Community Health Commons^™

Comparing Stroke Symptom Recognition And Intervention Times In The Rio Grande Valley, Joshua M. Ninan, Kelsey Baker

Research Symposium

This is a retrospective study that aims to evaluate the duration from onset of stroke-like symptoms to presentation to medical facilities for aid in the Rio Grande Valley. The main goal of the study is to understand the extent of pre-hospital delays with regards to the treatment of stroke in the RGV.

照顧者實用資訊手冊, 嶺南大學亞太老年學研究中心 Asia-Pacific Institute Of Ageing Studies, Lingnan University, Meng Soi, Florence Fong, Chak Kwan, Dickson Chan, Kin Chung Cheung, Lai Ieng Jay Lau, Sin Yui Sharon Chan, Kin Ho William Li, Ka Ho, Alan Li

Manual & Guide 手冊及指引

手冊源起

香港面對人口高齡化，醫療和福利系統無可避免面臨持續的挑戰。照顧者因壓力問題而引發的家庭悲劇時有發生，反映照顧者自身亦極需要社會的重視和支援。

現時照顧者人數眾多，當中不乏配偶、父母、子女、女婿、媳婦，對長者照顧及社會無酬的付出，確實值得社會的認同和肯定。然而，儘管本港為長者及照顧者提供不少支援服務，由於不同的原因，照顧者似乎未有善用現有的服務，常常需要一力承擔所有照顧的責任，這無疑增加了他們的壓力。

照顧者需求多樣性

照顧者有不同種類，所需要的服務或支援亦有所不同。例如：「新手照顧者」剛開始接觸照顧工作，需要盡快提升日常護理和相關的疾病知識，以及獲得合適的離院/復康服務支援。「隱蔽照顧者」一直承擔照顧工作但沒有接受任何支援，因此，他們需要的是服務提供者/鄰里的主動接觸，並被轉介合適的照顧服務，以分擔他們部分照顧工作。「高危照顧者」幾乎長時間被照顧的工作佔據了其生活，他們需要的是喘息空間和暫託服務，甚至可能是情緒支援。即使「資深的照顧者」也可能需要喘息或暫託的支援服務去減輕壓力；而結束了照顧工作的「畢業照顧者」，無論是情緒的支援，還是重新規劃財務與就業的安排，都有非常實際的需求。基於照顧者的不同需要，照顧者的支援和服務也是多樣化，如何讓不同種類的照顧者能夠輕易了解現有的社區支援服務、可考慮甚麼因素選取相關服務、如何獲取所需的支援包括申領經濟支援或預早準備長期護理開支、如何自強增值等，都是這本手冊希望解答的問題。

手冊的目的

編製這本手冊的目的就是要減少照顧者四處尋找資訊的麻煩，提供一個整全且易於瀏覽的資訊來源。本手冊主要有兩大目標：其一，幫助照顧者認識不同的服務和資源，積極尋求援助；其二是一站式提供豐富的資訊服務，提升照顧者的能力和平衡身心健康。

手冊的意義

此手冊的社會意義是期望提高大眾對照顧者需要的關注，並引導更多的行動以支援照顧者。如果您的親友是照顧者，又或您認識的朋友甚至鄰居正面對照顧家人的困難，您可以主動伸出援手，又或利用這本手冊作為啟示，向他們介紹相關的服務。

另外，這本手冊可以視作為支援照顧者的工具，讓照顧者明白在承擔照顧家人的重任時並不需要孤軍奮戰，也可以善用社區提供的各種資源和服務。

手冊架構

本手冊由四個主要部分組成，每部分都專注於特定的主題，旨在提供照顧者的全方位支援和資訊，幫助他們在面對挑戰時能夠有所依賴，並從中獲得力量：

第一部分主要提供基礎知識，其中包括不同種類的照顧者的介紹、四種長者常見疾病（包括認知障礙、中風、老年抑鬱和癌症）的病徵說明、以及照顧者可能面臨的壓力與「喘息服務」的重要性。第二部分專注介紹長者常用的社區及健康服務。我們按照地區將服務機構進行了分類，羅列「認知障礙、中風、老年抑鬱、癌症」常用的服務機構，此外，我們還提供家居安全、樂齡科技租賃服務，以及財務支援等相關建議。第三部分將焦點重新放回照顧者身上，提供了支援照顧者的社福機構介紹、照顧者同路人的心得分享，以及照顧者的培訓資訊，旨在幫助照顧者在面對困難時能自強不息。最後，在本手冊的結尾部分，我們特別邀請了四位專家學者就照顧者政策提出見解和建議，為加強照顧者支援服務提供新思路。

