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"Community Networks."
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The well-connected community : a networking approach to community development
Government policy is increasingly focused on the contribution that communities can make to civil society and democratic renewal. This book demonstrates how informal and formal networks strengthen community capacity and improve cross-sectoral working.
Book
Social support, health, and illness : a complicated relationship
When a person faces serious illness, having the support of one's partner can help protect against the full ravages of disease, and even hasten recovery. However, too much support can have grave clinical consequences for sufferers and exact a heavy emotional and financial toll on caregivers. Social Support, Health, and Illness is an up-to-date analysis of how social support can either help or hinder recovery for patients. A useful resource for clinical practitioners and researchers, Social Support, Health, and Illness addresses the effects of intimate support on a wide variety of medical and psychiatric conditions, including cancer, dementia, and chronic pain. Ranjan Roy uncovers the complexities underlying social support by tracing the concept's historical and theoretical development. Synthesizing insights from the latest research findings, Social Support, Health, and Illness offers a comprehensive look at the modifying and mitigating factors of intimacy on the outcomes of disease.
eBook
Reducing Racial Inequities in Health: Using What We Already Know to Take Action
This paper provides an overview of the scientific evidence pointing to critically needed steps to reduce racial inequities in health. First, it argues that communities of opportunity should be developed to minimize some of the adverse impacts of systemic racism. These are communities that provide early childhood development resources, implement policies to reduce childhood poverty, provide work and income support opportunities for adults, and ensure healthy housing and neighborhood conditions. Second, the healthcare system needs new emphases on ensuring access to high quality care for all, strengthening preventive health care approaches, addressing patients’ social needs as part of healthcare delivery, and diversifying the healthcare work force to more closely reflect the demographic composition of the patient population. Finally, new research is needed to identify the optimal strategies to build political will and support to address social inequities in health. This will include initiatives to raise awareness levels of the pervasiveness of inequities in health, build empathy and support for addressing inequities, enhance the capacity of individuals and communities to actively participate in intervention efforts and implement large scale efforts to reduce racial prejudice, ideologies, and stereotypes in the larger culture that undergird policy preferences that initiate and sustain inequities.
Journal Article
Doctors Serving People
Today's physicians are medical scientists, drilled in the basics of physiology, anatomy, genetics, and chemistry. They learn how to crunch data, interpret scans, and see the human form as a set of separate organs and systems in some stage of disease. Missing from their training is a holistic portrait of the patient as a person and as a member of a community. Yet a humanistic passion and desire to help people often are the attributes that compel a student toward a career in medicine. So what happens along the way to tarnish that idealism? Can a new approach to medical education make a difference?Doctors Serving Peopleis just such a prescriptive. While a professor at Rush Medical College in Chicago, Edward J. Eckenfels helped initiate and direct a student-driven program in which student doctors worked in the poor, urban communities during medical school, voluntarily and without academic credit. In addition to their core curriculum and clinical rotations, students served the social and health needs of diverse and disadvantaged populations. Now more than ten years old, the program serves as an example for other medical schools throughout the country. Its story provides a working model of how to reform medical education in America.
eBook
Heroes & cowards : the social face of war
Heroes and Cowards demonstrates the role that social capital plays in people's decisions. The makeup of various companies--whether soldiers were of the same ethnicity, age, and occupation--influenced whether soldiers remained loyal or whether they deserted. Costa and Kahn discuss how the soldiers benefited from friendships, what social factors allowed some to survive the POW camps while others died, and how punishments meted out for breaking codes of conduct affected men after the war. The book also examines the experience of African-American soldiers and makes important observations about how their comrades shaped their lives. --from publisher description
Book
Aging together : dementia, friendship, and flourishing communities
Never in human history have there been so many people entering old age—roughly one-third of whom will experience some form of neurodegeneration as they age. This seismic demographic shift will force us all to rethink how we live and deal with our aging population.
