sixty homeless, mentally ill adults were followed from hospital discharge through their first 2 years in community housing. Homeless people interact with health care providers across a cultural divide produced by vast differences in their lived experiences. This cultural distance limits access to the services that these individuals require to achieve residential stability.

Psychosocial Health Status of Persons Seeking Treatment for Exposure to Libby Amphibole Asbestos

PubMed Central

Weinert, Clarann; Hill, Wade G.; Winters, Charlene A.; Kuntz, Sandra W.; Rowse, Kimberly; Hernandez, Tanis; Black, Brad; Cudney, Shirley

2011-01-01

A cross-sectional exploratory study was conducted to describe the psychosocial health status of persons seeking health care for exposure to Libby amphibole asbestos (LAA). Health indicators including depression, stress, acceptance of illness, and satisfaction with access and financial aspects of care were obtained via electronic and paper-pencil survey. The exposure pathway and demographic data were gleaned from the health record. Of the 386 participants, more than one-third (34.5%) demonstrated significant levels of psychological distress. The oldest group of women had the lowest levels of depression and stress and the highest acceptance of illness. Gender, age, and satisfaction with financial resources were significantly related to depression, stress, and acceptance of illness. Satisfaction with access to care was significant only for stress. No differences in depression, stress, and acceptance of illness were found based on residence, exposure pathway, or insurance status. PMID:22007326

Improve Tracking of Workplace Injuries and Illnesses. Final rule.

PubMed

2016-05-12

OSHA is issuing a final rule to revise its Recording and Reporting Occupational Injuries and Illnesses regulation. The final rule requires employers in certain industries to electronically submit to OSHA injury and illness data that employers are already required to keep under existing OSHA regulations. The frequency and content of these establishment-specific submissions is set out in the final rule and is dependent on the size and industry of the employer. OSHA intends to post the data from these submissions on a publicly accessible Web site. OSHA does not intend to post any information on the Web site that could be used to identify individual employees. The final rule also amends OSHA's recordkeeping regulation to update requirements on how employers inform employees to report work-related injuries and illnesses to their employer. The final rule requires employers to inform employees of their right to report work-related injuries and illnesses free from retaliation; clarifies the existing implicit requirement that an employer's procedure for reporting work-related injuries and illnesses must be reasonable and not deter or discourage employees from reporting; and incorporates the existing statutory prohibition on retaliating against employees for reporting work-related injuries or illnesses. The final rule also amends OSHA's existing recordkeeping regulation to clarify the rights of employees and their representatives to access the injury and illness records.

Evaluation of a pilot promotora program for Latino forest workers in southern Oregon.

PubMed

Bush, Diane E; Wilmsen, Carl; Sasaki, Timothy; Barton-Antonio, Dinorah; Steege, Andrea L; Chang, Charlotte

2014-07-01

Forest work, an occupation with some of the highest injury and illness rates, is conducted primarily by Latino immigrant workers. This study evaluates a pilot program where promotoras (lay community health educators) provided occupational health and safety trainings for Latino forest workers. Evaluation methods included a focus group, post-tests, and qualitative feedback. Community capacity to address working conditions increased through (i) increased leadership and community access to information and resources; and (ii) increased worker awareness of workplace health and safety rights and resources. Fear of retaliation remains a barrier to workers taking action; nevertheless, the promotoras supported several workers in addressing-specific workplace issues. For working conditions to significantly improve, major structural influences need to be addressed. A long-term, organizationally supported promotora program can play a key role in linking and supporting change at the individual, interpersonal and community levels, contributing to and supporting structural change. © 2014 Wiley Periodicals, Inc.

Inadequate prescription-drug coverage for Medicare enrollees--a call to action.

PubMed

Soumerai, S B; Ross-Degnan, D

1999-03-04

In summary, most low-income elderly and disabled persons lack coverage for important medications, resulting in avoidable deterioration of health among those with chronic illnesses and use of expensive institutional services. Rapidly escalating drug costs, more restrictive drug-coverage policies, and a dramatic increase in the population of elderly and disabled persons will exacerbate these problems. With the current budget surplus, as well as bipartisan concern about health care needs and public concern about drug costs and coverage, it is time to act responsibly and aggressively. We recommend a national replication of the best features of state pharmacy-assistance programs in a federal-state insurance program for low-income Medicare enrollees, either alone or in combination with expanded Medicare coverage. Such a program will reduce the current inequitable situation in which the most vulnerable patients have the least access to medications, with serious medical and economic consequences.

Racial/Ethnic Differences in Cigarette Use: The Roles of Mental Illness and Health-Care Access/Utilization.

PubMed

Lo, Celia C; Yang, Fan; Ash-Houchen, William; Cheng, Tyrone C

2018-06-07

Empirical evidence supports a hypothesis that cigarettes may be used to cope with mental illness. Little research, however, addresses how race/ethnicity is linked to mental health and cigarette use. This study applied the self-medication hypothesis. It asked whether mental status was associated, via health-care access/utilization, with the cigarette use outcomes of four racial/ethnic groups. It also tested whether race/ethnicity moderated any such associations. We used nationally representative data from the 2009-2010 and 2011-2012 National Health and Nutrition Examination Surveys to link cigarette use to mental status and health-care access/utilization. The final sample included 3827 White respondents, 1635 African-American respondents, 1144 Mexican-American respondents, and 781 Hispanic American (other than Mexican-American) respondents. Consistent with earlier research and the self-medication hypothesis, we observed a positive relationship between cigarette use and mental status. Associations of cigarette use and health-care access/utilization sometimes failed to take expected directions. We concluded from the findings that race/ethnicity's moderating role in associations between cigarette use and health-care access was generally more advantageous to Whites than other groups examined. Where treatment is delayed by lack of access to, or lack of trust in, care providers, mental health may worsen-and it is often minority Americans who lack access and trust. If minority Americans' health is to improve, shrinking racial health disparities, then access to adequate health care must be available to them, facilitating prompt treatment of mental and other illness.

20 CFR 30.102 - In general, how does an employee file a claim for additional impairment or wage-loss under Part E...

Code of Federal Regulations, 2013 CFR

2013-04-01

... ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Filing Claims; Evidence and Burden of Proof; Special... covered illness or illnesses from the impairment rating that formed the basis for the last award of such...

20 CFR 30.901 - How does OWCP determine the extent of an employee's impairment that is due to a covered illness...

Code of Federal Regulations, 2012 CFR

2012-04-01

... employee's impairment that is due to a covered illness contracted through exposure to a toxic substance at... ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Impairment Benefits Under Part E of EEOICPA General...

20 CFR 30.901 - How does OWCP determine the extent of an employee's impairment that is due to a covered illness...

Code of Federal Regulations, 2014 CFR

2014-04-01

... employee's impairment that is due to a covered illness contracted through exposure to a toxic substance at... ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Impairment Benefits Under Part E of EEOICPA General...

20 CFR 30.901 - How does OWCP determine the extent of an employee's impairment that is due to a covered illness...

Code of Federal Regulations, 2011 CFR

2011-04-01

... employee's impairment that is due to a covered illness contracted through exposure to a toxic substance at... ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Impairment Benefits Under Part E of EEOICPA General...

20 CFR 30.901 - How does OWCP determine the extent of an employee's impairment that is due to a covered illness...

Code of Federal Regulations, 2013 CFR

2013-04-01

... employee's impairment that is due to a covered illness contracted through exposure to a toxic substance at... ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Impairment Benefits Under Part E of EEOICPA General...

20 CFR 30.901 - How does OWCP determine the extent of an employee's impairment that is due to a covered illness...

Code of Federal Regulations, 2010 CFR

2010-04-01

... employee's impairment that is due to a covered illness contracted through exposure to a toxic substance at... ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Impairment Benefits Under Part E of EEOICPA General...

2003 Oak Ridge National Laboratory Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-05-23

Annual Illness and Injury Surveillance Program report for 2003 for ORNL. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

Pilot Investigation of the Effectiveness of Respite Care for Carers of an Adult with Mental Illness

ERIC Educational Resources Information Center

Jardim, Claudia; Pakenham, Kenneth I.

2009-01-01

Informal carers of an adult with mental illness have asked that respite care be an integral component of mental health service provision. The present study involved a pilot investigation of the effectiveness of accessing respite care for carers of individuals with a mental illness. It was hypothesised that compared to carers who have not accessed…

Wearable Devices and Mobile Technologies for Supporting Behavioral Weight Loss Among People with Serious Mental Illness

PubMed Central

Naslund, John A.; Aschbrenner, Kelly A.; Scherer, Emily A.; McHugo, Gregory J.; Marsch, Lisa A.; Bartels, Stephen J.

2016-01-01

Promoting physical activity is essential for addressing elevated cardiovascular risk and high obesity rates affecting people with serious mental illness. Numerous challenges interfere with exercise participation in this high-risk group including mental health symptoms, low motivation, and limited access to safe and affordable options for physical activity. Wearable devices and mobile health technologies may afford new opportunities for promoting physical activity and supporting behavioral weight loss efforts. This exploratory study examined whether daily step count measured using Fitbit wearable devices was associated with weight loss and improved fitness among individuals with serious mental illness enrolled in a 6-month lifestyle program. Participants (n=34) had a schizophrenia spectrum disorder (23.5%), major depression (50.0%), or bipolar disorder (26.5%), and wore Fitbits most of the days (M=86.2%; SD=18.4%) they were enrolled in the study. At 6-months, higher average daily step count was associated with greater weight loss (F=5.07; df=1,32; p=0.0314), but not improved fitness (F=1.92; df=1,31; p=0.176). These findings demonstrate that encouraging participants with serious mental illness enrolled in lifestyle interventions to collect more steps may contribute to greater weight loss. This suggests that wearable devices may offer a feasible and potentially effective strategy for supporting behavioral weight loss in community mental health settings. PMID:27479104

Tools to Promote Shared Decision Making in Serious Illness: A Systematic Review.

PubMed

Austin, C Adrian; Mohottige, Dinushika; Sudore, Rebecca L; Smith, Alexander K; Hanson, Laura C

2015-07-01

Serious illness impairs function and threatens survival. Patients facing serious illness value shared decision making, yet few decision aids address the needs of this population. To perform a systematic review of evidence about decision aids and other exportable tools that promote shared decision making in serious illness, thereby (1) identifying tools relevant to the treatment decisions of seriously ill patients and their caregivers, (2) evaluating the quality of evidence for these tools, and (3) summarizing their effect on outcomes and accessibility for clinicians. We searched PubMed, CINAHL, and PsychInfo from January 1, 1995, through October 31, 2014, and identified additional studies from reference lists and other systematic reviews. Clinical trials with random or nonrandom controls were included if they tested print, video, or web-based tools for advance care planning (ACP) or decision aids for serious illness. We extracted data on the study population, design, results, and risk for bias using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. Each tool was evaluated for its effect on patient outcomes and accessibility. Seventeen randomized clinical trials tested decision tools in serious illness. Nearly all the trials were of moderate or high quality and showed that decision tools improve patient knowledge and awareness of treatment choices. The available tools address ACP, palliative care and goals of care communication, feeding options in dementia, lung transplant in cystic fibrosis, and truth telling in terminal cancer. Five randomized clinical trials provided further evidence that decision tools improve ACP documentation, clinical decisions, and treatment received. Clinicians can access and use evidence-based tools to engage seriously ill patients in shared decision making. This field of research is in an early stage; future research is needed to develop novel decision aids for other serious diagnoses and key decisions. Health care delivery organizations should prioritize the use of currently available tools that are evidence based and effective.

The efficacy of a senior outreach program in the reduction of hospital readmissions and emergency department visits among chronically ill seniors.

PubMed

Prior, Michael K; Bahret, Beverly A; Allen, Reva I; Pasupuleti, Sudershan

2012-01-01

This study reports on the effectiveness of a community-based senior outreach program in decreasing rehospitalizations and emergency department visits among chronically ill seniors. Participants had been repeatedly hospitalized with chronic illnesses and were subsequently served in an in-home program designed to address their psychosocial and medical needs. Participation in the program was found to be related to lower hospital readmission rates and emergency department usage. Clients also reported decreased financial concerns and depression and anxiety and increased social support. The study adds to the growing body of work supporting community-based programs as effective strategies for decreasing health care usage and improving quality of life for chronically ill seniors.

The Impact of Local Environmental Health Capacity on Foodborne Illness Morbidity in Maryland

PubMed Central

Resnick, Beth A.; Fox, Mary A.; McGready, John; Yager, James P.; Burke, Thomas A.

2011-01-01

Objectives. We evaluated the relationship between local food protection capacity and service provision in Maryland's 24 local food protection programs (FPPs) and incidence of foodborne illness at the county level. Methods. We conducted regression analyses to determine the relationship between foodborne illness and local FPP characteristics. We used the Centers for Disease Control and Prevention's FoodNet and Maryland Department of Health and Mental Hygiene outbreak data set, along with data on Maryland's local FPP capacity (workforce size and experience levels, budget) and service provision (food service facility inspections, public notification programs). Results. Counties with higher capacity, such as larger workforce, higher budget, and greater employee experience, had fewer foodborne illnesses. Counties with better performance and county-level regulations, such as high food service facility inspection rates and requiring certified food manager programs, respectively, had lower rates of illness. Conclusions. Counties with strong local food protection capacity and services can protect the public from foodborne illness. Research on public health services can enhance our understanding of the food protection infrastructure, and the effectiveness of food protection programs in preventing foodborne illness. PMID:21750282

The concept of stigma in mental illness as applied to Haitian Americans.

PubMed

Dieujuste, Colette

2016-06-01

To report on the analysis of the concept of the stigma of mental illness within the Haitian American community. Mental illness is a highly stigmatized condition within certain communities making it challenging for individuals to seek effective treatment. The consequences of such stigma can have lifelong corollaries for the individuals, the families and the communities. The concept of stigma is not fully developed in nursing; clarity of the concept of stigma of mental illness is still needed in the nursing literature. In order to assist patients in accessing mental health services, the concept of stigma must first be clarified. The method used for this concept analysis was that of Walker and Avant. Five attributes were identified, creating the following definition: labelling, stereotype, negative attitude, emotional response, and discrimination. The antecedents for stigma of mental illness are lack of knowledge about mental illness, emotional state and cultural beliefs and values. The origins of stigmatization of mental illness among Haitian Americans need to be understood. Mental health illnesses are stigmatized within the Haitian culture, which presents as a barrier to accessing help for many Haitian American women suffering from mental illness. The defining attributes can be used to develop tools to help clinicians identify patients being stigmatized. Once stigma is recognized, nurses can develop strategies and policies that can mitigate the effects of stigmatization of mental illness among this patient population. Further research is essential to examine the ways in which this concept impacts the Haitian American community, as well as effective strategies to help minimize its effects. © 2016 International Council of Nurses.

Childhood risk factors for criminal justice involvement in a sample of homeless people with serious mental illness.

PubMed

Desai, R A; Lam, J; Rosenheck, R A

2000-06-01

It has been suggested that criminal justice involvement among the homeless, particularly those with mental illness, is largely situational. The objective of this study was to assess, in a sample of homeless seriously mentally ill people, the prevalence of childhood conduct disorder behaviors as a risk factor for adult criminal activity as well as the extent and types of adult criminal justice contact. Data were taken from the national ACCESS program, which conducted extensive baseline interviews with 7,222 homeless seriously mentally ill adults. The interview assessed demographics, childhood risk factors for criminal activity such as conduct disorder behaviors, foster care, and parental abuse, as well as current illness severity and recent criminal justice contact. The 2-month arrest rate in this sample was much higher than national rates (11% compared with 1% annually in the general population). Although most arrests were for minor crimes (10.8%), there were also substantial rates of arrest for major (2.7%) and substance-related charges (2.0%). The prevalence of a history of conduct disorder behavior was also substantial (55% in male subjects, 40% in female subjects), and conduct disorder was a strong predictor of recent criminal justice involvement, even after controlling for other predictors of arrest (odds ratio = 1.76 for major crimes, 1.49 for minor crimes, and 1.98 for substance-related crimes). Recent literature has criticized a trend to criminalize homeless mentally ill persons for attempting to get needed food, shelter, or medical attention. However, these data indicate that at least some proportion of arrests in this population are of people who have been exhibiting antisocial behavior since early adolescence, and that early antisocial behavior is a strong predictor of all types of recent arrests in this population.

Development of an e-supported illness management and recovery programme for consumers with severe mental illness using intervention mapping, and design of an early cluster randomized controlled trial.

PubMed

Beentjes, Titus A A; van Gaal, Betsie G I; Goossens, Peter J J; Schoonhoven, Lisette

2016-01-19

E-mental health is a promising medium to keep mental health affordable and accessible. For consumers with severe mental illness the evidence of the effectiveness of e-health is limited. A number of difficulties and barriers have to be addressed concerning e-health for consumers with severe mental illness. One possible solution might be to blend e-health with face-to-face delivery of a recovery-oriented treatment, like the Illness Management & Recovery (IMR) programme. This paper describes the development of an e-health application for the IMR programme and the design of an early clustered randomized controlled trial. We developed the e-IMR intervention according to the six-step protocol of Intervention Mapping. Consumers joined the development group to address important and relevant issues for the target group. Decisions during the six-step development process were based on qualitative evaluations of the Illness Management & Recovery programme, structured interviews, discussion in the development group, and literature reviews on qualitative papers concerning consumers with severe mental illness, theoretical models, behavioural change techniques, and telemedicine for consumers with severe mental illness. The aim of the e-IMR intervention is to help consumers with severe mental illness to involve others, manage achieving goals, and prevent relapse. The e-IMR intervention consists of face-to-face delivery of the Illness Management & Recovery programme and an e-health application containing peer-testimonials on videos, follow up on goals and coping strategies, monitoring symptoms, solving problems, and communication opportunities. We designed an early cluster randomized controlled trial that will evaluate the e-IMR intervention. In the control condition the Illness Management & Recovery programme is provided. The main effect-study parameters are: illness management, recovery, psychiatric symptoms severity, self-management, quality of life, and general health. The process of the IMR program will be evaluated on fidelity and feasibility in semi-structured interviews with participants and trainers. Intervention Mapping provided a systematic procedure for the development of this e-health intervention for consumers with severe mental illness and the preparation of an early randomized controlled trial. The trial is registered in the Dutch Trial Register: NTR4772 .

Anesthesia through an intraosseous line using an 18-gauge intravenous needle for emergency pediatric surgery.

PubMed

Hamed, Riyadh Khudeir; Hartmans, Sharon; Gausche-Hill, Marianne

2013-09-01

To describe the success and complication rate of intraosseous (IO) access for delivery of anesthesia with the use of an 18-gauge (G) intravenous (IV) needle. Prospective study. Children's Welfare Teaching Hospital, Baghdad, Iraq. 300 critically ill infants and toddlers, age 3 weeks to 16 months, requiring emergency surgery for intra-abdominal or pelvic conditions, in whom peripheral or central access was not obtainable. Patients presented for surgery between 2007 and 2010. In 26 patients, the IO catheter was established when peripheral access was not obtained at the outset of surgery; in 4 patients standard peripheral vascular access failed during the surgical procedure and IO access was obtained. An 18-G IV needle was placed into the proximal tibia and attached to an extension set with a 3-way stopcock to deliver anesthesia. For 26 critically ill children and 4 other children, IV access failed during delivery of anesthesia; vascular access was successfully obtained within minutes in all 30 infants (100%) using the intraosseous route. Ninety percent (27/30) of patients awoke immediately postoperatively in good condition; 10% (3/30) went to the pediatric intensive care unit (PICU) for further care due to their critical preoperative condition. Complications associated with use of the IO route were considered minor (3/30 pts [10%]) and included extravasation of fluid in two cases and cellulitis in one. The IO route provided for rapid delivery of anesthesia, induction, and maintenance in this series of critically ill infants undergoing emergency surgery when other vascular access routes failed. Few complications were noted. Intraosseous access was achieved through a simple technique using an 18-gauge IV needle. © 2013 Elsevier Inc. All rights reserved.

Lack of access to medical care during Hurricane Sandy and mental health symptoms.

PubMed

Ruskin, Julia; Rasul, Rehana; Schneider, Samantha; Bevilacqua, Kristin; Taioli, Emanuela; Schwartz, Rebecca M

2018-06-01

Destruction caused by natural disasters compromises medical providers' and hospitals' abilities to administer care. Hurricane Sandy was particularly devastating, resulting in massive disruptions of medical care in the region. This study aimed to determine whether a lack of access to medical care during Hurricane Sandy was associated with posttraumatic stress disorder (PTSD) symptoms and other mental health/substance abuse outcomes. A secondary aim was to examine whether having a chronic illness moderates those associations. Self-reported medical access and mental health symptomatology were obtained from New York City and Long Island residents (n = 1669) following Hurricane Sandy under the Leaders in Gathering Hope Together project (10/23/2013-2/25/2015) and Project Restoration (6/5/2014-8/9/2016). Multivariable logistic regressions were utilized to determine the relationship between lack of access to medical care and mental health outcomes. Of the 1669 participants, 994 (59.57%) were female, 866 (51.89%) were white, and the mean age was 46.22 (SD = 19.2) years old. Those without access to medical care had significantly higher odds of showing symptoms of PTSD (AOR = 2.71, CI = [1.77-4.16]), as well as depression (AOR = 1.94, CI = [1.29-2.92]) and anxiety (AOR = 1.61, CI = [1.08-2.39]) compared to those with access. Lack of access to care was associated with a 2.12 point increase in perceived stress scale score (SE = 0.63). The interaction between having a chronic illness and lack of access to medical care was not significantly associated with any outcomes. The findings emphasize the importance of making medical care more accessible to patients, both chronically and acutely ill, during natural disasters to benefit their physical as well as their mental health.

A qualitative study of programs for parents with serious mental illness and their children: building practice-based evidence.

PubMed

Nicholson, Joanne; Hinden, Beth R; Biebel, Kathleen; Henry, Alexis D; Katz-Leavy, Judith

2007-10-01

The rationale for the development of effective programs for parents with serious mental illness and their children is compelling. Using qualitative methods and a grounded theory approach with data obtained in site visits, seven existing programs for parents with mental illness and their children in the United States are described and compared across core components: target population, theory and assumptions, funding, community and agency contexts, essential services and intervention strategies, moderators, and outcomes. The diversity across programs is strongly complemented by shared characteristics, the identification of which provides the foundation for future testing and the development of an evidence base. Challenges in program implementation and sustainability are identified. Qualitative methods are useful, particularly when studying existing programs, in taking steps toward building the evidence base for effective programs for parents with serious mental illness and their children.

Implications of educating the public on mental illness, violence, and stigma.

PubMed

Corrigan, Patrick W; Watson, Amy C; Warpinski, Amy C; Gracia, Gabriela

2004-05-01

This study examined how two types of public education programs influenced how the public perceived persons with mental illness, their potential for violence, and the stigma of mental illness. A total of 161 participants were randomly assigned to one of three programs: one that aimed to combat stigma, one that highlighted the association between violence and psychiatric disorders, and a control group. Participants who completed the education-about-violence program were significantly more likely to report attitudes related to fear and dangerousness, to endorse services that coerced persons into treatment and treated them in segregated areas, to avoid persons with mental illness in social situations, and to be reluctant to help persons with mental illness.

2003 Nevada Test Site Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-05-23

Annual Illness and Injury Surveillance Program report for 2003 for the Nevada Test Site. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

2003 Idaho National Engineering and Environmental Laboratory Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-05-23

Annual Illness and Injury Surveillance Program report for 2003 for Idaho National Lab. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

National Structural Survey of Veterans Affairs Home-Based Primary Care Programs.

PubMed

Karuza, Jurgis; Gillespie, Suzanne M; Olsan, Tobie; Cai, Xeuya; Dang, Stuti; Intrator, Orna; Li, Jiejin; Gao, Shan; Kinosian, Bruce; Edes, Thomas

2017-12-01

To describe the current structural and practice characteristics of the Department of Veterans Affairs (VA) Home-Based Primary Care (HBPC) program. We designed a national survey and surveyed HBPC program directors on-line using REDCap. We received 236 surveys from 394 identified HBPC sites (60% response rate). HBPC site characteristics were quantified using closed-ended formats. HBPC program directors were most often registered nurses, and HBPC programs primarily served veterans with complex chronic illnesses that were at high risk of hospitalization and nursing home care. Primary care was delivered using interdisciplinary teams, with nurses, social workers, and registered dietitians as team members in more than 90% of the sites. Most often, nurse practitioners were the principal primary care providers (PCPs), typically working with nurse case managers. Nearly 60% of the sites reported dual PCPs involving VA and community-based physicians. Nearly all sites provided access to a core set of comprehensive services and programs (e.g., case management, supportive home health care). At the same time, there were variations according to site (e.g., size, location (urban, rural), use of non-VA hospitals, primary care models used). HBPC sites reflected the rationale and mission of HBPC by focusing on complex chronic illness of home-based veterans and providing comprehensive primary care using interdisciplinary teams. Our next series of studies will examine how HBPC site structural characteristics and care models are related to the processes and outcomes of care to determine whether there are best practice standards that define an optimal HBPC structure and care model or whether multiple approaches to HBPC better serve the needs of veterans. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

Use of Mobile Phones, Computers and Internet Among Clients of an Inner-City Community Psychiatric Clinic

PubMed Central

COLDER CARRAS, MICHELLE; MOJTABAI, RAMIN; FURR-HOLDEN, C. DEBRA; EATON, WILLIAM; CULLEN, BERNADETTE A.M.

2017-01-01

Objective Recent years have witnessed an expansion of Internet- and mobile-phone-based interventions for health promotion, yet few studies have focused on the use of technology by individuals with mental illness. This study examined the extent to which patients at an inner-city community psychiatry clinic had access to information and communications technology (ICT) and how they used those resources. Methods Patients of an outpatient, inner-city community psychiatry program (N = 189) completed a survey that included questions about demographics and ICT use which were adapted from an existing local population-based health survey (community sample, N = 968). Frequencies of ICT use were assessed for the clinic sample and questions common to both the surveys completed by the clinic and community samples were compared using logistic regression. Results Among clinic cases, 105 (55.6%) reported owning or using a computer, 162 (85.7%) reported owning or using a mobile phone, and 112 (59.3%) reported using the Internet. Among those who used mobile phones, the majority reported using them daily; 42% of those who used the Internet reported using it several times per day. Differences in frequency of Internet use between samples were not significant, but clinic participants used the Internet more intensively to email, instant message, access health information, and use social media sites. Conclusions A majority of patients in this community psychiatry clinic sample use ICT. Greater access to and use of the Internet by those with mental illness has important implications for the feasibility and impact of technology-based interventions. PMID:24638044

Use of mobile phones, computers and internet among clients of an inner-city community psychiatric clinic.

