"I cry every day and night, I have my son tied in chains": physical restraint of people with schizophrenia in community settings in Ethiopia.

PubMed

Asher, Laura; Fekadu, Abebaw; Teferra, Solomon; De Silva, Mary; Pathare, Soumitra; Hanlon, Charlotte

2017-07-11

A primary rationale for scaling up mental health services in low and middle-income countries is to address human rights violations, including physical restraint in community settings. The voices of those with intimate experiences of restraint, in particular people with mental illness and their families, are rarely heard. The aim of this study was to understand the experiences of, and reasons for, restraint of people with schizophrenia in community settings in rural Ethiopia in order to develop constructive and scalable interventions. A qualitative study was conducted, involving 15 in-depth interviews and 5 focus group discussions (n = 35) with a purposive sample of people with schizophrenia, their caregivers, community leaders and primary and community health workers in rural Ethiopia. Thematic analysis was used. Most of the participants with schizophrenia and their caregivers had personal experience of the practice of restraint. The main explanations given for restraint were to protect the individual or the community, and to facilitate transportation to health facilities. These reasons were underpinned by a lack of care options, and the consequent heavy family burden and a sense of powerlessness amongst caregivers. Whilst there was pervasive stigma towards people with schizophrenia, lack of awareness about mental illness was not a primary reason for restraint. All types of participants cited increasing access to treatment as the most effective way to reduce the incidence of restraint. Restraint in community settings in rural Ethiopia entails the violation of various human rights, but the underlying human rights issue is one of lack of access to treatment. The scale up of accessible and affordable mental health care may go some way to address the issue of restraint. Clinicaltrials.gov NCT02160249 Registered 3rd June 2014.

Seeking to understand lived experiences of personal recovery in personality disorder in community and forensic settings - a qualitative methods investigation.

PubMed

Shepherd, Andrew; Sanders, Caroline; Shaw, Jenny

2017-08-01

Understandings of personal recovery have emerged as an alternative framework to traditional ideas of clinical progression, or symptom remission, in clinical practice. Most research in this field has focussed on the experience of individuals suffering with psychotic disorders and little research has been conducted to explore the experience of individuals with a personality disorder diagnosis, despite the high prevalence of such difficulties. The nature of the personality disorder diagnosis, together with high prevalence rates in forensic settings, renders the understanding of recovery in these contexts particularly problematic. The current study seeks to map out pertinent themes relating to the recovery process in personality disorder as described by individuals accessing care in either community or forensic settings. Individual qualitative interviews were utilised to explore the lived experience of those receiving a personality disorder diagnosis and accessing mental health care in either community or forensic settings. A thematic analysis was conducted to identify shared concepts and understanding between participants. Fourty-one individual participant interviews were conducted across forensic and community settings. Recovery was presented by participants as a developing negotiated understanding of the self, together with looked for change and hope in the future. Four specific themes emerged in relation to this process: 1. Understanding early lived experience as informing sense of self 2. Developing emotional control 3. Diagnosis as linking understanding and hope for change 4. The role of mental health services. Through considering personal recovery in personality disorder as a negotiated understanding between the individual, their social networks and professionals this study illustrates the complexity of working through such a process. Clarity of understanding in this area is essential to avoid developing resistance in the recovery process. Understanding of recovery in a variety of diagnostic categories and social settings is essential if a truly recovery orientated mental health service is to be developed.

Toward a Definition of a Community Choir

ERIC Educational Resources Information Center

Bell, Cindy L.

2008-01-01

Community choirs in America furnish the primary musical setting for adult amateur singers wishing to continue their choral experiences after formal public schooling or college. Nearly 1400 community choral organizations--or those meeting the established parameters--were catalogued by ACDA for its 2007 "National Registry of Community Choirs". A…

What Do Pediatric Residents Gain From an Experience in Juvenile Justice? A Qualitative Analysis of Community-Based Learning.

PubMed

Hanson, Elizabeth R; Finley, Erin P; Petershack, Jean A

2017-04-01

Training in advocacy and community pediatrics often involves the use of community site visits. However, data on the specific knowledge, skills, and attitudes gained from these experiences are limited. In this study we used qualitative analysis of written narratives to explore the response of residents to a juvenile justice experience. Pediatric residents participated in a week-long experience in the juvenile probation department and completed a written narrative. Narratives were analyzed using grounded theory to explore the effects of this experience on residents' views of youth in the juvenile justice system. Analysis of 29 narratives revealed 13 themes relating to 5 core concepts: social determinants of behavior, role of professionals and institutions, achieving future potential, resolving discrepancies, and distancing. A conceptual model was developed to explore the interactions of these concepts in the resident view of youth in the juvenile justice system. Of the themes only 3 (23%) were related to content explicitly covered in the assigned reading materials. Several important concepts emerged as elements of this experience, many of which were not covered in the explicit curriculum. Variability in attitudinal response to the experience raised important questions about the influence of the ideological framework of the learner and the hidden curriculum on the learning that occurs in community settings. We propose a theoretical model that delineates the factors that influence learning in community settings to guide educators in planning these types of experiences. Copyright © 2016 Academic Pediatric Association. All rights reserved.

The Experience of Community College for Developmental Students: Challenges and Motivations

ERIC Educational Resources Information Center

VanOra, Jason

2012-01-01

This article adds to existing literatures on "developmental students," or those placing into non-credit-bearing reading and/or writing classes, by exploring their own personal experiences of attending community college. The findings of this qualitative study, based on a set of semistructured interviews with 18 developmental students in…

Reflective learning in community-based dental education.

PubMed

Deogade, Suryakant C; Naitam, Dinesh

2016-01-01

Community-based dental education (CBDE) is the implementation of dental education in a specific social context, which shifts a substantial part of dental clinical education from dental teaching institutional clinics to mainly public health settings. Dental students gain additional value from CBDE when they are guided through a reflective process of learning. We propose some key elements to the existing CBDE program that support meaningful personal learning experiences. Dental rotations of 'externships' in community-based clinical settings (CBCS) are year-long community-based placements and have proven to be strong learning environments where students develop good communication skills and better clinical reasoning and management skills. We look at the characteristics of CBDE and how the social and personal context provided in communities enhances dental education. Meaningfulness is created by the authentic context, which develops over a period of time. Structured reflection assignments and methods are suggested as key elements in the existing CBDE program. Strategies to enrich community-based learning experiences for dental students include: Photographic documentation; written narratives; critical incident reports; and mentored post-experiential small group discussions. A directed process of reflection is suggested as a way to increase the impact of the community learning experiences. We suggest key elements to the existing CBDE module so that the context-rich environment of CBDE allows for meaningful relations and experiences for dental students and enhanced learning.

Nurses on a mission: a professional service learning experience with the inner-city homeless.

PubMed

Lashley, Mary

2007-01-01

Nursing students can play a vital role in addressing the health care needs of the homeless. Through professional service learning experiences in community-based settings, students learn how to partner with key community leaders and agencies to meet the needs of underserved populations and provide culturally competent care to diverse populations. This article describes the development of a professional service learning experience with the homeless in which a community-academic partnership was created to meet community needs. In an era of declining health care resources, such innovative partnerships serve to reduce health disparities and improve access to care while preparing students for community-based practice with at-risk and vulnerable populations.

Empowering Students through Service-Learning in a Community Psychology Course: A Case in Hong Kong

ERIC Educational Resources Information Center

Chan, Kevin; Ng, Eddie; Chan, Charles C.

2016-01-01

This article chronicles a service-learning (SL) subject on community psychology in Hong Kong (n = 26) and elaborates on how students experience concepts, frameworks, and values in community psychology and put them into practice at servicelearning settings. Upon acquiring basic concepts in community psychology, including sense of community,…

Dramatic Data: The Possibilities of Ethnodramatic Writing for Understanding the Experiences of English Learners in Community College Settings

ERIC Educational Resources Information Center

Cannon, Anneliese; Blair, Alissa

2014-01-01

In this article, we demonstrate how ethnodramatic writing can offer critically needed insights into the language learning and educational trajectories of a significant yet little researched group of immigrant English learners in community college settings. The participants' reflections and impressions about learning English and about U.S. culture…

Setting up a clinical trial for a novel disease: a case study of the Doxycycline for the Treatment of Nodding Syndrome Trial – challenges, enablers and lessons learned

PubMed Central

Anguzu, Ronald; Akun, Pamela R; Ogwang, Rodney; Shour, Abdul Rahman; Sekibira, Rogers; Ningwa, Albert; Nakamya, Phellister; Abbo, Catherine; Mwaka, Amos D; Opar, Bernard; Idro, Richard

2018-01-01

ABSTRACT A large amount of preparation goes into setting up trials. Different challenges and lessons are experienced. Our trial, testing a treatment for nodding syndrome, an acquired neurological disorder of unknown cause affecting thousands of children in Eastern Africa, provides a unique case study. As part of a study to determine the aetiology, understand pathogenesis and develop specific treatment, we set up a clinical trial in a remote district hospital in Uganda. This paper describes our experiences and documents supportive structures (enablers), challenges faced and lessons learned during set-up of the trial. Protocol development started in September 2015 with phased recruitment of a critical study team. The team spent 12 months preparing trial documents, procurement and training on procedures. Potential recruitment sites were pre-visited, and district and local leaders met as key stakeholders. Key enablers were supportive local leadership and investment by the district and Ministry of Health. The main challenges were community fears about nodding syndrome, adverse experiences of the community during previous research and political involvement. Other challenges included the number and delays in protocol approvals and lengthy procurement processes. This hard-to-reach area has frequent power and Internet fluctuations, which may affect cold chains for study samples, communication and data management. These concerns decreased with a pilot community engagement programme. Experiences and lessons learnt can reduce the duration of processes involved in trial-site set-up. A programme of community engagement and local leader involvement may be key to the success of a trial and in reducing community opposition towards participation in research. PMID:29382251

Setting up a clinical trial for a novel disease: a case study of the Doxycycline for the Treatment of Nodding Syndrome Trial - challenges, enablers and lessons learned.

PubMed

Anguzu, Ronald; Akun, Pamela R; Ogwang, Rodney; Shour, Abdul Rahman; Sekibira, Rogers; Ningwa, Albert; Nakamya, Phellister; Abbo, Catherine; Mwaka, Amos D; Opar, Bernard; Idro, Richard

2018-01-01

A large amount of preparation goes into setting up trials. Different challenges and lessons are experienced. Our trial, testing a treatment for nodding syndrome, an acquired neurological disorder of unknown cause affecting thousands of children in Eastern Africa, provides a unique case study. As part of a study to determine the aetiology, understand pathogenesis and develop specific treatment, we set up a clinical trial in a remote district hospital in Uganda. This paper describes our experiences and documents supportive structures (enablers), challenges faced and lessons learned during set-up of the trial. Protocol development started in September 2015 with phased recruitment of a critical study team. The team spent 12 months preparing trial documents, procurement and training on procedures. Potential recruitment sites were pre-visited, and district and local leaders met as key stakeholders. Key enablers were supportive local leadership and investment by the district and Ministry of Health. The main challenges were community fears about nodding syndrome, adverse experiences of the community during previous research and political involvement. Other challenges included the number and delays in protocol approvals and lengthy procurement processes. This hard-to-reach area has frequent power and Internet fluctuations, which may affect cold chains for study samples, communication and data management. These concerns decreased with a pilot community engagement programme. Experiences and lessons learnt can reduce the duration of processes involved in trial-site set-up. A programme of community engagement and local leader involvement may be key to the success of a trial and in reducing community opposition towards participation in research.

The Virginia Community Cadre Network: Community Reintegration of Persons with Spinal Cord Injury.

ERIC Educational Resources Information Center

Wilson, Walter C.; Thompson, Donald D.

1983-01-01

The Community Cadre Network in Virginia is a local support network for helping individuals with spinal cord injuries make the transition from an institutional setting to home and community life. Cadre members are people who have been through the experience of traumatic injury, rehabilitation, and return home. (SEW)

Integrated Experiential Education: Definitions and a Conceptual Model

ERIC Educational Resources Information Center

Fenton, Lara; Gallant, Karen

2016-01-01

Universities are currently embracing community engagement strategies to increase opportunities for student learning in community settings such as community organizations. Experiential learning is often touted as the pedagogy underlying such experiences. We undertook a research project exploring the challenges and benefits for students and faculty…

Sense of community responsibility in community collaboratives: advancing a theory of community as resource and responsibility.

PubMed

Nowell, Branda; Boyd, Neil M

2014-12-01

This paper contributes to the growing body of scholarship aimed at advancing our understanding of the experience of community by empirically investigating sense of community responsibility (SOC-R) in relation to traditional measures of sense of community (SOC) and indices of satisfaction, engagement, and leadership in interorganizational collaborative settings. Findings support the proposition that, although both are related to the experience of community, SOC and SOC-R emphasize different aspects of that experience and operate under different theoretical mechanisms of influence. SOC emphasizes community as a resource which was found to be a more salient aspect in differentiating those who will be more or less satisfied with their experience. In addition, SOC was found to predict general participation in a community collaborative. SOC-R emphasizes the experience of community as a responsibility which appears to be a stronger predictor in explaining higher order engagement requiring greater investment of time and resources. Even more importantly, this study indicates that SOC-R is uniquely equipped to help us advance models of community leadership. As such, it represents an important contribution to expanding our understanding of the factors that drive members' willingness to give of themselves toward collective aims.

Elevating Engagement and Community in Online Courses

ERIC Educational Resources Information Center

Cuthbertson, William; Falcone, Andrea

2014-01-01

Community, while inherent in assumptions about online education, rarely materializes as an integral component of the experience. Misconceptions and misguided motivations can derail participation and engagement in the online setting. Creating a successful online community is dependent on knowing what works in the face-to-face environment and…

Study of a tracking and data acquisition system for the 1990's. Volume 1: User community characteristics

NASA Technical Reports Server (NTRS)

Mccreary, T.

1981-01-01

Projected 1990's experiments; navigation requirements and potentials; communications requirements associated with space experiments; alternative forecast options; and operational impacts on experiments are covered. A baseline of plans for the TDAS User Community, including a set of generic experiments developed to supplement existing planning for the 1990's time frame is generated. It includes extensive summaries of collected data, and a bibliography. The data are representative of inputs obtained from NASA planning sources through September 1981.

Community Geography as a Model for International Research Experiences in Study Abroad Programs

ERIC Educational Resources Information Center

Hawthorne, Timothy L.; Atchison, Christopher; LangBruttig, Artis

2014-01-01

Collaborative engagement with local residents and organizations is often cited as one of the most valuable aspects of community-based research integration in classroom settings. However, little has been written on the impact of community engagement in international study abroad programs. We explore the use of community geography in Belize to…

Did Somebody Say Community? Young People’s Critiques of Conventional Community Narratives in the Context of a Local Drug Scene

PubMed Central

Fast, Danya; Shoveller, Jean; Small, Will; Kerr, Thomas

2014-01-01

The language of community is ubiquitous in academic, public health, and policy discourse about drug using populations. Yet, it has been argued that in some settings, the parameters of “the drug user community” are far from self-evident. We undertook this ethnographic investigation to explore experiences and understandings of a “drug user community” (sometimes referred to more specifically as a “street youth community”) among young people entrenched in Vancouver’s inner city drug scene. Our findings revealed that in this context, conventional notions of community—that is, a social network characterized by commonality, mutual responsibility, solidarity, and/or stability—resonated with some youth. However, most questioned the value of membership within this community, in which what they had in common with other youth were ongoing experiences of poverty, marginalization, and social exclusion. Many felt membership in the drug user community precluded their ability to be responsible and productive citizens within the wider community of “mainstream society.” Experiences of resource deprivation and everyday violence on the streets led many participants to emphasize the limited possibilities for community among their peers. We argue that it is important to critically examine heretofore essentializing assumptions about the nature of inner city drug user or street youth communities in order to better understand young people’s needs and desires in these settings. PMID:24634540

Organizing a Community Advanced Pharmacy Practice Experience

PubMed Central

Koenigsfeld, Carrie Foust; Tice, Angela L

2006-01-01

Setting up a community advanced pharmacy practice experience can be an overwhelming task for many pharmacy preceptors. This article provides guidance to pharmacist preceptors in developing a complete and effective community advanced pharmacy practice experience (APPE). When preparing for the APPE, initial discussions with the college or school of pharmacy are key. Benefits, training, and requirements should be addressed. Site preparation, including staff education, will assist in the development process. The preceptor should plan orientation day activities and determine appropriate evaluation and feedback methods. With thorough preparation, the APPE will be rewarding for both the student and the pharmacy site. PMID:17136163

Organizing a community advanced pharmacy practice experience.

PubMed

Koenigsfeld, Carrie Foust; Tice, Angela L

2006-02-15

Setting up a community advanced pharmacy practice experience can be an overwhelming task for many pharmacy preceptors. This article provides guidance to pharmacist preceptors in developing a complete and effective community advanced pharmacy practice experience (APPE). When preparing for the APPE, initial discussions with the college or school of pharmacy are key. Benefits, training, and requirements should be addressed. Site preparation, including staff education, will assist in the development process. The preceptor should plan orientation day activities and determine appropriate evaluation and feedback methods. With thorough preparation, the APPE will be rewarding for both the student and the pharmacy site.

Eliciting health care priorities in developing countries: experimental evidence from Guatemala.

PubMed

Font, Joan Costa; Forns, Joan Rovira; Sato, Azusa

2016-02-01

Although some methods for eliciting preferences to assist participatory priority setting in health care in developed countries are available, the same is not true for poor communities in developing countries whose preferences are neglected in health policy making. Existing methods grounded on self-interested, monetary valuations that may be inappropriate for developing country settings where community care is provided through 'social allocation' mechanisms. This paper proposes and examines an alternative methodology for eliciting preferences for health care programmes specifically catered for rural and less literate populations but which is still applicable in urban communities. Specifically, the method simulates a realistic collective budget allocation experiment, to be implemented in both rural and urban communities in Guatemala. We report evidence revealing that participatory budget-like experiments are incentive compatible mechanisms suitable for revealing collective preferences, while simultaneously having the advantage of involving communities in health care reform processes. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Post-acute rehabilitation care for older people in community hospitals and general hospitals--philosophies of care and patients' and caregivers' reported experiences: a qualitative study.

PubMed

Small, Neil; Green, John; Spink, Joanna; Forster, Anne; Young, John

2009-01-01

This article contrasts community hospital and general hospital philosophies of care and examines how they relate to patients' and caregivers' experiences. Semi-structured interviews with 42 staff were used to produce care setting vignettes in six community hospitals and four general hospitals in the midlands and north of England. The vignettes were used with 26 patients and 10 caregivers in semi-structured interviews. Community hospital and general hospital staff identified shared understandings of requirements for post-acute rehabilitation care for older people. Distinctive features were: general hospital--medical efficiency, helping patients get better, high standard of care, need for stimulation; community hospital--home-like setting, quiet, calm ambience, good views, orientated to elderly people, encouragement of social interaction, involvement of relatives in care. In the main there was symmetry between staff aspirations and patients' experience. However some concepts used and assumptions made by staff were not recognised by patients. These were characteristically reframed in patients' answers as if they were discussing subjective dimensions of care. There was patient and caregiver preference for the home-like environment of community hospitals. In care of older people, where the focus is rehabilitation, patient preferences are particularly pertinent and should be considered alongside clinical outcomes and cost-effectiveness.

Beyond the Classroom: International Education and the Community College. Volume IV. Working with Local Business To Enhance Asian-Pacific Understanding.

ERIC Educational Resources Information Center

Franco, Robert W., Ed.; Shimabukuro, James N., Ed.

Part of a four-volume set in which community college educators discuss their efforts to internationalize the educational experience of the students and communities they serve, volume IV in this series focuses on the growing importance of community colleges in providing short-term, intensive training in international business and intercultural…

Creating Community: One Institution's Experience with Communities of Practice

ERIC Educational Resources Information Center

Heath, Sally; McDonald, Jeanette

2012-01-01

This article examines the use and benefits of communities of practice (CoPs) in academic settings. In the 2010-2011 academic year Teaching Support Services at Wilfrid Laurier University introduced four theme-based CoPs for faculty and academic support staff after a successful pilot initiative. This article explores our motivation for focusing our…

Modifying a Social Problem-Solving Program With the Input of Individuals With Intellectual Disabilities and Their Staff

PubMed Central

Ailey, Sarah H.; Friese, Tanya R.; Nezu, Arthur M.

2016-01-01

Social problem-solving programs have shown success in reducing aggressive/challenging behaviors among individuals with intellectual disabilities in clinical settings, but have not been adapted for health promotion in community settings. We modified a social problem-solving program for the community setting of the group home. Multiple sequential methods were used to seek advice from community members on making materials understandable and on intervention delivery. A committee of group home supervisory staff gave advice on content and delivery. Cognitive interviews with individuals with intellectual disabilities and residential staff provided input on content wording and examples. Piloting the program provided experience with content and delivery. The process provides lessons on partnering with vulnerable populations and community stakeholders to develop health programs. PMID:22753149

Bridge to the future: nontraditional clinical settings, concepts and issues.

PubMed

Faller, H S; Dowell, M A; Jackson, M A

1995-11-01

Healthcare restructuring in the wake of healthcare reform places greater emphasis on primary healthcare. Clinical education in acute care settings and existing community health agencies are not compatible with teaching basic concepts, principles and skills fundamental to nursing. Problems of clients in acute care settings are too complex and clients in the community are often too dispersed for necessary faculty support and supervision of beginning nursing students. Nontraditional learning settings offer the baccalaureate student the opportunity to practice fundamental skills of care and address professional skills of negotiation, assertiveness, organization, collaboration and leadership. An overview of faculty designed clinical learning experiences in nontraditional sites such as McDonald's restaurants, inner city churches, YWCA's, the campus community and homes are presented. The legal, ethical and academic issues associated with nontraditional learning settings are discussed in relation to individual empowerment, decision making and evaluation. Implications for the future address the role of the students and faculty as they interact with the community in which they live and practice.

Creativity and power: a qualitative, exploratory study of student learning acquired in a community nursing setting that is applied in future settings.

PubMed

Merritt, Alan; Boogaerts, Marina

2014-01-01

Nursing students undertake clinical placements in a wide range of clinical areas as part of their preparation for professional practice, offering students the opportunity to learn about the clinical context and the work that nurses do. This descriptive study explores the implicit learnings that occur for students in a community nursing placement and whether they transfer the knowledge they gain in the community setting into practice in other settings. Participants in this research study described implicit learning from a community nursing context which they were able to utilise in their current practice. Three major themes emerged. Firstly, participants recognised that power relationships manifest differently in a community based setting. This manifest in a recognition of patient autonomy and a creative approach to enhancing the patient's power. The second, related theme involved the enabling of self-determination through collaborative decision making between nurse and the person receiving care. The third theme was the development of an understanding of self-management which manifest in appropriate referrals and what the participants considered high quality discharge planning. This recognition of practice beyond technical, rationalist manifestations suggests that students grasped the unarticulated, implicit dimensions of the community nurse role through their experiences in a community nursing placement.

The Setting is the Service: How the Architecture of Sober Living Residences Supports Community Based Recovery

PubMed Central

Wittman, Fried; Jee, Babette; Polcin, Douglas L.; Henderson, Diane

2014-01-01

The architecture of residential recovery settings is an important silent partner in the alcohol/drug recovery field. The settings significantly support or hinder recovery experiences of residents, and shape community reactions to the presence of sober living houses (SLH) in ordinary neighborhoods. Grounded in the principles of Alcoholics Anonymous, the SLH provides residents with settings designed to support peer based recovery; further, these settings operate in a community context that insists on sobriety and strongly encourages attendance at 12-step meetings. Little formal research has been conducted to show how architectural features of the recovery setting – building appearance, spatial layouts, furnishings and finishes, policies for use of the facilities, physical care and maintenance of the property, neighborhood features, aspects of location in the city – function to promote (or retard) recovery, and to build (or detract from) community support. This paper uses a case-study approach to analyze the architecture of a community-based residential recovery service that has demonstrated successful recovery outcomes for its residents, is popular in its community, and has achieved state-wide recognition. The Environmental Pattern Language (Alexander, Ishikawa, & Silverstein, 1977) is used to analyze its architecture in a format that can be tested, critiqued, and adapted for use by similar programs in many communities, providing a model for replication and further research. PMID:25328377

The Setting is the Service: How the Architecture of Sober Living Residences Supports Community Based Recovery.

PubMed

Wittman, Fried; Jee, Babette; Polcin, Douglas L; Henderson, Diane

2014-07-01

The architecture of residential recovery settings is an important silent partner in the alcohol/drug recovery field. The settings significantly support or hinder recovery experiences of residents, and shape community reactions to the presence of sober living houses (SLH) in ordinary neighborhoods. Grounded in the principles of Alcoholics Anonymous, the SLH provides residents with settings designed to support peer based recovery; further, these settings operate in a community context that insists on sobriety and strongly encourages attendance at 12-step meetings. Little formal research has been conducted to show how architectural features of the recovery setting - building appearance, spatial layouts, furnishings and finishes, policies for use of the facilities, physical care and maintenance of the property, neighborhood features, aspects of location in the city - function to promote (or retard) recovery, and to build (or detract from) community support. This paper uses a case-study approach to analyze the architecture of a community-based residential recovery service that has demonstrated successful recovery outcomes for its residents, is popular in its community, and has achieved state-wide recognition. The Environmental Pattern Language (Alexander, Ishikawa, & Silverstein, 1977) is used to analyze its architecture in a format that can be tested, critiqued, and adapted for use by similar programs in many communities, providing a model for replication and further research.

Older people's care experience in community and general hospitals: a comparative study.

PubMed

Green, John; Forster, Anne; Young, John; Small, Neil; Spink, Joanna

2008-07-01

Community hospitals are an important component of the post-acute care pathway for older people. The objective of this study was to describe and contrast patients' and carers' experiences of community and general hospitals. Interviews with patients and carers revealed similarities in the perceptions of care between the two settings. These included appreciation of staff sensitivity, a sense of security, encouragement of independence and lack of activity. The community hospital was appreciated for its location, atmosphere, accommodation, greater sense of freedom, quality of food and staff attitudes. UK health policy promotes the development of community hospitals. This should be progressed in a way that retains key strengths of the specific service they offer.

A model of service and training: threat assessment on a community college campus.

PubMed

Mrad, David F; Hanigan, Antoni J S; Bateman, Joyce R

2015-02-01

Forensic psychological assessment for targeted violence is a growing area of practice and community need. These threat assessments are particularly challenging on community college campuses given the broad range of students and the limited internal resources. A collaborative model of partnership between a community college and the training clinic of a doctoral program in clinical psychology has been developed and implemented. The model provides needed service to the community college and rich training experiences for doctoral students in psychology. Implementation of similar partnerships in other settings may be limited by the training and experience of doctoral faculty and the openness of behavioral intervention teams to external participants.

Traumatizing Aspects of Providing Counselling in Community Agencies to Survivors of Sexual Violence: A Concept Map

ERIC Educational Resources Information Center

Kadambi, Michaela A.; Truscott, Derek

2008-01-01

Concept mapping (a combined qualitative/quantitative approach) was used to clarify and understand 72 Canadian professionals' experience of what they found to be traumatizing about their work with sexual violence survivors in community settings. A sample of 30 professionals providing community-based treatment to survivors of sexual violence sorted…

Listening to the Community: Guidance from Native Community Members for Emerging Culturally Responsive Educators

ERIC Educational Resources Information Center

Rogers, Christine A.; Jaime, Angela M.

2010-01-01

Critical race theory (CRT) emphasizes the importance of listening to the counter-narratives of people from marginalized groups. However, the applicability of CRT in practical settings often remains unclear for educators and scholars. This project offers not only a place for Native community members to share their experiences and ideas, it also…

How a Beacon Community Program in New Orleans Helped Create a Better Health Care System by Building Relationships before Technology.

PubMed

Khurshid, Anjum; Brown, Lisanne

2014-01-01

In the aftermath of Hurricane Katrina, much of New Orleans' healthcare infrastructure was destroyed. Initial federal funding after the storm expanded primary care services and helped set up medical homes for New Orleans' large uninsured and underinsured population. Following that, the Beacon Community in New Orleans, charged with improving health care through the use of technology, decided the best way to accomplish those goals was to build community partnerships and introduce technology improvements based on their input and on their terms. The purpose of this paper is to describe how those partnerships were wrought, including the innovative use of a conceptual framework, and how they are being sustained; how different technologies were and are being introduced; and what the results have been so far. Past successful community experiences, as well as a proven conceptual framework, were used to help establish community partnerships and governance structures, as well as to demonstrate their linkages. This paper represents a compilation of reports and information from key Beacon leaders, staff and providers and their firsthand experiences in setting up those structures, as well as their conclusions. The community partnerships proved extremely successful in not only devising successful ways to introduce new technology into healthcare settings, but in sustaining those changes by creating a governance structure that has enough fluidity to adapt to changing circumstances. Building and developing community partnerships takes time and effort; however, these relationships are necessary and essential to introducing and sustaining new technologies in a healthcare setting and should be a first step for any organization looking to accomplish such goals.

Application of local policy to prevent alcohol problems: experiences from a community trial.

PubMed

Holder, H D; Reynolds, R I

1997-06-01

Alcohol policy conventionally has been established at the national or regional, state and provincial levels. Alcohol policy at any level is not actually limited to the regulation and control of alcohol production, wholesale distribution, and retail sales. There are a number of alternatives for setting alcohol policies within a local community. Building upon existing national and state/provincial laws, policy makers at the community level can set priorities for allocating resources and enforcing laws related to drinking and driving, underage alcohol sales, alcohol serving practices of bars and restaurants and geographical density of alcohol outlets in the community. This paper concludes from the Community Trials Project that policies established at the local level can reduce alcohol problems.

Effect of Extramural Experiences on Dental Students' Attitudes.

ERIC Educational Resources Information Center

Grantham, Emily V.; Block, Marvin J.

1983-01-01

A study designed to determine the effect of a set of community dentistry extramural experience on student attitudes is discussed. The experiences involved one or more of four underserved or special populations: the mentally retarded, the mentally ill, correctional center inmates, and indigent children. (Author/MLW)

Encouraging Civility as a Community College Leader

ERIC Educational Resources Information Center

Elsner, Paul A., Ed.; Boggs, George R., Ed.

2006-01-01

The contributors relate examples of situations in which leaders encountered unexpected and sometimes unprecedented incivility in their role as community college leaders. The chapters present their experiences, observations, lessons, and recommendations for handling crises that may befall leaders in an academic setting. This book contains the…

Helpful advice and hidden expertize: pharmacy users' experiences of community pharmacy accessibility.

PubMed

Lindsey, Laura; Husband, Andy; Steed, Liz; Walton, Robert; Todd, Adam

2017-09-01

In recent years community pharmacies have emerged as strategically important settings to deliver services aimed at promoting public health. In order to develop evidence-based approaches to public health interventions that exploit the unique accessibility of community pharmacies, it is important to determine how people experience care in this context. This study, therefore, aimed to describe how care is perceived and experienced in community pharmacies with particular focus on community pharmacy access. In-depth semi-structured interviews were used to explore the perceptions and experiences' of people using community pharmacies. A total of 30 participants were interviewed. Themes specifically emerged in relation to community pharmacy access; these fell into four main categories: relationships; time; lack of awareness; and empowerment. The experience of developing a trusting relationship with the pharmacist is an important consideration in the context of community pharmacy accessibility. This could be an important consideration when a person uses a community pharmacy to access a public health service. There is also a perceived lack of awareness among the general public about the extended role of community pharmacy; this is a potential barrier toward people using them. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Beyond the Classroom: International Education and the Community College. Volume I: Internationalizing the Curriculum with an Asian-Pacific Emphasis.

ERIC Educational Resources Information Center

Franco, Robert W., Ed.; Shimabukuro, James N., Ed.

Part of a four-volume set in which community college educators discuss their efforts to internationalize the educational experience of the students and communities they serve, volume I in this series highlights seven different but easily integrated strategies for adding an Asian-Pacific emphasis to the curriculum. Volume I includes: (1)…

Community College Nursing Students' Experience of Repeating a Course after Academic Failure

ERIC Educational Resources Information Center

Lewis, Lisa Scandale

2016-01-01

This narrative inquiry study looked at community college nursing student repeaters, those who have failed a required nursing course and then gone on to repeat the course. Nursing student repeaters are a population at especially high risk for attrition, and about whom little is known. The community college setting is an important site of nursing…

Ecology-Centered Experiences among Children and Adolescents: A Qualitative and Quantitative Analysis

ERIC Educational Resources Information Center

Orton, Judy

2013-01-01

The present research involved two studies that considered "ecology-centered experiences" (i.e., experiences with living things) as a factor in children's environmental attitudes and behaviors and adolescents' ecological understanding. The first study (Study 1) examined how a community garden provides children in an urban setting the…

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.

Recruitment and retention of rural physicians: outcomes from the rural physician associate program of Minnesota.

PubMed

Halaas, Gwen Wagstrom; Zink, Therese; Finstad, Deborah; Bolin, Keli; Center, Bruce

2008-01-01

Founded in 1971 with state funding to increase the number of primary care physicians in rural Minnesota, the Rural Physician Associate Program (RPAP) has graduated 1,175 students. Third-year medical students are assigned to primary care physicians in rural communities for 9 months where they experience the realities of rural practice with hands-on participation, mentoring, and one-to-one teaching. Students complete an online curriculum, participate in online discussion with fellow students, and meet face-to-face with RPAP faculty 6 times during the 9-month rotation. Projects designed to bring value to the community, including an evidence-based practice and community health assessment, are completed. To examine RPAP outcomes in recruiting and retaining rural primary care physicians. The RPAP database, including moves and current practice settings, was examined using descriptive statistics. On average, 82% of RPAP graduates have chosen primary care, and 68% family medicine. Of those currently in practice, 44% have practiced in a rural setting all of the time, 42% in a metropolitan setting and 14% have chosen both, with more than 50% of their time in rural practice. Rural origin has only a small association with choosing rural practice. RPAP data suggest that the 9-month longitudinal experience in a rural community increases the number of students choosing primary care practice, especially family medicine, in a rural setting.

Learning through Blogging: Students' Perspectives in Collaborative Blog-Enhanced Learning Communities

ERIC Educational Resources Information Center

Kuo, Yu-Chun; Belland, Brian R.; Kuo, Yu-Tung

2017-01-01

This study employed a mixed method approach to investigate the relationships between learners' blogging self-efficacy, sense of community, perceived collaborative learning, and perceived learning in classroom environments. Learners' perspectives of group learning experiences in blog-enhanced settings were examined. Participants were minority adult…

Predictable communities of soil bacteria in relation to nutrient concentration and successional stage in a laboratory culture experiment.

PubMed

Song, Woojin; Kim, Mincheol; Tripathi, Binu M; Kim, Hyoki; Adams, Jonathan M

2016-06-01

It is difficult to understand the processes that structure immensely complex bacterial communities in the soil environment, necessitating a simplifying experimental approach. Here, we set up a microcosm culturing experiment with soil bacteria, at a range of nutrient concentrations, and compared these over time to understand the relationship between soil bacterial community structure and time/nutrient concentration. DNA from each replicate was analysed using HiSeq2000 Illumina sequencing of the 16S rRNA gene. We found that each nutrient treatment, and each time point during the experiment, produces characteristic bacterial communities that occur predictably between replicates. It is clear that within the context of this experiment, many soil bacteria have distinct niches from one another, in terms of both nutrient concentration, and successional time point since a resource first became available. This fine niche differentiation may in part help to explain the coexistence of a diversity of bacteria in soils. In this experiment, we show that the unimodal relationship between nutrient concentration/time and species diversity often reported in communities of larger organisms is also evident in microbial communities. © 2015 Society for Applied Microbiology and John Wiley & Sons Ltd.

Community-based counselors' interventions for elementary school-age children coping with trauma.

PubMed

Nabors, Laura; Baker-Phibbs, Christina; Woodson, Kenneth

2016-01-01

Child trauma is a mental health concern and more information is needed about treatment in community mental health settings. This article presents results of a focus group and member checking sessions held with counselors who provided therapy for children experiencing posttraumatic stress disorder in a community-based setting. Results indicated that play and art techniques were commonly used during individual child therapy sessions. Sessions were child-directed and allowed children to review trauma experiences in a "safe" setting with an "expert" guide. Several themes were commonly addressed in sessions including opportunities to re-experience, release, and reorganize the trauma, building resilience or self-esteem for the child, promoting safety, and helping the child to regulate emotional reactions and behavior problems. Counselors focused on discussing ways to interact with the child to promote healing and there was a belief that children would return to a positive developmental trajectory after coping with traumatic experiences. Future research needs to address what works for whom, in terms of what interventions are useful in child-directed counseling sessions for children who have experienced specific types of trauma, such as sexual and physical abuse or witnessing domestic violence. Integration of knowledge from evidence-based treatments will also further inform clinical practice with children who have experienced traumatic events.

A panchayat level primary-care approach for adolescent services.

PubMed

Nair, M K C; Leena, M L; George, Babu; Sunitha, R M; Prasanna, G L; Russell, P S

2012-01-01

To develop a model for providing community adolescent care services in the primary care setting Need assessment was done among adolescents and perceived problems of adolescents were studied using qualitative and quantitative methods. Based on the results of these studies, a Family Life Education (FLE) module was prepared. Awareness programs were organized for all stakeholders in the community on adolescent issues. All anganwadi workers in the panchayat were trained to take interactive sessions for all the adolescents in the panchayat using the FLE module. Ward based Teen Clubs were formed in all the 13 wards of the Panchayat separately for boys and girls and FLE classes were given to them through anganwadi workers. An Adolescent Clinic was set up to provide necessary medical and counseling facilities. Adolescent Health Card was distributed to all Teen Club members and those who attended the adolescent clinics. The present approach stresses the need and feasibility of adolescent-centered, community-based interventions. The authors' experience showed that before starting any adolescent program, community awareness generation about the need and content of the program is very important for its success. The experience of this model has made it possible to up-scale the program to seven districts of southern Kerala as a service model. The experiences of the program gave a realistic picture of the needs and problems of adolescents and a simple feasible model for providing services to adolescents in the primary care setting that can be easily replicated in other parts of India.

Obtaining and providing health information in the community pharmacy setting.

PubMed

Iwanowicz, Susan L; Marciniak, Macary Weck; Zeolla, Mario M

2006-06-15

Community pharmacists are a valuable information resource for patients and other healthcare providers. The advent of new information technology, most notably the Internet, coupled with the rapid availability of new healthcare information, has fueled this demand. Pharmacy students must receive training that enables them to meet this need. Community advanced pharmacy practice experiences (APPEs) provide an excellent opportunity for students to develop and master drug information skills in a real-world setting. Preceptors must ensure that students are familiar with drug information resources and can efficiently identify the most useful resource for a given topic. Students must also be trained to assess the quality of resources and use this information to effectively respond to drug or health information inquiries. This article will discuss key aspects of providing drug information in the community pharmacy setting and can serve as a guide and resource for APPE preceptors.

Obtaining and Providing Health Information in the Community Pharmacy Setting

PubMed Central

Iwanowicz, Susan L.; Marciniak, Macary Weck; Zeolla, Mario M.

2006-01-01

Community pharmacists are a valuable information resource for patients and other healthcare providers. The advent of new information technology, most notably the Internet, coupled with the rapid availability of new healthcare information, has fueled this demand. Pharmacy students must receive training that enables them to meet this need. Community advanced pharmacy practice experiences (APPEs) provide an excellent opportunity for students to develop and master drug information skills in a real-world setting. Preceptors must ensure that students are familiar with drug information resources and can efficiently identify the most useful resource for a given topic. Students must also be trained to assess the quality of resources and use this information to effectively respond to drug or health information inquiries. This article will discuss key aspects of providing drug information in the community pharmacy setting and can serve as a guide and resource for APPE preceptors. PMID:17136178

Faculty Learning Communities: Improving Teaching in Higher Education

ERIC Educational Resources Information Center

Ward, Hsuying C.; Selvester, Paula M.

2012-01-01

Faculty learning communities (FLCs) are collaborative collegial groups of faculty and other teaching staff who are interested in and committed to the improvement of their teaching to accommodate a diverse student population through group discourse, reflection and goal setting. In this article, we describe our FLC experiences that were supported by…

Teacher Learning from Girls' Informal Science Experiences

ERIC Educational Resources Information Center

Birmingham, Daniel J.

2013-01-01

School science continues to fail to engage youth from non-dominant communities (Carlone, Huan-Frank & Webb, 2011). However, recent research demonstrates that informal science learning settings support both knowledge gains and increased participation in science among youth from non-dominant communities (Dierking, 2007; Falk et al., 2007; HFRP,…

Comparative Survey of Drug Use in a Community Service System.

ERIC Educational Resources Information Center

Zaharia, E. S.; Struxness, L.

1991-01-01

Drug use patterns were surveyed in Colorado's community services system for 1,282 individuals with developmental disabilities. A psychotropic drug use rate of 18.6 percent compared favorably to other reported rates and rates in Colorado's institutional settings. Substantial experience with psychotropic and anticonvulsant medications across all…

The AACC Leadership Competencies: Pennsylvania's Views and Experiences

ERIC Educational Resources Information Center

Boswell, Robert A.; Imroz, Sohel M.

2013-01-01

Community colleges in the United States are facing a shortage of leaders because many current leaders will retire within the next 10 years (Weisman & Vaughn, 2007). Student diversity, technological advancement, and increased accountability have expanded the required skill-set of community college leaders. To aid the next generation of leaders…

Methane- and Hydrogen-Influenced Microbial Communities in Hydrothermal Plumes above the Atlantis Massif, Mid Atlantic Ridge

NASA Astrophysics Data System (ADS)

Stewart, C. L.; Schrenk, M.

2017-12-01

Ultramafic-hosted hydrothermal systems associated with slow-spreading mid ocean ridges emit copious amounts of hydrogen and methane into the deep-sea, generated through a process known as serpentinization. Hydrothermal plumes carrying the reduced products of water-rock interaction dissipate and mix with deep seawater, and potentially harbor microbial communities adapted to these conditions. Methane and hydrogen enriched hydrothermal plumes were sampled from 3 sites near the Atlantis Massif (30°N, Mid Atlantic Ridge) during IODP Expedition 357 and used to initiate cultivation experiments targeting methanotrophic and hydrogenotrophic microorganisms. One set of experiments incubated the cultures at in situ hydrostatic pressures and gas concentrations resulting in the enrichment of gammaproteobacterial assemblages, including Marinobacter spp. That may be involved in hydrocarbon degradation. A second set of experiments pursued the anaerobic enrichment of microbial communities on solid media, resulting in the enrichment of alphaproteobacteria related to Ruegeria. The most prodigious growth in both case occurred in methane-enriched media, which may play a role as both an energy and carbon source. Ongoing work is evaluating the physiological characteristics of these isolates, including their metabolic outputs under different physical-chemical conditions. In addition to providing novel isolates from hydrothermal habitats near the Lost City Hydrothermal Field, these experiments will provide insight into the ecology of microbial communities from serpentinization influenced hydrothermal systems that may aid in future exploration of these sites.

Consumer perspectives about weight management services in a community pharmacy setting in NSW, Australia

PubMed Central

Um, Irene S.; Armour, Carol; Krass, Ines; Gill, Timothy; Chaar, Betty B.

2012-01-01

Abstract Background  Obesity is a public health challenge faced worldwide. Community pharmacists may be well placed to manage Australia’s obesity problem owing to their training, accessibility and trustworthiness. However, determining consumers’ needs is vital to the development of any new services or the evaluation of existing services. Objective  To explore Australian consumers’ perspectives regarding weight management services in the community pharmacy setting, including their past experiences and willingness to pay for a specific pharmacy‐based service. Design  An online cross‐sectional consumer survey was distributed through a marketing research company. The survey instrument comprised open‐ended and closed questions exploring consumers’ experiences of and preferences for weight management services in pharmacy. It also included an attitudinal measure, the Consumer Attitude to Pharmacy Weight Management Services (CAPWMS) scale. Setting and participants  A total of 403 consumers from New South Wales, Australia, completed the survey. Results  The majority of respondents had previously not sought a pharmacist’s advice regarding weight management. Those who had previously consulted a pharmacist were more willing to pay for and support pharmacy‐based services in the future. Most consumers considered pharmacists’ motivations to provide advice related to gaining profit from selling a product and expressed concerns about the perceived conflicts of interest. Participants also perceived pharmacists as lacking expertise and time. Conclusion  Although Australian consumers were willing to seek pharmacists’ advice about weight management, they perceived several barriers to the provision of weight management services in community pharmacy. If barriers are addressed, community pharmacies could be a viable and accessible setting to manage obesity. PMID:22646843

An Experience-Centered Curriculum: Exercises in Perception, Communication and Action. Educational Studies and Documents No. 17.

ERIC Educational Resources Information Center

Wolsk, David

This study describes a Unesco-sponsored experimental project in the United Nations Associated Schools designed to develop a new approach to education for international understanding. The class, school, and community provide the settings for activities based on the pupils' own behaviors and experiences. Experiments, demonstrations, critical…

"It makes us really look inferior to outsiders": Coping with psychosocial experiences associated with the lack of access to safe water and sanitation.

PubMed

Bisung, Elijah; Elliott, Susan J

2017-11-09

This paper explores daily experiences and coping resources related to the lack of access to safe water and adequate sanitation in Usoma, a lakeshore community in Western Kenya. A qualitative approach that involved 10 focus group discussions and 9 key informant interviews with community leaders, volunteers and professionals was used to explore the research objectives. Data were collected from June to August 2013. Daily practices and experiences around water and sanitation, such as water collection, open defecation and shared toilets, were a major concern to residents. In the absence of safe water, residents used social networks and support, financial resources and the nearby Lake Victoria as coping resources. Findings from this study are important for mobilizing resources in vulnerable settings as a first step towards designing community-based interventions. For public health practice, practitioners must work with - and collaborate across - sectors to enhance and strengthen social networks and cohesion, and protect the natural environment while working toward addressing water-related challenges in deprived settings.

DYNAMICS OF PARTICIPATIVE GROUPS.

ERIC Educational Resources Information Center

GIBB, JACK R.; AND OTHERS

THROUGH UNIVERSITY LABORATORY EXPERIMENTS, FIELD OBSERVATIONS IN INDUSTRIAL, COMMUNITY, AND EDUCATIONAL SETTINGS, AND EXPERIENCES IN CLASSES IN GROUP DYNAMICS, THE PARTICIPATIVE ACTION METHOD OF GROUP TRAINING FOR MORE EFFECTIVE PROBLEM SOLVING AND DECISION MAKING WAS DEVELOPED. IT IS BASED ON 8 PRINCIPLES--PHYSICAL REGROUPING, REDUCTION OF…

Investigating the experiences in a school-based occupational therapy program to inform community-based paediatric occupational therapy practice.

PubMed

Rens, Lezahn; Joosten, Annette

2014-06-01

A collaborative approach with teachers is required when providing community-based occupational therapy to educationally at risk children. Collaborators share common goals and interact and support each other but challenges arise in providing collaborative occupational therapy in settings outside the school environment. The aim of this study was to capture experiences of teachers and occupational therapists working within a school-based occupational therapy program to determine if their experiences could inform collaborative practice. In this pilot study, participant responses to questionnaires (n = 32) about their experiences formed the basis for focus groups and individual interviews. Two focus group were conducted, one with teachers (n = 11) and one with occupational therapy participants (n = 6). Individual interviews were conducted with the supervising occupational therapist, school principal and two leading teachers. Descriptive statistics were used to analyse the data from closed questions, and thematic analysis using a constant comparison approach was used to analyse open ended questions, focus groups and interviews. Three main themes emerged: (i) the need for occupational therapists to spend time in the school, to explain their role, build relationships, understand classroom routines and the teacher role; (ii) occupational therapists need to not see themselves as the expert but develop equal partnerships to set collaborative goals and (iii) occupational therapists advocating for all parties to be informed throughout the occupational therapy process. The pilot study findings identified teacher and therapist experiences within the school setting that could inform improved collaborative practice with teachers and community-based occupational therapists and these findings warrant further investigation. © 2013 Occupational Therapy Australia.

Primary care physicians’ experiences with electronic medical records

PubMed Central

Ludwick, Dave; Manca, Donna; Doucette, John

2010-01-01

OBJECTIVE To understand how remuneration and care setting affect the implementation of electronic medical records (EMRs). DESIGN Semistructured interviews were used to illicit descriptions from community-based family physicians (paid on a fee-for-service basis) and from urban, hospital, and academic family physicians (remunerated via alternative payment models or sessional pay for activities pertaining to EMR implementation). SETTING Small suburban community and large urban-, hospital-, and academic-based family medicine clinics in Alberta. All participants were supported by a jurisdictional EMR certification funding mechanism. PARTICIPANTS Physicians who practised in 1 or a combination of the above settings and had experience implementing and using EMRs. METHODS Purposive and maximum variation sampling was used to obtain descriptive data from key informants through individually conducted semistructured interviews. The interview guide, which was developed from key findings of our previous literature review, was used in a previous study of community-based family physicians on this same topic. Field notes were analyzed to generate themes through a comparative immersion approach. MAIN FINDINGS Physicians in urban, hospital, and academic settings leverage professional working relationships to investigate EMRs, a resource not available to community physicians. Physicians in urban, hospital, and academic settings work in larger interdisciplinary teams with a greater need for interdisciplinary care coordination, EMR training, and technical support. These practices were able to support the cost of project management or technical support resources. These physicians followed a planned system rollout approach compared with community physicians who installed their systems quickly and required users to transition to the new system immediately. Electronic medical records did not increase, or decrease, patient throughput. Physicians developed ways of including patients in the note-taking process. CONCLUSION We studied physicians’ procurement approaches under various payment models. Our findings do not suggest that one remuneration approach supports EMR adoption any more than another. Rather, this study suggests that stronger physician professional networks used in information gathering, more complete training, and in-house technical support might be more influential than remuneration in facilitating the EMR adoption experience. PMID:20090083

Impact of dilution on microbial community structure and functional potential: comparison of numerical simulations and batch culture experiments

NASA Technical Reports Server (NTRS)

Franklin, R. B.; Garland, J. L.; Bolster, C. H.; Mills, A. L.

2001-01-01

A series of microcosm experiments was performed using serial dilutions of a sewage microbial community to inoculate a set of batch cultures in sterile sewage. After inoculation, the dilution-defined communities were allowed to regrow for several days and a number of community attributes were measured in the regrown assemblages. Based upon a set of numerical simulations, community structure was expected to differ along the dilution gradient; the greatest differences in structure were anticipated between the undiluted-low-dilution communities and the communities regrown from the very dilute (more than 10(-4)) inocula. Furthermore, some differences were expected among the lower-dilution treatments (e.g., between undiluted and 10(-1)) depending upon the evenness of the original community. In general, each of the procedures used to examine the experimental community structures separated the communities into at least two, often three, distinct groups. The groupings were consistent with the simulated dilution of a mixture of organisms with a very uneven distribution. Significant differences in community structure were detected with genetic (amplified fragment length polymorphism and terminal restriction fragment length polymorphism), physiological (community level physiological profiling), and culture-based (colony morphology on R2A agar) measurements. Along with differences in community structure, differences in community size (acridine orange direct counting), composition (ratio of sewage medium counts to R2A counts, monitoring of each colony morphology across the treatments), and metabolic redundancy (i.e., generalist versus specialist) were also observed, suggesting that the differences in structure and diversity of communities maintained in the same environment can be manifested as differences in community organization and function.

An Idealized Test of the Response of the Community Atmosphere Model to Near-Grid-Scale Forcing Across Hydrostatic Resolutions

NASA Astrophysics Data System (ADS)

Herrington, A. R.; Reed, K. A.

2018-02-01

A set of idealized experiments are developed using the Community Atmosphere Model (CAM) to understand the vertical velocity response to reductions in forcing scale that is known to occur when the horizontal resolution of the model is increased. The test consists of a set of rising bubble experiments, in which the horizontal radius of the bubble and the model grid spacing are simultaneously reduced. The test is performed with moisture, through incorporating moist physics routines of varying complexity, although convection schemes are not considered. Results confirm that the vertical velocity in CAM is to first-order, proportional to the inverse of the horizontal forcing scale, which is consistent with a scale analysis of the dry equations of motion. In contrast, experiments in which the coupling time step between the moist physics routines and the dynamical core (i.e., the "physics" time step) are relaxed back to more conventional values results in severely damped vertical motion at high resolution, degrading the scaling. A set of aqua-planet simulations using different physics time steps are found to be consistent with the results of the idealized experiments.

Cancer Care Experiences and the Use of Complementary and Alternative Medicine at End of Life in Nova Scotia’s Black Communities

PubMed Central

Maddalena, Victor J.; Bernard, Wanda Thomas; Etowa, Josephine; Murdoch, Sharon Davis; Smith, Donna; Jarvis, Phyllis Marsh

2016-01-01

Purpose This qualitative study examines the meanings that African Canadians living in Nova Scotia, Canada, ascribe to their experiences with cancer, family caregiving, and their use of complementary and alternative medicine (CAM) at end of life. Design Case study methodology using in-depth interviews were used to examine the experiences of caregivers of decedents who died from cancer in three families. Findings For many African Canadians end of life is characterized by care provided by family and friends in the home setting, community involvement, a focus on spirituality, and an avoidance of institutionalized health services. Caregivers and their families experience multiple challenges (and multiple demands). There is evidence to suggest that the use of CAM and home remedies at end of life are common. Discussion The delivery of palliative care to African Canadian families should consider and support their preference to provide end-of-life care in the home setting. PMID:20220031

Myanmar: The Community Learning Centre Experience.

ERIC Educational Resources Information Center

Middelborg, Jorn; Duvieusart, Baudouin, Ed.

A community learning centre (CLC) is a local educational institution outside the formal education system, usually set up and managed by local people. CLCs were first introduced in Myanmar in 1994, and by 2001 there were 71 CLCs in 11 townships. The townships are characterized by remoteness, landlessness, unemployment, dependency on one cash crop,…

The Immortal Life of Henrietta Lacks: Using a Common Read to Transform a Learning Community

ERIC Educational Resources Information Center

Virtue, Emily; Wells, Gayle; MacKusick, Carol; Murphy-Nugen, Amy; Rose, Amy

2018-01-01

First-year seminars and learning communities (LC) have been used to help increase retention, provide continuity, and support students as they transition to the university setting. Another high impact educational practice--common intellectual experiences (CIE)--includes student activities centered on a theme to help facilitate learning, increase…

"Active Citizenship Is an Awesome Party!" Creating In-Between Spaces for the School-Community-University Partnership

ERIC Educational Resources Information Center

Moon, Seungho

2016-01-01

An arts-based afterschool program is introduced in advancing children's democratic citizenship and a sense of community. The ARtS Initiative (Aesthetic, Reflexive thoughts, & Sharing) has reimagined arts and aesthetics for young people in urban settings, providing an unquantifiable experience focused on promoting pluralistic societies. The…

Community Managed Services for Persons with Intellectual Disability: Andhra Pradesh Experience

ERIC Educational Resources Information Center

Narayan, Jayanthi; Pratapkumar, Raja; Reddy, Sudhakara P.

2017-01-01

In resource poor settings innovative and bottom-up approaches are required to provide services to people with with disabilities. In this context, the present paper explains a community-based model of manpower development and coordination of services for people with intellectual disabilities in unified state of Andhra Pradesh in India. Women with…

School-Community Partnerships in Rural Settings: Facilitating Positive Outcomes for Young Children Who Experience Maltreatment

ERIC Educational Resources Information Center

Hartman, Sara L.; Stotts, Jenny; Ottley, Jennifer R.; Miller, Rebecca

2017-01-01

Challenging conditions put young children at risk for maltreatment around the world, including in rural, southeastern Ohio. To combat these situations, several strategies are helpful in facilitating positive outcomes for young children. Specifically, when community entities and local school professionals work together, there is a greater…

Blogging through the Music Student Teaching Experience: Developing Virtual Communities of Practice

ERIC Educational Resources Information Center

Fitzpatrick, Kate R.

2014-01-01

Within educational settings, well-developed web-based social networking technologies such as interactive weblogs (blogs) can serve to effectively facilitate and mediate interactions among members of a "community of practice" (Chong, 2008; Wenger, White, & Smith, 2009). The purpose of this study was to investigate the use of an…

Columbo in the Classroom: An LD [Learning Disability] Experience in the Community College Setting.

ERIC Educational Resources Information Center

Matuskey, Patricia Varan; Losiewicz, Joan Michele

Guidelines are provided for faculty working with learning disabled (LD) students in the community college. After introductory material, the LD student is described as an individual of average or above average intelligence who demonstrates a significant discrepancy between intelligence and performance level because of problems in taking in,…

The Aboriginal Practical Experience and Its Impact on Pre-Service Teacher's Decisions about Living and Working in Remote in Indigenous Communities in Australia

ERIC Educational Resources Information Center

Jay, Jenny; Moss, Lynette; Cherednichenko, Brenda

2009-01-01

In June 2008, 10 pre-service teachers and 2 teacher educators from Edith Cowan University (ECU) participated in an existing community education program in rural and remote Indigenous communities in central Australia. From an intrepid start with a mountain of overloaded baggage and camping cutlery setting off the scanning machine at the airport,…

Stigma Experiences in Marginalized People Living With HIV Seeking Health Services and Resources in Canada.

PubMed

Donnelly, Leeann R; Bailey, Lauren; Jessani, Abbas; Postnikoff, Jonathan; Kerston, Paul; Brondani, Mario

HIV stigma may prevent people from obtaining a timely diagnosis and engaging in life-saving care. It may also prevent those who are HIV infected from seeking health and education resources, particularly if they are from marginalized communities. We inductively explored the roots of stigma and its impact on health services and resource seeking as experienced by HIV-infected members of marginalized communities in Vancouver, British Columbia, Canada, using a community-based participatory research framework. Five peer-facilitated focus groups were conducted with 33 Aboriginal, Latino, Asian, and African participants. Thematic analysis of the experiences revealed four dominant themes: beginnings of stigma, tensions related to disclosure, experiences of service seeking, and beyond HIV stigma and discrimination. Persons living with HIV from Aboriginal and refugee communities continue to experience disproportionate rates of stigma and discrimination. Fear remains a prime obstacle influencing these groups' abilities and willingness to access care in various settings. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Beginning community engagement at a busy biomedical research programme: Experiences from the KEMRI CGMRC-Wellcome Trust Research Programme, Kilifi, Kenya

PubMed Central

Marsh, Vicki; Kamuya, Dorcas; Rowa, Yvonne; Gikonyo, Caroline; Molyneux, Sassy

2008-01-01

There is wide acknowledgement of the need for community engagement in biomedical research, particularly in international settings. Recent debates have described theoretical approaches to identifying situations where this is most critical and potential mechanisms to achieve it. However, there is relatively little published experience of community engagement in practice. A major component of the Kenya Medical Research Institute (KEMRI) Wellcome Trust Research Programme is centred on Kilifi District General Hospital and surrounding community of 240,000 local residents. Documented community perceptions of the research centre are generally positive, but many indicate a low understanding of research and therapeutic misconceptions of its activities. As in other settings, these misunderstandings have contributed to concerns and rumours, and potentially undermine ethical aspects of research and local trust in the institution. Through a series of consultative activities, a community engagement strategy has been developed in Kilifi to strengthen mutual understanding between community members and the Centre. One important component is the establishment of a representative local resident network in different geographic locations commonly involved in research, to supplement existing communication channels. Early implementation of the strategy has provided new and diverse opportunities for dialogue, interaction and partnership building. Through the complex social interactions inherent in the community engagement strategy, the centre aims to build context specific ethical relations with local residents and to strengthen understanding of how ethical principles can be applied in practice. Evaluations over time will assess the effectiveness and sustainability of these strategies, provide generalisable information for similar research settings, and contribute to debates on the universality of ethical principles for research. This paper aims to summarise the rationale for community engagement in research, drawing on published literature and local findings, to outline the process of community engagement in Kilifi and to describe issues emerging from its development and early implementation. PMID:18375028

Northern nursing practice in a primary health care setting.

