Taking a Step to Identify How to Create Professional Learning Communities--Report of a Case Study of a Korean Public High School on How to Create and Sustain a School-Based Teacher Professional Learning Community

ERIC Educational Resources Information Center

Ahn, Joonkil

2017-01-01

This study intends to identify some key factors in creating and sustaining school-based teacher professional learning communities (PLCs) through a case study of a South Korean public high school. To achieve this, the study identified some essential infrastructure, preparation, and necessary social organization for creating PLCs. The ideal unit and…

Understanding Privilege as Loss: Community-Based Education at Temple University.

ERIC Educational Resources Information Center

Shorr, Lori; Rothman, Nancy; Parks, Steve

2001-01-01

Outlines some of the administrative changes included in Temple University's move toward a more community-based education agenda and focuses on one case, Temple Health Connection (THC). THC is an on-site, community- and university-supported medical facility that serves as a locus for community health care, student learning, and faculty research.…

Using Analysis of Governance to Unpack Community-Based Conservation: A Case Study from Tanzania.

PubMed

Robinson, Lance W; Makupa, Enock

2015-11-01

Community-based conservation policies and programs are often hollow with little real devolution. But to pass a judgment of community-based or not community-based on such initiatives and programs obscures what is actually a suite of attributes. In this paper, we analyze governance around a specific case of what is nominally community-based conservation-Ikona Wildlife Management Area (WMA) in Tanzania-using two complementary sets of criteria. The first relates to governance "powers": planning powers, regulatory powers, spending powers, revenue-generating powers, and the power to enter into agreements. The second set of criteria derive from the understanding of governance as a set of social functions: social coordination, shaping power, setting direction, and building community. The analysis helps to detail ways in which the Tanzanian state through policy and regulations has constrained the potential for Ikona WMA to empower communities and community actors. Although it has some features of community-based conservation, community input into how the governance social functions would be carried out in the WMA was constrained from the start and is now largely out of community hands. The two governance powers that have any significant community-based flavor-spending powers and revenue-generating powers-relate to the WMA's tourism activities, but even here the picture is equivocal at best. The unpacking of governance that we have done, however, reveals that community empowerment through the processes associated with creating and recognizing indigenous and community-conserved areas is something that can be pursued through multiple channels, some of which might be more strategic than others.

Case managers and the use of Medicare, Part D.

PubMed

Hensley, Melissa Anne

2011-01-01

The purpose of this study was to examine the experiences and opinions of community-based mental health case managers with the Medicare prescription drug benefit. A qualitative approach, consisting of analysis of data from 3 case manager focus groups, was used to achieve an understanding of the role that case managers played in beneficiaries' access to and use of prescription medicines. Two urban nonprofit community-based mental health agencies. Adults who are disabled by mental illness depend on case managers for information about their prescription drug insurance, help with formulary and plan switching information, and assistance with tasks related to medication adherence in the community. Common themes in the case managers' discussion were managing beneficiary problems, stress for beneficiaries, information and paperwork issues, and cynicism regarding health care reform. The critical role of case managers in the use of Medicare Part D is not well understood or appreciated. Case managers need to be informed about Medicare Part D and ready to advocate for their clients in the community. In addition, it is important for case managers to understand how Medicare Part D affects not only older adults, but also adults living with serious and persistent mental illness.

Community-Based Field Experiences in Teacher Education: Possibilities for a Pedagogical Third Space

ERIC Educational Resources Information Center

Hallman, Heidi L.

2012-01-01

The present article discusses the importance of community-based field experiences as a feature of teacher education programs. Through a qualitative case study, prospective teachers' work with homeless youth in an after-school initiative is presented. Framing community-based field experiences in teacher education through "third space" theory, the…

Exposure to community violence and self-harm in California: A multi-level, population-based, case-control study.

PubMed

Matthay, Ellicott C; Farkas, Kriszta; Skeem, Jennifer; Ahern, Jennifer

2018-06-07

Self-harm is a leading cause of morbidity and mortality. Exposure to community violence is an important and potentially modifiable feature of the social environment that may affect self-harm, but studies to date are limited in the samples and outcomes examined. We conducted a population-based, nested case-control study. Cases were all deaths and hospital visits due to self-harm in California, 2006-2013. We frequency-matched California resident population-based controls from the American Community Survey to cases on age, gender, race/ethnicity, and year of survey/injury. We assessed past-year community violence using deaths and hospital visits due to interpersonal violence in the community of residence. We estimated risk-difference parameters that were defined to avoid extrapolation and to capture associations between changes in the distribution of community violence and the population-level risk of self-harm. After adjustment for confounders, setting past-year community violence to the lowest monthly levels observed within each community over the study period was associated with a 30.1 (95% CI: 29.6 to 30.5) per 100,000 persons per year lower risk of nonfatal self-harm, but no difference in the risk of fatal self-harm. Associations for a parameter corresponding to a hypothetical violence prevention intervention targeting high-violence communities indicated a 5% decrease in self-harm at the population level. In sensitivity analyses, results were robust. This study strengthens evidence on the relationship between community violence and self-harm. Future research should investigate reasons for differential associations by age and gender and whether community violence prevention programs have meaningful impacts on self-harm.

Recruitment of participants through community pharmacies for a pharmacogenetic study of antihypertensive drug treatment.

PubMed

van Wieren-de Wijer, Diane B M A; Maitland-van der Zee, Anke-Hilse; de Boer, Anthonius; Stricker, Bruno H Ch; Kroon, Abraham A; de Leeuw, Peter W; Bozkurt, O; Klungel, Olaf H

2009-04-01

To describe the design, recruitment and baseline characteristics of participants in a community pharmacy based pharmacogenetic study of antihypertensive drug treatment. Participants enrolled from the population-based Pharmaco-Morbidity Record Linkage System. We designed a nested case-control study in which we will assess whether specific genetic polymorphisms modify the effect of antihypertensive drugs on the risk of myocardial infarction. In this study, cases (myocardial infarction) and controls were recruited through community pharmacies that participate in PHARMO. The PHARMO database comprises drug dispensing histories of about 2,000,000 subjects from a representative sample of Dutch community pharmacies linked to the national registrations of hospital discharges. In total we selected 31010 patients (2777 cases and 28233 controls) from the PHARMO database, of whom 15973 (1871 cases, 14102 controls) were approached through their community pharmacy. Overall response rate was 36.3% (n = 5791, 794 cases, 4997 controls), whereas 32.1% (n = 5126, 701 cases, 4425 controls) gave informed consent to genotype their DNA. As expected, several cardiovascular risk factors such as smoking, body mass index, hypercholesterolemia, and diabetes mellitus were more common in cases than in controls. Furthermore, cases more often used beta-blockers and calcium-antagonists, whereas controls more often used thiazide diuretics, ACE-inhibitors, and angiotensin-II receptor blockers. We have demonstrated that it is feasible to select patients from a coded database for a pharmacogenetic study and to approach them through community pharmacies, achieving reasonable response rates and without violating privacy rules.

"It's like Tuskegee in reverse": a case study of ethical tensions in institutional review board review of community-based participatory research.

PubMed

Malone, Ruth E; Yerger, Valerie B; McGruder, Carol; Froelicher, Erika

2006-11-01

Community-based participatory research (CBPR) addresses the social justice dimensions of health disparities by engaging marginalized communities, building capacity for action, and encouraging more egalitarian relationships between researchers and communities. CBPR may challenge institutionalized academic practices and the understandings that inform institutional review board deliberations and, indirectly, prioritize particular kinds of research. We present our attempt to study, as part of a CBPR partnership, cigarette sales practices in an inner-city community. We use critical and communitarian perspectives to examine the implications of the refusal of the university institutional review board (in this case, the University of California, San Francisco) to approve the study. CBPR requires expanding ethical discourse beyond the procedural, principle-based approaches common in biomedical research settings. The current ethics culture of academia may sometimes serve to protect institutional power at the expense of community empowerment.

Contribution of community health workers to surveillance of vaccine-preventable diseases in the Obala health district

PubMed Central

Vouking, Marius Zambou; Binde, Thierry; Tadenfok, Carine Nouboudem; Ekani, Jean Marie Edengue; Ekra, Daniel

2017-01-01

Introduction The establishment of effective community-based surveillance is an essential objective of all disease surveillance systems. Several studies and reports have found that the situation is far from optimal in several developing countries such as Cameroon. Methods We conducted a cross-sectional descriptive study to assess the contribution of community health workers to surveillance of vaccine-preventable diseases in Obala health district. The performance of community health workers was measured using: the number of cases referred to the health center, the percentage of accomplished referrals, the percentage of cases referred by community health workers confirmed by the staff of health centers. A questionnaire containing forty-seven questions (open-ended and closed-ended) was used for interviews with community health workers. The data were analyzed using SPSS 21 and Excel 2007. Counts and percentages are reported. Results The study showed that the age ranged of community health workers was from 24 to 61 years with an average of 37.9 years ± 6.7 years. The most represented age group was between 40 and 50 with a percentage of 38.6%. The male sex was more represented than the female sex (61.4% vs 38.6%) or a sex ratio male man of 1.7. Forty-five percent of community health workers were selected at a village meeting, 93.1% of community health workers were involved in the surveillance of vaccine-preventable diseases and 87% experienced at least one preventable disease. Only 45.8% of them had the case definitions of the four diseases. Analysis of community health workers attendance at organized health committee meetings showed that 79% of community health workers attended at least one health committee meeting in 2015 and only 49% were monitored in 2015. Community health workers reported 42 suspected cases of measles, 37 of which actually went to the nearest Health Center, a baseline rate of 88%. Conclusion Community health workers play a key role in the control of vaccine-preventable diseases in the Obala health district. Community-based surveillance is the foundation of surveillance activities. It is a mechanism based on simple case definitions of priority diseases and unexpected events or unusual conditions. Our study also reaffirms the importance of mastering case definitions and home visits and early detection of vaccine-preventable diseases. PMID:29610645

Bringing the Community Along: A Case Study of a School District's Information Technology Rural Development Initiative

ERIC Educational Resources Information Center

Schafft, Kai A.; Alter, Theodore R.; Bridger, Jeffrey C.

2006-01-01

We draw on interactional community theory to analyze the relationship between information technology and local development through a case study of a geographically isolated and economically disadvantaged rural school district. This district has used state-of-the-art information technology infrastructure in a broad-based community and economic…

Engaging the Community Cultural Wealth of Latino Immigrant Families in a Community-Based Program

ERIC Educational Resources Information Center

Gil, Elizabeth

2017-01-01

The purpose of this qualitative case study utilizing ethnographic methods was to understand how family members' participation in Digital Home, a community-based technology program in an urban mid-sized Midwestern city, built on and fostered Latino immigrant families' community cultural wealth (Yosso, 2005) in order to increase their abilities to…

Building capacity to address tobacco-related disparities among American Indian and Hispanic/Latino communities: conceptual and systemic considerations.

PubMed

Báezconde-Garbanati, Lourdes; Beebe, Laura A; Pérez-Stable, Eliseo J

2007-10-01

To discuss systemic and conceptual issues that surround capacity building for tobacco control in traditionally underserved communities, by presenting two case studies, one in an American Indian community and another in a Hispanic/Latino community. Key informant interviews, cross-sectional surveys and case study methods were used to create community-specific conceptual frameworks for building capacity for tobacco control. These models of capacity building serve as the backdrop for the development of the two case studies. SETTING, PARTICIPANTS, MEASUREMENTS: Interview and survey participants were identified through convenience and snowball sampling, using a community-based participatory process in an American Indian community in Oklahoma and among the Hispanic/Latino Tobacco Education Partnership (H/LTEP) organizations in California. Using qualitative and quantitative methods, two case studies were created based on the results of interviews with key informants in each of the respective communities, outcomes of efforts to build capacity in tobacco control are presented. The extent to which American Indian and Hispanic/Latino communities have the capacity to address effectively the disproportionate burden of tobacco abuse is contingent upon the presence of leadership, collaboration, programs, distribution of funds and resources, development of policies and an underlying understanding of community strengths, history, values and participation. Common characteristics emerge from the case studies that help bridge differences in definition and measurement across both populations and programs. The conceptual frameworks for capacity building presented provide insight that enhances the ability of priority populations to engage in tobacco control strategies using culturally and language appropriate interventions.

Improving Parolees' Participation in Drug Treatment and Other Services through Strengths Case Management.

PubMed

Prendergast, Michael; Cartier, Jerome J

2008-01-01

In an effort to increase participation in community aftercare treatment for substance-abusing parolees, an intervention based on a transitional case management (TCM) model that focuses mainly on offenders' strengths has been developed and is under testing. This model consists of completion, by the inmate, of a self-assessment of strengths that informs the development of the continuing care plan, a case conference call shortly before release, and strengths case management for three months post-release to promote retention in substance abuse treatment and support the participant's access to designated services in the community. The post-release component consists of a minimum of one weekly client/case manager meeting (in person or by telephone) for 12 weeks. The intervention is intended to improve the transition process from prison to community at both the individual and systems level. Specifically, the intervention is designed to improve outcomes in parolee admission to, and retention in, community-based substance-abuse treatment, parolee access to other needed services, and recidivism rates during the first year of parole. On the systems level, the intervention is intended to improve the communication and collaboration between criminal justice agencies, community-based treatment organizations, and other social and governmental service providers. The TCM model is being tested in a multisite study through the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) research cooperative funded by the National Institute of Drug Abuse.

COMMUNITY-BASED WATERSHED MANAGEMENT: CREATING A TOOL FOR PROGRAM EVALUATION AND DESIGN

EPA Science Inventory

The criteria will be assembled into a manual to be used by community organizers, academics, managers, or policy makers in evaluating community-based watershed management initiatives and in designing new watershed management programs. The case study will also be added to the b...

Leadership to Build a Democratic Community within School: A Case Study of Two Korean High Schools

ERIC Educational Resources Information Center

Kang, Young Taek; Printy, Susan

2009-01-01

This article aims to explore how democratic community is manifest in schools in Korea. It also tries to examine how leadership, specifically transformational leadership, functions in shaping a democratic community within a school. Toward this aim, we have conducted a case study of two religious high schools in Korea. Based on the findings from the…

Increased Use of Community Medicine Distributors and Rational Use of Drugs in Children Less than Five Years of Age in Uganda Caused by Integrated Community Case Management of Fever

PubMed Central

Kalyango, Joan N.; Lindstrand, Ann; Rutebemberwa, Elizeus; Ssali, Sarah; Kadobera, Daniel; Karamagi, Charles; Peterson, Stefan; Alfven, Tobias

2012-01-01

We compared use of community medicine distributors (CMDs) and drug use under integrated community case management and home-based management strategies in children 6–59 months of age in eastern Uganda. A cross-sectional study with 1,095 children was nested in a cluster randomized trial with integrated community case management (CMDs treating malaria and pneumonia) as the intervention and home-based management (CMDs treating only malaria) as the control. Care-seeking from CMDs was higher in intervention areas (31%) than in control areas (22%; P = 0.01). Prompt and appropriate treatment of malaria was higher in intervention areas (18%) than in control areas (12%; P = 0.03) and among CMD users (37%) than other health providers (9%). The mean number of drugs among CMD users compared with other health providers was 1.6 versus 2.4 in intervention areas and 1.4 versus 2.3 in control areas. Use of CMDs was low. However, integrated community case management of childhood illnesses increased use of CMDs and rational drug use. PMID:23136276

Success Factors for Community-Based Natural Resource Management (CBNRM): Lessons from Kenya and Australia

NASA Astrophysics Data System (ADS)

Measham, Thomas G.; Lumbasi, Jared A.

2013-09-01

Recent concerns over a crisis of identity and legitimacy in community-based natural resource management (CBNRM) have emerged following several decades of documented failure. A substantial literature has developed on the reasons for failure in CBNRM. In this paper, we complement this literature by considering these factors in relation to two successful CBNRM case studies. These cases have distinct differences, one focusing on the conservation of hirola in Kenya on community-held trust land and the other focusing on remnant vegetation conservation from grazing pressure on privately held farm land in Australia. What these cases have in common is that both CBNRM projects were initiated by local communities with strong attachments to their local environments. The projects both represent genuine community initiatives, closely aligned to the original aims of CBNRM. The intrinsically high level of "ownership" held by local residents has proven effective in surviving many challenges which have affected other CBNRM projects: from impacts on local livelihoods to complex governance arrangements involving non-government organizations and research organizations. The cases provide some signs of hope among broader signs of crisis in CBNRM practice.

Behavioural Comorbidity in Tanzanian Children with Epilepsy: A Community-Based Case-Control Study

ERIC Educational Resources Information Center

Burton, Kathryn; Rogathe, Jane; Hunter, Ewan; Burton, Matthew; Swai, Mark; Todd, Jim; Neville, Brian; Walker, Richard; Newton, Charles

2011-01-01

Aim: The aim of this study was to define the prevalence of and risk factors for behavioural disorders in children with epilepsy from a rural district of Tanzania by conducting a community-based case-control study. Method: One hundred and twelve children aged 6 to 14 years (55 males, 57 females; median age 12y) with active epilepsy (at least two…

Are community-based forest enterprises in the tropics financially viable? Case studies from the Brazilian Amazon

Treesearch

Shoana Humphries; Thomas P. Holmes; Karen Kainer; Carlos Gabriel Goncalves Koury; Edson Cruz; Rosana de Miranda Rocha

2012-01-01

Community-based forest management is an integral component of sustainable forest management and conservation in the Brazilian Amazon, where it has been heavily subsidized for the last ten years. Yet knowledge of the financial viability and impact of community-based forest enterprises (CFEs) is lacking. This study evaluates the profitability of three CFEs in the...

Community-Based Inquiry in Allied Health Biochemistry Promotes Equity by Improving Critical Thinking for Women and Showing Promise for Increasing Content Gains for Ethnic Minority Students

ERIC Educational Resources Information Center

Goeden, Terrah J.; Kurtz, Martha J.; Quitadamo, Ian J.; Thomas, Carin

2015-01-01

In the Community-Based Inquiry (CBI) instructional method, cooperative student groups complete case study activities based on scientific literature and conduct their own laboratory investigations that address authentic community needs. This study compared critical thinking and content knowledge outcomes between traditional Introduction to…

Consulting, Mediating, Conducting, and Supporting: How Community-Based Organizations Engage with Research to Influence Policy

ERIC Educational Resources Information Center

Winton, Sue; Evans, Michael P.

2016-01-01

Grounded in critical policy theories and democratic conceptions of research, case studies of three community-based organizations, one in Canada and two in the U.S., were analyzed to determine if and how the groups engaged with research in their efforts to influence education policy. The findings demonstrate that the community-based organizations…

Evaluation of community-based systems for the surveillance of day three-positive Plasmodium falciparum cases in Western Cambodia.

PubMed

Cox, Jonathan; Dy Soley, Lek; Bunkea, Tol; Sovannaroth, Siv; Soy Ty, Kheang; Ngak, Song; Bjorge, Steven; Ringwald, Pascal; Mellor, Steven; Sintasath, David; Meek, Sylvia

2014-07-22

Delayed clearance of Plasmodium falciparum parasites is used as an operational indicator of potential artemisinin resistance. Effective community-based systems to detect P. falciparum cases remaining positive 72 hours after initiating treatment would be valuable for guiding case follow-up in areas of known resistance risk and for detecting areas of emerging resistance. Systems incorporating existing networks of village malaria workers (VMWs) to monitor day three-positive P. falciparum cases were piloted in three provinces in western Cambodia. Quantitative and qualitative data were used to evaluate the wider feasibility and sustainability of community-based surveillance of day three-positive P. falciparum cases. Of 294 day-3 blood slides obtained across all sites (from 297 day-0 positives), 63 were positive for P. falciparum, an overall day-3 positivity rate of 21%. There were significant variations in the systems implemented by different partners. Full engagement of VMWs and health centre staff is critical. VMWs are responsible for a range of individual tasks including preparing blood slides on day-0, completing forms, administering directly observed therapy (DOT) on days 0-2, obtaining follow-up slides on day-3 and transporting slides and paperwork to their supervising health centre. When suitably motivated, unsalaried VMWs are willing and able to produce good quality blood smears and achieve very high rates of DOT and day-3 follow-up. Community-based surveillance of day-3 P. falciparum cases is feasible, but highly intensive, and as such needs strong and continuous support, particularly supervision and training. The purpose and role of community-based day-3 surveillance should be assessed in the light of resource requirements; scaling-up would need to be systematic and targeted, based on clearly defined epidemiological criteria. To be truly comprehensive, the system would need to be extended beyond VMWs to other public and private health providers.

Evaluation of community-based systems for the surveillance of day three-positive Plasmodium falciparum cases in Western Cambodia

PubMed Central

2014-01-01

Background Delayed clearance of Plasmodium falciparum parasites is used as an operational indicator of potential artemisinin resistance. Effective community-based systems to detect P. falciparum cases remaining positive 72 hours after initiating treatment would be valuable for guiding case follow-up in areas of known resistance risk and for detecting areas of emerging resistance. Methods Systems incorporating existing networks of village malaria workers (VMWs) to monitor day three-positive P. falciparum cases were piloted in three provinces in western Cambodia. Quantitative and qualitative data were used to evaluate the wider feasibility and sustainability of community-based surveillance of day three-positive P. falciparum cases. Results Of 294 day-3 blood slides obtained across all sites (from 297 day-0 positives), 63 were positive for P. falciparum, an overall day-3 positivity rate of 21%. There were significant variations in the systems implemented by different partners. Full engagement of VMWs and health centre staff is critical. VMWs are responsible for a range of individual tasks including preparing blood slides on day-0, completing forms, administering directly observed therapy (DOT) on days 0–2, obtaining follow-up slides on day-3 and transporting slides and paperwork to their supervising health centre. When suitably motivated, unsalaried VMWs are willing and able to produce good quality blood smears and achieve very high rates of DOT and day-3 follow-up. Conclusions Community-based surveillance of day-3 P. falciparum cases is feasible, but highly intensive, and as such needs strong and continuous support, particularly supervision and training. The purpose and role of community-based day-3 surveillance should be assessed in the light of resource requirements; scaling-up would need to be systematic and targeted, based on clearly defined epidemiological criteria. To be truly comprehensive, the system would need to be extended beyond VMWs to other public and private health providers. PMID:25052222

Strategies used by interdisciplinary rural health training programs to assure community responsiveness and recruit practitioners.

PubMed

Slack, Marion K; Cummings, Doyle M; Borrego, Matthew E; Fuller, Kathi; Cook, Sherrie

2002-05-01

In this article, the strategies used by five US rural interdisciplinary training grant programs to respond to local needs and to promote recruitment in rural communities are described. The programs provide training to 17 health care disciplines and serve disadvantaged Hispanic, African-American, Amish, Native American, and Anglo populations. Four programs are based in academic institutions; one is based in a community health center. The programs provide services to the rural communities through individual clinical or case management services, population-level interventions, and collaborative research. All programs use specific mechanisms (e.g. case conferences or participation in local coalitions) to facilitate collaboration with residents and to link student activities with community or individual needs. Unique strategies include the use of problem-based learning and community health workers on the interdisciplinary team to increase responsiveness. The programs also provide educational support to students while they work in the rural communities. Finally, the primary strategy used to promote recruitment is the training experience in rural communities. The programs also appear to indirectly improve the environment of rural practice.

Measles case fatality ratio in India a review of community based studies.

PubMed

Sudfeld, C R; Halsey, N A

2009-11-01

Measles remains a major cause of child mortality in India. Measles case fatality ratios (CFRs) vary substantially between countries and even within the same community over time. We present a review of Indian community-based measles CFR studies conducted from 1975 to 2008. PubMed, Cochrane Libraries, and all WHO databases were searched using a combination of terms. All community-based studies were abstracted into a database. We identified 25 studies with data on 27 communities. The median CFR was 1.63 per 100 cases (Q1= 0.00 and Q3= 5.06). Studies conducted after 1994 had significantly lower CFRs (P=0.031). Studies in rural settings had significantly higher CFRs compared to urban studies (P=0.015). No differences were found by study design or outbreak/endemic setting. This review suggests measles CFR may be declining in India. We hypothesize that increased measles vaccination coverage is the main factor contributing to the decline. Widespread vaccination increases both the average age of infection and the proportion of total measles cases previously vaccinated. Vitamin A treatment/supplementation is also likely to have contributed. In order to further reduce measles burden in India, vaccination and vitamin A treatment/supplementation coverage should be increased and a two dose vaccine strategy should be implemented in all areas.

Training in the Community-Collaborative Context: A Case Study

ERIC Educational Resources Information Center

Yamada, Racquel-María

2014-01-01

Emerging community-based methodologies call for collaboration with speech community members. Although motivated, community members may lack the tools or training to contribute actively. In response, many linguists deliver training workshops in documentation or preservation, while others train community members to record data. Although workshops…

Development of a validated clinical case definition of generalized tonic-clonic seizures for use by community-based health care providers.

PubMed

Anand, Krishnan; Jain, Satish; Paul, Eldho; Srivastava, Achal; Sahariah, Sirazul A; Kapoor, Suresh K

2005-05-01

To develop and test a clinical case definition for identification of generalized tonic-clonic seizures (GTCSs) by community-based health care providers. To identify symptoms that can help identify GTCSs, patients with history of a jerky movements or rigidity in any part of the body ever in life were recruited from three sites: the community, secondary care hospital, and tertiary care hospital. These patients were administered a 14-item structured interview schedule focusing on the circumstances surrounding the seizure. Subsequently, a neurologist examined each patient and, based on available investigations, classified them as GTCS or non-GTCS cases. A logistic regression analysis was performed to select symptoms that were to be used for case definition of GTCSs. Validity parameters for the case definition at different cutoff points were calculated in another set of subjects. In total, 339 patients were enrolled in the first phase of the study. The tertiary care hospital contributed the maximal number of GTCS cases, whereas cases of non-GTCS were mainly from the community. At the end of phase I, the questionnaire was shortened from 14 to eight questions based on statistical association and clinical judgment. After phase II, which was conducted among 170 subjects, three variables were found to be significantly related to the presence of GTCSs by logistic regression: absence of stress (13.1; 4.1-41.3), presence of frothing (13.7; 4.0-47.3), and occurrence in sleep (8.3; 2.0-34.9). As a case definition using only three variables did not provide sufficient specificity, three more variables were added based on univariate analysis of the data (incontinence during the episode and unconsciousness) and review of literature (injury during episode). A case definition consisting of giving one point to an affirmative answer for each of the six questions was tested. At a cutoff point of four, sensitivity was 56.9 (47.4-66.0) and specificity, 96.3 (86.2-99.4). Among the 197 GTCS and 26 new non-GTCS patients recruited from hospitals from select SEAR Member Countries, in phase III, the sensitivity of this clinical case definition was 72% and specificity, 100%. A stratified analysis by gender in all the three phases did not show any differences between the sexes. Based on these criteria, we recommend that all patients with a history of two or more episodes of jerking or rigidity of limbs, having a score of > or =4 in the case definition, be identified as having GTCSs and started on antiepileptic medications. This clinical case definition can be very useful for community-based health care providers to identify and manage cases of GTCSs in the community. This should play a major role in the reduction of treatment gap for epilepsy in developing countries.

Leadership and governance of community health worker programmes at scale: a cross case analysis of provincial implementation in South Africa.

PubMed

Schneider, Helen; Nxumalo, Nonhlanhla

2017-09-15

National community health worker (CHW) programmes are returning to favour as an integral part of primary health care systems, often on the back of pre-existing community based initiatives. There are significant challenges to the integration and support of such programmes, and they require coordination and stewardship at all levels of the health system. This paper explores the leadership and governance tasks of large-scale CHW programmes at sub-national level, through the case of national reforms to South Africa's community based sector, referred to as the Ward Based Outreach Team (WBOT) strategy. A cross case analysis of leadership and governance roles, drawing on three case studies of adoption and implementation of the WBOTs strategy at provincial level (Western Cape, North West and Gauteng) was conducted. The primary case studies mapped system components and assessed implementation processes and contexts. They involved teams of researchers and over 200 interviews with stakeholders from senior to frontline, document reviews and analyses of routine data. The secondary, cross case analysis specifically focused on the issues and challenges facing, and strategies adopted by provincial and district policy makers and managers, as they engaged with the new national mandate. From this key sub-national leadership and governance roles were formulated. Four key roles are identified and discussed: 1. Negotiating a fit between national mandates and provincial and district histories and strategies of community based services 2. Defining new organisational and accountability relationships between CHWs, local health services, communities and NGOs 3. Revising and developing new aligned and integrated planning, human resource, financing and information systems 4. Leading change by building new collective visions, mobilising political, including budgetary, support and designing implementation strategies. This analysis, from real-life systems, adds to understanding of the processes involved in developing CHW programmes at scale, and specifically the negotiated and multilevel nature of leadership and governance in such programmes, spanning analytic, managerial, technical and political roles.

A Community-Based Activities Survey: Systematically Determining the Impact on and of Faculty

ERIC Educational Resources Information Center

Perry, Lane; Farmer, Betty; Onder, David; Tanner, Benjamin; Burton, Carol

2015-01-01

As a descriptive case study from Western Carolina University (WCU), this article describes the development of a measuring, monitoring, and tracking system (the WCU Community-based Activities Survey) for faculty engagement in, adoption of, and impact through community engagement practices both internal and external to their courses. This paper will…

Recruitment Strategies and Costs Associated with Community-Based Research in a Mexican-Origin Population

ERIC Educational Resources Information Center

Mendez-Luck, Carolyn A.; Trejo, Laura; Miranda, Jeanne; Jimenez, Elizabeth; Quiter, Elaine S.; Mangione, Carol M.

2011-01-01

Purpose: We describe the recruitment strategies and personnel and materials costs associated with two community-based research studies in a Mexican-origin population. We also highlight the role that academic-community partnerships played in the outreach and recruitment process for our studies. We reviewed study documents using case study…

International Community-Based Service Learning: Two Comparative Case Studies of Benefits and Tensions

ERIC Educational Resources Information Center

Akhurst, Jacqueline

2016-01-01

The drives to internationalise the UK curriculum and psychology students' desires to work in communities are brought together in this paper. International community-based learning (ICBL) links with many psychology students' motivations to make contributions to others; with the potential to enhance students' learning and cultural sensitivities. The…

Institutionalizing Community-Based Learning and Research: The Case for External Networks

ERIC Educational Resources Information Center

Shrader, Elizabeth; Saunders, Mary Anne; Marullo, Sam; Benatti, Sylvia; Weigert, Kathleen Maas

2008-01-01

Conversations continue as to whether and how community-based learning and research (CBLR) can be most effectively integrated into the mission and practice of institutions of higher education (IHEs). In 2005, eight District of Columbia- (DC-) area universities affiliated with the Community Research and Learning (CoRAL) Network engaged in a planning…

Systems Thinking Tools as Applied to Community-Based Participatory Research: A Case Study

ERIC Educational Resources Information Center

BeLue, Rhonda; Carmack, Chakema; Myers, Kyle R.; Weinreb-Welch, Laurie; Lengerich, Eugene J.

2012-01-01

Community-based participatory research (CBPR) is being used increasingly to address health disparities and complex health issues. The authors propose that CBPR can benefit from a systems science framework to represent the complex and dynamic characteristics of a community and identify intervention points and potential "tipping points."…

An academic practice's transition to the business of medicine in the community. A case study.

PubMed

Griffin, S L; Schryver, D L

2000-01-01

This case study highlights the problems confronting a clinical practice corporation affiliated with a major medical school, and the business realizations it made in the acquisition of a community-based clinic. Launching a financially viable enterprise requires careful planning, determination of formal goals and expectations, an appropriate mix of physicians and services, a specific marketing campaign and community support.

Linking case management and community development.

PubMed

Austin, Carol D; McClelland, Robert W; Gursansky, Di

2006-01-01

Case management, in various forms, is now institutionalized as a core part of policy and programs designed to deliver home- and community-based services to older adults. The case management role, in theory, requires attention to both client and system goals, although in practice the system goals that have received most attention have been gatekeeping and resource allocation. While case managers have been admonished to find and develop resources in the community, this has primarily taken the form of including informal services in individual client care plans. What has been missing is focused attention to the potential of the community as a nurturing environment with the capacity to support older adults and their caregivers. Sustainable care for older adults cannot be achieved by formal service and family support alone. This article proposes the creation of linkages between case managers, who build the service arrangements for older people, and community developers, who are responsible for building community capacity and social capital. It is argued that this linkage is essential for establishing the foundations of a caring community with the capacity to support older people.

Teaching and Learning Technology and New Media in a Community-Based Program: Adult Educators and Older Learners' Experiences

ERIC Educational Resources Information Center

Hernandez, Regina

2016-01-01

This qualitative case study documented the experiences of two adult educators and four older learners' teaching and learning technology and new media in a community-based program in Texas. The research questions guiding this study included: (1) What can we learn from looking at the educational efforts of a community-based programs offering…

Indoor pollution as an occupational risk factor for tuberculosis among women: a population-based, gender oriented, case-control study in Southern Mexico.

PubMed

García-Sancho, Ma Cecilia; García-García, Lourdes; Báez-Saldaña, Renata; Ponce-De-León, Alfredo; Sifuentes-Osornio, José; Bobadilla-Del-valle, Miriam; Ferreyra-Reyes, Leticia; Cano-Arellano, Bulmaro; Canizales-Quintero, Sergio; Palacios-Merino, Luz del Carmen; Juárez-Sandino, Luis; Ferreira-Guerrero, Elizabeth; Cruz-Hervert, Luis Pablo; Small, Peter M; Pérez-Padilla, José Rogelio

2009-01-01

Indoor air pollution produced by biomass cooking fuels in developing countries has been associated with acute and chronic lower respiratory diseases, but has not been identified as an occupational exposure among women. To examine the relationship between the use of biomass cooking fuels (mainly wood) and tuberculosis (TB) among women living in rural areas in Southern Mexico. We conducted a population based case-control study in the health jurisdiction of Orizaba, Mexico. Cases were all incident female pulmonary TB patients, with Mycobacterium tuberculosis in sputum, living in communities with fewer than 15,000 inhabitants, diagnosed between March 1995 and April 2003. Woodsmoke exposure was assessed by applying a standardized questionnaire (ATS-DLD-78 questionnaire). Controls were randomly selected from sex-matched neighbors. Appropriate IRB approval was obtained. 42 TB cases and 84 community controls were recruited. Multivariate assessment showed that more than 20 years of exposure to smoke from biomass fuels was three times more frequent among cases than among controls [Odds ratio (OR): 3.3, 95% confidence interval (CI):1.06-10.30, p = 0.03], after controlling for age, body mass, household crowding, years of formal education and tobacco use. We found a strong association between the use of biomass cooking fuels and tuberculosis among women in a community-based, case-control study. Results of this study are intended to provide evidence to policy makers, community leaders and the general public on the importance of implementing gender oriented interventions that decrease the use of biomass fuels in poor communities in developing countries.

Predicting the decisions of hospital based child protection teams to report to child protective services, police and community welfare services.

PubMed

Benbenishty, Rami; Jedwab, Merav; Chen, Wendy; Glasser, Saralee; Slutzky, Hanna; Siegal, Gil; Lavi-Sahar, Zohar; Lerner-Geva, Liat

2014-01-01

This study examines judgments made by hospital-based child protection teams (CPTs) when determining if there is reasonable suspicion that a child has been maltreated, and whether to report the case to a community welfare agency, to child protective services (CPS) and/or to the police. A prospective multi-center study of all 968 consecutive cases referred to CPTs during 2010-2011 in six medical centers in Israel. Centers were purposefully selected to represent the heterogeneity of medical centers in Israel in terms of size, geographical location and population characteristics. A structured questionnaire was designed to capture relevant information and judgments on each child referred to the team. Bivariate associations and multivariate multinomial logistic regressions were conducted to predict whether the decisions would be (a) to close the case, (b) to refer the case to community welfare services, or (c) to report it to CPS and/or the police. Bivariate and multivariate analyses identified a large number of case characteristics associated with higher probability of reporting to CPS/police or of referral to community welfare services. Case characteristics associated with the decisions include socio-demographic (e.g., ethnicity and financial status), parental functioning (e.g., mental health), previous contacts with authorities and hospital, current referral characteristics (e.g., parental referral vs. child referral), physical findings, and suspicious behaviors of child and parent. Most of the findings suggest that decisions of CPTs are based on indices that have strong support in the professional literature. Existing heterogeneity between cases, practitioners and medical centers had an impact on the overall predictability of the decision to report. Attending to collaboration between hospitals and community agencies is suggested to support learning and quality improvement. Copyright © 2013 Elsevier Ltd. All rights reserved.

Community-based shared values as a 'Heart-ware' driver for integrated watershed management: Japan-Malaysia policy learning perspective

NASA Astrophysics Data System (ADS)

Mohamad, Zeeda Fatimah; Nasaruddin, Affan; Abd Kadir, Siti Norasiah; Musa, Mohd Noor; Ong, Benjamin; Sakai, Nobumitsu

2015-11-01

This paper explores the case for using ;community-based shared values; as a potential driver for the ;Heartware; aspects of governance in Integrated Watershed Management (IWM) - from a Japan-Malaysia policy learning perspective. This policy approach was originally inspired by the Japanese experience, and the paper investigates whether a similar strategy can be adapted in the Malaysian context-based on a qualitative exploratory case study of a local downstream watershed community. The community-based shared values are categorized into six functional values that can be placed on a watershed: industry, ecosystem, lifestyle, landscape, water resource and spirituality. The study confirmed the availability of a range of community-based shared values in each category that are promising to drive the heartware for integrated watershed management in the local Malaysian context. However, most of these shared values are either declining in its appreciation or nostalgic in nature. The paper ends with findings on key differences and similarities between the Malaysian and Japanese contexts, and concludes with lessons for international transfer of IWM heartware policy strategies between the two countries.

INCORPORATING NONCHEMICAL STRESSORS INTO CUMMULATIVE RISK ASSESSMENTS

EPA Science Inventory

The risk assessment paradigm has begun to shift from assessing single chemicals using "reasonable worst case" assumptions for individuals to considering multiple chemicals and community-based models. Inherent in community-based risk assessment is examination of all stressors a...

Rule-based exposure assessment versus case-by-case expert assessment using the same information in a community-based study.

PubMed

Peters, Susan; Glass, Deborah C; Milne, Elizabeth; Fritschi, Lin

2014-03-01

Retrospective exposure assessment in community-based studies is largely reliant on questionnaire information. Expert assessment is often used to assess lifetime occupational exposures, but these assessments generally lack transparency and are very time-consuming. We explored the agreement between a rule-based assessment approach and case-by-case expert assessment of occupational exposures in a community-based study. We used data from a case-control study of childhood acute lymphoblastic leukaemia in which parental occupational exposures were originally assigned by expert assessment. Key questions were identified from the completed parent questionnaires and, on the basis of these, rules were written to assign exposure levels to diesel exhaust, pesticides and solvents. We estimated exposure prevalence separately for fathers and mothers, and used κ statistics to assess the agreement between the two exposure assessment methods. Exposures were assigned to 5829 jobs among 1079 men and 6189 jobs among 1234 women. For both sexes, agreement was good for the two assessment methods of exposure to diesel exhaust at a job level (κ=0.70 for men and κ=0.71 for women) and at a person level (κ=0.74 and κ=0.75). The agreement was good to excellent for pesticide exposure among men (κ=0.74 for jobs and κ=0.84 at a person level) and women (κ=0.68 and κ=0.71 at a job and person level, respectively). Moderate to good agreement was observed for assessment of solvent exposure, which was better for women than men. The rule-based assessment approach appeared to be an efficient alternative for assigning occupational exposures in a community-based study for a selection of occupational exposures.

Promoting Environmental Justice through Community-Based Participatory Research: The Role of Community and Partnership Capacity

ERIC Educational Resources Information Center

Minkler, Meredith; Vasquez, Victoria Breckwich; Tajik, Mansoureh; Petersen, Dana

2008-01-01

Community-based participatory research (CBPR) increasingly is being used to study and address environmental justice. This article presents the results of a cross-site case study of four CBPR partnerships in the United States that researched environmental health problems and worked to educate legislators and promote relevant public policy. The…

A Case for Community-Run Pre-Schools and Daycare Centres.

ERIC Educational Resources Information Center

Renard, Rosamunde

This booklet advocates and describes the establishment of community run preschool and day care centers. The type described is based on the Laborie Community Education Centre in Saint Lucia, West Indies. Chapter 1 advocates establishing small, local institutions that are community managed, community owned, concerned with quality, and sustainable.…

Roles of Urban Indigenous Community Members in Collaborative Field-Based Teacher Preparation

ERIC Educational Resources Information Center

Lees, Anna

2016-01-01

This qualitative case study explored a community-university partnership for teacher preparation with an urban Indigenous community organization. The study examined the roles of Indigenous community partners as co-teacher educators working to better prepare teachers for the needs of urban Indigenous children and communities. The author collected…

Building research infrastructure in community health centers: a Community Health Applied Research Network (CHARN) report.

PubMed

Likumahuwa, Sonja; Song, Hui; Singal, Robbie; Weir, Rosy Chang; Crane, Heidi; Muench, John; Sim, Shao-Chee; DeVoe, Jennifer E

2013-01-01

This article introduces the Community Health Applied Research Network (CHARN), a practice-based research network of community health centers (CHCs). Established by the Health Resources and Services Administration in 2010, CHARN is a network of 4 community research nodes, each with multiple affiliated CHCs and an academic center. The four nodes (18 individual CHCs and 4 academic partners in 9 states) are supported by a data coordinating center. Here we provide case studies detailing how CHARN is building research infrastructure and capacity in CHCs, with a particular focus on how community practice-academic partnerships were facilitated by the CHARN structure. The examples provided by the CHARN nodes include many of the building blocks of research capacity: communication capacity and "matchmaking" between providers and researchers; technology transfer; research methods tailored to community practice settings; and community institutional review board infrastructure to enable community oversight. We draw lessons learned from these case studies that we hope will serve as examples for other networks, with special relevance for community-based networks seeking to build research infrastructure in primary care settings.

Building Research Infrastructure in Community Health Centers: A Community Health Applied Research Network (CHARN) Report

PubMed Central

Likumahuwa, Sonja; Song, Hui; Singal, Robbie; Weir, Rosy Chang; Crane, Heidi; Muench, John; Sim, Shao-Chee; DeVoe, Jennifer E.

2015-01-01

This article introduces the Community Health Applied Research Network (CHARN), a practice-based research network of community health centers (CHCs). Established by the Health Resources and Services Administration in 2010, CHARN is a network of 4 community research nodes, each with multiple affiliated CHCs and an academic center. The four nodes (18 individual CHCs and 4 academic partners in 9 states) are supported by a data coordinating center. Here we provide case studies detailing how CHARN is building research infrastructure and capacity in CHCs, with a particular focus on how community practice-academic partnerships were facilitated by the CHARN structure. The examples provided by the CHARN nodes include many of the building blocks of research capacity: communication capacity and “matchmaking” between providers and researchers; technology transfer; research methods tailored to community practice settings; and community institutional review board infrastructure to enable community oversight. We draw lessons learned from these case studies that we hope will serve as examples for other networks, with special relevance for community-based networks seeking to build research infrastructure in primary care settings. PMID:24004710

Community-based screening for obstetric fistula in Nigeria: a novel approach

PubMed Central

2014-01-01

Background Obstetric fistula continues to have devastating effects on the physical, social, and economic lives of thousands of women in many low-resource settings. Governments require credible estimates of the backlog of existing cases requiring care to effectively plan for the treatment of fistula cases. Our study aims to quantify the backlog of obstetric fistula cases within two states via community-based screenings and to assess the questions in the Demographic Health Survey (DHS) fistula module. Methods The screening sites, all lower level health facilities, were selected based on their geographic coverage, prior relationships with the communities and availability of fistula surgery facilities in the state. This cross-sectional study included women who presented for fistula screenings at study facilities based on their perceived fistula-like symptoms. Research assistants administered the pre-screening questionnaire. Nurse-midwives then conducted a medical exam. Univariate and bivariate analyses are presented. Results A total of 268 women attended the screenings. Based on the pre-screening interview, the backlog of fistula cases reported was 75 (28% of women screened). The backlog identified after the medical exam was 26 fistula cases (29.5% of women screened) in Kebbi State sites and 12 cases in Cross River State sites (6.7%). Verification assessment showed that the DHS questionnaire had 92% sensitivity, 83% specificity with 47% positive predictive value and 98% negative predictive value for identifying women afflicted by fistula among women who came for the screenings. Conclusions This methodology, involving effective, locally appropriate messaging and community outreach followed up with medical examination by nurse-midwives at lower level facilities, is challenging, but represents a promising approach to identify the backlog of women needing surgery and to link them with surgical facilities. PMID:24456506

Using computer aided case based reasoning to support clinical reasoning in community occupational therapy.

PubMed

Taylor, Bruce; Robertson, David; Wiratunga, Nirmalie; Craw, Susan; Mitchell, Dawn; Stewart, Elaine

2007-08-01

Community occupational therapists have long been involved in the provision of environmental control systems. Diverse electronic technologies with the potential to improve the health and quality of life of selected clients have developed rapidly in recent years. Occupational therapists employ clinical reasoning in order to determine the most appropriate technology to meet the needs of individual clients. This paper describes a number of the drivers that may increase the adoption of information and communication technologies in the occupational therapy profession. It outlines case based reasoning as understood in the domains of expert systems and knowledge management and presents the preliminary results of an ongoing investigation into the potential of a prototype computer aided case based reasoning tool to support the clinical reasoning of community occupational therapists in the process of assisting clients to choose home electronic assistive or smart house technology.

Cost and cost-effectiveness of community-based care for tuberculosis in Cape Town, South Africa.

PubMed

Sinanovic, E; Floyd, K; Dudley, L; Azevedo, V; Grant, R; Maher, D

2003-09-01

Guguletu and Nyanga areas of Cape Town, South Africa. To evaluate the affordability and cost-effectiveness of community involvement in tuberculosis (TB) care. A cost-effectiveness analysis comparing treatment for new smear-positive pulmonary and retreatment TB patients in two similar townships, one providing clinic-based-care with community-based observation options available for its TB patients (Guguletu) and one providing clinic-based care only, with no community-based observation of treatment (Nyanga). Costs were assessed from a societal perspective in 1997 US dollars, and cost-effectiveness was calculated as the cost per patient successfully treated. TB treatment in Guguletu was more cost-effective than TB treatment in Nyanga for both new and retreatment patients (dollars 726 vs. dollars 1201 and dollars 1419 vs. dollars 2058, respectively). This reflected both lower costs (dollars 495 vs. dollars 769 per patient treated for new cases; dollars 823 vs. dollars 1070 per patient treated for retreatment cases) and better treatment outcomes (successful treatment rate 68% vs. 64% and 58% vs. 52% for new and retreatment patients, respectively). Within Guguletu, community-based care was more than twice as cost-effective as clinic-based care (dollars 392 vs. dollars 1302 per patient successfully treated for new patients, and dollars 766 vs. dollars 2008 for retreatment patients), for similar reasons (e.g., for new cases, dollars 314 vs. dollars 703 per patient treated, successful treatment rate 80% vs. 54%). Community involvement in TB care can improve the affordability and cost-effectiveness of TB treatment in urban South Africa. Expansion in the Western Cape and in similar areas of the country is worthy of serious consideration by planners and policy-makers.

Incidental Becomes Visible: A Comparison of School- and Community-Based Field Experience Narratives

ERIC Educational Resources Information Center

Holder, K. C.; Downey, Jayne A.

2008-01-01

The purpose of this study was to describe and compare student learning documented using written field experience summary narratives and occurring in community-based or school-based locations. Utilizing a hybrid portraiture--instrumental case study design, two researchers selected participants from undergraduate educational psychology courses using…

Links between real and virtual networks: a comparative study of online communities in Japan and Korea.

PubMed

Ishii, Kenichi; Ogasahara, Morihiro

2007-04-01

The present study explores how online communities affect real-world personal relations based on a cross-cultural survey conducted in Japan and Korea. Findings indicate that the gratifications of online communities moderate the effects of online communities on social participation. Online communities are categorized into a real-group-based community and a virtual-network-based community. The membership of real-group-based online community is positively correlated with social bonding gratification and negatively correlated with information- seeking gratification. Japanese users prefer more virtual-network-based online communities, while their Korean counterparts prefer real-group-based online communities. Korean users are more active in online communities and seek a higher level of socializing gratifications, such as social bonding and making new friends, when compared with their Japanese counterparts. These results indicate that in Korea, personal relations via the online community are closely associated with the real-world personal relations, but this is not the case in Japan. This study suggests that the effects of the Internet are culture-specific and that the online community can serve a different function in different cultural environments.

The Keys to Governance and Stakeholder Engagement: The Southeast Michigan Beacon Community Case Study

PubMed Central

Des Jardins, Terrisca R.

2014-01-01

Community-based health information exchanges (HIEs) and efforts to consolidate and house data are growing, given the advent of Accountable Care Organizations (ACOs) under the Affordable Care Act and other similar population health focused initiatives. The Southeast Michigan Beacon Community (SEMBC) can be looked to as one case study that offers lessons learned, insights on challenges faced and accompanying workarounds related to governance and stakeholder engagement. The SEMBC case study employs an established Data Warehouse Governance Framework to identify and explain the necessary governance and stakeholder engagement components, particularly as they relate to community-wide data sharing and data warehouses or repositories. Perhaps the biggest lesson learned through the SEMBC experience is that community-based work is hard. It requires a great deal of community leadership, collaboration and resources. SEMBC found that organizational structure and guiding principles needed to be continually revisited and nurtured in order to build the relationships and trust needed among stakeholder organizations. SEMBC also found that risks and risk mitigation tactics presented challenges and opportunities at the outset and through the duration of the three year pilot period. Other communities across the country embarking on similar efforts need to consider realistic expectations about community data sharing infrastructures and the accompanying and necessary governance and stakeholder engagement fundamentals. PMID:25848612

Evaluation of Viewpoints of Health Care Professionals on the Role of Ethics Committees and Hospitals in the Resolution of Clinical Ethical Dilemmas Based on Practice Environment.

PubMed

Marcus, Brian S; Carlson, Jestin N; Hegde, Gajanan G; Shang, Jennifer; Venkat, Arvind

2016-03-01

We sought to evaluate whether health care professionals' viewpoints differed on the role of ethics committees and hospitals in the resolution of clinical ethical dilemmas based on practice location. We conducted a survey study from December 21, 2013 to March 15, 2014 of health care professionals at six hospitals (one tertiary care academic medical center, three large community hospitals and two small community hospitals). The survey consisted of eight clinical ethics cases followed by statements on whether there was a role for the ethics committee or hospital in their resolution, what that role might be and case specific queries. Respondents used a 5-point Likert scale to express their degree of agreement with the premises posed. We used the ANOVA test to evaluate whether respondent views significantly varied based on practice location. 240 health care professionals (108-tertiary care center, 92-large community hospitals, 40-small community hospitals) completed the survey (response rate: 63.6 %). Only three individual queries of 32 showed any significant response variations across practice locations. Overall, viewpoints did not vary across practice locations within question categories on whether the ethics committee or hospital had a role in case resolution, what that role might be and case specific queries. In this multicenter survey study, the viewpoints of health care professionals on the role of ethics committees or hospitals in the resolution of clinical ethics cases varied little based on practice location.

Community-Engagement Strategies of the Developmental Disabilities Practice-Based Research Network (DD-PBRN)

PubMed Central

Tyler, Carl; Werner, James J.

2016-01-01

There is often a rich but untold history of events that occurred and relationships that formed prior to the launching of a practice-based research network (PBRN.) This is particularly the case in PBRNs that are community-based and comprised of partnerships outside of the health care system. In this article we summarize an organizational "prenatal history" prior to the birth of a PBRN devoted to persons with developmental disabilities. Using a case study approach, this article describes the historical events that preceded and fostered the evolution of this PBRN and contrasts how the processes leading to the creation of this multi-stakeholder community-based PBRN differ from those of typical academic-clinical practice PBRNs. We propose potential advantages and complexities inherent to this newest iteration of PBRNs. PMID:25381081

Using Case-Based Pedagogy in the Philippines: A Narrative Inquiry

NASA Astrophysics Data System (ADS)

Arellano, Elvira L.; Barcenal, Tessie L.; Bilbao, Purita P.; Castellano, Merilin A.; Nichols, Sharon E.; Tippins, Deborah J.

2001-04-01

This study features use of case-based pedagogy as a context for exploring science teacher education reform. A central premise of the study is that science teacher education reform is a complex process characterised by the individual and collective narrative histories of teachers. The study was conducted at West Visayas State University in the Philippines as a collaborative research endeavour involving two US and four Filipino science teacher educators. The centrepiece of this study was a case experience prompted by reflection on prospective and practicing elementary teachers' written cases. Results of the study are presented here as a layered narrative. An initial layer explores how a case, written by a prospective teacher, was interwoven with her past and future life history. A second layer looks at sociocultural and professional tensions that mediated the participants' case experience. A third layer represents how the case experience provided a community that supported critical reflection among the research team members. Implications from the study emphasise that case-based pedagogy can serve as a basis for critical reflection to inform community-based approaches to science teacher education pedagogical and research reform.

Dialogical action: moving from community-based to community-driven participatory research.

PubMed

Montoya, Michael J; Kent, Erin E

2011-07-01

Proponents of community-based research advocate for the active involvement and engagement of community members, citing improved construct validity, intervention efficacy, and accountability. However, to create the conditions in which expertise is mutually constructed and in which no one is the object of research, a reconsideration of the fundamental ethos of community involvement and engagement is required. In this article, we seek to accomplish two goals: (a) to briefly assess the definitions of community health, focus groups, and dissemination that are often used in community-based research; and (b) to introduce an application of dialogical action that goes beyond traditional focus group methodology to promote the creation of an evolving and dynamic dialogue among campus and community stakeholders. An urban case study is presented.

Improving knowledge and behaviours related to the cause, transmission and prevention of Tuberculosis and early case detection: a descriptive study of community led Tuberculosis program in Flores, Indonesia.

PubMed

Dewi, Christa; Barclay, Lesley; Passey, Megan; Wilson, Shawn

2016-08-08

The community's awareness of Tuberculosis (TB) and delays in health care seeking remain important issues in Indonesia despite the extensive efforts of community-based TB programs delivered by a non-government organisation (NGO). This study explored the knowledge and behaviours in relation to TB and early diagnosis before and after an asset-based intervention designed to improve these issues. Six villages in Flores, Indonesia were purposively selected to participate in this study. Three villages served as intervention villages and the other three villages provided a comparison group. Data collection included interviews, group discussions, observations, field notes and audit of records. In total, 50 participants across six villages were interviewed and three group discussions were conducted in the intervention villages supplemented by 1 - 5 h of observation during monthly visits. Overall, participants in all villages had limited knowledge regarding the cause and transmission of TB before the intervention. The delay in health seeking behaviour was mainly influenced by ignorance of TB symptoms. Health care providers also contributed to delayed diagnosis by ignoring the symptoms of TB suspects at the first visit and failing to examine TB suspects with sputum tests. Stigmatisation of TB patients by the community was reported, although this did not seem to be common. Early case detection was less than 50 % in four of the six villages before the asset-based intervention. Knowledge of TB improved after the intervention in the intervention villages alongside improved education activities. Early case detection also increased in the intervention villages following this intervention. The behaviour changes related to prevention of TB were also obvious in the intervention villages but not the comparison group. This small project demonstrated that an asset-based intervention can result in positive changes in community's knowledge and behaviour in relation to TB and early case detection. A continuing education process is like to be required to maintain this outcome and to reach a wider community. Promoting community involvement and local initiatives and engaging health care providers were important elements in the community-based TB program implemented.

Faculty and Community Collaboration in Sustained Community-University Engagement Partnerships

ERIC Educational Resources Information Center

Allen, Angela Danyell

2009-01-01

This dissertation is a qualitative case study of the factors of collaboration between faculty and community partners in sustained community-university engagement partnerships at a public research university in the Midwest. Based on secondary data from an annual, online, mixed-method survey of faculty-reported engagement activity, parallel yet…

Preventing Truancy and Dropout among Urban Middle School Youth: Understanding Community-Based Action from the Student's Perspective

ERIC Educational Resources Information Center

Rodriguez, Louie F.; Conchas, Gilberto Q.

2009-01-01

This case study explores how a community-based truancy prevention program mediates against absenteeism, truancy, and dropping out and positively transforms the lives of Black and Latina/Latino middle school youth. Findings suggest that community-school partnerships are critical in the quest to combat truancy and the alarming dropout rate among…

Shared Values as Anchors of a Learning Community: A Case Study in Information Systems Design

ERIC Educational Resources Information Center

Giordano, Daniela

2004-01-01

This paper examines the role in both individual and organizational learning of the system of values sustained by a community undertaking a design task. The discussion is based on the results of a longitudinal study of a community of novice information system designers supported by a Web-based shared design memory which allows reuse of design…

Elevating "Low" Language for High Stakes: A Case for Critical, Community-Based Learning in a Medical Spanish for Heritage Learners Program

ERIC Educational Resources Information Center

Martinez, Glenn; Schwartz, Adam

2012-01-01

Critical approaches to Spanish heritage language (SHL) pedagogy have called for more meaningful engagement with heritage language communities (Leeman, 2005). In a recent survey, furthermore, SHL students expressed a desire for more community-based activities in SHL curricula (Beaudrie, Ducar, & Relano-Pastor, 2009). This paper reports on the…

"We make the path by walking it": building an academic community partnership with Boston Chinatown.

PubMed

Rubin, Carolyn Leung; Allukian, Nathan; Wang, Xingyue; Ghosh, Sujata; Huang, Chien-Chi; Wang, Jacy; Brugge, Doug; Wong, John B; Mark, Shirley; Dong, Sherry; Koch-Weser, Susan; Parsons, Susan K; Leslie, Laurel K; Freund, Karen M

2014-01-01

The potential for academic community partnerships are challenged in places where there is a history of conflict and mistrust. Addressing Disparities in Asian Populations through Translational Research (ADAPT) represents an academic community partnership between researchers and clinicians from Tufts Medical Center and Tufts University and community partners from Boston Chinatown. Based in principles of community-based participatory research and partnership research, this partnership is seeking to build a trusting relationship between Tufts and Boston Chinatown. This case study aims to provides a narrative story of the development and formation of ADAPT as well as discuss challenges to its future viability. Using case study research tools, this study draws upon a variety of data sources including interviews, program evaluation data and documents. Several contextual factors laid the foundation for ADAPT. Weaving these factors together helped to create synergy and led to ADAPT's formation. In its first year, ADAPT has conducted formative research, piloted an educational program for community partners and held stakeholder forums to build a broad base of support. ADAPT recognizes that long term sustainability requires bringing multiple stakeholders to the table even before a funding opportunity is released and attempting to build a diversified funding base.

A sham case-control study of effectiveness of DTP-Hib-hepatitis B vaccine against rotavirus acute gastroenteritis in Kenya

PubMed Central

2014-01-01

Background In many GAVI-eligible countries, effectiveness of new vaccines will be evaluated by case-control methodology. To inform the design and assess selection bias of a future case-control study of rotavirus vaccine effectiveness (VE) in western Kenya, we performed a sham case-control study evaluating VE of pentavalent vaccine (DTP-Hib-HepB) against rotavirus acute gastroenteritis (AGE). Methods From ongoing rotavirus surveillance, we defined cases as children 12 weeks to 23 months old with EIA-confirmed rotavirus AGE. We enrolled one community-based and two hospital-based control groups. We collected vaccination status from cards at enrollment, or later in homes, and evaluated VE by logistic regression. Results We enrolled 91 cases (64 inpatient, 27 outpatient), 252 non-rotavirus AGE facility-based controls (unmatched), 203 non-AGE facility-based controls (age-matched) and 271 community controls (age-matched). Documented receipt of 3 pentavalent doses was 77% among cases and ranged from 81-86% among controls. One percent of cases and 0-2% of controls had no pentavalent doses. The adjusted odds ratio of three versus zero doses for being a case was 3.27 (95% CI 0.01-1010) for community controls and 0.69 (95% CI 0.06-7.75) for non-rotavirus hospital-based AGE controls, translating to VE of -227% and 31%, respectively, with wide confidence intervals. (No facility-based non-AGE controls were unvaccinated.) Similar results were found for ≥2 pentavalent doses and for severe rotavirus AGE. Conclusions The study showed that it is feasible to carry out a real case control in the study area, but this needs to be done as soon as the vaccine is introduced to capture the real impact. Sham case-control or pilot studies before vaccine introduction can be useful in designing case-control VE studies. PMID:24517198

A sham case-control study of effectiveness of DTP-Hib-hepatitis B vaccine against rotavirus acute gastroenteritis in Kenya.