PubMed

Colder Carras, Michelle; Mojtabai, Ramin; Furr-Holden, C Debra; Eaton, William; Cullen, Bernadette A M

2014-03-01

Recent years have witnessed an expansion of Internet- and mobile-phone-based interventions for health promotion, yet few studies have focused on the use of technology by individuals with mental illness. This study examined the extent to which patients at an inner-city community psychiatry clinic had access to information and communications technology (ICT) and how they used those resources. Patients of an outpatient, inner-city community psychiatry program (N=189) completed a survey that included questions about demographics and ICT use which were adapted from an existing local population-based health survey (community sample, N=968). Frequencies of ICT use were assessed for the clinic sample and questions common to both the surveys completed by the clinic and community samples were compared using logistic regression. Among clinic cases, 105 (55.6%) reported owning or using a computer, 162 (85.7%) reported owning or using a mobile phone, and 112 (59.3%) reportedf using the Internet. Among those who used mobile phones, the majority reported using them daily; 42% of those who used the Internet reported using it several times per day. Differences in frequency of Internet use between samples were not significant, but clinic participants used the Internet more intensively to email, instant message, access health information, and use social media sites. A majority of patients in this community psychiatry clinic sample use ICT. Greater access to and use of the Internet by those with mental illness has important implications for the feasibility and impact of technology-based interventions.

Health and Social Security Needs of Rickshaw Pullers in Ranchi.

PubMed

Kumar, Anant; Thomas, Joe; Wadhwa, Sonal S; Mishra, Aprajita; Dasgupta, Smita

2016-07-01

A significant number of "marginalized" population groups are denied their health rights, healthcare access, benefits of government health programs, and other health-related social security benefits. These population groups, particularly the rickshaw pullers of India, are vulnerable because of their poor social and economic status, migration history, lack of permanent settlements, lack of social capital, and so on. These reasons, coupled with other social-political reasons, lead to no or limited access to health services and poor health conditions. This study intends to explore and understand the context and health seeking behavior of rickshaw pullers in Ranchi, the capital city of Jharkhand state in India, with special reference to wider social determinants of health such as, access, affordability, and delivery of health services. The data was collected from 1,000 rickshaw pullers from 40 "rickshaw garages" in Ranchi. The findings of the study show that rickshaw pullers can't afford to "attach" much importance to their health due to various reasons and suffer from a variety of occupational and other illnesses. The health conditions of the rickshaw pullers are affected by poverty, negligence, illiteracy, lack of awareness and unavailability of affordable, quality health services. These are only a symptom of the larger structural issues affecting health. The study suggests that rickshaw pullers, being a marginalized and excluded population group, require special health and social security programs that include safe, affordable, and accessible services along with a special focus on health education, behavior change, and promotion of appropriate health-seeking behavior.

Promising Practices for Making Recreation Programming Matter for People who Experience Mental Illness.

PubMed

Hutchinson, Susan L; Fenton, Lara

2018-05-01

There is merit in understanding how recreation-oriented programs for adults living with mental illness address barriers to participation and how programming is structured to create safe and inclusive environments, resulting in programming that amplifies the benefits of recreation for mental well-being. Following an environmental scan of programs targeting adults living with mental illness in Canada, ten coordinators in community mental health settings were interviewed. Four themes were constructed to reflect characteristics deemed to be 'promising practices' related to recreation-oriented programming: (a) barriers and solutions to individual participation, (b) characteristics of welcoming and supportive environments, (c) leadership characteristics, and (d) program characteristics.

["Nicht von schlechten Eltern - NischE": A Family Orientated Collaborative Care Approach to Support Children in Families with Mentally Ill Parents].

PubMed

Wabnitz, Pascal; Kronmüller, Klaus-Thomas; Wieskus-Friedemann, Erwin; Kliem, Sabine; Hoppmann, Johannes; Burek, Monika; Löhr, Michael; Kemper, Ulrich; Nienaber, André

2016-11-01

"Nicht von schlechten Eltern - NischE": A Family Orientated Collaborative Care Approach to Support Children in Families with Mentally Ill Parents The present work describes the setting- and multi-professional offer "NischE" in Gütersloh, a systemic approach for the care of children and their mentally ill parents. Children of mentally ill parents are a special risk group for developing their own mental illness. The aim of the collaborative care model between child and adolescent psychiatry, youth services and adult psychiatry is to enable affected families in terms of family-focused practice a low threshold access to different services. For this purpose, two positions have been created to advise the affected families and support access to the help system in the sense of a systemic case management in a project. The article describes the background and the need for the development of the offer, the current scientific knowledge base on the subject and illustrates the procedure using a case study from practice.

Novel technology as platform for interventions for caregivers and individuals with severe mental health illnesses: A systematic review.

PubMed

Meyer, Thomas D; Casarez, Rebecca; Mohite, Satyajit S; La Rosa, Nikki; Iyengar, M Sriram

2018-01-15

Severe mental illnesses (SMIs) have been found to be associated with both increases in morbidity-mortality, need for treatment care in patients themselves, and burden for relatives as caregivers. A growing number of web-based and mobile software applications have appeared that aim to address various barriers with respect to access to care. Our objective was to review and summarize recent advancements in such interventions for caregivers of individuals with a SMI. We conducted a systematic search for papers evaluating interactive mobile or web-based software (using no or only minimal support from a professional) specifically aimed at supporting informal caregivers. We also searched for those supporting patients with SMI so as to not to miss any which might include relatives. Out of a total of 1673 initial hits, we identified 11 articles reporting on 9 different mobile or web-based software programs. The main result is that none of those studies focused on caregivers, and the ones we identified using mobile or web-based applications were just for patients and not their relatives. Differentiating between online and offline available software might not always have been totally reliable, and we might have therefore missed some studies. In summary, the studies provided evidence that remotely accessible interventions for patients with SMI are feasible and acceptable to patients. No such empirically evaluated program was available for informal caregivers such as relatives. Keeping in mind the influential role of those informal caregivers in the process of treatment and self-management, this is highly relevant for public health. Supporting informal caregivers can improve well-being of both caregivers and patients. Copyright © 2017 Elsevier B.V. All rights reserved.

Do Parent Mental Illness and Family Living Arrangement Moderate the Effects of the Aussie Optimism Program on Depression and Anxiety in Children?

PubMed

Cheng, Maryanne; Rooney, Rosanna M; Kane, Robert T; Hassan, Sharinaz; Baughman, Natalie

2018-01-01

Parent mental illness and family living arrangement are associated with depression and anxiety in children, and may influence the effects of programs that aim to prevent these disorders. This study investigated whether these family context factors moderated the intervention effects of the enhanced Aussie Optimism Positive Thinking Skills program on depression and anxiety in primary school children. The intervention was a universal, cognitive-behavioral program, with a one hour session each week for 10 weeks, delivered by trained teachers. The participants were 502 children from 13 private schools, aged 9-11, with 347 in the intervention group and 155 in the control group. There were 267 females and 235 males. Data from 502 parents was also included. A cluster randomized controlled trial design was used, including eight intervention schools and five control schools. Depression and anxiety were assessed at pre-test, post-test, and 6-months follow-up. Information on parent mental illness and family living arrangement was collected through a parent questionnaire. The data was analyzed using covariance analysis with Generalized Linear Mixed Methods. At baseline, depressive and anxiety symptoms did not differ significantly based on parent mental illness. Symptoms of depression at baseline were significantly higher for children from a higher-risk family living arrangement, but anxiety symptoms were not. Parent mental illness and family living arrangement did not moderate the effects of the program on depression and anxiety at post-test or 6-months follow-up. Parent mental illness moderated the intervention effects on negative self-esteem, an aspect of depression, at post-test, with improvements seen only for children who did not have a parent with a mental illness. The findings indicate an association between family living arrangement and depressive symptoms in children. The findings suggest that the program is effective for children regardless of parent mental illness or family living arrangement, although parent mental illness has the capacity to influence the program's outcomes.

Describing and analysing primary health care system support for chronic illness care in Indigenous communities in Australia's Northern Territory - use of the Chronic Care Model.

PubMed

Si, Damin; Bailie, Ross; Cunningham, Joan; Robinson, Gary; Dowden, Michelle; Stewart, Allison; Connors, Christine; Weeramanthri, Tarun

2008-05-28

Indigenous Australians experience disproportionately high prevalence of, and morbidity and mortality from chronic illness such as diabetes, renal disease and cardiovascular disease. Improving the understanding of how Indigenous primary care systems are organised to deliver chronic illness care will inform efforts to improve the quality of care for Indigenous people. This cross-sectional study was conducted in 12 Indigenous communities in Australia's Northern Territory. Using the Chronic Care Model as a framework, we carried out a mail-out survey to collect information on material, financial and human resources relating to chronic illness care in participating health centres. Follow up face-to-face interviews with health centre staff were conducted to identify successes and difficulties in the systems in relation to providing chronic illness care to community members. Participating health centres had distinct areas of strength and weakness in each component of systems: 1) organisational influence - strengthened by inclusion of chronic illness goals in business plans, appointment of designated chronic disease coordinators and introduction of external clinical audits, but weakened by lack of training in disease prevention and health promotion and limited access to Medicare funding; 2) community linkages - facilitated by working together with community organisations (e.g. local stores) and running community-based programs (e.g. "health week"), but detracted by a shortage of staff especially of Aboriginal health workers working in the community; 3) self management - promoted through patient education and goal setting with clients, but impeded by limited focus on family and community-based activities due to understaffing; 4) decision support - facilitated by distribution of clinical guidelines and their integration with daily care, but limited by inadequate access to and support from specialists; 5) delivery system design - strengthened by provision of transport for clients to health centres, separate men's and women's clinic rooms, specific roles of primary care team members in relation to chronic illness care, effective teamwork, and functional pathology and pharmacy systems, but weakened by staff shortage (particularly doctors and Aboriginal health workers) and high staff turnover; and 6) clinical information systems - facilitated by wide adoption of computerised information systems, but weakened by the systems' complexity and lack of IT maintenance and upgrade support. Using concrete examples, this study translates the concept of the Chronic Care Model (and associated systems view) into practical application in Australian Indigenous primary care settings. This approach proved to be useful in understanding the quality of primary care systems for prevention and management of chronic illness. Further refinement of the systems should focus on both increasing human and financial resources and improving management practice.

20 CFR 30.200 - What is the scope of this subpart?

Code of Federal Regulations, 2013 CFR

2013-04-01

... EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Eligibility Criteria General... for eligibility for benefits for claims under Part B of EEOICPA relating to covered beryllium illness...

A Critical Review of OSHA Heat Enforcement Cases: Lessons Learned.

PubMed

Arbury, Sheila; Lindsley, Matthew; Hodgson, Michael

2016-04-01

The aim of the study was to review the Occupational Safety and Health Administration's (OSHA) 2012 to 2013 heat enforcement cases, using identified essential elements of heat illness prevention to evaluate employers' programs and make recommendations to better protect workers from heat illness. (1) Identify essential elements of heat illness prevention; (2) develop data collection tool; and (3) analyze OSHA 2012 to 2013 heat enforcement cases. OSHA's database contains 84 heat enforcement cases in 2012 to 2013. Employer heat illness prevention programs were lacking in essential elements such as providing water and shade; adjusting the work/rest proportion to allow for workload and effective temperature; and acclimatizing and training workers. In this set of investigations, most employers failed to implement common elements of illness prevention programs. Over 80% clearly did not rely on national standard approaches to heat illness prevention.

20 CFR 30.10 - Are all OWCP records relating to claims filed under EEOICPA considered confidential?

Code of Federal Regulations, 2012 CFR

2012-04-01

...' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT...

20 CFR 30.10 - Are all OWCP records relating to claims filed under EEOICPA considered confidential?

Code of Federal Regulations, 2014 CFR

2014-04-01

...' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT...

20 CFR 30.10 - Are all OWCP records relating to claims filed under EEOICPA considered confidential?

Code of Federal Regulations, 2010 CFR

2010-04-01

...' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT...

20 CFR 30.10 - Are all OWCP records relating to claims filed under EEOICPA considered confidential?

Code of Federal Regulations, 2013 CFR

2013-04-01

...' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT...

20 CFR 30.10 - Are all OWCP records relating to claims filed under EEOICPA considered confidential?

Code of Federal Regulations, 2011 CFR

2011-04-01

...' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT...

Symptoms of Mental Illness and Their Impact on Managing Type 2 Diabetes in Adults.

PubMed

Cimo, Adriana; Dewa, Carolyn S

2017-11-08

People with mental illnesses are more likely to experience diabetes-related complications that can reduce life expectancy by 10 to 15 years. Diabetes management and outcomes can be improved when lifestyle interventions addressing healthful eating habits and physical activity use content tailored to the learning needs of individuals or groups. Understanding the challenges that prevent adherence to diabetes recommendations can start to inform the design of tailored diabetes education care. The purpose of this pilot study was to explore the perspectives of clients with mental illnesses and type 2 diabetes with regard to challenges faced when engaging in diabetes self-care behaviours. Focus groups were held with 17 people who had type 2 diabetes and mental illnesses, including depressive disorder, bipolar disorder, anxiety disorder, schizophrenia and schizoaffective disorder. In the groups, participants were asked to share their experiences with diabetes self-care and access to diabetes-education services. Data were transcribed verbatim, assessed for quality and saturation and coded to identify relationships and meanings among identified themes. Participants identified many challenges and unmet needs that created multidimensional and interrelated barriers to care, ultimately resulting in poor diabetes self-care behaviours. Some challenges were psychological in nature and related to emotional states, lifestyles and food habits, perceptions of affordability, health literacy and value of health information. Other challenges included the physical states of health and social environments. Multidimensional diabetes education programs that consider psychological, physical and social challenges are needed to address the needs of people with mental illnesses. Copyright © 2017. Published by Elsevier Inc.

Cancer initiatives in developing countries.

PubMed

Mellstedt, H

2006-06-01

The coming decades will bring dramatic increases in morbidity and mortality from cancer in the developing world. The burden of cancer is increasing globally, with an expected 20 million new cases per year in 2020, half of which will be in low- and middle-income countries. Despite an already overwhelming burden of health problems, developing countries must somehow address this cancer pandemic and their alarming share of cancer illness. Many large-scale and innovative worldwide initiatives have been launched in the fight against cancer. These programs represent colossal efforts to expand resources for health education among people and healthcare workers in developing countries and to increase awareness of cancer prevention. Many novel evidence-based and culturally-relevant programs are being implemented for screening and early prevention of common cancers. Several key initiatives are supporting clinical research, guideline development, oncology training, and appropriate technology transfer, such as access to electronic medical literature. Treatment programs are expanding access and quality of radiologic and pharmacologic therapies for cancer. These initiatives represent an unprecedented level of and cooperation among international agencies, governmental and nongovernmental organizations, international foundations, scientific societies, local institutions, and industry. This review examines the scope of need in response to the increasing burden of cancer in the developing world and major initiatives that have been created to respond to these needs.

A program for thai rubber tappers to improve the cost of occupational health and safety.

PubMed

Arphorn, Sara; Chaonasuan, Porntip; Pruktharathikul, Vichai; Singhakajen, Vajira; Chaikittiporn, Chalermchai

2010-01-01

The purposes of this research were to determine the cost of occupational health and safety and work-related health problems, accidents, injuries and illnesses in rubber tappers by implementing a program in which rubber tappers were provided training on self-care in order to reduce and prevent work-related accidents, injuries and illnesses. Data on costs for healthcare, the prevention and the treatment of work-related accidents, injuries and illnesses were collected by interview using a questionnaire. The findings revealed that there was no relationship between what was spent on healthcare and the prevention of work-related accidents, injuries and illnesses and that spent on the treatment of work-related accidents, injuries and illnesses. The proportion of the injured subjects after the program implementation was significantly less than that before the program implementation (p<0.001). The level of pain after the program implementation was significantly less than that before the program implementation (p<0.05). The treatment costs incurred after the program implementation were significantly less than those incurred before the program implementation (p<0.001). It was demonstrated that this program raised the health awareness of rubber tappers. It strongly empowered the leadership in health promotion for the community.

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

Annual Illness and Injury Surveillance Program for 2004 for the Hanford site. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

Predictors of mental illness stigma and attitudes among college students: using vignettes from a campus common reading program.

PubMed

Feeg, Veronica D; Prager, Laura S; Moylan, Lois B; Smith, Kathleen Maurer; Cullinan, Meritta

2014-09-01

Research has demonstrated that stigmatizing mentally ill individuals is prevalent and often results in lack of adherence to or avoidance of treatment. The present study sought to examine attitudes of college students regarding mental illness as part of a campus-wide "common readings" program. The book selected was a non-fiction account of a young girl with mental illness and the program was developed to initiate dialogue about young people with mental problems. Faculty from multiple disciplines collaborated on the project. A sample of 309 students completed a web-based survey after reading a vignette about an adolescent girl with mental illness. The vignette description was based on a character in the book selected in the program. The instruments measured attribution of stigma, social distance, and familiarity with people who have mental illness. Results demonstrated that younger students and those who are less familiar with mental illness were more likely to stigmatize and maintain social distance from those who are mentally ill. Awareness of the study findings can assist health professionals and mental health workers to identify interventions that can decrease stigma. Psychiatric mental health nurses are well positioned to lead the education effort aimed at reducing stigmatizing attitudes among the public.

The feasibility of implementing cognitive remediation for work in community based psychiatric rehabilitation programs.

PubMed

McGurk, Susan R; Mueser, Kim T; Watkins, Melanie A; Dalton, Carline M; Deutsch, Heather

2017-03-01

Adding cognitive remediation to vocational rehabilitation services improves cognitive and work functioning in people with serious mental illness, but despite interest, the uptake of cognitive programs into community services has been slow. This study evaluated the feasibility of implementing an empirically supported cognitive remediation program in routine rehabilitation services at 2 sites. The Thinking Skills for Work (TSW) program was adapted for implementation at 2 sites of a large psychiatric rehabilitation agency providing prevocational services, but not community-based vocational services, which were provided off-site. Agency staff were trained to deliver TSW to clients with work or educational goals. Cognitive assessments were conducted at baseline and posttreatment, with work and school activity tracked for 2 years. Eighty-three participants enrolled in TSW, of whom 79.5% completed at least 6 of the 24 computer cognitive exercise sessions (M = 16.7) over an average of 18 weeks. Participants improved significantly from baseline to posttreatment in verbal learning and memory, speed of processing, and overall cognitive functioning. Over the follow-up, 25.3% of participants worked and 47.0% were involved in work or school activity. Higher work rates were observed at the site where participants had easier access to vocational services. The results support the feasibility of implementing the TSW program by frontline staff in agencies providing psychiatric rehabilitation, and suggest that ease of access to vocational services may influence work outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Accountability for the Quality of Care Provided to People with Serious Illness

PubMed Central

Hudson Scholle, Sarah; Briefer French, Jessica

2018-01-01

Abstract Background: Care for patients with serious illness is an emerging practice area that has gained attention as value-based purchasing has increased. While the number of programs is growing, their impact on care quality and outcomes is unknown. Objective: With support from the Gordon and Betty Moore Foundation, the National Committee for Quality Assurance (NCQA) is assessing the feasibility of creating an accountability program focused on serious illness care. Methods: This article describes the process of developing an accountability program, findings from our initial work, and our plans to develop measures for a serious illness care accountability program. We focused on three questions: 1. What patient populations should be targeted for measurement?2. What entities have accountability for ensuring high-quality care for serious illness?3. What structures, processes, and outcomes should be evaluated in an accountability program for serious illness care? Results: Our environmental scan showed that the evidence base for specific patient populations or care models is not sufficiently mature to justify traditional structure and process measures. In visits to serious illness care programs, we observed different staffing models, care models, care settings, and payment structures. We found a gap between recommended inclusion criteria and services when compared to inclusion criteria and services offered by existing programs. Conclusions: To address the challenges, NCQA intends to develop outcome measures driven by patient and family priorities. Structure and process measures will focus on building organizations' capacity to measure outcomes, including patient engagement and outcomes, linked to patient goals. PMID:29313755

20 CFR 30.506 - To whom and in what manner will OWCP pay compensation?

Code of Federal Regulations, 2010 CFR

2010-04-01

... LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Survivors... Part B of the Act, compensation for any consequential injury, illness, impairment or disease is limited...

Who's afraid of national laws? Pesticide corporations use trade negotiations to avoid bans and undercut public health protections in Central America.

PubMed

Rosenthal, Erika

2005-01-01

The agrochemical industry is using trade agreements to block proposed bans on pesticides identified as the worst occupational health hazards by a multi-country illness surveillance program in Central America. Through privileged access to closed-door negotiations, industry inserted deregulatory mechanisms, including a regional pesticide registry that invalidates national laws, investors' rights protection, and increased intellectual property protections, into the draft Central American Customs Union and the Central American Free Trade Agreement. These agreements undermine health-based national pesticide registration requirements; weaken health ministries' role in pesticide control; block marketing of cheaper, less toxic pesticides; and have a chilling effect on future pesticide regulatory activity. So long as corporations have privileged access to the trade negotiations and civil society is excluded, the resulting agreements will benefit special interests at the expense of public health.

Mobile health (mHealth) for mental health in Asia: objectives, strategies, and limitations.

PubMed

Brian, Rachel M; Ben-Zeev, Dror

2014-08-01

Mobile technologies are transforming the way in which we interact with one another, access resources, find information, and conduct business around the world. Harnessing the capabilities of mobile technologies to support health care initiatives worldwide has developed into a new interdisciplinary field called mobile health (mHealth). In the current paper, we review the penetration of mobile technology in Asia, and consider the integration of mobile technologies into the study, diagnoses, and treatment of mental disorders in the region. We outline how mHealth programs could improve mental health literacy, provide greater access to mental health services, extend community-based outreach and engagement, support self-management of illness, and regulate medication distribution. We end with a consideration of the potential barriers and limitations of mHealth for mental health, including funding, language and literacy barriers, power supply considerations, data security, and privacy issues. Copyright © 2014 Elsevier B.V. All rights reserved.

Use of a High-Flow Oxygen Delivery System in a Critically Ill Patient with Dementia

DTIC Science & Technology

2008-12-01

February 1, 2007. http://www.fda.gov/ cdrh /safety/ 020107_vapotherm.html. Accessed October 7, 2008. HIGH-FLOW OXYGEN IN A CRITICALLY ILL PATIENT WITH DEMENTIA RESPIRATORY CARE • DECEMBER 2008 VOL 53 NO 12 1743

Mental illness stigma and disclosure in college students.

PubMed

Corrigan, Patrick W; Kosyluk, Kristin A; Markowitz, Fred; Brown, Robyn Lewis; Conlon, Bridget; Rees, Jo; Rosenberg, Jessica; Ellefson, Sarah; Al-Khouja, Maya

2016-06-01

The aim of this study was to investigate the relationship between mental illness identity, shame, secrecy, public stigma, and disclosure amongst college students. Participants included 1393 college students from five postsecondary institutions. Structural equation modeling was used to examine two path models predicting disclosure and desire to join a program aiding with disclosure. Variables found to be significant in predicting disclosure included mental illness identity and public stigma. In turn, desire for disclosure predicted desire to join a program aiding in disclosure. Gender and race/ethnic differences were observed, with men and Whites more likely to want to disclose a mental illness or join a program aiding with disclosure compared with women and non-Whites, respectively. These findings suggest that some college students may find programs aiding in disclosure useful in assisting them to achieve their desire to be "out" with their mental illness.

A longitudinal study of administrative segregation.

PubMed

O'Keefe, Maureen L; Klebe, Kelli J; Metzner, Jeffrey; Dvoskin, Joel; Fellner, Jamie; Stucker, Alysha

2013-01-01

The use of administrative segregation for inmates with and without mental illness has generated considerable criticism. Segregated inmates are locked in single cells for 23 hours per day, are subjected to rigorous security procedures, and have restricted access to programs. In this study, we examined whether inmates in segregation would show greater deterioration over time on psychological symptoms than would comparison offenders. The subjects were male inmates, with and without mental illness, in administrative segregation, general population, or special-needs prison. Subjects completed the Brief Symptom Inventory at regular intervals for one year. Results showed differentiation between groups at the outset and statistically significant but small positive change over time across all groups. All groups showed the same change pattern such that there was not the hypothesized differential change of inmates within administrative segregation. This study advances the empirical research, but replication research is needed to make a better determination of whether and under what conditions harm may or may not occur to inmates in solitary confinement.

Psychoeducational and Cognitive Behavioral Treatment Programs: Implementation and Evaluation From 1995 to 2015 in Kraepelin's Former Hospital.

PubMed

Schaub, Annette; Hippius, Hanns; Möller, Hans-Jürgen; Falkai, Peter

2016-07-01

Programs that view individuals as capable of taking an active role in managing their illness have gained importance in Europe and the United States. This article describes the implementation and evaluation of group psychoeducational and cognitive behavioral treatment programs at the Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany, over the past 20 years. Implementing psychoeducational programs was the first step to establish cognitive behavioral psychotherapy and dispel the myth of schizophrenia for patients. Programs are also provided for patients with mood disorders, substance use disorders, or both. These groups include topics such as psychoeducation about the illness, establishing rewarding activities, stress management, cognitive therapy, and relapse prevention. More than 1000 patients with schizophrenia or mood disorders (380 schizophrenia, 563 major depression, and 110 bipolar) have participated in illness management groups to learn about their illness and its treatment, and to learn skills to manage their illness. Patients have expressed satisfaction with the programs, and research has supported their effectiveness. Individuals with severe disorders can benefit from psychoeducational and cognitive treatment programs if the programs are adapted to the level of neuropsychological functioning and compensate for cognitive deficits and emotional overload. These findings suggest that providing information about the illness and coping skills for patients and relatives are important for treatment outcome. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

20 CFR 30.303 - What information may OWCP request in connection with a claim under Part E of EEOICPA?

Code of Federal Regulations, 2014 CFR

2014-04-01

...' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT...

20 CFR 30.303 - What information may OWCP request in connection with a claim under Part E of EEOICPA?

Code of Federal Regulations, 2012 CFR

2012-04-01

...' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT...

20 CFR 30.16 - What penalties may be imposed in connection with a claim under the Act?

Code of Federal Regulations, 2013 CFR

2013-04-01

... PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS...

20 CFR 30.303 - What information may OWCP request in connection with a claim under Part E of EEOICPA?

Code of Federal Regulations, 2010 CFR

2010-04-01

...' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT...

20 CFR 30.303 - What information may OWCP request in connection with a claim under Part E of EEOICPA?

Code of Federal Regulations, 2013 CFR

2013-04-01

...' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT...

20 CFR 30.303 - What information may OWCP request in connection with a claim under Part E of EEOICPA?

Code of Federal Regulations, 2011 CFR

2011-04-01

...' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT...

Estimating earnings losses due to mental illness: a quantile regression approach.

