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Studies of Substance Abuse with Interventions for the Youth of Native American Indian Community #16

Community empowerment is one approach that is community based in its theoretical underpinnings and has been used to develop substance abuse prevention for Native American youth (Petoskey et al., 1998; Rowe, 1997). Generally, this method utilizes multiple strategies to increase knowledge about drugs and alcohol throughout a community and to change community norms regarding use. Often the initial step in the community empowerment approach is the development of a core group composed of community members who serve as leaders, role models, and decision makers regarding the implementation of prevention strategies. Petoskey et al. (1998) described the Parent, School and Community Partnership Program, a project that aimed to reduce alcohol, tobacco, and other drug (ATOD) use among Native American youth living on or near three reservations in northern Wisconsin and Minnesota. A major component of this program was the Red Cliff Wellness School Curriculum, a culturally focused, skills based substance abuse curriculum that was designed to be implemented by classroom teachers in Grades 4 through 12. In addition, the project involved the following: (a) the training of a small group of community members to be leaders and facilitators regarding community health, (b) a community curriculum offered to all members and designed to increase community involvement and problem solving around ATOD issues, and (c) teacher training in the implementation of the school-based curriculum. Outcome variables such as past-month substance use; attitudes toward use and perceptions of harmfulness; and attitudes toward school, academic achievement, absenteeism, and cultural involvement were assessed prior to curriculum implementation, at the end of the program year, and at 1-year follow-up. Comparison data were provided by similar schools that had agreed to collect data during Years 1 and 2 in order to receive the curriculum in Year 3. Although past-month alcohol use increased for both groups at follow-up, the authors reported a significant two-way interaction of site and time, indicating some slowing in the rise in alcohol use for participants in the intervention group. At all three data collection points, students who received the intervention reported lower levels of past-month marijuana use. Past-month cigarette use increased for both groups over time; however, this outcome was not a specific target of the intervention. Although there were no significant differences in likelihood to accept alcohol from friends between groups, students from the intervention group were less likely to accept marijuana at 1-year follow-up. Interestingly, these authors also found that increased frequency of attendance at powwows was associated with increased use of substances. Cultural affiliation has often been perceived as a protective factor, yet this study found a sex difference in the relationship between Indian identity and substance use:

Increased Indian identity was associated with decreased use in girls and increased use in boys. Rowe (1997) described the Target Community Partnership Project, an effort that utilized the community empowerment approach to address substance abuse with a Native American tribe in Washington State. Strategies used in this project included (a) creating partnerships among community members, professional services staff, and tribal departments; (b) implementing a process of ongoing training for the community around ATOD issues; (c) organizing community-wide alcohol- and drug-free events; (d) enhancing health, welfare, and youth services for those individuals with substance abuse or children affected by substance-abusing parents; and (e) advocating for new tribal policies restricting the use and abuse of drugs and alcohol. Several types of quantitative and qualitative outcomes were assessed over the course of approximately 4 years with adult and youth surveys conducted in the first and last years. Some of these included adult perception of harm from drugs and alcohol (as measured by an anonymous community survey), youth perception of harm from alcohol (as measured by a school survey), number of individuals referred to substance abuse treatment, number of families receiving services for alcohol and drug-related parenting problems, community perceptions of improvements in drug and alcohol use and drug dealing, community perception of social changes, tribal staff perception of changes in community norms, tribal policies related to ATOD, number of sober adults in the community, current youth alcohol use, current peer alcohol use, and number of alcohol and drug-related juvenile and adult arrests. Although the author described many positive overall changes in the community, including improved social conditions, a shift in social norms regarding drugs and alcohol, the creation of new policies and laws around substance use, and increased collaboration among tribal organizations, no significant change was found in adults’ perceived harmfulness of ATOD use. Because the sample of youth surveyed for quantitative data was likely too small to discern significant change over time, the only significant outcome was an increase in the number of friends that youth reported did not expect them to drink. In addition, Rowe indicated an increase in the number of individuals reportedly seeking abstinence. Although the numbers of drug- and alcohol related arrests, substance-related referrals, and referrals of families for services all increased, the author suggested that this was an indication of improved awareness among community members rather than an indication of rising use. Dorpat (1994) described a multi-arm prevention program implemented by the Puyallup Tribe of Indians, a tribe that inhabits a primarily urban reservation located in Tacoma, Washington. Although a description of the program does not indicate that its format was intentionally based on any particular community-based theory, the nature of the program’s development and content appears similar to other community-based interventions reported here.