PubMed

Khagayi, Sammy; Tate, Jacqueline E; Onkoba, Reuben; Parashar, Umesh; Odhiambo, Frank; Burton, Deron; Laserson, Kayla; Feikin, Daniel R

2014-02-11

In many GAVI-eligible countries, effectiveness of new vaccines will be evaluated by case-control methodology. To inform the design and assess selection bias of a future case-control study of rotavirus vaccine effectiveness (VE) in western Kenya, we performed a sham case-control study evaluating VE of pentavalent vaccine (DTP-Hib-HepB) against rotavirus acute gastroenteritis (AGE). From ongoing rotavirus surveillance, we defined cases as children 12 weeks to 23 months old with EIA-confirmed rotavirus AGE. We enrolled one community-based and two hospital-based control groups. We collected vaccination status from cards at enrollment, or later in homes, and evaluated VE by logistic regression. We enrolled 91 cases (64 inpatient, 27 outpatient), 252 non-rotavirus AGE facility-based controls (unmatched), 203 non-AGE facility-based controls (age-matched) and 271 community controls (age-matched). Documented receipt of 3 pentavalent doses was 77% among cases and ranged from 81-86% among controls. One percent of cases and 0-2% of controls had no pentavalent doses. The adjusted odds ratio of three versus zero doses for being a case was 3.27 (95% CI 0.01-1010) for community controls and 0.69 (95% CI 0.06-7.75) for non-rotavirus hospital-based AGE controls, translating to VE of -227% and 31%, respectively, with wide confidence intervals. (No facility-based non-AGE controls were unvaccinated.) Similar results were found for ≥2 pentavalent doses and for severe rotavirus AGE. The study showed that it is feasible to carry out a real case control in the study area, but this needs to be done as soon as the vaccine is introduced to capture the real impact. Sham case-control or pilot studies before vaccine introduction can be useful in designing case-control VE studies.

A Case Study Examination of Best Practices of Professional Learning Communities

ERIC Educational Resources Information Center

Akopoff, Tanya M.

2010-01-01

A current trend in education is that small teacher groups, called professional learning communities (PLC), are being advocated as a tool to help teachers reach struggling students. Educators planning to use PLC as an intervention strategy can benefit from research-based information about PLC best practices. This multiple case study addressed the…

The "One Voice" Project: A Case of Complexity in Community-Driven Education Reform

ERIC Educational Resources Information Center

Davis, Natalie R.; Monroe, Xavier J.; Drake, Thomas M.

2018-01-01

This case represents an effort to connect academic learning with educational reform in real time. It describes a district initiative to meaningfully engage a skeptical community and the subsequent attempts of university-based researchers to provide further entry points into the perspectives and concerns of educational partners. What is compelling…

Answering the Call for Accountability: An Activity and Cost Analysis Case Study

ERIC Educational Resources Information Center

Carducci, Rozana; Kisker, Carrie B.; Chang, June; Schirmer, James

2007-01-01

This article summarizes the findings of a case study on the creation and application of an activity-based cost accounting model that links community college salary expenditures to mission-critical practices within academic divisions of a southern California community college. Although initially applied as a financial management tool in private…

Community pharmacy-based point-of-care testing: A case study of pharmacist-physician collaborative working relationships.

PubMed

Bacci, Jennifer L; Klepser, Donald; Tilley, Heather; Smith, Jaclyn K; Klepser, Michael E

2018-01-01

Building collaborative working relationships (CWRs) with physicians or other prescribers is an important step for community pharmacists in establishing a collaborative practice agreement (CPA). This case study describes the individual, context, and exchange factors that drive pharmacist-physician CWR development for community pharmacy-based point-of-care (POC) testing. Two physicians who had entered in a CPA with community pharmacists to provide POC testing were surveyed and interviewed. High scores on the pharmacist-physician collaborative index indicated a high level of collaboration between the physicians and the pharmacist who initiated the relationship. Trust was established through the physicians' personal relationships with the pharmacist or due to the community pharmacy organization's strong reputation. The physicians' individual perceptions of community pharmacy-based POC testing affected their CWRs and willingness to establish a CPA. These findings suggest that exchange characteristics remain significant factors in CWR development. Individual factors may also contribute to physicians' willingness to advance their CWR to include a CPA for POC testing. Copyright © 2017 Elsevier Inc. All rights reserved.

The business case for provider participation in clinical trials research: an application to the National Cancer Institute's community clinical oncology program.

PubMed

Song, Paula H; Reiter, Kristin L; Weiner, Bryan J; Minasian, Lori; McAlearney, Ann Scheck

2013-01-01

Provider-based research networks (PBRNs) make clinical trials available in community-based practice settings, where most people receive their care, but provider participation requires both financial and in-kind contributions. The aim of this study was to explore whether providers believe there is a business case for participating in PBRNs and what factors contribute to the business case. We use a multiple case study methodology approach to examine the National Cancer Institute's community clinical oncology program, a long-standing federally funded PBRN. Interviews with 41 key informants across five sites, selected on the basis of organizational maturity, were conducted using a semistructured interview guide. We analyzed interview transcripts using an iterative, deductive process to identify themes and subthemes in the data. We found that a business case for provider participation in PBRNs may exist if both direct and indirect financial benefits are identified and included in the analysis and if the time horizon is long enough to allow those benefits to be realized. We identified specific direct and indirect financial benefits that were perceived as important contributors to the business case and the perceived length of time required for a positive return to accrue. As the lack of a business case may result in provider reluctance to participate in PBRNs, knowledge of the benefits we identified may be crucial to encouraging and sustaining participation, thereby preserving patient access to innovative community-based treatments. The results are also relevant to federally funded PBRNs outside of oncology or to providers considering participation in any clinical trials research.

Impact of Web-based Case Conferencing on Cancer Genetics Training Outcomes for Community-based Clinicians

PubMed Central

Blazer, Kathleen R.; Christie, Christina; Uman, Gwen; Weitzel, Jeffrey N.

2013-01-01

Introduction Technology and market forces are driving the demand for cancer risk assessment services in the community setting, where few clinicians are trained to order and interpret predictive genetic tests. City of Hope conducts a three-phase course in genetic cancer risk assessment (GCRA) for community-based clinicians, comprised of distance didactics, face-to-face workshops and 12 months of professional development. As designed, the course cannot meet increasing demands for GCRA training. Action research identified face-to-face workshops as a barrier to increasing course capacity. This study compared the learning effectiveness of Web-based case conferencing to face-to-face training. Methods A quasi-experimental design compared pre-post knowledge, skills and professional self-efficacy outcomes from 2009-2010 course cohorts (n=96). The intervention group (n=52) engaged in Web-based case conferences during distance learning; the comparison group (n=44) participated in the course as originally designed. Results Both groups and all practice disciplines demonstrated significant pre-to-post increases on all measures. Knowledge increases were higher for the intervention group (p < .015); skills and self-efficacy increases were comparable between groups (p < .33 and p < .30, respectively). Discussion Findings support the learning utility of Web-based case conferencing. Further studies may inform the development of tools to assess the impact of Web-based case conferencing on practice change and patient outcomes, in alignment with the highest standards of continuing professional development. PMID:22328115

Nationwide implementation of integrated community case management of childhood illness in Rwanda

PubMed Central

Mugeni, Catherine; Levine, Adam C; Munyaneza, Richard M; Mulindahabi, Epiphanie; Cockrell, Hannah C; Glavis-Bloom, Justin; Nutt, Cameron T; Wagner, Claire M; Gaju, Erick; Rukundo, Alphonse; Habimana, Jean Pierre; Karema, Corine; Ngabo, Fidele; Binagwaho, Agnes

2014-01-01

ABSTRACT Background: Between 2008 and 2011, Rwanda introduced integrated community case management (iCCM) of childhood illness nationwide. Community health workers in each of Rwanda's nearly 15,000 villages were trained in iCCM and equipped for empirical diagnosis and treatment of pneumonia, diarrhea, and malaria; for malnutrition surveillance; and for comprehensive reporting and referral services. Methods: We used data from the Rwanda health management information system (HMIS) to calculate monthly all-cause under-5 mortality rates, health facility use rates, and community-based treatment rates for childhood illness in each district. We then compared a 3-month baseline period prior to iCCM implementation with a seasonally matched comparison period 1 year after iCCM implementation. Finally, we compared the actual changes in all-cause child mortality and health facility use over this time period with the changes that would have been expected based on baseline trends in Rwanda. Results: The number of children receiving community-based treatment for diarrhea and pneumonia increased significantly in the 1-year period after iCCM implementation, from 0.83 cases/1,000 child-months to 3.80 cases/1,000 child-months (P = .01) and 0.25 cases/1,000 child-months to 5.28 cases/1,000 child-months (P<.001), respectively. On average, total under-5 mortality rates declined significantly by 38% (P<.001), and health facility use declined significantly by 15% (P = .006). These decreases were significantly greater than would have been expected based on baseline trends. Conclusions: This is the first study to demonstrate decreases in both child mortality and health facility use after implementing iCCM of childhood illness at a national level. While our study design does not allow for direct attribution of these changes to implementation of iCCM, these results are in line with those of prior studies conducted at the sub-national level in other low-income countries. PMID:25276592

Transgressing the norm: Transformative agency in community-based learning for sustainability in southern African contexts

NASA Astrophysics Data System (ADS)

Lotz-Sisitka, Heila; Mukute, Mutizwa; Chikunda, Charles; Baloi, Aristides; Pesanayi, Tichaona

2017-12-01

Environment and sustainability education processes are often oriented to change and transformation, and frequently involve the emergence of new forms of human activity. However, not much is known about how such change emerges from the learning process, or how it contributes to the development of transformative agency in community contexts. The authors of this article present four cross-case perspectives of expansive learning and transformative agency development in community-based education in southern Africa, studying communities pursuing new activities that are more socially just and sustainable. The four cases of community learning and transformative agency focus on the following activities: (1) sustainable agriculture in Lesotho; (2) seed saving and rainwater harvesting in Zimbabwe; (3) community-based irrigation scheme management in Mozambique; and (4) biodiversity conservation co-management in South Africa. The case studies all draw on cultural-historical activity theory to guide learning and change processes, especially third-generation cultural-historical activity theory (CHAT), which emphasises expansive learning in collectives across interacting activity systems. CHAT researchers, such as the authors of this article, argue that expansive learning can lead to the emergence of transformative agency. The authors extend their transformative agency analysis to probe if and how expansive learning might also facilitate instances of transgressing norms - viewed here as embedded practices which need to be reframed and changed in order for sustainability to emerge.

Effects of seasonal and pandemic influenza on health-related quality of life, work and school absence in England: Results from the Flu Watch cohort study.

PubMed

Fragaszy, Ellen B; Warren-Gash, Charlotte; White, Peter J; Zambon, Maria; Edmunds, William J; Nguyen-Van-Tam, Jonathan S; Hayward, Andrew C

2018-01-01

Estimates of health-related quality of life (HRQoL) and work/school absences for influenza are typically based on medically attended cases or those meeting influenza-like-illness (ILI) case definitions and thus biased towards severe disease. Although community influenza cases are more common, estimates of their effects on HRQoL and absences are limited. To measure quality-adjusted life days and years (QALDs and QALYs) lost and work/school absences among community cases of acute respiratory infections (ARI), ILI and influenza A and B and to estimate community burden of QALY loss and absences from influenza. Flu Watch was a community cohort in England from 2006 to 2011. Participants were followed up weekly. During respiratory illness, they prospectively recorded daily symptoms, work/school absences and EQ-5D-3L data and submitted nasal swabs for RT-PCR influenza testing. Average QALD lost was 0.26, 0.93, 1.61 and 1.84 for ARI, ILI, H1N1pdm09 and influenza B cases, respectively. 40% of influenza A cases and 24% of influenza B cases took time off work/school with an average duration of 3.6 and 2.4 days, respectively. In England, community influenza cases lost 24 300 QALYs in 2010/11 and had an estimated 2.9 million absences per season based on data from 2006/07 to 2009/10. Our QALDs and QALYs lost and work and school absence estimates are lower than previous estimates because we focus on community cases, most of which are mild, may not meet ILI definitions and do not result in healthcare consultations. Nevertheless, they contribute a substantial loss of HRQoL on a population level. © 2017 The Authors. Influenza and Other Respiratory Viruses. Published by John Wiley & Sons Ltd.

Understanding enrolment in community health insurance in sub-Saharan Africa: a population-based case-control study in rural Burkina Faso.

PubMed Central

De Allegri, Manuela; Kouyaté, Bocar; Becher, Heiko; Gbangou, Adjima; Pokhrel, Subhash; Sanon, Mamadou; Sauerborn, Rainer

2006-01-01

OBJECTIVE: To identify factors associated with decision to enrol in a community health insurance (CHI) scheme. METHODS: We conducted a population-based case-control study among 15 communities offered insurance in 2004 in rural Burkina Faso. For inclusion in the study, we selected all 154 enrolled (cases) and a random sample of 393 non-enrolled (controls) households. We used unconditional logistic regression (applying Huber-White correction to account for clustering at the community level) to explore the association between enrolment status and a set of household head, household and community characteristics. FINDINGS: Multivariate analysis revealed that enrolment in CHI was associated with Bwaba ethnicity, higher education, higher socioeconomic status, a negative perception of the adequacy of traditional care, a higher proportion of children living within the household, greater distance from the health facility, and a lower level of socioeconomic inequality within the community, but not with household health status or previous household health service utilization. CONCLUSION: Our study provides evidence that the decision to enrol in CHI is shaped by a combination of household head, household, and community factors. Policies aimed at enhancing enrolment ought to act at all three levels. On the basis of our findings, we discuss specific policy recommendations and highlight areas for further research. PMID:17143458

Teaching community diagnosis to medical students: evaluation of a case study approach.

PubMed

Bair, C W

1980-01-01

A unique case study approach to training medical students in community diagnosis techniques was initiated at the Medical College of Ohio at Toledo. This paper describes the five elements of this teaching method: preliminary specification of target community and data base; group problem-solving requirement; specification of desired output; defined performance objectives; and regularly scheduled time for analysis. Experience with the case study method over two years was evaluated to identify specific strengths and weaknesses. The identified strengths include use of limited educational time to introduce community health problems, development of experience in a collegial team work setting, and specific awareness of the types of data useful to the analysis of community health service problems. Negative evaluations suggested that the method was not conducive to the development of skills in three areas: ability to establish the relative importance of health problems in communities; ability to identify an appropriate health system response to a community health problem from feasible alternatives; and ability to anticipate the community impact of health program modifications or improvements. Potential explanations for these deficiencies include: need for increased didactic support in the classroom for particular skill areas; need to establish a direct field experience in community diagnosis; inappropriateness of the data base used for evaluation of particular skills; and the probability that quantitative analysis, as used in this evaluation, may not be sufficient in and of itself to measure the outcome of a community diagnosis experience.

Integrating community-based participatory research and informatics approaches to improve the engagement and health of underserved populations

PubMed Central

Schaefbauer, Chris L; Campbell, Terrance R; Senteio, Charles; Siek, Katie A; Bakken, Suzanne; Veinot, Tiffany C

2016-01-01

Objective We compare 5 health informatics research projects that applied community-based participatory research (CBPR) approaches with the goal of extending existing CBPR principles to address issues specific to health informatics research. Materials and methods We conducted a cross-case analysis of 5 diverse case studies with 1 common element: integration of CBPR approaches into health informatics research. After reviewing publications and other case-related materials, all coauthors engaged in collaborative discussions focused on CBPR. Researchers mapped each case to an existing CBPR framework, examined each case individually for success factors and barriers, and identified common patterns across cases. Results Benefits of applying CBPR approaches to health informatics research across the cases included the following: developing more relevant research with wider impact, greater engagement with diverse populations, improved internal validity, more rapid translation of research into action, and the development of people. Challenges of applying CBPR to health informatics research included requirements to develop strong, sustainable academic-community partnerships and mismatches related to cultural and temporal factors. Several technology-related challenges, including needs to define ownership of technology outputs and to build technical capacity with community partners, also emerged from our analysis. Finally, we created several principles that extended an existing CBPR framework to specifically address health informatics research requirements. Conclusions Our cross-case analysis yielded valuable insights regarding CBPR implementation in health informatics research and identified valuable lessons useful for future CBPR-based research. The benefits of applying CBPR approaches can be significant, particularly in engaging populations that are typically underserved by health care and in designing patient-facing technology. PMID:26228766

SOMWeb: a semantic web-based system for supporting collaboration of distributed medical communities of practice.

PubMed

Falkman, Göran; Gustafsson, Marie; Jontell, Mats; Torgersson, Olof

2008-08-26

Information technology (IT) support for remote collaboration of geographically distributed communities of practice (CoP) in health care must deal with a number of sociotechnical aspects of communication within the community. In the mid-1990s, participants of the Swedish Oral Medicine Network (SOMNet) began discussing patient cases in telephone conferences. The cases were distributed prior to the conferences using PowerPoint and email. For the technical support of online CoP, Semantic Web technologies can potentially fulfill needs of knowledge reuse, data exchange, and reasoning based on ontologies. However, more research is needed on the use of Semantic Web technologies in practice. The objectives of this research were to (1) study the communication of distributed health care professionals in oral medicine; (2) apply Semantic Web technologies to describe community data and oral medicine knowledge; (3) develop an online CoP, Swedish Oral Medicine Web (SOMWeb), centered on user-contributed case descriptions and meetings; and (4) evaluate SOMWeb and study how work practices change with IT support. Based on Java, and using the Web Ontology Language and Resource Description Framework for handling community data and oral medicine knowledge, SOMWeb was developed using a user-centered and iterative approach. For studying the work practices and evaluating the system, a mixed-method approach of interviews, observations, and a questionnaire was used. By May 2008, there were 90 registered users of SOMWeb, 93 cases had been added, and 18 meetings had utilized the system. The introduction of SOMWeb has improved the structure of meetings and their discussions, and a tenfold increase in the number of participants has been observed. Users submit cases to seek advice on diagnosis or treatment, to show an unusual case, or to create discussion. Identified barriers to submitting cases are lack of time, concern about whether the case is interesting enough, and showing gaps in one's own knowledge. Three levels of member participation are discernable: a core group that contributes most cases and most meeting feedback; an active group that participates often but only sometimes contribute cases and feedback; and a large peripheral group that seldom or never contribute cases or feedback. SOMWeb is beneficial for individual clinicians as well as for the SOMNet community. The system provides an opportunity for its members to share both high quality clinical practice knowledge and external evidence related to complex oral medicine cases. The foundation in Semantic Web technologies enables formalization and structuring of case data that can be used for further reasoning and research. Main success factors are the long history of collaboration between different disciplines, the user-centered development approach, the existence of a "champion" within the field, and nontechnical community aspects already being in place.

SOMWeb: A Semantic Web-Based System for Supporting Collaboration of Distributed Medical Communities of Practice

PubMed Central

Gustafsson, Marie; Jontell, Mats; Torgersson, Olof

2008-01-01

Background Information technology (IT) support for remote collaboration of geographically distributed communities of practice (CoP) in health care must deal with a number of sociotechnical aspects of communication within the community. In the mid-1990s, participants of the Swedish Oral Medicine Network (SOMNet) began discussing patient cases in telephone conferences. The cases were distributed prior to the conferences using PowerPoint and email. For the technical support of online CoP, Semantic Web technologies can potentially fulfill needs of knowledge reuse, data exchange, and reasoning based on ontologies. However, more research is needed on the use of Semantic Web technologies in practice. Objectives The objectives of this research were to (1) study the communication of distributed health care professionals in oral medicine; (2) apply Semantic Web technologies to describe community data and oral medicine knowledge; (3) develop an online CoP, Swedish Oral Medicine Web (SOMWeb), centered on user-contributed case descriptions and meetings; and (4) evaluate SOMWeb and study how work practices change with IT support. Methods Based on Java, and using the Web Ontology Language and Resource Description Framework for handling community data and oral medicine knowledge, SOMWeb was developed using a user-centered and iterative approach. For studying the work practices and evaluating the system, a mixed-method approach of interviews, observations, and a questionnaire was used. Results By May 2008, there were 90 registered users of SOMWeb, 93 cases had been added, and 18 meetings had utilized the system. The introduction of SOMWeb has improved the structure of meetings and their discussions, and a tenfold increase in the number of participants has been observed. Users submit cases to seek advice on diagnosis or treatment, to show an unusual case, or to create discussion. Identified barriers to submitting cases are lack of time, concern about whether the case is interesting enough, and showing gaps in one’s own knowledge. Three levels of member participation are discernable: a core group that contributes most cases and most meeting feedback; an active group that participates often but only sometimes contribute cases and feedback; and a large peripheral group that seldom or never contribute cases or feedback. Conclusions SOMWeb is beneficial for individual clinicians as well as for the SOMNet community. The system provides an opportunity for its members to share both high quality clinical practice knowledge and external evidence related to complex oral medicine cases. The foundation in Semantic Web technologies enables formalization and structuring of case data that can be used for further reasoning and research. Main success factors are the long history of collaboration between different disciplines, the user-centered development approach, the existence of a “champion” within the field, and nontechnical community aspects already being in place. PMID:18725355

A Case Study of Peer Educators in a Community-Based Program to Reduce Teen Pregnancy: Selected Characteristics Prior to Training, Perceptions of Training and Work, and Perceptions of How Participation in the Program Has Affected Them

ERIC Educational Resources Information Center

Beshers, Sarah C.

2007-01-01

This investigation is a case study of peer educators in a community-based teen pregnancy prevention program. Research questions focused on identifying ways in which peer educators differed from other teens and exploring the perceptions of the peer educators about their experience in the program and the ways in which it has affected them. Data were…

The Connotations of "Botho Philosophy" and Its Potential Contribution towards Environmental Conservation: The Case of Tlokoeng Community in Lesotho

ERIC Educational Resources Information Center

Mokuku, Tšepo

2017-01-01

This paper explores innovative environmental education strategies to conserve biodiversity in a rural-based context, in Lesotho. A case study approach was employed to investigate the community's conception of botho philosophy and how it might promote nature conservation. Focus Group Interviews were conducted with 105 participants. The responses…

Building the Case: Changing Consumer Perceptions of the Value of Expanded Community Pharmacist Services.

PubMed

Steckowych, Kathryn; Smith, Marie; Spiggle, Susan; Stevens, Andrew; Li, Hao

2018-01-01

The role of the community pharmacist has traditionally been a medication dispenser; however, community pharmacists' responsibilities must expand to include more direct patient care services in order to transform primary care practice. Use case-based scenarios to (1) determine factors that contribute to positive and negative consumer perceptions of expanded community pharmacist patient care roles, (2) identify facilitators and barriers that contribute to consumer perceptions of the value of expanded community pharmacist patient care services, and (3) develop a successful approach and strategies for increasing consumer advocacy for the value of expanded community pharmacist patient care services. Two consumer focus groups used scenario-based guided discussions and Likert scale questionnaires to elicit consumer reactions, facilitators, and barriers to expanded community pharmacist services. Convenience, timeliness, and accessibility were common positive reactions across all 3 scenarios. Team approach to care and trust were viewed as major facilitators. Participant concerns included uncertainty about pharmacist training and qualifications, privacy, pharmacists' limited bandwidth to accept new tasks, and potential increased patient costs. Common barriers to service uptake included a lack of insurance payment and physician preference to provide the services. Consumer unfamiliarity with non-traditional community pharmacist services is likely an influencer of consumers' hesitancy to utilize such services; therefore, an opportunity exists to engage consumers and advocacy organizations in supporting expanded community pharmacist roles. This study can inform consumers, advocates, community pharmacists, primary care providers, and community-based organizations on methods to shape consumer perceptions on the value of community pharmacist expanded services.

Community responses to government defunding of watershed projects: a comparative study in India and the USA.

PubMed

Koontz, Tomas M; Sen, Sucharita

2013-03-01

When central governments decentralize natural resource management (NRM), they often retain an interest in the local efforts and provide funding for them. Such outside investments can serve an important role in moving community-based efforts forward. At the same time, they can represent risks to the community if government resources are not stable over time. Our focus in this article is on the effects of withdrawal of government resources from community-based NRM. A critical question is how to build institutional capacity to carry on when the government funding runs out. This study compares institutional survival and coping strategies used by community-based project organizations in two different contexts, India and the United States. Despite higher links to livelihoods, community participation, and private benefits, efforts in the Indian cases exhibited lower survival rates than did those in the U.S. cases. Successful coping strategies in the U.S. context often involved tapping into existing institutions and resources. In the Indian context, successful coping strategies often involved building broad community support for the projects and creatively finding additional funding sources. On the other hand, the lack of local community interest, due to the top-down development approach and sometimes narrow benefit distribution, often challenged organizational survival and project maintenance.

Community Responses to Government Defunding of Watershed Projects: A Comparative Study in India and the USA

NASA Astrophysics Data System (ADS)

Koontz, Tomas M.; Sen, Sucharita

2013-03-01

When central governments decentralize natural resource management (NRM), they often retain an interest in the local efforts and provide funding for them. Such outside investments can serve an important role in moving community-based efforts forward. At the same time, they can represent risks to the community if government resources are not stable over time. Our focus in this article is on the effects of withdrawal of government resources from community-based NRM. A critical question is how to build institutional capacity to carry on when the government funding runs out. This study compares institutional survival and coping strategies used by community-based project organizations in two different contexts, India and the United States. Despite higher links to livelihoods, community participation, and private benefits, efforts in the Indian cases exhibited lower survival rates than did those in the U.S. cases. Successful coping strategies in the U.S. context often involved tapping into existing institutions and resources. In the Indian context, successful coping strategies often involved building broad community support for the projects and creatively finding additional funding sources. On the other hand, the lack of local community interest, due to the top-down development approach and sometimes narrow benefit distribution, often challenged organizational survival and project maintenance.

Pathways To Scaling-Up in Community Based Rehabilitation Agencies.

ERIC Educational Resources Information Center

Boyce, W.; Johnston, C.; Thomas, M.; Enns, H.; Naidu, D. M.; Tjandrakusuma, H.

1997-01-01

Scaling-up (the expansion or development of organizational activities of nongovernmental agencies to achieve greater impact) in community-based rehabilitation is described by using case study materials from industrialized and less-developed countries (India, Canada, and Indonesia) and focusing on differences in structural characteristics of…

Reduction in symptomatic malaria prevalence through proactive community treatment in rural Senegal.

PubMed

Linn, Annē M; Ndiaye, Youssoupha; Hennessee, Ian; Gaye, Seynabou; Linn, Patrick; Nordstrom, Karin; McLaughlin, Matt

2015-11-01

We piloted a community-based proactive malaria case detection model in rural Senegal to evaluate whether this model can increase testing and treatment and reduce prevalence of symptomatic malaria in target communities. Home care providers conducted weekly sweeps of every household in their village throughout the transmission season to identify patients with symptoms of malaria, perform rapid diagnostic tests (RDT) on symptomatic patients and provide treatment for positive cases. The model was implemented in 15 villages from July to November 2013, the high transmission season. Fifteen comparison villages were chosen from those implementing Senegal's original, passive model of community case management of malaria. Three sweeps were conducted in the comparison villages to compare prevalence of symptomatic malaria using difference in differences analysis. At baseline, prevalence of symptomatic malaria confirmed by RDT for all symptomatic individuals found during sweeps was similar in both sets of villages (P = 0.79). At end line, prevalence was 16 times higher in the comparison villages than in the intervention villages (P = 0.003). Adjusting for potential confounders, the intervention was associated with a 30-fold reduction in odds of symptomatic malaria in the intervention villages (AOR = 0.033; 95% CI: 0.017, 0.065). Treatment seeking also increased in the intervention villages, with 57% of consultations by home care providers conducted between sweeps through routine community case management. This pilot study suggests that community-based proactive case detection reduces symptomatic malaria prevalence, likely through more timely case management and improved care seeking behaviour. A randomised controlled trial is needed to further evaluate the impact of this model. © 2015 John Wiley & Sons Ltd.

Pre-Service Elementary Teachers' Experience in a Community of Practice through a Place-Based Inquiry

ERIC Educational Resources Information Center

Cook, Kristin; Buck, Gayle

2014-01-01

With this case study, we explored efforts to connect pre-service elementary teachers (PSTs) and campus scientists through place-based inquiry instruction. Using the framework of Community of Practice (CoP), the research question guiding this study was: what features of our place-based inquiry course intervention (involving PSTs and scientists)…

Developing a Deeper Understanding of Community-Based Pedagogies with Teachers: Learning with and from Teachers in Colombia

ERIC Educational Resources Information Center

Sharkey, Judy; Clavijo Olarte, Amparo; Ramírez, Luz Maribel

2016-01-01

Here we share findings from a 9-month qualitative case study involving a school-university professional development inquiry into how teachers develop, implement, and interpret community-based pedagogies (CBPs), an asset-based approach to curriculum that acknowledges mandated standards but begins with recognizing and valuing local knowledge. After…

The Intersection of Community-Based Writing and Computer-Based Writing: A Cyberliteracy Case Study.

ERIC Educational Resources Information Center

Gabor, Catherine

The learning goals that inform service learning as a whole can contribute to the computers and writing field significantly. This paper demonstrates how two lines of inquiry can be furthered, community-based writing and computers and writing, through new data and critical reflection on learning goals and communication tools. The paper presents a…

Indigenous cultural contexts for STEM experiences: snow snakes' impact on students and the community

NASA Astrophysics Data System (ADS)

Miller, Brant G.; Roehrig, Gillian

2018-03-01

Opportunities for American Indian youth to meaningfully engage in school-based science, technology, engineering, and mathematics (STEM) experiences have historically been inadequate. As a consequence, American Indian students perform lower on standardized assessments of science education than their peers. In this article we describe the emergence of meaning for students—as well as their community—resulting from Indigenous culturally-based STEM curriculum that used an American Indian tradition as a focal context. Specifically, the game of snow snakes ( Gooneginebig in Ojibwe) afforded an opportunity for STEM and culturally-based resources to work in unison. A case study research design was used with the bounded case represented by the community associated with the snow snake project. The research question guiding this study was: What forms of culturally relevant meaning do students and the community form as a result of the snow snake game? Results indicate evidence of increased student and community engagement through culturally-based STEM experiences in the form of active participation and the rejuvenation of a traditional game. Implications are discussed for using culturally-based contexts for STEM learning.

Service delivery, community development, and disability.

PubMed

Murphy, John W

2010-01-01

Service delivery has traditionally been based on market forces. When this is the case, the community becomes a silent partner in this process. Services, accordingly, are directed mostly to correcting personal ills and have little to do with community uplift. Another model, based on the work of Amartya Sen, is available that conceptualizes interventions in a very different way. If understood in the context of community development, the focus of services is social change, rather than merely personal rehabilitation. This reorientation is discussed in this article.

Comparison of patients diagnosed with gonorrhoea through community screening with those self-presenting to the genitourinary medicine clinic.

PubMed

Cook, Penny A; Evans-Jones, John; Mallinson, Harry; Wood, Martyn; Alloba, Fath; Jones, Kathy; Strodtbeck, Sara; Hanna-Bashara, Layla

2014-03-14

To compare the clinical, socioeconomic and demographic characteristics of individuals diagnosed with Neisseria gonorrhoeae (NG) in the community using a concomitant nucleic acid amplification test (NAAT, AptimaCombo2) as part of the (community-based) UK Chlamydia Screening Programme (CSP), with those diagnosed in hospital-based genitourinary medicine (GUM) services. A retrospective case note review of all 643 patients treated for NG at a GUM in north west England (January 2007-April 2009). All 643 treated for NG (including CSP cases, since all cases were referred to GUM for treatment). Limited data were available for 13 CSP cases who failed to attend GUM. Whether the case was detected in the community or GUM services. Predictors were demographics (age, gender, postcode for deprivation analysis), sexual history (eg, number of partners) and clinical factors (eg, culture positivity). 131 cases were diagnosed by CSP (13 of whom did not attend GUM). A further four cases were contacts of these. The GUM caseload was thus inflated by 23% (from 521 to 643). Community cases were overwhelmingly female (85% vs 27% in GUM, p<0.001) and younger (87% females were <25 years vs 70% GUM females, p=0.001). Logistic regression analysis restricted to the target age of the CSP (<25 years) revealed that CSP cases, compared with GUM cases, were more likely to reside in deprived areas (adjusted OR=5.6, 95% CI 1.4 to 21.8 and 5.3, CI 1.7 to 16.6 for the most and second most deprived group respectively, compared with the averagely deprived group, p=0.037) and be asymptomatic (adjusted OR=1.9, CI 1.1 to 3.4, p=0.02). Community screening for NG led to a 79% increase in the number of infections detected in women aged <25 years. Screening is targeted at young people, and tends to disproportionately attract young women, a group under-represented at GUM. Screening also contributed further to case detection in deprived areas.

Analysing a Web-Based E-Commerce Learning Community: A Case Study in Brazil.

ERIC Educational Resources Information Center

Joia, Luiz Antonio

2002-01-01

Demonstrates the use of a Web-based participative virtual learning environment for graduate students in Brazil enrolled in an electronic commerce course in a Masters in Business Administration program. Discusses learning communities; computer-supported collaborative work and collaborative learning; influences on student participation; the role of…

Implementation of Policy, Systems, and Environmental Community-Based Interventions for Cardiovascular Health Through a National Not-for-Profit: A Multiple Case Study.

PubMed

Garney, Whitney R; Szucs, Leigh E; Primm, Kristin; King Hahn, Laura; Garcia, Kristen M; Martin, Emily; McLeroy, Kenneth

2018-05-01

In 2014, the Centers for Disease Control and Prevention funded the American Heart Association to implement policy, systems, and environment-focused strategies targeting access to healthy food and beverages, physical activity, and smoke-free environments. To understand factors affecting implementation and variations in success across sites, evaluators conducted a multiple case study. Based on past literature, community sites were categorized as capacity-building or implementation-ready, for comparison. A sample of six communities were selected using a systematic selection tool. Through site visits, evaluators conducted interviews with program staff and community partners and assessed action plans. Evaluators identified important implications for nationally coordinated community-based prevention programming. Differences in implementation varied by the communities' readiness, with the most notable differences in how they planned activities and defined success. Existing partner relationships (or lack thereof) played a significant role, regardless of the American Heart Association's existing presence within the communities, in the progression of initiatives and the differences observed among phases. Last, goals in capacity-building sites were tied to organizational goals while goals in implementation-ready sites were more incremental with increased community influence and buy-in. Using national organizations as a mechanism to carry out large-scale community-based prevention work is a viable option that provides coordinated, wide-scale implementation without sacrificing a community's priorities or input. In funding future initiatives, the presence of relationships and the time needed to cultivate such relationships should be accounted for in the planning and implementation processes, as well as both local and national expectations.

Community Capacity for Implementing Clean Development Mechanism Projects Within Community Forests in Cameroon

PubMed Central

McCall, Michael K.; Bressers, Hans Th. A.

2007-01-01

There is a growing assumption that payments for environmental services including carbon sequestration and greenhouse gas emission reduction provide an opportunity for poverty reduction and the enhancement of sustainable development within integrated natural resource management approaches. Yet in experiential terms, community-based natural resource management implementation falls short of expectations in many cases. In this paper, we investigate the asymmetry between community capacity and the Land Use Land Use Change Forestry (LULUCF) provisions of the Clean Development Mechanism within community forests in Cameroon. We use relevant aspects of the Clean Development Mechanism criteria and notions of “community capacity” to elucidate determinants of community capacity needed for CDM implementation within community forests. The main requirements are for community capacity to handle issues of additionality, acceptability, externalities, certification, and community organisation. These community capacity requirements are further used to interpret empirically derived insights on two community forestry cases in Cameroon. While local variations were observed for capacity requirements in each case, community capacity was generally found to be insufficient for meaningful uptake and implementation of Clean Development Mechanism projects. Implications for understanding factors that could inhibit or enhance community capacity for project development are discussed. We also include recommendations for the wider Clean Development Mechanism/Kyoto capacity building framework. PMID:17377732

Pragmatism and Community Inquiry: A Case Study of Community-Based Learning

ERIC Educational Resources Information Center

Bruce, Bertram C.; Bloch, Naomi

2013-01-01

This paper develops a philosophical basis for the concept of community inquiry. Community inquiry derives from pragmatist theory as articulated by Dewey, Peirce, Addams, and others. Following Brendel, we discuss pragmatism in terms of its emphasis on the practical dimensions of inquiry, the pluralistic nature of the tools that are used to study…

How Do Communities Act? Unique Events and Purposeful Strategies in the Formation of an Industrial Base in Rivertown. [Revised].

ERIC Educational Resources Information Center

Brown, Ralph B.

Effective rural education depends on active community involvement. This ethnographic case study examines three models of community organization as an explanation of how community action occurs. The three models are: (1) individuals interacting in formal and informal groups; (2) networks of "weak ties" effective for diffusing information and…

Why STEM Learning Communities Work: The Development of Psychosocial Learning Factors through Social Interaction

ERIC Educational Resources Information Center

Carrino, Stephanie Sedberry; Gerace, William J.

2016-01-01

STEM learning communities facilitate student academic success and persistence in science disciplines. This prompted us to explore the underlying factors that make learning communities successful. In this paper, we report findings from an illustrative case study of a 2-year STEM-based learning community designed to identify and describe these…

Community of Communities: An Electronic Link to Integrating Cultural Diversity in Nursing Curriculum.

ERIC Educational Resources Information Center

Ryan, Marilyn; Ali, Nagia; Carlton, Kay Hodson

2002-01-01

The Community of Communities (COC) website contains information and case studies based on cultural assessment. Online nursing courses are linked to a cultural module in the COC. Evaluation results from 63 students showed that the COC increased awareness of the role of culture in health care and knowledge of international health practices.…

“We Make the Path by Walking It”: Building an Academic Community Partnership With Boston Chinatown

PubMed Central

Rubin, Carolyn Leung; Allukian, Nathan; Wang, Xingyue; Ghosh, Sujata; Huang, Chien-Chi; Wang, Jacy; Brugge, Doug; Wong, John B.; Mark, Shirley; Dong, Sherry; Koch-Weser, Susan; Parsons, Susan K.; Leslie, Laurel K.; Freund, Karen M.

2015-01-01

Background The potential for academic community partnerships are challenged in places where there is a history of conflict and mistrust. Addressing Disparities in Asian Populations through Translational Research (ADAPT) represents an academic community partnership between researchers and clinicians from Tufts Medical Center and Tufts University and community partners from Boston Chinatown. Based in principles of community-based participatory research and partnership research, this partnership is seeking to build a trusting relationship between Tufts and Boston Chinatown. Objectives This case study aims to provides a narrative story of the development and formation of ADAPT as well as discuss challenges to its future viability. Methods Using case study research tools, this study draws upon a variety of data sources including interviews, program evaluation data and documents. Results Several contextual factors laid the foundation for ADAPT. Weaving these factors together helped to create synergy and led to ADAPT’s formation. In its first year, ADAPT has conducted formative research, piloted an educational program for community partners and held stakeholder forums to build a broad base of support. Conclusions ADAPT recognizes that long term sustainability requires bringing multiple stakeholders to the table even before a funding opportunity is released and attempting to build a diversified funding base. PMID:25435562

Evaluating the social and economic impact of community-based prenatal care.

PubMed

Cramer, Mary E; Chen, Li-Wu; Roberts, Sara; Clute, Dorothea

2007-01-01

This article describes the evaluation and findings of a community-based prenatal care program, Omaha Healthy Start (OHS), designed to reduce local racial disparities in birth outcomes. This evaluative study used a comparative descriptive design, and Targeting Outcomes of Programs was the conceptual framework for evaluation. The evaluation followed 3 groups for 2 years: OHS birth mothers (N=79; N=157); non-OHS participant birth mothers (N=746; N=774); and Douglas County birth mothers (N=7,962; N=7,987). OHS provided case management, home visits, screening, referral, transportation, and health education to participants. Program outcome measures included low birth weight, infant mortality, adequacy of care, trimester of care, and costs of care. OHS birth outcomes improved during year 2, and there was a 31% cost saving in the average hospital expenditure compared with the nonparticipant groups. Preliminary evaluative analysis indicates that prenatal case management and community outreach can improve birth outcomes for minority women, while producing cost savings. Further prospective study is needed to document trends over a longer period of time regarding the relationship between community-based case management programs for minority populations, birth outcomes, and costs of care.

Cohorts and community: a case study of community engagement in the establishment of a health and demographic surveillance site in Malaysia

PubMed Central

Allotey, Pascale; Reidpath, Daniel D.; Devarajan, Nirmala; Rajagobal, Kanason; Yasin, Shajahan; Arunachalam, Dharmalingam; Imelda, Johanna Debora; Soyiri, Ireneous; Davey, Tamzyn; Jahan, Nowrozy

2014-01-01

Background Community engagement is an increasingly important requirement of public health research and plays an important role in the informed consent and recruitment process. However, there is very little guidance about how it should be done, the indicators for assessing effectiveness of the community engagement process and the impact it has on recruitment, retention, and ultimately on the quality of the data collected as part of longitudinal cohort studies. Methods An instrumental case study approach, with data from field notes, policy documents, unstructured interviews, and focus group discussions with key community stakeholders and informants, was used to explore systematically the implementation and outcomes of the community engagement strategy for recruitment of an entire community into a demographic and health surveillance site in Malaysia. Results For a dynamic cohort, community engagement needs to be an ongoing process. The community engagement process has likely helped to facilitate the current response rate of 85% in the research communities. The case study highlights the importance of systematic documentation of the community engagement process to ensure an understanding of the effects of the research on recruitment and the community. Conclusions A critical lesson from the case study data is the importance of relationships in the recruitment process for large population-based studies, and the need for ongoing documentation and analysis of the impact of cumulative interactions between research and community engagement. PMID:24804983

The Business Case for Provider Participation in Clinical Trials Research: An Application to the National Cancer Institute's Community Clinical Oncology Program

PubMed Central

Song, Paula H.; Reiter, Kristin L.; Weiner, Bryan J.; Minasian, Lori; McAlearney, Ann Scheck

2012-01-01

Background Provider-based research networks (PBRNs) make clinical trials available in community-based practice settings, where most people receive their care, but provider participation requires both financial and in-kind contributions. Purpose This study explores whether providers believe there is a business case for participating in PBRNs and what factors contribute to the business case. Methodology/Approach We use a multiple case study methodology approach to examine the National Cancer Institute's Community Clinical Oncology Program, a longstanding federally funded PBRN. Interviews with 41 key informants across five sites, selected on the basis of organizational maturity, were conducted using a semi-structured interview guide. We analyzed interview transcripts using an iterative, deductive process to identify themes and subthemes in the data. Findings We found that a business case for provider participation in PBRNs may exist if both direct and indirect financial benefits are identified and included in the analysis, and if the time horizon is long enough to allow those benefits to be realized. We identified specific direct and indirect financial benefits that were perceived as important contributors to the business case and the perceived length of time required for a positive return to accrue. Practice Implications As the lack of a business case may result in provider reluctance to participate in PBRNs, knowledge of the benefits we identified may be crucial to encouraging and sustaining participation, thereby preserving patient access to innovative community-based treatments. The results are also relevant to federally-funded PBRNs outside of oncology or to providers considering participation in any clinical trials research. PMID:23044836

Probing community nurses' professional basis: a situational case study in diabetic foot ulcer treatment.

PubMed

Schaarup, Clara; Pape-Haugaard, Louise; Jensen, Merete Hartun; Laursen, Anders Christian; Bermark, Susan; Hejlesen, Ole Kristian

2017-03-01

Complicated and long-lasting wound care of diabetic foot ulcers are moving from specialists in wound care at hospitals towards community nurses without specialist diabetic foot ulcer wound care knowledge. The aim of the study is to elucidate community nurses' professional basis for treating diabetic foot ulcers. A situational case study design was adopted in an archetypical Danish community nursing setting. Experience is a crucial component in the community nurses' professional basis for treating diabetic foot ulcers. Peer-to-peer training is the prevailing way to learn about diabetic foot ulcer, however, this contributes to the risk of low evidence-based practice. Finally, a frequent behaviour among the community nurses is to consult colleagues before treating the diabetic foot ulcers.

Using the critical incident technique in community-based participatory research: a case study.

PubMed

Belkora, Jeffrey; Stupar, Lauren; O'Donnell, Sara

2011-01-01

Successful community-based participatory research involves the community partner in every step of the research process. The primary study for this paper took place in rural, Northern California. Collaborative partners included an academic researcher and two community based resource centers that provide supportive services to people diagnosed with cancer. This paper describes our use of the Critical Incident Technique (CIT) to conduct Community-based Participatory Research. We ask: Did the CIT facilitate or impede the active engagement of the community in all steps of the study process? We identified factors about the Critical Incident Technique that were either barriers or facilitators to involving the community partner in every step of the research process. Facilitators included the CIT's ability to accommodate involvement from a large spectrum of the community, its flexible design, and its personal approach. Barriers to community engagement included training required to conduct interviews, depth of interview probes, and time required. Overall, our academic-community partners felt that our use of the CIT facilitated community involvement in our Community-Based Participatory Research Project, where we used it to formally document the forces promoting and inhibiting successful achievement of community aims.

Building a community-based culture of evaluation.

PubMed

Janzen, Rich; Ochocka, Joanna; Turner, Leanne; Cook, Tabitha; Franklin, Michelle; Deichert, Debbie

2017-12-01

In this article we argue for a community-based approach as a means of promoting a culture of evaluation. We do this by linking two bodies of knowledge - the 70-year theoretical tradition of community-based research and the trans-discipline of program evaluation - that are seldom intersected within the evaluation capacity building literature. We use the three hallmarks of a community-based research approach (community-determined; equitable participation; action and change) as a conceptual lens to reflect on a case example of an evaluation capacity building program led by the Ontario Brian Institute. This program involved two community-based groups (Epilepsy Southwestern Ontarioand the South West Alzheimer Society Alliance) who were supported by evaluators from the Centre for Community Based Research to conduct their own internal evaluation. The article provides an overview of a community-based research approach and its link to evaluation. It then describes the featured evaluation capacity building initiative, including reflections by the participating organizations themselves. We end by discussing lessons learned and their implications for future evaluation capacity building. Our main argument is that organizations that strive towards a community-based approach to evaluation are well placed to build and sustain a culture of evaluation. Copyright © 2017 Elsevier Ltd. All rights reserved.

A Case Study of Teacher Reflection: Examining Teacher Participation in a Video-Based Professional Learning Community

ERIC Educational Resources Information Center

Steeg, Susanna M.

2016-01-01

Professional learning communities (PLCs) constitute worthwhile spaces in which to study teacher participation in the reflective practices that have potential to shift their teaching. This qualitative case study details the interactions between dual-language and ELL teachers in a grade-level PLC as they met together to confer over video-clips of…

Acute respiratory infection case definitions for young children: a systematic review of community-based epidemiologic studies in South Asia.

PubMed

Roth, Daniel E; Gaffey, Michelle F; Smith-Romero, Evelyn; Fitzpatrick, Tiffany; Morris, Shaun K

2015-12-01

To explore the variability in childhood acute respiratory infection case definitions for research in low-income settings where there is limited access to laboratory or radiologic investigations. We conducted a systematic review of community-based, longitudinal studies in South Asia published from January 1990 to August 2013, in which childhood acute respiratory infection outcomes were reported. Case definitions were classified by their label (e.g. pneumonia, acute lower respiratory infection) and clinical content 'signatures' (array of clinical features that would be always present, conditionally present or always absent among cases). Case definition heterogeneity was primarily assessed by the number of unique case definitions overall and by label. We also compared case definition-specific acute respiratory infection incidence rates for studies reporting incidence rates for multiple case definitions. In 56 eligible studies, we found 124 acute respiratory infection case definitions. Of 90 case definitions for which clinical content was explicitly defined, 66 (73%) were unique. There was a high degree of content heterogeneity among case definitions with the same label, and some content signatures were assigned multiple labels. Within studies for which incidence rates were reported for multiple case definitions, variation in content was always associated with a change in incidence rate, even when the content differed by a single clinical feature. There has been a wide variability in case definition label and content combinations to define acute upper and lower respiratory infections in children in community-based studies in South Asia over the past two decades. These inconsistencies have important implications for the synthesis and translation of knowledge regarding the prevention and treatment of childhood acute respiratory infection. © 2015 John Wiley & Sons Ltd.

Beacon communities' public health initiatives: a case study analysis.

PubMed

Massoudi, Barbara L; Marcial, Laura H; Haque, Saira; Bailey, Robert; Chester, Kelley; Cunningham, Shellery; Riley, Amanda; Soper, Paula

2014-01-01

The Beacon Communities for Public Health (BCPH) project was launched in 2011 to gain a better understanding of the range of activities currently being conducted in population- and public health by the Beacon Communities. The project highlighted the successes and challenges of these efforts with the aim of sharing this information broadly among the public health community. The Beacon Community Program, designed to showcase technology-enabled, community-based initiatives to improve outcomes, focused on: building and strengthening health information technology (IT) infrastructure and exchange capabilities; translating investments in health IT to measureable improvements in cost, quality, and population health; and, developing innovative approaches to performance measurement, technology, and care delivery. Four multimethod case studies were conducted based on a modified sociotechnical framework to learn more about public health initiative implementation and use in the Beacon Communities. Our methodological approach included using document review and semistructured key informant interviews. NACCHO Model Practice Program criteria were used to select the public health initiatives included in the case studies. Despite differences among the case studies, common barriers and facilitators were found to be present in all areas of the sociotechnical framework application including structure, people, technology, tasks, overarching considerations, and sustainability. Overall, there were many more facilitators (range = 7-14) present for each Beacon compared to barriers (range = 4-6). Four influential promising practices were identified through the work: forging strong and sustainable partnerships; ensuring a good task-technology fit and a flexible and iterative design; fostering technology acceptance; and, providing education and demonstrating value. A common weakness was the lack of a framework or model for the Beacon Communities evaluation work. Sharing a framework or approach to evaluation at the beginning of implementation made the work more effective. Supporting evaluation to inform future implementations is important.

Reactive community-based self-administered treatment against residual malaria transmission: study protocol for a randomized controlled trial.

PubMed

Okebe, Joseph; Ribera, Joan Muela; Balen, Julie; Jaiteh, Fatou; Masunaga, Yoriko; Nwakanma, Davis; Bradley, John; Yeung, Shunmay; Peeters Grietens, Koen; D'Alessandro, Umberto

2018-02-20

Systematic treatment of all individuals living in the same compound of a clinical malaria case may clear asymptomatic infections and possibly reduce malaria transmission, where this is focal. High and sustained coverage is extremely important and requires active community engagement. This study explores a community-based approach to treating malaria case contacts. This is a cluster-randomized trial to determine whether, in low-transmission areas, treating individuals living in the same compound of a clinical malaria case with dihydroartemisinin-piperaquine can reduce parasite carriage and thus residual malaria transmission. Treatment will be administered through the local health system with the approach of encouraging community participation designed and monitored through formative research. The trial goal is to show that this approach can reduce in intervention villages the prevalence of Plasmodium falciparum infection toward the end of the malaria transmission season. Adherence and cooperation of the local communities are critical for the success of mass treatment campaigns aimed at reducing malaria transmission. By exploring community perceptions of the changing trends in malaria burden, existing health systems, and reaction to self-administered treatment, this study will develop and adapt a model for community engagement toward malaria elimination that is cost-effective and fits within the existing health system. Clinical trials.gov, NCT02878200 . Registered on 25 August 2016.

Collaborating with the Community: Lessons from a Rural School District

ERIC Educational Resources Information Center

Walker, Anne

2012-01-01

This article, based on case study research, highlights how a rural school district in the midwestern United States collaborated with local community organizations to meet the needs of English language learners after the district and community experienced rapid ethnic diversification. In particular, the district EL coordinator spearheaded the…

Sustaining Professional Learning Communities: Case Studies

ERIC Educational Resources Information Center

Hipp, Kristine; Huffman, Jane; Pankake, Anita; Olivier, Dianne

2008-01-01

The purpose is to document the ongoing development of two schools in becoming professional learning communities and the effects of meaningful collaboration on teacher learning. The question that guides this research is: How does a school become a sustainable professional learning community? The theoretical framework is based on the work of Senge,…

Burden and Historical Trend of Buruli Ulcer Prevalence in Selected Communities along the Offin River of Ghana.

PubMed

Ampah, Kobina Assan; Asare, Prince; Binnah, Daniel De-Graft; Maccaulley, Samuel; Opare, William; Röltgen, Katharina; Pluschke, Gerd; Yeboah-Manu, Dorothy

2016-04-01

Buruli ulcer (BU) is a neglected tropical skin disease caused by Mycobacterium ulcerans with more than two thirds of the global cases reported in West Africa. A nationwide active BU case search conducted in 1999 identified two health districts along the Offin River as two of the three most endemic districts in Ghana. Based on recent anecdotal accounts that transmission is unstable along the Offin River, we conducted from March to June 2013 an exhaustive household survey and active case search in 13 selected communities within a five-kilometer radius along the Offin River. The overall prevalence of BU was 2.3% among the surveyed population of 20,390 inhabitants and 477 of the total 480 cases detected (99.4%) were historical (healed) cases. By estimating the year of occurrence for each case per community and taking into account available passive surveillance records of health facilities and the District Health Directorate, we observed a general trend of continuous emergence of cases in communities located midstream the Offin River whereas downstream communities showed more sporadic patterns. We monitored the incidence of cases after the survey and recorded a cumulative incidence rate of 0.04% for the 13 communities over a 17-month active surveillance period from August 2013 to December 2014. Our data reveal an overall decline in BU incidence along the Offin River similar to the general decline in BU incidence in recent years reported by the World Health Organization for West Africa.

Challenges from Tuberculosis Diagnosis to Care in Community-Based Active Case Finding among the Urban Poor in Cambodia: A Mixed-Methods Study.

PubMed

Lorent, Natalie; Choun, Kimcheng; Malhotra, Shelly; Koeut, Pichenda; Thai, Sopheak; Khun, Kim Eam; Colebunders, Robert; Lynen, Lut

2015-01-01

While community-based active case finding (ACF) for tuberculosis (TB) holds promise for increasing early case detection among hard-to-reach populations, limited data exist on the acceptability of active screening. We aimed to identify barriers and explore facilitators on the pathway from diagnosis to care among TB patients and health providers. Mixed-methods study. We administered a survey questionnaire to, and performed in-depth interviews with, TB patients identified through ACF from poor urban settlements in Phnom Penh, Cambodia. Additionally, we conducted focus group discussions and in-depth interviews with community and public health providers involved in ACF, respectively. Acceptance of home TB screening was strong among key stakeholders due to perceived reductions in access barriers and in direct and indirect patient costs. Privacy and stigma were not an issue. To build trust and facilitate communication, the participation of community representatives alongside health workers was preferred. Most health providers saw ACF as complementary to existing TB services; however, additional workload as a result of ACF was perceived as straining operating capacity at public sector sites. Proximity to a health facility and disease severity were the strongest determinants of prompt care-seeking. The main reasons reported for delays in treatment-seeking were non-acceptance of diagnosis, high indirect costs related to lost income/productivity and transportation expenses, and anticipated side-effects from TB drugs. TB patients and health providers considered home-based ACF complementary to facility-based TB screening. Strong engagement with community representatives was believed critical in gaining access to high risk communities. The main barriers to prompt treatment uptake in ACF were refusal of diagnosis, high indirect costs, and anticipated treatment side-effects. A patient-centred approach and community involvement were essential in mitigating barriers to care in marginalised communities.

Challenges from Tuberculosis Diagnosis to Care in Community-Based Active Case Finding among the Urban Poor in Cambodia: A Mixed-Methods Study

PubMed Central

Malhotra, Shelly; Koeut, Pichenda; Thai, Sopheak; Khun, Kim Eam; Colebunders, Robert; Lynen, Lut

2015-01-01

Background While community-based active case finding (ACF) for tuberculosis (TB) holds promise for increasing early case detection among hard-to-reach populations, limited data exist on the acceptability of active screening. We aimed to identify barriers and explore facilitators on the pathway from diagnosis to care among TB patients and health providers. Methods Mixed-methods study. We administered a survey questionnaire to, and performed in-depth interviews with, TB patients identified through ACF from poor urban settlements in Phnom Penh, Cambodia. Additionally, we conducted focus group discussions and in-depth interviews with community and public health providers involved in ACF, respectively. Results Acceptance of home TB screening was strong among key stakeholders due to perceived reductions in access barriers and in direct and indirect patient costs. Privacy and stigma were not an issue. To build trust and facilitate communication, the participation of community representatives alongside health workers was preferred. Most health providers saw ACF as complementary to existing TB services; however, additional workload as a result of ACF was perceived as straining operating capacity at public sector sites. Proximity to a health facility and disease severity were the strongest determinants of prompt care-seeking. The main reasons reported for delays in treatment-seeking were non-acceptance of diagnosis, high indirect costs related to lost income/productivity and transportation expenses, and anticipated side-effects from TB drugs. Conclusions TB patients and health providers considered home-based ACF complementary to facility-based TB screening. Strong engagement with community representatives was believed critical in gaining access to high risk communities. The main barriers to prompt treatment uptake in ACF were refusal of diagnosis, high indirect costs, and anticipated treatment side-effects. A patient-centred approach and community involvement were essential in mitigating barriers to care in marginalised communities. PMID:26222545

Improving Problem-Based Learning in Creative Communities through Effective Group Evaluation

ERIC Educational Resources Information Center

West, Richard E.; Williams, Greg; Williams, David

2013-01-01

In this case study, we researched one cohort from the Center for Animation, a higher education teaching environment that has successfully fostered group creativity and learning outcomes through problem-based learning. Through live and videotaped observations of the interactions of this community over 18 months, in addition to focused interviews…

Case Studies of Student Mentoring in Three New York City Community-Based Organizations

ERIC Educational Resources Information Center

Truitt, Brett J.

2012-01-01

This researcher examined three selected New York City community-based organizations' roles in student mentoring and the building of social capital. The methodology included focus group interviews, individual interviews, shadowing, and the collection of archival materials. The data were analyzed through pattern, theme and discrepancy analysis to…

THE EMPACT COLLECTION

EPA Science Inventory

The TTSD of the USEPA's ORD/NRMRL has completed a series of technology transfer and risk communication handbooks, case studies, and summary reports for community-based environmental monitoring projects under EPA's Environmental Monitoring for Public Access and Community Tracking ...

Satellites for What? Creating User Communities for Space-based Data in France: The Case from LERTS to CESBIO.

PubMed

Cirac-Claveras, Gemma

2018-01-01

This article uses a French case to explore the who, how, and why of satellite remote-sensing development and its transition towards routine utilization in the domain of ecosystems ecology. It discusses the evolution of a community of technology developers promoting remote-sensing capabilities (mostly sponsored by the French space agency). They attempted to legitimate quality scientific practices, establish the authority of satellite remote-sensing data within academic institutions, and build a community of technology users. This article, hence, is intended to contribute to historical interest in how a community of users is constructed for a technological system.

The Legacy Project: A Case Study of Civic Capacity Building and Transformative Educational Leadership in a Community-Based Academic Enrichment Program

ERIC Educational Resources Information Center

Didlick-Davis, Celeste R.

2016-01-01

This study examines how a grassroots educational enrichment program in a small urban economically depressed area builds and uses civic capacity. Using qualitative data collected through a case study of the Legacy Academic Enrichment program in Middletown, Ohio, I identify factors that make Legacy sustainable and successful in a community that has…

The Transformation of a Florida Community College into a State College: A Case Study of the Impact on Institutional Culture, Mission, & Identity

ERIC Educational Resources Information Center

Hagen, Lisa J.

2012-01-01

A case-study was designed to assess the extent of change at a selected Florida community college that transformed into a state college. The purpose of the investigation was to explore how the transformation influenced institutional culture, mission, and identity based on the perceptions of faculty members and administrators. Data collection…

Innovating for Transformation in First Nations Health Using Community-Based Participatory Research.

PubMed

Kyoon-Achan, Grace; Lavoie, Josée; Avery Kinew, Kathi; Phillips-Beck, Wanda; Ibrahim, Naser; Sinclair, Stephanie; Katz, Alan

2018-06-01

Community-based participatory research (CBPR) provides the opportunity to engage communities for sustainable change. We share a journey to transformation in our work with eight Manitoba First Nations seeking to improve the health of their communities and discuss lessons learned. The study used community-based participatory research approach for the conceptualization of the study, data collection, analysis, and knowledge translation. It was accomplished through a variety of methods, including qualitative interviews, administrative health data analyses, surveys, and case studies. Research relationships built on strong ethics and protocols to enhance mutual commitment to support community-driven transformation. Collaborative and respectful relationships are platforms for defining and strengthening community health care priorities. We further discuss how partnerships were forged to own and sustain innovations. This article contributes a blueprint for respectful CBPR. The outcome is a community-owned, widely recognized process that is sustainable while fulfilling researcher and funding obligations.

[Intervention of Schizophrenia From the Community Model].

PubMed

Taborda Zapata, Eliana María; Montoya González, Laura Elisa; Gómez Sierra, Natalia María; Arteaga Morales, Laura María; Correa Rico, Oscar Andrés

2016-01-01

Schizophrenia is a complex disease for which pharmacological management is an insufficient therapeutic measure to ensure adaptation to the community and restoring the quality of life of the patient, with a multidimensional management and community interventions being necessary. Case report. This case report illustrates a multidisciplinary treatment response, based on a community care model for mental health from Envigado, Colombia. The management of schizophrenia requires multimodal interventions that include community screening, psychoeducation of individuals, their families and society, addressing different areas of operation that allow adaptation of the subject to his social environment. A integrated intervention that can be provided on a Community scale, with the implementation of policies that allow it to be applied. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Locating, characterizing and minimizing sources of error for a paper case-based structured oral examination in a multi-campus clerkship.

