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The goal of eliminating disparities in health care in the United States remains elusive. Even as quality improves on specific measures, disparities often persist. Addressing these disparities must begin with the fundamental step of bringing the nature of the disparities and the groups at risk for those disparities to light by collecting health care quality information stratified by race, ethnicity and language data. Then attention can be focused on where interventions might be best applied, and on planning and evaluating those efforts to inform the development of policy and the application of resources. A lack of standardization of categories for race, ethnicity, and language data has been suggested as one obstacle to achieving more widespread collection and utilization of these data. Race, Ethnicity, and Language Data identifies current models for collecting and coding race, ethnicity, and language data; reviews challenges involved in obtaining these data, and makes recommendations for a nationally standardized approach for use in health care quality improvement.
At a time when lesbian, gay, bisexual, and transgender individuals-often referred to under the umbrella acronym LGBT-are becoming more visible in society and more socially acknowledged, clinicians and researchers are faced with incomplete information about their health status. While LGBT populations often are combined as a single entity for research and advocacy purposes, each is a distinct population group with its own specific health needs. Furthermore, the experiences of LGBT individuals are not uniform and are shaped by factors of race, ethnicity, socioeconomic status, geographical location, and age, any of which can have an effect on health-related concerns and needs. The Health of Lesbian, Gay, Bisexual, and Transgender People assesses the state of science on the health status of LGBT populations, identifies research gaps and opportunities, and outlines a research agenda for the National Institute of Health. The report examines the health status of these populations in three life stages: childhood and adolescence, early/middle adulthood, and later adulthood. At each life stage, the committee studied mental health, physical health, risks and protective factors, health services, and contextual influences. To advance understanding of the health needs of all LGBT individuals, the report finds that researchers need more data about the demographics of these populations, improved methods for collecting and analyzing data, and an increased participation of sexual and gender minorities in research. The Health of Lesbian, Gay, Bisexual, and Transgender People is a valuable resource for policymakers, federal agencies including the National Institute of Health (NIH), LGBT advocacy groups, clinicians, and service providers.
The Temporary Assistance for Needy Families (TANF) block grant provides federal grants to states for a wide range of benefits, services, and activities. It is best known for helping states pay for cash welfare for needy families with children, but it funds a wide array of additional activities. TANF was created in the 1996 welfare reform law (P.L. 104-193). TANF funding and program authority were extended through FY2010 by the Deficit Reduction Act of 2005 (DRA, P.L. 109-171). TANF provides a basic block grant of $16.5 billion to the 50 states and District of Columbia, and $0.1 billion to U.S. territories. Additionally, 17 states qualify for supplemental grants that total $319 million. TANF also requires states to contribute from their own funds at least $10.4 billion for benefits and services to needy families with children -- this is known as the maintenance-of-effort (MOE) requirement. States may use TANF and MOE funds in any manner "reasonably calculated" to achieve TANF's statutory purpose. This purpose is to increase state flexibility to achieve four goals: (1) provide assistance to needy families with children so that they can live in their own homes or the homes of relatives; (2) end dependence of needy parents on government benefits through work, job preparation, and marriage; (3) reduce out-of-wedlock pregnancies; and (4) promote the formation and maintenance of two-parent families. Though TANF is a block grant, there are some strings attached to states' use of funds, particularly for families receiving "assistance" (essentially cash welfare). States must meet TANF work participation standards or be penalised by a reduction in their block grant. The law sets standards stipulating that at least 50% of all families and 90% of two-parent families must be participating, but these statutory standards are reduced for declines in the cash welfare caseload. (Some families are excluded from the participation rate calculation.) Activities creditable toward meeting these standards are focused on work or are intended to rapidly attach welfare recipients to the workforce; education and training is limited. Federal TANF funds may not be used for a family with an adult that has received assistance for 60 months. This is the five-year time limit on welfare receipt. However, up to 20% of the caseload may be extended beyond the five years for reason of "hardship", with hardship defined by the states. Additionally, states may use funds that they must spend to meet the TANF MOE to aid families beyond five years. TANF work participation rules and time limits do not apply to families receiving benefits and services not considered "assistance". Child care, transportation aid, state earned income tax credits for working families, activities to reduce out-of-wedlock pregnancies, activities to promote marriage and two-parent families, and activities to help families that have experienced or are "at risk" of child abuse and neglect are examples of such "nonassistance".
Physicians who choose to serve in public-sector mental healthcare settings and physicians-in-training assigned to public-sector mental health clinics may not be fully prepared for the many roles of the public and community psychiatrist. Public and Community Psychiatry is a concise guide for the resident and early-career psychiatrist called upon to serve in the roles of public-sector clinician, team member, advocate, administrator, and academician. Each chapter includes a concise description of these various roles and responsibilities and offers engaging examples of the public psychiatrist at work, as well as case-based problems typical of those faced by the public psychiatrist. Each chapter also features works of art and literature, usually from the public domain, in order to incorporate the core strengths of medical humanities into the dialogue of public-sector mental healthcare. This book aims to provide a level of support to psychiatrists that fosters their desire, individually and collectively, to serve the poor and the marginalized with grit and determination, and to broadly consider their potential to improve not only their patients' well-being, but also these patients' incorporation into their respective communities.
Guide to Effective Grant Writing: How to Write a Successful NIH Grant is written to help the 100,000+ post-graduate students and professionals who need to write effective proposals for grants. There is little or no formal teaching about the process of writing grants for NIH, and many grant applications are rejected due to poor writing and weak formulation of ideas. Procuring grant funding is the central key to survival for any academic researcher in the biological sciences; thus, being able to write a proposal that effectively illustrates one's ideas is essential. Covering all aspects of the proposal process, from the most basic questions about form and style to the task of seeking funding, this volume offers clear advice backed up with excellent examples. Included are a number of specimen proposals to help shed light on the important issues surrounding the writing of proposals. The Guide is a clear, straight-forward, and reader-friendly tool. Guide to Effective Grant Writing: How to Write a Successful NIH Grant Writing is based on Dr. Yang's extensive experience serving on NIH grant review panels; it covers the common mistakes and problems he routinely witnesses while reviewing grants.