PubMed

Marcotte, Dave E; Wilcox-Gök, Virginia

2003-09-01

The ability of workers to remain productive and sustain earnings when afflicted with mental illness depends importantly on access to appropriate treatment and on flexibility and support from employers. In the United States there is substantial variation in access to health care and sick leave and other employment flexibilities across the earnings distribution. Consequently, a worker's ability to work and how much his/her earnings are impeded likely depend upon his/her position in the earnings distribution. Because of this, focusing on average earnings losses may provide insufficient information on the impact of mental illness in the labor market. In this paper, we examine the effects of mental illness on earnings by recognizing that effects could vary across the distribution of earnings. Using data from the National Comorbidity Survey, we employ a quantile regression estimator to identify the effects at key points in the earnings distribution. We find that earnings effects vary importantly across the distribution. While average effects are often not large, mental illness more commonly imposes earnings losses at the lower tail of the distribution, especially for women. In only one case do we find an illness to have negative effects across the distribution. Mental illness can have larger negative impacts on economic outcomes than previously estimated, even if those effects are not uniform. Consequently, researchers and policy makers alike should not be placated by findings that mean earnings effects are relatively small. Such estimates miss important features of how and where mental illness is associated with real economic losses for the ill.

Mental illness-related stigma in healthcare

PubMed Central

Mantler, Ed; Szeto, Andrew

2017-01-01

Mental illness-related stigma, including that which exists in the healthcare system and among healthcare providers, creates serious barriers to access and quality care. It is also a major concern for healthcare practitioners themselves, both as a workplace culture issue and as a barrier for help seeking. This article provides an overview of the main barriers to access and quality care created by stigmatization in healthcare, a consideration of contributing factors, and a summary of Canadian-based research into promising practices and approaches to combatting stigma in healthcare environments. PMID:28929889

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

Annual Illness and Injury Surveillance Program report for 2003 for the East Tennessee Technology Park (K-25).The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

Evaluation of a family systems intervention for managing pediatric chronic illness: Mastering Each New Direction (MEND).

PubMed

Distelberg, Brian; Williams-Reade, Jackie; Tapanes, Daniel; Montgomery, Susanne; Pandit, Mayuri

2014-06-01

Family systems play a crucial, albeit complex, role in pediatric chronic illness. Unfortunately, very few psychosocial interventions are available to help these stressed families navigate the developmental steps of chronic illness. A new intervention (MEND) addresses the needs of these families and applies to a broad range of chronic illnesses. This article presents this family systems intervention as well as includes preliminary program evaluation data on 22 families that graduated from the program. Results show consistently strong effects across an array of psychosocial measures. Conclusions from this preliminary study suggest that families entering MEND present with high levels of stress due to the child's chronic illness, but after MEND, the level of stress and other functioning measures are comparable to those seen in healthy families, suggesting that the program offers a significant benefit to families with pediatric chronic illness. © 2014 FPI, Inc.

Evaluation of a Family Systems Intervention for Managing Pediatric Chronic Illness: Mastering Each New Direction (MEND)

PubMed Central

Distelberg, Brian; Williams-Reade, Jackie; Tapanes, Daniel; Montgomery, Susanne; Pandit, Mayuri

2015-01-01

Family systems play a crucial, albeit complex, role in pediatric chronic illness. Unfortunately, very few psychosocial interventions are available to help these stressed families navigate the developmental steps of chronic illness. A new intervention (MEND) addresses the needs of these families and applies to a broad range of chronic illnesses. This article presents this family systems intervention as well as includes preliminary program evaluation data on 22 families that graduated from the program. Results show consistently strong effects across an array of psychosocial measures. Conclusions from this preliminary study suggest that families entering MEND present with high levels of stress due to the child's chronic illness, but after MEND, the level of stress and other functioning measures are comparable to those seen in healthy families, suggesting that the program offers a significant benefit to families with pediatric chronic illness. PMID:24635346

Parents' help-seeking behaviours during acute childhood illness at home: A contribution to explanatory theory.

PubMed

Neill, Sarah J; Jones, Caroline H D; Lakhanpaul, Monica; Roland, Damian T; Thompson, Matthew J

2016-03-01

Uncertainty and anxiety surround parents' decisions to seek medical help for an acutely ill child. Consultation rates for children are rising, yet little is known about factors that influence parents' help-seeking behaviours. We used focus groups and interviews to examine how 27 parents of children under five years, from a range of socioeconomic groups in the East Midlands of England, use information to make decisions during acute childhood illness at home. This article reports findings elucidating factors that influence help-seeking behaviours. Parents reported that decision-making during acute childhood illness was influenced by a range of personal, social and health service factors. Principal among these was parents' concern to do the right thing for their child. Their ability to assess the severity of the illness was influenced by knowledge and experience of childhood illness. When parents were unable to access their general practitioner (GP), feared criticism from or had lost trust in their GP, some parents reported using services elsewhere such as Accident and Emergency. These findings contribute to explanatory theory concerning parents' help-seeking behaviours. Professional and political solutions have not reduced demand; therefore, collaborative approaches involving the public and professionals are now needed to improve parents' access to information. © The Author(s) 2014.

29 CFR 1904.36 - Prohibition against discrimination.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR RECORDING AND REPORTING OCCUPATIONAL INJURIES AND ILLNESSES Other OSHA Injury and Illness... provision of the Act also protects the employee who files a safety and health complaint, asks for access to...

29 CFR 1904.36 - Prohibition against discrimination.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR RECORDING AND REPORTING OCCUPATIONAL INJURIES AND ILLNESSES Other OSHA Injury and Illness... provision of the Act also protects the employee who files a safety and health complaint, asks for access to...

Web-Based Psychoeducation Program for Caregivers of First-Episode of Psychosis: An Experience of Chinese Population in Hong Kong.

PubMed

Chan, Sherry K W; Tse, Samson; Sit, Harrison Long Tin; Hui, Christy L M; Lee, Edwin H M; Chang, Wing C; Chen, Eric Y H

2016-01-01

Caregivers of patients with first-episode psychosis are often with little knowledge about the illness and experience more burden of care. Psychoeducation to caregivers has shown to be effective in improving outcomes of patients and possibly reduce stress of the caregivers. This has been recommended as one of the key psychosocial interventions for specific early intervention for psychosis service. However, the accessibility of the service, high case load of the health care professionals and self-stigma of caregivers are often the barriers of implementation of these programs in the real world. Incorporating the convenience of information access via internet and the concept of self-management approach, an interactive internet-based self-help psychoeducation program (iPEP) (www.ipep.hk) for the caregivers of patients with psychosis was established targeting the caregivers of patients with psychosis at early stage in Hong Kong. It provides a comprehensive online resource center in both written and video format on knowledge about psychosis, skills of care, and information of local resources. It also has a forum facilitate information exchange between healthcare professionals and the caregivers, allowing for self-management. Over 800 caregivers have joined the program as members. The evaluation of the subset of the members/users of the iPEP suggested that the iPEP program has been well received and appreciated by the caregivers of patients with first episode psychosis locally. It can potentially serve as a platform for future development of specific manual-based psychoeducation program for caregivers targeting at the needs of different groups.

Web-Based Psychoeducation Program for Caregivers of First-Episode of Psychosis: An Experience of Chinese Population in Hong Kong

PubMed Central

Chan, Sherry K. W.; Tse, Samson; Sit, Harrison Long Tin; Hui, Christy L. M.; Lee, Edwin H. M.; Chang, Wing C.; Chen, Eric Y. H.

2016-01-01

Caregivers of patients with first-episode psychosis are often with little knowledge about the illness and experience more burden of care. Psychoeducation to caregivers has shown to be effective in improving outcomes of patients and possibly reduce stress of the caregivers. This has been recommended as one of the key psychosocial interventions for specific early intervention for psychosis service. However, the accessibility of the service, high case load of the health care professionals and self-stigma of caregivers are often the barriers of implementation of these programs in the real world. Incorporating the convenience of information access via internet and the concept of self-management approach, an interactive internet-based self-help psychoeducation program (iPEP) (www.ipep.hk) for the caregivers of patients with psychosis was established targeting the caregivers of patients with psychosis at early stage in Hong Kong. It provides a comprehensive online resource center in both written and video format on knowledge about psychosis, skills of care, and information of local resources. It also has a forum facilitate information exchange between healthcare professionals and the caregivers, allowing for self-management. Over 800 caregivers have joined the program as members. The evaluation of the subset of the members/users of the iPEP suggested that the iPEP program has been well received and appreciated by the caregivers of patients with first episode psychosis locally. It can potentially serve as a platform for future development of specific manual-based psychoeducation program for caregivers targeting at the needs of different groups. PMID:28082935

20 CFR 30.103 - How does a claimant make sure that OWCP has the evidence necessary to process the claim?

Code of Federal Regulations, 2013 CFR

2013-04-01

... WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION... substitute forms. Form No. Title (1) EE-1 Claim for Benefits Under the Energy Employees Occupational Illness...

Psychometrics of the MHSIP Adult Consumer Survey.

PubMed

Jerrell, Jeanette M

2006-10-01

The reliability and validity of the Mental Health Statistics Improvement Program (MHSIP) Adult Consumer Survey were assessed in a statewide convenience sample of 459 persons with severe mental illness served through a public mental health system. Consistent with previous findings and the intent of its developers, three factors were identified that demonstrate good internal consistency, moderate test-retest reliability, and good convergent validity with consumer perceptions of other aspects of their care. The reliability and validity of the MHSIP Adult Consumer Survey documented in this study underscore its scientific and practical utility as an abbreviated tool for assessing access, quality and appropriateness, and outcome in mental health service systems.

Remote access to medical specialists: home care interactive patient management system

NASA Astrophysics Data System (ADS)

Martin, Peter J.; Draghic, Nicole; Wiesmann, William P.

1999-07-01

Diabetes management involves constant care and rigorous compliance. Glucose control is often difficult to maintain and onset of complications further compound health care needs. Status can be further hampered by geographic isolation from immediate medical infrastructures. The Home Care Interactive Patient Management System is an experimental telemedicine program that could improve chronic illness management through Internet-based applications. The goal of the system is to provide a customized, integrated approach to diabetes management to supplement and coordinate physician protocol while supporting routine patient activity, by supplying a set of customized automated services including health data collection, transmission, analysis and decision support.

Self care programs and multiple sclerosis: physical therapeutics treatment - literature review.

PubMed

Demaille-Wlodyka, S; Donze, C; Givron, P; Gallien, P

2011-03-01

To clarify the therapeutic education program impact with multiple sclerosis patients, literature review. Highlight contents and efficacy. A non-systematic review on Medline, PubMed and Cochrane library databases from 1966 to 2010 using the following keywords: "multiple sclerosis", "self-care", "self-management" and specific symptoms keywords. Clinical trials and randomized clinical trials, as well as literature reviews published in English, French and German will be analyzed. Counseling is a part of the non-pharmacological management of chronic illnesses such as multiple sclerosis. Symptoms' diversity and the different clinical forms limit standardized programs of self-care management, applicable to patients. In the literature review, counseling programs have often low metrology. A behavior change with patients and medical staff could exist. To empower the patient, to reduce symptoms' impact and to improve treatment access are the aims of educational therapy. Therapeutic education program for multiple sclerosis patients could progress with their standardization and assessment, for each sign. To promote the educational therapy of multiple sclerosis patients, a specific training for medical staff, as specific financing are necessary. 2011 Elsevier Masson SAS. All rights reserved.

Law & psychiatry: Gun laws and mental illness: how sensible are the current restrictions?

PubMed

Appelbaum, Paul S; Swanson, Jeffrey W

2010-07-01

This column describes federal and state laws to restrict access to firearms among people with mental illness. The contribution to public safety of these laws is likely to be small because only 3%-5% of violent acts are attributable to serious mental illness, and most do not involve guns. The categories of persons with mental illnesses targeted by the laws may not be at higher risk of violence than other subgroups in this population. The laws may deter people from seeking treatment for fear of losing the right to possess firearms and may reinforce stereotypes of persons with mental illnesses as dangerous.

Chart Card: feasibility of a tool for improving emergency department care in sickle cell disease.

PubMed

Neumayr, Lynne; Pringle, Steven; Giles, Stephen; Quirolo, Keith C; Paulukonis, Susan; Vichinsky, Elliott P; Treadwell, Marsha J

2010-11-01

Patients with sickle cell disease (SCD) are concerned with emergency department care, including time to treatment and staff attitudes and knowledge. Providers are concerned about rapid access to patient information and SCD treatment protocols. A software application that stores and retrieves encrypted personal medical information on a plastic credit card-sized Chart Card was designed. To determine the applicability and feasibility of the Chart Card on patient satisfaction with emergency department care and provider accessibility to patient information and care protocols. One-half of 44 adults (aged -18 years) and 50 children with SCD were randomized to either the Chart Card or usual care. Patient satisfaction was surveyed pre and post implementation of the Chart Card program, and emergency department staff was surveyed about familiarity with SCD treatment protocols. Patient satisfaction with emergency department care and efficacy in health care increased post Chart Card implementation. Providers valued immediate access to patient information and SCD treatment guidelines. The technology has potential for application in the treatment of other illnesses in other settings.

Hand hygiene instruction decreases illness-related absenteeism in elementary schools: a prospective cohort study

PubMed Central

2012-01-01

Background Illness-related absences have been shown to lead to negative educational and economic outcomes. Both hand washing and hand sanitizer interventions have been shown to be effective in reducing illness-related absences. However, while the importance of hand hygiene in schools is clear, the role of instruction in use is less obvious. The purpose of this study was to compare absenteeism rates among elementary students given access to hand hygiene facilities versus students given both access and short repetitive instruction in use, particularly during influenza season when illness-related absences are at a peak. Methods A hand hygiene intervention was implemented from October to May during the 2009/2010 academic year, including peak flu season, in two Chicago Public Elementary Schools among students grades pre-kindergarten to eighth grade (ages 4–14). Classrooms were systematically assigned to an intervention or control group by grade (cluster design). Hand hygiene facilities (sanitizer and soap) were made available to all students. Students in the intervention group also received short repetitive instruction in hand hygiene every 2 months. Only absences as a result of respiratory or gastrointestinal illness were used to establish illness-related absenteeism rates. Percent absent days were calculated and bivariate analyses were performed to compare percent absent days among students given access to hand hygiene facilities versus students given both access and instruction. Prior to the intervention, teachers’ perceptions of students’ hand hygiene were also evaluated. Teacher perceptions were analysed to describe attitudes and beliefs. Results Data were collected and analysed for 773 students reporting 1,886 absences during the study period (1.73% of total school days). Both the percent total absent days and percent illness-related absent days were significantly lower in the group receiving short instruction during flu season (P = 0.002, P < 0.001, respectively). This difference peaked during the influenza season (when intervention began) and declined in the following months. Teachers (n = 23) agreed that hand hygiene is not performed properly among students and reported time constraints as a barrier to frequent hand washing. Conclusions Adding hand hygiene instruction to existing hand hygiene practices improved attendance at public elementary schools during the flu season. Standardized and brief repetitive instruction in hand hygiene holds potential to significantly reduce absenteeism. PMID:22587432

Feasibility and acceptability of patient partnership to improve access to primary care for the physical health of patients with severe mental illnesses: an interactive guide.

PubMed

Pelletier, Jean-François; Lesage, Alain; Boisvert, Christine; Denis, Frédéric; Bonin, Jean-Pierre; Kisely, Steve

2015-09-14

Even in countries with universal healthcare systems, excess mortality rates due to physical chronic diseases in patients also suffering from serious mental illness like schizophrenia is such that their life expectancy could be lessened by up to 20 years. The possible explanations for this disparity include: unhealthy habits (i.e. smoking; lack of exercise); side-effects of psychotropic medication; delays in the detection or initial presentation leading to a more advanced disease at diagnosis; and inequity of access to services. The main objective of this paper is to explore the feasibility and acceptability of patient partnership for developing an interactive guide to improve access to primary care providers for chronic diseases management and health promotion among patients with severe mental illnesses. A participatory action research design was used to engage patients with mental illness as full research partners for a strategy for patient-oriented research in primary care for persons with schizophrenia who also have chronic physical illnesses. This strategy was also developed in partnership with a health and social services centre responsible for the health of the population of a territory with about 100,000 inhabitants in East-end Montreal, Canada. A new interactive guide was developed by patient research partners and used by 146 participating patients with serious mental illness who live on this territory, for them to be better prepared for their medical appointment with a General Practitioner by becoming more aware of their own physical condition. Patient research partners produced a series of 33 short videos depicting signs and symptoms of common chronic diseases and risk factors for the leading causes of mortality and study participants were able to complete the corresponding 33-item questionnaire on an electronic touch screen tablet. What proved to be most relevant in terms of interactivity was the dynamic that has developed among the study participants during the small group learning sessions, a training technique designed for healthcare professionals that was adapted for this project for, and with patient partners. This research has shown the feasibility and acceptability of patient partnership and patient-oriented research approaches to the R&D process of a new medical tool and intervention for patients with serious mental illness, and its acceptability for addressing inequity of this disadvantaged population in terms of access to primary care providers.

Why increasing availability of ART is not enough: a rapid, community-based study on how HIV-related stigma impacts engagement to care in rural South Africa.

PubMed

Treves-Kagan, Sarah; Steward, Wayne T; Ntswane, Lebogang; Haller, Robin; Gilvydis, Jennifer M; Gulati, Harnik; Barnhart, Scott; Lippman, Sheri A

2016-01-28

Stigma is a known barrier to HIV testing and care. Because access to antiretroviral therapy reduces overt illness and mortality, some scholars theorized that HIV-related stigma would decrease as treatment availability increased. However, the association between ART accessibility and stigma has not been as straightforward as originally predicted. We conducted a "situational analysis"--a rapid, community-based qualitative assessment to inform a combination HIV prevention program in high prevalence communities. In the context of this community-based research, we conducted semi-structured interviews and focus groups with 684 individuals in four low-resource sub-districts in North West Province, South Africa. In addition to using this data to inform programming, we examined the impact of stigma on the uptake of services. Findings suggested that anticipated stigma remains a barrier to care. Although participants reported less enacted stigma, or hostility toward people living with HIV, they also felt that HIV remains synonymous with promiscuity and infidelity. Participants described community members taking steps to avoid being identified as HIV-positive, including avoiding healthcare facilities entirely, using traditional healers, or paying for private doctors. Such behaviors led to delays in testing and accessing care, and problems adhering to medications, especially for men and youth with no other health condition that could plausibly account for their utilization of medical services. We conclude that providing access to ART alone will not end HIV-related stigma. Instead, individuals will remain hesitant to seek care as long as they fear that doing so will lead to prejudice and discrimination. It is critical to combat this trend by increasing cultural acceptance of being seropositive, integrating HIV care into general primary care and normalizing men and youths' accessing health care.

A Two-Year Multidisciplinary Training Program for the Frontline Workforce in Community Treatment of Severe Mental Illness.

PubMed

Ruud, Torleif; Flage, Karin Blix; Kolbjørnsrud, Ole-Bjørn; Haugen, Gunnar Brox; Sørlie, Tore

2016-01-01

Since 1999, a national two-year multidisciplinary onsite training program has been in operation in Norway. The program trains frontline workforce personnel who provide community treatment to people with severe mental illness. A national network of mental health workers, consumers, caregivers, and others providing or supporting psychosocial treatment and rehabilitation for people with severe mental illness has organized local onsite part-time training programs in collaboration with community mental health centers (CMHCs), municipalities, and primary care providers. CMHC and primary care staff are trained together to increase collaboration. Nationwide dissemination has continued, with new local programs established every year. Evaluations have shown that the program is successful.

A recovery-based outreach program in rural Victoria.

PubMed

Prabhu, Radha; Browne, Mark Oakley

2007-04-01

A recovery-based outreach program for people with severe mental illness in regional Victoria is described. The paper covers a description of the program, the services provided and outcomes achieved. The program emphasized active collaboration between patients and clinicians as outlined in the collaborative recovery model and recognized that recovery from mental illness is an individual, personal process. The program provided service to 108 people over 3 years and had a positive impact on clinicians, patients and carers. The benefits of recovery orientation, multidisciplinary teams, collaborative relationships and carer involvement are discussed. The paper highlights the need for a focus on recovery and comprehensive care for people with severe mental illness.

Wearable devices and mobile technologies for supporting behavioral weight loss among people with serious mental illness.

PubMed

Naslund, John A; Aschbrenner, Kelly A; Scherer, Emily A; McHugo, Gregory J; Marsch, Lisa A; Bartels, Stephen J

2016-10-30

Promoting physical activity is essential for addressing elevated cardiovascular risk and high obesity rates affecting people with serious mental illness. Numerous challenges interfere with exercise participation in this high-risk group including mental health symptoms, low motivation, and limited access to safe and affordable options for physical activity. Wearable devices and mobile health technologies may afford new opportunities for promoting physical activity and supporting behavioral weight loss efforts. This exploratory study examined whether daily step count measured using Fitbit wearable devices was associated with weight loss and improved fitness among individuals with serious mental illness enrolled in a 6-month lifestyle program. Participants (n=34) had a schizophrenia spectrum disorder (23.5%), major depression (50.0%), or bipolar disorder (26.5%), and wore Fitbits most of the days (M=86.2%; SD=18.4%) they were enrolled in the study. At 6-months, higher average daily step count was associated with greater weight loss (F=5.07; df=1,32; p=0.0314), but not improved fitness (F=1.92; df=1,31; p=0.176). These findings demonstrate that encouraging participants with serious mental illness enrolled in lifestyle interventions to collect more steps may contribute to greater weight loss. This suggests that wearable devices may offer a feasible and potentially effective strategy for supporting behavioral weight loss in community mental health settings. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Get Well Care: Guidelines for Programs Serving Mildly Ill Children.

ERIC Educational Resources Information Center

Montanari, Ellen Orton, Ed.

Although child care programs for mildly ill children are proliferating around the country, very few states have developed regulations for these types of programs, and no states have developed standards or guidelines. Based upon this concern, a group of medical and early childhood professionals, parents, and directors of programs for mildly ill…

Comment on E.F. Torrey and R.H. Yolken: "Psychiatric genocide: Nazi attempts to eradicate schizophrenia" (Schizophr Bull. 2010;36/1:26-32) and R.D. Strous: "psychiatric genocide: reflections and responsibilities" (Schizophr Bull. Advance access publication on February 4, 2010; doi:10.1093/schbul/sbq003).

PubMed

Haefner, Heinz

2010-05-01

Torrey and Yolken wonder whether the killing of mentally ill persons in Nazi Germany reduced the risk for schizophrenia in the following generation. Epidemiological data from Germany do not permit reliable comparisons. Torrey and Yolken point out that horrible crime is still only little known. Strous and several contributors on the Schizophrenia Research Forum confirm that view. The history of ideas shows that social Darwinism in the educated classes and the doctrine of degeneration in psychiatry widely influenced thinking prior to World War II. Psychiatrists, lacking effective treatment for steadily growing numbers of the mentally ill, were susceptible to these ideologies. In a first step, several countries introduced compulsory sterilization as a genetic means of preventing diseases believed to be hereditary. Hitler's megalomaniac idea of creating a new human species by steering human evolution through the elimination of "unfit" genes in the mentally ill and inferior races led to the breach of human rights. His euthanasia program-the biggest crime ever perpetrated on the sick-turned out to usher in the gas chambers of the Holocaust.

20 CFR 30.601 - Who may serve as a representative?

Code of Federal Regulations, 2014 CFR

2014-04-01

... EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Special Provisions...

20 CFR 30.601 - Who may serve as a representative?

Code of Federal Regulations, 2010 CFR

2010-04-01

... EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Special Provisions...

20 CFR 30.601 - Who may serve as a representative?

Code of Federal Regulations, 2013 CFR

2013-04-01

... EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Special Provisions...

20 CFR 30.601 - Who may serve as a representative?

Code of Federal Regulations, 2011 CFR

2011-04-01

... EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Special Provisions...

20 CFR 30.601 - Who may serve as a representative?

Code of Federal Regulations, 2012 CFR

2012-04-01

... EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Special Provisions...

Opening caregiver minds: National Alliance for the Mentally Ill's (NAMI) provider education program.

PubMed

Mohr, W K; Lafuze, J E; Mohr, B D

2000-10-01

The belief that poor parenting and dysfunctional families give rise to mental illness has been perpetuated by psychodynamic and family systems theories that lack supporting scientific evidence, and interventions based on these theories have failed to produce clinical improvements. Nevertheless the National Alliance for the Mentally III (NAMI) found that many clinical training programs continue to teach these outdated theories and interventions and that the mental health system is often destructive to family systems. This article describes a new 10-week program that is designed to educate service providers that will include families in the care of their chronically ill loved one. The program is based on a competence and adaptation rather than a pathology foundation and it shifts the discourse from causes to effects of illness.

Assessment of universal health coverage for adults aged 50 years or older with chronic illness in six middle-income countries

PubMed Central

Frenz, Patricia; Grabenhenrich, Linus; Keil, Thomas; Tinnemann, Peter

2016-01-01

Abstract Objective To assess universal health coverage for adults aged 50 years or older with chronic illness in China, Ghana, India, Mexico, the Russian Federation and South Africa. Methods We obtained data on 16 631 participants aged 50 years or older who had at least one diagnosed chronic condition from the World Health Organization Study on Global Ageing and Adult Health. Access to basic chronic care and financial hardship were assessed and the influence of health insurance and rural or urban residence was determined by logistic regression analysis. Findings The weighted proportion of participants with access to basic chronic care ranged from 20.6% in Mexico to 47.6% in South Africa. Access rates were unequally distributed and disadvantaged poor people, except in South Africa where primary health care is free to all. Rural residence did not affect access. The proportion with catastrophic out-of-pocket expenditure for the last outpatient visit ranged from 14.5% in China to 54.8% in Ghana. Financial hardship was more common among the poor in most countries but affected all income groups. Health insurance generally increased access to care but gave insufficient protection against financial hardship. Conclusion No country provided access to basic chronic care for more than half of the participants with chronic illness. The poor were less likely to receive care and more likely to face financial hardship in most countries. However, inequity of access was not fully determined by the level of economic development or insurance coverage. Future health reforms should aim to improve service quality and increase democratic oversight of health care. PMID:27034521

The role of gender in housing for individuals with severe mental illness: a qualitative study of the Canadian service context

PubMed Central

Kidd, Sean A; Virdee, Gursharan; Krupa, Terry; Burnham, Darrell; Hemingway, Dawn; Margolin, Indrani; Patterson, Michelle; Zabkiewicz, Denise

2013-01-01

Objective This study was undertaken to examine the role of gender as it relates to access to housing among individuals with severe mental illness (SMI) in Canada. Design An exploratory, qualitative approach was used to assess the perspectives of Canadian housing experts. The focus of inquiry was on the role of gender and associated intersections (eg, ethnicity) in pathways to housing access and housing needs for individuals with SMI. Setting A purposeful sampling strategy was undertaken to access respondents across all Canadian geographic regions, with diversity across settings (urban and rural) and service sectors (hospital based and community based). Participants –29 individuals (6 men and 23 women) considered to be experts in a housing service context as it pertains to SMI were recruited. On average, participants had worked for 15 years in services that specialised in the support and delivery of housing services to people with SMI. Measures Semistructured interviews with participants focused on the role gender plays in access to housing in their specific context. Barriers and facilitators were examined as were intersections with other relevant factors, such as ethnicity, poverty and parenthood. Quantitative ratings of housing accessibility as a function of gender were also collected. Results Participants across geographic contexts described a lack of shelter facilities for women, leading to a reliance on exploitative circumstances. Other findings included a compounding of discrimination for ethnic minority women, the unique resource problems faced in rural contexts, and the difficulties that attend access to shelter and housing for parents with SMI. Conclusions These findings suggest that, along with a generally poor availability of housing stock for individuals with SMI, access problems are compounded by a lack of attention to the unique needs and illness trajectories that attend gender. PMID:23794544

Use of computers and Internet among people with severe mental illnesses at peer support centers.