PubMed

Kumar, A; Bridgham, R; Potts, M; Gushurst, C; Hamp, M; Passal, D

2001-01-01

To determine consistency of assessment in a new paper case-based structured oral examination in a multi-community pediatrics clerkship, and to identify correctable problems in the administration of examination and assessment process. Nine paper case-based oral examinations were audio-taped. From audio-tapes five community coordinators scored examiner behaviors and graded student performance. Correlations among examiner behaviors scores were examined. Graphs identified grading patterns of evaluators. The effect of exam-giving on evaluators was assessed by t-test. Reliability of grades was calculated and the effect of reducing assessment problems was modeled. Exam-givers differed most in their "teaching-guiding" behavior, and this negatively correlated with student grades. Exam reliability was lowered mainly by evaluator differences in leniency and grading pattern; less important was absence of standardization in cases. While grade reliability was low in early use of the paper case-based oral examination, modeling of plausible effects of training and monitoring for greater uniformity in administration of the examination and assigning scores suggests that more adequate reliabilities can be attained.

Multimodal Literacies, Pedagogy, and the Construction of Identity-Based Social Movements: The Case of "Espina y Jugo" in Mexico

ERIC Educational Resources Information Center

Mein, Erika

2011-01-01

This article looks closely at how the process of artmaking linked to social critique unfolds in one community-based educational setting in Latin America. Drawing on nine months of ethnographic fieldwork with a community-based popular education organization in the northern desert of Mexico, the article examines the pedagogical uses of poetry,…

Community-based outbreaks of tuberculosis.

PubMed

Raffalli, J; Sepkowitz, K A; Armstrong, D

1996-05-27

Numerous recent reports have detailed outbreaks of tuberculosis in hospitals and other congregate settings. The characteristics of such settings, including high concentrations of infectious patients and immunocompromised hosts, the potential for sustained daily contact for weeks and often months, and improper precautions taken for protection, make them well suited for tuberculosis transmission. However, community-based outbreaks, which are the source of much public concern, have not been reviewed since 1964, when 109 community outbreaks were examined. Since few of the characteristics of institutional settings are present in the community, the lessons learned may not be applicable to community-based outbreaks. Furthermore, recent studies with analysis by restriction fragment length polymorphisms have documented unexpectedly high rates of primary disease in certain urban communities, suggesting that our understanding of community-based transmission may be incomplete. We reviewed all reported community-based outbreaks of tuberculosis occurring in the last 30 years to assess the basis of our current understanding of community-based transmission. More than 70 outbreaks were identified, with schools being the most common site. In most, a delay in diagnosis, sustained contact with the index case, inadequate ventilation, or overcrowding was contributory. We conclude that community-based outbreaks of tuberculosis continue to occur and that well-established risks contribute to most outbreaks. Many outbreaks can be prevented or limited by attention to basic infection control principles.

Reshaping the Boundaries of Community Engagement in Design Education: Global and Local Explorations

ERIC Educational Resources Information Center

Hicks, Travis L.; Radtke, Rebekah Ison

2015-01-01

Community-driven design is a current movement in the forefront of many designers' practices and on university campuses in design programs. The authors examine work from their respective public state universities' design programs as examples of best practices. In these case studies, the authors share experiences using community-based design…

Community Organizations' Programming and the Development of Community Science Teachers

ERIC Educational Resources Information Center

Varelas, Maria; Morales-Doyle, Daniel; Raza, Syeda; Segura, David; Canales, Karen; Mitchener, Carole

2018-01-01

In this study, we explored how science teacher candidates construct ideas about science teaching and learning in the context of partnerships with urban community-based organizations. We used a case study design focusing on a group of 10 preservice teachers' participation in educational programming that focused on environmental racism and connected…

Service-Learning and Emergent Communities of Practice: A Teacher Education Case Study

ERIC Educational Resources Information Center

Kaschak, Jennifer Cutsforth; Letwinsky, Karim Medico

2015-01-01

This study investigates the unexpected emergence of a community of practice in a middle level mathematics and science methods course. The authors describe how preservice teacher participation in a collaborative, project-based service-learning experience resulted in the formation of a community of practice characterized by teamwork, meaningful…

Creating New Learning Communities: Towards Effective E-Learning Production.

ERIC Educational Resources Information Center

Russell, David; Calvey, David; Banks, Mark

2003-01-01

Case study research and a literature review suggest that formation of new learning communities is a strategy being used to meet demand for electronic learning products such as CD-ROMs and web-based learning tools. Companies, external experts, clients, and learners are the constituents of the learning community that must converge to create…

Aboriginal Employment & Training Program Development--Toward an Internally Controlled Process.

ERIC Educational Resources Information Center

Stevenson, Phyllis Fay

A case study was conducted of the Peguis Adult High School program (PAHS), a community-based adult education in a Manitoba First Nation community for repeat dropouts and students who did not fit into regular high school. A literature review of the historical relationship between federal/provincial governments and First Nation communities examined…

Local and national trends in general surgery residents' operative experience: do work hour limitations negatively affect case volume in small community-based programs?

PubMed

Markelov, Alexey; Sakharpe, Aniket; Kohli, Harjeet; Livert, David

2011-12-01

The goals of this study were to analyze the impact of work hour restrictions on the operative case volume at a small community-based general surgery residency training program and compare changes with the national level. Annual national resident case log data from Accreditation Council for Graduate Medical Education (ACGME) website and case logs of graduating Easton Hospital residents (years 2002-2009) were used for analysis. Weighted average change in total number of cases in our institution was -1.20 (P = 0.52) vs 1.78 (P = 0.07) for the national program average with statistically significant difference on comparison (P = 0.027). We also found significant difference in case volume changes at the national level compared with our institution for the following ACGME defined subcategories: alimentary tract [8.19 (P < 0.01) vs -1.08 (P = 0.54)], abdomen [8.48 (P < 0.01) vs -6.29 (P < 0.01)], breast [1.91 (P = 0.89) vs -3.6 (P = 0.02)], and vascular [4.03 (P = 0.02) vs -3.98 (P = 0.01)]. Comparing the national trend to the community hospital we see that there is total increase in cases at the national level whereas there is a decrease in case volume at the community hospital. These trends can also be followed in ACGME defined subcategories which form the major case load for a general surgical training such as alimentary tract, abdominal, breast, and vascular procedures. We hypothesize that work hour restrictions have been favorable for the larger programs, as these programs were able to better integrate the night float system, restructure their call schedule, and implement institutional modifications which are too resource demanding for smaller training programs.

Community Mortality from Cholera: Urban and Rural Districts in Zimbabwe

PubMed Central

Morof, Diane; Cookson, Susan T.; Laver, Susan; Chirundu, Daniel; Desai, Sarika; Mathenge, Penninah; Shambare, Donald; Charimari, Lincoln; Midzi, Stanley; Blanton, Curtis; Handzel, Thomas

2013-01-01

In 2008–2009, Zimbabwe experienced an unprecedented cholera outbreak with more than 4,000 deaths. More than 60% of deaths occurred at the community level. We conducted descriptive and case–control studies to describe community deaths. Cases were in cholera patients who died outside health facilities. Two surviving cholera patients were matched by age, time of symptom onset, and location to each case-patient. Proxies completed questionnaires regarding mortality risk factors. Cholera awareness and importance of rehydration was high but availability of oral rehydration salts was low. A total of 55 case-patients were matched to 110 controls. The odds of death were higher among males (adjusted odd ratio [AOR] = 5.00, 95% confidence interval [CI] = 1.54–14.30) and persons with larger household sizes (AOR = 1.21, 95% CI = 1.00–1.46). Receiving home-based rehydration (AOR = 0.21, 95% CI = 0.06–0.71) and visiting cholera treatment centers (CTCs) (AOR = 0.07, 95% CI = 0.02–0.23) were protective. Receiving cholera information was associated with home-based rehydration and visiting CTCs. When we compared cases and controls who did not go to CTCs, males were still at increased odds of death (AOR = 5.00, 95% CI = 1.56–16.10) and receiving home-based rehydration (AOR = 0.14, 95% CI = 0.04–0.53) and being married (AOR = 0.26, 95% CI = 0.08–0.83) were protective. Inability to receive home-based rehydration or visit CTCs was associated with mortality. Community education must reinforce the importance of prompt rehydration and CTC referral. PMID:23400576

Community-based health care is an essential component of a resilient health system: evidence from Ebola outbreak in Liberia.

PubMed

Siekmans, Kendra; Sohani, Salim; Boima, Tamba; Koffa, Florence; Basil, Luay; Laaziz, Saïd

2017-01-17

Trained community health workers (CHW) enhance access to essential primary health care services in contexts where the health system lacks capacity to adequately deliver them. In Liberia, the Ebola outbreak further disrupted health system function. The objective of this study is to examine the value of a community-based health system in ensuring continued treatment of child illnesses during the outbreak and the role that CHWs had in Ebola prevention activities. A descriptive observational study design used mixed methods to collect data from CHWs (structured survey, n = 60; focus group discussions, n = 16), government health facility workers and project staff. Monthly data on child diarrhea and pneumonia treatment were gathered from CHW case registers and local health facility records. Coverage for community-based treatment of child diarrhea and pneumonia continued throughout the outbreak in project areas. A slight decrease in cases treated during the height of the outbreak, from 50 to 28% of registers with at least one treatment per month, was attributed to directives not to touch others, lack of essential medicines and fear of contracting Ebola. In a climate of distrust, where health workers were reluctant to treat patients, sick people were afraid to self-identify and caregivers were afraid to take children to the clinic, CHWs were a trusted source of advice and Ebola prevention education. These findings reaffirm the value of recruiting and training local workers who are trusted by the community and understand the social and cultural complexities of this relationship. "No touch" integrated community case management (iCCM) guidelines distributed at the height of the outbreak gave CHWs renewed confidence in assessing and treating sick children. Investments in community-based health service delivery contributed to continued access to lifesaving treatment for child pneumonia and diarrhea during the Ebola outbreak, making communities more resilient when facility-based health services were impacted by the crisis. To maximize the effectiveness of these interventions during a crisis, proactive training of CHWs in infection prevention and "no touch" iCCM guidelines, strengthening drug supply chain management and finding alternative ways to provide supportive supervision when movements are restricted are recommended.

Constant Communities in Complex Networks

NASA Astrophysics Data System (ADS)

Chakraborty, Tanmoy; Srinivasan, Sriram; Ganguly, Niloy; Bhowmick, Sanjukta; Mukherjee, Animesh

2013-05-01

Identifying community structure is a fundamental problem in network analysis. Most community detection algorithms are based on optimizing a combinatorial parameter, for example modularity. This optimization is generally NP-hard, thus merely changing the vertex order can alter their assignments to the community. However, there has been less study on how vertex ordering influences the results of the community detection algorithms. Here we identify and study the properties of invariant groups of vertices (constant communities) whose assignment to communities are, quite remarkably, not affected by vertex ordering. The percentage of constant communities can vary across different applications and based on empirical results we propose metrics to evaluate these communities. Using constant communities as a pre-processing step, one can significantly reduce the variation of the results. Finally, we present a case study on phoneme network and illustrate that constant communities, quite strikingly, form the core functional units of the larger communities.

Introducing Participatory Curriculum Development in China's Higher Education: The Case of Community-Based Natural Resource Management

ERIC Educational Resources Information Center

Gubo, Qi; Xiuli, Xu; Ting, Zuo; Xiaoyun, Li; Keke, Chen; Xiaowei, Gao; Miao, Ji; Lin, Liu; Miankui, Mao; Jingsong, Li; Yiching, Song; Zhipu, Long; Min, Lu; Juanwen, Yuan; Vernooy, Ronnie

2008-01-01

This article describes and reflects on a novel course developed at China Agricultural University to introduce Community-Based Natural Resource Management at the postgraduate level. This course, part of a larger educational renewal initiative addressing the current reform of China's higher education system, was developed through a participatory…

Teaching Community-Based Learning Course in Retailing Management

ERIC Educational Resources Information Center

Rhee, Eddie

2018-01-01

This study outlines the use of a community-based learning (CBL) applied to a Retailing Management course conducted in a 16-week semester in a private institution in the East Coast. The study addresses the case method of teaching and its potential weaknesses, and discusses experiential learning for a real-world application. It further addresses CBL…

Developing Tools for Community-Based Environmental Education for Migrant Children and Youth in Ghana

ERIC Educational Resources Information Center

Lawson, Elaine T.; Gordon, Christopher; Mensah, Adelina; Atipoe, Esinam

2015-01-01

This case study presents a detailed description of how community-based environmental education can be used to increase environment awareness and knowledge among migrant children and youth. Data was collected primarily from interviews and learning activities with 454 participants aged 11 to 19 years. The results show that children and youth are…

A Community-Based Research Approach to Develop an Educational Web Portal

ERIC Educational Resources Information Center

Preiser-Houy, Lara; Navarrete, Carlos J.

2011-01-01

Service-learning projects are becoming more prevalent in Information Systems education. This study explores the use of community-based research, a special kind of a service-learning strategy, in an Information Systems web development course. The paper presents a case study of a service-learning project to develop an educational web portal for a…

Immigration, Racial Profiling, and White Privilege: Community-Based Challenges and Practices for Adult Educators

ERIC Educational Resources Information Center

Kong, Luis J.

2010-01-01

In this chapter, the author will explore the significance of race from a social constructionist perspective. He will focus on immigration laws and on examples of legal cases that have set the stage for current definitions of whiteness and racial identification. A community-based transformational organizing model will be presented. The model will…

Work-Based Researchers and Communities of Practice: Conceptual and Gestational Dilemmas

ERIC Educational Resources Information Center

Sense, Andrew

2015-01-01

Drawing on a presumption that a Community of Practice (COP) can add significant value to the situated learning development of adults in any context, this paper exposes and analyses the challenges faced in facilitating the development of a COP involving part-time work-based researchers. Using an empirical case example involving a collaborative…

Final base case community analysis: Indian Springs, Nevada for the Clark County socioeconomic impact assessment of the proposed high- level nuclear waste repository at Yucca Mountain, Nevada

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1992-06-18

This document provides a base case description of the rural Clark County community of Indian Springs in anticipation of change associated with the proposed high-level nuclear waste repository at Yucca Mountain. As the community closest to the proposed site, Indian Springs may be seen by site characterization workers, as well as workers associated with later repository phases, as a logical place to live. This report develops and updates information relating to a broad spectrum of socioeconomic variables, thereby providing a `snapshot` or `base case` look at Indian Springs in early 1992. With this as a background, future repository-related developments maymore » be analytically separated from changes brought about by other factors, thus allowing for the assessment of the magnitude of local changes associated with the proposed repository. Given the size of the community, changes that may be considered small in an absolute sense may have relatively large impacts at the local level. Indian Springs is, in many respects, a unique community and a community of contrasts. An unincorporated town, it is a small yet important enclave of workers on large federal projects and home to employees of small- scale businesses and services. It is a rural community, but it is also close to the urbanized Las Vega Valley. It is a desert community, but has good water resources. It is on flat terrain, but it is located within 20 miles of the tallest mountains in Nevada. It is a town in which various interest groups diverge on issues of local importance, but in a sense of community remains an important feature of life. Finally, it has a sociodemographic history of both surface transience and underlying stability. If local land becomes available, Indian Springs has some room for growth but must first consider the historical effects of growth on the town and its desired direction for the future.« less

Cases as Shared Inquiry: A Dialogical Model of Teacher Preparation.

ERIC Educational Resources Information Center

Harrington, Helen L.; Garrison, James W.

1992-01-01

A dialogical model is proposed for connecting theory to practice in teacher education by conceiving of cases from case-based pedagogy as problems that initiate shared inquiry. Cases with genuine cognitive and axiological content can initiate self-directed, student-centered inquiry while building democratic dialogical communities. (SLD)

Engaging homeless youth in community-based participatory research: a case study from Skid Row, Los Angeles.

PubMed

Garcia, Analilia P; Minkler, Meredith; Cardenas, Zelenne; Grills, Cheryl; Porter, Charles

2014-01-01

Growing evidence highlights the benefits to youth of involvement in community-based participatory research. Less attention has been paid, however, to the contributions youth can make to helping change health-promoting policy through such work. We describe a multi-method case study of a policy-focused community-based participatory research project in the Skid Row area of downtown Los Angeles, California, where a small group of homeless youth worked with adult mentors to develop and conduct a survey of 96 homeless youth and used the findings to help secure health-promoting policy change. We review the partnership's work at each stage of the policy-making process; its successes in changing policy regarding recreation, juvenile justice, and education; and the challenges encountered, especially with policy enforcement. We share lessons learned, including the importance of strong adult mentors and of policy environments conducive to sustainable, health-promoting change for marginalized youth.

Expanding the chronic care framework to improve diabetes management: the REACH case study.

PubMed

Jenkins, Carolyn; Pope, Charlene; Magwood, Gayenell; Vandemark, Lisa; Thomas, Virginia; Hill, Karen; Linnen, Florene; Beck, Lorna Shelton; Zapka, Jane

2010-01-01

Reducing the burden of chronic conditions among minorities requires novel approaches to prevent and manage disease. This paper describes the expansion of the Chronic Care Model (CCM) to include a community focus for improving diabetes self-management and reducing health disparities. The literature review assesses the concept of "community" in improving outcomes as viewed by proponents of the CCM for chronic disease. The CCM was then modified and informed by experiences of a major community-based participatory action initiative to improve diabetes outcomes, the Racial and Ethnic Approaches to Community Health (REACH) Charleston and Georgetown Diabetes Coalition. Based on our experiences with community-based and health systems diabetes interventions, we present examples of improvements within both health delivery practice sites and other community systems that are essential for improving diabetes outcomes and reducing disparities. Building on the Centers for Disease Control and Prevention's (CDC) principles of community involvement, our coalition activities provide examples of working with community partners to frame this enhanced ecologically grounded Community CCM (CCCM). The resulting CCCM integrates expanded conceptual frameworks, evidence-based practice, community-based evidence and participatory actions, and highlights the possibilities and challenges for improving chronic disease outcomes and reducing disparities via community programs that foster individual, systems, community, and policy change.

Teleophthalmology with optical coherence tomography imaging in community optometry. Evaluation of a quality improvement for macular patients

PubMed Central

Kelly, Simon P; Wallwork, Ian; Haider, David; Qureshi, Kashif

2011-01-01

Purpose To describe a quality improvement for referral of National Health Service patients with macular disorders from a community optometry setting in an urban area. Methods Service evaluation of teleophthalmology consultation based on spectral domain optical coherence tomography images acquired by the community optometrist and transmitted to hospital eye services. Results Fifty patients with suspected macular conditions were managed via telemedicine consultation over 1 year. Responses were provided by hospital eye service-based ophthalmologists to the community optometrist or patient within the next day in 48 cases (96%) and in 34 (68%) patients on the same day. In the consensus opinion of the optometrist and ophthalmologist, 33 (66%) patients required further “face-to-face” medical examination and were triaged on clinical urgency. Seventeen cases (34%) were managed in the community and are a potential cost improvement. Specialty trainees were supervised in telemedicine consultations. Conclusion Innovation and quality improvement were demonstrated in both optometry to ophthalmology referrals and in primary optometric care by use of telemedicine with spectral domain optical coherence tomography images. E-referral of spectral domain optical coherence tomography images assists triage of macular patients and swifter care of urgent cases. Teleophthalmology is also, in the authors’ opinion, a tool to improve interdisciplinary professional working with community optometrists. Implications for progress are discussed. PMID:22174576

Building partnerships in community-based participatory research: budgetary and other cost considerations.

PubMed

Hoeft, Theresa J; Burke, Wylie; Hopkins, Scarlett E; Charles, Walkie; Trinidad, Susan B; James, Rosalina D; Boyer, Bert B

2014-03-01

Community-based participatory research (CBPR) is an important framework for partnering with communities to reduce health disparities. Working in partnership with community incurs additional costs, some that can be represented in a budget summary page and others that are tied to the competing demands placed on community and academic partners. These cost considerations can inform development of community-academic partnerships. We calculated costs from a case study based on an ongoing CBPR project involving a Community Planning Group (CPG) of community co-researchers in rural Alaska and a bicultural liaison group who help bridge communication between CPG and academic co-researchers. Budget considerations specific to CBPR include travel and other communication-related costs, compensation for community partners, and food served at meetings. We also identified sources of competing demands for community and academic partners. Our findings can inform budget discussions in community-academic partnerships. Discussions of competing demands on community partners' time can help plan timelines for CBPR projects. Our findings may also inform discussions about tenure and promotion policies that may represent barriers to participation in CBPR for academic researchers.

The emerging role of faith community nurses in prevention and management of chronic disease.

PubMed

McGinnis, Sandra L; Zoske, Frances M

2008-08-01

Faith community nursing, formerly known as parish nursing, is one model of care that relies heavily on older registered nurses (RNs) to provide population-based and other nonclinical services in community settings. Faith community nursing provides services not commonly available in the traditional health care system (e.g., community case management, community advocacy, community health education). With appropriate support, this model of nursing could be expanded into other settings within the community and has the potential to draw on the skills of experienced RNs to provide communities with services that address unmet health care needs.

Developing a community-led SMS reporting tool for the rapid assessment of lymphatic filariasis morbidity burden: case studies from Malawi and Ghana.

PubMed

Stanton, Michelle C; Mkwanda, Square Z; Debrah, Alexander Y; Batsa, Linda; Biritwum, Nana-Kwadwo; Hoerauf, Achim; Cliffe, Matthew; Best, Abigail; Molineux, Andrew; Kelly-Hope, Louise A

2015-05-16

Lymphoedema and hydrocoele are the two most common clinical manifestations of lymphatic filariasis (LF). In order to effectively target morbidity management strategies, more information is rapidly needed on morbidity burden across all endemic countries. The purpose of this study was to develop and test an SMS tool (MeasureSMS) which enables trained community-based health workers to report basic information on all cases they identified. The tool was trialled in Chikwawa district, Malawi and Ahanta West district, Ghana in 2014. Salaried health surveillance assistants (HSAs) identified and reported cases in Malawi whereas volunteer community health workers (CHWs) were used in Ghana. Health workers were trained in recognising lymphoedema and hydrocoeles and submitting individual case data using MeasureSMS, after which they undertook a LF morbidity survey. After the reporting period, a random sample of reported cases was visited by a physician to verify the health workers' diagnoses. The proportion of correctly diagnosed cases i.e. the positive predictive value (PPV) was then calculated. HSAs in Malawi successfully reported 256 unique cases by SMS from 107 communities (166 hydrocoele, 88 lymphoedema, 2 with both), resulting in an estimated adult prevalence of 17.7 per 10,000 and 33.0 per 10,000 for lymphoedema and hydrocoele respectively. In Ghana, despite being less experienced in using SMS, CHWs successfully reported 360 unique cases by SMS from 33 communities (169 hydrocoele, 185 lymphoedema, 6 with both), resulting in an estimated adult prevalence of 76.9 per 10,000 and 70.5 per 10,000 adults for lymphoedema and hydrocoele respectively. The verification exercise resulted in a PPV for lymphoedema and hydrocoele diagnosis of 90 % (n = 42, 95 % CI 76.5 - 96.9) and 92 % (n = 49, 95 % CI 79.5 - 97.4) in Malawi and 94 % (n = 34, 95 % CI 78.9 %-99.0 %) and 47 % (n = 59, 35.1 %-61.7 %) in Ghana, indicating that non-invasive methods for diagnosing hydrocoeles needed to be further emphasised. The study concludes that given the appropriate education and tools, community-based health workers are exceptionally well-placed to participate in quantifying LF morbidity burden, and other NTDs with observable symptoms. This concept has the potential to enable national programmes to more effectively monitor their community impact in an efficient, timely and cost-effective way.

Making the Case for a Positive Approach to Improving Organizational Performance in Higher Education Institutions: The Community College Abundance Model

ERIC Educational Resources Information Center

Shults, Christopher

2008-01-01

Increasingly hostile and turbulent environments have rendered top-down, problem-focused management structures inadequate for competing in the ever-changing postsecondary knowledge industry. The community college abundance model (CCAM), a strengths-based approach to performance enhancement in community colleges, is presented as a viable…

Creating Economic Lift: Jobs, Training, and Business Opportunities in Public and Indian Housing.

ERIC Educational Resources Information Center

Watkins, Dan

This document contains 10 case studies that examine community-based efforts to improve the economies and provide jobs in public and Indian housing communities. The innovative approaches described in the studies indicate the potential of local communities to address their most serious problems. The models have several common threads: creative and…

Utilizing Benchmarking to Study the Effectiveness of Parent-Child Interaction Therapy Implemented in a Community Setting

ERIC Educational Resources Information Center

Self-Brown, Shannon; Valente, Jessica R.; Wild, Robert C.; Whitaker, Daniel J.; Galanter, Rachel; Dorsey, Shannon; Stanley, Jenelle

2012-01-01

Benchmarking is a program evaluation approach that can be used to study whether the outcomes of parents/children who participate in an evidence-based program in the community approximate the outcomes found in randomized trials. This paper presents a case illustration using benchmarking methodology to examine a community implementation of…

School Leadership and Professional Learning Community: Case Study of Two Senior High Schools in Northeast China

ERIC Educational Resources Information Center

Wang, Ting

2016-01-01

This article presents findings of a qualitative study on school leadership and professional learning community in two high achieving senior high schools in Northeast China. The findings show that teachers participated in school-based communities of professional learning, such as Teaching and Research Groups, Lesson Preparation Groups, and Grade…

Professional Learning Communities' Impact on Science Teacher Classroom Practice in a Midwestern Urban School District

ERIC Educational Resources Information Center

Carpenter, Dan

2012-01-01

The purpose of this reputation-based, multiple-site case study was to explore professional learning communities' impact on teacher classroom practice. The goal of this research was to describe the administrator and teachers' perceptions with respect to professional learning communities as it related to teacher practice in their school. Educators…

Developing a Culture of Assessment through a Faculty Learning Community: A Case Study

ERIC Educational Resources Information Center

Schlitz, Stephanie A.; O'Connor, Margaret; Pang, Yanhui; Stryker, Deborah; Markell, Stephen; Krupp, Ethan; Byers, Celina; Jones, Sheila Dove; Redfern, Alicia King

2009-01-01

This article describes how a diverse, interdisciplinary team of faculty formed a topic-based faculty learning community. Following an introduction to faculty learning communities and a brief discussion of their benefit to faculty engaged in the process of adopting new technology, we explain how our team, through a competitive mini-grant…

A Leap of Trust: Qualitative Research in a Musical Community of Practice

ERIC Educational Resources Information Center

Godwin, Louise

2014-01-01

This article explores the process of determining an approach to the analysis of qualitative data collected as part of a case study research project involving children and teenagers from a community of musical practice--an all ages community-based fiddle group in central Scotland. The researcher's overarching goal is to find ways to increase…

Expanding the user base beyond HEP for the Ganga distributed analysis user interface

NASA Astrophysics Data System (ADS)

Currie, R.; Egede, U.; Richards, A.; Slater, M.; Williams, M.

2017-10-01

This document presents the result of recent developments within Ganga[1] project to support users from new communities outside of HEP. In particular I will examine the case of users from the Large Scale Survey Telescope (LSST) group looking to use resources provided by the UK based GridPP[2][3] DIRAC[4][5] instance. An example use case is work performed with users from the LSST Virtual Organisation (VO) to distribute the workflow used for galaxy shape identification analyses. This work highlighted some LSST specific challenges which could be well solved by common tools within the HEP community. As a result of this work the LSST community was able to take advantage of GridPP[2][3] resources to perform large computing tasks within the UK.

Community-Based Participatory Research and Policy Advocacy to Reduce Diesel Exposure in West Oakland, California

PubMed Central

Gonzalez, Priscilla A.; Garcia, Analilia P.; Gordon, Margaret; Garzón, Catalina; Palaniappan, Meena; Prakash, Swati; Beveridge, Brian

2011-01-01

We conducted a multimethod case study analysis of a community-based participatory research partnership in West Oakland, California, and its efforts to study and address the neighborhood's disproportionate exposure to diesel air pollution. We employed 10 interviews with partners and policymakers, participant observation, and a review of documents. Results of the partnership's truck count and truck idling studies suggested substantial exposure to diesel pollution and were used by the partners and their allies to make the case for a truck route ordinance. Despite weak enforcement, the partnership's increased political visibility helped change the policy environment, with the community partner now heavily engaged in environmental decision-making on the local and regional levels. Finally, we discussed implications for research, policy, and practice. PMID:21551381

Engaging Institutional Review Boards in Developing a Brief, Community-Responsive Human Subjects Training for Community Partners.

PubMed

Calzo, Jerel P; Bogart, Laura M; Francis, Evelyn; Kornetsky, Susan Z; Winkler, Sabune J; Kaberry, Julie

2016-01-01

Engaging community partners as co-investigators in community-based participatory research (CBPR) requires certification in the rules, ethics, and principles governing research. Despite developments in making human research protection trainings more convenient and standardized (eg, self-paced Internet modules), time constraints and the structure of the content (which may favor academic audiences) may hinder the training of community partners. This paper is motivated by a case example in which academic and community partners, and stakeholders of a community-based organization actively engaged the leadership of a pediatric hospital-based institutional review board (IRB) in implementing a brief, community-responsive human subjects training session. A 2-hour, discussion-based human subjects training was developed via collaborations between the IRB and the community and academic partners. Interviews with trainees and facilitators after the training were used to evaluate its acceptability and possible future applications. Local IRBs have the potential to assist community partners in building sufficient knowledge of human subjects research protections to engage in specific projects, thereby expediting the progress of vital research to address community needs. We propose the need for developing truncated human subjects education materials to train and certify community partners, and creating formally organized entities within academic and medical institutions that specialize in community-based research to guide the development and implementation of alternative human subjects training certification opportunities for community partners.

Florida's Medicaid AIDS Waiver: An Assessment of Dimensions of Quality

PubMed Central

Cowart, Marie E.; Mitchell, Jean M.

1995-01-01

Some State Medicaid agencies have implemented home and community-based waiver programs targeting acquired immunodeficiency syndrome (AIDS) patients. Under these initiatives, State Medicaid agencies can provide home and community-based services to persons with AIDS (PWA) as an alternative to more costly Medicaid-covered institutional care. This article evaluates quality of care under the Florida Medicaid waiver for PWA along two dimensions: program effectiveness and client satisfaction. Clients are generally satisfied with their case managers and the range and availability of services. Case managers appear to be well trained. Moreover, the probability of turnover is quite low, despite heavy caseloads and high mortality. The major difficulty faced by clients and case managers relates to the process of becoming Medicaid eligible. PMID:10151885

Change in stroke incidence from a population-based intervention trial in three urban communities in China.

PubMed

Wang, Wen-Zhi; Jiang, Bin; Wu, Sheng-Ping; Hong, Zhen; Yang, Qi-Dong; Sander, J W; Du, Xiao-Li; Bao, Qiu-Jiu

2007-01-01

Stroke has been the main cause of death in most urban residents in China since the 1990s. A community-based intervention trial carried out in China aimed to reduce the incidence and mortality of stroke. In 1991, two well-matched communities each with approximately 50,000 people were selected as intervention or control communities in the urban areas of Beijing, Shanghai and Changsha. Regular health education and health promotion activities were carried out between 1991 and 2000 in the intervention communities but no special action was taken in the control communities. Both fatal and nonfatal stroke cases were meticulously registered during the study in the two communities to assess the effect of long-term intervention. The trend in stroke incidence and the effect of intervention on stroke incidence were analyzed using a Poisson regression model adjusted for age, sex, year and city. Between 1991 and 2000, 2,273 first-ever stroke cases were registered in the intervention communities and 3,015 in the control communities. Geographic variation and changes in the incidence of stroke and its subtypes were found among these 3 cities. Through 10 years of intervention, incidence risks of all, ischemic and hemorrhagic strokes decreased by 11.4% (relative risk 0.8959; 95% confidence interval, CI, 0.8483-0.9460; p < 0.0001), 13.2% (relative risk 0.8676; 95% CI 0.8054-0.9345; p = 0.0002) and 7.2% (relative risk 0.9283; 95% CI 0.8517-1.0117; p = 0.0899), respectively, in the intervention compared with control communities. Accordingly, comprehensive community-based intervention measures could effectively reduce the incidence of stroke in the population. Copyright (c) 2007 S. Karger AG, Basel.

Use of partnership strategies to build radiation oncology disparities research programs in five Western Pennsylvania communities: an organizational case study.

PubMed

Morgenlander, Keith H; Heron, Dwight E; Schenken, Larry L

2009-01-01

Many cancer treatment and prevention trials as well as surveillance programs suffer from a disproportionately low rate of accrual and a high rate of noncompliance or dropouts of racial minorities and the poor. One suggested strategy to help remediate this trend is to directly involve those targeted populations within the development, implementation, and evaluation of these services. The Radiation Oncology Community Outreach Group (ROCOG) and Neighborhood Cancer Care Cooperative (NCCC) are designed based upon this type of highly collaborative organizational structure, consistent with the general principles of community-based participatory research. Funded by the National Cancer Institute Cancer Disparities Research Partnership program, ROCOG/NCCC provide oncology-focused, community hospital-based initiatives intended to help close the cancer disparities gap. This article presents a descriptive case study of the organizational and political process that preceded our grant proposal submission, the potential benefits and difficulties associated with our extensive collaborative model, and an example of how highly competitive health care organizations can become partners in narrowly focused initiatives aimed at a greater social good.

"For Some Reason, I'm Just Tired": Women Domestic Workers Persisting in Community-Based Programmes

ERIC Educational Resources Information Center

Cuban, Sondra

2007-01-01

A study of women migrant domestic workers in the USA and their reasons for participating and persisting in community-based literacy and ESOL programmes is presented. Case studies and themes were developed about the women's experiences of work life and how it connected to their programme participation. The findings revealed that the women had…

Fostering Teacher Learning Communities: A Case Study of a School-Based Leadership Team's Action Research

ERIC Educational Resources Information Center

Fischer, Kenneth Brian

2013-01-01

The purpose of this study is to examine how a school-based leadership team identifies and alters school conditions to foster the development of TLCs. Many educators, school leaders, and politicians have embraced teacher learning communities (TLCs) as a vehicle for school reform. Despite the considerable documentation of the capability for TLCs to…

Encounters with Difference: Community-Based New Media Programs and Practices

ERIC Educational Resources Information Center

Grauer, Kit; Castro, Juan Carlos; Lin, Ching-Chiu

2012-01-01

Community-based new media programs offer a distinct place of arts learning in the larger learning and media ecologies that teens and young adults navigate. As part of a 3-year case study of new media programs, the Gulf Islands Film and Television School (GIFTS) presents pedagogical and curricular insights that are relevant to both out-of- and…

Advancing Evaluation in Community Colleges: A Mixed Methods Case Study of Outcomes-Based Assessment Training in Student Affairs

ERIC Educational Resources Information Center

Russell, Tammy L.

2016-01-01

Many student affairs departments struggle to contribute to an institution's evidence base of student learning. In part, this results from student affairs personnel not having adequate training in how to assess learning outside the classroom. This is a particular challenge for small community colleges, in which individual units (e.g., admissions or…

Through Increasing "Information Literacy" Capital and Habitus (Agency): The Complementary Impact on Composition Skills When Appropriately Sequenced

ERIC Educational Resources Information Center

Karas, Timothy

2017-01-01

Through a case study approach of a cohort of community college students at a single community college, the impact on success rates in composition courses was analyzed based on the sequence of completing an information literacy course. Two student cohorts were sampled based on completing an information literacy course prior to, or concurrently with…

The Fundamental Lifestyle of a University Community: A Case Study of Higher Education in a Malaysian Institution

ERIC Educational Resources Information Center

Abdullah, Melissa Ng Lee Yen; Mey, See Ching

2012-01-01

This study identified the fundamental lifestyles adopted by a university community in Malaysia. Rapid growth and expansion of higher education in Malaysia is inevitable as the country moves from a production-based economy to one that is innovative and knowledge-based, requiring the development of a highly skilled and knowledgeable workforce.…

Barriers to Participation in a Community-Based Program to Control Transmission of Taenia solium in Peru.

PubMed

Beam, Michelle; Spencer, Angela; Fernandez, Lauralee; Atto, Ruth; Muro, Claudio; Vilchez, Percy; Gamboa, Ricardo; Olaya, Sandra; Ayvar, Viterbo; Gonzalez, Armando E; Garcia, Hector H; O'Neal, Seth E; For The Cysticercosis Working Group In Peru

2018-04-16

Infection of the brain with Taenia solium larvae (neurocysticercosis) is a leading cause of preventable epilepsy worldwide. Effective and sustainable strategies to control parasite transmission in rural endemic communities are needed to prevent the disease. Surveillance and targeted intervention around infected pigs (ring control strategy) have been shown to be effective when carried out by research teams. However, this strategy has not been implemented or tested as a community-based program. In this small trial in northern Peru, eight villages were randomly assigned to community-led surveillance and treatment (five villages, 997 residents) or control (three villages, 1,192 residents). In intervention villages, community-led surveillance and reporting were promoted by community health workers, radio advertisement, and school and household education. Each suspected pig infection was verified, with confirmed cases resulting in treatment with niclosamide for taeniasis and oxfendazole for pigs in clusters of homes nearby. No incentives beyond human and pig treatment were offered. Control villages received basic disease education but no treatment intervention in response to reports. Despite 14 case reports, community-based replication of ring control strategy did not replicate prior results. After 12 months, there was no change in seroincidence in intervention villages between the baseline and study end, and no difference compared with control villages. There was no difference in prevalence of taeniasis or porcine cysticercosis at study end. Community members described lack of knowledge as the main reason for not reporting infected pigs. Further exploration of methods to transfer ring strategy and other control interventions for cysticercosis to the community is needed.

A Mobile-Based Community Health Management Information System for Community Health Workers and Their Supervisors in 2 Districts of Zambia

PubMed Central

Biemba, Godfrey; Chiluba, Boniface; Yeboah-Antwi, Kojo; Silavwe, Vichaels; Lunze, Karsten; Mwale, Rodgers K; Russpatrick, Scott; Hamer, Davidson H

2017-01-01

ABSTRACT Introduction: Effective community health management information systems (C-HMIS) are important in low-resource countries that rely heavily on community-based health care providers. Zambia currently lacks a functioning C-HMIS to provide real-time, community-based health information from community health workers (CHWs) to health center staff and higher levels of the health system. Program Description: We developed a C-HMIS mobile platform for use by CHWs providing integrated community case management (iCCM) services and their supervisors to address challenges of frequent stock-outs and inadequate supportive supervision of iCCM-trained CHWs. The platform used simple feature mobile phones on which were loaded the District Health Information System version 2 (DHIS2) software and Java 2 platform micro edition (J2ME) aggregation and tracker applications. This project was implemented in Chipata and Chadiza districts, which supported previous mHealth programs and had cellular coverage from all 3 major network carriers in Zambia. A total of 40 CHWs and 20 CHW supervisors received mobile phones with data bundles and training in the mobile application, after which they implemented the program over a period of 5.5 months, from February to mid-July 2016. CHWs used the mobile phones to submit data on iCCM cases seen, managed, and referred, as well as iCCM medical and diagnostic supplies received and dispensed. Using their mobile phones, the supervisors tracked CHWs' reported cases with medicine consumption, sent CHWs feedback on their referrals, and received SMS reminders to set up mentorship sessions. Observations: CHWs were able to use the mobile application to send weekly reports to health center supervisors on disease caseloads and medical commodities consumed, to make drug and supply requisitions, and to send pre-referral notices to health centers. Health center staff used the mobile system to provide feedback to CHWs on the case outcomes of referred patients and to receive automated monthly SMS reminders to invite CHWs to the facility for mentorship. District- and central-level staff were able to access community-level health data in real time using passwords. Lessons Learned: C-HMIS, using simple feature phones, was feasible and viable for the provision of real-time community-based health information to all levels of the health care system in Zambia, but smartphones, laptops, or desktop computers are needed to perform data analysis and visualization. Ongoing technical support is needed to address the hardware and software challenges CHWs face in their day-to-day interaction with the application on their mobile phones. PMID:28855233

A Mobile-Based Community Health Management Information System for Community Health Workers and Their Supervisors in 2 Districts of Zambia.

PubMed

Biemba, Godfrey; Chiluba, Boniface; Yeboah-Antwi, Kojo; Silavwe, Vichaels; Lunze, Karsten; Mwale, Rodgers K; Russpatrick, Scott; Hamer, Davidson H

2017-09-27

Effective community health management information systems (C-HMIS) are important in low-resource countries that rely heavily on community-based health care providers. Zambia currently lacks a functioning C-HMIS to provide real-time, community-based health information from community health workers (CHWs) to health center staff and higher levels of the health system. We developed a C-HMIS mobile platform for use by CHWs providing integrated community case management (iCCM) services and their supervisors to address challenges of frequent stock-outs and inadequate supportive supervision of iCCM-trained CHWs. The platform used simple feature mobile phones on which were loaded the District Health Information System version 2 (DHIS2) software and Java 2 platform micro edition (J2ME) aggregation and tracker applications. This project was implemented in Chipata and Chadiza districts, which supported previous mHealth programs and had cellular coverage from all 3 major network carriers in Zambia. A total of 40 CHWs and 20 CHW supervisors received mobile phones with data bundles and training in the mobile application, after which they implemented the program over a period of 5.5 months, from February to mid-July 2016. CHWs used the mobile phones to submit data on iCCM cases seen, managed, and referred, as well as iCCM medical and diagnostic supplies received and dispensed. Using their mobile phones, the supervisors tracked CHWs' reported cases with medicine consumption, sent CHWs feedback on their referrals, and received SMS reminders to set up mentorship sessions. CHWs were able to use the mobile application to send weekly reports to health center supervisors on disease caseloads and medical commodities consumed, to make drug and supply requisitions, and to send pre-referral notices to health centers. Health center staff used the mobile system to provide feedback to CHWs on the case outcomes of referred patients and to receive automated monthly SMS reminders to invite CHWs to the facility for mentorship. District- and central-level staff were able to access community-level health data in real time using passwords. C-HMIS, using simple feature phones, was feasible and viable for the provision of real-time community-based health information to all levels of the health care system in Zambia, but smartphones, laptops, or desktop computers are needed to perform data analysis and visualization. Ongoing technical support is needed to address the hardware and software challenges CHWs face in their day-to-day interaction with the application on their mobile phones. © Biemba et al.

Comparative Study on the Characteristics of Community-Based Tourism between Pentingsari and Nglanggeran Tourism Village, Special Region Yogyakarta

NASA Astrophysics Data System (ADS)

Purbasari, Novia; Manaf, Asnawi

2018-02-01

Community-based tourism is one of the tourism development models that effectively used as a tool to alleviate poverty through empowerment strategy of the local community. Nevertheless, many people do not have adequate understanding on the characteristics of community-based tourism, which are used as a determinant in the tourism development. This article describes the comparison on characteristics of community-based tourism between Pentingsari and Nglanggeran. These villages were chosen because Pentingsari was a tourism village that able to apply the principles ethical codes of world tourism, shown by an award from the World Committee on Tourism Ethics Code and Nglanggeran was awarded as Best Tourism Village award in Indonesia from ASEAN Community Based Tourism Award 2017.The objectives of this study is to explore the characteristics of community-based tourism applied in the Pentingsari and Nglanggeran, and to identify any indicators that could be used to indicate those characteristics. The research achieves through in-depth interviews, observation, and review of documents. There were 17 persons as informants. Further, the observation was reached by directly observing in the both study cases. In addition, the data obtained through the review of secondary data from the local manager of tourism village. Generally, Pentingsari has characteristics as a community-based rural tourism, while Nglanggeran has characteristics as community-based ecotourism.

Malaria case detection using rapid diagnostic test at the community level in Ghana: consumer perception and practitioners' experiences.

PubMed

Danquah, Daniel A; Buabeng, Kwame O; Asante, Kwaku P; Mahama, Emmanuel; Bart-Plange, Constance; Owusu-Dabo, Ellis

2016-01-22

Ghana has scaled-up malaria control strategies over the past decade. Much as malaria morbidity and mortality seem to have declined with these efforts, there appears to be increased consumption of artemisinin-based combination therapy (ACT). This study explored the perception and experiences of community members and medicines outlet practitioners on malaria case detection using rapid diagnostic test (RDTs) to guide malaria therapy. This was a cross-sectional study using both quantitative and qualitative approaches for data. In-depth interviews with structured questionnaires were conducted among 197 practitioners randomly selected from community pharmacies and over-the-counter medicine sellers shops within two metropolis (Kumasi and Obuasi) in the Ashanti Region of Ghana. Two focus group discussions were also held in the two communities among female adult caregivers. Medicine outlet practitioners and community members often used raised body temperature of individuals as an index for malaria case detection. The raised body temperature was presumptively determined by touching the forehead with hands. Seventy percent of the practitioners' perceived malaria RDTs are used in hospitals and clinics but not in retail medicines outlets. Many of the practitioners and community members agreed to the need for using RDT for malaria case detection at medicine outlets. However, about 30% of the practitioners (n = 59) and some community members (n = 6) held the view that RDT negative results does not mean no malaria illness and would use ACT. Though malaria RDT use in medicines outlets was largely uncommon, both community members and medicine outlet practitioners welcomed its use. Public education is however needed to improve malaria case detection using RDTs at the community level, to inform appropriate use of ACT.

Influenza Transmission in a Community during a Seasonal Influenza A(H3N2) Outbreak (2010–2011) in Mongolia: A Community-Based Prospective Cohort Study

PubMed Central

Nukiwa-Souma, Nao; Burmaa, Alexanderyn; Kamigaki, Taro; Od, Ishiin; Bayasgalan, Namuutsetsegiin; Darmaa, Badarchiin; Suzuki, Akira; Nymadawa, Pagbajabyn; Oshitani, Hitoshi

2012-01-01

Background Knowledge of how influenza viruses spread in a community is important for planning and implementation of effective interventions, including social distancing measures. Households and schools are implicated as the major sites for influenza virus transmission. However, the overall picture of community transmission is not well defined during actual outbreaks. We conducted a community-based prospective cohort study to describe the transmission characteristics of influenza in Mongolia. Methods and Findings A total of 5,655 residents in 1,343 households were included in this cohort study. An active search for cases of influenza-like illness (ILI) was performed between October 2010 and April 2011. Data collected during a community outbreak of influenza A(H3N2) were analyzed. Total 282 ILI cases occurred during this period, and 73% of the subjects were aged <15 years. The highest attack rate (20.4%) was in those aged 1–4 years, whereas the attack rate in those aged 5–9 years was 10.8%. Fifty-one secondary cases occurred among 900 household contacts from 43 households (43 index cases), giving an overall crude household secondary attack rate (SAR) of 5.7%. SAR was significantly higher in younger household contacts (relative risk for those aged <1 year: 9.90, 1–4 years: 5.59, and 5–9 years: 6.43). We analyzed the transmission patterns among households and a community and repeated transmissions were detected between households, preschools, and schools. Children aged 1–4 years played an important role in influenza transmission in households and in the community at large. Working-age adults were also a source of influenza in households, whereas elderly cases (aged ≥65 years) had no link with household transmission. Conclusions Repeated transmissions between households, preschools, and schools were observed during an influenza A(H3N2) outbreak period in Mongolia, where subjects aged 1–4 years played an important role in influenza transmission. PMID:22427943

Web-Based Case Conferencing for Preservice Teacher Education: Electronic Discourse from the Field.

ERIC Educational Resources Information Center

Bonk, Curtis Jay; Malikowski, Steve; Angeli, Charoula; East, Judy

1998-01-01

The purpose of this study was to foster preservice teacher learning of educational psychology by creating a Web-based learning community using actual case situations experienced during field observations. Participants (146 undergraduate students) were assigned to two electronic-conferencing groups where they generated teaching vignettes related to…

Use of Case-Based Learning in Dental Hygiene Curricula.

ERIC Educational Resources Information Center

Vaughan, Dina Agnone; DeBiase, Christina B.; Gibson-Howell, Joan C.

1998-01-01

A survey investigated the extent of use of case-based learning in 141 dental hygiene programs. A majority of responding schools use the approach, most frequently in clinical dental hygiene, community dental health, and dental science courses. Proportion of instructional time was greatest in the content areas of special needs, ethics, medical…

From front yards to street corners: revitalizing neighborhoods through community-based land stewardship

Treesearch

Colleen Murphy-Dunning

2009-01-01

One of 18 articles inspired by the Meristem 2007 Forum, "Restorative Commons for Community Health." The articles include interviews, case studies, thought pieces, and interdisciplinary theoretical works that explore the relationship between human health and the urban...

The Vanguard of Community-based Integrated Care in Japan: The Effect of a Rural Town on National Policy

PubMed Central

Matsumoto, Masatoshi; Okita, Mitsuaki; Inoue, Kazuo; Takeuchi, Keisuke; Tsutsui, Takako; Nishimura, Shuhei; Hayashi, Takuo

2017-01-01

Introduction: Japan has the largest percentage of elderly people in the world. In 2012 the government implemented a community-based integrated care system which provides seamless community healthcare resources for elderly people with chronic diseases and disabilities. Methods: This paper describes the challenges of establishing a community-based integrated care system in 1974 in Mitsugi, a rural town of Japan. This system has influenced the government and become the model for the nationwide system. Results: In the 1970s, Mitsugi’s aging population was growing faster than Japan’s, but elder care was fragmented among a variety of service sections. A community-based integrated care system evolved because of the small but aging population size and the initiative of some local leaders of medical care and politics. After the system took effect, the proportion of bedridden people and medical care costs for the elderly dropped in Mitsugi while it continued to rise everywhere else in Japan. Mitsugi’s community-based integrated care system is now shaping national policy. Conclusion: Mitsugi is in the vanguard of Japan’s community-based integrated care system. The case showed the community-based integrated care system can diffuse from rural to urban areas. PMID:28970743

Collaborative leadership and the implementation of community-based fall prevention initiatives: a multiple case study of public health practice within community groups.

PubMed

Markle-Reid, Maureen; Dykeman, Cathy; Ploeg, Jenny; Kelly Stradiotto, Caralyn; Andrews, Angela; Bonomo, Susan; Orr-Shaw, Sarah; Salker, Niyati

2017-02-16

Falls among community-dwelling older adults are a serious public health concern. While evidence-based fall prevention strategies are available, their effective implementation requires broad cross-sector coordination that is beyond the capacity of any single institution or organization. Community groups comprised of diverse stakeholders that include public health, care providers from the public and private sectors and citizen volunteers are working to deliver locally-based fall prevention. These groups are examples of collective impact and are important venues for public health professionals (PHPs) to deliver their mandate to work collaboratively towards achieving improved health outcomes. This study explores the process of community-based group work directed towards fall prevention, and it focuses particular attention on the collaborative leadership practices of PHPs, in order to advance understanding of the competencies required for collective impact. Four community groups, located in Ontario, Canada, were studied using an exploratory, retrospective, multiple case study design. The criteria for inclusion were presence of a PHP, a diverse membership and the completion of an initiative that fit within the scope of the World Health Organization Fall Prevention Model. Data were collected using interviews (n = 26), focus groups (n = 4), and documents. Cross-case synthesis was conducted by a collaborative team of researchers. The community groups differed by membership, the role of the PHP and the type of fall prevention initiatives. Seven practice themes emerged: (1) tailoring to address context; (2) making connections; (3) enabling communication; (4) shaping a vision; (5) skill-building to mobilize and take action; (6) orchestrating people and projects; and (7) contributing information and experience. The value of recognized leadership competencies was underscored and the vital role of institutional supports was highlighted. To align stakeholders working towards fall prevention for community-dwelling older adults and establish a foundation for collective impact, public health professionals employed practices that reflected a collaborative leadership style. Looking ahead, public health professionals will want to shift their focus to evaluating the effectiveness of their group work within communities. They will also need to assess outcomes and evaluate whether the anticipated reductions in fall rates among community-dwelling older adults is being achieved.

Consideration of the influence of place on access to employment for persons with serious mental illness in northeastern Ontario.

PubMed

Rebeiro Gruhl, K L; Kauppi, C; Montgomery, P; James, S

2012-01-01

Despite increasing attention to employment within the mental health sector, reports indicate that people with serious mental illness (SMI) continue to experience limited employment success in the province of Ontario, Canada. Research specifies that people with SMI who live in rural places are less likely than those living in urban centers to have access to satisfactory employment services or to become gainfully employed. The objective of this study was to examine access to employment from the perspectives of people with SMI, mental health and vocational service providers, and decision-makers, and to explore whether place influenced their access to work in northeastern Ontario. A qualitative case study using community-based participatory research methods was chosen to examine the experience of access to competitive employment in two northeastern Ontario communities. The cases selected for study were two geographic areas in northeastern Ontario which provided best-practice, mental health services to persons with SMI. Community-based site partners advertised and recruited participants, and a consumer advisory provided input on key stakeholders, questions, findings and the study action plan. The study findings were informed by individual and group interviews conducted with 46 individuals who resided in both rural and urban settings in the case communities, and feedback from 49 participants who attended town hall forums for presentation of study findings and development of an action plan. The qualitative data was supported by a secondary data source reporting on the employment outcomes of 4112 people with SMI who received disability income support and who resided in the case communities. Qualitative data were analyzed inductively, and categories and themes were developed. Findings were member checked with all informants and town hall participants in each case community. This article draws on the findings of a larger study and reports on the influence of place to the low employment success experienced by people with SMI who reside in the case communities; 91.3% of those receiving disability income support are unemployed, and rural residents experience higher levels of unemployment than those in urban places. Place was found to influence access to employment in five ways: by limited access to employment support services in rural places, and to recommended ratios in urban places; by the use of different models and practices that were inconsistent with best practices for people with SMI; by the lack of a plan for the implementation of employment services in the case communities; by limited use of the available, dedicated vocational resources for employment purposes; and by inadequate supports provided to persons with SMI who wish to enter the workforce. The results also underscore how people with SMI continue to be perceived negatively regarding their capacity for employment. Such stereotypical attitudes additionally contributed to employment marginalization of people with SMI from the workforce, especially in rural communities. The study highlights the influence of geography and human resources to the implementation of best practice employment services and supports for persons with SMI. Important policy implications include the need to consider place when implementing evidence-based practices in places where geography, distance and human health resources limit the communities' capacity to successfully do so. The study also underscores the need to build community capacity for supported employment, especially in rural places, in order to improve the participation of people with SMI in employment, and subsequently, to help shift the communities' thinking about their capacity for work.

Communities respond to predatory lending.

PubMed

Caplan, Mary Ager

2014-04-01

Low-income communities in the United States have faced a history of financial marginalization and exploitation, most evident today in the proliferation of predatory financial services, such as payday lending and check-cashing services. Ameliorating the negative effects of predatory lending has become increasingly important on the agenda of community development efforts and the field of social work. Through the use of case studies, this article describes three specific strategies that communities use to increase financial inclusion and buffer against the deleterious effects of predatory lending: inclusion, community-based alternatives, and community advocacy.

Strategy community development based on local resources

NASA Astrophysics Data System (ADS)

Meirinawati; Prabawati, I.; Pradana, G. W.

2018-01-01

The problem of progressing regions is not far from economic problems and is often caused by the inability of the regions in response to changes in economic conditions that occur, so the need for community development programs implemented to solve various problems. Improved community effort required with the real conditions and needs of each region. Community development based on local resources process is very important, because it is an increase in human resource capability in the optimal utilization of local resource potential. In this case a strategy is needed in community development based on local resources. The community development strategy are as follows:(1) “Eight Line Equalization Plus” which explains the urgency of rural industrialization, (2) the construction of the village will be more successful when combining strategies are tailored to regional conditions, (3) the escort are positioning themselves as the Planner, supervisor, information giver, motivator, facilitator, connecting at once evaluators.

WebGIS based community services architecture by griddization managements and crowdsourcing services

NASA Astrophysics Data System (ADS)

Wang, Haiyin; Wan, Jianhua; Zeng, Zhe; Zhou, Shengchuan

2016-11-01

Along with the fast economic development of cities, rapid urbanization, population surge, in China, the social community service mechanisms need to be rationalized and the policy standards need to be unified, which results in various types of conflicts and challenges for community services of government. Based on the WebGIS technology, the article provides a community service architecture by gridding management and crowdsourcing service. The WEBGIS service architecture includes two parts: the cloud part and the mobile part. The cloud part refers to community service centres, which can instantaneously response the emergency, visualize the scene of the emergency, and analyse the data from the emergency. The mobile part refers to the mobile terminal, which can call the centre, report the event, collect data and verify the feedback. This WebGIS based community service systems for Huangdao District of Qingdao, were awarded the “2015’ national innovation of social governance case of typical cases”.

Costs of Illness Due to Endemic Cholera

PubMed Central

Poulos, C.; Riewpaiboon, A.; Stewart, J.F.; Clemens, J.; Guh, S.; Agtini, M.; Sur, D.; Islam, Z.; Lucas, M.; Whittington, D.

2013-01-01

Summary Economic analyses of cholera immunization programmes require estimates of the costs of cholera. The Diseases of the Most Impoverished programme measured the public, provider, and patient costs of culture-confirmed cholera in four study sites with endemic cholera using a combination of hospital- and community-based studies. Families with culture-proven cases were surveyed at home 7 and 14 days after confirmation of illness. Public costs were measured at local health facilities using a micro-costing methodology. Hospital-based studies found that the costs of severe cholera were USD 32 and 47 in Matlab and Beira. Community-based studies in North Jakarta and Kolkata found that cholera cases cost between USD 28 and USD 206, depending on hospitalization. Patient costs of illness as a percentage of average monthly income were 21% and 65% for hospitalized cases in Kolkata and North Jakarta, respectively. This burden on families is not captured by studies that adopt a provider perspective. PMID:21554781

Veterans Coming Home to the Community College: Linking Research to Practice

ERIC Educational Resources Information Center

Persky, Karen R.; Oliver, Diane E.

2011-01-01

Community colleges must prepare for change as increasing numbers of students who are veterans of the Iraq and Afghanistan Wars use their post-9/11 GI Bill benefits to join the colleges' diverse student bodies. Based on the findings of a mixed methods case study, needs of veterans at the community college are framed and discussed within five major…

Emotions and Sensemaking: A Consideration of a Community College Presidential Transition

ERIC Educational Resources Information Center

Kearney, Kerri S.

2013-01-01

A change in primary leadership for a community college presents distinct challenges for its employees. The case study research reported in this article is based on emotions and sensemaking data that were collected at an urban community college in the midst of a presidential transition. Analysis of the data led to a primary focus on the period of…

Conducting Research With Community Groups.

PubMed

Doornbos, Mary Molewyk; Ayoola, Adejoke; Topp, Robert; Zandee, Gail Landheer

2015-10-01

Nurse scientists are increasingly recognizing the necessity of conducting research with community groups to effectively address complex health problems and successfully translate scientific advancements into the community. Although several barriers to conducting research with community groups exist, community-based participatory research (CBPR) has the potential to mitigate these barriers. CBPR has been employed in programs of research that respond in culturally sensitive ways to identify community needs and thereby address current health disparities. This article presents case studies that demonstrate how CBPR principles guided the development of (a) a healthy body weight program for urban, underserved African American women; (b) a reproductive health educational intervention for urban, low-income, underserved, ethnically diverse women; and (c) a pilot anxiety/depression intervention for urban, low-income, underserved, ethnically diverse women. These case studies illustrate the potential of CBPR as an orientation to research that can be employed effectively in non-research-intensive academic environments. © The Author(s) 2015.

Conducting Research with Community Groups

PubMed Central

Doornbos, Mary Molewyk; Ayoola, Adejoke; Topp, Robert; Zandee, Gail Landheer

2016-01-01

Nurse scientists are increasingly recognizing the necessity of conducting research with community groups to effectively address complex health problems and successfully translate scientific advancements into the community. While several barriers to conducting research with community groups exist, community based participatory research (CBPR) has the potential to mitigate these barriers. CBPR has been employed in programs of research that respond in culturally sensitive ways to identify community needs and thereby address current health disparities. This manuscript presents case studies that demonstrate how CBPR principles guided the development of: (a) a healthy body weight program for urban, underserved African-American women, (b) a reproductive health educational intervention for urban, low-income, underserved, ethnically diverse women, and (c) a pilot anxiety/depression intervention for urban, low-income, underserved, ethnically diverse women. These case studies illustrate the potential of CBPR as an orientation to research that can be employed effectively in non-research intensive academic environments. PMID:25724557

A review of improved ethical practices in environmental and public health research: case examples from native communities.

PubMed

Quigley, Dianne

2006-04-01

This article presents a review of 14 case studies and articles of research ethics issues in the conduct of environmental and public health research with Native American and other indigenous populations. The purpose of this review is to highlight new practices in the ethical conduct of research with native community populations. The findings from this review can promote more dialogue and policy development on the issue of community protections in research. Formal guidelines exist in ethical codes for individual rights as human subjects, but there is a lack of development on community rights in the ethics of research. This review illustrates how community-based participatory research practices can provide working guidelines that can overcome past research harms. More important, the compilations of guidelines offer tested field methods for improving the ethical conduct of research with native community populations.

