• 【实现环境健康正义: 加拿大在健康促进方面进行全面研究,政策和倡导议程的经验。】 复制标题 收藏 收藏
    DOI:10.1093/heapro/daq041 复制DOI
    作者列表:Masuda JR,Poland B,Baxter J
    BACKGROUND & AIMS: :Spatial disparities in environmental quality and practices are contributing to rising health inequalities worldwide. To date, the field of health promotion has not contributed as significantly as it might to a systematic analysis of the physical environment as a determinant of health nor to a critique of inequitable environmental governance practices responsible for social injustice-particularly in the Canadian context. In this paper, we explore ways in which health promotion and environmental justice perspectives can be combined into an integrated movement for environmental health justice in health promotion. Drawing on Canadian experiences, we describe the historical contributions and limitations of each perspective in research, policy and particularly professional practice. We then demonstrate how recent environmental justice research in Canada is moving toward a deeper and multi-level analysis of environmental health inequalities, a development that we believe can inform a comprehensive research, policy and advocacy agenda in health promotion toward environmental health justice as a fundamental determinant of health. Lastly, we propose four key considerations for health promotion professionals to consider in advancing this movement.
    背景与目标: : 环境质量和做法的空间差异正在加剧世界范围内的健康不平等。迄今为止,健康促进领域并没有对作为健康决定因素的物理环境进行系统分析,也没有对造成社会不公正的不公平环境治理做法的批评 -- 特别是在加拿大背景下 -- 做出如此重大的贡献。在本文中,我们探讨了如何将健康促进和环境正义观点结合到健康促进中的环境健康正义综合运动中。借鉴加拿大的经验,我们描述了研究,政策,尤其是专业实践中每种观点的历史贡献和局限性。然后,我们展示了加拿大最近的环境正义研究如何朝着对环境健康不平等的更深入和多层次的分析迈进,我们认为这一发展可以为健康促进方面的全面研究,政策和倡导议程提供信息,以促进环境健康正义作为健康的基本决定因素。最后,我们提出了四个关键考虑因素,供健康促进专业人员在推进这一运动时考虑。
  • 【影响建立社区行动和倡导委员会的结构性问题。】 复制标题 收藏 收藏
    DOI:10.1093/her/cyt051 复制DOI
    作者列表:Weeks MR,Abbott M,Hilario H,Radda K,Medina Z,Prince M,Li J,Kaplan C
    BACKGROUND & AIMS: :The most effective woman-initiated method to prevent HIV/sexually transmitted infections is the female condom (FC). Yet, FCs are often difficult to find and denigrated or ignored by community health and service providers. Evidence increasingly supports the need to develop and test theoretically driven, multilevel interventions using a community-empowerment framework to promote FCs in a sustained way. We conducted a study in a midsized northeastern US city (2009-2013) designed to create, mobilize and build capacity of a community group to develop and implement multilevel interventions to increase availability, accessibility and support for FCs in their city. The Community Action and Advocacy Board (CAAB) designed and piloted interventions concurrently targeting community, organizational and individual levels. Ethnographic observation of the CAAB training and intervention planning and pilot implementation sessions documented the process, preliminary successes, challenges and limitations of this model. The CAAB demonstrated ability to conceptualize, plan and initiate multilevel community change. However, challenges in group decision-making and limitations in members' availability or personal capacity constrained CAAB processes and intervention implementation. Lessons from this experience could inform similar efforts to mobilize, engage and build capacity of community coalitions to increase access to and support for FCs and other novel effective prevention options for at-risk women.
