Community-Based Organisations and How to Support Their Use of Systematic Reviews: A Qualitative Study

ERIC Educational Resources Information Center

Wilson, Michael G.; Lavis, John N.

2011-01-01

Unlike for other health system stakeholders, there have been few visible efforts to support the use of research evidence in community-based organisations (CBOs). To begin to address this gap, we conducted focus groups and interviews with executive directors and programme managers of CBOs from the HIV/AIDS, diabetes and mental health and addictions…

CoP Sensing Framework on Web-Based Environment

NASA Astrophysics Data System (ADS)

Mustapha, S. M. F. D. Syed

The Web technologies and Web applications have shown similar high growth rate in terms of daily usages and user acceptance. The Web applications have not only penetrated in the traditional domains such as education and business but have also encroached into areas such as politics, social, lifestyle, and culture. The emergence of Web technologies has enabled Web access even to the person on the move through PDAs or mobile phones that are connected using Wi-Fi, HSDPA, or other communication protocols. These two phenomena are the inducement factors toward the need of building Web-based systems as the supporting tools in fulfilling many mundane activities. In doing this, one of the many focuses in research has been to look at the implementation challenges in building Web-based support systems in different types of environment. This chapter describes the implementation issues in building the community learning framework that can be supported on the Web-based platform. The Community of Practice (CoP) has been chosen as the community learning theory to be the case study and analysis as it challenges the creativity of the architectural design of the Web system in order to capture the presence of learning activities. The details of this chapter describe the characteristics of the CoP to understand the inherent intricacies in modeling in the Web-based environment, the evidences of CoP that need to be traced automatically in a slick manner such that the evidence-capturing process is unobtrusive, and the technologies needed to embrace a full adoption of Web-based support system for the community learning framework.

A support system for assessing local vulnerability to weather and climate

USGS Publications Warehouse

Coletti, Alex; Howe, Peter D.; Yarnal, Brent; Wood, Nathan J.

2013-01-01

The changing number and nature of weather- and climate-related natural hazards is causing more communities to need to assess their vulnerabilities. Vulnerability assessments, however, often require considerable expertise and resources that are not available or too expensive for many communities. To meet the need for an easy-to-use, cost-effective vulnerability assessment tool for communities, a prototype online vulnerability assessment support system was built and tested. This prototype tool guides users through a stakeholder-based vulnerability assessment that breaks the process into four easy-to-implement steps. Data sources are integrated in the online environment so that perceived risks—defined and prioritized qualitatively by users—can be compared and discussed against the impacts that past events have had on the community. The support system is limited in scope, and the locations of the case studies do not provide a sufficiently broad range of sample cases. The addition of more publically available hazard databases combined with future improvements in the support system architecture and software will expand opportunities for testing and fully implementing the support system.

An innovative Oklahoma program to coordinate interdisciplinary and interagency services for children with special healthcare needs at a county level.

PubMed

Wolraich, Mark; Lockhart, Jennifer; Worley, Louis

2013-03-01

Children and youth with special health care needs (CYSHCN) and their families often require multiple services from multiple providers in order to meet their needs. The Sooner SUCCESS (State Unified Children's Comprehensive Exemplary Services for Special Needs), was developed based on a complex adaptive systems approach allowing local coalitions to address their unique needs. Sooner SUCCESS provides support to families and service providers at the community level including a broad range of supports from simply helping a family identify and access a service that already exists to innovatively marshaling generic resources to meet a unique need. The program uses these family support activities coupled with the Community Needs Assessment to identify local service needs encouraging community capacity building by coordinating the efforts of the health, mental health, social and education systems to identify service gaps and develop community-based strategies to fill those gaps.

Mean-variance portfolio analysis data for optimizing community-based photovoltaic investment

PubMed Central

Shakouri, Mahmoud; Lee, Hyun Woo

2016-01-01

The amount of electricity generated by Photovoltaic (PV) systems is affected by factors such as shading, building orientation and roof slope. To increase electricity generation and reduce volatility in generation of PV systems, a portfolio of PV systems can be made which takes advantages of the potential synergy among neighboring buildings. This paper contains data supporting the research article entitled: PACPIM: new decision-support model of optimized portfolio analysis for community-based photovoltaic investment [1]. We present a set of data relating to physical properties of 24 houses in Oregon, USA, along with simulated hourly electricity data for the installed PV systems. The developed Matlab code to construct optimized portfolios is also provided in Supplementary materials. The application of these files can be generalized to variety of communities interested in investing on PV systems. PMID:26937458

Design and Construction for Community Health Service Precision Fund Appropriation System Based on Performance Management.

PubMed

Gao, Xing; He, Yao; Hu, Hongpu

2017-01-01

Allowing for the differences in economy development, informatization degree and characteristic of population served and so on among different community health service organizations, community health service precision fund appropriation system based on performance management is designed, which can provide support for the government to appropriate financial funds scientifically and rationally for primary care. The system has the characteristic of flexibility and practicability, in which there are five subsystems including data acquisition, parameter setting, fund appropriation, statistical analysis system and user management.

Water system hardware and management rehabilitation: Qualitative evidence from Ghana, Kenya, and Zambia.

PubMed

Klug, Tori; Shields, Katherine F; Cronk, Ryan; Kelly, Emma; Behnke, Nikki; Lee, Kristen; Bartram, Jamie

2017-05-01

Sufficient, safe, continuously available drinking water is important for human health and development, yet one in three handpumps in sub-Saharan Africa are non-functional at any given time. Community management, coupled with access to external technical expertise and spare parts, is a widely promoted model for rural water supply management. However, there is limited evidence describing how community management can address common hardware and management failures of rural water systems in sub-Saharan Africa. We identified hardware and management rehabilitation pathways using qualitative data from 267 interviews and 57 focus group discussions in Ghana, Kenya, and Zambia. Study participants were water committee members, community members, and local leaders in 18 communities (six in each study country) with water systems managed by a water committee and supported by World Vision (WV), an international non-governmental organization (NGO). Government, WV or private sector employees engaged in supporting the water systems were also interviewed. Inductive analysis was used to allow for pathways to emerge from the data, based on the perspectives and experiences of study participants. Four hardware rehabilitation pathways were identified, based on the types of support used in rehabilitation. Types of support were differentiated as community or external. External support includes financial and/or technical support from government or WV employees. Community actor understanding of who to contact when a hardware breakdown occurs and easy access to technical experts were consistent reasons for rapid rehabilitation for all hardware rehabilitation pathways. Three management rehabilitation pathways were identified. All require the involvement of community leaders and were best carried out when the action was participatory. The rehabilitation pathways show how available resources can be leveraged to restore hardware breakdowns and management failures for rural water systems in sub-Saharan Africa. Governments, NGOs, and private sector actors can better build capacity of community actors by focusing on their role in rehabilitating hardware and management and to ensure that they are able to quickly contact external support actors when needed for rehabilitation. Using qualitative and participatory methods allows for insight into rapid rehabilitation of hardware and management. Copyright © 2017 Elsevier GmbH. All rights reserved.

High-Efficiency Food Production in a Renewable Energy Based Micro-Grid

NASA Technical Reports Server (NTRS)

Bubenheim, David L.

2017-01-01

Controlled Environment Agriculture (CEA) systems can be used to produce high-quality, desirable food year round, and the fresh produce can positively contribute to the health and well being of residents in communities with difficult supply logistics. While CEA has many positive outcomes for a remote community, the associated high electric demands have prohibited widespread implementation in what is typically already a fully subscribed power generation and distribution system. Recent advances in CEA technologies as well as renewable power generation, storage, and micro-grid management are increasing system efficiency and expanding the possibilities for enhancing community supporting infrastructure without increasing demands for outside supplied fuels. We will present examples of how new lighting, nutrient delivery, and energy management and control systems can enable significant increases in food production efficiency while maintaining high yields in CEA.Examples from Alaskan communities where initial incorporation of renewable power generation, energy storage and grid management techniques have already reduced diesel fuel consumption for electric generation by more than 40 and expanded grid capacity will be presented. We will discuss how renewable power generation, efficient grid management to extract maximum community service per kW, and novel energy storage approaches can expand the food production, water supply, waste treatment, sanitation and other community support services without traditional increases of consumable fuels supplied from outside the community. These capabilities offer communities with a range of choices to enhance their communities. The examples represent a synergy of technology advancement efforts to develop sustainable community support systems for future space-based human habitats and practical implementation of infrastructure components to increase efficiency and enhance health and well-being in remote communities today and tomorrow.

Impact Challenges in Community Science-with-Practice: Lessons from PROSPER on Transformative Practitioner-Scientist Partnerships and Prevention Infrastructure Development

PubMed Central

Greenberg, Mark

2011-01-01

At present, evidence-based programs (EBPs) to reduce youth violence are failing to translate into widespread community practice, despite their potential for impact on this pervasive public health problem. In this paper we address two types of challenges in the achievement of such impact, drawing upon lessons from the implementation of a partnership model called PROSPER. First, we address five key challenges in the achievement of community-level impact through effective community planning and action: readiness and mobilization of community teams; maintaining EBP implementation quality; sustaining community teams and EBPs; demonstrating community-level impact; and continuous, proactive technical assistance. Second, we consider grand challenges in the large-scale translation of EBPs: (1) building, linking and expanding existing infrastructures to support effective EBP delivery systems, and (2) organizing networks of practitioner-scientist partnerships—networks designed to integrate diffusion of EBPs with research that examines effective strategies to do so. The PROSPER partnership model is an evidence-based delivery system for community-based prevention and has evolved through two decades of NIH-funded research, assisted by land grant universities' Cooperative Extension Systems. Findings and lessons of relevance to each of the challenges are summarized. In this context, we outline how practitioner-scientist partnerships can serve to transform EBP delivery systems, particularly in conjunction with supportive federal policy. PMID:21222151

Impact challenges in community science-with-practice: lessons from PROSPER on transformative practitioner-scientist partnerships and prevention infrastructure development.

PubMed

Spoth, Richard; Greenberg, Mark

2011-09-01

At present, evidence-based programs (EBPs) to reduce youth violence are failing to translate into widespread community practice, despite their potential for impact on this pervasive public health problem. In this paper we address two types of challenges in the achievement of such impact, drawing upon lessons from the implementation of a partnership model called PROSPER. First, we address five key challenges in the achievement of community-level impact through effective community planning and action: readiness and mobilization of community teams; maintaining EBP implementation quality; sustaining community teams and EBPs; demonstrating community-level impact; and continuous, proactive technical assistance. Second, we consider grand challenges in the large-scale translation of EBPs: (1) building, linking and expanding existing infrastructures to support effective EBP delivery systems, and (2) organizing networks of practitioner-scientist partnerships-networks designed to integrate diffusion of EBPs with research that examines effective strategies to do so. The PROSPER partnership model is an evidence-based delivery system for community-based prevention and has evolved through two decades of NIH-funded research, assisted by land grant universities' Cooperative Extension Systems. Findings and lessons of relevance to each of the challenges are summarized. In this context, we outline how practitioner-scientist partnerships can serve to transform EBP delivery systems, particularly in conjunction with supportive federal policy.

A Community of Practice Approach to Support for Ninth-Graders in Urban High Schools. Policy Brief

ERIC Educational Resources Information Center

Legters, Nettie; Parise, Leigh

2016-01-01

Providing ninth-graders with academic and social support can put more students on the graduation path, but it can be challenging for schools and school systems to implement that support routinely and effectively. This brief describes how Broward County Public Schools adopted a community of practice (CoP) approach to improve school-based teams'…

Development and evaluation of online evidence based guideline bank system.

PubMed

Park, Myonghwa

2006-01-01

The purpose of this study was to develop and evaluate the online evidence-based nursing practice guideline bank system to support the best evidence-based decision in the clinical and community practice settings. The main homepage consisted of seven modules for introduction of site, EBN, guideline bank, guideline development, guideline review, related sites, and community. The major contents in the guidelines were purpose, developer, intended audience, method of development, target population, testing, knowledge components, and evaluation. Electronic versions of the guidelines were displayed by XML, PDF, and PDA versions. The system usability were evaluated by general users, guideline developers, and guideline reviewers on the web and the results showed high scores of satisfaction. This online evidence-based guideline bank system could support nurses' best and cost-effective clinical decision using the sharable standardized guidelines with education module of evidence based nursing.

Post-Project Assessment of Community-Supported Emergency Transport Systems for Health Care Services in Tanzania

ERIC Educational Resources Information Center

Ahluwalia, Indu B.; Robinson, Dorcas; Vallely, Lisa; Myeya, Juliana; Ngitoria, Lukumay; Kitambi, Victor; Kabakama, Alfreda

2012-01-01

We examined the continuation of community-organized and financed emergency transport systems implemented by the Community-Based Reproductive Health Project (CBRHP) from 1998 to 2000 in two rural districts in Tanzania. The CBRHP was a multipronged program, one component of which focused on affordable transport to health facilities from the…

Community forensic psychiatry: restoring some sanity to forensic psychiatric rehabilitation.