如果按持份者來分類，手冊的四個部分的重點如下：

第一部分：照顧者的基礎知識

◎ 針對預備照顧者、新手以及隱蔽照顧者，讓他們了解照顧者的角色和需要；照顧體弱長者的基礎知識，並提供應對壓力的建議，包括自我照顧和喘息服務等。

第二部分：照顧者支援

◎ 針對所有護老者，提供長者常用的社區服務、健康服務和支援計劃，包括暫託、住宿、護送及陪診、善別支援、情緒支援、復康用品津貼及租賃的支援計劃，以及財務策劃師提供的理財貼士。

第三部分：照顧者自強

◎ 針對照顧者，資訊包括不同的照顧者支援組織、同路人和畢業照顧者的經驗心得、培訓課程，以及實用的電子資訊平台推介。

第四部分：對照顧者支援政策的看法和展望

◎ 針對服務提供者、政策倡議者及制定者，提供專家學者對照顧者服務及政策的未來發展方向的看法和建議，以期引發更多關於「如何為照顧者提供更好支持」的討論。

給讀者的使用指引

本手冊內容十分豐富，讀者可以先瀏覽目錄，選擇與您相關的部分進行細讀。對於新手照顧者或剛接觸/關注護老服務的人士(例如：學生、社區人士)，我們建議您可以參考手冊第24-33頁「給照顧者的智慧錦囊」的個案，了解不同照顧者可能面對的情境，這可能會給您一點概念，讓您可以考慮尋求哪些支援服務，又或您身邊照顧者朋友有哪些需要，以及如何協助他們獲取所需要的支援。我們深知閱讀本手冊時，您可能會遇到一些不明白的地方，請不必感到困惑。您可以嘗試找身邊的朋友、鄰居或社會服務機構的工作人員一起閱讀，或者向本中心的職員進行查詢。

此外，為方便讀者可以隨時隨地閱讀而不需要攜帶整本手冊，我們為本手冊設立了一個專屬網頁，免費下載整本手冊或某些章節內容。

希望您在閱讀的過程中能找到有用的資訊，並能從中獲得實際的幫助。

Life’S Essential 8: Optimizing Health In Older Adults, Manish Kumar, Ariela Orkaby, Caitlan Tighe, Dennis T Villareal, Hayley Billingsley, Michael G Nanna, Min Ji Kwak, Namit Rohant, Shreya Patel, Parag Goyal, Scott Hummel, Christina Al-Malouf, Amie Kolimas, Ashok Krishnaswami, Mike W Rich, James Kirkpatrick, Abdulla A Damluji, George A Kuchel, Daniel E Forman, Karen P Alexander

Faculty, Staff and Student Publications

The population worldwide is getting older as a result of advances in public health, medicine, and technology. Older individuals are living longer with a higher prevalence of subclinical and clinical cardiovascular disease (CVD). In 2010, the American Heart Association introduced a list of key prevention targets, known as "Life's Simple 7" to increase CVD-free survival, longevity, and quality of life. In 2022, sleep health was added to expand the recommendations to "Life's Essential 8" (eat better, be more active, stop smoking, get adequate sleep, manage weight, manage cholesterol, manage blood pressure, and manage diabetes). These prevention targets are intended to …

The Prevalence Of Human Papillomavirus Vaccination Among Racial And Ethnic Minority Adolescents During The Covid-19 Pandemic, Chinenye Lynette Ejezie, Lara S Savas, Casey Durand, Ross Shegog, Paula Cuccaro

Faculty, Staff and Student Publications

BACKGROUND: Human papillomavirus (HPV) vaccination among adolescents has steadily improved over the past several years. However, research conducted to determine whether the COVID-19 pandemic disrupted this positive trend in HPV vaccine initiation among racial and ethnic minority adolescents is limited. Therefore, this study was conducted to determine if the COVID-19 pandemic and the resulting changes in the US health-care sector affected the increasing HPV vaccine initiation among non-Hispanic Black and Hispanic adolescents aged 13-17 years.

