The document summarizes a project aimed at addressing heart health challenges among Filipino Americans. It discusses high rates of hypertension, diabetes, obesity, and smoking found in literature about Filipinos. It describes community health screenings conducted through the project that found over half of participants had elevated blood pressure, with many not taking medication. The project partnered with churches, organizations, businesses and health providers to engage the community and recruit over 1750 participants. Predictors of hypertension in the study population included being male, unemployed, overweight, having fair/poor health, living in the US over 15 years, and being over 52 years old. The project used photovoice to capture community members' stories and perspectives.
This document provides an overview of a presentation on optimizing neurovascular aging through nutritional and weight management techniques. The presentation discusses the importance of micronutrient adequacy and macronutrient balance in diet and their relationship to neurovascular health issues. It also discusses how our functioning as we age and freedom from disease and depression is dependent on our diet and behaviors. The presentation provides information on common micronutrient deficiencies in North America, physiological effects of deficiencies, and the role of antioxidants in brain and body health.
This document summarizes a study on geriatric morbidity patterns and depression levels in relation to family support in the aged population of Kashmir Valley, India. The study surveyed 210 people over age 60 and found that 67.6% had one ailment, 30.4% had two ailments, and 2% had more than three. It also found that 85.7% had family support, and those with support had lower depression levels than those without support. Family support was shown to correlate with lower depression and better health outcomes in the elderly population.
Deterioro en el estado general y pérdida de pesoIntegrarsalud
1) Unintentional weight loss of 10% or more in 6-12 months is defined as involuntary weight loss.
2) Common causes include cancer, gastrointestinal disorders, endocrine diseases, and psychological factors.
3) Involuntary weight loss is associated with increased mortality, hospital complications, disability, and reduced quality of life.
This document discusses possible links between vitamin D deficiency and various geriatric syndromes and common comorbidities. It begins by outlining how vitamin D receptors are present in many tissues beyond the musculoskeletal system. It then examines potential associations between vitamin D deficiency and increased risks of frailty, urinary incontinence, dementia/cognitive impairment, and depression in elderly populations. While evidence is limited and relationships are not clearly causal, several observational studies have found correlations between low vitamin D levels and higher rates of these conditions. More research is still needed, but maintaining adequate vitamin D status may help reduce risks of age-related diseases and functional decline.
This study examined the association between family history of type 2 diabetes and health beliefs and physical activity levels in African Americans. The researchers surveyed 133 African American churchgoers about their family history of diabetes, knowledge of diabetes risk factors, perceptions of susceptibility and severity of diabetes, and physical activity levels. They found that those with a family history of diabetes had greater knowledge of risk factors, were more likely to feel concern about developing diabetes influenced their health behaviors, and engaged in significantly more physical activity than those without a family history. The study suggests family history of diabetes may promote greater preventative behaviors by increasing perceived risk and health beliefs related to diabetes in African Americans.
This document provides an overview of a presentation on optimizing neurovascular aging through nutritional and weight management techniques. The presentation discusses the importance of micronutrient adequacy and macronutrient balance in diet and their relationship to neurovascular health issues. It also discusses how our functioning as we age and freedom from disease and depression is dependent on our diet and behaviors. The presentation provides information on common micronutrient deficiencies in North America, physiological effects of deficiencies, and the role of antioxidants in brain and body health.
This document summarizes a study on geriatric morbidity patterns and depression levels in relation to family support in the aged population of Kashmir Valley, India. The study surveyed 210 people over age 60 and found that 67.6% had one ailment, 30.4% had two ailments, and 2% had more than three. It also found that 85.7% had family support, and those with support had lower depression levels than those without support. Family support was shown to correlate with lower depression and better health outcomes in the elderly population.
Deterioro en el estado general y pérdida de pesoIntegrarsalud
1) Unintentional weight loss of 10% or more in 6-12 months is defined as involuntary weight loss.
2) Common causes include cancer, gastrointestinal disorders, endocrine diseases, and psychological factors.
3) Involuntary weight loss is associated with increased mortality, hospital complications, disability, and reduced quality of life.
This document discusses possible links between vitamin D deficiency and various geriatric syndromes and common comorbidities. It begins by outlining how vitamin D receptors are present in many tissues beyond the musculoskeletal system. It then examines potential associations between vitamin D deficiency and increased risks of frailty, urinary incontinence, dementia/cognitive impairment, and depression in elderly populations. While evidence is limited and relationships are not clearly causal, several observational studies have found correlations between low vitamin D levels and higher rates of these conditions. More research is still needed, but maintaining adequate vitamin D status may help reduce risks of age-related diseases and functional decline.
This study examined the association between family history of type 2 diabetes and health beliefs and physical activity levels in African Americans. The researchers surveyed 133 African American churchgoers about their family history of diabetes, knowledge of diabetes risk factors, perceptions of susceptibility and severity of diabetes, and physical activity levels. They found that those with a family history of diabetes had greater knowledge of risk factors, were more likely to feel concern about developing diabetes influenced their health behaviors, and engaged in significantly more physical activity than those without a family history. The study suggests family history of diabetes may promote greater preventative behaviors by increasing perceived risk and health beliefs related to diabetes in African Americans.
This document is a project proposal submitted by Javeed Ahmad Teeli to Indira Gandhi National Open University for their Post Graduate Diploma in Rural Development program. The project proposal is on the health problems faced by rural women in Breng block of Anantnag district in Jammu and Kashmir, India. It provides background information on Jammu and Kashmir, the district of Anantnag, and Breng block. It outlines the objectives of the study, data collection methods, and tables of findings from the research conducted in the village of Hiller.
MAP OF DISTRICT ANANTNAG
This map shows the location of Anantnag district in the Indian state of Jammu and Kashmir
Opportunity for Natural Selection among Bhuiyans: A Tribal Population of Keon...Binoy Kuiti
This study investigated the opportunity for natural selection among the Bhuiyan tribal population in Haldipani village, Keonjhar District, Odisha, India. Demographic data was collected from 83 households, including reproductive histories of 71 mothers aged 40+. The indices of mortality, fertility, and overall natural selection were calculated. Mortality was higher than fertility, possibly due to poor sanitation and healthcare access. The natural selection index of 0.7804 indicated a moderate level of selection pressure. This pressure could be reduced by improving socioeconomic conditions, health awareness, and education for this population.
This document is the introduction section of a research paper that examined physical activity patterns and psychological correlates of physical activity among primary, secondary, and junior college students in Singapore. It provides background on the importance of physical activity for health and discusses how physical activity tends to decline with age during schooling. The study aimed to understand the characteristics of physical activity participation and sedentary behaviors among different age groups of students in Singapore to inform physical activity programs.
This document reports a case study of a 16-year-old male patient with Wolfram syndrome type 1, a rare autosomal recessive disorder characterized by diabetes and optic nerve atrophy. The patient was first diagnosed with diabetes at age 6 and had very challenging blood glucose control despite intensive therapy. He also developed progressive optic nerve atrophy, neurogenic bladder, learning disabilities, and incomplete puberty. Genetic testing revealed two novel homozygous variants in the WFS1 gene, which is associated with Wolfram syndrome type 1. Despite poor metabolic control, he did not develop any microvascular complications over 10 years of follow-up. The case study aims to further investigate the causes of the patient's metabolic idiosyncras
This document discusses disparities in heart disease among women of different ethnicities. It summarizes that Native American, Hispanic, and African American women have higher rates of heart disease mortality compared to Asian American and white women. It then discusses various risk factors for heart disease like high cholesterol, diabetes, obesity rates, exercise levels, and smoking rates among different ethnic groups of women. It also addresses biases in referral to certain cardiac procedures and treatments among African American patients.
The document discusses the health status of women in India. It finds that women experience higher rates of infant and child mortality compared to men in many states. Literacy rates are also lower for women nationally. Enrollment is lower for females at all levels of education except post-graduation and MPhil. Overall, the analysis shows that women in India are at a disadvantage compared to men in terms of health outcomes and social indicators.