PubMed

Vukic, Adele; Keddy, Barbara

2002-12-01

This paper explicates the nature of outpost nursing work, and/or the day-to-day realities of northern nursing practice in a primary health care setting in Canada. The study was carried out to systematically explore the work of nurses in an indigenous setting. Institutional ethnography, pioneered by Dorothy Smith was the methodology used to guide this research. The theoretical perspective of this methodology does not seek causes or links but intends to explicate visible practices. It is intended to explicate the social organization of specific discourses that inform work processes of nurses working in remote indigenous communities. The data originated from various sources including spending 2 weeks in a northern remote community shadowing experienced nurses, taking field notes and audio taping interviews with these nurses. One of the two researchers was a northern practice nurse for many years and has had taught in an outpost nursing programme. As part of the process, texts were obtained from the site as data to be incorporated in the analysis. The lived experiences have added to the analytical understanding of the work of nurses in remote areas. Data uncovered documentary practices inherent to the work setting which were then analysed along with the transcribed interviews and field notes derived from the on-site visit. Identifying disjuncture in the discourse of northern nursing and the lived experience of the nurses in this study was central to the research process. The results indicated that the social organization of northern community nursing work required a broad generalist knowledge base for decision making to work effectively within this primary health care setting. The nurse as 'other' and the invisibility of nurses' work of building a trusting relationship with the community is not reflected in the discourse of northern nursing. Trust cannot be quantified or measured yet it is fundamental to working effectively with the community. The nurses in this study saw building trust to promote health and well-being in communities as very important, yet very difficult to achieve. The difficulty in part stems from the constraining, structural, administrative, historical, cultural and political contextual realities that have shaped northern community nursing.

76 FR 35000 - Agency Information Collection Activities; Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-15

... violence or trauma in any setting (including community or school violence; domestic violence; physical...--Trauma and Violence and Military Families. The new items will be added to the Transformation... families, experiences with trauma, and experiences with violence GFA, there is a proposed new data...

Undergraduate Psychology Students' Experiences with Creative Drama: A Multi-Case Study

ERIC Educational Resources Information Center

Wilcox, Ruth A.

2015-01-01

This qualitative multi-case study explored undergraduate psychology students' experiences participating in creative drama activities the instructor/researcher developed to teach psychological concepts. The study was conducted in three introductory and developmental courses in a mid-western community college setting. Participants (cases) included…

Ethical Considerations for Conducting Health Disparities Research in Community Health Centers: A Social-Ecological Perspective

PubMed Central

Scott, Ebony; Melendez, Jennifer; Rodriguez, Anna; Ramos, Rosio; Kanna, Balavenkatesh; Michelen, Walid

2013-01-01

Community health centers (CHCs) provide optimal research settings. They serve a high-risk, medically underserved population in the greatest need of intervention. Low socioeconomic status renders this population particularly vulnerable to research misconduct. Traditional principles of research ethics are often applied to participants only. The social-ecological model offers a comprehensive framework for applying these principles across multiple levels (participants, providers, organizations, communities, and policy). Our experience with the Trial Using Motivational Interviewing, Positive Affect and Self-Affirmation in African-Americans with Hypertension, a randomized trial conducted in CHCs, led us to propose a new platform for discussing research ethics; examine the social, community, and political factors surrounding research conducted in CHCs; and recommend how future research should be conducted in such settings. PMID:24134347

Ethical considerations for conducting health disparities research in community health centers: a social-ecological perspective.

PubMed

Boutin-Foster, Carla; Scott, Ebony; Melendez, Jennifer; Rodriguez, Anna; Ramos, Rosio; Kanna, Balavenkatesh; Michelen, Walid

2013-12-01

Community health centers (CHCs) provide optimal research settings. They serve a high-risk, medically underserved population in the greatest need of intervention. Low socioeconomic status renders this population particularly vulnerable to research misconduct. Traditional principles of research ethics are often applied to participants only. The social-ecological model offers a comprehensive framework for applying these principles across multiple levels (participants, providers, organizations, communities, and policy). Our experience with the Trial Using Motivational Interviewing, Positive Affect and Self-Affirmation in African-Americans with Hypertension, a randomized trial conducted in CHCs, led us to propose a new platform for discussing research ethics; examine the social, community, and political factors surrounding research conducted in CHCs; and recommend how future research should be conducted in such settings.

Intraprofessional Practice Education using a community partnership model.

PubMed

Hoffart, Caroline; Kuster-Orban, Cindy; Spooner, Crystal; Neudorf, Kim

2013-02-01

The Intraprofessional Practice Education (IPE) pilot project was designed to increase the number of high-quality practice education settings and to develop intraprofessional learning opportunities for nursing students from three different prelicensure programs. Students from the licensed practical nurse, registered nurse, and registered psychiatric nurse programs shared their practice education experience concurrently in a rural First Nations community. This project's framework, the Partnership Model for Community Health Nursing Education (PMCHNE), is described and includes an explanation of the planning and coordination that occurred prior to implementation of the pilot project. Various student practice education and cultural experiences are highlighted, and the results from the project's evaluation are discussed, including the utility of the PMCHNE and the benefits and challenges associated with implementing an IPE experience. Copyright 2013, SLACK Incorporated.

Provision of community-wide benefits in public health intervention research: the experience of investigators conducting research in the community setting in South Asia.

PubMed

Taylor, Holly A; Merritt, Maria W

2012-12-01

This article describes the types of community-wide benefits provided by investigators conducting public health research in South Asia as well as their self-reported reasons for providing such benefits. We conducted 52 in-depth interviews to explore how public health investigators in low-resource settings make decisions about the delivery of ancillary care to research subjects. In 39 of the interviews respondents described providing benefits to members of the community in which they conducted their study. We returned to our narrative dataset to find answers to two questions: What types of community-wide benefits do researchers provide when conducting public health intervention studies in the community setting, and what reasons do researchers give when asked why they provided community-wide benefits? The types of community-wide benefits delivered were directed to the health and well-being of the population. The most common types of benefits delivered were the facilitation of access to health care for individuals in acute medical need and emergency response to natural disasters. Respondents' self-reported reasons when asked why they provided such benefits fell into 2 general categories: intrinsic importance and instrumental importance. © 2012 Blackwell Publishing Ltd.

Implementing a high-fidelity simulation program in a community college setting.

PubMed

Tuoriniemi, Pamela; Schott-Baer, Darlene

2008-01-01

Despite their relatively high cost, there is heightened interest by faculty in undergraduate nursing programs to implement high-fidelity simulation (HFS) programs. High-fidelity simulators are appealing because they allow students to experience high-risk, low-volume patient problems in a realistic setting. The decision to purchase a simulator is the first step in the process of implementing and maintaining an HFS lab. Knowledge, technical skill, commitment, and considerable time are needed to develop a successful program. The process, as experienced by one community college nursing program, is described.

Community-based approaches to strengthen cultural competency in nursing education and practice.

PubMed

Anderson, Nancy Lois Ruth; Calvillo, Evelyn Ruiz; Fongwa, Marie Ngetiko

2007-01-01

This article explores existing informal as well as formal approaches that address health disparities in the communities where they occur, enhancing the opportunity to strengthen the cultural competency of providers, students, and faculty. A particular focus centers on the community-based participatory research approaches that involve community members, providing opportunities to develop mutually respectful, trusting relationships through co-teaching and co-learning experiences. With community-based participatory research approaches to community involvement in place, the stage is set for partnerships between communities and schools of nursing to collaboratively design, implement, and integrate informal and formal cultural competence components in nursing curricula.

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Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-30

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76 FR 53916 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-30

... violence or trauma in any setting (including community or school violence; domestic violence; physical...--Trauma and Violence and Military Families. The new items will be added to the Transformation... families, experiences with trauma, and experiences with violence GFA, there is a proposed new data...

Psychology as Field Experience: Impact on Attitudes Toward Social Interventions.

ERIC Educational Resources Information Center

Snellman, Lynn A.; And Others

An innovation in the teaching of undergraduate psychology courses is the implementation of a field experience that gives students the opportunity to apply newly learned skills and knowledge in a community setting. Changes in undergraduates' attitudes toward various delinquency interventions were examined as a result of participation in a…

The Knowledge Café: A Unique Teaching Experience

ERIC Educational Resources Information Center

Baim, Susan A.

2016-01-01

Teaching adult learners in a community-based educational setting differs in many ways from applying typical campus-based or online instructional best practices. Adult learners show tremendous diversity in their backgrounds, approach learning in a myriad of different ways, and rely heavily on their past experiences to help guide their future…

Young women's scientific identity formation in an urban context

NASA Astrophysics Data System (ADS)

Brickhouse, Nancy W.; Potter, Jennifer T.

2001-10-01

In this article we examine the scientific identity formation of two young women of color who attend an urban vocational high school. One young woman lives in an urban setting, while the other lives in a suburban setting. We describe how these young women's identities influence and respond to experiences in school science. In particular, we describe how the experience of marginalization can make membership in a school science community impossible or undesirable. We also describe the advantages that accrue to students who fit well with the ideal identities of an urban school. Finally, we describe some of the difficulties students face who aspire to scientific or technological competence yet do not desire to take on aspects of the identities associated with membership in school science communities.

Community and facility-level engagement in planning and budgeting for the government health sector--a district perspective from Kenya.

PubMed

O'Meara, Wendy Prudhomme; Tsofa, Benjamin; Molyneux, Sassy; Goodman, Catherine; McKenzie, F Ellis

2011-03-01

Health systems reform processes have increasingly recognized the essential contribution of communities to the success of health programs and development activities in general. Here we examine the experience from Kilifi district in Kenya of implementing annual health sector planning guidelines that included community participation in problem identification, priority setting, and planning. We describe challenges in the implementation of national planning guidelines, how these were met, and how they influenced final plans and budgets. The broad-based community engagement envisaged in the guidelines did not take place due to the delay in roll out of the Ministry of Health-trained community health workers. Instead, community engagement was conducted through facility management committees, though in a minority of facilities, even such committees were not involved. Some overlap was found in the priorities highlighted by facility staff, committee members and national indicators, but there were also many additional issues raised by committee members and not by other groups. The engagement of the community through committees influenced target and priority setting, but the emphasis on national health indicators left many local priorities unaddressed by the final work plans. Moreover, it appears that the final impact on budgets allocated at district and facility level was limited. The experience in Kilifi highlights the feasibility of engaging the community in the health planning process, and the challenges of ensuring that this engagement feeds into consolidated plans and future implementation. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Spoken Stories: A Narrative Inquiry on the Lives and Experiences of "Outsider Teachers"

ERIC Educational Resources Information Center

Makris, Sara

2012-01-01

When a teacher enters a classroom, a story begins. The plot is informed by its characters and setting-the students, faculty, and the surrounding community. If a teacher comes from outside this community--whether in terms of race, class, gender identity, sexual orientation, ethnicity, ability status, or culture--the plot thickens. Existing…

Community-Based Summer Learning Programs for School- Age Children: Research-to-Policy Resources

ERIC Educational Resources Information Center

Stephens, Samuel A.

2016-01-01

Summer learning experiences for school-age children can be provided in a variety of ways and settings, including summer school programs (often remedial), community-based programs (often a continuation of afterschool programs), and home-based programs (in which families are provided with information and resources to encourage reading, often run by…

Team Check-Up: Use 4 Goals to Assess a Professional Learning Community's Effectiveness

ERIC Educational Resources Information Center

Moirao, Daniel R.; Morris, Susan C.; Klein, Victor; Jackson, Joyce W.

2012-01-01

The experiences in the school districts highlighted in this article clarify a set of broad goals that all professional learning communities can use to assess their effectiveness: (1) Culture; (2) Knowledge; (3) Practice; and (4) Achievement. These schools and districts have an ongoing commitment to all four goals. All of them have instituted…

Lived Experience and Community Sport Coaching: A Phenomenological Investigation

ERIC Educational Resources Information Center

Cronin, Colum; Armour, Kathleen M.

2015-01-01

Coaching in the participation domain is the act of coaching participants that are less intensely engaged in sport than performance orientated athletes. This form of coaching is a popular activity occurring in community settings such as schools or sport clubs, and it is often undertaken with a broad range of social and health outcomes in mind. The…

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.

Respecting and protecting our relationships: a community research HIV prevention program for teen fathers and mothers.

PubMed

Lesser, Janna; Verdugo, Robert L; Koniak-Griffin, Deborah; Tello, Jerry; Kappos, Barbara; Cumberland, William G

2005-08-01

This article describes a two-phase community and academic collaboration funded by the California Collaborative Research Initiative to develop and test the feasibility of an innovative HIV prevention program relevant to the needs of the population of inner-city Latino teen parenting couples and realistic for implementation in community settings. The article describes (a) the identification of special issues that needed to be addressed before formation of a productive academic-community-based organization research partnership, including integrating a dominant theoretical model used in health education with principles of practice derived from clinical experience; (b) the first phase of the project that helped to inform the development of the HIV prevention program for couples; (c) examples from the intervention pilot study (Phase 2) that illustrate both the intervention strategies and the young participants' responses to the curriculum; and (d) the feasibility of program implementation and evaluation in a community setting.

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.

The Relationship between Academic Writing Experience and Academic Publishing for Graduate Physics Students

ERIC Educational Resources Information Center

Hess, Steven Timothy Michael

2012-01-01

Writing for scientific publication represents an opportunity to interact with colleagues and make a positive contribution to the academic community. However, there is a growing concern regarding the ability of graduate students' to transfer writing skill sets learned at the graduate and undergraduate levels into professional settings. The main…

Information Provision in Emergency Settings: The Experience of Refugee Communities in Zambia

ERIC Educational Resources Information Center

Kanyengo, Brendah Kakulwa; Kanyengo, Christine Wamunyima

2011-01-01

This article identifies information provision services in emergency settings using Zambia as a case study by identifying innovative ways of providing library and information services. The thrust of the article is to analyze information management practices of organizations that work within refugee camps and how they take specific cognizance of the…

Perceptions and Perspectives of Music Teachers in Urban Settings: Isolation, Conversation and Collaboration

ERIC Educational Resources Information Center

Sindberg, Laura K.

2014-01-01

Seven teachers from three schools in a major metropolitan community in the upper Midwest region of the USA participated in this case study designed to better understand the nature of music teacher isolation and interaction in the urban setting. Data analysis revealed several themes: "experiences of isolation," "urban factors,"…

Young women’s perceptions and experiences with contraception supply in community pharmacies

PubMed Central

Fakih, Souhiela; Batra, Peter; Gatny, Heather H; Kusunoki, Yasamin; Barber, Jennifer S.; Farris, Karen B.

2015-01-01

Background Unintended pregnancy is a major public health problem in the United States.. Correct contraceptive use can reduce the rate of unintended pregnancy. Community pharmacies are well positioned to provide contraceptives and advise about contraception. Objectives (1) determine young women’s perceptions and experiences with contraception supply in community pharmacies and (2) identify whether very pharmacy characteristics predicted positive experiences. Design This study was comprised of two cross-sectional surveys including an online women’s pharmacy perceptions and experiences (PPE) survey and a faxed/observed survey of community pharmacies. Setting One County in Michigan, USA Participants Young women and community pharmacies Main outcome measure The two surveys were merged to explore pharmacy characteristics that may impact women’s perceptions and experiences with community pharmacies. Multiple logistic regression analysis was used to explore relationships between pharmacy characteristics and positive outcomes. Results The response rate for the PPE survey was 54% (n= 334/637). Data from all community pharmacies in the county was retrieved via fax (n= 41/94, 43.6%) or observation (n= 53/94, 56.4%). Women were included in this analysis if they indicated a regular (most commonly used) pharmacy in the county of interest (n=210). Over 50% of women (n= 125/210) visited a pharmacy more than once per month. Sixty percent of women were currently using something to prevent pregnancy (n=124/210, 60.8%). Thirty-five percent of women had a positive experience (n=73/210, 34.8%). In the multiple logistic regression, women who visited a chain pharmacy had almost 65% lower odds of an overall positive experience with their regular pharmacy, compared to women who visited a grocery or mass merchandise pharmacy (OR: 0.35, 95% CI: 0.16, 0.75). Conclusion Young women visit community pharmacies and use contraceptives frequently. Interventions need to be developed and implemented to improve young women’s perceptions and experiences with contraception at community pharmacies. PMID:26003156

Exploring anti-community structure in networks with application to incompatibility of traditional Chinese medicine

NASA Astrophysics Data System (ADS)

Zhu, Jiajing; Liu, Yongguo; Zhang, Yun; Liu, Xiaofeng; Xiao, Yonghua; Wang, Shidong; Wu, Xindong

2017-11-01

Community structure is one of the most important properties in networks, in which a node shares its most connections with the others in the same community. On the contrary, the anti-community structure means the nodes in the same group have few or no connections with each other. In Traditional Chinese Medicine (TCM), the incompatibility problem of herbs is a challenge to the clinical medication safety. In this paper, we propose a new anti-community detection algorithm, Random non-nEighboring nOde expansioN (REON), to find anti-communities in networks, in which a new evaluation criterion, anti-modularity, is designed to measure the quality of the obtained anti-community structure. In order to establish anti-communities in REON, we expand the node set by non-neighboring node expansion and regard the node set with the highest anti-modularity as an anti-community. Inspired by the phenomenon that the node with higher degree has greater contribution to the anti-modularity, an improved algorithm called REONI is developed by expanding node set by the non-neighboring node with the maximum degree, which greatly enhances the efficiency of REON. Experiments on synthetic and real-world networks demonstrate the superiority of the proposed algorithms over the existing methods. In addition, by applying REONI to the herb network, we find that it can discover incompatible herb combinations.

Community Game Day: Using an End-of-Life Conversation Game to Encourage Advance Care Planning.

PubMed

Van Scoy, Lauren J; Reading, Jean M; Hopkins, Margaret; Smith, Brandi; Dillon, Judy; Green, Michael J; Levi, Benjamin H

2017-11-01

Advance care planning (ACP) is an important process that involves discussing and documenting one's values and preferences for medical care, particularly end-of-life treatments. This convergent, mixed-methods study assessed whether an end-of-life conversation card game is an acceptable and effective means for performing ACP for patients with chronic illness and/or their caregivers when deployed in a community setting. Twenty-two games (n = 93 participants) were held in community settings surrounding Hershey, PA in 2016. Participants were recruited using random sampling from patient databases and also convenience sampling (i.e., flyers). Quantitative questionnaires and qualitative focus group interviews were administered to assess the game experience and subsequent performance of ACP behaviors. Both quantitative and qualitative data found that Community Game Day was a well-received, positive experience for participants and 75% of participants performed ACP within three months post-intervention. These findings suggest that using a conversation game during community outreach is a useful approach for engaging patients and caregivers in ACP. The convergence of quantitative and qualitative data strongly supports the continued investigation of the game in randomized controlled trials. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

"Sticking Together!" Policy Activism from within a UK Coal-Mining Community

ERIC Educational Resources Information Center

Bright, N. Geoffrey

2012-01-01

This article reflects on some aspects of a doctoral ethnographic study of young people disaffected from schooling in a post-industrial space of ruin in a former coal-mining community in England. It considers how their experiences of resistance and refusal of schooling can, in the relational ethos of non-school support settings, come to speak back…

Learning and Literacy in an Online Gaming Community: Examples of Participatory Practices in a Sims Affinity Space

ERIC Educational Resources Information Center

Lee, Yoonhee Naseef

2012-01-01

The goal of this research was to understand the different kinds of learning that take place in "Mod The Sims" (MTS), an online "Sims" gaming community. The study aimed to explore users' experiences and to understand learning practices that are not commonly observed in formal educational settings. To achieve this goal, the…

"Daring to Volunteer": Some Reflections on Geographers, Geography Students and Evolving Institutional Support for Community Engagement in Higher Education

ERIC Educational Resources Information Center

Spalding, Richard

2013-01-01

Volunteering with our local community organizations (many of them charitable) is clearly set to become more of a feature of our lives as staff and students working in higher education. This activity is seen as potentially valuable in enhancing the student experience, particularly through a strengthening of students' employability prospects. This…

Leisure Activities for Retarded Children. A Task Analysis Approach. Integrating Trainable Mentally Retarded Children Through Community Education. ESEA Title IV, Part C.

ERIC Educational Resources Information Center

Minneapolis Public Schools, Minn.

Designed to meet the need of trainable mentally retarded persons for recreation skill training and for opportunities to experience leisure/social skill development in a community setting, the packet provides task analysis information on 114 activities. Information is provided on behavioral objectives, basic skills required, materials and…

Families' Experiences in Different Homeless and Highly Mobile Settings: Implications for School and Community Practice

ERIC Educational Resources Information Center

Miller, Peter M.

2015-01-01

Family homelessness has been on the rise throughout the United States in recent years. As a result, more schools and communities than ever are challenged to serve students whose lives are touched by instability, uncertainty, and crisis. To date, there has been little inquiry into how families' particular places of homelessness might shape school…

TraLaLa Blip: Community Music for the Electronically Abled

ERIC Educational Resources Information Center

Reimann, Randolf

2012-01-01

This article presents a personal reflection on the use of electronic music as a vehicle for community music in a disability setting. In order to do this, I draw on my experiences as the founder, facilitator, producer, tutor, sound artist and musician of TraLaLa Blip. I established the group in 2008, after having worked with people with…

Implementing Action Research and Professional Learning Communities in a Professional Development School Setting to Support Teacher Candidate Learning

ERIC Educational Resources Information Center

Shanks, Joyce

2016-01-01

The paper reviews teacher candidates' use of action research and the Professional Learning Community (PLC) concept to support their work in their pre-student teaching field experience. In this research study, teacher candidates are involved in a professional development school relationship that uses action research and PLCs to support candidate…

The Role of Intercessory Prayer in Fostering Students' Sense of Connectedness in Distance Education Courses

ERIC Educational Resources Information Center

LaBarbera, Robin

2016-01-01

Students in any classroom, whether online or in face-to-face settings, who feel a strong sense of community or connectedness are more likely to be successful and perceive satisfaction with the overall learning experience compared to those who feel separated from the community. The purpose of this study was to determine if there were significant…

A Phenomenological Inquiry into the Financial Education Experiences of Young, Low-Income Credit Union Members

ERIC Educational Resources Information Center

Santangelo, Dan

2012-01-01

This qualitative phenomenological study engaged 20 young, low-income credit union members who participated in financial education classes at Denver Community Credit Union. The study explored learning experiences that generated changes in money management behaviors and sought evidence of transformational learning in a nonformal education setting.…

Consumer perspectives about weight management services in a community pharmacy setting in NSW, Australia.

PubMed

Um, Irene S; Armour, Carol; Krass, Ines; Gill, Timothy; Chaar, Betty B

2014-08-01

Obesity is a public health challenge faced worldwide. Community pharmacists may be well placed to manage Australia's obesity problem owing to their training, accessibility and trustworthiness. However, determining consumers' needs is vital to the development of any new services or the evaluation of existing services. To explore Australian consumers' perspectives regarding weight management services in the community pharmacy setting, including their past experiences and willingness to pay for a specific pharmacy-based service. An online cross-sectional consumer survey was distributed through a marketing research company. The survey instrument comprised open-ended and closed questions exploring consumers' experiences of and preferences for weight management services in pharmacy. It also included an attitudinal measure, the Consumer Attitude to Pharmacy Weight Management Services (CAPWMS) scale. A total of 403 consumers from New South Wales, Australia, completed the survey. The majority of respondents had previously not sought a pharmacist's advice regarding weight management. Those who had previously consulted a pharmacist were more willing to pay for and support pharmacy-based services in the future. Most consumers considered pharmacists' motivations to provide advice related to gaining profit from selling a product and expressed concerns about the perceived conflicts of interest. Participants also perceived pharmacists as lacking expertise and time. Although Australian consumers were willing to seek pharmacists' advice about weight management, they perceived several barriers to the provision of weight management services in community pharmacy. If barriers are addressed, community pharmacies could be a viable and accessible setting to manage obesity. © 2012 John Wiley & Sons Ltd.

"Building the Natural Society of the Future": The Peckham Experiment (1943) as an Anarchist Account of Childhood and Education

ERIC Educational Resources Information Center

Charkin, Emily

2014-01-01

"The Peckham Experiment" (Innes H. Pearse and Lucy H. Crocker, Edinburgh: Scottish Academic Press, 1985) is a book about the Peckham Health Centre (1935-1950), which was a scientific experiment and community centre set up to identify and foster conditions of good health for local working-class families in South London. The book was…

Motivating and demotivating factors for community health workers: A qualitative study in urban slums of Delhi, India.

PubMed

George, Mathew Sunil; Pant, Shradha; Devasenapathy, Niveditha; Ghosh-Jerath, Suparna; Zodpey, Sanjay P

2017-04-01

Background Community health workers play an important role in delivering health-care services, especially to underserved populations in low- and middle-income countries. They have been shown to be successful in providing a range of preventive, promotive and curative services. This qualitative study investigated the factors motivating or demotivating community health workers in urban settings in Delhi, India. Methods In this sub-study of the ANCHUL (Ante Natal and Child Healthcare in Urban Slums) implementation research project, four focus-group discussions and nine in-depth interviews were conducted with community health workers and medical officers. Utilizing a reflexive and inductive qualitative methodology, the data set was coded, to allow categories of motivating and demotivating factors to emerge. Results Motivating factors identified were: support from family members for their work, improved self-identity, job satisfaction and a sense of social responsibility, prior experiences of ill health, the opportunity to acquire new skills and knowledge, social recognition and status conferred by the community, and flexible work and timings. Negative experiences in the community and at health centres, constraints in the local health system in response to the demand generated by the community health workers, and poor pay demotivated community health workers in this study, even causing some to quit their jobs. Conclusion Community-health-worker programmes that focus on ensuring the technical capacity of their staff may not give adequate attention to the factors that motivate or discourage these workers. As efforts get under way to ensure universal access to health care, it is important that these issues are recognized and addressed, to ensure that community health worker programmes are effective and sustainable.

Tolerance: Woven into the Fabric of the School, or Not?

ERIC Educational Resources Information Center

Pumpian, Ian

2013-01-01

Tolerance must be conceptualized based on the diversity that exists in our world, our communities, and our schools. The author posits that dealing with diversity is a 21st-century skill set and that tolerance of difference is a rudimentary element of that set. The diversity of experiences and situations that confront middle school students and…

The Faculties of Pharmacy Schools Should Make an Effort to Network with Community Pharmacies.

PubMed

Matsushita, Ryo

2016-01-01

By law, medical faculties are mandated to have a designated partner hospital for the purposes of student practical training. In contrast, pharmacy faculties do not have such a legal requirement for student training in a community pharmacy setting. Nevertheless, there are several public and private universities that do have community pharmacies. However, there is no national university that has established both an educational hospital and a community pharmacy. When Kanazawa University (KU) established a graduate school with a clinical pharmacy course, the faculty of KU deemed it necessary to set up an independent community pharmacy for the purpose of practical training. Thus, in 2003, the Acanthus Pharmacy was set up as the first educational community pharmacy in Japan, managed by a nonprofit organization, with the permission of the Ishikawa Pharmaceutical Association and local community pharmacists. Since that time, Acanthus has managed a clinical pharmacy practice for students from both the undergraduate and graduate schools of KU. From 2006, the undergraduate pharmacy program was changed to a 6-year program, and the Acanthus Pharmacy has continued its roles in educating undergraduate pharmaceutical students, medical students, and as a site of early exposure for KU freshmen. From our experience, it is important to have a real clinical environment available to university pharmacy faculty and students, especially in training for community pharmacy practices.

Psychological well-being of adolescents with physical disabilities in Zimbabwean inclusive community settings: An exploratory study

PubMed Central

Maree, Jacobus G.

2017-01-01

Background The purpose of this study was to explore the psychological well-being of adolescents with physical disabilities living in inclusive community settings of Makonde Urban in Zimbabwe. An inclusive community is one that aims to remove exclusionary practices within the community and promote community systems that accept all people irrespective of their difference. Inclusive communities on their own are not uniquely designed for people with disabilities, but most developing countries have adopted them as a basic strategy to influence and enhance psychological well-being of people with disabilities. Methods A constructivist lived experience perspective underpinned this research, in which multiple case studies were used to interact with the participants on inclusion and psychological well-being of adolescents with physical disabilities. Purposive sampling was used to select 14 participants (9 males and 5 females). Data were collected through face-to-face interviews and transcribed verbatim. Four themes emerged from the thematic analysis of data sources. Results It was found that participants who were adolescents with physical disabilities living in inclusive community settings of Makonde Urban in Zimbabwe were having high levels of autonomy and choice, purpose in life, positive relations with others and good personal growth and self-acceptance. Conclusion The findings of this study should enable inclusive communities’ policy-makers and researchers to better understand the psychological well-being of adolescents with physical disabilities living in inclusive communities. PMID:29134179

Complicating Counterspaces: Intersectionality and the Michigan Womyn's Music Festival.

PubMed

McConnell, Elizabeth A; Todd, Nathan R; Odahl-Ruan, Charlynn; Shattell, Mona

2016-06-01

The counterspaces framework articulated by Case and Hunter (2012), follows from community psychology's long-standing interest in the potential for settings to promote well-being and liberatory responses to oppression. This framework proposes that certain settings (i.e., "counterspaces") facilitate a specific set of processes that promote the well-being of marginalized groups. We argue that an intersectional analysis is crucial to understand whether and how counterspaces achieve these goals. We draw from literature on safe spaces and present a case study of the Michigan Womyn's Music Festival (Michfest) to illustrate the value of an intersectional analysis and explore how these processes operate. Based on 20 in-person interviews, 23 responses to an online survey, and ethnographic field notes, we show how Michfest was characterized by a particular intersection of identities at the setting level, and intersectional diversity complicated experiences at the individual level. Moreover, intersectional identities provided opportunities for dialogue and change at the setting level, including the creation of counterspaces within counterspaces. Overall, we demonstrate the need to attend to intersectionality in counterspaces, and more broadly in how we conceptualize settings in community psychology. © Society for Community Research and Action 2016.

The Impact of Elections on Cooperation: Evidence from a Lab-in-the-Field Experiment in Uganda

PubMed Central

Grossman, Guy; Baldassarri, Delia

2013-01-01

Communities often rely on sanctioning to induce public goods contributions. Past studies focus on how external agencies or peer sanctioning induce cooperation. In this article, we focus instead on the role played by centralized authorities, internal to the community. Combining “lab-in-the-field” experiments with observational data on 1,541 Ugandan farmers from 50 communities, we demonstrate the positive effect of internal centralized sanctioning authorities on cooperative behavior. We also show that the size of this effect depends on the political process by which authority is granted: subjects electing leaders contribute more to public goods than subjects who were assigned leaders through a lottery. To test the ecological validity of our findings, we relate farmers’ behavior in the experiment to their level of cooperation in their community organization. We show that deference to authority in the controlled setting predicts cooperative behavior in the farmers’ natural environment, in which they face a similar social dilemma. PMID:23729913

[Community health in primary health care teams: a management objective].

PubMed

Nebot Adell, Carme; Pasarin Rua, Maribel; Canela Soler, Jaume; Sala Alvarez, Clara; Escosa Farga, Alex

2016-12-01

To describe the process of development of community health in a territory where the Primary Health Care board decided to include it in its roadmap as a strategic line. Evaluative research using qualitative techniques, including SWOT analysis on community health. Two-steps study. Primary care teams (PCT) of the Catalan Health Institute in Barcelona city. The 24 PCT belonging to the Muntanya-Dreta Primary Care Service in Barcelona city, with 904 professionals serving 557,430 inhabitants. Application of qualitative methodology using SWOT analysis in two steps (two-step study). Step 1: Setting up a core group consisting of local PCT professionals; collecting the community projects across the territory; SWOT analysis. Step 2: From the needs identified in the previous phase, a plan was developed, including a set of training activities in community health: basic, advanced, and a workshop to exchange experiences from the PCTs. A total of 80 team professionals received specific training in the 4 workshops held, one of them an advanced level. Two workshops were held to exchange experiences with 165 representatives from the local teams, and 22 PCTs presenting their practices. In 2013, 6 out of 24 PCTs have had a community diagnosis performed. Community health has achieved a good level of development in some areas, but this is not the general situation in the health care system. Its progression depends on the management support they have, the local community dynamics, and the scope of the Primary Health Care. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Multi-Objective Community Detection Based on Memetic Algorithm

PubMed Central

2015-01-01

Community detection has drawn a lot of attention as it can provide invaluable help in understanding the function and visualizing the structure of networks. Since single objective optimization methods have intrinsic drawbacks to identifying multiple significant community structures, some methods formulate the community detection as multi-objective problems and adopt population-based evolutionary algorithms to obtain multiple community structures. Evolutionary algorithms have strong global search ability, but have difficulty in locating local optima efficiently. In this study, in order to identify multiple significant community structures more effectively, a multi-objective memetic algorithm for community detection is proposed by combining multi-objective evolutionary algorithm with a local search procedure. The local search procedure is designed by addressing three issues. Firstly, nondominated solutions generated by evolutionary operations and solutions in dominant population are set as initial individuals for local search procedure. Then, a new direction vector named as pseudonormal vector is proposed to integrate two objective functions together to form a fitness function. Finally, a network specific local search strategy based on label propagation rule is expanded to search the local optimal solutions efficiently. The extensive experiments on both artificial and real-world networks evaluate the proposed method from three aspects. Firstly, experiments on influence of local search procedure demonstrate that the local search procedure can speed up the convergence to better partitions and make the algorithm more stable. Secondly, comparisons with a set of classic community detection methods illustrate the proposed method can find single partitions effectively. Finally, the method is applied to identify hierarchical structures of networks which are beneficial for analyzing networks in multi-resolution levels. PMID:25932646

Multi-objective community detection based on memetic algorithm.

PubMed

Wu, Peng; Pan, Li

2015-01-01

Community detection has drawn a lot of attention as it can provide invaluable help in understanding the function and visualizing the structure of networks. Since single objective optimization methods have intrinsic drawbacks to identifying multiple significant community structures, some methods formulate the community detection as multi-objective problems and adopt population-based evolutionary algorithms to obtain multiple community structures. Evolutionary algorithms have strong global search ability, but have difficulty in locating local optima efficiently. In this study, in order to identify multiple significant community structures more effectively, a multi-objective memetic algorithm for community detection is proposed by combining multi-objective evolutionary algorithm with a local search procedure. The local search procedure is designed by addressing three issues. Firstly, nondominated solutions generated by evolutionary operations and solutions in dominant population are set as initial individuals for local search procedure. Then, a new direction vector named as pseudonormal vector is proposed to integrate two objective functions together to form a fitness function. Finally, a network specific local search strategy based on label propagation rule is expanded to search the local optimal solutions efficiently. The extensive experiments on both artificial and real-world networks evaluate the proposed method from three aspects. Firstly, experiments on influence of local search procedure demonstrate that the local search procedure can speed up the convergence to better partitions and make the algorithm more stable. Secondly, comparisons with a set of classic community detection methods illustrate the proposed method can find single partitions effectively. Finally, the method is applied to identify hierarchical structures of networks which are beneficial for analyzing networks in multi-resolution levels.

Managing Minor Ailments; The Public's Preferences for Attributes of Community Pharmacies. A Discrete Choice Experiment.

PubMed

Porteous, Terry; Ryan, Mandy; Bond, Christine; Watson, Margaret; Watson, Verity

2016-01-01

Demand for health services continues to rise. Greater use of community pharmacy services instead of medical services for minor ailments could help relieve pressure on healthcare providers in high-cost settings. Community pharmacies are recognised sources of treatment and advice for people wishing to manage these ailments. However, increasing the public's use of pharmacy services may depend on attributes of pharmacies and their staff. This study aimed to determine the general public's relative preferences for community pharmacy attributes using a discrete choice experiment (DCE). A UK-wide DCE survey of the general public was conducted using face-to-face computer-assisted personal interviews. Attributes and levels for the DCE were informed by a literature review and a cohort study of community pharmacy customers. The context for the experiment was a minor ailment scenario describing flu-like symptoms. The DCE choice sets described two hypothetical community pharmacy services; respondents were asked to choose which (if either) of the two pharmacies they would prefer to help them manage symptoms. Data from 1,049 interviews were analysed using an error components logit model. Willingness to pay (WTP), a monetary measure of benefit, was estimated for the different attribute levels. When seeking help or treatment for flu-like symptoms, respondents most valued a pharmacy service that would improve their understanding and management of symptoms (WTP = £6.28), provided by staff who are trained (WTP (pharmacist) = £2.63: WTP(trained assistant) = £3.22), friendly and approachable (WTP = £3.38). Waiting time, pharmacy location and availability of parking also contributed to respondents' preferences. WTP for a service comprising the best possible combination of attributes and levels was calculated as £55.43. Attributes of a community pharmacy and its staff may influence people's decisions about which pharmacy they would visit to access treatment and advice for minor ailments. In line with the public's preferences, offering community pharmacy services that help people to better understand and manage symptoms, are provided promptly by trained staff who are friendly and approachable, and in a local setting with easy access to parking, has the potential to increase uptake amongst those seeking help to manage minor ailments. In this way it may be possible to shift demand away from high-cost health services and make more efficient use of scarce public resources.

Filipino therapists' experiences and attitudes of interprofessional education and collaboration: A cross-sectional survey.

PubMed

Sy, Michael Palapal

2017-11-01

For the past more than 50 years, the World Health Organisation has acknowledged through empirical findings that health workers that learn together work together effectively to provide the best care for their patients. This study aimed to: (1) describe the perceived extent of interprofessional education (IPE) experience among Filipino occupational therapists (OTs), physical therapists (PTs), and speech-language-pathologists (SLPs); (2) identify their attitudes towards interprofessional collaboration (IPC); and (3) compare their attitudes towards IPC according to: prior IPE experience, classification of IPE experience, profession, years of practice, and practice setting. Using a cross-sectional survey design, a two-part questionnaire was sent to Filipino OTs, PTs, and SLPs working in the Philippines via an online survey application. The first part of the survey contained eight items of demographic information and the second part contained the 14-item Attitudes Towards Health Care Teams Scale (ATHCTS). Findings revealed that among the Filipino OT, PT and SLP respondents (n = 189), 70.9% had prior experience on IPE. Moreover, the three most commonly used IPE teaching-learning strategies were case discussion (clinical setting), small group discussion, didactics, and case discussion (community setting), while the use of didactics and case discussion (community setting) yielded more agreeable attitudes towards IPC. Among the 14 items in the ATHCTS, 11 were rated with agreeability and three items with neutrality. For professional variables, only the practice setting variable yielded a statistically significant finding confirming those working in the academia to be more agreeable towards IPC compared to other settings. However, years of practice and professional background variables both yielded no statistically significant difference implying no association between years of practice and attitude towards IPC and a homogenous composition among respondents, respectively. The results of this research are to springboard IPE initiatives within Philippine higher education institutions to enable evidence-based IPC approaches in clinical practice.

Enhancing undergraduate community placements: a critical review of current literature.

PubMed

Dickson, Caroline A W; Morris, Gillian; Gable, Clare

2015-04-01

In the face of the UK-wide policy shift to increased home care, inspiring and enabling the next generation of community nurses is more urgent than ever. The quality of the pre-registration practice learning experience is highly influential on career choices at the point of qualification. Given that 50% of learning by pre-registration students takes place in practice, mentors have a crucial role to play in preparing the next generation of nurses to work in the community. This article discusses the findings of a systematic and critical literature review of pre-registration placements that was funded by the Queen's Nursing Institute Scotland. The review found that students' experiences of learning in community settings are variable, and perceptions of students and mentors are misaligned in terms of what a quality placement should look like. Although there is no clear definition of what constitutes a community placement and there is some underuse of learning environments in areas such as general practice nursing, there are also a number of examples of new and imaginative placements. While these innovations provide 'whole experience' placements, they are currently lacking robust evaluation, despite their potential usefulness on a larger scale. Mentors have the opportunity to provide students with a range of learning opportunities that increase preparedness for working in the community, allowing final year students in particular greater influence over their learning experience. Students undertaking community practice learning, where they have a managed level of autonomy, are more likely to feel confident to take on community nursing roles.

Community-Academic Partnerships: Developing a Service-Learning Framework.

PubMed

Voss, Heather C; Mathews, Launa Rae; Fossen, Traci; Scott, Ginger; Schaefer, Michele

2015-01-01

Academic partnerships with hospitals and health care agencies for authentic clinical learning have become a major focus of schools of nursing and professional nursing organizations. Formal academic partnerships in community settings are less common despite evolving models of care delivery outside of inpatient settings. Community-Academic partnerships are commonly developed as a means to engage nursing students in service-learning experiences with an emphasis on student outcomes. The benefit of service-learning projects on community partners and populations receiving the service is largely unknown primarily due to the lack of structure for identifying and measuring outcomes specific to service-learning. Nursing students and their faculty engaged in service-learning have a unique opportunity to collaborate with community partners to evaluate benefits of service-learning projects on those receiving the service. This article describes the development of a service-learning framework as a first step toward successful measurement of the benefits of undergraduate nursing students' service-learning projects on community agencies and the people they serve through a collaborative community-academic partnership. Copyright © 2015 Elsevier Inc. All rights reserved.

What is at stake? Exploring the moral experience of stigma with Indian-Australians and Anglo-Australians living with depression.

PubMed

Brijnath, Bianca; Antoniades, Josefine

2018-04-01

This article applies the framework of moral experience to examine the cultural experience of stigma with Indian-Australians and Anglo-Australians living with depression in Melbourne, Australia. To date few studies have examined this dynamic in relation to mental illness and culture, and no studies have applied this framework in a culturally comparative way. Based on 58 in-depth interviews with people with depression recruited from the community, we explicate how stigma modulates what is at stake upon disclosure of depression, participants' lived experience following that disclosure, and how practices of health-seeking become stigmatised. Findings show that the social acceptance of depression jars against participants' experience of living with it. Denialism and fear of disclosure were overwhelming themes to emerge from our analysis with significant cultural differences; the Anglo-Australians disclosed their depression to family and friends and encountered significant resistance about the legitimacy of their illness. In contrast, many Indian-Australians, especially men, did not disclose their illness for fear of a damaged reputation and damaged social relations. For Indian-Australians, social relations in the community were at stake, whereas for Anglo-Australians workplace relations (but not community relations) were at stake. Participants' experiences in these settings also influenced their patterns of health-seeking behaviors and age and inter-generational relationships were important mediators of stigma and social support. These findings illuminate how stigma, culture, and setting are linked and they provide critical information necessary to identify and develop customised strategies to mitigate the harmful effects of stigma in particular cultural groups.

Automatic Identification of Messages Related to Adverse Drug Reactions from Online User Reviews using Feature-based Classification.

PubMed

Liu, Jingfang; Zhang, Pengzhu; Lu, Yingjie

2014-11-01

User-generated medical messages on Internet contain extensive information related to adverse drug reactions (ADRs) and are known as valuable resources for post-marketing drug surveillance. The aim of this study was to find an effective method to identify messages related to ADRs automatically from online user reviews. We conducted experiments on online user reviews using different feature set and different classification technique. Firstly, the messages from three communities, allergy community, schizophrenia community and pain management community, were collected, the 3000 messages were annotated. Secondly, the N-gram-based features set and medical domain-specific features set were generated. Thirdly, three classification techniques, SVM, C4.5 and Naïve Bayes, were used to perform classification tasks separately. Finally, we evaluated the performance of different method using different feature set and different classification technique by comparing the metrics including accuracy and F-measure. In terms of accuracy, the accuracy of SVM classifier was higher than 0.8, the accuracy of C4.5 classifier or Naïve Bayes classifier was lower than 0.8; meanwhile, the combination feature sets including n-gram-based feature set and domain-specific feature set consistently outperformed single feature set. In terms of F-measure, the highest F-measure is 0.895 which was achieved by using combination feature sets and a SVM classifier. In all, we can get the best classification performance by using combination feature sets and SVM classifier. By using combination feature sets and SVM classifier, we can get an effective method to identify messages related to ADRs automatically from online user reviews.

Challenges Facing Families at the End of Life in Three Settings

PubMed Central

Kehl, Karen A.; Kirchhoff, Karin T.; Kramer, Betty J.; Hovland-Scafe, Cyndi

2010-01-01

This study examined the challenges faced by family members at the end of life in different care settings and how those challenges compare across settings. A total of 30 participants, who had a family member die in inpatient hospice, a skilled nursing facility or a community support program were interviewed. Semi-structured interviews were recorded and transcribed. Text was coded using qualitative thematic analysis. Themes were determined by consensus. Twelve challenges were identified across care sites. Two themes emerged in all three settings: bearing witness and the experience of loss. The study findings contribute to our knowledge of family perceptions of care in different settings and raises awareness of the need for further research describing the experiences at the end of life in different settings and the importance of creating and testing interventions for both setting specific needs and universal issues. PMID:20563315

Exploring Students' Epistemological Knowledge of Models and Modelling in Science: Results from a Teaching/Learning Experience on Climate Change

ERIC Educational Resources Information Center

Tasquier, Giulia; Levrini, Olivia; Dillon, Justin

2016-01-01

The scientific community has been debating climate change for over two decades. In the light of certain arguments put forward by the aforesaid community, the EU has recommended a set of innovative reforms to science teaching such as incorporating environmental issues into the scientific curriculum, thereby helping to make schools a place of civic…

Reflective Dialogues in Community Music Engagement: An Exploratory Experience in a Singapore Nursing Home and Day-Care Centre for Senior Citizens

ERIC Educational Resources Information Center

Lum, Chee-Hoo

2011-01-01

This study documents a reflective journey of a community music programme initiated by a university music education faculty member and an occupational therapist within the setting of a nursing home and day-care centre in Singapore. Weekly music interaction sessions in conjunction with reminiscence therapy were conducted over a period of five…

Adverse Childhood Experiences (ACE) and Health-Risk Behaviors among Adults in a Developing Country Setting

ERIC Educational Resources Information Center

Ramiro, Laurie S.; Madrid, Bernadette J.; Brown, David W.

2010-01-01

Objective: This study aimed to examine the association among adverse childhood experiences, health-risk behaviors, and chronic disease conditions in adult life. Study population: One thousand and sixty-eight (1,068) males and females aged 35 years and older, and residing in selected urban communities in Metro Manila participated in the…

A Comparison of Learning Outcomes for Adult Students in On-Site and Online Service-Learning

ERIC Educational Resources Information Center

Schwehm, Jeremy S.; Lasker-Scott, Tennille; Elufiede, Oluwakemi

2017-01-01

As noted by Kolb's (1984) experiential learning theory, adults learn best through experiences. Typically delivered in a traditional, face-to-face classroom setting, service-learning integrates the knowledge learned in the classroom with real-world experience and community service. E-service-learning, service-learning delivered in part or entirely…

Building Connections in the First-Year Undergraduate Experience

ERIC Educational Resources Information Center

Countryman, June; Zinck, Andrew

2013-01-01

Concerned about the success rate of new students in our program we designed and implemented a compulsory set of experiences which aim to support students in their transition from high school to university by (1) developing their sense of belonging to a community of learners and by (2) articulating with them the interrelationships among their first…

From Home to Hall: The Transitional Experiences of Homeschooled Students Entering Residential University Settings

ERIC Educational Resources Information Center

Soufleris, Dawn Meza

2014-01-01

Research regarding homeschooled students and their transition to college has been focused on two distinct areas: their academic performance and success integrating into a university community. The purpose of this study was to analyze the transition experiences of students who were homeschooled prior to attendance at a residential university campus…

Consistency of the Health of the Nation Outcome Scales (HoNOS) at inpatient-to-community transition.

PubMed

Luo, Wei; Harvey, Richard; Tran, Truyen; Phung, Dinh; Venkatesh, Svetha; Connor, Jason P

2016-04-27

The Health of the Nation Outcome Scales (HoNOS) are mandated outcome-measures in many mental-health jurisdictions. When HoNOS are used in different care settings, it is important to assess if setting specific bias exists. This article examines the consistency of HoNOS in a sample of psychiatric patients transitioned from acute inpatient care and community centres. A regional mental health service with both acute and community facilities. 111 psychiatric patients were transferred from inpatient care to community care from 2012 to 2014. Their HoNOS scores were extracted from a clinical database; Each inpatient-discharge assessment was followed by a community-intake assessment, with the median period between assessments being 4 days (range 0-14). Assessor experience and professional background were recorded. The difference of HoNOS at inpatient-discharge and community-intake were assessed with Pearson correlation, Cohen's κ and effect size. Inpatient-discharge HoNOS was on average lower than community-intake HoNOS. The average HoNOS was 8.05 at discharge (median 7, range 1-22), and 12.16 at intake (median 12, range 1-25), an average increase of 4.11 (SD 6.97). Pearson correlation between two total scores was 0.073 (95% CI -0.095 to 0.238) and Cohen's κ was 0.02 (95% CI -0.02 to 0.06). Differences did not appear to depend on assessor experience or professional background. Systematic change in the HoNOS occurs at inpatient-to-community transition. Some caution should be exercised in making direct comparisons between inpatient HoNOS and community HoNOS scores. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Shared decision-making at the end of life: A focus group study exploring the perceptions and experiences of multi-disciplinary healthcare professionals working in the home setting.

PubMed

Brogan, Paula; Hasson, Felicity; McIlfatrick, Sonja

2018-01-01

Globally recommended in healthcare policy, Shared Decision-Making is also central to international policy promoting community palliative care. Yet realities of implementation by multi-disciplinary healthcare professionals who provide end-of-life care in the home are unclear. To explore multi-disciplinary healthcare professionals' perceptions and experiences of Shared Decision-Making at end of life in the home. Qualitative design using focus groups, transcribed verbatim and analysed thematically. A total of 43 participants, from multi-disciplinary community-based services in one region of the United Kingdom, were recruited. While the rhetoric of Shared Decision-Making was recognised, its implementation was impacted by several interconnecting factors, including (1) conceptual confusion regarding Shared Decision-Making, (2) uncertainty in the process and (3) organisational factors which impeded Shared Decision-Making. Multiple interacting factors influence implementation of Shared Decision-Making by professionals working in complex community settings at the end of life. Moving from rhetoric to reality requires future work exploring the realities of Shared Decision-Making practice at individual, process and systems levels.

Community engagement on the Thai–Burmese border: rationale, experience and lessons learnt

PubMed Central

Cheah, Phaik Yeong; Lwin, Khin Maung; Phaiphun, Lucy; Maelankiri, Ladda; Parker, Michael; Day, Nicholas P.; White, Nicholas J.; Nosten, François

2012-01-01

Community engagement is increasingly promoted in developing countries, especially in international health research, but there is little published experience. The Shoklo Malaria Research Unit (SMRU) conducts research with refugees, migrant workers, displaced people, and day migrants on the Thai-Burmese border, and has recently facilitated the set up of the Tak Province Border Community Ethics Advisory Board (T-CAB). Valuable lessons have been learnt from consultation with the T-CAB especially in the area of participant recruitment and the informed consent process. A lot of new research questions have emerged from consultation with the T-CAB. This paper describes our experience, lessons learnt and the unique challenges faced working with the T-CAB from its initial conception to date. We conclude that consultation with the T-CAB has made improvements in our research in particular operational and ethical aspects of our studies. PMID:22984375

Prevention of postpartum haemorrhage: cost consequences analysis of misoprostol in low-resource settings.

PubMed

Lang, Danielle L; Zhao, Fei-Li; Robertson, Jane

2015-11-23

While inferior to oxytocin injection in both efficacy and safety, orally administered misoprostol has been included in the World Health Organization Model List of Essential Medicines for use in the prevention of postpartum haemorrhage (PPH) in low-resource settings. This study evaluates the costs and health outcomes of use of oral misoprostol to prevent PPH in settings where injectable uterotonics are not available. A cost-consequences analysis was conducted from the international health system perspective, using data from a recent Cochrane systematic review and WHO's Mother-Baby Package Costing Spreadsheet in a hypothetical cohort of 1000 births in a mixed hospital (40% births)/community setting (60% births). Costs were estimated based on 2012 US dollars. Using oxytocin in the hospital setting and misoprostol in the community setting in a cohort of 1000 births, instead of oxytocin (hospital setting) and no treatment (community setting), 22 cases of PPH could be prevented. Six fewer women would require additional uterotonics and four fewer women a blood transfusion. An additional 130 women would experience shivering and an extra 42 women fever. Oxytocin/misoprostol was found to be cost saving (US$320) compared to oxytocin/no treatment. If misoprostol is used in both the hospital and community setting compared with no treatment (i.e. oxytocin not available in the hospital setting), 37 cases of PPH could be prevented; ten fewer women would require additional uterotonics; and six fewer women a blood transfusion. An additional 217 women would experience shivering and 70 fever. The cost savings would be US$533. Sensitivity analyses indicate that the results are sensitive to the incidence of PPH-related outcomes, drug costs and the proportion of hospital births. Our findings confirm that, even though misoprostol is not the optimum choice in the prevention of PPH, misoprostol could be an effective and cost-saving choice where oxytocin is not or cannot be used due to a lack of skilled birth attendants, inadequate transport and storage facilities or where a quality assured oxytocin product is not available. These benefits need to be weighed against the large number of additional side effects such as shivering and fever, which have been described as tolerable and of short duration.

Typhoid fever vaccination strategies.

PubMed

Date, Kashmira A; Bentsi-Enchill, Adwoa; Marks, Florian; Fox, Kimberley

2015-06-19

Typhoid vaccination is an important component of typhoid fever prevention and control, and is recommended for public health programmatic use in both endemic and outbreak settings. We reviewed experiences with various vaccination strategies using the currently available typhoid vaccines (injectable Vi polysaccharide vaccine [ViPS], oral Ty21a vaccine, and injectable typhoid conjugate vaccine [TCV]). We assessed the rationale, acceptability, effectiveness, impact and implementation lessons of these strategies to inform effective typhoid vaccination strategies for the future. Vaccination strategies were categorized by vaccine disease control strategy (preemptive use for endemic disease or to prevent an outbreak, and reactive use for outbreak control) and vaccine delivery strategy (community-based routine, community-based campaign and school-based). Almost all public health typhoid vaccination programs used ViPS vaccine and have been in countries of Asia, with one example in the Pacific and one experience using the Ty21a vaccine in South America. All vaccination strategies were found to be acceptable, feasible and effective in the settings evaluated; evidence of impact, where available, was strongest in endemic settings and in the short- to medium-term. Vaccination was cost-effective in high-incidence but not low-incidence settings. Experience in disaster and outbreak settings remains limited. TCVs have recently become available and none are WHO-prequalified yet; no program experience with TCVs was found in published literature. Despite the demonstrated success of several typhoid vaccination strategies, typhoid vaccines remain underused. Implementation lessons should be applied to design optimal vaccination strategies using TCVs which have several anticipated advantages, such as potential for use in infant immunization programs and longer duration of protection, over the ViPS and Ty21a vaccines for typhoid prevention and control. Copyright © 2015. Published by Elsevier Ltd.

Coping with Rural Poverty: Economic Survival and Moral Capital in Rural America

ERIC Educational Resources Information Center

Sherman, Jennifer

2006-01-01

The experience of rural poverty is in many ways unique from that of urban poverty. In the rural setting, social cohesion creates pressure on the poor to behave in ways that are consistent with local values. This paper, based on qualitative research done in an isolated, rural Northern California community, argues that in this setting the survival…

ENGAGING COMMUNITIES TO STRENGTHEN RESEARCH ETHICS IN LOW-INCOME SETTINGS: SELECTION AND PERCEPTIONS OF MEMBERS OF A NETWORK OF REPRESENTATIVES IN COASTAL KENYA

PubMed Central

Kamuya, Dorcas M; Marsh, Vicki; Kombe, Francis K; Geissler, P Wenzel; Molyneux, Sassy C

2013-01-01

There is wide agreement that community engagement is important for many research types and settings, often including interaction with ‘representatives’ of communities. There is relatively little published experience of community engagement in international research settings, with available information focusing on Community Advisory Boards or Groups (CAB/CAGs), or variants of these, where CAB/G members often advise researchers on behalf of the communities they represent. In this paper we describe a network of community members (‘KEMRI Community Representatives’, or ‘KCRs’) linked to a large multi-disciplinary research programme on the Kenyan Coast. Unlike many CAB/Gs, the intention with the KCR network has evolved to be for members to represent the geographical areas in which a diverse range of health studies are conducted through being typical of those communities. We draw on routine reports, self-administered questionnaires and interviews to: 1) document how typical KCR members are of the local communities in terms of basic characteristics, and 2) explore KCR's perceptions of their roles, and of the benefits and challenges of undertaking these roles. We conclude that this evolving network is a potentially valuable way of strengthening interactions between a research institution and a local geographic community, through contributing to meeting intrinsic ethical values such as showing respect, and instrumental values such as improving consent processes. However, there are numerous challenges involved. Other ways of interacting with members of local communities, including community leaders, and the most vulnerable groups least likely to be vocal in representative groups, have always been, and remain, essential. PMID:23433404

SPRUCE Large-Collar In Situ CO2 and CH4 Flux Data for the SPRUCE Experimental Plots: Whole-Ecosystem-Warming

DOE Data Explorer

Hanson, P. J. [Oak Ridge National Laboratory, U.S. Department of Energy, Oak Ridge, Tennessee, U.S.A.; Phillips, J. R. [Oak Ridge National Laboratory, U.S. Department of Energy, Oak Ridge, Tennessee, U.S.A.; Riggs, J. S. [Oak Ridge National Laboratory, U.S. Department of Energy, Oak Ridge, Tennessee, U.S.A.; Nettles, W. R. [Oak Ridge National Laboratory, U.S. Department of Energy, Oak Ridge, Tennessee, U.S.A.

2017-01-01

This data set reports community-level CO2 and CH4 flux measurements for the SPRUCE experimental study plots located in the S1-Bog. Surface flux measurements of CO2 and CH4 were made using open-path analyzers over an area of 1.13 m2 within each of 16 plots. A custom-designed chamber encloses the hummock-hollow topography and allows point in time measurements of the shrub, forb, Sphagnum spp. and the complex microbial community. These observations were made with ambient light and imposed dark conditions to allow estimates of community daytime and night respiratory processes. This data set is all inclusive – beginning in 2011 and continuing through the Whole-Ecosystem-Warming (WEW) phase of the experiment.

University Research--Reaching Out to the Community.

ERIC Educational Resources Information Center

Coleman, Elizabeth

1994-01-01

Describes three programs that are a result of a bead filtering system used for aquaculture developed in a university setting. Two of the programs described are career-training experiments for high school and junior high school students. (LZ)

Fostering Collaborative Leadership through Playbuilding

ERIC Educational Resources Information Center

Bishop, Kathy; Weigler, Will; Lloyd, Tracey; Beare, David

2017-01-01

Playbuilding is one response to the search for creative ways to approach leadership and learning. Drawing upon their practical experiences within community-based, secondary school, and university settings, the authors share stories and strategies for fostering collaborative leadership through playbuilding.

Rural Food and Physical Activity Assessment Using an Electronic Tablet-Based Application, New York, 2013-2014.

PubMed

Seguin, Rebecca A; Morgan, Emily H; Connor, Leah M; Garner, Jennifer A; King, Abby C; Sheats, Jylana L; Winter, Sandra J; Buman, Matthew P

2015-07-02

A community's built environment can influence health behaviors. Rural populations experience significant health disparities, yet built environment studies in these settings are limited. We used an electronic tablet-based community assessment tool to conduct built environment audits in rural settings. The primary objective of this qualitative study was to evaluate the usefulness of the tool in identifying barriers and facilitators to healthy eating and active living. The second objective was to understand resident perspectives on community features and opportunities for improvement. Participants were recruited from 4 rural communities in New York State. Using the tool, participants completed 2 audits, which consisted of taking pictures and recording audio narratives about community features perceived as assets or barriers to healthy eating and active living. Follow-up focus groups explored the audit experience, data captured, and opportunities for change. Twenty-four adults (mean age, 69.4 y (standard deviation, 13.2 y), 6 per community, participated in the study. The most frequently captured features related to active living were related to roads, sidewalks, and walkable destinations. Restaurants, nontraditional food stores, and supermarkets were identified in the food environment in relation to the cost, quality, and selection of healthy foods available. In general, participants found the assessment tool to be simple and enjoyable to use. An electronic tablet-based tool can be used to assess rural food and physical activity environments and may be useful in identifying and prioritizing resident-led change initiatives. This resident-led assessment approach may also be helpful for informing and evaluating rural community-based interventions.

Living in an older adult community: a pharmacy student's experience.

PubMed

Anastasia, Emily; Estus, Erica

2013-12-01

Interacting with older adults is a daily practice for pharmacists. It is important to understand how medications affect their wellbeing, but there are many other factors that affect quality of life. To truly understand some of the challenges facing older adults, Emily Anastasia, a sixth-year pharmacy student at the University of Rhode Island, moved into South Bay Retirement Living, a senior living community, for an eight-day immersion experience as a special project within one of her advanced pharmacy practice experience rotations. During her stay, she did not attend classes nor leave the facility unless on the South Bay bus with the other assisted living residents. She lived with a 92-year-old roommate, developed close friendships with many of the residents, and kept a detailed journal of her experience. The purpose of this reflection is to share her experience and recognize lifestyle as well as social and physical environment as factors in understanding the aging process. Immersing a pharmacy student within an assisted living community provides a unique opportunity to observe and appreciate characteristics of older adults that cannot be learned within a classroom setting.