METHODS: Using a cross-sectional design to examine data from the National Immunization Survey-Teen (2019-2021), logistic regression and moderation analysis were used to model race-specific variations …

Beyond Economics And Politics : A Sociological Review Of Local Long-Term Care Service Provision In China, Zhen Tian

Lingnan Theses (MPhil & PhD)

The socio-demographic transition presents a significant challenge that impacts the renewal of welfare arrangements and the reallocation of welfare responsibilities across sectors. Long-term care (LTC) services have emerged as a widely accepted strategy to promote the active daily living and human dignity of senior citizens. This study aims to assess the effective policy strategies employed in various Chinese contexts to address significant LTC policy concerns and synthesise lessons that can guide future policy decisions. The study addresses three questions to explore local variations in China's LTC service provision: (1) What differences exist in the long-term care services provision? (2) How …

Social Networks, Access To Healthcare, And The Health-Related Quality Of Life Of Young Informal Workers In Nigeria’S Construction Industry, Ayomide Oluwaseyi Oladosu

Lingnan Theses (MPhil & PhD)

Young informal workers in Nigeria face a significant decline in their health-related quality of life (HRQoL) due to their lack of control over their employment conditions. This problem is particularly pronounced among young informal workers in the construction industry, given its precarious and hazardous nature. To enhance HRQoL, these workers primarily rely on their social networks for support. However, given the level of hazards they encounter in the construction industry, social networks alone may not be sufficient to directly improve their HRQoL. Nevertheless, social networks can facilitate access to healthcare, which in turn may enhance HRQoL. Unfortunately, limited research has …

A.T. Still, School Of Osteopathic Medicine - Volume 1 Issue 1, August 2023 Full Issue, Editors ,

Intellectus

No abstract provided.

Breastfeeding Education Of Medical Students And Resident Physicians, Kathleen E.H. Douangchak D.O.

Intellectus

Breastfeeding is widely recognized for its medical and neurodevelopmental benefits, leading to the American Academy of Pediatrics (AAP) recommending exclusive breastfeeding for the first 6 months of an infant’s life with continuation through 2 years of age and beyond.1 However, this literature review finds that despite the 2022 update to the AAP’s recommendations, education on breastfeeding for physicians-in-training is inadequate. Though interventions have been shown to increase the breastfeeding knowledge and confidence of physicians, more research is needed to evaluate the efficacy of educational interventions. This paper emphasizes the urgency of implementing comprehensive interventions that address the gaps in breastfeeding …

Preparing For Pandemics: Lesson Plan Design For Children In Elementary School, Daniella Rivera, Enkhtsogt (Steve) Sainbayar, Saleem Choudry, Brittany Vaughn Pierce, Roxana Nouri-Nikbakht, Joy H. Lewis D.O., Phd

Intellectus

Context: The COVID-19 pandemic necessitated distance learning to attenuate the spread of the virus, and school-aged children were particularly affected by this change. Because of their age and education level, children generally lacked understanding about the pandemic and the preventive measures necessary to prevent the spread of this and other infectious diseases. It is unknown how many schools nationwide incorporated disease-prevention education in their curriculums during the pandemic. Therefore, developing distance learning interventions that convey these topics at their level of understanding is important to improve health literacy and raise their awareness of factors that positively influence health.

Objective: To …

Integration Of A Culturally Appropriate Method Of Delivering Health Information In A Non-Clinical Setting, Nancy Nguyen, Merett Saad, Andrew Vo, Alejandro Castaneda, Uriel Martinez, Jonathan Do, Kevin Trembley, Imran Javaid, Hargurbir Alhuwalia, Jaskirat Malhi, Carolina Quezada M.D., Joy H. Lewis D.O., Phd

Intellectus

Context:

A.T. Still University School of Osteopathic Medicine in Arizona (ATSU-SOMA) has an established partnership with Family HealthCare Network (FHCN). Initial meetings with the local community outreach department identified that a substantial majority of the Hispanic population served by this health center may lack access to health education. In particular, Spanish-speaking patients at the health center may face language barriers that impair the transfer of health education between the providers, patients, and their families.