This document provides a draft Master's of Public Health (MOP) proposal for a study examining cardiovascular disease (CVD) risk factors and premature heart disease mortality among Native Americans aged 45-64 living in North and South Dakota from 2010-2013. The study would use a nested case-control design within the Strong Heart Study cohort to examine the association between exposures like diabetes, hypertension, smoking and outcomes like premature heart disease mortality. The goal is to better understand high rates of premature heart disease in Native American populations and inform prevention programs. Ethical considerations around working with vulnerable populations and obtaining informed consent are discussed.
The document discusses several health issues facing communities in the United States and their relationship to the built environment. It notes that chronic diseases like diabetes and heart disease are on the rise due to issues like inactivity and obesity. Research is presented showing links between access to nature and better health outcomes. The challenges of addressing health at the individual level are discussed, highlighting the need for environmental changes to make active living easier. Maps show the increasing rates of obesity across the US from 1985 to 2007.
Jennifer Tremmel - Sex Differences In Cardiovascular DiseaseClayman Institute
This document discusses sex differences in cardiovascular disease. It summarizes that historically, heart disease studies primarily enrolled men. Women represent about half of cardiovascular disease patients but were underrepresented in clinical trials. Risk factors like diabetes and obesity confer greater relative risk of cardiovascular events in women than men. Symptom presentation of heart disease can differ between sexes, with women more likely to experience atypical symptoms. Guidelines recommend against menopausal hormone therapy for primary or secondary prevention of cardiovascular disease in women.
The Office of Research on Women's Health at the NIH works to ensure women's health issues are adequately studied and women are represented in clinical research. Cardiovascular disease is the leading cause of death among women in the United States, particularly for white, black, and Hispanic women. However, women often underestimate their risk and are less aware of heart disease compared to cancer. While all women face risks, minority women tend to have higher rates of risk factors like hypertension and diabetes. More research is still needed to improve prevention and treatment strategies for cardiovascular disease in all populations.
F - Improving Cardiovascular Health In African AmericansNathan Banda
The document discusses improving cardiovascular health in African Americans. It aims to increase awareness of genetic and behavioral risk factors for hypertension in this population. Hypertension is one of the biggest challenges to cardiovascular health for African Americans. The presentation reviews risk factors for hypertension such as age, race, family history, obesity, diet, stress, alcohol, and tobacco use. It also discusses the high prevalence of hypertension in African Americans and the impact of diet, exercise, weight control, and lifestyle changes on reducing hypertension risk and improving cardiovascular health.
Matthew Howse is a consultant nephrologist at the Royal Liverpool and Broadgreen University Hospitals NHS Trust and an honorary senior lecturer at the University of Liverpool. He received his medical degree from the University of Liverpool in 2005 and has worked in nephrology and general internal medicine since graduating. His clinical work focuses on nephrology, transplantation, pregnancy-related kidney disease, and general medicine. He also has a research focus and teaches medical students.
Tribal people in India suffer from a high burden of disease due to factors like poverty, poor hygiene, lack of access to healthcare, and nutritional deficiencies. They face both communicable diseases like malaria, tuberculosis, and leprosy as well as non-communicable diseases like diabetes and heart disease. Improving tribal health requires ensuring access to healthcare infrastructure and services, implementing public health programs, increasing health education, and addressing social and economic barriers that prevent tribes from utilizing available care.
African Americans in Wisconsin have significantly higher rates of poverty, lower education levels, and younger median age compared to the total Wisconsin population. The top three leading causes of death for African Americans are cancer, heart disease, and unintentional injury. However, the death rate for diabetes is over two times greater and for homicide is 14.7 times greater for African Americans compared to whites. Risk factors such as smoking, physical inactivity, and obesity are also higher among African Americans. Environmental and socioeconomic factors like living in urban areas with more exposure to pollution, lower SES, and lack of access to healthcare all contribute to the health disparities seen between African Americans and whites in Wisconsin.
This document provides background information on Crystal, an 8-year-old girl with a rare brain tumor who receives cancer treatment as an outpatient. It describes how Crystal has faced bullying from strangers, school personnel, and peers due to her physical appearance and limitations from cancer. The gym teacher failed to accommodate Crystal's needs and pushed her too hard physically. Peers often leave Crystal out of activities she cannot fully participate in, though they may not understand the impacts of cancer. The document argues more should be done to educate school staff and students about childhood cancer to reduce bullying and promote inclusion of outpatient patients like Crystal.
This document describes a study conducted by Georgia Southern University students to assess the nutritional knowledge of low-income adults in rural South Georgia. The students developed and implemented a 3-part nutrition education program called Healthy Habits 101 at Rebecca's Cafe, which serves meals to low-income residents. Participants completed pre- and post-tests to measure changes in knowledge of nutrition and chronic disease after the program. The findings support providing more comprehensive health education to rural populations, as lack of knowledge contributes to health disparities. Researchers may want to consider Rebecca's Cafe as an intervention site for future studies.
1. The document discusses women's health and well-being, with a focus on how it is defined and perceptions of it in different cultures and income levels.
2. It finds that for poorer women in developing countries, well-being often means having basic needs met and gaining empowerment through education and independence.
3. For women in wealthier countries, well-being debates commonly center around balancing work and family responsibilities, though subjective feelings can differ from objective measures of health and income.
4. The document examines perspectives from women, public health officials, and experts on factors influencing well-being and how women access health information.
O documento descreve os principais aspectos do plano espiritual de acordo com a doutrina espírita. Ele explica que o plano espiritual é onde as almas evoluem através de interações com outras almas e com a natureza espiritual. O documento também afirma que o plano espiritual tem leis e características físicas próprias que permitem a evolução contínua do espírito.
- A união da alma ao corpo ocorre gradualmente durante a gestação, com o cordão fluídico ligando o Espírito ao corpo à medida que este se desenvolve. A união é completa no momento do nascimento.
- Quando a criança nasce, a alma possui todas as idéias adquiridas anteriormente, mas em estado latente, retomando a consciência gradualmente à medida que os órgãos se desenvolvem.
- As idéias inatas têm origem no progresso intelectual adquirido pelas almas em exist
This document is a project proposal submitted by Javeed Ahmad Teeli to Indira Gandhi National Open University for their Post Graduate Diploma in Rural Development program. The project proposal is on the health problems faced by rural women in Breng block of Anantnag district in Jammu and Kashmir, India. It provides background information on Jammu and Kashmir, the district of Anantnag, and Breng block. It outlines the objectives of the study, data collection methods, and tables of findings from the research conducted in the village of Hiller.
MAP OF DISTRICT ANANTNAG
This map shows the location of Anantnag district in the Indian state of Jammu and Kashmir
Opportunity for Natural Selection among Bhuiyans: A Tribal Population of Keon...Binoy Kuiti
This study investigated the opportunity for natural selection among the Bhuiyan tribal population in Haldipani village, Keonjhar District, Odisha, India. Demographic data was collected from 83 households, including reproductive histories of 71 mothers aged 40+. The indices of mortality, fertility, and overall natural selection were calculated. Mortality was higher than fertility, possibly due to poor sanitation and healthcare access. The natural selection index of 0.7804 indicated a moderate level of selection pressure. This pressure could be reduced by improving socioeconomic conditions, health awareness, and education for this population.
This document is the introduction section of a research paper that examined physical activity patterns and psychological correlates of physical activity among primary, secondary, and junior college students in Singapore. It provides background on the importance of physical activity for health and discusses how physical activity tends to decline with age during schooling. The study aimed to understand the characteristics of physical activity participation and sedentary behaviors among different age groups of students in Singapore to inform physical activity programs.