The Training and Field Work Experiences of Community Health Workers conducting non-invasive, population-based screening for Cardiovascular Disease in Four Communities in Low and Middle-Income Settings

PubMed Central

Denman, Catalina A.; Montano, Carlos Mendoza; Gaziano, Thomas A.; Levitt, Naomi; Rivera-Andrade, Alvaro; Carrasco, Diana Munguía; Zulu, Jabu; Khanam, Masuma Akter; Puoane, Thandi

2015-01-01

Background Cardiovascular disease (CVD) is on the rise in low- and middle-income countries (LMIC) and is proving difficult to combat due to the emphasis on improving outcomes in maternal and child health and infectious diseases, against a backdrop of severe human resource and infrastructure constraints. Effective task-sharing from physicians or nurses to community health workers (CHWs) to conduct population-based screening for persons at risk, has the potential to mitigate the impact of CVD on vulnerable populations. CHWs in Bangladesh, Guatemala, Mexico, and South Africa were trained to conduct non-invasive population-based screening for persons at high risk for CVD. Objective (s) The objectives of this study were to quantitatively assess the performance of CHWs during training and to qualitatively capture their training and fieldwork experiences while conducting non-invasive screening for cardiovascular disease (CVD) risk in their communities. Methods Written tests were used to assess CHWs’ acquisition of content knowledge during training, and focus group discussions conducted to capture their training and fieldwork experiences. Results Training was effective at increasing the CHWs’ content knowledge of cardiovascular disease (CVD) and this knowledge was largely retained up to six months after the completion of field work. Common themes which need to be addressed when designing task sharing with CHWs in chronic diseases are identified, including language, respect, and compensation. The importance of having intimate knowledge of the community receiving services from design to implementation is underscored. Conclusions Effective training for screening for CVD in community settings should have a strong didactic core that is supplemented with culture-specific adaptations in the delivery of instruction. The incorporation of expert and intimate knowledge of the communities themselves is critical, from the design to implementation phases of training. Challenges such as role definition, defining career paths, and providing adequate remuneration, must be addressed. PMID:25754566

Impact and management of dual relationships in metropolitan, regional and rural mental health practice.

PubMed

Endacott, Ruth; Wood, Anita; Judd, Fiona; Hulbert, Carol; Thomas, Ben; Grigg, Margaret

2006-01-01

To explore the extent and impact of professional boundary crossings in metropolitan, regional and rural mental health practice in Victoria and identify strategies mental health clinicians use to manage dual relationships. Nine geographically located focus groups consisting of mental health clinicians: four focus groups in rural settings; three in a regional city and two in a metropolitan mental health service. A total of 52 participants were interviewed. Data revealed that professional boundaries were frequently breached in regional and rural settings and on occasions these breaches had a significantly negative impact. Factors influencing the impact were: longevity of the clinician's relationship with the community, expectations of the community, exposure to community 'gossip' and size of the community. Participants reported greater stress when the boundary crossing affected their partner and/or children. Clinicians used a range of proactive and reactive strategies, such as private telephone number, avoidance of social community activities, when faced with a potential boundary crossing. The feasibility of reactive strategies depended on the service configuration: availability of an alternative case manager, requirement for either patient or clinician to travel. The greater challenges faced by rural and regional clinicians were validated by metropolitan participants with rural experience and rural participants with metropolitan experience. No single strategy is used or appropriate for managing dual relationships in rural settings. Employers and professional bodies should provide clearer guidance for clinicians both in the management of dual relationships and the distinction between boundary crossings and boundary violation. Clinicians are clearly seeking to represent and protect the patients' interests; consideration should be given by consumer groups to steps that can be taken by patients to reciprocate.

Experiences in conducting multiple community-based HIV prevention trials among women in KwaZulu-Natal, South Africa

PubMed Central

2010-01-01

Background South Africa, with its scientific capacity, good infrastructure and high HIV incidence rates, is ideally positioned to conduct large-scale HIV prevention trials. The HIV Prevention Research Unit of the South African Medical Research Council conducted four phase III and one phase IIb trials of women-initiated HIV prevention options in KwaZulu-Natal between 2003 and 2009. A total of 7046 women participated, with HIV prevalence between 25% and 45% and HIV incidence ranging from 4.5-9.1% per year. Unfortunately none of the interventions tested had any impact on reducing the risk of HIV acquisition; however, extremely valuable experience was gained, lessons learned and capacity built, while the communities gained associated benefits. Experience Our experience in conducting these trials ranged from setting up community partnerships to developing clinical research sites and dissemination of trial results. Community engagement included setting up community-based research sites with approval from both political and traditional leaders, and developing community advisory groups to assist with the research process. Community-wide education on HIV/sexually transmitted infection prevention, treatment and care was provided to over 90 000 individuals. Myths and misconceptions were addressed through methods such as anonymous suggestion boxes in clinic waiting areas and intensive education and counselling. Attempts were made to involve male partners to foster support and facilitate recruitment of women. Peer educator programmes were initiated to provide ongoing education and also to facilitate recruitment of women to the trials. Recruitment strategies such as door-to-door recruitment and community group meetings were initiated. Over 90% of women enrolled were retained. Community benefits from the trial included education on HIV prevention, treatment and care and provision of ancillary care (such as Pap smears, reproductive health care and referral for chronic illnesses). Social benefits included training of home-based caregivers and sustainable ongoing HIV prevention education through peer educator programmes. Challenges Several challenges were encountered, including manipulation by participants of their eligibility criteria in order to enroll in the trial. Women attempted to co-enroll in multiple trials to benefit from financial reimbursements and individualised care. The trials became ethically challenging when participants refused to take up referrals for care due to stigma, denial of their HIV status and inadequate health infrastructure. Lack of disclosure of HIV status to partners and family members was particularly challenging. Some of the ethical dilemmas put to the test our responsibility as researchers and our obligation to provide health care to research participants. Conclusion Conducting these five trials in a period of six years provided us with invaluable insights into trial implementation, community participation, recruitment and retention, provision of care and dissemination of trial results. The critical mass of scientists trained as clinical trialists will continue to address the relentless HIV epidemic in our setting and ensure our commitment to finding a biomedical HIV prevention option for women in the future. PMID:20416063

Community pharmacists as educators in Danish residential facilities: a qualitative study.

PubMed

Mygind, Anna; El-Souri, Mira; Pultz, Kirsten; Rossing, Charlotte; Thomsen, Linda A

2017-08-01

To explore experiences with engaging community pharmacists in educational programmes on quality and safety in medication handling in residential facilities for the disabled. A secondary analysis of data from two Danish intervention studies where community pharmacists were engaged in educational programmes. Data included 10 semi-structured interviews with staff, five semi-structured interviews and three open-ended questionnaires with residential facility managers, and five open-ended questionnaires to community pharmacists. Data were thematically coded to identify key points pertaining to the themes 'pharmacists as educators' and 'perceived effects of engaging pharmacists in competence development'. As educators, pharmacists were successful as medicines experts. Some pharmacists experienced pedagogical challenges. Previous teaching experience and obtained knowledge of the local residential facility before teaching often provided sufficient pedagogical skills and tailored teaching to local needs. Effects of engaging community pharmacists included in most instances improved cooperation between residential facilities and community pharmacies through a trustful relationship and improved dialogue about the residents' medication. Other effects included a perception of improved patient safety, teaching skills and branding of the pharmacy. Community pharmacists provide a resource to engage in educational programmes on medication handling in residential facilities, which may facilitate improved cooperation between community pharmacies and residential facilities. However, development of pedagogical competences and understandings of local settings are prerequisites for facilities and pharmacists to experience the programmes as successful. © 2016 Royal Pharmaceutical Society.

Job satisfaction among chain community pharmacists: results from a pilot study

PubMed Central

Hincapie, Ana L.; Yandow, Stephanie; Hines, Stephanie; Martineau, Megan; Warholak, Terri

Objective The objectives of this study were to obtain pilot data concerning the job satisfaction of Tucson area retail chain setting and to identify the facets of community practice that have the greatest contribution to job satisfaction Methods This was a cross-sectional study of chain pharmacists in the Tucson area. The Warr-Cook-Wall questionnaire of job satisfaction was used to evaluate community pharmacists’ satisfaction with their current position. This study used Rasch analysis to assess the validity and reliability of the questionnaire. The Rasch scores obtained for each respondent were used as a dependent variable in univariate and bivariate analyses to evaluate differences in job satisfaction. Results A total of 32 pharmacists responded from 129 chain community pharmacies in the cities of Tucson, Marana and Oro Valley, Arizona. The mean (SD) Rasch score for job satisfaction was 0.93 (2.1). Results from bivariate analysis indicate that pharmacists in the Tucson area with practice experience outside community pharmacy were less satisfied with their job compared to those without experience outside community pharmacy (p<0.01). Conclusions This pilot evaluation suggests that having pharmacy experience outside community practice affects pharmacist job satisfaction. Additionally, findings from this study indicate that there is reliability and validity evidence to support the use of the modified Warr-Cook-Wall questionnaire for assessing overall job satisfaction in chain community pharmacy practice. PMID:24155841

Cross-Cordillera exchange mediated by the Panama Canal increased the species richness of local freshwater fish assemblages.

PubMed Central

Smith, Scott A.; Bell, Graham; Bermingham, Eldredge

2004-01-01

Completion of the Panama Canal in 1914 breached the continental divide and set into motion a natural experiment of unprecedented magnitude by bringing previously isolated freshwater fish communities into contact. The construction of a freshwater corridor connecting evolutionarily isolated communities in Pacific and Caribbean watersheds dramatically increased the rate of dispersal, without directly affecting species interactions. Here, we report that a large fraction of species have been able to establish themselves on the other side of the continental divide, whereas no species have become extinct, leading to a local increase in species richness. Our results suggest that communities are not saturated and that competitive exclusion does not occur over the time-scale previously envisioned. Moreover, the results of this unintentional experiment demonstrate that community composition and species richness were regulated by the regional process of dispersal, rather than by local processes such as competition and predation. PMID:15347510

Multicultural social policy and community participation in health: new opportunities and challenges for indigenous people.

PubMed

Torri, Maria Costanza

2012-01-01

Community participation in local health has assumed a central role in the reforms of public healthcare, being increasingly associated with the issue of decentralization of the health system. The aim of this paper is to raise questions regarding the structural approaches to multicultural social policy in Chile and to analyze the results of its implementation. The article analyzes the case study of Makewe Hospital, one of the pioneering experiences of intercultural health initiative in Chile. The Makewe Hospital, which involves the indigenous community of the Mapuche, provides interesting insights to understand the dynamics of multicultural social policy and presents an example of a successful initiative that has succeeded in involving local communities in multicultural health policy. This case study discusses the effectiveness of grassroots participation in multicultural healthcare provision and presents the main strengths and challenges for the replicability of this experience in other settings. Copyright © 2011 John Wiley & Sons, Ltd.

Value Added: Learning Communities, Experiential Process and Student Engagement in Life Long Learning in the Culinary Arts

ERIC Educational Resources Information Center

Smyth, Thomas J.

2016-01-01

Culinary Arts training at the associates level presents a set of challenges to the instructor. It has been my experience that as the work environment is changing, students face new challenges in the kitchen, including a new mix of skills, both technical and social in nature. In this piece, I reflect on a promising learning community model at our…

Understanding How Participants Become Champions and Succeed in Adopting Healthy Lifestyles: A Storytelling of a Community Health and Nutrition Program at a Land-Grant University

ERIC Educational Resources Information Center

Keo, Phalla Duong

2016-01-01

The purpose of this study was to investigate and understand the experiences of participants who become champions and succeed in adopting healthy lifestyles. The setting was a health and nutrition educational program at University of Minnesota Extension. The main research questions were: How do participants in the Community Health Education Program…

Experiences of Students with Disabilities in Selected Community and Technical Colleges. The Individual Accommodations Model: Accommodating Students with Disabilities in Post-Secondary Settings.

ERIC Educational Resources Information Center

Lancaster, Sean; Mellard, Daryl; Hoffman, Lesa

Student questionnaires were administered to 61 students with disabilities currently enrolled in community colleges in Kansas (n=20), Minnesota (n=23), and California (n=18). This information was collected through two campus visits during the fall of 1999. Students reported an average of 1.3 disabilities per person, ranging from 1-6. The most…

Hospital Security and Force Protection: A Guide to Ensuring Patient and Employee Safety

DTIC Science & Technology

2006-04-28

leader and set up training camps for his recruits. Through these experiences, Osama Bin Laden was able to obtain money , weapons, and develop connections...options to deter counterfeits . Hospital Security 50 Membership within community collaboratives or community-based organizations provides excellent...iris or fingerprints scans are resistant to theft and counterfeit , assuring access to only authorized personnel. Many theme parks are utilizing this

Mental health impacts of racial discrimination in Australian culturally and linguistically diverse communities: a cross-sectional survey.

PubMed

Ferdinand, Angeline S; Paradies, Yin; Kelaher, Margaret

2015-04-18

Racial discrimination denies those from racial and ethnic minority backgrounds access to rights such as the ability to participate equally and freely in community and public life, equitable service provision and freedom from violence. Our study was designed to examine how people from racial and ethnic minority backgrounds in four Australian localities experience and respond to racial discrimination, as well as associated health impacts. Data were collected from 1,139 Australians regarding types of racial discrimination experienced, settings for these incidents, response mechanisms and psychological distress as measured by the Kessler 6 (K6) Psychological Distress Scale. Age, education, religion, gender, visibility and rurality were all significantly associated with differences in the frequency of experiencing racial discrimination. Experiencing racial discrimination was associated with worse mental health. Mental health impacts were not associated with the type of discriminatory experience, but experiencing racial discrimination in shops and in employment and government settings was associated with being above the threshold for high or very high psychological distress. One out of twelve response mechanisms was found to be associated with lower stress following a discriminatory incident. Study results indicate that poorer mental health was associated with the volume of discrimination experienced, rather than the type of experience. However, the impact of experiencing discrimination in some settings was shown to be particularly associated with high or very high psychological distress. Our findings suggest that interventions designed to prevent the occurrence of racism have more potential to increase mental health in racial and ethnic minority communities than interventions that work with individuals in response to experiencing racism.

Curriculum & Instruction: Curriculum Outcomes, Learning Plan Negotiation, Career Explorations, Projects, Learning & Skill Building Levels, Competencies, Student Journals, Employer Seminars, Learning Resources. Handbook for Experience-Based Career Education.

ERIC Educational Resources Information Center

Anderson, Nancy; And Others

This is one of a set of five handbooks compiled by the Northwest Regional Educational Laboratory which describes the processes for planning and operating a total Experience-Based Career Education (EBCE) program. Processes and material are those developed by the original EBCE model--Community Experiences in Career Education or (CE)2. The area of…

Developing Dental Students' Awareness of Health Care Disparities and Desire to Serve Vulnerable Populations Through Service-Learning.

PubMed

Behar-Horenstein, Linda S; Feng, Xiaoying; Roberts, Kellie W; Gibbs, Micaela; Catalanotto, Frank A; Hudson-Vassell, Charisse M

2015-10-01

Service-learning in dental education helps students integrate knowledge with practice in an underserved community setting. The aim of this study was to explore how a service-learning experience affected a small group of dental students' beliefs about cultural competence, professionalism, career development, desire to practice in a community service setting, and perceptions about access and disparities issues. Prior to beginning their first year of dental school, five first-year dental students at one U.S. dental school participated in a six-week service-learning program in which they interned at one of three at-risk settings in order to experience health care delivery there. After the program, 60 reflective writing assignments completed by the participants were analyzed using grounded theory methods; interviews with the students were used to corroborate the findings from that analysis. Seven themes identified in the journal reflections and interview findings showed enhanced awareness of social health care issues and patient differences, as well as a social justice orientation and desire to address disparities. Building on this study, future research should explore the curricular components of service-learning programs to ensure students receive ample opportunity to reflect upon their experiences in order to integrate previously held assumptions with their newfound knowledge.

The Experiences of Older Students' Use of Web-Based Student Services

ERIC Educational Resources Information Center

Ho, Katy W.

2012-01-01

The purpose of this phenomenological case study was to understand the experiences of older students' use of web-based student services in a community college setting. For the purpose of this study the term "older student" was defined as people born between the years 1943 and 1960. This group of people, often described as the Baby Boomer…

The prevalence and experience of Australian naturopaths and Western herbalists working within community pharmacies.

PubMed

Braun, Lesley A; Spitzer, Ondine; Tiralongo, Evelin; Wilkinson, Jenny M; Bailey, Michael; Poole, Susan; Dooley, Michael

2011-05-23

Naturopaths and Western herbal medicine (WHM) practitioners were surveyed to identify their extent, experience and roles within the community pharmacy setting and to explore their attitudes to integration of complementary medicine (CM) practitioners within the pharmacy setting. Practising naturopaths and WHM practitioners were invited to participate in an anonymous, self-administered, on-line survey. Participants were recruited using the mailing lists and websites of CM manufacturers and professional associations. 479 practitioners participated. 24% of respondents (n=111) reported they had worked in community pharmacy, three-quarters for less than 5 years. Whilst in this role 74% conducted specialist CMs sales, 62% short customer consultations, 52% long consultations in a private room and 51% staff education. This was generally described as a positive learning experience and many appreciated the opportunity to utilise their specialist knowledge in the service of both customers and pharmacy staff. 14% (n=15) did not enjoy the experience of working in pharmacy at all and suggested pharmacist attitude largely influenced whether the experience was positive or not. Few practitioners were satisfied with the remuneration received. 44% of the total sample provided comment on the issue of integration into pharmacy, with the main concern being the perceived incommensurate paradigms of practice between pharmacy and naturopathy. Of the total sample, 38% reported that they would consider working as a practitioner in retail pharmacy in future. The level of integration of CM into pharmacy is extending beyond the mere stocking of supplements. Naturopaths and Western Herbalists are becoming utilised in pharmacies.

The prevalence and experience of Australian naturopaths and Western herbalists working within community pharmacies

PubMed Central

2011-01-01

Background Naturopaths and Western herbal medicine (WHM) practitioners were surveyed to identify their extent, experience and roles within the community pharmacy setting and to explore their attitudes to integration of complementary medicine (CM) practitioners within the pharmacy setting. Method Practising naturopaths and WHM practitioners were invited to participate in an anonymous, self-administered, on-line survey. Participants were recruited using the mailing lists and websites of CM manufacturers and professional associations. Results 479 practitioners participated. 24% of respondents (n = 111) reported they had worked in community pharmacy, three-quarters for less than 5 years. Whilst in this role 74% conducted specialist CMs sales, 62% short customer consultations, 52% long consultations in a private room and 51% staff education. This was generally described as a positive learning experience and many appreciated the opportunity to utilise their specialist knowledge in the service of both customers and pharmacy staff. 14% (n = 15) did not enjoy the experience of working in pharmacy at all and suggested pharmacist attitude largely influenced whether the experience was positive or not. Few practitioners were satisfied with the remuneration received. 44% of the total sample provided comment on the issue of integration into pharmacy, with the main concern being the perceived incommensurate paradigms of practice between pharmacy and naturopathy. Of the total sample, 38% reported that they would consider working as a practitioner in retail pharmacy in future. Conclusions The level of integration of CM into pharmacy is extending beyond the mere stocking of supplements. Naturopaths and Western Herbalists are becoming utilised in pharmacies PMID:21600060

What are community nurses experiences of assessing frailty and assisting in planning subsequent interventions?

PubMed

Britton, Hannah

2017-09-02

With an ageing population and increasing focus on community care, this study aimed to explore the experiences of community nurses in assessing frailty and planning interventions around frailty. Six community nurses were recruited for face-to-face semi-structured interviews as part of this qualitative study which was underpinned by a competence framework ( Royal College of Nursing, 2009 ). Thematic analysis was used and frailty was identified as an emerging topic within practice. Participants discussed several aspects associated with frailty; however, some uncertainty around the concept of frailty and its definition was noted, particularly for staff who had received limited frailty training. Participants had a growing awareness of frailty in practice, but challenges-including time constraints and staffing within some roles, a perception of limited services to support older people, and for some a lack of confidence and training-presented barriers to frailty assessment. The Rockwood frailty scale was used by participants within practice, but evidence suggested it was felt to lack validity within the community setting.

Community detection in complex networks using proximate support vector clustering

NASA Astrophysics Data System (ADS)

Wang, Feifan; Zhang, Baihai; Chai, Senchun; Xia, Yuanqing

2018-03-01

Community structure, one of the most attention attracting properties in complex networks, has been a cornerstone in advances of various scientific branches. A number of tools have been involved in recent studies concentrating on the community detection algorithms. In this paper, we propose a support vector clustering method based on a proximity graph, owing to which the introduced algorithm surpasses the traditional support vector approach both in accuracy and complexity. Results of extensive experiments undertaken on computer generated networks and real world data sets illustrate competent performances in comparison with the other counterparts.

Expert Recommender: Designing for a Network Organization

NASA Astrophysics Data System (ADS)

Reichling, Tim; Veith, Michael; Wulf, Volker

Recent knowledge management initiatives focus on expertise sharing within formal organizational units and informal communities of practice. Expert recommender systems seem to be a promising tool in support of these initiatives. This paper presents experiences in designing an expert recommender system for a knowledge- intensive organization, namely the National Industry Association (NIA). Field study results provide a set of specific design requirements. Based on these requirements, we have designed an expert recommender system which is integrated into the specific software infrastructure of the organizational setting. The organizational setting is, as we will show, specific for historical, political, and economic reasons. These particularities influence the employees’ organizational and (inter-)personal needs within this setting. The paper connects empirical findings of a long-term case study with design experiences of an expertise recommender system.

Sex differences in perceived risk and testing experience of HIV in an urban fishing setting in Ghana.

PubMed

Yawson, Alfred E; Appiah, Labi K; Yawson, Anita O; Bonsu, George; Aluze-Ele, Simon; Amanhyia, Nana A K Owusu; Lartey, Margaret; Adjei, Andrew A; Lawson, Aaron L; Beckwith, Curt; Kwara, Awewura; Flanigan, Timothy

2014-11-15

Understanding sex differences in willingness to test and testing experience could aid the design of focus interventions to enhance uptake and engagement with care, treatment and support services. This study determined differences in perceived risk of acquiring HIV, willingness to test and HIV testing experience in an urban fishing community. A cross-sectional community survey was conducted in 2013 among men and women in two fishing communities (Chorkor and James Town) in Accra. In all, 554 subjects (≥ 18 years) were involved, 264 in Chorkor and 290 in James Town. Data on demographic characteristics, perceived risk for HIV and willingness to test for HIV and testing experience were collected with a structured questionnaire. Descriptive statistics and Chi square test were used for the analysis at 95% significant level, using SPSS version 21. Of 554 subjects, 329 (59.4%) were females, and median age was 32 years. Overall, only 91(40.4%) men and 118(35.9%) women perceived themselves to be at risk of acquiring HIV. A significant proportion of women were willing to test for HIV compared to men (86.3% vs. 80.0%, P = 0.048). Women were more likely to have ever tested for HIV compared to men (42.2% vs. 28.6%, P = 0.001) and more women had tested within 12 months prior to survey than men (49.6% vs. 40.6%, P = 0.230). Of the number who had tested for HIV infection, a higher proportion of men tested voluntarily 42(65.6%), while a higher proportion of women tested as part of healthcare service received 96(69.1%); (P = 0.001; indicating women vs. men). Sex differences in risk perception and willingness to test need more focused public education and behaviour change communication strategies to achieve high coverage. Community-based strategies could improve HIV testing among men whilst more access to testing in health settings should be available to women in these communities.

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.

The Community Mentorship Program: Providing Community-Engagement Opportunities for Early-Stage Clinical and Translational Scientists to Facilitate Research Translation

PubMed Central

Patino, Cecilia M.; Kubicek, Katrina; Robles, Marisela; Kiger, Holly; Dzekov, Jeanne

2016-01-01

Problem A goal of the Southern California Clinical and Translational Science Institute (SC-CTSI) at the University of Southern California (USC) and Children's Hospital Los Angeles is to train early-stage clinical translational scientists (CTSs) to conduct research that improves the health of diverse communities. This goal aligns well with the Institute of Medicine's recommendations emphasizing community engagement in biomedical research that facilitates research translation. The Community Mentorship Program (CMP), created to complement community-engaged research (CER) didactics, matches CTSs with community mentors who help CTSs identify and complete community-engaged experiences that inform their research. Approach The CMP was piloted in 2013-2015 by the SC-CTSI Workforce Development and Community-Engagement cores. The CMP team matched three CTSs (assistant professors pursuing mentored career development awards, two with CER experience) with mentors at community-based organizations (CBOs) aligned with their research interests. Each mentor–mentee pair signed a memorandum of understanding. The CMP team checked in regularly, monitoring progress and addressing challenges in CTSs’ completion of their community-engaged experience. Outcomes All pairs completed at least one community-engaged activity informing the CTS's research. In exit interviews, the CTSs and CBO mentors expressed satisfaction with the program and stated they would continue to work together. The CTSs reported the program provided opportunities to develop networks outside academia, build trust within the community, and receive feedback and learn from individuals in communities affected by their research. Next Steps The CMP will be expanded to include all eligible early-career CTSs and promoted for use in similar settings outside the SC-CTSI. PMID:27508342

High-energy neutron depth-dose distribution experiment.

PubMed

Ferenci, M S; Hertel, N E

2003-01-01

A unique set of high-energy neutron depth-dose benchmark experiments were performed at the Los Alamos Neutron Science Center/Weapons Neutron Research (LANSCE/WNR) complex. The experiments consisted of filtered neutron beams with energies up to 800 MeV impinging on a 30 x 30 x 30 cm3 liquid, tissue-equivalent phantom. The absorbed dose was measured in the phantom at various depths with tissue-equivalent ion chambers. This experiment is intended to serve as a benchmark experiment for the testing of high-energy radiation transport codes for the international radiation protection community.

Shaping the Future of Patient Experience Measurement in Canadian Healthcare.

PubMed

Sutherland, Jason M

2017-10-01

Patients' experiences with healthcare providers can be tumultuous and stressful. Focusing on what matters, the experience of care is important to improving patients' quality of life. In this issue's lead article, Kuluski and colleagues (2017) propose moving beyond setting-based patient experience measures. In doing so, the authors emphasize the importance of caregivers and the communities in which patients live in improving patients' and caregivers' care experiences. To achieve these aims, however, the authors demand a higher level of reflexivity from provinces' healthcare funders and providers. © 2017 Longwoods Publishing.

An Intervention To Enhance the Food Environment in Public Recreation and Sport Settings: A Natural Experiment in British Columbia, Canada.

PubMed

Naylor, Patti-Jean; Olstad, Dana Lee; Therrien, Suzanne

2015-08-01

Publicly funded recreation and sports facilities provide children with access to affordable physical activities, although they often have unhealthy food environments that may increase child obesity risk. This study evaluated the impact of a capacity-building intervention (Healthy Food and Beverage Sales; HFBS) on organizational capacity for providing healthy food environments, health of vending machine products, and food policy development in recreation and sport facilities in British Columbia, Canada. Twenty-one HFBS communities received training, resources, and technical support to improve their food environment over 8 months in 2009-2010, whereas 23 comparison communities did not. Communities self-reported organizational capacity, food policies, and audited vending machine products at baseline and follow-up. Repeated-measures analysis of variance evaluated intervention impact. Intervention and comparison communities reported higher organizational capacity at follow-up; however, improvements were greater in HFBS communities (p<0.001). Healthy vending products increased from 11% to 15% (p<0.05), whereas unhealthy products declined from 56% to 46% (p<0.05) in HFBS communities, with no changes in comparison communities. At baseline 10% of HFBS communities reported having a healthy food policy, whereas 48% reported one at follow-up. No comparison communities had food policies. This is the first large, controlled study to examine the impact of an intervention to improve recreation and sport facility food environments. HFBS communities increased their self-rated capacity to provide healthy foods, healthy vending product offerings, and food policies to a greater extent than comparison communities. Recreation and sport settings are a priority setting for supporting healthy dietary behaviors among children.

Community pharmacists and Colleges of Pharmacy: the Ohio partnership.

PubMed

Sweeney, Marc A; Mauro, Vincent F; Cable, Gerald L; Rudnicki, Barbara M; Wall, Andrea L; Murphy, Christine C; Makarich, Joseph A; Kahaleh, Abir A

2005-01-01

To develop pharmacist practice standards, pharmacy preceptor standards, and objectives for students completing advanced practice community pharmacy rotations. Ohio. Pharmacy schools and community pharmacies that serve as advanced practice rotation sites. Developed standards for preceptors and objectives for student experiences. Focus groups that included both community pharmacists and pharmacy faculty collaborated on defining key standards for advanced community pharmacy rotations. Not applicable. Three main documents were produced in this initiative, and these are provided as appendices to this article. Professional and patient care guidelines for preceptors define minimum standards for these role models. Expectations of pharmacists as preceptors provide insights for managing this student-teacher relationship, which is fundamentally different from the more common employer-employee and coworker relationships found in pharmacies of all types. Objectives for student experiences during advanced practice community pharmacy rotations present core expectations in clinical, dispensing, patient education, wellness, and drug information areas. Through this collaboration, Ohio colleges of pharmacy developed a partnership with practitioners in community settings that should enhance the Ohio experiential educational program for student pharmacists. Use of the established guidelines will help educators and practitioners achieve their shared vision for advanced practice community pharmacy rotations and promote high-quality patient care.

Using Performance Tools to Support Experiments in HPC Resilience

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

Naughton, III, Thomas J; Boehm, Swen; Engelmann, Christian

2014-01-01

The high performance computing (HPC) community is working to address fault tolerance and resilience concerns for current and future large scale computing platforms. This is driving enhancements in the programming environ- ments, specifically research on enhancing message passing libraries to support fault tolerant computing capabilities. The community has also recognized that tools for resilience experimentation are greatly lacking. However, we argue that there are several parallels between performance tools and resilience tools . As such, we believe the rich set of HPC performance-focused tools can be extended (repurposed) to benefit the resilience community. In this paper, we describe the initialmore » motivation to leverage standard HPC per- formance analysis techniques to aid in developing diagnostic tools to assist fault tolerance experiments for HPC applications. These diagnosis procedures help to provide context for the system when the errors (failures) occurred. We describe our initial work in leveraging an MPI performance trace tool to assist in provid- ing global context during fault injection experiments. Such tools will assist the HPC resilience community as they extend existing and new application codes to support fault tolerances.« less

Hospice family members' perceptions of and experiences with end-of-life care in the nursing home.

PubMed

Oliver, Debra Parker; Washington, Karla; Kruse, Robin L; Albright, David L; Lewis, Alexandria; Demiris, George

2014-10-01

Even though more than 25% of Americans die in nursing homes, end-of-life care has consistently been found to be less than adequate in this setting. Even for those residents on hospice, end-of-life care has been found to be problematic. This study had 2 research questions; (1) How do family members of hospice nursing home residents differ in their anxiety, depression, quality of life, social networks, perceptions of pain medication, and health compared with family members of community dwelling hospice patients? (2) What are family members' perceptions of and experiences with end-of-life care in the nursing home setting? This study is a secondary mixed methods analysis of interviews with family members of hospice nursing home residents and a comparative statistical analysis of standard outcome measures between family members of hospice patients in the nursing home and family members of hospice patients residing in the community. Outcome measures for family members of nursing home residents were compared (n = 176) with family members of community-dwelling hospice patients (n = 267). The family members of nursing home residents reported higher quality of life; however, levels of anxiety, depression, perceptions of pain medicine, and health were similar for hospice family members in the nursing home and in the community. Lending an understanding to the stress for hospice family members of nursing home residents, concerns were found with collaboration between the nursing home and the hospice, nursing home care that did not meet family expectations, communication problems, and resident care concerns including pain management. Some family members reported positive end-of-life care experiences in the nursing home setting. These interviews identify a multitude of barriers to quality end-of-life care in the nursing home setting, and demonstrate that support for family members is an essential part of quality end-of-life care for residents. This study suggests that nursing homes should embrace the opportunity to demonstrate the value of family participation in the care-planning process. Copyright © 2014 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Hospice family members’ perceptions and experiences with end-of-life care in the nursing home

PubMed Central

Washington, Karla; Kruse, Robin L.; Albright, David L; Lewis, Alexandria; Demiris, George

2014-01-01

Objective Despite the fact that more than 25% of Americans die in nursing homes, end-of-life care has consistently been found to be less than adequate in this setting. Even for those residents on hospice, end-of-life care has been found to be problematic. This study had two research questions; 1) How do family members of hospice nursing home residents differ in their anxiety, depression, quality of life, social networks, perceptions of pain medication, and health compared to family members of community dwelling hospice patients? 2) What are family members’ perceptions of and experiences with end-of-life care in the nursing home setting? Methods This study is a secondary mixed methods analysis of interviews with family members of hospice nursing home residents and a comparative statistical analysis of standard outcome measures between family members of hospice patients in the nursing home and family member of hospice patients residing in the community. Results Outcome measures for family members of nursing home residents were compared (n=176) with family members of community dwelling hospice patients (n=267). The family members of nursing home residents reported higher quality of life however, levels of anxiety, depression, perceptions of pain medicine, and health were similar for hospice family members in the nursing home and in the community. Lending an understanding to the stress for hospice family members of nursing home residents concerns were found with collaboration between the nursing home and the hospice, nursing home care that did not meet family expectations, communication problems, and resident care concerns including pain management. Some family members reported positive end-of-life care experiences in the nursing home setting. Conclusion These interviews identify a multitude of barriers to quality end-of-life care in the nursing home setting, and demonstrate that support for family members is an essential part of quality end-of-life care for residents. This study suggests that nursing homes should embrace the opportunity to demonstrate the value of family participation in the care planning process. PMID:25017391

A social ecological approach to investigating relationships between housing and adaptive functioning for persons with serious mental illness.

PubMed

Kloos, Bret; Shah, Seema

2009-12-01

This paper seeks to advance mental health-housing research regarding which factors of housing and neighborhood environments are critical for adaptive functioning, health, and recovery for persons with serious mental illness (SMI). Housing and neighborhood environments are particularly important for persons with SMI because of the prevalence of poor housing conditions among this population. Most mental health-housing research has been limited by a focus on problems in environments and functioning. The paper seeks to expand the mental health-housing research agenda to consider protective factors that promote community integration and adaptive functioning. We provide an account of how social ecology theory transformed a research program, from examining individual risk factors to investigating the functioning of persons in the contexts of their housing and neighborhood experiences. The resulting housing environment framework-physical aspects of housing and neighborhoods, social environment of neighborhoods, and interpersonal relationships tied to housing-allows for identification of opportunities for health promotion and facilitation of participation in community-based settings. This program of research draws upon several methods to understand the social experience of persons with SMI living in community settings-survey research, qualitative interviews, Geographic Information Systems, participatory research, and visual ethnography. In this paper, we present how social ecology theory was instrumental in the development of new housing environment measures, the selection of appropriate research methods, and framing research questions that are building a new empirical base of knowledge about promoting adaptive functioning, health, and recovery for persons with SMI living in community settings.

The 'Silver Book' on elderly care in hospitals and community settings.

PubMed

Dawood, Mary

2012-08-01

The number of people aged 85 and over is set to increase by two-thirds in the next 20 years, making it imperative that appropriate structures are in place and guidance is available for clinicians in every setting on best practice in caring for older people over the first 24 hours of an urgent care episode. This article discusses the launch of the Silver Book, which recommends ways in which emergency admissions can be reduced and the experience of those admitted improved.

A rotorcraft flight database for validation of vision-based ranging algorithms

NASA Technical Reports Server (NTRS)

Smith, Phillip N.

1992-01-01

A helicopter flight test experiment was conducted at the NASA Ames Research Center to obtain a database consisting of video imagery and accurate measurements of camera motion, camera calibration parameters, and true range information. The database was developed to allow verification of monocular passive range estimation algorithms for use in the autonomous navigation of rotorcraft during low altitude flight. The helicopter flight experiment is briefly described. Four data sets representative of the different helicopter maneuvers and the visual scenery encountered during the flight test are presented. These data sets will be made available to researchers in the computer vision community.

Care transitions for frail, older people from acute hospital wards within an integrated healthcare system in England: a qualitative case study

PubMed Central

Baillie, Lesley; Gallini, Andrew; Corser, Rachael; Elworthy, Gina; Scotcher, Ann; Barrand, Annabelle

2014-01-01

Introduction Frail older people experience frequent care transitions and an integrated healthcare system could reduce barriers to transitions between different settings. The study aimed to investigate care transitions of frail older people from acute hospital wards to community healthcare or community hospital wards, within a system that had vertically integrated acute hospital and community healthcare services. Theory and methods The research design was a multimethod, qualitative case study of one healthcare system in England; four acute hospital wards and two community hospital wards were studied in depth. The data were collected through: interviews with key staff (n = 17); focus groups (n = 9) with ward staff (n = 36); interviews with frail older people (n = 4). The data were analysed using the framework approach. Findings Three themes are presented: Care transitions within a vertically integrated healthcare system, Interprofessional communication and relationships; Patient and family involvement in care transitions. Discussion and conclusions A vertically integrated healthcare system supported care transitions from acute hospital wards through removal of organisational boundaries. However, boundaries between staff in different settings remained a barrier to transitions, as did capacity issues in community healthcare and social care. Staff in acute and community settings need opportunities to gain better understanding of each other's roles and build relationships and trust. PMID:24868193

Benefit and impact of the Arizona land-use experiment: Executive summary

NASA Technical Reports Server (NTRS)

Goodwin, G.

1977-01-01

The benefits and impact of the Arizona Land-Use Experiment on the people of Arizona are examined along with the process of the technology transfer to the political and private sector of the Arizona community. Since the remotely-sensed data in use in Arizona consisted of a blend of spacecraft and aircraft information, it was hoped that the role of the aircraft in the transfer process would be identified and its benefit be determined in a real-world situation. In addition, the role of the institutional arrangements set up in Arizona to facilitate the transfer of remotely-sensed information to the user community was examined.

Operation of Grid-tied 5 kWDC solar array to develop Laboratory Experiments for Solar PV Energy System courses

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

Ramos, Jaime

2012-12-14

To unlock the potential of micro grids we plan to build, commission and operate a 5 kWDC PV array and integrate it to the UTPA Engineering building low voltage network, as a micro grid; and promote community awareness. Assisted by a solar radiation tracker providing on-line information of its measurements and performing analysis for the use by the scientific and engineering community, we will write, perform and operate a set of Laboratory experiments and computer simulations supporting Electrical Engineering (graduate and undergraduate) courses on Renewable Energy, as well as Senior Design projects.

Practicing ethnography in migration-related detention centers: A reflexive account.

PubMed

Esposito, Francesca

2017-01-01

Feminist scholars, as well as community psychologists, have advocated the role of reflexive engagement in the research process in order to challenge power relations. Moreover, the liberating potential of storytelling, especially when working with issues of diversity and marginalization, has been stressed. The purpose of this article is to reflect on an ethnographic work underway in the Identification and Expulsion Center-CIE of Ponte Galeria, Rome. How the researcher's identities, values, and experiences, alongside power and privilege, have influenced her positioning in the research setting and the relationships formed with the different setting members is the subject of discussion. In sharing the story of this work, the final intent is to contribute to the joint effort to foster a reflexive community psychology practice incorporating feminist goals and a dialogue about ethnography in community psychology.

Managing Minor Ailments; The Public’s Preferences for Attributes of Community Pharmacies. A Discrete Choice Experiment

PubMed Central

Ryan, Mandy; Bond, Christine; Watson, Margaret

2016-01-01

Background Demand for health services continues to rise. Greater use of community pharmacy services instead of medical services for minor ailments could help relieve pressure on healthcare providers in high-cost settings. Community pharmacies are recognised sources of treatment and advice for people wishing to manage these ailments. However, increasing the public’s use of pharmacy services may depend on attributes of pharmacies and their staff. This study aimed to determine the general public’s relative preferences for community pharmacy attributes using a discrete choice experiment (DCE). Method A UK-wide DCE survey of the general public was conducted using face-to-face computer-assisted personal interviews. Attributes and levels for the DCE were informed by a literature review and a cohort study of community pharmacy customers. The context for the experiment was a minor ailment scenario describing flu-like symptoms. The DCE choice sets described two hypothetical community pharmacy services; respondents were asked to choose which (if either) of the two pharmacies they would prefer to help them manage symptoms. Data from 1,049 interviews were analysed using an error components logit model. Willingness to pay (WTP), a monetary measure of benefit, was estimated for the different attribute levels. Results When seeking help or treatment for flu-like symptoms, respondents most valued a pharmacy service that would improve their understanding and management of symptoms (WTP = £6.28), provided by staff who are trained (WTP (pharmacist) = £2.63: WTP(trained assistant) = £3.22), friendly and approachable (WTP = £3.38). Waiting time, pharmacy location and availability of parking also contributed to respondents’ preferences. WTP for a service comprising the best possible combination of attributes and levels was calculated as £55.43. Conclusion Attributes of a community pharmacy and its staff may influence people’s decisions about which pharmacy they would visit to access treatment and advice for minor ailments. In line with the public’s preferences, offering community pharmacy services that help people to better understand and manage symptoms, are provided promptly by trained staff who are friendly and approachable, and in a local setting with easy access to parking, has the potential to increase uptake amongst those seeking help to manage minor ailments. In this way it may be possible to shift demand away from high-cost health services and make more efficient use of scarce public resources. PMID:27031588

Frontline over ivory tower: key competencies in community-based curricula.

PubMed

Millar, Adam; Malcolm, Janine; Cheng, Alice; Fine, Rebecca; Wong, Rene

2015-01-01

The Royal College of Physicians and Surgeons of Canada mandates that community experiences be incorporated into medicine-based specialties. Presently there is wide variability in community endocrine experiences across Canadian training programs. This is complicated by the paucity of literature providing guidance on what constitutes a 'community' rotation. A modified Delphi technique was used to determine the CanMEDS competencies best taught in a community endocrinology curriculum. The Delphi technique is a qualitative-research method that uses a series of questionnaires sent to a group of experts with controlled feedback provided by the researchers after each survey round. The experts in this study included endocrinology program directors, community endocrinologists, endocrinology residents and recent endocrinology graduates. Thirty four out of 44 competencies rated by the panel were deemed suitable for a community curriculum. The experts considered the "Manager" role best taught in the community, while they considered the community least suitable to learn the "Medical Expert" competency. To our knowledge, this is the first time the content of a community-based subspecialty curriculum was determined using the Delphi process in Canada. These findings suggest that community settings have potential to fill in gaps in residency training in regards to the CanMEDS Manager role. The results will aid program directors in designing competency-based community endocrinology rotations and competency-based community rotations in other medical subspecialty programs.

Rural Oregon community perspectives: introducing community-based participatory research into a community health coalition.

PubMed

Young-Lorion, Julia; Davis, Melinda M; Kirks, Nancy; Hsu, Anna; Slater, Jana Kay; Rollins, Nancy; Aromaa, Susan; McGinnis, Paul

2013-01-01

The Community Health Improvement Partnership (CHIP) model has supported community health development in more than 100 communities nationally. In 2011, four rural Oregon CHIPs collaborated with investigators from the Oregon Rural Practice-based Research Network (ORPRN), a component of the Oregon Clinical and Translational Research Institute (OCTRI), to obtain training on research methods, develop and implement pilot research studies on childhood obesity, and explore matches with academic partners. This article summarizes the experiences of the Lincoln County CHIP, established in 2003, as it transitioned from CHIP to Community Health Improvement and Research Partnership (CHIRP). Our story and lessons learned may inform rural community-based health coalitions and academicians who are engaged in or considering Community-based participatory research (CBPR) partnerships. Utilizing existing infrastructure and relationships in community and academic settings provides an ideal starting point for rural, bidirectional research partnerships.

Community-based field implementation scenarios of a short message service reporting tool for lymphatic filariasis case estimates in Africa and Asia.

PubMed

Mableson, Hayley E; Martindale, Sarah; Stanton, Michelle C; Mackenzie, Charles; Kelly-Hope, Louise A

2017-01-01

Lymphatic filariasis (LF) is a neglected tropical disease (NTD) targeted for global elimination by 2020. Currently there is considerable international effort to scale-up morbidity management activities in endemic countries, however there remains a need for rapid, cost-effective methods and adaptable tools for obtaining estimates of people presenting with clinical manifestations of LF, namely lymphoedema and hydrocele. The mHealth tool ' MeasureSMS-Morbidity ' allows health workers in endemic areas to use their own mobile phones to send clinical information in a simple format using short message service (SMS). The experience gained through programmatic use of the tool in five endemic countries across a diversity of settings in Africa and Asia is used here to present implementation scenarios that are suitable for adapting the tool for use in a range of different programmatic, endemic, demographic and health system settings. A checklist of five key factors and sub-questions was used to determine and define specific community-based field implementation scenarios for using the MeasureSMS-Morbidity tool in a range of settings. These factors included: (I) tool feasibility (acceptability; community access and ownership); (II) LF endemicity (high; low prevalence); (III) population demography (urban; rural); (IV) health system structure (human resources; community access); and (V) integration with other diseases (co-endemicity). Based on experiences in Bangladesh, Ethiopia, Malawi, Nepal and Tanzania, four implementation scenarios were identified as suitable for using the MeasureSMS-Morbidity tool for searching and reporting LF clinical case data across a range of programmatic, endemic, demographic and health system settings. These include: (I) urban, high endemic setting with two-tier reporting; (II) rural, high endemic setting with one-tier reporting; (III) rural, high endemic setting with two-tier reporting; and (IV) low-endemic, urban and rural setting with one-tier reporting. A decision-making framework built from the key factors and questions, and the resulting four implementation scenarios is proposed as a means of using the MeasureSMS-Morbidity tool. This framework will help national LF programmes consider appropriate methods to implement a survey using this tool to improve estimates of the clinical burden of LF. Obtaining LF case estimates is a vital step towards the elimination of LF as a public health problem in endemic countries.

What has changed in the evidence for early experience? Update of a BEME systematic review.

PubMed

Yardley, Sarah; Littlewood, Sonia; Margolis, Stephen A; Scherpbier, Albert; Spencer, John; Ypinazar, Valmae; Dornan, Tim

2010-01-01

We previously reviewed evidence published from 1992 to 2001 concerning early experience for healthcare undergraduates (Dornan T, Littlewood S, Margolis S, Scherpbier A, Spencer J, Ypinazar V. 2006. How can experience in clinical and community settings contribute to early medical education? A BEME systematic review. Med Teach 28:3-18). This subsequent study reviews evidence published from 2002 to 2008. Identify changes in the evidence base; determine the value of re-reviewing; set a future research agenda. The same search strategy as in the original review was repeated. Newly identified publications were critically appraised against the same benchmarks of strength and educational importance. Twenty-four new empirical studies of early authentic experience in education of health professionals met our inclusion criteria, yielding 96 outcomes. Sixty five outcomes (from 22 studies) were both educationally important and based on strong evidence. A new significant theme was found: the use of early experience to help students understand and align themselves with patient and community perspectives on illness and healthcare. More publications were now from outside Europe and North America. In addition to supporting the findings of our original review, this update shows an expansion in research sources, and a shift in research content focus. There are still questions, however, about how early authentic experience leads to particular learning outcomes and what will make it most educationally effective.

Management of hypertension in an Australian community pharmacy setting - patients' beliefs and perspectives.

PubMed

Bajorek, Beata V; LeMay, Kate S; Magin, Parker J; Roberts, Christopher; Krass, Ines; Armour, Carol L

2017-08-01

To explore patients' perspectives and experiences following a trial of a pharmacist-led service in hypertension management. A qualitative study comprising individual interviews was conducted. Patients of a community pharmacy, where a pharmacist-led hypertension management service had been trialled in selected metropolitan regions in Sydney (Australia), were recruited to the study. Emergent themes describing patients' experiences and perspectives on the service were elicited via thematic analysis (using manual inductive coding). Patients' (N = 18) experiences of the service were extremely positive, especially around pharmacists' monitoring of blood pressure and provision of advice about medication adherence. Patients' participation in the service was based on their trust in, and relationship with, their pharmacist. The perception of working in a 'team' was conveyed through the pharmacist's caring style of communication and the relaxed atmosphere of the community pharmacy. Patients felt that the community pharmacy was an obvious place for such a service because of their regular contact with the pharmacist, but was limited because the pharmacists were not able to prescribe medication. Patients were extremely positive about the role of, and their experience of, the pharmacy-based hypertension management service. Factors contributing to the patients' positive experiences provide important insights for community pharmacy practice. Good rapport with the pharmacist and a long-term relationship underpin patient engagement in such services. Restrictions on the pharmacists' scope of practice prevent their expertise, and the benefits of their accessibility as a primary point of contact, from being fully realised. © 2016 Royal Pharmaceutical Society.

Student nurse dyads create a community of learning: proposing a holistic clinical education theory.

PubMed

Ruth-Sahd, Lisa A

2011-11-01

This paper is a report of a qualitative study of students' experiences of cooperative learning in the clinical setting. Although cooperative learning is often used successfully in the classroom, it has not been documented in the clinical setting with sophomore nursing students being paired with other sophomore nursing students. Using a grounded theory methodology a sample of 64 participants (32 student nurse dyads, eight clinical groups, in two different acute care institutions) were observed on their first day in the clinical setting while working as cooperative partners. Interviews were also conducted with students, patients and staff preceptors. Data were collected in the fall of 2008, spring and fall of 2009 and the spring of 2010 using semi-structured interviews and reflective surveys. Data were analysed using the constant comparative method. A holistic clinical education theory for student nurses was identified from the data. This theory includes a reciprocal relationship among five categories relevant to a community of learning: supportive clinical experience; improved transition into practice; enhanced socialization into the profession; increased accountability and responsibility; and emergence of self-confidence as a beginning student nurse. The use of student dyads creates a supportive learning environment while students were able to meet the clinical learning objectives. Cooperative learning in the clinical setting creates a community of learning while instilling very early in the education process the importance of teamwork. This approach to clinical instruction eases the transition from the classroom to the clinical learning environment, and improves patient outcomes. © 2011 Blackwell Publishing Ltd.

Rural Community as Context and Teacher for Health Professions Education

PubMed Central

Baral, Kedar; Allison, Jill; Upadhyay, Shambu; Bhandary, Shital; Shrestha, Shrijana

2016-01-01

Nepal is a low-income, landlocked country located on the Indian subcontinent between China and India. The challenge of finding human resources for rural community health care settings is not unique to Nepal. In spite of the challenges, the health sector has made significant improvement in national health indices over the past half century. However, in terms of access to and quality of health services and impact, there remains a gross urban-rural disparity. The Patan Academy of Health Sciences (PAHS) has adopted a community-based education model, termed “community based learning and education" (CBLE), as one of the principal strategies and pedagogic methods. This method is linked to the PAHS mission of improving rural health in Nepal by training medical students through real-life experience in rural areas and developing a positive attitude among its graduates towards working in rural areas. This article outlines the PAHS approach of ruralizing the academy, which aligns with the concept of community engagement in health professional education. We describe how PAHS has embedded medical education in rural community settings, encouraging the learning context to be rural, fostering opportunities for community and peripheral health workers to participate in teaching-learning as well as evaluation of medical students, and involving community people in curriculum design and implementation. PMID:27980887

Experiencing racism in health care: the mental health impacts for Victorian Aboriginal communities.

PubMed

Kelaher, Margaret A; Ferdinand, Angeline S; Paradies, Yin

2014-07-07

To examine experiences of racism in health settings and their impact on mental health among Aboriginal Australians. A cross-sectional survey of experiences of racism and mental health was conducted in two metropolitan and two rural Victorian local government areas (LGAs) between 1 December 2010 and 31 October 2011. Participants included 755 Aboriginal Australians aged over 18 years who had resided in the relevant LGA for at least a year. The response rate across all LGAs was 99%. Being above or below the threshold for high or very high psychological distress on the Kessler Psychological Distress Scale. 221 participants reported experiences of racism in health settings in the past 12 months. The results suggested that people experiencing racism in health settings (OR, 4.49; 95% CI, 2.28-8.86) and non-health settings (OR, 2.66; 95% CI, 1.39-5.08) were more likely than people who did not experience racism to be above the threshold for high or very high psychological distress. Experiencing interpersonal racism in health settings is associated with increased psychological distress over and above what would be expected in other settings. This finding supports the rationale for improving cultural competency and reducing racism as a means of closing the health gap between Aboriginal and other Australians. Capitalising on this investment will require explicitly evaluating the impact of these initiatives on reducing patient experiences of racism.

Intersections of Critical Systems Thinking and Community Based Participatory Research: A Learning Organization Example with the Autistic Community

PubMed Central

Raymaker, Dora M

2016-01-01

Critical systems thinking (CST) and community based participatory research (CBPR) are distinct approaches to inquiry which share a primary commitment to holism and human emancipation, as well as common grounding in critical theory and emancipatory and pragmatic philosophy. This paper explores their intersections and complements on a historical, philosophical, and theoretical level, and then proposes a hybrid approach achieved by applying CBPR's principles and considerations for operationalizing emancipatory practice to traditional systems thinking frameworks and practices. This hybrid approach is illustrated in practice with examples drawn from of the implementation of the learning organization model in an action research setting with the Autistic community. Our experience of being able to actively attend to, and continuously equalize, power relations within an organizational framework that otherwise has great potential for reinforcing power inequity suggests CBPR's principles and considerations for operationalizing emancipatory practice could be useful in CST settings, and CST's vocabulary, methods, and clarity around systems thinking concepts could be valuable to CBPR practioners. PMID:27833398

Intersections of Critical Systems Thinking and Community Based Participatory Research: A Learning Organization Example with the Autistic Community.

PubMed

Raymaker, Dora M

2016-10-01

Critical systems thinking (CST) and community based participatory research (CBPR) are distinct approaches to inquiry which share a primary commitment to holism and human emancipation, as well as common grounding in critical theory and emancipatory and pragmatic philosophy. This paper explores their intersections and complements on a historical, philosophical, and theoretical level, and then proposes a hybrid approach achieved by applying CBPR's principles and considerations for operationalizing emancipatory practice to traditional systems thinking frameworks and practices. This hybrid approach is illustrated in practice with examples drawn from of the implementation of the learning organization model in an action research setting with the Autistic community. Our experience of being able to actively attend to, and continuously equalize, power relations within an organizational framework that otherwise has great potential for reinforcing power inequity suggests CBPR's principles and considerations for operationalizing emancipatory practice could be useful in CST settings, and CST's vocabulary, methods, and clarity around systems thinking concepts could be valuable to CBPR practioners.

Practitioner Research Briefs, 1998-1999 Report Series.

ERIC Educational Resources Information Center

Virginia Adult Educators Research Network, Dayton.

The collection of articles addresses current issues in adult and adult basic education in Virginia communities. Titles include: "Goal-Setting in the New River Valley: Teachers' Perceptions and Strategies" (Sue Barton); "What Happens When ESL Students Experience Authentic Work Situations?" (Pat Bowyer); "Orientation to…

Community-based dental education and the importance of faculty development.

PubMed

McAndrew, Maureen

2010-09-01

Community-based dental education offers a variety of positive learning experiences for students while providing needed dental services for the underserved. More dental students are being instructed by a growing body of largely volunteer community-based faculty who practice in a wide range of community settings including community hospitals and clinics, nursing homes, and private practices. These geographically dispersed instructors may have little experience as educators. Their practice styles and their motivation to improve teaching effectiveness are likely to differ from the styles and motivation of school-based faculty members. Moreover, many dental schools have begun to emphasize practices that may be unfamiliar to community-based faculty such as evidence-based practice. Providing faculty development for them is challenging, yet crucial to the success of these programs and dental education in general. Fundamental elements that must be considered for effective community faculty development programming include fostering a culture of respect between school-based and community faculty members, basing programs on the actual needs of these educators, integrating principles of adult learning theory, and establishing ongoing institutional support. This article provides background on this movement, reviews the literature for faculty development programs geared specifically to community-based educators, makes recommendations for development programs for these dental educators, and includes suggestions for future research.

Service-Learning in Communities of Elders (SLICE): Development and Evaluation of an Introductory Geriatrics Course for Medical Students.

PubMed

Laks, Jordana; Wilson, Lindsay A; Khandelwal, Christine; Footman, Eleni; Jamison, Margaret; Roberts, Ellen

2016-01-01

Medical students have limited exposure to Geriatrics in their traditional training. Service-learning offers students the opportunity to engage with older adult communities and become more comfortable interacting with this population. A preclinical elective course was developed to expand medical students' experiences in Geriatrics through service-learning. In this course, students conducted needs assessments in diverse older adult communities, created health education projects to address community-identified needs, and reflected on their experiences through written assignments and presentations. The course instructor presented lectures on special topics in Geriatrics, including ageism and health literacy. The curriculum aimed to familiarize students with older adults' needs in a variety of settings. Over 3 years, 74 students participated in the service-learning course. Students were assigned to older adult community sites, where they conducted needs assessments and designed and implemented original educational projects targeting community concerns. Program evaluation methods included a validated survey assessing students' attitudes toward older adults, course evaluations, review of student assignments and projects, and feedback from older adult participants and site coordinators. Students gained hands-on experience working with older adults and designing appropriate health education projects. Analysis of attitude surveys demonstrated students' increased interest in Geriatrics as a career. Both students and older adult participants described enjoyable, valuable experiences gained from service-learning activities. Students appreciated the combination of community and classroom learning about Geriatrics. Service-learning was most constructive at sites with responsive coordinators, engaged older adults, and a need for health education resources. The course challenged students to assess health needs in communities that included cognitively impaired elders and to design educational projects tailored to older adults.

Evaluating Recommendation Systems

NASA Astrophysics Data System (ADS)

Shani, Guy; Gunawardana, Asela

Recommender systems are now popular both commercially and in the research community, where many approaches have been suggested for providing recommendations. In many cases a system designer that wishes to employ a recommendation system must choose between a set of candidate approaches. A first step towards selecting an appropriate algorithm is to decide which properties of the application to focus upon when making this choice. Indeed, recommendation systems have a variety of properties that may affect user experience, such as accuracy, robustness, scalability, and so forth. In this paper we discuss how to compare recommenders based on a set of properties that are relevant for the application. We focus on comparative studies, where a few algorithms are compared using some evaluation metric, rather than absolute benchmarking of algorithms. We describe experimental settings appropriate for making choices between algorithms. We review three types of experiments, starting with an offline setting, where recommendation approaches are compared without user interaction, then reviewing user studies, where a small group of subjects experiment with the system and report on the experience, and finally describe large scale online experiments, where real user populations interact with the system. In each of these cases we describe types of questions that can be answered, and suggest protocols for experimentation. We also discuss how to draw trustworthy conclusions from the conducted experiments. We then review a large set of properties, and explain how to evaluate systems given relevant properties. We also survey a large set of evaluation metrics in the context of the properties that they evaluate.

Rehabilitation goal setting with community dwelling adults with acquired brain injury: a theoretical framework derived from clinicians' reflections on practice.

PubMed

Prescott, Sarah; Fleming, Jennifer; Doig, Emmah

2017-06-11

The aim of this study was to explore clinicians' experiences of implementing goal setting with community dwelling clients with acquired brain injury, to develop a goal setting practice framework. Grounded theory methodology was employed. Clinicians, representing six disciplines across seven services, were recruited and interviewed until theoretical saturation was achieved. A total of 22 clinicians were interviewed. A theoretical framework was developed to explain how clinicians support clients to actively engage in goal setting in routine practice. The framework incorporates three phases: a needs identification phase, a goal operationalisation phase, and an intervention phase. Contextual factors, including personal and environmental influences, also affect how clinicians and clients engage in this process. Clinicians use additional strategies to support clients with impaired self-awareness. These include structured communication and metacognitive strategies to operationalise goals. For clients with emotional distress, clinicians provide additional time and intervention directed at new identity development. The goal setting practice framework may guide clinician's understanding of how to engage in client-centred goal setting in brain injury rehabilitation. There is a predilection towards a client-centred goal setting approach in the community setting, however, contextual factors can inhibit implementation of this approach. Implications for Rehabilitation The theoretical framework describes processes used to develop achievable client-centred goals with people with brain injury. Building rapport is a core strategy to engage clients with brain injury in goal setting. Clients with self-awareness impairment benefit from additional metacognitive strategies to participate in goal setting. Clients with emotional distress may need additional time for new identity development.

Community service provider perceptions of implementing older adult fall prevention in Ontario, Canada: a qualitative study.