Objective:

The purpose of this study was to provide health educational presentations in Spanish in order to improve health knowledge relating to women’s and children’s health. …

Covid-19 Infection With Severe Hypothermia In A Fully Vaccinated Patient, Kathleen E.H. Douangchak

Intellectus

Hypothermia is an uncommon presentation of COVID-19 infection, typically observed in patients with severe disease prior to the availability of vaccines. However, the occurrence of hypothermia in vaccinated patients with COVID-19 disease has not yet been documented. This case reports a rare presentation of severe hypothermia in a 41-year-old female with COVID-19 disease, who suffered from several comorbidities, including heart failure with preserved ejection fraction, chronic pericardial effusion, nephrotic syndrome, CKD 4, hypertension, type 2 diabetes, thyroid cancer status post-thyroidectomy with resultant postsurgical hypothyroidism, glaucoma, and anemia of chronic disease. Upon presentation, the patient was encephalopathic with hypothermia of 27.2 …

Community Reintegration Of Formerly Incarcerated Persons: An Occupational Therapy Guidebook, Shauntrice Woodberry, Angela Labrie Blackwell Phd, Otr, Steven Gerardi Phd, Otr

Summer 2023 Virtual OTD Capstone Symposium

The recidivism rates in the US are the highest, as the current research suggests the majority of offenders (two-thirds) released from prison in any given year will be reincarcerated within three years (Eggers et al., 2006). The high rates of recidivism suggest that the criminal justice system has not been able to successfully identify the needs of incarcerated individuals necessary to support the success of their community integration process.

Since there are no published guidelines available to OT practitioners to guide their provision of community reintegration services to formerly incarcerated persons, the product of this capstone was a guidebook.

Exploring The Post-Surgical Needs Of Guatemalan Children And Their Families From Low Socioeconomic Status (Ses) Communities Using An Occupational Therapy Perspective, Diana Del Carmen Tojin Romero, Karen Aranha, Angela Labrie Blackwell

Summer 2023 Virtual OTD Capstone Symposium

Background: Despite a decline in infant mortality rates in the Global South (GS), there has been a rise in congenital and developmental disabilities. International short-term medical (ISTM) missions in Guatemala seek to address the surgical needs of children from low SES communities, but the understanding of the impacts of such assistance and the post-surgical needs of these communities remains limited. Embracing the Human Rights-Based Approach (HRBA) to healthcare as a foundation for this study recognizes health as a fundamental human right. The main tenets of this approach will guide this investigation to understand the post-surgical needs of children and their …

The Perceived Benefits Of Belonging To A Community Organization For People With Parkinson's Disease (Pwpd): An Ethnographic Study, Alexis Fortes, Mary Ann Smith, Karen Aranha, Kelli Cabrera

Summer 2023 Virtual OTD Capstone Symposium

Background: Persons with Parkinson’s (PwPD) seek to age in place and slow the functional decline that comes with the disease process. Membership in community-based and fitness programs provides a social safe environment that significantly impacts an individual’s psychological well-being and occupational independence. The American Occupational Therapy Association (AOTA) supports and promotes partnering with community organizations that promote and valuemaintaining occupational independence for community dwellers.

Objective: This study investigated the perceived benefits of belonging to a community organization that supports health management and well-being for PwPD.

Methods: A qualitative ethnographic study used immersive participant observation, and conducted two …

Evidence Based Practices To Guide Practitioners On Providing Racially Informed Care (Ric): A Scoping Review, Veronica Ajose, Angela Labrie Blackwell, Charae Mcconnell

Summer 2023 Virtual OTD Capstone Symposium

All forms of racism impact the health, well-being, safety, and occupations of Black, Indigenous, and People of Color (BIPOC). There is a gap in Occupational Therapy (OT) curricula and literature on how practitioners should address the issue of racism. This presentation presents the background, problem, purpose, methods, results, and implications for occupational therapy practice for a scoping review that sought to review sought to identify and synthesize interventions that align with Racially Informed Care (RIC).