PubMed

Brunette, Mary F; Aschbrenner, Kelly A; Ferron, Joelle C; Ustinich, Lee; Kelly, Michael; Grinley, Thomas

2017-12-01

Peer support centers are an ideal setting where people with severe mental illnesses can access the Internet via computers for online health education, peer support, and behavioral treatments. The purpose of this study was to assess computer use and Internet access in peer support agencies. A peer-assisted survey assessed the frequency with which consumers in all 13 New Hampshire peer support centers (n = 702) used computers to access Internet resources. During the 30-day survey period, 200 of the 702 peer support consumers (28%) responded to the survey. More than 3 quarters (78.5%) of respondents had gone online to seek information in the past year. About half (49%) of respondents were interested in learning about online forums that would provide information and peer support for mental health issues. Peer support centers may be a useful venue for Web-based approaches to education, peer support, and intervention. Future research should assess facilitators and barriers to use of Web-based resources among people with severe mental illness in peer support centers. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Child and youth telepsychiatry in rural and remote primary care.

PubMed

Pignatiello, Antonio; Teshima, John; Boydell, Katherine M; Minden, Debbie; Volpe, Tiziana; Braunberger, Peter G

2011-01-01

Young people with psychological or psychiatric problems are managed largely by primary care practitioners, many of whom feel inadequately trained, ill equipped, and uncomfortable with this responsibility. Accessing specialist pediatric and psychological services, often located in and near large urban centers, is a particular challenge for rural and remote communities. Live interactive videoconferencing technology (telepsychiatry) presents innovative opportunities to bridge these service gaps. The TeleLink Mental Health Program at The Hospital for Sick Children in Toronto offers a comprehensive, collaborative model of enhancing local community systems of care in rural and remote Ontario using videoconferencing. With a focus on clinical consultation, collaborative care, education and training, evaluation, and research, ready access to pediatric psychiatrists and other specialist mental health service providers can effectively extend the boundaries of the medical home. Medical trainees in urban teaching centers are also expanding their knowledge of and comfort level with rural mental health issues, various complementary service models, and the potentials of videoconferencing in providing psychiatric and psychological services. Committed and enthusiastic champions, a positive attitude, creativity, and flexibility are a few of the necessary attributes ensuring viability and integration of telemental health programs. Copyright © 2011 Elsevier Inc. All rights reserved.

The Clinician as Leader: Why, How, and When.

PubMed

Stoller, James K

2017-11-01

Clinicians are inveterate leaders. We lead patients through the difficult maze of illness, families through the travails of ill loved ones, and physicians-in-training through the gauntlet of learning medicine. Yet, in the context of a range of leadership styles that effective leaders must be able to deploy situationally, physician leaders have traditionally defaulted to a "command and control" style that fosters the concept of physicians as "Viking warriors" or "heroic lone healers." The perverse effects of "command and control" are that this style conspires against collaboration and tends to be perpetuated as aspiring leaders emulate their predecessors. Because healthcare faces challenges of cost, access, and quality and is in the throes of change, the current landscape requires effective leadership. Though still relatively uncommon among healthcare organizations, frontrunner organizations are offering leadership development programs. The design of such programs requires clarity about requisite leadership competencies and about how and when to best to deliver such curricula. As one example, the American Thoracic Society has launched its Emerging Leaders Program (ELP), which is currently offering a leadership development curriculum to 18 selected emerging leaders. The ATS ELP curriculum focuses on awareness of self and system and incorporates highly participatory sessions on emotional intelligence, teambuilding, change management, situational leadership, appreciative inquiry, process and quality improvement, strategic planning, and organizational culture. Short-term deliverables are the development and presentation of business plans for innovations proposed by the group. Hoped for longer-term outcomes include an enhanced leadership pipeline for global respiratory health.

20 CFR 30.302 - Who pays the costs associated with subpoenas?

Code of Federal Regulations, 2011 CFR

2011-04-01

... LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED...

20 CFR 30.600 - May a claimant designate a representative?

Code of Federal Regulations, 2014 CFR

2014-04-01

... ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Special Provisions...

20 CFR 30.302 - Who pays the costs associated with subpoenas?

Code of Federal Regulations, 2014 CFR

2014-04-01

... LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED...

20 CFR 30.600 - May a claimant designate a representative?

Code of Federal Regulations, 2011 CFR

2011-04-01

... ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Special Provisions...

20 CFR 30.302 - Who pays the costs associated with subpoenas?

Code of Federal Regulations, 2010 CFR

2010-04-01

... LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED...

20 CFR 30.600 - May a claimant designate a representative?

Code of Federal Regulations, 2012 CFR

2012-04-01

... ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Special Provisions...

20 CFR 30.600 - May a claimant designate a representative?

Code of Federal Regulations, 2010 CFR

2010-04-01

... ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Special Provisions...

20 CFR 30.302 - Who pays the costs associated with subpoenas?

Code of Federal Regulations, 2013 CFR

2013-04-01

... LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED...

20 CFR 30.600 - May a claimant designate a representative?

Code of Federal Regulations, 2013 CFR

2013-04-01

... ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Special Provisions...

20 CFR 30.302 - Who pays the costs associated with subpoenas?

Code of Federal Regulations, 2012 CFR

2012-04-01

... LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED...

Contextualising renal patient routines: Everyday space-time contexts, health service access, and wellbeing.

PubMed

McQuoid, Julia; Jowsey, Tanisha; Talaulikar, Girish

2017-06-01

Stable routines are key to successful illness self-management for the growing number of people living with chronic illness around the world. Yet, the influence of chronically ill individuals' everyday contexts in supporting routines is poorly understood. This paper takes a space-time geographical approach to explore the everyday space-time contexts and routines of individuals with chronic kidney disease (CKD). We ask: what is the relationship between renal patients' space-time contexts and their ability to establish and maintain stable routines, and, what role does health service access play in this regard? We draw from a qualitative case study of 26 individuals with CKD in Australia. Data comprised self-reported two day participant diaries and semi-structured interviews. Thematic analysis of interview transcripts was guided by an inductive-deductive approach. We examined the embeddedness of routines within the space-time contexts of participants' everyday lives. We found that participants' everyday space-time contexts were highly complex, especially for those receiving dialysis and/or employed, making routines difficult to establish and vulnerable to disruption. Health service access helped shape participants' everyday space-time contexts, meaning that incidences of unpredictability in accessing health services set-off 'ripple effects' within participants' space-time contexts, disrupting routines and making everyday life negotiation more difficult. The ability to absorb ripple effects from unpredictable health services without disrupting routines varied by space-time context. Implications of these findings for the deployment of the concept of routine in health research, the framing of patient success in self-managing illness, and health services design are discussed. In conclusion, efforts to understand and support individuals in establishing and maintaining routines that support health and wellbeing can benefit from approaches that contextualise and de-centre everyday human behaviour. Opportunities to support renal patients in managing illness and experiencing wellbeing outside the clinical setting lie in a space-time re-design of chronic care services. Copyright © 2017 Elsevier Ltd. All rights reserved.

Contextualising renal patient routines: Everyday space-time contexts, health service access, and wellbeing

PubMed Central

McQuoid, Julia; Jowsey, Tanisha; Talaulikar, Girish

2017-01-01

Stable routines are key to successful illness self-management for the growing number of people living with chronic illness around the world. Yet, the influence of chronically ill individuals’ everyday contexts in supporting routines is poorly understood. This paper takes a space-time geographical approach to explore the everyday space-time contexts and routines of individuals with chronic kidney disease (CKD). We ask: what is the relationship between renal patients’ space-time contexts and their ability to establish and maintain stable routines, and, what role does health service access play in this regard? We draw from a qualitative case study of 26 individuals with CKD in Australia. Data comprised self-reported two day participant diaries and semi-structured interviews. Thematic analysis of interview transcripts was guided by an inductive-deductive approach. We examined the embeddedness of routines within the space-time contexts of participants’ everyday lives. We found that participants’ everyday space-time contexts were highly complex, especially for those receiving dialysis and/or employed, making routines difficult to establish and vulnerable to disruption. Health service access helped shape participants’ everyday space-time contexts, meaning that incidences of unpredictability in accessing health services set-off ‘ripple effects’ within participants’ space-time contexts, disrupting routines and making everyday life negotiation more difficult. The ability to absorb ripple effects from unpredictable health services without disrupting routines varied by space-time context. Implications of these findings for the deployment of the concept of routine in health research, the framing of patient success in self-managing illness, and health services design are discussed. In conclusion, efforts to understand and support individuals in establishing and maintaining routines that support health and wellbeing can benefit from approaches that contextualise and de-centre everyday human behaviour. Opportunities to support renal patients in managing illness and experiencing wellbeing outside the clinical setting lie in a space-time re-design of chronic care services. PMID:28482275

20 CFR 30.220 - What are the criteria for eligibility for benefits relating to chronic silicosis?

Code of Federal Regulations, 2010 CFR

2010-04-01

...' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT... disease that arose as a consequence of the accepted chronic silicosis. ...

Increasing US health plan coverage for exercise programming in community mental health settings for people with serious mental illness: a position statement from the Society of Behavior Medicine and the American College of Sports Medicine.

PubMed

Pratt, Sarah I; Jerome, Gerald J; Schneider, Kristin L; Craft, Lynette L; Buman, Matthew P; Stoutenberg, Mark; Daumit, Gail L; Bartels, Stephen J; Goodrich, David E

2016-09-01

Adults with serious mental illness die more than 10 years earlier than the average American. Premature mortality is due to the high prevalence of preventable diseases including cardiovascular disease and diabetes. Poor lifestyle behaviors including lack of exercise and physical inactivity contribute to the epidemic levels of obesity, diabetes, and cardiovascular disease observed among adults with serious mental illness. Not surprisingly, people with serious mental illness are among the most costly consumers of health services due to increased visits for poorly managed mental and physical health. Recent studies have demonstrated that exercise interventions based on community mental health settings can significantly improve physical and mental health in people with serious mental illness. However, current funding regulations limit the ability of community mental health settings to offer exercise programming services to people with serious mental illness. Policy efforts are needed to improve the dissemination and sustainability of exercise programs for people with serious mental illness.

Health Update: Care of Ill Children in Child Care Programs.

ERIC Educational Resources Information Center

Aronson, Susan S.

1987-01-01

Discusses differing opinions about (1) exclusion of ill children from child care; (2) the meaning of fever; (3) appropriate care for ill children; (4) transfer of information about ill children in child care; and (5) written policies and procedures for care of ill children. (NH)

Using the brain's fight-or-flight response for predicting mental illness on the human space flight program

NASA Astrophysics Data System (ADS)

Losik, L.

A predictive medicine program allows disease and illness including mental illness to be predicted using tools created to identify the presence of accelerated aging (a.k.a. disease) in electrical and mechanical equipment. When illness and disease can be predicted, actions can be taken so that the illness and disease can be prevented and eliminated. A predictive medicine program uses the same tools and practices from a prognostic and health management program to process biological and engineering diagnostic data provided in analog telemetry during prelaunch readiness and space exploration missions. The biological and engineering diagnostic data necessary to predict illness and disease is collected from the pre-launch spaceflight readiness activities and during space flight for the ground crew to perform a prognostic analysis on the results from a diagnostic analysis. The diagnostic, biological data provided in telemetry is converted to prognostic (predictive) data using the predictive algorithms. Predictive algorithms demodulate telemetry behavior. They illustrate the presence of accelerated aging/disease in normal appearing systems that function normally. Mental illness can predicted using biological diagnostic measurements provided in CCSDS telemetry from a spacecraft such as the ISS or from a manned spacecraft in deep space. The measurements used to predict mental illness include biological and engineering data from an astronaut's circadian and ultranian rhythms. This data originates deep in the brain that is also damaged from the long-term exposure to cortisol and adrenaline anytime the body's fight or flight response is activated. This paper defines the brain's FOFR; the diagnostic, biological and engineering measurements needed to predict mental illness, identifies the predictive algorithms necessary to process the behavior in CCSDS analog telemetry to predict and thus prevent mental illness from occurring on human spaceflight missions.

Alcohol consumption and use of health care services in people with severe mental illness and stressful childhood experiences.

PubMed

Schneeberger, Andres R; Huber, Christian G; Seixas, Azizi; Muenzenmaier, Kristina H; Lang, Undine E; Castille, Dorothy; Larkin, Stefan; Link, Bruce G

2017-01-01

People who suffer from severe mental illness often present with histories of abuse during childhood. Alcohol use disorders is a common co-morbidity of survivors of childhood abuse and neglect. This study analyzes the effects of stressful childhood experiences, a proxy for trauma, on the frequency of alcohol consumption and the utilization of health care services in a population of people with severe mental illness. There were 111 men (mean age: 35 years) and 72 women (mean age: 40.0 years) with severe mental illness that were recruited from psychiatric outpatient clinics in New York City. The analysis focused on lifetime prevalence of stressful childhood experiences, alcohol consumption, and utilization of health care services over time. The longitudinal data were analyzed over 12 months with a level-2 model (multilevel modeling). Out of the participants, 41.5% reported a history of more than four types of abusive experiences. There were 33.3% that had a DSM-IV diagnosis of alcohol abuse and 27.3% qualified for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of alcohol dependence throughout their lives. Stressful childhood experiences predicted an increased frequency of alcohol consumption over time. People with histories of childhood abuse had more often been to outpatient clinics and 12-step programs, but at the same time showed lower frequency rates of psychiatrist visits and visits to outpatient clinics. Childhood abuse is prevalent in people with severe mental illness and is related to an increased alcohol consumption. Despite an increased need of health care services, affected persons might encounter more barriers to access them.

Effects of Brief Psychoeducational Program on Stigma in Malaysian Pre-clinical Medical Students: A Randomized Controlled Trial.

PubMed

Fernandez, Aaron; Tan, Kit-Aun; Knaak, Stephanie; Chew, Boon How; Ghazali, Sazlina Shariff

2016-12-01

If presented with serious mental illness (SMI), individuals' low help-seeking behaviors and poor adherence to treatment are associated with negative stereotypes and attitudes of healthcare providers. In this study, we examined the effects of a brief psychoeducational program on reducing stigma in pre-clinical medical students. One hundred and two pre-clinical medical students (20-23 years old) were randomly assigned to face-to-face contact + educational lecture (n = 51) condition or video-based contact + educational lecture (n = 51) condition. Measures of pre-clinical medical students' mental illness-related stigma using the Opening Minds Stigma Scale for Health Care Providers (OMS-HC) were administered at pre-, post-treatment, and 1-month follow-up. A 2 (condition: face-to-face contact + educational lecture, video-based contact + educational lecture) by 3 (time: pre-treatment, post-treatment, and 1-month follow-up) mixed model MANOVA was conducted on the Attitudes, Disclosure and Help-Seeking, and Social Distance OMS-HC subscales. Participants' scores on all subscales changed significantly across time, regardless of conditions. To determine how participants' scores changed significantly over time on each subscale, Bonferroni follow-up comparisons were performed to access pairwise differences for the main effect of time. Specifically, pairwise comparisons produced a significant reduction in Social Distance subscale between pre-treatment and post-treatment and between pre-treatment and 1-month follow-up, and a significant increase between post-treatment and 1-month follow-up, regardless of conditions. With respect to the Attitudes and Disclosure and Help-Seeking subscales, pairwise comparisons produced a significant reduction in scores between pre-treatment and post-treatment and a significant increase between post-treatment and 1-month follow-up. Our findings provide additional evidence that educational lecture on mental illness, coupled with either face-to-face contact or video-based contact, is predictive of positive outcomes in anti-stigma programs targeting future healthcare providers.

An eHealth Intervention for Patients in Rural Areas: Preliminary Findings From a Pilot Feasibility Study

PubMed Central

Schrader, Geoffrey; Harris, Melanie; Newman, Lareen; Lynn, Sarah; Peterson, Leigh; Battersby, Malcolm

2014-01-01

Background eHealth facilitation of chronic disease management has potential to increase engagement and effectiveness and extend access to care in rural areas. Objective The objective of this study was to demonstrate the feasibility and acceptability of an eHealth system for the management of chronic conditions in a rural setting. Methods We developed an online management program which incorporated content from the Flinders Chronic Condition Management Program (Flinders Program) and used an existing software platform (goACT), which is accessible by patients and health care workers using either Web-enabled mobile phone or Internet, enabling communication between patients and clinicians. We analyzed the impact of this eHealth system using qualitative and simple quantitative methods. Results The eHealth system was piloted with 8 recently hospitalized patients from rural areas, average age 63 (SD 9) years, each with an average of 5 chronic conditions and high level of psychological distress with an average K10 score of 32.20 (SD 5.81). Study participants interacted with the eHealth system. The average number of logins to the eHealth system by the study participants was 26.4 (SD 23.5) over 29 weeks. The login activity was higher early in the week. Conclusions The pilot demonstrated the feasibility of implementing and delivering a chronic disease management program using a Web-based patient-clinician application. A qualitative analysis revealed burden of illness and low levels of information technology literacy as barriers to patient engagement. PMID:24927511

An eHealth Intervention for Patients in Rural Areas: Preliminary Findings From a Pilot Feasibility Study.

PubMed

Schrader, Geoffrey; Bidargaddi, Niranjan; Harris, Melanie; Newman, Lareen; Lynn, Sarah; Peterson, Leigh; Battersby, Malcolm

2014-06-12

eHealth facilitation of chronic disease management has potential to increase engagement and effectiveness and extend access to care in rural areas. The objective of this study was to demonstrate the feasibility and acceptability of an eHealth system for the management of chronic conditions in a rural setting. We developed an online management program which incorporated content from the Flinders Chronic Condition Management Program (Flinders Program) and used an existing software platform (goACT), which is accessible by patients and health care workers using either Web-enabled mobile phone or Internet, enabling communication between patients and clinicians. We analyzed the impact of this eHealth system using qualitative and simple quantitative methods. The eHealth system was piloted with 8 recently hospitalized patients from rural areas, average age 63 (SD 9) years, each with an average of 5 chronic conditions and high level of psychological distress with an average K10 score of 32.20 (SD 5.81). Study participants interacted with the eHealth system. The average number of logins to the eHealth system by the study participants was 26.4 (SD 23.5) over 29 weeks. The login activity was higher early in the week. The pilot demonstrated the feasibility of implementing and delivering a chronic disease management program using a Web-based patient-clinician application. A qualitative analysis revealed burden of illness and low levels of information technology literacy as barriers to patient engagement.

Exploration of patients' readiness for an eHealth management program for chronic heart failure: a preliminary study.

PubMed

Nahm, Eun-Shim; Blum, Kay; Scharf, Barbara; Friedmann, Erika; Thomas, Sue; Jones, Deborah; Gottlieb, Stephen S

2008-01-01

Heart failure (HF) is a major public health problem in the United States. Approximately 5 million Americans are living with HF, and each year, 550,000 more are newly diagnosed. With recent, rapidly advancing technologies, many studies have examined the effects of technology-based HF management programs. Most of these studies focused on telemonitoring devices, lacking an aspect to motivate individuals to manage their own illnesses. This exploratory study was conducted to (1) examine the readiness of patients with HF in using an eHealth program that includes both telemonitoring and motivational components (ie, Web learning modules, eCommunication) and (2) assess the specific needs of patients with HF that can be addressed by a future eHealth program. This was a single group descriptive study using a convenience sample. A total of 44 patients with HF (mean age, 72.8 years; range, 55-85 years) were recruited from the pool of enrollees of the Medicare Coordinated Care Demonstration project for HF management that used only a telemonitoring component. Although only 10 participants were users, among 34 nonusers, 17 reported availability of Web access, and 15 reported that they would use the Internet if access and training were available. Overall, confidence for using telemonitoring devices and Web-based health modules was high, with means of 27 (range, 3-30) and 7.6 (range, 1-10), respectively. Confidence for learning health information using Web modules, however, was lower with a mean of 41.5 (range, 8-80). The 2 most highly rated health information needs were research findings (n = 41, 93.2%) and medication (n = 39, 88.6%). Most participants would like to have e-mail communication with healthcare providers. The findings showed the participants' high readiness to use the proposed eHealth program if access and training were provided. This study used a small convenience sample. Further studies are needed with larger, diverse samples.

When public health and genetic privacy collide: positive and normative theories explaining how ACA's expansion of corporate wellness programs conflicts with GINA's privacy rules.

PubMed

Bard, Jennifer S

2011-01-01

The Patient Protection and Affordable Care Act of 2010 (ACA) contains many provisions intended to increase access to and lower the cost of health care by adopting public health measures. One of these promotes the use of at-work wellness programs by both providing employers with grants to develop these programs and also increasing their ability to tie the price employees pay for health insurance for participating in these programs and meeting specific health goals. Yet despite ACA's specific alteration of three different statues which had in the past shielded employees from having to contribute to the cost of their health insurance based on their achieving employer-designated health markers, it chose to leave alone recently enacted rules implementing the Genetic Non-Discrimination Act (GINA), which prohibits employers from asking employees about their family health history in any context, including assessing their risk for setting wellness targets. This article reviews how both the changes made by ACA and the restrictions recently put place by GINA will affect the way employers are likely to structure Wellness Programs. It also considers how these changes reflect the competing social goals of both ACA, which seeks to expand access to the population by lowering costs, and GINA, which seeks to protect individuals from discrimination. It does so by analyzing both positive theories about how these new laws will function and normative theories explaining the likelihood of future friction between the interests of the population of the United States as a whole who are in need of increased and affordable access to health care, and of the individuals living in this country who risk discrimination, as science and medicine continue to make advances in linking genetic make-up to risk of future illness. © 2011 American Society of Law, Medicine & Ethics, Inc.

Diarrheal Illness among Women, Infants, and Children (WIC) Program Participants in Miami, Florida: Implications for Nutrition Education

ERIC Educational Resources Information Center

Davila, Evelyn P.; Trepka, Mary Jo; Newman, Frederick L.; Huffman, Fatma G.; Dixon, Zisca

2009-01-01

Objective: To assess risk factors for diarrheal illness among clients of a Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinic in Miami, FL. Design: A cross-sectional survey with questions about demographics, food safety practices, and diarrheal illness. Setting: WIC clinic operated by the Miami-Dade County Health…

20 CFR 30.911 - Does maximum medical improvement always have to be reached for an impairment to be included in...

Code of Federal Regulations, 2012 CFR

2012-04-01

... paragraph (a) of this section, if OWCP finds that an employee's covered illness is in the terminal stages... OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Impairment Benefits Under Part E of EEOICPA...

20 CFR 30.911 - Does maximum medical improvement always have to be reached for an impairment to be included in...

Code of Federal Regulations, 2011 CFR

2011-04-01

... paragraph (a) of this section, if OWCP finds that an employee's covered illness is in the terminal stages... OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Impairment Benefits Under Part E of EEOICPA...

20 CFR 30.911 - Does maximum medical improvement always have to be reached for an impairment to be included in...

Code of Federal Regulations, 2010 CFR

2010-04-01

... paragraph (a) of this section, if OWCP finds that an employee's covered illness is in the terminal stages... OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Impairment Benefits Under Part E of EEOICPA...

20 CFR 30.911 - Does maximum medical improvement always have to be reached for an impairment to be included in...

Code of Federal Regulations, 2013 CFR

2013-04-01

... paragraph (a) of this section, if OWCP finds that an employee's covered illness is in the terminal stages... OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Impairment Benefits Under Part E of EEOICPA...

20 CFR 30.911 - Does maximum medical improvement always have to be reached for an impairment to be included in...

Code of Federal Regulations, 2014 CFR

2014-04-01

... paragraph (a) of this section, if OWCP finds that an employee's covered illness is in the terminal stages... OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Impairment Benefits Under Part E of EEOICPA...

Availability of essential health services in post-conflict Liberia.

PubMed

Kruk, Margaret E; Rockers, Peter C; Williams, Elizabeth H; Varpilah, S Tornorlah; Macauley, Rose; Saydee, Geetor; Galea, Sandro

2010-07-01

To assess the availability of essential health services in northern Liberia in 2008, five years after the end of the civil war. We carried out a population-based household survey in rural Nimba county and a health facility survey in clinics and hospitals nearest to study villages. We evaluated access to facilities that provide index essential services: artemisinin combination therapy for malaria, integrated management of childhood illness, human immunodeficiency virus (HIV) counselling and testing, basic emergency obstetric care and treatment of mental illness. Data were obtained from 1405 individuals (98% response rate) selected with a three-stage population-representative sampling method, and from 43 of Nimba county's 49 health facilities selected because of proximity to the study villages. Respondents travelled an average of 136 minutes to reach a health facility. All respondents could access malaria treatment at the nearest facility and 55.9% could access HIV testing. Only 26.8%, 14.5%, and 12.1% could access emergency obstetric care, integrated management of child illness and mental health services, respectively. Although there has been progress in providing basic services, rural Liberians still have limited access to life-saving health care. The reasons for the disparities in the services available to the population are technical and political. More frequently available services (HIV testing, malaria treatment) were less complex to implement and represented diseases favoured by bilateral and multilateral health sector donors. Systematic investments in the health system are required to ensure that health services respond to current and future health priorities.

The Healthcare Needs of Latinos with Serious Mental Illness and the Potential of Peer Navigators.

PubMed

Corrigan, Patrick W; Torres, Alessandra; Lara, Juana L; Sheehan, Lindsay; Larson, Jonathon E

2017-07-01

Latinos with serious mental illness get sick and die much younger than other adults. In this paper, we review findings of a community based participatory research project meant to identify important healthcare needs, barriers to these needs, solutions to the barriers, and the promise of peer navigators as a solution. Findings from focus groups reflected general concerns of people with mental illness (e.g., insurance, engagement, accessibility) and Latinos with serious mental illness (e.g., immigration, language, and family). Feedback and analyses especially focused on the potential of peer navigators. Implications of these findings for integrated care of Latinos with serious mental illness are discussed.