PubMed

Dykeman, Catherine S; Markle-Reid, Maureen F; Boratto, Lorna J; Bowes, Chris; Gagné, Hélène; McGugan, Jennifer L; Orr-Shaw, Sarah

2018-02-01

Despite evidence for effective fall prevention interventions, measurable reductions in older adult (≥ 65 years) fall rates remain unrealized. This study aimed to describe the perceived barriers to and effective strategies for the implementation of evidence-based fall prevention practices within and across diverse community organizations. This study is unique in that it included community service providers who are not generally thought to provide fall prevention services to older adults, such as retail business, community support, volunteer services, community foundations, recreation centres, and various emergency services. Interviews and focus groups were conducted with a purposive sampling of providers (n = 84) in varied roles within diverse community-based organizations across disparate geographical settings. Community service providers experience significant multi-level barriers to fall prevention within and across organizations and settings. The overall challenge of serving dispersed populations in adverse environmental conditions was heightened in northern rural areas. Barriers across the system, within organizations and among providers themselves emerged along themes of Limited Coordination of Communication, Restrictive Organizational Mandates and Policies, Insufficient Resources, and Beliefs about Aging and Falls. Participants perceived that Educating Providers, Working Together, and Changing Policies and Legislation were strategies that have worked or would work well in implementing fall prevention. An unintentional observation was made that several participants in this extremely varied sample identified expanded roles in fall prevention for themselves during the interview process. Community service providers experience disabling contexts for implementing fall prevention on many levels: their specific geography, their service systems, their organizations and themselves. A systemic lack of fit between the older adult and fall prevention services limits access, making fall prevention inaccessible, unaccommodating, unavailable, unaffordable, and unacceptable. Educating Providers, Working Together, and Changing Policies and Legislation offers promise to create more enabling contexts for community stakeholders, including those who do not initially see their work as preventing falls.

Reclaiming Our Traditions, Raising Some Questions.

ERIC Educational Resources Information Center

Hands On, 1994

1994-01-01

Several members of the Sequoia Foxfire Teachers Network in California discuss their teaching experiences in multicultural classroom settings, including issues of empowerment and democracy, difficulties in communicating with children who have different language and cultural backgrounds, problems in developing a sense of community among students,…

Does temperature structure phytoplankton community composition in the Ross Sea, Antarctica?

EPA Science Inventory

The Ross Sea polynya experiences one of the largest phytoplankton blooms in the Southern Ocean. Energy flow potential within the Ross Sea food web is primarily set by diatoms and prymnesiophytes, the latter dominated by Phaeocystis antarctica. We investigated physical, chemical,...

42 CFR 485.904 - Condition of participation: Personnel qualifications.

Code of Federal Regulations, 2014 CFR

2014-10-01

...: SPECIALIZED PROVIDERS Conditions of Participation: Community Mental Health Centers (CMHCs) § 485.904 Condition... social work experience in a psychiatric healthcare setting. (5) Mental health counselor. A professional... knowledge to provide a range of behavioral health services to clients. The mental health counselor conducts...

Detecting concerted demographic response across community assemblages using hierarchical approximate Bayesian computation.

PubMed

Chan, Yvonne L; Schanzenbach, David; Hickerson, Michael J

2014-09-01

Methods that integrate population-level sampling from multiple taxa into a single community-level analysis are an essential addition to the comparative phylogeographic toolkit. Detecting how species within communities have demographically tracked each other in space and time is important for understanding the effects of future climate and landscape changes and the resulting acceleration of extinctions, biological invasions, and potential surges in adaptive evolution. Here, we present a statistical framework for such an analysis based on hierarchical approximate Bayesian computation (hABC) with the goal of detecting concerted demographic histories across an ecological assemblage. Our method combines population genetic data sets from multiple taxa into a single analysis to estimate: 1) the proportion of a community sample that demographically expanded in a temporally clustered pulse and 2) when the pulse occurred. To validate the accuracy and utility of this new approach, we use simulation cross-validation experiments and subsequently analyze an empirical data set of 32 avian populations from Australia that are hypothesized to have expanded from smaller refugia populations in the late Pleistocene. The method can accommodate data set heterogeneity such as variability in effective population size, mutation rates, and sample sizes across species and exploits the statistical strength from the simultaneous analysis of multiple species. This hABC framework used in a multitaxa demographic context can increase our understanding of the impact of historical climate change by determining what proportion of the community responded in concert or independently and can be used with a wide variety of comparative phylogeographic data sets as biota-wide DNA barcoding data sets accumulate. © The Author 2014. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.

Developing an Interventional Pulmonary Service in a Community-Based Private Practice: A Case Study.

PubMed

French, Kim D; Desai, Neeraj R; Diamond, Edward; Kovitz, Kevin L

2016-04-01

Interventional pulmonology (IP) is a field that uses minimally invasive techniques to diagnose, treat, and palliate advanced lung disease. Technology, formal training, and reimbursement for IP procedures have been slow to catch up with other interventional subspecialty areas. A byproduct of this pattern has been limited IP integration in private practice settings. We describe the key aspects and programmatic challenges of building an IP program in a community-based setting. A philosophical and financial buy-in by stakeholders and a regionalization of services, within and external to a larger practice, are crucial to success. Our experience demonstrates that a successful launch of an IP program increases overall visits as well as procedural volume without cannibalizing existing practice volume. We hope this might encourage others to provide this valuable service to their own communities. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Participatory health system priority setting: Evidence from a budget experiment.

PubMed

Costa-Font, Joan; Forns, Joan Rovira; Sato, Azusa

2015-12-01

Budget experiments can provide additional guidance to health system reform requiring the identification of a subset of programs and services that accrue the highest social value to 'communities'. Such experiments simulate a realistic budget resource allocation assessment among competitive programs, and position citizens as decision makers responsible for making 'collective sacrifices'. This paper explores the use of a participatory budget experiment (with 88 participants clustered in social groups) to model public health care reform, drawing from a set of realistic scenarios for potential health care users. We measure preferences by employing a contingent ranking alongside a budget allocation exercise (termed 'willingness to assign') before and after program cost information is revealed. Evidence suggests that the budget experiment method tested is cognitively feasible and incentive compatible. The main downside is the existence of ex-ante "cost estimation" bias. Additionally, we find that participants appeared to underestimate the net social gain of redistributive programs. Relative social value estimates can serve as a guide to aid priority setting at a health system level. Copyright © 2015 Elsevier Ltd. All rights reserved.

Roles of community helpers in using the Medicare Part D benefit

PubMed Central

Hensley, Melissa A.

2013-01-01

Objectives To examine the experiences of low-income Part D beneficiaries with mental illness and their use of community helpers to access prescription medicines. Methods Individual semi-structured interviews were conducted with 26 Medicare beneficiaries with mental illness in community settings. The transcripts were analyzed for content related to community help-seeking and attitudes toward family and professional helpers. Results Medicare Part D beneficiaries with mental illness used the assistance of community helpers extensively. Pharmacists, nurses, community mental health case managers, and family members assisted beneficiaries with understanding their benefit plans and interpreting paperwork from plans and government agencies. Community helpers also assisted with tasks related to medication adherence. Mental health consumers appreciated the help that they received from family members and professionals. Conclusion This group of Medicare beneficiaries would have experienced difficulty in using their benefits and obtaining their medication without considerable help from professionals and family members in the community. PMID:21317520

LWS/SET End-to-End Data System

NASA Technical Reports Server (NTRS)

Giffin, Geoff; Sherman, Barry; Colon, Gilberto (Technical Monitor)

2002-01-01

This paper describes the concept for the End-to-End Data System that will support NASA's Living With a Star Space Environment Testbed missions. NASA has initiated the Living With a Star (LWS) Program to develop a better scientific understanding to address the aspects of the connected Sun-Earth system that affect life and society. A principal goal of the program is to bridge the gap.between science, engineering, and user application communities. The Space Environment Testbed (SET) Project is one element of LWS. The Project will enable future science, operational, and commercial objectives in space and atmospheric environments by improving engineering approaches to the accommodation and/or mitigation of the effects of solar variability on technological systems. The End-to-end data system allows investigators to access the SET control center, command their experiments, and receive data from their experiments back at their home facility, using the Internet. The logical functioning of major components of the end-to-end data system are described, including the GSFC Payload Operations Control Center (POCC), SET Payloads, the GSFC SET Simulation Lab, SET Experiment PI Facilities, and Host Systems. Host Spacecraft Operations Control Centers (SOCC) and the Host Spacecraft are essential links in the end-to-end data system, but are not directly under the control of the SET Project. Formal interfaces will be established between these entities and elements of the SET Project. The paper describes data flow through the system, from PI facilities connecting to the SET operations center via the Internet, communications to SET carriers and experiments via host systems, to telemetry returns to investigators from their flight experiments. It also outlines the techniques that will be used to meet mission requirements, while holding development and operational costs to a minimum. Additional information is included in the original extended abstract.

Clinicians' Experience with and Attitudes toward Discussing Advance Directives with Terminally Ill Patients and Their Families in a Chinese Community.

PubMed

Luk, Yan; Ngai, Cheong; Chau, Shi San; Lam, Ming Yin Alison; Wong, On Wai; Holm, Marianne

2015-09-01

Although advance directives (ADs) are already exercised in many Western countries, cultural differences surrounding death and dying may potentially pose challenges to the implementation of ADs in a Chinese community. It is therefore relevant to explore the experience with and attitudes towards ADs of health care professionals, who are trained in Western medicine but working in a Chinese cultural setting. Hong Kong represents a unique setting for this. The study objective was to evaluate clinicians' experience with and attitudes towards discussing ADs with terminally ill patients and their families. In this descriptive pilot study, we conducted a cross-sectional questionnaire survey among doctors working in the largest teaching hospital at the University of Hong Kong. Seventy-seven out of 269 doctors working in the surveyed departments completed the questionnaire. The majority of participants (n=72; 94%) indicated willingness to initiate discussions about ADs and 62% (n=48) supported the AD to be recognized as a legally binding document but only 49% (n=38) had past experience of such discussions. Clinicians were generally receptive of the concept of the AD, willing to practice it clinically, and supported its legal recognition. However, AD discussions were an infrequent encounter, hence many clinicians lack experience and are unfamiliar with relevant guidelines. Large-scale studies within the health care professions as well as qualitative studies further exploring potential barriers should follow.

Community-based participatory research and user-centered design in a diabetes medication information and decision tool.

PubMed

Henderson, Vida A; Barr, Kathryn L; An, Lawrence C; Guajardo, Claudia; Newhouse, William; Mase, Rebecca; Heisler, Michele

2013-01-01

Together, community-based participatory research (CBPR), user-centered design (UCD), and health information technology (HIT) offer promising approaches to improve health disparities in low-resource settings. This article describes the application of CBPR and UCD principles to the development of iDecide/Decido, an interactive, tailored, web-based diabetes medication education and decision support tool delivered by community health workers (CHWs) to African American and Latino participants with diabetes in Southwest and Eastside Detroit. The decision aid is offered in English or Spanish and is delivered on an iPad in participants' homes. The overlapping principles of CBPR and UCD used to develop iDecide/Decido include a user-focused or community approach, equitable academic and community partnership in all study phases, an iterative development process that relies on input from all stakeholders, and a program experience that is specified, adapted, and implemented with the target community. Collaboration between community members, researchers, and developers is especially evident in the program's design concept, animations, pictographs, issue cards, goal setting, tailoring, and additional CHW tools. The principles of CBPR and UCD can be successfully applied in developing health information tools that are easy to use and understand, interactive, and target health disparities.

Canada's new medical school: The Northern Ontario School of Medicine: social accountability through distributed community engaged learning.

PubMed

Strasser, Roger P; Lanphear, Joel H; McCready, William G; Topps, Maureen H; Hunt, D Dan; Matte, Marie C

2009-10-01

Like many rural regions around the world, Northern Ontario has a chronic shortage of doctors. Recognizing that medical graduates who have grown up in a rural area are more likely to practice in the rural setting, the Government of Ontario, Canada, decided in 2001 to establish a new medical school in the region with a social accountability mandate to contribute to improving the health of the people and communities of Northern Ontario. The Northern Ontario School of Medicine (NOSM) is a joint initiative of Laurentian University and Lakehead University, which are located 700 miles apart. This paper outlines the development and implementation of NOSM, Canada's first new medical school in more than 30 years. NOSM is a rural distributed community-based medical school which actively seeks to recruit students into its MD program who come from Northern Ontario or from similar northern, rural, remote, Aboriginal, Francophone backgrounds. The holistic, cohesive curriculum for the MD program relies heavily on electronic communications to support distributed community engaged learning. In the classroom and in clinical settings, students explore cases from the perspective of physicians in Northern Ontario. Clinical education takes place in a wide range of community and health service settings, so that the students experience the diversity of communities and cultures in Northern Ontario. NOSM graduates will be skilled physicians ready and able to undertake postgraduate training anywhere, but with a special affinity for and comfort with pursuing postgraduate training and clinical practice in Northern Ontario.

NASA Ocean Altimeter Pathfinder Project. Report 1; Data Processing Handbook

NASA Technical Reports Server (NTRS)

Koblinsky, C. J.; Beckley, Brian D.; Ray, Richard D.; Wang, Yan-Ming; Tsaoussi, Lucia; Brenner, Anita; Williamson, Ron

1998-01-01

The NOAA/NASA Pathfinder program was created by the Earth Observing System (EOS) Program Office to determine how satellite-based data sets can be processed and used to study global change. The data sets are designed to be long time-sedes data processed with stable calibration and community consensus algorithms to better assist the research community. The Ocean Altimeter Pathfinder Project involves the reprocessing of all altimeter observations with a consistent set of improved algorithms, based on the results from TOPEX/POSEIDON (T/P), into easy-to-use data sets for the oceanographic community for climate research. This report describes the processing schemes used to produce a consistent data set and two of the products derived f rom these data. Other reports have been produced that: a) describe the validation of these data sets against tide gauge measurements and b) evaluate the statistical properties of the data that are relevant to climate change. The use of satellite altimetry for earth observations was proposed in the early 1960s. The first successful space based radar altimeter experiment was flown on SkyLab in 1974. The first successful satellite radar altimeter was flown aboard the Geos-3 spacecraft between 1975 and 1978. While a useful data set was collected from this mission for geophysical studies, the noise in the radar measured and incomplete global coverage precluded ft from inclusion in the Ocean Altimeter Pathfinder program. This program initiated its analysis with the Seasat mission, which was the first satellite radar altimeter flown for oceanography.

A Mixed Methods Approach to Evaluate Partnerships and Implementation of the Massachusetts Prevention and Wellness Trust Fund.

PubMed

Lee, Rebekka M; Ramanadhan, Shoba; Kruse, Gina R; Deutsch, Charles

2018-01-01

Background: Strong partnerships are critical to integrate evidence-based prevention interventions within clinical and community-based settings, offering multilevel and sustainable solutions to complex health issues. As part of Massachusetts' 2012 health reform, The Prevention and Wellness Trust Fund (PWTF) funded nine local partnerships throughout the state to address hypertension, pediatric asthma, falls among older adults, and tobacco use. The initiative was designed to improve health outcomes through prevention and disease management strategies and reduce healthcare costs. Purpose: Describe the mixed-methods study design for investigating PWTF implementation. Methods: The Consolidated Framework for Implementation Research guided the development of this evaluation. First, the study team conducted semi-structured qualitative interviews with leaders from each of nine partnerships to document partnership development and function, intervention adaptation and delivery, and the influence of contextual factors on implementation. The interview findings were used to develop a quantitative survey to assess the implementation experiences of 172 staff from clinical and community-based settings and a social network analysis to assess changes in the relationships among 72 PWTF partner organizations. The quantitative survey data on ratings of perceived implementation success were used to purposively select 24 staff for interviews to explore the most successful experiences of implementing evidence-based interventions for each of the four conditions. Conclusions: This mixed-methods approach for evaluation of implementation of evidence-based prevention interventions by PWTF partnerships can help decision-makers set future priorities for implementing and assessing clinical-community partnerships focused on prevention.

Community action research track: Community-based participatory research and service-learning experiences for medical students.

PubMed

Gimpel, Nora; Kindratt, Tiffany; Dawson, Alvin; Pagels, Patti

2018-04-01

Community-based participatory research (CBPR) and service-learning are unique experiential approaches designed to train medical students how to provide individualized patient care from a population perspective. Medical schools in the US are required to provide support for service-learning and community projects. Despite this requirement, few medical schools offer structured service-learning. We developed the Community Action Research Track (CART) to integrate population medicine, health promotion/disease prevention and the social determinants of health into the medical school curriculum through CBPR and service-learning experiences. This article provides an overview of CART and reports the program impact based on students' participation, preliminary evaluations and accomplishments. CART is an optional 4‑year service-learning experience for medical students interested in community health. The curriculum includes a coordinated longitudinal program of electives, community service-learning and lecture-based instruction. From 2009-2015, 146 CART students participated. Interests in public health (93%), community service (73%), primary care (73%), CBPR (60%) and community medicine (60%) were the top reasons for enrolment. Significant improvements in mean knowledge were found when measuring the principles of CBPR, levels of prevention, determining health literacy and patient communication strategies (all p's < 0.05). Most students (73%) were satisfied with CART. Projects were disseminated by at least 65 posters and four oral presentations at local, national and international professional meetings. Six manuscripts were published in peer-reviewed journals. CART is an innovative curriculum for training future physicians to be community-responsive physicians. CART can be replicated by other medical schools interested in offering a longitudinal CBPR and service-learning track in an urban metropolitan setting.

Beyond Blackboards: Engaging Underserved Middle School Students in Engineering

ERIC Educational Resources Information Center

Blanchard, Sarah; Judy, Justina; Muller, Chandra; Crawford, Richard H.; Petrosino, Anthony J.; Christina K. White,; Lin, Fu-An; Wood, Kristin L.

2015-01-01

"Beyond Blackboards" is an inquiry-centered, after-school program designed to enhance middle school students' engagement with engineering through design-based experiences focused on the 21st Century Engineering Challenges. Set within a predominantly lowincome, majority-minority community, our study aims to investigate the impact of…

Selective Mutism: Treating the Silent Child

ERIC Educational Resources Information Center

Shott, Elizabeth F.; Warren, Mary Ellen

2011-01-01

Infant mental health specialists are increasingly expected to treat complex mental health disorders in very young children. Selective mutism is an anxiety disorder which can lead to functional impairment across home, preschool, and community settings. The authors share their experiences with Keylah, a preschooler with significant social anxiety…

The Outdoor Classroom. Experiencing Nature in the Elementary Curriculum.

ERIC Educational Resources Information Center

Alexander, Phyllis, Ed.; And Others

Through direct experience within natural settings, outdoor education allows students to learn about environmental concerns such as migration of birds, weather systems, wildlife habitats, watersheds, soil erosion, geological formations, food chains, and community resources. All subject areas in the present curriculum can be enriched through outdoor…

Social Supports in Inclusive Settings: An Essential Component to Community Living

ERIC Educational Resources Information Center

Irvine, Angela; Lupart, Judy

2006-01-01

Inclusion has increased the participation rates of individuals with disabilities in school, employment and recreation activities. Proper supports are needed in these environments to encourage adequate self-esteem and successful social interactions. Without positive social interactions, individuals may experience loneliness and isolation that could…

Rural Food and Physical Activity Assessment Using an Electronic Tablet-Based Application, New York, 2013–2014

PubMed Central

Morgan, Emily H.; Connor, Leah M.; Garner, Jennifer A.; King, Abby C.; Sheats, Jylana L.; Winter, Sandra J.; Buman, Matthew P.

2015-01-01

Introduction A community’s built environment can influence health behaviors. Rural populations experience significant health disparities, yet built environment studies in these settings are limited. We used an electronic tablet-based community assessment tool to conduct built environment audits in rural settings. The primary objective of this qualitative study was to evaluate the usefulness of the tool in identifying barriers and facilitators to healthy eating and active living. The second objective was to understand resident perspectives on community features and opportunities for improvement. Methods Participants were recruited from 4 rural communities in New York State. Using the tool, participants completed 2 audits, which consisted of taking pictures and recording audio narratives about community features perceived as assets or barriers to healthy eating and active living. Follow-up focus groups explored the audit experience, data captured, and opportunities for change. Results Twenty-four adults (mean age, 69.4 y [standard deviation, 13.2 y]), 6 per community, participated in the study. The most frequently captured features related to active living were related to roads, sidewalks, and walkable destinations. Restaurants, nontraditional food stores, and supermarkets were identified in the food environment in relation to the cost, quality, and selection of healthy foods available. In general, participants found the assessment tool to be simple and enjoyable to use. Conclusion An electronic tablet–based tool can be used to assess rural food and physical activity environments and may be useful in identifying and prioritizing resident-led change initiatives. This resident-led assessment approach may also be helpful for informing and evaluating rural community-based interventions. PMID:26133645

Using Self-Reported Patient Experiences to Understand Patient Burden: Learnings from Digital Patient Communities in Ankylosing Spondylitis.

PubMed

Sunkureddi, Prashanth; Gibson, Dawn; Doogan, Stephen; Heid, John; Benosman, Samir; Park, Yujin

2018-03-01

Online communities contain a wealth of information containing unsolicited patient experiences that may go beyond what is captured by guided surveys or patient-reported outcome (PRO) instruments used in clinical settings. This study described patient experiences reported online to better understand the day-to-day disease burden of ankylosing spondylitis (AS). Unguided, English-language patient narratives reported between January 2010 and May 2016 were collected from 52 online sources (e.g., general/health social networking sites, patient-physician Q&A sites, AS forums). Using natural language processing combined with manual curation, patient-reported experiences within narratives were evaluated and categorized into social, physical, emotional, cognitive, and role activity (SPEC-R) concepts to assess functional impairment. The same SPEC-R categorization was applied to 5 AS-specific PRO instruments to evaluate their coverage of concepts extracted from patient narratives. A total of 34,780 narratives from 3449 patients with AS were included. Physical aspects of AS (e.g., pain and mobility) were most commonly reported by patients (86.7%), followed by emotional (32.5%), cognitive (23.6%), role activity (8.7%) and social (5.1%). Some frequently discussed subconcepts were effectively captured by ≥ 2 PRO instruments, such as pain (65.3%), asthenia (19.9%), musculoskeletal impairment (19.9%), depression (9.9%), and anger/frustration (5.4%); others [e.g., anxiety (19.1%), mental impairment (3.2%), impulsivity (2.9%)] were not addressed by any of the PRO instruments. These findings highlight the importance of analyzing patient experiences beyond clinical trial settings and physician reports; continuous assessment of existing PRO instruments in collaboration with patients may increase their utility in real-world settings. Novartis Pharmaceuticals Corporation.

Painful languages of the body: experiences of headache among women in two Peruvian communities.

PubMed

Darghouth, Sarah; Pedersen, Duncan; Bibeau, Gilles; Rousseau, Cecile

2006-09-01

This exploratory study focuses on the understandings of and experiences with headache in two settings in Peru: the Quechua-speaking district of Ayacucho, in southern Peru, and a poor urban district of Lima Metropolitana. More specifically, it explores the personal and collective meanings constructed around women's headache experiences. Structured and open-ended interviews were administered to patients suffering headache to elicit interpretations of headache episodes. An analysis of the collected narratives suggests that headache is often comprehended in a polysemic framework, where meanings ascribed in bodily, emotional, family, and social terms articulate individual and shared notions of suffering within larger contexts of social dislocation. Often woven into experiences of solitude, headache accounts are lived and told in dynamic temporal spaces, and narrate dissolution of family ties and tensions associated with women's roles. The results underscore the significance of patients' subjective interpretations of painful experiences and underscore the connections between bodily and emotional pain and distress experienced at family, community, and larger social levels.

Of mulattos, mischlinge, and Minsky's machines.

PubMed

Nathanson, B N

1989-01-01

Hegel once remarked that "what experience and history teach us is that people and governments never have learned anything from history or acted on principles deduced from it." Historically, efforts to define a human being sufficiently equipped biologically or politically to meet a set of factitious standards for inclusion in the community of mankind have invariably resulted in unspeakable injustices. The continuing exclusion of the human fetus from this community is another (and the latest) tragic example of the historical myopia of which Hegel spoke.

Caregiving setting and Baby Boomer caregiver stress processes: Findings from the National Study of Caregiving (NSOC).

PubMed

Moon, Heehyul; Rote, Sunshine; Beaty, Jeff A

The aim of this study was to provide a comprehensive understanding of how the caregiving setting relates to caregiving experience among Baby Boomer caregivers (CGs). Based on a secondary data analysis (the National Study of Caregiving, N = 782), compared with CGs providing care to an older adult living in the community, CGs to older adults in non-NH residential care settings reported better emotional well-being, self-rated health, and relationship quality and less provision of assistance older adults with daily activities. While chronic conditions, relationship quality, and financial strain were associated with the health and well-being for both CG groups, degree of informal support was more consequential for the health of CGs providing care to older adults in the community. Our results provide critical information on the risk factors and areas of intervention for both CG groups. Copyright © 2016 Elsevier Inc. All rights reserved.

Little shop of errors: an innovative simulation patient safety workshop for community health care professionals.

PubMed

Tupper, Judith B; Pearson, Karen B; Meinersmann, Krista M; Dvorak, Jean

2013-06-01

Continuing education for health care workers is an important mechanism for maintaining patient safety and high-quality health care. Interdisciplinary continuing education that incorporates simulation can be an effective teaching strategy for improving patient safety. Health care professionals who attended a recent Patient Safety Academy had the opportunity to experience firsthand a simulated situation that included many potential patient safety errors. This high-fidelity activity combined the best practice components of a simulation and a collaborative experience that promoted interdisciplinary communication and learning. Participants were challenged to see, learn, and experience "ah-ha" moments of insight as a basis for error reduction and quality improvement. This innovative interdisciplinary educational training method can be offered in place of traditional lecture or online instruction in any facility, hospital, nursing home, or community care setting. Copyright 2013, SLACK Incorporated.

Community Advisory Boards Guiding Engaged Research Efforts within a Clinical Translational Sciences Award: Key Contextual Factors Explored.

PubMed

Halladay, Jacqueline R; Donahue, Katrina E; Sleath, Betsy; Reuland, Dan; Black, Adina; Mitchell, C Madeline; Breland, Carol E; Coyne-Beasley, Tamera; Mottus, Kathleen; Watson, Sable Noelle; Lewis, Virginia; Wynn, Mysha; Corbie-Smith, Giselle

2017-01-01

Engaging stakeholders in research carries the promise of enhancing the research relevance, transparency, and speed of getting findings into practice. By describing the context and functional aspects of stakeholder groups, like those working as community advisory boards (CABs), others can learn from these experiences and operationalize their own CABs. Our objective is to describe our experiences with diverse CABs affiliated with our community engagement group within our institution's Clinical Translational Sciences Award (CTSA). We identify key contextual elements that are important to administering CABs. A group of investigators, staff, and community members engaged in a 6-month collaboration to describe their experiences of working with six research CABs. We identified the key contextual domains that illustrate how CABS are developed and sustained. Two lead authors, with experience with CABs and identifying contextual domains in other work, led a team of 13 through the process. Additionally, we devised a list of key tips to consider when devising CABs. The final domains include (1) aligned missions among stakeholders (2) resources/support, (3) defined operational processes/shared power, (4) well-described member roles, and (5) understanding and mitigating challenges. The tips are a set of actions that support the domains. Identifying key contextual domains was relatively easy, despite differences in the respective CAB's condition of focus, overall mission, or patient demographics represented. By contextualizing these five domains, other research and community partners can take an informed approach to move forward with CAB planning and engaged research.

Cultural Translation of Interventions: Diabetes Care in American Samoa

PubMed Central

Rosen, Rochelle K.; Batts-Turner, Marian; Bereolos, Nicole; House, Meaghan; Held, Rachel Forster; Nu'usolia, Ofeira; Tuitele, John; Goldstein, Michael G.; McGarvey, Stephen T.

2010-01-01

Translation of research advances into clinical practice for at-risk communities is important to eliminate disease disparities. Adult type 2 diabetes prevalence in the US territory of American Samoa is 21.5%, but little intervention research has been carried out there. We discuss our experience with cultural translation, drawing on an emerging implementation science, which aims to build a knowledge base on adapting interventions to real-world settings. We offer examples from our behavioral intervention study, Diabetes Care in American Samoa, which was adapted from Project Sugar 2, a nurse and community health worker intervention to support diabetes self-management among urban African Americans. The challenges we experienced and solutions we used may inform adaptations of interventions in other settings. PMID:20864729

Nursing faculty roles in international service-learning projects.

PubMed

Kohlbry, Pamela; Daugherty, JoAnn

2013-01-01

The purpose of this article is to describe faculty roles related to the design and implementation of an international nursing service-learning project. The impetus for this project was the 2008 American Association of Colleges of Nursing (AACN) recommendations for using service-learning and immersion of students in diverse communities to improve nursing education in the area of cultural competency (American Association of Colleges of Nursing, 2008a). We define service-learning as a learning experience engaging students in meeting community needs in an international setting so as to offer a different perspective into community health practices and to promote cultural competency. Based on our experience with service-learning, we identified four faculty roles in developing these types of projects. We define these roles as initiator, collaborator, facilitator, and advocate. This article will discuss the application of these faculty roles in developing service-learning opportunities with students. Copyright © 2013 Elsevier Inc. All rights reserved.

A comparison of methods and results in recruiting white and black women into reproductive studies: the MMC-PSU cooperative center on reproduction experience.

PubMed

Sweet, Stephanie; Legro, Richard S; Coney, PonJola

2008-07-01

Establishing a holistic approach for the enrollment of subjects into clinical trials that includes strategies for the recruitment of non-traditional and minority populations has been an elusive task. The existence of such a design, that is understood and embraced by investigators and the target communities, would streamline the current level of commitment of time, energy and resources. This is necessary to successfully encourage individual and community participation in research studies. The Center for Research in Reproduction at Meharry set out to recruit a large number of African American women volunteers of reproductive age into clinical trials. The experience, of recruiting volunteers from the African American community for clinical trials in the Meharry Medical College/Pennsylvania State University (MMC/PSU)'s Cooperative Center for Research in Reproduction at Meharry, is presented.

Community detection in complex networks using link prediction

NASA Astrophysics Data System (ADS)

Cheng, Hui-Min; Ning, Yi-Zi; Yin, Zhao; Yan, Chao; Liu, Xin; Zhang, Zhong-Yuan

2018-01-01

Community detection and link prediction are both of great significance in network analysis, which provide very valuable insights into topological structures of the network from different perspectives. In this paper, we propose a novel community detection algorithm with inclusion of link prediction, motivated by the question whether link prediction can be devoted to improving the accuracy of community partition. For link prediction, we propose two novel indices to compute the similarity between each pair of nodes, one of which aims to add missing links, and the other tries to remove spurious edges. Extensive experiments are conducted on benchmark data sets, and the results of our proposed algorithm are compared with two classes of baselines. In conclusion, our proposed algorithm is competitive, revealing that link prediction does improve the precision of community detection.

Exploring the process of professional socialisation and development during pharmacy pre-registration training in England.

PubMed

Jee, Samuel D; Schafheutle, Ellen I; Noyce, Peter R

2016-08-01

To explore the process of professional socialisation in pharmacy trainees during pre-registration training. A prospective, longitudinal qualitative design was used. A purposive sample of 20 trainees from community and hospital pharmacy in North West England was recruited. A total of 79 semi-structured interviews were conducted with trainees on three occasions during training and once four months after training. Data were analysed thematically using template analysis. Early on in training, non-pharmacists played a significant role in socialising trainees into the work setting; pharmacists played the stronger role towards the end. Pre-registration tutors were strong role models throughout training. Training experiences differed between settings, where services provided and patient mix varied. Hospital trainees learnt about specialist medicines on ward rotations. Community trainees developed knowledge of over-the-counter, and less complex, medicines. In hospital, trainees were exposed to a range of role models in comparison to community where this was generally limited to a small pharmacy team. Newly qualified pharmacists were challenged by having full responsibility and accountability. This study showed the experiences encountered by trainees that affect their professional socialisation. More standardisation across training sites may reduce the variation in experiences and professional socialisation and development. Formal training for pre-registration tutors and support staff that play a key role in supporting trainees could be considered. Support for newly qualified pharmacists may allay the challenging transition they face when entering practice. © 2016 Royal Pharmaceutical Society.

Ten Years Later: A Study of the Experiences of Non-Traditional Women Students Who Succeeded in A Community College Setting with the Help of A Mentor Program

ERIC Educational Resources Information Center

Bradford, Gyndolyn

2017-01-01

The idea of mentoring in higher education is considered a good thing for students and faculty. What is missing in the research is how does mentoring influence and shape the student experience, does mentoring help retention, and how does it contribute to student development? (Crisp, Baker, Griffin, Lunsford, Pifer, 2017). The mentoring relationship…

Dynamic simulation of crime perpetration and reporting to examine community intervention strategies.

PubMed

Yonas, Michael A; Burke, Jessica G; Brown, Shawn T; Borrebach, Jeffrey D; Garland, Richard; Burke, Donald S; Grefenstette, John J

2013-10-01

To develop a conceptual computational agent-based model (ABM) to explore community-wide versus spatially focused crime reporting interventions to reduce community crime perpetrated by youth. Agents within the model represent individual residents and interact on a two-dimensional grid representing an abstract nonempirically grounded community setting. Juvenile agents are assigned initial random probabilities of perpetrating a crime and adults are assigned random probabilities of witnessing and reporting crimes. The agents' behavioral probabilities modify depending on the individual's experience with criminal behavior and punishment, and exposure to community crime interventions. Cost-effectiveness analyses assessed the impact of activating different percentages of adults to increase reporting and reduce community crime activity. Community-wide interventions were compared with spatially focused interventions, in which activated adults were focused in areas of highest crime prevalence. The ABM suggests that both community-wide and spatially focused interventions can be effective in reducing overall offenses, but their relative effectiveness may depend on the intensity and cost of the interventions. Although spatially focused intervention yielded localized reductions in crimes, such interventions were shown to move crime to nearby communities. Community-wide interventions can achieve larger reductions in overall community crime offenses than spatially focused interventions, as long as sufficient resources are available. The ABM demonstrates that community-wide and spatially focused crime strategies produce unique intervention dynamics influencing juvenile crime behaviors through the decisions and actions of community adults. It shows how such models might be used to investigate community-supported crime intervention programs by integrating community input and expertise and provides a simulated setting for assessing dimensions of cost comparison and intervention effect sustainability. ABM illustrates how intervention models might be used to investigate community-supported crime intervention programs.

Dietary Change: What Are the Responses and Roles of Significant Others?

ERIC Educational Resources Information Center

Paisley, Judy; Beanlands, Heather; Goldman, Joanne; Evers, Susan; Chappell, Janet

2008-01-01

Objective: This study examined the impact of one person's dietary change on the experiences of a significant other with whom they regularly shared meals. Design: Qualitative constant comparison approach using semistructured interviews. Setting: Community-based. Participants: Forty-two participants were recruited using a stratified purposive…

Open Circuit Television and the Community College.

ERIC Educational Resources Information Center

Long Beach City Coll., CA.

This report describes the setting, implementation, and findings of an experiment in educational telecasting of 17 one-hour lectures, a course for college credit in lower division health education. Units included (1) quackery, (2) self-diagnosis, (3) preventive medicine, (4) syphilis and gonorrhea, (5) environmental health, (6) cancer, (7) heart…

Health Care Needs of Adults with Mental Retardation.

ERIC Educational Resources Information Center

Rubin, I. Leslie

1987-01-01

Experience with provision of optimal health services to mentally retarded individuals in institutional settings can be applied and adapted to design services for such adults living in the community. Coordination of health care by a team of nurses, primary care physicians, and special medical services is recommended. (Author/DB)

Adolescents' Experience with Workplace Aggression: School Health Implications

ERIC Educational Resources Information Center

Smith, Carolyn R.; Fisher, Bonnie S.; Gillespie, Gordon L.; Beery, Theresa A.; Gates, Donna M.

2013-01-01

Aggression exposure is a critical health issue facing adolescents in the United States. Exposure occurs in various settings including home, school, and the community. An emerging context for aggression exposure is in the workplace. Thirty adolescent employees age 16-18 participated in a qualitative study exploring proposed responses to future…

New beginnings in hospice.

PubMed

Ryndes, T

1995-01-01

Healthcare decisionmakers in acute settings might well benefit from lessons learned over two decades of hospice experience providing community-based, cost-effective care. Now the hospice concepts of interdisciplinary symptom management and transition counseling are being made available to patients and families long before they reach the traditional six-month prognosis entry point.

In-Home Alternatives for Community Recreation Participation by Older Adults.

ERIC Educational Resources Information Center

Wilhite, Barbara

1992-01-01

Recreation and physical education professionals can positively influence the well-being and life experiences of home-centered elderly clients who are often deprived of social and physical needs. The article discusses the value of extending recreation, health, and physical fitness services into home settings, providing suggestions for accomplishing…

Legal Education as a Joint Venture.

ERIC Educational Resources Information Center

Murphy, Cornelius F.

1979-01-01

The traditional practice of training lawyers in an academic setting only is challenged, and it is proposed that an apprenticeship or field experience element be added. The responsibility for this lies with both the academic and legal communities. Available from Ohio Northern University, 525 S. Main St., Ada, OH 45810; $5.00. (MSE)

Cultural Immersion for Inservice Teachers: A Model and Some Outcomes.

ERIC Educational Resources Information Center

Mahan, James M.

The Inservice Teacher Cultural Immersion Model of Indiana University has placed 122 inservice teachers in summer graduate practicum positions in distant Native American communities. The model was developed so that teachers can have an innovative and personal experience learning about Native Americans in their own cultural setting. The program…

Knowledge of Some Derivational Processes in Two Samples of Bilingual Children

ERIC Educational Resources Information Center

Marckworth, M. Lois

1978-01-01

A report on a study concerning the bilingual child in a monolingual community. It investigates the acquisition of a set of English derivational morphemes by bilingual children and the effect of external factors, such as school, exposure time, age and home, in the children's language experience. (AMH)

Toward a Holistic Theory of Informal Jewish Education

ERIC Educational Resources Information Center

Shapiro, Harvey

2007-01-01

Contrary to the view that socialization ought to precede education, in this article the author suggests that social and emotional dimensions are always present in religious, educational, moral, and aesthetic collective experience. In educational settings, socialization is part of the intentional process of creating a community of learners and is…

Food Security in Older Australians from Different Cultural Backgrounds

ERIC Educational Resources Information Center

Radermacher, Harriet; Feldman, Susan; Bird, Stephen

2010-01-01

Objective: To investigate the experiences and barriers to food security of community-dwelling older people. Design: Quantitative questionnaire and 5 focus group discussions using purposive sampling. Setting: Shire of Melton, Victoria, Australia. Participants: Thirty-seven people (13 male and 24 female), between 58 and 85 years of age, from…

The Online Classroom: A Thorough Depiction of Distance Learning Spaces

ERIC Educational Resources Information Center

McKenna, Kelly

2018-01-01

This study investigated the online higher education learning space of a doctoral program offered at a distance. It explored the learning space, the stakeholders, utilization, and creators of the space. Developing a successful online classroom experience that incorporates an engaging environment and dynamic community setting conducive to learning…

Expanding Horizons through Global Learning in Out-of-School Time

ERIC Educational Resources Information Center

Menten, Alexis

2011-01-01

The demands and opportunities of globalization involve not only America's economic competitiveness, but also national security, the need for tolerance in increasingly diverse communities, and a need to solve pressing social issues. To be successful, students need a comprehensive and integrated set of global learning experiences that help them…

Australian Home Education: A Model

ERIC Educational Resources Information Center

Barratt-Peacock, John

2003-01-01

If home education is not just school in another place, how can we conceptualise it and how does it work? This paper considers the peculiar set of relationships that characterise home-educating families and traces their extension out into the wider community. It further shows how, through the ongoing family conversation, experiences gained from…

Children's Experimental Workshop: Expanding the Park Experience to Children with Special Needs.

ERIC Educational Resources Information Center

Ross, Wendy, Ed.; And Others

The handbook was designed to assist those interested in developing accessible programs for the handicapped in a variety of settings - parks, recreational areas, community centers, and other cultural and educational facilities - by providing information on how the Children's Experimental Workshop (CEW) was created, implemented, and evaluated. The…

Improving Quality at the Point of Service

ERIC Educational Resources Information Center

Smith, Charles; Akiva, Tom; Arrieux, Dominique; Jones, Monica M.

2006-01-01

The journey into middle childhood frequently involves a journey into the community of an after-school program, weekend club, or summer camp. Although out-of-school-time settings are less formal than school in academic requirements, they have the potential to provide key developmental experiences: relationship building, learning, and self- and…

Juvenile Justice Reform: State Experiences. Criminal Justice Paper #4.

ERIC Educational Resources Information Center

Pierce, Robert; Yondorf, Barbara

Community-based programs in the juvenile justice system present a promising alternative to the disappointing results achieved by large institutional facilities. A diverse group of states has found that intensive, individualized services provided in small, family-like residential settings or in the juvenile's own home yield comparable or reduced…

Language Core Values in a Multicultural Setting: An Australian Experience.

ERIC Educational Resources Information Center

Smolicz, Jerzy J.

1991-01-01

Reviews European Community and Australian language policies. Considers cultural-economic interface in Australia with respect to current interest in teaching Asian languages for trade purposes. Discusses Australia's growing acceptance of languages other than English and its affect on Aboriginal people. Urges the better utilization of the country's…

Optimizing support vector machine learning for semi-arid vegetation mapping by using clustering analysis

NASA Astrophysics Data System (ADS)

Su, Lihong

In remote sensing communities, support vector machine (SVM) learning has recently received increasing attention. SVM learning usually requires large memory and enormous amounts of computation time on large training sets. According to SVM algorithms, the SVM classification decision function is fully determined by support vectors, which compose a subset of the training sets. In this regard, a solution to optimize SVM learning is to efficiently reduce training sets. In this paper, a data reduction method based on agglomerative hierarchical clustering is proposed to obtain smaller training sets for SVM learning. Using a multiple angle remote sensing dataset of a semi-arid region, the effectiveness of the proposed method is evaluated by classification experiments with a series of reduced training sets. The experiments show that there is no loss of SVM accuracy when the original training set is reduced to 34% using the proposed approach. Maximum likelihood classification (MLC) also is applied on the reduced training sets. The results show that MLC can also maintain the classification accuracy. This implies that the most informative data instances can be retained by this approach.

Community Football Teams for People with Intellectual Disabilities in Secure Settings: "They Take You off the Ward, It Was Like a Nice Day, and Then You Get Like Medals at the End"

ERIC Educational Resources Information Center

Hudson, Nicholas Andrew; Mrozik, Jennifer Hella; White, Rose; Northend, Kristian; Moore, Steve; Lister, Katherine; Rayner, Kelly

2018-01-01

Background: People with learning disabilities (LD) are particularly vulnerable to mental health and behavioural difficulties, and it has been shown that regular exercise can improve psychosocial well-being as well as physical fitness. This research aims to explore the experiences of men with LD detained in secure settings who have engaged in…

Developing a sleep apnoea clinic for prisoners.

PubMed

Reynolds, Sue

People in prison may experience barriers in accessing health services. By exploring some of these barriers and how they have been overcome, this article describes how prisoners were made aware of obstructive sleep apnoea and the associated risks, and how a clinic was set up in a prison healthcare centre. It shows how access to a community service was made available to the prisoners, and details how the service was set up, how it operates and what the outcomes achieved.

Community annotation experiment for ground truth generation for the i2b2 medication challenge

PubMed Central

Solti, Imre; Xia, Fei; Cadag, Eithon

2010-01-01

Objective Within the context of the Third i2b2 Workshop on Natural Language Processing Challenges for Clinical Records, the authors (also referred to as ‘the i2b2 medication challenge team’ or ‘the i2b2 team’ for short) organized a community annotation experiment. Design For this experiment, the authors released annotation guidelines and a small set of annotated discharge summaries. They asked the participants of the Third i2b2 Workshop to annotate 10 discharge summaries per person; each discharge summary was annotated by two annotators from two different teams, and a third annotator from a third team resolved disagreements. Measurements In order to evaluate the reliability of the annotations thus produced, the authors measured community inter-annotator agreement and compared it with the inter-annotator agreement of expert annotators when both the community and the expert annotators generated ground truth based on pooled system outputs. For this purpose, the pool consisted of the three most densely populated automatic annotations of each record. The authors also compared the community inter-annotator agreement with expert inter-annotator agreement when the experts annotated raw records without using the pool. Finally, they measured the quality of the community ground truth by comparing it with the expert ground truth. Results and conclusions The authors found that the community annotators achieved comparable inter-annotator agreement to expert annotators, regardless of whether the experts annotated from the pool. Furthermore, the ground truth generated by the community obtained F-measures above 0.90 against the ground truth of the experts, indicating the value of the community as a source of high-quality ground truth even on intricate and domain-specific annotation tasks. PMID:20819855

Sown species richness and realized diversity can influence functioning of plant communities differently.

PubMed

Rychtecká, Terezie; Lanta, Vojtěch; Weiterová, Iva; Lepš, Jan

2014-08-01

Biodiversity-ecosystem functioning experiments (BEF) typically manipulate sown species richness and composition of experimental communities to study ecosystem functioning as a response to changes in diversity. If sown species richness is taken as a measure of diversity and aboveground biomass production as a measure of community functioning, then this relationship is usually found to be positive. The sown species richness can be considered the equivalent of a local species pool in natural communities. However, in addition to species richness, realized diversity is also an important community diversity component. Realized diversity is affected by environmental filtering and biotic interactions operating within a community. As both sown species richness and the realized diversity in BEF studies (as well as local species pool vs observed realized richness in natural communities) can differ markedly, so can their effects on the community functioning. We tested this assumption using two data sets: data from a short-term pot experiment and data from the long-term Jena biodiversity plot experiment. We considered three possible predictors of community functioning (aboveground biomass production): sown species richness, realized diversity (defined as inverse of Simpson dominance index), and survivor species richness. Sown species richness affected biomass production positively in all cases. Realized diversity as well as survivor species richness had positive effects on biomass in approximately half of cases. When realized diversity or survivor species richness was tested together with sown species richness, their partial effects were none or negative. Our results suggest that we can expect positive diversity-productivity relationship when the local species pool size is the decisive factor determining realized observed diversity; in other cases, the shape of the diversity-functioning relationship may be quite opposite.

Community health development: a strategy for reinventing America's health care system one community at a time.

PubMed

Felix, Michael R J; Burdine, James N; Wendel, Monica L; Alaniz, Angie

2010-04-01

The purpose of this article is to propose a set of ideas for reinventing America's health care system, one community at a time. Community health development is proposed as a strategy and approach to population health improvement, the ultimate goal of health care reform. The practice of community health development, particularly the partnership approach, provides guidance about how this approach might be employed as a national health care reform strategy. Examples of two communities successfully using the partnership approach illustrate the methods described. Six specific recommendations for policy makers and public administrators in the new administration resulting from our experience with community health development are presented. First, adopt and apply community health development (CHD) as the American approach for facilitating population health improvement and building community capacity. Second, the partnership approach should be promoted as a model for communities to use in implementing CHD. Third, make the community-level the focus for planning, implementing, evaluating, and sustaining a full continuum of health and human services. Fourth, formally recognize the social determinants of health as a key component of a new population/community health status model and as a public policy driver for health care reform, marketplace issues, and population health status improvement at all levels of society. Fifth is a call for a national strategy for the recruitment, training, education, and support of individuals to facilitate this community movement. Sixth, Congress and the Obama Administration adopt and apply CHD as a national strategy and utilize American community-based experiences to bring about a national plan.

Improving resolution of dynamic communities in human brain networks through targeted node removal

PubMed Central

Turner, Benjamin O.; Miller, Michael B.; Carlson, Jean M.

2017-01-01

Current approaches to dynamic community detection in complex networks can fail to identify multi-scale community structure, or to resolve key features of community dynamics. We propose a targeted node removal technique to improve the resolution of community detection. Using synthetic oscillator networks with well-defined “ground truth” communities, we quantify the community detection performance of a common modularity maximization algorithm. We show that the performance of the algorithm on communities of a given size deteriorates when these communities are embedded in multi-scale networks with communities of different sizes, compared to the performance in a single-scale network. We demonstrate that targeted node removal during community detection improves performance on multi-scale networks, particularly when removing the most functionally cohesive nodes. Applying this approach to network neuroscience, we compare dynamic functional brain networks derived from fMRI data taken during both repetitive single-task and varied multi-task experiments. After the removal of regions in visual cortex, the most coherent functional brain area during the tasks, community detection is better able to resolve known functional brain systems into communities. In addition, node removal enables the algorithm to distinguish clear differences in brain network dynamics between these experiments, revealing task-switching behavior that was not identified with the visual regions present in the network. These results indicate that targeted node removal can improve spatial and temporal resolution in community detection, and they demonstrate a promising approach for comparison of network dynamics between neuroscientific data sets with different resolution parameters. PMID:29261662

The Community Mentorship Program: Providing Community-Engagement Opportunities for Early-Stage Clinical and Translational Scientists to Facilitate Research Translation.

PubMed

Patino, Cecilia M; Kubicek, Katrina; Robles, Marisela; Kiger, Holly; Dzekov, Jeanne

2017-02-01

A goal of the Southern California Clinical and Translational Science Institute (SC-CTSI) at the University of Southern California and Children's Hospital Los Angeles is to train early-stage clinical and translational scientists (CTSs) to conduct research that improves the health of diverse communities. This goal aligns well with the Institute of Medicine's recommendations emphasizing community engagement in biomedical research that facilitates research translation. The Community Mentorship Program (CMP), created to complement community-engaged research didactics, matches CTSs with community mentors who help them identify and complete community-engaged experiences that inform their research. The CMP was piloted in 2013-2015 by the SC-CTSI Workforce Development and Community Engagement cores. The CMP team matched three CTSs (assistant professors pursuing mentored career development awards) with mentors at community-based organizations (CBOs) aligned with their research interests. Each mentor-mentee pair signed a memorandum of understanding. The CMP team checked in regularly, monitoring progress and addressing challenges in CTSs' completion of their community-engaged experience. Each pair completed at least one community-engaged activity informing the CTS's research. In exit interviews, the CTSs and CBO mentors expressed satisfaction with the program and stated that they would continue to work together. The CTSs reported that the program provided opportunities to develop networks outside academia, build trust within the community, and receive feedback and learn from individuals in communities affected by their research. The CMP will be expanded to include all eligible early-career CTSs and promoted for use in similar settings outside the SC-CTSI.

A Risk Radar driven by Internet of intelligences serving for emergency management in community.

PubMed

Huang, Chongfu; Wu, Tong; Renn, Ortwin

2016-07-01

Today, most of the commercial risk radars only have the function to show risks, as same as a set of risk matrixes. In this paper, we develop the Internet of intelligences (IOI) to drive a risk radar monitoring dynamic risks for emergency management in community. An IOI scans risks in a community by 4 stages: collecting information and experience about risks; evaluating risk incidents; verifying; and showing risks. Employing the information diffusion method, we optimized to deal with the effective information for calculating risk value. Also, a specific case demonstrates the reliability and practicability of risk radar. Copyright © 2016 Elsevier Inc. All rights reserved.

“I’m stronger than I thought”: Native women reconnecting to body, health, and place

PubMed Central

Schultz, Katie; Walters, Karina L.; Beltran, Ramona; Stroud, Sandy; Johnson-Jennings, Michelle

2016-01-01

This community-based research applied principles of wilderness experience programming and Indigenous knowledges in an exploratory intervention designed to address health disparities in a tribal community. Drawing on historical trauma frameworks, tribal members rewalked the Trail of Tears to consider its effect on contemporary tribal health. Qualitative data from tribal members suggest that engagement with place and experiential learning, particularly the physical and emotional challenge of the Trail, facilitated changes in health beliefs, attitudes, and behaviors. Deep engagement outside of traditional health service settings should be considered in interventions and may be particularly effective in promoting positive health behaviors in Native communities. PMID:27164432

The future: a primary care-led NHS.

PubMed

Cross, Sue

2010-04-01

The NHS is becoming increasingly primary care and community focused and the role of the community nurse is becoming more significant, not just in managing long-term conditions and end of life but in providing vital help and education. Helping people become more knowledgeable about maintaining both their own health and that of their families at home or within the community is vital - the desired end being less need for expensive hospital care. As the demand to implement more complex services grows, so the need for nurses to contribute to the planning and delivery of services becomes more important. Nurses in the community have the experience and practical knowledge and must use it to influence commissioning and engage proactively, and positively, with current policy agendas and with the people whose responsibility it is to implement them. Change in primary care is constant and increasingly it is the frontline deliverers of services that drive that change and help set the agenda. As more care and treatment is devolved from the secondary to primary care setting, there must be greater integration between general practice and the community nursing team, with each helping and informing the other to deliver a world class primary care service.

Two approaches, one problem: Cultural constructions of type II diabetes in an indigenous community in Yucatán, Mexico.

PubMed

Frank, Sarah M; Durden, T Elizabeth

2017-01-01

The emerging epidemic of obesity and type II diabetes in Mexico has recently propelled the nation into the public health spotlight. In the state of Yucatán, the experience of diabetes is greatly impacted by two cultural constructions of disease. In this setting, elements of Yucatec Mayan health practices as well as the biomedical model affect the approach to type II diabetes. Both frameworks offer unique understandings of the etiology of diabetes and recommend different ways to manage the condition. Based on in-depth and semi-structured interviews with both community members and clinicians, the present study seeks to understand how diabetes is understood and treated in indigenous settings in rural Yucatán. We explore the context in which community members navigate between locally available healthcare options, choose one over the other, or incorporate strategies from both into their diabetes care regimens. The tension between indigenous community members and their biomedical healthcare providers, the changing food environment of this community, and the persistence of traditional gender constructions affect the management of type II diabetes and its associated symptoms. Copyright © 2016 Elsevier Ltd. All rights reserved.

Interprofessional education and practice guide No. 5: Interprofessional teaching for prequalification students in clinical settings.

PubMed

Lie, Désirée A; Forest, Christopher P; Kysh, Lynn; Sinclair, Lynne

2016-05-01

The importance of interprofessional education in health professions training is increasingly recognised through new accreditation guidelines. Clinician teachers from different professions may find themselves being asked to teach or supervise learners from multiple health professions, focusing on interprofessional dynamics, interprofessional communication, role understanding, and the values and ethics of collaboration. Clinician teachers often feel prepared to teach learners from their own profession but may feel ill prepared to teach learners from other professions. In this guide, we draw upon the collective experience from two countries: an institution from the United States with experience in guiding faculty to teach in a student-run interprofessional clinic and an institution from Canada that offers interprofessional experiences to students in community and hospital settings. This guide offers teaching advice to clinician educators in all health professions who plan to or already teach in an interprofessional clinical setting. We anticipate that clinician teachers can learn to fully engage learners from different professions, precept effectively, recognise common pitfalls, increase their confidence, reflect, and become role models to deliver effective teaching in interprofessional settings.

Experiences and perspectives of community health workers from implementing treatment for schistosomiasis using the community directed intervention strategy in an informal settlement in Kisumu City, western Kenya.

PubMed

Odhiambo, Gladys O; Musuva, Rosemary M; Odiere, Maurice R; Mwinzi, Pauline N

2016-09-15

The Community Directed Intervention (CDI) strategy has been used to conduct various health interventions in Africa, including control of Neglected Tropical Diseases (NTDs). Although the CDI approach has shown good results in the control of onchocerciasis and lymphatic filariasis with respect to treatment coverage using community drug distributors, its utility in the control of schistosomiasis among urban poor is yet to be established. Using a longitudinal qualitative study, we explored the experiences, opportunities, challenges as well as recommendations of Community Health Workers (CHWs) after participation in annual mass drug administration (MDA) activities for schistosomiasis using the CDI approach in an urban setting. Unstructured open-ended group discussions were conducted with CHWs after completion of annual MDA activities. Narratives were obtained from CHWs using a digital audio recorder during the group discussions, transcribed verbatim and translated into English where applicable. Thematic decomposition of data was done using ATLAS.ti. software, and themes explored using the principle of interpretative phenomenological analysis (IPA). From the perspective of the CHWs, opportunities for implementing CDI in urban settings, included the presence of CHWs, their supervisory structures and their knowledge of intervention areas, and opportunity to integrate MDA with other health interventions. Several challenges were mentioned with regards to implementing MDA using the CDI strategy among them lack of incentives, fear of side effects, misconceptions regarding treatment and mistrust, difficulties working in unsanitary environmental conditions, insecurity, and insufficient time. A key recommendation in promoting more effective MDA using the CDI approach was allocation of more time to the exercise. Findings from this study support the feasibility of using CDI for implementing MDA for schistosomiasis in informal settlements of urban areas. Extensive community sensitization and provision of incentives may help address the aforementioned challenges associated with implementing MDA using the CDI strategy. Opportunities highlighted in this study may be of value to other programmes that may be considering the adoption of the CDI strategy for rolling out interventions in the urban setting.

Does the design and implementation of proven innovations for delivering basic primary health care services in rural communities fit the urban setting: the case of Ghana’s Community-based Health Planning and Services (CHPS)

PubMed Central

2014-01-01

Background Rapid urban population growth is of global concern as it is accompanied with several new health challenges. The urban poor who reside in informal settlements are more vulnerable to these health challenges. Lack of formal government public health facilities for the provision of health care is also a common phenomenon among communities inhabited by the urban poor. To help ameliorate this situation, an innovative urban primary health system was introduced in urban Ghana, based on the milestones model developed with the rural Community-Based Health Planning and Services (CHPS) system. This paper provides an overview of innovative experiences adapted while addressing these urban health issues, including the process of deriving constructive lessons needed to inform discourse on the design and implementation of the sustainable Community-Based Health Planning and Services (CHPS) model as a response to urban health challenges in Southern Ghana. Methods This research was conducted during the six-month pilot of the urban CHPS programme in two selected areas acting as the intervention and control arms of the design. Daily routine data were collected based on milestones initially delineated for the rural CHPS model in the control communities whilst in the intervention communities, some modifications were made to the rural milestones. Results The findings from the implementation activities revealed that many of the best practices derived from the rural CHPS experiment could not be transplanted to poor urban settlements due to the unique organizational structures and epidemiological characteristics found in the urban context. For example, constructing Community Health Compounds and residential facilities within zones, a central component to the rural CHPS strategy, proved inappropriate for the urban sector. Night and weekend home visit schedules were initiated to better accommodate urban residents and increase coverage. The breadth of the disease burden of the urban residents also requires a broader expertise and training of the CHOs. Conclusions Access to improved urban health services remains a challenge. However, current policy guidelines for the implementation of a primary health model based on rural experiences and experimental design requires careful review and modifications to meet the needs of the urban settings. PMID:24690310

Does the design and implementation of proven innovations for delivering basic primary health care services in rural communities fit the urban setting: the case of Ghana's Community-based Health Planning and Services (CHPS).

PubMed

Adongo, Philip Baba; Phillips, James F; Aikins, Moses; Arhin, Doris Afua; Schmitt, Margaret; Nwameme, Adanna U; Tabong, Philip Teg-Nefaah; Binka, Fred N

2014-04-01

Rapid urban population growth is of global concern as it is accompanied with several new health challenges. The urban poor who reside in informal settlements are more vulnerable to these health challenges. Lack of formal government public health facilities for the provision of health care is also a common phenomenon among communities inhabited by the urban poor. To help ameliorate this situation, an innovative urban primary health system was introduced in urban Ghana, based on the milestones model developed with the rural Community-Based Health Planning and Services (CHPS) system. This paper provides an overview of innovative experiences adapted while addressing these urban health issues, including the process of deriving constructive lessons needed to inform discourse on the design and implementation of the sustainable Community-Based Health Planning and Services (CHPS) model as a response to urban health challenges in Southern Ghana. This research was conducted during the six-month pilot of the urban CHPS programme in two selected areas acting as the intervention and control arms of the design. Daily routine data were collected based on milestones initially delineated for the rural CHPS model in the control communities whilst in the intervention communities, some modifications were made to the rural milestones. The findings from the implementation activities revealed that many of the best practices derived from the rural CHPS experiment could not be transplanted to poor urban settlements due to the unique organizational structures and epidemiological characteristics found in the urban context. For example, constructing Community Health Compounds and residential facilities within zones, a central component to the rural CHPS strategy, proved inappropriate for the urban sector. Night and weekend home visit schedules were initiated to better accommodate urban residents and increase coverage. The breadth of the disease burden of the urban residents also requires a broader expertise and training of the CHOs. Access to improved urban health services remains a challenge. However, current policy guidelines for the implementation of a primary health model based on rural experiences and experimental design requires careful review and modifications to meet the needs of the urban settings.