This document reports a case study of a 16-year-old male patient with Wolfram syndrome type 1, a rare autosomal recessive disorder characterized by diabetes and optic nerve atrophy. The patient was first diagnosed with diabetes at age 6 and had very challenging blood glucose control despite intensive therapy. He also developed progressive optic nerve atrophy, neurogenic bladder, learning disabilities, and incomplete puberty. Genetic testing revealed two novel homozygous variants in the WFS1 gene, which is associated with Wolfram syndrome type 1. Despite poor metabolic control, he did not develop any microvascular complications over 10 years of follow-up. The case study aims to further investigate the causes of the patient's metabolic idiosyncras
This document discusses disparities in heart disease among women of different ethnicities. It summarizes that Native American, Hispanic, and African American women have higher rates of heart disease mortality compared to Asian American and white women. It then discusses various risk factors for heart disease like high cholesterol, diabetes, obesity rates, exercise levels, and smoking rates among different ethnic groups of women. It also addresses biases in referral to certain cardiac procedures and treatments among African American patients.
The document discusses the health status of women in India. It finds that women experience higher rates of infant and child mortality compared to men in many states. Literacy rates are also lower for women nationally. Enrollment is lower for females at all levels of education except post-graduation and MPhil. Overall, the analysis shows that women in India are at a disadvantage compared to men in terms of health outcomes and social indicators.
This document provides a draft Master's of Public Health (MOP) proposal for a study examining cardiovascular disease (CVD) risk factors and premature heart disease mortality among Native Americans aged 45-64 living in North and South Dakota from 2010-2013. The study would use a nested case-control design within the Strong Heart Study cohort to examine the association between exposures like diabetes, hypertension, smoking and outcomes like premature heart disease mortality. The goal is to better understand high rates of premature heart disease in Native American populations and inform prevention programs. Ethical considerations around working with vulnerable populations and obtaining informed consent are discussed.
The document discusses several health issues facing communities in the United States and their relationship to the built environment. It notes that chronic diseases like diabetes and heart disease are on the rise due to issues like inactivity and obesity. Research is presented showing links between access to nature and better health outcomes. The challenges of addressing health at the individual level are discussed, highlighting the need for environmental changes to make active living easier. Maps show the increasing rates of obesity across the US from 1985 to 2007.
Jennifer Tremmel - Sex Differences In Cardiovascular DiseaseClayman Institute
This document discusses sex differences in cardiovascular disease. It summarizes that historically, heart disease studies primarily enrolled men. Women represent about half of cardiovascular disease patients but were underrepresented in clinical trials. Risk factors like diabetes and obesity confer greater relative risk of cardiovascular events in women than men. Symptom presentation of heart disease can differ between sexes, with women more likely to experience atypical symptoms. Guidelines recommend against menopausal hormone therapy for primary or secondary prevention of cardiovascular disease in women.
The Office of Research on Women's Health at the NIH works to ensure women's health issues are adequately studied and women are represented in clinical research. Cardiovascular disease is the leading cause of death among women in the United States, particularly for white, black, and Hispanic women. However, women often underestimate their risk and are less aware of heart disease compared to cancer. While all women face risks, minority women tend to have higher rates of risk factors like hypertension and diabetes. More research is still needed to improve prevention and treatment strategies for cardiovascular disease in all populations.
F - Improving Cardiovascular Health In African AmericansNathan Banda
The document discusses improving cardiovascular health in African Americans. It aims to increase awareness of genetic and behavioral risk factors for hypertension in this population. Hypertension is one of the biggest challenges to cardiovascular health for African Americans. The presentation reviews risk factors for hypertension such as age, race, family history, obesity, diet, stress, alcohol, and tobacco use. It also discusses the high prevalence of hypertension in African Americans and the impact of diet, exercise, weight control, and lifestyle changes on reducing hypertension risk and improving cardiovascular health.
Matthew Howse is a consultant nephrologist at the Royal Liverpool and Broadgreen University Hospitals NHS Trust and an honorary senior lecturer at the University of Liverpool. He received his medical degree from the University of Liverpool in 2005 and has worked in nephrology and general internal medicine since graduating. His clinical work focuses on nephrology, transplantation, pregnancy-related kidney disease, and general medicine. He also has a research focus and teaches medical students.
Tribal people in India suffer from a high burden of disease due to factors like poverty, poor hygiene, lack of access to healthcare, and nutritional deficiencies. They face both communicable diseases like malaria, tuberculosis, and leprosy as well as non-communicable diseases like diabetes and heart disease. Improving tribal health requires ensuring access to healthcare infrastructure and services, implementing public health programs, increasing health education, and addressing social and economic barriers that prevent tribes from utilizing available care.
African Americans in Wisconsin have significantly higher rates of poverty, lower education levels, and younger median age compared to the total Wisconsin population. The top three leading causes of death for African Americans are cancer, heart disease, and unintentional injury. However, the death rate for diabetes is over two times greater and for homicide is 14.7 times greater for African Americans compared to whites. Risk factors such as smoking, physical inactivity, and obesity are also higher among African Americans. Environmental and socioeconomic factors like living in urban areas with more exposure to pollution, lower SES, and lack of access to healthcare all contribute to the health disparities seen between African Americans and whites in Wisconsin.
This document provides background information on Crystal, an 8-year-old girl with a rare brain tumor who receives cancer treatment as an outpatient. It describes how Crystal has faced bullying from strangers, school personnel, and peers due to her physical appearance and limitations from cancer. The gym teacher failed to accommodate Crystal's needs and pushed her too hard physically. Peers often leave Crystal out of activities she cannot fully participate in, though they may not understand the impacts of cancer. The document argues more should be done to educate school staff and students about childhood cancer to reduce bullying and promote inclusion of outpatient patients like Crystal.
This document describes a study conducted by Georgia Southern University students to assess the nutritional knowledge of low-income adults in rural South Georgia. The students developed and implemented a 3-part nutrition education program called Healthy Habits 101 at Rebecca's Cafe, which serves meals to low-income residents. Participants completed pre- and post-tests to measure changes in knowledge of nutrition and chronic disease after the program. The findings support providing more comprehensive health education to rural populations, as lack of knowledge contributes to health disparities. Researchers may want to consider Rebecca's Cafe as an intervention site for future studies.
1. The document discusses women's health and well-being, with a focus on how it is defined and perceptions of it in different cultures and income levels.
2. It finds that for poorer women in developing countries, well-being often means having basic needs met and gaining empowerment through education and independence.
3. For women in wealthier countries, well-being debates commonly center around balancing work and family responsibilities, though subjective feelings can differ from objective measures of health and income.
4. The document examines perspectives from women, public health officials, and experts on factors influencing well-being and how women access health information.
O documento descreve os principais aspectos do plano espiritual de acordo com a doutrina espírita. Ele explica que o plano espiritual é onde as almas evoluem através de interações com outras almas e com a natureza espiritual. O documento também afirma que o plano espiritual tem leis e características físicas próprias que permitem a evolução contínua do espírito.
- A união da alma ao corpo ocorre gradualmente durante a gestação, com o cordão fluídico ligando o Espírito ao corpo à medida que este se desenvolve. A união é completa no momento do nascimento.
- Quando a criança nasce, a alma possui todas as idéias adquiridas anteriormente, mas em estado latente, retomando a consciência gradualmente à medida que os órgãos se desenvolvem.
- As idéias inatas têm origem no progresso intelectual adquirido pelas almas em exist
Chw panel presentation lr slides 03.13.2013kalusugan1
This document summarizes a panel discussion on using community health workers (CHWs) to address health disparities in Asian American communities through culturally appropriate research and practice. It provides an overview of CHW models and training approaches. It then introduces three CHW programs serving Filipino, Bangladeshi, and Korean/South Asian communities in New York City, describing their community-based participatory research design, adaptation of curricula to be culturally relevant, and findings about addressing factors like access to care, food environment, and role of ethnic media. Community members describe health issues in their communities and roles of the CHWs.