Spectroscopy of neutron rich nuclei using cold neutron induced fission of actinide targets at the ILL: The EXILL campaign

NASA Astrophysics Data System (ADS)

Blanc, A.; de France, G.; Drouet, F.; Jentschel, M.; Köster, U.; Mancuso, C.; Mutti, P.; Régis, J. M.; Simpson, G.; Soldner, T.; Ur, C. A.; Urban, W.; Vancraeyenest, A.

2013-12-01

One way to explore exotic nuclei is to study their structure by performing γ-ray spectroscopy. At the ILL, we exploit a high neutron flux reactor to induce the cold fission of actinide targets. In this process, fission products that cannot be accessed using standard spontaneous fission sources are produced with a yield allowing their detailed study using high resolution γ-ray spectroscopy. This is what was pursued at the ILL with the EXILL (for EXOGAM at the ILL) campaign. In the present work, the EXILL setup and performance will be presented.

20 CFR 30.15 - May EEOICPA benefits be assigned, transferred or garnished?

Code of Federal Regulations, 2012 CFR

2012-04-01

..., DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED...

20 CFR 30.602 - Who is responsible for paying the representative's fee?

Code of Federal Regulations, 2013 CFR

2013-04-01

..., DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED...

20 CFR 30.602 - Who is responsible for paying the representative's fee?

Code of Federal Regulations, 2014 CFR

2014-04-01

..., DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED...

20 CFR 30.15 - May EEOICPA benefits be assigned, transferred or garnished?

Code of Federal Regulations, 2013 CFR

2013-04-01

..., DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED...

20 CFR 30.602 - Who is responsible for paying the representative's fee?

Code of Federal Regulations, 2010 CFR

2010-04-01

..., DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED...

20 CFR 30.602 - Who is responsible for paying the representative's fee?

Code of Federal Regulations, 2012 CFR

2012-04-01

..., DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED...

20 CFR 30.106 - Can OWCP request employment verification from other sources?

Code of Federal Regulations, 2013 CFR

2013-04-01

..., DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED...

20 CFR 30.602 - Who is responsible for paying the representative's fee?

Code of Federal Regulations, 2011 CFR

2011-04-01

..., DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED...

20 CFR 30.508 - What is beryllium sensitivity monitoring?

Code of Federal Regulations, 2010 CFR

2010-04-01

... ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Survivors; Payments... has established chronic beryllium disease. ...

Medical Marijuana programs: implications for cannabis control policy--observations from Canada.

PubMed

Fischer, Benedikt; Kuganesan, Sharan; Room, Robin

2015-01-01

While prohibition has been the dominant regime of cannabis control in most countries for decades, an increasing number of countries have been implementing cannabis control reforms recently, including decriminalization or even legalization frameworks. Canada has held out from this trend, although it has among the highest cannabis use rates in the world. Cannabis use is universally criminalized, and the current (conservative) federal government has vowed not to implement any softening reforms to cannabis control. As a result of several higher court decisions, the then federal government was forced to implement a 'medical marijuana access regulations' program in 2001 to allow severely ill patients therapeutic use and access to therapeutic cannabis while shielding them from prosecution. The program's regulations and approval processes were complex and subject to extensive criticism; initial uptake was low and most medical marijuana users continued their use and supply outside the program's auspices. This year, the government introduced new 'marijuana for medical purposes regulations', which allow physicians to 'authorize' medical marijuana use for virtually any health condition for which this is considered beneficial; supply is facilitated by licensed commercial producers. It is expected that some 500,000 users, and dozens of commercial producers will soon be approved under the program, arguably constituting - as with medical marijuana schemes elsewhere, e.g. in California--de facto 'legalization'. We discuss the question whether the evolving scope and realities of 'medical cannabis' provisions in Canada offer a 'sneaky side door' or a 'better third way' to cannabis control reform, and what the potential wider implications are of these developments. Copyright © 2014. Published by Elsevier B.V.

Individual Factors Predicting Mental Health Court Diversion Outcome

ERIC Educational Resources Information Center

Verhaaff, Ashley; Scott, Hannah

2015-01-01

Objective: This study examined which individual factors predict mental health court diversion outcome among a sample of persons with mental illness participating in a postcharge diversion program. Method: The study employed secondary analysis of existing program records for 419 persons with mental illness in a court diversion program. Results:…

A School Reentry Program for Chronically Ill Children.

ERIC Educational Resources Information Center

Worchel-Prevatt, Frances F.; Heffer, Robert W.; Prevatt, Bruce C.; Miner, Jennifer; Young-Saleme, Tammi; Horgan, Daniel; Lopez, Molly A.; Frankel, Lawrence; Rae, William A.

1998-01-01

Describes a school reintegration program aimed at overcoming the numerous psychological, physical, environmental, and family-based deterrents to school reentry for chronically ill children. The program uses a systems approach to children's mental health with an emphasis on multiple aspects of the child's environment (i.e., family, medical…

The Depiction of Mental Illnesses in Children's Television Programs

ERIC Educational Resources Information Center

Wahl, Otto; Hanrahan, Erin; Karl, Kelly; Lasher, Erin; Swaye, Janel

2007-01-01

Concern has been expressed that negative attitudes toward people with mental illnesses begin to develop early in childhood. This study examines one of the possible sources of learning of such negative attitudes--children's television programs. Two hundred sixty-nine (269) hours of children's television programming were videotaped, viewed, and…

MAPP: A Multimedia Instructional Program for Youths with Chronic Illness.

ERIC Educational Resources Information Center

Murdock, Peggy O'Hara; McClure, Christopher; Lage, Onelia G.; Sarkar, Dilip; Shaw, Kimberly

The Multimedia Approach to Pregnancy Prevention (MAPP) is an expert intelligence multimedia program administered in outpatient and inpatient clinics in the University of Miami/Jackson Children's Hospital (Florida). The target population for the MAPP program is youths aged 9-14 years, diagnosed with chronic illnesses (asthma, diabetes, and sickle…

Factors affecting vocational outcomes of people with chronic illness participating in a supported competitive open employment program in Hong Kong.

PubMed

Lee, Rosalia K Y; Chan, Chetwyn C H

2005-01-01

This study aimed to analyze the ability of the Patient Retraining and Vocational Resettlement (PRAVR) program to enhance the vocational outcomes of individuals with chronic illness, and to study the socio-demographic factors associated with successful vocational outcome. A retrospective study of 548 individuals with various types of chronic illness who enrolled in the program between 1995 and 2003. Their socio-demographic data and their employment outcome after a six-month job skills retraining and job settlement service were collected for analysis. The program was found to enhance the vocational outcomes of patients who completed the program. Logistic regression identified significant factors predicting successful vocational outcomes. For the male patients, the chances of employment were higher if the onset of illness had occurred at least 10 years before (odd ratios = 0.326). For the female patients, the chances of employment were higher if they had been unemployed for less than 1 year (odd ratio = 3.8). The PRAVR program is able to enhance the vocational outcomes of people with chronic illness in Hong Kong. The factors which were found to relate to successful employment were unique to the local situation. Further studies should explore these factors in a more in-depth manner.

Use of the SF-8 to assess health-related quality of life for a chronically ill, low-income population participating in the Central Louisiana Medication Access Program (CMAP).

PubMed

Lefante, John J; Harmon, Gary N; Ashby, Keith M; Barnard, David; Webber, Larry S

2005-04-01

The utility of the SF-8 for assessing health-related quality of life (HRQL) is demonstrated. Race and gender differences in physical component (PCS) and mental component (MCS) summary scores among participants in the CENLA Medication Access Program (CMAP), along with comparisons to the United States population are made. Age-adjusted multiple linear regression analyses were used to compare 1687 CMAP participants to the US population. Internal race and gender comparisons, adjusting for age and the number of self reported diagnoses, were also obtained. The paired t-test was used to assess 6-month change in PCS and MCS scores for a subset of 342 participants. CMAP participants have PCS and MCS scores that are significantly 10-12 points lower than the US population, indicating lower self-reported HRQL. Females have significantly higher PCS and significantly lower MCS than males. African-Americans have significantly higher MCS than Caucasians. Significant increases in both PCS and MCS were observed for the subset of participants after 6 months of intervention. The expected lower baseline PCS and MCS measures and the expected associations with age and number of diagnoses indicate that the SF-8 survey is an effective tool for measuring the HRQL of participants in this program. Preliminary results indicate significant increases in both PCS and MCS 6 months after intervention.

Managing workplace depression: an untapped opportunity for occupational health professionals.

PubMed

Putnam, Kelly; McKibbin, Laura

2004-03-01

Depression is one of the most prevalent and costly health issues affecting the American work force. Despite well established research demonstrating the association between employee depression and reduced on-the-job productivity, increased absenteeism, and higher health care use, most employers remain largely unresponsive to the need for company based depression initiatives. Organizational and individual barriers can prevent companies from effectively managing employee depression. Organizational barriers include information gaps, lack of data to justify increased investment in employee mental health programs, and employers' ambiguous roles in addressing depression. Individual barriers such as an inability to recognize signs and symptoms; stigma; confidentiality and privacy concerns; and unavailability of easily accessible, quality resources can keep employees who are depressed from seeking treatment. Many occupational health professionals may feel ill prepared or uncomfortable taking the lead in creating more aggressive worksite responses to depression, but they are, perhaps, in the best of all possible positions within an organization to succeed. Occupational health professionals have the credentials, credibility, training, and experience necessary to build a strong case for business leaders for why investing in workplace depression programs is so important. Occupational health professionals are the most qualified to design and deliver destigmatized, customer friendly programs and services for employees to access for help with depression, and to integrate their services with other departments such as benefits, health promotion, EAP, and human resources, to create an effective, organization-wide depression initiative.

The Police Response to Mental Illness on Campus

ERIC Educational Resources Information Center

Margolis, Gary J.; Shtull, Penny R.

2012-01-01

Campus police officers are often among the initial contacts for behavioral incidents involving people with mental illness. Their training and access to resources influence decisions to direct the individual to support services and/or through campus disciplinary processes and/or the criminal justice system. Over the past decade, there has been an…

20 CFR 30.1 - What rules govern the administration of EEOICPA and this chapter?

Code of Federal Regulations, 2013 CFR

2013-04-01

..., DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED...

20 CFR 30.1 - What rules govern the administration of EEOICPA and this chapter?

Code of Federal Regulations, 2014 CFR

2014-04-01

..., DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED...

20 CFR 30.1 - What rules govern the administration of EEOICPA and this chapter?

Code of Federal Regulations, 2012 CFR

2012-04-01

..., DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED...

20 CFR 30.1 - What rules govern the administration of EEOICPA and this chapter?

Code of Federal Regulations, 2011 CFR

2011-04-01

..., DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED...

20 CFR 30.1 - What rules govern the administration of EEOICPA and this chapter?

Code of Federal Regulations, 2010 CFR

2010-04-01

..., DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED...

Should patients with self-inflicted illness receive lower priority in access to healthcare resources? Mapping out the debate.

PubMed

Sharkey, Kerith; Gillam, Lynn

2010-11-01

The distribution of scarce healthcare resources is an increasingly important issue due to factors such as expensive 'high tech' medicine, longer life expectancies and the rising prevalence of chronic illness. Furthermore, in the current healthcare context lifestyle-related factors such as high blood pressure, tobacco use and obesity are believed to contribute significantly to the global burden of disease. As such, this paper focuses on an ongoing debate in the academic literature regarding the role of responsibility for illness in healthcare resource allocation: should patients with self-caused illness receive lower priority in access to healthcare resources? This paper critically describes the lower priority debate's 12 key arguments and maps out their relationships. This analysis reveals that most arguments have been refuted and that the debate has stalled and remains unresolved. In conclusion, we suggest progression could be achieved by inviting multidisciplinary input from a range of stakeholders for the development of evidence-based critical evaluations of existing arguments and the development of novel arguments, including the outstanding rebuttals.

Mental health first aid for the elderly: A pilot study of a training program adapted for helping elderly people.

PubMed

Svensson, Bengt; Hansson, Lars

2017-06-01

Epidemiological studies have shown a high prevalence of mental illness among the elderly. Clinical data however indicate both insufficient detection and treatment of illnesses. Suggested barriers to treatment include conceptions that mental health symptoms belong to normal aging and lack of competence among staff in elderly care in detecting mental illness. A Mental Health First Aid (MHFA) training program for the elderly was developed and provided to staff in elderly care. The aim of this study was to investigate changes in knowledge in mental illness, confidence in helping a person, readiness to give help and attitudes towards persons with mental illness. Single group pre-test-post-test design. The study group included staff in elderly care from different places in Sweden (n = 139). Significant improvements in knowledge, confidence in helping an elderly person with mental illness and attitudes towards persons with mental illness are shown. Skills acquired during the course have been practiced during the follow-up. The adaption of MHFA training for staff working in elderly care gives promising results. Improvements in self-reported confidence in giving help, attitudes towards persons with mental illness and actual help given to persons with mental illness are shown. However, the study design allows no firm conclusions and a randomized controlled trail is needed to investigate the effectiveness of the program. Outcomes should include if the detection and treatment of mental illness among the elderly actually improved.

Implementing residential treatment for prison inmates with mental illness.

PubMed

O'Connor, Frederica W; Lovell, David; Brown, Linda

2002-10-01

There is evidence that mentally ill offenders (MIOs) in prisons commit more infractions, serve longer sentences, and are more likely to be victimized than inmates who are not mentally ill. Humanistic and prison management interests are served if intervention programs minimize symptoms and promote coping and other functional skills. A collaborative agreement was established between Washington State Department of Corrections and a consortium of University of Washington faculty to mutually develop a prison-based program of clinical management and psychoeducation for MIOs. The resulting program is described, along with rationale, planning processes, implementation, and initial evaluation. Most aspects of the planned program are in place. Clinical and behavioral progress by inmates following program participation has been documented. Issues concerning treatment program implementation in prisons are discussed. Copyright 2002, Elsevier Science (USA). All rights reserved.

Neighbourly support of people with chronic illness; is it related to neighbourhood social capital?

PubMed

Waverijn, Geeke; Heijmans, Monique; Groenewegen, Peter P

2017-01-01

The neighbourhood may provide resources for health. It is to date unknown whether people who live in neighbourhoods with more social capital have more access to practical and emotional support by neighbours, or whether this is a resource only available to those who are personally connected to people in their neighbourhood. We investigated whether support by neighbours of people with chronic illness was related to neighbourhood social capital and to individual neighbourhood connections. Furthermore, we investigated whether support received from neighbours by people with chronic illness differed according to demographic and disease characteristics. We collected data on support by neighbours and individual connections to neighbours among 2272 people with chronic illness in 2015. Data on neighbourhood social capital were collected among 69,336 people in 3425 neighbourhoods between May 2011 and September 2012. Neighbourhood social capital was estimated with ecometric measurements. We conducted multilevel regression analyses. People with chronic illness were more likely to receive practical and emotional support from neighbours if they had more individual connections to people in their neighbourhood. People with chronic illness were not more likely to receive practical and emotional support from neighbours if they lived in a neighbourhood with more social capital. People with chronic illness with moderate physical disabilities or with comorbidity, and people with chronic illness who lived together with their partner or children, were more likely to receive support from neighbours. To gain more insight into the benefits of neighbourhood social capital, it is necessary to differentiate between the resources only accessible through individual connections to people in the neighbourhood and resources provided through social capital on the neighbourhood level. Copyright © 2016 Elsevier Ltd. All rights reserved.

School-based asthma disease management.

PubMed

Tinkelman, David; Schwartz, Abby

2004-06-01

Asthma is the most common chronic childhood illness and the leading cause of missed school days. School is a potential location for establishing an asthma education program for children and their parents/caregivers designed to improve disease management. To determine whether a comprehensive, school-based asthma management program, in addition to a conventional disease management program, can reduce measures of asthma control, student absenteeism, and caregiver lost workdays. School nurses recruited parents/caregivers of students with asthma from three urban elementary and middle schools. Children were identified as having asthma by a previous diagnosis from their personal physician. Parents were invited to attend educational sessions about the program. Students received peak flow meters and training in their use and had access to an interactive asthma diary to record symptoms, peak flow, and medicine usage. They received monthly asthma education at school and had access to an online asthma education program and additional handouts. Parents received several educational calls regarding asthma and had a 24-hour, 7-days-a-week emergency number to call if problems arose. At 6 months, missed school days and unscheduled doctor visits were reduced by two thirds (n = 41; p< 0.01 for each). Caregivers' perception of children's activity level increased by 11% (n = 26; p = 0.037). Daytime and nighttime frequency of symptoms dropped by 62% and 34%, respectively (n = 32; p < 0.007 and p<0.03 for each). These trends continued at 12 months, although only reduction in frequency of symptoms attained statistical significance. A comprehensive, school-based asthma management program can successfully improve asthma control and reduce absenteeism in elementary and middle school students and caregiver lost workdays.

Sport and eating disorders - understanding and managing the risks.

PubMed

Currie, Alan

2010-06-01

There is strong and consistent evidence that eating disorders are prevalent in sport and especially in weight sensitive sports such as endurance, weight category and aesthetic sports as well as jumping events. These illnesses are not only common but lead to significant physical and psychological morbidity and impaired performances.Sports organizations, and by extension the professionals whose job it is to help and support athletes, have important roles in dealing with these conditions. Preventative practices can be adopted if there is an understanding of how the sports environment contributes to the development of eating disorders. Some disorders can be difficult to detect especially in a sports environment and simple screening instruments are available. Athletes may also need help to access appropriate treatment whilst they are recovering.In many sports prevention, screening and support programs have been developed for a variety of medical conditions or sportsrelated injuries. Similar programs should be developed for eating disorders.

Intentions to work during terminal illness: an exploratory study of antecedent conditions.

PubMed

Westaby, James D; Versenyi, Andrea; Hausmann, Robert C

2005-11-01

Facing a terminal illness is an unimaginably difficult experience, yet many individuals intend to work despite their prognosis. However, research has not systematically examined the potential antecedents underlying such intentions. Using behavioral intention theory as an underlying framework, this study hypothesized that reasons for working (intrinsic and extrinsic), the will to live, disability severity, accessibility of travel, and age would predict intentions to work during terminal illness. A representative sample of medically diagnosed amyotrophic lateral sclerosis (a.k.a. Lou Gehrig's disease) patients with a mean life expectancy of approximately 3 years participated (mean age=57.8 years). Controlling for length of diagnosis, employment status, and demographic variables, results indicated that intrinsic reasons were particularly strong predictors of intentions, followed by age, disability severity, and accessibility of travel. Exploratory findings also indicated that behavioral intentions were positively related to future employment status, consistent with past theory. ((c) 2005 APA, all rights reserved).

Mine Safety and Health Administration's Part 50 program does not fully capture chronic disease and injury in the Illinois mining industry.

PubMed

Almberg, Kirsten S; Friedman, Lee S; Swedler, David; Cohen, Robert A

2018-05-01

The Mine Safety and Health Administration (MSHA) requires reporting of injuries and illnesses to their Part 50 program. A 2011 study indicated that the Part 50 program did not capture many cases of injury in Kentucky, causing concern about underreporting in other states. MSHA Part 50 reports from Illinois for 2001-2013 were linked to Illinois Workers' Compensation Commission (IWCC) data. IWCC cases not found in the Part 50 data were considered unreported. Overall, the Part 50 Program did not capture 66% of IWCC cases from 2001 to 2013. Chronic injuries or illnesses were more likely to be unreported to MSHA. The majority of occupational injuries and illnesses found in the IWCC from this time period, were not captured by Part 50. Inaccurate reporting of injuries and illnesses to the Part 50 program hinders MSHA's ability to enforce safety and health standards in the mining industry. © 2018 Wiley Periodicals, Inc.

[Development of Empowerment Program for Persons with Chronic Mental Illness and Evaluation of Impact].

PubMed

Kim, Mijung; Lee, Kyunghee

2015-12-01

This study was done to develop an empowerment program for people with chronic mental illness and to analyze effects of the program on level of empowerment. The research was conducted using a nonequivalent control group pretest-posttest design. Participants were 37 people with chronic mental illness (experimental group: 18, control group: 19). The empowerment program was provided for 8 weeks (15 sessions). Data were collected between July 21 and October 17, 2014. Data were analyzed using Chi-square, Fisher's exact test, Sapiro-Wilk test, and Repeated measure ANOVA with SPSS/WIN 18.0. Quantitative results show that self-efficacy, interpersonal relationships, attitudes in the workplace, occupational performance capacity, and levels of empowered execute were significantly better in the experimental group compared to the control group. Study findings indicate that this empowerment program for persons with chronic mental illness is effective for improving self efficacy, interpersonal skills, attitudes in the workplace, occupational performance capacity, levels of empowered execute.

The Carter Center Mental Health Program: addressing the public health crisis in the field of mental health through policy change and stigma reduction.

PubMed

Palpant, Rebecca G; Steimnitz, Rachael; Bornemann, Thomas H; Hawkins, Katie

2006-04-01

Some of the most pervasive and debilitating illnesses are mental illnesses, according to World Health Organization's The World Health Report 2001--Mental Health: New Understanding, New Hope. Neuropsychiatric conditions account for four of the top five leading causes of years of life lived with disability in people aged 15 to 44 in the Western world. Many barriers prevent people with mental illnesses from seeking care, such as prohibitive costs, lack of insurance, and the stigma and discrimination associated with mental illnesses. The Carter Center Mental Health Program, established in 1991, focuses on mental health policy issues within the United States and internationally. This article examines the public health crisis in the field of mental health and focuses on The Carter Center Mental Health Program's initiatives, which work to increase public knowledge of and decrease the stigma associated with mental illnesses through their four strategic goals: reducing stigma and discrimination against people with mental illnesses; achieving equity of mental health care comparable with other health services; advancing early promotion, prevention, and early intervention services for children and their families; and increasing public awareness about mental illnesses and mental health issues.

20 CFR 30.603 - Are there any limitations on what the representative may charge the claimant for his or her...

Code of Federal Regulations, 2010 CFR

2010-04-01

... OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS...

20 CFR 30.603 - Are there any limitations on what the representative may charge the claimant for his or her...

Code of Federal Regulations, 2014 CFR

2014-04-01

... OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS...

20 CFR 30.105 - What must DOE do after an employee or survivor files a claim?

Code of Federal Regulations, 2013 CFR

2013-04-01

..., DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED...

20 CFR 30.603 - Are there any limitations on what the representative may charge the claimant for his or her...

Code of Federal Regulations, 2011 CFR

2011-04-01

... OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS...

20 CFR 30.603 - Are there any limitations on what the representative may charge the claimant for his or her...

Code of Federal Regulations, 2012 CFR

2012-04-01

... OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS...

20 CFR 30.603 - Are there any limitations on what the representative may charge the claimant for his or her...

Code of Federal Regulations, 2013 CFR

2013-04-01

... OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS...

Decreasing the Stigma of Mental Illness Through a Student-Nurse Mentoring Program: A Qualitative Study.

PubMed

Fokuo, J Konadu; Goldrick, Virginia; Rossetti, Jeanette; Wahlstrom, Carol; Kocurek, Carla; Larson, Jonathon; Corrigan, Patrick

2017-04-01

Stigma is defined as endorsing prejudicial attitudes about mental illness leading to discriminatory behaviors. It undermines the quality of medical care received by people with mental illness. Research suggests contact based interventions are effective in reducing stigma and increasing positive attitudes towards people with mental illness. This paper describes the development of a consumer led student-nurse mentoring program as part of nursing student education. People with lived mental health experience would mentor student nurses regarding the harmful effects of stigma and the beneficial outcomes of affirming attitudes. Seventy members of stakeholder groups (people with lived mental health experience and student nurses) participated in focus groups. Qualitative analyses revealed themes across stakeholder groups regarding: perceived mental health stigma from nurses, ways to reduce stigma, target message for the mentorship program, characteristics of mentors and logistics in developing such a program within the student nurse curricula.

Social support for South Asian Muslim parents with life-limiting illness living in Scotland: a multiperspective qualitative study.

PubMed

Gaveras, Eleni Margareta; Kristiansen, Maria; Worth, Allison; Irshad, Tasneem; Sheikh, Aziz

2014-02-06

To explore experiences of social support needs among South Asian Muslim patients with life-limiting illness, living in Scotland, who are parents of young children. Secondary analysis of data from a multiperspective, longitudinal Scottish study involving in-depth semistructured interviews with patients, their nominated carers and healthcare professionals. Data were analysed using interpretive phenomenological analysis. Edinburgh, Scotland. South-Asian Muslim patients with life-limiting illness with children under the age of 18 (n=8), their carer (n=6) and their healthcare professional. Access and provision of social support in palliative care. Open-ended qualitative interviews identified four main themes: (1) parental sadness over being unable to provide tangible support; (2) parental desire to continue to provide emotional support; (3) limited availability of informal social support networks; and (4) differing perspectives between healthcare professionals and patients on patient access to social support sources, with a subtheme being the capacity of male carers to provide social support. South-Asian parents at the end of life had limited access to extended-network support. Gender roles appeared as challenging for healthcare providers who at times overestimated the amount of support a female carer could provide and underestimated the amount of support male carers provided. Implications for practice include the need for greater awareness by healthcare providers of the social support needs of ethnic minority and migrant parents with life-limiting illnesses and especially an awareness of the importance of the role of male and female carers. Further research is needed to explore how the timing of migration impacts the need for and availability of tangible and emotional informal social support among ethnic minority parents with life-limiting illness.

Social support for South Asian Muslim parents with life-limiting illness living in Scotland: a multiperspective qualitative study

PubMed Central

Gaveras, Eleni Margareta; Kristiansen, Maria; Worth, Allison; Irshad, Tasneem; Sheikh, Aziz

2014-01-01

Objective To explore experiences of social support needs among South Asian Muslim patients with life-limiting illness, living in Scotland, who are parents of young children. Design Secondary analysis of data from a multiperspective, longitudinal Scottish study involving in-depth semistructured interviews with patients, their nominated carers and healthcare professionals. Data were analysed using interpretive phenomenological analysis. Setting Edinburgh, Scotland. Participants South-Asian Muslim patients with life-limiting illness with children under the age of 18 (n=8), their carer (n=6) and their healthcare professional. Main outcome measures Access and provision of social support in palliative care. Results Open-ended qualitative interviews identified four main themes: (1) parental sadness over being unable to provide tangible support; (2) parental desire to continue to provide emotional support; (3) limited availability of informal social support networks; and (4) differing perspectives between healthcare professionals and patients on patient access to social support sources, with a subtheme being the capacity of male carers to provide social support. South-Asian parents at the end of life had limited access to extended-network support. Gender roles appeared as challenging for healthcare providers who at times overestimated the amount of support a female carer could provide and underestimated the amount of support male carers provided. Implications for practice include the need for greater awareness by healthcare providers of the social support needs of ethnic minority and migrant parents with life-limiting illnesses and especially an awareness of the importance of the role of male and female carers. Further research is needed to explore how the timing of migration impacts the need for and availability of tangible and emotional informal social support among ethnic minority parents with life-limiting illness. PMID:24503303

Using an intervention mapping framework to develop an online mental health continuing education program for pharmacy staff.

