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Background: The paper examines the role of community-based participatory research (CBPR) within the context of social justice literature and practice. Methods: Two CBPR case studies addressing health inequities related to Type 2 Diabetes and Cardiovascular disease were selected from a national cross-site study assessing effective academic-community research partnerships. One CBPR partnership works with African Americans in rural Pemiscot County, Missouri and the other CBPR partnership works with African American and Latinos in urban South Bronx, New York City. Data collection included semi-structured key informant interviews and focus groups. Analysis focused on partnerships' context/ history and their use of multiple justice-oriented strategies to achieve systemic and policy changes in order to address social determinants of health in their communities. Results: Community context and history shaped each partnership's strategies to address social determinants. Four social justice approaches (identity/recognition, procedural, distributive, and structural justice) used by both partnerships were identified. These social justice approaches were employed to address underlying causes of inequitable distribution of resources and power structures, while remaining within a scientific research framework. Conclusion: CBPR can bridge the role of science with civic engagement and political participation, empowering community members to become political agents who integrate evidence into their social justice organizing strategies. [ABSTRACT FROM AUTHOR]

Objective Research has demonstrated that early intervention for children with autism can lead to improvements in core symptoms and enhance cognition, adaptive functioning, and quality of life. Unfortunately, most children are diagnosed too late to fully benefit from these services. Even in regions where diagnosis of autism can reliably be made, families often face additional barriers in accessing quality services. This article describes case examples in which Autism Speaks' Global Autism Public Health ( GAPH) Initiative partnered with communities to facilitate a process of multi-stakeholder collaboration to better understand local autism priorities related to awareness activities, early diagnosis, and developing autism surveillance systems. Method This paper utilised a nested case study to demonstrate how GAPH employs multi-stakeholder collaboration, community-based participatory research (CBPR) and consensus building to enhance early identification in low-resource settings. Each of these processes influenced different phases of the projects. Results In the first example, Autism Speaks adopted a CBPR approach to understand and address barriers to help-seeking behaviour among the Korean community affected by autism in New York City. The second example describes an international effort to develop open-source screening and diagnostic tools for autism that can be delivered by non-specialists in low-resource settings. The last example describes efforts to facilitate the development of an autism registry in Ireland to inform health policy decisions. Conclusions Collectively, these examples outline approaches the GAPH initiative uses to support global communities in working to overcome challenges related to the needs of individuals with autism and their families. [ABSTRACT FROM AUTHOR]

In 1947, a smallpox outbreak occurred in New York City with a total of twelve cases and two deaths. In order to contain this outbreak, the New York City Department of Health launched a mass immunization campaign that over a period of some 60 days vaccinated 6.35 million people. This article examines in detail the epidemiology of this outbreak and the measures employed to contain it. In 1976, a swine influenza strain was isolated among a few recruits at a US Army training camp at Fort Dix, New Jersey. It was concluded at the time that this virus possibly represented a re-appearance of the 1918 influenza pandemic influenza strain. As a result, a mass national immunization program was launched by the federal government. From its inception, the program encountered a myriad of challenges ranging from doubts that it was even necessary to the development of Guillain-Barré paralysis among some vaccine recipients. This paper examines the planning for and implementation of the swine flu immunization program in New York City. It also compares it to the smallpox vaccination program of 1947. Despite equivalent financial and personnel resources, leadership and organizational skills, the 1976 program only immunized approximately a tenth of the number of New York City residents vaccinated in 1947. The reasons for these marked differences in outcomes are discussed in detail. [ABSTRACT FROM AUTHOR]

Urban stormwater runoff management systems are usually designed to meet performance standards based on historical climate data, which are assumed to be stationary. Based on the evidence from climate change impact studies, in the near future, stormwater management systems, within the built environment, may need to meet performance expectations under climatic conditions different from historical climate. Considering the impacts of climate change on rainfall intensities and stormwater runoff peak flow and volumes, and in turn the effectiveness of mitigation, practices for urban stormwater management are desirable. This paper presents the results of a climate change impact study on urban stormwater runoff in the Bronx River watershed, New York City. Considering the impacts of climate change on watershed runoff, the potential for low-impact development (LID) controls to mitigate the impacts was investigated. Stormwater runoff and LID controls were modeled using the U.S. EPA Storm Water Management Model version 5 (EPA SWMM5). The simulations were driven by historical precipitation modified to represent future projections using a change factor methodology based on precipitation from the Coupled Model Intercomparison Project Phase 5 (CMIP5). Using the change factor method, historical precipitation was perturbed to obtain future data, based on three climate scenarios projecting maximum, mean, and minimum values for rainfall. Results of frequency analysis performed on the simulated peak flow rates, with different recurrence intervals, showed a noticeable increase in the frequency of occurrence of extreme storm events and their peak values, under future extreme climate conditions. An LID control scenario consisting of rainwater harvesting, porous pavement, and bioretention was designed and evaluated using the SWMM model. The results showed that, while average increase in historical annual runoff volume under climate change impacts was approximately 48%, the LID controls could provide an average reduction of 41% in annual runoff volume. Application of the LID controls also reduced peak flow rates by an average of 8 to 13%. LID implementation decreased watershed runoff corresponding to 2-year and 50-year return periods, by 28 and 14%, respectively. In conclusion, retrofits with LID controls may provide not only their inherent benefits (e.g., runoff volume and water quality), but also additional climate impact mitigation benefits for stormwater runoff. [ABSTRACT FROM AUTHOR]