PubMed

Skipworth, J; Humberstone, V

2002-01-01

To review clinical and legal paradigms of community forensic mental health care, with specific focus on New Zealand, and to develop a clinically based set of guiding principles for service development in this area. The general principles of rehabilitating mentally disordered offenders, and assertive community care programmes were reviewed and applied to the law and policy in a New Zealand forensic mental health setting. There is a need to develop comprehensive community treatment programmes for mentally disordered offenders. The limited available research supports assertive community treatment models, with specialist forensic input. Ten clinically based principles of care provision important to forensic mental health assertive community treatment were developed. Deinstitutionalization in forensic psychiatry lags behind the rest of psychiatry, but can only occur with well-supported systems in place to assess and manage risk in the community setting. The development of community-based forensic rehabilitation services in conjunction with general mental health is indicated.

AphidBase: A centralized bioinformatic resource for annotation of the pea aphid genome

PubMed Central

Legeai, Fabrice; Shigenobu, Shuji; Gauthier, Jean-Pierre; Colbourne, John; Rispe, Claude; Collin, Olivier; Richards, Stephen; Wilson, Alex C. C.; Tagu, Denis

2015-01-01

AphidBase is a centralized bioinformatic resource that was developed to facilitate community annotation of the pea aphid genome by the International Aphid Genomics Consortium (IAGC). The AphidBase Information System designed to organize and distribute genomic data and annotations for a large international community was constructed using open source software tools from the Generic Model Organism Database (GMOD). The system includes Apollo and GBrowse utilities as well as a wiki, blast search capabilities and a full text search engine. AphidBase strongly supported community cooperation and coordination in the curation of gene models during community annotation of the pea aphid genome. AphidBase can be accessed at http://www.aphidbase.com. PMID:20482635

Divorce in the context of domestic violence against women in Vietnam.

PubMed

Vu, Ha Song; Schuler, Sidney; Hoang, Tu Anh; Quach, Trang

2014-06-01

This paper examines obstacles for women who face domestic violence in making decisions about divorce and in seeking and securing support for a divorce. The research was undertaken in the context of a project in one district of a coastal province in Vietnam that sought to reduce gender based-violence and mitigate its effects. Data from in-depth interviews and focus-group discussions are used to examine abused women's attitudes, strategies and behaviours and the responses of people in their communities and in the support system established by the project. The findings show that social norms supporting marriage discourage abused women from seeking divorce and, in some cases, any kind of support, and discourage community-based support networks, police and local court systems from providing effective assistance to these women.

Research on Livable Community Evaluation Based on GIS

NASA Astrophysics Data System (ADS)

Yin, Zhangcai; Wu, Yang; Jin, Zhanghaonan; Zhang, Xu

2018-01-01

Community is the basic unit of the city. Research on livable community could provide a bottom-up research path for the realization of livable city. Livability is the total factor affecting the quality of community life. In this paper, livable community evaluation indexes are evaluated based on GIS and fuzzy comprehensive evaluation method. Then the sum-index and sub-index of community livability are both calculated. And community livable evaluation index system is constructed based on the platform of GIS. This study provides theoretical support for the construction and management of livable communities, so as to guide the development and optimization of city.

Pythium invasion of plant-based life support systems: biological control and sources

NASA Technical Reports Server (NTRS)

Jenkins, D. G.; Cook, K. L.; Garland, J. L.; Board, K. F.; Sager, J. C. (Principal Investigator)

2000-01-01

Invasion of plant-based life support systems by plant pathogens could cause plant disease and disruption of life support capability. Root rot caused by the fungus, Pythium, was observed during tests of prototype plant growth systems containing wheat at the Kennedy Space Center (KSC). We conducted experiments to determine if the presence of complex microbial communities in the plant root zone (rhizosphere) resisted invasion by the Pythium species isolated from the wheat root. Rhizosphere inocula of different complexity (as assayed by community-level physiological profile: CLPP) were developed using a dilution/extinction approach, followed by growth in hydroponic rhizosphere. Pythium growth on wheat roots and concomitant decreases in plant growth were inversely related to the complexity of the inocula during 20-day experiments in static hydroponic systems. Pythium was found on the seeds of several different wheat cultivars used in controlled environmental studies, but it is unclear if the seed-borne fungal strain(s) were identical to the pathogenic strain recovered from the KSC studies. Attempts to control pathogens and their effects in hydroponic life support systems should include early inoculation with complex microbial communities, which is consistent with ecological theory.

Enhanced Learning through Electronic Communities: A Research Review.

ERIC Educational Resources Information Center

Burgstahler, Sheryl; Swift, Catherine

This report, in support of the project "Enhanced Learning through Electronic Communities," investigated successful practices of electronic communities. A literature review was conducted and a survey was sent to 15 system operators of networks that had a community-based focus with ancillary educational components and networks that focused primarily…

The challenges of reshaping disease specific and care oriented community based services towards comprehensive goals: a situation appraisal in the Western Cape Province, South Africa.

PubMed

Schneider, Helen; Schaay, Nikki; Dudley, Lilian; Goliath, Charlyn; Qukula, Tobeka

2015-09-30

Similar to other countries in the region, South Africa is currently reorienting a loosely structured and highly diverse community care system that evolved around HIV and TB, into a formalized, comprehensive and integrated primary health care outreach programme, based on community health workers (CHWs). While the difficulties of establishing national CHW programmes are well described, the reshaping of disease specific and care oriented community services, based outside the formal health system, poses particular challenges. This paper is an in-depth case study of the challenges of implementing reforms to community based services (CBS) in one province of South Africa. A multi-method situation appraisal of CBS in the Western Cape Province was conducted over eight months in close collaboration with provincial stakeholders. The appraisal mapped the roles and service delivery, human resource, financing and governance arrangements of an extensive non-governmental organisation (NGO) contracted and CHW based service delivery infrastructure that emerged over 15-20 years in this province. It also gathered the perspectives of a wide range of actors - including communities, users, NGOs, PHC providers and managers - on the current state and future visions of CBS. While there was wide support for new approaches to CBS, there are a number of challenges to achieving this. Although largely government funded, the community based delivery platform remains marginal to the formal public primary health care (PHC) and district health systems. CHW roles evolved from a system of home based care and are limited in scope. There is a high turnover of cadres, and support systems (supervision, monitoring, financing, training), coordination between CHWs, NGOs and PHC facilities, and sub-district capacity for planning and management of CBS are all poorly developed. Reorienting community based services that have their origins in care responses to HIV and TB presents an inter-related set of resource mobilisation, system design and governance challenges. These include not only formalising community based teams themselves, but also the forging of new roles, relationships and mind-sets within the primary health care system, and creating greater capacity for contracting and engaging a plural set of actors - government, NGO and community - at district and sub-district level.

Development of a health information technology-based data system in community-based hospice and palliative care.

PubMed

Abernethy, Amy P; Wheeler, Jane L; Bull, Janet

2011-05-01

Few hospice and palliative care organizations use health information technology (HIT) for data collection and management; the feasibility and utility of a HIT-based approach in this multi-faceted, interdisciplinary context is unclear. To develop a HIT-based data infrastructure that serves multiple hospice and palliative care sites, meeting clinical and administrative needs with data, technical, and analytic support. Through a multi-site academic/community partnership, a data infrastructure was collaboratively developed, pilot-tested at a community-based site, refined, and demonstrated for data collection and preliminary analysis. Additional sites, which participated in system development, became prepared to contribute data to the growing aggregate database. Electronic data collection proved feasible in community-based hospice and palliative care. The project highlighted "success factors" for implementing HIT in this field: engagement of site-based project "champions" to promote the system from within; involvement of stakeholders at all levels of the organization, to promote culture change and buy-in; attention to local needs (e.g., data for quality reporting) and requirements (e.g., affordable cost, efficiency); consideration of practical factors (e.g., potential to interfere with clinical flow); provision of adequate software, technical, analytic, and statistical support; availability of flexible HIT options (e.g., different data-collection platforms); and adoption of a consortium approach in which sites can support one another, learn from each others' experiences, pool data, and benefit from economies of scale. In hospice and palliative care, HIT-based data collection/management has potential to generate better understanding of populations and outcomes, support quality assessment/quality improvement, and prepare sites to participate in research. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Social responsibility and the academic medical center: building community-based systems for the nation's health.

PubMed

Foreman, S

1994-02-01

Academic medical centers have fulfilled several of their missions with immense success but have failed to fulfill others. They have responded only modestly to the needs of the nation's underserved rural and urban communities. The author calls on academic medical centers to take an aggressively active role in building the medical infrastructure now missing in these communities and outlines a multi-part agenda for institutional commitment. It includes developing community-based systems of primary care, outreach programs, and social supports; training professionals committed to serving isolated and poor communities; and performing research that will extend the knowledge base to include the health and social issues of the disadvantaged. (Examples are given of institutions that have pioneered these kinds of community-based activities.) To build the new infrastructure, financing must be secured (various sources are discussed), a community-based faculty must be developed, and each institution's leadership--the medical school dean, the hospital executive, and the department chairmen--must come together around a new agenda and support it materially and psychologically, making whatever changes are needed in the corporate culture. The author warns that if centers do not undertake this responsibility for the health of the underserved, a critical job will go undone, a huge opportunity will have been missed, and American society will be the poorer.

Guiding Principles for Data Architecture to Support the Pathways Community HUB Model

PubMed Central

Zeigler, Bernard P.; Redding, Sarah; Leath, Brenda A.; Carter, Ernest L.; Russell, Cynthia

2016-01-01

Introduction: The Pathways Community HUB Model provides a unique strategy to effectively supplement health care services with social services needed to overcome barriers for those most at risk of poor health outcomes. Pathways are standardized measurement tools used to define and track health and social issues from identification through to a measurable completion point. The HUB use Pathways to coordinate agencies and service providers in the community to eliminate the inefficiencies and duplication that exist among them. Pathways Community HUB Model and Formalization: Experience with the Model has brought out the need for better information technology solutions to support implementation of the Pathways themselves through decision-support tools for care coordinators and other users to track activities and outcomes, and to facilitate reporting. Here we provide a basis for discussing recommendations for such a data infrastructure by developing a conceptual model that formalizes the Pathway concept underlying current implementations. Requirements for Data Architecture to Support the Pathways Community HUB Model: The main contribution is a set of core recommendations as a framework for developing and implementing a data architecture to support implementation of the Pathways Community HUB Model. The objective is to present a tool for communities interested in adopting the Model to learn from and to adapt in their own development and implementation efforts. Problems with Quality of Data Extracted from the CHAP Database: Experience with the Community Health Access Project (CHAP) data base system (the core implementation of the Model) has identified several issues and remedies that have been developed to address these issues. Based on analysis of issues and remedies, we present several key features for a data architecture meeting the just mentioned recommendations. Implementation of Features: Presentation of features is followed by a practical guide to their implementation allowing an organization to consider either tailoring off-the-shelf generic systems to meet the requirements or offerings that are specialized for community-based care coordination. Discussion: Looking to future extensions, we discuss the utility and prospects for an ontology to include care coordination in the Unified Medical Language System (UMLS) of the National Library of Medicine and other existing medical and nursing taxonomies. Conclusions and Recommendations: Pathways structures are an important principle, not only for organizing the care coordination activities, but also for structuring the data stored in electronic form in the conduct of such care. We showed how the proposed architecture encourages design of effective decision support systems for coordinated care and suggested how interested organizations can set about acquiring such systems. Although the presentation focuses on the Pathways Community HUB Model, the principles for data architecture are stated in generic form and are applicable to any health information system for improving care coordination services and population health. PMID:26870743

GET SMARTE: A DECISION SUPPORT SYSTEM TO REVITALIZE COMMUNITIES - CABERNET 2007

EPA Science Inventory

Sustainable Management Approaches and Revitalization Tools - electronic (SMARTe), is an open-source, web-based, decision support system for developing and evaluating future reuse scenarios for potentially contaminated land. SMARTe contains information and analysis tools for all a...

Collecting data along the continuum of prevention and care: a Continuous Quality Improvement approach.

PubMed

Indyk, Leonard; Indyk, Debbie

2006-01-01

For the past 14 years, a team of applied social scientists and system analysts has worked with a wide variety of Community- Based Organizations (CBO's), other grassroots agencies and networks, and Medical Center departments to support resource, program, staff and data development and evaluation for hospital- and community-based programs and agencies serving HIV at-risk and affected populations. A by-product of this work has been the development, elaboration and refinement of an approach to Continuous Quality Improvement (CQI) which is appropriate for diverse community-based providers and agencies. A key component of our CQI system involves the installation of a sophisticated relational database management and reporting system (DBMS) which is used to collect, analyze, and report data in an iterative process to provide feedback among the evaluators, agency administration and staff. The database system is designed for two purposes: (1) to support the agency's administrative internal and external reporting requirements; (2) to support the development of practice driven health services and early intervention research. The body of work has fostered a unique opportunity for the development of exploratory service-driven research which serves both administrative and research needs.