Tangled paths: Three experienced teachers' growth in understanding during an extended science community of practice professional development effort

NASA Astrophysics Data System (ADS)

Brown, Nancy Melamed

This qualitative investigation extends the study of teacher learning within a reform-based community of practice model of professional development. This long-term, multiple case study examined three experienced teachers' transformations in thinking about science instruction. Data were collected during the three years of the Guided Inquiry supporting Multiple Literacies research project, designed to develop instructional practices informed by a socio-cultural, inquiry-based orientation. Data sources included: transcripts of semi-structured interviews collected at strategic points, the teacher's journals, initial application information, and teachers' written case studies. Using an interpretive case study approach, tenets of the teachers' orientations were identified through a recursive process. Results are organized to reflect two principles that were integral to the design of the professional development community. The first principle describes changes in teachers' orientations about the goals and characteristics of science instruction in the elementary grades. The second describes changes about teachers' knowledge about themselves as learners and the influence of this knowledge on their thinking about science instruction and student learning. Illustrative findings indicate that: (a) it is possible for teachers' language regarding conceptions of their practice to change with only superficial change in their orientations, (b) teachers can hold dualistic ways of thinking about their practice, (c) in some cases, teachers use a significant amount of autobiography about their own learning to explain their practice; over time, this was replaced with warrants using the language that developed within the professional development community, and (d) long-term case studies revealed differences in orientations that emerged and were refined over time. These findings provide strong support for communities of practice as a model of professional development and hold implications for advancing teacher learning.

Stirring up the Mud: Using a Community-Based Participatory Approach to Address Health Disparities through a Faith-Based Initiative

PubMed Central

Kaplan, Sue A.; Ruddock, Charmaine; Golub, Maxine; Davis, Joyce; Foley, Robert; Devia, Carlos; Rosen, Rosa; Berry, Carolyn; Barretto, Brenda; Carter, Toni; Irish-Spencer, Evalina; Marchena, Maria; Purcaro, Ellenrita; Calman, Neil

2011-01-01

This case study provides a mid-course assessment of the Bronx Health REACH faith-based initiative four years into its implementation. The study uses qualitative methods to identify lessons learned and to reflect on the benefits and challenges of using a community-based participatory approach for the development and evaluation of a faith-based program designed to address health disparities. Key findings concern the role of pastoral leadership, the importance of providing a religious context for health promotion and health equality messages, the challenges of creating a bilingual/bi-cultural program, and the need to provide management support to the lay program coordinators. The study also identifies lessons learned about community-based evaluation and the importance of addressing community concern about the balance between evaluation and program. Finally, the study identifies the challenges that lie ahead, including issues of program institution-alization and sustainability. PMID:20168022

Community pharmacy-based case finding for COPD in urban and rural settings is feasible and effective.

PubMed

Fathima, Mariam; Saini, Bandana; Foster, Juliet M; Armour, Carol L

2017-01-01

Case finding of patients at risk of COPD by community pharmacists could identify a substantial number of people with undiagnosed COPD, but little is known about the feasibility and effectiveness of pharmacy-based COPD case finding using microspirometry. The objective of this study was to assess the feasibility and effectiveness of COPD case-finding service provided by community pharmacists, utilizing a combination of risk assessment questionnaire and microspirometry. A 6-month service was conducted in 21 community pharmacies in Australia. Pharmacists trained in COPD case finding, including lung function test (LFT), invited their patients aged ≥35 years with a history of smoking and/or respiratory symptoms to participate. High-risk patients were identified via a COPD risk assessment questionnaire (Initial Screening Questionnaire [ISQ]) and underwent LFT. Pharmacists referred patients with a forced expiratory volume in 1 second (FEV 1 )/forced expiratory volume in 6 seconds (FEV 6 ) ratio <0.75 to their general practitioner (GP) for further assessment and diagnosis. In all, 91 of 167 (54%) patients had an ISQ score >3 indicating high COPD risk. Of the 157 patients who were able to complete LFT, 61 (39%) had an FEV 1 /FEV 6 ratio of <0.75 and were referred to their GP. Patients with high ISQ symptoms scores (>3) were at a significantly higher risk of an FEV 1 /FEV 6 ratio of <0.75, compared to patients with fewer COPD symptoms. A total of 15 (10%) patients were diagnosed with COPD by their GP. Another eight (5%) patients were diagnosed with other medical conditions and 87% of these were initiated on treatment. Although only half of all screened patients lived in regional areas, 93% of those diagnosed with COPD were from regional areas. A brief community pharmacy-based COPD case-finding service utilizing the ISQ, LFT and GP referral is feasible and may lead to identification and diagnosis of a substantial number of people with COPD. This might be an important strategy for reducing the burden of COPD, particularly for those living in rural locations.

Community pharmacy-based case finding for COPD in urban and rural settings is feasible and effective

PubMed Central

Fathima, Mariam; Saini, Bandana; Foster, Juliet M; Armour, Carol L

2017-01-01

Background and objective Case finding of patients at risk of COPD by community pharmacists could identify a substantial number of people with undiagnosed COPD, but little is known about the feasibility and effectiveness of pharmacy-based COPD case finding using microspirometry. The objective of this study was to assess the feasibility and effectiveness of COPD case-finding service provided by community pharmacists, utilizing a combination of risk assessment questionnaire and microspirometry. Methods A 6-month service was conducted in 21 community pharmacies in Australia. Pharmacists trained in COPD case finding, including lung function test (LFT), invited their patients aged ≥35 years with a history of smoking and/or respiratory symptoms to participate. High-risk patients were identified via a COPD risk assessment questionnaire (Initial Screening Questionnaire [ISQ]) and underwent LFT. Pharmacists referred patients with a forced expiratory volume in 1 second (FEV1)/forced expiratory volume in 6 seconds (FEV6) ratio <0.75 to their general practitioner (GP) for further assessment and diagnosis. Results In all, 91 of 167 (54%) patients had an ISQ score >3 indicating high COPD risk. Of the 157 patients who were able to complete LFT, 61 (39%) had an FEV1/FEV6 ratio of <0.75 and were referred to their GP. Patients with high ISQ symptoms scores (>3) were at a significantly higher risk of an FEV1/FEV6 ratio of <0.75, compared to patients with fewer COPD symptoms. A total of 15 (10%) patients were diagnosed with COPD by their GP. Another eight (5%) patients were diagnosed with other medical conditions and 87% of these were initiated on treatment. Although only half of all screened patients lived in regional areas, 93% of those diagnosed with COPD were from regional areas. Conclusion A brief community pharmacy-based COPD case-finding service utilizing the ISQ, LFT and GP referral is feasible and may lead to identification and diagnosis of a substantial number of people with COPD. This might be an important strategy for reducing the burden of COPD, particularly for those living in rural locations. PMID:29075108

Global estimate of the incidence of clinical pneumonia among children under five years of age.

PubMed Central

Rudan, Igor; Tomaskovic, Lana; Boschi-Pinto, Cynthia; Campbell, Harry

2004-01-01

OBJECTIVE: Clinical pneumonia (defined as respiratory infections associated with clinical signs of pneumonia, principally pneumonia and bronchiolitis) in children under five years of age is still the leading cause of childhood mortality in the world. In this paper we aim to estimate the worldwide incidence of clinical pneumonia in young children. METHODS: Our estimate for the developing world is based on an analysis of published data on the incidence of clinical pneumonia from community based longitudinal studies. Among more than 2000 studies published since 1961, we identified 46 studies that reported the incidence of clinical pneumonia, and 28 of these met pre-defined quality criteria. FINDINGS: The estimate of the median incidence from those studies was 0.28 episodes per child-year (e/cy). The 25-75% interquartile range was 0.21-0.71. We assessed the plausibility of this estimate using estimates of global mortality from acute respiratory infections and reported case fatality rates for all episodes of clinical pneumonia reported in community-based studies or the case-fatality rate reported only for severe cases and estimates of the proportion of severe cases occurring in a defined population or community. CONCLUSION: The overlap between the ranges of the estimates implies that a plausible incidence estimate of clinical pneumonia for developing countries is 0.29 e/cy. This equates to an annual incidence of 150.7 million new cases, 11-20 million (7-13%) of which are severe enough to require hospital admission. In the developed world no comparable data are available. However, large population-based studies report that the incidence of community-acquired pneumonia among children less than five years old is approximately 0.026 e/cy, suggesting that more than 95% of all episodes of clinical pneumonia in young children worldwide occur in developing countries. PMID:15654403

Empowerment Praxis: Community Organizing to Redress Systemic Health Disparities.

PubMed

Douglas, Jason A; Grills, Cheryl T; Villanueva, Sandra; Subica, Andrew M

2016-12-01

Social and environmental determinants of childhood obesity present a public health dilemma, particularly in low-income communities of color. Case studies of two community-based organizations participating in the Robert Wood Johnson Foundation's Communities Creating Healthy Environments (CCHE) childhood obesity initiative demonstrate multilevel, culturally situated community organizing strategies to address the root causes of this public health disparity. Informed by a 3-lens prescription-Social Justice, Culture-Place, and Organizational Capacity-contained in the CCHE Change Model and Evaluation Frame, we present examples of individual, organizational, and community empowerment to redress systemic inequities that manifest in poor health outcomes for people of color. These case studies offer compelling evidence that public health disparities in these communities may effectively be abated through strategies that employ bottom-up, community-level approaches for (a) identifying proximal and distal determinants of public health disparities, and (b) empowering communities to directly redress these inequities. Guided by this ecological framework, application of the CCHE evaluation approach demonstrated the necessity to document the granularity of community organizing for community health, adding to the community psychology literature on empowering processes and outcomes. © Society for Community Research and Action 2016.

Humidifier Disinfectants Are a Cause of Lung Injury among Adults in South Korea: A Community-Based Case-Control Study

PubMed Central

Kwon, Geun-Yong; Gwack, Jin; Park, Young-Joon; Youn, Seung-Ki; Kwon, Jun-Wook; Yang, Byung-Guk; Lee, Moo-Song; Jung, Miran; Lee, Hanyi; Jun, Byung-Yool; Lim, Hyun-Sul

2016-01-01

Backgrounds An outbreak of lung injury among South Korean adults was examined in a hospital-based case-control study, and the suspected cause was exposure to humidifier disinfectant (HD). However, a case-control study with community-dwelling controls was needed to validate the previous study’s findings, and to confirm the exposure-response relationship between HD and lung injury. Methods Each case of lung injury was matched with four community-dwelling controls, according to age (±3 years), sex, residence, and history of childbirth since 2006 (for women). Environmental risk factors, which included type and use of humidifier and HD, were investigated using a structured questionnaire during August 2011. The exposure to HD was calculated for both cases and controls, and the corresponding risks of lung injury were compared. Results Among 28 eligible cases, 16 patients agreed to participate, and 60 matched controls were considered eligible for this study. The cases were more likely to have been exposed to HD (odds ratio: 116.1, 95% confidence interval: 6.5–2,063.7). All cases were exposed to HDs containing polyhexamethyleneguanidine phosphate, and the risk of lung injury increased with the cumulative exposure, duration of exposure, and exposure per day. Conclusions This study revealed a statistically significant exposure-response relationship between HD and lung injury. Therefore, continuous monitoring and stricter evaluation of environmental chemicals’ safety should be conducted. PMID:26990641

Case Management for Patients with Complex Multimorbidity: Development and Validation of a Coordinated Intervention between Primary and Hospital Care

PubMed Central

Giménez-Campos, María Soledad; Villar-López, Julia; Faubel-Cava, Raquel; Donat-Castelló, Lucas; Valdivieso-Martínez, Bernardo; Soriano-Melchor, Elisa; Bahamontes-Mulió, Amparo; García-Gómez, Juan M.

2017-01-01

In the past few years, healthcare systems have been facing a growing demand related to the high prevalence of chronic diseases. Case management programs have emerged as an integrated care approach for the management of chronic disease. Nevertheless, there is little scientific evidence on the impact of using a case management program for patients with complex multimorbidity regarding hospital resource utilisation. We evaluated an integrated case management intervention set up by community-based care at outpatient clinics with nurse case managers from a telemedicine unit. The hypothesis to be tested was whether improved continuity of care resulting from the integration of community-based and hospital services reduced the use of hospital resources amongst patients with complex multimorbidity. A retrospective cohort study was performed using a sample of 714 adult patients admitted to the program between January 2012 and January 2015. We found a significant decrease in the number of emergency room visits, unplanned hospitalizations, and length of stay, and an expected increase in the home care hospital-based episodes. These results support the hypothesis that case management interventions can reduce the use of unplanned hospital admissions when applied to patients with complex multimorbidity. PMID:28970745

Age-Related Differences in Influenza B Infection by Lineage in a Community-Based Sentinel System, 2010-2011 to 2015-2016, Canada.

PubMed

Skowronski, Danuta M; Chambers, Catharine; De Serres, Gaston; Sabaiduc, Suzana; Winter, Anne-Luise; Dickinson, James A; Gubbay, Jonathan B; Fonseca, Kevin; Drews, Steven J; Charest, Hugues; Martineau, Christine; Krajden, Mel; Petric, Martin; Bastien, Nathalie; Li, Yan

2017-09-15

Age-related differences in influenza B lineage detection were explored in the community-based Canadian Sentinel Practitioner Surveillance Network (SPSN) from 2010-2011 to 2015-2016. Whereas >80% of B(Victoria) cases were <40 years old, B(Yamagata) cases showed a bimodal age distribution with 27% who were <20 years old and 61% who were 30-64 years old, but with a notable gap in cases between 20 and 29 years old (4%). Overall, the median age was 20 years lower for B(Victoria) vs B(Yamagata) cases (20 vs 40 years; P < .01). Additional phylodynamic and immuno-epidemiological research is needed to understand age-related variation in influenza B risk by lineage, with potential implications for prevention and control across the lifespan. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

A First Grade Chinese Student's Self-Efficacy Beliefs about Learning English in American Classrooms and a Chinese Community

ERIC Educational Resources Information Center

Wang, Chuang

2007-01-01

Through a single case study and from the interpretive paradigm, the author described a first-grade student?s self-efficacy beliefs about learning English in various English language learning tasks and across school-based and home-based contexts. The student came from China and had been living in a Chinese community in the United States for one…

Evaluating Area-Based Interventions: The Case of "Communities for Children"

ERIC Educational Resources Information Center

Cortis, Natasha

2008-01-01

Increasingly, governments in wealthy countries are designing early intervention initiatives around principles of "community regeneration" or "place management". Because these initiatives are multi-site, aimed at long-term systemic change, and implemented amidst a range of other initiatives, assessing their quality and outcomes…

Interventions to improve utilization of cataract surgical services by girls: Case studies from Asia and Africa.

PubMed

Adhisesha Reddy, Priya; Kishiki, Elizabeth A; Thapa, Hari Bahadur; Demers, Lisa; Geneau, Robert; Bassett, Ken

2018-06-01

Gender and blindness initiatives continue to make eye care personnel aware of the service utilization inequity strongly favouring men, yet interventions to reduce that inequity, particularly for girls, are under developed. This descriptive study gathered quantitative data on the degree of gender equity at five Child Eye Health Tertiary Facilities (CEHTFs) in Asia and Africa and conducted in-depth interviews with eye care personnel to assess their strategies and capacity to reduce gender inequity. Cataract surgery was utilized to assess the degree of inequity and success of interventions to reduce inequity in case finding, service utilization, and follow-up. CEHTF administrative data showed significant gender inequity in cataract surgical services favouring boys in all settings. CEHTFs actively seek children through community and school-based outreach, yet do not have initiatives to reduce gender inequity. Little gender inequity was found among children receiving surgical and follow-up care, although two out of three children were boys. CEHTF staff, despite being aware, offered no effective means to reduce gender inequity involving cataract surgical services. Interventions that successfully increased service utilization by girls came from individual cases, involving extraordinary effort by a single eye care programme person. Community-based case finders such as Anganwadi workers in India, Female Community Health Volunteers (FCHVs) in Nepal, and Key Informants (KIs) in Africa are necessary to identify children in need of cataract services, but insufficient to increase service utilization by girls. Secondary, often extra-ordinary community-based interventions by eye care personnel are needed in all settings.

A decision model for selecting sustainable drinking water supply and greywater reuse systems for developing communities with a case study in Cimahi, Indonesia.

PubMed

Henriques, Justin J; Louis, Garrick E

2011-01-01

Capacity Factor Analysis is a decision support system for selection of appropriate technologies for municipal sanitation services in developing communities. Developing communities are those that lack the capability to provide adequate access to one or more essential services, such as water and sanitation, to their residents. This research developed two elements of Capacity Factor Analysis: a capacity factor based classification for technologies using requirements analysis, and a matching policy for choosing technology options. First, requirements analysis is used to develop a ranking for drinking water supply and greywater reuse technologies. Second, using the Capacity Factor Analysis approach, a matching policy is developed to guide decision makers in selecting the appropriate drinking water supply or greywater reuse technology option for their community. Finally, a scenario-based informal hypothesis test is developed to assist in qualitative model validation through case study. Capacity Factor Analysis is then applied in Cimahi Indonesia as a form of validation. The completed Capacity Factor Analysis model will allow developing communities to select drinking water supply and greywater reuse systems that are safe, affordable, able to be built and managed by the community using local resources, and are amenable to expansion as the community's management capacity increases. Copyright © 2010 Elsevier Ltd. All rights reserved.

Engaging Institutional Review Boards in Developing a Brief, Community-Responsive Human Subjects Training for Community Partners

PubMed Central

Calzo, Jerel P.; Bogart, Laura M.; Francis, Evelyn; Kornetsky, Susan Z.; Winkler, Sabune J.; Kaberry, Julie M.

2017-01-01

BACKGROUND Engaging community partners as co-investigators in community-based participatory research (CBPR) requires certification in the rules, ethics, and principles governing research. Despite developments in making human research protection trainings more convenient and standardized (e.g., self-paced Internet modules), time constraints and the structure of the content (which may favor academic audiences) may hinder the training of community partners. OBJECTIVES This paper is motivated by a case example in which academic and community partners, and stakeholders of a community-based organization actively engaged the leadership of a pediatric hospital-based Institutional Review Board (IRB) in implementing a brief, community-responsive human subjects training session. METHODS A two hour, discussion-based human subjects training was developed via collaborations between the IRB and the community and academic partners. Interviews with trainees and facilitators after the training were used to evaluate its acceptability and possible future applications. CONCLUSIONS Local Institutional Review Boards have the potential to assist community partners in building sufficient knowledge of human subjects research protections to engage in specific projects, thereby expediting the progress of vital research to address community needs. We propose the need for developing truncated human subjects education materials to train and certify community partners, and creating formally organized entities within academic and medical institutions that specialize in community-based research to guide the development and implementation of alternative human subjects training certification opportunities for community partners. PMID:28230554

A case study in the use of community-based participatory research in public health nursing.

PubMed

Savage, Christine L; Xu, Yin; Lee, Rebecca; Rose, Barbara L; Kappesser, Mary; Anthony, Jean Spann

2006-01-01

There is growing demand for research using a community-based participatory (CBPR) approach. CBPR requires that the academic research team actively partner with community members and stakeholders in the entire research process. The community members are full partners with the researchers in relation to the development and implementation of the study, analysis of the data, and dissemination of the findings. The purpose of this article is to review four basic principles of CBPR and provide an example of how these CBPR principles were used in an ethnographic study related to the culture of African American infant health. In the pilot study, CBPR provided the framework for recruitment and retention of participants, ongoing data analysis, and dissemination of findings. Using CBPR provided the researchers an introduction into the selected community. Community members served as key informants about the culture of the community and provided access to potential participants. The community partners contributed to analysis of emerging themes and in the dissemination of findings to the community, stakeholders, and the scientific community. CBPR provides opportunities for community health nurse researchers to conduct research with vulnerable populations and sets the stage for implementing evidenced-based nursing interventions in the community.

Organizing and delivering case management services: lessons from the National Long Term Care Channeling Demonstration.

PubMed

Christianson, J B; Applebaum, R; Carcagno, G; Phillips, B

1988-01-01

This article discusses issues relating to the design and internal administration of a case-management agency for community based home care for the elderly. Included in the article are issues relating to screening procedures, assessment and case management activities, cost controls, automated management information systems, and personnel matters. The analysis is based on the experience of the National Long Term Care Demonstration ("Channeling") which established and evaluated ten case management projects nationwide under federal funding.

NGO Partnerships in Using Ecotourism for Conservation: Systematic Review and Meta-Analysis.

PubMed

Romero-Brito, Tania P; Buckley, Ralf C; Byrne, Jason

2016-01-01

We analyse 214 cases worldwide where non-governmental organisations (NGOs) use ecotourism for conservation. Other stakeholders in these initiatives include local communities, the private sector, and government agencies. Stakeholder relationships determine NGO roles and project management structures and governance. We classified cases into 10 structural categories based on the initiating stakeholder and the NGO role, and used these categories to analyze geographic patterns and success factors. Most of the 214 cases are community-based (~170; 79%); most are in developing countries (190; 89%); and most are in protected areas (196; 91%). Frequencies of structural categories differ between continents. More cases in Latin America and Asia are initiated by NGOs and local communities, and more in Africa by the private sector. Case-study authors used a range of economic, socio-cultural and environmental criteria to judge whether projects were successful. At global scale, we found no significant association between project success and the involvement of private tourism entrepreneurs. Projects involving either local or international NGOs had higher success rates than those that involved both simultaneously. Future research could adopt political ecology approaches to examine: the factors that lead NGOs to adopt ecotourism enterprises; their internal decision-making processes and strategies; their interactions with the stakeholders involved; and their conservation goals and outcomes.

NGO Partnerships in Using Ecotourism for Conservation: Systematic Review and Meta-Analysis

PubMed Central

Romero-Brito, Tania P.; Byrne, Jason

2016-01-01

We analyse 214 cases worldwide where non-governmental organisations (NGOs) use ecotourism for conservation. Other stakeholders in these initiatives include local communities, the private sector, and government agencies. Stakeholder relationships determine NGO roles and project management structures and governance. We classified cases into 10 structural categories based on the initiating stakeholder and the NGO role, and used these categories to analyze geographic patterns and success factors. Most of the 214 cases are community-based (~170; 79%); most are in developing countries (190; 89%); and most are in protected areas (196; 91%). Frequencies of structural categories differ between continents. More cases in Latin America and Asia are initiated by NGOs and local communities, and more in Africa by the private sector. Case-study authors used a range of economic, socio-cultural and environmental criteria to judge whether projects were successful. At global scale, we found no significant association between project success and the involvement of private tourism entrepreneurs. Projects involving either local or international NGOs had higher success rates than those that involved both simultaneously. Future research could adopt political ecology approaches to examine: the factors that lead NGOs to adopt ecotourism enterprises; their internal decision-making processes and strategies; their interactions with the stakeholders involved; and their conservation goals and outcomes. PMID:27893800

Interactions in the microbiome: communities of organisms and communities of genes

PubMed Central

Boon, Eva; Meehan, Conor J; Whidden, Chris; Wong, Dennis H-J; Langille, Morgan GI; Beiko, Robert G

2014-01-01

A central challenge in microbial community ecology is the delineation of appropriate units of biodiversity, which can be taxonomic, phylogenetic, or functional in nature. The term ‘community’ is applied ambiguously; in some cases, the term refers simply to a set of observed entities, while in other cases, it requires that these entities interact with one another. Microorganisms can rapidly gain and lose genes, potentially decoupling community roles from taxonomic and phylogenetic groupings. Trait-based approaches offer a useful alternative, but many traits can be defined based on gene functions, metabolic modules, and genomic properties, and the optimal set of traits to choose is often not obvious. An analysis that considers taxon assignment and traits in concert may be ideal, with the strengths of each approach offsetting the weaknesses of the other. Individual genes also merit consideration as entities in an ecological analysis, with characteristics such as diversity, turnover, and interactions modeled using genes rather than organisms as entities. We identify some promising avenues of research that are likely to yield a deeper understanding of microbial communities that shift from observation-based questions of ‘Who is there?’ and ‘What are they doing?’ to the mechanistically driven question of ‘How will they respond?’ PMID:23909933

Addressing the Health of Formerly Imprisoned Persons in a Distressed Neighborhood Through a Community Collaborative Board

PubMed Central

Smith, Vivian C.; Jemal, Alexis

2016-01-01

This article provides a case study evaluating the structure and dynamic process of a Community Collaborative Board that had the goal of creating an evidence-based substance abuse/health intervention for previously incarcerated individuals. Meeting agendas, attendance, minutes, video recording of meetings, and in-depth interviews with 13 Community Collaborative Board members were used to conduct an independent process evaluation. Open coding identified quotes exemplifying specific themes and/or patterns across answers related to the desired domain. Several themes were identified regarding membership engagement, retention, and power distribution. Results showed member retention was due to strong personal commitment to the targeted problem. Analysis also revealed an unequal power distribution based on participants' background. Nevertheless, the development of an innovative, community-based health intervention manual was accomplished. Aspects of the process, such as incentives, subcommittees, and trainings, enhanced the Board's ability to integrate the community and scientific knowledge to accomplish its research agenda. Community-based participatory research was a useful framework in enhancing quality and efficiency in the development of an innovative, substance abuse/health intervention manual for distressed communities. Overall, this article sheds light on a process that illustrates the integration of community-based and scientific knowledge to address the health, economic, and societal marginalization of low-income, minority communities. PMID:26055460

Climate Voices: Bridging Scientist Citizens and Local Communities across the United States

NASA Astrophysics Data System (ADS)

Wegner, K.; Ristvey, J. D., Jr.

2016-12-01

Based out of the University Corporation for Atmospheric Research (UCAR), the Climate Voices Science Speakers Network (climatevoices.org) has more than 400 participants across the United States that volunteer their time as scientist citizens in their local communities. Climate Voices experts engage in nonpartisan conversations about the local impacts of climate change with groups such as Rotary clubs, collaborate with faith-based groups on climate action initiatives, and disseminate their research findings to K-12 teachers and classrooms through webinars. To support their participants, Climate Voices develops partnerships with networks of community groups, provides trainings on how to engage these communities, and actively seeks community feedback. In this presentation, we will share case studies of science-community collaborations, including meta-analyses of collaborations and lessons learned.

Challenges and Rewards on the Road to Translational Systems Biology in Acute Illness: Four Case Reports from Interdisciplinary Teams

PubMed Central

An, Gary; Hunt, C. Anthony; Clermont, Gilles; Neugebauer, Edmund; Vodovotz, Yoram

2007-01-01

Introduction Translational systems biology approaches can be distinguished from mainstream systems biology in that their goal is to drive novel therapies and streamline clinical trials in critical illness. One systems biology approach, dynamic mathematical modeling (DMM), is increasingly used in dealing with the complexity of the inflammatory response and organ dysfunction. The use of DMM often requires a broadening of research methods and a multidisciplinary team approach that includes bioscientists, mathematicians, engineers, and computer scientists. However, the development of these groups must overcome domain-specific barriers to communication and understanding. Methods We present four case studies of successful translational, interdisciplinary systems biology efforts, which differ by organizational level from an individual to an entire research community. Results Case 1 is a single investigator involved in DMM of the acute inflammatory response at Cook County Hospital, in which extensive translational progress was made using agent-based models of inflammation and organ damage. Case 2 is a community-level effort from the University of Witten-Herdecke in Cologne, whose efforts have led to the formation of the Society for Complexity in Acute Illness. Case 3 is an institution-based group, the Biosystems Group at the University of California, San Francisco, whose work has included a focus on a common lexicon for DMM. Case 4 is an institution-based, trans-disciplinary research group (the Center for Inflammation and Regenerative Modeling at the University of Pittsburgh, whose modeling work has led to internal education efforts, grant support, and commercialization. Conclusion A transdisciplinary approach, which involves team interaction in an iterative fashion to address ambiguity and is supported by educational initiatives, is likely to be necessary for DMM in acute illness. Community-wide organizations such as the Society of Complexity in Acute Illness (SCAI) must strive to facilitate the implementation of DMM in sepsis/trauma research into the research community as a whole. PMID:17548029

Purposes and Approaches of Selected Mentors in School-Based Mentoring: A Collective Case Study

ERIC Educational Resources Information Center

Frels, Rebecca K.; Onwuegbuzie, Anthony J.; Bustamante, Rebecca M.; Garza, Yvonne; Nelson, Judith A.; Nichter, Mary; Leggett, Elsa Soto

2013-01-01

Over the last decade, community leaders have connected with students through school-based mentoring (SBM) programs (e.g., adults who mentor at-risk students). However, research in the area of SBM is only on the cusp of understanding relationship elements for impacting youth. In this collective case study, we examined the perceptions and…

Community-based approaches to strategic environmental assessment: Lessons from Costa Rica

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sinclair, A. John; Sims, Laura; Spaling, Harry

This paper describes a community-based approach to strategic environmental assessment (SEA) using a case study of the Instituto Costarricense de Electricidad's (ICE) watershed management agricultural program (WMAP) in Costa Rica. The approach focused on four highly interactive workshops that used visioning, brainstorming and critical reflection exercises. Each workshop represented a critical step in the SEA process. Through this approach, communities in two rural watersheds assessed the environmental, social and economic impacts of a proposed second phase for WMAP. Lessons from this community-based approach to strategic environmental assessment include a recognition of participants learning what a participatory SEA is conceptually andmore » methodologically; the role of interactive techniques for identifying positive and negative impacts of the proposed program and generating creative mitigation strategies; the effect of workshops in reducing power differentials among program participants (proponent, communities, government agencies); and, the logistical importance of notice, timing and location for meaningful participation. The community-based approach to SEA offers considerable potential for assessing regional (watershed) development programs focused on sustainable resource-based livelihoods.« less

Navigating the AIDS industry: being poor and positive in Tanzania.

PubMed

Boesten, Jelke

2011-01-01

This article shows how poor people living with HIV/AIDS in Tanzania navigate a myriad of actors, agencies and organizations to obtain the aid they need to survive. It focuses on community-based organizations which establish networks of care through which people obtain care, treatment and financial support. A case study of a roadside town in Tanzania illustrates that these community-based networks of care — essential to the survival of many — are partly the product of the AIDS industry, which encourages the establishment of community-based organizations and voluntary service delivery rather than more formalized systems of care. Community-based organizations, however, are so poorly supported that they often deploy self-destructive strategies. The need to strategically navigate the AIDS industry creates tension and even conflict among HIV-positive activists, the people they represent and the wider community, which undermines rather than strengthens community-based interventions. Whilst the AIDS industry promises inclusion of HIV-positive people in the response to HIV/AIDS, it succeeds only partially, with the result that it may potentially do more harm than good.

Does External Funding Help Adaptation? Evidence from Community-Based Water Management in the Colombian Andes

NASA Astrophysics Data System (ADS)

Murtinho, Felipe; Eakin, Hallie; López-Carr, David; Hayes, Tanya M.

2013-11-01

Despite debate regarding whether, and in what form, communities need external support for adaptation to environmental change, few studies have examined how external funding impacts adaptation decisions in rural resource-dependent communities. In this article, we use quantitative and qualitative methods to assess how different funding sources influence the initiative to adapt to water scarcity in the Colombian Andes. We compare efforts to adapt to water scarcity in 111 rural Andean communities with varied dependence on external funding for water management activities. Findings suggest that despite efforts to use their own internal resources, communities often need external support to finance adaptation strategies. However, not all external financial support positively impacts a community’s abilities to adapt. Results show the importance of community-driven requests for external support. In cases where external support was unsolicited, the results show a decline, or “crowding-out,” in community efforts to adapt. In contrast, in cases where communities initiated the request for external support to fund their own projects, findings show that external intervention is more likely to enhance or “crowds-in” community-driven adaptation.

Networks Analysis of a Regional Ecosystem of Afterschool Programs

ERIC Educational Resources Information Center

Russell, Martha G.; Smith, Marc A.

2011-01-01

Case studies have documented the impact of family-school-community collaboration in afterschool programs on increasing awareness about the problems of at-risk youth, initiating dialogue among leaders and community representatives, developing rich school-based information systems, and demonstrating how to build strong relationships between public…

Community-Based Outbreak of Neisseria meningitidis Serogroup C Infection in Men who Have Sex with Men, New York City, New York, USA, 2010−2013

PubMed Central

Weiss, Don; Ridpath, Alison; Zucker, Jane R.; Geevarughese, Anita; Rakeman, Jennifer; Varma, Jay K.

2015-01-01

In September 2012, the New York City Department of Health and Mental Hygiene identified an outbreak of Neisseria meningitidis serogroup C invasive meningococcal disease among men who have sex with men (MSM). Twenty-two case-patients and 7 deaths were identified during August 2010−February 2013. During this period, 7 cases in non-MSM were diagnosed. The slow-moving outbreak was linked to the use of websites and mobile phone applications that connect men with male sexual partners, which complicated the epidemiologic investigation and prevention efforts. We describe the outbreak and steps taken to interrupt transmission, including an innovative and wide-ranging outreach campaign that involved direct, internet-based, and media-based communications; free vaccination events; and engagement of community and government partners. We conclude by discussing the challenges of managing an outbreak affecting a discrete community of MSM and the benefits of using social networking technology to reach this at-risk population. PMID:26197087

Key principles of community-based natural resource management: a synthesis and interpretation of identified effective approaches for managing the commons.

PubMed

Gruber, James S

2010-01-01

This article examines recent research on approaches to community-based environmental and natural resource management and reviews the commonalities and differences between these interdisciplinary and multistakeholder initiatives. To identify the most effective characteristics of Community-based natural resource management (CBNRM), I collected a multiplicity of perspectives from research teams and then grouped findings into a matrix of organizational principles and key characteristics. The matrix was initially vetted (or "field tested") by applying numerous case studies that were previously submitted to the World Bank International Workshop on CBNRM. These practitioner case studies were then compared and contrasted with the findings of the research teams. It is hoped that the developed matrix may be useful to researchers in further focusing research, understanding core characteristics of effective and sustainable CBNRM, providing practitioners with a framework for developing new CBNRM initiatives for managing the commons, and providing a potential resource for academic institutions during their evaluation of their practitioner-focused environmental management and leadership curriculum.

Community perceptions and attitudes on malaria case management and the role of community health workers.

PubMed

Owek, Collins J; Oluoch, Elizabeth; Wachira, Juddy; Estambale, Benson; Afrane, Yaw A

2017-07-04

Community Case Management of malaria (CCMm) is one of the new approaches adopted by the World Health Organization for malaria endemic countries to reduce the burden of malaria for vulnerable populations. It is based on the evidence that well-trained and supervised community health workers (CHWs) can provide prompt and adequate treatment to fever cases within 24 h to help reduce morbidity and mortality associated with malaria among under-five children. The perception and attitudes of the community members on the CHWs' role is of greater importance for acceptance of their services. The aim of the study was to assess community's perception and attitude towards CCMm and on CHWs who undertake it. This study was conducted in five districts in western Kenya where Community Case Management was being undertaken. This was a qualitative cross-sectional study in which in-depth interviews and focus group discussions were conducted with mothers of under-five children and key stakeholders. Overall, there were more positive expressions of perceptions and attitudes of the community members towards the CCMm programme and the role of CHWs. The positive perceptions included among others; recognition and appreciation of services of CHWs, bringing health services to close proximity to the community, avoiding long queues in the health facilities, provision of health education that encourages good health practices, and promotion of positive health-seeking behaviour from within the communities. This programme is not without challenges as some of the negative perceptions expressed by the community members included the fact that some clinicians doubt the capacity of CHWs on dispensing drugs in the community, some CHWs do not keep client's secrets and mistrust of CHWs due to conflicting information by government. It was evident that the community had more positive perceptions and attitudes towards the role of CHWs in CCMm than negative ones. There should however, be deliberate efforts towards sustaining the positive aspects and addressing the negative concerns raised by the community and the health care practitioners.

Beacon Communities’ Public Health Initiatives: A Case Study Analysis

PubMed Central

Massoudi, Barbara L.; Marcial, Laura H.; Haque, Saira; Bailey, Robert; Chester, Kelley; Cunningham, Shellery; Riley, Amanda; Soper, Paula

2014-01-01

Introduction: The Beacon Communities for Public Health (BCPH) project was launched in 2011 to gain a better understanding of the range of activities currently being conducted in population- and public health by the Beacon Communities. The project highlighted the successes and challenges of these efforts with the aim of sharing this information broadly among the public health community. Background: The Beacon Community Program, designed to showcase technology-enabled, community-based initiatives to improve outcomes, focused on: building and strengthening health information technology (IT) infrastructure and exchange capabilities; translating investments in health IT to measureable improvements in cost, quality, and population health; and, developing innovative approaches to performance measurement, technology, and care delivery. Methods: Four multimethod case studies were conducted based on a modified sociotechnical framework to learn more about public health initiative implementation and use in the Beacon Communities. Our methodological approach included using document review and semistructured key informant interviews. NACCHO Model Practice Program criteria were used to select the public health initiatives included in the case studies. Findings: Despite differences among the case studies, common barriers and facilitators were found to be present in all areas of the sociotechnical framework application including structure, people, technology, tasks, overarching considerations, and sustainability. Overall, there were many more facilitators (range = 7–14) present for each Beacon compared to barriers (range = 4–6). Discussion: Four influential promising practices were identified through the work: forging strong and sustainable partnerships; ensuring a good task-technology fit and a flexible and iterative design; fostering technology acceptance; and, providing education and demonstrating value. Conclusions: A common weakness was the lack of a framework or model for the Beacon Communities evaluation work. Sharing a framework or approach to evaluation at the beginning of implementation made the work more effective. Supporting evaluation to inform future implementations is important. PMID:25848620

Increases in HIV Testing and Case Detection from NIMH Project Accept (HPTN 043) among 16–32 Year Olds: A Randomized Community-Based Intervention in Tanzania, Zimbabwe, and Thailand

PubMed Central

Sweat, Michael; Morin, Stephen; Celentano, David; Mulawa, Marta; Singh, Basant; Mbwambo, Jessie; Kawichai, Surinda; Chingono, Alfred; Khumalo-Sakutukwa, Gertrude; Gray, Glenda; Richter, Linda; Kulich, Michal; Sadowski, Andrew; Coates, Thomas

2011-01-01

SUMMARY BACKGROUND HIV counseling and testing is the gateway to treatment and care and provides important preventative and personal benefits to recipients. However, in developing countries the majority of HIV infected persons have not been tested for HIV. Combining community mobilization, mobile community-based HIV testing and counseling, and post-test support may increase HIV testing rates. METHODS We randomly assigned half of 10 rural communities in Tanzania, 8 in Zimbabwe, and 14 in Thailand to receive a multiple component community-based voluntary counseling and testing (CBVCT) intervention together with access to standard clinic-based voluntary counseling and testing (SVCT). The control communities received only SVCT. The intervention was provided for approximately 3 years. The primary study endpoint is HIV incidence and is pending completion of the post-intervention assessment. This is a descriptive interim analysis examining the percentage of the total population aged 16–32 years tested for HIV across study arms, and differences in client characteristics by study arm. FINDINGS A higher percentage of 16–32 year-olds were tested in intervention communities than in control communities (37% vs. 9% in Tanzania; 51% vs. 5% in Zimbabwe; and 69% vs. 23% in Thailand). The mean difference between the percentage of the population tested in CBVCT versus SVCT communities was 40.4% across the 3 country study arm pairs, (95% CI 15.8% – 64.7%, p-value 0.019, df=2). Despite higher prevalence of HIV among those testing at SVCT venues the intervention detected 3.6 times more HIV infected clients in the CBVCT communities than in SVCT communities (952 vs. 264, p< 0.001). Over time the rate of repeat testing grew substantially across all sites to 28% of all those testing for HIV by the end of the intervention period. INTERPRETATION This multiple component, community-level intervention is effective at both increasing HIV testing rates and detecting HIV cases in rural settings in developing countries. PMID:21546309

Dynamic Integration of Mobile JXTA with Cloud Computing for Emergency Rural Public Health Care

PubMed Central

Rajkumar, Rajasekaran; Sriman Narayana Iyengar, Nallani Chackravatula

2013-01-01

Objectives The existing processes of health care systems where data collection requires a great deal of labor with high-end tasks to retrieve and analyze information, are usually slow, tedious, and error prone, which restrains their clinical diagnostic and monitoring capabilities. Research is now focused on integrating cloud services with P2P JXTA to identify systematic dynamic process for emergency health care systems. The proposal is based on the concepts of a community cloud for preventative medicine, to help promote a healthy rural community. We investigate the approaches of patient health monitoring, emergency care, and an ambulance alert alarm (AAA) under mobile cloud-based telecare or community cloud controller systems. Methods Considering permanent mobile users, an efficient health promotion method is proposed. Experiments were conducted to verify the effectiveness of the method. The performance was evaluated from September 2011 to July 2012. A total of 1,856,454 cases were transported and referred to hospital, identified with health problems, and were monitored. We selected all the peer groups and the control server N0 which controls N1, N2, and N3 proxied peer groups. The hospital cloud controller maintains the database of the patients through a JXTA network. Results Among 1,856,454 transported cases with beneficiaries of 1,712,877 cases there were 1,662,834 lives saved and 8,500 cases transported per day with 104,530 transported cases found to be registered in a JXTA network. Conclusion The registered case histories were referred from the Hospital community cloud (HCC). SMS messages were sent from node N0 to the relay peers which connected to the N1, N2, and N3 nodes, controlled by the cloud controller through a JXTA network. PMID:24298441

Dynamic Integration of Mobile JXTA with Cloud Computing for Emergency Rural Public Health Care.

PubMed

Rajkumar, Rajasekaran; Sriman Narayana Iyengar, Nallani Chackravatula

2013-10-01

The existing processes of health care systems where data collection requires a great deal of labor with high-end tasks to retrieve and analyze information, are usually slow, tedious, and error prone, which restrains their clinical diagnostic and monitoring capabilities. Research is now focused on integrating cloud services with P2P JXTA to identify systematic dynamic process for emergency health care systems. The proposal is based on the concepts of a community cloud for preventative medicine, to help promote a healthy rural community. We investigate the approaches of patient health monitoring, emergency care, and an ambulance alert alarm (AAA) under mobile cloud-based telecare or community cloud controller systems. Considering permanent mobile users, an efficient health promotion method is proposed. Experiments were conducted to verify the effectiveness of the method. The performance was evaluated from September 2011 to July 2012. A total of 1,856,454 cases were transported and referred to hospital, identified with health problems, and were monitored. We selected all the peer groups and the control server N0 which controls N1, N2, and N3 proxied peer groups. The hospital cloud controller maintains the database of the patients through a JXTA network. Among 1,856,454 transported cases with beneficiaries of 1,712,877 cases there were 1,662,834 lives saved and 8,500 cases transported per day with 104,530 transported cases found to be registered in a JXTA network. The registered case histories were referred from the Hospital community cloud (HCC). SMS messages were sent from node N0 to the relay peers which connected to the N1, N2, and N3 nodes, controlled by the cloud controller through a JXTA network.

Community-based youth tobacco control interventions: cost effectiveness of the Full Court Press project.

PubMed

Ross, Hana; Powell, Lisa M; Bauer, Joseph E; Levy, David T; Peck, Richard M; Lee, Hye-Ryeon

2006-01-01

We evaluated the impact of a community-based tobacco control project that was implemented in the city of Tucson, Arizona, USA, between 1996 and 2001. The project's goal was to reduce the prevalence of youth smoking through change in social norms at schools and in communities and workplaces. As is often the case, these community-based health promotion interventions were implemented in conjunction with other broader programmes, in this case implemented on the state level. Taking into account state level interventions as well as changes in sociodemographic and economic environment over the course of the project (e.g. increases in cigarette prices), we measure the net effect of the intervention in terms of the number of people who quit or did not initiate smoking and by the discounted life-years gained. To establish the value of investing into community-based intervention, we calculated the real discounted cost per quit and per life-year gained of 3789 US dollars and 3942 US dollars, respectively. These compare favourably with the real cost per quit of 4270 US dollars when implementing the 1996 US Clinical Practice Guideline for smoking cessation but exceed the real cost of 2923 US dollars per discounted life-year gained when following the guideline. A sensitivity analysis that assumed 5% programme persistence (i.e. 5% of the programme's impact would last forever in the absence of future funding for the programme), one-third would relapse and that one-third of those who quit may have quit smoking even without the programme, suggested a lower cost per discounted life-year saved of 3476 US dollars. The cost effectiveness of this project compares favourably with other tobacco control interventions. Despite its relatively small target group, this community-based intervention was cost effective.

Trust Building in Virtual Communities

NASA Astrophysics Data System (ADS)

Mezgár, István

By using different types of communication networks various groups of people can come together according to their private or business interest forming a Virtual Community. In these communities cooperation and collaboration plays an important role. As trust is the base of all human interactions this fact is even more valid in case of virtual communities. According to different experiments the level of trust in virtual communities is highly influenced by the way/mode of communication and by the duration of contact. The paper discusses the ways of trust building focusing on communication technologies and security aspects in virtual communities.

[Special Report: Adult Education and Primary Health Care.

ERIC Educational Resources Information Center

Vijayendra, T.; And Others

1982-01-01

A series of five case studies examines (1) literacy, health, and conscientization in the Mandar region of India; (2) the training of community health workers in Indonesia; (3) the Chinese strategy combining health, political will, and participation; (4) British community-based health education programs, and (5) participatory methodology for…

Future Search in School District Change: Connection, Community, and Results

ERIC Educational Resources Information Center

Schweitz, Rita; Martens, Kim; Aronson, Nancy; Weisbord, Marvin; Janoff, Sandra

2005-01-01

This book contains sixteen compelling case studies that illustrate the power of future search to create lasting, whole system change. Future Search in School District Change: Connection, Community, and Results chronicles ways in which educational institutions have used broad-based stakeholder involvement to improve education. These experiences, by…

From Academic Vision to Physical Manifestation

ERIC Educational Resources Information Center

Walleri, R. Dan; Becker, William E.

2004-01-01

This community college-based case study describes and analyzes how a new mission and vision adopted by the college trustees was translated into a facility master plan. The vision is designed to serve the needs of the community and facilitate economic development, especially in the areas of health occupations, biotechnology and…

Community-Based Research and Approaches to Social Change: The Case of the Hispanic Health Council.

ERIC Educational Resources Information Center

Schensul, Jean J.; And Others

1981-01-01

This article reviews six programs that have applied anthropological concepts, methods, and research to implementing change in American schools, school districts, and communities. The programs are: (1) the West Philadelphia (Pennsylvania) Free School, an experimental alternative education program that emphasizes freedom, individualized instruction,…

Open Crowdsourcing: Leveraging Community Software Developers for IT Projects

ERIC Educational Resources Information Center

Phair, Derek

2012-01-01

This qualitative exploratory single-case study was designed to examine and understand the use of volunteer community participants as software developers and other project related roles, such as testers, in completing a web-based application project by a non-profit organization. This study analyzed the strategic decision to engage crowd…

Perceived School Effectiveness: Case Study of a Liverpool College

ERIC Educational Resources Information Center

Samy, M.; Cook, K.

2009-01-01

Purpose: A quantitative effectiveness measurement based on the perceptions of the local community has been established as an effective mode of evaluating the level of satisfaction or perceived effectiveness of a school. In order to measure the level of effectiveness as perceived by their communities, educational institutions could use this…

Sustainability Education as a Catalyst for University and Community Partnerships

ERIC Educational Resources Information Center

Lishawa, Shane; Schubel, Adam; Varty, Alison; Tuchman, Nancy

2010-01-01

Universities are uniquely positioned to lead society toward sustainability and their collaborations with community organizations are essential to this transition. The Biodiesel Program at Loyola University at Chicago Center for Urban Environmental Research and Policy provides a case study of course-based service learning projects facilitating…

Building Action Research Teams: A Case of Struggles and Successes

ERIC Educational Resources Information Center

Du, Fengning

2009-01-01

Teaching teams can hold the promise of being an ideal vehicle in which collaborative action research is conducted. This case documents the mixed results of a team leader's efforts to improve teaching and introduce inquiry-based professional development through action research in a community college. This case paints a realistic and…

Description of Exemplar Cases in the Intensive Mental Health Program: Illustrations of Application of the Therapeutic Model

ERIC Educational Resources Information Center

Nelson, Timothy D.; Mashunkashey, Joanna O.; Mitchell, Montserrat C.; Benson, Eric R.; Vernberg, Eric M.; Roberts, Michael C.

2008-01-01

We describe cases from the clinical records in the Intensive Mental Health Program to illustrate the diverse presenting problems, intervention strategies, therapeutic process, and outcomes for children receiving services in this school-based, community-oriented treatment model. Cases reflect varying degrees of treatment response and potential…

Cost-effectiveness of the community-based management of severe acute malnutrition by community health workers in southern Bangladesh.

PubMed

Puett, Chloe; Sadler, Kate; Alderman, Harold; Coates, Jennifer; Fiedler, John L; Myatt, Mark

2013-07-01

This study assessed the cost-effectiveness of adding the community-based management of severe acute malnutrition (CMAM) to a community-based health and nutrition programme delivered by community health workers (CHWs) in southern Bangladesh. The cost-effectiveness of this model of treatment for severe acute malnutrition (SAM) was compared with the cost-effectiveness of the 'standard of care' for SAM (i.e. inpatient treatment), augmented with community surveillance by CHWs to detect cases, in a neighbouring area. An activity-based cost model was used, and a societal perspective taken, to include all costs incurred in the programme by providers and participants for the management of SAM in both areas. Cost data were coupled with programme effectiveness data. The community-based strategy cost US$26 per disability-adjusted life year (DALY) averted, compared with US$1344 per DALY averted for inpatient treatment. The average cost to participant households for their child to recover from SAM in community treatment was one-sixth that of inpatient treatment. These results suggest that this model of treatment for SAM is highly cost-effective and that CHWs, given adequate supervision and training, can be employed effectively to expand access to treatment for SAM in Bangladesh.

The Roles of Science in Local Resilience Policy Development: A Case Study of Three U.S. Cities

NASA Astrophysics Data System (ADS)

Clavin, C.; Gupta, N.

2015-12-01

The development and deployment of resilience policies within communities in the United States often respond to the place-based, hazard-specific nature of disasters. Prior to the onset of a disaster, municipal and regional decision makers establish long-term development policies, such as land use planning, infrastructure investment, and economic development policies. Despite the importance of incorporating disaster risk within community decision making, resilience and disaster risk are only one consideration community decision makers weigh when choosing how and whether to establish resilience policy. Using a case study approach, we examine the governance, organizational, management, and policy making processes and the involvement of scientific advice in designing and implementing resilience policy in three U.S. communities: Los Angeles, CA; Norfolk, VA; and Flagstaff, AZ. Disaster mitigation or resilience initiatives were developed and deployed in each community with differing levels and types of scientific engagement. Engagement spanned from providing technical support with traditional risk assessment to direct engagement with community decision makers and design of community resilience outreach. Best practices observed include embedding trusted, independent scientific advisors with strong community credibility within local government agencies, use of interdisciplinary and interdepartmental expert teams with management and technical skillsets, and establishing scientifically-informed disaster and hazard scenarios to enable community outreach. Case study evidence suggest science communication and engagement within and across municipal government agencies and scientifically-informed direct engagement with community stakeholders are effective approaches and roles that disaster risk scientists can fill to support resilience policy development.

[Implementation of a community tele-epidemiological surveillance system using information and communication technologies in Paraguay].

PubMed

Galván, Pedro; Cane, Virgilio; Samudio, Margarita; Cabello, Agueda; Cabral, Margarita; Basogain, Xavier; Rivas, Ronald; Hilario, Enrique

2014-01-01

Report preliminary results of the application of the BONIS system in community tele-epidemiological surveillance in Paraguay. A study of viability and implementation carried out in the Family Health Unit located in Bañado Sur in the city of Asunción by the Paraguay River. The system automatically records personal data and symptoms of individuals who make telephone reports, and suspected cases of dengue are classified and prioritized. This information goes to community agents for follow-up and to specialists in charge of epidemiological surveillance. From April 2010 to August 2011, 1 028 calls to the system were logged. Of 157 reported cases of fever, home visits were made to 140 (89.2%); of these, fever and headache or body ache were confirmed in 52 (37.1%) cases, and headache or body ache without fever in 58 (41.4%) cases. Community agents referred 49 (35.0%) of them for medical consultation and blood tests, and they took blood samples in the homes of 19; of these, 56 (82.3%) were positive for dengue and 12 (17.4%) for influenza. Paraguay has a low-cost community tele-epidemiological surveillance system based on information and communication technologies and open-source software, which is scalable to other health symptoms and disorders of interest. To enable its acceptance and application, education programs should be developed to strengthen the management and promotion of community health.

Increasing Community Access to Fresh Fruits and Vegetables: A Case Study of the Farm Fresh Market Pilot Program in Cobb County, Georgia, 2014

PubMed Central

Coleman, Anne-Marie; Hermstad, April K.; Honeycutt, Sally; Munoz, Jennifer; Loh, Lorna; Brown, Agnes F.; Shipley, Rebecca; Kegler, Michelle C.

2016-01-01

Background Ecological models of health suggest that to effectively prevent chronic disease, community food environments must support healthy eating behaviors. However, disparities in access to healthy foods persist in the United States. Community Context The Farm Fresh Market (FFM) was a fruit and vegetable market that sold low-cost fresh produce in Cobb County, Georgia in 2014. Methods This case study describes the development of the FFM through a community engagement process and presents evaluation results from the project’s pilot implementation. Community engagement strategies included forming a community advisory board, conducting a needs assessment, and contracting with a community-based organization to implement the FFM. Outcome In the pilot year, the FFM served an average of 28.7 customers and generated an average of $140.20 in produce sales per market day. Most returning customers lived in the local community and reported a range of socioeconomic backgrounds. Most returning customers strongly agreed that the FFM made it easier (69.0%) and less expensive (79.0%) for them to buy fresh fruits and vegetables, reported that they ate more vegetables (65.0%) and fruit (55.0%) as a result of the FFM, and reported that they were very satisfied with the FFM overall (92.0%). Interpretation Results from this community case study underscore the importance of engaging communities in the development of community food environment interventions. Results also suggest that the FFM initiative was a feasible and acceptable way to respond to the community-identified public health priority of increasing access to healthy foods. PMID:26963860

Everglades Landscape Model: Integrated Assessment of Hydrology, Biogeochemistry, and Biology

NASA Astrophysics Data System (ADS)

Fitz, H. C.; Wang, N.; Sklar, F. H.

2002-05-01

Water management infrastructure and operations have fragmented the greater Everglades into separate, impounded basins, altering flows and hydropatterns. A significant area of this managed system has experienced anthropogenic eutrophication. This combination of altered hydrology and water quality has interacted to degrade vegetative habitats and other ecological characteristics of the Everglades. One of the modeling tools to be used in developing restoration alternatives is the Everglades Landscape Model (ELM), a process-based, spatially explicit simulation of ecosystem dynamics across a heterogeneous, 10,000 km2 region. The model has been calibrated to capture hydrologic and surface water quality dynamics across most of the Everglades landscape over decadal time scales. We evaluated phosphorus loading throughout the Everglades system under two base scenarios. The 1995 base case assumed current management operations, with phosphorus inflow concentrations fixed at their long term, historical average. The 2050 base case assumed future modifications in water and nutrient management, with all managed inflows to the Everglades having reduced phosphorus concentrations. In an example indicator subregion that currently is highly eutrophic, the 31-yr simulations predicted that desirable periphyton and macrophyte communities were maintained under the 2050 base case, whereas in the 1995 base case, periphyton biomass and production decreased to negligible levels and macrophytes became extremely dense. The negative periphyton response in the 1995 base case was due to high phosphorus loads and rapid macrophyte growth that shaded this algal community. Along an existing 11 km eutrophication gradient, the model indicated that the 2050 base case had ecologically significant reductions in phosphorus accumulation compared to the 1995 base case. Indicator regions (in Everglades National Park) distant from phosphorus inflow points also exhibited reductions in phosphorus accumulation under the 2050 base case, albeit to a lesser extent due to its distance from phosphorus inflows. The ELM fills a critical information need in Everglades management, and has become an accepted tool in evaluating scenarios of potential restoration of the natural system.

The contribution of a non-governmental organisation's Community Based Tuberculosis Care Programme to case finding in Myanmar: trend over time.

PubMed

Maung, Htet Myet Win; Saw, Saw; Isaakidis, Petros; Khogali, Mohammed; Reid, Anthony; Hoa, Nguyen Binh; Zaw, Ko Ko; Thein, Saw; Aung, Si Thu

2017-04-03

It is estimated that the standard, passive case finding (PCF) strategy for detecting cases of tuberculosis (TB) in Myanmar has not been successful: 26% of cases are missing. Therefore, alternative strategies, such as active case finding (ACF) by community volunteers, have been initiated since 2011. This study aimed to assess the contribution of a Community Based TB Care Programme (CBTC) by local non-government organizations (NGOs) to TB case finding in Myanmar over 4 years. This was a descriptive study using routine, monitoring data. Original data from the NGOs were sent to a central registry within the National TB Programme and data for this study were extracted from that database. Data from all 84 project townships in five regions and three states in Myanmar were used. The project was launched in 2011. Over time, the number of presumptive TB cases that were referred decreased, except in the Yangon Region, although in some areas, the numbers fluctuated. At the same time, there was a trend for the proportion of cases treated, compared to those referred, that decreased over time (P = 0.051). Overall, among 84 townships, the contribution of CBTC to total case detection deceased from 6% to 4% over time (P < 0.001). Contrary to expectations and evidence from previous studies in other countries, a concerning reduction in TB case finding by local NGO volunteer networks in several areas in Myanmar was recorded over 4 years. This suggests that measures to support the volunteer network and improve its performance are needed. They may include discussion with local NGOs human resources personnel, incentives for the volunteers, closer supervision of volunteers and improved monitoring and evaluation tools.

Traditions and Customs in Community Development: The Case of Nkanu West and Nkanu East Local Government Areas of Enugu State, Nigeria

ERIC Educational Resources Information Center

Adekola, G.; Egbo, Nwoye Charles

2016-01-01

This study examined the influence of traditions and customs on community development in Nkanu West and Nkanu East Local Government Areas of Enugu State. The study was carried out with three objectives and three null hypotheses. The research adopted descriptive survey design with a population of 2,125 members of community Based Organizations in the…

Teaching nutrition to medical students: a community-based problem-solving approach.

PubMed

Bhattacharji, S; Joseph, A; Abraham, S; Muliyil, J; John, K R; Ethirajan, N

1990-01-01

This paper presents a community-based problem-solving educational programme which aims at teaching medical and other health science students the importance of nutrition and its application. Through community surveys students assess the nutritional status of children under five using different anthropometric methods. They understand the cultural beliefs and customs related to food fads and the reasons for them. They also acquire the skill to educate the community using the information gathered. They use epidemiological methods such as case control study to find associations between malnutrition and other causative factors. Feedback from students has been positive and evaluation of students' knowledge before and after the programme has shown significant improvement.

A comparison of home care clients and nursing home residents: can community based care keep the elderly and disabled at home?

PubMed

Shugarman, L R; Fries, B E; James, M

1999-01-01

Admission cohorts from the Michigan Medicaid Home and Community-Based Waiver program and Ohio nursing homes were compared on measures of resource utilization including a modified Resource Utilization Groups (RUG-III) system, Activities of Daily Living (ADLs), and overall case mix. We found that, contrary to previous research, the two samples were remarkably similar across RUG-III categories. However, the nursing home sample was more functionally impaired on measures of ADL functioning and overall case mix. Results of this study may inform policymakers and providers of the potential for maintaining the appropriate population in the home with government-funded home care.

Opening up their doors: perspectives on the involvement of the African American faith community in HIV prevention in four communities.

PubMed

Wooster, Joanna; Eshel, Ariela; Moore, Andrea; Mishra, Meenoo; Toledo, Carlos; Uhl, Gary; Aguero, Linda Wright-De

2011-09-01

In 1998, the U.S. government launched the Minority AIDS Initiative (MAI) to address growing ethnic and racial disparities in HIV/AIDS cases. The CDC performed an evaluation of its MAI-funded programs, including an assessment of community stakeholders' perspective on the involvement of the faith community in HIV prevention. Individual interviews (N = 113) were conducted annually over 3 years in four communities. The majority of participants described a change in faith community's attitudes toward HIV and a rise in HIV-related activities conducted by faith-based organizations. Participants attributed changes to faith-based funding, acknowledgment by African American community leadership that HIV is a serious health issue, and faith leaders' desire to become more educated on HIV/AIDS. Participants reported conservative faith doctrine and stigma as barriers to faith community involvement. The findings suggest that although barriers remain, there is an increased willingness to address HIV/AIDS, and the faith community serves as a vital resource in HIV prevention.

School of pharmacy-based medication therapy management program: development and initial experience.

PubMed

Lam, Annie; Odegard, Peggy Soule; Gardner, Jacqueline

2012-01-01

To describe a school of pharmacy-community pharmacy collaborative model for medication therapy management (MTM) service and training. University of Washington (UW) School of Pharmacy (Seattle), from July to December 2008. MTM services and training. A campus-based MTM pharmacy was established for teaching, practice, and collaboration with community pharmacies to provide comprehensive medication reviews (CMRs) and MTM training. Number of collaborating pharmacies, number of patients contacted, number of CMRs conducted, and estimated cost avoidance (ECA). UW Pharmacy Cares was licensed as a Class A pharmacy (nondispensing) and signed "business associate" agreements with six community pharmacies. During July to December 2008, 10 faculty pharmacists completed training and 5 provided CMR services to 17 patients (5 telephonic and 12 face-to-face interviews). A total of 67 claims (17 CMRs and 50 CMR-generated claims) were submitted for reimbursement of $1,642 ($96.58/CMR case). Total ECA was $54,250, averaging $3,191.19 per patient. Seven student pharmacists gained CMR interview training. Interest in collaboration by community pharmacies was lower than expected; however, the campus-community practice model addressed unmet patient care needs, reduced outstanding MTM CMR case loads, increased ECA, and facilitated faculty development and training of student pharmacists.