PRIDE (Positive Reinforcement in Drug Education) was a prevention program conceived and developed through the guidance of the Puyallup Tribal Council and local school administration. Its four components included (a) development of students’ cultural identity through both curricular and extracurricular instruction and activities in the schools; (b) implementation of a school-based prevention curriculum dealing with health awareness, drug and alcohol awareness, refusal skills, and life skills; (c) enforcement of a security policy for reducing in-school drug use and development of a drug-free environment on school campuses; and (d) coordinated counseling, referral, and/or case management services for those students identified as drug users. Although the author reported that a formal process evaluation supported program efficacy, only one post intervention student survey was described in terms of outcome evaluation. This survey demonstrated high rates of expected school completion and positive attitudes about health among students. The survey also indicated 22% of high school students reported drinking to get drunk. The author compared this with a public school survey conducted separately from the study in which 46% of local high school juniors reported drinking to get drunk once per month. Although these outcomes appear positive, efficacy is difficult to establish without baseline or comparison group data.

If you have ever been to a dentist in Tulsa ...


TULSA, Okla. (AP) — Health officials are urging 7,000 patients of an Oklahoma dentist to seek medical tests to ensure they haven't been exposed to hepatitis or the virus that causes AIDS.

The Oklahoma and Tulsa health departments said Thursday that the patients may have been exposed to viruses at clinics operated by Dr. W. Scott Harrington. The agencies said they found "major violations" of the Oklahoma Dental Act.

Spokeswoman Kaitlin Snider of the Tulsa Health Department says Harrington voluntarily closed his practice and is cooperating with investigators.

Letters are being sent to 7,000 patients from Harrington's clinics in Tulsa and suburban Owasso since 2007. The letters recommend testing for hepatitis B, hepatitis C and HIV. The agencies say it is rare for infections to spread in occupational settings but that tests are important.


A cyclone of crap ...

Exclusive: Congressional Ethics Probe Adds to Michele Bachmann’s Political Woes

Eighteen months ago, the Minnesota House member was considered an unlikely but undeniable Republican rising star, winning the Iowa straw poll that unofficially begins the primary season. Today, she is embroiled in a litany of legal proceedings related to her rolling disaster of a presidential campaign—including a Office of Congressional Ethics investigation into campaign improprieties that has not previously been reported.

The Daily Beast has learned that federal investigators are now interviewing former Bachmann campaign staffers nationwide about alleged intentional campaign-finance violations. The investigators are working on behalf of the Office of Congressional Ethics, which probes reported improprieties by House members and their staffs and then can refer cases to the House Ethics Committee.

“I have been interviewed by investigators,” says Peter Waldron, a former Bachmann staffer who’s embroiled in his own fight with his former boss, involving his allegations of pay-to-play politics and improper payments by the campaign—making him one of several members of Bachmann’s inner circle who’ve fallen out with the woman they once hoped would become commander in chief. While he was careful to avoid specifics in regard to the investigating body, Waldron said that “investigators came [and] interviewed me and are interviewing other staff members across the country.”

Two other former staffers confirmed the existence of the investigation this weekend, and on Monday Bachmann’s campaign counsel, William McGinley, of the high-powered firm Patton Boggs, confirmed that the Office of Congressional Ethics (OCE) was looking into the congresswoman’s presidential campaign last year.


Lowbrow Limpball again ...

Rush Limbaugh: Beyonce's new song means she 'understands it's worth it to bow down' to men

Rush Limbaugh is giving Beyoncé's new single two thumbs down in the feminism department.
The talk show host, 62, spent part of his show on Wednesday criticizing the pop singer for pulling a "total 180" with her new single "Bow Down/I Been On."

Citing a story in The Telegraph, Limbaugh claimed that, rather than extolling women's independence in her song, Beyoncé is encouraging women to be subservient to their spouses.
"Bow Down," according to Limbaugh, advises women to "put up with it."

Read more: http://www.nydailynews.com/entertainment/gossip/rush-limbaugh-beyonce-anti-feminist-article-1.1294359#ixzz2OBqZlXQW

Studies of Substance Abuse with Interventions for the Youth of Native American Indian Community #15

Universal, selective, and indicated substance abuse prevention programs are all commonly found in American Indian communities. Distinctions between different types of prevention are often blurred; however, as commonly the entire community is considered at risk and is the focus of intervention. Unfortunately, the majority of prevention efforts in Indian Country have not been rigorously evaluated for efficacy. In addition, specific details of these programs often are not published or available in a manner that allows them to be easily shared with other communities. Moran and Reaman (2002) provided information on prevention programs that have not been published in the mainstream literature. Limited program information can also be found through SAMHSA’s Center for Substance Abuse Prevention (2003; see also Western Center for the Application of Prevention Technologies, 2002). While many of these programs have the potential for success in combating Indian adolescent substance abuse and for making valuable contributions to the development of prevention efforts in other communities, this study focuses on reviewing those studies that have been evaluated and published in peer refereed journals.