    背景与目标: : 由妇女发起的预防艾滋病毒/性传播感染的最有效方法是女用避孕套 (FC)。然而,社区卫生和服务提供商通常很难找到、诋毁或忽视社区卫生和服务提供商。越来越多的证据支持需要使用社区赋权框架来开发和测试理论驱动的多层次干预措施,以持续的方式促进FCs。我们在美国东北部中型城市 (2009-2013) 进行了一项研究,旨在创建,动员和建设社区团体的能力,以开发和实施多层次干预措施,以增加其城市中FCs的可用性,可及性和支持。社区行动和倡导委员会 (CAAB) 同时针对社区,组织和个人级别设计并试行了干预措施。对CAAB培训和干预计划以及试点实施会议的人种学观察记录了该模型的过程,初步成功,挑战和局限性。CAAB表现出了概念化,计划和发起多层次社区变革的能力。但是,小组决策中的挑战以及成员可用性或个人能力的限制限制了CAAB流程和干预实施。从这一经验中吸取的教训可以为动员、参与和建设社区联盟能力的类似努力提供信息,以增加对FCs和其他针对高危妇女的新型有效预防选择的机会和支持。
  • 【教学健康倡导: 对研究生医学学员的教育干预措施的系统回顾。】 复制标题 收藏 收藏
    DOI:10.1097/ACM.0000000000003063 复制DOI
    作者列表:Scott MD,McQueen S,Richardson L
    BACKGROUND & AIMS: PURPOSE:A systematic review was undertaken to characterize the training approaches that are currently being implemented in postgraduate medical education to teach residents advocacy skills. METHOD:An initial search was conducted in MEDLINE, PubMed, Embase, ERIC, and PsycINFO in November 2016 (updated in December 2017) for articles discussing postgraduate medical education interventions covering advocacy. Articles published between 1995 and 2017 were included. Two authors independently reviewed titles and abstracts (and, if needed, the full text) for inclusion; disagreements were resolved by consensus. Data were extracted from studies to characterize the content and pedagogy of the interventions by mapping them to the CanMEDS health advocate core competencies and key concepts. RESULTS:A total of 3,027 unique abstracts were retrieved; 2,864 were excluded upon title and abstract review, and another 85 were excluded upon full-text review. Seventy-eight total articles were included. More studies involved residents from pediatrics, psychiatry, primary care or preventative medicine, or internal medicine than from emergency medicine, surgery, obstetrics and gynecology, or neurology. Published interventions varied widely by pedagogical approach and assessment method. CONCLUSIONS:Using the CanMEDS framework, this review maps the breadth and nature of postgraduate medical education interventions in health advocacy, with applicability to community organizations, program directors, educators, and administrators working to develop advocacy training interventions. Areas of focus included adapting practice to respond to the needs of or advocacy in partnership with patients, communities, or populations served; determinants of health; health promotion; mobilizing resources as needed; and social accountability.
    背景与目标:
  • 【在儿童倡导中心识别同情满意度、倦怠和创伤压力。】 复制标题 收藏 收藏
    DOI:10.1016/j.chiabu.2019.104240 复制DOI
    作者列表:Letson MM,Davis C,Sherfield J,Beer OWJ,Phillips R,Wolf KG
    BACKGROUND & AIMS: BACKGROUND:Little research exists examining burnout related to the multidisciplinary team (MDT) working in a Children's Advocacy Center (CAC) setting. OBJECTIVES:To measure compassion satisfaction, burnout, and secondary traumatic stress (STS) among CAC MDT professionals; identify work and worker characteristics that may impact compassion satisfaction, burnout, and STS; understand professional and personal impacts of occupational stress; and explore coping responses. PARTICIPANTS AND SETTING:A cross sectional survey was sent electronically to child abuse professionals working in CAC settings across the United States. METHODS:Demographics and work characteristics were collected. Participants completed the Professional Quality of Life (ProQOL) to evaluate compassion satisfaction, burnout, and STS and answered open-ended questions regarding professional and personal impacts of occupational stress. Upon completion, participants received their ProQOL scores and additional stress management resources. RESULTS:A total of 885 participants completed the ProQOL (mean age = 42.07; 85% female). Overall mean scores were average for compassion satisfaction, high average for burnout, and in the top quartile for STS. All three scales differed significantly by MDT professional role (ps < 0.001 to 0.01) and employment length (ps < 0.001 to 0.003). Child welfare workers had significantly higher burnout scores than all other professions except law enforcement and prosecutors and significantly lower compassion satisfaction scores than most others. Professionals providing on-call services had significantly higher burnout (p <  0.001). CONCLUSIONS:These results contribute to our understanding of MDT professions who might be at higher risk for burnout and STS and help inform future interventions to support the MDT.