A case-control comparison of direct healthcare-provider medical costs of chronic idiopathic constipation and irritable bowel syndrome with constipation in a community-based cohort

PubMed Central

Herrick, Linda M.; Spalding, William M.; Saito, Yuri A.; Moriarty, James; Schleck, Cathy

2017-01-01

Objective Patients with constipation account for 3.1 million United States physician visits a year, but care costs for patients with irritable bowel syndrome with constipation (IBS-C) or chronic idiopathic constipation (CIC) compared to the general public have received little study. The study aim was to describe healthcare utilization and compare medical costs for patients with IBS-C or CIC versus matched controls from a community-based sample. Methods A nested case-control sample (IBS-C and CIC cases) and matched controls (1:2) for each case group were selected from Olmsted County, MN individuals responding to a community-based survey of gastrointestinal symptoms (2008) who received healthcare from a participating Rochester Epidemiology Project (REP) provider. Using REP healthcare utilization data, unadjusted and adjusted standardized costs were compared for the 2- and 10-year periods prior to the survey for 115 IBS-C patients and 230 controls and 365 CIC patients and 730 controls. Two time periods were chosen as these conditions are episodic but long-term. Results Outpatient costs for IBS-C ($6,800) and CIC ($6,284) patients over a 2-year period prior to the survey were significantly higher than controls ($4,242 and $5,254 respectively) after adjusting for co-morbidities, age, and sex. IBS-C outpatient costs ($25,448) and emergency room costs ($6,892) were significantly higher than controls ($21,024 and $3,962 respectively) for the 10-year period prior. Unadjusted data analyses of cases compared to controls demonstrated significantly higher imaging costs for IBS-C cases and procedure costs for CIC cases over the 10-year period. Limitations Data were collected from a random community sample primarily receiving care from a limited number of providers in that area. Conclusions Patients with IBS-C and CIC had significantly higher outpatient costs for the 2-year period compared with controls. IBS-C patients also had higher ER costs than the general population. PMID:27783533

Re-emerging Lassa fever outbreaks in Nigeria: Re-enforcing "One Health" community surveillance and emergency response practice.

PubMed

Tambo, Ernest; Adetunde, Oluwasegun T; Olalubi, Oluwasogo A

2018-04-28

We evaluated the impact of man-made conflict events and climate change impact in guiding evidence-based community "One Health" epidemiology and emergency response practice against re-/emerging epidemics. Increasing evidence of emerging and re-emerging zoonotic diseases including recent Lassa fever outbreaks in almost 20 states in Nigeria led to 101 deaths and 175 suspected and confirmed cases since August 2015. Of the 75 laboratory confirmed cases, 90 deaths occurred representing 120% laboratory-confirmed case fatality. The outbreak has been imported into neighbouring country such as Benin, where 23 deaths out of 68 cases has also been reported. This study assesses the current trends in re-emerging Lassa fever outbreak in understanding spatio-geographical reservoir(s), risk factors pattern and Lassa virus incidence mapping, inherent gaps and raising challenges in health systems. It is shown that Lassa fever peak endemicity incidence and prevalence overlap the dry season (within January to March) and reduced during the wet season (of May to November) annually in Sierra Leone, Senegal to Eastern Nigeria. We documented a scarcity of consistent data on rodent (reservoirs)-linked Lassa fever outbreak, weak culturally and socio-behavioural effective prevention and control measures integration, weak or limited community knowledge and awareness to inadequate preparedness capacity and access to affordable case management in affected countries. Hence, robust sub/regional leadership commitment and investment in Lassa fever is urgently needed in building integrated and effective community "One Health" surveillance and rapid response approach practice coupled with pest management and phytosanitation measures against Lassa fever epidemic. This offers new opportunities in understanding human-animal interactions in strengthening Lassa fever outbreak early detection and surveillance, warning alerts and rapid response implementation in vulnerable settings. Leveraging on Africa CDC centre, advances in cloud-sourcing and social media tools and solutions is core in developing and integrating evidence-based and timely risk communication, and reporting systems in improving contextual community-based immunization and control decision making policy to effectively defeat Lassa fever outbreak and other emerging pandemics public health emergencies in Africa and worldwide.

Incidence and 30-day case fatality rate of first-ever stroke in urban Nigeria: the prospective community based Epidemiology of Stroke in Lagos (EPISIL) phase II results.

PubMed

Danesi, Mustapha A; Okubadejo, Njideka U; Ojini, Frank I; Ojo, Oluwadamilola O

2013-08-15

Stroke is a leading cause of death worldwide and a major contributor to global disease burden. Although epidemiologic information from a community perspective is important in determining the magnitude of the burden in specific regions, and directing equitable distribution of health resources, data on the incidence of stroke in developing countries in Africa are scarce. To determine the current incidence rate and short-term (30-day) case fatality rate (CFR) of stroke in urban Nigeria, and provide age-adjusted and gender-specific incidence rates to enable comparison with global populations. The study was a prospective community-based stroke registry enrolling hospitalized and non-hospitalized first-ever in a lifetime stroke cases presenting at all health facilities (hospitals, homeopathic caregivers, physiotherapy clinics) located in the designated community. Pre-hospitalization deaths due to stroke were not included in our study. The study was conducted between January 1st and December 31st 2007 in Surulere Local Government Area of Lagos State, south western Nigeria, a mixed-income urban locality with a population of approximately 750,000 based on data from the National Population Commission. Stroke was defined using the World Health Organization (WHO) clinical criteria. Case fatality at 30-days post stroke was determined at follow-up on 160 hospitalized stroke cases. 189 first-ever strokes, comprised of 112 men and 77 women (mean±SD age 58.5±13.5 years) were documented, giving a crude incidence rate of 25.2 per 100,000 per year (95% confidence interval 21.6- 28.8). The gender-specific rates were 28.3/100,000 and 21.3/100,000 for males and females respectively. The age-adjusted incidence rate was 54.08 per 100,000 per year (adjusted to the WHO New World Population). Hospitalization rate was 84.6%, while the CFR (hospitalized) was 16.2%. The stroke incidence in this urban sub-Saharan African community remains lower than that in emerging and developed economies, although the age- and gender-related trends and CFR are comparable to that in developed countries. Copyright © 2013 Elsevier B.V. All rights reserved.

Results of community deliberation about social impacts of ecological restoration: comparing public input of self-selected versus actively engaged community members.

PubMed

Harris, Charles C; Nielsen, Erik A; Becker, Dennis R; Blahna, Dale J; McLaughlin, William J

2012-08-01

Participatory processes for obtaining residents' input about community impacts of proposed environmental management actions have long raised concerns about who participates in public involvement efforts and whose interests they represent. This study explored methods of broad-based involvement and the role of deliberation in social impact assessment. Interactive community forums were conducted in 27 communities to solicit public input on proposed alternatives for recovering wild salmon in the Pacific Northwest US. Individuals identified by fellow residents as most active and involved in community affairs ("AE residents") were invited to participate in deliberations about likely social impacts of proposed engineering and ecological actions such as dam removal. Judgments of these AE participants about community impacts were compared with the judgments of residents motivated to attend a forum out of personal interest, who were designated as self-selected ("SS") participants. While the magnitude of impacts rated by SS participants across all communities differed significantly from AE participants' ratings, in-depth analysis of results from two community case studies found that both AE and SS participants identified a large and diverse set of unique impacts, as well as many of the same kinds of impacts. Thus, inclusion of both kinds of residents resulted in a greater range of impacts for consideration in the environmental impact study. The case study results also found that the extent to which similar kinds of impacts are specified by AE and SS group members can differ by type of community. Study results caution against simplistic conclusions drawn from this approach to community-wide public participation. Nonetheless, the results affirm that deliberative methods for community-based impact assessment involving both AE and SS residents can provide a more complete picture of perceived impacts of proposed restoration activities.

Results of Community Deliberation About Social Impacts of Ecological Restoration: Comparing Public Input of Self-Selected Versus Actively Engaged Community Members

NASA Astrophysics Data System (ADS)

Harris, Charles C.; Nielsen, Erik A.; Becker, Dennis R.; Blahna, Dale J.; McLaughlin, William J.

2012-08-01

Participatory processes for obtaining residents' input about community impacts of proposed environmental management actions have long raised concerns about who participates in public involvement efforts and whose interests they represent. This study explored methods of broad-based involvement and the role of deliberation in social impact assessment. Interactive community forums were conducted in 27 communities to solicit public input on proposed alternatives for recovering wild salmon in the Pacific Northwest US. Individuals identified by fellow residents as most active and involved in community affairs ("AE residents") were invited to participate in deliberations about likely social impacts of proposed engineering and ecological actions such as dam removal. Judgments of these AE participants about community impacts were compared with the judgments of residents motivated to attend a forum out of personal interest, who were designated as self-selected ("SS") participants. While the magnitude of impacts rated by SS participants across all communities differed significantly from AE participants' ratings, in-depth analysis of results from two community case studies found that both AE and SS participants identified a large and diverse set of unique impacts, as well as many of the same kinds of impacts. Thus, inclusion of both kinds of residents resulted in a greater range of impacts for consideration in the environmental impact study. The case study results also found that the extent to which similar kinds of impacts are specified by AE and SS group members can differ by type of community. Study results caution against simplistic conclusions drawn from this approach to community-wide public participation. Nonetheless, the results affirm that deliberative methods for community-based impact assessment involving both AE and SS residents can provide a more complete picture of perceived impacts of proposed restoration activities.

Promoting wellbeing and improving access to mental health care through community champions in rural India: the Atmiyata intervention approach.

PubMed

Shields-Zeeman, Laura; Pathare, Soumitra; Walters, Bethany Hipple; Kapadia-Kundu, Nandita; Joag, Kaustubh

2017-01-01

There are limited accounts of community-based interventions for reducing distress or providing support for people with common mental disorders (CMDs) in low and middle-income countries. The recently implemented Atmiyata programme is one such community-based mental health intervention focused on promoting wellness and reducing distress through community volunteers in a rural area in the state of Maharashtra, India. This case study describes the content and the process of implementation of Atmiyata and how community volunteers were trained to become Atmiyata champions and mitras ( friends ). The Atmiyata programme trained Atmiyata champions to provide support and basic counselling to community members with common mental health disorders, facilitate access to mental health care and social benefits, improve community awareness of mental health issues, and to promote well-being. Challenges to implementation included logistical challenges (difficult terrain and weather conditions at the implementation site), content-related challenges (securing social welfare benefits for people with CMDs), and partnership challenges (turnover of public health workers involved in referral chain, resistance from public sector mental health specialists). The case study serves as an example for how such a model can be sustained over time at low cost. The next steps of the programme include evaluation of the impact of the Atmiyata intervention through a pre-post study and adapting the intervention for further scale-up in other settings in India.

Community resiliency as a measure of collective health status: perspectives from rural communities.

PubMed

Kulig, Judith C; Edge, Dana; Joyce, Brenda

2008-12-01

Community resiliency is a theoretical framework useful for describing the process used by communities to address adversity. A mixed-method 2-year case study was conducted to gather information about community resiliency in 2 rural communities. This article focuses on the themes generated from qualitative interviews with 55 members of these communities. The participants viewed community as a place of interdependence and interaction. The majority saw community resiliency as the ability to address challenges. Characteristics included physical and social infrastructure, population characteristics, conceptual characteristics, and problem-solving processes. Barriers included negative individual attitudes and lack of infrastructure in rural communities. Nurses could play a key role in enhancing the resiliency of rural communities by developing and implementing programs based on the Community Resiliency Model, which was supported in this study.

An Asset-Based Approach to Tribal Community Energy Planning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gutierrez, Rachael A.; Martino, Anthony; Begay, Sandra K.

Community energy planning is a vital component of successful energy resource development and project implementation. Planning can help tribes develop a shared vision and strategies to accomplish their energy goals. This paper explores the benefits of an asset-based approach to tribal community energy planning. While a framework for community energy planning and federal funding already exists, some areas of difficulty in the planning cycle have been identified. This paper focuses on developing a planning framework that offsets those challenges. The asset-based framework described here takes inventory of a tribe’s capital assets, such as: land capital, human capital, financial capital, andmore » political capital. Such an analysis evaluates how being rich in a specific type of capital can offer a tribe unique advantages in implementing their energy vision. Finally, a tribal case study demonstrates the practical application of an asset-based framework.« less

Chapter 11. Community analysis-based methods

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cao, Y.; Wu, C.H.; Andersen, G.L.

2010-05-01

Microbial communities are each a composite of populations whose presence and relative abundance in water or other environmental samples are a direct manifestation of environmental conditions, including the introduction of microbe-rich fecal material and factors promoting persistence of the microbes therein. As shown by culture-independent methods, different animal-host fecal microbial communities appear distinctive, suggesting that their community profiles can be used to differentiate fecal samples and to potentially reveal the presence of host fecal material in environmental waters. Cross-comparisons of microbial communities from different hosts also reveal relative abundances of genetic groups that can be used to distinguish sources. Inmore » increasing order of their information richness, several community analysis methods hold promise for MST applications: phospholipid fatty acid (PLFA) analysis, denaturing gradient gel electrophoresis (DGGE), terminal restriction fragment length polymorphism (TRFLP), cloning/sequencing, and PhyloChip. Specific case studies involving TRFLP and PhyloChip approaches demonstrate the ability of community-based analyses of contaminated waters to confirm a diagnosis of water quality based on host-specific marker(s). The success of community-based MST for comprehensively confirming fecal sources relies extensively upon using appropriate multivariate statistical approaches. While community-based MST is still under evaluation and development as a primary diagnostic tool, results presented herein demonstrate its promise. Coupled with its inherently comprehensive ability to capture an unprecedented amount of microbiological data that is relevant to water quality, the tools for microbial community analysis are increasingly accessible, and community-based approaches have unparalleled potential for translation into rapid, perhaps real-time, monitoring platforms.« less

Increasing Community Access to Fresh Fruits and Vegetables: A Case Study of the Farm Fresh Market Pilot Program in Cobb County, Georgia, 2014.

PubMed

Woodruff, Rebecca C; Coleman, Anne-Marie; Hermstad, April K; Honeycutt, Sally; Munoz, Jennifer; Loh, Lorna; Brown, Agnes F; Shipley, Rebecca; Kegler, Michelle C

2016-03-10

Ecological models of health suggest that to effectively prevent chronic disease, community food environments must support healthy eating behaviors. However, disparities in access to healthy foods persist in the United States. The Farm Fresh Market (FFM) was a fruit and vegetable market that sold low-cost fresh produce in Cobb County, Georgia in 2014. This case study describes the development of the FFM through a community engagement process and presents evaluation results from the project's pilot implementation. Community engagement strategies included forming a community advisory board, conducting a needs assessment, and contracting with a community-based organization to implement the FFM. In the pilot year, the FFM served an average of 28.7 customers and generated an average of $140.20 in produce sales per market day. Most returning customers lived in the local community and reported a range of socioeconomic backgrounds. Most returning customers strongly agreed that the FFM made it easier (69.0%) and less expensive (79.0%) for them to buy fresh fruits and vegetables, reported that they ate more vegetables (65.0%) and fruit (55.0%) as a result of the FFM, and reported that they were very satisfied with the FFM overall (92.0%). Results from this community case study underscore the importance of engaging communities in the development of community food environment interventions. Results also suggest that the FFM initiative was a feasible and acceptable way to respond to the community-identified public health priority of increasing access to healthy foods.

Validity of calendar day-based definitions for community-onset bloodstream infections.

PubMed

Laupland, Kevin B; Gregson, Daniel B; Church, Deirdre L

2015-04-02

Community-onset (CO) bloodstream infections (BSI) are those BSI where the blood culture is drawn <48 hours from hospital admission. However, exact times of culture draw or hospital admission are not always available. We evaluated the validity of using 2- or 3- calendar day based definitions for CO-BSI by comparing to a "gold standard" 48-hour definition. Among the population-based cohort of 14,106 episodes of BSI studied, 10,543 were classified as CO based on "gold standard" 48-hour criteria. When 2-day and 3-day definitions were applied, 10,396 and 10,707 CO-BSI episodes were ascertained, respectively. All but 147 (1.4%) true CO-BSI cases were included by using the 2-day definition. When the 3-day definition was applied, all cases of CO-BSI were identified but and additional 164 (1.5%) cases of hospital-onset HO-BSI were also included. Thus the sensitivity and specificity of the 2-day definition was 98.6% and 100% and for the 3-day definition was 100% and 98.5%, respectively. Overall, only 311 (2.2%) cases were potentially miss-classifiable using either the 2- or 3-calendar day based definitions. Use of either a 2- or 3-day definition is highly accurate for classifying CO-BSI.

Use of social network analysis in maternity care to identify the profession most suited for case manager role.

PubMed

Groenen, Carola J M; van Duijnhoven, Noortje T L; Faber, Marjan J; Koetsenruijter, Jan; Kremer, Jan A M; Vandenbussche, Frank P H A

2017-02-01

To improve Dutch maternity care, professionals start working in interdisciplinary patient-centred networks, which includes the patients as a member. The introduction of the case manager is expected to work positively on both the individual and the network level. However, case management is new in Dutch maternity care. The present study aims to define the profession that would be most suitable to fulfil the role of case manager. The maternal care network in the Nijmegen region was determined by using Social Network Analysis (SNA). SNA is a quantitative methodology that measures and analyses patient-related connections between different professionals working in a network. To identify the case manager we focused on the position, reach, and connections in the network of the maternal care professionals. Maternity healthcare professionals in a single region of the Netherlands with an average of 4,500 births/year. The participants were 214 individual healthcare workers from eight different professions. The total network showed 3948 connections between 214 maternity healthcare professionals with a density of 0.08. Each profession had some central individuals in the network. The 52 community-based midwives were responsible for 51% of all measured connections. The youth health doctors and nurses were mostly situated on the periphery and less connected. The betweenness centrality had the highest score in obstetricians and community-based midwives. Only the community-based midwives had connections with all other groups of professions. Almost all professionals in the network could reach other professionals in two steps. Copyright © 2016 Elsevier Ltd. All rights reserved.

Pinworm Eradication in Community Residential Settings for People with Developmental Disabilities.

ERIC Educational Resources Information Center

Kastner, Theodore; And Others

1992-01-01

A public health approach was used to eliminate pinworm from a system of community residential settings for individuals with developmental disabilities. The approach involved screening and treatment of staff members and clients living and working in close proximity to index cases, and prophylactically treating many clients and staff based on…

Combining Community-Based Learning and Catholic Social Teaching in Educating for Democratic Citizenship

ERIC Educational Resources Information Center

Sullivan, Susan Crawford; Post, Margaret A.

2011-01-01

College students are in a key developmental stage for cultivating their civic identities. This article draws on a case example to show how courses focused on educating students for democratic citizenship--courses on leadership, community organizing, social movements, or other related topics--prove to be excellent venues for integrating Catholic…

Community-Based Philosophy and Service-Learning: A Case Study at Barry University

ERIC Educational Resources Information Center

Schlaerth, Christian A.

2014-01-01

Service-learning, as a pedagogical technique, presents unique learning opportunities for students, where they get to use their skills and knowledge from courses to help improve communities that have particular needs. Barry University has recently begun to expand it program across the school, reaching into disciplines that are not often associated…

Assessing the Positive Influence of Music Activities in Community Development Programs

ERIC Educational Resources Information Center

Dillon, Steve

2006-01-01

This article describes a framework for assessing the positive influence of music activities in community development programs. It examines hybrid music, health and rich media approaches to creative case study with the purpose of developing more compelling evidence based advocacy that examines the claims of a causal link. This preliminary study…

Mission-Driven Adaptability in a Changing National Training System

ERIC Educational Resources Information Center

Zoellner, Don; Stephens, Anne; Joseph, Victor; Monro, Davena

2017-01-01

This case study of an adult and community education provider based in far north Queensland describes its capacity to balance various iterations of public policy against its vision for the future of Aboriginal and Torres Straits Islanders. Community-controlled organisations wanting to contribute to economic and social development in regional/remote…

Effectiveness of a weight loss program in community-cased primary care offices: High-intensity intervention versus low-intensity intervention

USDA-ARS?s Scientific Manuscript database

Despite the call for primary care providers (PCPs) to offer obese patients intense behavioral therapy for weight loss, few studies have examined the effectiveness of such interventions in real-world, community-based medical practices. This study evaluated the effectiveness of a physician-guided weig...

Toward Community Research and Coalitional Literacy Practices for Educational Justice

ERIC Educational Resources Information Center

Campano, Gerald; Ghiso, María Paula; Yee, Mary; Pantoja, Alicia

2013-01-01

Community-based research can provide an avenue for understanding the complexities of students' and families' lives and working together for educational justice through what we refer to as coalitional literacy practices. In this article, we share a critical incident about a student's absence from school as an illustrative case of the grass-roots…

Revista Interamericana de Educacion de Adultos, 2001 (Interamerican Journal of Adult Education, 2001).

ERIC Educational Resources Information Center

Guerra, Alfonso Rangel, Ed.

2001-01-01

Articles in this volume, written in Spanish, focus on the following: high school education in rural areas; adult and popular education in the 90s; systemizing educational processes in rural communities based on a restoration of their cultural heritage (case Tzintzuntzan, Michoacan); fostering sustainable communities; human rights and human…

A Collaborative Model for Community-Based Health Care Screening of Homeless Adolescents.

ERIC Educational Resources Information Center

Busen, Nancy H.; Beech, Bettina

1997-01-01

A multidisciplinary team from community organizations serving the homeless and from universities collaborated in screening 150 homeless adolescents for psychosocial and physical risks. The population had a history of physical, sexual, and substance abuse as well as high rates of HIV and hepatitis B. Case management by advanced practice nurses was…

American Government: An Introduction Using MicroCase with Distance Learners.

ERIC Educational Resources Information Center

Rosberg, William H.

In spring 1997, a project used MicroCase, a computer-based statistical analysis and data retrieval system, to offer an American Government class to distance students at Iowa's Kirkwood Community College (KCC). Students participated in the course at one of the college's 10 learning centers via a statewide fiber-optic network. MicroCase provided the…

An integrated approach to modeling resource utilization for rural communities in developing countries.

PubMed

Hartter, Joel; Boston, Kevin

2007-10-01

Resource consumption in developing countries has been the focus of a considerable amount of research. What has been understudied however, has been the feedback affects of resource consumption on resource availability to both households and communities. Heavy reliance on natural resources and intensive smallholder agriculture common to many rural communities in developing countries has forced people to fulfill short-term needs to the detriment of long-term ecological and livelihood sustainability. This paper introduces a conceptual framework to examine how individuals and households fulfill daily caloric needs and the aggregate effects on resource availability and consumption. Data were collected from a large number of published case studies of rural land-use dynamics, growth and yield models, and human livelihoods were reviewed from scientific journals, reports published by NGOs, and government reports. Using inputs defined by the user, the model tracks annual fuelwood and agricultural land use based on meeting individual energy demands. A case-study-based analysis was patterned after smallholder agriculturalists at the family and community level. Three scenarios are presented in this paper using data from Uganda to illustrate the application of this model.

Deterministic and fuzzy-based methods to evaluate community resilience

NASA Astrophysics Data System (ADS)

Kammouh, Omar; Noori, Ali Zamani; Taurino, Veronica; Mahin, Stephen A.; Cimellaro, Gian Paolo

2018-04-01

Community resilience is becoming a growing concern for authorities and decision makers. This paper introduces two indicator-based methods to evaluate the resilience of communities based on the PEOPLES framework. PEOPLES is a multi-layered framework that defines community resilience using seven dimensions. Each of the dimensions is described through a set of resilience indicators collected from literature and they are linked to a measure allowing the analytical computation of the indicator's performance. The first method proposed in this paper requires data on previous disasters as an input and returns as output a performance function for each indicator and a performance function for the whole community. The second method exploits a knowledge-based fuzzy modeling for its implementation. This method allows a quantitative evaluation of the PEOPLES indicators using descriptive knowledge rather than deterministic data including the uncertainty involved in the analysis. The output of the fuzzy-based method is a resilience index for each indicator as well as a resilience index for the community. The paper also introduces an open source online tool in which the first method is implemented. A case study illustrating the application of the first method and the usage of the tool is also provided in the paper.

Modeling Joint Exposures and Health Outcomes for Cumulative Risk Assessment: the Case of Radon and Smoking

EPA Science Inventory

Community-based cumulative risk assessment requires characterization of exposures to multiple chemical and non-chemical stressors, with consideration of how the non-chemical stressors may influence risks from chemical stressors. Residential radon provides an interesting case exam...

The Environmental Protection Agency's Community-Focused Exposure and Risk Screening Tool (C-FERST) and its potential use for environmental justice efforts.

PubMed

Zartarian, Valerie G; Schultz, Bradley D; Barzyk, Timothy M; Smuts, Marybeth; Hammond, Davyda M; Medina-Vera, Myriam; Geller, Andrew M

2011-12-01

Our primary objective was to provide higher quality, more accessible science to address challenges of characterizing local-scale exposures and risks for enhanced community-based assessments and environmental decision-making. After identifying community needs, priority environmental issues, and current tools, we designed and populated the Community-Focused Exposure and Risk Screening Tool (C-FERST) in collaboration with stakeholders, following a set of defined principles, and considered it in the context of environmental justice. C-FERST is a geographic information system and resource access Web tool under development for supporting multimedia community assessments. Community-level exposure and risk research is being conducted to address specific local issues through case studies. C-FERST can be applied to support environmental justice efforts. It incorporates research to develop community-level data and modeled estimates for priority environmental issues, and other relevant information identified by communities. Initial case studies are under way to refine and test the tool to expand its applicability and transferability. Opportunities exist for scientists to address the many research needs in characterizing local cumulative exposures and risks and for community partners to apply and refine C-FERST.

Rural Community Leaders’ Perceptions of Environmental Health Risks

PubMed Central

Larsson, Laura S.; Butterfield, Patricia; Christopher, Suzanne; Hill, Wade

2015-01-01

Qualitative description was used to explore how rural community leaders frame, interpret, and give meaning to environmental health issues affecting their constituents and communities. Six rural community leaders discussed growth, vulnerable families, and the action avoidance strategies they use or see used in lieu of adopting health-promoting behaviors. Findings suggest intervention strategies should be economical, use common sense, be sensitive to regional identity, and use local case studies and “inside leadership.” Occupational health nurses addressing the disparate environmental health risks in rural communities are encouraged to use agenda-neutral, scientifically based risk communication efforts and foster collaborative relationships among nurses, planners, industry, and other community leaders. PMID:16562621

Filling the gap in functional trait databases: use of ecological hypotheses to replace missing data.

PubMed

Taugourdeau, Simon; Villerd, Jean; Plantureux, Sylvain; Huguenin-Elie, Olivier; Amiaud, Bernard

2014-04-01

Functional trait databases are powerful tools in ecology, though most of them contain large amounts of missing values. The goal of this study was to test the effect of imputation methods on the evaluation of trait values at species level and on the subsequent calculation of functional diversity indices at community level using functional trait databases. Two simple imputation methods (average and median), two methods based on ecological hypotheses, and one multiple imputation method were tested using a large plant trait database, together with the influence of the percentage of missing data and differences between functional traits. At community level, the complete-case approach and three functional diversity indices calculated from grassland plant communities were included. At the species level, one of the methods based on ecological hypothesis was for all traits more accurate than imputation with average or median values, but the multiple imputation method was superior for most of the traits. The method based on functional proximity between species was the best method for traits with an unbalanced distribution, while the method based on the existence of relationships between traits was the best for traits with a balanced distribution. The ranking of the grassland communities for their functional diversity indices was not robust with the complete-case approach, even for low percentages of missing data. With the imputation methods based on ecological hypotheses, functional diversity indices could be computed with a maximum of 30% of missing data, without affecting the ranking between grassland communities. The multiple imputation method performed well, but not better than single imputation based on ecological hypothesis and adapted to the distribution of the trait values for the functional identity and range of the communities. Ecological studies using functional trait databases have to deal with missing data using imputation methods corresponding to their specific needs and making the most out of the information available in the databases. Within this framework, this study indicates the possibilities and limits of single imputation methods based on ecological hypothesis and concludes that they could be useful when studying the ranking of communities for their functional diversity indices.

Filling the gap in functional trait databases: use of ecological hypotheses to replace missing data

PubMed Central

Taugourdeau, Simon; Villerd, Jean; Plantureux, Sylvain; Huguenin-Elie, Olivier; Amiaud, Bernard

2014-01-01

Functional trait databases are powerful tools in ecology, though most of them contain large amounts of missing values. The goal of this study was to test the effect of imputation methods on the evaluation of trait values at species level and on the subsequent calculation of functional diversity indices at community level using functional trait databases. Two simple imputation methods (average and median), two methods based on ecological hypotheses, and one multiple imputation method were tested using a large plant trait database, together with the influence of the percentage of missing data and differences between functional traits. At community level, the complete-case approach and three functional diversity indices calculated from grassland plant communities were included. At the species level, one of the methods based on ecological hypothesis was for all traits more accurate than imputation with average or median values, but the multiple imputation method was superior for most of the traits. The method based on functional proximity between species was the best method for traits with an unbalanced distribution, while the method based on the existence of relationships between traits was the best for traits with a balanced distribution. The ranking of the grassland communities for their functional diversity indices was not robust with the complete-case approach, even for low percentages of missing data. With the imputation methods based on ecological hypotheses, functional diversity indices could be computed with a maximum of 30% of missing data, without affecting the ranking between grassland communities. The multiple imputation method performed well, but not better than single imputation based on ecological hypothesis and adapted to the distribution of the trait values for the functional identity and range of the communities. Ecological studies using functional trait databases have to deal with missing data using imputation methods corresponding to their specific needs and making the most out of the information available in the databases. Within this framework, this study indicates the possibilities and limits of single imputation methods based on ecological hypothesis and concludes that they could be useful when studying the ranking of communities for their functional diversity indices. PMID:24772273

Estimation of community-level influenza-associated illness in a low resource rural setting in India.

PubMed

Saha, Siddhartha; Gupta, Vivek; Dawood, Fatimah S; Broor, Shobha; Lafond, Kathryn E; Chadha, Mandeep S; Rai, Sanjay K; Krishnan, Anand

2018-01-01

To estimate rates of community-level influenza-like-illness (ILI) and influenza-associated ILI in rural north India. During 2011, we conducted household-based healthcare utilization surveys (HUS) for any acute medical illness (AMI) in preceding 14days among residents of 28villages of Ballabgarh, in north India. Concurrently, we conducted clinic-based surveillance (CBS) in the area for AMI episodes with illness onset ≤3days and collected nasal and throat swabs for influenza virus testing using real-time polymerase chain reaction. Retrospectively, we applied ILI case definition (measured/reported fever and cough) to HUS and CBS data. We attributed 14days of risk-time per person surveyed in HUS and estimated community ILI rate by dividing the number of ILI cases in HUS by total risk-time. We used CBS data on influenza positivity and applied it to HUS-based community ILI rates by age, month, and clinic type, to estimate the community influenza-associated ILI rates. The HUS of 69,369 residents during the year generated risk-time of 3945 person-years (p-y) and identified 150 (5%, 95%CI: 4-6) ILI episodes (38 ILI episodes/1,000 p-y; 95% CI 32-44). Among 1,372 ILI cases enrolled from clinics, 126 (9%; 95% CI 8-11) had laboratory-confirmed influenza (A (H3N2) = 72; B = 54). After adjusting for age, month, and clinic type, overall influenza-associated ILI rate was 4.8/1,000 p-y; rates were highest among children <5 years (13; 95% CI: 4-29) and persons≥60 years (11; 95%CI: 2-30). We present a novel way to use HUS and CBS data to generate estimates of community burden of influenza. Although the confidence intervals overlapped considerably, higher point estimates for burden among young children and older adults shows the utility for exploring the value of influenza vaccination among target groups.

Food system sustainability for health and well-being of Indigenous Peoples.

PubMed

Kuhnlein, Harriet V

2015-09-01

To describe how Indigenous Peoples understand how to enhance use of their food systems to promote sustainability, as demonstrated in several food-based interventions. Comments contributed by partners from case studies of Indigenous Peoples and their food systems attending an international meeting were implemented with public health interventions at the community level in nine countries. The Rockefeller Foundation Bellagio Conference Center in Bellagio, Italy, where experiences from case studies of Indigenous Peoples were considered and then conducted in their home communities in rural areas. Leaders of the Indigenous Peoples' case studies, their communities and their academic partners. Reported strategies on how to improve use of local food systems in case study communities of Indigenous Peoples. Indigenous Peoples' reflections on their local food systems should be encouraged and acted upon to protect and promote sustainability of the cultures and ecosystems that derive their food systems. Promoting use of local traditional food biodiversity is an essential driver of food system sustainability for Indigenous Peoples, and contributes to global consciousness for protecting food biodiversity and food system sustainability more broadly. Key lessons learned, key messages and good practices for nutrition and public health practitioners and policy makers are given.

Modelling of occupational respirable crystalline silica exposure for quantitative exposure assessment in community-based case-control studies.

PubMed

Peters, Susan; Vermeulen, Roel; Portengen, Lützen; Olsson, Ann; Kendzia, Benjamin; Vincent, Raymond; Savary, Barbara; Lavoué, Jérôme; Cavallo, Domenico; Cattaneo, Andrea; Mirabelli, Dario; Plato, Nils; Fevotte, Joelle; Pesch, Beate; Brüning, Thomas; Straif, Kurt; Kromhout, Hans

2011-11-01

We describe an empirical model for exposure to respirable crystalline silica (RCS) to create a quantitative job-exposure matrix (JEM) for community-based studies. Personal measurements of exposure to RCS from Europe and Canada were obtained for exposure modelling. A mixed-effects model was elaborated, with region/country and job titles as random effect terms. The fixed effect terms included year of measurement, measurement strategy (representative or worst-case), sampling duration (minutes) and a priori exposure intensity rating for each job from an independently developed JEM (none, low, high). 23,640 personal RCS exposure measurements, covering a time period from 1976 to 2009, were available for modelling. The model indicated an overall downward time trend in RCS exposure levels of -6% per year. Exposure levels were higher in the UK and Canada, and lower in Northern Europe and Germany. Worst-case sampling was associated with higher reported exposure levels and an increase in sampling duration was associated with lower reported exposure levels. Highest predicted RCS exposure levels in the reference year (1998) were for chimney bricklayers (geometric mean 0.11 mg m(-3)), monument carvers and other stone cutters and carvers (0.10 mg m(-3)). The resulting model enables us to predict time-, job-, and region/country-specific exposure levels of RCS. These predictions will be used in the SYNERGY study, an ongoing pooled multinational community-based case-control study on lung cancer.

Penn Center for Community Health Workers: Step-by-Step Approach to Sustain an Evidence-Based Community Health Worker Intervention at an Academic Medical Center.

PubMed

Morgan, Anna U; Grande, David T; Carter, Tamala; Long, Judith A; Kangovi, Shreya

2016-11-01

Community-engaged researchers who work with low-income communities can be reliant on grant funding. We use the illustrative case of the Penn Center for Community Health Workers (PCCHW) to describe a step-by-step framework for achieving financial sustainability for community-engaged research interventions. PCCHW began as a small grant-funded research project but followed an 8-step framework to engage both low-income patients and funders, determine outcomes, and calculate return on investment. PCCHW is now fully funded by Penn Medicine and delivers the Individualized Management for Patient-Centered Targets (IMPaCT) community health worker intervention to 2000 patients annually.

Consolidated Afloat Networks and Enterprise Services (CANES). Manpower, Personnel, and Training Implications

DTIC Science & Technology

2009-01-01

certification and proceed to a unit. They are represented in the stock “Later pass to 4YOS ,” and the rest of their career follows the same path as ITs who...In the Status Quo and the Base Case, all ITs enter on a four-years-of-service ( 4YOS ) contract. In Case 1, which reflects current plans for ITs, the...IT community is split between those entering with 4YOS and those entering with 6YOS contracts. Thirty-five percent of the community enters with a

Factors Associated with Fatal Outcomes Following Cholera-Like Syndrome in Far North Region of Cameroon: A Community-Based Survey.

PubMed

Djouma, Fabrice N; Ateudjieu, Jerome; Ram, Malathi; Debes, Amanda K; Sack, David A

2016-12-07

This study demonstrates that most cholera deaths in this region of Cameroon occur out of hospital. This is a region which is prone to cholera, and interventions are needed to improve access to emergency medical care, especially during cholera outbreaks. Cameroon has experienced 14 cholera epidemics during the last 20 years, and these have had high case fatality rates. This study attempted to assess the effect of delays in seeking care and the locations of care as possible risk factors for cholera mortality. The study used data from a community-based survey regarding the circumstances of 97 fatal cases and 197 control (nonfatal) cases following a cholera-like syndrome in villages with cholera-like diseases during cholera outbreaks in Cameroon during 2009-2011. Deaths occurred in one of four environments: the community, in a temporary community treatment center (TCTC), in transit to a treatment center, or in a hospital (39%, 32%, 5%, and 24%, respectively). Using a case-control analysis, factors associated with deaths included the nonuse of a cholera treatment center, receiving health care in a TCTC instead of a hospital, and greater than 4 hours delay between the onset of symptoms and the decision to go to a treatment center (odds ratios of 17.1 [confidence interval (CI): 7.0-41.8], 2.5 [CI: 1.2-5.0], and 2.2 [CI: 1.0-4.6], respectively). During cholera epidemics, a higher proportion of deaths are still occurring in communities. The nonuse and delays in deciding to go a treatment center, and treatment at TCTC rather than a hospital were risk factors for death among patients with cholera-like syndrome in Cameroon. Informing people on community management of cholera-like syndrome and improving care in all health facilities are needed to reduce deaths during cholera epidemics. © The American Society of Tropical Medicine and Hygiene.

Label propagation algorithm for community detection based on node importance and label influence

NASA Astrophysics Data System (ADS)

Zhang, Xian-Kun; Ren, Jing; Song, Chen; Jia, Jia; Zhang, Qian

2017-09-01

Recently, the detection of high-quality community has become a hot spot in the research of social network. Label propagation algorithm (LPA) has been widely concerned since it has the advantages of linear time complexity and is unnecessary to define objective function and the number of community in advance. However, LPA has the shortcomings of uncertainty and randomness in the label propagation process, which affects the accuracy and stability of the community. For large-scale social network, this paper proposes a novel label propagation algorithm for community detection based on node importance and label influence (LPA_NI). The experiments with comparative algorithms on real-world networks and synthetic networks have shown that LPA_NI can significantly improve the quality of community detection and shorten the iteration period. Also, it has better accuracy and stability in the case of similar complexity.

Promoting community socio-ecological sustainability through technology: A case study from Chile

NASA Astrophysics Data System (ADS)

Aguayo, Claudio; Eames, Chris

2017-12-01

The importance of community learning in effecting social change towards ecological sustainability has been recognised for some time. More recently, the use of Information and Communication Technology (ICT) tools to promote socio-ecological sustainability has been shown to have potential in community education for sustainable development (ESD). The effective design and use of technology for community learning implies an understanding of a range of cross-dimensional factors including: socio-cultural characteristics and needs of the target audience; considerations of available and culturally responsive types of technology; and non-formal pedagogical ESD strategies for community empowerment. In addition, both technology itself and social communities are dynamically evolving and complex entities. This article presents a case study which evaluated the potential of ICT for promoting ecological literacy and action competence amongst community members in southern Chile. The case study addressed the ecological deterioration of a lake, which is having deep social, economic, recreational and cultural implications locally. The authors' research involved developing a theoretical framework for the design, implementation and use of ICT for community learning for sustainability. The framework was based on key ideas from ESD, ICT and community education, and was underpinned by a systems thinking approach to account for the dynamism and complexity of such settings. Activity theory provided a frame to address overarching socio-cultural elements when using technology as a mediating tool for community learning. The authors' findings suggest that the use of an ICT tool, such as a website, can enhance ecological literacy in relation to a local socio-ecological issue.

Costs of a community-based glaucoma detection programme: analysis of the Philadelphia Glaucoma Detection and Treatment Project.

PubMed

Pizzi, Laura T; Waisbourd, Michael; Hark, Lisa; Sembhi, Harjeet; Lee, Paul; Crews, John E; Saaddine, Jinan B; Steele, Deon; Katz, L Jay

2018-02-01

Glaucoma is the foremost cause of irreversible blindness, and more than 50% of cases remain undiagnosed. Our objective was to report the costs of a glaucoma detection programme operationalised through Philadelphia community centres. The analysis was performed using a healthcare system perspective in 2013 US dollars. Costs of examination and educational workshops were captured. Measures were total programme costs, cost/case of glaucoma detected and cost/case of any ocular disease detected (including glaucoma). Diagnoses are reported at the individual level (therefore representing a diagnosis made in one or both eyes). Staff time was captured during site visits to 15 of 43 sites and included time to deliver examinations and workshops, supervision, training and travel. Staff time was converted to costs by applying wage and fringe benefit costs from the US Bureau of Labor Statistics. Non-staff costs (equipment and mileage) were collected using study logs. Participants with previously diagnosed glaucoma were excluded. 1649 participants were examined. Mean total per-participant examination time was 56 min (SD 4). Mean total examination cost/participant was $139. The cost/case of glaucoma newly identified (open-angle glaucoma, angle-closure glaucoma, glaucoma suspect, or primary angle closure) was $420 and cost/case for any ocular disease identified was $273. Glaucoma examinations delivered through this programme provided significant health benefit to hard-to-reach communities. On a per-person basis, examinations were fairly low cost, though opportunities exist to improve efficiency. Findings serve as an important benchmark for planning future community-based glaucoma examination programmes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Social Networks and Community-Based Natural Resource Management

NASA Astrophysics Data System (ADS)

Lauber, T. Bruce; Decker, Daniel J.; Knuth, Barbara A.

2008-10-01

We conducted case studies of three successful examples of collaborative, community-based natural resource conservation and development. Our purpose was to: (1) identify the functions served by interactions within the social networks of involved stakeholders; (2) describe key structural properties of these social networks; and (3) determine how these structural properties varied when the networks were serving different functions. The case studies relied on semi-structured, in-depth interviews of 8 to 11 key stakeholders at each site who had played a significant role in the collaborative projects. Interview questions focused on the roles played by key stakeholders and the functions of interactions between them. Interactions allowed the exchange of ideas, provided access to funding, and enabled some stakeholders to influence others. The exchange of ideas involved the largest number of stakeholders, the highest percentage of local stakeholders, and the highest density of interactions. Our findings demonstrated the value of tailoring strategies for involving stakeholders to meet different needs during a collaborative, community-based natural resource management project. Widespread involvement of local stakeholders may be most appropriate when ideas for a project are being developed. During efforts to exert influence to secure project approvals or funding, however, involving specific individuals with political connections or influence on possible sources of funds may be critical. Our findings are consistent with past work that has postulated that social networks may require specific characteristics to meet different needs in community-based environmental management.

What motivates use of community-based human immunodeficiency virus testing in rural South Africa?

PubMed Central

Upadhya, Devesh; Moll, Anthony P; Brooks, Ralph P; Friedland, Gerald; Shenoi, Sheela V

2016-01-01

Despite substantial progress in implementing human immunodeficiency virus testing, challenges remain in achieving widespread uptake particularly in rural resource-limited settings. We sought to understand motivations for human immunodeficiency virus testing in a community-based human immunodeficiency virus testing programme in rural South Africa. We conducted a questionnaire survey in participants undergoing voluntary human immunodeficiency virus testing within an ongoing community-based integrated human immunodeficiency virus/TB intensive case finding programme at congregate rural settings. Participants responded to a six-item non-mutually exclusive motivations survey which included the topics of feeling ill, recent HV exposure, risky lifestyle, illness in a family member, and pregnancy. Among 2068 respondents completing the survey, 1393 (67.4%) were women, median age was 40 years (IQR 19–56), and 1235 (59.7%) were first time testers. Among all testers, 142 (6.9%) were human immunodeficiency virus-positive with median CD4 count 346 (IQR 218–542). Community-based testing for human immunodeficiency virus is acceptable and meets the needs of community members in rural South Africa. Motivations for human immunodeficiency virus testing at the community level are complex and differ according to gender, age, site of community testing, and human immunodeficiency virus status. These differences can be utilised to improve the focus and yield of community-based human immunodeficiency virus screening. PMID:26134323

Transformative Use of an Improved All-Payer Hospital Discharge Data Infrastructure for Community-Based Participatory Research: A Sustainability Pathway

PubMed Central

Salemi, Jason L; Salinas-Miranda, Abraham A; Wilson, Roneé E; Salihu, Hamisu M

2015-01-01

Objective To describe the use of a clinically enhanced maternal and child health (MCH) database to strengthen community-engaged research activities, and to support the sustainability of data infrastructure initiatives. Data Sources/Study Setting Population-based, longitudinal database covering over 2.3 million mother–infant dyads during a 12-year period (1998–2009) in Florida. Setting: A community-based participatory research (CBPR) project in a socioeconomically disadvantaged community in central Tampa, Florida. Study Design Case study of the use of an enhanced state database for supporting CBPR activities. Principal Findings A federal data infrastructure award resulted in the creation of an MCH database in which over 92 percent of all birth certificate records for infants born between 1998 and 2009 were linked to maternal and infant hospital encounter-level data. The population-based, longitudinal database was used to supplement data collected from focus groups and community surveys with epidemiological and health care cost data on important MCH disparity issues in the target community. Data were used to facilitate a community-driven, decision-making process in which the most important priorities for intervention were identified. Conclusions Integrating statewide all-payer, hospital-based databases into CBPR can empower underserved communities with a reliable source of health data, and it can promote the sustainability of newly developed data systems. PMID:25879276

A Comparison of Two Approaches to Safety Analysis Based on Use Cases

NASA Astrophysics Data System (ADS)

Stålhane, Tor; Sindre, Guttorm

Engineering has a long tradition in analyzing the safety of mechanical, electrical and electronic systems. Important methods like HazOp and FMEA have also been adopted by the software engineering community. The misuse case method, on the other hand, has been developed by the software community as an alternative to FMEA and preliminary HazOp for software development. To compare the two methods misuse case and FMEA we have run a small experiment involving 42 third year software engineering students. In the experiment, the students should identify and analyze failure modes from one of the use cases for a commercial electronic patient journals system. The results of the experiment show that on the average, the group that used misuse cases identified and analyzed more user related failure modes than the persons using FMEA. In addition, the persons who used the misuse cases scored better on perceived ease of use and intention to use.

Phases of "pre-engagement" capacity building: discovery, exploration, and trial alliance.

PubMed

Campbell-Voytal, Kimberly

2010-01-01

Academic prevention researchers who engage limited-resource communities may find that organizational or community capacity for prevention is low. Community organizations, neighborhoods, and academic partners may lack shared issue awareness, mutual interests, and interactive skills necessary for collaborative intervention. Existing capacity building models either ignore a 'pre-engagement' phase or acknowledge it without offering strategic detail. An exploratory or developmental phase before active engagement can be achieved through co-located work in a community setting. The construct, "ecology of practice," provides conceptual background for examining how "shared work" introduces and prepares partners for future collaboration consistent with community-based participatory research (CBPR) principles. This paper presents two case studies where pre-engagement capacity building involved partners who were initially unaware, disinterested, or unable to engage in preventive interventions. These cases illustrate how mutual participation in shared "ecologies of practice" enabled an exchange of cultural knowledge, skill, and language that laid the groundwork for future preventive intervention. A trajectory of developmental work in each case occurred over 5 years. Historical timelines, interviews, and personal communications between community and academic leaders were reviewed and common themes identified. A model of "pre-capacity building" emerged. Capacity-building models that detail strategies for developing equitable engagement in under-resourced settings will more effectively move best practices into vulnerable communities. Preventive interventions must be translated equitably if health disparities are to be reduced.

Exploring the patterns of alpine vegetation of Eastern Bhutan: a case study from the Merak Himalaya.

PubMed

Jamtsho, Karma; Sridith, Kitichate

2015-01-01

A survey was conducted from March to September 2012 along the altitudinal gradient of the Jomokungkhar trail in the Merak Himalaya of Sakteng Wildlife Sanctuary to study the floristic compositions and the patterns of alpine vegetation of Eastern Bhutan. The vegetation of the sampled plots is classified into five types of communities based on the hierarchical cluster analysis at similarity index 63% viz., (1) Riverine Community; (2) Abies-Rhododendron Woodland Community; (3) Juniperus Scrub Community; (4) Rhododendron Krummholz and (5) Alpine Meadow, based on the floristic compositions. In addition, it was noticed that the fragile alpine environment of the Merak Himalaya has high plant diversity and important plants that are susceptible to the anthropogenic pressures.

Ethics and community-based participatory research: perspectives from the field.

PubMed

Bastida, Elena M; Tseng, Tung-Sung; McKeever, Corliss; Jack, Leonard

2010-01-01

Exploring the importance of ethical issues in the conduct of community-based participatory research (CBPR) continues to be an important topic for researchers and practitioners. This article uses the Beyond Sabor Project, a CBPR project implemented in the Lower Rio Grande Valley, as a case example to discuss ethical issues such as the importance of increasing community involvement in research, ensuring that communities benefit from the research, sharing leadership roles, and sensitive issues regarding data collection and sharing. Thereafter, this article concludes with a brief discussion of six principles that can inform the practice of ethical conduct when implementing CBPR studies. This article also lists additional reading resources on the importance of ethics in the conduct of CBPR.

Cost effectiveness of home and community-based care

PubMed Central

Vertrees, James C.; Manton, Kenneth G.; Adler, Gerald S.

1989-01-01

Medicaid section 2176 waivers allow States to provide home and community-based care to Medicaid eligibles who, but for these services, would enter Medicaid-funded nursing homes. One of the conditions required by Congress for granting these waivers is that this substitution results in no additional Medicaid spending (budget neutrality). The results of case studies of two of these waiver programs, one in California and one in Georgia, are presented in this article. The case studies contain a description of the operation of these programs in some detail. Next, the data and techniques needed to assess the ability of these programs to achieve budget neutrality are presented, and the performance of these programs along this dimension is evaluated. PMID:10313280

There Are No Children Here: The Case of an Inner-City School Addressing Issues Facing Children and Families Living in Poverty

ERIC Educational Resources Information Center

Sallee, Mariel; Boske, Christa

2013-01-01

This case is based on real-life experiences of community school members within Horner School--an inner-city public school. Specifically, the case explores challenges faced by Cathleen, a 1st-year, White, female principal, who was hired by central office to "revamp a charter school" to promote a quality education for all children. The case raises…

Problem-Based Learning and Civic Engagement in Undergraduate Education

ERIC Educational Resources Information Center

Keegan, Louise C.; Losardo, Angela; McCullough, Kim C.

2017-01-01

Problem-based learning and civic engagement are complementary constructivist andragogical approaches that emphasize active learning by guiding students to develop their own understanding and knowledge of a topic through experience and reflection. By providing examples of clinical cases and community-based experiences, these approaches can enhance…

Clinical reasoning and population health: decision making for an emerging paradigm of health care.

PubMed

Edwards, Ian; Richardson, Barbara

2008-01-01

Chronic conditions now provide the major disease and disability burden facing humanity. This development has necessitated a reorientation in the practice skills of health care professions away from hospital-based inpatient and outpatient care toward community-based management of patients with chronic conditions. Part of this reorientation toward community-based management of chronic conditions involves practitioners' understanding and adoption of a concept of population health management based on appropriate theoretical models of health care. Drawing on recent studies of expertise in physiotherapy, this article proposes a clinical reasoning and decision-making framework to meet these challenges. The challenge of population and community-based management of chronic conditions also provides an opportunity for physiotherapists to further clarify a professional epistemology of practice that embraces the kinds of knowledge and clinical reasoning processes used in physiotherapy practice. Three case studies related to the management of chronic musculoskeletal pain in different populations are used to exemplify the range of epistemological perspectives that underpin community-based practice. They illustrate the link between conceptualizations of practice problems and knowledge sources that are used as a basis for clinical reasoning and decision making as practitioners are increasingly required to move between the clinic and the community.

Using a participatory approach to the development of a school-based physical activity policy in an Indigenous community.

PubMed

Hogan, Lindsay; García Bengoechea, Enrique; Salsberg, Jon; Jacobs, Judi; King, Morrison; Macaulay, Ann C

2014-12-01

This study is part of a larger community-based participatory research (CBPR) project to develop, implement, and evaluate the physical activity component of a school-based wellness policy. The policy intervention is being carried out by community stakeholders and academic researchers within the Kahnawake Schools Diabetes Prevention Project, a well-established health promotion organization in the Indigenous community of Kahnawake, Quebec. We explored how a group of stakeholders develop a school physical activity policy in a participatory manner, and examined factors serving as facilitators and barriers to the development process. This case study was guided by an interpretive description approach and draws upon data from documentary analysis and participant observation. A CBPR approach allowed academic researchers and community stakeholders to codevelop a physical activity policy that is both evidence-based and contextually appropriate. The development process was influenced by a variety of barriers and facilitators including working within existing structures, securing appropriate stakeholders, and school contextual factors. This research offers a process framework that others developing school-based wellness policies may use with appropriate modifications based on local environments. © 2014, American School Health Association.

Community-Associated Methicillin-Resistant Staphylococcus aureus Case Studies

PubMed Central

Sowash, Madeleine G.; Uhlemann, Anne-Catrin

2014-01-01

Over the past decade, the emergence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has changed the landscape of S. aureus infections around the globe. Initially recognized for its ability to cause disease in young and healthy individuals without healthcare exposures as well as for its distinct genotype and phenotype, this original description no longer fully encompasses the diversity of CA-MRSA as it continues to expand its niche. Using four case studies, we highlight a wide range of the clinical presentations and challenges of CA-MRSA. Based on these cases we further explore the globally polygenetic background of CA-MRSA with a special emphasis on generally less characterized populations. PMID:24085688

Considering departures from current timber harvesting policies: case studies of four communities in the Pacific Northwest.

Treesearch

Con H Schallau; Paul E. Polzin

1983-01-01

U.S. Department of Agriculture regulations permit departures from current National Forest timber harvesting policies when "implementation of base harvest schedules.., would cause a substantial adverse impact upon a community .... " This paper describes the kinds of information needed for forest managers to adequately assess the relevance of the departure...

The Tie that Binds: Building Discourse Communities and Group Cohesion through Computer-Based Conferences.

ERIC Educational Resources Information Center

Selfe, Cynthia L.; Eilola, J. Daniel

1988-01-01

Discussion of the use of electronic conferencing to form a discourse community focuses on a case study of student consultants working in a microcomputer lab supporting writing courses at Michigan Technological University. The formulation of a group identity, as well as group values, goals, and expectations are discussed. (16 references) (LRW)

Sexperts! Disrupting Injustice through HIV Prevention and Legal Rights Education with Transgenders in Thailand

ERIC Educational Resources Information Center

Walsh, Christopher S.; Chaiyajit, Nada

2012-01-01

In addition to growing epidemics of HIV transgenders in Thailand, a low awareness of how to access justice increases their vulnerability to HIV infection. This paper presents a unique case study of how one community-based and led organisations used social networking and instant messaging to address this problem among transgender community in…

Knowledge of Mental Capacity Issues in Community Teams for Adults with Learning Disabilities

ERIC Educational Resources Information Center

Willner, Paul; Jenkins, Rosemary; Rees, Paul; Griffiths, Vanessa J.; John, Elinor

2011-01-01

Background: The aim of this study was to evaluate the state of knowledge of mental capacity issues among health and social services professionals working in community teams supporting people with learning disabilities. Methods A structured interview was constructed around three scenarios, based on actual cases, concerning a financial/legal issue,…

Gender and Education for All: Progress and Problems in Achieving Gender Equity

ERIC Educational Resources Information Center

Chisamya, Grace; DeJaeghere, Joan; Kendall, Nancy; Khan, Marufa Aziz

2012-01-01

The paper explores the effects of rapid increases in gender parity in primary schooling in Bangladesh and Malawi on gender inequities in schools and communities. Based on an analysis of comparative case studies of marginalized communities, we argue that educational initiatives focused on achieving gender parity provide limited evidence that girls'…

Program Evaluation and Replications of School-Based Mental Health Services and Family-Community Interventions with Chronically Disruptive Students

ERIC Educational Resources Information Center

Carpenter-Aeby, Tracy; Aeby, Victor G.

2005-01-01

Although outcomes for alternative schools may be mixed, it is generally agreed that counseling, therapy, group work, case management, and family-community involvement have been credited in some effective programs. This study examined program evaluations from 1994-1999 for an alternative school for chronically disruptive students (599 students,…

Lessons for Research Policy and Practice: The Case of Co-Enquiry Research with Rural Communities

ERIC Educational Resources Information Center

Caruso, Emily; Schunko, Christoph; Corbera, Esteve; Ruiz Mallén, Isabel; Vogl, Christian R.; Martin, Gary; Arrázola, Susana; Bandeira, Fábio Pedro; Calvo Boyero, Diana; Camacho Benavides, Claudia; Cardoso, Thiago Mota; Chan-Dzul, Albert; Conde, Esther; del Campo García, Carlos; Huanca, Tomás; Sampaio, José Augusto Laranjeiras; Oliveros Lopez, Sara; Porter-Bolland, Luciana; Ruiz Betancourt, Olga

2016-01-01

This article explores the relationship between institutional funding for research and community-based or co-enquiry research practice. It examines the implementation of co-enquiry research in the COMBIOSERVE project, which was funded by the European Commission's Seventh Framework Programme for research and innovation, between the years 2012 and…

It's Who You Know "and" What You Know: The Process of Creating Partnerships between Schools and Communities

ERIC Educational Resources Information Center

Hands, Catherine

2005-01-01

Based on qualitative research, this article aims to clarify the process of creating school-community partnerships. Two secondary schools with numerous partnerships were selected within a southern Ontario school board characterized by economic and cultural diversity. Drawing on the within- and cross-case analyses of documents, observations, and 25…

When Business Gets Involved: A Case Study of Business Community Involvement in Minnesota's Early Childhood Education Policy

ERIC Educational Resources Information Center

Kovach, Melissa

2009-01-01

The report details Minnesota's early childhood education (ECE) activities from 2003 to the present, with a particular focus on the role of the business community. Although the report illustrates how fact-based information, partnered with dedicated and well-connected people and organized task forces, creates change, there remain components of…

An exploration of a fire-affected community undergoing change in New Zealand

Treesearch

Pamela J. Jakes; Laura Kelly; Lisa Langer

2010-01-01

In the first case study of a fire-affected community in New Zealand's rural-urban interface, researchers found evidence to support findings raised in other countries regarding evacuation, blaming behaviour and perceptions of risk. Differences were evident based on ownership tenure, including less awareness of wildfire risk and preparedness among those with shorter...

Team Learning: Through the Relational Dynamics of Co-operation and Rivalry in Team Communities

ERIC Educational Resources Information Center

Lotz, Maja

2010-01-01

This paper explores the constructive links between cooperation, rivalry, and learning within the structure of team communities. Drawing upon social learning theory and qualitative data from case studies conducted in Danish team-based firms, the main purpose is to argue that both cooperation and rivalry are important triggers for mobilizing…

Models of Community Learning Networks in Canada = Modeles de reseaux d'apprentissage communautaires au Canada.

ERIC Educational Resources Information Center

Human Resources Development Canada, Hull (Quebec). Office of Learning Technologies.

Canada-based community learning networks (CLNs) were examined to provide an operational definition of CLNs, design a framework for their review and analysis, and identify best practices in CLNs. Data were collected from three sources: interviews with 16 key stakeholders in CLNs, literature review, and case studies of five Canadian CLNs. The…

Toward Kuleana (Responsibility): A Case Study of a Contextually Grounded Intervention for Native Hawaiian Youth and Young Adults1

PubMed Central

Trinidad, Alma M.O.

2009-01-01

As a minority ethnic group, Native Hawaiian youth and young adults face an array of issues associated with colonization, such as persistent structural discrimination and the loss of land and indigenous ways of knowing. They are also at risk for a wide range of negative behaviors, including interpersonal violence, suicide, substance use, and juvenile delinquency. This article explores how community youth development, critical pedagogies, and Hawaiian epistemology can help Native Hawaiian young adults cope with such issues. It begins with a brief discussion of critiques on conventional youth violence prevention programs. To address these critiques, three bodies of literature are introduced: 1) community youth development, 2) critical pedagogy, and 3) community epistemology. Data were derived from a single case study of a community-based youth program. The program, located in an impoverished, rural community in Hawai‘i, entailed running an organic farm. Seventeen participants were involved in the study. Semi-structured interviews were used to collect data. Utilizing critical indigenous qualitative research, a content analysis of the interviews was conducted to build a working conceptual model. Preliminary findings suggest that a program with key processes of community youth development, critical pedagogies, and Hawaiian epistemology may serve as a vehicle for health and wellness, thus preventing a host of negative behaviors, such as violence. Based on the findings, a critical contextually based approach to violence prevention that focuses on providing opportunities for Native Hawaiian young adults to take an active participatory role in promoting health is proposed. PMID:20161447

Capacity Building Resource Management Of Coastal Areas To Improve The Local Economic Based By Cross-Cutting Partnerships: Case Study on Panjang Beach Bengkulu City

NASA Astrophysics Data System (ADS)

Darmi, Titi

2017-02-01

The western part of Bengkulu city is a coastal region approximately 525 km, along the coast lies the tourism object which become the flagship of Bengkulu province. Coastal tourism is made as the pre-eminent is Panjang beach. Management of two beaches has not been managed optimally, so that is not yet on the economy have implications for communities, the people majority are fishermen, the highest poverty levels of Bengkulu city. The purpose of this research is to examine the development capacity of resource management and coastal areas of Panjang beach should be able to increase income community along the coast. Research method is using qualitative research types with approach case studies, which can investigate and phenomena identify that occur, and explain how and why about the income community arround the beaches, using the instrumental case study. Determination of samples is done based on the purposes and research problems, primary data sources are collected by in-depth interviews, FGD, and secondary data source are collected by observation and documentation. Data relating to be interpreted set forth in proposition because the result of the organized with matching pattern competition. The study results indicate there has been no integrated and suitability management between province and the city; stakeholders participation in community empowerment on the coast has been optimal; leadership commitment related to enhance institutional capacity is too weak, and there has not been a policy of managing the Panjang beach Bengkulu based on information technology.