Kalusugan Coalition is a non-profit organization serving the Filipino community in NYC. Their mission is to improve health through network development, education, research, community action and advocacy. They operate various programs including AsPIRE to address hypertension, ARUGA for breast health education, and Pinoy HEALIN' to promote healthy eating and active living. Kalusugan Coalition also conducts policy advocacy and works as navigators to help enroll individuals in health insurance through the ACA exchange.
The document provides information and tips for designing an app for the Coffee Run game, including maintaining consistent style and color throughout the app design. It examines several app icon and screenshot ideas, considering how effectively they represent the game and stand out visually. Target audiences for the game are listed as mainstream, teenagers, adults, and those interested in quick, addictive, repetitive games. Font styles and color options for the app design are also displayed.
The document provides information and ideas for designing an app for a coffee run game. It discusses targeting a mainstream audience including teenagers and adults. It explores several app icon and screenshot ideas, considering factors like colors, graphics, and how well they represent the game. Font styles and color options for the app design are also reviewed.
O documento discute a transformação íntima e como libertar-se de vícios e defeitos através de um processo de autoconhecimento e cultivo de virtudes. Ele descreve as fases da transformação incluindo arrependimento, desânimo e conformação, e como conhecer os próprios vícios e defeitos para poder combatê-los, substituindo-os por virtudes como perseverança e compaixão.
Atitude é a ação que tomamos perante a vida e influencia nossos resultados, seja para o bem ou para o mal. Devemos ter atitudes positivas e seguir o exemplo de Cristo de amor e caridade. Respeite os outros e tenha fé que Deus sabe o que é melhor, mesmo nos momentos difíceis.
Um dicionário de situações da vida pode ajudar a entender que até os desafios como sofrimento e contratempos têm propósito de nos fazer crescer espiritualmente, se tivermos fé.
This document is a list of examinees registered to take the Board Licensure Examination for Professional Teachers in Tuguegarao City on September 29, 2013. It includes the examinees' names, seat numbers, schools graduated from, and room assignments for the exam. Examinees are instructed to report to their assigned rooms before 6:30 AM and verify their information, and to contact the PRC office if any errors are found in the data.
The document provides information and tips for designing an app for the Coffee Run game, including maintaining consistent style and color throughout the app design. It examines several app icon and screenshot ideas, considering how effectively they represent the game and stand out visually. Target audiences for the game are listed as mainstream, teenagers, adults, and those interested in quick, addictive, repetitive games. Font styles and color options for the app design are also displayed.
Este documento discute a importância da mudança no processo de evolução espiritual. A mudança é necessária para o progresso individual e a adaptação às novas circunstâncias. No entanto, os seres humanos frequentemente resistem à mudança. A aceitação de si mesmo, compreensão das origens emocionais dos problemas e assumir responsabilidade por suas ações facilitam o processo de mudança.
O documento descreve os princípios da evolução segundo o Espiritismo, incluindo que: 1) a evolução é um processo contínuo de aprendizado para se tornar mais feliz através de encarnações sucessivas; 2) todos os seres, incluindo anjos e demônios, são iguais perante Deus e evoluíram em estágios diferentes; 3) a educação espírita busca a regeneração moral do ser humano para a construção de um mundo mais justo e fraterno.
O documento discute três conceitos principais:
1) O livre-arbítrio é conquistado quando o espírito atinge um nível evolutivo que permite escolhas, tornando-se responsável por seu próprio destino.
2) A lei de causa e efeito estabelece que cada ação gera uma consequência, seja boa ou má, de acordo com a escolha feita.
3) A lei de ação e reação funciona da mesma forma, onde o que semeia determina o que será colhido no futuro.
Public Health Issues for Asian Communities in Christchurch: Challenges and Tr...Human Rights Commission
This document discusses health statistics and issues for Asian populations in the Christchurch, New Zealand area. It provides demographic data showing the Asian population has grown to over 27,000 people. It then examines several health-related topics for Asians including youth sexual health, diabetes prevalence, immunization rates, language barriers, and the importance of culture and face. It notes that the last health needs analysis was in 2004 and is now out of date, and that there continue to be issues with access to interpreters, understanding medical instructions, and discrimination.
American journal of health education.2009ALe Galindo
This document provides an overview of diabetes in children and teens. It states that approximately 186,300 youth under age 20 in the US have either type 1 or type 2 diabetes. Type 2 diabetes, once considered an adult disease, is becoming more common in overweight minority youth over age 10. Risk factors for type 2 diabetes include obesity rates among children increasing. The article discusses the need for healthy eating, physical activity, weight loss, and family support to help prevent and manage type 2 diabetes in youth.
Rebuilding the Health Care System in New Orleans and the UScentralconference
The document discusses rebuilding the health care system in New Orleans post-Hurricane Katrina and applying Jewish principles of health care. It notes that pre-Katrina, Louisiana ranked 50th in health outcomes and had high rates of poverty, uninsured individuals, and health disparities. After Katrina, most hospitals and health infrastructure was destroyed, exacerbating access issues. The document advocates redesigning the system based on primary care-centered models shown to improve outcomes and lower costs through principles like comprehensive and coordinated care.
1) A study assessed the prevalence of diagnosed diabetes and diabetes mortality rate in a large Puerto Rican community in Chicago. 2) The prevalence of diabetes was found to be 20.8%, the highest reported for Puerto Ricans and twice as high as rates for Puerto Ricans in New York and Puerto Rico. 3) The diabetes mortality rate of 67.6 per 100,000 population was more than twice the rates for all of Chicago and the US.
Latinos in the U.S. and Northeast Florida: A Health Overview
Feb. 25, 2005
This is part 1 of an 8 part series of seminars on Hispanic Health Issues brought to you by the University of North Florida’s Dept. of Public Health, College of Health, a grant from AETNA, and the cooperation of Duval County Health Department.
The document summarizes a health needs assessment conducted in rural communities in Chiapas, Mexico. It provides demographic data showing that most residents are young, have low levels of education, work in farming or as homemakers, and have low incomes. It also reports on residents' self-reported health issues and living conditions. The study aimed to identify health, economic, and social needs to help guide a new healthcare project in the region. Local promoters were trained to administer surveys to gather data on residents' demographics, symptoms, nutrition, living standards, and physical measurements.
The document discusses strategies for improving diabetes management programs to better serve racially and ethnically diverse patient populations. It emphasizes the importance of cultural competence and addressing health beliefs, alternative treatments, language barriers, and family roles that are specific to different ethnic groups. Effective programs elicit patients' cultural health beliefs, educate practitioners, provide language assistance, and address social factors like racism that can influence health outcomes.
Community hlth planning_project_final 2Casey Burritt
The document summarizes a community health project conducted by Old Dominion University nursing students in partnership with Miles Memorial United Methodist Church and Sentara Health Prevention. The students assessed the health of the church congregation through surveys and interviews. Their assessment found that high blood pressure was a major health concern, along with allergies, obesity, and depression. The students developed a health plan to address these issues through education and screenings. The congregation is made up of mostly older adults and Caucasians. Literature reviews found that high blood pressure increases with age and is more prevalent in Europe and associated with risk factors like smoking. The project aimed to promote health and prevent illness in the congregation.
Health care disparities exist between different racial and ethnic groups in the United States. The WHO defines health disparities as differences in health outcomes that are closely linked to social and economic disadvantage. There can be up to a 33 year difference in life expectancy between racial groups. Disparities are driven by social determinants like education, income, and environment. Minority groups face greater barriers to accessing quality health care due to lack of insurance, language barriers, and provider biases. Addressing disparities requires improvements in data collection, the health workforce, and policies aimed at promoting equity.
The document discusses efforts to improve cancer prevention education and access for Asian American women through community outreach events from 2005-2009. It notes the linguistic, logistical, and financial challenges involved in organizing these large events with many community partners. It then summarizes several research studies from this outreach work that highlight gaps in awareness of cancer prevention strategies like vaccines among Asian American women, especially those with limited English proficiency.
