College counseling has entered an era that promises to be radically different than any time in its previous 100-year history. College students in this 21st century are more technologically advanced than previous generations and more likely to take virtual classes than previous generations of college students. Traditional services provided by the college counseling center are: individual and group counseling, psychoeducational groups, evaluation and assessment, career counseling, consultation to faculty and staff, medication management and resident advisor (RA) training. Nontraditional services are defined as virtual counseling, advising, and related services offered via distance technology. College counseling centers have long offered types of self-instructional services. They will need to address social media in ways that are both ethically sound and also able to effectively engage college students in seeking counseling services. The counselor can administer the Dimensions of a Healthy Lifestyle Scale (DHLS) to the client and then discuss the findings.

As best friends in a small Midwestern town, Jon and Stephen, both extremely bright and inquisitive, often talked with each other about their dreams of jobs they would have as adults. Throughout childhood, made alive through imaginative play, their wide-ranging ideas about careers were inspired largely by television and movie characters. They were enthralled with the idea of “special powers” to save the universe, but soon realized that “superhero” wasn’t a career. A few years later, they considered becoming crime scene investigators, lawyers, emergency room doctors, and, briefly, even astronauts. Jon and Stephen were inseparable and were regarded by the elementary school’s Gifted and Talented (G/T) coordinator as the most academically advanced students in her memory. They loved to learn, had vivid imaginations, and inspired their classmates and each other to “dream big” about the future. They were big fish in a little pond (e.g., Marsh, 1987; Salchegger, 2016).

Then Jon’s family relocated to an affluent suburban neighborhood on the West Coast after his father took a position in Silicon Valley. Jon, in middle school, had to adjust to a new set of expectations and found the adjustment quite challenging—in fact, far more so than he had imagined. Surrounded by a large group of intense and extremely driven students, who all seemed to aspire to top-tier universities, and struck by the harsh realization that he was no longer one of the very best students, Jon now felt as if he were a fish out of water. He was plagued with self-doubt about his abilities and future educational and career prospects. Compared to the other students, who had long positioned themselves to earn coveted spots in the local STEM-oriented magnet high school, Jon felt inadequately prepared to compete and felt his excitement for learning fading quickly. Once a confident and enthusiastic student, Jon was immobilized by his fear of making mistakes, especially in the presence of his new peers, and he began to retreat from others both at school and at home. He had difficulty dealing with even minor setbacks and grew to resent the students who seemed ambitious and competitive. Adopting a defensive posture, Jon downplayed the importance of thinking about future goals; in his own words, it was “stupid” to worry too much about college and career. Although he generally maintained respectable grades (mainly to make his parents happy and to keep their anxieties at bay), he refused to take the most challenging courses at school and stopped taking academic risks. Since he was getting mostly As and Bs and an occasional C on his report card, Jon’s parents were not alarmed by the changes in his behavior and failed to notice that he had turned away from learning. His academic self-concept had taken a major hit.

In contrast to Jon, Stephen remained in the same small Midwestern school district for the remainder of his precollege years and continued to feel passionate—about everything! Stephen’s parents encouraged him to indulge his intellectual curiosity and explore every subject that captured his interest. But Stephen had difficulty narrowing his interests for the sake of establishing career direction. When he was first exposed to chemistry, for instance, he quickly memorized the periodic table and spent many nights at the dinner table teaching his younger brother everything he had learned about each element. Later, when introduced to physics, he could hardly contain his excitement about quantum field theory, cosmic inflation, fluid dynamics, and a host of other topics. Of course, he also loved math and was eager to learn computer languages. Adept not only in STEM subjects, Stephen also excelled in and enjoyed writing, history, and politics. However, because the school district was small and lacked resources, he often learned advanced content on his own by reading books and searching the Internet. The local public high school he attended offered few Advanced Placement (AP) courses, and school officials believed they could not justify offering additional AP courses just for him. Without his friend Jon, he had no intellectual peer with whom he could share ideas and interact meaningfully. As his precollege years progressed, Stephen did not gain sufficient clarity about educational and career direction to focus his efforts on developing any particular interest to a high level outside of the classroom.