Development of a community-based diabetes and hypertension preventive program.

PubMed

Wang, C Y; Abbott, L J

1998-12-01

The purpose of this project was to develop rapport with a Chinese Community Association and then establish preventive diabetic and hypertension programs with the Chinese in Chinatown, Hawaii. Subjects were recruited from this Chinese Community Association. Two hundred Chinese responded to the invitation. Among these, 75 individuals had either Type 2 diabetes, hypertension or both. Thirty-six males and 39 females ranging in age from 51 years old to 96 years old (Mean = 71.76, SD = 9.58) participated. Surveys and educational programs were carried out in Chinese. Results were described in terms of quantitative measures (family support and health outcomes) and qualitative experiences (case studies). Eighty percent of participants had decreased their diastolic blood pressure from above 95 mmHg to below 90 mmHg and systolic blood pressure from above 155 mmHg to below 140 mmHg. Ninety-five (n = 71) percent of participants had maintained their glucose level within the 90 mg/dL to 150 mg/dL range with a mean reduction of 57.86 mg/dL in one year. The hardest thing for families was the glucose self-monitoring. Case studies suggested that open-minded active listening and persistence formed the basis for developing a culturally sensitive community-based self management program for chronic diseases. Collaboration among the community, public health nurses, and diabetes nurse educators facilitated the process of community education and health promotion.

A community engagement process for families with children with disabilities: lessons in leadership and policy.

PubMed

Vargas, Claudia María; Arauza, Consuelo; Folsom, Kim; Luna, María del Rosario; Gutiérrez, Lucy; Frerking, Patricia Ohliger; Shelton, Kathleen; Foreman, Carl; Waffle, David; Reynolds, Richard; Cooper, Phillip J

2012-01-01

This article examines a community engagement process developed as part of leadership training for clinical trainees in the Oregon Leadership Education for Neurodevelopmental and Related Disabilities (LEND) Program in a complex community with diverse families who have children with disabilities. The goal is to examine the process and lessons learned for clinical trainees and their mentors from such a process. This is a case study conducted as community-engaged action research by participant-observers involved in the Cornelius community for the past 4 years. The authors include faculty members and clinical trainees of the Oregon LEND Program at the Oregon Health & Science University, families with children with disabilities in the community, and city officials. It is a critical case study in that it studied a community engagement process in one of the poorest communities in the region, with an unusually high population of children with disabilities, and in a community that is over half Latino residents. Lessons learned here can be helpful in a variety of settings. Community engagement forum, community engagement processes, a debriefing using a seven-element feasibility framework, and trainee evaluations are key elements. A community engagement forum is a meeting to which community members and stakeholders from pertinent agencies are invited. Community engagement processes used include a steering committee made up of, and guided by community members which meets on a regular basis to prioritize and carry out responses to problems. Trainee evaluations are based on a set of questions to trigger open-ended responses. Lessons learned are based on assessments of initial and long-term outcomes of the community engagement processes in which families, community members, local officials and LEND trainees and faculty participate as well as by trainee participant-observations, end of year evaluations and trainee debriefings at the time of the initial community assessment forum. The thesis that emerges is that community engagement processes can afford significant opportunities for clinicians in training to develop their leadership skills toward improving maternal and child health for minority families with children with disabilities while building capacity in families for advocacy and facilitating change in the community.

Engaging New Migrants in Infectious Disease Screening: A Qualitative Semi-Structured Interview Study of UK Migrant Community Health-Care Leads

PubMed Central

Seedat, Farah; Hargreaves, Sally; Friedland, Jonathan S.

2014-01-01

Migration to Europe - and in particular the UK - has risen dramatically in the past decades, with implications for public health services. Migrants have increased vulnerability to infectious diseases (70% of TB cases and 60% HIV cases are in migrants) and face multiple barriers to healthcare. There is currently considerable debate as to the optimum approach to infectious disease screening in this often hard-to-reach group, and an urgent need for innovative approaches. Little research has focused on the specific experience of new migrants, nor sought their views on ways forward. We undertook a qualitative semi-structured interview study of migrant community health-care leads representing dominant new migrant groups in London, UK, to explore their views around barriers to screening, acceptability of screening, and innovative approaches to screening for four key diseases (HIV, TB, hepatitis B, and hepatitis C). Participants unanimously agreed that current screening models are not perceived to be widely accessible to new migrant communities. Dominant barriers that discourage uptake of screening include disease-related stigma present in their own communities and services being perceived as non-migrant friendly. New migrants are likely to be disproportionately affected by these barriers, with implications for health status. Screening is certainly acceptable to new migrants, however, services need to be developed to become more community-based, proactive, and to work more closely with community organisations; findings that mirror the views of migrants and health-care providers in Europe and internationally. Awareness raising about the benefits of screening within new migrant communities is critical. One innovative approach proposed by participants is a community-based package of health screening combining all key diseases into one general health check-up, to lessen the associated stigma. Further research is needed to develop evidence-based community-focused screening models - drawing on models of best practice from other countries receiving high numbers of migrants. PMID:25330079

Higher Education and the Law.

ERIC Educational Resources Information Center

Edwards, Harry T.; Nordin, Virginia Davis

The proliferation of laws, regulations, and judicial opinions affecting higher education and the nature of the impact of these laws on the academic community are examined. Designed for use by both students and practitioners, the book employs the "case method" design based on the belief that law cases furnish the best sources for study…

Evaluating Community-Based Participatory Research to Improve Community-Partnered Science and Community Health

PubMed Central

Hicks, Sarah; Duran, Bonnie; Wallerstein, Nina; Avila, Magdalena; Belone, Lorenda; Lucero, Julie; Magarati, Maya; Mainer, Elana; Martin, Diane; Muhammad, Michael; Oetzel, John; Pearson, Cynthia; Sahota, Puneet; Simonds, Vanessa; Sussman, Andrew; Tafoya, Greg; Hat, Emily White

2013-01-01

Background Since 2007, the National Congress of American Indians (NCAI) Policy Research Center (PRC) has partnered with the Universities of New Mexico and Washington to study the science of community-based participatory research (CBPR). Our goal is to identify facilitators and barriers to effective community–academic partnerships in American Indian and other communities, which face health disparities. Objectives We have described herein the scientific design of our National Institutes of Health (NIH)-funded study (2009–2013) and lessons learned by having a strong community partner leading the research efforts. Methods The research team is implementing a mixed-methods study involving a survey of principal investigators (PIs) and partners across the nation and in-depth case studies of CBPR projects. Results We present preliminary findings on methods and measures for community-engaged research and eight lessons learned thus far regarding partnership evaluation, advisory councils, historical trust, research capacity development of community partner, advocacy, honoring each other, messaging, and funding. Conclusions Study methodologies and lessons learned can help community–academic research partnerships translate research in communities. PMID:22982842

Design-Based Research: Case of a Teaching Sequence on Mechanics

ERIC Educational Resources Information Center

Tiberghien, Andree; Vince, Jacques; Gaidioz, Pierre

2009-01-01

Design-based research, and particularly its theoretical status, is a subject of debate in the science education community. In the first part of this paper, a theoretical framework drawn up to develop design-based research will be presented. This framework is mainly based on epistemological analysis of physics modelling, learning and teaching…

Conducting Science Inquiry in Primary Classrooms: Case Studies of Two Preservice Teachers' Inquiry-Based Practices

ERIC Educational Resources Information Center

Leonard, Jacqueline; Boakes, Norma; Moore, Cara M.

2009-01-01

This study examined the impact of an intervention designed to promote inquiry-based instruction among early childhood/elementary preservice teachers in Earth science. Preservice teachers participated in training sessions and community-based internships to deepen Earth science content knowledge and develop inquiry-based practices. Analyses of Earth…

Adapting cognitive behavioral therapy for psychosis for case managers: increasing access to services in a community mental health agency.

PubMed

Montesano, Vicki L; Sivec, Harry J; Munetz, Mark R; Pelton, Jeremy R; Turkington, Douglas

2014-03-01

The purpose of this article is twofold: (a) to describe the adaptation of an evidence-based practice and, (b) using a dissemination framework, to describe the process of implementing the practice at a community mental health agency. The authors describe the training concept and dissemination framework of implementing an emerging practice: high-yield cognitive behavioral techniques for psychosis, which is rooted in cognitive behavioral therapy. Thirteen case managers who represented teams from across the agency delivered the adapted practice at a community mental health agency. Implementation required buy in from all stakeholders, communication across disciplines, persistence, and flexibility. It appears that the use of a dissemination framework that is grounded in the literature, yet flexible, eases the process of implementing an adapted practice. Further research focusing on the effectiveness of this approach, along with the impact of implementing a full spectrum of cognitive behavioral therapy services for individuals with persistent psychotic symptoms, based on cognitive behavioral therapy principles, is indicated.

Practical Tips for Establishing Partnerships With Academic Researchers: A Resource Guide for Community-Based Organizations.

PubMed

Darling, Margaret; Gonzalez, Florencia; Graves, Kristi; Sheppard, Vanessa B; Hurtado-de-Mendoza, Alejandra; Leventhal, Kara-Grace; Caicedo, Larisa

2015-01-01

Research exists on strategies for successful conduct of community-based participatory research (CBPR). Unfortunately, few published resources are available to advise community-based organizations (CBOs) on preparation for and engagement in CBPR. We aimed to create a resource for CBOs that describes how an organization can prepare for and participate in CBPR. We used a case study approach of one CBO with a decade-long history of collaboration with academic researchers. We identified lessons learned through a retrospective review of organizational records and the documentation of experiences by CBO leadership and research partners. The findings were then labeled according to CBPR Partnership Readiness Model dimensions. The review of CBO documents and key informant interviews yielded ten practical tips to increase organizational readiness for and engagement in CBPR. By understanding the best practices for organizational readiness for and participation in CPBR, CBOs will be better equipped to actively participate in community-academic partnerships.

Epidemiology and burden of systemic lupus erythematosus in a Southern European population: data from the community-based lupus registry of Crete, Greece.

PubMed

Gergianaki, Irini; Fanouriakis, Antonis; Repa, Argyro; Tzanakakis, Michalis; Adamichou, Christina; Pompieri, Alexandra; Spirou, Giorgis; Bertsias, Antonios; Kabouraki, Eleni; Tzanakis, Ioannis; Chatzi, Leda; Sidiropoulos, Prodromos; Boumpas, Dimitrios T; Bertsias, George K

2017-12-01

Several population-based studies on systemic lupus erythematosus (SLE) have been reported, yet community-based, individual-case validated, comprehensive reports are missing. We studied the SLE epidemiology and burden on the island of Crete during 1999-2013. Multisource case-finding included patients ≥15 years old. Cases were ascertained by the ACR 1997, SLICC 2012 criteria and rheumatologist diagnosis, and validated through synthesis of medical charts, administrative and patient-generated data. Overall age-adjusted/sex-adjusted incidence was 7.4 (95% CI 6.8 to 7.9) per 100 000 persons/year, with stabilising trends in women but increasing in men, and average (±SD) age of diagnosis at 43 (±15) years. Adjusted and crude prevalence (December 2013) was 123.4 (113.9 to 132.9) and 143 (133 to 154)/10 5 (165/10 5 in urban vs 123/10 5 in rural regions, p<0.001), respectively. Age-adjusted/sex-adjusted nephritis incidence was 0.6 (0.4 to 0.8) with stable trends, whereas that of neuropsychiatric SLE was 0.5 (0.4 to 0.7) per 100 000 persons/year and increasing. Although half of prevalent cases had mild manifestations, 30.5% developed organ damage after 7.2 (±6.6) years of disease duration, with the neuropsychiatric domain most frequently afflicted, and 4.4% of patients with nephritis developed end-stage renal disease. The ACR 1997 and SLICC 2012 classification criteria showed high concordance (87%), yet physician-based diagnosis occurred earlier than criteria-based in about 20% of cases. By the use of a comprehensive methodology, we describe the full spectrum of SLE from the community to tertiary care, with almost half of the cases having mild disease, yet with significant damage accrual. SLE is not rare, affects predominantly middle-aged women and is increasingly recognised in men. Neuropsychiatric disease is an emerging frontier in lupus prevention and care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A heuristic framework for understanding the role of participatory decision making in community-based non-profits.

PubMed

Bess, Kimberly D; Perkins, Douglas D; Cooper, Daniel G; Jones, Diana L

2011-06-01

This paper explores the role of member participation in decision-making (PDM) from an organizational learning (OL) perspective. Community-based organizations (CBOs) serve as mediators between the individual and the local community, often providing the means for community member participation and benefiting organizationally from members' input. Community psychologists have recognized these benefits; however, the field has paid less attention to the role participation plays in increasing CBOs' capacity to meet community needs. We present a framework for exploring how CBO contextual factors influence the use of participatory decision-making structures and practices, and how these affect OL. We then use the framework to examine PDM in qualitative case study analysis of four CBOs: a youth development organization, a faith-based social action coalition, a low-income neighborhood organization, and a large human service agency. We found that organizational form, energy, and culture each had a differential impact on participation in decision making within CBOs. We highlight how OL is constrained in CBOs and document how civic aims and voluntary membership enhanced participation and learning.

Stakeholder-based SWOT analysis for successful municipal solid waste management in Lucknow, India.

PubMed

Srivastava, P K; Kulshreshtha, K; Mohanty, C S; Pushpangadan, P; Singh, A

2005-01-01

The present investigation is a case study of Lucknow, the main metropolis in Northern India, which succumbs to a major problem of municipal solid waste and its management. A qualitative investigation using strengths, weaknesses, opportunities and threats analysis (SWOT) has been successfully implemented through this community participation study. This qualitative investigation emphasizes the limited capabilities of the municipal corporation's resources to provide proper facilitation of the municipal solid waste management (MSWM) services without community participation in Lucknow city. The SWOT analysis was performed to formulate strategic action plans for MSWM in order to mobilize and utilize the community resources on the one hand and municipal corporation's resources on the other. It has allowed the introduction of a participatory approach for better collaboration between the community and municipal corporation in Lucknow (India). With this stakeholder-based SWOT analysis, efforts were made to explore the ways and means of converting the possible "threats" into "opportunities" and changing the "weaknesses" into "strengths" regarding a community-based MSWM programme. By this investigation, concrete strategic action plans were developed for both the community and municipal corporation to improve MSWM in Lucknow.

Public health accreditation and metrics for ethics: a case study on environmental health and community engagement.

PubMed

Bernheim, Ruth Gaare; Stefanak, Matthew; Brandenburg, Terry; Pannone, Aaron; Melnick, Alan

2013-01-01

As public health departments around the country undergo accreditation using the Public Health Accreditation Board standards, the process provides a new opportunity to integrate ethics metrics into day-to-day public health practice. While the accreditation standards do not explicitly address ethics, ethical tools and considerations can enrich the accreditation process by helping health departments and their communities understand what ethical principles underlie the accreditation standards and how to use metrics based on these ethical principles to support decision making in public health practice. We provide a crosswalk between a public health essential service, Public Health Accreditation Board community engagement domain standards, and the relevant ethical principles in the Public Health Code of Ethics (Code). A case study illustrates how the accreditation standards and the ethical principles in the Code together can enhance the practice of engaging the community in decision making in the local health department.

AAC and community partnerships: the participation path to community inclusion.

PubMed

Batorowicz, Beata; McDougall, Stacy; Shepherd, Tracy A

2006-09-01

The Life Needs Model (LNM) of service delivery emphasizes the importance of community participation in children's development and quality of life. This article is a case illustration of two community partnership programs based on the LNM. StoryTime and Dress Up and Drama provide participation opportunities in the community for children who use Augmentative and Alternative Communication (AAC). The authors describe the development and implementation of both programs. Regardless of level of functioning, each child who participated in the programs did so by communicating, interacting socially, and controlling the environment. Multiple benefits for children, parents/caregivers, community partners, and AAC clinicians are highlighted. The authors hope that this article will assist others in developing partnerships and implementing inclusive practices within their communities.

A method for analyzing the business case for provider participation in the National Cancer Institute's Community Clinical Oncology Program and similar federally funded, provider-based research networks.

PubMed

Reiter, Kristin L; Song, Paula H; Minasian, Lori; Good, Marjorie; Weiner, Bryan J; McAlearney, Ann Scheck

2012-09-01

The Community Clinical Oncology Program (CCOP) plays an essential role in the efforts of the National Cancer Institute (NCI) to increase enrollment in clinical trials. Currently, there is little practical guidance in the literature to assist provider organizations in analyzing the return on investment (ROI), or business case, for establishing and operating a provider-based research network (PBRN) such as the CCOP. In this article, the authors present a conceptual model of the business case for PBRN participation, a spreadsheet-based tool and advice for evaluating the business case for provider participation in a CCOP organization. A comparative, case-study approach was used to identify key components of the business case for hospitals attempting to support a CCOP research infrastructure. Semistructured interviews were conducted with providers and administrators. Key themes were identified and used to develop the financial analysis tool. Key components of the business case included CCOP start-up costs, direct revenue from the NCI CCOP grant, direct expenses required to maintain the CCOP research infrastructure, and incidental benefits, most notably downstream revenues from CCOP patients. The authors recognized the value of incidental benefits as an important contributor to the business case for CCOP participation; however, currently, this component is not calculated. The current results indicated that providing a method for documenting the business case for CCOP or other PBRN involvement will contribute to the long-term sustainability and expansion of these programs by improving providers' understanding of the financial implications of participation. Copyright © 2011 American Cancer Society.

Twelve months of implementation of health care performance-based financing in Burkina Faso: A qualitative multiple case study.

PubMed

Ridde, Valéry; Yaogo, Maurice; Zongo, Sylvie; Somé, Paul-André; Turcotte-Tremblay, Anne-Marie

2018-01-01

To improve health services' quantity and quality, African countries are increasingly engaging in performance-based financing (PBF) interventions. Studies to understand their implementation in francophone West Africa are rare. This study analysed PBF implementation in Burkina Faso 12 months post-launch in late 2014. The design was a multiple and contrasted case study involving 18 cases (health centres). Empirical data were collected from observations, informal (n = 224) and formal (n = 459) interviews, and documents. Outside the circle of persons trained in PBF, few in the community had knowledge of it. In some health centres, the fact that staff were receiving bonuses was intentionally not announced to populations and community leaders. Most local actors thought PBF was just another project, but the majority appreciated it. There were significant delays in setting up agencies for performance monitoring, auditing, and contracting, as well as in the payment. The first audits led rapidly to coping strategies among health workers and occasionally to some staging beforehand. No community-based audits had yet been done. Distribution of bonuses varied from one centre to another. This study shows the importance of understanding the implementation of public health interventions in Africa and of uncovering coping strategies. © 2017 The Authors. The International Journal of Health Planning and Management Published by John Wiley & Sons Ltd.

Ecology of the aging human brain.

PubMed

Sonnen, Joshua A; Santa Cruz, Karen; Hemmy, Laura S; Woltjer, Randall; Leverenz, James B; Montine, Kathleen S; Jack, Clifford R; Kaye, Jeffrey; Lim, Kelvin; Larson, Eric B; White, Lon; Montine, Thomas J

2011-08-01

Alzheimer disease, cerebral vascular brain injury, and isocortical Lewy body disease (LBD) are the major contributors to dementia in community- and population-based studies. To estimate the prevalence of clinically silent forms of these diseases in cognitively normal (CN) adults. Autopsy study. Community- and population based. A total of 1672 brain autopsies from the Adult Changes in Thought study, Honolulu-Asia Aging Study, Nun Study, and Oregon Brain Aging Study, of which 424 met the criteria for CN. Of these, 336 cases had a comprehensive neuropathologic examination of neuritic plaque density, Braak stage for neurofibrillary tangles, LB distribution, and number of cerebral microinfarcts. Forty-seven percent of CN cases had moderate or frequent neuritic plaque density; of these, 6% also had Braak stage V or VI for neurofibrillary tangles. Fifteen percent of CN cases had medullary LBD; 8% also had nigral and 4% isocortical LBD. The presence of any cerebral microinfarcts was identified in 33% and of high-level cerebral microinfarcts in 10% of CN individuals. Overall, the burden of lesions in each individual and their comorbidity varied widely within each study but were similar across studies. These data show an individually varying complex convergence of subclinical diseases in the brain of older CN adults. Appreciating this ecology should help guide future biomarker and neuroimaging studies and clinical trials that focus on community- and population-based cohorts.

Rebuilding community resilience in a post-war context: developing insight and recommendations - a qualitative study in Northern Sri Lanka.

PubMed

Somasundaram, Daya; Sivayokan, Sambasivamoorthy

2013-01-11

Individuals, families and communities in Northern Sri Lanka have undergone three decades of war trauma, multiple displacements, and loss of family, kin, friends, homes, employment and other valued resources. The objective of the study was understanding common psychosocial problems faced by families and communities, and the associated risk and protective factors, so that practical and effective community based interventions can be recommended to rebuild strengths, adaptation, coping strategies and resilience. This qualitative, ecological study is a psychosocial ethnography in post-war Northern Sri Lanka obtained through participant observation; case studies; key- informant interviews; and focus groups discussions with mental health and psychosocial community workers as well as literature survey of media and organizational reports. Qualitative analysis of the data used ethnography, case studies, phenomenology, grounded theory, hermeneutics and symbolic interactionism techniques. Quantitative data on suicide was collected for Jaffna and Killinochchi districts. Complex mental health and psychosocial problems at the individual, family and community levels in a post-war context were found to impair recovery. These included unresolved grief; individual and collective trauma; insecurity, self-harm and suicides; poverty and unemployment; teenage and unwanted pregnancies; alcoholism; child abuse and neglect; gender based violence and vulnerability including domestic violence, widows and female headed-household, family conflict and separation; physical injuries and handicap; problems specific for children and elderly; abuse and/or neglect of elderly and disabled; anti-social and socially irresponsible behaviour; distrust, hopelessness, and powerlessness. Protective factors included families; female leadership and engagement; cultural and traditional beliefs, practices and rituals; and creative potential in narratives, drama and other arts. Risk factors that were impeding community rehabilitation and recovery included continuing military governance, depletion of social capital particularly lack of trust, hope and socio-economic opportunity structures for development that would engender a sense of collective efficacy. In view of the widespread trauma at the individual, family and collective levels, community based programmes to increase local awareness, knowledge and skills to deal with common mental health and psychosocial issues; and training of community level workers and others in basic mental health and psychosocial problem solving are recommended to rebuild family and community agency and resilience. The use of cultural practices and school based programmes would rekindle community processes.

Rebuilding community resilience in a post-war context: developing insight and recommendations - a qualitative study in Northern Sri Lanka

PubMed Central

2013-01-01

Background Individuals, families and communities in Northern Sri Lanka have undergone three decades of war trauma, multiple displacements, and loss of family, kin, friends, homes, employment and other valued resources. The objective of the study was understanding common psychosocial problems faced by families and communities, and the associated risk and protective factors, so that practical and effective community based interventions can be recommended to rebuild strengths, adaptation, coping strategies and resilience. Methods This qualitative, ecological study is a psychosocial ethnography in post-war Northern Sri Lanka obtained through participant observation; case studies; key- informant interviews; and focus groups discussions with mental health and psychosocial community workers as well as literature survey of media and organizational reports. Qualitative analysis of the data used ethnography, case studies, phenomenology, grounded theory, hermeneutics and symbolic interactionism techniques. Quantitative data on suicide was collected for Jaffna and Killinochchi districts. Results Complex mental health and psychosocial problems at the individual, family and community levels in a post-war context were found to impair recovery. These included unresolved grief; individual and collective trauma; insecurity, self-harm and suicides; poverty and unemployment; teenage and unwanted pregnancies; alcoholism; child abuse and neglect; gender based violence and vulnerability including domestic violence, widows and female headed-household, family conflict and separation; physical injuries and handicap; problems specific for children and elderly; abuse and/or neglect of elderly and disabled; anti-social and socially irresponsible behaviour; distrust, hopelessness, and powerlessness. Protective factors included families; female leadership and engagement; cultural and traditional beliefs, practices and rituals; and creative potential in narratives, drama and other arts. Risk factors that were impeding community rehabilitation and recovery included continuing military governance, depletion of social capital particularly lack of trust, hope and socio-economic opportunity structures for development that would engender a sense of collective efficacy. Conclusions In view of the widespread trauma at the individual, family and collective levels, community based programmes to increase local awareness, knowledge and skills to deal with common mental health and psychosocial issues; and training of community level workers and others in basic mental health and psychosocial problem solving are recommended to rebuild family and community agency and resilience. The use of cultural practices and school based programmes would rekindle community processes. PMID:23305538

A Deep Stochastic Model for Detecting Community in Complex Networks

NASA Astrophysics Data System (ADS)

Fu, Jingcheng; Wu, Jianliang

2017-01-01

Discovering community structures is an important step to understanding the structure and dynamics of real-world networks in social science, biology and technology. In this paper, we develop a deep stochastic model based on non-negative matrix factorization to identify communities, in which there are two sets of parameters. One is the community membership matrix, of which the elements in a row correspond to the probabilities of the given node belongs to each of the given number of communities in our model, another is the community-community connection matrix, of which the element in the i-th row and j-th column represents the probability of there being an edge between a randomly chosen node from the i-th community and a randomly chosen node from the j-th community. The parameters can be evaluated by an efficient updating rule, and its convergence can be guaranteed. The community-community connection matrix in our model is more precise than the community-community connection matrix in traditional non-negative matrix factorization methods. Furthermore, the method called symmetric nonnegative matrix factorization, is a special case of our model. Finally, based on the experiments on both synthetic and real-world networks data, it can be demonstrated that our algorithm is highly effective in detecting communities.

The role of communities in sustainable land and forest management: The case of Nyanga, Zvimba and Guruve districts of Zimbabwe

PubMed Central

Sagonda, Ruvimbo; Kaundikiza, Munyaradzi

2016-01-01

Forest benefit analysis is vital in ensuring sustainable community-based natural resources management. Forest depletion and degradation are key issues in rural Zimbabwe and strategies to enhance sustainable forest management are continually sought. This study was carried out to assess the impact of forests on communities from Nyanga, Guruve and Zvimba districts of Zimbabwe. It is based on a Big Lottery Fund project implemented by Progressio-UK and Environment Africa. It focuses on identifying replicable community forest and land management strategies and the level of benefits accruing to the community. Analysis of change was based on the Income and Food Security and Forest benefits, which also constitutes the tools used during the research. The study confirms the high rate of deforestation and the increased realisation by communities to initiate practical measures aimed at protecting and sustaining forest and land resources from which they derive economic and social benefits. The results highlight the value of community structures (Farmer Field Schools and Environmental Action Groups) as conduits for natural resource management. The interconnectivity among forests, agricultural systems and the integral role of people are recognised as key to climate change adaptation.

The dynamics of community and NGO partnership: primary health care experiences in rural Mali.

PubMed

Solomon, Yodit; Ballif-Spanvill, Bonnie; Ward, Carol; Fuhriman, Addie; Widdision-Jones, Kacey

2008-12-01

Utilizing ethnographic research methods, this case study examines the experiences of an NGO-sponsored health care program in rural Mali. The findings indicate that while, in principle, the organization operates from an alternative development base, it has been unable to decentralize the decision-making process and facilitate community dialogue and participation. Numerous problems resulted, including superficial forms of local participation, lack of community ownership, non-remuneration of health workers and midwives, inadequate training, and ultimately, limited program gains. The analyses highlight the complexity and dynamic nature of health program implementation in a developing context, and suggest several factors important to project success. These include drawing on diverse local perspectives, promoting broad-based participation, and providing culturally appropriate ways to include all community members, particularly women.

Achieving Research Impact Through Co-creation in Community-Based Health Services: Literature Review and Case Study.

PubMed

Greenhalgh, Trisha; Jackson, Claire; Shaw, Sara; Janamian, Tina

2016-06-01

Co-creation-collaborative knowledge generation by academics working alongside other stakeholders-is an increasingly popular approach to aligning research and service development. It has potential for "moving beyond the ivory towers" to deliver significant societal impact via dynamic, locally adaptive community-academic partnerships. Principles of successful co-creation include a systems perspective, a creative approach to research focused on improving human experience, and careful attention to governance and process. If these principles are not followed, co-creation efforts may fail. Co-creation-collaborative knowledge generation by academics working alongside other stakeholders-reflects a "Mode 2" relationship (knowledge production rather than knowledge translation) between universities and society. Co-creation is widely believed to increase research impact. We undertook a narrative review of different models of co-creation relevant to community-based health services. We contrasted their diverse disciplinary roots and highlighted their common philosophical assumptions, principles of success, and explanations for failures. We applied these to an empirical case study of a community-based research-service partnership led by the Centre of Research Excellence in Quality and Safety in Integrated Primary-Secondary Care at the University of Queensland, Australia. Co-creation emerged independently in several fields, including business studies ("value co-creation"), design science ("experience-based co-design"), computer science ("technology co-design"), and community development ("participatory research"). These diverse models share some common features, which were also evident in the case study. Key success principles included (1) a systems perspective (assuming emergence, local adaptation, and nonlinearity); (2) the framing of research as a creative enterprise with human experience at its core; and (3) an emphasis on process (the framing of the program, the nature of relationships, and governance and facilitation arrangements, especially the style of leadership and how conflict is managed). In both the literature review and the case study, co-creation "failures" could often be tracked back to abandoning (or never adopting) these principles. All co-creation models made strong claims for significant and sustainable societal impacts as a result of the adaptive and developmental research process; these were illustrated in the case study. Co-creation models have high potential for societal impact but depend critically on key success principles. To capture the nonlinear chains of causation in the co-creation pathway, impact metrics must reflect the dynamic nature and complex interdependencies of health research systems and address processes as well as outcomes. © 2016 Milbank Memorial Fund.

Participating in a Community of Learners enhances resident perceptions of learning in an e-mentoring program: proof of concept

PubMed Central

2011-01-01

Background Community learning and e-mentoring, learning methods used in higher education, are not used to any extent in residency education. Yet both have the potential to enhance resident learning and, in the case of community learning, introduce residents to basic lifelong learning skills. We set out to determine whether residents participating in an Internet based e-mentoring program would, with appropriate facilitation, form a community of learners (CoL) and hold regular community meetings. We also determined resident and faculty perceptions of CoL and Internet sessions as effective learning experiences. Methods A six-month e-mentoring pilot was offered to 10 Radiology residents in the Aga Khan University Postgraduate Medical Education Program in Nairobi, Kenya (AKUHN) with a Professor of Radiology, located at University of Virginia, USA, acting as the e-mentor. Monthly Internet case-based teaching sessions were facilitated by the e-mentor. In addition, residents were coached by a community facilitator to form CoL and collectively work through clinical cases at weekly face-to-face CoL sessions. Event logs described observed resident activity at CoL sessions; exit survey and interviews were used to elicit perceptions of CoL and Internet sessions as effective learning experiences. Results Resident adoption of CoL behaviors was observed, including self-regulation, peer mentoring and collaborative problem solving. Analysis revealed high resident enthusiasm and value for CoL. Surveys and interviews indicated high levels of acceptance of Internet learning experiences, although there was room for improvement in audio-visual transmission technologies. Faculty indicated there was a need for a larger multi-specialty study. Conclusions The pilot demonstrated resident acceptance of community building and collaborative learning as valued learning experiences, addressing one barrier to its formal adoption in residency education curricula. It also highlighted the potential of e-mentoring as a means of expanding faculty and teaching materials in residency programs in developing countries. PMID:21266070

Community burden and prognostic impact of reduced kidney function among patients hospitalized with acute decompensated heart failure: The Atherosclerosis Risk in Communities (ARIC) Study Community Surveillance.

PubMed

Matsushita, Kunihiro; Kwak, Lucia; Hyun, Noorie; Bessel, Marina; Agarwal, Sunil K; Loehr, Laura R; Ni, Hanyu; Chang, Patricia P; Coresh, Josef; Wruck, Lisa M; Rosamond, Wayne

2017-01-01

Kidney dysfunction is prevalent and impacts prognosis in patients with acute decompensated heart failure (ADHF). However, most previous reports were from a single hospital, limiting their generalizability. Also, contemporary data using new equation for estimated glomerular filtration rate (eGFR) are needed. We analyzed data from the ARIC Community Surveillance for ADHF conducted for residents aged ≥55 years in four US communities between 2005-2011. All ADHF cases (n = 5, 391) were adjudicated and weighted to represent those communities (24,932 weighted cases). The association of kidney function (creatinine-based eGFR by the CKD-EPI equation and blood urea nitrogen [BUN]) during hospitalization with 1-year mortality was assessed using logistic regression. Based on worst and last serum creatinine, there were 82.5% and 70.6% with reduced eGFR (<60 ml/min/1.73m2) and 37.4% and 26.6% with severely reduced eGFR (<30 ml/min/1.73m2), respectively. Lower eGFR (regardless of last or worst eGFR), particularly eGFR <30 ml/min/1.73m2, was significantly associated with higher 1-year mortality independently of potential confounders (odds ratio 1.60 [95% CI 1.26-2.04] for last eGFR 15-29 ml/min/1.73m2 and 2.30 [1.76-3.00] for <15 compared to eGFR ≥60). The association was largely consistent across demographic subgroups. Of interest, when both eGFR and BUN were modeled together, only BUN remained significant. Severely reduced eGFR (<30 ml/min/1.73m2) was observed in ~30% of ADHF cases and was an independent predictor of 1-year mortality in community. For prediction, BUN appeared to be superior to eGFR. These findings suggest the need of close attention to kidney dysfunction among ADHF patients.

Traumatic Loss and Natural Disaster: A Case Study of a School-Based Response to Hurricanes Katrina and Rita

ERIC Educational Resources Information Center

Clettenberg, Stacey; Gentry, Judy; Held, Matthew; Mock, Lou Ann

2011-01-01

This article tracks the trajectory and impact of Hurricanes Katrina and Rita on the communities of Houston/Harris County, Texas, USA, the schools, children, and families; along with the community partnerships that addressed the trauma and upheaval. Following the influx of individuals and families who were displaced by Hurricanes Katrina and Rita…

Experiences and Perceptions of Mentors in a Community Mentoring Program for At-Risk Students

ERIC Educational Resources Information Center

Allen, Belinda K.

2013-01-01

This phenomenological case study explored the perceptions and experiences of mentors who work for a community-based mentoring program that was created to provide at-risk minority students with male role models. Most studies from the past 20 years have assessed mainly the academic, social, and emotional outcomes of mentoring among at-risk minority…

Faculty Social Capital at Work in a Community College Student Success and Completion Initiative

ERIC Educational Resources Information Center

Funaro, Janette

2017-01-01

The purpose of this case study was to examine the role of social capital in the enactment of a faculty-based initiative designed to improve student success and completion at one community college. The concept of social capital--or the actual and potential resources that are embedded in relationships--has been examined in research studies in many…

When Communities Collide: The Shared Construction and Defence of Community and Identity during a Teaching Practicum

ERIC Educational Resources Information Center

Trent, John

2014-01-01

This article describes the results of a qualitative multiple case study investigation of the experiences of preservice teachers during a teaching practicum in Hong Kong. The study uses in-depth interviews with pairs of student teachers and their school-based supporting teachers to understand how the former positioned themselves as particular types…

The Effect of a Community College Promise Scholarship on Access and Success

ERIC Educational Resources Information Center

Pluhta, Elizabeth A.; Penny, G. Richard

2013-01-01

Based on a mixed methods case study design, the current study reports on a Promise Scholarship program offered by a community college and its affiliated foundation to graduating students at a nearby high school located in a low-income neighborhood of a large city and with a high proportion of African American and other students of color. Using a…

Social Network Analysis of a Scientist-Practitioner Research Initiative Established to Facilitate Science Dissemination and Implementation within States and Communities

ERIC Educational Resources Information Center

Ginexi, Elizabeth M.; Huang, Grace; Steketee, Michael; Tsakraklides, Sophia; MacAllum, Keith; Bromberg, Julie; Huffman, Amanda; Luke, Douglas A.; Leischow, Scott J.; Okamoto, Janet M.; Rogers, Todd

2017-01-01

This article presents a case study of a scientist-practitioner research network established by the National Cancer Institute's State and Community Tobacco Control Research Initiative. While prior programs have focused on collaboration among scientists, a goal here was to encourage collaborations with non-university, practice-based partners. Two…

Museums and Health: A Case Study of Research and Practice at the Children's Museum of Manhattan

ERIC Educational Resources Information Center

Ackerman, Andrew

2016-01-01

This article will discuss how museums may serve as community anchors by catalyzing and helping to sustain significant behavioral and attitudinal changes among the public. When museums integrate research, deep community roots and trust, and a museum and arts-based pedagogy, they are uniquely positioned to effect change. The article will review a…

The Case for a Paradigm Shift in Extension from Information-Centric to Community-Centric Programming

ERIC Educational Resources Information Center

Strong, Emma; Rowntree, Jason; Thurlow, Kable; Raven, Matt R.

2015-01-01

Since its establishment through the Smith-Lever Act, the Cooperative Extension Service has sought to use non-formal education programs centered on community needs to provide research-based information. However, the onset of the information age has transformed the way knowledge is shared and as a result altered the way people access information.…

Think Locally, Act Globally: Comparing Urban, Suburban, and Rural Colleges' Internationalization: The Case of the CÉGEPS

ERIC Educational Resources Information Center

Bègin-Caouette, Olivier

2013-01-01

Community colleges were created to respond to the specific needs of their local community, yet the growing transnational connections established between institutions seem to give the "local", a global outlook. Based on a survey to which 39 of Québec general and vocational colleges (CEGEPs)--81% of the population--responded, this article…

Early Preservice Teachers' Experiences of the Environment: A Case Study of Participation in a Community Outdoor Event

ERIC Educational Resources Information Center

van Rooy, Wilhelmina

2017-01-01

Clean Up Australia Day is the country's largest community-based environmental annual event when participants work in teams to remove rubbish from their local environment. This article describes an interpretive study in which a sample of preservice primary teachers' (n = 30) responses to questions about their involvement in the event were evaluated…

Community Creation by Means of a Social Media Paradigm

ERIC Educational Resources Information Center

Fernando, Isuru

2010-01-01

Purpose: The purpose of this paper is to present a case study from which a framework for the purposeful building of knowledge communities by means of social media is formulated. Design/methodology/approach: The approach first takes the form of a literature review. Based on a review of literature as well as on various data sets and surveys within…

Programa de Fortalecimiento de Capacidades: Reflections on a Case Study of Community-Based Teacher Education Set in Rural Northern Peru

ERIC Educational Resources Information Center

Alsop, Steve; Ames, Patricia; Arroyo, Graciela Cordero; Dippo, Don

2010-01-01

This article explores distinctive features of a 5-year international education development project set in rural northern Peru (PROMEB, the "Proyecto de Mejoramiento de la Educacion Basica"). Grounded within a partnership between teacher educators from Peru, Mexico and Canada, and rural Peruvian teachers, students and their communities,…

Community-Engaged Courses in a Conflict Zone: A Case Study of the Israeli Academic Corpus

ERIC Educational Resources Information Center

Golan, Daphna; Shalhoub-Kevorkian, Nadera

2014-01-01

This article is based on an action-oriented study of 13 community-engaged courses at 11 institutions of higher education in Israel. These courses were not part of peace education programs but rather accredited academic courses in various disciplines, all of which included practice and theory. The purpose of this article is to demonstrate how these…

Cost-effectiveness analysis of the national implementation of integrated community case management and community-based health planning and services in Ghana for the treatment of malaria, diarrhoea and pneumonia.

PubMed

Escribano Ferrer, Blanca; Hansen, Kristian Schultz; Gyapong, Margaret; Bruce, Jane; Narh Bana, Solomon A; Narh, Clement T; Allotey, Naa-Korkor; Glover, Roland; Azantilow, Naa-Charity; Bart-Plange, Constance; Sagoe-Moses, Isabella; Webster, Jayne

2017-07-05

Ghana has developed two main community-based strategies that aim to increase access to quality treatment for malaria, diarrhoea and suspected pneumonia: the integrated community case management (iCCM) and the community-based health planning and services (CHPS). The aim of the study was to assess the cost-effectiveness of these strategies under programme conditions. A cost-effectiveness analysis was conducted. Appropriate diagnosis and treatment given was the effectiveness measure used. Appropriate diagnosis and treatment data was obtained from a household survey conducted 2 and 8 years after implementation of iCCM in the Volta and Northern Regions of Ghana, respectively. The study population was carers of children under-5 years who had fever, diarrhoea and/or cough in the last 2 weeks prior to the interview. Costs data was obtained mainly from the National Malaria Control Programme (NMCP), the Ministry of Health, CHPS compounds and from a household survey. Appropriate diagnosis and treatment of malaria, diarrhoea and suspected pneumonia was more cost-effective under the iCCM than under CHPS in the Volta Region, even after adjusting for different discount rates, facility costs and iCCM and CHPS utilization, but not when iCCM appropriate treatment was reduced by 50%. Due to low numbers of carers visiting a CBA in the Northern Region it was not possible to conduct a cost-effectiveness analysis in this region. However, the cost analysis showed that iCCM in the Northern Region had higher cost per malaria, diarrhoea and suspected pneumonia case diagnosed and treated when compared to the Volta Region and to the CHPS strategy in the Northern Region. Integrated community case management was more cost-effective than CHPS for the treatment of malaria, diarrhoea and suspected pneumonia when utilized by carers of children under-5 years in the Volta Region. A revision of the iCCM strategy in the Northern Region is needed to improve its cost-effectiveness. Long-term financing strategies should be explored including potential inclusion in the National Health Insurance Scheme (NHIS) benefit package. An acceptability study of including iCCM in the NHIS should be conducted.

Billing code algorithms to identify cases of peripheral artery disease from administrative data

PubMed Central

Fan, Jin; Arruda-Olson, Adelaide M; Leibson, Cynthia L; Smith, Carin; Liu, Guanghui; Bailey, Kent R; Kullo, Iftikhar J

2013-01-01

Objective To construct and validate billing code algorithms for identifying patients with peripheral arterial disease (PAD). Methods We extracted all encounters and line item details including PAD-related billing codes at Mayo Clinic Rochester, Minnesota, between July 1, 1997 and June 30, 2008; 22 712 patients evaluated in the vascular laboratory were divided into training and validation sets. Multiple logistic regression analysis was used to create an integer code score from the training dataset, and this was tested in the validation set. We applied a model-based code algorithm to patients evaluated in the vascular laboratory and compared this with a simpler algorithm (presence of at least one of the ICD-9 PAD codes 440.20–440.29). We also applied both algorithms to a community-based sample (n=4420), followed by a manual review. Results The logistic regression model performed well in both training and validation datasets (c statistic=0.91). In patients evaluated in the vascular laboratory, the model-based code algorithm provided better negative predictive value. The simpler algorithm was reasonably accurate for identification of PAD status, with lesser sensitivity and greater specificity. In the community-based sample, the sensitivity (38.7% vs 68.0%) of the simpler algorithm was much lower, whereas the specificity (92.0% vs 87.6%) was higher than the model-based algorithm. Conclusions A model-based billing code algorithm had reasonable accuracy in identifying PAD cases from the community, and in patients referred to the non-invasive vascular laboratory. The simpler algorithm had reasonable accuracy for identification of PAD in patients referred to the vascular laboratory but was significantly less sensitive in a community-based sample. PMID:24166724

Sanitation and income improvement by local community as sustainable participatory development

NASA Astrophysics Data System (ADS)

Ikemi, M.

2017-03-01

Most people in low-income areas such as rural village in Africa and urban slum in Southeast Asia live with limited economic resources and poor sanitation conditions. In order to deal with the situation, many of the people have formed community-based organizations and joined the organization activities for the common purpose of improving these conditions as participatory development. This study attempts to examine and evaluate the impact of the activities in their respective local communities. From the case study in two villages of rural Senegal, self-help effort is considered essential to solve the people’s income and hygiene problems through their community participation for sustainable development. For the implementation, the organizational solidarity, adequate water supply and water management are crucially needed. It is suggested to encourage community-based organizations effectively working for income improvement to also consider practicing for sanitation improvement.

The Role for Community-Based Participatory Research in Formulating Policy Initiatives: Promoting Safety and Health for In-Home Care Workers and Their Consumers

PubMed Central

Gong, Fang; Ayala, Linda; Stock, Laura; McDevitt, Susannah; Heaney, Cathy

2009-01-01

Although community-based participatory research (CBPR) can be effective in influencing policy, the process of formulating policy initiatives through CBPR is understudied. We describe a case study to illustrate how alliances among various community partners could be united to formulate policy directions. In collaboration with partners, the National Institute for Occupational Safety and Health initiated a project aimed at improving health and safety for low-income elderly and disabled persons and their in-home care workers. Community partners and stakeholders participated in focus groups, stakeholder interviews, and meetings; they played multiple roles including identifying organizational policy changes the partners could initiate immediately, as well as broader public policy goals. Results indicated that a strong community partnership, participation, and shared values contributed to successful formulation of policy initiatives. PMID:19890153

Essential Resources for Implementation and Sustainability of Evidence-Based Health Promotion Programs: A Mixed Methods Multi-Site Case Study.

PubMed

Dattalo, M; Wise, M; Ford Ii, J H; Abramson, B; Mahoney, J

2017-04-01

As of October 2016, use of federal Older Americans Act funds for health promotion and disease prevention will be restricted to the Administration on Aging's criteria for high-level evidence-based health promotion programs. Dissemination of these programs to rural communities remains limited. Therefore a strong need exists to identify strategies that facilitate program implementation and sustainability. The objective of this study was to compare organizational readiness and implementation strategies used by rural communities that achieved varying levels of success in sustaining evidence-based health promotion programs for older adults. We utilized a qualitative multi-site case study design to analyze the longitudinal experiences of eight rural sites working to implement evidence-based health promotion program over 3 years (8/2012-7/2015). Multiple sources of data (interviews, documents, reports, surveys) from each site informed the analysis. We used conventional content analysis to conduct a cross-case comparison to identify common features of rural counties that successfully implemented and sustained their target evidence-based health promotion program. Readiness to implement evidence-based programs as low at baseline as all site leaders described needing to secure additional resources for program implementation. Sites that successfully utilized six essential resources implemented and sustained greater numbers of workshops: (1) External Partnerships, (2) Agency Leadership Commitment, (3) Ongoing Source of Workshop Leaders, (4) Health Promotion Coordination Tasks Assigned to Specific Staff, (5) Organizational Stability, and (6) Change Team Engagement. The six essential resources described in this study can help rural communities assess their readiness to implement health promotion programs and work secure the resources necessary for successful implementation.

Emerging new practices in technology to support independent community access for people with intellectual and cognitive disabilities.

PubMed

Stock, Steven E; Davies, Daniel K; Wehmeyer, Michael L; Lachapelle, Yves

2011-01-01

The concept of community access is a multidimensional term, which may involve issues related to physical access, knowledge and information, power and control, relationships and communications, advocacy, participation and quality of life [21]. This paper discusses historical and emerging practices and interventions related to physical access to community and community based information for individuals with cognitive disabilities such as intellectual disability, autism or traumatic brain injury. While much societal attention has been paid to features of independent community access for populations such as individuals with hearing, vision or physical disabilities, less attention has focused on independent community access for people with intellectual and other significant cognitive disabilities. Attitudes and actions by families and professional service communities are often mixed for some individuals in this population. The somewhat limited research base in these areas is explored, including a case study review and results from several promising feasibility studies. The paper concludes with comments concerning future prospects and recommendations for improving independent community access for persons with significant cognitive disabilities.

The "Boom" and "Bust" Patterns of Communities within the Energy Rich Region of West Virginia: A Case Study of Moundsville

NASA Astrophysics Data System (ADS)

Kiger, Brandon S.

The increasing worldwide demand for energy will provide Energy Rich Regions (ERRs) the opportunity to increase their wealth and quality of living. However, a reoccurring pattern of boom and bust cycles in ERRs suggests the need for more sustainable development strategies. A mixed methods approach (case study) is employed to explore the "wicked human problems" occurring in one community, Moundsville, WV and to discover development patterns that might inform sustainable development strategies for the future. This study explores briefly the distant past development patterns, and in greater detail the pre-boom and most current boom in natural gas. First, data will be derived from a conceptual "Energy Rich Region Template" that explores the sustainability of development from the inclusive wealth forms of natural, human, and physical capital. The qualitative data analysis software (MAXQDA) is used to systematically collect and organize data and information into a community-wide knowledge base (specifically the seven years of city council minutes). This framework can assist future research dedicated to similar cases. Furthermore, this case may support communities and or policymakers in the development of a programming guide for converting the natural capital into other reproducible capital forms, thus avoiding the development cycle of boom and bust.

Economic evaluation of a group-based exercise program for falls prevention among the older community-dwelling population.

PubMed

McLean, Kendra; Day, Lesley; Dalton, Andrew

2015-03-26

Falls among older people are of growing concern globally. Implementing cost-effective strategies for their prevention is of utmost importance given the ageing population and associated potential for increased costs of fall-related injury over the next decades. The purpose of this study was to undertake a cost-utility analysis and secondary cost-effectiveness analysis from a healthcare system perspective, of a group-based exercise program compared to routine care for falls prevention in an older community-dwelling population. A decision analysis using a decision tree model was based on the results of a previously published randomised controlled trial with a community-dwelling population aged over 70. Measures of falls, fall-related injuries and resource use were directly obtained from trial data and supplemented by literature-based utility measures. A sub-group analysis was performed of women only. Cost estimates are reported in 2010 British Pound Sterling (GBP). The ICER of GBP£51,483 per QALY for the base case analysis was well above the accepted cost-effectiveness threshold of GBP£20,000 to £30,000 per QALY, but in a sensitivity analysis with minimised program implementation the incremental cost reached GBP£25,678 per QALY. The ICER value at 95% confidence in the base case analysis was GBP£99,664 per QALY and GBP£50,549 per QALY in the lower cost analysis. Males had a 44% lower injury rate if they fell, compared to females resulting in a more favourable ICER for the women only analysis. For women only the ICER was GBP£22,986 per QALY in the base case and was below the cost-effectiveness threshold for all other variations of program implementation. The ICER value at 95% confidence was GBP£48,212 in the women only base case analysis and GBP£23,645 in the lower cost analysis. The base case incremental cost per fall averted was GBP£652 (GBP£616 for women only). A threshold analysis indicates that this exercise program cannot realistically break even. The results suggest that this exercise program is cost-effective for women only. There is no evidence to support its cost-effectiveness in a group of mixed gender unless the costs of program implementation are minimal. Conservative assumptions may have underestimated the true cost-effectiveness of the program.

Surveillance for tuberculosis in a rural community in The Philippines.

PubMed

Lopez, A L; Aldaba, J G; Ama, C G; Sylim, P G; Geraldino, X D; Sarol, J N; Salonga, A M

2016-11-01

Estimates of the tuberculosis (TB) burden in the Philippines are largely dependent on prevalence surveys. To conduct a prospective community-based survey to generate epidemiological data on TB among patients seeking care in public health centres in a rural municipality in the Philippines. Prospective surveillance and follow-up of presumptive TB cases from May 2013 to July 2015. Of 1622 participants with presumptive TB, 468 (28.8%) (95%CI 26.6-31.1) were diagnosed with TB. The annual TB case notification rate in San Juan was 212 (95%CI 184-242) per 100 000 population. There were nine TB-attributable deaths during the study period. Only 8.8% (95%CI 6.2-11.32) of the cases were children aged <15 years; 274 (58.5%) cases were bacteriologically confirmed. Of 210 isolates tested for antimicrobial resistance, 49 (23.3%, 95%CI 17.58-29.02) were resistant. Resistance to isoniazid (INH) was common (n = 33, 15.7%); multidrug-resistant TB was 1.9%. TB remains an important health problem in the Philippines. We identified low case detection of TB in children and high INH resistance rates in this rural community.

Rethinking sources of representative controls for the conduct of case-control studies in minority populations.

PubMed

Bandera, Elisa V; Chandran, Urmila; Zirpoli, Gary; McCann, Susan E; Ciupak, Gregory; Ambrosone, Christine B

2013-05-31

Recruitment of controls remains a challenge in case-control studies and particularly in studies involving minority populations. We compared characteristics of controls recruited through random digit dialing (RDD) to those of community controls enrolled through churches, health events and other outreach sources among women of African ancestry (AA) participating in the Women's Circle of Health Study, a case-control study of breast cancer. Odds ratios and 95% confidence intervals were also computed using unconditional logistic regression to evaluate the impact of including the community controls for selected variables relevant to breast cancer and for which there were significant differences in distribution between the two control groups. Compared to community controls (n=347), RDD controls (n=207) had more years of education and higher income, lower body mass index, were more likely to have private insurance, and less likely to be single. While the percentage of nulliparous women in the two groups was similar, community controls tended to have more children, have their first child at a younger age, and were less likely to breastfeed their children. Dietary intake was similar in the two groups. Compared to census data, the combination of RDD and community controls seems to be more representative of the general population than RDD controls alone. Furthermore, the inclusion of the community group had little impact on the magnitude of risk estimates for most variables, while enhancing statistical power. Community-based recruitment was found to be an efficient and feasible method to recruit AA controls.

Cultural Competence Development, Critical Service Learning, and Latino/a Youth Empowerment: A Qualitative Case Study

ERIC Educational Resources Information Center

Vargas, Lucila C.; Erba, Joseph

2017-01-01

As universities create service-learning programs, educators are experimenting with pedagogical approaches that enhance learning outcomes while benefiting communities. We present a qualitative case study of a radio-based, service-learning program, grounded in a Freirean foundation and aimed at developing the cultural competence and sense of…

Making the Case for Universal School-Based Mental Health Screening

ERIC Educational Resources Information Center

Humphrey, Neil; Wigelsworth, Michael

2016-01-01

Mental health difficulties affect 1 in 10 children and adolescents, and up to half of adult cases begin during the school years. The individual and societal impacts of such difficulties are huge, and include poorer quality of life, lost economic productivity, destabilisation of communities, and high rates of health, education and social care…

A School Council's Experience with School Improvement: A Saskatchewan Case Study

ERIC Educational Resources Information Center

Preston, Jane P.

2012-01-01

Based on a qualitative case study conducted within one Saskatchewan (Canada) rural community, the purpose of this article is to describe the challenges a school council faced when supporting a school improvement plan. The primary data for the study were 35 semi-structured individual interviews conducted with school council members, teachers, and…

Youth Leadership Development through School-Based Civic Engagement Activities: A Case Study

ERIC Educational Resources Information Center

Horstmeier, Robin Peiter; Ricketts, Kristina G.

2009-01-01

Leadership development through a civic engagement activity in a local FFA chapter is explored. Through a case study design, researchers illuminate a project that encouraged youth leadership development through the creation and execution of a civic engagement project in their own local community. Holistically, FFA members viewed the project as a…

The Crisis Response to a School-Based Hostage Event: A Case Study

ERIC Educational Resources Information Center

Crepeau-Hobson, Franci; Summers, Laura L.

2011-01-01

During the past two decades there has been increased public, professional, and legislative interest in school crisis prevention and intervention. It is recommended that comprehensive crisis teams be established at the school, district, and community levels. A case study was conducted in which interviews were utilized to facilitate an increased…

And the Survey Says: The Case for Community Engagement

ERIC Educational Resources Information Center

Johnson, Paul A.

2009-01-01

Often superintendents and boards of education employ an expert-based, school-centered, "decide and defend" decision making approach when dealing with critical school district issues. In the case presented here, involving what to do with an historic school building, it is an approach that did not yield the result the superintendent or board of…

Linking High Risk Postpartum Women with a Technology Enabled Health Coaching Program to Reduce Diabetes Risk and Improve Wellbeing: Program Description, Case Studies, and Recommendations for Community Health Coaching Programs

PubMed Central

Thomas, Melanie; Delgadillo-Duenas, Adriana T.; Leong, Karen; Najmabadi, Adriana; Harleman, Elizabeth; Rios, Christina; Quan, Judy; Soria, Catalina; Handley, Margaret A.

2016-01-01

Background. Low-income minority women with prior gestational diabetes mellitus (pGDM) or high BMIs have increased risk for chronic illnesses postpartum. Although the Diabetes Prevention Program (DPP) provides an evidence-based model for reducing diabetes risk, few community-based interventions have adapted this program for pGDM women. Methods. STAR MAMA is an ongoing randomized control trial (RCT) evaluating a hybrid HIT/Health Coaching DPP-based 20-week postpartum program for diabetes prevention compared with education from written materials at baseline. Eligibility includes women 18–39 years old, ≥32 weeks pregnant, and GDM or BMI > 25. Clinic- and community-based recruitment in San Francisco and Sonoma Counties targets 180 women. Sociodemographic and health coaching data from a preliminary sample are presented. Results. Most of the 86 women included to date (88%) have GDM, 80% were identified as Hispanic/Latina, 78% have migrant status, and most are Spanish-speaking. Women receiving the intervention indicate high engagement, with 86% answering 1+ calls. Health coaching callbacks last an average of 9 minutes with range of topics discussed. Case studies presented convey a range of emotional, instrumental, and health literacy-related supports offered by health coaches. Discussion. The DPP-adapted HIT/health coaching model highlights the possibility and challenge of delivering DPP content to postpartum women in community settings. This trial is registered with ClinicalTrials.gov NCT02240420. PMID:27830157

Linking High Risk Postpartum Women with a Technology Enabled Health Coaching Program to Reduce Diabetes Risk and Improve Wellbeing: Program Description, Case Studies, and Recommendations for Community Health Coaching Programs.

PubMed

Athavale, Priyanka; Thomas, Melanie; Delgadillo-Duenas, Adriana T; Leong, Karen; Najmabadi, Adriana; Harleman, Elizabeth; Rios, Christina; Quan, Judy; Soria, Catalina; Handley, Margaret A

2016-01-01

Background . Low-income minority women with prior gestational diabetes mellitus (pGDM) or high BMIs have increased risk for chronic illnesses postpartum. Although the Diabetes Prevention Program (DPP) provides an evidence-based model for reducing diabetes risk, few community-based interventions have adapted this program for pGDM women. Methods . STAR MAMA is an ongoing randomized control trial (RCT) evaluating a hybrid HIT/Health Coaching DPP-based 20-week postpartum program for diabetes prevention compared with education from written materials at baseline. Eligibility includes women 18-39 years old, ≥32 weeks pregnant, and GDM or BMI > 25. Clinic- and community-based recruitment in San Francisco and Sonoma Counties targets 180 women. Sociodemographic and health coaching data from a preliminary sample are presented. Results . Most of the 86 women included to date (88%) have GDM, 80% were identified as Hispanic/Latina, 78% have migrant status, and most are Spanish-speaking. Women receiving the intervention indicate high engagement, with 86% answering 1+ calls. Health coaching callbacks last an average of 9 minutes with range of topics discussed. Case studies presented convey a range of emotional, instrumental, and health literacy-related supports offered by health coaches. Discussion . The DPP-adapted HIT/health coaching model highlights the possibility and challenge of delivering DPP content to postpartum women in community settings. This trial is registered with ClinicalTrials.gov NCT02240420.

Partner notification in cooperation with community-based organizations among HIV-positive men who have sex with men in two Chinese cities.

PubMed

Fu, Xiaojing; Qi, Jinlei; Hu, Yifei; Pan, Xiaohong; Li, Youfang; Liu, Hui; Wu, Di; Yin, Wenyuan; Zhao, Yuan; Shan, Duo; Zhang, Nanci Nanyi; Zhang, Dapeng; Sun, Jiangping

2016-09-01

The epidemic of HIV/AIDS among Chinese men who have sex with men (MSM) is rapidly escalating. We implemented partner notification among HIV-infected MSM, cooperating with MSM-serving community-based organizations (CBOs) in two Chinese cities from June 2014 to May 2015. CBOs participated in identifying new HIV-positive MSM utilizing rapid HIV tests and partner notification among index cases. 253 index cases were recruited and 275 sexual partners were notified and tested with 10.5% screened positive. Compared with previously identified index cases, the proportion of contactable sexual partners of newly identified index cases was higher, but the testing rate was lower (p < 0.001). Overall, 83.7% of sexual partners were casual with a contactable rate of 24.9% and a HIV testing rate of 71.1%. Having no contact information for sexual partners and fear of disclosure of HIV status are the main reasons for declining partner notification. It is feasible and effective to perform partner notification in cooperation with CBOs serving Chinese MSM. © The Author(s) 2016.