    背景与目标:
  • 【自闭症谱系中的道德倡导: 超越部分代表。】 复制标题 收藏 收藏
    DOI:10.1080/15265161.2020.1730482 复制DOI
    作者列表:McCoy MS,Liu EY,Lutz ASF,Sisti D
    BACKGROUND & AIMS: :Recent debates within the autism advocacy community have raised difficult questions about who can credibly act as a representative of a particular population and what responsibilities that role entails. We attempt to answer these questions by defending a set of evaluative criteria that can be used to assess the legitimacy of advocacy organizations and other nonelectoral representatives. With these criteria in hand, we identify a form of misrepresentation common but not unique to autism advocacy, which we refer to as partial representation. Partial representation occurs when an actor claims to represent a particular group of people but appropriately engages with only a subset of that group. After highlighting symbolic and substantive harms associated with partial representation, we propose several strategies for overcoming it.
    背景与目标: : 自闭症倡导社区最近的辩论提出了一个棘手的问题,即谁可以可信地充当特定人群的代表,以及这一角色需要承担什么责任。我们试图通过捍卫一套可用于评估倡导组织和其他非选举代表的合法性的评估标准来回答这些问题。有了这些标准,我们确定了自闭症倡导中常见但并非唯一的虚假陈述形式,我们将其称为部分陈述。当演员声称代表特定的人群但仅适当地与该人群的一个子集互动时,就会发生部分表示。在强调与部分表示相关的象征性和实质性危害之后,我们提出了几种克服它的策略。
  • 【患者倡导/家长支持小组的作用。】 复制标题 收藏 收藏
    DOI:10.7196/samj.6976 复制DOI
    作者列表:Hall JG
    BACKGROUND & AIMS: :Parent support/patient advocacy groups for rare genetic disorders have emerged as an important force. They provide information, encourage research (both by participation in research and by raising money for research), give families and affected family members the opportunity to learn from each other, and open the way for social and intellectual interaction between families, affected individuals, researchers and healthcare providers. New IT technologies increase the opportunities for collaboration and information exchange around the world. These groups have become an important resource for families, genetic counsellors and medical/clinical genetic professionals. 
    背景与目标: : 罕见遗传疾病的父母支持/患者倡导团体已成为重要力量。他们提供信息,鼓励研究 (通过参与研究和筹集研究资金),给家庭和受影响的家庭成员相互学习的机会,并为家庭、受影响的个人、研究人员和医疗保健提供者之间的社会和智力互动开辟道路。新的信息技术增加了世界各地合作和信息交流的机会。这些群体已成为家庭,遗传咨询师和医学/临床遗传专业人员的重要资源。
  • 【英国全面无烟立法: 倡导是如何赢得胜利的。】 复制标题 收藏 收藏
    DOI:10.1136/tc.2007.020255 复制DOI
    作者列表:Arnott D,Dockrell M,Sandford A,Willmore I
    BACKGROUND & AIMS: OBJECTIVE:To examine how a government committed to a voluntary approach was forced by an effective advocacy coalition to introduce comprehensive smoke-free legislation. METHODS:A diary was kept from the start of the campaign in 2003, backed up by journal and press articles, and information downloaded from the web. Regular public opinion polls were also carried out to supplement government surveys and polls conducted by the media. RESULTS:The 1997 Labour Government was committed to a voluntary approach to deal with the problem of secondhand smoke. By 2003, efforts to persuade government to introduce regulation of workplace secondhand smoke through a health and safety code of practice with exemptions for the hospitality trade, had failed. Despite a lack of support from the government, including the health minister, a new strategy by health advocates focusing on comprehensive workplace legislation was able to succeed. CONCLUSIONS:In a democracy it is crucial to develop public knowledge and belief in the extent of the risks of secondhand smoke. Gaining public and media support for the issue can ensure that government has to take action and that the legislation will be enforceable. The interests of the tobacco industry and the hospitality trade differ and this can be used to gain hospitality trade support for comprehensive national legislation in order to ensure a level playing field and protection from litigation.
