More Than Just An Eyesore: Local Insights And Solutions on Vacant Land And Urban Health

Vacant land is a significant economic problem for many cities, but also may affect the health and safety of residents. In order for community-based solutions to vacant land to be accepted by target populations, community members should be engaged in identifying local health impacts and generating solutions. We conducted 50 in-depth semi-structured interviews with people living in Philadelphia, Pennsylvania, a city with high vacancy, about the impact of vacant land on community and individual health and safety, as well as ideas for solutions to vacant land. Participants described a neighborhood physical environment dominated by decaying abandoned homes and overgrown vacant lots which affected community well-being, physical health, and mental health. Vacant land was thought to affect community well-being by overshadowing positive aspects of the community, contributing to fractures between neighbors, attracting crime, and making residents fearful. Vacant land was described as impacting physical health through injury, the buildup of trash, and attraction of rodents, as well as mental health through anxiety and stigma. Participants had several ideas for solutions to vacant land in their community, including transformation of vacant lots into small park spaces for the elderly and playgrounds for youth, and the use of abandoned homes for subsidized housing and homeless shelters. A few participants took pride in maintaining vacant lots on their block, and others expressed interest in performing maintenance but lacked the resources to do so. Public health researchers and practitioners, and urban planners should engage local residents in the design and implementation of vacant land strategies. Furthermore, municipalities should ensure that the health and safety impact of vacant land helps drive policy decisions around vacant land.     

More Than Meets the Eye: Relationship Between Low Health Literacy and Poor Vision in Hospitalized Patients

Patient-centered care includes involving patients and their families in self-management of chronic diseases. Identifying and addressing barriers to self-management, including those related to health literacy and vision limitations, may enhance one's ability to self-manage. A set of brief verbal screening questions (BVSQ) that does not rely on sufficient vision to assess health literacy was developed by Chew and colleagues in the outpatient setting. The authors aimed to evaluate the usefulness of this tool for hospitalized patients and to determine the prevalence of poor vision among inpatients. In a prospective study, the BVSQ and the Rapid Estimate of Adult Learning in Medicine–Revised (REALM-R; among participants with sufficient vision, ≥ 20/50 Snellen) were administered to general medicine inpatients. Of 893 participants, 79% were African American, and 57% were female; the mean age was 53 years. Among 668 participants who completed both tools, the proportion with low health literacy was 38% with the BVSQ versus 47% with the REALM-R (p = .0001). Almost one fourth of participants had insufficient vision; participants with insufficient vision were more likely to be identified as having low health literacy by the BVSQ, compared with those with sufficient vision (59% vs. 38%, p < .001).     

Nurse Overestimation of Patients' Health Literacy

Patient education and effective communication are core elements of the nursing profession; therefore, awareness of a patient's health literacy is integral to patient care, safety, education, and counseling. Several past studies have suggested that health care providers overestimate their patient's health literacy. In this study, the authors compare inpatient nurses' estimate of their patient's health literacy to the patient's health literacy using Newest Vital Sign as the health literacy measurement. A total of 65 patients and 30 nurses were enrolled in this trial. The results demonstrate that nurses incorrectly identify patients with low health literacy. In addition, overestimates outnumber underestimates 6 to 1. The results reinforce previous evidence that health care providers overestimate a patient's health literacy. The overestimation of a patient's health literacy by nursing personnel may contribute to the widespread problem of poor health outcomes and hospital readmission rates.     

Accelerating Early Language and Literacy Skills Through a Preschool-Home Partnership Using Dialogic Reading: a Randomized Trial

Background

This study tested a preschool-home partnership intervention, in which early childhood teachers encouraged the parents/caregivers of preschoolers to engage in dialogic reading at home. This was an experimental test of Bronfenbrenner’s hypothesis that parental involvement in early care and education programs should promote child development, as well as a test of a train-the-trainer approach to the dialogic reading intervention.

Objective

The current study focuses on testing the causality of parent involvement: (1) homework assigned to parents/caregivers will improve the early language and literacy skills of their 2?~?3-year-old children; (2) gains by children in the intervention group with low pre-test language and literacy score, low family literacy score, and high parents/caregivers’ extent of using dialogic reading strategies at home will show larger gains in literacy scores than their counterparts.

Methods

A sample of 12 early care and education programs, 18 early childhood teachers, 87 two–to three-year-old children and their parents/caregivers were followed for 18?~?20 weeks after assignment to the intervention group or the control group.

Results

The impacts of the six-week parent involvement intervention continued to grow during the six-week follow-up phase, and represented substantial gains of the intervention group in four aspects of early language and literacy skills.

Conclusion

This study provides evidence that a simple homework assignment intervention can be an effective tool to promote child development when parents/caregivers are engaged. The intervention also had ongoing influence on children’s early language and literacy skills, even after the intervention period had ended.