PubMed

Wheeler, Amanda; Fowler, Jane; Hattingh, Laetitia

2013-01-01

Current mental health policy in Australia recognizes that ongoing mental health workforce development is crucial to mental health care reform. Community pharmacy staff are well placed to assist people with mental illness living in the community; however, staff require the knowledge and skills to do this competently and effectively. This article presents the systematic planning and development process and content of an education and training program for community pharmacy staff, using a program planning approach called intervention mapping. The intervention mapping framework was used to guide development of an online continuing education program. Interviews with mental health consumers and carers (n = 285) and key stakeholders (n = 15), and a survey of pharmacy staff (n = 504) informed the needs assessment. Program objectives were identified specifying required attitudes, knowledge, skills, and confidence. These objectives were aligned with an education technique and delivery strategy. This was followed by development of an education program and comprehensive evaluation plan. The program was piloted face to face with 24 participants and then translated into an online program comprising eight 30-minute modules for pharmacists, 4 of which were also used for support staff. The evaluation plan provided for online participants (n ≅ 500) to be randomized into intervention (immediate access) or control groups (delayed training access). It included pre- and posttraining questionnaires and a reflective learning questionnaire for pharmacy staff and telephone interviews post pharmacy visit for consumers and carers. An online education program was developed to address mental health knowledge, attitudes, confidence, and skills required by pharmacy staff to work effectively with mental health consumers and carers. Intervention mapping provides a systematic and rigorous approach that can be used to develop a quality continuing education program for the health workforce. Copyright © 2013 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

Walk-in Model for Ill Care in an Urban Academic Pediatric Clinic.

PubMed

Warrick, Stephen; Morehous, John; Samaan, Zeina M; Mansour, Mona; Huentelman, Tracy; Schoettker, Pamela J; Iyer, Srikant

2018-04-01

Since the Institute of Medicine's 2001 charge to reform health care, there has been a focus on the role of the medical home. Access to care in the proper setting and at the proper time is central to health care reform. We aimed to increase the volume of patients receiving care for acute illnesses within the medical home rather than the emergency department or urgent care center from 41% to 60%. We used quality improvement methods to create a separate nonemergency care stream in a large academic primary care clinic serving 19,000 patients (90% Medicaid). The pediatric primary care (PPC) walk-in clinic opened in July 2013 with service 4 hours per day and expanded to an all-day clinic in October 2013. Statistical process control methods were used to measure the change over time in the volume of ill patients and visits seen in the PPC walk-in clinic. Average weekly walk-in nonemergent ill-care visits increased from 61 to 158 after opening the PPC walk-in clinic. The percentage of nonemergent ill-care visits in the medical home increased from 41% to 45%. Visits during regular clinic hours increased from 55% to 60%. Clinic cycle time remained unchanged. Implementation of a walk-in care stream for acute illness within the medical home has allowed us to provide ill care to a higher proportion of patients, although we have not yet achieved our predicted volume. Matching access to demand is key to successfully meeting patient needs. Copyright © 2018 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Ethno-cultural variations in the experience and meaning of mental illness and treatment: implications for access and utilization.

PubMed

Carpenter-Song, Elizabeth; Chu, Edward; Drake, Robert E; Ritsema, Mieka; Smith, Beverly; Alverson, Hoyt

2010-04-01

We conducted a study to investigate how understandings of mental illness and responses to mental health services vary along ethno-racial lines. Participants were 25 African American, Latino, and Euro-American inner-city residents in Hartford Connecticut diagnosed with severe mental illness and currently enrolled in a larger study of a community mental health center. Data were collected through 18 months of ethnographic work in the community. Overall, Euro-Americans participants were most aligned with professional disease-oriented perspectives on severe mental illness and sought the advice and counsel of mental health professionals. African-American and Latino participants emphasized non-biomedical interpretations of behavioral, emotional, and cognitive problems and were critical of mental health services. Participants across the sample expressed expectations and experiences of psychiatric stigma. Although Euro-Americans were aware of the risk of social rejection because of mental illness, psychiatric stigma did not form a core focus of their narrative accounts. By contrast, stigma was a prominent theme in the narrative accounts of African Americans, for whom severe mental illness was considered to constitute private "family business." For Latino participants, the cultural category of nervios appeared to hold little stigma, whereas psychiatric clinical labels were potentially very socially damaging. Our findings provide further empirical support for differences in symptom interpretation and definitions of illness among persons from diverse ethno-racial backgrounds. First-person perspectives on contemporary mental health discourses and practices hold implications for differential acceptability of mental health care that may inform variations in access and utilization of services in diverse populations.

Army dependents: childhood illness and health provision.

PubMed

Giles, Sarah

2005-06-01

This small qualitative study explored attitudes of a group of Army wives to childhood illness and their expectations of health provision. The author's practice serves a population mainly comprising of Army dependents where GP attendance rates are double the national average. Two focus groups were organised using health visitor groups attached to the practice. Transcripts were examined to produce a framework for semi-structured interviews with nine mothers, who were selected by purposive sampling. Mothers were asked about symptoms, coping, social problems, decisions to take action, health provision and support. Data were analysed and sorted, using the principles of grounded theory, into four main themes: attitude to child's illness, coping, Army culture and accessibility to health services. Many Army wives appear to suffer from high levels of stress. It seemed that the coping ability of the mother was affected by the constant turbulence and isolation of Army life. While mothers displayed a knowledge of common illnesses, they had fears of the unknown and of life threatening illnesses. They sometimes managed childhood illness at home owing to lack of transport. The author concluded that some Army wives suffer from stress and lack confidence in their mothering skills when their children are ill, which may be due, in part, to the constant cycle of postings and isolation from family and services. They need easily accessible health facilities and information regarding these services. Communication should be encouraged between civilian services and the Army. It appears that Army dependents require more support from their GP practice than the average civilian family, offering opportunity for nurses and health visitors to provide alternative and proactive services.

Annual Statistical Report, 1988. Client Assistance Program, Protection & Advocacy System for Persons with Mental Illness, Protection & Advocacy System for Persons with Developmental Disabilities.

ERIC Educational Resources Information Center

National Association of Protection and Advocacy Systems, Washington, DC.

The report summarizes: (1) 1988 program data for state Protection and Advocacy Systems for persons with developmental disabilities and persons with mental illness, and (2) 1988 program data for Client Assistance Programs. The data are derived from reports from 56 states and territories. In addition to nationwide data totals, each state's…

Taking Psychedelics Seriously.

PubMed

Byock, Ira

2018-04-01

Psychiatric research in the 1950s and 1960s showed potential for psychedelic medications to markedly alleviate depression and suffering associated with terminal illness. More recent published studies have demonstrated the safety and efficacy of psilocybin, MDMA, and ketamine when administered in a medically supervised and monitored approach. A single or brief series of sessions often results in substantial and sustained improvement among people with treatment-resistant depression and anxiety, including those with serious medical conditions. Need and Clinical Considerations: Palliative care clinicians occasionally encounter patients with emotional, existential, or spiritual suffering, which persists despite optimal existing treatments. Such suffering may rob people of a sense that life is worth living. Data from Oregon show that most terminally people who obtain prescriptions to intentionally end their lives are motivated by non-physical suffering. This paper overviews the history of this class of drugs and their therapeutic potential. Clinical cautions, adverse reactions, and important steps related to safe administration of psychedelics are presented, emphasizing careful patient screening, preparation, setting and supervision. Even with an expanding evidence base confirming safety and benefits, political, regulatory, and industry issues impose challenges to the legitimate use of psychedelics. The federal expanded access program and right-to-try laws in multiple states provide precendents for giving terminally ill patients access to medications that have not yet earned FDA approval. Given the prevalence of persistent suffering and growing acceptance of physician-hastened death as a medical response, it is time to revisit the legitimate therapeutic use of psychedelics.

78 FR 40513 - Division of Energy Employees Occupational Illness Compensation; Proposed Extension of Existing...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-05

... Occupational Illness Compensation; Proposed Extension of Existing Collection; Comment Request ACTION: Notice... is soliciting comments concerning the proposed collection: Energy Employees Occupational Illness... Energy Employees Occupational Illness Compensation Program Act of 2000, as amended (EEOICPA or Act), 42 U...

Designing websites for persons with cognitive deficits: Design and usability of a psychoeducational intervention for persons with severe mental illness.

PubMed Central

Rotondi, Armando J.; Sinkule, Jennifer; Haas, Gretchen L.; Spring, Michael B.; Litschge, Christine M.; Newhill, Christina E.; Ganguli, Rohan; Anderson, Carol M.

2013-01-01

The purpose of this study was to develop an understanding of the design elements that influence the ability of persons with severe mental illness (SMI) and cognitive deficits to use a website, and to use this knowledge to design a web-based telehealth application to deliver a psychoeducation program to persons with schizophrenia and their families. Usability testing was conducted with 98 persons with SMI. First, individual website design elements were tested. Based on these results, theoretical website design models were used to create several alternative websites. These designs were tested for their ability to facilitate use by persons with SMI. The final website design is presented. The results indicate that commonly prescribed design models and guidelines produce websites that are poorly suited and confusing to persons with SMI. Our findings suggest an alternative model that should be considered when designing websites and other telehealth interventions for this population. Implications for future studies addressing the characteristics of accessible designs for persons with SMI and cognitive deficits are discussed. PMID:26321884

Lung disease in indigenous children.

PubMed

Chang, A B; Brown, N; Toombs, M; Marsh, R L; Redding, G J

2014-12-01

Children in indigenous populations have substantially higher respiratory morbidity than non-indigenous children. Indigenous children have more frequent respiratory infections that are, more severe and, associated with long-term sequelae. Post-infectious sequelae such as chronic suppurative lung disease and bronchiectasis are especially prevalent among indigenous groups and have lifelong impact on lung function. Also, although estimates of asthma prevalence among indigenous children are similar to non-indigenous groups the morbidity of asthma is higher in indigenous children. To reduce the morbidity of respiratory illness, best-practice medicine is essential in addition to improving socio-economic factors, (eg household crowding), tobacco smoke exposure, and access to health care and illness prevention programs that likely contribute to these issues. Although each indigenous group may have unique health beliefs and interfaces with modern health care, a culturally sensitive and community-based comprehensive care system of preventive and long term care can improve outcomes for all these conditions. This article focuses on common respiratory conditions encountered by indigenous children living in affluent countries where data is available. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

An Internet discussion board for parents of mentally ill young children.

PubMed

Scharer, Kathleen

2005-01-01

This paper reports parents' use of electronic bulletin board for social support during a pilot study of an Internet intervention. Parents participated for a mean of 13.83 weeks. The convenience sample consisted of six parents. Data were from site access information and parents' postings. Excluding one mother who checked frequently for messages, mothers have an average of 5.2 postings. Excluding this one mother, the postings/ accesses ratio was greater than 60%. Parents made postings in four categories of "child's illness" having 37 comments and 36 comments for "group maintenance". While the study findings cannot be generalized, these results suggest that parents will use electronic discussion boards.

Reviewing Illness Self-Management Programs: A Selection Guide for Consumers, Practitioners, and Administrators.

PubMed

Petros, Ryan; Solomon, Phyllis

2015-11-01

Illness self-management (ISM) programs for adults with serious mental illness offer strategies to increase self-directed recovery activities to maximize wellness and increase independence from the service delivery system. This article describes five of the most popular ISM programs: Pathways to Recovery, The Recovery Workbook, Building Recovery of Individual Dreams and Goals through Education and Support, Wellness and Recovery Action Planning, and Illness Management and Recovery. It provides guidance for administrators, practitioners, and consumers for the purposes of selecting the program or programs providing the best fit. The framework for describing the five programs encompasses four contextual domains that supplement empirical evidence for a more comprehensive evaluation: structure, value orientation toward recovery, methods of teaching, and educational content. Contextual domains distinguish programs from one another, including length and time commitment, requisite resources, inclusion of group support, utilization of medical language and pathology, degree of traditional didactic education, and prioritization of consumer-driven self-exploration. The authors also searched PsycINFO, Google Scholar, and Cochrane Reviews for empirical evidence and evaluated the five programs on the strength of the evidence and the effectiveness of the intervention. Evidence of program effectiveness was found to range from low to moderate. However, empirical evidence alone is insufficient for selecting among the five programs, and contextual domains may offer the most relevant guidance by matching program features with goals of consumers, practitioners, and administrators.

Type 1 Diabetes eHealth Psychoeducation: Youth Recruitment, Participation, and Satisfaction

PubMed Central

Jaser, Sarah S; Faulkner, Melissa S; Murphy, Kathryn; Delamater, Alan; Grey, Margaret

2013-01-01

Background The Internet and other eHealth technologies offer a platform for improving the dissemination and accessibility of psychoeducational programs for youth with chronic illness. However, little is known about the recruitment process and yield of diverse samples in Internet research with youth who have a chronic illness. Objective The purpose of this study was to compare the demographic and clinical characteristics of youth with Type 1 diabetes on recruitment, participation, and satisfaction with 2 eHealth psychoeducational programs. Methods Youth with Type 1 diabetes from 4 sites in the United States were invited to participate (N=510) with 320 eligible youth consenting (mean age=12.3, SD 1.1; 55.3% female; 65.2% white; and mean A1C=8.3, SD 1.5). Data for this secondary analysis included demographic information (age, race/ethnicity, and income), depressive symptoms, and recruitment rates, including those who refused at point of contact (22.0%), passive refusers who consented but did not participate (15.3%), and those who enrolled (62.7%). Participation (80% lessons completed) and a satisfaction survey (ie, how helpful, enjoyable) were also analyzed. Chi-square or analysis of variance (ANOVA) analyses were used. Results There were significant differences in recruitment rates by income and race/ethnicity such that black, Hispanic, or mixed race/ethnicity and low-income youth were more likely to refuse passively compared to white and higher-income youth who were more likely to enroll (P<.001). Participation in program sessions was high, with 78.1% of youth completing at least 4 of 5 sessions. There were no significant differences in participation by program, age, gender, or race/ethnicity. Low-income youth were less likely to participate (P=.002). Satisfaction in both programs was also high (3.9 of 5). There were significant gender, race/ethnicity, and income differences, in that girls (P=.001), black, Hispanic, or mixed race/ethnicity youth (P=.02), and low-income youth (P=.02) reported higher satisfaction. There were no differences in satisfaction by program or age. Conclusions Results indicate that black, Hispanic, or mixed race/ethnicity youth and low-income youth with Type 1 diabetes are less likely to enroll in Internet-based research than white and higher-income youth; thus, creative recruitment approaches are needed. Low-income youth were less likely to participate, possibly due to access. However, once enrolled, youth of diverse race/ethnicity and low-income youth with Type 1 diabetes were as highly satisfied with the eHealth programs as white youth and those with higher income. Results suggest that eHealth programs have the potential to reach diverse youth and be appealing to them. PMID:23360729

20 CFR 30.12 - What process is used by a person who wants to obtain copies of or amend EEOICPA claim records?

Code of Federal Regulations, 2014 CFR

2014-04-01

... WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION...

20 CFR 30.12 - What process is used by a person who wants to obtain copies of or amend EEOICPA claim records?

Code of Federal Regulations, 2013 CFR

2013-04-01

... WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION...

20 CFR 30.113 - What are the requirements for written medical documentation, contemporaneous records, and other...

Code of Federal Regulations, 2013 CFR

2013-04-01

... ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Filing Claims; Evidence and Burden of Proof; Special...

20 CFR 30.301 - May subpoenas be issued for witnesses and documents in connection with a claim under Part B of...

Code of Federal Regulations, 2011 CFR

2011-04-01

... OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS...

20 CFR 30.301 - May subpoenas be issued for witnesses and documents in connection with a claim under Part B of...

Code of Federal Regulations, 2014 CFR

2014-04-01

... OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS...

20 CFR 30.301 - May subpoenas be issued for witnesses and documents in connection with a claim under Part B of...

Code of Federal Regulations, 2013 CFR

2013-04-01

... OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS...

20 CFR 30.112 - What kind of evidence is needed to establish covered employment and how will that evidence be...

Code of Federal Regulations, 2013 CFR

2013-04-01

... OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS...

20 CFR 30.12 - What process is used by a person who wants to obtain copies of or amend EEOICPA claim records?

Code of Federal Regulations, 2012 CFR

2012-04-01

... WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION...

20 CFR 30.12 - What process is used by a person who wants to obtain copies of or amend EEOICPA claim records?

Code of Federal Regulations, 2010 CFR

2010-04-01

... WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION...

20 CFR 30.301 - May subpoenas be issued for witnesses and documents in connection with a claim under Part B of...

Code of Federal Regulations, 2012 CFR

2012-04-01

... OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS...

Intraosseous infusions: a review for the anesthesiologist with a focus on pediatric use.

PubMed

Tobias, Joseph D; Ross, Allison Kinder

2010-02-01

Intraosseous (IO) access is used most frequently for emergency care of critically ill infants and children when IV access cannot be rapidly achieved. Despite its efficacy in such situations, applications outside of the emergency room or resuscitation scenario have been limited. Furthermore, although the technique is emphasized in the teaching of those caring for critically ill infants and children in the emergency room or critical care setting, there is limited emphasis on its potential use in the perioperative setting. When peripheral venous access cannot be achieved in the operating room, alternative means of securing vascular access such as central line placement or surgical cutdown are generally successful; however, these techniques may be time consuming. Anyone providing anesthesia care for infants and children may want to become facile with the use of IO infusions for selected indications. We present the history of IO infusions, review the anatomy of the bone marrow space, discuss the potential role of IO infusions in the perioperative period, and analyze its adverse effect profile.

Alcohol use and selected health conditions of 1991 Gulf War veterans: survey results, 2003-2005.

PubMed

Coughlin, Steven S; Kang, Han K; Mahan, Clare M

2011-05-01

A sizable literature has analyzed the frequency of alcohol consumption and patterns of drinking among veterans. However, few studies have examined patterns of alcohol use in veterans of the first Gulf War or factors associated with problem drinking in this population. We examined the frequency and patterns of alcohol use in male and female veterans who served in the 1991 Gulf War or during the same era and the relationships between alcohol use and selected health conditions. We analyzed data from a follow-up survey of health information among population-based samples of 15,000 Gulf War and 15,000 Gulf Era veterans. Data had been collected from 9,970 respondents during 2003 through 2005 via a structured questionnaire or telephone survey. Posttraumatic stress disorder (PTSD), major depressive disorder (MDD), unexplained multisymptom illness (MSI), and chronic fatigue syndrome (CFS)-like illness were more frequent among veterans with problem drinking than those without problem drinking. Approximately 28% of Gulf War veterans with problem drinking had PTSD compared with 13% of Gulf War veterans without problem drinking. In multivariate analysis, problem drinking was positively associated with PTSD, MDD, unexplained MSI, and CFS-like illness after adjustment for age, sex, race/ethnicity, branch of service, rank, and Gulf status. Veterans who were problem drinkers were 2.7 times as likely to have PTSD as veterans who were not problem drinkers. These findings indicate that access to evidence-based treatment programs and systems of care should be provided for veterans who abuse alcohol and who have PTSD and other war-related health conditions and illnesses.

Acute Pesticide-Related Illness Among Farmworkers: Barriers to Reporting to Public Health Authorities

PubMed Central

Prado, Joanne Bonnar; Mulay, Prakash R.; Kasner, Edward J.; Bojes, Heidi K.; Calvert, Geoffrey M.

2018-01-01

Farmworkers are at high risk of acute occupational pesticide-related illness (AOPI) and AOPI surveillance is vital to preventing these illnesses. Data on such illnesses are collected and analyzed to identify high-risk groups, high-risk pesticides, and root causes. Interventions to address these risks and root causes include farmworker outreach, education, and regulation. Unfortunately, it is well known that AOPI is underreported, meaning that the true burden of this condition remains unknown. This article reviews the barriers to reporting of farmworker AOPI to public health authorities and provides some practical solutions. Information is presented using the social-ecological model spheres of influence. Factors that contribute to farmworker AOPI underreporting include fear of job loss or deportation, limited English proficiency (LEP), limited access to health care, lack of clinician recognition of AOPI, farmworker ineligibility for workers’ compensation (WC) benefits in many states, insufficient resources to conduct AOPI surveillance, and constraints in coordinating AOPI investigations across state agencies. Solutions to address these barriers include: emphasizing that employers encourage farmworkers to report safety concerns; raising farmworker awareness of federally qualified health centers (FQHCs) and increasing the availability of these clinics; improving environmental toxicology training to health-care students and professionals; encouraging government agencies to investigate pesticide complaints and provide easy-to-read reports of investigation findings; fostering public health reporting from electronic medical records, poison control centers (PCCs), and WC; expanding and strengthening AOPI state-based surveillance programs; and developing interagency agreements to outline the roles and responsibilities of each state agency involved with pesticide safety. PMID:28762882

A Survey of Online and Mobile Technology Use at Peer Support Agencies.

PubMed

Aschbrenner, Kelly A; Naslund, John A; Grinley, Thomas; Bienvenida, John Carlo M; Bartels, Stephen J; Brunette, Mary

2018-01-04

Understanding how individuals with mental illness who receive services at peer support agencies use technology can inform the development of online and mobile health interventions tailored for users in these non-traditional mental health settings. The purpose of this study was to assess the use of technology among individuals with mental illness at peer support agencies. A survey delivered within peer support agencies (PSAs) in one state assessed technology use among individuals ages 18 and over with a self-identified mental illness receiving services at these agencies. In total, 195 individuals from 10 PSAs completed the survey. Eighty-two percent of respondents used the internet, with 63% of respondents connected to the internet at the PSAs. Eighty one percent of respondents owned a cell phone, 70% used text messaging, 58% owned smartphones, 61% used mobile applications, and 72% used social media. PSA users under age 55 were significantly more likely to own a smartphone than PSA users age 55 and older. Among internet users, 71% had searched for health information online and 57% had searched for mental health information online. Many individuals who receive services at PSAs have access to online and mobile technologies. These technologies may be leveraged to expand the reach of evidence-based health and mental health programs to individuals in these non-traditional mental health settings. Future research should explore the feasibility of intervention strategies that involve PSAs as a resource for linking people with mental illness to online and mobile support for their health and wellness goals.

There’s No Place Like(a)Home: Ontological Security Among Persons with Serious Mental Illness in the United States

PubMed Central

Padgett, Deborah K.

2007-01-01

As the homelessness ‘crisis’ in the United States enters a third decade, few are as adversely affected as persons with serious mental illness. Despite recent evidence favoring a ‘housing first’ approach, the dominant ‘treatment first’ approach persists in which individuals must climb a ladder of program requirements before becoming eligible for an apartment of their own. Drawing upon the concept of ‘ontological security’, this qualitative study examines the subjective meaning of ‘home’ among 39 persons who were part of a unique urban experiment that provided New York City’s homeless mentally ill adults with immediate access to independent housing in the late 1990s. The study design involved purposively sampling from the experimental (housing first) group (N=21) and the control (treatment first) group (N=18) and conducting two life history interviews with each participant. Markers of ontological security--constancy, daily routines, privacy, and having a secure base for identity construction—provided sensitizing concepts for grounded theory analyses designed to also yield emergent, or new, themes. Findings revealed clear evidence of the markers of ontological security among participants living in their own apartments. This study expands upon previous research showing that homeless mentally ill persons are capable of independent living in the community. The emergent theme of ‘what’s next’ questions and uncertainty about the future points to the need to address problems of stigma and social exclusion that extend beyond the minimal achievement of having a ‘home’. PMID:17355900

"You don't look like one of them": disclosure of mental illness in the workplace as an ongoing dilemma.

PubMed

Peterson, Debbie; Currey, Nandika; Collings, Sunny

2011-01-01

The purpose of this study was to describe the pressures surrounding disclosure of a mental illness in the New Zealand workplace. Using qualitative methods and general inductive analysis, the study included twenty-two employed New Zealanders with experience of mental illnesses. Fear of discrimination, and legal, practical and moral pressures contributed to tension between workplace disclosure and non-disclosure of a mental illness. The decision to disclose a mental illness is a dilemma throughout the employment process, not just a problem for the beginning of an employment relationship. Employees with experience of mental illnesses and their employers need to be able to access advice throughout this process on disclosure issues. Disclosure is irreversible; therefore, the decision to disclose, and its timing, must remain at the discretion of the employee.

Giving Your Patrons the World: Barriers to, and the Value of, International Interlibrary Loan

ERIC Educational Resources Information Center

Munson, Kurt; Thompson, Hilary H.

2018-01-01

Using the 2011 and 2015 survey by the Reference and User Services Association Sharing and Transforming Access to Resources Section (RUSA STARS) of international interlibrary loans (ILL), the authors explore barriers to this method of meeting patrons' information needs. They evaluate international ILL in the context of developments in the…

Rates of Mental Illness and Associated Academic Impacts in Ontario's College Students

ERIC Educational Resources Information Center

Holmes, Alana; Silvestri, Robert

2016-01-01

Staff at campus-based counselling and disability centres in 15 of Ontario's 24 community colleges completed 3,536 surveys on 1,964 individual students querying the presence of mental illness and academic challenges as reported by students accessing these services. Survey data were analyzed to determine prevalence rates of mental disorders and…

Service user perspectives on the experience of illness and pathway to care in first-episode psychosis: a qualitative study within the TOP project.

PubMed

Jansen, Jens Einar; Wøldike, Peter Michael; Haahr, Ulrik Helt; Simonsen, Erik

2015-03-01

Delays in initiating treatment are associated with poor clinical and functional outcomes, yet there remains unclarity as to what facilitates and what acts as barriers to accessing appropriate support for first-episode psychosis. To explore this we examined service users' views of their illness trajectory and help-seeking behavior. To describe service-users' experiences with and understanding of their illness and pathway to care, including their need for treatment, the role of their relatives and experience with the treatment service. In-depth interviews were conducted with eleven randomly selected service users (median age 20, range 15-24, 6 males, 5 females) diagnosed with a first-episode psychosis and currently enrolled in treatment for this disorder. Fear of stigma, lack of knowledge about mental illness and normalisation of symptoms were barriers to accessing appropriate treatment, while support from significant others and information accessed by internet were reported as important elements in seeking appropriate treatment. The findings regarding barriers to treatment are in accordance with themes found in earlier studies and serve to validate these. Our study highlights the need to include psychological factors such as normalisation of symptoms and fear of stigma when attempting to reduce DUP in early psychosis, in addition to initiatives to reduce service delays. Also, a greater use of the potentials inherent in Internet and social media platforms seems important in this regard.