From the bush to the big smoke--development of a hybrid urban community based medical education program in the Northern Territory, Australia.

PubMed

Morgan, S; Smedts, A; Campbell, N; Sager, R; Lowe, M; Strasser, S

2009-01-01

The Northern Territory (NT) of Australia is a unique setting for training medical students. This learning environment is characterised by Aboriginal health and an emphasis on rural and remote primary care practice. For over a decade the NT Clinical School (NTCS) of Flinders University has been teaching undergraduate medical students in the NT. Community based medical education (CBME) has been demonstrated to be an effective method of learning medicine, particularly in rural settings. As a result, it is rapidly gaining popularity in Australia and other countries. The NTCS adopted this model some years ago with the implementation of its Rural Clinical School; however, urban models of CBME are much less well developed than those in rural areas. There is considerable pressure to better incorporate CBME into medical student teaching environment, particularly because of the projected massive increase in student numbers over the next few years. To date, the community setting of urban Darwin, the NT capital city, has not been well utilised for medical student training. In 2008, the NTCS enrolled its first cohort of students in a new hybrid CBME program based in urban Darwin. This report describes the process and challenges involved in development of the program, including justification for a hybrid model and the adaptation of a rural model to an urban setting. Relationships were established and formalised with key partners and stakeholders, including GPs and general practices, Aboriginal medical services, community based healthcare providers and other general practice and community organisations. Other significant issues included curriculum development and review, development of learning materials and the establishment of robust evaluation methods. Development of the CBME model in Darwin posed a number of key challenges. Although the experience of past rural programs was useful, a number of distinct differences were evident in the urban setting. Change leadership and inter-professional collaboration were key strengths in the implementation and ongoing evaluation of the program. The program will provide important information about medical student training in urban community settings, and help inform other clinical schools considering the adoption of similar models.

Attitudes of qualified vs. student mental health nurses towards an individual diagnosed with schizophrenia.

PubMed

Linden, Mark; Kavanagh, Rory

2012-06-01

  This paper is the report of a study which sought to compare the attitudes held by student and qualified mental health nurses towards individuals with schizophrenia in the Republic of Ireland.   Media portrayals of individuals with schizophrenia often include images of aggression and violence. With global initiatives aimed at reducing the stigma and exclusion associated with mental illness, the attitudes of those who care for people with schizophrenia are of particular interest.   A survey was administered to 66 student mental health nurses, and 121 qualified mental health nurses. Participants completed the community attitudes to mental illness scale and the social interaction scale in 2009. Multivariate analysis of variance was used to test for the effects of qualification, work setting, years of experience and education on the measures.   Nurses employed in a community setting held more positive attitudes, when compared with colleagues who worked in an inpatient setting, as measured by the community mental health ideology subscale, indicating their desire to promote community care for individuals with schizophrenia. Nurses working in an inpatient setting held more socially restrictive attitudes indicating that they felt individuals with schizophrenia were dangerous and should be avoided. These findings were statistically significant at the P < 0·05 level.   Mental health nurses must be alerted to the fact that holding negative attitudes may adversely affect the therapeutic relationship and ultimately lead to stigmatization and its negative consequences. © 2011 The Authors Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

Effects of water fluoridation on caries experience in the primary dentition in a high caries risk community in Queensland, Australia.

PubMed

Koh, Rongzhen; Pukallus, Margaret L; Newman, Bruce; Foley, Michael; Walsh, Laurence J; Seow, W Kim

2015-01-01

In December 2008, artificial water fluoridation was introduced for the first time to the Logan-Beaudesert district in the state of Queensland, Australia. The aim of this study was to evaluate the effects of water fluoridation in the primary dentition in this community after a period of 36 months. Children aged 4-9 years with clinical examinations and bitewing radiographs (BWs) taken before water fluoridation (pre-F) were randomly selected as comparison controls for age matched children who had been exposed to a mean period of 36 months of water fluoridation (post-F). A total of 201 sets of pre-F BWs from children (mean age 6.95 ± 1.05 years) and 256 sets of post-F BWs from children (mean age 7.19 ± 1.23 years) attending schools in the district were randomly selected. Caries experience in the primary dentition was determined as decayed, missing or filled teeth/surfaces (dmft/dmfs). The caries prevalence for the pre-F group was 87% compared to 75% in the post-F group (Odds ratio (OR): 0.44, 95% CI: 0.27-0.72). Overall, there was a 19 percent reduction of mean dmft from 4.54 in the pre-F group to 3.66 in the post-F group (p = 0.005). After fluoridation, the dmfs was reduced from 6.68 to 5.17 (p = 0.0056). The distal surfaces of maxillary first primary molars experienced the greatest reduction (26%) in caries experience after water fluoridation (p < 0.001). After only 36 months of water fluoridation there was a significant drop in caries prevalence from 87 to 75% and a 19% reduction in caries experience in a community with one of the highest caries rates in Australia.

Combined effects of solar ultraviolet radiation and nutrients addition on growth, biomass and taxonomic composition of coastal marine phytoplankton communities of Patagonia.

PubMed

Marcoval, M Alejandra; Villafañe, Virginia E; Helbling, E Walter

2008-05-29

Experiments (6-8 days) were conducted during late summer, late fall and late winter, 2003 with waters collected off Bahía Nueva, Chubut, Argentina (42.7 degrees S, 65 degrees W) to determine the combined effects of solar ultraviolet radiation (UVR, 280-400 nm) and nutrient addition on phytoplankton communities. Samples were put in UVR-transparent containers and incubated under two radiation treatments: (a) Samples exposed to full solar radiation (PAB treatment, 280-400 nm) and (b) Samples exposed only to PAR (PAR treatment, 400-700 nm). At the beginning of the experiments, nutrients (i.e., NaPO(4)H(2) and NaNO(3)) were added to one set of samples from each radiation treatment (N cultures) whereas in the other set, nutrients remained at the concentration of the seawater. Chlorophyll a, biomass, UV-absorbing compounds and taxonomic composition were recorded throughout the experiments. N cultures always had significantly higher growth rates (P<0.05) than that in non-enriched cultures. At the beginning of experiments, phytoplankton communities were generally dominated by monads and flagellates but by the end, diatoms comprised the bulk of biomass, with only one to four taxa dominating, suggesting a selection towards more tolerant/less sensitive species. Over the experimental time frame, the observed taxonomic changes were mostly due to nutrient availability, and to a lesser extent to solar UVR exposure. Overall, the results indicate that environmental conditions (i.e., light history, nutrient concentration) together with the physiological status of the cells play a very important role at the time to assess the combined effect of nutrient addition and solar radiation on coastal phytoplankton assemblages from Patagonia.

Consensus methodology to determine minor ailments appropriate to be directed for management within community pharmacy.

PubMed

Nazar, Hamde; Nazar, Zachariah; Yeung, Andre; Maguire, Mike; Connelly, Alex; Slight, Sarah P

2018-01-04

National Health Service (NHS) 111, a medical helpline for urgent care used within the England and Scotland, receives significant numbers of patient calls yearly for a range of clinical conditions. Some are considered high acuity and mainly directed to urgent and emergency care. Low acuity conditions are also directed to these costly, overburdened services. Community pharmacy is a recognised setting for effective low acuity condition management and could offer an alternative. To design and evaluate a new NHS111 pathway re-directing patients with low acuity conditions to community pharmacy. Two consensus development stakeholder workshops were undertaken. A "low acuity" condition was defined as one that can be clinically assessed by a community pharmacist and requires a treatment and/or advice available within a community pharmacy. Retrospective NHS111 patient data (February-August 2016) from the North East of England and access to the NHS Pathways clinical decision support software were available to stakeholders. The NHS111 data demonstrated the volume of patient calls for these conditions that could have been redirected to community pharmacy. Stakeholders reached consensus that 64 low acuity conditions could be safely redirected to community pharmacy via NHS111. This represented approximately 35,000 patients (11.5% of total) being shifted away from the higher cost settings in the North East region alone during February-August 2016. The stakeholder group discussions provided rationale behind their classifications of conditions to ensure patient safety, the care experience and added value. The resulting definitive list of low acuity conditions that could be directed to community pharmacy via NHS111 could result in a shift of workload from urgent and emergency care settings. Future work needs to evaluate the cost, clinical outcomes, patient satisfaction of a community pharmacy referral service that has the potential to improve integration of community pharmacy in the wider NHS. Copyright © 2018 Elsevier Inc. All rights reserved.

Third-Year Pharmacy Students' Work Experience and Attitudes and Perceptions of the Pharmacy Profession

PubMed Central

Schondelmeyer, Stephen W.; Hadsall, Ronald S.; Schommer, Jon C.

2008-01-01

Objectives To describe PharmD students' work experiences and activities; examine their attitudes towards their work; examine perceptions of preceptor pharmacists they worked with; and determine important issues associated with career preference. Methods A written survey was administered to third-year doctor of pharmacy (PharmD) students at 8 colleges and schools of pharmacy in the Midwest. Results Five hundred thirty-three students (response rate = 70.4%) completed the survey instrument. Nearly 100% of PharmD students reported working in a pharmacy by the time their advanced pharmacy practice experiences (APPEs) began. Seventy-eight percent reported working in a community pharmacy, and 67% had worked in a chain community pharmacy. For all practice settings, students reported spending 69% of their time on activities such as compounding, dispensing, and distribution of drug products. Conclusions Most students are working in community pharmacy (mainly chain) positions where their primary function is traditional drug product dispensing and distribution. Having a controllable work schedule was the variable most strongly associated with career choice for all students. PMID:18698391

Language, games and the role of interpreters in psychiatric diagnosis: a Wittgensteinian thought experiment.

PubMed

Thomas, P; Shah, A; Thornton, T

2009-06-01

British society is becoming increasingly culturally and linguistically diverse. This poses a major challenge to mental health services charged with the responsibility to work in ways that respect cultural and linguistic difference. In this paper we investigate the problems of interpretation in the diagnosis of depression using a thought experiment to demonstrate important features of language-games, an idea introduced by Ludwig Wittgenstein in his late work, Philosophical investigations. The thought experiment draws attention to the importance of culture and contexts in understanding the meaning of particular utterances. This has implications not only for how we understand the role of interpreters in clinical settings, and who might best be suited to function in such a role, but more generally it draws attention to the importance of involving members of black minority ethnic (BME) communities in working alongside mainstream mental health services. We conclude that the involvement of BME community development workers inside, alongside and outside statutory services can potentially improve the quality of care for people from BME communities who use these services.

Patient experience and use of probiotics in community-based health care settings.

PubMed

Chin-Lee, Blake; Curry, William J; Fetterman, John; Graybill, Marie A; Karpa, Kelly

2014-01-01

To investigate patient experience with probiotics and factors that influence probiotic use among adult patients. Patients were invited to complete a questionnaire that assessed their experiences and opinions regarding probiotics. Questionnaires were distributed to patients seeking primary health care services at a family and community medicine practice site and a community pharmacy. Patients were invited to complete the questionnaire while awaiting the physician or waiting for prescriptions to be filled. Overall, 162 surveys were completed and returned (66% response rate) from patients aged 18 to 89 years of age (mean 49.5 years). Most patients (n=107; 65%) were familiar with the term "probiotic", and 49 patients (29.9%) had personally used the supplements in the past. Of those who had used probiotics, the majority (57%) had used the supplements to maintain "good gastrointestinal health" and most (59%) felt that the supplements had been beneficial. However, most (59%) had not informed their health care provider about their use of the supplements. Use of probiotic supplements is common among consumers, but may not be reported to health care providers.

Patient experience and use of probiotics in community-based health care settings

PubMed Central

Chin-Lee, Blake; Curry, William J; Fetterman, John; Graybill, Marie A; Karpa, Kelly

2014-01-01

Objective To investigate patient experience with probiotics and factors that influence probiotic use among adult patients. Method Patients were invited to complete a questionnaire that assessed their experiences and opinions regarding probiotics. Questionnaires were distributed to patients seeking primary health care services at a family and community medicine practice site and a community pharmacy. Patients were invited to complete the questionnaire while awaiting the physician or waiting for prescriptions to be filled. Results Overall, 162 surveys were completed and returned (66% response rate) from patients aged 18 to 89 years of age (mean 49.5 years). Most patients (n=107; 65%) were familiar with the term “probiotic”, and 49 patients (29.9%) had personally used the supplements in the past. Of those who had used probiotics, the majority (57%) had used the supplements to maintain “good gastrointestinal health” and most (59%) felt that the supplements had been beneficial. However, most (59%) had not informed their health care provider about their use of the supplements. Conclusion Use of probiotic supplements is common among consumers, but may not be reported to health care providers. PMID:25382972

Beyond these walls: Can psychosocial clubhouses promote the social integration of adults with serious mental illness in the community?

PubMed

Gumber, Shinakee; Stein, Catherine H

2018-03-01

The study examined factors associated with community integration experiences of adults with serious mental illness who were members of psychosocial rehabilitation clubhouses in New York City. Ninety-two clubhouse members completed an online survey. The study examined relative contribution of adults' reports of individual factors (self-reported psychiatric symptoms, self-esteem), community supports (self-reported employment status and perceived family support), and the clubhouse environment (self-reported time spent in the clubhouse, clubhouse supportiveness, and practical orientation) in accounting for variation in members' reports of social integration within the clubhouse and within the larger community. Hierarchical linear regression results suggest a differential pattern of variables associated with participants' experience of social integration within the clubhouse versus outside the clubhouse with the larger non-mental-health consumers. Adults' reports of more time spent in the clubhouse and perceptions of clubhouse environment as having a more practical orientation were associated with adults' reports of greater social integration within the clubhouse. In contrast, greater self-esteem and being independently employed were associated with greater social integration outside the clubhouse. Perceived family support was associated with higher levels of social integration both within and outside the clubhouse setting. Conclusion and Implication for Practice: Greater social integration of clubhouse members both in and outside the clubhouse environment is essential in understanding community integration. Recommendations for the clubhouse model to improve community integration experiences of its members are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Trust of community health workers influences the acceptance of community-based maternal and child health services.

PubMed

Grant, Merridy; Wilford, Aurene; Haskins, Lyn; Phakathi, Sifiso; Mntambo, Ntokozo; Horwood, Christiane M

2017-05-29

Community health workers (CHWs) are a component of the health system in many countries, providing effective community-based services to mothers and infants. However, implementation of CHW programmes at scale has been challenging in many settings. To explore the acceptability of CHWs conducting household visits to mothers and infants during pregnancy and after delivery, from the perspective of community members, professional nurses and CHWs themselves. Primary health care clinics in five rural districts in KwaZulu-Natal, South Africa. A qualitative exploratory study was conducted where participants were purposively selected to participate in 19 focus group discussions based on their experience with CHWs or child rearing. Poor confidentiality and trust emerged as key barriers to CHW acceptability in delivering maternal and child health services in the home. Most community members felt that CHWs could not be trusted because of their lack of professionalism and inability to maintain confidentiality. Familiarity and the complex relationships between household members and CHWs caused difficulties in developing and maintaining a relationship of trust, particularly in high HIV prevalence settings. Professional staff at the clinic were crucial in supporting the CHW's role; if they appeared to question the CHW's competency or trustworthiness, this seriously undermined CHW credibility in the eyes of the community. Understanding the complex contextual challenges faced by CHWs and community members can strengthen community-based interventions. CHWs require training, support and supervision to develop competencies navigating complex relationships within the community and the health system to provide effective care in communities.

The influence of ecology on chimpanzee (Pan troglodytes) cultural behavior: a case study of five Ugandan chimpanzee communities.

PubMed

Gruber, Thibaud; Potts, Kevin B; Krupenye, Christopher; Byrne, Maisie-Rose; Mackworth-Young, Constance; McGrew, William C; Reynolds, Vernon; Zuberbühler, Klaus

2012-11-01

The influence of ecology on the development of behavioral traditions in animals is controversial, particularly for chimpanzees (Pan troglodytes), for which it is difficult to rule out environmental influences as a cause of widely observed community-specific behavioral differences. Here, we investigated 3 potential scenarios that could explain the natural variation in a key extractive tool behavior, "fluid-dip," among several communities of chimpanzees of the Pan troglodytes schweinfurthii subspecies in Uganda. We compared data from previous behavioral ecological studies, field experiments, and long-term records of chimpanzee tool-using behavior. We focused on the quality of the available food, dietary preferences, and tool sets of 5 different communities, and carried out a standardized field experiment to test systematically for the presence of fluid-dip in 4 of these communities. Our results revealed major differences in habitat, available diet, and tool use behavior between geographically close communities. However, these differences in ecology and feeding behavior failed to explain the differences in tool use across communities. We conclude that ecological variables may lead both to innovation and loss of behavioral traditions, while contributing little to their transmission within the community. Instead, as soon as a behavioral tradition is established, sociocognitive factors likely play a key maintenance role as long as the ecological conditions do not change sufficiently for the tradition to be abandoned.

Caring for patients on home enteral nutrition: Reported complications by home carers and perspectives of community nurses.

PubMed

Lim, Mei Ling; Yong, Bei Yi Paulynn; Mar, Mei Qi Maggie; Ang, Shin Yuh; Chan, Mei Mei; Lam, Madeleine; Chong, Ngian Choo Janet; Lopez, Violeta

2018-07-01

To explore the experiences of community nurses and home carers, in caring for patients on home enteral nutrition. The number of patients on home enteral nutrition is on the increase due to advancement in technology and shift in focus of providing care from acute to community care settings. A mixed-method approach was adopted. (i) A face-to-face survey design was used to elicit experience of carers of patients on home enteral nutrition. (ii) Focus group interviews were conducted with community nurses. Ninety-nine carers (n = 99) were recruited. Patient's mean age that they cared for was aged 77.7 years (SD = 11.2), and they had been on enteral feeding for a mean of 29 months (SD = 23.0). Most were bed-bound (90%) and required full assistance with their feeding (99%). Most were not on follow-up with dietitians (91%) and dentists (96%). The three most common reported gastrointestinal complications were constipation (31%), abdominal distension (28%) and vomiting (22%). Twenty community nurses (n = 20) were recruited for the focus group interviews. Four main themes emerged from the analysis: (i) challenge of accessing allied health services in the community; (ii) shorter length of stay in the acute care setting led to challenges in carers' learning and adaptation; (iii) transition gaps between hospital and home care services; and (iv) managing expectations of family. To facilitate a better transition of care for patients, adequate training for carers, standardising clinical practice in managing patients with home enteral nutrition and improving communication between home care services and the acute care hospitals are needed. This study highlighted the challenges faced by community home care nurses and carers. Results of this study would help to inform future policies and practice changes that would improve the quality of care received by patients on home enteral nutrition. © 2018 John Wiley & Sons Ltd.

OBSIP: Advancing Capabilities and Expanding the Ocean Bottom Seismology Community

NASA Astrophysics Data System (ADS)

Aderhold, K.; Evers, B.

2016-12-01

The Ocean Bottom Seismograph Instrument Pool (OBSIP) is a National Science Foundation sponsored instrument facility that provides ocean bottom seismometers (OBS) and technical support for research in the areas of marine geology, seismology, and geodynamics. OBSIP is comprised of an OBSIP Management Office (OMO) and three Institutional Instrument Contributors (IICs), who each contribute instruments and technical support to the pool. OBSIP operates both short period and broadband OBS instruments with a variety of capabilities to operate in shallow or deep water over both short and long term durations. Engineering developments at the IICs include capability for freshwater deployments, increased recording duration (15+ months), more efficient recovery systems, and sensor upgrades for a less heterogeneous fleet. OBSIP will provide instruments for three experiments in 2016 with deployments along a 1500 km transect in the South Atlantic, a large active-source experiment on the Chilean megathrust, and the very first seismometers ever deployed in Yellowstone Lake. OBSIP OMO strives to lower the barrier to working with OBS data by performing quality checks on data, investigating and responding to community questions, and providing data products like horizontal orientation calculations. This has resulted in a significant increase in new users to OBS data, especially for the open data sets from community seismic experiments. In 2015 the five-year Cascadia Initiative community seismic experiment concluded with over 250 OBS deployments and recoveries in an extensive grid off-shore Washington, Oregon, and California. The logistics of the Cascadia Initiative were challenging, but lessons were learned and efficiencies have been identified for implementation in future experiments. Large-scale community seismic experiments that cross the shoreline like the Cascadia Initiative and the Eastern North American Margin experiment have led to the proposal of even more ambitious endeavors like the Subduction Zone Observatory. OBSIP also is working to develop international collaboration and networking between OBS operators and researchers through special interest group meetings and the biannual OBS Symposium, to be held again in Fall 2017.

Narrative pedagogy with evolving case study--A transformative approach to gerontic nursing practice for undergraduate nursing students.

PubMed

Laver, Shaorn; Croxon, Lyn

2015-09-01

Engaging nursing students in the complexities of care across community, acute, rehabilitation and residential aged care settings is challenging. Equally challenging is conceptualising and promoting diverse and comprehensive health assessments across care settings that reflect clinical reality, inform clinical decision making, traverse theory and practice, and transform clinical practice knowledge. This article describes the use of narrative and evolving case study as a teaching-learning tool utilised by the authors in a third year undergraduate gerontic nursing subject in a pre-service nursing degree at a rural university. Principles of transformative learning and strengths based nursing were drawn upon in the development of the case study. The aim of the approach was to draw on embedded knowledge and the experiences of students and academics from assorted practice settings to facilitate understanding of the lived experiences of an older community dwelling couple. Using social learning strategies students were encouraged to analyse and think critically and creatively about the situations they were presented with. They identified possible solutions that would be acceptable to the couple. Building on the older couple's strengths, achievements and personal social capital, the aim was to develop a positive paradigm for health and the way older people are viewed by nursing students. Copyright © 2015 Elsevier Ltd. All rights reserved.

Pharmacist home visits: A 1-year experience from a community pharmacy.

PubMed

Monte, Scott V; Passafiume, Sarah N; Kufel, Wesley D; Comerford, Patrick; Trzewieczynski, Dean P; Andrus, Kenneth; Brody, Peter M

2016-01-01

To provide experience on the methods and costs for delivering a large-scale community pharmacist home visit service. Independent urban community pharmacy, Buffalo, NY. Mobile Pharmacy Solutions provides traditional community pharmacy walk-in service and a suite of clinically oriented services, including outbound adherence calls linked to home delivery, payment planning, medication refill synchronization, adherence packaging, and pharmacist home visits. Pharmacist daily staffing included three dispensing pharmacists, one residency-trained pharmacist, and two postgraduate year 1 community pharmacy residents. A large-scale community pharmacy home visit service delivered over a 1-year period. Pharmacist time and cost to administer the home visit service as well as home visit request sources and description of patient demographics. A total of 172 visits were conducted (137 initial, 35 follow-up). Patients who received a home visit averaged 9.8 ± 5.2 medications and 3.0 ± 1.6 chronic disease states. On average, a home visit required 2.0 ± 0.8 hours, which included travel time. The percentages of visits completed by pharmacists and residents were 60% and 40%, respectively. The amounts of time to complete a visit were similar. Average home visit cost including pharmacist time and travel was $119 ($147 for a pharmacist, $77 for a resident). In this community pharmacy-based home visit service, costs are an important factor, with each pharmacist visit requiring 2 hours to complete. This experience provides a blueprint and real-world perspective for community pharmacies endeavoring to implement a home visit service and sets a foundation for future prospective trials to evaluate the impact of the service on important indicators of health and cost. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

On the frontline of eastern Burma's chronic conflict--listening to the voices of local health workers.

PubMed

Footer, Katherine H A; Meyer, Sarah; Sherman, Susan G; Rubenstein, Leonard

2014-11-01

Globally, attacks on and interferences with health workers and healthcare delivery, including targeted violence towards providers, attacks on hospitals and delays and denial of health care, represent a serious humanitarian and human rights issue. However, gaps in research about these events persist, limiting the evidence base from which to understand and address the problem. This paper focuses on experiences of local health workers in eastern Burma's chronic conflict, including their strategies for addressing security and ensuring access to vulnerable ethnic communities in the region. Face-to-face in-depth interviews were conducted in June and August 2012 with 27 health workers from three health organizations that operate throughout eastern Burma, with their operational head quarters located in Mae Sot, Tak Province, Thailand. Qualitative analysis found that health workers in this setting experience violent and non-violent interferences with their work, and that the Burmese government's military activities in the region have severely impacted access to care, which remains restricted. Data show that innovative security strategies have emerged, including the important role of the community in ensuring securer access to health care. This study underscores health workers' concern for improved data collection to support the rights of health workers to provide health care, and the rights of community members to receive health care in conflict-affected settings. Findings will inform the development of an incident reporting form to improve systematic data collection and documentation of attacks on health in this setting. Copyright © 2014 Elsevier Ltd. All rights reserved.

Reflections of a community-based participatory researcher from the intersection of disability advocacy, engineering, and the academy.

PubMed

Raymaker, Dora M

2017-09-01

This article uses an evocative autoethnographic approach to explore the experience of being an insider-researcher in a community-based participatory research setting. Taking a holistic perspective and using the form of narrative story-telling, I examine the dynamics between the typically marginalizing (but sometimes empowering) experience of being an autistic woman and the typically privileging (but sometimes oppressive) experience of being an engineering professional, during a time of career upheaval. Themes of motivations and mentors, adversity from social services and the academy, belonging, the slipperiness of intersectional positioning, feedback cycles of opportunity, dichotomies of competence and inadequacy, heightened stakes, and power and resistance are explored through the narrative. While primarily leaving the narrative to speak for itself per the qualitative approach taken, the article concludes with a discussion of how the personal experiences described relate both to the broader work of insider-researchers within disability-related fields, and to misconceptions about self-reflection and capacity for story-telling in individuals on the autism spectrum.

Appropriate technology for rural India - solar decontamination of water for emergency settings and small communities.

PubMed

Kang, Gagandeep; Roy, Sheela; Balraj, Vinohar

2006-09-01

A commercial solar water heating system was evaluated for its effectiveness in decontaminating drinking water with a view to use in emergency situations. A total of 18 seeding experiments carried out over 6 months with 10(5) to 10(7)Escherichia coli/ml showed that the solar heater produced 125 l of bacteriologically safe water in 4 h when the ambient temperature was above 30 degrees C, with a holding time of at least 2 h. The solar water heating system is inexpensive, easy to transport and set up and could provide safer drinking water for 50 people a day. It would be effective in the decrease and prevention of waterborne disease in emergency situations, and is appropriate for use in small communities.

The Spirit of Culture: Applying Cultural Competency to Strength-Based Youth Development.

ERIC Educational Resources Information Center

Lucero, Maria Guajardo

Applying the research-based developmental assets list of 40 positive relationships, experiences, and values as a framework for positive youth development provides communities with a set of factors associated with increased healthy behaviors and fewer high-risk behaviors. Beginning with a question regarding the applicability of this model for youth…

A Capabilities Approach to Higher Education: Geocapabilities and Implications for Geography Curricula

ERIC Educational Resources Information Center

Walkington, Helen; Dyer, Sarah; Solem, Michael; Haigh, Martin; Waddington, Shelagh

2018-01-01

A geographical education offers more than skills, subject knowledge and generic attributes. It also develops a set of discipline-specific capabilities that contribute to a graduate's future learning and experience, granting them special ways of thinking for lifelong development and for contributing to the welfare of themselves, their community and…

Desegregation and Its Impact on Institutional Culture at a Historically Black University

ERIC Educational Resources Information Center

Malfatti-Rachell, Gabrielle

2009-01-01

In this case study, 38 Black and White participants shared their recollections of intergroup contact during the first 15 years of desegregation (1954-1969) at a Historically Black University in a predominantly White Midwestern community. Faculty and alumnae/i candidly evoked their experiences in this unusual desegregation setting and their…

From Our Eyes: Learning from Indigenous Peoples.

ERIC Educational Resources Information Center

O'Meara, Sylvia, Ed.; West, Douglas A., Ed.

The purpose of the conference and this book is to begin to establish the parameters of a new period of interaction between indigenous and non-Native peoples of North America through their experiences in university and academic practices and settings. The book exposes academic communities to indigenous learning and indigenous knowledge with the…

Ethnicity and Schooling: A Caribbean Case Study.

ERIC Educational Resources Information Center

Gibson, Margaret A.

What is the relationship of ethnicity to students' experiences in and responses to schooling? How is success in school related to ethnicity? In this dissertation the schools and community of St. Croix, U.S. Virgin Islands, provide the setting for a multi-ethnic comparative case study in educational anthropology which addresses these questions.…

Start with Service

ERIC Educational Resources Information Center

Riordan, Emily

2013-01-01

Community service has become a key part of the high school experience, with students eager to set themselves apart from one another on the path to college or to find opportunities to discover and develop new passions, creativity, and leadership skills. The author discusses The Green Apple Day of Service, an annual event that brings volunteers from…

Reconnecting Children through Outdoor Education. COEO Research Document: Executive Summary

ERIC Educational Resources Information Center

Foster, Andrea; Linney, Grant

2007-01-01

Outdoor and Experiential Education (OEE) is a vital learning methodology for today's children and young people. Its provision of safe, educator-framed and hands-on experiences in outdoor settings provides unique, vital and lasting benefits in terms of education for curriculum and community, education for character, education for wellbeing and…

Practical Strategies for Minimizing Challenging Behaviors in the Preschool Classroom

ERIC Educational Resources Information Center

Jiang, Hui S.; Jones, Sarah Y.

2016-01-01

Challenging behaviors can happen to children with a variety of abilities in all kinds of settings, and children's early experiences as members of classroom communities serve as the foundation on which lifelong patterns of social behaviors are constructed. Therefore, helping children with challenging behaviors become fully included is essential for…

Ship, Captain, and Crew in Education: Reflections on a Psychedelic Experience.

ERIC Educational Resources Information Center

Marland, S. P., Jr.

This paper discusses the U.S. Office of Education's attempt to stimulate drug education, and a few exemplary programs amongst those it supports. President Nixon's 1970 National Action Committee on Drug Education set up a program for training classroom teachers, and formulated guidelines for programs to educate people in schools, communities, and…

Diabetes Education Needs of Chinese Australians: A Qualitative Study

ERIC Educational Resources Information Center

Choi, Tammie S. T.; Walker, Karen Z.; Ralston, Robin A.; Palermo, Claire

2015-01-01

Objective: The aim of this study was to evaluate a type 2 diabetes education programme for Chinese Australians, based on the experience of participants and by exploring the unique needs of Chinese patients, their health beliefs and their cultural behaviours. Design and setting: A qualitative ethnographic study was undertaken in a community health…

Negligence Liability of K-12 Chemistry Teachers: The Need for Legal Balance and Responsible Action

ERIC Educational Resources Information Center

Zirkel, Perry A.; Barnes, Marianne B.

2011-01-01

The science education community promotes inquiry teaching and learning enhanced by the school laboratory experience, and this emphasis is reflected in state and national science education standards. However, science teachers, especially those in chemistry settings, have been known to avoid laboratory activities because of fear of legal liability…

Being Muslim and American: Turkish-American Children Negotiating Their Religious Identities in School Settings

ERIC Educational Resources Information Center

Isik-Ercan, Zeynep

2015-01-01

Religious diversity in schools is a growing interest among educational researchers. This qualitative case study examines how 15 Turkish-Muslim children in elementary and middle school negotiated their religious identities as they responded to various experiences in American schools and in their communities. Unlike some earlier studies that…

Work-Experience and Work-Study Programs for Students with Special Needs: Quality Indicators of Transition Services.

ERIC Educational Resources Information Center

Wisniewski, Lech A.; And Others

1991-01-01

This article proposes a continuum of employment training options for students with special needs and identifies program quality indicators in the areas of assessment and the Individual Education Plan; the employment training program; community-based settings; provisions for on-site training and evaluation; and interagency cooperation. (DB)

Experience with a Drug Screening Program at a School of Pharmacy

ERIC Educational Resources Information Center

Cates, Marshall E.; Hogue, Michael D.

2012-01-01

Substance use and abuse among pharmacy students is a concern of pharmacy schools, boards of pharmacy, and training sites alike. Pharmacy students must complete approximately 30% of their academic coursework in experiential settings such as community pharmacies, hospitals, and other health systems as part of any accredited pharmacy school's…

Reflections on Service-Learning: Student Experiences in a Sport-Based Youth Development Course

ERIC Educational Resources Information Center

Whitley, Meredith A.; Farrell, Kelly; Maisonet, Cindy; Hoffer, Andrew

2017-01-01

Service-learning courses provide students with practical opportunities to enhance their learning and development in the field, along with getting students engaged in different communities and settings. However, there are still many challenges to designing and offering effective service-learning courses, such as requiring all students to…

Successful outsourcing: improving quality of life through integrated support services.

PubMed

Bates, Jason; Sharratt, Martin; King, John

2014-01-01

This article examines the way that non-clinical support services are provided in healthcare settings through outsourcing partnerships. The integrated support services model and benefits to patient experience and safety as well as organizational efficiency and effectiveness are explored through an examination of services at a busy urban community hospital.

Becoming Close with Others Online: Distributed Community Building in Online PBL Courses

ERIC Educational Resources Information Center

vanOostveen, Roland; Childs, Elizabeth; Clarkson, Jessica; Flynn, Kathleen

2016-01-01

Engaging in an online course has traditionally been perceived to be a lonely experience, with students busy viewing video lectures, working on problem sets and interacting intermittently with others using asynchronous technologies. More recently, over the past 6-7 years, online courses have become recognized as viable delivery vehicles for online…

Prospective Effects of Violence Exposure across Multiple Contexts on Early Adolescents' Internalizing and Externalizing Problems

ERIC Educational Resources Information Center

Mrug, Sylvie; Windle, Michael

2010-01-01

Background: Violence exposure within each setting of community, school, or home has been linked with internalizing and externalizing problems. Although many children experience violence in multiple contexts, the effects of such cross-contextual exposure have not been studied. This study addresses this gap by examining independent and interactive…

The Promises of History: Pedagogic Principles and Processes of Change

ERIC Educational Resources Information Center

Nicholson, Helen

2010-01-01

This paper offers a brief reading of the history of theatre education and applied theatre as a way to reflect on the principles and values that have informed their development. It argues that a critical genealogy of this history suggests that theatrical experiments in educational and community settings have always responded creatively and…

Preservice Teachers' Expectations for Schools with Children of Color and Second-Language Learners.

ERIC Educational Resources Information Center

Terrill, Marguerite; Mark, Dianne L. H.

2000-01-01

Investigated preservice teachers' expectations for racially and linguistically diverse students in different school settings. Most respondents were white, with low comfort and safety levels for schools and communities with children of color. Most wanted to teach in white, suburban schools; had little experience teaching minority children; and held…

ArchiCamps: Exploring Architecture and a Sense of Place

ERIC Educational Resources Information Center

Morris, Ronald V.; Stanis, Suzanne Rollins

2017-01-01

Lessons in community building and cultural understanding are important aspects of a 21st-century education. Through such lessons, students gain the keys to societal understanding as they gain knowledge about their cultural and historical contexts, and use that understanding as a setting for exploration of deeper values, emotional experiences, and…

Use of topical haemoglobin on sloughy wounds in the community setting.

PubMed

Bateman, Sharon Dawn

2015-09-01

This evaluation aimed to determine whether the use of a haemoglobin spray solution expedited sloughy wound healing. A descriptive evaluation was undertaken within a community setting exploring 25 patients presenting with sloughy healing and non-healing wounds, and the effects of 8 topically administered haemoglobin treatments over a 4-week period. Standard wound cleansing and dressing management were continued, with no changes to pre-evaluation regimens, and care being provided by the patients themselves or by a carer. Data were collected weekly with regard to primary outcomes of slough reduction, wound surface area reduction, patient ease of use (self-care), and overall product experience. At 4 weeks, all wounds demonstrated positive measured endpoints of slough elimination and continued wound-size reduction. Patients and carers found the product easy to use (self-caring) with an overall positive wound care experience. The administration of a haemoglobin spray solution on patients presenting with sloughy wounds resulted in positive healing outcomes of slough elimination and wound reduction alongside positive self-care and product satisfaction. Continued evaluation is recommended to build upon the evidence of this form of treatment.

Results of the Greenland ice sheet model initialisation experiments: ISMIP6 - initMIP-Greenland

NASA Astrophysics Data System (ADS)

Goelzer, Heiko; Nowicki, Sophie; Edwards, Tamsin; Beckley, Matthew

2017-04-01

Ice sheet model initialisation has a large effect on projected future sea-level contributions and gives rise to important uncertainties. The goal of this intercomparison exercise for the continental-scale Greenland ice sheet is therefore to compare, evaluate and improve the initialisation techniques used in the ice sheet modelling community. The initMIP-Greenland project is the first in a series of ice sheet model intercomparison activities within ISMIP6 (Ice Sheet Model Intercomparison Project for CMIP6). The experimental set-up has been designed to allow comparison of the initial present-day state of the Greenland ice sheet between participating models and against observations. Furthermore, the initial states are tested with two schematic forward experiments to evaluate the initialisation in terms of model drift (forward run without any forcing) and response to a large perturbation (prescribed surface mass balance anomaly). We present and discuss results that highlight the wide diversity of data sets, boundary conditions and initialisation techniques used in the community to generate initial states of the Greenland ice sheet.

The effects of pediatric community simulation experience on the self-confidence and satisfaction of baccalaureate nursing students: A quasi-experimental study.

PubMed

Lubbers, Jaclynn; Rossman, Carol

2016-04-01

Simulation in nursing education is a means to transform student learning and respond to decreasing clinical site availability. This study proposed an innovative simulation experience where students completed community based clinical hours with simulation scenarios. The purpose of this study was to determine the effects of a pediatric community simulation experience on the self-confidence of nursing students. Bandura's (1977) Self-Efficacy Theory and Jeffries' (2005) Nursing Education Simulation Framework were used. This quasi-experimental study collected data using a pre-test and posttest tool. The setting was a private, liberal arts college in the Midwestern United States. Fifty-four baccalaureate nursing students in a convenience sample were the population of interest. The sample was predominantly female with very little exposure to simulation prior to this study. The participants completed a 16-item self-confidence instrument developed for this study which measured students' self-confidence in pediatric community nursing knowledge, skill, communication, and documentation. The overall study showed statistically significant results (t=20.70, p<0.001) and statistically significant results within each of the eight 4-item sub-scales (p<0.001). Students also reported a high level of satisfaction with their simulation experience. The data demonstrate that students who took the Pediatric Community Based Simulation course reported higher self-confidence after the course than before the course. Higher self-confidence scores for simulation participants have been shown to increase quality of care for patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

Service Learning Trips Abroad Benefit Both Communities and Seasoned Health Educators.

PubMed

Gan, Jody C

2018-05-01

Service learning experiences abroad provide an excellent opportunity for seasoned health educators to share their skills with underresourced communities in other parts of the world while enriching their own professional development. Health educators have not traditionally participated in short-term medical service trips, which have become a popular humanitarian effort, yet their contributions can expand the scope of these efforts. With our responsibilities often focused on assessing needs, planning, implementing, and evaluation, seasoned health educators can provide guidance for new initiatives and share health promotion materials and other resources with communities in other parts of the world. In this commentary, I detail my experience as the first health educator to volunteer with a medical brigade that has served a rural community in Honduras for nearly two decades, and describe my added contribution of a brief intervention to address teen pregnancy during the brigade's annual, medically oriented visit. I also reflect on the benefits to my professional growth from this opportunity to immerse myself in four very familiar areas of responsibility for health education in a new and unknown setting.

Technologies and Methods Used at the Laboratory for Atmospheric and Space Physics (LASP) to Serve Solar Irradiance Data

NASA Technical Reports Server (NTRS)

Pankratz, Chris; Beland, Stephane; Craft, James; Baltzer, Thomas; Wilson, Anne; Lindholm, Doug; Snow, Martin; Woods, Thomas; Woodraska, Don

2018-01-01

The Laboratory for Atmospheric and Space Physics (LASP) at the University of Colorado in Boulder, USA operates the Solar Radiation and Climate Experiment (SORCE) NASA mission, as well as several other NASA spacecraft and instruments. Dozens of Solar Irradiance data sets are produced, managed, and disseminated to the science community. Data are made freely available to the scientific immediately after they are produced using a variety of data access interfaces, including the LASP Interactive Solar Irradiance Datacenter (LISIRD), which provides centralized access to a variety of solar irradiance data sets using both interactive and scriptable/programmatic methods. This poster highlights the key technological elements used for the NASA SORCE mission ground system to produce, manage, and disseminate data to the scientific community and facilitate long-term data stewardship. The poster presentation will convey designs, technological elements, practices and procedures, and software management processes used for SORCE and their relationship to data quality and data management standards, interoperability, NASA data policy, and community expectations.

Effective nutrition education for Aboriginal Australians: lessons from a diabetes cooking course.

PubMed

Abbott, Penelope A; Davison, Joyce E; Moore, Louise F; Rubinstein, Raechelle

2012-01-01

To examine the experiences of Aboriginal Australians with or at risk of diabetes who attended urban community cooking courses in 2002-2007; and to develop recommendations for increasing the uptake and effectiveness of nutrition education in Aboriginal communities. Descriptive qualitative approach using semistructured interviews with 23 Aboriginal course participants aged 19-72. Verbatim transcripts were coded using NVivo 7 software, and qualitative analysis was undertaken. Engagement and learning were increased by emphasizing the social aspects of the program, holding the course in a familiar Aboriginal community-controlled health setting and using small group learning with Aboriginal peers. Partnership with a vocational training institute provided teaching expertise, but there was conflict between vocational and health promotion objectives. Nutrition programs for Aboriginal Australians should be social, flexible, and held in accessible, culturally appropriate settings and focus on healthful cooking techniques using simple, affordable ingredients. Copyright © 2012 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Maximizing value and minimizing barriers: Patient-centered community consultation for research in emergency settings.

PubMed

Fordyce, Christopher B; Roe, Matthew T; Dickert, Neal W

2017-02-01

Patients with cardiac arrest and other life-threatening emergencies are unable to provide prospective consent for clinical trials. In the United States and other countries, regulations permit an exception from the requirement for informed consent in emergency settings. However, many potential barriers exist, as evidenced by the scarcity of US trials conducted under exception from the requirement for informed consent. One persistent challenge is the requirement that investigators consult communities prior to study approval. To improve the community consultation process for emergency studies under exception from the requirement for informed consent, we propose that prioritizing engagement of individuals who have experienced the condition under study, or are at high risk for the condition, fulfills regulatory goals and represents the interests of potential enrollees and the community without impeding research. Prioritizing patients engages individuals who are more likely to understand the concerns and experiences of study subjects, to appreciate risks and benefits of the study, and to understand the impact of the disease and intervention on patients' lives than are members of the general public. Similarly, those explicitly at high risk are more likely to identify as potential participants and may impart some level of accountability on the investigator. Finally, the most logical community of relevance is defined by a combination of condition-related experience and living in the area where a study will be conducted; geographic and condition-related communities should not be treated as distinct. In this sense, patients, their family members, and individuals at high risk within the catchment area represent the appropriate "community." Exception from the requirement for informed consent regulations have advanced the goal of improving care for emergency conditions, but common interpretations of the community consultation requirement threaten research in the United States. Focusing on the goals of learning from and demonstrating respect for those most directly affected by a study through engaging people most connected to the condition of interest will make community consultation more valuable, better inform institutional review boards, and increase efficiency.

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.

Community pharmacists' experience with pharmacogenetic testing.

PubMed

Moaddeb, Jivan; Mills, Rachel; Haga, Susanne B

2015-01-01

Appendix 1 Statements of knowledge of correct medication use Appendix 2 Statements of self-efficacy of correct medication use Appendix 3 Statements of skills of correct medication use To characterize the experiences and feasibility of offering pharmacogenetic (PGx) testing in a community pharmacy setting. Pharmacists were invited to complete a survey about PGx testing for each patient who was offered testing. If the patient consented, pharmacists were also asked to complete a follow-up survey about the process of returning PGx testing results to patients and follow-up with the prescribing provider. Community pharmacies in North Carolina from August through November 2014. Pharmacists at five community pharmacies. Patient consent for testing, time to introduce PGx testing initially and communicate results, interpretation of test results, and recommended medication changes. Of the 69 patients offered testing, 56 (81%) consented. Pre-test counseling typically lasted 1-5 minutes (81%), and most patients (55%) did not have any questions about the testing. Most pharmacists reported test results to patients by phone (84%), with discussions taking less than 1 minute (48%) or 1-5 minutes (52%). Most pharmacists believed the patients understood their results either very well (54%) or somewhat well (41%). Pharmacists correctly interpreted 47 of the 53 test results (89%). All of the incorrect interpretations were for patients with test results indicating a dosing or drug change (6/19; 32%). Pharmacists reported contacting the ordering physician for four patients to discuss results indicating a dosage or drug change. The provision of PGx services in a community pharmacy setting appears feasible, requiring little additional time from the pharmacist, and many patients seem interested in PGx testing. Additional training may be necessary to improve test result interpretation, as well as for communication with both patients and ordering physicians.

Experiences of stigma and discrimination in social and healthcare settings among trans people living with HIV in the UK.

PubMed

Hibbert, M; Wolton, A; Crenna-Jennings, W; Benton, L; Kirwan, P; Lut, I; Okala, S; Ross, M; Furegato, M; Nambiar, K; Douglas, N; Roche, J; Jeffries, J; Reeves, I; Nelson, M; Weerawardhana, C; Jamal, Z; Hudson, A; Delpech, V

2018-07-01

The People Living with HIV StigmaSurvey UK 2015 was a community led national survey investigating experiences of people living with HIV in the UK in the past 12 months. Participants aged 18 and over were recruited through over 120 cross-sector community organisations and 46 HIV clinics to complete an anonymous online survey. Trans is an umbrella term which refers to individuals whose current gender identity is different to the gender they were assigned at birth. Trans participants self-identified via gender identity and gender at birth questions. Descriptive analyses of reported experiences in social and health care settings were conducted and multivariate logistic regression analyses were used to identify sociodemographic predictors of reporting being treated differently to non-HIV patients, and being delayed or refused healthcare treatment in the past 12 months. 31 out of 1576 participants (2%) identified as trans (19 trans women, 5 trans men, 2 gender queer/non-binary, 5 other). High levels of social stigma were reported for all participants, with trans participants significantly more likely to report worrying about verbal harassment (39% vs. 23%), and exclusion from family gatherings (23% vs. 9%) in the last 12 months, compared to cisgender participants. Furthermore, 10% of trans participants reported physical assault in the last 12 months, compared to 4% of cisgender participants. Identifying as trans was a predictor of reporting being treated differently to non-HIV patients (48% vs. 30%; aOR 2.61, CI 1.06, 6.42) and being delayed or refused healthcare (41% vs. 16%; aOR 4.58, CI 1.83, 11.44). Trans people living with HIV in the UK experience high levels of stigma and discrimination, including within healthcare settings, which is likely to impact upon health outcomes. Trans-specific education and awareness within healthcare settings could help to improve service provision for this demographic.

Detecting communities in large networks

NASA Astrophysics Data System (ADS)

Capocci, A.; Servedio, V. D. P.; Caldarelli, G.; Colaiori, F.

2005-07-01

We develop an algorithm to detect community structure in complex networks. The algorithm is based on spectral methods and takes into account weights and link orientation. Since the method detects efficiently clustered nodes in large networks even when these are not sharply partitioned, it turns to be specially suitable for the analysis of social and information networks. We test the algorithm on a large-scale data-set from a psychological experiment of word association. In this case, it proves to be successful both in clustering words, and in uncovering mental association patterns.

The Roles of Pharmacy Schools in Bridging the Gap Between Law and Practice.

PubMed

Adams, Alex J; Dering-Anderson, Allison; Klepser, Michael E; Klepser, Donald

2018-05-01

Progressive pharmacy laws do not always lead to progressive pharmacy practice. Progressive laws are necessary, but not sufficient for pharmacy services to take off in practice. Pharmacy schools can play critical roles by working collaboratively with community pharmacies to close the gap between law and practice. Our experiences launching pharmacy-based point-of-care testing services in community pharmacy settings illustrate some of the roles schools can play, including: developing and providing standardized training, developing template protocols, providing workflow support, sparking collaboration across pharmacies, providing policy support, and conducting research.

Using qualitative insights to change practice: exploring the culture of antibiotic prescribing and consumption for urinary tract infections

PubMed Central

Duane, Sinead; Domegan, Christine; Callan, Aoife; Galvin, Sandra; Cormican, Martin; Bennett, Kathleen; Murphy, Andrew W

2016-01-01

Objectives The aim of this paper is to explore the culture of antibiotic prescribing and consumption in the community for urinary tract infections (UTI) from the perspective of the general practitioners (GPs) and community member. Design Indepth interviews were conducted with GPs, and focus groups were held with community members. Setting General practice and community setting. Participants 15 GPs practising in rural and urban locations in Ireland participated in the indepth interviews. 6 focus groups (n=42) with participants who had direct or indirect experiences with UTI were also undertaken. Results The decision to prescribe or consume an antibiotic for a UTI is a set of complex processes including need recognition, information search and evaluation processes governed by the relationship and interactions between the GP and the patient. Different GP and patient decision-making profiles emerged emphasising the diversity and variety of general practice in real-life settings. The GP findings showed a requirement for more microbiological information on antibiotic resistance patterns to inform prescribing decisions. Focus group participants wanted a conversation with the GP about their illness and the treatment options available. Conclusions Collectively, this research identified the consultation as a priority intervention environment for stimulating change in relation to antibiotics. This paper demonstrates how qualitative research can identify the interacting processes which are instrumental to the decision to prescribe or consume an antibiotic for a suspected UTI. Qualitative research empowers researchers to investigate the what, how and why of interventions in real-life setting. Qualitative research can play a critical and instrumental role in designing behavioural change strategies with high impact on practice. The results of this research were used to design a complex intervention informed by social marketing. Trial registration number NCT01913860; Pre-results. PMID:26754175

Information and communication technology and community-based health sciences training in Uganda: perceptions and experiences of educators and students.

PubMed

Chang, Larry W; Mwanika, Andrew; Kaye, Dan; Muhwezi, Wilson W; Nabirye, Rose C; Mbalinda, Scovia; Okullo, Isaac; Kennedy, Caitlin E; Groves, Sara; Sisson, Stephen D; Burnham, Gilbert; Bollinger, Robert C

2012-01-01

Information and communication technology (ICT) has been advocated as a powerful tool for improving health education in low-resource settings. However, few evaluations have been performed of ICT perceptions and user experiences in low-resource settings. During late 2009, an internet-based survey on ICT was administered to students, tutors, and faculty members associated with a Community-Based Education and Service (COBES) program in Uganda. 255 surveys were completed. Response rates varied (students, 188/684, 27.5%; tutors, 14/27, 51.9%; faculty, 53/335, 15.8%). Most respondents owned mobile phones (98%). Students were less likely (p < 0.001) to own laptops (25%) compared to tutors (71%) and faculty (85%). Internet access at rural sites was uncommon; mobile phone coverage was almost universally present. Laptop ownership and internet and mobile phone access was not associated with high valuation of students' COBES experiences. Free text responses found that respondents valued ICT access for research, learning, and communication purposes. In summary, ICT penetration in this population is primarily manifest by extensive mobile phone ownership. Internet access in rural educational sites is still lacking, but students and educators appear eager to utilize this resource if availability improves. ICT may offer a unique opportunity to improve the quality of teaching and learning for COBES participants.

Sustaining Family Physicians in Urban Underserved Settings.

PubMed

Getzin, Anne; Bobot, Bonnie L; Simpson, Deborah

2016-11-01

Our objective was to identify factors that sustain family physicians practicing in Milwaukee's underserved urban areas. Family physicians with clinical careers in Milwaukee's urban, underserved communities were identified and invited to participate in a 45-60 minute interview using a literature-based semi-structured protocol. Each interview was transcribed and de-identified prior to independent analysis using a grounded theory qualitative approach by two authors to yield sustaining themes. The project was determined not human subjects research per Aurora Health Care IRB. Sixteen family physicians were identified; six of 11 who met inclusion criteria agreed to interview. Four general domains central to sustaining family physicians working with underserved populations were identified: (1) cognitive traits and qualities (trouble shooting, resilience, flexibility), (2) core values (medicine as mechanism to address social justice), (3) skills (self-care, communication, clinical management), and (4) support systems (supportive family/employer, job flexibility, leadership opportunities, staff function as team). The formation of these personal attributes and skills was partly shaped by experiences (from childhood to medical training to work experience) and by personal drivers that varied by individual. Common was that the challenges of providing care in urban underserved settings was seen as rewarding in and of itself and aligned with these physicians' values and skills. Family physicians working with underserved populations described possessing a combination of values, cognitive qualities, skill sets, and support systems. While family physicians face complex challenges in quality care goals in urban underserved settings, training in the personal and professional skill sets identified by participants may improve physician retention in such communities.

Occupational performance and self-determination: the role of the occupational therapist as volunteer in two mountain communities.

PubMed

Boyle, Moira

2014-02-01

Occupational therapists involved in volunteer programmes do so as either a volunteer or as a professional working with volunteers. This study outlines two such programmes: one in regional Queensland, with refugees settling into a life in Australia, and one in Bhutan, with an organisation assisting families of children with disabilities. In both instances, the author has been involved as a volunteer, drawing on her occupational therapy skills, the Person-Environment-Occupation Model and self-determination theory as theoretical frameworks. This report offers an insight into two geographically and culturally different volunteer programmes, and outlines the potential for occupational therapists to be involved in cross-cultural experiences, within Australia and abroad. In the Australian setting the author is working with newly arrived refugees from Africa, Iran and Iraq in a local community group the Toowoomba Refugee and Migrant Service. Within the Bhutanese setting the author is working with the Ability Bhutan Society, an organisation established by a group of local parents with the initial aim of sharing experiences and information relating to their children with disabilities. The descriptions of each volunteering experience outline the opportunities for facilitating the development of independence, self-determination and acquisition of new roles in two cross-cultural communities by an occupational therapist working as a volunteer. An occupational therapist's ability to assess the interaction between a person or organisation's skills, the environment in which that person or organisation is functioning, and the desired occupational outcomes of that person or organisation, enables a unique and valuable contribution as a volunteer. © 2014 Occupational Therapy Australia.

"Without this program, women can lose their lives": migrant women's experiences with the Safe Abortion Referral Programme in Chiang Mai, Thailand.

PubMed

Tousaw, Ellen; La, Ra Khin; Arnott, Grady; Chinthakanan, Orawee; Foster, Angel M

2017-11-01

For displaced and migrant women in northern Thailand, access to health care is often limited, unwanted pregnancy is common, and unsafe abortion is a major contributor to maternal death and disability. Based on a pilot project and situational analysis research, in 2015 a multinational team introduced the Safe Abortion Referral Programme (SARP) in Chiang Mai, Thailand, to reduce the socio-linguistic, economic, documentation, and transportation barriers women from Burma face in accessing safe and legal abortion care in Thailand. Our qualitative study documented the experiences of women with unwanted pregnancies who accessed the SARP in order to inform programme improvement and expansion. We conducted 22 in-depth, in-person interviews and analysed them for content and themes using deductive and inductive techniques. Women were overwhelmingly positive about their experiences using the SARP. They reported lack of costs, friendly programme staff, accompaniment to and interpretation at the providing facility, and safety of services as key features. Financial and legal circumstances shaped access to the programme and women learned about the SARP through word-of-mouth and community workshops. After accessing the SARP and receiving support, women became community advocates for reproductive health. Efforts to expand the programme and raise awareness in migrant communities appear warranted. Our findings suggest that referral programmes for safe and legal abortion can be successful in settings with large displaced and migrant populations. Identifying ways to work within legal constraints to expand access to safe services has the potential to reduce harm from unsafe abortion even in humanitarian settings.

Primary birthing attendants and birth outcomes in remote Inuit communities--a natural "experiment" in Nunavik, Canada.

PubMed

Simonet, F; Wilkins, R; Labranche, E; Smylie, J; Heaman, M; Martens, P; Fraser, W D; Minich, K; Wu, Y; Carry, C; Luo, Z-C

2009-07-01

There is a lack of data on the safety of midwife-led maternity care in remote or indigenous communities. In a de facto natural "experiment", birth outcomes were assessed by primary birthing attendant in two sets of remote Inuit communities. A geocoding-based retrospective birth cohort study in 14 Inuit communities of Nunavik, Canada, 1989-2000: primary birth attendants were Inuit midwives in the Hudson Bay (1529 Inuit births) vs western physicians in Ungava Bay communities (1197 Inuit births). The primary outcome was perinatal death. Secondary outcomes included stillbirth, neonatal death, post-neonatal death, preterm, small-for-gestational-age and low birthweight birth. Multilevel logistic regression was used to obtain the adjusted odds ratios (aOR) controlling for maternal age, marital status, parity, education, infant sex and plurality, community size and community-level random effects. The aORs (95% confidence interval) for perinatal death comparing the Hudson Bay vs Ungava Bay communities were 1.29 (0.63 to 2.64) for all Inuit births and 1.13 (0.48 to 2.47) for Inuit births at > or =28 weeks of gestation. There were no statistically significant differences in the crude or adjusted risks of any of the outcomes examined. Risks of perinatal death were somewhat but not significantly higher in the Hudson Bay communities with midwife-led maternity care compared with the Ungava Bay communities with physician-led maternity care. These findings are inconclusive, although the results excluding extremely preterm births are more reassuring concerning the safety of midwife-led maternity care in remote indigenous communities.

Effect of environmental exposure to hydrogen sulfide on central nervous system and respiratory function: a systematic review of human studies

PubMed Central

Lim, Eunjung; Mbowe, Omar; Lee, Angela S. W.; Davis, James

2016-01-01

Background Assessment of the health effects of low-level exposure to hydrogen sulfide (H2S) on humans through experiments, industrial, and community studies has shown inconsistent results. Objective To critically appraise available studies investigating the effect of H2S on the central nervous system (CNS) and on respiratory function. Methods A search was conducted in 16 databases for articles published between January 1980 and July 2014. Two researchers independently evaluated potentially relevant papers based on a set of inclusion/exclusion criteria. Results Twenty-seven articles met the inclusion criteria: 6 experimental, 12 industry-based studies, and 10 community-based studies (one article included both experimental and industry-based studies). The results of the systematic review varied by study setting and quality. Several community-based studies reported associations between day-to-day variations in H2S levels and health outcomes among patients with chronic respiratory conditions. However, evidence from the largest and better-designed community-based studies did not support that chronic, ambient H2S exposure has health effects on the CNS or respiratory function. Results from industry-based studies varied, reflecting the diversity of settings and the broad range of H2S exposures. Most studies did not have individual measurements of H2S exposure. Discussion The results across studies were inconsistent, justifying the need for further research. PMID:27128692

Effect of environmental exposure to hydrogen sulfide on central nervous system and respiratory function: a systematic review of human studies.

PubMed

Lim, Eunjung; Mbowe, Omar; Lee, Angela S W; Davis, James

2016-01-01

Assessment of the health effects of low-level exposure to hydrogen sulfide (H2S) on humans through experiments, industrial, and community studies has shown inconsistent results. To critically appraise available studies investigating the effect of H2S on the central nervous system (CNS) and on respiratory function. A search was conducted in 16 databases for articles published between January 1980 and July 2014. Two researchers independently evaluated potentially relevant papers based on a set of inclusion/exclusion criteria. Twenty-seven articles met the inclusion criteria: 6 experimental, 12 industry-based studies, and 10 community-based studies (one article included both experimental and industry-based studies). The results of the systematic review varied by study setting and quality. Several community-based studies reported associations between day-to-day variations in H2S levels and health outcomes among patients with chronic respiratory conditions. However, evidence from the largest and better-designed community-based studies did not support that chronic, ambient H2S exposure has health effects on the CNS or respiratory function. Results from industry-based studies varied, reflecting the diversity of settings and the broad range of H2S exposures. Most studies did not have individual measurements of H2S exposure. The results across studies were inconsistent, justifying the need for further research.

Community structure from spectral properties in complex networks

NASA Astrophysics Data System (ADS)

Servedio, V. D. P.; Colaiori, F.; Capocci, A.; Caldarelli, G.

2005-06-01

We analyze the spectral properties of complex networks focusing on their relation to the community structure, and develop an algorithm based on correlations among components of different eigenvectors. The algorithm applies to general weighted networks, and, in a suitably modified version, to the case of directed networks. Our method allows to correctly detect communities in sharply partitioned graphs, however it is useful to the analysis of more complex networks, without a well defined cluster structure, as social and information networks. As an example, we test the algorithm on a large scale data-set from a psychological experiment of free word association, where it proves to be successful both in clustering words, and in uncovering mental association patterns.