    背景与目标:
  • 【根据日本人口的老龄化,根据正常上颌切骨管的改变,倡导上颌切骨管囊肿的诊断标准。】 复制标题 收藏 收藏
    DOI:10.1186/s13005-019-0209-5 复制DOI
    作者列表:Ueda N,Tanaka T,Oda M,Wakasugi-Sato N,Matsumoto-Takeda S,Miyamura Y,Jyoujima T,Kiyota K,Tsutsumi K,Morimoto Y
    BACKGROUND & AIMS: BACKGROUND:The purpose of the present study was to describe the CT imaging findings of normal incisive canals and incisive canal cysts and propose cut-off values to differentiate between them. METHODS:A total of 220 normal subjects and 40 patients with incisive canal cysts on multi-detector row computed tomography (MDCT) were retrospectively analyzed. The shapes, sizes, anatomic variations, Hounsfield scale values, and so on of maxillary incisive canals and the sizes and Hounsfield scale values of maxillary incisive canal cysts were analyzed. RESULTS:A significant difference in sizes of maxillary incisive canals in normal subjects was found between males and females. The sizes of maxillary incisive canals were significantly wider during aging, but shapes, anatomic variations, and Hounsfield scale values in the maxillary incisive canals were not significantly different with aging. A significant difference in sizes but not Hounsfield scale values was found between normal maxillary incisive canals and maxillary incisive canal cysts. Based on a cut-off of over 6 mm in the width of incisive canals, maxillary incisive canal cysts could not be appropriately diagnosed for subjects over 60 years of age. Over 60 years of age, maxillary incisive canal cysts could be appropriately diagnosed based on a cut-off of over 7.1 mm in width of incisive canals. When maxillary incisive canals of the hourglass types were seen on sagittal sections, significantly more patients had maxillary incisive canal cysts than other types. CONCLUSION:In coincidentally diagnosing asymptomatic incisive canal cysts on imaging, we should apply different cut-offs for the size of the maxillary incisive canal for patients over and under 60 years of age. Specifically, the cut-offs for the long axis of maxillary incisive canal cysts were 7.1 mm for patients over 60 years of age and 6.0 mm for those under 60 years of age. In addition, we should pay attention to wider canals with hourglass shapes as indicative of cystic change of maxillary incisive canals.
    背景与目标:
  • 9 Health advocacy. 复制标题 收藏 收藏

    【健康宣传。】 复制标题 收藏 收藏
    DOI:10.1080/0142159X.2017.1245853 复制DOI
    作者列表:Hubinette M,Dobson S,Scott I,Sherbino J
    BACKGROUND & AIMS: :In the medical profession, activities related to ensuring access to care, navigating the system, mobilizing resources, addressing health inequities, influencing health policy and creating system change are known as health advocacy. Foundational concepts in health advocacy include social determinants of health and health inequities. The social determinants of health (i.e. the conditions in which people live and work) account for a significant proportion of an individual's and a population's health outcomes. Health inequities are disparities in health between populations, perpetuated by economic, social, and political forces. Although it is clear that efforts to improve the health of an individual or population must consider "upstream" factors, how this is operationalized in medicine and medical education is controversial. There is a lack of clarity around how health advocacy is delineated, how physicians' scope of responsibility is defined and how teaching and assessment is conceptualized and enacted. Numerous curricular interventions have been described in the literature; however, regardless of the success of isolated interventions, understanding health advocacy instruction, assessment and evaluation will require a broader examination of processes, practices and values throughout medicine and medical education. To support the instruction, assessment and evaluation of health advocacy, a novel framework for health advocacy is introduced. This framework was developed for several purposes: defining and delineating different types and approaches to advocacy, generating a "roadmap" of possible advocacy activities, establishing shared language and meaning to support communication and collaboration across disciplines and providing a tool for the assessment of learners and for the evaluation of teaching and programs. Current approaches to teaching and assessment of health advocacy are outlined, as well as suggestions for future directions and considerations.