This article shares the experiences and lessons learned from a community project that aims to develop a technology-based solution to improve communications between service users and service providers. Through this multi-year project in the Capital District of New York State, a team of social workers and engineers created a mobile app prototype based on the feedback from the community. This case study shares insights for conceptualizing various phases of community engagement as well as for recruiting multiple groups of stakeholders in the process of creating a collective vision for technology development. [ABSTRACT FROM AUTHOR]

Since U.S. Congress’ 2010 passing of the Affordable Care Act and the creation of numerous care coordination programs, Mount Sinai Hospital’s Department of Social Work Services has experienced exponential growth. The Department is deeply committed to recruiting and developing the most talented social workers to best meet the needs of patients and family caregivers and to serve as integral, valued members of interdisciplinary care teams. Traditional learning methods are insufficient for a staff of hundreds, given the changes in health care and the complexity of the work. This necessitates the use of new training and education methods to maintain the quality of professional development. This article provides an overview of the Department’s strategy and creation of a professional development learning platform to transform clinical social work practice. It reviews various education models that utilize an e-learning management system and case studies using standardized patients. These models demonstrate innovative learning approaches for both new and experienced social workers in health care. The platform’s successes and challenges and recommendations for future development and sustainability are outlined. [ABSTRACT FROM AUTHOR]

The U.S. spends just 5% of its health care budget to prevent morbidity and mortality. This study surveyed N.Y. State community health centers' (CHCs) population health activities aligned with the N.Y. Prevention Agenda (response rate of 72%). More than half of CHCs considered population health a high priority. Chronic disease and reducing preventable infections were the leading activity areas. One third of activities were dedicated to patient treatment follow-up. Community health centers reported that more than two-thirds of all activities received no funding. Despite a commitment to population health among CHCs, widespread improvements in population health may remain limited without an increase in dedicated funding to support community-based prevention strategies. [ABSTRACT FROM AUTHOR]

This study was designed to assess the impact of a decision-making curriculum (PEER-DM) on the social peer relationship knowledge and self-protective decision-making skills of adolescents with disabilities in hypothetical situations involving negative peer pressure. A randomized design was used to assign students with disabilities from self-contained special education classes to an intervention group (n = 22) or a wait-list control group (n = 20). ANCOVA analyses, using pretest scores as covariates, indicated that students who were trained on PEER-DM had significantly higher effective decision-making action and correct risk perception scores, relative to participants in the control group. This study provides supporting evidence that PEER-DM is a promising intervention for students with disabilities, including those with identified autism spectrum disorders, during transition years to help them develop a better understanding of positive and negative peer relationships and learn systematic decision-making skills for improved handling of social situations in the school and community, especially situations involving negative peer pressure. The study adds credence to using systematic, strategy-based decision making interventions designed to address the cognitive, emotional and motivational processes underlying adolescent decision making in sensitive interpersonal situations involving peer pressure. The study points to the lack of preparedness to handle situations of negative peer pressure as a serious social and health risk for adolescents with disabilities that deserves urgent and concerted attention in transition services programming. Implications for future curriculum-development efforts and replication of treatment findings are discussed. Future research examining disability-specific patterns of decision-making in peer situations and comparisons with typically developing populations is recommended. [ABSTRACT FROM AUTHOR]

In 2007, the Martin Luther King, Jr.- Harbor Hospital (MLK- Harbor), which served a large safety- net population in South Los Angeles, closed due to quality challenges. Shortly thereafter, an agreement was made to establish a new hospital, Martin Luther King, Jr. Community Hospital (MLKCH), to serve the unmet needs of the community. To assist the newly appointed MLKCH Board of Directors in building a culture of quality, we conducted a series of interviews with five high- performing hospital systems. In this report, we describe our findings. The hospitals we interviewed achieved a culture of quality by: 1) developing guiding principles that foster quality; 2) hiring and retaining personnel who are stewards of quality; 3) promoting efficient resource utilization; 4) developing a wellorganized quality improvement infrastructure; and 5) cultivating integrated, patient- centric care. The institutions highlighted in this report provide important lessons for MLKCH and other safety- net institutions. [ABSTRACT FROM AUTHOR]