Availability of essential health services in post-conflict Liberia

PubMed Central

Rockers, Peter C; Williams, Elizabeth H; Varpilah, S Tornorlah; Macauley, Rose; Saydee, Geetor; Galea, Sandro

2010-01-01

Abstract Objective To assess the availability of essential health services in northern Liberia in 2008, five years after the end of the civil war. Methods We carried out a population-based household survey in rural Nimba county and a health facility survey in clinics and hospitals nearest to study villages. We evaluated access to facilities that provide index essential services: artemisinin combination therapy for malaria, integrated management of childhood illness, human immunodeficiency virus (HIV) counselling and testing, basic emergency obstetric care and treatment of mental illness. Findings Data were obtained from 1405 individuals (98% response rate) selected with a three-stage population-representative sampling method, and from 43 of Nimba county’s 49 health facilities selected because of proximity to the study villages. Respondents travelled an average of 136 minutes to reach a health facility. All respondents could access malaria treatment at the nearest facility and 55.9% could access HIV testing. Only 26.8%, 14.5%, and 12.1% could access emergency obstetric care, integrated management of child illness and mental health services, respectively. Conclusion Although there has been progress in providing basic services, rural Liberians still have limited access to life-saving health care. The reasons for the disparities in the services available to the population are technical and political. More frequently available services (HIV testing, malaria treatment) were less complex to implement and represented diseases favoured by bilateral and multilateral health sector donors. Systematic investments in the health system are required to ensure that health services respond to current and future health priorities. PMID:20616972

[Stigma as perceived by schizophrenics and depressives].

PubMed

Holzinger, Anita; Beck, Michael; Munk, Ingrid; Weithaas, Sandra; Angermeyer, Matthias C

2003-10-01

The goal of this study is to investigate the stigma of mental illness from the perspective of the persons directly affected by it. 210 patients with schizophrenia or major depression were questioned about anticipated and concrete stigmatization experiences, using a questionnaire especially developed for this study. Most of the patients expected negative reactions from the environment. Three quarters were convinced that their job application would be rejected when it became known that they are mentally ill. Almost two thirds felt apprehensive that others would avoid them due to their illness. There is hardly any difference between schizophrenia and depressive patients' assessment of stigmatization of mentally ill people. Concrete stigmatization experiences were most frequently reported in the domain of interpersonal interaction. Second comes the distorted picture of mentally ill people that is depicted in the media and experienced as hurtful by the patients. The obstacles to access social roles (partnership, work, etc.) perceived by the patients come third. Participants least frequently mentioned structural discrimination, i. e. disadvantages regarding psychiatric treatment or rehabilitation measures. Contrary to anticipated stigmatization, there are differences between the two diagnostic groups when it comes to concrete stigmatization experiences. Schizophrenia patients more frequently report that others would avoid contact with them and that the access to social roles was especially complicated for them. They also seemed to be more exposed to structural discrimination than depressive patients. Based on the results of this study, ways are discussed of how stigmatization and discrimination of mentally ill people can be reduced.

Workplace accommodations for people with mental illness: a scoping review.

PubMed

McDowell, Caitlin; Fossey, Ellie

2015-03-01

Disability discrimination legislation means that employees with a disability or mental illness are legally entitled to reasonable workplace accommodations that enable them to work effectively and safely. This scoping review aims to investigate the types of workplace accommodations provided for people with mental illness, and their costs and benefits. A literature search was conducted using five electronic databases. Peer reviewed research articles published between 1993 and June 2013 were included in this scoping review and their quality was assessed. Opinion papers, reports, and case descriptions were excluded. Nine studies explored workplace accommodations for people with mental illness. The most commonly reported work-related accommodations were flexible scheduling/reduced hours, modified training and supervision, and modified job duties/descriptions. The least common type of accommodation was physical modification to the workplace. For employees with persistent mental illness who were accessing a supported employment agency, the majority of accommodations related to support from the job coach or employment specialist, such as facilitating communication with the employer during hiring or on the job. The quality of the studies varied considerably and the benefits of the accommodations are not yet well documented. There is limited evidence that a larger number of workplace accommodations are associated with longer job tenure. Workplace accommodations appear to be important to support employees with mental illness, but more accessible information about how disability discrimination legislation applies to this population is needed. Future research should address the implementation and effectiveness of mental health-related workplace accommodations.

Recidivism of Offenders with Mental Illness Released from Prison to an Intensive Community Treatment Program

ERIC Educational Resources Information Center

Theurer, Gregory; Lovell, David

2008-01-01

An intensive case management treatment program for mentally ill offenders (MIOs) is outlined, and subsequent recidivism of participants is evaluated. Features of the program and its development are discussed. Sixty-four (64) participants released from state prison between 1998 and 2003 were matched with a group of MIOs released earlier on eight…

20 CFR 30.619 - Do all the parties to this type of tort suit have to take these actions?

Code of Federal Regulations, 2010 CFR

2010-04-01

... PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS... employee and his or her spouse, with the covered Part B employee claiming for chronic beryllium disease and...

Teaching Children about Mental Health and Illness: A School Nurse Health Education Program

ERIC Educational Resources Information Center

DeSocio, Janiece; Stember, Lisa; Schrinsky, Joanne

2006-01-01

A mental health education program designed by school nurses for children ages 10-12 was developed in 2000-2001 and expanded with broader distribution in 2004-2005. Six classroom sessions, each 45 minutes in length, provided information and activities to increase children's awareness of mental health and illness. Education program content included…

42 CFR 51.22 - Governing authority.

Code of Federal Regulations, 2010 CFR

2010-10-01

... THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM Program Administration and... representation of individuals with mental illness who are, or have been eligible for services, or have received or are receiving mental health services, and family members, guardians, advocates, or authorized...

20 CFR 30.300 - What process will OWCP use to decide claims for entitlement and to provide for administrative...

Code of Federal Regulations, 2014 CFR

2014-04-01

... OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Adjudicatory Process § 30.300 What process...

20 CFR 30.300 - What process will OWCP use to decide claims for entitlement and to provide for administrative...

Code of Federal Regulations, 2013 CFR

2013-04-01

... OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Adjudicatory Process § 30.300 What process...

20 CFR 30.111 - What is the claimant's responsibility with respect to burden of proof, production of documents...

Code of Federal Regulations, 2013 CFR

2013-04-01

... OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Filing Claims; Evidence and Burden of Proof...

20 CFR 30.300 - What process will OWCP use to decide claims for entitlement and to provide for administrative...

Code of Federal Regulations, 2012 CFR

2012-04-01

... OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Adjudicatory Process § 30.300 What process...

20 CFR 30.300 - What process will OWCP use to decide claims for entitlement and to provide for administrative...

Code of Federal Regulations, 2011 CFR

2011-04-01

... OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Adjudicatory Process § 30.300 What process...

Case Manager Perspectives on the Role of Treatment in Supportive Housing for People with Severe Mental Illness

PubMed Central

Stanhope, Victoria; Choy-Brown, Mimi; Tiderington, Emmy; Henwood, Benjamin F.; Padgett, Deborah K.

2016-01-01

Objective Growing recognition exists of housing as a social determinant of health, and thus, health care reform initiatives are expanding the reach of health care beyond traditional settings. One result of this expansion is increased Medicaid funds for supportive-housing programs for people with severe mental illnesses. This qualitative study explores the ways in which case managers working in a supportive housing program approach treatment and how their approach is influenced by both program requirements and their beliefs about mental illness. Method The study is part of a longitudinal qualitative study on recovery for people with severe mental illnesses living in supportive housing. Multiple interviews (n = 55) with 24 case managers from a residential-continuum supportive-housing program were conducted over 18 months. To provide an in-depth view of case manager perspectives, the study uses thematic analysis with multiple coders. Results Overall, case managers understand supportive housing as being a treatment program but predominantly characterize treatment as medication management. The following themes emerged: believing medication to be the key to success in the program, persuading residents to take medication, and questioning the utility of the program for residents who were not medication adherent. Conclusions Case managers understand supportive housing to be a treatment program; however, given the external constraints and their own beliefs about mental illness, case managers often equate treatment with taking medication. Study findings demonstrate the need to train case managers about mental health recovery and integrated health care. The findings also have implications for policies that tie housing to services. PMID:28163830

First choice of treatment place in the pathways to epileptic care at the outpatient department of University of Gondar Hospital, Northwest Ethiopia: Cross-sectional institutional based study.

PubMed

Bifftu, Berhanu Boru; Dachew, Berihun Assefa; Tiruneh, Bewket Tadesse; Alemu, Wondale Getinet

2017-01-01

Epilepsy treatment gap range from 87% to 98%. In spite of this, there is a gross inadequacy of the availability, accessibility and affordability of Anti-Epileptic Drugs. In countries like Ethiopia, where most populations are less aware about mental health problems, most people seek help for their illness from traditional healers. Thus, the main purpose of this study was to assess the pathways to epilepsy care and associated factors. Cross-sectional study design utilized among 409 participants selected by systematic random sampling technique. Pathways to epilepsy care were assessed by using the WHO Pathway Study tool. Multivariable logistic regression was done to identify factors associated with pathways to epileptic care. Overall, 162 (39.6%) of participants first contacted with modern treatment. Two hundred and forty seven (60.4%) of participants counted traditional healers and religious healers were the most common (47.2%). Being men, attending higher education, urban residence, short duration of illness, social support and age at the onset of illness were factors associated with first contact with modern treatment. Modern treatment was not the first place of choice for the majority of the respondents. Strengthening awareness creation program about epilepsy and its treatment is highly recommended with special emphases to urban dwellers and less educated people.

Long-Term Condition Self-Management Support in Online Communities: A Meta-Synthesis of Qualitative Papers.

PubMed

Allen, Chris; Vassilev, Ivaylo; Kennedy, Anne; Rogers, Anne

2016-03-10

Recent years have seen an exponential increase in people with long-term conditions using the Internet for information and support. Prior research has examined support for long-term condition self-management through the provision of illness, everyday, and emotional work in the context of traditional offline communities. However, less is known about how communities hosted in digital spaces contribute through the creation of social ties and the mobilization of an online illness "workforce." The aim was to understand the negotiation of long-term condition illness work in patient online communities and how such work may assist the self-management of long-term conditions in daily life. A systematic search of qualitative papers was undertaken using various online databases for articles published since 2004. A total of 21 papers met the inclusion criteria of using qualitative methods and examined the use of peer-led online communities for those with a long-term condition. A qualitative meta-synthesis was undertaken and the review followed a line of argument synthesis. The main themes identified in relation to the negotiation of self-management support were (1) redressing offline experiential information and knowledge deficits, (2) the influence of modeling and learning behaviors from others on self-management, (3) engagement that validates illness and negates offline frustrations, (4) tie formation and community building, (5) narrative expression and cathartic release, and (6) dissociative anonymity and invisibility. These translated into a line of argument synthesis in which four network mechanisms for self-management support in patient online communities were identified. These were (1) collective knowledge and identification through lived experience; (2) support, information, and engagement through readily accessible gifting relationships; (3) sociability that extends beyond illness; and (4) online disinhibition as a facilitator in the negotiation of self-management support. Social ties forged in online spaces provide the basis for performing relevant self-management work that can improve an individual's illness experience, tackling aspects of self-management that are particularly difficult to meet offline. Membership in online groups can provide those living with a long-term condition with ready access to a self-management support illness workforce and illness and emotional support. The substitutability of offline illness work may be particularly important to those whose access to support offline is either limited or absent. Furthermore, such resources require little negotiation online because information and support is seemingly gifted to the community by its members.

Long-Term Condition Self-Management Support in Online Communities: A Meta-Synthesis of Qualitative Papers

PubMed Central

Vassilev, Ivaylo; Kennedy, Anne; Rogers, Anne

2016-01-01

Background Recent years have seen an exponential increase in people with long-term conditions using the Internet for information and support. Prior research has examined support for long-term condition self-management through the provision of illness, everyday, and emotional work in the context of traditional offline communities. However, less is known about how communities hosted in digital spaces contribute through the creation of social ties and the mobilization of an online illness “workforce.” Objective The aim was to understand the negotiation of long-term condition illness work in patient online communities and how such work may assist the self-management of long-term conditions in daily life. Methods A systematic search of qualitative papers was undertaken using various online databases for articles published since 2004. A total of 21 papers met the inclusion criteria of using qualitative methods and examined the use of peer-led online communities for those with a long-term condition. A qualitative meta-synthesis was undertaken and the review followed a line of argument synthesis. Results The main themes identified in relation to the negotiation of self-management support were (1) redressing offline experiential information and knowledge deficits, (2) the influence of modeling and learning behaviors from others on self-management, (3) engagement that validates illness and negates offline frustrations, (4) tie formation and community building, (5) narrative expression and cathartic release, and (6) dissociative anonymity and invisibility. These translated into a line of argument synthesis in which four network mechanisms for self-management support in patient online communities were identified. These were (1) collective knowledge and identification through lived experience; (2) support, information, and engagement through readily accessible gifting relationships; (3) sociability that extends beyond illness; and (4) online disinhibition as a facilitator in the negotiation of self-management support. Conclusions Social ties forged in online spaces provide the basis for performing relevant self-management work that can improve an individual’s illness experience, tackling aspects of self-management that are particularly difficult to meet offline. Membership in online groups can provide those living with a long-term condition with ready access to a self-management support illness workforce and illness and emotional support. The substitutability of offline illness work may be particularly important to those whose access to support offline is either limited or absent. Furthermore, such resources require little negotiation online because information and support is seemingly gifted to the community by its members. PMID:26965990

The development of an internet-based knowledge exchange platform for pediatric critical care clinicians worldwide*.

PubMed

Wolbrink, Traci A; Kissoon, Niranjan; Burns, Jeffrey P

2014-03-01

Advances in Internet technology now enable unprecedented global collaboration and collective knowledge exchange. Up to this time, there have been limited efforts to use these technologies to actively promote knowledge exchange across the global pediatric critical care community. To develop an open-access, peer-reviewed, not-for-profit Internet-based learning application, OPENPediatrics, a collaborative effort with the World Federation of Pediatric Intensive and Critical Care Societies, was designed to promote postgraduate educational knowledge exchange for physicians, nurses, and others caring for critically ill children worldwide. Description of program development. International multicenter tertiary pediatric critical care units across six continents. Multidisciplinary pediatric critical care providers. A software application, providing information on demand, curricular pathways, and videoconferencing, downloaded to a local computer. In 2010, a survey assessing postgraduate educational needs was distributed through World Federation of Pediatric Intensive and Critical Care Societies to constituent societies. Four hundred and twenty-nine critical care providers from 49 countries responded to the single e-mail survey request. Respondents included 68% physicians and 28% nurses who care for critically ill children. Fifty-two percent of respondents reported accessing the Internet at least weekly to obtain professional educational information. The five highest requests were for educational content on respiratory care [mechanical ventilation] (48% [38%]), sepsis (28%), neurology (25%), cardiology (14%), extracorporeal membrane oxygenation (10%), and ethics (8%). Based on these findings, and in collaboration with researchers in adult learning and online courseware, an application was developed and is currently being used by 770 registered users in 60 countries. We describe here the development and implementation of an Internet-based application which is among the first efforts designed to promote global knowledge exchange for physicians and nurses caring for critically ill children. This application has the potential to evolve new methods in postgraduate education. Ongoing assessment of the efficacy of Internet-based learning platforms will be necessary.

Chronically Ill Children in America: Background and Recommendations.

ERIC Educational Resources Information Center

Hobbs, Nicholas; And Others

The report examines chronic illness in children and considers issues and recommendations for change in public policies and programs affecting chronically ill children and their families. The background chapter notes the significance of the problem, reviews 11 diseases that are representative of the severe chronic illnesses of childhood: juvenile…

Program for the Chronically Ill.

ERIC Educational Resources Information Center

Schoenherr, Arline; Schnarr, Barbara

The program for chronically ill students in the Detroit public schools is described. Forms are presented listing needed information and implications for teachers of the following conditions: diabetes, sickle cell anemia, chronic renal failure, congenital heart disease, hemophilia, rheumatoid arthritis, asthma, leukemia, and cystic fibrosis. The…

Linking Quality and Spending to Measure Value for People with Serious Illness.

PubMed

Ryan, Andrew M; Rodgers, Phillip E

2018-03-01

Healthcare payment is rapidly evolving to reward value by measuring and paying for quality and spending performance. Rewarding value for the care of seriously ill patients presents unique challenges. To evaluate the state of current efforts to measure and reward value for the care of seriously ill patients. We performed a PubMed search of articles related to (1) measures of spending for people with serious illness and (2) linking spending and quality measures and rewarding performance for the care of people with serious illness. We limited our search to U.S.-based studies published in English between January 1, 1960, and March 31, 2017. We supplemented this search by identifying public programs and other known initiatives that linked quality and spending for the seriously ill and extracted key program elements. Our search related to linking spending and quality measures and rewarding performance for the care of people with serious illness yielded 277 articles. We identified three current public programs that currently link measures of quality and spending-or are likely to within the next few years-the Oncology Care Model; the Comprehensive End-Stage Renal Disease Model; and Home Health Value-Based Purchasing. Models that link quality and spending consist of four core components: (1) measuring quality, (2) measuring spending, (3) the payment adjustment model, and (4) the linking/incentive model. We found that current efforts to reward value for seriously ill patients are targeted for specific patient populations, do not broadly encourage the use of palliative care, and have not closely aligned quality and spending measures related to palliative care. We develop recommendations for policymakers and stakeholders about how measures of spending and quality can be balanced in value-based payment programs.

Linking Quality and Spending to Measure Value for People with Serious Illness

PubMed Central

Rodgers, Phillip E.

2018-01-01

Abstract Background: Healthcare payment is rapidly evolving to reward value by measuring and paying for quality and spending performance. Rewarding value for the care of seriously ill patients presents unique challenges. Objective: To evaluate the state of current efforts to measure and reward value for the care of seriously ill patients. Design: We performed a PubMed search of articles related to (1) measures of spending for people with serious illness and (2) linking spending and quality measures and rewarding performance for the care of people with serious illness. We limited our search to U.S.-based studies published in English between January 1, 1960, and March 31, 2017. We supplemented this search by identifying public programs and other known initiatives that linked quality and spending for the seriously ill and extracted key program elements. Results: Our search related to linking spending and quality measures and rewarding performance for the care of people with serious illness yielded 277 articles. We identified three current public programs that currently link measures of quality and spending—or are likely to within the next few years—the Oncology Care Model; the Comprehensive End-Stage Renal Disease Model; and Home Health Value-Based Purchasing. Models that link quality and spending consist of four core components: (1) measuring quality, (2) measuring spending, (3) the payment adjustment model, and (4) the linking/incentive model. We found that current efforts to reward value for seriously ill patients are targeted for specific patient populations, do not broadly encourage the use of palliative care, and have not closely aligned quality and spending measures related to palliative care. Conclusions: We develop recommendations for policymakers and stakeholders about how measures of spending and quality can be balanced in value-based payment programs. PMID:29091529

A Controlled Trial of a Novel Primary Prevention Program for Lyme Disease and Other Tick-Borne Illnesses

ERIC Educational Resources Information Center

Daltroy, Lawren H.; Phillips, Charlotte; Lew, Robert; Wright, Elizabeth; Shadick, Nancy A.; Liang, Matthew H.

2007-01-01

To evaluate a theory-based educational program to prevent Lyme disease and other tick-borne illnesses (TBI), a randomized controlled trial of an educational program was delivered to ferry passengers traveling to an endemic area in southeastern Massachusetts. Rates of TBI and precautionary and tick check behaviors were measured over three summers…

Easy Access

ERIC Educational Resources Information Center

Gettelman, Alan

2009-01-01

School and university restrooms, locker and shower rooms have specific ADA accessibility requirements that serve the needs of staff, students and campus visitors who are disabled as a result of injury, illness or age. Taking good care of them is good for the reputation of a sensitive community institution, and fosters positive public relations.…

Family caregiver recruitment via social media: challenges, opportunities and lessons.

PubMed

Hansen, Dana; Sheehan, Denice K; Stephenson, Pam

2017-02-02

Illness blogs are a way seriously ill people communicate publicly about their illness journey. As communication about serious illness increases on social media, it is important to evaluate how this affects the family caregiver. However, identifying and accessing family caregivers remains challenging, especially via social media. The aim of this article is to report the opportunities, challenges and lessons learned from using social media to recruit family caregivers. Recruitment methods included posting study invitations on illness blogs, advertising through Facebook and placing study fliers in the community. Using social media to recruit was inexpensive and provided a wide geographical reach. One important finding was discovering the importance of using language in the recruitment materials that family caregivers could identify with to help deem themselves as eligible to participate in the study.

Association between public views of mental illness and self-stigma among individuals with mental illness in 14 European countries.

PubMed

Evans-Lacko, S; Brohan, E; Mojtabai, R; Thornicroft, G

2012-08-01

Little is known about how the views of the public are related to self-stigma among people with mental health problems. Despite increasing activity aimed at reducing mental illness stigma, there is little evidence to guide and inform specific anti-stigma campaign development and messages to be used in mass campaigns. A better understanding of the association between public knowledge, attitudes and behaviours and the internalization of stigma among people with mental health problems is needed. This study links two large, international datasets to explore the association between public stigma in 14 European countries (Eurobarometer survey) and individual reports of self-stigma, perceived discrimination and empowerment among persons with mental illness (n=1835) residing in those countries [the Global Alliance of Mental Illness Advocacy Networks (GAMIAN) study]. Individuals with mental illness living in countries with less stigmatizing attitudes, higher rates of help-seeking and treatment utilization and better perceived access to information had lower rates of self-stigma and perceived discrimination and those living in countries where the public felt more comfortable talking to people with mental illness had less self-stigma and felt more empowered. Targeting the general public through mass anti-stigma interventions may lead to a virtuous cycle by disrupting the negative feedback engendered by public stigma, thereby reducing self-stigma among people with mental health problems. A combined approach involving knowledge, attitudes and behaviour is needed; mass interventions that facilitate disclosure and positive social contact may be the most effective. Improving availability of information about mental health issues and facilitating access to care and help-seeking also show promise with regard to stigma.

Recommendations to reduce inequalities for LGBT people facing advanced illness: ACCESSCare national qualitative interview study

PubMed Central

Bristowe, Katherine; Hodson, Matthew; Wee, Bee; Almack, Kathryn; Johnson, Katherine; Daveson, Barbara A; Koffman, Jonathan; McEnhill, Linda; Harding, Richard

2017-01-01

Background: Lesbian, gay, bisexual and/or trans (LGBT) people have higher risk of certain life-limiting illnesses and unmet needs in advanced illness and bereavement. ACCESSCare is the first national study to examine in depth the experiences of LGBT people facing advanced illness. Aim: To explore health-care experiences of LGBT people facing advanced illness to elicit views regarding sharing identity (sexual orientation/gender history), accessing services, discrimination/exclusion and best-practice examples. Design: Semi-structured in-depth qualitative interviews analysed using thematic analysis. Setting/participants: In total, 40 LGBT people from across the United Kingdom facing advanced illness: cancer (n = 21), non-cancer (n = 16) and both a cancer and a non-cancer conditions (n = 3). Results: In total, five main themes emerged: (1) person-centred care needs that may require additional/different consideration for LGBT people (including different social support structures and additional legal concerns), (2) service level or interactional (created in the consultation) barriers/stressors (including heteronormative assumptions and homophobic/transphobic behaviours), (3) invisible barriers/stressors (including the historical context of pathology/criminalisation, fears and experiences of discrimination) and (4) service level or interactional facilitators (including acknowledging and including partners in critical discussions). These all shape (5) individuals’ preferences for disclosing identity. Prior experiences of discrimination or violence, in response to disclosure, were carried into future care interactions and heightened with the frailty of advanced illness. Conclusion: Despite recent legislative change, experiences of discrimination and exclusion in health care persist for LGBT people. Ten recommendations, for health-care professionals and services/institutions, are made from the data. These are simple, low cost and offer potential gains in access to, and outcomes of, care for LGBT people. PMID:28502218

Recommendations to reduce inequalities for LGBT people facing advanced illness: ACCESSCare national qualitative interview study.

PubMed

Bristowe, Katherine; Hodson, Matthew; Wee, Bee; Almack, Kathryn; Johnson, Katherine; Daveson, Barbara A; Koffman, Jonathan; McEnhill, Linda; Harding, Richard

2018-01-01

Lesbian, gay, bisexual and/or trans (LGBT) people have higher risk of certain life-limiting illnesses and unmet needs in advanced illness and bereavement. ACCESSCare is the first national study to examine in depth the experiences of LGBT people facing advanced illness. To explore health-care experiences of LGBT people facing advanced illness to elicit views regarding sharing identity (sexual orientation/gender history), accessing services, discrimination/exclusion and best-practice examples. Semi-structured in-depth qualitative interviews analysed using thematic analysis. In total, 40 LGBT people from across the United Kingdom facing advanced illness: cancer ( n = 21), non-cancer ( n = 16) and both a cancer and a non-cancer conditions ( n = 3). In total, five main themes emerged: (1) person-centred care needs that may require additional/different consideration for LGBT people (including different social support structures and additional legal concerns), (2) service level or interactional (created in the consultation) barriers/stressors (including heteronormative assumptions and homophobic/transphobic behaviours), (3) invisible barriers/stressors (including the historical context of pathology/criminalisation, fears and experiences of discrimination) and (4) service level or interactional facilitators (including acknowledging and including partners in critical discussions). These all shape (5) individuals' preferences for disclosing identity. Prior experiences of discrimination or violence, in response to disclosure, were carried into future care interactions and heightened with the frailty of advanced illness. Despite recent legislative change, experiences of discrimination and exclusion in health care persist for LGBT people. Ten recommendations, for health-care professionals and services/institutions, are made from the data. These are simple, low cost and offer potential gains in access to, and outcomes of, care for LGBT people.