    背景与目标: : 在医学界,与确保获得护理、导航系统、调动资源、解决健康不平等、影响健康政策和创造系统变革有关的活动被称为健康宣传。健康倡导的基本概念包括健康和健康不平等的社会决定因素。健康的社会决定因素 (即人们生活和工作的条件) 在个人和人口的健康结果中占很大比例。健康不平等是人口之间的健康差异,由经济,社会和政治力量长期存在。尽管很明显,改善个人或人群健康的努力必须考虑 “上游” 因素,但如何在医学和医学教育中实施这一措施仍存在争议。关于如何描述健康倡导,如何定义医生的责任范围以及如何概念化和制定教学和评估,缺乏明确性。文献中已经描述了许多课程干预措施; 但是,无论孤立的干预措施是否成功,了解健康倡导指导,评估和评估都需要对整个医学和医学教育的过程,实践和价值观进行更广泛的检查。为了支持对健康倡导的指导,评估和评估,引入了一种新颖的健康倡导框架。该框架的开发目的有几个: 定义和描述倡导的不同类型和方法,生成可能的倡导活动的 “路线图”,建立共享的语言和含义以支持跨学科的交流和协作,并提供评估学习者的工具以及对教学和计划的评估。概述了当前的健康倡导教学和评估方法,以及对未来方向和考虑的建议。
  • 【畸形患者身份和目标的定性分析: 弱势群体循证宣传的准备。】 复制标题 收藏 收藏
    DOI:10.1097/SAP.0b013e31827fb471 复制DOI
    作者列表:Tapia VJ,Chang DC,Ramirez M,Gosman A
    BACKGROUND & AIMS: INTRODUCTION:Economically and socially vulnerable patients with deformities are likely to live a marginalized life, reducing their quality of life and societal participation. An evidence-based approach is needed for these patients who may not be able to advocate for themselves. The objective of this study is to identify important aspects of the perceived identity of adult patients with deformities. METHODS:This retrospective qualitative analysis is of applicant responses to an intake questionnaire for Fresh Start Surgical Gifts, a charitable reconstructive surgery organization serving children and adults with deformities. Five open-ended questions were analyzed and grouped into 2 broad categories: Identity and Goals. Keywords were identified by an online survey website and subjective judgment of the investigators. Keywords were then combined into broader themes. RESULTS:Seventy respondents with a mean age of 24.79 (median 23) between 1992 and 2011 were analyzed. Social and professional issues were the most frequently occurring themes among Identity and Goals questions. CONCLUSION:The current identity of patients with deformities centers on social aspects of their lives, rather than a career or profession, yet they do hold both professional and social aspirations. This research will guide the development of an objective tool to measure patient-reported impact and outcomes of reconstructive plastic surgery.
    背景与目标:
  • 【残疾婴儿与安乐死: 对我们倡导的挑战。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Smith JD
    BACKGROUND & AIMS: -2
    背景与目标: -2
  • 12 Web-based training in family advocacy. 复制标题 收藏 收藏

    【基于网络的家庭宣传培训。】 复制标题 收藏 收藏
    DOI:10.1097/HTR.0b013e31824e1d43 复制DOI
    作者列表:McLaughlin KA,Glang A,Beaver SV,Gau JM,Keen S
    BACKGROUND & AIMS: OBJECTIVE:To examine the efficacy of an interactive multimedia intervention that teaches advocacy skills to people caring for a family member with traumatic brain injury. PARTICIPANTS:A total of 201 individuals (control, n = 97; treatment, n = 104) providing support to a family member with traumatic brain injury. DESIGN:Randomized controlled study. MAIN MEASURES:Caregiver knowledge, skill application, behavioral intention, and overall life satisfaction. INTERVENTION:The Brain Injury Partners program, a Web site focused on advocacy, communication skills, and resources for families affected by brain injury. RESULTS:Univariate analyses revealed that compared with the control group, the Brain Injury Partners group reported statistically significant higher adjusted means for application, knowledge, and attitudes scales immediately postintervention and at follow-up. Satisfaction with life, assessed at follow-up but not posttest, was not significant. DISCUSSION:This study demonstrated the effectiveness of a Web-based intervention to teach effective skills to caregivers advocating for a family member with traumatic brain injury.