Susan H. McFadden and John T. McFadden propose a radical reconstruction of our societal understanding of old age. Rather than categorizing elders based on their cognitive consciousness, the McFaddens contend that the only humanistic, supportive, and realistic approach is to find new ways to honor and recognize the dignity, worth, and personhood of those journeying into dementia. Doing so, they argue, counters the common view of dementia as a personal tragedy shared only by close family members and replaces it with the understanding that we are all living with dementia as the baby boomers age, particularly as early screening becomes more common and as a cure remains elusive. The McFaddens' inclusive vision calls for social institutions, especially faith communities, to build supportive, ongoing friendships that offer hospitality to all persons, regardless of cognitive status.
Drawing on medicine, social science, philosophy, and religion to provide a broad perspective on aging, Aging Together offers a vision of relationships filled with love, joy, and hope in the face of a condition that all too often elicits anxiety, hopelessness, and despair.
eBook
Sex, Shame, and Violence
For more than three decades, Kathleen Cash has lived and worked with impoverished people, learning about their lives. Listening to them talk about their feelings of shame, Cash heard how people suffered from being unable to change what was happening to them--HIV infection, sexual and domestic violence, violence toward children, and environmental degradation. She saw that many interventions lacked emotional and cultural integrity and thus did little to alleviate these hardships. So Cash went outside the conventional approaches to health promotion and social justice and devised a community narrative practice, a strategy for engaging people through storytelling. From numerous ethnographic interviews, she pieced together cultural stories in a way that resonated with community people and revealed the paradoxes in their suffering. Cash recruited local artists to illustrate the stories in a form resembling a graphic novel and distributed these booklets for community discussion. (This book includes excerpts from these illustrated stories.)
In Thailand, Bangladesh, Haiti, Uganda, and the United States, people learned to talk about forbidden subjects and say what they could never say before. They stood up to each other, reconciled, and made health-seeking decisions. By helping others, they repaired themselves. In cathartic conversations they acknowledged shame, which led to acts of courage and generosity.
eBook
GWAS and enrichment analyses of non-alcoholic fatty liver disease identify new trait-associated genes and pathways across eMERGE Network
Background
Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver illness with a genetically heterogeneous background that can be accompanied by considerable morbidity and attendant health care costs. The pathogenesis and progression of NAFLD is complex with many unanswered questions. We conducted genome-wide association studies (GWASs) using both adult and pediatric participants from the Electronic Medical Records and Genomics (eMERGE) Network to identify novel genetic contributors to this condition.
Methods
First, a natural language processing (NLP) algorithm was developed, tested, and deployed at each site to identify 1106 NAFLD cases and 8571 controls and histological data from liver tissue in 235 available participants. These include 1242 pediatric participants (396 cases, 846 controls). The algorithm included billing codes, text queries, laboratory values, and medication records. Next, GWASs were performed on NAFLD cases and controls and case-only analyses using histologic scores and liver function tests adjusting for age, sex, site, ancestry, PC, and body mass index (BMI).
Results
Consistent with previous results, a robust association was detected for the PNPLA3 gene cluster in participants with European ancestry. At the PNPLA3-SAMM50 region, three SNPs, rs738409, rs738408, and rs3747207, showed strongest association (best SNP rs738409
p
= 1.70 × 10
− 20
). This effect was consistent in both pediatric (
p
= 9.92 × 10
− 6
) and adult (
p
= 9.73 × 10
− 15
) cohorts. Additionally, this variant was also associated with disease severity and NAFLD Activity Score (NAS) (
p
= 3.94 × 10
− 8
, beta = 0.85). PheWAS analysis link this locus to a spectrum of liver diseases beyond NAFLD with a novel negative correlation with gout (
p
= 1.09 × 10
− 4
). We also identified novel loci for NAFLD disease severity, including one novel locus for NAS score near
IL17RA
(rs5748926,
p
= 3.80 × 10
− 8
), and another near
ZFP90-CDH1
for fibrosis (rs698718,
p
= 2.74 × 10
− 11
). Post-GWAS and gene-based analyses identified more than 300 genes that were used for functional and pathway enrichment analyses.
Conclusions
In summary, this study demonstrates clear confirmation of a previously described NAFLD risk locus and several novel associations. Further collaborative studies including an ethnically diverse population with well-characterized liver histologic features of NAFLD are needed to further validate the novel findings.
Journal Article