Findings are from an investigation of 24 criminal domestic violence courts (DVCs) across New York, testing their effect on recidivism, case processing, and case resolutions. Overall, we found a small positive impact on recidivism among convicted offenders. We further found that the sex of defendants moderated the court impact on case resolutions; that is, among male defendants only, DVCs increased conviction rates and sentences involving jail or prison. In addition, multi-level, multivariate analyses found that court policies specifically designed to increase victim safety, hold offenders accountable, and reduce offender recidivism (through deterrence or rehabilitation) were instrumental in reducing recidivism. [ABSTRACT FROM AUTHOR]

Background: Herbal medicine use, highly prevalent in the general population, is often a neglected component of the medical history. Herbs are presumed safe because they are 'natural' self-care products. We call attention to the following issues: Panax ginseng, one of the most frequently used herbal medicines, has complex pharmacological activity, and can be associated with severe psychiatric symptoms. Physicians may be unfamiliar with herbal therapy risks, and the need for further education and systematic research is highlighted. Objective: To describe two cases of new onset manic psychoses associated with high dose, chronic ginseng use, and review the relevant literature. Case reports: A 23-year-old man developed acute mania after one month of daily ginseng use and intermittent cannabis use. A 79-year-old man developed hypomania while using ginseng and yohimbine for erectile dysfunction, and had a recurrence of mania after stopping yohimbine but increasing his daily intake of ginseng. Conclusions/ Summary: Symptoms of mania fully remitted within days upon discontinuation of ginseng and supportive treatment. Available data prevent a clear determination of causation; however, ginseng-induced mania in the these and previous case reports is suggested by the following: patients had no prior psychiatric history, daily use of ginseng was temporally associated with mania onset, patients ingested much higher doses for a longer duration than recommended in Traditional Chinese Medicine (TCM), and withdrawal of ginseng led to rapid remission. Generally well tolerated, many physicians are unaware that ginseng may be associated with acute and significant psychiatric disturbances for certain at-risk individuals. [ABSTRACT FROM AUTHOR]

Heterosexism in HHS and other organizations has deeply affected lesbian, gay, bisexual, transgender, and queer workers. However, there are positive signs that heterosexism at work is changing. This descriptive, cross-sectional study examined a convenience sample of HHS providers' (N = 69) perceptions of organizational tolerance for heterosexism. Findings of the study are that these HHS providers perceived low tolerance for heterosexism within their organizations. There were slight differences when the perpetrator of heterosexism was a work supervisor. This article also considers how HHS administrators can foster environments that support the unique contributions of sexual minorities in the workplace. [ABSTRACT FROM AUTHOR]

Increasing interest has been shown in shared decision making (SDM) to improve mental health care communication between underserved immigrant minorities and their providers. Nonetheless, very little is known about this process. The following is a qualitative study of fifteen primary care providers at two Federally Qualified Health Centers in New York and their experience during depression treatment decision making. Respondents described a process characterized in between shared and paternalistic models of treatment decision making. Barriers to SDM included discordant models of illness, stigma, varying role expectations and decision readiness. Respondents reported strategies used to overcome barriers including understanding illness perceptions and the role of the community in the treatment process, dispelling stigma using cultural terms, orienting patients to treatment and remaining available regarding the treatment decision. Findings from this study have implications for planning SDM interventions to guide primary care providers through treatment engagement for depression. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

We determined the cost of care for 2 diagnosis and management approaches for acute otitis media (AOM) among children 6 to 30 months old. A case–control design was used. Cases included 208 children diagnosed with AOM based on a bulging tympanic membrane (TM) and treated with amoxicillin/clavulanate. Controls (5:1 ratio) included 1020 children with AOM diagnosed not requiring bulging of the TM and treated with amoxicillin. Fewer cases (49%) than controls (69%) were diagnosed with AOM (P < .001), fewer were diagnosed with recurrent AOM or AOM treatment failure (0.34 vs 1.6/child; P < .0001), and fewer had insertion of tympanostomy tubes (6.3% vs 14.8%) due to recurrent AOM (P < .0001). The combined direct payments and indirect costs for management of AOM were $539/case versus $1,023/control. Using Rochester NY payments generalized to the US birth cohort, this case diagnosis and treatment strategy could save $1.008 billion per year. [ABSTRACT FROM PUBLISHER]

Venovenous extracorporeal membrane oxygenation (ECMO) is used for patients with severe, potentially reversible, respiratory failure unresponsive to conventional management. It is relatively contraindicated in patients with traumatic brain injury (TBI) due to bleeding complications and use of anticoagulation. We report two cases of TBI patients treated with ECMO. [ABSTRACT FROM PUBLISHER]