No contexto da saÃde o meio ambiente passou a ter importÃncia a partir de novas reflexÃes sobre os conceitos de saÃde e de ambiente Por algum tempo a saÃde era vista sob a Ãtica da doenÃa com uma noÃÃo predominantemente biolÃgica o ambiente pelo seu aspecto biofÃsico Essa dissertaÃÃo surge a partir da compreensÃo do conceito de saÃde no contexto atual e refletindo sobre a interface com o ambiente para a promoÃÃo da saÃde no cotidiano dos Agentes ComunitÃrios de SaÃde (ACS) em Equipes da EstratÃgia SaÃde da FamÃlia (ESF) Portanto esta pesquisa objetivou compreender sob a Ãtica dos ACS as implicaÃÃes que a relaÃÃo saÃde e ambiente promovem na sua prÃtica profissional no MunicÃpio de Juazeiro do Norte Cariri cearense Conduzimos a pesquisa com o estudo do tipo exploratÃrio com abordagem qualitativa A pesquisa foi realizada no MunicÃpio de Juazeiro do Norte CE no perÃodo de setembro de 2012 a fevereiro de 2013 tendo como sujeitos os ACS das duas Equipes da ESF do Bairro Parque AntÃnio Vieira selecionadas a partir da aplicaÃÃo de um roteiro de escolha Para a coleta de dados utilizamos um formulÃrio sÃcio demogrÃfico e em seguida a entrevista semiestruturada Para complemento outro procedimento utilizado foi o de observaÃÃo participante a qual aconteceu a partir de visitas periÃdicas ao campo de atuaÃÃo dos ACS com a construÃÃo do diÃrio de campo Para a anÃlise do material coletado utilizamos o mÃtodo da anÃlise de discurso A partir da anÃlise realizada do discurso contido nas falas dos ACS e observaÃÃo participante do local do estudo concluÃmos que se faz necessÃrio no cenÃrio de atuaÃÃo dos ACS uma articulaÃÃo mais efetiva da interface saÃde e ambiente com foco na visÃo positiva da saÃde Ou seja conduzir as aÃÃes dos ACS para a promoÃÃo da qualidade de vida da populaÃÃo procurando desfocar o que à evidente em seus discursos hoje a doenÃa Portanto se faz necessÃrio nesse contexto o fortalecimento de PolÃticas PÃblicas voltadas para a educaÃÃo permanente dos profissionais que atuam nessas equipes da ESF ACS abordando a interface saÃde e ambiente bem como que favoreÃam a intersetorialidade e a atuaÃÃo profissional voltadas para a qualidade de vida da populaÃÃo trazendo para o eixo norteador da reflexÃo aqui apresentada a importÃncia entre o saber e o agir cotidiano dos ACS Com os resultados dessa pesquisa pretendemos contribuir para o fortalecimento das aÃÃes intersetoriais envolvendo as temÃticas saÃde e ambiente tornando mais evidente a importÃncia desta relaÃÃo para a promoÃÃo da saÃde e assim efetivamente fortalecer a qualidade de vida da populaÃÃo por eles assistida / In the context of health the environment now has importance from new reflections on the concepts of health and environment For awhile health was seen from the perspective of the disease with a predominantly biological sense the biophysical environment by their appearance This thesis comes from an understanding of the concept of health in the current context and reflecting on the interface with the environment to health promotion in daily Community Health Agents (CHA) teams in the Family Health Strategy (FHS) Therefore this research aimed to understand the perspective of the ACS the implications of the relationship between health and the environment promote their professional practice in the city of Juazeiro do Norte Cearà Cariri We conduct research with an exploratory study with a qualitative approach The survey was conducted in the city of Juazeiro do Norte CE from September 2012 to February 2013 having as subject the ACS of the two teams FHS Barrio Parque Antonio Vieira selected from the application of a script of choice To collect data we used a form socio demographic and then the semi structured interview For addition another procedure was used participant observation which happened from regular visits to the field of action of ACS with the construction of a field journal To analyze the collected data we use the method of discourse analysis From the analysis of the speech contained in the reports of the ACS and participant observation study site we conclude that it is necessary in the setting of ACS performance of a joint interface more effective health and environment focusing on positive view of health Ie drive the actions of ACS for the promotion of quality of life looking blur which is evident in his speeches today the disease Therefore it is necessary in this context the strengthening of public policies aimed at continuing education for professionals working in these teams FHS ACS interface addressing health and environment as well as to promote intersectoral and professional practice focused on quality of life population bringing to the guiding principle of reflection presented here the importance between knowing and acting of the ACS routine With the results of this study aim to contribute to the strengthening of intersectoral actions involving health and environmental issues making it clear the importance of this relationship to health promotion and thus effectively strengthen the quality of life they assisted