A Cybernetic Approach to the Modeling of Agent Communities

NASA Technical Reports Server (NTRS)

Truszkowski, Walt; Karlin, Jay

2000-01-01

In an earlier paper [1] examples of agent technology in a NASA context were presented. Both groundbased and space-based applications were addressed. This paper continues the discussion of one aspect of the Goddard Space Flight Center's continuing efforts to develop a community of agents that can support both ground-based and space-based systems autonomy. The paper focuses on an approach to agent-community modeling based on the theory of viable systems developed by Stafford Beer. It gives the status of an initial attempt to capture some of the agent-community behaviors in a viable system context. This paper is expository in nature and focuses on a discussion of the modeling of some of the underlying concepts and infrastructure that will serve as the basis of more detailed investigative work into the behavior of agent communities. The paper is organized as follows. First, a general introduction to agent community requirements is presented. Secondly, a brief introduction to the cybernetic concept of a viable system is given. This concept forms the foundation of the modeling approach. Then the concept of an agent community is modeled in the cybernetic context.

Data near processing support for climate data analysis

NASA Astrophysics Data System (ADS)

Kindermann, Stephan; Ehbrecht, Carsten; Hempelmann, Nils

2016-04-01

Climate data repositories grow in size exponentially. Scalable data near processing capabilities are required to meet future data analysis requirements and to replace current "data download and process at home" workflows and approaches. On one hand side, these processing capabilities should be accessible via standardized interfaces (e.g. OGC WPS), on the other side a large variety of processing tools, toolboxes and deployment alternatives have to be supported and maintained at the data/processing center. We present a community approach of a modular and flexible system supporting the development, deployment and maintenace of OGC-WPS based web processing services. This approach is organized in an open source github project (called "bird-house") supporting individual processing services ("birds", e.g. climate index calculations, model data ensemble calculations), which rely on basic common infrastructural components (e.g. installation and deployment recipes, analysis code dependencies management). To support easy deployment at data centers as well as home institutes (e.g. for testing and development) the system supports the management of the often very complex package dependency chain of climate data analysis packages as well as docker based packaging and installation. We present a concrete deployment scenario at the German Climate Computing Center (DKRZ). The DKRZ one hand side hosts a multi-petabyte climate archive which is integrated e.g. into the european ENES and worldwide ESGF data infrastructure, and on the other hand hosts an HPC center supporting (model) data production and data analysis. The deployment scenario also includes openstack based data cloud services to support data import and data distribution for bird-house based WPS web processing services. Current challenges for inter-institutionnal deployments of web processing services supporting the european and international climate modeling community as well as the climate impact community are highlighted. Also aspects supporting future WPS based cross community usage scenarios supporting data reuse and data provenance aspects are reflected.

A Community Health Worker-Based Program for Elderly People With Hypertension in Indonesia: A Qualitative Study, 2013.

PubMed

Rahmawati, Riana; Bajorek, Beata

2015-10-15

Hypertension is prevalent in the elderly, but treatment is often inadequate, particularly in developing countries. The objective of this study was to explore the role of a community-based program in supporting patients with hypertension in an Indonesian rural community. A qualitative study comprising observation and in-depth interviews was conducted in an Integrated Health Service Post for the Elderly (IHSP-Elderly) program in Bantul district (Yogyakarta province). Eleven members of IHSP-Elderly program (ie, hypertensive patients), 3 community health workers (CHWs), and 1 district health staff member were interviewed to obtain their views about the role of the IHSP-Elderly program in hypertension management. Data were analyzed using thematic analysis. CHWs played a prominent role as the gatekeepers of health care in the rural community. In supporting hypertension management, CHWs served members of the IHSP-Elderly program by facilitating blood pressure checks and physical exercise and providing health education. Members reported various benefits, such as a healthier feeling overall, peer support, and access to affordable health care. Members felt that IHSP-Elderly program could do more to provide routine blood pressure screening and improve the process of referral to other health care services. CHWs have the potential to liaise between rural communities and the wider health care system. Their role needs to be strengthened through targeted organizational support that aims to improve delivery of, and referral to, care. Further study is needed to identify the key factors for effective CHW-based programs in rural communities and the incorporation of these programs into the health care system.

Effecting Successful Community Re-Entry: Systems of Care Community Based Mental Health Services

ERIC Educational Resources Information Center

Estes, Rebecca I.; Fette, Claudette; Scaffa, Marjorie E.

2005-01-01

The need for system reform for child and adolescent mental health services, long recognized as a vital issue, continues to challenge mental health professionals. While past legislation has not adequately addressed the issues, the 2003 President's New Freedom Commission may begin to reorient mental health systems toward recovery. Supported by this…

Empowering communities and strengthening systems to improve transgender health: outcomes from the Pehchan programme in India

PubMed Central

Shaikh, Simran; Mburu, Gitau; Arumugam, Viswanathan; Mattipalli, Naveen; Aher, Abhina; Mehta, Sonal; Robertson, James

2016-01-01

Introduction Transgender populations face inequalities in access to HIV, health and social services. In addition, there is limited documentation of models for providing appropriately tailored services and social support for transgender populations in low- and middle-income countries. This paper presents outcomes of the Global Fund-supported Pehchan programme, which aimed to strengthen community systems and provide HIV, health, legal and social services to transgender communities across 18 Indian states through a rights-based empowerment approach. Methods We used a pre- and post-intervention cross-sectional survey design with retrospective analysis of programmatic data. Using stratified sampling, we identified 268 transgender participants in six Indian states from a total of 48,280 transgender people served by Pehchan through 186 community-based organizations. We quantified the impact of interventions by comparing baseline and end line indicators of accessed health social and legal services. We also assessed end line self-efficacy and collective action with regard to social support networks. Results There were significant increases in community-based demand and use of tailored health, legal, social and psychological services over the time of the Pehchan programme. We report significant increases in access to condoms (12.5%, p<0.001) and condom use at last anal sex with both regular (18.1%, p<0.001) and casual (8.1%, p<0.001) male partners. Access to HIV outreach education and testing and counselling services significantly increased (20.10%, p<0.001; 33.7%, p<0.001). In addition, significant increases in access to emergency crisis response (19.7%, p<0.001), legal support (26.8%, p<0.001) and mental health services (33.0%, p<0.001) were identified. Finally, we note that the Pehchan programme successfully provided a platform for the formation, collectivization and visibility of peer support groups. Conclusions The Pehchan programme's community involvement, rights-based collectivization and gender-affirming approaches significantly improved both demand and access to tailored HIV, health and social services for transgender individuals across India. Furthermore, the Pehchan programme successfully fostered both self-efficacy and collective identity and served as a model for addressing the unique health needs of transgender communities. Continued strengthening of health, social and community systems to better respond to the unique needs of transgender communities is needed in order to sustain these gains. PMID:27431474

Empowering communities and strengthening systems to improve transgender health: outcomes from the Pehchan programme in India.

PubMed

Shaikh, Simran; Mburu, Gitau; Arumugam, Viswanathan; Mattipalli, Naveen; Aher, Abhina; Mehta, Sonal; Robertson, James

2016-01-01

Transgender populations face inequalities in access to HIV, health and social services. In addition, there is limited documentation of models for providing appropriately tailored services and social support for transgender populations in low- and middle-income countries. This paper presents outcomes of the Global Fund-supported Pehchan programme, which aimed to strengthen community systems and provide HIV, health, legal and social services to transgender communities across 18 Indian states through a rights-based empowerment approach. We used a pre- and post-intervention cross-sectional survey design with retrospective analysis of programmatic data. Using stratified sampling, we identified 268 transgender participants in six Indian states from a total of 48,280 transgender people served by Pehchan through 186 community-based organizations. We quantified the impact of interventions by comparing baseline and end line indicators of accessed health social and legal services. We also assessed end line self-efficacy and collective action with regard to social support networks. There were significant increases in community-based demand and use of tailored health, legal, social and psychological services over the time of the Pehchan programme. We report significant increases in access to condoms (12.5%, p<0.001) and condom use at last anal sex with both regular (18.1%, p<0.001) and casual (8.1%, p<0.001) male partners. Access to HIV outreach education and testing and counselling services significantly increased (20.10%, p<0.001; 33.7%, p<0.001). In addition, significant increases in access to emergency crisis response (19.7%, p<0.001), legal support (26.8%, p<0.001) and mental health services (33.0%, p<0.001) were identified. Finally, we note that the Pehchan programme successfully provided a platform for the formation, collectivization and visibility of peer support groups. The Pehchan programme's community involvement, rights-based collectivization and gender-affirming approaches significantly improved both demand and access to tailored HIV, health and social services for transgender individuals across India. Furthermore, the Pehchan programme successfully fostered both self-efficacy and collective identity and served as a model for addressing the unique health needs of transgender communities. Continued strengthening of health, social and community systems to better respond to the unique needs of transgender communities is needed in order to sustain these gains.

The Impact of School Level and Socioeconomic Variables on the Adoption of School Community Based Management in Hawaii's Public Schools.

ERIC Educational Resources Information Center

O'Hora-Weir, M. Eileen; Ganopole, Selina

The School Community Based Management (SCBM) process for the Hawaii public school system, legislated in 1989, elicits input from administrators, teachers, support staff, parents, students, and community members. SCBM shifts some of the decision making powers to the school and can be adopted by a school on a voluntary basis. This study develops a…

Information system needs in health promotion: a case study of the Safe Community programme using requirements engineering methods.

PubMed

Timpka, Toomas; Olvander, Christina; Hallberg, Niklas

2008-09-01

The international Safe Community programme was used as the setting for a case study to explore the need for information system support in health promotion programmes. The 14 Safe Communities active in Sweden during 2002 were invited to participate and 13 accepted. A questionnaire on computer usage and a critical incident technique instrument were distributed. Sharing of management information, creating social capital for safety promotion, and injury data recording were found to be key areas that need to be further supported by computer-based information systems. Most respondents reported having access to a personal computer workstation with standard office software. Interest in using more advanced computer applications was low, and there was considerable need for technical user support. Areas where information systems can be used to make health promotion practice more efficient were identified, and patterns of computers usage were described.

The Evidence-base for Using Ontologies and Semantic Integration Methodologies to Support Integrated Chronic Disease Management in Primary and Ambulatory Care: Realist Review. Contribution of the IMIA Primary Health Care Informatics WG.

PubMed

Liyanage, H; Liaw, S-T; Kuziemsky, C; Terry, A L; Jones, S; Soler, J K; de Lusignan, S

2013-01-01

Most chronic diseases are managed in primary and ambulatory care. The chronic care model (CCM) suggests a wide range of community, technological, team and patient factors contribute to effective chronic disease management. Ontologies have the capability to enable formalised linkage of heterogeneous data sources as might be found across the elements of the CCM. To describe the evidence base for using ontologies and other semantic integration methods to support chronic disease management. We reviewed the evidence-base for the use of ontologies and other semantic integration methods within and across the elements of the CCM. We report them using a realist review describing the context in which the mechanism was applied, and any outcome measures. Most evidence was descriptive with an almost complete absence of empirical research and important gaps in the evidence-base. We found some use of ontologies and semantic integration methods for community support of the medical home and for care in the community. Ubiquitous information technology (IT) and other IT tools were deployed to support self-management support, use of shared registries, health behavioural models and knowledge discovery tools to improve delivery system design. Data quality issues restricted the use of clinical data; however there was an increased use of interoperable data and health system integration. Ontologies and semantic integration methods are emergent with limited evidence-base for their implementation. However, they have the potential to integrate the disparate community wide data sources to provide the information necessary for effective chronic disease management.

Educating for Community Change: Higher Education's Proposed Role in Community Transformation through the Federal Promise Neighborhood Policy

ERIC Educational Resources Information Center

Hudson, Elizabeth

2013-01-01

This study investigated a federal comprehensive community initiative, the Promise Neighborhood initiative, in order to understand higher education community engagement in an embedded context. Promise Neighborhood programs aim to create a place-based system of family and education services that can support youth from early childhood through college…

Systems development and difficulties in implementing procedures for elder abuse prevention among private community general support centers in Japan.

PubMed

Nakanishi, Miharu; Nakashima, Taeko; Yamaoka, Yukako; Hada, Keiko; Tanaka, Hideaki

2014-01-01

The present study examines differences in systems development and difficulties in implementing procedures for elder abuse prevention in 1,119 private and 606 public community general support centers under the public long-term care insurance program in Japan. The private community general support centers showed more difficulty implementing procedures than the public community general support centers. Controlling for the type of municipality, progress in systems development did not differ between the private and public community general support centers. Further research should examine how the characteristics of municipal governments are related to systems development in community general support centers.

