Kristine Qureshi

This comprehensive textbook contains information on a wide array of topics, including the organization of care, population health, the fundamental challenges of health disparities, health care financing and economics, and health information technology’s role in improving care and protecting privacy. New chapters on public health preparedness and its role in mitigating effects on health and the health system and the medical and social challenges of caring for older adults provide insight into important, ongoing challenges and what those challenges reflect about our system of care. With an increased emphasis on health disparities, population health, and health equity, this textbook includes a timely focus on how social and behavioral determinants influence health outcomes. Students will gain a deeper understanding of public health systems and their societal role and of the economic perspectives that drive health care managers and the system. Thorough coverage of the rapid changes that are reshaping our system, in addition to an evaluation of our nation’s achievement of health care value, will equip students with the critical knowledge they need to enter this dynamic and complex field. The book also includes cutting-edge, evidence-based information on preventive medicine, innovative approaches to control health care costs, initiatives to achieve high-quality and value-based care, and much more from prominent scholars, practitioners, and educators within health care management, public health, population health, health policy, medical care, and nursing.

COVID-19 has taught us that even the most powerful nations of the world cannot declare that they are immune to disasters. Public health preparedness denotes the ability of a community or nation to recover from emergencies or disasters. The words “emergency” and “disaster” can seem overlapping, but a thin line separates them. An emergency is a serious event that needs immediate actions to preserve life or assets, whereas a disaster is a serious disruption at a large scale when the community is not capable to respond adequately. But even after implementing efforts to prevent or lessen damage from untoward events, emergencies and disasters will still occur. Across the United States, a standardized system for disaster incident management is used. Public health plays an important role in preventing, mitigating, detecting, responding to, and recovering from all types of disasters.

The purpose of this study was to identify individual characteristics, behaviors, and psychosocial factors associated with symptoms of post-traumatic stress disorder (PTSD) among World Trade Center (WTC) disaster evacuation survivors. The study utilized a mixed-method design. In-depth interviews were conducted using a prepared script. PTSD was assessed using the PTSD checklist-civilian (PCL-C; a score ≥ 50 indicates probable PTSD). Thematic analysis was conducted to identify factors associated with PTSD. A purposive sample of 29 WTC evacuees was recruited using a multimodal recruitment strategy. Eligibility included: history of evacuation from the WTC (Tower 1 and/or Tower 2) on September 11, 2001, and decisional capacity for informed consent. Five participants had PCL-C scores ≥ 50. Thematic analysis identified resiliency factors (protective for PTSD), including leadership, taking action based on “gut” feelings (to evacuate), social support (staying in a group), going on “automatic survival” mode, and previous training on emergency response. Risk factors for PTSD included lack of emergency response training, lack of sense of urgency, poor physical condition, lack of communication skills, lack of direction, peri-event physical injury, peri-event traumatic exposure (horror), and moral injury (guilt and remorse). Several modifiable factors that may confer resilience were identified. In particular, the role of emergency response training in preventing disaster-related mental illness should be explored as a possible strategy for enhancing resilience to disaster events.

This article provides an update on the progress of the “Call to Action: Nurses as Leaders in Disaster Preparedness and Response.” A steering committee, initiated, directed, and supported by the Veterans Emergency Management Evaluation Center of the US Department of Veterans Affairs, has undertaken the work of bringing together subject matter experts to develop a vision for the future of disaster nursing. The ultimate goal is to ensure that every nurse is a prepared nurse. As one result of this work, the Society for the Advancement of Disaster Nursing has held its inaugural meeting in December 2016.

The aim of this study was to identify factors that serve as facilitators and barriers for breastfeeding among Chuukese immigrant women living in Guam. Traditionally, Chuukese women exclusively breastfeed their babies; however, it is reported that breastfeeding decreases among these women when they migrate to Guam. Little is known about why this happens. A qualitative approach that included key informant interviews and focus groups of Chuukese women (N = 24) who had migrated to Guam and delivered a baby on Guam within the past 5 years was completed. The project interview or discussion guides were guided by the Theory of Reasoned Action and explored facilitators and barriers for successful breastfeeding among these Chuukese immigrant women. Among this population, key facilitators for breastfeeding included high levels of self-confidence, family support, knowledge about breastfeeding, and the existence of strong traditional Chuukese cultural values. Key barriers included experiences of cultural conflict or social change, lack of support from their local community, family and health-care staff, as well as limited self-knowledge about how to manage common breastfeeding problems. Where more facilitators were reported, breastfeeding was more often practiced, and where more barriers were reported, formula feeding was more likely. Social factors, health system policies, and proactive nursing support are important influencing factors for breastfeeding among the Chuukese immigrant population on Guam. Nursing can play key roles in policy, professional leadership and practice, and social advocacy to support breastfeeding promotion and maintenance on Guam.