The principal source of information in this study comes from searches of the MEDLINE and PsycINFO databases. Information on qualitative findings has been included where relevant, although the emphasis here is on presenting quantitative outcome data. The programs reviewed tend to fall into two categories: those that target entire communities for change and those that focus their efforts primarily on individual behavior change.

Several researchers have suggested that programs that target an entire community rather than specific individuals may be more effective for the prevention and treatment of substance abuse in American Indian and Alaskan Native youth (Beauvais & LaBoueff, 1985; E. D. Edwards & Edwards, 1988; Gutierres, Russo, & Urbanski, 1994; LaFromboise, Trimble, & Mohatt, 1990; Petoskey et al., 1998; Wiebe & Huebert, 1996). A community based approach may be preferred for a variety of reasons. Some authors have described the inclusion of an entire community in the intervention as consistent with Native values and traditions, which stress collective decision making in resolving community or tribal concerns (E. D. Edwards & Edwards, 1988; LaFromboise et al., 1990). Others have emphasized the role that sociocultural factors play in the development of drug and alcohol abuse and argued that a more comprehensive approach is necessary to address risk factors at familial and community levels (Gutierres et al., 1994). Most authors agree that whether a curriculum is intended to serve primarily individuals or larger groups, community support for the intervention is vital to the success of any treatment or prevention program (Beauvais & LaBoueff, 1985; E. D. Edwards & Edwards, 1988; LaFromboise et al., 1990; Wiebe & Huebert, 1996).

The Connection Between Obesity and Poverty

A new report finds shows that Americans are getting fatter and notes worse rates among those with low incomes, but some states don’t exactly fit the pattern.

Our colleague Katherine Hobson on the Health Blog points to a study from the Trust for America’s Health and the Robert Wood Johnson Foundation that looks at the increase in obesity rates across the U.S.

The report notes higher obesity rates nationally among low-income adults. “More than 33% of adults who earn less than $15,000 per year were obese, compared with 24.6% of those who earn at least $50,000 per year,” the authors state.

Comparing poverty rates in the U.S. with obesity rates, a pretty strong correlation emerges. Check out this map on poverty rates from the Census Bureau and look at this map on obesity rates, where you can see a lot of overlap. For example, Mississippi has both the highest poverty rate and the highest obesity rate in the country.

But as the report notes, there isn’t just one factor leading to increases in obesity, as some states clearly buck the trend. Maryland has the second-lowest poverty rate in the country, but is near the national average for obesity.

On the other side of the coin, New Mexico has the third-highest poverty rate in the U.S., but has a below average rate of obesity. New York has a higher than average poverty rate, but is among the 10 lowest states in obesity.


Poverty and obesity

Coverage of obesity in the British press has doubled in the past year and threatens to become an 'epidemic' in its own right. It is almost impossible to pick up a daily or Sunday paper without being exposed to headlines featuring words such as 'time-bomb' and ill-founded assertions that the present generation of children will die before their parents. The sounds of wringing hands and admonishments to eat 'properly' have become almost deafening.

In the midst of this 'headless chicken' panic about growing girths — and especially the girths of children — government agencies appear to have given in to the food-correctness lobbyists who have sought to pin the blame for the disaster squarely on those greedy multinational purveyors of lard, sugar and salt — the culpable 'fat cats' who have, apparently, single-handedly created our fat nation. The Food Standards Agency, for example, has announced a plan to 'overhaul food promotion to children' despite the fact that in its own evidence just 2 months ago to the Commons Select Health Committee regarding advertising of food to children it conceded that:

"The conclusions that the researchers drew was that the evidence is not there to draw any conclusions on the magnitude of the effect."

In what we take to be proper science-based approaches, if the magnitude of an effect cannot be measured then it cannot be said to exist at all. Rational and evidence-based thinking clearly no longer stands in the way of appeasing the growing clamour for action on obesity, even when there is no evidence that the proposed measures will have the slightest impact. The 'let's be seen to be something, no matter how misguided' philosophy has long been a familiar response of agencies that have run out of proper ideas.

Amidst this disoriented casting around for culprits and simple solutions, driven hard by media hype, it was refreshing to read in the Observer a thoughtful article by David Smith that for once dealt with some of the real issues underlying the rise in obesity — poverty and disadvantage. It has become fashionable to believe that in the modern Blairite Britain such features of British society are no longer with us — that we are all now 'middle class' and that the old social and economic distinctions that were once an intrinsic feature of our culture have been consigned to history. Not so, sadly, for the people of Glasgow's East End where life expectancy is around 60 and falling and where the average diet is about as unhealthy as it can get. Obesity is but one of the symptoms of the impoverishment that plagues their lives.