In the US, one in every eight deaths is due to an obesity-related chronic health condition (ORCHC). More than half of African American women (AAW) 20 years old or older are obese or morbidly obese, as are 63% of menopausal AAW. Many have ORCHC that increase their morbidity and mortality and increase health care costs. In 2013, 42.6 percent of AAs living in South Carolina (SC) were obese. The purpose of this cross-sectional study was to identify the cognitive, behavioral, biological, and demographic factors that influence health outcomes (BMI, and ORCHC) of AAW living in rural SC. A sample of 200 AAW (50 in each of the 4 groups of rurality by menopausal status), 18-64 years, completed the: Menopausal Rating Scale (symptoms); Body Image Assessment for Obesity (self-perception of body); Mental Health Inventory; Block Food Frequency Questionnaire; Eating Behaviors and Chronic Conditions, Traditional Food Habits, and Food Preparation Technique questionnaires – and measures for Body Mass Index. Most rural, and premenopausal AAW were single and not living with a partner. Premenopausal women had significantly higher educational levels. Sixty percent of AAW had between 1 and 5 ORCHC. Most AAW used salt based seasonings, ate deep fried foods 1 to 3 times a week, and ate outside the home 1 to 3 times a month. Few AAW knew the correct daily serving for grains and dairy, and most consumed less than the recommended daily serving of fruits, vegetables and dairy. Morbidly obese AAW used more traditional food preparation techniques than obese and normal-weight AAW. Rural, and menopausal AAW had significantly higher morbid obesity levels, consumed larger portions of meats and vegetables, and reported more body image dissatisfaction than very rural AAW, and premenopausal AAW, respectively. Controlling for socioeconomic factors the relationships between perceptions of body images, psychological distress, and psychological wellbeing remained significant for numbers of ORCHC

In 2010, men who have sex with men (MSM) represented 4% of the population in the United States (US) and accounted for 78% of all new Human Immunodeficiency Virus (HIV) infections among Hispanic men. Hispanic men who have sex with men (HMSM) accounted for the third largest number of new HIV infections (6,700 cases). This dissertation explored the effects of age, loneliness, substance use, depression, and social support on high risk sexual behaviors that predispose middle aged HMSM to sexually transmitted infections (STIs) and HIV infection risk. A sample of 150 urban HMSM aged 40 to 65 were surveyed in this study. Singer’s Syndemics Theory (1996) provided this study’s theoretical framework. Data was analyzed using a variety of parametric and non-parametric statistics. Loneliness, social support, depressive symptoms, alcohol/drug use, and sexual risk behaviors were found to have an influence on HIV infection status in this study. Partner status, religious affiliation and age did have an influence on alcohol use in this study’s participants. Also, participants with increased age had increased depressive symptoms in this study. Lastly, depressive symptoms, substance use, social support, and loneliness did have an influence on sexual risk behaviors in this study’s participants, specifically alcohol use and illicit drug use. The findings from this study should be used to assess, diagnose, plan, implement and evaluate prevention strategies geared to reduce STI and HIV infection in this population. Future research should build on these findings and develop tailored risk reduction interventions addressing HMSM, with particular attention to the understudied age group of the middle aged HMSM.

The purpose of this study was to determine if the students in the 5th grade class at Granite Hill Elementary were overweight or obese. The research questions included: (a) Does the Granite Hill Elementary School population mirror the world wide trend of increasing childhood overweight and childhood obesity, and (b) how does the Granite Hill Elementary School population compare to the International Obesity Task Force standards?

Introduction and Background: Today, in 2022, there is a community that receives discrimination, lack of acceptance, and lack of equality. This is the LGBTQ community. They suffer from the indifferences of the way they express themselves resulting in a rise of mental health issues and overall health disparities. Purpose Statement: The purpose of this review is to explore the disparities in mental health for the LGBT community including young adolescents and older adults. The question that drives this review is how does being a member of the LGBT community effect mental health. Literature Review: This literature review utilized search engines such as PubMed, ETSU One Search, and Google Scholar. Articles were chosen from within the past five years and corresponded with disparities in mental health for the LGBT community and the effects of acceptance from others. Key words used during the search of articles included “LGBT”, “mental health”, “suicide”, and “nursing”. A total of four articles and one systematic review were selected. Findings: Adolescents who didn’t have acceptance from others had a higher risk of suicide. Many mental health and substance abuse facilities didn’t have LGBT-specific programs. Healthcare professionals expressed the lack of training with LGBT clients but were willing to learn as it is relevant to their practice. Conclusions: The United States is under pressure as we watch the LGBT community become victims of inequality and health disparities. There is a need for more training and cultural competency, and implications of programs and resources specifically for the LGBT community.