Implementing community participation through legislative reform: a study of the policy framework for community participation in the Western Cape province of South Africa

PubMed Central

2012-01-01

Background Amidst an evolving post-apartheid policy framework for health, policymakers have sought to institutionalize community participation in Primary Health Care, recognizing participation as integral to realizing South Africa’s constitutional commitment to the right to health. With evolving South African legislation supporting community involvement in the health system, early policy developments focused on Community Health Committees (HCs) as the principal institutions of community participation. Formally recognized in the National Health Act of 2003, the National Health Act deferred to provincial governments in establishing the specific roles and functions of HCs. As a result, stakeholders developed a Draft Policy Framework for Community Participation in Health (Draft Policy) to formalize participatory institutions in the Western Cape province. Methods With the Draft Policy as a frame of analysis, the researchers conducted documentary policy analysis and semi-structured interviews on the evolution of South African community participation policy. Moving beyond the specific and unique circumstances of the Western Cape, this study analyzes generalizable themes for rights-based community participation in the health system. Results Framing institutions for the establishment, appointment, and functioning of community participation, the Draft Policy proposed a formal network of communication – from local HCs to the health system. However, this participation structure has struggled to establish itself and function effectively as a result of limitations in community representation, administrative support, capacity building, and policy commitment. Without legislative support for community participation, the enactment of superseding legislation is likely to bring an end to HC structures in the Western Cape. Conclusions Attempts to realize community participation have not adequately addressed the underlying factors crucial to promoting effective participation, with policy reforms necessary: to codify clearly defined roles and functions of community representation; to outline how communities engage with government through effective and accountable channels for participation; and to ensure extensive training and capacity building of community representatives. Given the public health importance of structured and effective policies for community participation, and the normative importance of participation in realizing a rights-based approach to health, this analysis informs researchers on the challenges to institutionalizing participation in health systems policy and provides practitioners with a research base to frame future policy reforms. PMID:22920557

Guiding Principles for Data Architecture to Support the Pathways Community HUB Model.

PubMed

Zeigler, Bernard P; Redding, Sarah; Leath, Brenda A; Carter, Ernest L; Russell, Cynthia

2016-01-01

The Pathways Community HUB Model provides a unique strategy to effectively supplement health care services with social services needed to overcome barriers for those most at risk of poor health outcomes. Pathways are standardized measurement tools used to define and track health and social issues from identification through to a measurable completion point. The HUB use Pathways to coordinate agencies and service providers in the community to eliminate the inefficiencies and duplication that exist among them. Experience with the Model has brought out the need for better information technology solutions to support implementation of the Pathways themselves through decision-support tools for care coordinators and other users to track activities and outcomes, and to facilitate reporting. Here we provide a basis for discussing recommendations for such a data infrastructure by developing a conceptual model that formalizes the Pathway concept underlying current implementations. The main contribution is a set of core recommendations as a framework for developing and implementing a data architecture to support implementation of the Pathways Community HUB Model. The objective is to present a tool for communities interested in adopting the Model to learn from and to adapt in their own development and implementation efforts. Experience with the Community Health Access Project (CHAP) data base system (the core implementation of the Model) has identified several issues and remedies that have been developed to address these issues. Based on analysis of issues and remedies, we present several key features for a data architecture meeting the just mentioned recommendations. Presentation of features is followed by a practical guide to their implementation allowing an organization to consider either tailoring off-the-shelf generic systems to meet the requirements or offerings that are specialized for community-based care coordination. Looking to future extensions, we discuss the utility and prospects for an ontology to include care coordination in the Unified Medical Language System (UMLS) of the National Library of Medicine and other existing medical and nursing taxonomies. Pathways structures are an important principle, not only for organizing the care coordination activities, but also for structuring the data stored in electronic form in the conduct of such care. We showed how the proposed architecture encourages design of effective decision support systems for coordinated care and suggested how interested organizations can set about acquiring such systems. Although the presentation focuses on the Pathways Community HUB Model, the principles for data architecture are stated in generic form and are applicable to any health information system for improving care coordination services and population health.

Decision-support systems for natural-hazards and land-management issues

USGS Publications Warehouse

Dinitz, Laura; Forney, William; Byrd, Kristin

2012-01-01

Scientists at the USGS Western Geographic Science Center are developing decision-support systems (DSSs) for natural-hazards and land-management issues. DSSs are interactive computer-based tools that use data and models to help identify and solve problems. These systems can provide crucial support to policymakers, planners, and communities for making better decisions about long-term natural hazards mitigation and land-use planning.

Using Technology to Facilitate Collaboration in Community-Based Participatory Research (CBPR)

PubMed Central

Jessell, Lauren; Smith, Vivian; Jemal, Alexis; Windsor, Liliane

2017-01-01

This study explores the use of Computer-Supported Collaborative Work (CSCW) technologies, by way of a computer-based system called iCohere. This system was used to facilitate collaboration conducting Community-Based Participatory Research (CBPR). Data was gathered from 13 members of a Community Collaborative Board (CCB). Analysis revealed that iCohere served the following functions: facilitating communication, providing a depository for information and resource sharing, and allowing for remote meeting attendance. Results indicated that while iCohere was useful in performing these functions, less expensive technologies had the potential to achieve similar goals if properly implemented. Implications for future research on CSCW systems and CBPR are discussed. PMID:29056871

Community Support for the Public Schools in a Large Metropolitan Area. Final Report.

ERIC Educational Resources Information Center

Smith, Ralph V.; And Others

An extensive survey was conducted in 1965 by a team of white and Negro interviewers in an application of ecological theory to a study of the support relationship between the community and its school system. Findings are based upon interview data from a probability sample of 931 respondents selected from the population of persons 21 years of age…

34 CFR 380.5 - What activities may the Secretary fund under community-based supported employment projects?

Code of Federal Regulations, 2011 CFR

2011-07-01

... the Secretary fund under community-based supported employment projects? (a) Authorized activities. The following activities are authorized under community-based projects: (1) Job search assistance. (2) Job... Community-Based Supported Employment projects for the provision of extended supported employment services...

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

PubMed

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

2007-08-01

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

Connecting Vulnerable Children and Families to Community-Based Programs Strengthens Parents' Perceptions of Protective Factors

ERIC Educational Resources Information Center

Hughes, Marcia; Joslyn, Allison; Wojton, Morella; O'Reilly, Mairead; Dworkin, Paul H.

2016-01-01

We employed principles from a nationally recognized prevention model on family support to investigate whether connecting vulnerable children to community-based programs and services through a statewide intervention system, the "Help Me Grow" program, strengthens parents' perceptions of protective factors. We used a parent survey modeled…

Le Bon Samaritain: A Community-Based Care Model Supported by Technology.

PubMed

Gay, Valerie; Leijdekkers, Peter; Gill, Asif; Felix Navarro, Karla

2015-01-01

The effective care and well-being of a community is a challenging task especially in an emergency situation. Traditional technology-based silos between health and emergency services are challenged by the changing needs of the community that could benefit from integrated health and safety services. Low-cost smart-home automation solutions, wearable devices and Cloud technology make it feasible for communities to interact with each other, and with health and emergency services in a timely manner. This paper proposes a new community-based care model, supported by technology, that aims at reducing healthcare and emergency services costs while allowing community to become resilient in response to health and emergency situations. We looked at models of care in different industries and identified the type of technology that can support the suggested new model of care. Two prototypes were developed to validate the adequacy of the technology. The result is a new community-based model of care called 'Le Bon Samaritain'. It relies on a network of people called 'Bons Samaritains' willing to help and deal with the basic care and safety aspects of their community. Their role is to make sure that people in their community receive and understand the messages from emergency and health services. The new care model is integrated with existing emergency warning, community and health services. Le Bon Samaritain model is scalable, community-based and can help people feel safer, less isolated and more integrated in their community. It could be the key to reduce healthcare cost, increase resilience and drive the change for a more integrated emergency and care system.

A trait-based approach for examining microbial community assembly

NASA Astrophysics Data System (ADS)

Prest, T. L.; Nemergut, D.

2015-12-01

Microorganisms regulate all of Earth's major biogeochemical cycles and an understanding of how microbial communities assemble is a key part in evaluating controls over many types of ecosystem processes. Rapid advances in technology and bioinformatics have led to a better appreciation for the variation in microbial community structure in time and space. Yet, advances in theory are necessary to make sense of these data and allow us to generate unifying hypotheses about the causes and consequences of patterns in microbial biodiversity and what they mean for ecosystem function. Here, I will present a metaanalysis of microbial community assembly from a variety of successional and post-disturbance systems. Our analysis shows various distinct patterns in community assembly, and the potential importance of nutrients and dispersal in shaping microbial community beta diversity in these systems. We also used a trait-based approach to generate hypotheses about the mechanisms driving patterns of microbial community assembly and the implications for function. Our work reveals the importance of rRNA operon copy number as a community aggregated trait in helping to reconcile differences in community dynamics between distinct types of successional and disturbed systems. Specifically, our results demonstrate that decreases in average copy number can be a common feature of communities across various drivers of ecological succession, supporting a transition from an r-selected to a K-selected community. Importantly, our work supports the scaling of the copy number trait over multiple levels of biological organization, from cells to populations and communities, and has implications for both ecology and evolution. Trait-based approaches are an important next step to generate and test hypotheses about the forces structuring microbial communities and the subsequent consequences for ecosystem function.

Facilitating a transition from compulsory detention of people who use drugs towards voluntary community-based drug dependence treatment and support services in Asia.

PubMed

Tanguay, Pascal; Kamarulzaman, Adeeba; Aramrattana, Apinun; Wodak, Alex; Thomson, Nicholas; Ali, Robert; Vumbaca, Gino; Lai, Gloria; Chabungbam, Anand

2015-10-16

Evidence indicates that detention of people who use drugs in compulsory centers in the name of treatment is common in Cambodia, China, Indonesia, Lao PDR, Malaysia, Myanmar, Philippines, Thailand, and Vietnam. The expansion of such practices has been costly, has not generated positive health outcomes, and has not reduced supply or demand for illicit drugs. United Nations agencies have convened several consultations with government and civil society stakeholders in order to facilitate a transition to voluntary evidence- and community-based drug dependence treatment and support services. In an effort to support such efforts, an informal group of experts proposes a three-step process to initiate and accelerate national-level transitions. Specifically, the working group recommends the establishment of a national multisectoral decision-making committee to oversee the development of national transition plans, drug policy reform to eliminate barriers to community-based drug dependence treatment and support services, and the integration of community-based drug dependence treatment in existing national health and social service systems.In parallel, the working group recommends that national-level transitions should be guided by overarching principles, including ethics, human rights, meaningful involvement of affected communities, and client safety, as well as good governance, transparency, and accountability. The transition also represents an opportunity to review the roles and responsibilities of various agencies across the public health and public security sectors in order to balance the workload and ensure positive results. The need to accelerate national-level transitions to voluntary community-based drug dependence treatment and support services is compelling--on economic, medical, sustainable community development, and ethical grounds--as extensively documented in the literature. In this context, the expert working group fully endorses initiation of a transition towards voluntary evidence- and community-based drug dependence treatment and support services across the region, as well as the steady scale-down of compulsory centers for drug users.Components of voluntary community-based drug dependence treatment and support services are being implemented in Cambodia, China, Indonesia, Malaysia, and Thailand. However, significant technical and financial support will be required to be allocated from national budgets and by international development agencies in order to complete the transition and reduce the reliance on detention of people who use drugs in Asia.

Aboriginal health learning in the forest and cultivated gardens: building a nutritious and sustainable food system.

PubMed

Stroink, Mirella L; Nelson, Connie H

2009-01-01

Sustainable food systems are those in which diverse foods are produced in close proximity to a market. A dynamic, adaptive knowledge base that is grounded in local culture and geography and connected to outside knowledge resources is essential for such food systems to thrive. Sustainable food systems are particularly important to remote and Aboriginal communities, where extensive transportation makes food expensive and of poorer nutritional value. The Learning Garden program was developed and run with two First Nation communities in northwestern Ontario. With this program, the team adopted a holistic and experiential model of learning to begin rebuilding a knowledge base that would support a sustainable local food system. The program involved a series of workshops held in each community and facilitated by a community-based coordinator. Topics included cultivated gardening and forest foods. Results of survey data collected from 20 Aboriginal workshop participants are presented, revealing a moderate to low level of baseline knowledge of the traditional food system, and a reliance on the mainstream food system that is supported by food values that place convenience, ease, and price above the localness or cultural connectedness of the food. Preliminary findings from qualitative data are also presented on the process of learning that occurred in the program and some of the insights we have gained that are relevant to future adaptations of this program.

Sustainability of the Communities That Care prevention system by coalitions participating in the Community Youth Development Study.

PubMed

Gloppen, Kari M; Arthur, Michael W; Hawkins, J David; Shapiro, Valerie B

2012-09-01

Community prevention coalitions are a common strategy to mobilize stakeholders to implement tested and effective prevention programs to promote adolescent health and well-being. This article examines the sustainability of Communities That Care (CTC) coalitions approximately 20 months after study support for the intervention ended. The Community Youth Development Study is a community-randomized trial of the CTC prevention system. Using data from 2007 and 2009 coalition leader interviews, this study reports changes in coalition activities from a period of study support for CTC (2007) to 20 months following the end of study support for CTC (2009), measured by the extent to which coalitions continued to meet specific benchmarks. Twenty months after study support for CTC implementation ended, 11 of 12 CTC coalitions in the Community Youth Development Study still existed. The 11 remaining coalitions continued to report significantly higher scores on the benchmarks of phases 2 through 5 of the CTC system than did prevention coalitions in the control communities. At the 20-month follow-up, two-thirds of the CTC coalitions reported having a paid staff person. This study found that the CTC coalitions maintained a relatively high level of implementation fidelity to the CTC system 20 months after the study support for the intervention ended. However, the downward trend in some of the measured benchmarks indicates that continued high-quality training and technical assistance may be important to ensure that CTC coalitions maintain a science-based approach to prevention, and continue to achieve public health impacts on adolescent health and behavior outcomes. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Factors affecting success of an integrated community-based telehealth system.