Assisted living administrators must have a comprehensive understanding of current federal, state, and local laws and regulations that relate to accessibility, fire safety, and disaster preparedness within assisted living facilities. Awareness of landmark federal laws and agencies are an important first step in this process. This chapter presents and briefly discusses Federal legislation, which includes the Americans with Disabilities Act of 1990 as amended by the Americans with Disabilities Amendment Act of 2008, the Occupational Safety and Health Act of 1970, and the creation of the Federal Emergency Manpower Agency. It also identifies important national fire safety codes. The chapter discusses and presents selected issues related to accessibility, fire safety, and disaster preparedness as important components of the work of administrators. Finally, it presents best practices in selected areas associated with fire safety and disaster preparedness.

This chapter provides a conceptual framework for understanding access to medical care and discusses many of the barriers faced by residents of rural communities. The sociodemographic characteristics of rural residents differ from those of urban populations in ways that may affect their need for medical care. A substantial body of research indicates that individuals without health insurance coverage are at substantially greater risk for poor medical care access and health outcomes. One of the more intractable access problems facing rural Americans is the relatively lower supply of medical care professionals practicing in rural versus urban settings. To address the shortage of health care professionals, the more limited financial resources of rural residents, and the geographic dispersion of rural populations, the federal government has implemented a number of programs aimed at improving access to rural medical care.

Healthcare organizations must undergo accreditation and/or certification on a regular basis. Accreditation and certification validate an institution and may bring distinction for high standards. This chapter reviews the ways healthcare organizations and provider groups achieve accreditation and describe the most notable healthcare award. It discusses how organizations can become more consistent and reliable. Healthcare organizations seeking accreditation must undergo an on-site review by Joint Commission trained survey teams every 3 years. Any health plan sold on the health insurance exchanges as outlined by the Affordable Care Act requires accreditation through National Committee for Quality Assurance, but many unaccredited plans are still sold through employers or in the private market. Leaders in highly reliable organizations understand that employees involved in direct patient care understand best the state of the equipment and the adequacy of the processes to care for patients. Processes must be designed to support the organizational strategy.

The past century and a half has witnessed remarkable achievements in child health in the United States. Disparities exist for many health conditions because societal and environmental influences determine how children’s bodies form and grow, and experience determines how they think and feel. This chapter outlines the contours of the problem of health inequity for children by delineating some statistics drawn from U.S. sources. It illustrates the situation by giving an example of the path through which societal inequity leads to poor health and developmental outcomes in a child with asthma. Despite what can look like a very distressing picture, all is not bleak. There are tried and true interventions that are working all over the United States. The chapter shares some of these ideas and provides bibliographic references for the reader to analyze deeper into learning about the causes of and interventions for addressing disparities in child health.

While differences in health outcomes between men and women emerged in the last century, the differences in health outcomes between groups distinguished by race, ethnicity, and other socially related factors have persisted for more than a century; as long as we have had data in the United States and across the globe. Improvements in population health and achieving health equity require an accelerated development of an area of specialization that can explicate how and why inequities among men exist, and present evidence that informs efforts to improve the health of men and reduce inequities among them. This chapter describes the phenomenon of "diseases of despair" and how it relates to men’s health disparities. It discusses how it differs from other disparity populations. It explains why discussions of men’s health disparities should inherently take an intersectionality lens and describes health disparities faced by African American men in particular.

Activity keys provide detailed suggestions for how one might craft the answer for a given activity. Part IV of the text provides the “how-to” practice chapters for the act phase to help you learn each of the steps in this phase. All of the work in the act phase builds on the work in define and study phases. This chapter provides the answer for each of the following activity keys namely, create integrated set of recommendations; develop key implementation milestones; revisit stakeholder analysis; create communication plan; implement communication plan and validate approval/consensus of recommendations; develop detailed implementation plan; and monitor results against key performance indicators.