In Obesity Epidemic, Poverty Is an Ignored Contagion

Under the category “Summer Rentals That Have Gone Terribly Wrong,” there are perhaps few parallels to the experience of Charles Henry Warren, a Manhattan banker who, in 1906, took a house in Oyster Bay on Long Island’s North Shore. By the end of the season, Mr. Warren’s young daughter had developed typhoid. She was soon followed in illness by Mr. Warren’s wife, a second daughter, two maids and a gardener. At the time, typhoid, a bacterial illness spread through contaminated food and water, was largely a disease of the urban poor. The property’s owner, George Thompson, concerned that the house, on which he relied for rental income, would become associated with tenement filth in the minds of wealthy New Yorkers, invited a sanitary engineer to determine the source of the outbreak.

What the medical investigator, George Soper, discovered was that the Warrens’ cook, Mary Mallon, an Irish immigrant, had left an imprint of malady in other quarters of upper-class Manhattan and its summer enclaves. Typhoid, he wrote, had erupted in every household in which Mallon had worked over the previous decade. An asymptomatic carrier of the disease, Ms. Mallon would be known to history as Typhoid Mary and spend most of the remainder of her life quarantined on North Brother Island in the East River, having failed to abide by a promise to cease working in the city’s kitchens.

The events supply the narrative of “Fever,” a new novel by Mary Beth Keane, which arrives at a time when we are once again debating the parameters of public health policy’s encroachments on our behaviors. Last week, a State Supreme Court justice in Manhattan used the words “arbitrary and capricious” in striking down the Bloomberg administration’s efforts to limit the size of sugary drinks (which pertained to certain sweetened beverages but not others, and some retail environments but not all). The phrase, though, could have been similarly applied a century ago to the city’s treatment of Ms. Mallon, given that officials were not in the habit of isolating other healthy carriers whom they had identified as ignoring ordinances against the spread of the disease.



I wonder why poverty is ignored .....

Lower-Income Neighborhoods Associated With Higher Obesity Rates

Obesity prevalence has increased significantly among adults and children in the U.S. over the last two decades. A new study appearing in the journal Nutrition Reviews reveals that characteristics of neighborhoods, including the area’s income level, the built environment, and access to healthy food, contribute to the continuing obesity epidemic.

They found that neighborhoods with decreased economic and social resources have higher rates of obesity. They also found that residents in low-income urban areas are more likely to report greater neighborhood barriers to physical activity, such as limited opportunities for daily walking or physical activity and reduced access to stores that sell healthy foods, especially large supermarkets.

In order to organize the different approaches to assessing neighborhood-level determinants of obesity, the authors present a conceptual framework. The framework is intended to guide future inquiry by describing pathways through which neighborhoods might influence body weight.

Consisting of three inter-related layers, the framework includes the influence of social factors, access to quality food and exercise, and individual factors including behavioral intentions. Each level has indirect and direct influences on behavioral choices and may ultimately impact weight.



So we complain about our healthcare costs which are directly related to obesity which is directly related to income, DUH ....

Obama's Best Jokes From His Gridiron Speech

President Obama poked fun at the Washington press corps, Republicans, and himself at the annual Gridiron dinner. Here are some of the best jokes from his comedy routine:

On the sequester: "I know some of you have noticed that I'm dressed a little differently from the other gentlemen. Because of sequester, they cut my tails. My joke writers have been placed on furlough. I know a lot of you reported that no one will feel any immediate impact because of the sequester. Well, you're about to find out how wrong you are."

On Marco Rubio (after pausing to drink from a glass of water): "That, Marco Rubio, is how you take a sip of water."

On mixing up Star Wars and Star Trek references: "After a very public mix-up last week, my communications team has provided me with an easy way to distinguish between 'Star Trek' and 'Star Wars.' Spock is what Maureen Dowd calls me. Darth Vader is what John Boehner calls me."

On Washington Post reporter Bob Woodward: "I know that some folks think we responded to Woodward too aggressively. But hey, when has -- can anybody tell me when an administration has ever regretted picking a fight with Bob Woodward? What's the worst that could happen? "

On his special someone: "Now I'm sure that you've noticed that there's somebody very special in my life who is missing tonight, somebody who has always got my back, stands with me no matter what and gives me hope no matter how dark things seem. So tonight, I want to publicly thank my rock, my foundation -- thank you, Nate Silver."

On his new administration: "With all these new faces, it's hard to keep track of who is in, who is out. And I know it's difficult for you guys as reporters. But I can offer you an easy way of remembering the new team. If Ted Cruz calls somebody a communist, then you know they're in my cabinet."

On Joe Biden: "Look, it's no secret that my Vice President is still ambitious. But let's face it, his age is an issue. Just the other day, I had to take Joe aside and say, 'Joe, you are way too young to be the pope.'"


Read full transcript here ; http://politicalhumor.about.com/od/barackobama/a/Obama-Gridiron-Speech-2013.htm

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