PubMed

Hsieh, Hui-Lung; Tsai, Chung-Hung; Chih, Wen-Hai; Lin, Huei-Hsieh

2015-01-01

The rise of chronic and degenerative diseases in developed countries has become one critical epidemiologic issue. Telehealth can provide one viable way to enhance health care, public health, and health education delivery and support. The study aims to empirically examine and evaluate the success factors of community-based telehealth system adoption. The valid 336 respondents are the residents of a rural community in Taiwan. The structural equation modeling (SEM) was used to assess the proposed model applied to telehealth. The findings showed the research model had good explanatory power and fitness. Also, the findings indicated that system quality exerted the strongest overall effect on intention to use. Furthermore, service quality exerted the strongest overall effect on user satisfaction. The findings also illustrated that the joint effects of three intrinsic qualities (system quality, information quality, and service quality) on use were mediated by user satisfaction and intention to use. The study implies that community-based telehealth service providers should improve three intrinsic qualities to enhance user satisfaction and intention to use, which in turn can lead to increase the usage of the telehealth equipment. The integrated community-based telehealth system may become an innovative and suitable way to deliver better care to the residents of communities.

Community case management of malaria: exploring support, capacity and motivation of community medicine distributors in Uganda.

PubMed

Banek, Kristin; Nankabirwa, Joaniter; Maiteki-Sebuguzi, Catherine; DiLiberto, Deborah; Taaka, Lilian; Chandler, Clare I R; Staedke, Sarah G

2015-05-01

In Uganda, community services for febrile children are expanding from presumptive treatment of fever with anti-malarials through the home-based management of fever (HBMF) programme, to include treatment for malaria, diarrhoea and pneumonia through Integrated Community Case Management (ICCM). To understand the level of support available, and the capacity and motivation of community health workers to deliver these expanded services, we interviewed community medicine distributors (CMDs), who had been involved in the HBMF programme in Tororo district, shortly before ICCM was adopted. Between October 2009 and April 2010, 100 CMDs were recruited to participate by convenience sampling. The survey included questionnaires to gather information about the CMDs' work experience and to assess knowledge of fever case management, and in-depth interviews to discuss experiences as CMDs including motivation, supervision and relationships with the community. All questionnaires and knowledge assessments were analysed. Summary contact sheets were made for each of the 100 interviews and 35 were chosen for full transcription and analysis. CMDs faced multiple challenges including high patient load, limited knowledge and supervision, lack of compensation, limited drugs and supplies, and unrealistic expectations of community members. CMDs described being motivated to volunteer for altruistic reasons; however, the main benefits of their work appeared related to 'becoming someone important', with the potential for social mobility for self and family, including building relationships with health workers. At the time of the survey, over half of CMDs felt demotivated due to limited support from communities and the health system. Community health worker programmes rely on the support of communities and health systems to operate sustainably. When this support falls short, motivation of volunteers can wane. If community interventions, in increasingly complex forms, are to become the solution to improving access to primary health care, greater attention to what motivates individuals, and ways to strengthen health system support are required. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014.

A Community Health Worker–Based Program for Elderly People With Hypertension in Indonesia: A Qualitative Study, 2013

PubMed Central

Bajorek, Beata

2015-01-01

Introduction Hypertension is prevalent in the elderly, but treatment is often inadequate, particularly in developing countries. The objective of this study was to explore the role of a community-based program in supporting patients with hypertension in an Indonesian rural community. Methods A qualitative study comprising observation and in-depth interviews was conducted in an Integrated Health Service Post for the Elderly (IHSP-Elderly) program in Bantul district (Yogyakarta province). Eleven members of IHSP-Elderly program (ie, hypertensive patients), 3 community health workers (CHWs), and 1 district health staff member were interviewed to obtain their views about the role of the IHSP-Elderly program in hypertension management. Data were analyzed using thematic analysis. Results CHWs played a prominent role as the gatekeepers of health care in the rural community. In supporting hypertension management, CHWs served members of the IHSP-Elderly program by facilitating blood pressure checks and physical exercise and providing health education. Members reported various benefits, such as a healthier feeling overall, peer support, and access to affordable health care. Members felt that IHSP-Elderly program could do more to provide routine blood pressure screening and improve the process of referral to other health care services. Conclusion CHWs have the potential to liaise between rural communities and the wider health care system. Their role needs to be strengthened through targeted organizational support that aims to improve delivery of, and referral to, care. Further study is needed to identify the key factors for effective CHW-based programs in rural communities and the incorporation of these programs into the health care system. PMID:26469948

Linking case management and community development.

PubMed

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

2006-01-01

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

How can policy strengthen community support for children in military families?

PubMed

Boberiene, Liepa V; Hornback, Bradley J

2014-09-01

The extraordinary demands of recent wars have increased burdens on many military families and existing systems of care. The sacrifices made by service members are made also by their children and families, and these sacrifices can have long-term consequences. Therefore, military children and families cannot go unrecognized and unsupported. Policy responses should be less about diagnosing and treating individuals and more about recognizing and supporting families' and communities' resilience in the face of wartime deployment. Policy should focus on identifying military children in diverse communities and supporting them where they live, learn, and receive care. A range of community-based prevention strategies could decrease stress before it escalates into serious mental health issues. Efforts to develop family resilience during deployment and reintegration are extremely important in facilitating children's healthy development and veterans' recovery. Military personnel should partner with community leaders to implement effective programs providing emotional, social, and practical support to families. Emphasizing family cohesion, community social support, and comprehensive programs through education and health care organizations would go a long way in fostering families' resilience. At the same time, pro- grams should be monitored and evaluated, and military and civilian researchers should share data on family risk and resilience to improve evidence- based approaches. Such efforts would benefit not only military children, but also larger populations as programs improve family and community capacity to support thriving and mitigate challenges in the face of adversity.

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

PubMed

Boesten, Jelke

2011-01-01

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

Towards a strategic alignment of public health and primary care practices at local levels - the case of severe and enduring mental illness.

PubMed

Banarsee, Ricky; Kelly, Cornelius; El-Osta, Austen; Thomas, Paul; Brophy, Chris

2018-03-01

The rapidly increasing number of people who have long-term conditions requires a system of coordinated support for self-care throughout the NHS. A system to support self-care needs to be aligned to systems that support shared-care and community development, making it easier for the multidisciplinary teams who provide care to also help patients and populations to help themselves. Public health practitioners need to work closely with clinicians to achieve this. The best place to coordinate this partnership is a community-based coordinating hub, or local health community - a geographic area of about 50,000 population where different contributions to self-care can be aligned. A shared vision for both health and disease management is needed to ensure consistent messaging by all. A three tier system of shared care can help to combine vertical and horizontal integration. This paper uses severe and enduring mental illness as an exemplar to anticipate the design of such a system.

Community Multiscale Air Quality Model

EPA Science Inventory

The U.S. EPA developed the Community Multiscale Air Quality (CMAQ) system to apply a “one atmosphere” multiscale and multi-pollutant modeling approach based mainly on the “first principles” description of the atmosphere. The multiscale capability is supported by the governing di...

Hope and despair: community health assistants' experiences of working in a rural district in Zambia.

PubMed

Zulu, Joseph Mumba; Kinsman, John; Michelo, Charles; Hurtig, Anna-Karin

2014-05-25

In order to address the challenges facing the community-based health workforce in Zambia, the Ministry of Health implemented the national community health assistant strategy in 2010. The strategy aims to address the challenges by creating a new group of workers called community health assistants (CHAs) and integrating them into the health system. The first group started working in August 2012. The objective of this paper is to document their motivation to become a CHA, their experiences of working in a rural district, and how these experiences affected their motivation to work. A phenomenological approach was used to examine CHAs' experiences. Data collected through in-depth interviews with 12 CHAs in Kapiri Mposhi district and observations were analysed using a thematic analysis approach. Personal characteristics such as previous experience and knowledge, passion to serve the community and a desire to improve skills motivated people to become CHAs. Health systems characteristics such as an inclusive work culture in some health posts motivated CHAs to work. Conversely, a non-inclusive work culture created a social structure which constrained CHAs' ability to learn, to be innovative and to effectively conduct their duties. Further, limited supervision, misconceptions about CHA roles, poor prioritisation of CHA tasks by some supervisors, as well as non- and irregular payment of incentives also adversely affected CHAs' ability to work effectively. In addition, negative feedback from some colleagues at the health posts affected CHA's self-confidence and professional outlook. In the community, respect and support provided to CHAs by community members instilled a sense of recognition, appreciation and belonging in CHAs which inspired them to work. On the other hand, limited drug supplies and support from other community-based health workers due to their exclusion from the government payroll inhibited CHAs' ability to deliver services. Programmes aimed at integrating community-based health workers into health systems should adequately consider multiple incentives, effective management, supervision and support from the district. These should be tailored towards enhancing the individual, health system and community characteristics that positively impact work motivation at the local level if such programmes are to effectively contribute towards improved primary healthcare.

Hope and despair: community health assistants’ experiences of working in a rural district in Zambia

PubMed Central

2014-01-01

Background In order to address the challenges facing the community-based health workforce in Zambia, the Ministry of Health implemented the national community health assistant strategy in 2010. The strategy aims to address the challenges by creating a new group of workers called community health assistants (CHAs) and integrating them into the health system. The first group started working in August 2012. The objective of this paper is to document their motivation to become a CHA, their experiences of working in a rural district, and how these experiences affected their motivation to work. Methods A phenomenological approach was used to examine CHAs’ experiences. Data collected through in-depth interviews with 12 CHAs in Kapiri Mposhi district and observations were analysed using a thematic analysis approach. Results Personal characteristics such as previous experience and knowledge, passion to serve the community and a desire to improve skills motivated people to become CHAs. Health systems characteristics such as an inclusive work culture in some health posts motivated CHAs to work. Conversely, a non-inclusive work culture created a social structure which constrained CHAs’ ability to learn, to be innovative and to effectively conduct their duties. Further, limited supervision, misconceptions about CHA roles, poor prioritisation of CHA tasks by some supervisors, as well as non- and irregular payment of incentives also adversely affected CHAs’ ability to work effectively. In addition, negative feedback from some colleagues at the health posts affected CHA’s self-confidence and professional outlook. In the community, respect and support provided to CHAs by community members instilled a sense of recognition, appreciation and belonging in CHAs which inspired them to work. On the other hand, limited drug supplies and support from other community-based health workers due to their exclusion from the government payroll inhibited CHAs’ ability to deliver services. Conclusions Programmes aimed at integrating community-based health workers into health systems should adequately consider multiple incentives, effective management, supervision and support from the district. These should be tailored towards enhancing the individual, health system and community characteristics that positively impact work motivation at the local level if such programmes are to effectively contribute towards improved primary healthcare. PMID:24886146

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.

Web-based Traffic Noise Control Support System for Sustainable Transportation

NASA Astrophysics Data System (ADS)

Fan, Lisa; Dai, Liming; Li, Anson

Traffic noise is considered as one of the major pollutions that will affect our communities in the future. This paper presents a framework of web-based traffic noise control support system (WTNCSS) for a sustainable transportation. WTNCSS is to provide the decision makers, engineers and publics a platform to efficiently access the information, and effectively making decisions related to traffic control. The system is based on a Service Oriented Architecture (SOA) which takes the advantages of the convenience of World Wide Web system with the data format of XML. The whole system is divided into different modules such as the prediction module, ontology-based expert module and dynamic online survey module. Each module of the system provides a distinct information service to the decision support center through the HTTP protocol.

Usability evaluation of the interactive Personal Patient Profile-Prostate decision support system with African American men.

PubMed

Jaja, Cheedy; Pares-Avila, Jose; Wolpin, Seth; Berry, Donna

2010-04-01

The Personal Patient Profile-Prostate (P4) program is an interactive Web-based decision support system that provides men with localized prostate cancer customized education and coaching with which to make the best personal treatment decision. This study assessed functionality and usability of the P4 program and identified problems in user-computer interaction in a sample of African American men. Usability testing was conducted with 12 community-dwelling African American adult men. The health status of participants was not known or collected by the research team. Each participant worked with the P4 program and provided simultaneous feedback using the "think aloud" technique. Handwritten field notes were collated and assigned to 3 standard coded categories. Aspects of P4 program usability was made based on common issues in the assigned categories. Summary statistics were derived for types and frequency of usability issues noted in the coded data. Twelve participants reported a total of 122 usability comments, with a mean of 9 usability comments. The most common usability issue by participant was completeness of information content, which comprised 53 (43%) of the total issues. Comprehensibility of text and graphics was second, comprising 51 (42%) of the total issues. This study provided initial inventory of usability issues for community African American men that may potentially interfere with application of the P4 system in the community setting and overall system usability, confirming the need for usability testing of a culturally appropriate Internet-based decision support system before community application.