Moving health promotion communities online: a review of the literature.

PubMed

Sunderland, Naomi; Beekhuyzen, Jenine; Kendall, Elizabeth; Wolski, Malcom

There is a need to enhance the effectiveness and reach of complex health promotion initiatives by providing opportunities for diverse health promotion practitioners and others to interact in online settings. This paper reviews the existing literature on how to take health promotion communities and networks into online settings. A scoping review of relevant bodies of literature and empirical evidence was undertaken to provide an interpretive synthesis of existing knowledge on the topic. Sixteen studies were identified between 1986 and 2007. Relatively little research has been conducted on the process of taking existing offline communities and networks into online settings. However, more research has focused on offline (i.e. not mediated via computer networks); 'virtual' (purely online with no offline interpersonal contact); and 'multiplex' communities (i.e. those that interact across both online and offline settings). Results are summarised under three themes: characteristics of communities in online and offline settings; issues in moving offline communities online, and designing online communities to match community needs. Existing health promotion initiatives can benefit from online platforms that promote community building and knowledge sharing. Online e-health promotion settings and communities can successfully integrate with existing offline settings and communities to form 'multiplex' communities (i.e. communities that operate fluently across both online and offline settings).

Communicating a diagnosis of Autism Spectrum Disorder - a qualitative study of parents' experiences.

PubMed

Abbott, Mandy; Bernard, Paul; Forge, Jenny

2013-07-01

Not enough is known about parents' experiences of receiving the news that their child warrants a diagnosis of Autism Spectrum Disorder (ASD). Sharing this information with parents is an important and difficult part of Child and Adolescent Mental Health (CAMH) practice. Qualitative methodology was used to explore the experiences of the 'feedback session' with nine sets of parents in a community Child and Adolescent Mental Health Service (CAMHS) in North East England. Parents gave vivid accounts of their experiences and described issues relating to the structure, style and content of the session. The experiences of CAMHS users should inform the development of good practice in this important area.

Rural-to-Urban Migrants' Experiences with Primary Care under Different Types of Medical Institutions in Guangzhou, China

PubMed Central

Zeng, Jiazhi; Shi, Leiyu; Zou, Xia; Chen, Wen; Ling, Li

2015-01-01

Objectives China is facing the unprecedented challenge of rapidly increasing rural-to-urban migration. Migrants are in a vulnerable state when they attempt to access to primary care services. This study was designed to explore rural-to-urban migrants’ experiences in primary care, comparing their quality of primary care experiences under different types of medical institutions in Guangzhou, China. Methods The study employed a cross-sectional survey of 736 rural-to-urban migrants in Guangzhou, China in 2014. A validated Chinese version of Primary Care Assessment Tool—Adult Short Version (PCAT-AS), representing 10 primary care domains was used to collect information on migrants’ quality of primary care experiences. These domains include first contact (utilization), first contact (accessibility), ongoing care, coordination (referrals), coordination (information systems), comprehensiveness (services available), comprehensiveness (services provided), family-centeredness, community orientation and culturally competent. These measures were used to assess the quality of primary care performance as reported from patients’ perspective. Analysis of covariance was conducted for comparison on PCAT scores among migrants accessing primary care in tertiary hospitals, municipal hospitals, community health centers/community health stations, and township health centers/rural health stations. Multiple linear regression models were used to explore factors associated with PCAT total scores. Results After adjustments were made, migrants accessing primary care in tertiary hospitals (25.49) reported the highest PCAT total scores, followed by municipal hospitals (25.02), community health centers/community health stations (24.24), and township health centers/rural health stations (24.18). Tertiary hospital users reported significantly better performance in first contact (utilization), first contact (accessibility), coordination (information system), comprehensiveness (service available), and cultural competence. Community health center/community health station users reported significantly better experience in the community orientation domain. Township health center/rural health station users expressed significantly better experience in the ongoing care domain. There were no statistically significant differences across settings in the ongoing care, comprehensiveness (services provided), and family-centeredness domains. Multiple linear regression models showed that factors positively associated with higher PCAT total scores also included insurance covering parts of healthcare payment (P<0.001). Conclusions This study highlights the need for improvement in primary care provided by primary care institutions for rural-to-urban migrants. Relevant policies related to medical insurance should be implemented for providing affordable healthcare services for migrants accessing primary care. PMID:26474161

Issues in the analysis of oligonucleotide tiling microarrays for transcript mapping

NASA Technical Reports Server (NTRS)

Royce, Thomas E.; Rozowsky, Joel S.; Bertone, Paul; Samanta, Manoj; Stolc, Viktor; Weissman, Sherman; Snyder, Michael; Gerstein, Mark

2005-01-01

Traditional microarrays use probes complementary to known genes to quantitate the differential gene expression between two or more conditions. Genomic tiling microarray experiments differ in that probes that span a genomic region at regular intervals are used to detect the presence or absence of transcription. This difference means the same sets of biases and the methods for addressing them are unlikely to be relevant to both types of experiment. We introduce the informatics challenges arising in the analysis of tiling microarray experiments as open problems to the scientific community and present initial approaches for the analysis of this nascent technology.

Means and extremes: building variability into community-level climate change experiments.

PubMed

Thompson, Ross M; Beardall, John; Beringer, Jason; Grace, Mike; Sardina, Paula

2013-06-01

Experimental studies assessing climatic effects on ecological communities have typically applied static warming treatments. Although these studies have been informative, they have usually failed to incorporate either current or predicted future, patterns of variability. Future climates are likely to include extreme events which have greater impacts on ecological systems than changes in means alone. Here, we review the studies which have used experiments to assess impacts of temperature on marine, freshwater and terrestrial communities, and classify them into a set of 'generations' based on how they incorporate variability. The majority of studies have failed to incorporate extreme events. In terrestrial ecosystems in particular, experimental treatments have reduced temperature variability, when most climate models predict increased variability. Marine studies have tended to not concentrate on changes in variability, likely in part because the thermal mass of oceans will moderate variation. In freshwaters, climate change experiments have a much shorter history than in the other ecosystems, and have tended to take a relatively simple approach. We propose a new 'generation' of climate change experiments using down-scaled climate models which incorporate predicted changes in climatic variability, and describe a process for generating data which can be applied as experimental climate change treatments. © 2013 John Wiley & Sons Ltd/CNRS.

Research Experiences in Community College Science Programs

NASA Astrophysics Data System (ADS)

Beauregard, A.

2011-12-01

The benefits of student access to scientific research opportunities and the use of data in curriculum and student inquiry-driven approaches to teaching as effective tools in science instruction are compelling (i.e., Ledley, et al., 2008; Gawel & Greengrove, 2005; Macdonald, et al., 2005; Harnik & Ross. 2003). Unfortunately, these experiences are traditionally limited at community colleges due to heavy faculty teaching loads, a focus on teaching over research, and scarce departmental funds. Without such hands-on learning activities, instructors may find it difficult to stimulate excitement about science in their students, who are typically non-major and nontraditional. I present two different approaches for effectively incorporating research into the community college setting that each rely on partnerships with other institutions. The first of these is a more traditional approach for providing research experiences to undergraduate students, though such experiences are limited at community colleges, and involves student interns working on a research project under the supervision of a faculty member. Specifically, students participate in a water quality assessment study of two local bayous. Students work on different aspects of the project, including water sample collection, bio-assay incubation experiments, water quality sample analysis, and collection and identification of phytoplankton. Over the past four years, nine community college students, as well as two undergraduate students and four graduate students from the local four-year university have participated in this research project. Aligning student and faculty research provides community college students with the unique opportunity to participate in the process of active science and contribute to "real" scientific research. Because students are working in a local watershed, these field experiences provide a valuable "place-based" educational opportunity. The second approach links cutting-edge oceanographic research with my community college students by partnering with a research oceanographer. Through this partnership, students have had access to an active oceanographic researcher through classroom visits, use of data in curriculum, and research/cruise progress updates. With very little research activity currently going on at the community college, this "window" into scientific research is invaluable. Another important aspect of this project is the development of a summer internship program that has allowed four community college students to work directly with an oceanographer in her lab for ten weeks. This connection of community college students with world-class scientists in the field promotes better understanding of research and potentially may encourage more students to major in the sciences. In either approach, the interaction with scientists at different stages of their careers, from undergraduate and graduate students at universities to post docs and research scientists, also provides community college students with the opportunity to gain insight into possible career pathways. For both majors and non-majors, a key outcome of such experiences will be gaining experience in using inquiry and reasoning through the scientific method and becoming comfortable with data and technology.

More Than a Feeling: Public Expectations About Emotional Responses to Criminal Victimization.

PubMed

Wrede, Olof; Ask, Karl

2015-01-01

Crime victims' emotional display in legal settings has been found to influence credibility judgments. The specific nature of public expectations about crime victims' emotional responses have, however, not been adequately investigated. In an experimental vignette study, respondents in a community sample (N = 404) estimated the likelihood that female and male victims would experience 7 distinct emotions in response to 5 types of crimes. Across all crime types, female victims were expected to experience significantly more situation-focused (anxiety, fear) and inward-focused (guilt, shame, sadness) emotions, and significantly less other-focused emotions (hatred, anger) than male victims. This calls for an increased focus on distinct emotions in future research on victim's emotions. Implications for victims in legal and social settings are discussed.

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

Challenges for consent and community engagement in the conduct of cluster randomized trial among school children in low income settings: experiences from Kenya.

PubMed

Okello, George; Jones, Caroline; Bonareri, Maureen; Ndegwa, Sarah N; McHaro, Carlos; Kengo, Juddy; Kinyua, Kevin; Dubeck, Margaret M; Halliday, Katherine E; Jukes, Matthew C H; Molyneux, Sassy; Brooker, Simon J

2013-05-16

There are a number of practical and ethical issues raised in school-based health research, particularly those related to obtaining consent from parents and assent from children. One approach to developing, strengthening, and supporting appropriate consent and assent processes is through community engagement. To date, much of the literature on community engagement in biomedical research has concentrated on community- or hospital-based research, with little documentation, if any, of community engagement in school-based health research. In this paper we discuss our experiences of consent, assent and community engagement in implementing a large school-based cluster randomized trial in rural Kenya. Data collected as part of a qualitative study investigating the acceptability of the main trial, focus group discussions with field staff, observations of practice and authors' experiences are used to: 1) highlight the challenges faced in obtaining assent/consent; and 2) strategies taken to try to both protect participant rights (including to refuse and to withdraw) and ensure the success of the trial. Early meetings with national, district and local level stakeholders were important in establishing their co-operation and support for the project. Despite this support, both practical and ethical challenges were encountered during consenting and assenting procedures. Our strategy for addressing these challenges focused on improving communication and understanding of the trial, and maintaining dialogue with all the relevant stakeholders throughout the study period. A range of stakeholders within and beyond schools play a key role in school based health trials. Community entry and information dissemination strategies need careful planning from the outset, and with on-going consultation and feedback mechanisms established in order to identify and address concerns as they arise. We believe our experiences, and the ethical and practical issues and dilemmas encountered, will be of interest for others planning to conduct school-based research in Africa. National Institute of Health NCT00878007.

Challenges for consent and community engagement in the conduct of cluster randomized trial among school children in low income settings: experiences from Kenya

PubMed Central

2013-01-01

Background There are a number of practical and ethical issues raised in school-based health research, particularly those related to obtaining consent from parents and assent from children. One approach to developing, strengthening, and supporting appropriate consent and assent processes is through community engagement. To date, much of the literature on community engagement in biomedical research has concentrated on community- or hospital-based research, with little documentation, if any, of community engagement in school-based health research. In this paper we discuss our experiences of consent, assent and community engagement in implementing a large school-based cluster randomized trial in rural Kenya. Methods Data collected as part of a qualitative study investigating the acceptability of the main trial, focus group discussions with field staff, observations of practice and authors’ experiences are used to: 1) highlight the challenges faced in obtaining assent/consent; and 2) strategies taken to try to both protect participant rights (including to refuse and to withdraw) and ensure the success of the trial. Results Early meetings with national, district and local level stakeholders were important in establishing their co-operation and support for the project. Despite this support, both practical and ethical challenges were encountered during consenting and assenting procedures. Our strategy for addressing these challenges focused on improving communication and understanding of the trial, and maintaining dialogue with all the relevant stakeholders throughout the study period. Conclusions A range of stakeholders within and beyond schools play a key role in school based health trials. Community entry and information dissemination strategies need careful planning from the outset, and with on-going consultation and feedback mechanisms established in order to identify and address concerns as they arise. We believe our experiences, and the ethical and practical issues and dilemmas encountered, will be of interest for others planning to conduct school-based research in Africa. Trial registration National Institute of Health NCT00878007 PMID:23680181

The Anne Frank Haven: A case of an alternative educational program in an integrative Kibbutz setting

NASA Astrophysics Data System (ADS)

Ben-Peretz, Miriam; Giladi, Moshe; Dror, Yuval

1992-01-01

The essential features of the programme of the Anne Frank Haven are the complete integration of children from low SES and different cultural backgrounds with Kibbutz children; a holistic approach to education; and the involvement of the whole community in an "open" residential school. After 33 years, it is argued that the experiment has proved successful in absorbing city-born youth in the Kibbutz, enabling at-risk populations to reach significant academic achievements, and ensuring their continued participation in the dominant culture. The basic integration model consists of "layers" of concentric circles, in dynamic interaction. The innermost circle is the class, the learning community. The Kibbutz community and the foster parents form a supportive, enveloping circle, which enables students to become part of the outer community and to intervene in it. A kind of meta-environment, the inter-Kibbutz partnership and the Israeli educational system, influence the program through decision making and guidance. Some of the principles of the Haven — integration, community involvement, a year's induction for all new students, and open residential settings — could be useful for cultures and societies outside the Kibbutz. The real "secret" of success of an alternative educational program is the dedicated, motivated and highly trained staff.

Negotiating Risk: Knowledge and Use of HIV Prevention by Persons With Serious Mental Illness Living in Supportive Housing

PubMed Central

Kloos, Bret; Gross, Steven M.; Meese, Katharine J.; Meade, Christina S.; Doughty, Jhan D.; Hawkins, Dietra D.; Zimmerman, Susan O.; Snow, David L.; Sikkema, Kathleen J.

2008-01-01

As a population, persons with serious mental illness (SMI) have an elevated risk for HIV infection. However, relatively little is known about how the risk of HIV has affected their lives, how persons with SMI evaluate their HIV risk, and what preventive measures they undertake. Furthermore, relatively little is known about community-based HIV prevention for persons with SMI as most interventions have been restricted to clinical settings. This report presents findings on the HIV-related experiences of persons with SMI living in supportive housing programs, one possible setting for implementing community-based HIV prevention with this population. The qualitative investigation interviewed 41 men and women living in five supportive housing programs. In-depth, qualitative interviews elicited discussion of research participants’ (a) experiences with HIV, (b) knowledge about HIV and HIV prevention, (c) assessments of their own risk, (d) descriptions of how they apply their prevention knowledge, and (e) reports of barriers for HIV prevention. Research participants describe social networks that have substantial contact with persons affected by HIV. However, contrary to some expectations of persons with SMI, research participants report using HIV prevention knowledge in negotiating their risk of contracting HIV. The implications of these findings are discussed in terms of their relevance for implementing community-based HIV prevention for persons with SMI. PMID:16389505

Integrating telehealth services into a remote allied health service: A pilot study.

PubMed

O'Hara, Rebecca; Jackson, Sarah

2017-02-01

The continuity of care for people with neurological conditions in a remote northwest Queensland town as services are currently only available intermittently. Mixed methods design using questionnaires and staff review of the program and processes. Intermittent community rehabilitation service for clients with neurological conditions has been offered in Mount Isa and is supported by a similar fulltime service in Townsville. Both services use a unique client-centred, student-assisted, interprofessional model of care. Understanding participant experiences by obtaining feedback from clients, students and allied health professionals (AHPs) regarding their experiences of using telehealth in this setting. Previous clients of the North West Community Rehabilitation service were offered a review assessment using telehealth by an interprofessional team. Using telehealth enabled the client, remote AHP and students in Mount Isa to be connected to expert assistance in Townsville. The findings suggest that telehealth was useful in a community rehabilitation setting to provide review services for clients. This improved continuity of care for these clients because without this telehealth assessment, the clients would have had to wait up to 12 months for the next service period in Mount Isa or travel to a major urban centre to access a similar service. Feedback from clients, students and AHPs was positive; however, some challenges were identified. Recommendations for future service delivery using telehealth are outlined in the paper. © 2015 National Rural Health Alliance Inc.

The fundamentals of integrating service in a post-licensure RN to BSN program.

PubMed

Washington-Brown, Linda; Ritchie, Arlene

2014-01-01

Integrating service in a post-licensure registered nurse to bachelor of science in nursing (RN to BSN) program provides licensed registered nurse (RN) students the opportunity to learn, develop, and experience different cultures while serving the community and populations in need (McKinnon & Fitzpatrick, 2012). Service to the community, integrated with academic learning can be applied in a wide variety of settings, including schools, universities, and community faith-based organizations. Academic service-learning (ASL) can involve a group of students, a classroom, or an entire school. In the RN to BSN program, the authors use a student-directed service learning approach that integrates service-learning throughout the curriculum. RN students are introduced to service-learning at program orientation prior to the start of classes and receive reinforcement and active engagement throughout the curriculum. The students and volunteer agencies receive and give benefits from the services provided and the life lessons gained through mentorship, education, and hands-on experiences.

ARCUS Project Managers and the Intangible Infrastructure of Large Interdisciplinary Arctic Research Networks

NASA Astrophysics Data System (ADS)

Myers, B.; Wiggins, H. V.; Turner-Bogren, E. J.; Warburton, J.

2017-12-01

Project Managers at the Arctic Research Consortium of the U.S. (ARCUS) lead initiatives to convene, communicate with, and connect the Arctic research community across challenging disciplinary, geographic, temporal, and cultural boundaries. They regularly serve as the organizing hubs, archivists and memory-keepers for collaborative projects comprised of many loosely affiliated partners. As leading organizers of large open science meetings and other outreach events, they also monitor the interdisciplinary landscape of community needs, concerns, opportunities, and emerging research directions. However, leveraging the ARCUS Project Manager role to strategically build out the intangible infrastructure necessary to advance Arctic research requires a unique set of knowledge, skills, and experience. Drawing on a range of lessons learned from past and ongoing experiences with collaborative science, education and outreach programming, this presentation will highlight a model of ARCUS project management that we believe works best to support and sustain our community in its long-term effort to conquer the complexities of Arctic research.

Linking public health nursing competencies and service-learning in a global setting.

PubMed

Brown, Cynthia L

2017-09-01

Nurse educators in baccalaureate programs are charged with addressing student competence in public health nursing practice. These educators are also responsible for creating nursing student opportunities for civic engagement and development of critical thinking skills. The IOM report (2010) on the Future of Nursing emphasizes the nurse educator's role in promoting collaborative partnerships that incorporate interdisciplinary and intraprofessional efforts to promote health. The purpose of this article is to describe an innovative approach to address public health nursing competencies and to improve the health and well-being of indigenous populations in a global setting through promotion of collaboration and service- learning principles. As part of a hybrid elective course, baccalaureate nursing students from various nursing tracks participated in a 2 week immersion experience in Belize that included preimmersion preparation. These students were to collaborate among themselves and with Belizean communities to address identified health knowledge deficits and health-related needs for school-aged children and adult populations. Students successfully collaborated in order to meet health-related needs and to engage in health promotion activities in the Toledo district of Belize. They also gained practice in developing public health nursing competencies for entry-level nursing practice. Implementation of service-learning principles provided students with opportunities for civic engagement and self-reflection. Some challenges existed from the students', faculty, and global community's perspectives. Lack of culturally appropriate and country specific health education materials was difficult for students and the community. Faculty encountered challenges in communicating and collaborating with the Belizean partners. Commonalities exist between entry-level public health nursing competencies and service-learning principles. Using service-learning principles in the development of public health experiences increases the likelihood of success in achieving these competencies. While students demonstrated intraprofessional collaboration in a global setting, these same collaborative opportunities can occur in local communities. © 2017 Wiley Periodicals, Inc.

A community initiative for developing data and modeling driven curriculum modules for hydrology education

NASA Astrophysics Data System (ADS)

Ruddell, B. L.; Merwade, V.

2010-12-01

Hydrology and geoscience education at the undergraduate and graduate levels may benefit greatly from a structured approach to pedagogy that utilizes modeling, authentic data, and simulation exercises to engage students in practice-like activities. Extensive evidence in the educational literature suggests that students retain more of their instruction, and attain higher levels of mastery over content, when interactive and practice-like activities are used to contextualize traditional lecture-based and theory-based instruction. However, it is also important that these activities carefully link the use of data and modeling to abstract theory, to promote transfer of knowledge to other contexts. While this type of data-based activity has been practiced in the hydrology classroom for decades, the hydrology community still lacks a set of standards and a mechanism for community-based development, publication, and review of this type of curriculum material. A community-based initiative is underway to develop a set curriculum materials to teach hydrology in the engineering and geoscience university classroom using outcomes-based, pedagogically rigorous modules that use authentic data and modeling experiences to complement traditional lecture-based instruction. A preliminary design for a community cyberinfrastructure for shared module development and publication, and for module topics and outcomes and ametadata and module interoperability standards, will be presented, along with the results of a series of community surveys and workshops informing this design.

The Importance of Interdisciplinary Research Training and Community Dissemination

PubMed Central

Vessali, Misha; Pratt, Jacob A.; Watts, Samantha; Pratt, Janey S.; Raghavan, Preeti; DeSilva, Jeremy M.

2015-01-01

Abstract Funding agencies and institutions are creating initiatives to encourage interdisciplinary research that can be more easily translated into community initiatives to enhance health. Therefore, the current research environment calls for interdisciplinary education and skills to create sustained partnerships with community institutions. However, formalized opportunities in both of these areas are limited for students embarking on research careers. The purpose of this paper is to underscore the historical and current importance of providing interdisciplinary training and community dissemination for research students. We also suggest an approach to begin to address the existing gap. Specifically, we suggest embedding a 10‐week summer rotation into existing research curricula with the goals of: (1) providing students with a hands‐on interdisciplinary research experience, (2) facilitating dialogue between research students and community settings to disseminate science to the public, and (3) sparking collaborations among researchers who seek to create a way to sustain summer program rotations with grant funding. PMID:26508528

Canadian Palliative Community Milrinone Infusions: A Case Series.

PubMed

Reimche, Ruthanne; Salcedo, Daniel

2016-01-01

Abstract Symptom managementfor end-of-life heartfailure (HF) patients is a significant concern. Currently, Canadian practice does not support community milrinone therapy in end-of-life HF patients. Two patients had severe HF that was unresponsive to optimal medications. Further optimization and furosemide infusions were ineffective for symptom management. Both patients' symptoms were better controlled with optimal medication, furosemide, and milrinone infusions. A tailored discharge plan was developed to assist with community milrinone infusions. We discuss the challenges and successes of transitioning two patients to the community. By providing symptom management and meaningful patient and family experience, both patients were able to die in a setting of their choosing. Milrinone infusions as a bridge to end of life may improve symptoms and quality of life. Select patients may benefit from milrinone infusions with resources put in place; these end-of-life HF patients can be supported in the community.

Errorless Learning for Training Individuals With Schizophrenia at a Community Mental Health Setting Providing Work Experience

PubMed Central

Kern, Robert S.; Liberman, Robert P.; Becker, Deborah R.; Drake, Robert E.; Sugar, Catherine A.; Green, Michael F.

2009-01-01

The effects of errorless learning (EL) on work performance, tenure, and personal well-being were compared with conventional job training in a community mental health fellowship club offering 12-week time-limited work experience. Participants were 40 clinically stable schizophrenia and schizoaffective disorder outpatients randomly assigned to EL vs conventional instruction (CI) at a thrift-type clothing store. EL participants received training on how to perform their assigned job tasks based on principles of EL, such as error reduction and automation of task performance. CI participants received training common to other community-based entry-level jobs that included verbal instruction, a visual demonstration, independent practice, and corrective feedback. Participants were scheduled to work 2 hours per week for 12 weeks. For both groups, job training occurred during the first 2 weeks at the worksite. Work performance (assessed using the Work Behavior Inventory, WBI) and personal well-being (self-esteem, job satisfaction, and work stress) were assessed at weeks 2, 4, and 12. Job tenure was defined as the number of weeks on the job or total number of hours worked prior to quitting or study end. The EL group performed better than the CI group on the Work Quality Scale from the WBI, and the group differences were relatively consistent over time. Results from the survival analyses of job tenure revealed a non-significant trend favoring EL. There were no group differences on self-esteem, job satisfaction, or work stress. The findings provide modest support for the extensions of EL to community settings for enhancing work performance. PMID:18326529

Errorless learning for training individuals with schizophrenia at a community mental health setting providing work experience.

PubMed

Kern, Robert S; Liberman, Robert P; Becker, Deborah R; Drake, Robert E; Sugar, Catherine A; Green, Michael F

2009-07-01

The effects of errorless learning (EL) on work performance, tenure, and personal well-being were compared with conventional job training in a community mental health fellowship club offering 12-week time-limited work experience. Participants were 40 clinically stable schizophrenia and schizoaffective disorder outpatients randomly assigned to EL vs conventional instruction (CI) at a thrift-type clothing store. EL participants received training on how to perform their assigned job tasks based on principles of EL, such as error reduction and automation of task performance. CI participants received training common to other community-based entry-level jobs that included verbal instruction, a visual demonstration, independent practice, and corrective feedback. Participants were scheduled to work 2 hours per week for 12 weeks. For both groups, job training occurred during the first 2 weeks at the worksite. Work performance (assessed using the Work Behavior Inventory, WBI) and personal well-being (self-esteem, job satisfaction, and work stress) were assessed at weeks 2, 4, and 12. Job tenure was defined as the number of weeks on the job or total number of hours worked prior to quitting or study end. The EL group performed better than the CI group on the Work Quality Scale from the WBI, and the group differences were relatively consistent over time. Results from the survival analyses of job tenure revealed a non-significant trend favoring EL. There were no group differences on self-esteem, job satisfaction, or work stress. The findings provide modest support for the extensions of EL to community settings for enhancing work performance.

Integrated musculoskeletal service design by GP consortia

PubMed Central

2011-01-01

Background Musculoskeletal conditions are common in primary care and are associated with significant co-morbidity and impairment of quality of life. Traditional care pathways combined community-based physiotherapy with GP referral to hospital for a consultant opinion. Locally, this model led to only 30% of hospital consultant orthopaedic referrals being listed for surgery, with the majority being referred for physiotherapy. The NHS musculoskeletal framework proposed the use of interface services to provide expertise in diagnosis, triage and management of musculoskeletal problems not requiring surgery. The White Paper Equity and Excellence: Liberating the NHS has replaced PCT commissioning with GP consortia, who will lead future service development. Setting Primary and community care, integrated with secondary care, in the NHS in England. Question How can GP consortia lead the development of integrated musculoskeletal services? Review: The Ealing experience We explore here how Ealing implemented a ‘See and Treat’ interface clinic model to improve surgical conversion rates, reduce unnecessary hospital referrals and provide community treatment more efficiently than a triage model. A high-profile GP education programme enabled GPs to triage in their practices and manage patients without referral. Conclusion In Ealing, we demonstrated that most patients with musculoskeletal conditions can be managed in primary care and community settings. The integrated musculoskeletal service provides clear and fast routes to secondary care. This is both clinically effective and cost-effective, reserving hospital referral for patients most likely to need surgery. GP consortia, in conjunction with strong clinical leadership, inbuilt organisational and professional learning, and a GP champion, are well placed to deliver service redesign by co-ordinating primary care development, local commissioning of community services and the acute commissioning vehicles responsible for secondary care. The immediate priority for GP consortia is to develop a truly integrated service by facilitating consultant opinions within a community setting. PMID:25949643

Innovative Strategies for Building Community Resilience: Lessons from the Frontlines of Climate Change Capacity-Building

NASA Astrophysics Data System (ADS)

Abrash Walton, A.

2017-12-01

There is broad scientific consensus that climate change is occurring; however, there is limited implementation of measures to create resilient local communities (Abrash Walton, Simpson, Rhoades, & Daniels, 2016; Adger, Arnell, & Tompkins, 2005; Glavovic & Smith, 2014; Moser & Ekstrom, 2010; Picketts, Déry, & Curry, 2014). Communities that are considered climate leaders in the United States may have adopted climate change plans, yet few have actually implemented the policies, projects and recommendations in those plans. A range of innovative, education strategies have proven effective in building the capacity of local decision makers to strengthen community resilience. This presentation draws on the results of two years of original research regarding the information and support local decision makers require for effective action. Findings are based on information from four datasets, with more than 600 respondents from 48 U.S. states and 19 other countries working on local adaptation in a range of capacities. These research results can inform priority setting for public policy, budget setting, and action as well as private sector funding and investment. The presentation will focus, in particular, on methods and results of a pioneering Facilitated Community of Practice model (FCoP) for building climate preparedness and community resilience capacity, among local-level decision makers. The FCoP process includes group formation and shared capacity building experience. The process can also support collective objective setting and creation of structures and processes for ongoing sustainable collaboration. Results from two FCoPs - one fully online and the other hybrid - suggest that participants viewed the interpersonal and technical assistance elements of the FCoP as highly valuable. These findings suggest that there is an important need for facilitated networking and other relational aspects of building capacity among those advancing resilience at the local level.

Empowering community settings: agents of individual development, community betterment, and positive social change.

PubMed

Maton, Kenneth I

2008-03-01

The pathways and processes through which empowering community settings influence their members, the surrounding community and the larger society are examined. To generate the proposed pathways and processes, a broad range of studies of community settings were reviewed, in the domains of adult well-being, positive youth development, locality development, and social change. A set of organizational characteristics and associated processes leading to member empowerment across domains were identified, as well as three pathways through which empowering settings in each domain contribute to community betterment and positive social change. The paper concludes with an examination of the ways that community psychology and allied disciplines can help increase the number and range of empowering settings, and enhance the community and societal impact of existing ones.

Student Perceptions of a Recreation Trail Assignment as a Valuable Learning Experience for Geography Undergraduates

ERIC Educational Resources Information Center

Mullens, Jo Beth

2016-01-01

Charging undergraduate geography students with the task of designing a recreational trail in their local community offers an engaging experiential opportunity with potential to advance geographic learning in a real-world setting. This article presents an assignment in which students were asked to develop a recreational trail proposal for an…

Your Voice Counts: Listening to the Voice of High School Students with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Saggers, Beth; Hwang, Yoon-Suk; Mercer, K. Louise

2011-01-01

Supporting students with autism spectrum disorders (ASDs) in inclusive settings presents both opportunities and significant challenges to school communities. This study, which explored the lived experience of nine students with ASD in an inclusive high school in Australia, is based on the belief that by listening to the voices of students, school…

Older Adults' Perspectives on Home Exercise after Falls Rehabilitation: Understanding the Importance of Promoting Healthy, Active Ageing

ERIC Educational Resources Information Center

Hawley, Helen

2009-01-01

Objective To explore what might encourage older people to exercise at home after falls rehabilitation. Design: Qualitative research methods were used based on a grounded theory approach, to provide insights into older adults' experiences following a fall, of both rehabilitation and home exercise. Setting: Community dwellings. Method: Nine…

Young Children and the Arts: Nurturing Imagination and Creativity

ERIC Educational Resources Information Center

Korn-Bursztyn, Carol, Ed.

2012-01-01

Young Children and the Arts: Nurturing Imagination and Creativity examines the place of the arts in the experiences of young and very young children at home and in out-of-home settings at school and in the community. There is great need for development of resources in the arts specifically designed to introduce babies and toddlers to participatory…

Engaged Research in a University Setting: Results and Reflections on Three Decades of a Partnership to Improve Juvenile Justice

ERIC Educational Resources Information Center

Davidson, William S., II; Petersen, Jodi; Hankins, Sean; Winslow, Maureen

2010-01-01

Michigan State University's Adolescent Project (MSUAP) was founded in the mid-1970s to create university-community collaboration through which innovative educational experiences would be offered, best practice intervention practices employed, and sound scientific methodology used to address the pressing social issue of juvenile delinquency. The…

Know Your Capital City. Bulletin, 1950, No. 18

ERIC Educational Resources Information Center

Willcockson, Mary

1950-01-01

Since any good citizen wants to know how his Government works, as an initial experience it is necessary to become acquainted with the setting--Washington, D. C. This bulletin serves as in introduction to the Capital. It provides an historical and a present-day background for appreciating the city. What kind of a community is Washington? Why does…

Community-Based Programs for Children and Youth: Our Experiences in Design, Implementation, and Evaluation

ERIC Educational Resources Information Center

O'Neil, Margaret E.; Fragala-Pinkham, Maria; Ideishi, Roger I.; Ideishi, Siobhan K.

2012-01-01

Pediatric physical and occupational therapists are in the unique position to provide therapeutic and health promotion interventions to children and youth with special health care needs (CYSHCN) including those with chronic conditions (such as overweight and obesity) in a variety of settings. In this commentary, the authors share their experiences…

Crafting the "Greenbook": Framers Reflect on the Vision, Process, and Lessons Learned

ERIC Educational Resources Information Center

Janczewski, Colleen; Dutch, Nicole; Wang, Kathleen

2008-01-01

Guided by research and the experiences of judges nationwide, the National Council of Juvenile and Family Court Judges made a commitment in 1998 to improve community response to families experiencing domestic violence and child maltreatment. A year later, the council's work culminated in a set of recommendations commonly called the "Greenbook,"…

Using phylogenetic probes for quantification of stable isotope labeling and microbial community analysis

DOEpatents

Brodie, Eoin L; DeSantis, Todd Z; Karaoz, Ulas; Andersen, Gary L

2014-12-09

Herein is described methods for a high-sensitivity means to measure the incorporation of stable isotope labeled substrates into RNA following stable isotope probing experiments (SIP). RNA is hybridized to a set of probes such as phylogenetic microarrays and isotope incorporation is quantified such as by secondary ion mass spectrometer imaging (NanoSIMS).

Venturing beyond the Gates: Facilitating Successful Reentry with Entrepreneurship. Summer 2007

ERIC Educational Resources Information Center

Lindahl, Nicole

2007-01-01

The rising number of individuals returning to communities from prison and jail represents one of the defining issues of time. Individuals reentering society face myriad challenges, not the least of which is securing viable employment; in addition, each individual has a unique set of experiences, needs and resources. This project stems from the…

A Second Chance: Meanings of Body Weight, Diet, and Physical Activity to Women Who Have Experienced Cancer

ERIC Educational Resources Information Center

Maley, Mary; Warren, Barbour S.; Devine, Carol M.

2013-01-01

Objective: To understand the meanings of diet, physical activity, and body weight in the context of women's cancer experiences. Design: Grounded theory using 15 qualitative interviews and 3 focus groups. Setting: Grassroots community cancer organizations in the northeastern United States. Participants: Thirty-six white women cancer survivors; 86%…

Evidence for Site-Specific, Systematic Adaptation of Substance Prevention Curriculum with High-Risk Youths in Community and Alternative School Settings

ERIC Educational Resources Information Center

Holleran Steiker, Lori K.; Hopson, Laura M.; Goldbach, Jeremy T.; Robinson, Charletta

2014-01-01

The problem of substance use among older youths is often disregarded in prevention research. The prevailing perception has been that prevention programming is developmentally inappropriate for those who are actively experimenting with substances. This project examines the differential effectiveness of youth-driven adaptations of the evidence-based…

Striving for a Better World: Lessons from Freire in Grenada, Jamaica and Australia

ERIC Educational Resources Information Center

Hickling-Hudson, Anne

2014-01-01

The author of this paper considers the influence of Paulo Freire's pedagogical philosophy on educational practice in three different geographical/political settings. She begins with reflections on her experience as a facilitator at Freire's seminar, held in Grenada in 1980 for teachers and community educators, on the integration of work and study.…

Power, fairness and trust: understanding and engaging with vaccine trial participants and communities in the setting up the EBOVAC-Salone vaccine trial in Sierra Leone.

PubMed

Enria, Luisa; Lees, Shelley; Smout, Elizabeth; Mooney, Thomas; Tengbeh, Angus F; Leigh, Bailah; Greenwood, Brian; Watson-Jones, Deborah; Larson, Heidi

2016-11-08

This paper discusses the establishment of a clinical trial of an Ebola vaccine candidate in Kambia District, Northern Sierra Leone during the epidemic, and analyses the role of social science research in ensuring that lessons from the socio-political context, the recent experience of the Ebola outbreak, and learning from previous clinical trials were incorporated in the development of community engagement strategies. The paper aims to provide a case study of an integrated social science and communications system in the start-up phase of the clinical trial. The paper is based on qualitative research methods including ethnographic observation, interviews with trial participants and key stakeholder interviews. Through the case study of EBOVAC Salone, the paper suggests ways in which research can be used to inform communication strategies before and during the setting up of the trial. It explores notions of power, fairness and trust emerging from analysis of the Sierra Leonean context and through ethnographic research, to reflect on three situations in which social scientists and community liaison officers worked together to ensure successful community engagement. Firstly, a section on "power" considers the pitfalls of considering communities as homogeneous and shows the importance of understanding intra-community power dynamics when engaging communities. Secondly, a section on "fairness" shows how local understandings of what is fair can help inform the design of volunteer recruitment strategies. Finally, a section on "trust" highlights how historically rooted rumours can be effectively addressed through active dialogue rather than through an approach focused on correcting misinformation. The paper firstly emphasises the value of social science in the setting up of clinical trials, in terms of providing an in depth understanding of context and social dynamics. Secondly, the paper suggests the importance of a close collaboration between research and community engagement to effectively confront political and social dynamics, especially in the context of an epidemic.

Fellowships in Community Pharmacy Research: Experiences of Five Schools and Colleges of Pharmacy

PubMed Central

Snyder, Margie E.; Frail, Caitlin K.; Gernant, Stephanie A.; Bacci, Jennifer L.; Coley, Kim C.; Colip, Lauren M.; Ferreri, Stefanie P.; Hagemeier, Nicholas E.; McGivney, Melissa Somma; Rodis, Jennifer L.; Smith, Megan G.; Smith, Randall B.

2017-01-01

Objective To describe common facilitators, challenges, and lessons learned of five schools and colleges of pharmacy in establishing community pharmacy research fellowships. Setting Five schools and colleges of pharmacy in the United States. Practice Description Schools and colleges of pharmacy with existing community partnerships identified a need and ability to develop opportunities for pharmacists to engage in advanced research training. Practice Innovation Community pharmacy fellowships, each structured as two years in length and in combination with graduate coursework, have been established at the University of Pittsburgh, Purdue University, East Tennessee State University, University of North Carolina at Chapel Hill and The Ohio State University. Evaluation Program directors from each of the five community pharmacy research fellowships identified common themes pertaining to program structure, outcomes, and lessons learned to assist others planning similar programs. Results Common characteristics across the programs include length of training, pre-requisites, graduate coursework, mentoring structure, and immersion into a pharmacist patient care practice. Common facilitators have been the existence of strong community pharmacy partnerships, creating a fellowship advisory team, and networking. A common challenge has been recruitment, with many programs experiencing at least one year without filling the fellowship position. All program graduates (n=4) have been successful in securing pharmacy faculty positions. Conclusion Five schools and colleges of pharmacy share similar experiences in implementing community pharmacy research fellowships. Early outcomes show promise for this training pathway in growing future pharmacist-scientists focused on community pharmacy practice. PMID:27083852

The Community Preceptor Crisis: Recruiting and Retaining Community-Based Faculty to Teach Medical Students-A Shared Perspective From the Alliance for Clinical Education.

PubMed

Christner, Jennifer G; Dallaghan, Gary Beck; Briscoe, Gregory; Casey, Petra; Fincher, Ruth Marie E; Manfred, Lynn M; Margo, Katherine I; Muscarella, Peter; Richardson, Joshua E; Safdieh, Joseph; Steiner, Beat D

2016-01-01

Community-based instruction is invaluable to medical students, as it provides "real-world" opportunities for observing and following patients over time while refining history taking, physical examination, differential diagnosis, and patient management skills. Community-based ambulatory settings can be more conducive to practicing these skills than highly specialized, academically based practice sites. The Association of American Medical Colleges and other national medical education organizations have expressed concern about recruitment and retention of preceptors to provide high-quality educational experiences in community-based practice sites. These concerns stem from constraints imposed by documentation in electronic health records; perceptions that student mentoring is burdensome resulting in decreased clinical productivity; and competition between allopathic, osteopathic, and international medical schools for finite resources for medical student experiences. In this Alliance for Clinical Education position statement, we provide a consensus summary of representatives from national medical education organizations in 8 specialties that offer clinical clerkships. We describe the current challenges in providing medical students with adequate community-based instruction and propose potential solutions. Our recommendations are designed to assist clerkship directors and medical school leaders overcome current challenges and ensure high-quality, community-based clinical learning opportunities for all students. They include suggesting ways to orient community clinic sites for students, explaining how students can add value to the preceptor's practice, focusing on educator skills development, recognizing preceptors who excel in their role as educators, and suggesting forms of compensation.

Living with diabetes on Baffin Island: Inuit storytellers share their experiences.

PubMed

Bird, Susan M; Wiles, Janine L; Okalik, Looee; Kilabuk, Jonah; Egeland, Grace M

2008-01-01

The prevention and management of Type 2 diabetes mellitus has become a concern in Inuit communities across Canada. Although Inuit living with diabetes in remote Canadian Arctic communities could help guide the development of health services, their voices have not been heard. The experiences and perceptions of Inuit themselves are often overlooked in research. In this study, Inuit living in a small rural Arctic community on Baffin Island were invited to share their experiences of living with diabetes. A qualitative multi-case study approach was taken. In-depth interviews (n=4), field observations, and informal interviews over one month in the community were used to build and contextualize the cases. In-depth interviews were transcribed, and analyzed using holistic thematic analysis and open coding. Accessibility was a concern with respect to foods, health knowledge, language interpretation and health services. In all methods of analysis, the importance of language and effective cross-cultural communication figured prominently. It was also evident that trust and rapport is crucial when discussing diabetes. There was strong interest in promoting diabetes education and prevention within the community. These findings suggest that current health education and services may not be adequate for this setting. The voices of Inuit should be integral in steering the direction of their future diabetes education and health service delivery. Focusing on language barriers may help to improve the accessibility of knowledge about diabetes and nutrition, and enhance relationships between non-Inuit health service providers and Inuit.

Shared decision making in Swedish community mental health services - an evaluation of three self-reporting instruments.

PubMed

Rosenberg, David; Schön, Ulla-Karin; Nyholm, Maria; Grim, Katarina; Svedberg, Petra

2017-04-01

Despite the potential impact of shared decision making on users satisfaction with care and quality in health care decisions, there is a lack of knowledge and skills regarding how to work with shared decision making among health care providers. The aim of this study was to evaluate the psychometric properties of three instruments that measure varied dimensions of shared decision making, based on self-reports by clients, in a Swedish community mental health context. The study sample consisted of 121 clients with experience of community mental health care, and involved in a wide range of decisions regarding both social support and treatment. The questionnaires were examined for face and content validity, internal consistency, test-retest reliability and construct validity. The instruments displayed good face and content validity, satisfactory internal consistency and a moderate to good level of stability in test-retest reliability with fair to moderate construct correlations, in a sample of clients with serious mental illness and experience of community mental health services in Sweden. The questionnaires are considered to be relevant to the decision making process, user-friendly and appropriate in a Swedish community mental health care context. They functioned well in settings where non-medical decisions, regarding social and support services, are the primary focus. The use of instruments that measure various dimensions of the self-reported experience of clients, can be a key factor in developing knowledge of how best to implement shared decision making in mental health services.

Virtual DRI dataset development

NASA Astrophysics Data System (ADS)

Hixson, Jonathan G.; Teaney, Brian P.; May, Christopher; Maurer, Tana; Nelson, Michael B.; Pham, Justin R.

2017-05-01

The U.S. Army RDECOM CERDEC NVESD MSD's target acquisition models have been used for many years by the military analysis community for sensor design, trade studies, and field performance prediction. This paper analyzes the results of perception tests performed to compare the results of a field DRI (Detection, Recognition, and Identification Test) performed in 2009 to current Soldier performance viewing the same imagery in a laboratory environment and simulated imagery of the same data set. The purpose of the experiment is to build a robust data set for use in the virtual prototyping of infrared sensors. This data set will provide a strong foundation relating, model predictions, field DRI results and simulated imagery.

[Community vegetable gardens as a health promotion activity: an experience in Primary Healthcare Units].

PubMed

Costa, Christiane Gasparini Araújo; Garcia, Mariana Tarricone; Ribeiro, Silvana Maria; Salandini, Marcia Fernanda de Sousa; Bógus, Cláudia Maria

2015-10-01

Urban and peri-urban agriculture (UPA) is being practiced in different settings, contributing to the improvement of health in communities and healthier environments. In order to identify the meanings and implications of the practice of UPA in Primary Healthcare Units (PHU) as an activity of health promotion (HP), and to what extent its therapeutic dimension characterizes it as an activity aligned with complementary and integrative practices (CIP), a qualitative cross-sectional study was performed in Embu das Artes, State of São Paulo. From the analysis, the following main themes arose: health concept, health outcomes, the return to traditional practices and habits and the reorientation of health services. It was possible to identify the close link between the cultivation of vegetable gardens and HP guidelines and fields of action, such as creating healthier environments, boosting community actions, developing personal skills, stimulating autonomy and empowerment and demands for the reorientation of services. The garden activities, set up in PHU areas, proved to be an implementation strategy of CIP. The conclusion reached is that vegetable gardening activities in community gardens are seen to be health promotion practices that integrate key elements of CIP.

SciJourn is magic: construction of a science journalism community of practice

NASA Astrophysics Data System (ADS)

Nicholas, Celeste R.

2017-06-01

This article is the first to describe the discoursal construction of an adolescent community of practice (CoP) in a non-school setting. CoPs can provide optimal learning environments. The adolescent community centered around science journalism and positioned itself dichotomously in relationship to school literacy practices. The analysis focuses on recordings from a panel-style research interview from an early implementation of the Science Literacy Through Science Journalism (SciJourn) project. Researchers trained high school students participating in a youth development program to write science news articles. Students engaged in the authentic practices of professional science journalists, received feedback from a professional editor, and submitted articles for publication. I used a fine-grained critical discourse analysis of genre, discourse, and style to analyze student responses about differences between writing in SciJourn and in school. Students described themselves as agentic in SciJourn and passive in school, using an academic writing discourse of deficit to describe schooling experiences. They affiliated with and defined a SciJourn CoP, constructing positive journalistic identities therein. Educators are encouraged to develop similar CoPs. The discursive features presented may be used to monitor the development of communities of practice in a variety of settings.

Polycythemia Vera Management and Challenges in the Community Health Setting

PubMed Central

Gerds, Aaron T.; Dao, Kim-Hien

2017-01-01

Patients with polycythemia vera (PV) experience shortened survival, increased risk of thromboembolic and hemorrhagic events, and burdensome symptoms. For all patients with PV, treatment with aspirin and hematocrit control with phlebotomy are recommended. In addition, patients with high-risk status or poor hematocrit control benefit from cytoreductive therapy with hydroxyurea, although approximately 1 in 4 patients develops resistance or intolerance. For patients who are resistant to or intolerant of hydroxyurea, studies have shown that ruxolitinib, a Janus kinase 1/2 inhibitor, provides hematocrit control, reduces spleen size, normalizes blood counts, and improves PV-related symptoms. For many patients, PV is managed in a community health setting, and it is important that community hematologists, oncologists, and internists are familiar with the contemporary management of PV to improve patient outcomes, including management for patients who present with unique health-care needs. This review provides an overview of current treatment options for patients with PV and discusses challenging circumstances encountered by community providers in the management of PV, including symptom assessment, identification of hydroxyurea resistance/intolerance, pregnancy, elective surgeries, concomitant immunosuppressants, and managing patients in areas with limited access to specialized hematologic care. PMID:28095380

Global Health: Preparation for Working in Resource-Limited Settings.

PubMed

St Clair, Nicole E; Pitt, Michael B; Bakeera-Kitaka, Sabrina; McCall, Natalie; Lukolyo, Heather; Arnold, Linda D; Audcent, Tobey; Batra, Maneesh; Chan, Kevin; Jacquet, Gabrielle A; Schutze, Gordon E; Butteris, Sabrina

2017-11-01

Trainees and clinicians from high-income countries are increasingly engaging in global health (GH) efforts, particularly in resource-limited settings. Concomitantly, there is a growing demand for these individuals to be better prepared for the common challenges and controversies inherent in GH work. This is a state-of-the-art review article in which we outline what is known about the current scope of trainee and clinician involvement in GH experiences, highlight specific considerations and issues pertinent to GH engagement, and summarize preparation recommendations that have emerged from the literature. The article is focused primarily on short-term GH experiences, although much of the content is also pertinent to long-term work. Suggestions are made for the health care community to develop and implement widely endorsed preparation standards for trainees, clinicians, and organizations engaging in GH experiences and partnerships. Copyright © 2017 by the American Academy of Pediatrics.

Developing quality indicators for community services: the case of district nursing.

PubMed

Davies, Philippa; Wye, Lesley; Horrocks, Sue; Salisbury, Chris; Sharp, Debbie

2011-01-01

Quality indicators exist for the acute and primary care sectors in the National Health Service (NHS), but until recently little attention has been given to measuring the quality of community services. The innovative project described in this paper attempted to address that gap. To produce a framework for developing quality indicators for Bristol Community Health services. To develop a set of initial indicators for Bristol Community Health services using the proposed framework. After familiarising ourselves with community services and NHS policy, gathering the views of stakeholders and consulting the literature on quality indicators, we designed a framework for indicator development, using the 'test' case of the district nursing service. The long list of possible indicators came from best practice guidelines for wound, diabetes and end of life care, the three conditions most commonly treated by district nurses. To narrow down this list we surveyed and held workshops with district nurses, interviewed service users by telephone and met with commissioners and senior community health managers. The final set of quality indicators for district nurses included 23 organisational and clinical process and outcome indicators and eight patient experience indicators. These indicators are now being piloted, together with two potential tools identified to capture patient reported outcomes. Developing quality indicators for community services is time consuming and resource intensive. A range of skills are needed including clinical expertise, project management and skills in evidence-based medicine. The commitment and involvement of front-line professionals is crucial.

Volunteers in Ethiopia's women's development army are more deprived and distressed than their neighbors: cross-sectional survey data from rural Ethiopia.

PubMed

Maes, Kenneth; Closser, Svea; Tesfaye, Yihenew; Gilbert, Yasmine; Abesha, Roza

2018-02-14

Many Community Health Workers (CHWs) experience the same socioeconomic and health needs as their neighbors, given that they are by definition part of their communities. Yet very few studies aim to measure and characterize experiences of deprivation, poverty, and wellbeing among community health workers. This study quantitatively examines deprivation and wellbeing in Ethiopia's Women's Development Army (WDA), a massive unpaid community health workforce intended to improve population health and modernize the country. We conducted a survey of 422 volunteer WDA leaders and community members in rural Amhara state, part of a mixed-methods ethnographic study of the experiences of women in the WDA. The survey asked a variety of questions about respondents' demographics, education, assets, and access to government services. We also used survey measures to evaluate respondents' levels of household food and water security, stressful life events, social support, work burden, and psychological distress. Volunteer WDA leaders and community members alike tend to have very low levels of schooling and household assets, and to be heavily burdened with daily work in several domains. Large proportions are food and water insecure, many are in debt, and many experience stretches of time with no money at all. Our survey also revealed differences between volunteer WDA leaders and other women that warrant attention. Leaders are less likely to be married and more likely to be divorced or separated. Leaders are also more likely to experience some aspects of food insecurity and report greater levels of psychological distress and more stressful life events. They also report slightly less social support than other women. In rural Amhara, women who seek out and/or are sought and recruited for leader roles in the WDA are a population living in precarity. In several domains, they experience even more hardship than their neighbors. These findings highlight a need for careful attention and further research into processes of volunteer CHW selection, and to determine whether or not volunteering for CHW programs increases socioeconomic and health risks among volunteers. CHW programs in settings of poverty should stop using unpaid labor and seek to create more paid CHW jobs.

Collaboratory for the Study of Earthquake Predictability

NASA Astrophysics Data System (ADS)

Schorlemmer, D.; Jordan, T. H.; Zechar, J. D.; Gerstenberger, M. C.; Wiemer, S.; Maechling, P. J.

2006-12-01

Earthquake prediction is one of the most difficult problems in physical science and, owing to its societal implications, one of the most controversial. The study of earthquake predictability has been impeded by the lack of an adequate experimental infrastructure---the capability to conduct scientific prediction experiments under rigorous, controlled conditions and evaluate them using accepted criteria specified in advance. To remedy this deficiency, the Southern California Earthquake Center (SCEC) is working with its international partners, which include the European Union (through the Swiss Seismological Service) and New Zealand (through GNS Science), to develop a virtual, distributed laboratory with a cyberinfrastructure adequate to support a global program of research on earthquake predictability. This Collaboratory for the Study of Earthquake Predictability (CSEP) will extend the testing activities of SCEC's Working Group on Regional Earthquake Likelihood Models, from which we will present first results. CSEP will support rigorous procedures for registering prediction experiments on regional and global scales, community-endorsed standards for assessing probability-based and alarm-based predictions, access to authorized data sets and monitoring products from designated natural laboratories, and software to allow researchers to participate in prediction experiments. CSEP will encourage research on earthquake predictability by supporting an environment for scientific prediction experiments that allows the predictive skill of proposed algorithms to be rigorously compared with standardized reference methods and data sets. It will thereby reduce the controversies surrounding earthquake prediction, and it will allow the results of prediction experiments to be communicated to the scientific community, governmental agencies, and the general public in an appropriate research context.

Transitioning from acute to primary health care nursing: an integrative review of the literature.

PubMed

Ashley, Christine; Halcomb, Elizabeth; Brown, Angela

2016-08-01

This paper seeks to explore the transition experiences of acute care nurses entering employment in primary health care settings. Internationally the provision of care in primary health care settings is increasing. Nurses are moving from acute care settings to meet the growing demand for a primary health care workforce. While there is significant research relating to new graduate transition experiences, little is known about the transition experience from acute care into primary health care employment. An integrative review, guided by Whittemore and Knafl's (2005) approach, was undertaken. Following a systematic literature search eight studies met the inclusion criteria. Papers which met the study criteria were identified and assessed against the inclusion and exclusion criteria. Papers were then subjected to methodological quality appraisal. Thematic analysis was undertaken to identify key themes within the data. Eight papers met the selection criteria. All described nurses transitioning to either community or home nursing settings. Three themes were identified: (1) a conceptual understanding of transition, (2) role losses and gains and (3) barriers and enablers. There is a lack of research specifically exploring the transitioning of acute care nurses to primary health care settings. To better understand this process, and to support the growth of the primary health care workforce there is an urgent need for further well-designed research. There is an increasing demand for the employment of nurses in primary health care settings. To recruit experienced nurses it is logical that many nurses will transition into primary health care from employment in the acute sector. To optimise retention and enhance the transition experience of these nurses it is important to understand the transition experience. © 2016 John Wiley & Sons Ltd.

Experience with an extended-release opioid formulation designed to reduce abuse liability in a community-based pain management clinic

PubMed Central

Rubino, Daniel

2011-01-01

Context With the growing public health concern over rising rates of opioid abuse, physicians have a responsibility to incorporate safeguards into their practice to minimize the potential for opioid misuse, abuse, and diversion. Patient-specific treatment regimens should include steps to monitor treatment success with regard to optimal pain management as well as inappropriate use of opioids and other substances. Opioid formulations designed to be less attractive for abuse are also being developed. While future studies are needed to determine the impact of such formulations in addressing the issue of opioid misuse in the community as a whole, the experience of practitioners who have utilized these formulations can highlight the practical steps to incorporate such formulations into the everyday patient-care setting. Purpose The purpose of this report is to describe experience in managing patients with chronic, moderate-to-severe pain using morphine sulfate and naltrexone hydrochloride extended release capsules (MS-sNT) (EMBEDA®, King Pharmaceuticals® Inc, Bristol, TN, which was acquired by Pfizer Inc, New York, NY, in March 2011), a formulation designed with features to deter abuse/misuse, in a community-based pain management clinic. Case presentations Case reports demonstrating a clinical management plan for assessment, initial interview procedures, explanation/discussion of proposed therapies, patients’ treatment goals, conversion to MS-sNT, and titration and treatment outcomes are provided. Results The management approach yielded successful outcomes including pain relief, improved quality of life, treatment satisfaction, and patient acceptance of a formulation designed to deter abuse/misuse. Discussion The cases presented demonstrate that the communication accompanying complete pretreatment assessment, goal-setting and expectations, and attention to individual patient needs can enable optimization of pain-related outcomes, resulting in improved quality of life for patients and fostering patient acceptance of formulations designed to help address opioid abuse/misuse issues in the community at large. PMID:22069367

When procedures meet practice in community pharmacies: qualitative insights from pharmacists and pharmacy support staff

PubMed Central

Ashcroft, Darren M

2016-01-01

Objectives Our aim was to explore how members of community pharmacy staff perceive and experience the role of procedures within the workplace in community pharmacies. Setting Community pharmacies in England and Wales. Participants 24 community pharmacy staff including pharmacists and pharmacy support staff were interviewed regarding their view of procedures in community pharmacy. Transcripts were analysed using thematic analysis. Results 3 main themes were identified. According to the ‘dissemination and creation of standard operating procedures’ theme, community pharmacy staff were required to follow a large amount of procedures as part of their work. At times, complying with all procedures was not possible. According to the ‘complying with procedures’ theme, there are several factors that influenced compliance with procedures, including work demands, the high workload and the social norm within the pharmacy. Lack of staff, pressure to hit targets and poor communication also affected how able staff felt to follow procedures. The third theme ‘procedural compliance versus using professional judgement’ highlighted tensions between the standardisation of practice and the professional autonomy of pharmacists. Pharmacists feared being unsupported by their employer for working outside of procedures, even when acting for patient benefit. Some support staff believed that strictly following procedures would keep patients and themselves safe. Dispensers described following the guidance of the pharmacist which sometimes meant working outside of procedures, but occasionally felt unable to voice concerns about not working to rule. Conclusions Organisational resilience in community pharmacy was apparent and findings from this study should help to inform policymakers and practitioners regarding factors likely to influence the implementation of procedures in community pharmacy settings. Future research should focus on exploring community pharmacy employees' intentions and attitudes towards rule-breaking behaviour and the impact this may have on patient safety. PMID:27266770

Mobilization for cervical cancer screening: lessons from a poor-urban Yoruba community in Nigeria.

PubMed

Thomas, J O; Babarinsa, I A; Ajayi, I O; Fawole, O; Ojemakinde, K O; Omigbodun, A O

2005-03-01

Cervical cancer is a major public health problem worldwide and it remains one of the commonest malignancies in Nigeria. Screening remains the most effective tool for the detection of pre-invasive stages of cervical cancer, giving the opportunity for prompt and effective treatment before the emergence of invasive disease. In Nigeria, as in most developing countries, the concept of screening for cancer and its pre-emptive treatment is underdeveloped. The fact that the facilities and logistics for cervical cancer screening are generally located in the hospital setting, a place where one goes when ill, according to local beliefs, makes acceptance more difficult. That Nigeria urgently needs to set up or develop cervical screening programmes that will reach women outside the hospital setting in a culturally acceptable milieu is not in doubt. A community cervical screening survey for the prevalence of cervical intraepithelial neoplasia and HPV infection was initiated in Idikan, a poor-urban inner core area of Ibadan. The challenges and experiences encountered in the execution of the project which could serve as useful knowledge to those undertaking similar exercises, requiring mass mobilization for cancer screening of an uninformed group, are highlighted. Our experience in the course of this study is important as it brought out the probable influences of community dynamics and social organization in illness decisions and prescriptions for health operative in this particular population group. Cervical cancer screening programmes should therefore make provisions to accommodate the occasional outcomes as we had encountered. In addition, screening programmes in developing societies would require sensitive designs that should address the cultural attitudes, personal conflicts, expectations of treatment and overall context of preventive care.

