Mission Possible: Improving the Lives of All Older Adults in Marin

In 2012, Marin County's Division of Aging and Adult Services conducted a needs assessment that provided a detailed account of the demographics, economic security, health, housing, status of caregiving, and quality of life for the county's older adult population. This report also revealed that people's own assessment of their health was less positive among Hispanic/Latino and African American older adults compared to their white counterparts. The survey findings were supplemented by conducting community forums among specific groups (i.e., AfricanAmerican, Latino/Hispanic, family caregivers, low-income persons, and residents in rural areas) to gain insight into service needs and service barriers.These findings reinforce the results of a 2008 assessment in which nearly half of the Marin service agencies surveyed identified inadequacy in the cultural competence of their services. Ninety-one percent indicated that the lack of services for low-income older adults was a moderate to widespread problem. These challenges were also echoed in focus groups conducted with Spanish-speaking and lesbian, gay, bisexual, and transgender (LGBT) older adults.While prior efforts have improved understanding of the needs of Marin's older adults, there remains a gap in knowledge of the availability and status of culturally competent services among Marin's service providers. This effort sought to address this gap and identify organizational strategies that would improve the ability of agencies to provide high quality services to a diverse population of older adults in Marin County

Investing in Leadership Development: A Tool for Systems Change in the Community Health Center Field

Over the course of 12 years, the Blue Shield of California Foundation committed nearly $20 million to growing a pool of community health center leaders who were prepared to be effective agents of change in their organizations and in the safety net field. This signature investment, the Clinic Leadership Institute, was implemented in partnership with the Healthforce Center at University of California, San Francisco, in anticipation of a generation of California health center leaders beginning to transition into retirement. During the institute\u27s 10 cohorts, access to community health centers dramatically increased with the Affordable Care Act, and this — coupled with rising costs of health care — continued to underscore how crucial community health centers were to accessible and quality care for poor and underserved populations. A study spanning 10 cohorts of alumni found that the institute served a critical role in supporting community health center leaders and their organizations in navigating these changes, while also building alumni networks advocating for community health centers in county- and state-level policy. The program equipped 258 individuals to lead and deliver care in a field marked by continuous change, complexity, and mounting demand. Drawing on these findings, we make the case that investment in leadership development is a critical philanthropic tool for field building and, ultimately, systems change. We explore how the foundation made the most of this investment through intentional funding, design, and strategic considerations

A Clinical Study Of Pranada Gutika And Kasisadi Taila In The Management Of Arsha Roga With Special Reference To Hemorrhoids.

Context: Ayurveda is a science of life and more than just a medical system. Ayurveda has taken the foremost place in the management of crippling disease. Arsha is one of the prime important disease from Ashta Mahagada. Ayurveda, the ancient science of medicine of India has detail information and description of Arsha. According to Ayurvedic Samprapti Mithya Aahara-Vihara is one of the important etiological factors of it. Arsha Roga, which can be compared with hemorrhoids due to its clinical appearance. Arsha is more than another anorectal ailment, near about one third of population suffering from anorectal diseases. Aims: To study the efficacy of Pranada Gutika and Kasisadi Taila in the management of Arsha Roga (Hemorrhoids). Materials and Methods: 30 clinically diagnosed patients were selected and administered Pranada Gutika 2 tab. (each tablet 500 mg) three times in a day with lukewarm water, after meal for 30 days and Kasisadi Taila Pichu Dharana for 7 days. Study design- Single centre and open label clinical study. Results: Statistically highly significant result was found in Mandagni (Indigestion), Vibandha (Constipation), Raktastrava (Bleeding per rectum), Arshabhransa (Protrusion of pile mass), Guda Kandu (Itching), Guda Vedana (Pain in ano), Guda Srava (Discharge per rectum) and also in Hb %, ESR and symptoms of Arsha Roga. Conclusions: Therapy in the form of administration of Pranada Gutika and Kasisadi Taila was effective in the management of Arsha Roga (Hemorrhoids)