Designing and implementing a trust-wide quality assurance programme.

PubMed

Coope, Sally-Ann

2018-04-02

Derbyshire Community Health Services (DCHS) NHS Foundation Trust provides a wide range of community-based health services. After the Care Quality Commission (CQC) found gaps in the trust's assurance process, its board decided to develop a method of continuous quality improvements that could be used as a basis for the trust's quality assurance system. The trust adapted and built on an acute model so it was suitable for community services. The final assurance system, Quality Always, has four elements: the clinical assessment and accreditation scheme; leadership development; 'champions' within clinical teams to support and promote the scheme; and dashboards to record and monitor progress. A system to recognise and reward achievement was essential for success. Quality Always has resulted in better care quality, an improved CQC rating, a sense of achievement among staff, the development of support networks, learning (especially among support staff) and good practice being shared.

Building flexibility and managing complexity in community mental health: lessons learned in a large urban centre.

PubMed

Stergiopoulos, Vicky; Saab, Dima; Francombe Pridham, Kate; Aery, Anjana; Nakhost, Arash

2018-01-24

Across many jurisdictions, adults with complex mental health and social needs face challenges accessing appropriate supports due to system fragmentation and strict eligibility criteria of existing services. To support this underserviced population, Toronto's local health authority launched two novel community mental health models in 2014, inspired by Flexible Assertive Community Team principles. This study explores service user and provider perspectives on the acceptability of these services, and lessons learned during early implementation. We purposively sampled 49 stakeholders (staff, physicians, service users, health systems stakeholders) and conducted 17 semi-structured qualitative interviews and 5 focus groups between October 23, 2014 and March 2, 2015, exploring stakeholder perspectives on the newly launched team based models, as well as activities and strategies employed to support early implementation. Interviews and focus groups were audio recorded, transcribed verbatim and analyzed using thematic analysis. Findings revealed wide-ranging endorsement for the two team-based models' success in engaging the target population of adults with complex service needs. Implementation strengths included the broad recognition of existing service gaps, the use of interdisciplinary teams and experienced service providers, broad partnerships and collaboration among various service sectors, training and team building activities. Emerging challenges included lack of complementary support services such as suitable housing, organizational contexts reluctant to embrace change and risk associated with complexity, as well as limited service provider and organizational capacity to deliver evidence-based interventions. Findings identified implementation drivers at the practitioner, program, and system levels, specific to the implementation of community mental health interventions for adults with complex health and social needs. These can inform future efforts to address the health and support needs of this vulnerable population.

Facilitating the development of a county health coverage plan with data from a community-based health survey.

PubMed

Kruger, Daniel J; Hamacher, Linda; Strugar-Fritsch, Donna; Shirey, Lauren; Renda, Emily; Zimmerman, Marc A

2010-07-01

Community-Based Participatory Research (CBPR) has the twin goals of generating data and shaping policy decisions, yet examples that combine these goals are scarce in the literature. We describe how a community-based survey was created and used to help develop a county health plan. The Genesee Health Plan (GHP), a community-initiated non-profit organization, provides primary care, prescription drugs, and specialty care to uninsured, low-income adults through a network of independent physicians, clinics, and hospital systems. As part of an advocacy effort, GHP supporters used results from the Speak to Your Health! Community Survey to gain financial and political support for GHP. Our study, which used CBPR principles, was created by the community, local health department, and university partners. As a result, Genesee County became one of the first counties in the United States to make basic health care available to nearly all of its uninsured, low-income adults.

Family first: Community-based supports for refugees.

PubMed

Pejic, Vanja; Hess, Robyn S; Miller, Gloria E; Wille, Alice

2016-01-01

This article presents a community-based approach that targets family interventions and services through a preventive, family systems ecological framework. A public health approach is used to emphasize the need for a tiered model of family support that builds on the strengths of refugee families while recognizing their specific needs and challenges. The rationale for a family systems ecological perspective is presented to highlight the critical features of effective family support programs for refugee families, followed by a discussion regarding the transitions and adaptation faced by refugee families when entering the United States. Finally, a public-health problem solving model is employed to promote a comprehensive vision for how more effective support can be developed to best serve the mental health needs of refugee families. An integrated case example highlighting the Somali Parent Program, a family-focused intervention, is also provided. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Social support and responsiveness in online patient communities: impact on service quality perceptions.

PubMed

Nambisan, Priya; Gustafson, David H; Hawkins, Robert; Pingree, Suzanne

2016-02-01

Hospitals frequently evaluate their service quality based on the care and services provided to patients by their clinical and non-clinical staff.(1,2) However, such evaluations do not take into consideration the many interactions that patients have in online patient communities with the health-care organization (HCO) as well as with peer patients. Patients' interactions in these online communities could impact their perceptions regarding the HCO's service quality. The objective of this pilot study was to evaluate the impact of social support and responsiveness that patients experience in an HCO's online community on patients' perceptions regarding the HCO's service quality. The study data are collected from CHESS, a health-care programme (Comprehensive Health Enhancement Support System) run by the Centre for Health Enhancement System Studies at the University of Wisconsin-Madison. Findings show that the social support and the responsiveness received from peer patients in the online patient communities will impact patients' perceptions regarding the service quality of the HCO even when the organizational members themselves do not participate in the online discussions. The results indicate that interactions in such HCO-provided online patient communities should not be ignored as they could translate into patients' perceptions regarding HCOs' service quality. Ways to improve responsiveness and social support in an HCO's online patient community are discussed. © 2014 John Wiley & Sons Ltd.

Who Should We Target? The Impact of Individual and Family Characteristics on the Expressed Need for Community-Based Treatment Support in HIV Patients in South Africa.

PubMed

Wouters, Edwin; Booysen, Frederik le Roux; Masquillier, Caroline

2016-01-01

Reviews of impact evaluations of community-based health workers and peer support groups highlight the considerable variability in the effectiveness of such support in improving antiretroviral treatment (ART) outcomes. Evidence indicates that community-based support interventions targeting patients known to be at risk will probably display better results than generic interventions aimed at the entire population of people living with HIV. It is however difficult to identify these at-risk populations, rendering knowledge on the characteristics of patients groups who are in need of community-based support a clear research priority. The current study aims to address the knowledge gap by exploring the predictors of the willingness to (1) receive the support from a community-based health worker or (2) to participate in a support group in public sector ART programme of the Free State Province of South Africa. Based on the Individual-Family-Community framework for HIV research, the study employs a comprehensive approach by not only testing classical individual-level but also family-level predictors of the willingness to receive community-based support. In addition to individual-level predictors-such as age, health status and coping styles-our analysis demonstrated the importance of family characteristics. The results indicated that discrepancies in the family's changeability level were an important predictor of the demand for community-based support services. Conversely, the findings indicated that patients living in a family more flexible than deemed ideal are more likely to require the support of a community health worker. The current study expands theory by indicating the need to acknowledge all social ecological levels in the study of chronic HIV care. The detection of both individual level and family level determinants of the expressed need for community-based support can inform health policy to devise strategies to target scarce resources to those vulnerable patients who report the greatest need for this support. In this way, the study results are a first step in an attempt to move away from generic, broad based community-based interventions towards community support that is tailored to the patient needs at both the individual and family level.

Developing Tomorrow's Integrated Community Health Systems: A Leadership Challenge for Public Health and Primary Care

PubMed Central

Welton, William E.; Kantner, Theodore A.; Katz, Sheila Moriber

1997-01-01

As the nation's health system moves away from earlier models to one grounded in population health and market-based systems of care, new challenges arise for public health professionals, primary care practitioners, health plan and institutional managers, and community leaders. Among the challenges are the need to develop creative concepts of organization and accountability and to assure that dynamic, system-oriented structures support the new kind of leadership that is required. Developing tomorrow's integrated community health systems will challenge the leadership skills and integrative abilities of public health professionals, primary care practitioners, and managers. These leaders and their new organizations must, in turn, assume increased accountability for improving community health. PMID:9184684

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

PubMed Central

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

2017-01-01

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

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

PubMed

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

2017-09-27

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

A Space-Based Near-Earth Object Survey Telescope in Support of Human Exploration, Solar System Science, and Planetary Defense

NASA Technical Reports Server (NTRS)

Abell, Paul A.

2011-01-01

Human exploration of near-Earth objects (NEOs) beginning in 2025 is one of the stated objectives of U.S. National Space Policy. Piloted missions to these bodies would further development of deep space mission systems and technologies, obtain better understanding of the origin and evolution of our Solar System, and support research for asteroid deflection and hazard mitigation strategies. As such, mission concepts have received much interest from the exploration, science, and planetary defense communities. One particular system that has been suggested by all three of these communities is a space-based NEO survey telescope. Such an asset is crucial for enabling affordable human missions to NEOs circa 2025 and learning about the primordial population of objects that could present a hazard to the Earth in the future.

Convergent Technologies in Distance Learning Delivery.

ERIC Educational Resources Information Center

Wheeler, Steve

1999-01-01

Describes developments in British education in distance learning technologies. Highlights include networking the rural areas; communication, community, and paradigm shifts; digital compression techniques and telematics; Web-based material delivered over the Internet; system flexibility; social support; learning support; videoconferencing; and…

A community-based approach to the promotion of breastfeeding in Mexico.

PubMed

Rodriguez-Garcia, R; Aumack, K J; Ramos, A

1990-01-01

A comprehensive education strategy is presented that links training, community education, research, and mass-media efforts to enhance breastfeeding practices. Breastfeeding promotion models, an administrative system, and lessons learned during the project are described. The keys to effective breastfeeding promotion are shown to be accurate information; appropriate education, training, and follow-up; and a supportive administrative system.

An environmental scan of emergency response systems and services in remote First Nations communities in Northern Ontario.

PubMed

Mew, E J; Ritchie, S D; VanderBurgh, D; Beardy, J L; Gordon, J; Fortune, M; Mamakwa, S; Orkin, A M

2017-01-01

Approximately 24,000 Ontarians live in remote Indigenous communities with no road access. These communities are a subset of Nishnawbe Aski Nation (NAN), a political grouping of 49 First Nations communities in Northern Ontario, Canada. Limited information is available regarding the status of emergency care in these communities. We aimed to understand emergency response systems, services, and training in remote NAN communities. We used an environmental scan approach to compile information from multiple sources including community-based participatory research. This included the analysis of data collected from key informant interviews (n=10) with First Nations community health leaders and a multi-stakeholder roundtable meeting (n=33) in October 2013. Qualitative analysis of the interview data revealed four issues related to emergency response systems and training: (1) inequity in response capacity and services, (2) lack of formalised dispatch systems, (3) turnover and burnout in volunteer emergency services, and (4) challenges related to first aid training. Roundtable stakeholders supported the development of a community-based emergency care system to address gaps. Existing first response, paramedical, and ambulance service models do not meet the unique geographical, epidemiological and cultural needs in most NAN communities. Sustainable, context-appropriate, and culturally relevant emergency care systems are needed.

Supporting community annotation and user collaboration in the integrated microbial genomes (IMG) system.

PubMed

Chen, I-Min A; Markowitz, Victor M; Palaniappan, Krishna; Szeto, Ernest; Chu, Ken; Huang, Jinghua; Ratner, Anna; Pillay, Manoj; Hadjithomas, Michalis; Huntemann, Marcel; Mikhailova, Natalia; Ovchinnikova, Galina; Ivanova, Natalia N; Kyrpides, Nikos C

2016-04-26

The exponential growth of genomic data from next generation technologies renders traditional manual expert curation effort unsustainable. Many genomic systems have included community annotation tools to address the problem. Most of these systems adopted a "Wiki-based" approach to take advantage of existing wiki technologies, but encountered obstacles in issues such as usability, authorship recognition, information reliability and incentive for community participation. Here, we present a different approach, relying on tightly integrated method rather than "Wiki-based" method, to support community annotation and user collaboration in the Integrated Microbial Genomes (IMG) system. The IMG approach allows users to use existing IMG data warehouse and analysis tools to add gene, pathway and biosynthetic cluster annotations, to analyze/reorganize contigs, genes and functions using workspace datasets, and to share private user annotations and workspace datasets with collaborators. We show that the annotation effort using IMG can be part of the research process to overcome the user incentive and authorship recognition problems thus fostering collaboration among domain experts. The usability and reliability issues are addressed by the integration of curated information and analysis tools in IMG, together with DOE Joint Genome Institute (JGI) expert review. By incorporating annotation operations into IMG, we provide an integrated environment for users to perform deeper and extended data analysis and annotation in a single system that can lead to publications and community knowledge sharing as shown in the case studies.

Application of NASA's advanced life support technologies in polar regions

NASA Astrophysics Data System (ADS)

Bubenheim, D. L.; Lewis, C.