This document summarizes a presentation by Magda Peck on women's health advocacy. It discusses leading causes of death for women in the US including heart disease and cancer. It also provides statistics on health conditions affecting US women such as obesity and smoking rates. The document reviews recommendations from reports on improving women's health research and access to preventive services. It discusses the importance of annual well-woman visits and expanded insurance coverage of women's healthcare under the Affordable Care Act. The presentation emphasizes the role of women in making health decisions and advocating for their own health and the health of others.
The home visit is a crucial responsibility of family doctors. By doing home visits the physician and the team become more aware of the nature of the illness and other factors that playing role in either increasing the burden or decreasing the severity of the disease 9Such as the home environment, the family members interactions, and others...)
This document discusses the role of physical education and sport in society and education. It covers several topics:
1) Changing demographics in the US and how this impacts physical education. The population is becoming older and more diverse.
2) The wellness movement and importance of physical activity for health. Inactivity is rising while obesity levels increase.
3) Educational reform movements and ensuring physical education is not considered a "frill" but rather an important part of the core curriculum.
4) Recommendations to promote physical activity through physical education, community programs, and developing lifelong healthy habits.
Family physicians and primary care are essential for strong healthcare systems and improved population health outcomes. Studies from numerous countries have shown that greater emphasis on primary care, through measures like increased primary care physician supply and comprehensive primary health services, is associated with lower costs, reduced health inequities, decreased preventable hospitalizations, and lower mortality rates. In contrast, reliance on specialist care has been linked to higher costs and greater mortality. Strong primary healthcare should be the foundation of any national health system.
Optimized Aging with Nutritional & Weight Management TechniquesLouis Cady, MD
In this lecture, presented on August 15, 2014 for the USI Mid-America institute on Aging, Dr. Cady covered the under appreciated physiology of micronutrients and deficiency syndrome, the concept of the "Triage Theory of Aging" from Dr. Bruce Ames, and reviewed the literature on nutritional supplementation. This covered carotenoids, peer-reviewed studies on carotenoids and mortality, peer-reviewed studies on carotenoids and risk of breast cancer, peer review articles on lipid preoccupation, antioxidants, and the chances of survival in the institutionalized elderly, Raman spectroscopy as a marker of antioxidant nutritional deficiency, the explosion of obesity in our population in the US, and optimal antiaging strategies. The "Seven Secrets of Optimizing Body Composition" was reviewed at the end. References are attached.
Speaker presentation from U.S. News Healthcare of Tomorrow leadership summit, Nov. 17-19, 2019 in Washington, DC. Find out more about this forum at www.usnewshot.com.
This document summarizes a panel discussion on tackling childhood obesity. The panelists were experts from major medical institutions across the US. They discussed trends showing rising rates of childhood obesity and the health risks that increase with severity of obesity. Treatment approaches discussed included lifestyle interventions, medications, and weight loss surgery. Barriers to care mentioned were lack of education and resources, as well as the need to address bias and stigma. The role of healthcare systems in population health approaches through primary care, advocacy, and supporting specialized obesity programs was also covered.
A Population Health Imperative: Tackling Childhood Obesity (All Slides)
AsPIRE FANHS conference
1. Filipino Americans and “High
Blood”: Addressing Challenges of
Heart Health
Rhodora Ursua, MPH
Project Director
July 23, 2010
FANHS 13th Biennial National Conference
2. act
Project EXPORT P60 Center
CSAAH was founded in 2003 and funded by NIH/NCMHD as a Center of
Excellence dedicated to the research and reduction of health disparities
affecting Asian Americans through research, training, and partnership.
4. Mission
Kalusugan Coalition is a multidisciplinary collaboration dedicated to
creating a unified voice to improve the health of the Filipino
community in the NY/NJ area through network development,
educational activities, research, community action, and advocacy.
5. What the literature shows:
Filipinos and Hypertension
Heart disease accounted for 33% of all deaths for Filipino
Americans compared to 19% for Vietnamese, 24% for
Koreans, 28% for Japanese, and 29% for Chinese.
Ryan et al., 2000
The rate of hypertension was highest among Filipino men
and women compared to other Asian Americans Klatsky et
al., 1991
Filipinos ranked among the lowest in adherence to
antihypertensive medication when compared to other
groups.
Taira et al., 2007
6. What the literature shows:
Filipinos and Diabetes
Diabetes is more common among Filipino than in Whites and other
Asian Pacific Islander subgroups
[Filipinos (21.2%), Whites (8.1 %), All Asians combined
(12.9%)].
Javier et al., 2007; Gomez et al, 2004.
Filipinos had a higher incidence of diabetes (34.7% vs. 24.1%)
than whites.
Ryan et al., 2000
Filipinas had higher prevalence of type 2 diabetes and metabolic
syndrome compared to White women [Filipina women (36.4%),
Caucasian women (8.7%)].
Araneta et al., 2002
7. What the literature shows:
Filipinos and Obesity
Filipino adults (14%) were more than twice as likely to be
obese as Asian Indian (6%), Vietnamese (5%), or Chinese
adults (4%).
CDC, National Health Interview Surveys, 2004-2006.
Filipino men (42%) and Filipino women (26%) had higher
median BMI readings (all with a BMI ≥ 24) when compared to
other Asian ethnic subgroups.
Lauderdale and Rathouz, 2000 (Hawaii).
A comparison study among Asian and Pacific Islander adults in
Hawaii found Filipinos to be the least active (31.8%, 18.6%).
Mampilly et al., 2005.
Dramatic rise in overweight and obesity in adult Filipino
women: 28% of Filipina non-pregnant women (n=1,943) were
overweight (25<BMI<30).
Adair et al., 2004 (Cebu, Philippines, 1983-1999).
8. What the literature shows:
Filipinos and Smoking
The California Health Information survey showed that 1 out
of 4 Filipino-American adults smoke, ranking third among
other Asian subgroups.
Maxwell et al., 2005.
In a sample of 318 Filipino American men,70% reported
having ever smoked at least 100 cigarette in their entire
life.
Maxwell et al., 2007.
9. Filipino Population in NYC & NJ
Total Filipino Population
10,223
New York State: 120,940
New Jersey State: 121,197 5,446
Total NYS & NJS: 242,137
Note: Alone or in Combination
Source: U.S. Census Community
Health Survey, 2008
33,225
NJ - largest population by county
Morris County - 3,459 7,918
Essex County - 8,406
Union County - 6,313
Middlesex - 13,507 5,246
Bergen County - 15,403
Hudson County - 30,066
10. Cardiovascular disease as
prominent health concern
(n=120)
Source: Abesamis-Mendoza et al., (2007), Community Health Needs & Resource Assessment
11. Financial barriers as most commonly
experienced health care access barrier
Source: Abesamis-Mendoza et al., (2007), Community Health Needs & Resource Assessment
12. Project AsPIRE: Overall Goal
To improve the health care access
and status for Hypertension and
CVD in the NYC/NJ Filipino American
community through interventions by
community health workers
13. The Big Picture
Potential funding for 11 years
3 year 5 year 3 year
planning implementation dissemination
grant grant grant
Funding by NIH/NCMHD for health
disparities intervention research
14. Community-Based Participatory Research
(CBPR)
“A collaborative approach to research
that equitably involves all partners in
the research process and recognizes
the unique strengths that each brings”.