Combined node and link partitions method for finding overlapping communities in complex networks

PubMed Central

Jin, Di; Gabrys, Bogdan; Dang, Jianwu

2015-01-01

Community detection in complex networks is a fundamental data analysis task in various domains, and how to effectively find overlapping communities in real applications is still a challenge. In this work, we propose a new unified model and method for finding the best overlapping communities on the basis of the associated node and link partitions derived from the same framework. Specifically, we first describe a unified model that accommodates node and link communities (partitions) together, and then present a nonnegative matrix factorization method to learn the parameters of the model. Thereafter, we infer the overlapping communities based on the derived node and link communities, i.e., determine each overlapped community between the corresponding node and link community with a greedy optimization of a local community function conductance. Finally, we introduce a model selection method based on consensus clustering to determine the number of communities. We have evaluated our method on both synthetic and real-world networks with ground-truths, and compared it with seven state-of-the-art methods. The experimental results demonstrate the superior performance of our method over the competing ones in detecting overlapping communities for all analysed data sets. Improved performance is particularly pronounced in cases of more complicated networked community structures. PMID:25715829

Outcomes and impact of community-based rehabilitation programmes in Chinese communities.

PubMed

Chung, Eva Y; Packer, Tanya L

2017-04-01

To identify the most common and most valued outcomes of community-based rehabilitation (CBR) in Chinese communities and to map these to the CBR evaluation framework. A multiple, embedded case study design was used. Four CBR programmes in China met the criteria for inclusion and participated. Data collection, via participant "story telling", followed the procedures of the most significant change technique (MSC) over a period for five months. Content analysis with thematic coding was used to detect the common significant changes described in "top-rated" stories and in the entire pool of stories. Meta-analysis using the CBR framework was carried out to enrich the understanding of programme outcomes. A total of 101 stories were collected in the two rounds of story collection from the four programmes. Aggregated results demonstrated that, across all programmes, 78.21% of stories focused on changes in people with disabilities, 9.9% described aspects of programme development, 8.91% reported on outcomes related to CBR workers, and only 2.97% were focused on advocacy. When mapped against the elements of the CBR framework the MSCs among these four programmes were (1) psychosocial changes, (2) increased family participation and (3) improved physical functioning. CBR practice in Chinese communities remains orientated towards an approach of functional rehabilitation rather than community-based inclusive development. Implications for rehabilitation Community-based rehabilitation is a strategy for community-based inclusive development. Commonly reported significant outcomes of community-based rehabilitation programmes in China focus on changes in psychosocial and physical status of people with disabilities and family participation. Community-based rehabilitation in China continues to focus on traditional rehabilitation. New efforts and directions are needed to also include goals of equity and community inclusion. Further efforts to promote the use of CBR guideline with the goal of facilitating inclusion and equal participation are strongly recommended.

The Promise of Community-Based Participatory Research for Health Equity: A Conceptual Model for Bridging Evidence With Policy

PubMed Central

Cacari-Stone, Lisa; Garcia, Analilia P.; Minkler, Meredith

2014-01-01

Insufficient attention has been paid to how research can be leveraged to promote health policy or how locality-based research strategies, in particular community-based participatory research (CBPR), influences health policy to eliminate racial and ethnic health inequities. To address this gap, we highlighted the efforts of 2 CBPR partnerships in California to explore how these initiatives made substantial contributions to policymaking for health equity. We presented a new conceptual model and 2 case studies to illustrate the connections among CBPR contexts and processes, policymaking processes and strategies, and outcomes. We extended the critical role of civic engagement by those communities that were most burdened by health inequities by focusing on their political participation as research brokers in bridging evidence and policymaking. PMID:25033119

Targeting community-dwelling urinary incontinence sufferers: a multi-disciplinary community based model for conservative continence services.

PubMed

St John, Winsome; Wallis, Marianne; James, Heather; McKenzie, Shona; Guyatt, Sheridan

2004-10-01

This paper presents an argument that there is a need to provide services that target community-dwelling incontinence sufferers, and presents a demonstration case study of a multi-disciplinary, community-based conservative model of service delivery: The Waterworx Model. Rationale for approaches taken, implementation of the model, evaluation and lessons learned are discussed. In this paper community-dwelling sufferers of urinary incontinence are identified as an underserved group, and useful information is provided for those wishing to establish services for them. The Waterworx Model of continence service delivery incorporates three interrelated approaches. Firstly, client access is achieved by using community-based services via clinic and home visits, creating referral pathways and active promotion of services. Secondly, multi-disciplinary client care is provided by targeting a specific client group, multi-disciplinary assessment, promoting client self-management and developing client knowledge and health literacy. Finally, interdisciplinary collaboration and linkages is facilitated by developing multidisciplinary assessment tools, using interdisciplinary referrals, staff development, multi-disciplinary management and providing professional education. Implementation of the model achieved greater client access, improvement in urinary incontinence and client satisfaction. Our experiences suggest that those suffering urinary incontinence and living in the community are an underserved group and that continence services should be community focussed, multi-disciplinary, generalist in nature.

How Institutions Respond to Training Packages.

ERIC Educational Resources Information Center

Boorman, Andrew

The impact of the transition to training packages (TPs) on institutionally based training in Australia was examined. Information was gathered from 14 case studies of registered trade organizations (RTOs) delivering qualifications to institutionally based students in TPs in the following areas: administration, beauty therapy, community services,…

Jobs to Manufacturing Careers: Work-Based Courses. Work-Based Learning in Action

ERIC Educational Resources Information Center

Kobes, Deborah

2016-01-01

This case study, one of a series of publications exploring effective and inclusive models of work-based learning, finds that work-based courses bring college to the production line by using the job as a learning lab. Work-based courses are an innovative way to give incumbent workers access to community college credits and degrees. They are…

A Pilot Study: Facilitating Cross-Cultural Understanding with Project-Based Collaborative Learning in an Online Environment

ERIC Educational Resources Information Center

Shadiev, Rustam; Hwang, Wu-Yuin; Huang, Yueh-Min

2015-01-01

This study investigated three aspects: how project-based collaborative learning facilitates cross-cultural understanding; how students perceive project-based collaborative learning implementation in a collaborative cyber community (3C) online environment; and what types of communication among students are used. A qualitative case study approach…

Multilevel perspectives on community intervention: an example from an Indo-US HIV prevention project in Mumbai, India.

PubMed

Schensul, Stephen L; Saggurti, Niranjan; Singh, Rajendra; Verma, Ravi K; Nastasi, Bonnie K; Mazumder, Papiya Guha

2009-06-01

This paper explores the meaning and applicability of multilevel interventions and the role of ethnography in identifying intervention opportunities and accounting for research design limitations. It utilizes as a case example the data and experiences from a 6-year, NIMH-funded, intervention to prevent HIV/STI among married men in urban poor communities in Mumbai, India. The experiences generated by this project illustrate the need for multilevel interventions to include: (1) ethnographically driven formative research to delineate appropriate levels, stakeholders and collaborators; (2) identification of ways to link interventions to the local culture and community context; (3) the development of a model of intervention that is sufficiently flexible to be consistently applied to different intervention levels using comparable culturally congruent concepts and approaches; (4) mechanisms to involve community residents, community based organizations and community-based institutions; and (5) approaches to data collection that can evaluate the impact of the project on multiple intersecting levels.

Welfare Reform: Bibliographies of Case Management and Agency/Client Contracting.

DTIC Science & Technology

1988-03-11

Case Management *4 Ss made up about one-fifth of the cases in the program but made inordi- nate demands on the time and emotional resources of their...from their families, or their families face emotional strain in caring for the elderly member. Case management with a coordinator is a way to link the...based chronically mentally ill persons of the Community Support Program (CSP) of the National Institute of Men - % tal Health. Information was obtained on

Development of a tool for assessment and care planning for dementia-related problem behaviors in home and community-based services programs: the Problem Behavior Inventory.

PubMed

Phillips, V L; Diwan, Sadhna; Egner, Amanda

2002-01-01

To describe development, validity, and application of the Problem Behavior Inventory (PBI), a tool to assess dementia-related problem behaviors (DRPBs) in community-based populations. Demographic, contact, and disease-specific data were extracted from client files from a Medicaid-funded home and community-based services program. Primary caregivers completed standard surveys relating to the care recipients' memory, mood, and behaviors. The client (care recipient) completed the Mini-Mental Status Exam (MMSE). Cognitively impaired clients, enrolled in the Community Care Services Program (CCSP) during a reference month, and their primary caregivers, were identified by CCSP case managers for participation in the study. Primary caregivers completed the Revised Memory and Behavior Problem Checklist (RMBPC). Clients screening positive for the presence of DRPBs based on caregiver responses to the RMBPC were then assessed using the Problem Behavior Inventory (PBI). Within the CCSP sample, the most prevalent behavior was appearing sad or depressed (67%), while the most frequent behavior was seeking attention, occurring at least daily in 58% of the group. The most bothersome behaviors were being sexually inappropriate, wandering, and misbehaving in public. Examination by behavior category (physical, verbal, mood, etc.) revealed a strong relationship between level of bother and behavior frequency. Frequency of verbal behaviors was positively related to MMSE scores, whereas frequency of ADL-related behaviors was inversely related to MMSE scores. Bother scores were not associated with MMSE scores. This study documents that the PBI is a valid, useful, and feasible tool for assessing DRPBs in community populations. Case managers using the PBI can determine specific problem behavior areas among client populations and for individual clients and institute client-specific interventions to address each issue.

Effectiveness of Different Models of Case Management for Substance-Abusing Populations

PubMed Central

Vanderplasschen, Wouter; Wolf, Judith; Rapp, Richard C.; Broekaert, Eric

2007-01-01

Case management has been implemented in substance abuse treatment to improve (cost-) effectiveness, but controversy exists about its potential to realize this objective. A systematic and comprehensive review of peer-reviewed articles (n = 48) published between 1993 and 2003 is presented, focusing on the effects of different models of case management among various substance-abusing populations. Results show that several studies have reported positive effects, but only some randomized and controlled trials have demonstrated the effectiveness of case management compared with other interventions. Longitudinal effects of this intervention remain unclear. Although no compelling evidence was found for the effectiveness of case management, some evidence is available about the (differential) effectiveness of intensive case management and assertive community treatment for homeless and dually-diagnosed substance abusers. Strengths-based and generalist case management have proven to be relatively effective for substance abusers in general. Most positive effects concern reduced use of inpatient services and increased utilization of community-based services, prolonged treatment retention, improved quality of life, and high client satisfaction. Outcomes concerning drug use and psychosocial functioning are less consistent, but seem to be mediated by retention in treatment and case management. Further research is required to learn more about the extent of the effects of this intervention, how long these are sustained and what specific elements cause particular outcomes. PMID:17523588

Using information communication technology in models of integrated community-based primary health care: learning from the iCOACH case studies.

PubMed

Steele Gray, Carolyn; Barnsley, Jan; Gagnon, Dominique; Belzile, Louise; Kenealy, Tim; Shaw, James; Sheridan, Nicolette; Wankah Nji, Paul; Wodchis, Walter P

2018-06-26

Information communication technology (ICT) is a critical enabler of integrated models of community-based primary health care; however, little is known about how existing technologies have been used to support new models of integrated care. To address this gap, we draw on data from an international study of integrated models, exploring how ICT is used to support activities of integrated care and the organizational and environmental barriers and enablers to its adoption. We take an embedded comparative multiple-case study approach using data from a study of implementation of nine models of integrated community-based primary health care, the Implementing Integrated Care for Older Adults with Complex Health Needs (iCOACH) study. Six cases from Canada, three each in Ontario and Quebec, and three in New Zealand, were studied. As part of the case studies, interviews were conducted with managers and front-line health care providers from February 2015 to March 2017. A qualitative descriptive approach was used to code data from 137 interviews and generate word tables to guide analysis. Despite different models and contexts, we found strikingly similar accounts of the types of activities supported through ICT systems in each of the cases. ICT systems were used most frequently to support activities like care coordination by inter-professional teams through information sharing. However, providers were limited in their ability to efficiently share patient data due to data access issues across organizational and professional boundaries and due to system functionality limitations, such as a lack of interoperability. Even in innovative models of care, managers and providers in our cases mainly use technology to enable traditional ways of working. Technology limitations prevent more innovative uses of technology that could support disruption necessary to improve care delivery. We argue the barriers to more innovative use of technology are linked to three factors: (1) information access barriers, (2) limited functionality of available technology, and (3) organizational and provider inertia.

Diabetic retinopathy screening with pharmacy-based teleophthalmology in a semiurban setting: a cost-effectiveness analysis.

PubMed

Coronado, Andrea C; Zaric, Gregory S; Martin, Janet; Malvankar-Mehta, Monali; Si, Francie F; Hodge, William G

2016-01-01

Diabetic eye complications are the leading cause of visual loss among working-aged people. Pharmacy-based teleophthalmology has emerged as a possible alternative to in-person examination that may facilitate compliance with evidence-based recommendations and reduce barriers to specialized eye care. The objective of this study was to estimate the cost-effectiveness of mobile teleophthalmology screening compared with in-person examination (primary care) for the diabetic population residing in semiurban areas of southwestern Ontario. A decision tree was constructed to compare in-person examination (comparator program) versus pharmacy-based teleophthalmology (intervention program). The economic model was designed to identify patients with more than minimal diabetic retinopathy, manifested by at least 1 microaneurysm at examination (modified Airlie House classification grade of ≥ 20). Cost-effectiveness was assessed as cost per case detected (true-positive result) and cost per case correctly diagnosed (including true-positive and true-negative results). The cost per case detected was $510 with in-person examination and $478 with teleophthalmology, and the cost per case correctly diagnosed was $107 and $102 respectively. The incremental cost-effectiveness ratio was $314 per additional case detected and $73 per additional case correctly diagnosed. Use of pharmacologic dilation and health care specialists' fees were the most important cost drivers. The study showed that a compound teleophthalmology program in a semiurban community would be more effective but more costly than in-person examination. The findings raise the question of whether the benefits of pharmacy-based teleophthalmology in semiurban areas, where in-person examination is still available, are equivalent to those observed in remote communities. Further study is needed to investigate the impact of this program on the prevention of severe vision loss and quality of life in a semiurban setting.

Healing traditions and men's sexual health in Mumbai, India: the realities of practiced medicine in urban poor communities.

PubMed

Schensul, Stephen L; Mekki-Berrada, Abdelwahed; Nastasi, Bonnie; Saggurti, Niranjan; Verma, Ravi K

2006-06-01

Men's pre- and extra-marital sexual behavior has been identified as the primary factor in the growing HIV/STI epidemic among both males and females in India. One major barrier to reaching men has been their underutilization of public health services, which has severely limited programs geared to prevention and early case identification. A significant number of men in India have strong culturally-based sexual health concerns, much of which are derived from "semen-loss" and deficiencies in sexual performance. This paper reports on an ongoing Indo-US project that has focused on men's concerns about sexual health problems and assesses the services provided by non-allopaths in three low-income communities in Mumbai. Findings indicate that the primary health resources for these men are private, community-based non-allopaths, who identify themselves as ayurvedic, unani and homeopathic providers. The paper suggests that the combination of strong culturally-based sexual health concerns and the presence of private non-allopaths who manage these problems present a window of opportunity for intervention programs to address the challenge of HIV/STI prevention and early case identification in India.

Designing for Online Collaborations and Local Environmental Action In Citizen Science: A Multiple Case Study

NASA Astrophysics Data System (ADS)

Kermish-Allen, Ruth

Traditional citizen science projects have been based on the scientific communities need to gather vast quantities of high quality data, neglecting to ask what the project participants get in return. How can participants be seen more as collaborative partners in citizen science projects? Online communities for citizen science are expanding rapidly, giving participants the opportunity to take part in a wide range of activities, from monitoring invasive species to identifying far-off galaxies. These communities can bring together the virtual and physical worlds in new ways that are egalitarian, collaborative, applied, localized and globalized to solve real environmental problems. There are a small number of citizen science projects that leverage the affordances of an online community to connect, engage, and empower participants to make local change happen. This multiple case study applies a conceptual framework rooted in sociocultural learning theory, Non-Hierarchical Online Learning Communities (NHOLCs), to three online citizen communities that have successfully fostered online collaboration and on-the-ground environmental actions. The purpose of the study is to identify the range and variation of the online and programmatic functions available in each project. The findings lead to recommendations for designing these innovative communities, specifically the technological and programmatic components of online citizen science communities that support environmental actions in our backyards.

A community-based participatory research study of HIV and HPV vulnerabilities and prevention in two Pacific Islander communities: ethical challenges and solutions.

PubMed

DiStefano, Anthony; Peters, Ruth; Tanjasiri, Sora Park; Quitugua, Lourdes; Dimaculangan, Jeany; Hui, Brian; Barrera-Ng, Angelica; Vunileva, 'Isileli; Tui'one, Vanessa; Takahashi, Lois

2013-02-01

We describe ethical issues that emerged during a one-year CBPR study of HIV and human papillomavirus (HPV) vulnerabilities and prevention in two Pacific Islander (PI) communities, and the collaborative solutions to these challenges reached by academic and community partners. In our project case study analysis, we found that ethical tensions were linked mainly to issues of mutual trust and credibility in PI communities; cultural taboos associated with the nexus of religiosity and traditional PI culture; fears of privacy breaches in small, interconnected PI communities; and competing priorities of scientific rigor versus direct community services. Mutual capacity building and linking CBPR practice to PI social protocols are required for effective solutions and progress toward social justice outcomes.

Facility and market factors affecting transitions from nursing home to community.

PubMed

Arling, Greg; Abrahamson, Kathleen A; Cooke, Valerie; Kane, Robert L; Lewis, Teresa

2011-09-01

Research into nursing home transitions has given limited attention to the facility or community contexts. To identify facility and market factors affecting transitions of nursing home residents back to the community. Multilevel models were used to estimate effects of facility and market factors on facility-level community discharge rates after controlling for resident demographic, health, and functional conditions. Facility discharge rates were adjusted using Empirical Bayes estimation. Annual cohort of first-time admissions (N=24,648) to 378 Minnesota nursing facilities in 75 nursing home markets from July 2005 to June 2006. Community discharge within 90 days of admission; facility occupancy, payer mix, ownership, case-mix acuity, size, admissions from hospitals, nurse staffing level, and proportion of admissions preferring or having support to return to the community; and nursing market population size, average occupancy, market concentration, and availability of home and community-based services. Rates of community discharge (Empirical Bayes residual) were highest in facilities with more residents preferring community discharge, more Medicare days, higher nurse staffing levels, and higher occupancy. In addition, facilities had higher community discharge rates if they were located in markets with a greater ratio of home and community-based services recipients to nursing home residents and with larger populations. State Medicaid programs should undertake system-level interventions that encourage nursing facilities to reduce unused bed capacity, balance the mix of payers, invest in nurse staffing, and take other steps to promote community discharges. In addition, states should increase home and community-based services, particularly in markets with low community discharge rates.

Factors associated with poor knowledge among adults on tuberculosis in Bangladesh: results from a nationwide survey.

PubMed

Hossain, Shahed; Zaman, Khalequ; Quaiyum, Abdul; Banu, Sayera; Husain, Ashaque; Islam, Akramul; Borgdorff, Martien; van Leth, Frank

2015-05-01

In 2012, Bangladesh continues to be one of the 22 high tuberculosis (TB) burden countries in the world. Although free diagnosis and management for TB is available throughout the country, case notification rate/100,000 population for new smear positive (NSP) cases under the national TB control programme (NTP) remained at around 70/100,000 population and have not changed much since 2006. Knowledge on TB disease, treatment and its management could be an important predictor for utilization of TB services and influence case detection under the NTP. Our objective is to describe knowledge of TB among newly diagnosed TB cases and community controls to assess factors associated with poor knowledge in order to identify programmatic implications for control measures. Embedded in TB prevalence survey 2007-2009, we included 240 TB cases from the TB registers and 240 persons ≥ 15 years of age randomly selected from the households where the survey was implemented. All participants were interviewed using a structured, pre-tested questionnaire to evaluate their TB knowledge. Regression analyses were done to assess associations with poor knowledge of TB. Our survey documented that overall there was fair knowledge in all domains investigated. However, based on the number of correct answers to the questionnaires, community controls showed significantly poorer knowledge than the TB cases in the domains of TB transmission (80% vs. 88%), mode of transmission (67% vs. 82%), knowing ≥ 1 suggestive symptoms including cough (78% vs. 89%), curability of TB (90% vs. 98%) and availability of free treatment (75% vs. 95%). Community controls were more likely to have poor knowledge of TB issues compared to the TB cases even after controlling for other factors such as education and occupation in a multivariate model (OR 3.46, 95% CI: 2.00-6.09). Knowledge on various aspects of TB and TB services varies significantly between TB cases and community controls in Bangladesh. The overall higher levels of knowledge in TB cases could identify them as peer educators in ongoing communication approaches to improve care seeking behavior of the TB suspects in the community and hence case detection.

The future of metabolomics in ELIXIR

PubMed Central

van Rijswijk, Merlijn; Beirnaert, Charlie; Caron, Christophe; Cascante, Marta; Dominguez, Victoria; Dunn, Warwick B.; Ebbels, Timothy M. D.; Giacomoni, Franck; Gonzalez-Beltran, Alejandra; Hankemeier, Thomas; Haug, Kenneth; Izquierdo-Garcia, Jose L.; Jimenez, Rafael C.; Jourdan, Fabien; Kale, Namrata; Klapa, Maria I.; Kohlbacher, Oliver; Koort, Kairi; Kultima, Kim; Le Corguillé, Gildas; Moreno, Pablo; Moschonas, Nicholas K.; Neumann, Steffen; O’Donovan, Claire; Reczko, Martin; Rocca-Serra, Philippe; Rosato, Antonio; Salek, Reza M.; Sansone, Susanna-Assunta; Satagopam, Venkata; Schober, Daniel; Shimmo, Ruth; Spicer, Rachel A.; Spjuth, Ola; Thévenot, Etienne A.; Viant, Mark R.; Weber, Ralf J. M.; Willighagen, Egon L.; Zanetti, Gianluigi; Steinbeck, Christoph

2017-01-01

Metabolomics, the youngest of the major omics technologies, is supported by an active community of researchers and infrastructure developers across Europe. To coordinate and focus efforts around infrastructure building for metabolomics within Europe, a workshop on the “Future of metabolomics in ELIXIR” was organised at Frankfurt Airport in Germany. This one-day strategic workshop involved representatives of ELIXIR Nodes, members of the PhenoMeNal consortium developing an e-infrastructure that supports workflow-based metabolomics analysis pipelines, and experts from the international metabolomics community. The workshop established metabolite identification as the critical area, where a maximal impact of computational metabolomics and data management on other fields could be achieved. In particular, the existing four ELIXIR Use Cases, where the metabolomics community - both industry and academia - would benefit most, and which could be exhaustively mapped onto the current five ELIXIR Platforms were discussed. This opinion article is a call for support for a new ELIXIR metabolomics Use Case, which aligns with and complements the existing and planned ELIXIR Platforms and Use Cases. PMID:29043062

The future of metabolomics in ELIXIR.

PubMed

van Rijswijk, Merlijn; Beirnaert, Charlie; Caron, Christophe; Cascante, Marta; Dominguez, Victoria; Dunn, Warwick B; Ebbels, Timothy M D; Giacomoni, Franck; Gonzalez-Beltran, Alejandra; Hankemeier, Thomas; Haug, Kenneth; Izquierdo-Garcia, Jose L; Jimenez, Rafael C; Jourdan, Fabien; Kale, Namrata; Klapa, Maria I; Kohlbacher, Oliver; Koort, Kairi; Kultima, Kim; Le Corguillé, Gildas; Moreno, Pablo; Moschonas, Nicholas K; Neumann, Steffen; O'Donovan, Claire; Reczko, Martin; Rocca-Serra, Philippe; Rosato, Antonio; Salek, Reza M; Sansone, Susanna-Assunta; Satagopam, Venkata; Schober, Daniel; Shimmo, Ruth; Spicer, Rachel A; Spjuth, Ola; Thévenot, Etienne A; Viant, Mark R; Weber, Ralf J M; Willighagen, Egon L; Zanetti, Gianluigi; Steinbeck, Christoph

2017-01-01

Metabolomics, the youngest of the major omics technologies, is supported by an active community of researchers and infrastructure developers across Europe. To coordinate and focus efforts around infrastructure building for metabolomics within Europe, a workshop on the "Future of metabolomics in ELIXIR" was organised at Frankfurt Airport in Germany. This one-day strategic workshop involved representatives of ELIXIR Nodes, members of the PhenoMeNal consortium developing an e-infrastructure that supports workflow-based metabolomics analysis pipelines, and experts from the international metabolomics community. The workshop established metabolite identification as the critical area, where a maximal impact of computational metabolomics and data management on other fields could be achieved. In particular, the existing four ELIXIR Use Cases, where the metabolomics community - both industry and academia - would benefit most, and which could be exhaustively mapped onto the current five ELIXIR Platforms were discussed. This opinion article is a call for support for a new ELIXIR metabolomics Use Case, which aligns with and complements the existing and planned ELIXIR Platforms and Use Cases.

Integrated Community Case Management of Childhood Illness in Ethiopia: Implementation Strength and Quality of Care

PubMed Central

Miller, Nathan P.; Amouzou, Agbessi; Tafesse, Mengistu; Hazel, Elizabeth; Legesse, Hailemariam; Degefie, Tedbabe; Victora, Cesar G.; Black, Robert E.; Bryce, Jennifer

2014-01-01

Ethiopia has scaled up integrated community case management of childhood illness (iCCM) in most regions. We assessed the strength of iCCM implementation and the quality of care provided by health extension workers (HEWs). Data collectors observed HEWs' consultations with sick children and carried out gold standard re-examinations. Nearly all HEWs received training and supervision, and essential commodities were available. HEWs provided correct case management for 64% of children. The proportions of children correctly managed for pneumonia, diarrhea, and malnutrition were 72%, 79%, and 59%, respectively. Only 34% of children with severe illness were correctly managed. Health posts saw an average of 16 sick children in the previous 1 month. These results show that iCCM can be implemented at scale and that community-based HEWs can correctly manage multiple illnesses. However, to increase the chances of impact on child mortality, management of severe illness and use of iCCM services must be improved. PMID:24799369

Community case management of malaria: exploring support, capacity and motivation of community medicine distributors in Uganda.

PubMed

Banek, Kristin; Nankabirwa, Joaniter; Maiteki-Sebuguzi, Catherine; DiLiberto, Deborah; Taaka, Lilian; Chandler, Clare I R; Staedke, Sarah G

2015-05-01

In Uganda, community services for febrile children are expanding from presumptive treatment of fever with anti-malarials through the home-based management of fever (HBMF) programme, to include treatment for malaria, diarrhoea and pneumonia through Integrated Community Case Management (ICCM). To understand the level of support available, and the capacity and motivation of community health workers to deliver these expanded services, we interviewed community medicine distributors (CMDs), who had been involved in the HBMF programme in Tororo district, shortly before ICCM was adopted. Between October 2009 and April 2010, 100 CMDs were recruited to participate by convenience sampling. The survey included questionnaires to gather information about the CMDs' work experience and to assess knowledge of fever case management, and in-depth interviews to discuss experiences as CMDs including motivation, supervision and relationships with the community. All questionnaires and knowledge assessments were analysed. Summary contact sheets were made for each of the 100 interviews and 35 were chosen for full transcription and analysis. CMDs faced multiple challenges including high patient load, limited knowledge and supervision, lack of compensation, limited drugs and supplies, and unrealistic expectations of community members. CMDs described being motivated to volunteer for altruistic reasons; however, the main benefits of their work appeared related to 'becoming someone important', with the potential for social mobility for self and family, including building relationships with health workers. At the time of the survey, over half of CMDs felt demotivated due to limited support from communities and the health system. Community health worker programmes rely on the support of communities and health systems to operate sustainably. When this support falls short, motivation of volunteers can wane. If community interventions, in increasingly complex forms, are to become the solution to improving access to primary health care, greater attention to what motivates individuals, and ways to strengthen health system support are required. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014.

Shifting the burden or expanding access to care? Assessing malaria trends following scale-up of community health worker malaria case management and reactive case detection.

PubMed

Larsen, David A; Winters, Anna; Cheelo, Sanford; Hamainza, Busiku; Kamuliwo, Mulakwa; Miller, John M; Bridges, Daniel J

2017-11-02

Malaria is a significant burden to health systems and is responsible for a large proportion of outpatient cases at health facilities in endemic regions. The scale-up of community management of malaria and reactive case detection likely affect both malaria cases and outpatient attendance at health facilities. Using health management information data from 2012 to 2013 this article examines health trends before and after the training of volunteer community health workers to test and treat malaria cases in Southern Province, Zambia. An estimated 50% increase in monthly reported malaria infections was found when community health workers were involved with malaria testing and treating in the community (incidence rate ratio 1.52, p < 0.001). Furthermore, an estimated 6% decrease in outpatient attendance at the health facility was found when community health workers were involved with malaria testing and treating in the community. These results suggest a large public health benefit to both community case management of malaria and reactive case detection. First, the capacity of the malaria surveillance system to identify malaria infections was increased by nearly one-third. Second, the outpatient attendance at health facilities was modestly decreased. Expanding the capacity of the malaria surveillance programme through systems such as community case management and reactive case detection is an important step toward malaria elimination.

Experience from a multicentre stroke register: a preliminary report

PubMed Central

Hatano, S.

1976-01-01

In collaboration with 15 centres in 10 countries of Africa, Asia, and Europe, WHO started a pilot study of a community-based stroke register, with standardized methods. Preliminary data were obtained on 6395 new cases of stroke in defined study communities, from May 1971 to September 1974. Information on incidence rates, clinical profiles, diagnosis, management, and course and prognosis for these patients is given. PMID:1088404

The Social Rate of Return on Investment in Vocational Education: A Case Study in a Rural Appalachian Ohio Community.

ERIC Educational Resources Information Center

Yackee, Keith W.

Based on Ghazalah's findings, which indicated that vocational education was an extremely profitable investment for both society and the individual choosing to go into a vocational program, the variables that had an effect on wages and earnings were examined. With the cooperation of a vocational school in a rural Appalachian Ohio community, data…

Not Driven by High-Stakes Tests: Exploring Science Assessment and College Readiness of Students from an Urban Portfolio Community High School

ERIC Educational Resources Information Center

Fleshman, Robin Earle

2017-01-01

This case study seeks to explore three research questions: (1) What science teaching and learning processes, perspectives, and cultures exist within the science classroom of an urban portfolio community high school? (2) In what ways does the portfolio-based approach prepare high school students of color for college level science coursework,…

Economic Impact of Second-Home Communities: A Case Study of Lake Latonka, Pa. Economic Research Service Report ERS-452.

ERIC Educational Resources Information Center

Brown, Richard N., Jr.

Based on the results of a lot-owner survey and on data from public records and other sources relative to the development of a second-home community in Lake Latonka, Pennsylvania (begun in 1964 and sold out in 1966), economic impacts were estimated by applying appropriate income multipliers to reported use and development expenditures. It was…

Bridging Literacy Practices through Storytelling, Translanguaging, and an Ethnographic Partnership: A Case Study of Dominican Students at Bronx Community College

ERIC Educational Resources Information Center

Parmegiani, Andrea

2014-01-01

This article reports on my attempt to use storytelling as an entry point into academic discourse in a learning community designed to meet the learning needs of ESL students who recently emigrated from the Dominican Republic. Based on research suggesting a correlation between academic success in a second language and first language literacy skills,…

Try to Be a Hero: Community Service Learning as a Pedagogy for Moral-Political Education and Leadership Development in the Chinese University

ERIC Educational Resources Information Center

Waite, Paul Daniel

2009-01-01

Based on ten months of ethnographic fieldwork, including more than 65 in-depth interviews with Chinese university students and higher education administrators, this study examines the roots of an emerging community service learning movement in mainland China. The dissertation focuses on a case study of a pioneering Chinese Party State-sponsored…

Academic-Hospital Partnership: Conducting a Community Health Needs Assessment as a Service Learning Project.

PubMed

Krumwiede, Kelly A; Van Gelderen, Stacey A; Krumwiede, Norma K

2015-01-01

The purposes of this service learning project were to trial nursing student application of the Community-Based Collaborative Action Research (CBCAR) framework while conducting a community health needs assessment and to assess the effectiveness of the CBCAR framework in providing real-world learning opportunities for enhancing baccalaureate nursing students' public health knowledge. In this case study analysis, the CBCAR framework linked service learning and community health needs assessment with public health nursing core competencies. Fifteen nursing students partnered with collaborative members. Student observational field notes and narrative reflections were analyzed qualitatively for fidelity to the CBCAR framework and to evaluate student public health knowledge. Students successfully employed the CBCAR framework in collaboration with the critical access hospital and community stakeholders to design and conduct the community health needs assessment. Service learning themes were real-world solutions, professional development, community collaboration, and making a difference. Students developed skills in six of the eight domains of the Quad Council's core competencies for public health nurses. Community-Based Collaborative Action Research facilitates collaborative partnerships and relationships throughout the research process. Students benefited by applying what they have learned from their education to a real community who lacks resources. © 2014 Wiley Periodicals, Inc.

Thinking big

NASA Astrophysics Data System (ADS)

Collins, Harry

2008-02-01

Physicists are often quick to discount social research based on qualitative techniques such as ethnography and "deep case studies" - where a researcher draws conclusions about a community based on immersion in the field - thinking that only quantitative research backed up by statistical analysis is sound. The balance is not so clear, however.

Dose as a Tool for Planning and Implementing Community-Based Health Strategies.

PubMed

Kuo, Elena S; Harner, Lisa T; Frost, Madeline C; Cheadle, Allen; Schwartz, Pamela M

2018-05-01

A major challenge in community-based health promotion is implementing strategies that could realistically improve health at the population level. Population dose methodology was developed to help understand the combined impact of multiple strategies on population-level health behaviors. This paper describes one potential use of dose: as a tool for working collaboratively with communities to increase impact when planning and implementing community-level initiatives. Findings are presented from interviews conducted with 11 coordinators who used dose for planning and implementing local efforts with community coalitions. During early-stage planning, dose was used as a tool for strategic planning, and as a framework to build consensus among coalition partners. During implementation, a dose lens was used to revise strategies to increase their reach (the number of people exposed to the intervention) or strength (the relative change in behavior for each exposed person) to create population-level impact. A case study is presented, illustrating how some community coalitions and evaluators currently integrate dose into the planning and implementation of place-based healthy eating and active living strategies. Finally, a planning checklist was developed for program coordinators and evaluators. This article is part of a supplement entitled Building Thriving Communities Through Comprehensive Community Health Initiatives, which is sponsored by Kaiser Permanente, Community Health. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Developing a Community-Wide Initiative to Address Childhood Adversity and Toxic Stress: A Case Study of The Philadelphia ACE Task Force.

PubMed

Pachter, Lee M; Lieberman, Leslie; Bloom, Sandra L; Fein, Joel A

The Philadelphia ACE Task Force is a community based collaborative of health care providers, researchers, community-based organizations, funders, and public sector representatives. The mission of the task force is to provide a venue to address childhood adversity and its consequences in the Philadelphia metropolitan region. In this article we describe the origins and metamorphosis of the Philadelphia ACE Task Force, which initially was narrowly focused on screening for adverse childhood experiences (ACEs) in health care settings but expanded its focus to better represent a true community-based approach to sharing experiences with addressing childhood adversity in multiple sectors of the city and region. The task force has been successful in developing a research agenda and conducting research on ACEs in the urban context, and has identified foci of local activity in the areas of professional training and workforce development, community education, and local practical interventions around adversity, trauma, and resiliency. In this article we also address the lessons learned over the first 5 years of the task force's existence and offers recommendations for future efforts to build a local community-based ACEs collaborative. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Critical Factors for Successful Practice of Disaster-Resilient Community in Urban City

NASA Astrophysics Data System (ADS)

Chou, J. S.; Wu, J. H.

2017-12-01

Due to special geographical environment, Taiwan is a natural disaster-prone area, which often suffers from earthquakes, typhoons and other natural hazards, resulting in heavy casualties and huge property losses. Furthermore, effect of global warming increases extreme climate events and leads to frequent and severe natural disasters. Therefore, disaster prevention and response are not only an important issue of government policy, but also a critical issue of people's life. Rather than over-reliance on government assistance, the spontaneous participation and co-operation by people can complete specific disaster preparedness and reinforce local energy of disaster prevention and response. Although the concept of disaster-resilient community (DRC) has been shaped for a period of time, residents in the community cannot keep up the pace with government, which may decrease the effectiveness of DRC development. Thus, the study of theory and practice of urban DRC becomes an imperative need. This article is a qualitative case study, which uses the participant observation and self-reflection in action research methods to collect relevant information for empirical validation. Particularly, this investigation is supplemented by service work experience in DRC promotion conducted by the researchers. According to the qualitative analyses of case communities during training process of disaster prevention and preparedness, we can identify the critical factors affecting the level of community-based disaster prevention and protection works. Based on the literature and empirical supports, the factors are discussed through three spindle constructs respectively, namely coping strategy, operations management and organizational behavior. Based on the findings of this study, we make conclusions and suggestions for related authority in sustainably promoting DRC.

Lessons Learned From Community-Based Approaches to Sodium Reduction

PubMed Central

Kane, Heather; Strazza, Karen; Losby PhD, Jan L.; Lane, Rashon; Mugavero, Kristy; Anater, Andrea S.; Frost, Corey; Margolis, Marjorie; Hersey, James

2017-01-01

Purpose This article describes lessons from a Centers for Disease Control and Prevention initiative encompassing sodium reduction interventions in six communities. Design A multiple case study design was used. Setting This evaluation examined data from programs implemented in six communities located in New York (Broome County, Schenectady County, and New York City); California (Los Angeles County and Shasta County); and Kansas (Shawnee County). Subjects Participants (n = 80) included program staff, program directors, state-level staff, and partners. Measures Measures for this evaluation included challenges, facilitators, and lessons learned from implementing sodium reduction strategies. Analysis The project team conducted a document review of program materials and semi structured interviews 12 to 14 months after implementation. The team coded and analyzed data deductively and inductively. Results Five lessons for implementing community-based sodium reduction approaches emerged: (1) build relationships with partners to understand their concerns, (2) involve individuals knowledgeable about specific venues early, (3) incorporate sodium reduction efforts and messaging into broader nutrition efforts, (4) design the program to reduce sodium gradually to take into account consumer preferences and taste transitions, and (5) identify ways to address the cost of lower-sodium products. Conclusion The experiences of the six communities may assist practitioners in planning community-based sodium reduction interventions. Addressing sodium reduction using a community-based approach can foster meaningful change in dietary sodium consumption. PMID:24575726

The role of community context in planning and implementing community-based health promotion projects.

PubMed

Kegler, Michelle C; Rigler, Jessica; Honeycutt, Sally

2011-08-01

The current study examines how community context affected collaborative planning and implementation in eight sites participating in a healthy cities and communities initiative in California. Data are from 23 focus groups conducted with coalition members, and 76 semi-structured interviews with local coordinators and community leaders. Multiple case study methods were used to identify major themes related to how five contextual domains influenced collaborative planning and implementation. Results showed that history of collaboration can influence resources and interpersonal and organizational connections available for planning and implementation, as well as priorities selected for action. Community politics and history can affect which segments of the community participate in a planning process and what issues are prioritized, as well as the pool of partners willing to aid in implementation. Some community norms and values bring people together and others appear to limit involvement from certain groups. Community demographics and economic conditions may shape outreach strategies for planning and implementation, and may also shape priorities. Geography can play a role in assessment methods, priority selection, partners available to aid in implementation, and participation in activities and events. Results suggest that community context plays a substantive role in shaping how community-based health promotion projects unfold. Copyright © 2011 Elsevier Ltd. All rights reserved.

Harnessing the power of the grassroots to conduct public health research in sub-Saharan Africa: a case study from western Kenya in the adaptation of community-based participatory research (CBPR) approaches.

PubMed

Kamanda, Allan; Embleton, Lonnie; Ayuku, David; Atwoli, Lukoye; Gisore, Peter; Ayaya, Samuel; Vreeman, Rachel; Braitstein, Paula

2013-01-31

Community-based participatory research (CBPR) is a collaborative approach to research that involves the equitable participation of those affected by an issue. As the field of global public health grows, the potential of CBPR to build capacity and to engage communities in identification of problems and development and implementation of solutions in sub-Saharan Africa has yet to be fully tapped. The Orphaned and Separated Children's Assessments Related to their Health and Well-Being (OSCAR) project is a longitudinal cohort of orphaned and non-orphaned children in Kenya. This paper will describe how CBPR approaches and principles can be incorporated and adapted into the study design and methods of a longitudinal epidemiological study in sub-Saharan Africa using this project as an example. The CBPR framework we used involves problem identification, feasibility and planning; implementation; and evaluation and dissemination. This case study will describe how we have engaged the community and adapted CBPR methods to OSCAR's Health and Well-being Project's corresponding to this framework in four phases: 1) community engagement, 2) sampling and recruitment, 3) retention, validation, and follow-up, and 4) analysis, interpretation and dissemination. To date the study has enrolled 3130 orphaned and separated children, including children living in institutional environments, those living in extended family or other households in the community, and street-involved children and youth. Community engagement and participation was integral in refining the study design and identifying research questions that were impacting the community. Through the participation of village Chiefs and elders we were able to successfully identify eligible households and randomize the selection of participants. The on-going contribution of the community in the research process has been vital to participant retention and data validation while ensuring cultural and community relevance and equity in the research agenda. CBPR methods have the ability to enable and strengthen epidemiological and public health research in sub-Saharan Africa within the social, political, economic and cultural contexts of the diverse communities on the continent. This project demonstrates that adaptation of these methods is crucial to the successful implementation of a community-based project involving a highly vulnerable population.

Harnessing the power of the grassroots to conduct public health research in sub-Saharan Africa: a case study from western Kenya in the adaptation of community-based participatory research (CBPR) approaches

PubMed Central

2013-01-01

Background Community-based participatory research (CBPR) is a collaborative approach to research that involves the equitable participation of those affected by an issue. As the field of global public health grows, the potential of CBPR to build capacity and to engage communities in identification of problems and development and implementation of solutions in sub-Saharan Africa has yet to be fully tapped. The Orphaned and Separated Children’s Assessments Related to their Health and Well-Being (OSCAR) project is a longitudinal cohort of orphaned and non-orphaned children in Kenya. This paper will describe how CBPR approaches and principles can be incorporated and adapted into the study design and methods of a longitudinal epidemiological study in sub-Saharan Africa using this project as an example. Methods The CBPR framework we used involves problem identification, feasibility and planning; implementation; and evaluation and dissemination. This case study will describe how we have engaged the community and adapted CBPR methods to OSCAR’s Health and Well-being Project’s corresponding to this framework in four phases: 1) community engagement, 2) sampling and recruitment, 3) retention, validation, and follow-up, and 4) analysis, interpretation and dissemination. Results To date the study has enrolled 3130 orphaned and separated children, including children living in institutional environments, those living in extended family or other households in the community, and street-involved children and youth. Community engagement and participation was integral in refining the study design and identifying research questions that were impacting the community. Through the participation of village Chiefs and elders we were able to successfully identify eligible households and randomize the selection of participants. The on-going contribution of the community in the research process has been vital to participant retention and data validation while ensuring cultural and community relevance and equity in the research agenda. Conclusion CBPR methods have the ability to enable and strengthen epidemiological and public health research in sub-Saharan Africa within the social, political, economic and cultural contexts of the diverse communities on the continent. This project demonstrates that adaptation of these methods is crucial to the successful implementation of a community-based project involving a highly vulnerable population. PMID:23368931

Peasant Identity: Contributions towards a Rural Psychology from an Argentinean Case Study

ERIC Educational Resources Information Center

Landini, Fernando

2012-01-01

Within the field of psychology, little attention has been paid to studying the identity of rural people, in particular the peasantry. To explore this issue, a case study was undertaken in a community located in Argentina. The research identified three different dimensions of peasants' identity. The first one, positive identity, is based on…

Becoming Qualified to Teach Low-literate Refugees: A Case Study of One Volunteer Instructor

ERIC Educational Resources Information Center

Perry, Kristen H.

2013-01-01

This case study investigates Carolyn, an effective volunteer ESL and literacy instructor of adult African refugees, in order to understand both what it means to be a qualified instructor, and also how community-based volunteer instructors may become more qualified. The study's findings suggest that Carolyn's qualifications are a combination of…

Learning in Collaboration: A Case Study of a Community Based Partnership Program

ERIC Educational Resources Information Center

Syam, Devarati S.

2010-01-01

This ethnographic case study investigated a multi-agency partnership project in a Midwestern city, the goal of which was to holistically address the health, safety and wellness issues of teen girls in an alternative school. The researcher was one of the eleven partners representing five different organizations that came together to create a…

Building a Dangerous Outpost in the Green Mountain State: A Case Study of Educator Preparation Policymaking

ERIC Educational Resources Information Center

McGough, David J.; Bedell, Claudine; Tinkler, Barri

2018-01-01

Poised at a bifurcation, the educator preparation community in Vermont faced either the adoption of a generic product for the assessment of initial educator licensure candidates or the comprehensive revision of a longstanding state-based assessment portfolio. Using a case study approach and narrative methods, specifically the Narrative Policy…

Providing Better Education Services to the Poor: Accountability and Context in the Case of Guatemalan Decentralization

ERIC Educational Resources Information Center

Gershberg, Alec Ian; Meade, Ben; Andersson, Sven

2009-01-01

We explore how two community-based reform models align with the World Bank's "World Development Report 2004" accountability framework. Using a qualitative case study of rural Guatemalan primary schools, we examine local governance through interviews with a range of stakeholders. While both reforms appear appropriate according to the…

Organizational Influences in Technology Adoption Decisions: A Case Study of Digital Libraries

ERIC Educational Resources Information Center

Oguz, Fatih

2016-01-01

The purpose of this study was to understand the organizational level decision factors in technology adoption in the context of digital libraries. A qualitative case study approach was used to investigate the adoption of a specific technology, XML-based Web services, in digital libraries. Rogers' diffusion of innovations and Wenger's communities of…

Clinical Practice as Natural Laboratory for Psychotherapy Research: A Guide to Case-Based Time-Series Analysis

ERIC Educational Resources Information Center

Borckardt, Jeffrey J.; Nash, Michael R.; Murphy, Martin D.; Moore, Mark; Shaw, Darlene; O'Neil, Patrick

2008-01-01

Both researchers and practitioners need to know more about how laboratory treatment protocols translate to real-world practice settings and how clinical innovations can be systematically tested and communicated to a skeptical scientific community. The single-case time-series study is well suited to opening a productive discourse between practice…

An Elder Abuse Assessment Team in an Acute Hospital Setting.

ERIC Educational Resources Information Center

The Beth Israel Hospital Elder Assessment Team

1986-01-01

Describes a hospital-based multidisciplinary team designed to assess and respond to cases of suspected abuse or neglect of elders from both institutional and community settings. Presence of the team has increased the hospital staff's awareness of elder abuse and neglect, as well as their willingness to refer suspected cases for further assessment.…

Instructional Design: Case Studies in Communities of Practice

ERIC Educational Resources Information Center

Keppell, Michael, Ed.

2007-01-01

"Instructional Design: Case Studies in Communities of Practice" documents real-world experiences of instructional designers and staff developers who work in communities of practice. "Instructional Design: Case Studies in Communities of Practice" explains the strategies and heuristics used by instructional designers when working…

Spaces of care in the third sector: understanding the effects of professionalization.

PubMed

Carey, Gemma; Braunack-Mayer, Annette; Barraket, Jo

2009-11-01

Increasingly the health and welfare needs of individuals and communities are being met by third sector, or not-for-profit, organizations. Since the 1980s third sector organizations have been subject to significant, sector-wide changes, such as the development of contractual funding and an increasing need to collaborate with governments and other sectors. In particular, the processes of 'professionalization' and 'bureaucratization' have received significant attention and are now well documented in third sector literature. These processes are often understood to create barriers between organizations and their community groups and neutralize alternative forms of service provision. In this article we provide a case study of an Australian third sector organization undergoing professionalization. The case study draws on ethnographic and qualitative interviews with staff and volunteers at a health-based third sector organization involved in service provision to marginalized community groups. We examine how professionalization alters organizational spaces and dynamics and conclude that professionalized third sector spaces may still be 'community' spaces where individuals may give and receive care and services. Moreover, we suggest that these community spaces hold potential for resisting the neutralizing effects of contracting.

Evaluating clinic and community-based lifestyle interventions for obesity reduction in a low-income Latino neighborhood: Vivamos Activos Fair Oaks Program.

PubMed

Drieling, Rebecca L; Ma, Jun; Stafford, Randall S

2011-02-14

Obesity exerts an enormous health impact through its effect on coronary heart disease and its risk factors. Primary care-based and community-based intensive lifestyle counseling may effectively promote weight loss. There has been limited implementation and evaluation of these strategies, particularly the added benefit of community-based intervention, in low-income Latino populations. The Vivamos Activos Fair Oaks project is a randomized clinical trial designed to evaluate the clinical and cost-effectiveness of two obesity reduction lifestyle interventions: clinic-based intensive lifestyle counseling, either alone (n = 80) or combined with community health worker support (n = 80), in comparison to usual primary care (n = 40). Clinic-based counseling consists of 15 group and four individual lifestyle counseling sessions provided by health educators targeting behavior change in physical activity and dietary practices. Community health worker support includes seven home visits aimed at practical implementation of weight loss strategies within the person's home and neighborhood. The interventions use a framework based on Social Cognitive Theory, the Transtheoretical Model of behavior change, and techniques from previously tested lifestyle interventions. Application of the framework was culturally tailored based on past interventions in the same community and elsewhere, as well as a community needs and assets assessment. The interventions include a 12-month intensive phase followed by a 12-month maintenance phase. Participants are obese Spanish-speaking adults with at least one cardiovascular risk factor recruited from a community health center in a low-income neighborhood of San Mateo County, California. Follow-up assessments occur at 6, 12, and 24 months for the primary outcome of percent change in body mass index at 24 months. Secondary outcomes include specific cardiovascular risk factors, particularly blood pressure and fasting glucose levels. If successful, this study will provide evidence for broad implementation of obesity interventions in minority populations and guidance about the selection of strategies involving clinic-based case management and community-based community health worker support. ClinicalTrials.gov: NCT01242683.

Developing and pilot testing of a tool for "clinicosocial case study" assessment of community medicine residents.

PubMed

Gohel, Manisha; Singh, Uday Shankar; Bhanderi, Dinesh; Phatak, Ajay

2016-01-01

Practical and clinical skills teaching should constitute a core part of the postgraduate curriculum of Community Medicine. The clinicosocial case study is a method to enhance learners' skills but there is no generally accepted organized system of formative assessment and structured feedback to guide students. A new tool based on the principles of mini-Clinical Evaluation Exercise (mini CEX) was developed and pilot tested as a 'clinicosocial case study' assessment of community medicine residents with feedback as a core component. Ten core domains of clinicosocial skills were identified after reviewing the relevant literature and input from local experts in community medicine and medical education. We pilot tested the tool with eight faculty members to assess five residents during clinicosocial case presentations on a variety of topics. Kappa statistic and Bland Altman plots were used to assess agreement between faculty members' average assessment scores. Cronbach's alpha was used to test the internal consistency with faculty members as domains. All 95% confidence limits using the Bland-Altman method were within the predetermined limit of 2 points. The overall Kappa between two faculty members was fair ranging from 0.2 to 0.3. Qualitative feedback revealed that both faculty and residents were enthusiastic about the process but faculty suggested further standardization, while residents suggested streamlining of the process. This new assessment tool is available for objective and unbiased assessment of residents through 'clinicosocial case study,' which enriches learning through comprehensive feedback. Further validation in different settings is needed.

Increased risk of default among previously treated tuberculosis cases in the Western Cape Province, South Africa.

PubMed

Marx, F M; Dunbar, R; Hesseling, A C; Enarson, D A; Fielding, K; Beyers, N

2012-08-01

To investigate, in two urban communities with high tuberculosis (TB) incidence and high rates of TB recurrence, whether a history of previous TB treatment is associated with treatment default. Retrospective cohort study of TB cases with an episode of treatment recorded in the clinic-based treatment registers between 2002 and 2007. Probabilistic record linkage was used to ascertain treatment history of TB cases back to 1996. Based on the outcome of their most recent previous treatment episode, previously treated cases were compared to new cases regarding their risk of treatment default. Previous treatment success (adjusted odds ratio [aOR] 1.79; 95%CI 1.17-2.73), previous default (aOR 6.18, 95%CI 3.68-10.36) and previous failure (aOR 9.72, 95%CI 3.07-30.78) were each independently associated with treatment default (P < 0.001). Other factors independently associated with default were male sex (P = 0.003) and age 19-39 years (P < 0.001). Previously treated TB cases are at increased risk of treatment default, even after previous successful treatment. This finding is of particular importance in a setting where recurrent TB is very common. Adherence to treatment should be ensured in new and retreatment cases to increase cure rates and reduce transmission of TB in the community.

Media advocacy: lessons from community experiences.

PubMed

Jernigan, D H; Wright, P A

1996-01-01

Media advocacy is the strategic use of mass media and community organizing as a resource for advancing a social or public policy initiative. Across the United States, communities are using media advocacy to promote healthier public policies and environments. The U.S. Center for Substance Abuse Prevention commissioned numerous case studies of media advocacy on alcohol and tobacco issues in a diverse array of communities, including efforts in African-American and Latino communities or using computer-based electronic communication systems. The paper describes these efforts briefly, and summarizes lessons learned, including: media advocacy can lead to larger victories when used as a complement to community organizing in the context of a larger strategic vision for policy change; like policy advocacy, media advocacy is best done in the context of clear long-term goals; conscious framing, guiding the choice of spokespeople, visuals, and messages, can alter media coverage and public debate of health policies; advocates need to respect the media but also remember that they have power in relation to the media; and media advocacy is often controversial and not suited to every situation. The case studies show that media advocacy is a potent tool for public health workers, making an important contribution to campaigns to promote healthier public policies.

Supporting Latino communities' natural helpers: a case study of promotoras in a research capacity building course.

PubMed

Otiniano, Angie Denisse; Carroll-Scott, Amy; Toy, Peggy; Wallace, Steven P

2012-08-01

Promotores have unique access to underserved and hard-to-reach Latino communities facing health disparities. Although promotores are involved in community change, they rarely receive training that gives them the skills to be partners in research. We present a case study of promotoras who participated in a research capacity building course focused on assessing community health needs. Data comes from course application surveys, follow-up notes, and narratives from qualitative phone interviews of eight promotoras. Content analysis drawing from grounded theory was conducted to identify and describe emerging themes. Four themes emerged as promotoras discussed their experience learning basic research skills and teaching others: (1) challenges, (2) support, (3) building capacity, and (4) using research. Promotores play an important role in the health of Latino communities and are increasingly asked to participate in research processes; however they have few opportunities for training and professional development in this area. Capacity building opportunities for promotores need to be tailored to their needs and provide them with support. Fostering collaboration between promotores and partnering with local community-based organizations can help facilitate needed research skill-building among promotores.

A professional learning community model: a case study of primary teachers community in west Bandung

NASA Astrophysics Data System (ADS)

Sari, A.; Suryadi, D.; Syaodih, E.

2018-05-01

The purpose of this study is to provide an alternative model of professional learning community for primary school teachers in improving the knowledge and professional skills. This study is a qualitative research with case study method with data collection is an interview, observation and document and triangulation technique for validation data that focuses on thirteen people 5th grade elementary school teacher. The results showed that by joining a professional learning community, teachers can share both experience and knowledge to other colleagues so that they can be able to continue to improve and enhance the quality of their learning. This happens because of the reflection done together before, during and after the learning activities. It was also revealed that by learning in a professional learning community, teachers can learn in their own way, according to need, and can collaborate with their colleagues in improving the effectiveness of learning. Based on the implementation of professional learning community primary school teachers can be concluded that teachers can develop the curriculum, the students understand the development, overcome learning difficulties faced by students and can make learning design more effective and efficient.

Spatial and Temporal Spread of Acute Viral Respiratory Infections in Young Children Living in High-Altitude Rural Communities: A Prospective Household-Based Study

PubMed Central

Cherry, Charlotte Buehler; Griffin, Marie R.; Edwards, Kathryn M.; Williams, John V.; Gil, Ana I.; Verastegui, Hector; Lanata, Claudio F.; Grijalva, Carlos G

2016-01-01

Background Few studies have described patterns of transmission of viral acute respiratory infections (ARI) in children in developing countries. We examined the spatial and temporal spread of viral ARI among young children in rural Peruvian highland communities. Previous work has described intense social interactions in those communities, which could influence the transmission of viral infections. Methods We enrolled and followed children <3 years of age for detection of ARI during the 2009–2011 respiratory seasons in a rural setting with relatively wide geographic dispersion of households and communities. Viruses detected included influenza, respiratory syncytial virus (RSV), human metapneumovirus (MPV), and parainfluenza 2 and 3 viruses (PIV2; PIV3). We used geospatial analyses to identify specific viral infection hot spots with high ARI incidence. We also explored the local spread of ARI from index cases using standard deviational ellipses. Results Geospatial analyses revealed hot spots of high ARI incidence around the index cases of influenza outbreaks and RSV outbreak in 2010. Although PIV3 in 2009 and PIV2 in 2010 showed distinct spatial hot spots, clustering was not in proximity to their respective index cases. No significant aggregation around index cases was noted for other viruses. Standard deviational ellipse analyses suggested that influenza B and RSV in 2010, and MPV in 2011 spread temporally in alignment with the major road network. Conclusions Despite the geographic dispersion of communities in this rural setting, we observed a rapid spread of viral ARI among young children. Influenza strains and RSV in 2010 had distinctive outbreaks arising from their index cases. PMID:27404599

Trends in myocardial infarction rates and case fatality by anatomical location in four United States communities, 1987 to 2008 (from the Atherosclerosis Risk in Communities Study).

PubMed

Newman, Jonathan D; Shimbo, Daichi; Baggett, Chris; Liu, Xiaoxi; Crow, Richard; Abraham, Joellyn M; Loehr, Laura R; Wruck, Lisa M; Folsom, Aaron R; Rosamond, Wayne D

2013-12-01

Although the incidence of and mortality after ST-segment elevation myocardial infarction (STEMI) is decreasing, time trends in anatomical location of STEMI and associated short-term prognosis have not been examined in a population-based community study. We determined 22-year trends in age- and race-adjusted gender-specific incidences and 28-day case fatality of hospitalized STEMI by anatomic infarct location among a stratified random sample of 35- to 74-year-old residents of 4 communities in the Atherosclerosis Risk in Communities study. STEMI infarct location was assessed by 12-lead electrocardiograms from the hospital record and was coded as anterior, inferior, lateral, and multilocation STEMIs using the Minnesota code. From 1987 to 2008, a total of 4,845 patients had an incident STEMI; 37.2% were inferior STEMI, 32.8% were anterior, 16.8% occurred in multiple infarct locations, and 13.2% were lateral STEMI. For inferior, anterior, and lateral STEMIs in both men and women, significant decreases were observed in the age-adjusted annual incidence and the associated 28-day case fatality. In contrast, for STEMI in multiple infarct locations, neither the annual incidence nor the 28-day case fatality changed over time. The age- and race-adjusted annual incidence and associated 28-day case fatality of STEMI in anterior, inferior, and lateral infarct locations decreased during 22 years of surveillance; however, no decrease was observed for STEMI in multiple infarct locations. In conclusion, our findings suggest that there is room for improvement in the care of patients with multilocation STEMI. Copyright © 2013 Elsevier Inc. All rights reserved.

Community-based prevention of hepatitis-B-related liver cancer: Australian insights

PubMed Central

Kansil, Melanie Q; Porwal, Mamta; Penman, Andrew G; George, Jacob

2014-01-01

Abstract Problem Although most primary hepatocellular cancers (HCCs) are attributable to chronic viral hepatitis and largely preventable, such cancers remain a leading cause of cancer-related mortality wherever chronic hepatitis B is endemic. Approach Many HCCs could be prevented by increasing awareness and knowledge of hepatitis B, optimizing the monitoring of chronic hepatitis B and using antiviral treatments – but there are gaps in the implementation of such strategies. Local setting The “B Positive” programme, based in Sydney, Australia, is designed to improve hepatitis-B-related health outcomes among immigrants from countries with endemic hepatitis B. The programme offers information about disease screening, vaccination and treatment options, as well as optimized access to care. Relevant changes The B Positive programme has been informed by economic modelling. The programme offers culturally tailored education on chronic hepatitis B to target communities and their health practitioners and regular follow-up through a population-based registry of cases. Lessons learnt As the costs of screening for chronic hepatitis B and follow-up are relatively low and less than one in every four cases may require antiviral drugs, optimizing access to treatment seems an appropriate and cost-effective management option. The identification and accurate staging of cases and the judicious use of antiviral medications are predicated upon an informed and educated health workforce. As establishing community trust is a lengthy process, delaying the implementation of programmes against chronic hepatitis B until antiviral drugs become cheaper is unwarranted. PMID:24839327

Providing Health Care to Latino Immigrants: Community-Based Efforts in the Rural Midwest

PubMed Central

Casey, Michelle M.; Blewett, Lynn A.; Call, Kathleen T.

2004-01-01

We examined case studies of 3 rural Midwestern communities to assess local health care systems’ response to rapidly growing Latino populations. Currently, clinics provide free or low-cost care, and schools, public health, social services, and religious organizations connect Latinos to the health care system. However, many unmet health care needs result from lack of health insurance, limited income, and linguistic and cultural barriers. Targeted safety net funding would help meet Latino health care needs in rural communities with limited resources. PMID:15451737

Site-Based Management in Education: Rochester City School District Case Study.