1997-01-01

NASA's advanced life support technologies are being combined with Arctic science and engineering knowledge in the Advanced Life Systems for Extreme Environments (ALSEE) project. This project addresses treatment and reduction of waste, purification and recycling of water, and production of food in remote communities of Alaska. The project focus is a major issue in the state of Alaska and other areas of the Circumpolar North; the health and welfare of people, their lives and the subsistence lifestyle in remote communities, care for the environment, and economic opportunity through technology transfer. The challenge is to implement the technologies in a manner compatible with the social and economic structures of native communities, the state, and the commercial sector. NASA goals are technology selection, system design and methods development of regenerative life support systems for planetary and Lunar bases and other space exploration missions. The ALSEE project will provide similar advanced technologies to address the multiple problems facing the remote communities of Alaska and provide an extreme environment testbed for future space applications. These technologies have never been assembled for this purpose. They offer an integrated approach to solving pressing problems in remote communities.

Under the radar: community safety nets for AIDS-affected households in sub-Saharan Africa.

PubMed

Foster, G

2007-01-01

Safety nets are mechanisms to mitigate the effects of poverty on vulnerable households during times of stress. In sub-Saharan Africa, extended families, together with communities, are the most effective responses enabling access to support for households facing crises. This paper reviews literature on informal social security systems in sub-Saharan Africa, analyses changes taking place in their functioning as a result of HIV/AIDS and describes community safety net components including economic associations, cooperatives, loan providers, philanthropic groups and HIV/AIDS initiatives. Community safety nets target households in greatest need, respond rapidly to crises, are cost efficient, based on local needs and available resources, involve the specialized knowledge of community members and provide financial and psycho-social support. Their main limitations are lack of material resources and reliance on unpaid labour of women. Changes have taken place in safety net mechanisms because of HIV/AIDS, suggesting the resilience of communities rather than their impending collapse. Studies are lacking that assess the value of informal community-level transfers, describe how safety nets assist the poor or analyse modifications in response to HIV/AIDS. The role of community safety nets remains largely invisible under the radar of governments, non-governmental organizations and international bodies. External support can strengthen this system of informal social security that provides poor HIV/AIDS-affected households with significant support.

Community Air Monitoring for Pesticide Drift Using Pesticide Action Network's (PAN) Drift Catcher

NASA Astrophysics Data System (ADS)

Marquez, E.

2016-12-01

Community air monitoring projects for pesticides in the air have been conducted by PAN in collaboration with community members and locally based groups engaged around pesticide issues. PAN is part of an international network working to promote a just, thriving food system and replace the use of hazardous pesticides with ecologically sound alternatives. The Drift Catcher is an air-monitoring device with a design based on the California Air Resource Board's air monitoring equipment, and has been used in community-based projects in 11 states. Observations of pesticide drift made by community members cannot always be confirmed by regulatory agencies—if an inspection is made hours or days after a drift incident, the evidence may no longer be present. The Drift Catcher makes it possible to collect scientific evidence of pesticide drift in areas where people live, work, and play. One of the most recent Drift Catcher projects was done in California, in partnership with the Safe Strawberry Coalition and led by the statewide coalition Californians for Pesticide Reform. The data were used to support a call for stronger mitigation rules for the fumigant chloropicrin and to support a campaign asking for stronger pesticide rules to protect children attending school in close proximity to agricultural fields. The Drift Catcher data are used by organizers and community members to engage policymakers with the intention of making policy change on a local and/or statewide level. On the national level, PAN's Drift Catcher data has helped win regulatory recognition of volatilization drift for pesticides other than fumigants. Lessons learned from conducting community-based research projects will also be discussed. PAN is also currently assessing other community-based monitoring tools, such as community surveys and drift questionnaires that may allow communities to collect data that can also support the campaign work.

Community Reintegration for People with Psychiatric Disabilities: Challenging Systemic Barriers to Service Provision and Public Policy through Participatory Action Research

ERIC Educational Resources Information Center

Mirza, Mansha; Gossett, Andrea; Chan, Nathan Kai-Cheong; Burford, Larry; Hammel, Joy

2008-01-01

People with psychiatric disabilities represent a growing group within the population of nursing home residents in the USA. Despite a preference for living in community-based settings, the availability of supportive services for community living is hindered by barriers at both the service provision and public policy levels. Therefore, understanding…

New York State's Community Colleges: Cost-Effective Engines of Educational Access and Economic Development.

ERIC Educational Resources Information Center

McCall, H. Carl

New York State's 36 community colleges have operated under serious financial constraints since the beginning of the last recession in 1990, which diminished state funding and induced program cuts and higher tuition. New York's community college system was established based on a funding model of one-third each by State aid, local support, and…

The Latina paradox: an opportunity for restructuring prenatal care delivery.

PubMed

McGlade, Michael S; Saha, Somnath; Dahlstrom, Marie E

2004-12-01

Latina mothers in the United States enjoy surprisingly favorable birth outcomes despite their social disadvantages. This "Latina paradox" is particularly evident among Mexican-born women. The social and cultural factors that contribute to this paradox are maintained by community networks--informal systems of prenatal care that are composed of family, friends, community members, and lay health workers. This informal system confers protective factors that provide a behavioral context for healthy births. US-born Latinas are losing this protection, although it could be maintained with the support of community-based informal care systems. We recommend steps to harness the benefits of informal systems of prenatal care in Latino communities to meet the increasing needs of pregnant Latina women.

Who Should We Target? The Impact of Individual and Family Characteristics on the Expressed Need for Community-Based Treatment Support in HIV Patients in South Africa

PubMed Central

Wouters, Edwin; Booysen, Frederik le Roux; Masquillier, Caroline

2016-01-01

Reviews of impact evaluations of community-based health workers and peer support groups highlight the considerable variability in the effectiveness of such support in improving antiretroviral treatment (ART) outcomes. Evidence indicates that community-based support interventions targeting patients known to be at risk will probably display better results than generic interventions aimed at the entire population of people living with HIV. It is however difficult to identify these at-risk populations, rendering knowledge on the characteristics of patients groups who are in need of community-based support a clear research priority. The current study aims to address the knowledge gap by exploring the predictors of the willingness to (1) receive the support from a community-based health worker or (2) to participate in a support group in public sector ART programme of the Free State Province of South Africa. Based on the Individual-Family-Community framework for HIV research, the study employs a comprehensive approach by not only testing classical individual-level but also family-level predictors of the willingness to receive community-based support. In addition to individual-level predictors—such as age, health status and coping styles—our analysis demonstrated the importance of family characteristics. The results indicated that discrepancies in the family’s changeability level were an important predictor of the demand for community-based support services. Conversely, the findings indicated that patients living in a family more flexible than deemed ideal are more likely to require the support of a community health worker. The current study expands theory by indicating the need to acknowledge all social ecological levels in the study of chronic HIV care. The detection of both individual level and family level determinants of the expressed need for community-based support can inform health policy to devise strategies to target scarce resources to those vulnerable patients who report the greatest need for this support. In this way, the study results are a first step in an attempt to move away from generic, broad based community-based interventions towards community support that is tailored to the patient needs at both the individual and family level. PMID:27741239

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

Breastfeeding protection, promotion, and support in the United States: a time to nudge, a time to measure.

PubMed

Pérez-Escamilla, Rafael; Chapman, Donna J

2012-05-01

Strong evidence-based advocacy efforts have now translated into high level political support and concrete goals for improving breastfeeding outcomes among women in the United States. In spite of this, major challenge remain for promoting, supporting and especially for protecting breastfeeding in the country. The goals of this commentary are to argue in favor of: A) Changes in the default social and environmental systems, that would allow women to implement their right to breastfeed their infants, B) A multi-level and comprehensive monitoring system to measure process and outcomes indicators in the country. Evidence-based commentary. Breastfeeding rates in the United States can improve based on a well coordinated social marketing framework. This approach calls for innovative promotion through mass media, appropriate facility based and community based support (e.g., Baby Friendly Hospital Initiative, WIC-coordinated community based peer counseling), and adequate protection for working women (e.g., longer paid maternity leave, breastfeeding or breast milk extraction breaks during the working day) and women at large by adhering and enforcing the WHO ethics Code for the Marketing of Breast Milk Substitutes. Sound infant feeding practices monitoring systems, which include WIC administrative food package data, are needed. Given the current high level of political support to improve breastfeeding in the United States, a window of opportunity has been opened. Establishing breastfeeding as the social norm in the USA will take time, but the global experience indicates that it can be done.

SMARTe: An MCDA Approach To Revitalize Communities And Restore The Environment

EPA Science Inventory

SMARTe (Sustainable Management Approaches and Revitalization Tools - electronic) is a free, open-source, web-based, decision-support system that helps revitalization stakeholders (communities, developers, regulators, etc.) overcome obstac...

Comparing a paper based monitoring and evaluation system to a mHealth system to support the national community health worker programme, South Africa: an evaluation

PubMed Central

2014-01-01

Background In an attempt to address a complex disease burden, including improving progress towards MDGs 4 and 5, South Africa recently introduced a re-engineered Primary Health Care (PHC) strategy, which has led to the development of a national community health worker (CHW) programme. The present study explored the development of a cell phone-based and paper-based monitoring and evaluation (M&E) system to support the work of the CHWs. Methods One sub-district in the North West province was identified for the evaluation. One outreach team comprising ten CHWs maintained both the paper forms and mHealth system to record household data on community-based services. A comparative analysis was done to calculate the correspondence between the paper and phone records. A focus group discussion was conducted with the CHWs. Clinical referrals, data accuracy and supervised visits were compared and analysed for the paper and phone systems. Results Compared to the mHealth system where data accuracy was assured, 40% of the CHWs showed a consistently high level (>90% correspondence) of data transfer accuracy on paper. Overall, there was an improvement over time, and by the fifth month, all CHWs achieved a correspondence of 90% or above between phone and paper data. The most common error that occurred was summing the total number of visits and/or activities across the five household activity indicators. Few supervised home visits were recorded in either system and there was no evidence of the team leader following up on the automatic notifications received on their cell phones. Conclusions The evaluation emphasizes the need for regular supervision for both systems and rigorous and ongoing assessments of data quality for the paper system. Formalization of a mHealth M&E system for PHC outreach teams delivering community based services could offer greater accuracy of M&E and enhance supervision systems for CHWs. PMID:25106499

Creating a Longitudinal Integrated Clerkship with Mutual Benefits for an Academic Medical Center and a Community Health System

PubMed Central

Poncelet, Ann Noelle; Mazotti, Lindsay A; Blumberg, Bruce; Wamsley, Maria A; Grennan, Tim; Shore, William B

2014-01-01

The longitudinal integrated clerkship is a model of clinical education driven by tenets of social cognitive theory, situated learning, and workplace learning theories, and built on a foundation of continuity between students, patients, clinicians, and a system of care. Principles and goals of this type of clerkship are aligned with primary care principles, including patient-centered care and systems-based practice. Academic medical centers can partner with community health systems around a longitudinal integrated clerkship to provide mutual benefits for both organizations, creating a sustainable model of clinical training that addresses medical education and community health needs. A successful one-year longitudinal integrated clerkship was created in partnership between an academic medical center and an integrated community health system. Compared with traditional clerkship students, students in this clerkship had better scores on Clinical Performance Examinations, internal medicine examinations, and high perceptions of direct observation of clinical skills. Advantages for the academic medical center include mitigating the resources required to run a longitudinal integrated clerkship while providing primary care training and addressing core competencies such as systems-based practice, practice-based learning, and interprofessional care. Advantages for the community health system include faculty development, academic appointments, professional satisfaction, and recruitment. Success factors include continued support and investment from both organizations’ leadership, high-quality faculty development, incentives for community-based physician educators, and emphasis on the mutually beneficial relationship for both organizations. Development of a longitudinal integrated clerkship in a community health system can serve as a model for developing and expanding these clerkship options for academic medical centers. PMID:24867551

Creating a longitudinal integrated clerkship with mutual benefits for an academic medical center and a community health system.

PubMed

Poncelet, Ann Noelle; Mazotti, Lindsay A; Blumberg, Bruce; Wamsley, Maria A; Grennan, Tim; Shore, William B

2014-01-01

The longitudinal integrated clerkship is a model of clinical education driven by tenets of social cognitive theory, situated learning, and workplace learning theories, and built on a foundation of continuity between students, patients, clinicians, and a system of care. Principles and goals of this type of clerkship are aligned with primary care principles, including patient-centered care and systems-based practice. Academic medical centers can partner with community health systems around a longitudinal integrated clerkship to provide mutual benefits for both organizations, creating a sustainable model of clinical training that addresses medical education and community health needs. A successful one-year longitudinal integrated clerkship was created in partnership between an academic medical center and an integrated community health system. Compared with traditional clerkship students, students in this clerkship had better scores on Clinical Performance Examinations, internal medicine examinations, and high perceptions of direct observation of clinical skills.Advantages for the academic medical center include mitigating the resources required to run a longitudinal integrated clerkship while providing primary care training and addressing core competencies such as systems-based practice, practice-based learning, and interprofessional care. Advantages for the community health system include faculty development, academic appointments, professional satisfaction, and recruitment.Success factors include continued support and investment from both organizations' leadership, high-quality faculty development, incentives for community-based physician educators, and emphasis on the mutually beneficial relationship for both organizations. Development of a longitudinal integrated clerkship in a community health system can serve as a model for developing and expanding these clerkship options for academic medical centers.