--W.K. Kellogg Foundation (2001)
16. Engaged community in
participant recruitment
Involved churches, businesses, CBOs with Filipino
base
Trained members within these groups about the study
& how to collect data
Administered survey in Tagalog when necessary
Recruited Filipino health professionals to conduct
screening
Utilized health education materials in Tagalog
17. In partnership with…
17 faith based organizations
New Jersey New York
•Day by Day Christian Ministries St. Lucy’s
•Christian Living Fellowship St. Sebastian’s
•St. Joseph’s Church St. Bartholomew’s
•St. Aedan’s Church Elmhurst Baptist Church
•St. Mary’s Church Most Precious Blood Church
•Sisters of Our Lady of the Poor Our Lady of Pompeii
•Our Lady of Victories Hillside Church of Christ
•COMFI Corpus Christi Church
18. 15 civic, government, and
community organizations
NJ
Pan-American Concerned Citizens League (PACCAL)
Philippine American Veterans Organization (PAVO)
City Hall-Jersey City
CREATE Charter School
NY
Anak Bayan NY/NJ
Damayan Migrant Workers’ Association
Filipino American Human Services, Inc. (FAHSI)
Philippine Consulate
Philippine Forum
Philippine Jaycees
Renaissance Charter School
NYC Department of Health
Ugnayan ng Mga Anak ng Bayan
19. 10 local businesses
NJ
Phil-Am Trading Co.
Kusina
Kabalen
Blue Ribbon
Rowena’s
Topnotch
Monica Claire Restaurant
Philippine National Bank
NY
Johnny Air Cargo
Sally’s Restaurant
20. 31 health providers
17. Dr. Erie Agustin
1. APICHA 18. Dr. Apiado
2. Bellevue Occupational Health 19. Dr. Expedito Castillo
3. Cabrini Medical Center 20. Dr. Mark Causin
4. Charles B. Wang Community Health Center 21. Merryl Foz, RN
5. Child Center of New York 22. Myrna Deleon, RN
6. Elmhurst Hospital-Cardiology Department 23. Dr. Arnil Neri
7. Horizon Medical Center 24. Dr. Oca
8. Philippine Nurses Association-NY 25. Dr. Zenaida Santos
9. Philippine Medical Association in America 26. Dr. Marissa Santos
10. Queens Hospital 27. Violeta Totanes, RN
11. Philippine Physical Therapists 28. Cora Velasco, RN
12. Metropolitan Family Health Network (Garfield) 29. Nino Velasco, RN
13. NYU Medical School 30. Rodelia Villanueva, RN
14. NYU Dental School 31. Kim Quilban, RN
15. United Home Care
16. UPMASA
21. AsPIRE Screening Data
Sample size: n=1750
Gender: 68% female, 32% male
Geography: NYC (n=1011), NJ (n=719)
Place of birth: 94% born in Philippines
Insurance status: 45% uninsured
Self-perceived health status:
Poor (2%)
Fair (21%)
22. Hypertension among 1750 Filipinos
3 out of 5
1 out of 2 1 out of 2 individuals individuals
individuals had with elevated BP were taking BP
elevated BP NOT taking BP medication still
medication had elevated BP
23. Body Mass Index (BMI)
Among 1428 Filipinos 2 OUT OF 5 WERE OVERWEIGHT
Underweight Normal Overweight Obese
Gender TOTAL
(> 18.5) (18.5 - 24.9) (25 - 29.9) ( < 30 )
Male 6(1.3%) 188 (40.2%) 236 (50.4%) 38(8.1%) 486
Female 16 (1.5%) 520(54.2%) 353 (36.8%) 71 (7.4%) 960
TOTAL 22(1.5%) 708(49.6%) 589 (41.2%) 109 (7.6%) 1428
25. Family history of cardiac event
Self reported family* event
Stroke Congestive Heart Attack
Heart Failure
669 (38.2%) 317 (18%) 522 (30%)
*Family includes: father, mother, siblings, and grandparents.
(n=1750)
26. Predictors of Hypertension
Compared to their counterparts, Filipinos in this study were
•2 times more likely to be hypertensive if they were:
•Male
•Unemployed
•Overweight
•Rated their health as fair or poor
•Living in U.S. more than 15 years
•4 times more likely to be hypertensive if they were obese
•5 times more likely to be hypertensive if they were older than 52 years
28. Filipino restaurants: food availabilty
“This is a picture of a
busy block in Woodside,
Queens that has at least
5 Filipino restaurants
next to each other.
Many Filipinos go to this
one area. Since all the
restaurants are on one
block, this creates
a problem because
Filipinos eat a lot.”
-Filipino youth
29. Filipino diet: high salt + large portions
“This is what I ate. It’s
really salty and really good.
It’s one of my favorite
dishes. It’s so unhealthy. I
didn’t finish the plate
because it was a big
serving. This shows that
we need to be aware of our
comfort foods. It’s common
to eat this everyday for
breakfast. It’s very filling.”
– Filipino youth
30. Gardening: healthy food and sense of
community
Garden in the backyard- Healthy Food
and Balance Diet
“My husband and I are excited when spring
starts. We have seeds of different kinds of
vegetables to plant in our backyard. It is
our joy to see and watch when it starts to
have leaves, flowers and the fruit etc. We
watch the plants every morning. Besides
that it is an exercise for us. We enjoy it.
We harvest a lot. We share some to our
friends, neighbors, church member and
senior citizen friends, like ampalaya -bitter
squash, tomatoes, okra, eggplant,
peppers, snake squash (upo), cucumber
etc. Thank God for the blessings that will
promote good health, strength and sound
mind.”
-Greg and Andrea Fadul
31. Dancing to exercise…
Line Dancing
I selected this picture because it is a kind of exercise that I love doing.
It entertains others, young and elderly alike. It does good to one’s
health and well-being since it keeps one moving and feeling happy doing it
with the music. Once you take part in this activity, you’re forced to
memorize the sequence of the dance for better performance and grace.
The act of memorizing is good exercise for the brain, because delaying
being Alzheimer.
-Filipino senior
38. CHW Roles: Social Support
“We have strong connections to the community so we are able to
influence people on how to be healthy. Oftentimes when I do
home visits, the participants tell me how thankful they are.
They never thought there would be someone that would go out
of their way to visit them and show concern for their health
and take their blood pressure.” –AsPIRE CHW
40. CHW Roles: Advocates
•Individual level (i.e. advocate for
patient’s needs at physician visits)
•Systems level (i.e. advocate for
streamlined referral systems with hospital
administrators; public hearings to inform
legislators of challenges community faces
and recommended solutions)
41. Lessons learned: CHWs as an
investment in health equity
CHWs are valuable in bridging gaps
CHWs facilitate trust building in the community to
engage in research projects
CHWs serve as voice for undocumented/underserved
immigrants through advocacy efforts
CHWs build capacity of researchers/interns/coalition
members to appropriately conduct CBPR project in
community
Leadership and capacity buildingbuilds sustainability
42. Other initiatives addressing Filipino
health in NYC
APA HEALIN’ –food and active living
initiative
PROJECT CHARGE – policy advocacy on
health care reform
43. Sharing our story…
Abesamis-Mendoza et.al. “Filipino Community Health
Needs and Resource Assessment: An Exploratory
Study of Filipinos in the New York Metropolitan
Area.” (2005)
Ursua, R, Abesamis-Mendoza N, Kwong K, Ho-Asjoe, H,
Chung, W, Wong, S.S. “Addressing Cardiovascular
Health Disparities in Filipino and Chinese Immigrant
Communities in New York Metropolitan Area.” Praeger
Handbook of Asian American Health: Taking Notice and
Taking Action.(2009)
Aguilar, D, Abesamis-Mendoza, N, Ursua, R, Divino L.A.,
Cadag, C., Gavin N. “Lessons Learned and Challenges
in Building a Filipino Health Coalition.” Health
Promotion Practice. 2010 May;11(3):428-36. Epub 2008
Dec 19.
44. For more information:
Rhodora Ursua
Project Director, Project AspIRE
212-263-3776
rhodora.ursua@nyumc.org
www.kalusugancoalition.org
www.med.nyu.edu/csaah
This presentation was made possible by Grant Number R24 MD001786 from
NCMHD and its contents are solely the responsibility of the authors and do not
necessarily represent the official views of the NCMHD.
45. Acknowledgements
Special acknowledgement
to all the community
members who agreed to
participate in this study.