    背景与目标:
  • 【围堵抵制: 控烟宣传的工具。】 复制标题 收藏 收藏
    DOI:10.1136/tc.2005.011247 复制DOI
    作者列表:Offen N,Smith EA,Malone RE
    BACKGROUND & AIMS: OBJECTIVES:To propose criteria to help advocates: (1) determine when tobacco related boycotts may be useful; (2) select appropriate targets; and (3) predict and measure boycott success. METHODS:Analysis of tobacco focused boycotts retrieved from internal tobacco industry documents websites and other scholarship on boycotts. RESULTS:Tobacco related boycotts may be characterised by boycott target and reason undertaken. Most boycotts targeted the industry itself and were called for political or economic reasons unrelated to tobacco disease, often resulting in settlements that gave the industry marketing and public relations advantages. Even a lengthy health focused boycott of tobacco industry food subsidiaries accomplished little, making demands the industry was unlikely to meet. In contrast, a perimetric boycott (targeting institutions at the perimeter of the core target) of an organisation that was taking tobacco money mobilised its constituency and convinced the organisation to end the practice. CONCLUSIONS:Direct boycotts of the industry have rarely advanced tobacco control. Perimetric boycotts of industry allies offer advocates a promising tool for further marginalising the industry. Successful boycotts include a focus on the public health consequences of tobacco use; an accessible point of pressure; a mutual interest between the target and the boycotters; realistic goals; and clear and measurable demands.
    背景与目标:
  • 【定位艾滋病毒和艾滋病的全球治理: 探索跨国宣传网络的地域。】 复制标题 收藏 收藏
    DOI:10.1016/j.healthplace.2012.02.006 复制DOI
    作者列表:Marx C,Halcli A,Barnett C
    BACKGROUND & AIMS: :Over the last two decades, HIV and AIDS have been framed as a "global problem". In the process, transnational advocacy networks have emerged as important actors, and particular places are recognised as key nodes in global HIV and AIDS governance. Using the example of London, UK, this paper examines how these networks are involved in local articulations of global governance and reveals that 'global' processes are inflected by the locations through which networks are routed. The example suggests the need for further analysis of the geographies through which HIV and AIDS is reconfiguring power relations at a variety of spatial scales.
    背景与目标: : 在过去的二十年中,艾滋病毒和艾滋病被视为 “全球问题”。在此过程中,跨国宣传网络已成为重要的参与者,特定的地方被认为是全球艾滋病毒和艾滋病治理的关键节点。本文以英国伦敦为例,研究了这些网络如何参与全球治理的本地表达,并揭示了 “全球” 过程受网络路由位置的影响。该示例表明,需要进一步分析艾滋病毒和艾滋病在各种空间尺度上重新配置权力关系的地理位置。
  • 【宣传: 综合精神卫生系统中的关键组成部分。】 复制标题 收藏 收藏
    DOI:10.1111/j.1939-0025.2011.01143.x 复制DOI
    作者列表:Stylianos S,Kehyayan V
    BACKGROUND & AIMS: :Although rights protection and best interest perspectives are frequently viewed as diametric opposites, mental health advocacy is an important strategy in pursuit of both civil rights and therapeutic goals for people with mental illness. Independent, client-centered advocacy supports the attainment of consumer-identified goals for recovery, equality, and social inclusion and mitigates the negative consequences of stigma and discrimination. Advocacy strives to return decision-making authority to consumers and thus to empower them to play a more central role in their own care, treatment, rehabilitation, and life choices.
    背景与目标: : 尽管权利保护和最大利益观点经常被视为截然相反的观点,但精神卫生倡导是追求精神疾病患者的公民权利和治疗目标的重要策略。以客户为中心的独立倡导支持实现消费者确定的康复,平等和社会包容目标,并减轻污名和歧视的负面影响。倡导致力于将决策权归还给消费者,从而使他们能够在自己的护理,治疗,康复和生活选择中发挥更重要的作用。

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