Disasters disproportionately impact certain segments of the population, including children, pregnant women, people living with disabilities and chronic conditions and those who are underserved and under-resourced. One of the most vulnerable groups includes the community-dwelling elderly. Post-disaster analyses indicate that these individuals have higher risk of disaster-related morbidity and mortality. They also have suboptimal levels of disaster preparedness in terms of their ability to shelter-in-place or evacuate to a shelter. The reasons for this have not been well characterized, although impaired health, financial limitations, and social isolation are believed to act as barriers to preparedness as well as to adaptability to changes in the environment both during and in the immediate aftermath of disasters. In order to identify strategies that address barriers to preparedness, we recently conducted a qualitative study of 50 elderly home care recipients living in San Francisco. Data were collected during in-home, in-person interviews using a semi-structured interview guide that included psychosocial constructs based on the social cognitive preparedness model and a new 13-item preparedness checklist. The mean preparedness score was 4.74 (max 13, range 1–11, SD. 2.11). Over 60 % of the participants reported that they had not made back-up plans for caregiver assistance during times of crisis, 74 % had not made plans for transportation to a shelter, 56 % lacked a back-up plan for electrical equipment in case of power outages, and 44 % had not prepared an emergency contacts list—the most basic element of preparedness. Impairments, disabilities, and resource limitations served as barriers to preparedness. Cognitive processes that underlie motivation and intentions for preparedness behaviors were lacking. There were limitations with respect to critical awareness of hazards (saliency), self-efficacy, outcome expectancy, and perceived responsibility. There was also a lack of trust in response agencies and authorities and a limited sense of community. Participants wanted to be prepared and welcomed training, but physical limitations kept many of them home bound. Training of home care aides, the provision of needed resources, and improved community outreach may be helpful in improving disaster outcomes in this vulnerable segment of the population.

Aim: The aim of this article was to present experiences from the field in the context of the International Council of Nurses' Leadership for Change™ programme, which celebrates 20 years of excellence in 2016 for developing the leadership and management capacity of nurses worldwide.Background: The programme was launched in 1996 in order to boost nurse participation in the healthcare policy‐making process, globally, and to foster within the nursing profession the requisite skills for nurses to lobby for and assume a greater responsibility in the leadership and management of health care services.Introduction: Over the course of two decades, the programme has been implemented in cooperation between ICN, national nurses associations, the World Health Organization, Ministries of Health and a variety of donor organizations such as the W.K. Kellogg Foundation and development agencies such as USAID and AUSAID. The programme has been implemented in more than 60 nations throughout Africa, Asia, Europe, the Middle East, Latin America and the Pacific Islands, to name a few regions.Methods: This article offers an overview of the impact that certified ICN LFC nurse trainers and their colleagues have had in the United Arab Emirates, Vietnam and the United States of America and is affiliated islands and the North Pacific Islands.Results: Twenty years of growth and empowerment are now the ongoing legacy of the ICN LFC Program, which has graduated and deployed nurse trainers around the world and achieved significant advances in the professional development of nurse leaders on an international scale.Implications for nursing and health policy: Nurse leaders can improve the health and well‐being of their nations in collaboration with consumers and other key stakeholders. Nurse leaders are critical in improving health systems, their work places and broader societal challenges through sound nursing practice, education, research and evidence‐based health and social policy change.

Objective: To determine essential workers' ability and willingness to report to duty during a serious pandemic outbreak and to identify modifiable risk factors. Methods: Workers (N = 1103) from six essential workgroups completed an anonymous, cross-sectional survey. Results: Although a substantial proportion of participants reported that they would be able (80%), fewer would be willing (65%) to report to duty. Only 49% of participants would be both able and willing. Factors significantly associated with ability/willingness included individual-level (eg, intentions to adhere to respiratory protection and pandemic vaccination recommendations) and organizational-level factors (eg, preparedness planning for respiratory protection and worker vaccination programs). Conclusions: During a serious pandemic event, non–illness-related shortfalls among essential workers could be substantial. Organizational preparedness efforts should focus on worker protection programs and the development of policies that would facilitate the attendance of healthy workers.