The Sustained,Positive Impact of a Native American Cultures and Health Course on Students’ Education and Practice-Related Choices

Objective. To encourage pharmacy students to elect education and practice opportunities in Native American communities, including careers with the Indian Health Service (IHS).Methods. Students in 2 elective courses were educated on various aspects of contemporary Native American life in urban and reservation environments, including cultural traditions, social and health-related challenges, health access disparities, and cultural approaches to health and wellness. The teachers were Native American leaders and healers primarily from Plains tribes, as well as non-Native American practitioners affiliated with IHS hospitals and tribal health facilities. Students kept reflective journals, and a subset spent 5 days immersed in a rural Navajo community where they lived and worked alongside IHS practitioners and Community Health Representatives.Results. Student engagement with IHS opportunities was tracked for 11 years. Of the 69 pharmacy students who completed the electives, 11 applied for a Junior Commissioned Officer Student Training and Externship Program (Jr. COSTEP) (8 accepted, 6 completed), 43 requested one or more IHS APPEs (43 accepted, 32 completed, 8 in progress), 17 applied for an IHS residency (1 pending, 8 accepted, 5 completed), and 5 became IHS Commissioned Corps officers. Five additional students accepted an IHS or tribal position, with 3 pursuing a USPHS commission.Conclusion. Since the first report on the impact of this elective experience was published, the course continues to meet its primary objective of promoting interest in IHS/tribal education experiences and pharmacy practice careers.     

Neonatal Cardiac Arrest From Left Ventricular Cardiac Hemangioma: A Surprising Presentation

Cardiac hemangioma is rare, even more when leading to a cardiovascular collapse in a seemingly healthy newborn. A 6-day-old neonate had a tamponade caused by a basolateral hemangioma of the left ventricle. Partial surgical resection was performed. A congenital lobular capillary hemangioma was diagnosed upon histologic examination. The patient recovered completely and shows normal development at the 12-month follow-up.     

Responding to Employment Needs

Abstract

This article reports on a study investigating employment-related support to individuals with HIV/AIDS from the perspective of service providers. Surveys were completed by AIDS Service Organizations (ASOs) and Vocational Rehabilitation (VR) administrators and counselors that examined the extent to which support around employment was provided, the type of work-related services delivered, and outreach practices offered to this population. Findings indicated that although employment is becoming an increasingly important concern to this population, service providers have a limited capacity to respond to such needs. Strategies are presented for social workers and other professionals to consider as they work to support individuals with HIV/AIDS with employment-related concerns.     

RESOLVING PROBLEMS ASSOCIATED WITH ALCOHOL AND DRUG MISUSE: UNDERSTANDING RELATIONS BETWEEN ADDICTIVE BEHAVIOR CHANGE AND THE USE OF SERVICES

“Natural resolutions” highlight how influences on addictive behavior change may differ from and interact with influences on the use of substance-related services. These distinct literatures are summarized and implicate extra-therapeutic environmental variables in both processes. Whether assisted by interventions or not, stable resolutions are surrounded by environmental contexts characterized by improved circumstances across several years that bracket cessation of substance misuse. Psychosocial problems associated with substance use increase help-seeking, and interventions enhance improvements that typically follow initial resolution. Implications for promoting help-seeking and behavior change and necessary revisions in conventional views about relations between the processes are discussed. [Translations are provided in the International Abstracts section of this issue.]     

Methods for Early Assessment of the Societal Value of Health Technologies: A Scoping Review and Proposal for Classification

ObjectivesEarly assessments of health technologies help to better align and integrate their development and assessment. Such assessments can take many forms and serve different purposes, hampering users in their selection of the most appropriate method for a specific goal. The aim of this scoping review was to structure the large set of methods according to their specific goal.MethodsA scoping review was conducted using PubMed and reference lists of retrieved articles, to identify review studies with a methodological focus. From the included reviews, all individual methods were listed. Based on additional literature and examples, we extracted the specific goal of each method. All goals were clustered to derive a set of subclasses and methods were grouped into these subclasses.ResultsOf the 404 screened, 5 reviews were included, and 1 was added when searching reference lists. The reviews described 56 methods, of which 43 (77%) were included and classified as methods to (1) explore the nature and magnitude of the problem, (2) estimate the nature and magnitude of the expected (societal) value, (3) identify conditions for the potential value to materialize, and (4) help develop and design the type of research that is needed.ConclusionsThe wide range of methods for exploring the societal value of health technologies at an early stage of development can be subdivided into a limited number of classes, distinguishing methods according to their specific objective. This facilitates selection of appropriate methods, depending on the specific needs and aims.     

Histoire et fonctions des Unités pour Malades Difficiles (1re partie). Du quartier de sûreté à l’Unité pour Malades Difficiles de Villejuif,plus d’un siècle de prise en charge

This article is the first in a series of three, dedicated to the history and functions of what is known as a UMD in France: Unités pour Malades Difficiles, or “Units for Difficult Patients”. This particular article focuses on the oldest such secure structure, UMD Henri Colin, created in 1910 in Villejuif as a quartier de sûreté, or a “secure ward”. The article aims to detail evolutions in treatment and the types of patient treated over more than one hundred years, parallel to social change. Four distinct chronological periods are examined, for their perspective on professional practice as much as for the reasons given for patients’ admission and the psychopathological profiles of “dangerous” patients. Clinical vignettes are used to illustrate this historical evolution.