     

做一个比上司还"聪明"的人

人在职场，我们都逃不过要面对上司，因此，与上司相处就是每个在职者的必修课。这个学问深无止境，让你有无限深造的可能。没有什么不可能，只要你掌握了以下秘笈，一定会成为比上司还“聪明”的人。     

Communication Skills Training and Patients' Satisfaction

Effective physician-patient encounters require the doctor to have consulting skills that facilitate communication flow. When adequate communication does not occur, patients express dissatisfaction with their medical interactions. Many medical students show interview behaviors that may not contribute to patients' satisfaction. Poor communication skills reduce the reliability of elicited medical information and lead to reduced satisfaction for both patients and students. In the present study, a communication skills training course was evaluated using ratings of students' videotaped history-taking interviews with patients and patients' satisfaction ratings. Trained students showed significantly improved consultation skills and techniques compared with a group of control students who displayed few changes in behavior over the course of the study. Satisfaction ratings given by patients of students improved significantly after training, whereas ratings given by patients of control group students decreased over the same period.     

Effects of an Afterschool Early Literacy Intervention on the Reading Skills of Children in Public Housing Communities

Background

Afterschool programs (ASPs) in the United States have been implemented in low income neighborhoods to enable at-risk youth to access educational support services to increase academic skills. However, mixed findings about the ASPs positively affecting academic performance suggests a need for additional evaluative studies.

Objective

The current study examines the effects of literacy training on the reading skills of kindergarten to third grade students who were enrolled in a community-based ASP in four public housing neighborhoods. Participants received structured literacy and reading training, individual tutoring, and a choice-based book distribution program.

Method

Assignment to treatment and comparison groups was based on residence in public housing neighborhoods. We implemented a quasi-experimental design to compare improvements in reading proficiency among ASP literacy program participants in four public housing neighborhoods and a comparable group of students residing in two other public housing neighborhoods without this ASP. Participants were enrolled in grades K to 3 (n = 543). The study lasted for 4 years, and an intent-to-treat approach was used to analyze outcomes.

Results

Mixed-effects models indicated that among a full sample and propensity-score matched sample, ASP participants demonstrated significantly better reading proficiency than comparison group participants over time.

Conclusions

Study findings provide preliminary evidence that it is possible to impact reading proficiency for very high-risk students in the early grades of elementary school. ASPs that target literacy among low-income students could play an important role in boosting student achievement, and therefore in narrowing the achievement gap as young people progress through school.

     

Sometimes a Cigar [Magazine] is More Than Just a Cigar [Magazine]: Pro-Smoking Arguments in Cigar Aficionado, 1992-2000

Since its first issue in 1992, few periodicals have enjoyed the rapid growth and international popularity of Cigar Aficionado. Although the magazine professes to simply celebrate "the good life and the joys of cigar smoking," we argue that it serves a more insidious function; specifically, the periodical supplies readers with 7 persuasive strategies aimed at rebuking dominant anti-smoking health assertions: (a) the cigars- are-not-cigarettes argument, (b) the life-is-dangerous argument, (c) the health-benefits argument, (d) the moderation argument, (e) the old-smokers argument, (f) the bad-science argument, and (g) the good-science argument. These pro-smoking arguments ultimately serve to relieve the cognitive dissonance associated with the consumption of a potentially deadly product and to maintain a loyal readership, free from guilt or anxiety.     

More Than a Destination: Contraceptive Decision Making as a Journey

BackgroundContraceptive use is widely recognized as a means of reducing adverse health-related outcomes. However, dominant paradigms of contraceptive counseling may rely on a narrow definition of “evidence” (i.e., scientifically accurate but exclusive of individual women's experiences). Given increased enthusiasm for long-acting, reversible contraceptive methods, such paradigms may reinforce counseling that overprivileges effectiveness, particularly for groups considered at high risk of unintended pregnancy. This study investigates where and how women's experiences fit into the definition of evidence these counseling protocols use.MethodsUsing a qualitative approach, this analysis draws on semistructured interviews with 38 young (ages 18–24) Black and Latina women. We use a qualitative content analysis approach, with coding categories derived directly from the textual data.FindingsOur analysis suggests that contraceptive decision making is an iterative, relational, reflective journey. Throughout contraceptive histories, participants described experiences evolving to create a foundation from which decision-making power was drawn. The same contraceptive-related decisions were revisited repeatedly, with knowledge accrued along the way. The cumulative experience of using, assigning meanings to, and developing values around contraception meant that young women experienced contraceptive decision making as a dynamic process.Implications for PracticeThis journey creates a rich body of evidence that informs contraceptive decision making. To provide appropriate, acceptable, patient-centered family planning care, providers must engage with evidence grounded in women's expertise on their contraceptive use in addition to medically accurate data on method effectiveness, side effects, and contraindications.     

Medical Records: More Than the Health Insurance Portability and Accountability Act

It is the responsibility of each organization, including private practice businesses, to maintain a comprehensive medical records retention policy. While registered dietitian nutritionists (RDNs) are qualified and competent business owners, navigating through the challenges of proper medical record management can be difficult without a sound policy. A comprehensive medical record retention policy consists of 4 major components: creation, utilization, maintenance, and destruction as well as a retention schedule. Successful implementation of a comprehensive medical record retention policy promotes positive clinician-patient interaction and avoidance of potential legal ramifications.