Purpose LGBTQ patients experience marginalization and discrimination when seeking healthcare in the Southern Region of the United States. As a result, they experience negative healthcare outcomes. Collecting sexual orientation/gender identity (SOGI data) is vital in decreasing health disparities and improving hospitalized LGBTQ patients’ quality of care. Providers cannot adequately assess health risk factors or deliver culturally competent care without SOGI data knowledge. Aims The aim is to collect SOGI data during intake to implement a standard of care to promote LGBTQ health outcomes and decrease marginalization. Processes To understand how to provide high-quality care to LGBTQ patients, providers receive instruction on the importance of collecting SOGI data and cultural competency training using the Gay and Lesbian Medical Association (GLMA) guideline. After IRB determined the project as not research involving human subjects, SOGI data questions (your current gender identity is and describe your sexual orientation) were added to the EHR demographic health history section. Provider adoption of collecting SOGI data is measured by extracting data from the EHR. Results Results will determine the providers’ responsiveness to implementing SOGI data questions into the EHR. Limitations Provider having a choice of collecting SOGI data, the small sample size of providers, and the project’s location are limitations. Conclusions LGBTQ individuals have more health inequities and face marginalization when accessing healthcare. SOGI data collection is essential for assessing health risk factors, improving health outcomes, and creating a safe and inclusive healthcare environment for LGBTQ patients.

No description available.

Background: Substance use and misuse have a negative impact on health care outcomes, specifically in the older adult population. Older adults are at risk due to several factors occurring toward the end of life such as changing family dynamics, loss of friends and loved ones, and chronic diseases. Substance use in older adults with chronic diseases in rural areas remains poorly studied. This study examines older adults greater than 55 of age in the state of Tennessee, U.S.A. Design and methods: Data was extracted from the 2019 National Behavioral Risk Factor Surveillance System (BRFSS) with a subsample for the State of Tennessee (N = 6242) and individuals over age 55 (N = 3389). Results: At least 33.7% (N = 1143) of older adults have a chronic disease, and 24.4% (N = 828) have at least two or more chronic diseases. Alcohol use in the past month was reported in 29.4% of older adults; however, chronic disease status was not associated with alcohol use. Marijuana use and smoking in the past month were significant for older adults with two or more chronic diseases. Low income and less high school education were associated with chronic disease and smoking. Conclusions: Marijuana use and smoking were found to be significant in older adults with chronic disease, but not with alcohol use. Preventative measures such as screening tools, education, and providing resources to patients should be targeted to populations at risk to promote overall health outcomes.

Aim. The aim of this study was to examine the relationship of advance care planning protocols with hospitalization, rehospitalization, and emergency department use rates in U. S. home health agencies (HHA). Background. Since 2003, CMS has required HHAs to report on quality outcomes such as hospitalization, rehospitalization, and emergency department use rates, made publicly available online. Advance care planning (ACP) is a conversation about beliefs, goals, values, future treatment choices, and designation of a surrogate decision-maker, that someone has in advance of a health crisis. Most existing studies on ACP have taken place outside of HHAs among populations with serious illnesses such as HIV/AIDS, cancer, dementia, and end stage renal disease. Meanwhile, the U.S. home health population is living longer with chronic conditions such as pulmonary and cardiovascular illnesses. Effective January 1, 2016, the Center for Medicare and Medicaid Innovation implemented the Home Health Value-Based Purchasing (HHVBP) Model among home health agencies (HHAs) in nine states representing each geographic region in the United States. Agencies in these states began competing on value in the HHVBP model, and reimbursement rates began to be tied to quality performance (innovation.cms.gov). As part of HHVBP, CMS implemented an additional process-level mandate requiring them to report on ACP, though this data is not publicly available. It is currently unknown how ACP protocols in HHAs may affect agencies’ overall rates of acute care services use. Methods. Electronic surveys about ACP protocols were distributed to HHAs. Existing data about demographics, diagnoses, hospitalization, rehospitalization, and ED use were accessed online via CMS websites. Descriptive and regression analyses were conducted using the electronic survey results and the existing data. Results. Associations between the variables were observed and compared to the hypotheses. Statistical significance was found in the relationship between ACP protocols and hospitalization, where one increased the other increased. Several trends were found: Agencies with increased total percentage of cardiac and pulmonary diagnoses tended to have increased hospitalization rates; agencies with increased average age of patients tended to have increased ACPP scores; and agencies with increased proportion of Black patients tended to have higher hospitalization rates.

Tennesseans have been experiencing increasing rates of sexually transmitted diseases since the year 2000. Those rates are highest among those 15- to 24-year-olds. At the same time, Tennessee policy requires the teaching of abstinence as the primary form of sexual health education and emphasized the use of abstinence-only curriculum. The school nurse represents an available resource in the Tennessee public schools. The purpose of the qualitative study was to explore, describe, and interpret the perceptions and experiences of public-school nurses from rural, suburban, and urban areas of Tennessee related to the sexual health and sexual health education of students. School nurses were recruited from across the state and from a variety of communities to complete an electronic survey and to participate in individual interviews. Critical Discourse Analysis was used to analyze results in the context of the existing sociocultural and power structures. The research plan included a comparison of results from participants in rural, suburban, and urban areas that could not be done because of the limited responses obtained from potential participants. Emerging themes in light of the limited participant responses created a view of power structures within the context of existing conditions that may be impacting the sexual health of students.