Editor's Notes
IN 2003 : NYU School of Medicine was awarded a grant from the NIH/NCMHD to establish a Project EXPORT Center: EXPORT stands for Excellence in Partnerships, Outreach, Research, and Training) – only one of its kind in the nation to address Asian American health disparities Importance of a center like this: Today, Asian Americans constitute 5 percent of the total U.S. population and are the fastest growing racial/ethnic group in the United States (U.S. Census Bureau, 2004). They represent a diverse community comprising over 30 countries of origin and representing various cultures, traditional beliefs, religions, years in the U.S., degrees of acculturation, levels of English proficiency, and socioeconomic status. It is projected that by the year 2050 there will be 33.4 million residents whose only race is Asian, which translates to a 213 percent increase, compared to a 49 percent increase in the U.S. population as a whole over the same period (U.S. Census Bureau, 2004). Yet, despite rapid increases in the population during the last three decades, Asian Americans remain one of the most poorly understood and neglected racial/ethnic minority groups (Lin-Fu, 1993; Ghosh, 2003).
Notes for ‘Project Development Process’ Slide: Filipino Americans are the second largest Asian American ethnic group in the country. Yet they remain one of the most underserved and under-researched communities. OUTREACH : Kara & Noilyn In February 2004, the NYU Center for the Study of Asian American Health (CSAAH) started a health outreach initiative to identify and address the health concerns in the Filipino American community in the New York Metropolitan Area. CSAAH reached out to the Filipino American Human Services, Inc. (FAHSI), a local CBO, about collaborative opportunities to address Filipino American health. Shortly thereafter, an ad-hoc group comprising of representatives from CSAAH, FAHSI, as well as Dr. Benjamin Ileto, a well-respected Filipino community leader, began to meet on a regular basis to plan a community health forum. COMMUNITY FORUM: The organizers invited representatives from Filipino-serving organizations, associations, health professionals, and public interest lawyers to participate in a panel discussion in April 2004. The community health forum was a historic event that brought together, for the first time, over 100 health professionals and community members to begin the dialogue about what they perceived to be the most pressing concerns of the Filipino American community in NYC and New Jersey. Participants were also asked to suggest strategies to address these issues. This led to the initiation of a community health needs assessment and the development of a Filipino Community Advisory Committee which eventually evolved into the Kalusugan Coalition. KALUSUGAN COALITION & CHNA: Since then, individuals representing various sectors of the Filipino community (Filipino artists, students, youth, immigrant advocates, community organizers, health professionals, and academic researchers) have met monthly to reflect on the community’s needs and share experiences about the health and quality of life for Filipinos in the New York/New Jersey area. We also analyzed the findings. We clearly demonstrated that there was minimal research on this community in this area, and thru the CHNA – cardiovascular disease was identified as a priority health concern by over 2/3rds of the participants, and community members identified the different barriers that impede them from accessing the healthcare system. NIH/NCMHD The needs assessment and the strong partnership with this entity- KC –placed our Center in a good position to apply for federal funding by the NIH which was calling for proposals on health disparities intervention research that is jointly conducted by communities and researchers. Hence Project AsPIRE was born.
Explain narra tree – valued for its healing properties and strength. A national symbol of the philippines Narra is a tree valued for its healing properties, strength and beauty. Found in the Pacific and Asia, narra trees are used to treat ailments like tuberculosis and arthritis. Trees signify life, knowledge, growth, prosperity, stability, and reciprocity.
NOTES: BULLET 1: Ryan article: “ Coronary heart disease in Filipino and Filipino-American patients: prevalence of risk factors and outcomes of treatment” Results: - Filipino-Americans have a higher prevalence of hypertension and diabetes (34.7% vs. 24.1%, p<0.001) Filipino-American ethnicity is an independent predictor of higher mortality after catherization laboratory intervention and increased need for late reintervention. BULLET 2: Klatsky article: “ Cardiovascular Risk Factors among Asian Americans Living in Northern California” (from American Journal of Public Health) Odds Ratio (Male OR = 0.9, Female OR = 0.6; M Other Asian OR = 3.4, F Other Asian = 1.5) This study examined data among 13,031 persons self-classified as 5951 Chinese, 4211 Filipinos, 1703 Japanese, and 1166 other Asians. Covariates in regression analyses were age, smoking, alcohol, education, and marital status. There are significant differences in risk factors among Asian Americans. Filipino women over the age of 50 had a higher rate of hypertension (65%) than both African American women (63%) and than the general U.S. population of women (47%) - over the age of 50. BULLET 3: Taira article: “ Antihypertensive Adherence and Drug Class among Asian Pacific Americans” Examined factors including drug class, associated with antihypertensive adherence for 28,395 adults in Hawaii. Population included Japanese (n = 13,836), Filipino (n = 3,812), Chinese (n = 2,280), Korean (n = 450), part-Hawaiian (n = 3,746), and white (n = 3,920) patients. Additional Results : Patient factors associated with lower adherence included younger age, higher morbidity and history of heart disease. Patient factors were also significantly related to adherence, including gender and seeing a sub-specialist. Seeing a physician of the same ethnicity.
BULLET 1: Javier article a. “Filipino Child Health in the United States: Do Health and Health Care Disparities Exist?” Compared with white women, Filipino women have a higher prevalence of diabetes and metabolic syndrome despite the fact that 90% of Filipino women were not defined as obese Study suggests that the high prevalence of diabetes in Filipinos may be missed by health care providers because they are not obese by Western standards (Javier et al., 2007) BULLET 3: “Araneta article” “ Type 2 diabetes and metabolic syndrome in Filipina-American women: A high-risk nonobese population” Cross-sectional study Study population: Community-dwelling women aged 50-69 years Mostly from San Diego county, California Filipino women with diabetes have a greater waist girth In general: Several studies have found a relationship between diabetes and hypertension in Filipino Americans: According to the National Vital Statistics Reports (17), in 2002 Filipino mothers (data not available by place of birth) had the highest rate of gestational diabetes among all measured subgroups at 59.8 per 1,000. Another study using national data reported that Philippine-born Filipino mothers are significantly more likely to have diabetes during pregnancy than U.S.-born Filipino mothers
NOTES Intro: Overweight in adults is a strong determinant of variance in CVD risk factor prevalence. The rise in the prevalence of overweight and obesity (body mass index ≥25 kg m−2) is, in part, a negative consequence of the increasing economic developments of many lower- and middle-income countries in the Asia–Pacific region. BULLET 1: METHODS : Data on Native Hawaiian/Part Native Hawaiian (N=585), Filipino (N=548), Japanese (N=871), and White (N=1728) adults were obtained from the Hawaii 2001 Behavioral Risk Factor Surveillance System (BRFSS), which contained more detailed questions on ethnicity than are collected by most states. Six physical activity categories were compared: inactive, insufficient (some activity but less than recommended activity), moderate activity (> or = 30 minutes of moderate activity > or = 5 days a week), vigorous activity (> or = 20 minutes of vigorous activity > or = 3 days a week), recommended activity (meeting either moderate or vigorous activity requirements), and a recently suggested target of > or = 60 minutes of moderate activity 7 days a week or > or = 20 minutes of vigorous activity > or = 4 days a week. BULLET 2: Lauderdale and Rathouz article “ Coronary heart disease in Filipino and Filipino-American patients: prevalence of risk factors and outcomes of treatment. International journal of obesity and related metabolic disorders” This study had a sample size of 7263 Asian Americans Family income is strongly inversely related to BMI for women For US-born Asian American women, there is a strong inverse association between BMI and income The inverse association between income and BMI, however, is very weak and of marginal statistical significance for foreign-born Asian American women, just 0.06 kg/m^2 per $10,000 income BULLET 3: Mampilly article “ Prevalence of physical activity levels by ethnicity among adults in Hawaii, BRFSS 2001 “ Japanese ranked in second when it comes to being physical active (32.1%, 20.4%) Whites were more active than any of the three subgroups (47.2%, 35.4%) BULLET 4: Adair article “ Lipid profiles in adolescent Filipinos: relation to birth weight and maternal energy status during pregnancy” Sample size: n = 3327, Filipino women, Cebu, Philippines followed from 1983-1999 Weight gain was positively associated with urban residence, improved socioeconomic status, fewer pregnancies and months of lactation, and more away-from home work hours.
