The author worked in a public health research lab, after graduation from college. She liked the flexibility of nursing and the promise to always have a job. She was fascinated by the intricacy of the mind-body intersection and how horribly wrong things could get with seemingly small perturbations. She felt that nursing school discouraged any consideration of a career in psychiatric nursing, as a mentor shared a comment by one of her advisors years ago that “only the bad nurses go into psychiatry”. A common occurrence was the admission of patients with psychiatric needs in addition to medical comorbidities. She cared for patients who had anxiety as a consequence of hospitalization, depression due to chronic illness, persons suffering from acute delirium, as well as someone with dementia secondary to HIV. Later she accepted a job at a local community health center that serves a predominance of Latino immigrants.
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The concept of risk behaviors became a model for public health interventions in the late 1970s and 1980s. This chapter describes contemporary knowledge on the risk behaviors of gender and sexual minority (GSM) persons. It highlights research findings, with particular attention paid to studies of different GSM subgroups, and evaluates interventions that have sought to modify behaviors in the pursuit of better health outcomes. The chapter then focuses on the potential contributions of other theoretical frameworks to the study of GSM risk behaviors, including opportunities to incorporate disclosure, resilience, intersectionality, and minority stress theories. It also presents recommendations for future directions for researching health risk behaviors among GSM persons, addressing the risk of harming GSM populations, and diverting attention and resources from addressing justice and social determinants of GSM health. The chapter concludes with suggestions for future research and interventions in support of more equitable health outcomes.
This concluding chapter summarizes the major points regarding elder abuse (EA) presented in the preceding chapters. It concludes the chapter by taking one last opportunity to encourage exploration and initiation of system-level efforts to solve a major public health problem. The socioecological framework for violence prevention utilized within domestic and global public health work is applicable and extendable to EA. Throughout this book, the authors have argued that EA is a public health problem and that EA may well be among the most under-recognized and under-resourced population health problems of the early 21st century. Public health has frameworks, tools, approaches, relationships, structures, systems, and a variety of agents and organizations poised to address the problem of EA. The imprimatur of the growing population of older adults and the character of demographic transitions occurring globally provide the perfect rationale for action—now.
Nurses have a key role in the identification, treatment, and control of the transmission of infection within the correctional setting. The prevalence of infectious disease among the incarcerated has great impact on the safety and security of correctional facilities and on the public health. Nursing interventions that prevent communicable diseases such as ectoparasites, Human Immunodeficiency Virus, Methicillin-Resistant Staphylococcus aureus (MRSA), Sexually Transmitted Infections (STIs) include screening, patient education and counseling, immunization, monitoring treatment compliance, and symptom management. Handwashing, or hand hygiene, is arguably the best overall workplace practice for preventing spread of infection. Isolation procedures are used to control transmission of disease when treating patients with known or suspected transmissible infections. Nursing procedures involved in prevention and control of communicable diseases include medication administration, monitoring inmate adherence to the treatment plan, education, counseling to reduce risk of disease transmission, collaboration with public health organizations, and discharge planning.
This chapter explains the concept of vulnerability and demographics of vulnerable populations. Poverty is the primary cause of vulnerability: It limits resources in many areas of life. From a public health perspective, a population is vulnerable by virtue of status, which means that some groups are at greater risk than others. Faith community nurses (FNCs) may have many or few opportunities to work with vulnerable persons, depending on the demographics of the faith community. Living in poverty decreases access to resources. It increases the likelihood that a person will experience adversity related to physical, psychological, and social health, as well as poor housing, nutrition, health care services, and education. FCNs need to be knowledgeable about programs such as social services, welfare, Medicaid, Women, Infants, and Children (WIC), and the Children’s Health Insurance Program (CHIP), as well as local food banks.