Common Accounting System for Monitoring the ATLAS Distributed Computing Resources

NASA Astrophysics Data System (ADS)

Karavakis, E.; Andreeva, J.; Campana, S.; Gayazov, S.; Jezequel, S.; Saiz, P.; Sargsyan, L.; Schovancova, J.; Ueda, I.; Atlas Collaboration

2014-06-01

This paper covers in detail a variety of accounting tools used to monitor the utilisation of the available computational and storage resources within the ATLAS Distributed Computing during the first three years of Large Hadron Collider data taking. The Experiment Dashboard provides a set of common accounting tools that combine monitoring information originating from many different information sources; either generic or ATLAS specific. This set of tools provides quality and scalable solutions that are flexible enough to support the constantly evolving requirements of the ATLAS user community.

Towards systems genetic analyses in barley: Integration of phenotypic, expression and genotype data into GeneNetwork.

PubMed

Druka, Arnis; Druka, Ilze; Centeno, Arthur G; Li, Hongqiang; Sun, Zhaohui; Thomas, William T B; Bonar, Nicola; Steffenson, Brian J; Ullrich, Steven E; Kleinhofs, Andris; Wise, Roger P; Close, Timothy J; Potokina, Elena; Luo, Zewei; Wagner, Carola; Schweizer, Günther F; Marshall, David F; Kearsey, Michael J; Williams, Robert W; Waugh, Robbie

2008-11-18

A typical genetical genomics experiment results in four separate data sets; genotype, gene expression, higher-order phenotypic data and metadata that describe the protocols, processing and the array platform. Used in concert, these data sets provide the opportunity to perform genetic analysis at a systems level. Their predictive power is largely determined by the gene expression dataset where tens of millions of data points can be generated using currently available mRNA profiling technologies. Such large, multidimensional data sets often have value beyond that extracted during their initial analysis and interpretation, particularly if conducted on widely distributed reference genetic materials. Besides quality and scale, access to the data is of primary importance as accessibility potentially allows the extraction of considerable added value from the same primary dataset by the wider research community. Although the number of genetical genomics experiments in different plant species is rapidly increasing, none to date has been presented in a form that allows quick and efficient on-line testing for possible associations between genes, loci and traits of interest by an entire research community. Using a reference population of 150 recombinant doubled haploid barley lines we generated novel phenotypic, mRNA abundance and SNP-based genotyping data sets, added them to a considerable volume of legacy trait data and entered them into the GeneNetwork http://www.genenetwork.org. GeneNetwork is a unified on-line analytical environment that enables the user to test genetic hypotheses about how component traits, such as mRNA abundance, may interact to condition more complex biological phenotypes (higher-order traits). Here we describe these barley data sets and demonstrate some of the functionalities GeneNetwork provides as an easily accessible and integrated analytical environment for exploring them. By integrating barley genotypic, phenotypic and mRNA abundance data sets directly within GeneNetwork's analytical environment we provide simple web access to the data for the research community. In this environment, a combination of correlation analysis and linkage mapping provides the potential to identify and substantiate gene targets for saturation mapping and positional cloning. By integrating datasets from an unsequenced crop plant (barley) in a database that has been designed for an animal model species (mouse) with a well established genome sequence, we prove the importance of the concept and practice of modular development and interoperability of software engineering for biological data sets.

The menopause transition experiences of Chinese Singaporean women: an exploratory qualitative study.

PubMed

Lim, Hui-Koon; Mackey, Sandra

2012-06-01

Menopause, a developmental occurrence that takes place in midlife, marks the end of a woman's fertile phase. Cultural norms, social influences, and personal perceptions related to menopause may influence its meaning and how each woman experiences this transition. Little is known about the menopausal experiences of Asian women. This study explores the menopause transition experiences of ethnic Chinese women in Singapore. Using a qualitative design, the researchers conducted audio-taped interviews in 2010 with 14 menopausal and postmenopausal Chinese Singaporean women aged 40-60 years. Thematic analysis was used to analyze interviews. Two main themes were identified: (a) experiencing symptoms and (b) managing symptoms during menopause transition. The most commonly reported symptoms were abnormal bleeding, hot flushes, and emotional changes. Most participants described their transition to be uneventful and ordinary and reported two significant symptoms at most. The strategies women used to manage their transition included using Western and traditional Chinese medical interventions and seeking support from family and friends. This study provides new insights into how ethnic Chinese women in Singapore experience menopause transition. Findings can assist nurses and healthcare workers in the local context to better understand menopausal women's needs and guide nurses to implement suitable health promotional strategies for women under their care in both hospital and community settings. Although ethnicity is not necessarily a determinant of symptom experience during menopause transition, health education for menopausal women should be based on knowledge of culture-specific practices. Nurses caring for menopausal women in hospital and community settings in Singapore should evaluate the use of medications prescribed by Western and Chinese herbal medical professionals as well as those that are self-prescribed.

The PMIP4 contribution to CMIP6 - Part 3: The last millennium, scientific objective, and experimental design for the PMIP4 past1000 simulations

NASA Astrophysics Data System (ADS)

Jungclaus, Johann H.; Bard, Edouard; Baroni, Mélanie; Braconnot, Pascale; Cao, Jian; Chini, Louise P.; Egorova, Tania; Evans, Michael; Fidel González-Rouco, J.; Goosse, Hugues; Hurtt, George C.; Joos, Fortunat; Kaplan, Jed O.; Khodri, Myriam; Klein Goldewijk, Kees; Krivova, Natalie; LeGrande, Allegra N.; Lorenz, Stephan J.; Luterbacher, Jürg; Man, Wenmin; Maycock, Amanda C.; Meinshausen, Malte; Moberg, Anders; Muscheler, Raimund; Nehrbass-Ahles, Christoph; Otto-Bliesner, Bette I.; Phipps, Steven J.; Pongratz, Julia; Rozanov, Eugene; Schmidt, Gavin A.; Schmidt, Hauke; Schmutz, Werner; Schurer, Andrew; Shapiro, Alexander I.; Sigl, Michael; Smerdon, Jason E.; Solanki, Sami K.; Timmreck, Claudia; Toohey, Matthew; Usoskin, Ilya G.; Wagner, Sebastian; Wu, Chi-Ju; Leng Yeo, Kok; Zanchettin, Davide; Zhang, Qiong; Zorita, Eduardo

2017-11-01

The pre-industrial millennium is among the periods selected by the Paleoclimate Model Intercomparison Project (PMIP) for experiments contributing to the sixth phase of the Coupled Model Intercomparison Project (CMIP6) and the fourth phase of the PMIP (PMIP4). The past1000 transient simulations serve to investigate the response to (mainly) natural forcing under background conditions not too different from today, and to discriminate between forced and internally generated variability on interannual to centennial timescales. This paper describes the motivation and the experimental set-ups for the PMIP4-CMIP6 past1000 simulations, and discusses the forcing agents orbital, solar, volcanic, and land use/land cover changes, and variations in greenhouse gas concentrations. The past1000 simulations covering the pre-industrial millennium from 850 Common Era (CE) to 1849 CE have to be complemented by historical simulations (1850 to 2014 CE) following the CMIP6 protocol. The external forcings for the past1000 experiments have been adapted to provide a seamless transition across these time periods. Protocols for the past1000 simulations have been divided into three tiers. A default forcing data set has been defined for the Tier 1 (the CMIP6 past1000) experiment. However, the PMIP community has maintained the flexibility to conduct coordinated sensitivity experiments to explore uncertainty in forcing reconstructions as well as parameter uncertainty in dedicated Tier 2 simulations. Additional experiments (Tier 3) are defined to foster collaborative model experiments focusing on the early instrumental period and to extend the temporal range and the scope of the simulations. This paper outlines current and future research foci and common analyses for collaborative work between the PMIP and the observational communities (reconstructions, instrumental data).

Profile of 1 year of fieldwork experiences for undergraduate occupational therapy students from a large regional Australian university.

PubMed

Mackenzie, Lynette; O'Toole, Gjyn

2017-10-01

Objective Fieldwork experience is a significant component of many health professional education programs and affects future practice for graduates. The present study used self-reported student data to produce a profile of undergraduate student placement experiences. Methods Cross-sectional surveys exploring placement location, setting and client types, models of supervision, interventions and financial costs were completed by students following each placement. Data were analysed using descriptive analysis. Results Placements were predominantly conducted outside capital cities (69.8%; n=184), with 25.8% (n=68) in rural settings. Students experienced predominantly public health in-patient settings and community settings, with only 15% experiencing private settings. Conclusions The placement profile of undergraduate occupational therapy students appeared to be consistent with workforce reports on occupational therapy professional practice. What is known about the topic? Fieldwork experienced by health professional students is critical to preparing new graduates for practice. Although the World Federation of Occupational Therapy provides guidance on what is required for occupational therapy fieldwork experience, little is known about what students actually experience during their fieldwork placements. What does this paper add? The present study is the first to document the range of fieldwork experienced by occupational therapy students in one program over 1 year, and provides the basis for comparison with other occupational therapy programs, as well as other disciplines nationally and internationally. What are the implications for practitioners? Occupational therapy students experienced few opportunities in private practice or speciality services, and had mostly one-on-one supervision. To provide a future workforce that is able to address the changing health system, it is vital that students are exposed to a range of fieldwork experiences and supervision styles that replicate the demands of future practice.

Performance in quasi-firms: an example from the Community Clinical Oncology Program.

PubMed

Lacey, L M; Hynes, D M; Kaluzny, A D

1992-01-01

In this analysis, the authors examined the effects of different sets of process, structure, and environmental variables on the performance of the CCOP as a quasi-firm. Specifically, they distinguished between internal organizational processes, structural, and size characteristics of the CCOP and the organizational environment created by prior NCI program experience and the relationship within the quasi-firm. The analysis revealed that these sets of organizational and environmental characteristics have differential effects on treatment accrual. The strongest predictors are those associated with the quasi-firm relationship between the CCOP and its chosen research bases. Any definitive policy implications for the design of organizational network relationships--especially the CCOPs--will require further analysis. Particular attention needs to be given to the longitudinal nature of the relationships and the ability of these organizational and environmental factors to affect other aspects of performance. Several points have been made within this initial assessment. First, the structural character of the CCOP and its relationship to its organizational environment are important factors affecting accrual performance. The subtleties of this multivariate model are not as important as simply demonstrating that the various internal and external characteristics of these organizations as quasi-firms simultaneously affect their ability to accrue patients to clinical trials. Secondly, the importance of research base relations, and particularly the significant role of nurses, needs to be emphasized. While CCOPs were originally designed as a network of physicians and hospitals, it appears that an infrastructure of professionally active nurses working within a larger organizational environment is critical to success--at least as defined by accrual to treatment protocols. Finally, the failure of prior experience with other NCI community programs to affect CCOP accrual performance suggests that such experience does not assure "organizational learning" that may enhance performance. This suggests that CCOPs can be designated de novo to maximize performance without necessarily having to undergo a developmental or experiential phase involving community cancer programs to be effective. However, the authors suspect that another method of characterizing experience may produce different results. Further analyses of these data will test these results against other measures of CCOP performance. Specifically, attention will be given to whether this same set of characteristics is predictive of accrual to cancer control research protocols. Similarly, these same organizational characteristics may or may not be associated with other dimensions of CCOP performance such as changes in physician practice patterns and/or levels of institutionalization of the CCOP within its local community.(ABSTRACT TRUNCATED AT 400 WORDS)

A small-area analysis of inequalities in chronic disease prevalence across urban and non-urban communities in the Province of Nova Scotia, Canada, 2007-2011.

PubMed

Terashima, Mikiko; Rainham, Daniel G C; Levy, Adrian R

2014-05-13

Small-area studies of health inequalities often have an urban focus, and may be limited in their translatability to non-urban settings. Using small-area units representing communities, this study assessed the influence of living in different settlement types (urban, town and rural) on the prevalence of four chronic diseases (heart disease, cancer, diabetes and stroke) and compared the degrees of associations with individual-level and community-level factors among the settlement types. The associations between community-level and individual-level characteristics and prevalence of the chronic diseases were assessed using logistic regression (multilevel and non-multilevel) models. Individual-level data were extracted from the Canadian Community Health Survey (2007-2011). Indices of material deprivation and social isolation and the settlement type classification were created using the Canadian Census. Respondents living in towns were 21% more likely to report one of the diseases than respondents living in urban communities even after accounting for individual-level and community-level characteristics. Having dependent children appeared to have protective effects in towns, especially for males (OR: 0.49 (95% CI 0.27 to 0.90)). Unemployment had a strong association for all types of communities, but being unemployed appeared to be particularly damaging to health of males in urban communities (OR: 2.48 (95% CI 1.43 to 4.30)). The study showed that those living in non-urban settings, particularly towns, experience extra challenges in maintaining health above and beyond the socioeconomic condition and social isolation of the communities, and individual demographic, behavioural and socioeconomic attributes. Our findings also suggest that health inequality studies based on urban-only settings may underestimate the risks by some factors. Ways to devise meaningful small-area units comparable in all settlement types are necessary to help plan effective provision of chronic disease-related health services and programmes on a regional scale. 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 conceptual framework for invasion in microbial communities.

PubMed

Kinnunen, Marta; Dechesne, Arnaud; Proctor, Caitlin; Hammes, Frederik; Johnson, David; Quintela-Baluja, Marcos; Graham, David; Daffonchio, Daniele; Fodelianakis, Stilianos; Hahn, Nicole; Boon, Nico; Smets, Barth F

2016-12-01

There is a growing interest in controlling-promoting or avoiding-the invasion of microbial communities by new community members. Resource availability and community structure have been reported as determinants of invasion success. However, most invasion studies do not adhere to a coherent and consistent terminology nor always include rigorous interpretations of the processes behind invasion. Therefore, we suggest that a consistent set of definitions and a rigorous conceptual framework are needed. We define invasion in a microbial community as the establishment of an alien microbial type in a resident community and argue how simple criteria to define aliens, residents, and alien establishment can be applied for a wide variety of communities. In addition, we suggest an adoption of the community ecology framework advanced by Vellend (2010) to clarify potential determinants of invasion. This framework identifies four fundamental processes that control community dynamics: dispersal, selection, drift and diversification. While selection has received ample attention in microbial community invasion research, the three other processes are often overlooked. Here, we elaborate on the relevance of all four processes and conclude that invasion experiments should be designed to elucidate the role of dispersal, drift and diversification, in order to obtain a complete picture of invasion as a community process.

A conceptual framework for invasion in microbial communities

PubMed Central

Kinnunen, Marta; Dechesne, Arnaud; Proctor, Caitlin; Hammes, Frederik; Johnson, David; Quintela-Baluja, Marcos; Graham, David; Daffonchio, Daniele; Fodelianakis, Stilianos; Hahn, Nicole; Boon, Nico; Smets, Barth F

2016-01-01

There is a growing interest in controlling—promoting or avoiding—the invasion of microbial communities by new community members. Resource availability and community structure have been reported as determinants of invasion success. However, most invasion studies do not adhere to a coherent and consistent terminology nor always include rigorous interpretations of the processes behind invasion. Therefore, we suggest that a consistent set of definitions and a rigorous conceptual framework are needed. We define invasion in a microbial community as the establishment of an alien microbial type in a resident community and argue how simple criteria to define aliens, residents, and alien establishment can be applied for a wide variety of communities. In addition, we suggest an adoption of the community ecology framework advanced by Vellend (2010) to clarify potential determinants of invasion. This framework identifies four fundamental processes that control community dynamics: dispersal, selection, drift and diversification. While selection has received ample attention in microbial community invasion research, the three other processes are often overlooked. Here, we elaborate on the relevance of all four processes and conclude that invasion experiments should be designed to elucidate the role of dispersal, drift and diversification, in order to obtain a complete picture of invasion as a community process. PMID:27137125

Community pharmacy incident reporting: a new tool for community pharmacies in Canada.

PubMed

Ho, Certina; Hung, Patricia; Lee, Gary; Kadija, Medina

2010-01-01

Incident reporting offers insight into a variety of intricate processes in healthcare. However, it has been found that medication incidents are under reported in the community pharmacy setting. The Community Pharmacy Incident Reporting (CPhIR) program was created by the Institute for Safe Medication Practices Canada specifically for incident reporting in the community pharmacy setting in Canada. The initial development of key elements for CPhIR included several focus-group teleconferences with pharmacists from Ontario and Nova Scotia. Throughout the development and release of the CPhIR pilot, feedback from pharmacists and pharmacy technicians was constantly incorporated into the reporting program. After several rounds of iterative feedback, testing and consultation with community pharmacy practitioners, a final version of the CPhIR program, together with self-directed training materials, is now ready to launch. The CPhIR program provides users with a one-stop platform to report and record medication incidents, export data for customized analysis and view comparisons of individual and aggregate data. These unique functions allow for a detailed analysis of underlying contributing factors in medication incidents. A communication piece for pharmacies to share their experiences is in the process of development. To ensure the success of the CPhIR program, a patient safety culture must be established. By gaining a deeper understanding of possible causes of medication incidents, community pharmacies can implement system-based strategies for quality improvement and to prevent potential errors from occurring again in the future. This article highlights key features of the CPhIR program that will assist community pharmacies to improve their drug distribution system and, ultimately, enhance patient safety.

Leisure-time youth centres as health-promoting settings: Experiences from multicultural neighbourhoods in Sweden.

PubMed

Fredriksson, Ingela; Geidne, Susanna; Eriksson, Charli

2018-02-01

The aim of this paper is to advocate for the importance of meaningful leisure time for young people from a health-promotion perspective using experiences from two youth centres in multicultural neighbourhoods in Sweden. In this practice-based study, data were collected between 2012 and 2014 at two youth centres in multicultural, socially deprived suburbs in Sweden using surveys with 12- to 16-year-old adolescents ( n = 207), seven individual interviews with staff and three cooperation partners in the neighbourhoods, and six group interviews with adolescents (50% girls). Quantitative, qualitative and mixed methods were used for analysis. As part of the youth centres' strategies, they are open and inclusive, foster supportive relationships, emphasise youth empowerment, and integrate family, school and community in their work. The youth centres are health-promoting settings with regard to four of the action areas in the Ottawa Charter: build healthy public policy, create supportive environments, strengthen community actions and develop personal skills. There is a need for a variety and a combination of various structured and unstructured leisure-time activities because young people's background and life situation plays a role for their participation in leisure-time activities. We conclude that youth centres are well placed to be or to become health-promoting settings if the activities takes place in a structured environment.

Implementing a WIC-Based Intervention to Promote Exclusive Breastfeeding: Challenges, Facilitators, and Adaptive Strategies.

PubMed

Eldridge, Johanna D; Hartnett, Josette O; Lee, Furrina F; Sekhobo, Jackson P; Edmunds, Lynn S

Understand factors that contributed to the implementation of a successful multicomponent intervention to promote exclusive breastfeeding (EBF) within Special Supplemental Nutrition Program for Woman, Infants, and Children (WIC) clinics. Qualitative study of staff implementers' experiences using implementation status reports, facilitated group discussion immediately after implementation, and WIC administrative data. WIC staff from 12 clinics participated in an EBF Learning Community composed of 8 intervention trainings and ongoing support from trainers and peers. A total of 47 WIC staff including 11 directors, 20 other administrators, 8 nutritionists, and 6 peer counselors. A WIC-integrated EBF promotion initiative, supported through a Learning Community, composed of prenatal screening, tailored trimester-specific counseling, and timely postpartum follow-up. Challenges and facilitators to implementation within clinics. Iterative qualitative analysis using directed, emergent, and thematic coding. Implementation experiences were characterized by (1) perceived benefits of implementation, including improved EBF knowledge and counseling confidence among staff; and (2) managing implementation, including responding to challenges posed by clinic settings (resources, routine practices, values, and perceptions of mothers) through strategies such as adapting clinic practices and intervention components. Implementation was shaped by clinic setting and adaptive strategies. Future WIC interventions may benefit from formal consideration of intervention fit with local clinic setting and allowable adaptations. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Associate degree nursing in a community-based health center network: lessons in collaboration.

PubMed

Connolly, Charlene; Wilson, Diane; Missett, Regina; Dooley, Wanda C; Avent, Pamela A; Wright, Ronda

2004-02-01

This exemplar highlights the ability of community experiences to enhance nursing students' understanding of the principles of community-based care: advocating self-care; focusing on prevention, family, culture, and community; providing continuity of care; and collaborating. An innovative teaching-practice model (i.e., a nurse-managed "network" of clinics), incorporating service-learning, was created. The Network's purposes are to provide practice sites in community-based primary care settings for student clinical rotations, increasing the awareness of the civic and social responsibility to provide quality health care for disadvantaged populations; and to reduce health disparities by increasing access to free primary health care, including health promotion and disease prevention, for disadvantaged individuals. Network clients receive free health care, referrals, and guidance to effectively obtain additional health care resources for themselves and their families. The Network is a national pioneer in modeling the delivery of primary care services through a faculty-student practice plan, with leadership emanating from a community college.

Passive Suicidal Ideation and Community Mental Health Resources in South Africa.

PubMed

Collins, Pamela Y; Kondos, Leeza; Pillai, Aravind; Joestl, Sarah S; Frohlich, Janet

2016-07-01

South African communities continue to experience elevated incidence and prevalence of HIV infection. Passive suicidal ideation (PSI) may be one expression of distress in high prevalence communities. We report the prevalence of PSI and examine the relationship between PSI and participation in community organizations in a semi-rural sample of South African adults (N = 594). The prevalence of PSI in the 2 weeks prior to the interview was 9.1 %. Members of burial societies (Χ (2) = 7.34; p = 0.01) and stokvels (Χ (2) = 4.1; p = 0.04) (community-based savings groups) reported significantly less PSI compared to other respondents. Using a multivariate model adjusted for demographic characteristics, psychological distress, and socioeconomic status, we found lower odds of reporting PSI for members of burial societies (OR 0.48, CI 0.25 -0.91). Participation in community organizations that provide contextually salient resources in settings with high levels of distress may be a resource for mental health.

Design and Implementation of a Community Health Worker HIV Treatment and Prevention Intervention in an HIV Hot Spot Fishing Community in Rakai, Uganda.

PubMed

Long, Amanda; Mbabali, Ismail; Hutton, Heidi E; Thomas, Alvin G; Bugos, Eva; Mulamba, Jeremiah; Amico, Kathy Rivet; Nalugoda, Fred; Gray, Ronald H; Wawer, Maria J; Nakigozi, Gertrude; Chang, Larry W

Innovative approaches are needed to increase engagement in HIV treatment and prevention services, particularly in HIV hot spots. Here, we detail our design, training approach, and early implementation experiences of a community-based HIV intervention called "health scouts." The intervention, utilizing a novel, theory-based approach, trained 10 community residents in an HIV hot spot fishing community to use motivational interviewing strategies and a mobile phone-based counseling application. During the first 3 months, 771 residents (median 82/health scout, range 27-160) were counseled. A directly observed Motivational Interviewing Treatment Integrity scale-based evaluation found adequate performance (median score 20/25, range 11-23). The health scout intervention was feasible to implement in a high HIV-prevalence fishing community, and its impact on HIV care outcomes will be evaluated in an ongoing cluster randomized trial. If found to be effective, it may be an important strategy for responding to HIV in high-burden settings.

Recruiting Filipino Immigrants in a Randomized Controlled Trial Promoting Enrollment in an Evidence-Based Parenting Intervention.

PubMed

Javier, Joyce R; Reyes, Angela; Coffey, Dean M; Schrager, Sheree M; Samson, Allan; Palinkas, Lawrence; Kipke, Michele D; Miranda, Jeanne

2018-05-17

Filipinos, the second largest Asian subgroup in the U.S., experience significant youth behavioral health disparities but remain under-represented in health research. We describe lessons learned from using the Matching Model of Recruitment to recruit 215 Filipinos to participate in a large, randomized controlled trial of a culturally tailored video aimed at increasing enrollment in the Incredible Years® Parent Program. We recruited participants from schools, churches, clinics, community events, and other community-based locations. Facilitators of participation included: partnership with local community groups, conducting research in familiar settings, building on existing social networks, and matching perspectives of community members and researchers. Findings suggest recruitment success occurs when there is a match between goals of Filipino parents, grandparents and the research community. Understanding the perspectives of ethnic minority communities and effectively communicating goals of research studies are critical to successful recruitment of hard-to-reach immigrant populations in randomized controlled trials.

Social Media and Myeloproliferative Neoplasms (MPN): Analysis of Advanced Metrics From the First Year of a New Twitter Community: #MPNSM.

PubMed

Pemmaraju, Naveen; Utengen, Audun; Gupta, Vikas; Kiladjian, Jean-Jacques; Mesa, Ruben; Thompson, Michael A

2016-12-01

The social media platform Twitter has provided the hematology/oncology community with unprecedented, novel methods of interpersonal communication and increased ability for the dissemination of important updates in a rapidly moving field. The advent, and subsequent success, of disease-specific Twitter communities have further enabled interested healthcare stakeholders to become quickly organized around a unique set of rare medical conditions, such as hematologic malignancies, that, historically, generally lack large amounts of reliable online information. One example is the Twitter community #MPNSM (myeloproliferative neoplasms on social media), which was started approximately one and half years ago and has served as a recognized venue for discussion among many members of the MPN community, including patients, researchers, providers, and advocacy organizations. This article will focus on understanding the impact of the founding of this community via the analysis of advanced Twitter metrics of user experience, from the first year of use for this novel healthcare hashtag.

Exposure to violence predicts poor educational outcomes in young children in South Africa and Malawi

PubMed Central

Sherr, L.; Hensels, I. S.; Skeen, S.; Tomlinson, M.; Roberts, K. J.; Macedo, A.

2016-01-01

Background Violence during childhood may affect short and long-term educational factors. There is scant literature on younger children from resource poor settings. Methods This study assessed child violence experiences (harsh punishment and exposure to domestic or community violence) and school enrolment, progress and attendance in children attending community-based organisations in South Africa and Malawi (n=989) at baseline and at 15 months' follow-up, examining differential experience of HIV positive, HIV affected and HIV unaffected children. Results Violence exposure was high: 45.4% experienced some form of psychological violence, 47.8% physical violence, 46.7% domestic violence and 41.8% community violence. Primary school enrolment was 96%. Violence was not associated with school enrolment at baseline but, controlling for baseline, children exposed to psychological violence for discipline were more than ten times less likely to be enrolled at follow-up (OR 0.09; 95% CI 0.01 to 0.57). Harsh discipline was associated with poor school progress. For children HIV positive a detrimental effect of harsh physical discipline was found on school performance (OR 0.10; 95% CI 0.02 to 0.61). Conclusion Violence experiences were associated with a number of educational outcomes, which may have long-term consequences. Community-based organisations may be well placed to address such violence, with a particular emphasis on the challenges faced by children who are HIV positive. PMID:26678567

Coupling the Community Atmospheric Model (CAM) with the Statistical Spectral Interpolation (SSI) System under ESMF

NASA Technical Reports Server (NTRS)

daSilva, Arlindo

2004-01-01

The first set of interoperability experiments illustrates the role ESMF can play in integrating the national Earth science resources. Using existing data assimilation technology from NCEP and the National Weather Service, the Community Atmosphere Model (CAM) was able to ingest conventional and remotely sensed observations, a capability that could open the door to using CAM for weather as well as climate prediction. CAM, which includes land surface capabilities, was developed by NCAR, with key components from GSFC. In this talk we will describe the steps necessary for achieving the coupling of these two systems.

Emotional rescue: the role of emotional intelligence and emotional labour on well-being and job-stress among community nurses.

PubMed

Karimi, Leila; Leggat, Sandra G; Donohue, Lisa; Farrell, Gerald; Couper, Greta E

2014-01-01

To investigate the extent to which emotional labour and emotional intelligence are associated with well-being and job-stress among a group of Australian community nurses. The moderating role of emotional intelligence was evaluated as a key factor in the rescue of healthcare workers from job-stress, thus increasing job retention. Although emotional labour has been broadly investigated in the literature, the contribution of emotional labour and emotional intelligence to the well-being and experience of job-stress in a community nursing setting requires further exploration. This study used a cross-sectional quantitative research design with data collected from Australian community nurses. Australian community nurses (n = 312) reported on their perceived emotional labour, emotional intelligence and their levels of well-being and job-stress using a paper and pencil survey in 2010. Results from structural equation modelling support the hypothesis that both emotional labour and emotional intelligence have significant effects on nurses' well-being and perceived job-stress. Emotional intelligence plays a moderating role in the experience of job-stress. These findings provide additional evidence for the important effects that emotional labour and emotional intelligence can have on well-being and job-stress among community nurses. The potential benefits of emotional intelligence in the nurses' emotional work have been explored. © 2013 John Wiley & Sons Ltd.

Evaluation of a community transition to professional practice program for graduate registered nurses in Australia.

PubMed

Aggar, Christina; Gordon, Christopher J; Thomas, Tamsin H T; Wadsworth, Linda; Bloomfield, Jacqueline

2018-03-26

Australia has an increasing demand for a sustainable primary health care registered nursing workforce. Targeting graduate registered nurses who typically begin their nursing career in acute-care hospital settings is a potential workforce development strategy. We evaluated a graduate registered nurse Community Transition to Professional Practice Program which was designed specifically to develop and foster skills required for primary health care. The aims of this study were to evaluate graduates' intention to remain in the primary health care nursing workforce, and graduate competency, confidence and experiences of program support; these were compared with graduates undertaking the conventional acute-care transition program. Preceptor ratings of graduate competence were also measured. All of the 25 graduates (n = 12 community, n = 13 acute-care) who completed the questionnaire at 6 and 12 months intended to remain in nursing, and 55% (n = 6) of graduates in the Community Transition Program intended to remain in the primary health care nursing workforce. There were no differences in graduate experiences, including level of competence, or preceptors' perceptions of graduate competence, between acute-care and Community Transition Programs. The Community Transition to Professional Practice program represents a substantial step towards developing the primary health care health workforce by facilitating graduate nurse employment in this area. Copyright © 2018 Elsevier Ltd. All rights reserved.

Moral experience: a framework for bioethics research.

PubMed

Hunt, Matthew R; Carnevale, Franco A

2011-11-01

Theoretical and empirical research in bioethics frequently focuses on ethical dilemmas or problems. This paper draws on anthropological and phenomenological sources to develop an alternative framework for bioethical enquiry that allows examination of a broader range of how the moral is experienced in the everyday lives of individuals and groups. Our account of moral experience is subjective and hermeneutic. We define moral experience as "Encompassing a person's sense that values that he or she deem important are being realised or thwarted in everyday life. This includes a person's interpretations of a lived encounter, or a set of lived encounters, that fall on spectrums of right-wrong, good-bad or just-unjust". In our conceptualisation, moral experience is not limited to situations that are heavily freighted with ethically-troubling ramifications or are sources of debate and disagreement. Important aspects of moral experience are played out in mundane and everyday settings. Moral experience provides a research framework, the scope of which extends beyond the evaluation of ethical dilemmas, processes of moral justification and decision-making, and moral distress. This broad research focus is consistent with views expressed by commentators within and beyond bioethics who have called for deeper and more sustained attention in bioethics scholarship to a wider set of concerns, experiences and issues that better captures what is ethically at stake for individuals and communities. In this paper we present our conceptualisation of moral experience, articulate its epistemological and ontological foundations and discuss opportunities for empirical bioethics research using this framework.

Social meanings and understandings in patient-nurse interaction in the community practice setting: a grounded theory study

PubMed Central

2012-01-01

Background The patient-nurse relationship is a traditional concern of healthcare research. However, patient-nurse interaction is under examined from a social perspective. Current research focuses mostly on specific contexts of care delivery and experience related to medical condition or illness, or to nurses’ speciality. Consequentially, this paper is about the social meanings and understandings at play within situated patient-nurse interaction in the community practice setting in a transforming healthcare service. Methods Grounded theory methodology was used and the research process was characterised by principles of theoretical sensitivity and constant comparative analysis. The field of study was four health centres in the community. The participants were patients and nurses representative of those attending or working in the health centres and meeting there by scheduled appointment. Data collection methods were observations, informal interviews and semi-structured interviews. Results Key properties of ‘Being a good patient, being a good nurse’, ‘Institutional experiences’ and ‘Expectations about healthcare’ were associated with the construction of a category entitled ‘Experience’. Those key properties captured that in an evolving healthcare environment individuals continually re-constructed their reality of being a patient or nurse as they endeavoured to perform appropriately; articulation of past and present healthcare experiences was important in that process. Modus operandi in role as patient was influenced by past experiences in healthcare and by those in non-healthcare institutions in terms of engagement and involvement (or not) in interaction. Patients’ expectations about interaction in healthcare included some uncertainly as they strived to make sense of the changing roles and expertise of nurses and, differentiating between the roles and expertise of nurses and doctors. Conclusions The importance of social meanings and understandings in patient-nurse interaction is not fully apparent to nurses, but important in the patient experience. Seeking understanding from a social perspective makes a contribution to enhancing knowledge about patient-nurse interaction with subsequent impact on practice, in particular the development of the patient-nurse relationship. The implications are that the meanings and understandings patients and nurses generate from experiences beyond and within their situated interaction are pivotal to the development of their relationship in the transforming community healthcare environment. PMID:22950713

Evaluating the Real-World Effectiveness of Cognitive-Behavior Therapy Efficacy Research on Eating Disorders: A Case Study from a Community-based Clinical Setting

PubMed Central

Lowe, Michael R.; Bunnell, Douglas W.; Neeren, Amy M.; Chernyak, Yelena; Greberman, Laurel

2009-01-01

Objective There is a growing consensus that there is a need to test the real-world effectiveness of eating disorder therapies that show promise in efficacy research. The current paper provides a narrative account of an NIMH-funded study that attempted to apply efficacy findings from CBT research to an Intensive Outpatient Program (IOP) at the largest community-based eating disorder program in the United States. Method We describe the study as originally envisioned as well as the various challenges that the researchers and the IOP staff encountered in implementing this study. Results The different training, assumptions, and “ways of knowing” of the research team and the treatment staff in regard to the nature of eating disorders and their treatment created multiple challenges for both groups during the study period. We describe valuable lessons learned about how to - and how not to -implement effectiveness designs in clinical settings that are relatively unfamiliar with empirically-based research findings. Discussion It is hoped that our experience in attempting to apply efficacy-based research findings on eating disorders treatment in a community-based clinical setting will prove helpful to other researchers and service providers engaging in such translational research. PMID:20063375

The provision of neuropsychological services in rural/regional settings: professional and ethical issues.

PubMed

Allott, Kelly; Lloyd, Susan

2009-07-01

Despite rapid growth of the discipline of clinical neuropsychology during recent times, there is limited information regarding the identification and management of professional and ethical issues associated with the practice of neuropsychology within rural settings. The aim of this article is to outline the characteristics unique to practicing neuropsychology in rural communities and to describe the potential professional and ethical dilemmas that might arise. Issues are illustrated using examples from neuropsychological practice in a rural/regional setting in Victoria, Australia. Relative to urban regions, there is an inequality in the distribution of psychologists, including neuropsychologists, in rural areas. The unique characteristics of rural and regional communities that impact on neuropsychological practice are: 1) limited resources in expertise, technology, and community services, 2) greater travel distances and costs, 3) professional isolation, and 4) beliefs about psychological services. These characteristics lower the threshold for particular ethical issues. The ethical issues that require anticipation and careful management include: 1) professional competence, 2) multiple relationships, and 3) confidentiality. Through increased awareness and management of rural-specific professional and ethical issues, rural neuropsychologists can experience their work as rewarding and enjoyable. Specific guidelines for identifying, managing, and resolving ethically and professionally challenging situations that may arise during rural practice are provided.

The roles, barriers and experiences of rehabilitation therapists in disaster relief: post-earthquake Haiti 2010.

PubMed

Klappa, Susan; Audette, Jennifer; Do, Sandy

2014-01-01

This article describes the roles and experiences of rehabilitation therapists involved in disaster relief work (DRW) in Haiti after the 2010 earthquake. The results of a pilot study and phenomenological study are presented. A phenomenological study of rehabilitation providers' experiences in post-disaster relief care is presented along with preliminary pilot study results. The phenomenological study explored the experiences of therapists from a lived experience perspective through the roles they played in DRW. Participants provided disaster relief through direct patient care, adaptive equipment sourcing and allocation, education and training, community outreach and logistic or administrative duties. Barriers and challenges included: (1) emotions: ups and downs; (2) challenges: working at the edge of practice; (3) education: key to success and sustainability; (4) lessons learned: social responsibility is why we go; and (5) difficulty coming home: no one understands. Therapists play a key role in disaster relief situations. Data presented should encourage organizations to include therapists from early planning to implementation of relief services. Further studies are needed to evaluate the impact of rehabilitation interventions in disaster settings. Understanding the roles and experiences of therapists in disaster relief setting is important Certain barriers to providing care in post-disaster settings exist Those participating in disaster response should be well prepared and aware of that they might be asked to do.

Understanding consumers' initial expectations of community-based residential mental health rehabilitation in the context of past experiences of care: A mixed-methods pragmatic grounded theory analysis.

PubMed

Parker, Stephen; Meurk, Carla; Newman, Ellie; Fletcher, Clayton; Swinson, Isabella; Dark, Frances

2018-04-16

This study explores how consumers expect community-based residential mental health rehabilitation to compare with previous experiences of care. Understanding what consumers hope to receive from mental health services, and listening to their perspectives about what has and has not worked in previous care settings, may illuminate pathways to improved service engagement and outcomes. A mixed-methods research design taking a pragmatic approach to grounded theory guided the analysis of 24 semi-structured interviews with consumers on commencement at three Community Care Units (CCUs) in Australia. Two of these CCUs were trialling a staffing model integrating peer support work with clinical care. All interviews were conducted by an independent interviewer within the first 6 weeks of the consumer's stay. All participants expected the CCU to offer an improvement on previous experiences of care. Comparisons were made to acute and subacute inpatient settings, supported accommodation, and outpatient care. Consumers expected differences in the people (staff and co-residents), the focus of care, physical environ, and rules and regulations. Participants from the integrated staffing model sites articulated the expected value of a less clinical approach to care. Overall, consumers' expectations aligned with the principles articulated in policy frameworks for recovery-oriented practice. However, their reflections on past care suggest that these services continue to face significant challenges realizing these principles in practice. Paying attention to the kind of working relationship consumers want to have with mental health services, such as the provision of choice and maintaining a practical and therapeutic supportive focus, could improve their engagement and outcomes. © 2018 Australian College of Mental Health Nurses Inc.

Research protocol for a digital intervention to reduce stigma among males with a personal experience of suicide in the Australian farming community.

PubMed

Kennedy, Alison J; Versace, Vincent Lawrence; Brumby, Susan A

2016-11-29

Australian farming communities have up to twice the suicide rate of the general population. Men, particularly, demonstrate debilitating self- and perceived-stigma associated with an experience of suicide. The Ripple Effect is aimed to reduce suicide stigma within the social, cultural, geographical and psychological contexts in which it occurs. A mixed-method design with multi-level evaluation will be effected following the development and delivery of a personalised website experience (combining shared stories, education, personal goal setting and links to resources) to farming men, aged 30-64 years, with an experience of suicide. Pre- and post-surveys will be used to assess changes in self- and perceived-stigma and suicide literacy. Online feedback from participants and semi-structured interviews during follow-up will be thematically analysed. This project will provide information about increasingly accessible, innovative approaches to reducing the debilitating health and wellbeing effects of suicide stigma on a population of Australia's farmers. This research protocol was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) (ACTRN: ACTRN12616000289415 ) on 7 th March, 2016.

Impact of attitudes and beliefs regarding African American sexual behavior on STD prevention and control in African American communities: unintended consequences.

PubMed

Valentine, Jo A

2008-12-01

Compared to whites, blacks experience significant health disparities for sexually transmitted diseases, particularly in the rates of chlamydia, gonorrhea, and syphilis. To develop more effective interventions to control and prevent STDs, public health practitioners should better understand and respond to factors that facilitate sexual risk-taking behaviors and impede access to STD health care and make use of factors that promote sexual health. Legacies of slavery, racism, and economic or class discrimination leave many blacks suspicious of interventions aimed at improving the welfare of their communities. Sexual behavior, in particular, has been used to justify social oppression of blacks in the United States. Although efforts to engage affected black communities in improving STD health care delivery have been undertaken, bias, prejudice, and stereotyping continue to contribute to negative experiences for many blacks across health care settings, including those involving STD care. Implementing more effective interventions to reduce the disparate burden of bacterial STDs in black communities requires accessible and acceptable STD health care. Understanding and addressing the potential impact of both provider and patient attitudes can improve these service delivery outcomes.

Experimental salt marsh islands: A model system for novel metacommunity experiments

NASA Astrophysics Data System (ADS)

Balke, Thorsten; Lõhmus, Kertu; Hillebrand, Helmut; Zielinski, Oliver; Haynert, Kristin; Meier, Daniela; Hodapp, Dorothee; Minden, Vanessa; Kleyer, Michael

2017-11-01

Shallow tidal coasts are characterised by shifting tidal flats and emerging or eroding islands above the high tide line. Salt marsh vegetation colonising new habitats distant from existing marshes are an ideal model to investigate metacommunity theory. We installed a set of 12 experimental salt marsh islands made from metal cages on a tidal flat in the German Wadden Sea to study the assembly of salt marsh communities in a metacommunity context. Experimental plots at the same elevation were established within the adjacent salt marsh on the island of Spiekeroog. For both, experimental islands and salt marsh enclosed plots, the same three elevational levels were realised while creating bare patches open for colonisation and vegetated patches with a defined transplanted community. One year into the experiment, the bare islands were colonised by plant species with high fecundity although with a lower frequency compared to the salt marsh enclosed bare plots. Initial plant community variations due to species sorting along the inundation gradient were evident in the transplanted vegetation. Competitive exclusion was not observed and is only expected to unfold in the coming years. Our study highlights that spatially and temporally explicit metacommunity dynamics should be considered in salt marsh plant community assembly and disassembly.

Migration, violence, and safety among migrant sex workers: a qualitative study in two Guatemalan communities.

PubMed

Rocha-Jiménez, Teresita; Brouwer, Kimberly C; Silverman, Jay G; Morales-Miranda, Sonia; Goldenberg, Shira M

2016-09-01

Despite reports of high levels of violence among women migrants in Central America, limited evidence exists regarding the health and safety of migrant sex workers in Central America. This study is based on 16 months of field research (November 2012-February 2014), including ethnographic fieldwork, in-depth interviews, and focus groups conducted with 52 internal and international migrant female sex workers in Tecún Umán and Quetzaltenango, Guatemala, key transit and destination communities for both international and internal migrants. The analysis explored migration-related determinants of susceptibility to violence experienced by migrant sex workers across different phases of migration. Violence in home communities and economic considerations were key drivers of migration. Unsafe transit experiences (eg undocumented border crossings) and negative interactions with authorities in destination settings (eg extortion) contributed to migrant sex workers' susceptibility to violence, while enhanced access to information on immigration policies and greater migration and sex work experience were found to enhance agency and resilience. Findings suggest the urgent need for actions that promote migrant sex workers' safety in communities of origin, transit, and destination, and programmes aimed at preventing and addressing human rights violations within the context of migration and sex work.

Nonpareil 3: Fast Estimation of Metagenomic Coverage and Sequence Diversity.

PubMed

Rodriguez-R, Luis M; Gunturu, Santosh; Tiedje, James M; Cole, James R; Konstantinidis, Konstantinos T

2018-01-01

Estimations of microbial community diversity based on metagenomic data sets are affected, often to an unknown degree, by biases derived from insufficient coverage and reference database-dependent estimations of diversity. For instance, the completeness of reference databases cannot be generally estimated since it depends on the extant diversity sampled to date, which, with the exception of a few habitats such as the human gut, remains severely undersampled. Further, estimation of the degree of coverage of a microbial community by a metagenomic data set is prohibitively time-consuming for large data sets, and coverage values may not be directly comparable between data sets obtained with different sequencing technologies. Here, we extend Nonpareil, a database-independent tool for the estimation of coverage in metagenomic data sets, to a high-performance computing implementation that scales up to hundreds of cores and includes, in addition, a k -mer-based estimation as sensitive as the original alignment-based version but about three hundred times as fast. Further, we propose a metric of sequence diversity ( N d ) derived directly from Nonpareil curves that correlates well with alpha diversity assessed by traditional metrics. We use this metric in different experiments demonstrating the correlation with the Shannon index estimated on 16S rRNA gene profiles and show that N d additionally reveals seasonal patterns in marine samples that are not captured by the Shannon index and more precise rankings of the magnitude of diversity of microbial communities in different habitats. Therefore, the new version of Nonpareil, called Nonpareil 3, advances the toolbox for metagenomic analyses of microbiomes. IMPORTANCE Estimation of the coverage provided by a metagenomic data set, i.e., what fraction of the microbial community was sampled by DNA sequencing, represents an essential first step of every culture-independent genomic study that aims to robustly assess the sequence diversity present in a sample. However, estimation of coverage remains elusive because of several technical limitations associated with high computational requirements and limiting statistical approaches to quantify diversity. Here we described Nonpareil 3, a new bioinformatics algorithm that circumvents several of these limitations and thus can facilitate culture-independent studies in clinical or environmental settings, independent of the sequencing platform employed. In addition, we present a new metric of sequence diversity based on rarefied coverage and demonstrate its use in communities from diverse ecosystems.

Putting the community back in community ecology and education: the role of field schools and private reserves in the ethical training of primatologists.

PubMed

Garber, P A; Molina, A; Molina, R L

2010-09-01

In 1993 and 1999, with the assistance of a Nicaraguan family, we founded La Suerte Biological Research Station in northeastern Costa Rica and Ometepe Biological Research Station in southern Nicaragua as a privately owned conservation-oriented business. Our goal was to develop a program of sustainable community ecology focused on education, research, and the conservation of primates and tropical forests. In order to accomplish this we developed field courses in which undergraduate and graduate students conduct scientific research, experience local cultures, and learn about conservation. Over 120 of these students have received doctoral degrees or are currently in graduate programs. Four doctoral dissertations, several MA theses, and some 20 scientific articles have been published based on research conducted at our field stations. In order to achieve our long-term goals of preserving the environment, we also needed to engage directly with local communities to address their needs and concerns. To this end, we developed a series of community-based initiatives related to health care, bilingual education, and conservation education using traditional and on-line teaching tools. In this article, we describe our efforts in Costa Rica and Nicaragua teaching conservation-oriented field courses and working with the local human communities. Building upon these experiences, we outline a set of ethical considerations and responsibilities for private reserves, conservation-oriented businesses, NGOs, and conservancies that help integrate members of the local community as stakeholders in conservation. (c) 2010 Wiley-Liss, Inc.

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.

Redefining Intersectionality Theory through the Lens of African American Young Adolescent Girls' Racialized Experiences

ERIC Educational Resources Information Center

Harrison, Lisa

2017-01-01

The research presented uses intersectionality theory as a lens to study the racial identity construction of four African American young adolescent girls. The findings suggest that race was largely situated in a Black-White discourse for the girls in the study. When limited information was provided in home, school, and community settings, the…

Transport of lead and diesel fuel through a peat soil near Juneau, AK: a pilot study.

Treesearch

Julian Deiss; Carl Byers; Dave Clover; Dave D' Amore; Alan Love; Malcolm A. Menzies; J. Powell; Todd M. Walter

2004-01-01

A set of peat column experiments was used to determine the transport potential of lead (Pb) and diesel range organics (DRO) in palustrine slope wetlands near Juneau, AK. This project is important to southeast Alaskan communities because limited land resources are forcing development of regional wetlands. This study was instigated by concerns that proposed modifications...

Engaging with and Moving on from Participatory Research: A Personal Reflection

ERIC Educational Resources Information Center

Gristy, Cath

2015-01-01

In this paper, I respond to the call to articulate experiences of the messy realities of participatory research. I reflect on my engagement and struggle with the realities and ethics of a piece of case study research, which set out with a participatory approach. The project involved a group of young people from an isolated rural community who…

From a Sense of Stereotypically Foreign to Belonging in a Science Community: Ways of Experiential Descriptions about High School Students' Science Internship

ERIC Educational Resources Information Center

Hsu, Pei-Ling; Roth, Wolff-Michael

2010-01-01

Science educators often suggest that students should learn science in ways and settings that bear family resemblance with "the real thing." Internship in science laboratories constitutes one such way in which students may learn science and learn about science. However, very little is known about "how" participants experience a…

Prepared for School Violence: School Counselors' Perceptions of Preparedness for Responding to Acts of School Violence

ERIC Educational Resources Information Center

Chambers, Rebecca Anne; Zyromski, Brett; Asner-Self, Kimberly K.; Kimemia, Muthoni

2010-01-01

Analyses of 103 St. Louis metro area school counselors' using the National School Violence Survey (Astor et al., 1997; Astor et al., 2000; Furlong et al., 1996) suggests school counselors' perceptions of school violence and their preparedness to respond to said violence vary by both community setting and years of experience. Discussion frames the…

Beasts of burden or organised cooperation: the story of a mental health team in remote, Indigenous Australia.

PubMed

Hunter, Ernest; Onnis, Leigh-Ann; Santhanam-Martin, Radhika; Skalicky, Judy; Gynther, Bruce; Dyer, Geraldine

2013-12-01

This paper aims to describe the growth of a regionally-based mental health team providing services to remote Indigenous communities in far north Queensland. By drawing on their experience, the authors are able to identify factors supporting the development and sustained capacity of integrated mental health teams, working in challenging remote settings.

Know Your Capital City. First Edition. Bulletin, 1958, No. 15

ERIC Educational Resources Information Center

Willcockson, Mary

1958-01-01

Since any good citizen wants to know how his Government works, as an initial experience it is necessary to become acquainted with the setting--Washington, D. C. This bulletin serves as an introduction to the Capital. It provides an historical and a present-day background for appreciating the city. What kind of a community is Washington? Why does…

Assessing Levels of Personal Autonomy among Israeli Adults with Intellectual Disabilities Living in Group Homes and Apartment Settings.

ERIC Educational Resources Information Center

Schwartz, Chaya

1995-01-01

Israeli adults (n=52) with intellectual disabilities who resided in community apartments were found to be more independent and to experience more choice-making opportunities than group home residents (n=68). The groups did not differ in age, gender, or level of intellectual disability, suggesting that the variation between groups is probably…

The Depiction of Significant Others in Tinto's "Rites of Passage": A Reconceptualization of the Influence of Family and Community in the Persistence Process.

ERIC Educational Resources Information Center

Nora, Amaury

2002-01-01

Theorizes about interrelations between "rites of passage" in Tinto's (1993) Student Integration Model, and support from significant others in Nora and Cabrera's (1996) Student Adjustment Model. Depicts how both sets of factors impact social and academic experiences and integration, commitment levels to attainment of an educational goal…

Getting Back to the Woods: Familial Perspectives on Culture and Preschoolers' Acquisition of Self-Regulation and Emotion Regulation

ERIC Educational Resources Information Center

Boyer, Wanda

2013-01-01

Discourse on culture is vital to early childhood educators' understanding of the young child in various socio-cultural experiences in family and community settings. In this article, the author will present a contemporary definition of culture. This article will then discuss the developmental constructs of self-regulation and emotion regulation and…

Picking Up the Mantle of "Expert": Assigned Roles, Assertion of Identity, and Peer Recognition within a Programming Class

ERIC Educational Resources Information Center

Fields, Deborah; Enyedy, Noel

2013-01-01

Changing an established role in a classroom is difficult. It involves constructing a new set of relations within a community. In this article we investigate how students with newly developed interest and experience in programming developed outside the classroom pick up and establish their roles as experts in programming within the classroom…

A Tale of Two First-Year Teachers: One Likely to Continue, One Likely to Drop Out

ERIC Educational Resources Information Center

Ingwalson, Gail; Thompson, James, Jr.

2007-01-01

This comparative study explores the experience of two first-year teachers in starkly different school systems, one in a small city on the northern plains and the other in a Midwest urban community. Using this comparative method, the authors looked at the similarities and differences of two different educational settings to collect data regarding…

The effectiveness of three sets of school-based instructional materials and community training on the acquisition and generalization of community laundry skills by students with severe handicaps.

PubMed

Morrow, S A; Bates, P E

1987-01-01

This study examined the effectiveness of three sets of school-based instructional materials and community training on acquisition and generalization of a community laundry skill by nine students with severe handicaps. School-based instruction involved artificial materials (pictures), simulated materials (cardboard replica of a community washing machine), and natural materials (modified home model washing machine). Generalization assessments were conducted at two different community laundromats, on two machines represented fully by the school-based instructional materials and two machines not represented fully by these materials. After three phases of school-based instruction, the students were provided ten community training trials in one laundromat setting and a final assessment was conducted in both the trained and untrained community settings. A multiple probe design across students was used to evaluate the effectiveness of the three types of school instruction and community training. After systematic training, most of the students increased their laundry performance with all three sets of school-based materials; however, generalization of these acquired skills was limited in the two community settings. Direct training in one of the community settings resulted in more efficient acquisition of the laundry skills and enhanced generalization to the untrained laundromat setting for most of the students. Results of this study are discussed in regard to the issue of school versus community-based instruction and recommendations are made for future research in this area.

The Carbon-Land Model Intercomparison Project (C-LAMP): A Model-Data Comparison System for Evaluation of Coupled Biosphere-Atmosphere Models

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

Hoffman, Forrest M; Randerson, Jim; Thornton, Peter E

2009-01-01

The need to capture important climate feebacks in general circulation models (GCMs) has resulted in new efforts to include atmospheric chemistry and land and ocean biogeochemistry into the next generation of production climate models, now often referred to as Earth System Models (ESMs). While many terrestrial and ocean carbon models have been coupled to GCMs, recent work has shown that such models can yield a wide range of results, suggesting that a more rigorous set of offline and partially coupled experiments, along with detailed analyses of processes and comparisons with measurements, are warranted. The Carbon-Land Model Intercomparison Project (C-LAMP) providesmore » a simulation protocol and model performance metrics based upon comparisons against best-available satellite- and ground-based measurements (Hoffman et al., 2007). C-LAMP provides feedback to the modeling community regarding model improvements and to the measurement community by suggesting new observational campaigns. C-LAMP Experiment 1 consists of a set of uncoupled simulations of terrestrial carbon models specifically designed to examine the ability of the models to reproduce surface carbon and energy fluxes at multiple sites and to exhibit the influence of climate variability, prescribed atmospheric carbon dioxide (CO{sub 2}), nitrogen (N) deposition, and land cover change on projections of terrestrial carbon fluxes during the 20th century. Experiment 2 consists of partially coupled simulations of the terrestrial carbon model with an active atmosphere model exchanging energy and moisture fluxes. In all experiments, atmospheric CO{sub 2} follows the prescribed historical trajectory from C{sup 4}MIP. In Experiment 2, the atmosphere model is forced with prescribed sea surface temperatures (SSTs) and corresponding sea ice concentrations from the Hadley Centre; prescribed CO{sub 2} is radiatively active; and land, fossil fuel, and ocean CO{sub 2} fluxes are advected by the model. Both sets of experiments have been performed using two different terrestrial biogeochemistry modules coupled to the Community Land Model version 3 (CLM3) in the Community Climate System Model version 3 (CCSM3): The CASA model of Fung, et al., and the carbon-nitrogen (CN) model of Thornton. Comparisons against Ameriflus site measurements, MODIS satellite observations, NOAA flask records, TRANSCOM inversions, and Free Air CO{sub 2} Enrichment (FACE) site measurements, and other datasets have been performed and are described in Randerson et al. (2009). The C-LAMP diagnostics package was used to validate improvements to CASA and CN for use in the next generation model, CLM4. It is hoped that this effort will serve as a prototype for an international carbon-cycle model benchmarking activity for models being used for the Inter-governmental Panel on Climate Change (IPCC) Fifth Assessment Report. More information about C-LAMP, the experimental protocol, performance metrics, output standards, and model-data comparisons from the CLM3-CASA and CLM3-CN models are available at http://www.climatemodeling.org/c-lamp.« less

Report on the Third Workshop on Sustainable Software for Science: Practice and Experiences (WSSSPE3)

NASA Astrophysics Data System (ADS)

Katz, Daniel S.; Choi, Sou-Cheng T.; Niemeyer, Kyle E.; Hetherington, James; Löffler, Frank; Gunter, Dan; Idaszak, Ray; Brandt, Steven R.; Miller, Mark A.; Gesing, Sandra; Jones, Nick D.; Weber, Nic; Marru, Suresh; Allen, Gabrielle; Penzenstadler, Birgit; Venters, Colin C.; Davis, Ethan; Hwang, Lorraine; Todorov, Ilian; Patra, Abani; de Val-Borro, Miguel

2016-02-01

This report records and discusses the Third Workshop on Sustainable Software for Science: Practice and Experiences (WSSSPE3). The report includes a description of the keynote presentation of the workshop, which served as an overview of sustainable scientific software. It also summarizes a set of lightning talks in which speakers highlighted to-the-point lessons and challenges pertaining to sustaining scientific software. The final and main contribution of the report is a summary of the discussions, future steps, and future organization for a set of self-organized working groups on topics including developing pathways to funding scientific software; constructing useful common metrics for crediting software stakeholders; identifying principles for sustainable software engineering design; reaching out to research software organizations around the world; and building communities for software sustainability. For each group, we include a point of contact and a landing page that can be used by those who want to join that group's future activities. The main challenge left by the workshop is to see if the groups will execute these activities that they have scheduled, and how the WSSSPE community can encourage this to happen.

Promoting interprofessional learning with medical students in home care settings.

PubMed

Solomon, Patricia; Risdon, Cathy

2011-01-01

The home care setting is ideal for medical students to learn about the importance of interprofessional collaboration in the community. This project examined the impact of a unique program designed to facilitate medical students' knowledge and awareness of the challenges of interprofessional care in the home. In pairs, medical students participated in two community visits with preceptors from different professions. Students completed a structured personal reflection after their first visit. Students and preceptors participated in focus groups or interviews to identify strengths and challenges of the experiences. The structured reflections and the focus group and interview transcripts were analyzed qualitatively. 164 medical students and 36 preceptors participated in 326 visits. There were high ratings of satisfaction from students and preceptors. Students developed unexpected insights into peoples' lives, developed a greater understanding of the patient's perspective and determinants of health, learned about others' scope of practice, and developed an appreciation of the limitations of their own scope of practice. Preceptors had high expectations for student performance and engagement and enjoyed the opportunity to impart their knowledge to future physicians. Although organizationally complex, the program evaluation suggestions that students and preceptors benefit from interprofessional experiences in the home.

General practice recruitment for people at risk of schizophrenia: the Buckingham experience.

PubMed

Falloon, I R

2000-11-01

The process of detecting people at high risk of schizophrenia from a community sample is a major challenge for prevention of psychotic disorders. The aim of this paper is to describe early detection procedures that can be implemented in primary care settings. A selected literature review is supplemented by experiences and data obtained during the Buckingham Integrated Mental Health Care Project. General medical practitioners have been favoured as the agents most likely to prove helpful in detecting the key risk factors that predict the onset of schizophrenic disorders, as well as in recognising the earliest signs and symptoms of these conditions. However, the practical problems of screening for multiple and subtle risk factors in general practice are substantial, and general practitioners (GPs) often have difficulty recognising the earliest signs of a psychotic episode. A range of strategies to assist GPs detect early signs of psychosis in their patients are considered. It is feasible to implement primary care setting early detection procedures for people at risk of schizophrenia. Implementation is aided by the use of a brief screening questionnaire, training sessions and case supervision; and increased collaboration with mental health services and other community agencies.

“Violence. Enough already”: findings from a global participatory survey among women living with HIV

PubMed Central

Orza, Luisa; Bewley, Susan; Chung, Cecilia; Crone, E Tyler; Nagadya, Hajjarah; Vazquez, Marijo; Welbourn, Alice

2015-01-01

Introduction Women living with HIV are vulnerable to gender-based violence (GBV) before and after diagnosis, in multiple settings. This study's aim was to explore how GBV is experienced by women living with HIV, how this affects women's sexual and reproductive health (SRH) and human rights (HR), and the implications for policymakers. Methods A community-based, participatory, user-led, mixed-methods study was conducted, with women living with HIV from key affected populations. Simple descriptive frequencies were used for quantitative data. Thematic coding of open qualitative responses was performed and validated with key respondents. Results In total, 945 women living with HIV from 94 countries participated in the study. Eighty-nine percent of 480 respondents to an optional section on GBV reported having experienced or feared violence, either before, since and/or because of their HIV diagnosis. GBV reporting was higher after HIV diagnosis (intimate partner, family/neighbours, community and health settings). Women described a complex and iterative relationship between GBV and HIV occurring throughout their lives, including breaches of confidentiality and lack of SRH choice in healthcare settings, forced/coerced treatments, HR abuses, moralistic and judgemental attitudes (including towards women from key populations), and fear of losing child custody. Respondents recommended healthcare practitioners and policymakers address stigma and discrimination, training, awareness-raising, and HR abuses in healthcare settings. Conclusions Respondents reported increased GBV with partners and in families, communities and healthcare settings after their HIV diagnosis and across the life-cycle. Measures of GBV must be sought and monitored, particularly within healthcare settings that should be safe. Respondents offered policymakers a comprehensive range of recommendations to achieve their SRH and HR goals. Global guidance documents and policies are more likely to succeed for the end-users if lived experiences are used. PMID:26643458

"Violence. Enough already": findings from a global participatory survey among women living with HIV.