NOTES Introduction to Filipinos and Smoking According to Klatsky, there is a correlation between the rate of smoking and hypertension in Filipinos (Klatsky et al., 1996). Smoking was determined to be more common in Filipino-American men (Gomez et al, 2004) compared with Whites and other Asian male subgroups. BULLET 1: Maxwell article: “ Smoking prevalence and correlates among Chinese- and Filipino-American adults: findings from the 2001 California health interview survey ” The 2001 California Health Interview Survey (CHIS) indicate that for Asian women, acculturation to the U.S. is linked with increased smoking prevalence rates Yet smoking rates were higher among foreign-born vs. U.S.-born Asian males. BULLET 2: Maxwell article: “ Understanding tobacco use among Filipino American men” Based on a Smoking Beliefs Scale (Cronbach’s alpha = .84), smokers were more likely than nonsmokers to agree that smoking can alleviate stress, depression, boredom, and that smoking is part of social interactions, being a man, maturity. ………………………………………………… -il0i08pino women than foreign-born Filipino women, but higher in foreign born Filipino men than in American born Filipino men. Gomez and colleagues (2002) demonstrated that smoking rates began as early as age 18 years among Filipinos.
To further understand the makeup of the Filipino community, community leaders also provided feedback about which neighborhoods had large concentrations of Filipinos. Their insight was supported by an examination of U.S. Census 2008 data showing the highest geographic concentrations of Filipinos in the Elmhurst, Woodside, Jackson Heights, Astoria, and Jamaica areas of Queens County, NY and the West Side area of Jersey City, New Jersey. In particular, community partners also identified ethnic enclaves where especially underserved low-income Filipinos resided. GIS technology was used to develop asset maps depicting these concentrations and the resources available for Filipinos. These helped the team create appropriate outreach strategies to reach a sample that was representative of the general Filipino population.
One part our social assessment was the administration of a Filipino Community Health Needs and Resource Assessment, which included the following methods: (a) surveys with Filipino American adults (n = 135) to assess health priorities and barriers, (b) focus groups with cross-sections of the community (e.g., adolescents, senior citizens) (n = 52 focus group participants) and (c) open-ended interviews with key informant community leaders (n = 5) (Abesamis-Mendoza et al., 2007). This Assessment found that 71% of Filipino adults either had a CVD health concern or had a family member with a CVD health concern. Respondents also suggested a holistic approach that integrates health education, advocacy, collaboration across sectors, and capacity building of social service and health providers to work with the Filipino community.
CBPR is not a method per se but an orientation to research that may employ any of a number of qualitative and quantitative methodologies.
3) culturally appropriate outreach and recruitment strategies; and Involve churches, businesses, cbo’s with Filipino base Train members within these groups about the study – so they in turn could recruit their members to be screened, to administer the screening tool in tagalong therefore non-threatening since they know them Tagalog-speaking survey administrators Recruit Filipino health professionals to conduct screening Health education materials in Tagalog
So this is what CBPR is all about –it means a academic and community partners working together in a study at all phases from planning, implement, and analyze
All variables significant at p<0.05 were placed into a logistic regression model, adjusting for other factors (Table 3). Individuals older than 52 were 5.2 times more likely to be hypertensive compared to individuals age 52 and younger (p<0.001). Males were 1.8 times more likely to be hypertensive than females (p<0.01) and unemployed individuals were 1.9 times more likely to be hypertensive (p<0.05). When adjusting for other factors and using the Asian WHO guidelines, overweight individuals were 1.8 times more likely to be hypertensive (p<0.05), and obese individuals were 4.2 times more likely to be hypertensive (p<0.001). Self-reported health status was also found to be significant, individuals who rated their health as fair or poor were 1.9 times more likely to be hypertensive compared to those who rated their health as excellent or very good, and individuals who rated their health as good were 1.7 times more likely to be hypertensive compared to those who rated their health as excellent or very good (p<0.05). Finally, individuals who had lived in the U.S. for more than 15 years were 2.1 times more likely to be hypertensive compared to individuals who had lived in the U.S. for 5 years or less (p<0.01), and individuals who had lived in the U.S between 5-15 years were 1.7 times more likely to be hypertensive compared to individuals who had lived in the U.S for 5 years or less (p<0.05).
This is the 2 nd picture - tapsilog is a traditional dish made of 2 fried eggs, fatty beef, and served with garlic fried rice. Trish says “This is what I ate …” Both of these pictures prompted a discussion about traditional Filipino dishes and comfort foods. The fact that everyone started salivating and saying how hungry they were each time we looked at this photo speaks to the cultural recognition and craving of these types of food. Even though they knew it wasn’t the healthiest thing to eat, they naturally wanted to have it. It certainly made everyone hungry! Rhodora also raised the issue of portion control. The foods served in these restaurants are cheap and served on large platters – there aren’t different sizes of plates and customers can’t control how much is piled on. Part of Project AsPIRE’s outreach involves reaching restaurant owners. It’s tricky when they may feel threatened if they think that all we want to do is blame them for all their unhealthy food, but the intention is to get them to offer healthy menu options without having to change the entire menu
Project AsPIRE CHW received 115 hours of training
Outreach Community organizing (e.g. Health fairs/relationship building w/ various sectors) Participant Recruitment (e.g. Coordination of health fairs) Health education Home visiting Informal counseling Monitoring blood pressure/diabetes; assuring adherence to medication taking and appointment keeping with PCPs and specialists Developing health education materials Social support Linking and negotiating participants’ access to a primary care physician (PCP) Translation/ interpretation Data collection/foster community engagement in research Advocacy (for appropriate translation of materials; for discounted services; for improved health access for immigrant communities) Trainers of future CHWs
Outreach Community organizing (e.g. Health fairs/relationship building w/ various sectors) Participant Recruitment (e.g. Coordination of health fairs) Health education Home visiting Informal counseling Monitoring blood pressure/diabetes; assuring adherence to medication taking and appointment keeping with PCPs and specialists Developing health education materials Social support Linking and negotiating participants’ access to a primary care physician (PCP) Translation/ interpretation Data collection/foster community engagement in research Advocacy (for appropriate translation of materials; for discounted services; for improved health access for immigrant communities) Trainers of future CHWs
Please emphasize in this slide the importance capacity building in the community. Our CHW model has already been replicated in the community. In 2008, the main community partner in Project AsPIRE which is Kalusugan Coalition hired 3 CHWs from Jersey City and Queens area. In this aspect, we are achieving one of the main focus of CBPR and its shows how the model we created are sustainable in the long run.
CHWs are advocates at both an individual and systems level. For example, Henry and Rico advocate for their patient’s needs during a physician’s visit, but also speak on behalf of their clients’ needs to hospital administrators in order to develop streamlined referral systems for participants to more easily access health providers. In addition, AsPIRE’s CHWs conduct advocacy at a government policy level through testimonies, often times as the sole representative of the Filipino community, at public hearings with state government officials.
CHWs are valuable in bridging gaps for underserved/new immigrant communities who lack health access i.e. demystifying HC system Facilitate trust building in the community to engage in research project (b/c they’re trusted by community; know/understand community cultural norms/values/beliefs; speak the language, etc.) CHWs as voice for rights of undocumented/underserved immigrants through advocacy efforts (i.e. negotiating for affordable rates; advocating for comprehensive coverage, etc.) CHWs build capacity of researchers/interns/coalition members how to appropriately conduct CBPR project in community (includes outreach/retention) Leadership and capacity building builds sustainability ( the use of community organizing as a tool to increase participation and commitment of community members to collectively get involved in decision-making related to theirs and their community’s health, helps to ensure the sustainability of their initiatives )