Estimation Of Health Risks Caused By Metals Contained In E-Cigarette Aerosol Through Passive Vaping, Wei-Chung Su, Jinho Lee, Kai Zhang, Su-Wei Wong, Anne Buu

Faculty, Staff and Student Publications

It is expected that secondary exposure to e-cigarette aerosol (passive vaping) will soon become an issue of public health. Passive vaping inhales e-cigarette aerosol containing similar harmful substances as active vaping. However, parallel studies on passive vaping are minimal. Therefore, there is a need for passive vaping-related health risk studies to assess the impact of vaping on public health. This research conducted a series of experiments in a room using a puffing machine and the Mobile Aerosol Lung Deposition Apparatus (MALDA) to study e-cigarette aerosol respiratory deposition through passive vaping. The experimental data acquired were applied to estimate the deposited …

Identifying Associations Between The Family Environment And Anxiety And Depression Among Children Ages 0-17 In The United States, Reagan A. Richardson, Nicole M. Holt

OUR Journal: ODU Undergraduate Research Journal

This study analyzes whether physical, emotional & neurological, family environment, or community-related factors display the strongest association with anxiety and depression among children ages 0-17 in the United States.

Using IBM SPSS v. 27, we conducted a univariate and multivariate logistic regression analysis on data from the 2017 National Survey of Children’s Health (NSCH) with a sample size of 21,599. Our independent variables included 30 questions from the NSCH which were compared to a mental health index score.

Our study shows that about 10.6% of children suffer from either anxiety, depression, or both, and the univariate model found that 19 …

A Program Evaluation Of Domestic Violence Screening At A Large Urban Hospital., Taylor L'Heureux

Doctor of Nursing Practice Papers

Domestic violence has been deemed a direct invasion and violation of human rights by the World Health Organization (2021). Due to the continuous rise in cases of domestic violence, national organizations like the United States Preventative Services Task Force (USPSTF) have recommended that healthcare providers screen patients for this abuse. The purpose of this study was to reinforce the current screening procedure and protocol to ensure that each patient was screened for domestic violence before being discharged from the hospital. This study evaluated a quality improvement project formed to promote the completion of a preexisting domestic violence screening form that …

Clinical And Demographic Attributes Of Patients With Diabetes Associated With The Utilization Of Telemedicine In An Urban Medically Underserved Population Area, Lisa Ariellah Ward, Gulzar H. Shah, Kristie C. Waterfield

Health Policy & Community Health: Faculty Publications

Marginalized populations often experience health disparities due to the significant obstacles to care associated with social, economic, and environmental inequities. When compared with advantaged social groups, these populations frequently experience increased risks, poorer health outcomes, and reduced quality of life (QoL). This research examines the clinical and demographic characteristics—age, gender, and race—related to patients with varying stages of type 2 diabetes mellitus (T2DM), comparing the utilization of telemedicine (TM) with traditional healthcare face-to-face (F2F) appointments in an urban medically underserved population area (UMUPA). A logistic regression model, was used to analyze retrospective electronic patient health records (EHRs) from 1 January …

Adaptation And Formative Evaluation Of Online Decision Support To Implement Evidence-Based Strategies To Increase Hpv Vaccination Rates In Pediatric Clinics, Ross Shegog, Lara S Savas, Erica L Frost, Laura C Thormaehlen, Travis Teague, Jack Steffy, Catherine Mary Healy, Laura Aubree Shay, Sharice Preston, Sally W Vernon

Faculty, Staff and Student Publications

Human papilloma virus (HPV) vaccination rates remain below national goals in the United States despite the availability of evidence-based strategies to increase rates. The Adolescent Vaccination Program (AVP) is a multi-component intervention demonstrated to increase HPV vaccination rates in pediatric clinics through the implementation of six evidence-based strategies. The purpose of this study, conducted in Houston, Texas, from 2019-2021, was to adapt the AVP into an online decision support implementation tool for standalone use and to evaluate its feasibility for use in community clinics. Phase 1 (Adaptation) comprised clinic interviews (