PubMed

Orza, Luisa; Bewley, Susan; Chung, Cecilia; Crone, E Tyler; Nagadya, Hajjarah; Vazquez, Marijo; Welbourn, Alice

2015-01-01

Women living with HIV are vulnerable to gender-based violence (GBV) before and after diagnosis, in multiple settings. This study's aim was to explore how GBV is experienced by women living with HIV, how this affects women's sexual and reproductive health (SRH) and human rights (HR), and the implications for policymakers. A community-based, participatory, user-led, mixed-methods study was conducted, with women living with HIV from key affected populations. Simple descriptive frequencies were used for quantitative data. Thematic coding of open qualitative responses was performed and validated with key respondents. In total, 945 women living with HIV from 94 countries participated in the study. Eighty-nine percent of 480 respondents to an optional section on GBV reported having experienced or feared violence, either before, since and/or because of their HIV diagnosis. GBV reporting was higher after HIV diagnosis (intimate partner, family/neighbours, community and health settings). Women described a complex and iterative relationship between GBV and HIV occurring throughout their lives, including breaches of confidentiality and lack of SRH choice in healthcare settings, forced/coerced treatments, HR abuses, moralistic and judgemental attitudes (including towards women from key populations), and fear of losing child custody. Respondents recommended healthcare practitioners and policymakers address stigma and discrimination, training, awareness-raising, and HR abuses in healthcare settings. Respondents reported increased GBV with partners and in families, communities and healthcare settings after their HIV diagnosis and across the life-cycle. Measures of GBV must be sought and monitored, particularly within healthcare settings that should be safe. Respondents offered policymakers a comprehensive range of recommendations to achieve their SRH and HR goals. Global guidance documents and policies are more likely to succeed for the end-users if lived experiences are used.

Faith-based organizing for youth: one organization's district campaign for small schools policy.

PubMed

Snyder, Ron

2008-01-01

Oakland Community Organizations (OCO) has worked for over ten years to improve educational opportunities in low-income neighborhoods in Oakland, California. The work of thousands of parent, teacher, youth, and community leaders has resulted in the formation of nearly fifty new small schools and more than ten charters, creating settings for individualized learning environments and the opportunity for quality choices for many of Oakland's low-income families. In this article, OCO's executive director, Ron Snyder, outlines a four-phase organizing process undertaken by OCO, based on a set of organizing principles that have sustained community-led education reform despite constant changes in the political and school district environment: the centrality of love (self-interest) as a motivator for advocacy; the importance of quality research and powerful ideas (vision) as alternatives to the status quo; application of a model that creates a common structure, language, and experience to sustain leaders; the need for institutional and network power to apply leverage; the flexibility to seize opportunity when the window is open; and faithfulness to the object of our love: our children.

Reverse engineering a social agent-based hidden markov model--visage.

PubMed

Chen, Hung-Ching Justin; Goldberg, Mark; Magdon-Ismail, Malik; Wallace, William A

2008-12-01

We present a machine learning approach to discover the agent dynamics that drives the evolution of the social groups in a community. We set up the problem by introducing an agent-based hidden Markov model for the agent dynamics: an agent's actions are determined by micro-laws. Nonetheless, We learn the agent dynamics from the observed communications without knowing state transitions. Our approach is to identify the appropriate micro-laws corresponding to an identification of the appropriate parameters in the model. The model identification problem is then formulated as a mixed optimization problem. To solve the problem, we develop a multistage learning process for determining the group structure, the group evolution, and the micro-laws of a community based on the observed set of communications among actors, without knowing the semantic contents. Finally, to test the quality of our approximations and the feasibility of the approach, we present the results of extensive experiments on synthetic data as well as the results on real communities, such as Enron email and Movie newsgroups. Insight into agent dynamics helps us understand the driving forces behind social evolution.

The administration of rescue medication to children with prolonged acute convulsive seizures in the community: what happens in practice?

PubMed

Wait, Suzanne; Lagae, Lieven; Arzimanoglou, Alexis; Beghi, Ettore; Bennett, Christine; Cross, J Helen; Mifsud, Janet; Schmidt, Dieter; Harvey, Gordon

2013-01-01

This paper presents the findings of a review of existing clinical and non-clinical guidance on the management of children with prolonged acute convulsive seizures (PCS) and the administration of rescue medication in community settings. Findings are based on desk- and web-based research in 6 countries. Published clinical guidelines are mostly limited to the hospital setting and offer few explicit recommendations for community settings. Non-clinical guidance on the management of medicines at school exists at the national or regional level in all 6 countries, however rescue epilepsy medication is often not mentioned specifically. Existing legal frameworks are vague and open to interpretation. As a result, whether a child receives rescue medication at school depends primarily on the availability of a willing teacher who accepts responsibility for administering it to that child during school hours. Comprehensive guidelines are clearly needed that provide practical guidance to ensure that children with PCS are treated as quickly as possible in all community settings. Recommendations for future action include: providing clearer information on PCS and rescue medication to parents and schools; putting in place an individual healthcare plan for every child with a history of PCS at his or her school; collecting more empirical data to gain a better understanding of the experience of children with PCS at school, their parents and teachers; and finally, implementing systematic training for all carers of children with PCS. The epilepsy specialist may play an important role in ensuring that these recommendations are put into place for their patients. Copyright © 2012 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Reprint: Good laboratory practice: preventing introduction of bias at the bench

PubMed Central

Macleod, Malcolm R; Fisher, Marc; O’Collins, Victoria; Sena, Emily S; Dirnagl, Ulrich; Bath, Philip MW; Buchan, Alistair; van der Worp, H Bart; Traystman, Richard J; Minematsu, Kazuo; Donnan, Geoffrey A; Howells, David W

2009-01-01

As a research community, we have failed to show that drugs, which show substantial efficacy in animal models of cerebral ischemia, can also improve outcome in human stroke. Accumulating evidence suggests this may be due, at least in part, to problems in the design, conduct, and reporting of animal experiments which create a systematic bias resulting in the overstatement of neuroprotective efficacy. Here, we set out a series of measures to reduce bias in the design, conduct and reporting of animal experiments modeling human stroke. PMID:18797473

Detailed Results from the Flame Extinguishment Experiment (FLEX) March 2009 to December 2011

NASA Technical Reports Server (NTRS)

Dietrich, Daniel L.; Ferkul, Paul V.; Bryg, Victoria M.; Nayagam, M. Vedha; Hicks, Michael C.; Williams, Forman A.; Dryer, Frederick L.; Shaw, Benjamin D.; Choi, Mun Y.; Avedisian, C. Thomas

2015-01-01

The Flame Extinguishment Experiment (FLEX) program is a continuing set of experiments on droplet combustion, performed employing the Multi-User Droplet Combustion Apparatus (MDCA), inside the chamber of the Combustion Integrated Rack (CIR), which is located in the Destiny module of the International Space Station (ISS). This report describes the experimental hardware, the diagnostic equipment, the experimental procedures, and the methods of data analysis for FLEX. It also presents the results of the first 284 tests performed. The intent is not to interpret the experimental results but rather to make them available to the entire scientific community for possible future interpretations.

Perceptions of the care received from Australian palliative care services: A caregiver perspective.

PubMed

Pidgeon, Tanya M; Johnson, Claire E; Lester, Leanne; Currow, David; Yates, Patsy; Allingham, Samuel F; Bird, Sonia; Eagar, Kathy

2018-04-01

ABSTRACTBackground:Caregiver satisfaction and experience surveys help health professionals to understand, measure, and improve the quality of care provided for patients and their families. Our aim was to explore caregiver perceptions of the care received from Australian specialist palliative care services. Caregivers of patients receiving palliative care in services registered with Australia's Palliative Care Outcomes Collaboration were invited to participate in a caregiver survey. The survey included the FAMCARE-2 and four items from the Ongoing Needs Identification: Caregiver Profile questionnaire. Surveys were completed by 1,592 caregivers from 49 services. Most respondents reported high satisfaction and positive experiences. Caregivers receiving care from community-based palliative care teams were less satisfied with the management of physical symptoms and comfort (odds ratio [OR] = 0.29; 95% confidence interval [CI95%] = 0.14, 0.59), with patient psychological care (OR = 0.56; CI95% = 0.32, 0.98), and with family support (OR = 0.52; CI95% = 0.35, 0.77) than caregivers of patients in an inpatient setting. If aged over 60 years, caregivers were less likely to have their information needs met regarding available support services (OR = 0.98; CI95% = 0.97, 0.98) and carer payments (OR = 0.99; CI95% = 0.98, 1.00). Also, caregivers were less likely to receive adequate information about carer payments if located in an outer regional area (OR = 0.41; CI95% = 0.25, 0.64). With practical training, caregivers receiving care from community services reported inadequate information provision to support them in caring for patients (OR = 0.60; CI95% = 0.45, 0.81). While our study identified caregivers as having positive and satisfactory experiences across all domains of care, there is room for improvement in the delivery of palliative care across symptom management, as well as patient and caregiver support, especially in community settings. Caregiver surveys can facilitate the identification and evaluation of both patients' and caregivers' experiences, satisfaction, distress, and unmet needs.

Central On-Line Data Directory

NASA Technical Reports Server (NTRS)

Thieman, J.

1986-01-01

The National Space Science Data Center (NSSDC) Central On-Line Data Directory (CODD), which allows the general scientist remote access to information about data sets available not only at NSSDC, but throughout the scientific community, is discussed. A user may search for data set information within CODD by specifying spacecraft name, experiment name, investigator name, and/or keywords. CODD will include information on atmospheric science data sets contained not only within the PCDS, but also within other data sets that are deemed important. Keywords to be used in locating these data sets are currently being formulated. The main type of keyword to be used for categorization of data sets will be discipline related. The primary discipline keyword for PCDS-type data sets would be ATMOSPHERIC SCIENCE. A good set of subdiscipline keywords is needed under this discipline to subdivide the data sets. A sheet containing a strawman set of subdiscipline keywords was distributed, and a request was made for the knowledgeable scientists to modify or replace the proposed keywords.

Conceptualisation of knowledge construction in community service-learning programmes in nursing education.

PubMed

Mthembu, Sindi Z; Mtshali, Fikile G

2013-01-01

Practices in higher education have been criticised for not developing and preparing students for the expertise required in real environments. Literature reports that educational programmes tend to favour knowledge conformation rather than knowledge construction; however, community service learning (CSL) is a powerful pedagogical strategy that encourages students to make meaningful connections between the content in the classroom and real-life experiences as manifested by the communities. Through CSL, learning is achieved by the active construction of knowledge supported by multiple perspectives within meaningful real contexts, and the social interactions amongst students are seen to play a critical role in the processes of learning and cognition. This article reflects facilitators’ perspective of the knowledge construction process as used with students doing community service learning in basic nursing programmes. The aim of this article was to conceptualise the phenomenon of knowledge construction and thereby provide educators with a shared meaning and common understanding, and to analyse the interaction strategies utilised by nurse educators in the process of knowledge construction in community service-learning programmes in basic nursing education. A qualitative research approach based on a grounded theory research design was used in this article. Two nursing education institutions were purposively selected. Structured interviews were conducted with 16 participants. The results revealed that the knowledge construction in community service-learning programmes is conceptualised as having specific determinants, including the use of authentic health-related problems, academic coaching through scaffolding, academic discourse-dialogue, interactive learning in communities of learners, active learning, continuous reflection as well as collaborative and inquiry-based learning. Upon completion of an experience, students create and test generated knowledge in different contextual health settings. It was concluded that knowledge is constructed by students as a result of their interaction with the communities in their socio-cultural context and is mediated by their prior concrete experiences. The implication of this is that students construct knowledge that can be applied in their future work places.

Quasi-experiments to establish causal effects of HIV care and treatment and to improve the cascade of care

PubMed Central

Bor, Jacob; Geldsetzer, Pascal; Venkataramani, Atheendar; Bärnighausen, Till

2015-01-01

Purpose of review Randomized, population-representative trials of clinical interventions are rare. Quasi-experiments have been used successfully to generate causal evidence on the cascade of HIV care in a broad range of real-world settings. Recent findings Quasi-experiments exploit exogenous, or quasi-random, variation occurring naturally in the world or because of an administrative rule or policy change to estimate causal effects. Well designed quasi-experiments have greater internal validity than typical observational research designs. At the same time, quasi-experiments may also have potential for greater external validity than experiments and can be implemented when randomized clinical trials are infeasible or unethical. Quasi-experimental studies have established the causal effects of HIV testing and initiation of antiretroviral therapy on health, economic outcomes and sexual behaviors, as well as indirect effects on other community members. Recent quasi-experiments have evaluated specific interventions to improve patient performance in the cascade of care, providing causal evidence to optimize clinical management of HIV. Summary Quasi-experiments have generated important data on the real-world impacts of HIV testing and treatment and on interventions to improve the cascade of care. With the growth in large-scale clinical and administrative data, quasi-experiments enable rigorous evaluation of policies implemented in real-world settings. PMID:26371463

Quasi-experiments to establish causal effects of HIV care and treatment and to improve the cascade of care.

PubMed

Bor, Jacob; Geldsetzer, Pascal; Venkataramani, Atheendar; Bärnighausen, Till

2015-11-01

Randomized, population-representative trials of clinical interventions are rare. Quasi-experiments have been used successfully to generate causal evidence on the cascade of HIV care in a broad range of real-world settings. Quasi-experiments exploit exogenous, or quasi-random, variation occurring naturally in the world or because of an administrative rule or policy change to estimate causal effects. Well designed quasi-experiments have greater internal validity than typical observational research designs. At the same time, quasi-experiments may also have potential for greater external validity than experiments and can be implemented when randomized clinical trials are infeasible or unethical. Quasi-experimental studies have established the causal effects of HIV testing and initiation of antiretroviral therapy on health, economic outcomes and sexual behaviors, as well as indirect effects on other community members. Recent quasi-experiments have evaluated specific interventions to improve patient performance in the cascade of care, providing causal evidence to optimize clinical management of HIV. Quasi-experiments have generated important data on the real-world impacts of HIV testing and treatment and on interventions to improve the cascade of care. With the growth in large-scale clinical and administrative data, quasi-experiments enable rigorous evaluation of policies implemented in real-world settings.

Completeness of breast cancer operative reports in a community care setting.

PubMed

Eng, Jordan Lang; Baliski, Christopher Ronald; McGahan, Colleen; Cai, Eric

2017-10-01

The narrative operative report represents the traditional means by which breast cancer surgery has been documented. Previous work has established that omissions occur in narrative operative reports produced in an academic setting. The goal of this study was to determine the completeness of breast cancer narrative operative reports produced in a community care setting and to explore the effect of a surgeon's case volume and years in practice on the completeness of these reports. A standardized retrospective review of operative reports produced over a consecutive 2 year period was performed using a set of procedure-specific elements identified through a review of the relevant literature and work done locally. 772 operative reports were reviewed. 45% of all elements were completely documented. A small positive trend was observed between case volume and completeness while a small negative trend was observed between years in practice and completeness. The dictated narrative report inadequately documents breast cancer surgery irrespective of the recording surgeon's volume or experience. An intervention, such as the implementation of synoptic reporting, should be considered in an effort to maximize the utility of the breast cancer operative report. Copyright © 2017. Published by Elsevier Ltd.

Addressing excess risk of overdose among recently incarcerated people in the USA: harm reduction interventions in correctional settings.

PubMed

Brinkley-Rubinstein, Lauren; Cloud, David H; Davis, Chelsea; Zaller, Nickolas; Delany-Brumsey, Ayesha; Pope, Leah; Martino, Sarah; Bouvier, Benjamin; Rich, Josiah

2017-03-13

Purpose The purpose of this paper is to discuss overdose among those with criminal justice experience and recommend harm reduction strategies to lessen overdose risk among this vulnerable population. Design/methodology/approach Strategies are needed to reduce overdose deaths among those with recent incarceration. Jails and prisons are at the epicenter of the opioid epidemic but are a largely untapped setting for implementing overdose education, risk assessment, medication assisted treatment, and naloxone distribution programs. Federal, state, and local plans commonly lack corrections as an ingredient in combating overdose. Harm reduction strategies are vital for reducing the risk of overdose in the post-release community. Findings Therefore, the authors recommend that the following be implemented in correctional settings: expansion of overdose education and naloxone programs; establishment of comprehensive medication assisted treatment programs as standard of care; development of corrections-specific overdose risk assessment tools; and increased collaboration between corrections entities and community-based organizations. Originality/value In this policy brief the authors provide recommendations for implementing harm reduction approaches in criminal justice settings. Adoption of these strategies could reduce the number of overdoses among those with recent criminal justice involvement.

Plant defense compounds: systems approaches to metabolic analysis.

PubMed

Kliebenstein, Daniel J

2012-01-01

Systems biology attempts to answer biological questions by integrating across diverse genomic data sets. With the increasing ability to conduct genomics experiments, this integrative approach is being rapidly applied across numerous biological research communities. One of these research communities investigates how plants utilize secondary metabolites or defense metabolites to defend against attack by pathogens and other biotic organisms. This use of systems biology to integrate across transcriptomics, metabolomics, and genomics is significantly enhancing the rate of discovery of genes, metabolites, and bioactivities for plant defense compounds as well as extending our knowledge of how these compounds are regulated. Plant defense compounds are also providing a unique proving platform to develop new approaches that enhance the ability to conduct systems biology with existing and previously unforseen genomics data sets. This review attempts to illustrate both how systems biology is helping the study of plant defense compounds and vice versa.

LWS/SET Technology Experiment Carrier

NASA Technical Reports Server (NTRS)

Sherman, Barry; Giffin, Geoff

2002-01-01

This paper examines the approach taken to building a low-cost, modular spacecraft bus that can be used to support a variety of technology experiments in different space environments. It describes the techniques used and design drivers considered to ensure experiment independence from as yet selected host spacecraft. It describes the technology experiment carriers that will support NASA's Living With a Star Space Environment Testbed space missions. NASA has initiated the Living With a Star (LWS) Program to develop a better scientific understanding to address the aspects of the connected Sun-Earth system that affect life and society. A principal goal of the program is to bridge the gap between science, engineering, and user application communities. The Space Environment Testbed (SET) Project is one element of LWS. The Project will enable future science, operational, and commercial objectives in space and atmospheric environments by improving engineering approaches to the accommodation and/or mitigation of the effects of solar variability on technological systems. The SET Project is highly budget constrained and must seek to take advantage of as yet undetermined partnering opportunities for access to space. SET will conduct technology validation experiments hosted on available flight opportunities. The SET Testbeds will be developed in a manner that minimizes the requirements for accommodation, and will be flown as flight opportunities become available. To access the widest range of flight opportunities, two key development requirements are to maintain flexibility with respect to accommodation constraints and to have the capability to respond quickly to flight opportunities. Experiments, already developed to the technology readiness level of needing flight validation in the variable Sun-Earth environment, will be selected on the basis of the need for the subject technology, readiness for flight, need for flight resources and particular orbit. Experiments will be accumulated by the Project and manifested for specific flight opportunities as they become available. The SET Carrier is designed to present a standard set of interfaces to SET technology experiments and to be modular and flexible enough to interface to a variety of possible host spacecraft. The Carrier will have core components and mission unique components. Once the core carrier elements have been developed, only the mission unique components need to be defined and developed for any particular mission. This approach will minimize the mission specific cost and development schedule for a given flight opportunity. The standard set of interfaces provided by SET to experiments allows them to be developed independent of the particulars of a host spacecraft. The Carrier will provide the power, communication, and the necessary monitoring features to operate experiments. The Carrier will also provide all of the mechanical assemblies and harnesses required to adapt experiments to a particular host. Experiments may be hosted locally with the Carrier or remotely on the host spacecraft. The Carrier design will allow a single Carrier to support a variable number of experiments and will include features that support the ability to incrementally add experiments without disturbing the core architecture.

Comparison of community and hospital pharmacists' attitudes and behaviors on medication error disclosure to the patient: A pilot study.

PubMed

Kim, ChungYun; Mazan, Jennifer L; Quiñones-Boex, Ana C

To determine pharmacists' attitudes and behaviors on medication errors and their disclosure and to compare community and hospital pharmacists on such views. An online questionnaire was developed from previous studies on physicians' disclosure of errors. Questionnaire items included demographics, environment, personal experiences, and attitudes on medication errors and the disclosure process. An invitation to participate along with the link to the questionnaire was electronically distributed to members of two Illinois pharmacy associations. A follow-up reminder was sent 4 weeks after the original message. Data were collected for 3 months, and statistical analyses were performed with the use of IBM SPSS version 22.0. The overall response rate was 23.3% (n = 422). The average employed respondent was a 51-year-old white woman with a BS Pharmacy degree working in a hospital pharmacy as a clinical staff member. Regardless of practice settings, pharmacist respondents agreed that medication errors were inevitable and that a disclosure process is necessary. Respondents from community and hospital settings were further analyzed to assess any differences. Community pharmacist respondents were more likely to agree that medication errors were inevitable and that pharmacists should address the patient's emotions when disclosing an error. Community pharmacist respondents were also more likely to agree that the health care professional most closely involved with the error should disclose the error to the patient and thought that it was the pharmacists' responsibility to disclose the error. Hospital pharmacist respondents were more likely to agree that it was important to include all details in a disclosure process and more likely to disagree on putting a "positive spin" on the event. Regardless of practice setting, responding pharmacists generally agreed that errors should be disclosed to patients. There were, however, significant differences in their attitudes and behaviors depending on their particular practice setting. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Understanding the ways in which health visitors manage anxiety in cross-cultural work: a qualitative study.

PubMed

Cuthill, Fiona

2014-10-01

This paper is a report of part of a study that explored the ways in which health visitors manage uncertainty and anxiety when working with clients across cultures. Internationally health care professionals are required to deliver a high standard of culturally appropriate care to increasingly diverse communities and yet problems persist. Research evidence informing cultural 'competence' is focused largely around student experience and consequently little is known about the day-to-day experiences of health professionals in diverse community settings. Anxiety and uncertainty are increasingly recognised as important emotions experienced by a variety of health care professionals when working across cultures and yet the ways in which anxiety and uncertainty is managed in practice is less well understood. Grounded theory methodology was used and 21 semi-structured interviews were conducted with participating health visitors in the North East of England between May 2008 and September 2009. All participants described themselves as white. This study identified three different positions adopted by the health visitors to manage uncertainty and anxiety in their work across cultures. Identified as, 'Fixing a culture', 'Reworking the equality agenda' and 'Asserting the professional self', these strategies identify the ways in which health visitors try to manage the uncertainty and anxiety they feel when working in diverse communities. All of these strategies attempt in different ways to negate cultural difference and to render culture as static and known. Given that health professionals report anxiety and uncertainty when working across diverse community settings, identification of the strategies used by health visitors to manage that anxiety is important for both policy and practice. New strategies need to be developed to help health professionals to manage uncertainty and anxiety in ways that promote both cultural safe care and health equity.

USCT data challenge

NASA Astrophysics Data System (ADS)

Ruiter, Nicole V.; Zapf, Michael; Hopp, Torsten; Gemmeke, Hartmut; van Dongen, Koen W. A.

2017-03-01

In the past years we have perceived within the USCT research community a demand for freely available USCT data sets. Inspired by the idea of Open Science, this collection of data sets could stimulate the collaboration and the exchange of ideas and experiences between USCT researchers. In addition, it may lead to comprehensive comparison of different reconstruction algorithms and their results. Finally, by collecting feedback from the users about data and system architecture, valuable information is gathered for further development of measurement setups. For the above reasons, we have initiated a digital portal with several reference data sets and access scripts under free licenses. To kick off this initiative, we organized a USCT data challenge event at SPIE Medical Imaging 2017.

Treatment of Individuals with Borderline Personality Disorder Using Dialectical Behavior Therapy in a Community Mental Health Setting: Clinical Application and a Preliminary Investigation

ERIC Educational Resources Information Center

Ben-Porath, Denise D.; Peterson, Gregory A.; Smee, Jacqueline

2004-01-01

This article describes an effort to implement and examine dialectical behavior therapy's (DBT) effectiveness in a community mental health setting. Modifications made to address unique aspects of community mental health settings are described. Barriers encountered in implementation of DBT treatment in community mental health settings, such as staff…

Best practice principles for community-based obesity prevention: development, content and application.

PubMed

King, L; Gill, T; Allender, S; Swinburn, B

2011-05-01

Best practice in obesity prevention has generally been defined in terms of 'what' needs to be done while neglecting 'how'. A multifaceted definition of best practice, which combines available evidence on what actions to take, with an established process for interpreting this information in a specific community context, provides a more appropriate basis for defining the principles of best practice in community-based obesity prevention. Based on analysis of a range of literature, a preliminary set of principles was drafted and progressively revised through further analyses of published literature and a series of consultations. The framework for best practice principles comprises: community engagement, programme design and planning, evaluation, implementation and sustainability, and governance. Specific principles were formulated within this framework. While many principles were generic, distinctive features of obesity prevention were also covered. The engagement of end-users influenced the design of the formatting of the outputs, which represent three levels of knowledge transfer: detailed evidence summaries, guiding questions for programme planners and a briefer set of questions for simpler communication purposes. The best practice principles provide a valuable mechanism for the translation of existing evidence and experience into the decision-making processes for planning, implementing and evaluating the complex community-based interventions needed for successful obesity prevention. © 2010 The Authors. obesity reviews © 2010 International Association for the Study of Obesity.

Experiences of mental health nursing staff working with voice hearers in an acute setting: An interpretive phenomenological approach.

PubMed

McMullan, E; Gupta, A; Collins, S C

2018-04-01

WHAT IS KNOWN ON THE SUBJECT?: Community mental health staff and their service users have reported mixed views on the importance of talking about the content of voices. Community staff have reported feeling that they do not have the skills to explore voice content and worry about making things worse. Voice hearers experiencing extreme distress due to the content of their voices can access support through acute inpatient mental health services. No previous studies have focused on the experiences of staff who nurse voice hearers at a time of acute distress. WHAT DOES THIS STUDY ADD TO EXISTING KNOWLEDGE?: MHNs and HSWs working with voice hearers in acute distress report feeling powerless and helpless, as they feel that they cannot lessen the distress experienced by the voice hearer. Despite these difficult feelings, staff report finding ways of coping, including using structured tools to help make sense of their service users' voice-hearing experiences and accessing reflective practice forums. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Due to the current context of increased acuity and limited resources in acute services, there may be a need to further protect time for staff to access reflective practice groups and supervision forums to help them manage the difficult feelings arising from their work with voice hearers. Introduction Mental health nursing (MHN) staff in acute settings work with voice hearers at times of crises when they experience high levels of distress. Previous research has focused on community mental health staff's experiences and their service users views on exploring the content of voices. No studies have explored this from an acute mental health service perspective. Aim This study therefore sought to explore the experiences of staff working with voice hearers in an acute mental health service. Method Due to the exploratory nature of the research, a qualitative design was chosen. Three MHNs and five healthcare support workers (HSWs) were interviewed. The data were analysed using Interpretative Phenomenological Analysis. Results A group analysis elicited three master themes: "It's quite scary really, not unlike a horror movie;" "I can only influence what's in front of me;" and "Just chipping away". Discussion Staff working with voice hearers in acute settings experience feelings of powerlessness and helplessness, as they feel unable to reduce the distress experienced by voice hearers in their care. Staff employ coping strategies to help manage these difficult feelings, including using structured tools in their work with voice hearers and attending reflective practice forums. Implications for Practice Acute mental health services may need to protect time for staff to access regular reflective practice and other supervision forums to help manage their feelings of powerlessness and helplessness arising from their work with voice hearers. © 2017 John Wiley & Sons Ltd.

Decadal climate prediction in the large ensemble limit

NASA Astrophysics Data System (ADS)

Yeager, S. G.; Rosenbloom, N. A.; Strand, G.; Lindsay, K. T.; Danabasoglu, G.; Karspeck, A. R.; Bates, S. C.; Meehl, G. A.

2017-12-01

In order to quantify the benefits of initialization for climate prediction on decadal timescales, two parallel sets of historical simulations are required: one "initialized" ensemble that incorporates observations of past climate states and one "uninitialized" ensemble whose internal climate variations evolve freely and without synchronicity. In the large ensemble limit, ensemble averaging isolates potentially predictable forced and internal variance components in the "initialized" set, but only the forced variance remains after averaging the "uninitialized" set. The ensemble size needed to achieve this variance decomposition, and to robustly distinguish initialized from uninitialized decadal predictions, remains poorly constrained. We examine a large ensemble (LE) of initialized decadal prediction (DP) experiments carried out using the Community Earth System Model (CESM). This 40-member CESM-DP-LE set of experiments represents the "initialized" complement to the CESM large ensemble of 20th century runs (CESM-LE) documented in Kay et al. (2015). Both simulation sets share the same model configuration, historical radiative forcings, and large ensemble sizes. The twin experiments afford an unprecedented opportunity to explore the sensitivity of DP skill assessment, and in particular the skill enhancement associated with initialization, to ensemble size. This talk will highlight the benefits of a large ensemble size for initialized predictions of seasonal climate over land in the Atlantic sector as well as predictions of shifts in the likelihood of climate extremes that have large societal impact.

SigReannot-mart: a query environment for expression microarray probe re-annotations.

PubMed

Moreews, François; Rauffet, Gaelle; Dehais, Patrice; Klopp, Christophe

2011-01-01

Expression microarrays are commonly used to study transcriptomes. Most of the arrays are now based on oligo-nucleotide probes. Probe design being a tedious task, it often takes place once at the beginning of the project. The oligo set is then used for several years. During this time period, the knowledge gathered by the community on the genome and the transcriptome increases and gets more precise. Therefore re-annotating the set is essential to supply the biologists with up-to-date annotations. SigReannot-mart is a query environment populated with regularly updated annotations for different oligo sets. It stores the results of the SigReannot pipeline that has mainly been used on farm and aquaculture species. It permits easy extraction in different formats using filters. It is used to compare probe sets on different criteria, to choose the set for a given experiment to mix probe sets in order to create a new one.

The Geoengineering Model Intercomparison Project Phase 6 (GeoMIP6): Simulation design and preliminary results

DOE PAGES

Kravitz, Benjamin S.; Robock, Alan; Tilmes, S.; ...

2015-10-27

We present a suite of new climate model experiment designs for the Geoengineering Model Intercomparison Project (GeoMIP). This set of experiments, named GeoMIP6 (to be consistent with the Coupled Model Intercomparison Project Phase 6), builds on the previous GeoMIP project simulations, and has been expanded to address several further important topics, including key uncertainties in extreme events, the use of geoengineering as part of a portfolio of responses to climate change, and the relatively new idea of cirrus cloud thinning to allow more long wave radiation to escape to space. We discuss experiment designs, as well as the rationale formore » those designs, showing preliminary results from individual models when available. We also introduce a new feature, called the GeoMIP Testbed, which provides a platform for simulations that will be performed with a few models and subsequently assessed to determine whether the proposed experiment designs will be adopted as core (Tier 1) GeoMIP experiments. In conclusion, this is meant to encourage various stakeholders to propose new targeted experiments that address their key open science questions, with the goal of making GeoMIP more relevant to a broader set of communities.« less

Developing accreditation for community based surgery: the Irish experience.

PubMed

Ní Riain, Ailís; Collins, Claire; O'Sullivan, Tony

2018-02-05

Purpose Carrying out minor surgery procedures in the primary care setting is popular with patients, cost effective and delivers at least as good outcomes as those performed in the hospital setting. This paper aims to describe the central role of clinical leadership in developing an accreditation system for general practitioners (GPs) undertaking community-based surgery in the Irish national setting where no mandatory accreditation process currently exists. Design/methodology/approach In all, 24 GPs were recruited to the GP network. Ten pilot standards were developed addressing GPs' experience and training, clinical activity and practice supporting infrastructure and tested, using information and document review, prospective collection of clinical data and a practice inspection visit. Two additional components were incorporated into the project (patient satisfaction survey and self-audit). A multi-modal evaluation was undertaken. A majority of GPs was included at all stages of the project, in line with the principles of action learning. The steering group had a majority of GPs with relevant expertise and representation of all other actors in the minor surgery arena. The GP research network contributed to each stage of the project. The project lead was a GP with minor surgery experience. Quantitative data collected were analysed using Predictive Analytic SoftWare. Krueger's framework analysis approach was used to analyse the qualitative data. Findings A total of 9 GPs achieved all standards at initial review, 14 successfully completed corrective actions and 1 GP did not achieve the required standard. Standards were then amended to reflect findings and a supporting framework was developed. Originality/value The flexibility of the action-learning approach and the clinical leadership design allowed for the development of robust quality standards in a short timeframe.

Improvement of the SEP protocol based on community structure of node degree

NASA Astrophysics Data System (ADS)

Li, Donglin; Wei, Suyuan

2017-05-01

Analyzing the Stable election protocol (SEP) in wireless sensor networks and aiming at the problem of inhomogeneous cluster-heads distribution and unreasonable cluster-heads selectivity and single hop transmission in the SEP, a SEP Protocol based on community structure of node degree (SEP-CSND) is proposed. In this algorithm, network node deployed by using grid deployment model, and the connection between nodes established by setting up the communication threshold. The community structure constructed by node degree, then cluster head is elected in the community structure. On the basis of SEP, the node's residual energy and node degree is added in cluster-heads election. The information is transmitted with mode of multiple hops between network nodes. The simulation experiments showed that compared to the classical LEACH and SEP, this algorithm balances the energy consumption of the entire network and significantly prolongs network lifetime.

Online Community Detection for Large Complex Networks

PubMed Central

Pan, Gang; Zhang, Wangsheng; Wu, Zhaohui; Li, Shijian

2014-01-01

Complex networks describe a wide range of systems in nature and society. To understand complex networks, it is crucial to investigate their community structure. In this paper, we develop an online community detection algorithm with linear time complexity for large complex networks. Our algorithm processes a network edge by edge in the order that the network is fed to the algorithm. If a new edge is added, it just updates the existing community structure in constant time, and does not need to re-compute the whole network. Therefore, it can efficiently process large networks in real time. Our algorithm optimizes expected modularity instead of modularity at each step to avoid poor performance. The experiments are carried out using 11 public data sets, and are measured by two criteria, modularity and NMI (Normalized Mutual Information). The results show that our algorithm's running time is less than the commonly used Louvain algorithm while it gives competitive performance. PMID:25061683

[Health promotion based on assets: how to work with this perspective in local interventions?

PubMed

Cofiño, Rafael; Aviñó, Dory; Benedé, Carmen Belén; Botello, Blanca; Cubillo, Jara; Morgan, Antony; Paredes-Carbonell, Joan Josep; Hernán, Mariano

2016-11-01

An asset-based approach could be useful to revitalise health promotion or community health interventions combining work with multiple partnerships, positive health, community engagement, equity and orientation of health determinants. We set some recommendations about how to incorporate the assets model in programmes, projects and interventions in health promotion. Some techniques are described for assets mapping and some experiences with this methodology being developed in different regions are systematised. We propose the term "Asset-based Health Promotion/Community Health" as an operational definition to work at the local level with a community engagement and participatory approach, building alliances between different institutions at the state-regional level and trying to create a framework for action with the generation of evaluations and evidence to work on population interventions from the perspective of positive health. Copyright © 2016 SESPAS. All rights reserved.

Residency exposures and anticipated future involvement in community settings.

PubMed

Goldshore, Matthew A; Solomon, Barry S; Downs, Stephen M; Pan, Richard; Minkovitz, Cynthia S

2014-01-01

To assess how exposures to community activities in residency impact anticipated future involvement in community child health settings. Prospective cohort study of pediatric residents from 10 programs (12 sites) who completed training between 2003 and 2009. Residents reported annual participation for ≥ 8 days in each of 7 community activities (eg, community settings, child health advocacy) in the prior year. At the start and end of residency, residents reported anticipated involvement in 10 years in 8 community settings (eg, school, shelter). Anticipated involvement was dichotomized: moderate/substantial ("high") versus none/limited ("low"). Logistic regression modeled whether residency exposures independently influenced anticipated future involvement at the end of residency. A total of 683 residents completed surveys at the start and end of residency (66.8% participation). More than half of trainees reported ≥ 8 days' of involvement in community settings (65.6%) or child health advocacy (53.6%) in residency. Fewer anticipated high involvement in at least 1 community setting at the end of residency than at the start (65.5% vs 85.6%, P < .001). Participation in each community activity mediated but did not moderate relations between anticipated involvement at the start and end of residency. In multivariate models, exposure to community settings in residency was associated with anticipated involvement at end of residency (adjusted odds ratio 1.5; 95% confidence interval 1.2, 2.0). No other residency exposures were associated. Residents who anticipate high involvement in community pediatrics at the start of residency participate in related opportunities in training. Exposure to community settings during residency may encourage community involvement after training. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Junior doctor psychiatry placements in hospital and community settings: a phenomenological study.

PubMed

Beattie, Sharon; Crampton, Paul E S; Schwarzlose, Cathleen; Kumar, Namita; Cornwall, Peter L

2017-09-27

The proportion of junior doctors required to complete psychiatry placements in the UK has increased, due in part to vacant training posts and psychiatry career workforce shortages, as can be seen across the world. The aim of this study was to understand the lived experience of a Foundation Year 1 junior doctor psychiatry placement and to understand how job components influence attitudes. The study was conducted using a cross-sectional qualitative phenomenological approach. Hospital and community psychiatry department settings in the North East of England, UK. In total, 14 Foundation Year 1 junior doctors were interviewed including seven men and seven women aged between 23 and 34 years. The majority had completed their medical degree in the UK and were White British. The lived experience of a junior doctor psychiatry placement was understood by three core themes: exposure to patient recovery, connectedness with others in the healthcare team and subjective interpretations of psychiatry. The experiences were moderated by instances of role definition, reaction to the specialty and the organisational fit of the junior doctor capacity in the specialty. The study reinforces and adds to the literature by identifying connectedness as being important for both job satisfaction and morale, which is currently damaged within the junior doctor population. The study provides in-depth insights into the lived experience of psychiatry placements and can be taken forward by educationalists to ensure the placements are meaningful experiences for junior doctors by developing role definition, belonging, structure and psychiatric care responsibility. © 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.

Development of a screening tool to identify female survivors of gender-based violence in a humanitarian setting: qualitative evidence from research among refugees in Ethiopia

PubMed Central

2013-01-01

Background High levels of gender-based violence (GBV) persist among conflict-affected populations and within humanitarian settings and are paralleled by under-reporting and low service utilization. Novel and evidence-based approaches are necessary to change the current state of GBV amongst these populations. We present the findings of qualitative research, which were used to inform the development of a screening tool as one potential strategy to identify and respond to GBV for females in humanitarian settings. Methods Qualitative research methods were conducted from January-February 2011 to explore the range of experiences of GBV and barriers to reporting GBV among female refugees. Individual interview participants (n=37) included female refugees (≥15 years), who were survivors of GBV, living in urban or one of three camps settings in Ethiopia, and originating from six conflict countries. Focus group discussion participants (11 groups; 77 participants) included health, protection and community service staff working in the urban or camp settings. Interviews and discussions were conducted in the language of preference, with assistance by interpreters when needed, and transcribed for analysis by grounded-theory technique. Results Single and multiple counts of GBV were reported and ranged from psychological and social violence; rape, gang rape, sexual coercion, and other sexual violence; abduction; and physical violence. Domestic violence was predominantly reported to occur when participants were living in the host country. Opportunistic violence, often manifested by rape, occurred during transit when women depended on others to reach their destination. Abduction within the host country, and often across borders, highlighted the constant state of vulnerability of refugees. Barriers to reporting included perceived and experienced stigma in health settings and in the wider community, lack of awareness of services, and inability to protect children while mothers sought services. Conclusions Findings demonstrate that GBV persists across the span of the refugee experience, though there is a transition in the range of perpetrators and types of GBV that are experienced. Further, survivors experience significant individual and system barriers to disclosure and service utilization. The findings suggest that routine GBV screening by skilled service providers offers a strategy to confidentially identify and refer survivors to needed services within refugee settings, potentially enabling survivors to overcome existing barriers. PMID:23758886

“Because we all trust and care about each other”: Exploring Tensions Translating a Theater-based HIV Prevention Intervention into a New Context

PubMed Central

Mouw, Mary Sherwyn; Taboada, Arianna; Steinert, Scarlett; Willis, Stephanie; Lightfoot, Alexandra F.

2016-01-01

Background A theater-based HIV prevention intervention developed in urban California was piloted with a new partnership in North Carolina. Objectives To describe the experience of translating a complex program with an enhanced partnership approach; barriers and facilitators of implementation in the new setting; and challenges and benefits of interdisciplinary, collaborative interventions. Methods We gathered perspectives of local stakeholders involved in program implementation through process evaluation interviews and focus groups with undergraduates, a college instructor, school district administrators, and high school teachers. Results Implementing the intervention in a new setting proved feasible and successful; however, mistaken assumptions and unrecognized similarities about teaching priorities, philosophies, and values produced latent tensions amongst stakeholder groups, and were a limiting factor in partnership functioning. Conclusions Implementing a cross-disciplinary intervention in a new setting is best achieved through a local community-engaged process, with active involvement of relevant stakeholders. We suggest strategies to strengthen community partnerships cooperating in implementation of complex, context-tailored interventions. PMID:27346770

Breast cancer navigation and patient satisfaction: exploring a community-based patient navigation model in a rural setting.

PubMed

Hook, Ann; Ware, Laurie; Siler, Bobbie; Packard, Abbot

2012-07-01

To explore patient satisfaction among newly diagnosed patients with breast cancer in a rural community setting using a nurse navigation model. Nonexperimental, descriptive study. Large, multispecialty physician outpatient clinic serving about 150 newly diagnosed patients with breast cancer annually at the time of the study. 103 patients using nurse navigation services during a two-year period. A researcher-developed 14-item survey tool using a Likert-type scale was mailed to about 300 navigated patients. Nurse navigation and patient satisfaction. The majority of participants (n = 73, 72%) selected "strongly agree" in each survey statement when questioned about the benefits of nurse navigation. Patients receiving nurse navigation for breast cancer are highly satisfied with the services offered in this setting. Findings from this study offer insight regarding the effectiveness of an individualized supportive care approach to nurses and providers of oncology care. That information can be used to guide the implementation of future nurse navigation programs, determine effective methods of guiding patients through the cancer experience, and aid in promoting the highest standard of oncology care.

The urban and community health pathway: preparing socially responsive physicians through community-engaged learning.

PubMed

Meurer, Linda N; Young, Staci A; Meurer, John R; Johnson, Sheri L; Gilbert, Ileen A; Diehr, Sabina

2011-10-01

One of five options for the new required Medical College of Wisconsin Pathways program, the Urban and Community Health Pathway (UCHP), links training with community needs and assets to prepare students with the knowledge, skills, and attitudes to provide effective care in urban, underserved settings; promote community health; and reduce health disparities. Students spend at least 10 hours per month on pathway activities: 4 hours of core material delivered through readings, didactics, case discussions, and site visits; and at least 6 hours of experiential noncore activities applying core competencies, guided by an Individualized Learning Plan and faculty advisor. Noncore activities include community-engaged research, service-learning activities or other relevant experiences, and submission of a synthesis paper addressing pathway competencies. The first cohort of students began their pathways in January 2010. Of 560 participating students, 95 (of which 48 were first-year, 21 second-year, and 26 third-year students) selected UCHP. Core sessions focused on public health, social determinants, cultural humility, poverty, the local healthcare system, and safety net. During noncore time, students engaged in projects addressing homelessness, obesity, advocacy, Hmong and Latino health, HIV, asthma, and violence prevention. Students enjoyed working with peers across classes and favored interactive, community-based sessions over didactics in the classroom. Students' papers reflected a range of service and scholarly activities and a deepened appreciation of social and economic influences on health. The UCHP enriches the traditional curriculum with individualized, community-based experiences to build knowledge about health determinants and skills in partnering with communities to improve health. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Litter quality versus soil microbial community controls over decomposition: a quantitative analysis

USGS Publications Warehouse

Cleveland, Cory C.; Reed, Sasha C.; Keller, Adrienne B.; Nemergut, Diana R.; O'Neill, Sean P.; Ostertag, Rebecca; Vitousek, Peter M.

2014-01-01

The possible effects of soil microbial community structure on organic matter decomposition rates have been widely acknowledged, but are poorly understood. Understanding these relationships is complicated by the fact that microbial community structure and function are likely to both affect and be affected by organic matter quality and chemistry, thus it is difficult to draw mechanistic conclusions from field studies. We conducted a reciprocal soil inoculum × litter transplant laboratory incubation experiment using samples collected from a set of sites that have similar climate and plant species composition but vary significantly in bacterial community structure and litter quality. The results showed that litter quality explained the majority of variation in decomposition rates under controlled laboratory conditions: over the course of the 162-day incubation, litter quality explained nearly two-thirds (64 %) of variation in decomposition rates, and a smaller proportion (25 %) was explained by variation in the inoculum type. In addition, the relative importance of inoculum type on soil respiration increased over the course of the experiment, and was significantly higher in microcosms with lower litter quality relative to those with higher quality litter. We also used molecular phylogenetics to examine the relationships between bacterial community composition and soil respiration in samples through time. Pyrosequencing revealed that bacterial community composition explained 32 % of the variation in respiration rates. However, equal portions (i.e., 16 %) of the variation in bacterial community composition were explained by inoculum type and litter quality, reflecting the importance of both the meta-community and the environment in bacterial assembly. Taken together, these results indicate that the effects of changing microbial community composition on decomposition are likely to be smaller than the potential effects of climate change and/or litter quality changes in response to increasing atmospheric CO2 concentrations or atmospheric nutrient deposition.

Involving lay community researchers in epidemiological research: experiences from a seroprevalence study among sub-Saharan African migrants.

PubMed

Nöstlinger, Christiana; Loos, Jasna

2016-01-01

Community-based participatory research (CBPR) has received considerable attention during past decades as a method to increase community ownership in research and prevention. We discuss its application to epidemiological research using the case of second-generation surveillance conducted among sub-Saharan African (SSA) migrants in Antwerp city. To inform evidence-based prevention planning for this target group, this HIV-prevalence study used two-stage time-location sampling preceded by formative research. Extensive collaborative partnerships were built with community organizations, a Community Advisory Board provided input throughout the project, and community researchers were trained to participate in all phases of the seroprevalence study. Valid oral fluid samples for HIV testing were collected among 717 SSA migrants and linked to behavioural data assessed through an anonymous survey between December 2013 and August 2014. A qualitative content analysis of various data sources (extensive field notes, minutes of intervision, and training protocols) collected at 77 data collection visits in 51 settings was carried out to describe experiences with challenges and opportunities inherent to the CBPR approach at three crucial stages of the research process: building collaborative partnerships; implementing the study; dissemination of findings including prevention planning. The results show that CBPR is feasible in conducting scientifically sound epidemiological research, but certain requirements need to be in place. These include among others sufficient resources to train, coordinate, and supervise community researchers; continuity in the implementation; transparency about decision-taking and administrative procedures, and willingness to share power and control over the full research process. CBPR contributed to empowering community researchers on a personal level, and to create greater HIV prevention demand in the SSA communities.

Developmental Change in Social Responsibility during Adolescence: An Ecological Perspective

PubMed Central

Wray-Lake, Laura; Syvertsen, Amy K.; Flanagan, Constance A.

2015-01-01

Social responsibility can be defined as a set of prosocial values representing personal commitments to contribute to community and society. Little is known about developmental change – and predictors of that change – in social responsibility during adolescence. The present study used an accelerated longitudinal research design to investigate the developmental trajectory of social responsibility values and ecological assets across family, school, community, and peer settings that predict these values. Data come from a three-year study of 3,683 U.S. adolescents enrolled in upper-level elementary, middle school, and high schools in rural, semi-urban, and urban communities. Social responsibility values significantly decreased from age 9 to 16 before leveling off in later adolescence. Family compassion messages and democratic climate, school solidarity, community connectedness, and trusted friendship positively predicted within-person change in adolescents’ social responsibility values. These findings held after accounting for other individual-level and demographic factors and provide support for the role of ecological assets in adolescents’ social responsibility development. In addition, fair society beliefs and volunteer experience had positive between- and within-person associations with social responsibility values. The manuscript discusses theoretical and practical implications of the conclusion that declines in ecological assets may partly explain age-related declines in social responsibility values. PMID:26619322

Building an evidence-base for the training of evidence-based treatments in community settings: Use of an expert-informed approach.

PubMed

Scudder, Ashley; Herschell, Amy D

2015-08-01

In order to make EBTs available to a large number of children and families, developers and expert therapists have used their experience and expertise to train community-based therapists in EBTs. Understanding current training practices of treatment experts may be one method for establishing best practices for training community-based therapists prior to comprehensive empirical examinations of training practices. A qualitative study was conducted using surveys and phone interviews to identify the specific procedures used by treatment experts to train and implement an evidence-based treatment in community settings. Twenty-three doctoral-level, clinical psychologists were identified to participate because of their expertise in conducting and training Parent-Child Interaction Therapy. Semi-structured qualitative interviews were completed by phone, later transcribed verbatim, and analyzed using thematic coding. The de-identified data were coded by two independent qualitative data researchers and then compared for consistency of interpretation. The themes that emerged following the final coding were used to construct a training protocol to be empirically tested. The goal of this paper is to not only understand the current state of training practices for training therapists in a particular EBT, Parent-Child Interaction Therapy, but to illustrate the use of expert opinion as the best available evidence in preparation for empirical evaluation.

Developmental change in social responsibility during adolescence: An ecological perspective.

PubMed

Wray-Lake, Laura; Syvertsen, Amy K; Flanagan, Constance A

2016-01-01

Social responsibility can be defined as a set of prosocial values representing personal commitments to contribute to community and society. Little is known about developmental change-and predictors of that change-in social responsibility during adolescence. The present study used an accelerated longitudinal research design to investigate the developmental trajectory of social responsibility values and ecological assets across family, school, community, and peer settings that predict these values. Data come from a 3-year study of 3,683 U.S. adolescents enrolled in upper-level elementary, middle, and high schools in rural, semiurban, and urban communities. Social responsibility values significantly decreased from age 9 to 16 before leveling off in later adolescence. Family compassion messages and democratic climate, school solidarity, community connectedness, and trusted friendship, positively predicted within-person change in adolescents' social responsibility values. These findings held after accounting for other individual-level and demographic factors and provide support for the role of ecological assets in adolescents' social responsibility development. In addition, fair society beliefs and volunteer experience had positive between- and within-person associations with social responsibility values. The manuscript discusses theoretical and practical implications of the conclusion that declines in ecological assets may partly explain age-related declines in social responsibility values. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Implementing Evidence-Based Teen Pregnancy-Prevention Interventions in a Community-Wide Initiative: Building Capacity and Reaching Youth.

PubMed

House, L Duane; Tevendale, Heather D; Martinez-Garcia, Genevieve

2017-03-01

To describe efforts to implement evidence-based interventions (EBIs) within multicomponent, community-wide initiatives to reduce teen pregnancy. During 2011-2014, we collected information about the capacity (i.e., knowledge, confidence, training, and experience) of state and community-based organizations to support implementation of the following: EBIs, number and characteristics of youth served by EBIs, type of EBIs implemented, EBI settings, hours of training, and technical assistance provided. State and community-based organizations reported these data annually; however, training and technical assistance was reported monthly. We used aggregated data from these annual and monthly reports to describe the implementation of EBIs in the community-wide initiative project. From baseline in 2011-2014, state and community-based organizations increased their capacities to support program partners in delivering EBIs. They provided 5,015 hours of technical assistance and training on topics, including ensuring adequate capacity, process and outcome evaluation, program planning, and continuous quality improvement. Program partners increased the number of youth reached by an EBI in targeted communities by 349%, from 4,304 in the first year of implementation in 2012 to 19,344 in 2014. Most youth in 2014 received sexuality education programs (59%), whereas smaller percentages received abstinence-based, youth development, and clinic-based programs. Most youth were reached through schools (72%) and community-based organizations (16%), and smaller numbers were reached in other settings (e.g., faith-based organizations, health centers). Building and monitoring the capacity of program partners to deliver EBIs through technical assistance and training is important. In addition, partnering with schools leads to reaching more youth. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Assessment of knowledge and practice of community pharmacy personnel on diabetes mellitus management in Kathmandu district: a cross sectional descriptive study.

PubMed

Shrestha, M; Maharjan, R; Prajapati, A; Ghimire, S; Shrestha, N; Banstola, A

2015-01-01

Pharmacists are the most reachable healthcare professionals to many chronically ill patients. It has been found that pharmacists see patients with diabetes up to five times more often than any other healthcare provider. Therefore, to provide quality health care to patients it is important that they have appropriate knowledge and practice on diabetes mellitus management. Thus, this study was conducted to assess the knowledge and practice of diabetes mellitus management among community pharmacy personnel involved in retail community pharmacies of Kathmandu. Three hundred and fifteen community pharmacies, selected by systematic random sampling were surveyed by using pre-validated self-administered questionnaires. The first set of questionnaire evaluated the community pharmacy personnel's diabetes knowledge based on a pre-validated 20-item questionnaire. The second set of questionnaire documented about the practice of community pharmacy personnel on diabetes mellitus management which contained 22 questions. Data was entered in EPI Data and analyzed by using SPSS version 20. This survey demonstrated that 76.5 % respondents had poor knowledge and 86.4 % had negative practice on diabetes mellitus (DM) management. Only 26.2 % respondents had good knowledge as well as good practice. 31.4 % of respondents had poor knowledge as well as poor practice on DM management. Laws and regulations regarding community pharmacy personnel need to be implemented. There should be more advanced and experiment based training. Additionally, the provision for further education curriculum in pharmacy education should be implemented which should intensively include disease and proper management. Guidelines covering diabetes care should be distributed and implemented throughout community pharmacies.

Vocational bias: a potential pitfall in the use of key informant interviews in pediatric community needs assessments.

PubMed

Northrip, Kimberly; Chen, Candice; Marsh, Jennifer

2008-04-29

Key informants are individuals with insight into a community or a problem of interest. Our objective was to evaluate the effect of the employment type of key informants on the outcome of a pediatric needs assessment for an urban community. Twenty-one interviews were conducted during the course of a pediatric community needs assessment. As part of the interview, informants were asked to list the top three problems facing children in their community. We analyzed their answers to determine if informant responses differed by employment type. Key informants were divided into four employment types: health care setting, social service, business, and infrastructure. Responses were coded as being primarily one of three types: medical, social, or resource. Our results showed that those informants who worked in a health care setting listed medical problems more often than those who did not (p < 0.04). Those who worked in social services listed resource problems more often than those who did not (p < 0.05). Those in business and infrastructure positions listed more social problems (p < 0.37). No difference was observed in response type between those who had lived in the community at some point and those who had not. This study lends support to the hypothesis that informants' reporting of community problems is biased by their vocation. Clinicians often focus their needs assessments on health care workers. This study suggests, however, that we need to take into consideration the bias this presents and to seek to interview people with diverse work experiences. By limiting the process to health care workers, clinicians are likely to get a skewed perspective of a community's needs and wants.

Methane-related metabolisms of deep-sea sediments captured with a colonization experiment.

NASA Astrophysics Data System (ADS)

Carr, S. A.; Wheat, C. G.; Orcutt, B.; Kopf, A.; Saffer, D. M.; Toczko, S.

2016-12-01

NanTroSEIZE is a multi-expedition project of the International Ocean Discovery Program (IODP) designed to investigate the Nankai Trough subduction zone. In 2016, a long-term borehole instrument package known as the "GeniusPlug" was collected from Hole C0010A after a six-year deployment within the sediment of a major fault zone, at a depth of 400 mbsf. This GeniusPlug included a set of osmotically-driven pumps, which continuously pumped in situ deep seated, formation water through a microbiological colonization experiment (flow-through osmo colonization system (FLOCS)). This FLOCS experiment contained cassettes of olivine, barite, and sediment collected from nearby Hole C0004D, to serve as colonization substrates. While similar FLOCS have been deployed within boreholes in the igneous oceanic crust, this FLOCS experiment represents the first to be deployed within a sedimentary environment, and thus represents the first opportunity to observe how pore water communities colonize sediment and rock substrates. Initial geochemistry results suggest that conditions within the FLOCS experiment were similar to a methane-sulfate transition zone, and initial enrichment cultures inoculated with the FLOCS substrates demonstrate methane production. Here, we will present integrated results of culturing experiments and culture-independent genomic investigations as a means to elucidate the methane-related metabolisms of these colonizing communities.

Recovering from the ShakeOut earthquake

USGS Publications Warehouse

Wein, Anne; Johnson, Laurie; Bernknopf, Richard

2011-01-01

Recovery from an earthquake like the M7.8 ShakeOut Scenario will be a major endeavor taking many years to complete. Hundreds of Southern California municipalities will be affected; most lack recovery plans or previous disaster experience. To support recovery planning this paper 1) extends the regional ShakeOut Scenario analysis into the recovery period using a recovery model, 2) localizes analyses to identify longer-term impacts and issues in two communities, and 3) considers the regional context of local recovery.Key community insights about preparing for post-disaster recovery include the need to: geographically diversify city procurement; set earthquake mitigation priorities for critical infrastructure (e.g., airport), plan to replace mobile homes with earthquake safety measures, consider post-earthquake redevelopment opportunities ahead of time, and develop post-disaster recovery management and governance structures. This work also showed that communities with minor damages are still sensitive to regional infrastructure damages and their potential long-term impacts on community recovery. This highlights the importance of community and infrastructure resilience strategies as well.

Strengthening STEM Education through Community Partnerships

PubMed Central

Lopez, Colleen A.; Rocha, Jon; Chapman, Matthew; Rocha, Kathleen; Wallace, Stephanie; Baum, Steven; Lawler, Brian R.; Mothé, Bianca R.

2017-01-01

California State University San Marcos (CSUSM) and San Marcos Elementary Schools have established a partnership to offer a large-scale community service learning opportunity to enrich science curriculum for K-5 students. It provides an opportunity for science, technology, engineering, and math (STEM) majors to give back to the community, allowing them to experience teaching in an elementary classroom setting, in schools that lack the resources and science instructor specialization needed to instill consistent science curricula. CSUSM responded to this need for more STEM education by mobilizing its large STEM student body to design hands-on, interactive science lessons based on Next Generation Science Standards (NGSS). Since 2012, the program has reached out to over four thousand K-5 students, and assessment data have indicated an increase in STEM academic performance and interest. PMID:28725512

Strengthening STEM Education through Community Partnerships.

PubMed

Lopez, Colleen A; Rocha, Jon; Chapman, Matthew; Rocha, Kathleen; Wallace, Stephanie; Baum, Steven; Lawler, Brian R; Mothé, Bianca R

2016-01-01

California State University San Marcos (CSUSM) and San Marcos Elementary Schools have established a partnership to offer a large-scale community service learning opportunity to enrich science curriculum for K-5 students. It provides an opportunity for science, technology, engineering, and math (STEM) majors to give back to the community, allowing them to experience teaching in an elementary classroom setting, in schools that lack the resources and science instructor specialization needed to instill consistent science curricula. CSUSM responded to this need for more STEM education by mobilizing its large STEM student body to design hands-on, interactive science lessons based on Next Generation Science Standards (NGSS). Since 2012, the program has reached out to over four thousand K-5 students, and assessment data have indicated an increase in STEM academic performance and interest.

Sexual harassment and prior sexual trauma among African-American and white American women.

PubMed

Wyatt, G E; Riederle, M

1994-01-01

This study examined the relationship between sexual harassment in work, educational, and social settings and sexual abuse in childhood and/or adulthood in a stratified community sample of 248 African-American and white American women. The cumulative impact of sexual victimization on women's sense of general well-being was also examined. Those most likely to be sexually harassed in work and social settings were women with contact sexual abuse histories, regardless of ethnicity. The work status of harassers of women with sexual abuse histories differed significantly by ethnic group. Although women with prior sexual abuse experiences from both ethnic groups most frequently reported a response to sexual harassment at work, they least frequently did so in social settings. A history of childhood sexual abuse was more negatively associated with African- American women's well-being than were repeated experiences of sexual violence. Future research should address the implications of ethnic and cultural issues on the cumulative impact of incidents of sexual violence on women of color.