RESUMEN
OBJECTIVES: To describe the prevalence, distribution and risk factors for hepatitis C virus (HCV) infection among homeless adults using eight Health Care for the Homeless (HCH) clinics nationally. METHODS: Data were collected for 387 participants through blood draws, structured interviews, chart reviews. RESULTS: Overall prevalence of HCV-antibody positivity was 31.0%, including 70.0% among injection drug users and 15.5% among reported non-injectors. Much HCV infection was hidden as the majority (53.3%) of HCV-antibody positive participants was unaware of their status. Independent risk factors for HCV among the total sample included injection drug use, prison, and tattoos; among injectors, risk factors included prison and three or more years of injection drug use; among reported non-injectors, risk factors included tattoos and prison. CONCLUSION: These HCH clinics serve high concentrations of HCV-infected injectors, making these and similar clinics priority intervention sites for aggressive screening, education, testing, and treatment for HCV and other blood-borne diseases.
Asunto(s)
Centros Comunitarios de Salud , Hepatitis C/epidemiología , Hepatitis C/etiología , Personas con Mala Vivienda , Atención Primaria de Salud , Adolescente , Adulto , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , San Francisco/epidemiología , Adulto JovenAsunto(s)
Características Culturales , Conocimientos, Actitudes y Práctica en Salud , Personas con Mala Vivienda/psicología , Valores Sociales , Actitud Frente a la Salud/etnología , Personas con Mala Vivienda/educación , Personas con Mala Vivienda/estadística & datos numéricos , Humanos , Relaciones Interpersonales , Estilo de Vida , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Pobreza/psicología , Conducta Social , Apoyo Social , Sociología Médica , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/psicología , Confianza , Estados Unidos/epidemiologíaAsunto(s)
Publicidad , Industria Farmacéutica , Medicamentos sin Prescripción/efectos adversos , Medicamentos bajo Prescripción/efectos adversos , Administración de la Seguridad/organización & administración , Trastornos Relacionados con Sustancias/prevención & control , Cocaína/efectos adversos , Control de Medicamentos y Narcóticos/organización & administración , Humanos , Metanfetamina/efectos adversos , Descongestionantes Nasales/efectos adversos , Seudoefedrina/efectos adversos , Trastornos Relacionados con Sustancias/etiología , Estados UnidosRESUMEN
This chapter focuses on the National Institutes of Health (NIH) T32 National Research Service Award (NRSA) funding mechanism, designed to enhance the development of nurse scientists. The general history and principles underlying NIH funding for T32s as well as the National Institute of Nursing Research's (NINR) involvement in the NRSA program is described, highlighting the University of California Los Angeles School of Nursing's T32 training program in vulnerable populations research and the program and career trajectory data from close to two-thirds of NINR-funded T32s directors. Recommendations for the improvement of NINR-funded T32 training programs are identified. Findings include the need for increased collaboration between institutions receiving T32 funding from the NINR.
Asunto(s)
Educación de Postgrado en Enfermería/organización & administración , National Institutes of Health (U.S.)/organización & administración , Investigación en Enfermería , Investigadores/educación , Apoyo a la Formación Profesional/organización & administración , Poblaciones Vulnerables , California , Necesidades y Demandas de Servicios de Salud , Estado de Salud , Humanos , Mentores , Modelos de Enfermería , Investigación en Enfermería/educación , Investigación en Enfermería/organización & administración , Objetivos Organizacionales , Preceptoría/organización & administración , Apoyo a la Investigación como Asunto/organización & administración , Facultades de Enfermería/organización & administración , Factores Socioeconómicos , Enfermería Transcultural/educación , Enfermería Transcultural/organización & administración , Estados Unidos , Poblaciones Vulnerables/etnología , Poblaciones Vulnerables/estadística & datos numéricosRESUMEN
This article describes a process of evaluating and adapting existing clinical practice guidelines (CPGs) for homeless individuals by different healthcare providers in multiple healthcare settings across the country. Data were collected using a standardized evaluation tool in nine sites across the United States. Clinicians completed an evaluation of the CPG after every use. Most clinicians used the CPG five times. Descriptive statistics were reported on the characteristics of the clinicians, and the utility of the guidelines and written comments. Clinicians had an average of 12 years of clinical experience, 8 years of which were specifically spent working with homeless individuals. Ninety-one percent of the clinicians practiced in urban settings. The majority of clinicians felt the adapted guidelines met evaluation criteria. The major weaknesses reported the delineation of outreach and case management activities. Results did not vary by clinicians' disciplines, years of experience, or any other indicators. Clients and clinicians providing primary care to homeless individuals may benefit from utilizing Health Care for the Homeless Clinicians' Network adapted CPGs to assure quality, evidenced-based care to a vulnerable population.