ERIC Educational Resources Information Center

Gross, Alan

This paper describes outcomes of a partnership between the Rochester City School District (New York) and the Kodak 21st Century Learning Challenge consulting program for improving school-based planning team (S-BPT) operations. The purpose of the school-based planning team is to involve the entire school community in improving school effectiveness.…

Performance-Based Funding: State Policy Influences on Small Rural Community Colleges

ERIC Educational Resources Information Center

Thornton, Zoë Mercedes; Friedel, Janice Nahra

2016-01-01

Performance-based funding (PBF) models intend to increase efficiency and productivity of the institution, thereby influencing organizational change. This change may be structural, programmatic, or procedural, and it may affect institutional practice and/or policy. The purpose of this qualitative case study was to understand the organizational…

An attempt to implement tools to support examination of community-based activities for disaster mitigation: A case study in Toyokawa city, Japan

NASA Astrophysics Data System (ADS)

Karashima, Kazuki; Ohgai, Akira

2017-10-01

Japan is a country with a high risk for earthquake disasters. The measures used to promote structures' seismic safety, such as reconstruction, widening narrow roads, and the response capacities to deal with huge earthquakes are important. Techniques to support the examination of countermeasures to huge earthquakes are required. To improve this capability, the authors developed tools to: (1) evaluate fire-spread risk, (2) evaluate the difficulty of emergency response and evacuation, and (3) evaluate capacities of neighborhood communities for disaster mitigation. The usefulness of the tools was clarified by the demonstration experiments of previous studies. The next step was implementation of the tools in community-based activities for disaster mitigation. This study aimed to clarify the usability and problems of implementing the tools in community-based activities. The tools were used at several workshops in actual community-based activities for disaster mitigation for one year. After the last workshop, interviews and a questionnaire were conducted on municipal staff and consultant staff. The results found that the tools visually showed the fire-spread risk, the difficulty of evacuation under current conditions and after improvements, and the effects of each disaster mitigation activity. The users could easily explore the draft plans to promote seismic safety of urban structures and response capabilities. The tools were positively incorporated into some community-based activities for disaster mitigation. Thus, the tools have the possibility of successful use at continuing community-based activities and the possibility of implementing the tools will be promoted.

The case of a city where 1 in 6 residents is a refugee: ecological factors and host community adaptation in successful resettlement.

PubMed

Smith, R Scott

2008-12-01

The notable success of an upstate New York community in resettling refugees raises the question of whether multiple waves of resettlement over a 15-year period have resulted in greater accommodation to refugees. Structured interviews based on transactional models of acculturation were used along with archival data to explore ecological factors supporting a host community's behavioral flexibility and perseverance in response to the influx of refugees. Evidence suggests that socioeconomic climate, historical background/social norms, and the organizational structure of agencies involved in resettlement moderate successful inclusion of refugees into a host community in a bidirectional process.

Evidence-Informed, Individual Treatment of a Child with Sexual Behavior Problems: A Case Study.

PubMed

Allen, Brian; Berliner, Lucy

2015-11-01

Children with sexual behavior problems pose a significant challenge for community-based mental health clinicians. Very few clinical trials are available to guide intervention and those interventions that are available are based in a group format. The current case study demonstrates the application of evidence-informed treatment techniques during the individual treatment of a 10-year-old boy displaying interpersonal sexual behavior problems. Specifically, the clinician adapts and implements a group-based model developed and tested by Bonner et al. (1999) for use with an individual child and his caregivers. Key points of the case study are discussed within the context of implementing evidence-informed treatments for children with sexual behavior problems.

The North Country on the Job Network: a unique role for occupational health nurses in a community coalition.

PubMed

Kennedy, Margaret Q; Badger, Elizabeth; Pompeii, Lisa; Lipscomb, Hester J

2003-05-01

1. Through a community based program, nurses were hired by a rural medical center to facilitate care for injured workers in the community. This placed the nurses outside the industrial and insurance arenas. 2. Rapid access to care and expedited return to work were made possible largely through improved communication, facilitated by the nurse case coordinators, among all involved parties (i.e., workers, employers, health care providers, insurance carriers). 3. The program provides access to occupational health nurses, or case managers, to a large number of rural workers--many of whom work for small employers and would not have these services otherwise. 4. The simple administrative model has resulted in increased numbers of workers returning to work with decreasing numbers of transitional or modified duty days.

Pathways of Adaptation: Two Case Studies with One Evidence-Based Substance Use Prevention Program Tailored for Indigenous Youth.

PubMed

Ivanich, Jerreed D; Mousseau, Alicia C; Walls, Melissa; Whitbeck, Les; Whitesell, Nancy Rumbaugh

2018-06-06

Indigenous communities often face disproportionate challenges across a variety of health domains, and effective prevention strategies are sorely needed. Unfortunately, evidence is scant regarding what approaches are effective for these communities. A common approach is to take an evidence-based practice or program with documented effectiveness in other populations and implement it with Indigenous populations. While a science of intervention adaptation is emerging, there remains little guidance on processes for adaptation that strategically leverage both existing scientific evidence and Indigenous prevention strategies. In this paper, two case studies illustrate promising practices for adaptation, documenting the approaches of two research teams funded under the National Institutes of Health's initiative to support Intervention Research to Improve Native American Health (IRINAH). These teams worked with distinct Indigenous populations in the USA and Canada to culturally adapt the same prevention program, the Iowa Strengthening Families Program for Parents and Youth 10-14. The approaches of these two teams and the programs that resulted are compared and contrasted, and critical elements of adaptation in partnership with Indigenous communities are discussed.

[60 years of the equilibrium theory of insular biogeography: problems of testing, results of the field studies, applied importance].

PubMed

Akatov, V V

2012-01-01

A review is presented of publications dealing with analysis of species richness of island biological communities and habitat islands based on the equilibrium theory of insular biogeography by MacArthur and Wilson (1963). Principal points of the theory are considered along with its shortcomings, problems and results of its testing. Also, possibilities are appraised for using recommendations elaborated on the base of the theory in nature conservation practice. The results of island and habitat island biota studies indicate that in many cases data corroborate the equilibrium theory while in many other cases they do not. In particular, for cenoses fragmented 50-250 years ago, especially for the ones formed by long living species, there have been no conspicuous effects of species relaxation detected. At that, the theory prediction of substantial reduction in species richness of fragmented communities in the long run is hardly disputed. The results of studies conducted in the field of insular biogeography are taken as a basis for recommendations on the long-term conservation of isolated communities integrity, although mostly they are of qualitative nature.

Clustering Financial Time Series by Network Community Analysis

NASA Astrophysics Data System (ADS)

Piccardi, Carlo; Calatroni, Lisa; Bertoni, Fabio

In this paper, we describe a method for clustering financial time series which is based on community analysis, a recently developed approach for partitioning the nodes of a network (graph). A network with N nodes is associated to the set of N time series. The weight of the link (i, j), which quantifies the similarity between the two corresponding time series, is defined according to a metric based on symbolic time series analysis, which has recently proved effective in the context of financial time series. Then, searching for network communities allows one to identify groups of nodes (and then time series) with strong similarity. A quantitative assessment of the significance of the obtained partition is also provided. The method is applied to two distinct case-studies concerning the US and Italy Stock Exchange, respectively. In the US case, the stability of the partitions over time is also thoroughly investigated. The results favorably compare with those obtained with the standard tools typically used for clustering financial time series, such as the minimal spanning tree and the hierarchical tree.

Structural alterations of faecal and mucosa-associated bacterial communities in irritable bowel syndrome.

PubMed

Durbán, Ana; Abellán, Juan J; Jiménez-Hernández, Nuria; Salgado, Patricia; Ponce, Marta; Ponce, Julio; Garrigues, Vicente; Latorre, Amparo; Moya, Andrés

2012-04-01

Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder in western countries. Previous studies on IBS, mostly based on faecal samples, suggest alterations in the intestinal microbiota. However, no consensus has been reached regarding the association between specific bacteria and IBS. We explore the alterations of intestinal bacterial communities in IBS using massive sequencing of amplified 16S rRNA genes. Mucosal biopsies of the ascending and descending colon and faeces from 16 IBS patients and 9 healthy controls were analysed. Strong inter-individual variation was observed in the composition of the bacterial communities in both patients and controls. These communities showed less diversity in IBS cases. There were larger differences in the microbiota composition between biopsies and faeces than between patients and controls. We found a few over-represented and under-represented taxa in IBS cases with respect to controls. The detected alterations varied by site, with no changes being consistent across sample types. © 2012 Society for Applied Microbiology and Blackwell Publishing Ltd.

Power and empowerment: Fostering effective collaboration in meeting the needs of orphans and vulnerable children

PubMed Central

WALLIS, A.; DUKAY, V.; MELLINS, C.

2009-01-01

In sub-Saharan Africa, HIV/AIDS has resulted in a rapidly growing population of orphans and vulnerable children (OVC). These OVC have strained the traditional safety net provided by extended families to its breaking point. Increasingly, community-based initiatives are emerging to fill the gap. However, relatively little is known about these efforts and their effectiveness. This article looks at one such initiative in rural Tanzania, and explores the relationship between local communities that seek to empower themselves to address the needs of their OVC and external organisations that have the resources and power to help them. This case study describes the successful effort of a community to build a Centre housing its orphans, and the subsequent closure of that Centre despite its evident success, because of a conflict between internal and external interests. This case study is used as the basis of a broader discussion on how those with power, and communities seeking empowerment, are complexly intertwined. PMID:19626505

Developing and Conducting a Dissertation Study through the Community-Based Participatory Research Approach.

PubMed

Nadimpalli, S B; Van Devanter, N; Kavathe, R; Islam, N

2016-06-01

The community-based participatory research (CBPR) approach has been shown to be innovative and effective in conducting research with communities experiencing health disparities. Doctoral nursing students, and other doctoral students in the health sciences, who are interested in this approach can benefit through structured CBPR training experiences in learning how to engage with communities, build community capacity, share resources, implement CBPR study plans, and disseminate results of CBPR-focused studies. The objectives of this case-study are to demonstrate ways in which one doctoral student aligned with academic mentors and a funded CBPR project to build a relationship with the Sikh Asian Indian (AI) community of New York City to develop and implement a CBPR-focused doctoral dissertation study. The purpose of the research was to examine the relationship between the experience of perceived discrimination and health outcomes in this community. CBPR methods utilized in developing the study entailed the author partaking in formal and informal CBPR learning experiences, building relationships with community and academic partners early on through volunteering, developing a research plan in collaboration with members of the community and academic partners, identifying an appropriate setting and methods for recruitment and data collection, increasing capacity and resources for all partners (the author, community, and academic), and presenting dissertation study findings to the community. In conclusion, CBPR-focused doctoral experiences are novel pedagogical and professional approaches for nursing and health science students which can lead to mutual benefits for all involved, and ultimately successful and effective community-based health research.

Decision support environment for medical product safety surveillance.

PubMed

Botsis, Taxiarchis; Jankosky, Christopher; Arya, Deepa; Kreimeyer, Kory; Foster, Matthew; Pandey, Abhishek; Wang, Wei; Zhang, Guangfan; Forshee, Richard; Goud, Ravi; Menschik, David; Walderhaug, Mark; Woo, Emily Jane; Scott, John

2016-12-01

We have developed a Decision Support Environment (DSE) for medical experts at the US Food and Drug Administration (FDA). The DSE contains two integrated systems: The Event-based Text-mining of Health Electronic Records (ETHER) and the Pattern-based and Advanced Network Analyzer for Clinical Evaluation and Assessment (PANACEA). These systems assist medical experts in reviewing reports submitted to the Vaccine Adverse Event Reporting System (VAERS) and the FDA Adverse Event Reporting System (FAERS). In this manuscript, we describe the DSE architecture and key functionalities, and examine its potential contributions to the signal management process by focusing on four use cases: the identification of missing cases from a case series, the identification of duplicate case reports, retrieving cases for a case series analysis, and community detection for signal identification and characterization. Published by Elsevier Inc.

Enhanced Web-Based Otitis Study Case vs Simple Paper-Case: Impact on Medical Student Objective Structured Clinical Exam (OSCE) Performance.

PubMed

Malloy, Michael H

2002-12-01

Distance education methods have taken on greater importance as medical student education has moved off campus into the community. What the best methods are for conveying information to students at distant sites has not been determined. To determine if students at distant community sites who received an otitis media study case by e-mail that was enhanced with a referral to a web-based otitis study case, performed better on otitis OSCE stations than students who received the same case not enhanced with visuals or referrals to a web-based otitis case. Students were randomized by community site to receive either the enhanced (E) or simple otitis study case (S). Students were e-mailed an otitis media study case during the 5th week of the rotation. Those randomized to the E-case received a case that started with a case scenario followed by a "Task" that instructed them to go to this web address: http://www.aap.org/otitismedia/www/vc/ear/index.cfm (American Academy of Pediatrics Otitis Web Site). They were then to select "Case 1" which was a continuation of the case scenario present on their e-mail. A list of learning objectives was also printed on the e-mail. Students receiving the S-case viewed the same case scenario and objectives, but were not instructed to go to the web-page. All students rotated through two OSCE otitis stations. In the first station they interviewed a simulated patient(OSCE-SP) and counseled her on the management of her 12 month old with otitis. Within that station they viewed a video of a pneumoscopic exam of two ears, one ear with otitis and the other ear normal. At the 2 nd otitis station the student presented the case to a faculty and was asked a series of questions about otitis media(OSCE-PR). Scores on the two stations were compared by group. There were 198 students who took the OSCE. 178 (90%) responded to a survey that indicated they had opened and read the e-mailed case. There were 87 students in the E-group and 91 in the S-group. The mean ±s.d. OSCE-SP station score for the E-group was 72.6 ±12.0 vs 75.4 ±9.8 for the S-group, p=0.09. For the otitis presentation station the scores for the E-group and S-group were respectively, 82.9 ±9.6 and 83.7 ±9.4, p=0.55. These data suggest that enhanced visual distance education cases may offer no distinct advantage over simple paper-type case study guides.

Enhancing Ear and Hearing Health Access for Children With Technology and Connectivity.

PubMed

Swanepoel, De Wet

2017-10-12

Technology and connectivity advances are demonstrating increasing potential to improve access of service delivery to persons with hearing loss. This article demonstrates use cases from community-based hearing screening and automated diagnosis of ear disease. This brief report reviews recent evidence for school- and home-based hearing testing in underserved communities using smartphone technologies paired with calibrated headphones. Another area of potential impact facilitated by technology and connectivity is the use of feature extraction algorithms to facilitate automated diagnosis of most common ear conditions from video-otoscopic images. Smartphone hearing screening using calibrated headphones demonstrated equivalent sensitivity and specificity for school-based hearing screening. Automating test sequences with a forced-choice response paradigm allowed persons with minimal training to offer screening in underserved communities. The automated image analysis and diagnosis system for ear disease demonstrated an overall accuracy of 80.6%, which is up to par and exceeds accuracy rates previously reported for general practitioners and pediatricians. The emergence of these tools that capitalize on technology and connectivity advances enables affordable and accessible models of service delivery for community-based ear and hearing care.

Designing for expansive science learning and identification across settings

NASA Astrophysics Data System (ADS)

Stromholt, Shelley; Bell, Philip

2017-10-01

In this study, we present a case for designing expansive science learning environments in relation to neoliberal instantiations of standards-based implementation projects in education. Using ethnographic and design-based research methods, we examine how the design of coordinated learning across settings can engage youth from non-dominant communities in scientific and engineering practices, resulting in learning experiences that are more relevant to youth and their communities. Analyses highlight: (a) transformative moments of identification for one fifth-grade student across school and non-school settings; (b) the disruption of societal, racial stereotypes on the capabilities of and expectations for marginalized youth; and (c) how youth recognized themselves as members of their community and agents of social change by engaging in personally consequential science investigations and learning.

Optimizing community case management strategies to achieve equitable reduction of childhood pneumonia mortality: An application of Equitable Impact Sensitive Tool (EQUIST) in five low- and middle-income countries.

PubMed

Waters, Donald; Theodoratou, Evropi; Campbell, Harry; Rudan, Igor; Chopra, Mickey

2012-12-01

The aim of this study was to populate the Equitable Impact Sensitive Tool (EQUIST) framework with all necessary data and conduct the first implementation of EQUIST in studying cost-effectiveness of community case management of childhood pneumonia in 5 low- and middle-income countries with relation to equity impact. Wealth quintile-specific data were gathered or modelled for all contributory determinants of the EQUIST framework, namely: under-five mortality rate, cost of intervention, intervention effectiveness, current coverage of intervention and relative disease distribution. These were then combined statistically to calculate the final outcome of the EQUIST model for community case management of childhood pneumonia: US$ per life saved, in several different approaches to scaling-up. The current 'mainstream' approach to scaling-up of interventions is never the most cost-effective. Community-case management appears to strongly support an 'equity-promoting' approach to scaling-up, displaying the highest levels of cost-effectiveness in interventions targeted at the poorest quintile of each study country, although absolute cost differences vary by context. The relationship between cost-effectiveness and equity impact is complex, with many determinants to consider. One important way to increase intervention cost-effectiveness in poorer quintiles is to improve the efficiency and quality of delivery. More data are needed in all areas to increase the accuracy of EQUIST-based estimates.

Sustaining health education research programs in Aboriginal communities.

PubMed

Wisener, Katherine; Shapka, Jennifer; Jarvis-Selinger, Sandra

2017-09-01

Despite evidence supporting the ongoing provision of health education interventions in First Nations communities, there is a paucity of research that specifically addresses how these programs should be designed to ensure sustainability and long-term effects. Using a Community-Based Research approach, a collective case study was completed with three Canadian First Nations communities to address the following research question: What factors are related to sustainable health education programs, and how do they contribute to and/or inhibit program success in an Aboriginal context? Semi-structured interviews and a sharing circle were completed with 19 participants, including members of community leadership, external partners, and program staff and users. Seven factors were identified to either promote or inhibit program sustainability, including: 1) community uptake; 2) environmental factors; 3) stakeholder awareness and support; 4) presence of a champion; 5) availability of funding; 6) fit and flexibility; and 7) capacity and capacity building. Each factor is provided with a working definition, influential moderators, and key evaluation questions. This study is grounded in, and builds on existing research, and can be used by First Nations communities and universities to support effective sustainability planning for community-based health education interventions.

Integrated cluster- and case-based surveillance for detecting stage III zoonotic pathogens: an example of Nipah virus surveillance in Bangladesh.

PubMed

Naser, A M; Hossain, M J; Sazzad, H M S; Homaira, N; Gurley, E S; Podder, G; Afroj, S; Banu, S; Rollin, P E; Daszak, P; Ahmed, B-N; Rahman, M; Luby, S P

2015-07-01

This paper explores the utility of cluster- and case-based surveillance established in government hospitals in Bangladesh to detect Nipah virus, a stage III zoonotic pathogen. Physicians listed meningo-encephalitis cases in the 10 surveillance hospitals and identified a cluster when ⩾2 cases who lived within 30 min walking distance of one another developed symptoms within 3 weeks of each other. Physicians collected blood samples from the clustered cases. As part of case-based surveillance, blood was collected from all listed meningo-encephalitis cases in three hospitals during the Nipah season (January-March). An investigation team visited clustered cases' communities to collect epidemiological information and blood from the living cases. We tested serum using Nipah-specific IgM ELISA. Up to September 2011, in 5887 listed cases, we identified 62 clusters comprising 176 encephalitis cases. We collected blood from 127 of these cases. In 10 clusters, we identified a total of 62 Nipah cases: 18 laboratory-confirmed and 34 probable. We identified person-to-person transmission of Nipah virus in four clusters. From case-based surveillance, we identified 23 (4%) Nipah cases. Faced with thousands of encephalitis cases, integrated cluster surveillance allows targeted deployment of investigative resources to detect outbreaks by stage III zoonotic pathogens in resource-limited settings.

Airborne bacterial assemblage in a zero carbon building: A case study.

PubMed

Leung, M H Y; Tong, X; Tong, J C K; Lee, P K H

2018-01-01

Currently, there is little information pertaining to the airborne bacterial communities of green buildings. In this case study, the air bacterial community of a zero carbon building (ZCB) in Hong Kong was characterized by targeting the bacterial 16S rRNA gene. Bacteria associated with the outdoor environment dominated the indoor airborne bacterial assemblage, with a modest contribution from bacteria associated with human skin. Differences in overall community diversity, membership, and composition associated with short (day-to-day) and long-term temporal properties were detected, which may have been driven by specific environmental genera and taxa. Furthermore, time-decay relationships in community membership (based on unweighted UniFrac distances) and composition (based on weighted UniFrac distances) differed depending on the season and sampling location. A Bayesian source-tracking approach further supported the importance of adjacent outdoor air bacterial assemblage in sourcing the ZCB indoor bioaerosol. Despite the unique building attributes, the ZCB microbial assemblage detected and its temporal characteristics were not dissimilar to that of conventional built environments investigated previously. Future controlled experiments and microbial assemblage investigations of other ZCBs will undoubtedly uncover additional knowledge related to how airborne bacteria in green buildings may be influenced by their distinctive architectural attributes. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Engaging stakeholder communities as body image intervention partners: The Body Project as a case example.

PubMed

Becker, Carolyn Black; Perez, Marisol; Kilpela, Lisa Smith; Diedrichs, Phillippa C; Trujillo, Eva; Stice, Eric

2017-04-01

Despite recent advances in developing evidence-based psychological interventions, substantial changes are needed in the current system of intervention delivery to impact mental health on a global scale (Kazdin & Blase, 2011). Prevention offers one avenue for reaching large populations because prevention interventions often are amenable to scaling-up strategies, such as task-shifting to lay providers, which further facilitate community stakeholder partnerships. This paper discusses the dissemination and implementation of the Body Project, an evidence-based body image prevention program, across 6 diverse stakeholder partnerships that span academic, non-profit and business sectors at national and international levels. The paper details key elements of the Body Project that facilitated partnership development, dissemination and implementation, including use of community-based participatory research methods and a blended train-the-trainer and task-shifting approach. We observed consistent themes across partnerships, including: sharing decision making with community partners, engaging of community leaders as gatekeepers, emphasizing strengths of community partners, working within the community's structure, optimizing non-traditional and/or private financial resources, placing value on cost-effectiveness and sustainability, marketing the program, and supporting flexibility and creativity in developing strategies for evolution within the community and in research. Ideally, lessons learned with the Body Project can be generalized to implementation of other body image and eating disorder prevention programs. Copyright © 2015 Elsevier Ltd. All rights reserved.

Use of an Internet-based community surveillance network to predict seasonal communicable disease morbidity.

PubMed

Hammond, Lucinda; Papadopoulos, Spyridon; Johnson, Candice F; MaWhinney, Samantha; Nelson, Bernard; Todd, James K

2002-03-01

We designed an Internet-based surveillance network that linked community clinic diagnoses with viral isolation rates and admission patterns at a related children's hospital. We hypothesized that community surveillance would successfully predict subsequent hospital admissions and laboratory viral isolations. Secondarily, we expected the network to monitor trends in disease and that posting this information on a Web site would be useful to physicians in daily practice. Data were collected from December 1999 through August 2000. Information was summarized and posted weekly on a Web site. Active public piloting of the site took place during August 2000, after which the project was evaluated through an electronic mail survey. The predictive ability of the community surveillance data was evaluated by multivariate linear regression. Increases in the community diagnosis of most syndromes under surveillance, including lower respiratory infections (adjusted R(2) = 0.7086) and gastroenteritis (adjusted R(2) = 0.6532) successfully predicted an increase in subsequent hospital admissions. Community surveillance also successfully predicted laboratory isolation of associated viral organisms. Physicians completing the evaluation (N = 11) indicated that the site provided information useful in daily practice for both physician and parent education. An Internet-based surveillance network linking a hospital with community physicians is beneficial to the hospital in predicting waves of severe cases requiring admission and reciprocally provides useful information to physicians in daily practice regarding the incidence and cause of seasonal disease in the community.

How community action, science and common sense can work together to develop an alternative way to combat desertification.

PubMed

Bethune, Shirley; Schachtschneider, Klaudia

2004-12-01

The Spitzkoppe Community Campsite in western Namibia lies in an area with very limited water resources. Water scarcity places a constraint on community income generation and development opportunities. The existing water resources are overexploited and to ensure future water security, the community must take sustainable water management into consideration in their daily lives and business ventures, including tourism. This has been successfully achieved at the Spitzkoppe Community Campsite through a combination of high community motivation, organisation and action, the involvement of researchers and trainers in water resource management and support from developers. The most appropriate water management solutions were found through ongoing practical testing of different strategies and technologies over two years. This paper presents a case study of a community-based tourist camp at Spitzkoppe and traces the community's progress towards developing an alternative way to combat desertification and a potentially lucrative tourist business.

A template for integrated community sustainability planning.

PubMed

Ling, Christopher; Hanna, Kevin; Dale, Ann

2009-08-01

This article describes a template for implementing an integrated community sustainability plan. The template emphasizes community engagement and outlines the components of a basic framework for integrating ecological, social and economic dynamics into a community plan. The framework is a series of steps that support a sustainable community development process. While it reflects the Canadian experience, the tools and techniques have applied value for a range of environmental planning contexts around the world. The research is case study based and draws from a diverse range of communities representing many types of infrastructure, demographics and ecological and geographical contexts. A critical path for moving local governments to sustainable community development is the creation and implementation of integrated planning approaches. To be effective and to be implemented, a requisite shift to sustainability requires active community engagement processes, political will, and a commitment to political and administrative accountability, and measurement.

Case study in designing a research fundamentals curriculum for community health workers: a university-community clinic collaboration.

PubMed

Dumbauld, Jill; Kalichman, Michael; Bell, Yvonne; Dagnino, Cynthia; Taras, Howard L

2014-01-01

Community health workers (CHWs) are increasingly incorporated into research teams. Training them in research methodology and ethics, while relating these themes to a community's characteristics, may help to better integrate these health promotion personnel into research teams. An interactive training course on research fundamentals for CHWs was designed and implemented jointly by a community agency serving a primarily Latino, rural population and an academic health center. A focus group of community members and input from community leaders comprised a community-based participatory research model to create three 3-hour interactive training sessions. The resulting curriculum was interactive and successfully stimulated dialogue between trainees and academic researchers. By choosing course activities that elicited community-specific responses into each session's discussion, researchers learned about the community as much as the training course educated CHWs about research. The approach is readily adaptable, making it useful to other communities where CHWs are part of the health system.

75 FR 65355 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-22

... Project Case Studies of Communities and States Funded under Community Activities under the Communities..., system, and environmental changes. Intensive case studies will be conducted with 24 sites: Six ARRA... Act. The case study sites will be selected to include a mix of State or community characteristics...

77 FR 41986 - Division of Nursing, Public Health Nursing Community Based Model of PHN Case Management Services

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-17

... scientific literature related to epidemiology, statistics, surveillance, Healthy People 2020 Objectives, and... eligible projects or activities. This requirement applies whether the delinquency is attributable to the...

OA27 Rural palliative care for low resource settings among marginalised communities in the south indian state of tamilnadu - a new venture with two and a half years of outcome.

PubMed

Thiagarajan, Mohanasundaram

2015-04-01

India with a total of 1.27 Billion (2014) population and over 73% of them are living in rural areas. Cancer remaining as the second cause of death in rural community and at any given time over 4 million cancer cases are living in our country and most of them are diagnosed at their advanced stages and suffering with intractable pain and 'total sufferings'. At present, time available for palliative care services is less than 1% for the needy, it is mostly spread out around the urban areas leaving the remaining 73% of rural sufferers in lack of availability, accessibility, acceptability and affordability. To identify the need for palliative care, in a particular Block of the district, and provide home based total care. Selection of 'Andanallur' village block with a population of nearly 100,000. Sensitisation of the health care staff, village members, self help groups and schools and through the Information, educative and communication methods. Conduction of a primary survey to identify the needy Examination and short listing cases for home based Palliative care Home based palliative care The project was started in 2011 January and 156 cases short listed; 121 cases started with home care and 52 cases had passed away, 8 cases were given end of life care. Palliative care reaching the sufferers directly Reaching the unreachable and under-privileged Need based 'total care' at their door steps Empowering and training the family members. © 2015, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A falls case summary: Application of the public health nursing intervention wheel.

PubMed

Leahy-Warren, Patricia; Day, Mary Rose; Philpott, Lloyd; Glavin, Kari; Gjevjon, Edith Roth; Steffenak, Anne Kjersti Myhrene; Nordhagen, Live S; Egge, Hilde; Healy, Elizabeth; Mulcahy, Helen

2018-04-20

The Public Health Intervention Wheel (PHIW) is a population-based practice model that encompasses three levels of practice (community, systems, and individual/family) and 17 public health interventions. Each intervention and practice level contributes to improving population health. Public health nurses (PHNs) provide care at the three levels of practice. Prevention of falls is a public health issue and the majority of falls happen at home. Therefore, prevention and management of falls in the community could benefit from a public health systems approach by PHNs underpinned by the PHIW. A hypothetical case is presented of a 78-year-old gentleman who had a fall which resulted in a fractured right acetabulum and surgery before being discharged home. The aim of this paper was to use a case summary to illustrate PHN practice in the context of the PHIW as applied to falls management and prevention. This paper focuses on fall incidence and PHN response in Ireland and Norway. The PHIW is described and relevant interventions from the PHIW are applied to PHN practice in managing the case. The PHIW model provides insight into the potential scope of public health nursing in falls, articulating PHN practice in the community. © 2018 Wiley Periodicals, Inc.

Fast Fragmentation of Networks Using Module-Based Attacks

PubMed Central

Requião da Cunha, Bruno; González-Avella, Juan Carlos; Gonçalves, Sebastián

2015-01-01

In the multidisciplinary field of Network Science, optimization of procedures for efficiently breaking complex networks is attracting much attention from a practical point of view. In this contribution, we present a module-based method to efficiently fragment complex networks. The procedure firstly identifies topological communities through which the network can be represented using a well established heuristic algorithm of community finding. Then only the nodes that participate of inter-community links are removed in descending order of their betweenness centrality. We illustrate the method by applying it to a variety of examples in the social, infrastructure, and biological fields. It is shown that the module-based approach always outperforms targeted attacks to vertices based on node degree or betweenness centrality rankings, with gains in efficiency strongly related to the modularity of the network. Remarkably, in the US power grid case, by deleting 3% of the nodes, the proposed method breaks the original network in fragments which are twenty times smaller in size than the fragments left by betweenness-based attack. PMID:26569610

Assessing participatory practices in community-based natural resource management: experiences in community engagement from southern Africa.

PubMed

Dyer, J; Stringer, L C; Dougill, A J; Leventon, J; Nshimbi, M; Chama, F; Kafwifwi, A; Muledi, J I; Kaumbu, J-M K; Falcao, M; Muhorro, S; Munyemba, F; Kalaba, G M; Syampungani, S

2014-05-01

The emphasis on participatory environmental management within international development has started to overcome critiques of traditional exclusionary environmental policy, aligning with shifts towards decentralisation and community empowerment. However, questions are raised regarding the extent to which participation in project design and implementation is meaningful and really engages communities in the process. Calls have been made for further local-level (project and community-scale) research to identify practices that can increase the likelihood of meaningful community engagement within externally initiated projects. This paper presents data from three community-based natural resource management (CBNRM) project case studies from southern Africa, which promote Joint Forest Management (JFM), tree planting for carbon and conservation agriculture. Data collection was carried out through semi-structured interviews with key stakeholders, community-level meetings, focus groups and interviews. We find that an important first step for a meaningful community engagement process is to define 'community' in an open and participatory manner. Two-way communication at all stages of the community engagement process is shown to be critical, and charismatic leadership based on mutual respect and clarity of roles and responsibilities is vital to improve the likelihood of participants developing understanding of project aims and philosophy. This can lead to successful project outcomes through community ownership of the project goals and empowerment in project implementation. Specific engagement methods are found to be less important than the contextual and environmental factors associated with each project, but consideration should be given to identifying appropriate methods to ensure community representation. Our findings extend current thinking on the evaluation of participation by making explicit links between the community engagement process and project outcomes, and by identifying further criteria that can be considered in process and outcome-based evaluations. We highlight good practices for future CBNRM projects which can be used by project designers and initiators to further the likelihood of successful project outcomes. Copyright © 2014. Published by Elsevier Ltd.

A comprehensive grid to evaluate case management's expected effectiveness for community-dwelling frail older people: results from a multiple, embedded case study.

PubMed

Van Durme, Thérèse; Schmitz, Olivier; Cès, Sophie; Anthierens, Sibyl; Maggi, Patrick; Delye, Sam; De Almeida Mello, Johanna; Declercq, Anja; Macq, Jean; Remmen, Roy; Aujoulat, Isabelle

2015-06-18

Case management is a type of intervention expected to improve the quality of care and therefore the quality of life of frail, community-dwelling older people while delaying institutionalisation in nursing homes. However, the heterogeneity, multidimensionality and complexity of these interventions make their evaluation by the means of classical approaches inadequate. Our objective was twofold: (i) to propose a tool allowing for the identification of the key components that explain the success of case management for this population and (ii) to propose a typology based on the results of this tool. The process started with a multiple embedded case study design in order to identify the key components of case management. Based on the results of this first step, data were collected among 22 case management interventions, in order to evaluate their expected effectiveness. Finally, multiple correspondence analyses was conducted to propose a typology of case management. The overall approach was informed by Wagner's Chronic Care Model and the theory of complexity. The study identified a total of 23 interacting key components. Based on the clustering of response patterns of the 22 case management projects included in our study, three types of case management programmes were evidenced, situated on a continuum from a more "socially-oriented" type towards a more "clinically-oriented" type of case management. The type of feedback provided to the general practitioner about both the global geriatric assessment and the result of the intervention turned out to be the most discriminant component between the types. The study design allowed to produce a tool that can be used to distinguish between different types of case management interventions and further evaluate their effect on frail older people in terms of the delaying institutionalisation, functional and cognitive status, quality of life and societal costs.

Evaluating Hospital-Based Surveillance for Outbreak Detection in Bangladesh: Analysis of Healthcare Utilization Data

PubMed Central

Nikolay, Birgit; Salje, Henrik; Sturm-Ramirez, Katharine; Azziz-Baumgartner, Eduardo; Homaira, Nusrat; Iuliano, A. Danielle; Paul, Repon C.; Hossain, M. Jahangir; Cauchemez, Simon; Gurley, Emily S.

2017-01-01

Background The International Health Regulations outline core requirements to ensure the detection of public health threats of international concern. Assessing the capacity of surveillance systems to detect these threats is crucial for evaluating a country’s ability to meet these requirements. Methods and Findings We propose a framework to evaluate the sensitivity and representativeness of hospital-based surveillance and apply it to severe neurological infectious diseases and fatal respiratory infectious diseases in Bangladesh. We identified cases in selected communities within surveillance hospital catchment areas using key informant and house-to-house surveys and ascertained where cases had sought care. We estimated the probability of surveillance detecting different sized outbreaks by distance from the surveillance hospital and compared characteristics of cases identified in the community and cases attending surveillance hospitals. We estimated that surveillance detected 26% (95% CI 18%–33%) of severe neurological disease cases and 18% (95% CI 16%–21%) of fatal respiratory disease cases residing at 10 km distance from a surveillance hospital. Detection probabilities decreased markedly with distance. The probability of detecting small outbreaks (three cases) dropped below 50% at distances greater than 26 km for severe neurological disease and at distances greater than 7 km for fatal respiratory disease. Characteristics of cases attending surveillance hospitals were largely representative of all cases; however, neurological disease cases aged <5 y or from the lowest socioeconomic group and fatal respiratory disease cases aged ≥60 y were underrepresented. Our estimates of outbreak detection rely on suspected cases that attend a surveillance hospital receiving laboratory confirmation of disease and being reported to the surveillance system. The extent to which this occurs will depend on disease characteristics (e.g., severity and symptom specificity) and surveillance resources. Conclusion We present a new approach to evaluating the sensitivity and representativeness of hospital-based surveillance, making it possible to predict its ability to detect emerging threats. PMID:28095468

Quality Audit in the Fastener Industry

NASA Technical Reports Server (NTRS)

Reagan, John R.

1995-01-01

Both the financial and quality communities rely on audits to verify customers records. The financial community is highly structured around three categories of risk, INHERENT RISK, CONTROL RISK, and DETECTION RISK. Combined, the product of these three categories constitute the AUDIT RISK. The financial community establishes CONTROL RISK based in large part on a systems level understanding of the process flow. This system level understanding is best expressed in a flowchart. The quality community may be able to adopt this structure and thereby reduce cost while maintaining and enhancing quality. The quality community should attempt to flowchart the systems level quality process before beginning substantive testing. This theory needs to be applied in several trial cases to prove or disprove this hypothesis

Quality audit in the fastener industry

NASA Astrophysics Data System (ADS)

Reagan, John R.

1995-09-01

Both the financial and quality communities rely on audits to verify customers records. The financial community is highly structured around three categories of risk, INHERENT RISK, CONTROL RISK, and DETECTION RISK. Combined, the product of these three categories constitute the AUDIT RISK. The financial community establishes CONTROL RISK based in large part on a systems level understanding of the process flow. This system level understanding is best expressed in a flowchart. The quality community may be able to adopt this structure and thereby reduce cost while maintaining and enhancing quality. The quality community should attempt to flowchart the systems level quality process before beginning substantive testing. This theory needs to be applied in several trial cases to prove or disprove this hypothesis

What community-level strategies are needed to secure women’s property rights in Western Kenya? Laying the groundwork for a future structural HIV prevention intervention

PubMed Central

Dworkin, Shari L.; Lu, Tiffany; Grabe, Shelly; Kwena, Zachary; Mwaura-Muiru, Esther; Bukusi, Elizabeth

2014-01-01

Despite the recognized need for structural-level HIV prevention interventions that focus on economic empowerment to reduce women’s HIV risks, few science-based programs have focused on securing women’s land ownership as a primary or secondary HIV risk reduction strategy. The current study focused on a community-led land and property rights model that was implemented in two rural areas of western Kenya where HIV prevalence was high (24–30%) and property rights violations were common. The program was designed to reduce women’s HIV risk at the community level by protecting and enhancing women’s access to and ownership of land. Through in-depth interviews with 50 program leaders and implementers of this program we sought to identify the strategies that were used to prevent, mediate, and resolve property rights violations. Results included four strategies: (1) rights-based education of both women and men individually and at the community level, (2) funeral committees that intervene to prevent property grabbing and disinheritance, (3) paralegal training of traditional leaders and community members and local adjudication of cases of property rights violations, and (4) referring property rights violations to the formal justice system when these are not resolved at the community level. Study participants underscored that local mediation of cases resulted in a higher success rate than women experienced in the formal court system, underscoring the importance of community-level solutions to property rights violations. The current study assists researchers in understanding the steps needed to prevent and resolve women’s property rights violations so as to bolster the literature on potential structural HIV prevention interventions. Future research should rigorously test property rights programs as a structural HIV prevention intervention. PMID:24116828

The hidden costs: Identification of indirect costs associated with acute gastrointestinal illness in an Inuit community.

PubMed

King, Nia; Vriezen, Rachael; Edge, Victoria L; Ford, James; Wood, Michele; Harper, Sherilee

2018-01-01

Acute gastrointestinal illness (AGI) incidence and per-capita healthcare expenditures are higher in some Inuit communities as compared to elsewhere in Canada. Consequently, there is a demand for strategies that will reduce the individual-level costs of AGI; this will require a comprehensive understanding of the economic costs of AGI. However, given Inuit communities' unique cultural, economic, and geographic contexts, there is a knowledge gap regarding the context-specific indirect costs of AGI borne by Inuit community members. This study aimed to identify the major indirect costs of AGI, and explore factors associated with these indirect costs, in the Inuit community of Rigolet, Canada, in order to develop a case-based context-specific study framework that can be used to evaluate these costs. A mixed methods study design and community-based methods were used. Qualitative in-depth, group, and case interviews were analyzed using thematic analysis to identify and describe indirect costs of AGI specific to Rigolet. Data from two quantitative cross-sectional retrospective surveys were analyzed using univariable regression models to examine potential associations between predictor variables and the indirect costs. The most notable indirect costs of AGI that should be incorporated into cost-of-illness evaluations were the tangible costs related to missing paid employment and subsistence activities, as well as the intangible costs associated with missing community and cultural events. Seasonal cost variations should also be considered. This study was intended to inform cost-of-illness studies conducted in Rigolet and other similar research settings. These results contribute to a better understanding of the economic impacts of AGI on Rigolet residents, which could be used to help identify priority areas and resource allocation for public health policies and programs.

What community-level strategies are needed to secure women's property rights in Western Kenya? Laying the groundwork for a future structural HIV prevention intervention.

PubMed

Dworkin, Shari L; Lu, Tiffany; Grabe, Shelly; Kwena, Zachary; Mwaura-Muiru, Esther; Bukusi, Elizabeth

2014-01-01

Despite the recognized need for structural-level HIV prevention interventions that focus on economic empowerment to reduce women's HIV risks, few science-based programs have focused on securing women's land ownership as a primary or secondary HIV risk reduction strategy. The current study focused on a community-led land and property rights model that was implemented in two rural areas of western Kenya where HIV prevalence was high (24-30%) and property rights violations were common. The program was designed to reduce women's HIV risk at the community level by protecting and enhancing women's access to and ownership of land. Through in-depth interviews with 50 program leaders and implementers of this program we sought to identify the strategies that were used to prevent, mediate, and resolve property rights violations. Results included four strategies: (1) rights-based education of both women and men individually and at the community level, (2) funeral committees that intervene to prevent property grabbing and disinheritance, (3) paralegal training of traditional leaders and community members and local adjudication of cases of property rights violations, and (4) referring property rights violations to the formal justice system when these are not resolved at the community level. Study participants underscored that local mediation of cases resulted in a higher success rate than women experienced in the formal court system, underscoring the importance of community-level solutions to property rights violations. The current study assists researchers in understanding the steps needed to prevent and resolve women's property rights violations so as to bolster the literature on potential structural HIV prevention interventions. Future research should rigorously test property rights programs as a structural HIV prevention intervention.

The Crosstown initiative: art, community, and placemaking in Memphis.

PubMed

Thomas, Elizabeth; Pate, Sarah; Ranson, Anna

2015-03-01

This case study examines an arts organization at the center of an urban neighborhood revitalization effort and its contributions to creative placemaking and inclusive community building. The study documents innovative arts practices and explores their meaning for a local context, an understudied city in the Mid-South region of the United States. It builds on the research team's ongoing work as teachers, students, and scholars in partnership with the arts organization. It includes systematic participant observation, interviews with stakeholders, and a review of historical and contemporary media coverage. We found that the organization and its practices provided a rich context for exploring an expanded sense of community including bridging social capital and place-based frameworks. Analysis suggests that the organization's intentional arts based practices bring multiple understandings of community and art into meaningful dialogue through the generation of creative and social friction. These practices illustrate one context-specific strategy addressing the tensions in a community-diversity dialectic (Townley et al. in Am J Commun Psychol 47:69-85, 2011).

The self-built ecovillage in L'Aquila, Italy: community resilience as a grassroots response to environmental shock.

PubMed

Fois, Francesca; Forino, Giuseppe

2014-10-01

The paper applies the community resilience approach to the post-disaster case of Pescomaggiore, an Italian village affected by the L'Aquila earthquake in 2009. A group of residents refused to accept the housing recovery solutions proposed by the government, opting for autonomous recovery. They developed a housing project in the form of a self-built ecovillage, characterised by earthquake-proof buildings made of straw and wood. The project is a paradigmatic example of a community-based response to an external shock. It illustrates the concept of 'community resilience', which is widely explored in the scientific debate but still vaguely defined. Based on qualitative methodologies, the paper seeks to understand how the community resilience process can be enacted in alternative social practices such as ecovillages. The goal is to see under which conditions natural disasters can be considered windows of opportunity for sustainability. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

The Business Case for Palliative Care: Translating Research Into Program Development in the U.S.

PubMed

Cassel, J Brian; Kerr, Kathleen M; Kalman, Noah S; Smith, Thomas J

2015-12-01

Specialist palliative care (PC) often embraces a "less is more" philosophy that runs counter to the revenue-centric nature of most health care financing in the U.S. A special business case is needed in which the financial benefits for organizations such as hospitals and payers are aligned with the demonstrable clinical benefits for patients. Based on published studies and our work with PC programs over the past 15 years, we identified 10 principles that together form a business model for specialist PC. These principles are relatively well established for inpatient PC but are only now emerging for community-based PC. Three developments that are key for the latter are the increasing penalties from payers for overutilization of hospital stays, the variety of alternative payment models such as accountable care organizations, which foster a population health management perspective, and payer-provider partnerships that allow for greater access to and funding of community-based PC. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Teaching Excellence and Innovative Practices: A Case Study of National Awardee Teachers of India

ERIC Educational Resources Information Center

Sengupta, Aparajita; Tyagi, Harish Kumar

2016-01-01

Aim: The study intended to identify the contributions of the National awardee teachers to the teaching learning process through their teaching excellence and innovative practices which can act as exemplary model for the entire teaching community. Method: Attempts has been made to carry out a qualitative study where two selected cases are based on…

Exploring the Experiences of Successful Completers of a System of Care for Children and Their Families through Case Narratives

ERIC Educational Resources Information Center

Anderson, Jeffrey A.; McIntyre, Janet S.; Somers, John W.

2004-01-01

This paper explores the experiences of three young people with emotional and behavioral challenges and their families as they entered, participated in, and completed a community-based system of care. Using a case narrative approach, the characteristics and experiences of the children and families who successfully completed the Dawn Project system…

A Standardized Certification Program for Case Managers Serving Frail Elderly Texans. Module II: Assessment and Care Plan Development.

ERIC Educational Resources Information Center

Lusky, Richard A.; And Others

This learning module is one of three training modules that were developed for members of the Texas Gerontological Consortium for Continuing Education to use in preparing case managers working in human service professions coordinating community-based programs for frail elderly Texans. Module II deals with the following topics: assessment (role of…

Culturally Responsive Peace Education: A Case Study at One Urban Latino K-8 Catholic School

ERIC Educational Resources Information Center

Buck, Brandon

2016-01-01

This paper presents a case study of a yearlong research-based peace education program at one urban K-8 private Catholic school situated in a community plagued by structural violence in an enclave of a large Midwestern city. To frame the analysis, the author employs concepts central to culturally responsive pedagogy (including cultural competence,…

Leadership for Primary Health Care. Levels, Functions, and Requirements Based on Twelve Case Studies. Public Health Papers No. 82.

ERIC Educational Resources Information Center

Flahault, Daniel; Roemer, Milton I.

This book considers the role of and the need for primary health care leadership, drawing upon case studies and research from the World Health Organization (WHO) communities. The differing levels and functions of leadership in primary health care are delineated, with particular emphasis given to regarding the leadership concept as "effective…

Morality as the Substructure of Social Justice: Religion in Education as a Case in Point

ERIC Educational Resources Information Center

Potgieter, Ferdinand J.

2011-01-01

Moral issues and principles do not only emerge in cases of conflict among, for instance, religious communities or political parties; indeed they form the moral substructure of notions of social justice. During periods of conflict each opponent claims justice for his/her side and bases the claim on certain principles. In this article, reference is…

Exploring Adult Basic Education--Quality Services with Limited Funding: Qualitative Multiple Case Study

ERIC Educational Resources Information Center

Calaf, Dolores C.

2017-01-01

English for Speakers of Other Languages (ESOL) classes are in great demand by immigrant adults in the Boston area. The problem investigated in this study was the limited funding to implement ESOL programs in Boston, which has resulted in waiting lists for many contracted community-based programs. The purpose of this qualitative multiple case study…

Development of a virtual multidisciplinary lung cancer tumor board in a community setting.

PubMed

Stevenson, Marvaretta M; Irwin, Tonia; Lowry, Terry; Ahmed, Maleka Z; Walden, Thomas L; Watson, Melanie; Sutton, Linda

2013-05-01

Creating an effective platform for multidisciplinary tumor conferences can be challenging in the rural community setting. The Duke Cancer Network created an Internet-based platform for a multidisciplinary conference to enhance the care of patients with lung cancer. This conference incorporates providers from different physical locations within a rural community and affiliated providers from a university-based cancer center 2 hours away. An electronic Web conferencing tool connects providers aurally and visually. Conferences were set up using a commercially available Web conferencing platform. The video platform provides a secure Web site coupled with a secure teleconference platform to ensure patient confidentiality. Multiple disciplines are invited to participate, including radiology, radiation oncology, thoracic surgery, pathology, and medical oncology. Participants only need telephone access and Internet connection to participate. Patient histories and physicals are presented, and the Web conferencing platform allows radiologic and histologic images to be reviewed. Treatment plans for patients are discussed, allowing providers to coordinate care among the different subspecialties. Patients who need referral to the affiliated university-based cancer center for specialized services are identified. Pertinent treatment guidelines and journal articles are reviewed. On average, there are 10 participants with one to two cases presented per session. The use of a Web conferencing platform allows subspecialty providers throughout the community and hours away to discuss lung cancer patient cases. This platform increases convenience for providers, eliminating travel to a central location. Coordination of care for patients requiring multidisciplinary care is facilitated, shortening evaluation time before definitive treatment plan.

An academic, business, and community alliance to promote evidence-based public health policy: the case of primary seat belt legislation.

PubMed

Goldzweig, Irwin A; Schlundt, David G; Moore, Wayne E; Smith, Patricia E; Zoorob, Roger J; Levine, Robert S

2013-08-01

An academic, business, and community alliance comprising 285 organizations, including 43 national groups represented on a Blue Ribbon Panel organized by the U.S. Secretary of Transportation, targeted Arkansas, Florida, Mississippi, Minnesota, Tennessee, and Wisconsin for high involvement/intervention consisting of community organization and other political action to support passage of primary seat belt laws. State-level alliance activities began in January 2003. All six states enacted a primary seat belt law between 2004 and 2009. From January 2003 to May 2010, passage of primary legislation was 4.5 times as likely (95% CI 1.90, 10.68) in states with high versus low alliance involvement. Positive interaction between high alliance involvement and offers of federal incentives may have occurred as well. This evidence of success suggests that academic-business-community alliances for action to promote evidence-based public health policy may be effective.

Resiliency and affordability of housing design, Kampong Cieunteung-Bale Endah in Bandung Regency as a case study

NASA Astrophysics Data System (ADS)

Nurdini, Allis; Yovita, Wanda; Negri, Patriot

2017-12-01

Recently the discussion about resiliency and housing design has been fast developed, including design for housing on riverfront as marginal area that usually occupied by low income people. The low income people generally will be the worst affected community in flood disaster situation, because of their un-affordability to achieve quality housing design. In other side, the funding support capacity especially from the local government is limited, so that the resilient environment also need to be supported by the community itself. In this context, the study about low income people's affordability to achieve resilient housing design is essential. This study was conducted to identify two important points: the design choice and the affordability level of resilient housing from the community viewpoints. Kampong Cieunteung, in Bale Endah Area, Bandung Regency is chosen as a case study, because this area annually experience severe flood from overflow of the Citarum River branch. In preliminary research phase, approximately 60% of the Kampong Cieunteung's resident need to stay and become indication that the community need resilient housing design to accommodate their live hood. The next phase, the contingent valuation method was implemented to gain resilient design choice and affordability perspective from the community. It is concluded that the community have ability to choose the resilient housing design based on their aspiration and based on their ability to pay. The result indicates that resilient housing design should have character of optional, module co-operational, and incremental to be afforded by the low income people.

Trachoma and Relative Poverty: A Case-Control Study.

PubMed

Habtamu, Esmael; Wondie, Tariku; Aweke, Sintayehu; Tadesse, Zerihun; Zerihun, Mulat; Zewdie, Zebideru; Callahan, Kelly; Emerson, Paul M; Kuper, Hannah; Bailey, Robin L; Mabey, David C W; Rajak, Saul N; Polack, Sarah; Weiss, Helen A; Burton, Matthew J

2015-11-01

Trachoma is widely considered a disease of poverty. Although there are many epidemiological studies linking trachoma to factors normally associated with poverty, formal quantitative data linking trachoma to household economic poverty within endemic communities is very limited. Two hundred people with trachomatous trichiasis were recruited through community-based screening in Amhara Region, Ethiopia. These were individually matched by age and gender to 200 controls without trichiasis, selected randomly from the same sub-village as the case. Household economic poverty was measured through (a) A broad set of asset-based wealth indicators and relative household economic poverty determined by principal component analysis (PCA, (b) Self-rated wealth, and (c) Peer-rated wealth. Activity participation data were collected using a modified 'Stylised Activity List' developed for the World Bank's Living Standards Measurement Survey. Trichiasis cases were more likely to belong to poorer households by all measures: asset-based analysis (OR = 2.79; 95%CI: 2.06-3.78; p<0.0001), self-rated wealth (OR, 4.41, 95%CI, 2.75-7.07; p<0.0001) and peer-rated wealth (OR, 8.22, 95% CI, 4.59-14.72; p<0.0001). Cases had less access to latrines (57% v 76.5%, p = <0.0001) and higher person-to-room density (4.0 v 3.31; P = 0.0204) than the controls. Compared to controls, cases were significantly less likely to participate in economically productive activities regardless of visual impairment and other health problems, more likely to report difficulty in performing activities and more likely to receive assistance in performing productive activities. This study demonstrated a strong association between trachomatous trichiasis and relative poverty, suggesting a bidirectional causative relationship possibly may exist between poverty and trachoma. Implementation of the full SAFE strategy in the context of general improvements might lead to a virtuous cycle of improving health and wealth. Trachoma is a good proxy of inequality within communities and it could be used to target and evaluate interventions for health and poverty alleviation.

Sex differences in case fatality before and after admission to hospital after acute cardiac events: analysis of community based coronary heart disease register.

PubMed Central

Sonke, G. S.; Beaglehole, R.; Stewart, A. W.; Jackson, R.; Stewart, F. M.

1996-01-01

OBJECTIVE: To determine whether the reported higher case fatality in hospital after an acute cardiac event in women can be explained by sex differences in mortality before admission and in baseline risk factors. DESIGN: Analyses of data from a community based coronary heart disease register. SETTING: Auckland region, New Zealand. SUBJECTS: 5106 patients aged 25-64 years with an acute cardiac event leading to coronary death or definite myocardial infarction within 28 days of onset, occurring between 1986 and 1992. MAIN OUTCOME MEASURES: Case fatality before admission, 28 day case fatality for patients in hospital, and total case fatality after an acute cardiac event. RESULTS: Despite a more unfavourable risk profile women tended to have lower case fatality before admission than men (crude odds ratio 0.88; 95% confidence interval 0.77 to 1.02). Adjustment for age, living arrangements, smoking, medical history, and treatment increased the effect of sex (0.72; 0.60 to 0.86). After admission to hospital, women had a higher case fatality than men (1.76; 1.43 to 2.17), but after adjustment for confounders this was reduced to 1.18 (0.89 to 1.58). Total case fatality 28 days after an acute cardiac event showed no significant difference between men and women (0.85; 0.70 to 1.02) CONCLUSIONS: The higher case fatality after an acute cardiac event in women admitted to hospital is largely explained by differences in living status, history, and medical treatment and is balanced by a lower case fatality before admission. PMID:8870571

Preventing readmissions through comprehensive discharge planning.

PubMed

Hunter, Tabitha; Nelson, James Rex; Birmingham, Jackie

2013-01-01

Case managers, including nurses and social workers, provide essential services to hospitalized patients, including mandated discharge planning that has been shown to impact patient safety and patient outcomes. The heightened attention to readmission is evident in both reimbursement and accreditation initiatives. The Centers for Medicare & Medicaid Services, Office of Clinical Standards & Quality/Survey & Certification Group, is revising worksheets to be used by surveyors to review how hospitals are complying with the Medicare Conditions of Participation with a focus on discharge planning as it relates to patient safety. This is an opportunity for case managers to apply the principles of case management to the targeted problem of readmissions. Now case managers must identify the reasons for readmission on a patient-by-patient basis, collect data, analyze processes, and then change practice in the hospital and work more closely with community-based providers. The purpose of this article is to recommend improvement in a consistent case management practice that will positively influence patient readmissions. Hospital-based case managers who are responsible for discharge planning functions. Hospital administrators will also find this information valuable as a tool to assess strategies to control preventable readmissions and to comply with the Medicare Conditions of Participation for discharge planning. Hospital-based case managers, responsible for discharge planning, have a unique opportunity to interact face-to-face with patients who are readmitted to determine factors that lead to the readmission. Case managers need to change their practice to include assessing patients on the basis of their prior level of care. Pharmacists need to play a bigger role in discharge planning, especially for patients who have experienced a potentially avoidable readmission. Working closely with community-based providers is essential to target reasons for readmission. The Medicare Conditions of Participation for Discharge Planning can be used not only to show compliance but as tools to evaluate current practice and identify areas of improvement. Preventable readmissions or rehospitalizations directly affect patient safety, patient outcome, hospital reimbursement, and hospital accreditation. Preventable readmissions can be controlled by comprehensive discharge planning. Case managers are directly involved in discharge planning and thus have direct accountability regarding readmissions; therefore, they must refine the admission assessment screening to include specific information based on a patient's preadmission level of care. Collaboration with community-based providers is essential to managing readmissions or rehospitalizations. Hospitals will find it beneficial to track readmissions by using specific data points unique to readmissions such as source of admission and previous length of stay. Self-assessment of compliance will help identify opportunities for quality improvement in the case management department. PLEASE NOTE: Rules and regulations are constantly changing. It is critical to monitor changes in standards. Information contained in this article is current at the time of submission, and readers are encouraged to review the content of this article with administration before implementing changes.

Impact of Community-Based DOT on Tuberculosis Treatment Outcomes: A Systematic Review and Meta-Analysis

PubMed Central

Zhang, HaiYang; Ehiri, John; Yang, Huan; Tang, Shenglan; Li, Ying

2016-01-01

Background Poor adherence to tuberculosis (TB) treatment can lead to prolonged infectivity and poor treatment outcomes. Directly observed treatment (DOT) seeks to improve adherence to TB treatment by observing patients while they take their anti-TB medication. Although community-based DOT (CB-DOT) programs have been widely studied and promoted, their effectiveness has been inconsistent. The aim of this study was to critical appraise and summarize evidence of the effects of CB-DOT on TB treatment outcomes. Methods Studies published up to the end of February 2015 were identified from three major international literature databases: Medline/PubMed, EBSCO, and EMBASE. Unpublished data from the grey literature were identified through Google and Google Scholar searches. Results Seventeen studies involving 12,839 pulmonary TB patients (PTB) in eight randomized controlled trials (RCTs) and nine cohort studies from 12 countries met the criteria for inclusion in this review and 14 studies were included in meta-analysis. Compared with clinic-based DOT, pooled results of RCTs for all PTB cases (including smear-negative or -positive, new or retreated TB cases) and smear-positive PTB cases indicated that CB-DOT promoted successful treatment [pooled RRs (95%CIs): 1.11 (1.02–1.19) for all PTB cases and 1.11 (1.02–1.19) for smear-positive PTB cases], and completed treatment [pooled RRs (95%CIs): 1.74(1.05, 2.90) for all PTB cases and 2.22(1.16, 4.23) for smear-positive PTB cases], reduced death [pooled RRs (95%CIs): 0.44 (0.26–0.72) for all PTB cases and 0.39 (0.23–0.66) for smear-positive PTB cases], and transfer out [pooled RRs (95%CIs): 0.37 (0.23–0.61) for all PTB cases and 0.42 (0.25–0.70) for smear-positive PTB cases]. Pooled results of all studies (RCTs and cohort studies) with all PTB cases demonstrated that CB-DOT promoted successful treatment [pooled RR (95%CI): 1.13 (1.03–1.24)] and curative treatment [pooled RR (95%CI): 1.24 (1.04–1.48)] compared with self-administered treatment. Conclusions CB-DOT did improved TB treatment outcomes according to the pooled results of included studies in this review. Studies on strategies for implementation of patient-centered and community-centered CB-DOT deserve further attention. PMID:26849656

Evaluating social and ecological vulnerability of coral reef fisheries to climate change.

PubMed

Cinner, Joshua E; Huchery, Cindy; Darling, Emily S; Humphries, Austin T; Graham, Nicholas A J; Hicks, Christina C; Marshall, Nadine; McClanahan, Tim R

2013-01-01

There is an increasing need to evaluate the links between the social and ecological dimensions of human vulnerability to climate change. We use an empirical case study of 12 coastal communities and associated coral reefs in Kenya to assess and compare five key ecological and social components of the vulnerability of coastal social-ecological systems to temperature induced coral mortality [specifically: 1) environmental exposure; 2) ecological sensitivity; 3) ecological recovery potential; 4) social sensitivity; and 5) social adaptive capacity]. We examined whether ecological components of vulnerability varied between government operated no-take marine reserves, community-based reserves, and openly fished areas. Overall, fished sites were marginally more vulnerable than community-based and government marine reserves. Social sensitivity was indicated by the occupational composition of each community, including the importance of fishing relative to other occupations, as well as the susceptibility of different fishing gears to the effects of coral bleaching on target fish species. Key components of social adaptive capacity varied considerably between the communities. Together, these results show that different communities have relative strengths and weaknesses in terms of social-ecological vulnerability to climate change.