The field of public health is the oldest form of organized health concerns in American society. Hospitals extended or introduced social services in their organizations. One of the medical students was Dr. Robert Kane, who did his military service as medical director of the Native American reservation at Shiprock and wrote about it in his first Springer book Federal Health Care with Reservations. Dr. Steven Jonas also founded a Springer Series on Medical Education, which includes books with social and humanitarian perspectives in the medical field. Public health grew and expanded and developed close academic proximity with health administration, social work, and rehabilitation. Springer published books in all these fields, where the buyers would purchase books focused on their own interests or academic work. For earlier years, comparable figures could be presented with nursing dominating the list of publishing fields.
- Go to chapter: HIV/AIDS Risk Reduction With Couples: Implications for Reducing Health Disparities in HIV/AIDS Prevention
HIV/AIDS Risk Reduction With Couples: Implications for Reducing Health Disparities in HIV/AIDS Prevention
Twenty-five years into the epidemic, AIDS remains a significant public health issue that highlights the persistence of health disparities in the United States. This chapter provides an example of the best case scenario outcome: a new emergent evidence-based model for reducing HIV/AIDS risk with serodiscordant couples worthy of dissemination, and adaptation to new culturally distinct populations. It reviews current research on HIV prevention for couples and highlight the rationale for conducting couple-based intervention research. The chapter describes the process of designing Project Connect, a cultural- and gender-specific HIV/STI prevention intervention. It presents theories that guided the study. The chapter describes the content of the intervention and finally discusses the implications of the efficacy of Project Connect for the design and dissemination of culturally-congruent interventions to address the AIDS epidemic among ethnically diverse women and their male partners.
The Transmissible spongiform encephalopathies (TSEs) form a group of illnesses, characterized by a pathological form of the native prion protein, which results in a rapidly progressive neurodegenerative illness. They also are responsible for Gerstmann-Strâussler-Scheinker (GSS) syndrome and fatal familial insomnia (FFI), and they have been produced experimentally in several other animals. Creutzfeldt-Jakob disease (CJD) is the most common TSE in humans. Human prion diseases have three etiologies: (a) sporadic, (b) genetic, and (c) acquired. Human prion diseases are important to understand because of their underlying pathophysiology, public health implications, and clinical features that often result in misdiagnosis. This chapter reviews the historical discovery of prion diseases and the formulation of the prion hypothesis. It explores prion hypothesis and the neuropathogenesis of prion diseases. The chapter ends with a description of the diagnosis, prognosis, and experimental treatment of human prion diseases.
- Go to chapter: What Types of Public Health Proposals Should Agencies Be Funding and What Types of Evidence Should Matter?: Scientific and Ethical Considerations
What Types of Public Health Proposals Should Agencies Be Funding and What Types of Evidence Should Matter?: Scientific and Ethical Considerations
This chapter delves into critical issues involved in finding an appropriate balance between scientific and ethical considerations in assessing merits of community health intervention research. It discusses the emerging challenges to the field posed by the recent call for “evidence-based” public health and addresses the need for achieving a sound balance among the demands for collecting the most rigorous scientific evidence possible. The chapter then takes up the question of ethical concerns regarding fair allocation of public resources at National Institutes of Health. It argues that the skew toward individual interventions has resulted in an undue emphasis on individual behavior change as a common yet not necessarily warranted outcome measure in the hierarchy of funded research. It concludes with a recommendation based on the work of Daniels and Sabin (1997) for using a fair procedure, called “accountability for reasonableness”, for making decisions regarding priority of different types of health research.
In the mid-1970s, aging became a popular, even a fashionable topic. Professors made efforts to add gerontology to their teaching competence. And many colleges introduced courses in gerontology, or courses on aging-related aspects within the fields of psychology, sociology, psychiatry, public health, and nursing. Jack Bot-winick published in 1973 his textbook Aging and Behavior, with a new edition in 1978 and a third one in 1984. For the planning of future volumes the board had regular meetings held at the annual conventions of the Gerontological Society of America (G.S.A.), usually one of the mornings. This project lived and continues through 28 years and brought much prestige, good new authors, and some money to Springer. The large field was subdivided into its disciplines: psychology, psychiatry, medicine, nursing, public health, social work; and the expert board members were asked to assemble lists of terms that should form the body of the encyclopedia.