Forensic psychiatry in India: Past, present, and future

PubMed Central

Nambi, S.; Ilango, Siva; Prabha, Lakshmi

2016-01-01

Forensic psychiatry is a subspecialty of psychiatry, in which scientific and clinical expertise is applied to legal issues in legal contexts embracing civil, criminal, correctional, or legislative matters. Forensic psychiatry is still in an infant stage in India and other developing countries. Law is the sanctioning discipline, and Psychiatry is the therapeutic discipline. Due to various reasons, Forensic Psychiatry is reared as Cinderella in our country; “which is much neglected, ignored, misinterpreted, and misunderstood. Legislation forms an integral component in the implementation of Mental Health Care; there is a dynamic relationship between the concept of mental illness, treatment of the mentally ill, and the law. Mental Health legislation is essential in protecting the rights and dignity of persons with Mental Disorders and for implementing effectively the mental health services. “Effective mental health legislation can provide a legal frame work to integrate mental health services in the community as to overcome stigma, discrimination, and exclusion of mentally ill persons. Legislations can also create enforceable standards for high quality medical care and improve access to care and protect civil, political, social, and economic rights of the mentally ill individual, including right to access to education, employment, housing, and social security.” PMID:28216766

Report on Honduras: ripples in the pond--the financial crisis and remittances to chronically ill patients in Honduras.

PubMed

Piette, John D; Mendoza-Avelares, Milton O; Chess, Laura; Milton, Evan C; Matiz Reyes, Armando; Rodriguez-Saldaña, Joel

2012-01-01

The U.S. financial crisis has affected employment opportunities for Latino immigrants, and this could affect their ability to send financial assistance, or "remittances", to chronically ill family members in their home country. In a cross-sectional survey of 624 chronically ill adults conducted in Honduras between June and August 2009, respondents reported their receipt of remittances, health service use, and cost-related access barriers. Fifty-four percent of respondents reported relatives living outside the country, and of this group, 66 percent (37% of the overall sample) received remittances. Seventy-four percent of respondents receiving remittances reported a decrease over the prior year, mostly due to job losses among their relatives abroad. Respondents reporting reductions in remittances received significantly less per month, on average, than those without a reduction (US $170 vs. $234; p = 0.01). In multivariate models, respondents experiencing a reduction in remittances used fewer health services and medications due to cost concerns. Remittance payments from relatives resident in the United States are a major source of income for chronically ill individuals in Latin America. Most recipients of remittances reported a reduction during the financial downturn that affected their access to care.

Forensic psychiatry in India: Past, present, and future.

PubMed

Nambi, S; Ilango, Siva; Prabha, Lakshmi

2016-12-01

Forensic psychiatry is a subspecialty of psychiatry, in which scientific and clinical expertise is applied to legal issues in legal contexts embracing civil, criminal, correctional, or legislative matters. Forensic psychiatry is still in an infant stage in India and other developing countries. Law is the sanctioning discipline, and Psychiatry is the therapeutic discipline. Due to various reasons, Forensic Psychiatry is reared as Cinderella in our country; "which is much neglected, ignored, misinterpreted, and misunderstood. Legislation forms an integral component in the implementation of Mental Health Care; there is a dynamic relationship between the concept of mental illness, treatment of the mentally ill, and the law. Mental Health legislation is essential in protecting the rights and dignity of persons with Mental Disorders and for implementing effectively the mental health services. "Effective mental health legislation can provide a legal frame work to integrate mental health services in the community as to overcome stigma, discrimination, and exclusion of mentally ill persons. Legislations can also create enforceable standards for high quality medical care and improve access to care and protect civil, political, social, and economic rights of the mentally ill individual, including right to access to education, employment, housing, and social security."

2010 Kansas City Plant Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-06-20

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2010 Savannah River Site Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-09-12

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2007 Hanford Site Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety, and Security

2009-07-16

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2010 Idaho National Laboratory Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-09-26

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2010 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-08-16

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2007 Pantex Plant Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-07-31

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2006 Hanford Site Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-05-14

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2010 Pantex Plant Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-06-29

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2010 Sandia National Laboratory Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-10-26

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2006 Pantex Plant Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-05-19

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2010 Argonne National Laboratory Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-06-20

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

Too Costly To Be Ill: Health Care Access and Health Seeking Behaviors among Rural-to-urban Migrants in China

PubMed Central

Hong, Yan; Li, Xiaoming; Stanton, Bonita; Lin, Danhua; Fang, Xiaoyi; Rong, Mao; Wang, Jing

2007-01-01

Of the 114 million rural-to-urban migrants in China, most have only temporary employment in the cities. Because of their non-urban residence, they are not entitled to many benefits and services accorded to most urban dwellers. Only limited research has been conducted on the health care access and health seeking behaviors of this population. This study, based on qualitative data from in-depth interviews with 90 rural-to-urban migrants, found that migrants had limited access to regular medical services. Lack of insurance coverage, high cost, and exacting work schedules have resulted in use of unsupervised self-treatment or substandard care. Their health seeking behaviors have led to suboptimal health consequences including delayed treatment of illnesses. Findings from this study underscore the importance of reducing institutional barriers to health services and providing affordable health care to this population. PMID:18277099

Internet access and utilization for health information among university students in Islamabad.

PubMed

Shaikh, Irshad Ali; Shaikh, Masood Ali; Kamal, Anila; Masood, Sobia

2008-01-01

Internet has changed the way we live and work. Advent of this technology has fundamentally transformed our lives the way invention of automobile changed how our lives and cities looked and worked before. Practically no information is available on the use of Internet for health by the people of Pakistan. The Objectives of the study were to assess the access and utilization pattern of Internet by university students in Islamabad, with emphasis on the healthcare information seeking. An anonymous, self-administered, and pre-tested questionnaire with questions on the access, and usage pattern of Internet, seeking health care information online, and belief about reliability of such information; was distributed to only those students who were enrolled in masters or higher degree programs. A total of 600 students were approached and 598 (99.7%) completed the questionnaires. The mean age of students was 23.5 years (range 19-40). The majority of students (423) were enrolled in masters program. Four hundred and sixty-eight students (78.26%) students had access to the computer either at home or at their university hostel. While 304 (50.84%) students had Internet access at home or in their university hostel. Out of 304 students who reported having access to Internet in the past three months, one hundred and thirty-nine (43.4%) students replied affirmatively to the question of having used Internet for seeking health care information. And 109 (78.4%) thought that such information was reliable. Out of 139 students who had used Internet for seeking health information, 35 (25.2%) students replied affirmatively to the question of having discussed health information obtained from Internet with their doctor/physician whom they visited for any illness/treatment. Majority of Islamabad university students in this study had access to computer and Internet. Young and healthy state of this educated age group perhaps accounts for limited use of Internet for seeking healthcare related information. However, high reliability of Internet obtained health information needs to be further studied in terms of websites utilized for seeking such information.

"Alternative to Prison" Programs for the Mentally Ill Offender

ERIC Educational Resources Information Center

Schaefer, Nicole J.; Stefancic, Ana

2003-01-01

Mentally ill offenders represent a substantial proportion of jail and prison inmates. Despite the fact that confining mentally ill offenders can and often will exacerbate their mental illness, the quality of mental health services available to them remains poor and insufficient. Up to date, only a few cities and counties have considered a more…

Firearms regulation, violence and the mentally ill: a contemporary Antipodean appraisal.

PubMed

Chappell, Duncan

2014-01-01

As recent cases of mass murder at Utoya Island in Norway, and in the United States (US) at Virginia Tech, Virginia; Tucson, Arizona; Aurora, Colorado; and Newtown, Connecticut all illustrate, acts of extreme violence involving high powered weapons and committed by persons with a presumed or confirmed mental illness tend to arouse intense public and political debates about the efficacy of firearm regulation and control. Following these tragedies, in the US at least, various law reform measures have been proposed and in some cases implemented designed principally to make it more difficult for mentally ill persons to gain access to firearms. In this article it is contended that measures like these are at best tinkering with the margins of gun control and also have the tendency to reinforce the stigma and discrimination experienced by persons with a mental illness, while perpetuating stereotypes of them as dangerous to themselves and others. Despite these limitations, and while firearm regulation policies and practices vary widely across the globe, most nations still seek in some way to limit access to guns by persons with a mental illness. This article explores in more detail how such policies and practices have been applied in the Australian State of New South Wales and the lessons to be learned elsewhere from this experience. Copyright © 2014 Elsevier Ltd. All rights reserved.

Equitable Access to Healthcare Services and Income Replacement for Cancer: Is Critical Illness Insurance a Help or a Hindrance?

PubMed Central

Longo, Christopher J.

2010-01-01

Canada's publicly funded healthcare system ensures that medically necessary hospital and physician services are available without financial barriers, but not all community-based care is covered. Consequently, many patients experience financial shocks (FS) related to community-based healthcare services not funded by government, and perhaps also from lost income, a situation that may be difficult for patients to avoid. Critical illness insurance (CII) offers a patient-funded alternative to those who qualify and desire protection against FS, leaving those without CII exposed. The author discusses the benefits and limitations of CII to mitigate financially derived healthcare access inequities, using cancer as an example. PMID:21532761

Physical activity and unplanned illness-related work absenteeism: Data from an employee wellness program.

PubMed

Losina, Elena; Yang, Heidi Y; Deshpande, Bhushan R; Katz, Jeffrey N; Collins, Jamie E

2017-01-01

Illness-related absenteeism is a major threat to work productivity. Our objective was to assess the relationship between physical activity and unplanned illness-related absenteeism from work. We implemented physical activity program for sedentary non-clinician employees of a tertiary medical center. Financial rewards were available for reaching accelerometer-measured ambulatory physical activity goals over a 24-week period. We categorized participants into three groups based on mean levels of physical activity: low (0-74 min/week), medium (75-149 min/week) and meeting CDC guidelines (≥150 min/week). We built a multivariable Poisson regression model to evaluate the relationship between physical activity and rates of unplanned illness-related absenteeism. The sample consisted of 292 employees who participated in the program. Their mean age was 38 years (SD 11), 83% were female, and 38% were obese. Over the 24 intervention weeks, participants engaged in a mean of 90 min/week (SD 74) of physical activity and missed a mean of 14 hours of work (SD 38) due to illness. Unplanned absenteeism due to illness was associated with physical activity. As compared to the group meeting CDC guidelines, in multivariable analyses those in the medium physical activity group had a 2.4 (95% CI 1.3-4.5) fold higher rate of illness-related absenteeism and those in the lowest physical activity group had a 3.5 (95% CI 1.7-7.2) fold higher rate of illness-related absenteeism. Less physical activity was associated with more illness-related absenteeism. Workforce-based interventions to increase physical activity may thus be a promising vehicle to reduce unplanned illness-related absenteeism.

Physical activity and unplanned illness-related work absenteeism: Data from an employee wellness program

PubMed Central

Yang, Heidi Y.; Katz, Jeffrey N.; Collins, Jamie E.

2017-01-01

Background Illness-related absenteeism is a major threat to work productivity. Our objective was to assess the relationship between physical activity and unplanned illness-related absenteeism from work. Methods We implemented physical activity program for sedentary non-clinician employees of a tertiary medical center. Financial rewards were available for reaching accelerometer-measured ambulatory physical activity goals over a 24-week period. We categorized participants into three groups based on mean levels of physical activity: low (0–74 min/week), medium (75–149 min/week) and meeting CDC guidelines (≥150 min/week). We built a multivariable Poisson regression model to evaluate the relationship between physical activity and rates of unplanned illness-related absenteeism. Results The sample consisted of 292 employees who participated in the program. Their mean age was 38 years (SD 11), 83% were female, and 38% were obese. Over the 24 intervention weeks, participants engaged in a mean of 90 min/week (SD 74) of physical activity and missed a mean of 14 hours of work (SD 38) due to illness. Unplanned absenteeism due to illness was associated with physical activity. As compared to the group meeting CDC guidelines, in multivariable analyses those in the medium physical activity group had a 2.4 (95% CI 1.3–4.5) fold higher rate of illness-related absenteeism and those in the lowest physical activity group had a 3.5 (95% CI 1.7–7.2) fold higher rate of illness-related absenteeism. Discussion Less physical activity was associated with more illness-related absenteeism. Workforce-based interventions to increase physical activity may thus be a promising vehicle to reduce unplanned illness-related absenteeism. PMID:28472084

Interwoven histories: Mental health nurses with experience of mental illness, qualitative findings from a mixed methods study.

PubMed

Oates, Jennifer; Drey, Nicholas; Jones, Julia

2018-02-15

The effects of mental health nurses' own experience of mental illness or being a carer have rarely been researched beyond the workplace setting. This study aimed to explore how the experience of mental illness affects mental health nurses' lives outside of and inside work. A sample of 26 mental health nurses with personal experience of mental illness took part in semistructured interviews. Data were analysed thematically using a six-phase approach. The analysis revealed the broad context of nurses' experiences of mental illness according to three interwoven themes: mental illness as part of family life; experience of accessing services; and life interwoven with mental illness. Participants typically described personal and familial experience of mental illness across their life course, with multiple causes and consequences. The findings suggest that nurses' lives outside of work should be taken into account when considering the impact of their personal experience of mental illness. Similarly being a nurse influences how mental illness is experienced. Treatment of nurses with mental illness should account for their nursing expertise whilst recognizing that the context for nurses' mental illness could be much broader than the effect of workplace stress. © 2018 Australian College of Mental Health Nurses Inc.

Receipt and Perceived Helpfulness of Mental Illness Information: Findings from the Australian National Survey of Mental Health and Wellbeing.

PubMed

Graham, Annette L; Brooker, Joanne; Hasking, Penelope; Clarke, David; Meadows, Graham

2017-10-20

The distribution of mental illness information is a crucial element of mental health promotion initiatives. We assessed the receipt and perceived helpfulness of such information in Australia. Data from the Australian National Survey of Mental Health and Wellbeing indicated that, during the year prior to the survey, 33.7% of Australians received mental illness information; of these, 51.2% found it helpful. Among people with a mental disorder, 46.1% received information; of these, 67.4% found it helpful. Non-English speakers and the socially disadvantaged were less likely to receive mental illness information. Older and less educated respondents were less likely to both receive mental illness information and find it helpful. Mental health service users were more likely to receive mental illness information perceived as helpful than those who had not accessed such services. Better targeted information interventions are required to ensure those most likely to benefit receive mental illness-related information.

Suggested avenues to reduce the stigma of mental illness in the Middle East.

PubMed

Sewilam, Ahmed M; Watson, Annie M M; Kassem, Ahmed M; Clifton, Sue; McDonald, Margaret C; Lipski, Rebecca; Deshpande, Smita; Mansour, Hader; Nimgaonkar, Vishwajit L

2015-03-01

Stigma toward mentally ill individuals acts as a barrier to accessing care and receiving treatment. To review current evidence pertaining to stigma toward mental illness in the Middle East in order to inform effective and sustainable interventions in this region. We conducted a systematic literature search using the PubMed database and evaluated all identified studies according to specific inclusion criteria. Stigma toward individuals with mental illness does exist in the Middle East. Stigmatizing attitudes are particularly high toward culturally proscribed mental illnesses like alcohol abuse and lower for other disorders such as depression and psychosis. We propose the following initiatives to reduce stigma toward mental illness in the Middle East: (a) educate families to enable them to support their affected relatives, (b) increase cooperation between psychiatrists and faith healers and (c) educate young people in schools to increase their awareness and understanding of mental illnesses and to combat negative stereotypes. © The Author(s) 2014.

Collaborative Approaches and Policy Opportunities for Accelerated Progress toward Effective Disease Prevention, Care, and Control: Using the Case of Poverty Diseases to Explore Universal Access to Affordable Health Care.

PubMed

Laokri, Samia

2017-01-01

There is a massive global momentum to progress toward the sustainable development and universal health coverage goals. However, effective policies to health-care coverage can only emerge through high-quality services delivered to empowered care users by means of strong local health systems and a translational standpoint. Health policies aimed at removing user fees for a defined health-care package may fail at reaching desired results if not applied with system thinking. Secondary data analysis of two country-based cost-of-illness studies was performed to gain knowledge in informed decision-making toward enhanced access to care in the context of resource-constraint settings. A scoping review was performed to map relevant experiences and evidence underpinning the defined research area, the economic burden of illness. Original studies reflected on catastrophic costs to patients because of care services use and related policy gaps. Poverty diseases such as tuberculosis (TB) may constitute prime examples to assess the extent of effective high-priority health-care coverage. Our findings suggest that a share of the economic burden of illness can be attributed to implementation failures of health programs and supply-side features, which may highly impair attainment of the global stated goals. We attempted to define and discuss a knowledge development framework for effective policy-making and foster system levers for integrated care. Bottlenecks to effective policy persist and rely on interrelated patterns of health-care coverage. Health system performance and policy responsiveness have to do with collaborative work among all health stakeholders. Public-private mix strategies may play a role in lowering the economic burden of disease and solving some policy gaps. We reviewed possible added value and pitfalls of collaborative approaches to enhance dynamic local knowledge development and realize integration with the various health-care silos. Despite a large political commitment and mobilization efforts from funding, the global development goal of financial protection for health-newly adopted in TB control as no TB-affected household experiencing catastrophic expenditure-may remain aspirational. To enhance effective access to care for all, innovative opportunities in patient-centered and collaborative practices must be taken. Further research is greatly needed to optimize the use of locally relevant knowledge, networks, and technologies.

The Feasibility of Instituting a Department Head Screen in the Naval Special Warfare Community.

DTIC Science & Technology

1985-12-01

community, and through use of the Structured Accession Planning System for Officers (STRAP-O) model, projects the community from 1985 to 1991 both with and...Placement Officer. It looks at the current state of the NSW community, and through use of the Structured Accession Planning System for Officers (STRAP-0...ACCESSION PLANNING SYSTEM FOR OFFICERS----------------------------------------19 Ill. NAVAL SPECIAL WARFARE COMMUNITY RESPONSE TO PROPOSAL

Care for chronic illness in Australian general practice – focus groups of chronic disease self-help groups over 10 years: implications for chronic care systems reforms

PubMed Central

Martin, Carmel M; Peterson, Chris; Robinson, Rowena; Sturmberg, Joachim P

2009-01-01

Background Chronic disease is a major global challenge. However, chronic illness and its care, when intruding into everyday life, has received less attention in Asia Pacific countries, including Australia, who are in the process of transitioning to chronic disease orientated health systems. Aim The study aims to examine experiences of chronic illness before and after the introduction of Australian Medicare incentives for longer consultations and structured health assessments in general practice. Methods Self-help groups around the conditions of diabetes, epilepsy, asthma and cancer identified key informants to participate in 4 disease specific focus groups. Audio taped transcripts of the focus groups were coded using grounded theory methodology. Key themes and lesser themes identified using a process of saturation until the study questions on needs and experiences of care were addressed. Thematic comparisons were made across the 2002/3 and 1992/3 focus groups. Findings At times of chronic illness, there was need to find and then ensure access to 'the right GP'. The 'right GP or specialist' committed to an in-depth relationship of trust, personal rapport and understanding together with clinical and therapeutic competence. The 'right GP', the main specialist, the community nurse and the pharmacist were key providers, whose success depended on interprofessional communication. The need to trust and rely on care providers was balanced by the need for self-efficacy 'to be in control of disease and treatment' and 'to be your own case manager'. Changes in Medicare appeared to have little penetration into everyday perceptions of chronic illness burden or time and quality of GP care. Inequity of health system support for different disease groupings emerged. Diabetes, asthma and certain cancers, like breast cancer, had greater support, despite common experiences of disease burden, and a need for research and support programs. Conclusion Core themes around chronic illness experience and care needs remained consistent over the 10 year period. Reforms did not appear to alleviate the burden of chronic illness across disease groups, yet some were more privileged than others. Thus in the future, chronic care reforms should build from greater understanding of the needs of people with chronic illness. PMID:19161636

A pilot program in rural telepsychiatry for deaf and hard of hearing populations.

PubMed

Crowe, Teresa; Jani, Suni; Jani, Sushma; Jani, Niranjan; Jani, Raja

2016-03-01

Access to mental health care in deaf communities is limited by cultural considerations, availability of translators, and technological considerations. Telepsychiatry can mitigate the deaf community's lack of access to care by allowing for deaf individuals in remote communities access to care with facilities that cater to their needs. Community Behavioral Health, Arundel Lodge, and Gallaudet University worked in conjunction to test three hypotheses: 1.Telepsychiatry will be as effective as traditional face-to-face psychotherapy with deaf adults who have chronic mental illness.2.Patients living in remote locations will report an improvement in accessibility to mental health services.3.Patients who receive telepsychiatry will report a comparable level of satisfaction of services to those receiving traditional services. The patient sample consisted of 24 participants, 13 women, 11 men. Telepsychiatry sessions were scheduled based on each patient's individual treatment plan against a control group who saw their providers face to face. The telepsychiatry and in-person groups were slightly different at baseline. Analysis of the data revealed no significant difference in coping abilities and psychiatric symptoms between those receiving face-to-face psychotherapy and those receiving telepsychiatry. The quality and outcome of care was equal to in-person for the telepsychiatry in deaf patients. Since telepsychiatry does not compromise the quality of care, it is a good means of reaching out to members of the deaf community that cannot readily access mental health resources that meet their needs.

2007 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-07-31

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2007 East Tennessee Technology Park Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-07-13

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2010 Lawrence Livermore National Laboratory Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-08-16

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2010 Nevada National Security Site Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-07-28

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2006 Oak Ridge National Laboratory Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-05-16

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2006 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-03-06

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2006 Y-12 National Security Complex Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-04-17

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2010 East Tennessee Technology Park Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-08-16

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2006 Los Alamos National Laboratory Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-06-13

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2010 Oak Ridge National Laboratory Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-07-28

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2007 Idaho National Laboratory Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2009-05-04

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2007 Lawrence Livermore National Laboratory Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-05-20

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2010 Y-12 National Security Complex Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2011-08-31

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2006 Lawrence Livermore National Laboratory Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-03-27

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2006 Savannah River Site Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-08-20

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2006 Nevada Test Site Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-04-24

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

2006 Kansas City Plant Annual Illness and Injury Surveillance Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

2008-06-13

The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

The Illness Experience of Undocumented Immigrants With End-stage Renal Disease.

PubMed

Cervantes, Lilia; Fischer, Stacy; Berlinger, Nancy; Zabalaga, Maria; Camacho, Claudia; Linas, Stuart; Ortega, Debora

2017-04-01

The exclusion of undocumented immigrants from Medicare coverage for hemodialysis based on a diagnosis of end-stage renal disease (ESRD) requires physicians in some states to manage chronic illness in this population using emergent-only hemodialysis. Emergent-only dialysis is expensive and burdensome for patients. To understand the illness experience of undocumented immigrants with ESRD who lack access to scheduled hemodialysis. A qualitative, semistructured, interview study was conducted in a Colorado safety-net hospital from July 1 to December 31, 2015, with 20 undocumented immigrants (hereinafter referred to as undocumented patients) with ESRD and no access to scheduled hemodialysis. Demographic information was collected from the participants' medical records. The interviews were audiorecorded, translated, and then transcribed verbatim. The interviews were analyzed using inductive qualitative theme analysis by 4 research team members from March 1 to June 30, 2016. Themes and subthemes from semistructured interviews. All 20 undocumented patients included in the study (10 men and 10 women; mean [SD] age, 51.4 [13.8] years) had been in the United States for at least 5 years preceding their diagnosis with ESRD. They described the following 4 main themes: (1) a distressing symptom burden and unpredictable access to emergent-only hemodialysis, (2) death anxiety associated with weekly episodes of life-threatening illness, (3) family and social consequences of accommodating emergent-only hemodialysis, and (4) perceptions of the health care system. Undocumented patients with ESRD experience debilitating, potentially life-threatening physical symptoms and psychosocial distress resulting from emergent-only hemodialysis. States excluding undocumented immigrants with ESRD from scheduled dialysis should reconsider their policies.

CDC, TJC Urge Providers To Up Their Game on Antibiotic Stewardship.

PubMed

Srinivasan, Arjun; Vento, Todd

2017-03-01

With data showing continued increases in the use of antibiotics, even in cases in which such prescribing is unnecessary and ill-advised, both the CDC and TJC are pushing initiatives aimed at improving antibiotic stewardship. The initiatives stress the importance of patient and provider education, the tracking of antibiotic use and resistance, and the need for top-level support. Although smaller hospitals face challenges in meeting the new standards, some health systems are getting around the problem through the use of telemedicine. The CDC is pushing hospitals to implement seven core elements that the agency maintains are critical to an effective antibiotic stewardship program. TJC has established a new standard requiring all hospitals to create antibiotic stewardship programs that are steered by a multidisciplinary team. Intermountain Healthcare in Salt Lake City is helping smaller hospitals in its network meet these new TJC and CDC directives by supplying support and expertise via telemedicine. The telehealth program also enables both emergency and inpatient providers to access infectious disease expertise when patients present with issues of concern.

A home health care approach to exercise for persons with Alzheimer's disease.

PubMed

Logsdon, Rebecca G; McCurry, Susan M; Teri, Linda

2005-01-01

Regular exercise is a mainstay of preventive health care for individuals of all ages. Research with older adults has shown that exercise reduces risk of chronic illness, maintains mobility and function, enhances mood, and may even improve cognitive function. For individuals with dementia, exercise programs are particularly likely to improve health, mood, and quality of life; the challenge at this time is to make exercise accessible and enjoyable, demonstrate its benefits, and convince family caregivers of its worth for individuals with dementia. Home health providers are uniquely positioned to assist caregivers in developing and implementing a home exercise program for their care recipient with dementia. Results of a controlled critical trial conducted at the University of Washington have demonstrated the feasibility and efficacy of a home health exercise and problem solving intervention (Reducing Disability in Alzheimer's Disease, or RDAD) for decreasing physical, psychological, and behavioral disabilities associated with dementia. This article describes the RDAD program, discusses the role of home health providers in its delivery, and provides an example of its implementation.

[The needs of mentally ill parents--a review of the literature].

PubMed

Howard, Louise M; Underdown, Helen

2011-01-01

Approximately 10 % of women and 6 % of men who become parents will experience mental health problems and a significant proportion of these have a severe psychiatric illness. This paper provides a literature review of the needs of parents with severe mental illness. Literature review. Mothers with severe mental illness have a wide range of complex health and social care needs in addition to their parenting needs, which must be addressed by services in pregnancy and postpartum to optimise outcomes. There is limited evidence on the needs of fathers with severe mental illness but they may have a greater number of needs than women, and a greater need for training in parenting skills than women suffering from severe mental illness. Parents with severe mental illness may experience stigma and discrimination, and fear accessing services due to fears of losing custody of their child. Although a significant proportion of parents with severe mental illness do lose custody, many can successfully parent if adequate support is available and needs are assessed and managed by a multi-disciplinary team. © Georg Thieme Verlag KG Stuttgart · New York.

The Chronic Illness Initiative: Supporting College Students with Chronic Illness Needs at DePaul University

ERIC Educational Resources Information Center

Royster, Lynn; Marshall, Olena

2008-01-01

College students with chronic illness find it difficult to succeed in traditional degree programs due to disruptions caused by relapses and unpredictable waxing and waning symptoms. College disability offices are often unable to help, both because their standard supports are not appropriate and because students with chronic illness frequently do…

DOE Office of Scientific and Technical Information (OSTI.GOV)

U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.