Behavioral Health in Rural America: Understanding Citizen Perceptions and Willingness to Respond to Community Needs

Amid nationwide efforts to address behavioral health needs, rural communities often face unique challenges and a lack of resources. This study presents a bottom-up approach used by one rural community in the Midwest to respond to their needs regarding mental health and substance use. A survey instrument was developed from interviews with community stakeholders and disseminated in both online and paper formats. The survey sought to understand citizen perspectives regarding quality of life, barriers to treatment, and willingness to engage in efforts to address the community’s needs. Data from 1,303 respondents (71.5% women, 54.7% income \u3c$42,000) were analyzed using descriptive statistics and chi-square analyses. Results indicate that cost of treatment, shame, and lack of privacy were a barrier for most citizens’ treatment-seeking behavior. In addition, many citizens were willing to engage in strategies to address the community’s needs, including increased county spending, forming a neighborhood watch, and donating money. Differences associated with gender and income emerged across perceptions and willingness to support efforts. Implications for community efforts are discussed

Prevalence of dyslipidaemia and associated risk factors in a rural population in south-western Uganda : a community based survey

BACKGROUND: The burden of dyslipidaemia is rising in many low income countries. However, there are few data on the prevalence of, or risk factors for, dyslipidaemia in Africa. METHODS: In 2011, we used the WHO Stepwise approach to collect cardiovascular risk data within a general population cohort in rural south-western Uganda. Dyslipidaemia was defined by high total cholesterol (TC) ≥ 5.2 mmol/L or low high density lipoprotein cholesterol (HDL-C) 6% (men aOR=3.00, 95%CI=1.37-6.59; women aOR=2.74, 95%CI=1.77-4.27). The odds of high TC was also higher among married men, and women with higher education or high BMI. CONCLUSION: Low HDL-C prevalence in this relatively young rural population is high whereas high TC prevalence is low. The consequences of dyslipidaemia in African populations remain unclear and prospective follow-up is required

Reflections on project ECHO: qualitative findings from five different ECHO programs

Project ECHO (Extension for Community Healthcare Outcomes) was developed in 2003 as an innovative model to facilitate continuing education and professional development. ECHO emphasizes ‘moving knowledge, not people.’ To accomplish this, ECHO programs use virtual collaboration and case-based learning to allow practitioners, including those in rural and underserved areas, to receive specialist training. The ECHO model has expanded rapidly and is now used in 44 countries. Preliminary research on ECHO’s efficacy and effectiveness has shown promising results, but evidence remains limited and appropriate research outcomes have not been clearly defined. To improve the evidence basis for ECHO, this study of 5 ECHO programs (cancer prevention/survivorship, integrated pain management, hepatitis C, HIV, and LGBTQ+ health care elucidated actionable insights about the ECHO programs and directions in which future evaluations and research might progress. This was a qualitative study following COREQ standards. A trained interviewer conducted 10 interviews and 5 focus groups with 25 unique, purposively sampled ECHO attendees (2 interviews and 1 focus group for each of the 5 programs). Data were transcribed verbatim and analyzed using the general inductive approach, then reviewed for reliability. We identified four major categories (reasons to join ECHO, value of participating in ECHO, ways to improve ECHO, and barriers to participation) composed of 23 primary codes. We suggest that thematic saturation was achieved, and a coherent narrative about ECHO emerged for discussion. Participants frequently indicated they received valuable learning experiences and thereby changed their practice; rigorous trials of learning and patient-level outcomes are warranted. This study also found support for the idea that the ECHO model should be studied for its role in convening communities of practice and reducing provider isolation as an outcome in itself. Additional implications, including for interprofessional education and model evolution, were also identified and discussed

The progress and promise of RNA medicine—an arsenal of targeted treatments

In the last decade, there has been a shift in research, clinical development, and commercial activity to exploit the many roles of RNA in physiology for use in medicine. With the rapid success in the development of lipid-RNA nanoparticles for mRNA vaccines against COVID-19 and with several approved RNA-based drugs, RNA has catapulted to the forefront of drug research. With diverse functions beyond the role of mRNA in producing antigens or therapeutic proteins, many classes of RNA serve a regulatory role in cells and tissues. These RNAs have potential as new therapeutics, with the RNA itself serving as either a drug or a target. These new types of RNA drugs require a plethora of modification chemistries to improve their therapeutic benefit. We describe the current state of the art for RNA medicine. Using the CAS Content Collection data, we examine the publication trends covering the roles of RNA in the cell, the application of RNA in medicine, and the use of chemical modifications and nanotechnology to deliver effective RNA pharmaceuticals to their cellular targets. This review reveals the sustained global effort that propelled this field to the cusp of realization for novel medical applications of RNA in many diseases. It serves as an easy-to-understand overview so that scientists from many different disciplines can appreciate the current state of the field of RNA medicine and join in solving the remaining challenges for fulfilling its potential

Protecting biological diversity in the North Woods region of the upper Great Lakes States

Master of ScienceLandscape ArchitectureUniversity of Michiganhttp://deepblue.lib.umich.edu/bitstream/2027.42/101565/1/39015040057914.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/101565/2/39015040057914.pd

Autismo : reevaluación de los conceptos y el tratamiento

Material fotocopiadoEl objetivo del presente trabajo es ofrecer una visión general de los conocimientos, la investigación, la educación y la práctica clínica en el campo del autismo. Tras una introducción sobre su diagnóstico y definición, se exponen las características sociales, comportamentales y cognitivas del autismo. Seguidamente se estudia dicho trastorno desde los distintos puntos de vista: la conducta social, el lenguaje, los problemas neurofisiológicos, estudios bioquímicos y hematológicos, así como otros factores externos como son el ambiente familiar. Para terminar se exponen las distintas terapias a desarrollar con niños autistas.MadridBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín, 5; 28014 Madrid; Tel. +34917748000; [email protected]