Describing and analysing primary health care system support for chronic illness care in Indigenous communities in Australia's Northern Territory - use of the Chronic Care Model.

PubMed

Si, Damin; Bailie, Ross; Cunningham, Joan; Robinson, Gary; Dowden, Michelle; Stewart, Allison; Connors, Christine; Weeramanthri, Tarun

2008-05-28

Indigenous Australians experience disproportionately high prevalence of, and morbidity and mortality from chronic illness such as diabetes, renal disease and cardiovascular disease. Improving the understanding of how Indigenous primary care systems are organised to deliver chronic illness care will inform efforts to improve the quality of care for Indigenous people. This cross-sectional study was conducted in 12 Indigenous communities in Australia's Northern Territory. Using the Chronic Care Model as a framework, we carried out a mail-out survey to collect information on material, financial and human resources relating to chronic illness care in participating health centres. Follow up face-to-face interviews with health centre staff were conducted to identify successes and difficulties in the systems in relation to providing chronic illness care to community members. Participating health centres had distinct areas of strength and weakness in each component of systems: 1) organisational influence - strengthened by inclusion of chronic illness goals in business plans, appointment of designated chronic disease coordinators and introduction of external clinical audits, but weakened by lack of training in disease prevention and health promotion and limited access to Medicare funding; 2) community linkages - facilitated by working together with community organisations (e.g. local stores) and running community-based programs (e.g. "health week"), but detracted by a shortage of staff especially of Aboriginal health workers working in the community; 3) self management - promoted through patient education and goal setting with clients, but impeded by limited focus on family and community-based activities due to understaffing; 4) decision support - facilitated by distribution of clinical guidelines and their integration with daily care, but limited by inadequate access to and support from specialists; 5) delivery system design - strengthened by provision of transport for clients to health centres, separate men's and women's clinic rooms, specific roles of primary care team members in relation to chronic illness care, effective teamwork, and functional pathology and pharmacy systems, but weakened by staff shortage (particularly doctors and Aboriginal health workers) and high staff turnover; and 6) clinical information systems - facilitated by wide adoption of computerised information systems, but weakened by the systems' complexity and lack of IT maintenance and upgrade support. Using concrete examples, this study translates the concept of the Chronic Care Model (and associated systems view) into practical application in Australian Indigenous primary care settings. This approach proved to be useful in understanding the quality of primary care systems for prevention and management of chronic illness. Further refinement of the systems should focus on both increasing human and financial resources and improving management practice.

A business model for managing system change through strategic financing and performance indicators: a case study.

PubMed

Armstrong, Mary I; Milch, Heidi; Curtis, Peter; Endress, Phillip

2012-06-01

This article describes how a system of care operated by a county government agency used a fiscal crisis as the opportunity to reform its children's system. A cross-system response to the crisis is outlined that includes a system of care framework coupled with a business model, inter-departmental collaboration and leadership, the use of strategic reinvestment strategies, and a quality improvement system that focuses on key indicators. Implementation of the system change is described with a specific focus on cross-system entry points, financing strategies that re-allocate funds from deep-end programs to community-based services, and management oversight through the use of performance indicators to monitor and support effectiveness. This article examines the results of the system change, including the diversion of youth from system penetration, the reduction in residential treatment bed days, the re-allocation of these savings to community-based services, and the outcomes of children who were diverted from residential care and served in the community. The article offers a number of recommendations for other communities contemplating system change.

Scalable principles of community-based high-value care for seriously ill individuals: Diamonds in the rough.

PubMed

Parikh, Ravi B; Bowman, Brynn; Dahlin, Constance; Twohig, Jeanne S; Meier, Diane E

2017-03-01

Early, integrated palliative care has been shown to improve quality of life and reduce utilization in both inpatient and outpatient settings. As health systems shift to risk-based payment structures, palliative care will play an increasing role in improving value of care outside of the hospital. Based on successful models of community-based palliative care, we identify six principles - interdisciplinary team-based care; 24/7 access and responsiveness; concurrent palliative care with disease-directed treatment; targeting services to high-risk patients; integrated medical and social supports; and caregiver support - that are widely implemented because of their impact on improving value for seriously ill individuals. Copyright © 2016 Elsevier Inc. All rights reserved.

It's Complicated: Negotiating Between Traditional Research and Community-Based Participatory Research in a Translational Study.

PubMed

Hopkins, Allison L; Moore-Monroy, Martha; Wilkinson-Lee, Ada M; Nuño, Velia Leybas; Armenta, Alexandra; Lopez, Elvia; Vanzzini, Susan; Garcia, Francisco A

2016-01-01

The Interactive Systems Framework (ISF), a guide for translational research, encourages the balancing of traditional research and community-based participatory research (CBPR) approaches. This paper focuses on the challenges, solutions, and lessons learned in applying the ISF to our translational research project. A community-campus partnership translated evidence-based screening guidelines on sexually transmitted infections (STIs) and depression into culturally relevant educational materials. Community health workers (CHWs) disseminated the information through a cross-over design to Hispanic women in Pima County, Arizona. Challenges, solutions, and lessons learned were identified throughout this process. We identified challenges in the areas of research design, and in the ISF systems of prevention synthesis and translation, prevention support, and prevention delivery. We successfully negotiate solutions between the scientific and local community that resulted in acceptable compromises for both groups. The model presented by the ISF is difficult to achieve, but we offer concrete solutions to community members and scientists to move toward that ideal.

A Value-Based Case Study to Increasing Community Mentoring in STEM for Hispanic Students

NASA Astrophysics Data System (ADS)

Moreno, Gilberto

This case study investigates the implementation of a unique community-driven mentoring pilot program (PASOS2) forging stronger community and K-12 partnerships. Focused on surfacing what matters most in engaging community mentors, this case study explores a civic organization's quest to impact, expand, and bring value via mentoring to Hispanic students' pursuit of post-secondary studies with emphasis in STEM careers. A major stumbling block faced by many underprivileged students is the lack of mentorship vital to expanding their social capital support system. This innovative mentoring approach provides students with critical access to STEM community empowerment agents supporting aspiring students' dreams. Analytical methods and principles of case study research focus on how community mentor choices impact community mentorship value. The study examines whether or not a formal mentoring system with a value-driven mentoring curriculum matters in attracting, preparing, and sustaining community mentors to advocate for STEM careers to Hispanic students. A mentor value equation is introduced correlating mentor capacity to build student relationships, demystify STEM, deliver career guidance, and fortify student readiness. A formal mentor development training program integrates a technology-based 'grit' software platform to enhance student awareness, understanding, and commitment to considering a STEM career. Through the investigation of a formal mentoring experience, the study reveals what best practices, tools, and techniques influence community mentor engagement. The findings of this case study underscore the value in preparing community mentor capacity and competency. The very nature of the PASOS2 project being civic community-based informs other communities on how their investments can fortify Hispanic student social capital in their successful pursuit of STEM careers.

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

PubMed

McGinnis, Sandra L; Zoske, Frances M

2008-08-01

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

"It Starts out with Little Things": An Exploration of Urban Adolescents' Support-Seeking Strategies in the Context of School

ERIC Educational Resources Information Center

Brion-Meisels, Gretchen

2016-01-01

Background: Student support systems have become a permanent structure in most U.S. public schools, responsible for ensuring equal access to support services. Typically utilized before special education is deemed necessary, these supports often include a range of school- and community-based services such as tutors, mentors, out-of-school time…

Building beyond the Evaluation Of Environmental Education and Sustainable Development in African Schools and Communities: The Women Global Green Action Network (WGGAN) Africa Perspective

ERIC Educational Resources Information Center

Enie, Rosemary Olive Mbone

2006-01-01

This article describes the Community Health Education and School Sanitation (CHESS) Project, an initiative by the Women Global Green Action Network International to support community-based environmental projects in Africa. The CHESS Project uses women, children and youth to develop more sustainable health and sanitation systems in urban and rural…

American Indian Women Cancer Survivor's Needs and Preferences: Community Support for Cancer Experiences.

PubMed

Burnette, Catherine E; Roh, Soonhee; Liddell, Jessica; Lee, Yeon-Shim

2018-03-15

Cancer (the focus of this inquiry) is the leading cause of death among American Indian and Alaska Native women. The purpose of this study was to identify American Indian women cancer survivors' needs and preferences related to community supports for their cancer experience. This qualitative study examined female American Indian cancer survivors' needs and preferences about community support. The sample included 43 American Indian women cancer survivors (the types of cancer survivors included cervical cancer: n = 14; breast cancer: n = 14; and colon and other types: n = 15) residing in the Northern Plains region, in the state of South Dakota. Data were analyzed using qualitative content analysis and were collected between June of 2014 and February of 2015. When asked about their needs and preferences, 82% of participants (n = 35) of female American Indian cancer survivors reported at least one of the following most commonly reported themes: cancer support groups (n = 31, 72%), infrastructure for community support (n = 17, 40%), and cancer education (n = 11, 26%). In addition to the aforementioned themes, 33% of participants (n = 14) indicated the need for an improved healthcare system, with 11% (n = 5) of participants expressly desiring the integration of spirituality and holistic healing options. The majority of American Indian women cancer survivor participants of this study identified a need for more community-based support systems and infrastructures to aid with the cancer survivor experience. Results warrant a community approach to raise awareness, education, and support for American Indian cancer survivors.

Exploration of the Factors That Support Learning: Web-Based Activity and Testing Systems in Community College Algebra

ERIC Educational Resources Information Center

Hauk, Shandy; Matlen, Bryan

2016-01-01

A variety of computerized interactive learning platforms exist. Most include instructional supports in the form of problem sets. Feedback to users ranges from a single word like "Correct!" to offers of hints and partially to fully worked examples. Behind-the-scenes design of such systems varies as well --from static dictionaries of…

Exploration of the Factors That Support Learning: Web-Based Activity and Testing Systems in Community College Algebra [Contributed Report

ERIC Educational Resources Information Center

Hauk, Shandy; Matlen, Bryan; Thomas, Larry

2017-01-01

A variety of computerized interactive learning platforms exist. Most include instructional supports in the form of problem sets. Feedback to users ranges from a single word like "Correct!" to offers of hints and partially- to fully-worked examples. Behind-the-scenes design of systems varies as well--from static dictionaries of problems…

Knowledge Discovery from Posts in Online Health Communities Using Unified Medical Language System.

PubMed

Chen, Donghua; Zhang, Runtong; Liu, Kecheng; Hou, Lei

2018-06-19

Patient-reported posts in Online Health Communities (OHCs) contain various valuable information that can help establish knowledge-based online support for online patients. However, utilizing these reports to improve online patient services in the absence of appropriate medical and healthcare expert knowledge is difficult. Thus, we propose a comprehensive knowledge discovery method that is based on the Unified Medical Language System for the analysis of narrative posts in OHCs. First, we propose a domain-knowledge support framework for OHCs to provide a basis for post analysis. Second, we develop a Knowledge-Involved Topic Modeling (KI-TM) method to extract and expand explicit knowledge within the text. We propose four metrics, namely, explicit knowledge rate, latent knowledge rate, knowledge correlation rate, and perplexity, for the evaluation of the KI-TM method. Our experimental results indicate that our proposed method outperforms existing methods in terms of providing knowledge support. Our method enhances knowledge support for online patients and can help develop intelligent OHCs in the future.

Critical care nursing. Expanding roles and responsibilities within the community.

PubMed

Bigler, B R

1990-09-01

The health care system in the United States is undergoing many changes, including the return of chronically dependent individuals who are medically fragile to the community's homes and schools. Community-based health care, when compared with hospital care, is more cost effective and is the consumer's preference. The supportive technology to perform skilled therapies is available and recent legislation, although not adequate, provides support. Not only is the community becoming an arena for the provision of more complex care, it is also becoming an arena for addressing ethical issues. The nursing profession is challenged to prepare skilled nurses for the greater independence that is required in community-based practice. Nurses need to become more aware of the authority inherent in their professional role in order to most effectively address and resolve the more complex and often intensive care needs of their clients who are medically fragile and being cared for in the community and to guide their families in the resolution of related ethical dilemmas.

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

PubMed

Schneider, Helen; Nxumalo, Nonhlanhla

2017-09-15

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

Geographic Health Information Systems: A Platform To Support The ‘Triple Aim’

PubMed Central

Miranda, Marie Lynn; Ferranti, Jeffrey; Strauss, Benjamin; Neelon, Brian; Califf, Robert M.

2014-01-01

Despite the rapid growth of electronic health data, most data systems do not connect individual patient records to data sets from outside the health care delivery system. These isolated data systems cannot support efforts to recognize or address how the physical and environmental context of each patient influences health choices and health outcomes. In this article we describe how a geographic health information system in Durham, North Carolina, links health system and social and environmental data via shared geography to provide a multidimensional understanding of individual and community health status and vulnerabilities. Geographic health information systems can be useful in supporting the Institute for Healthcare Improvement’s Triple Aim Initiative to improve the experience of care, improve the health of populations, and reduce per capita costs of health care. A geographic health information system can also provide a comprehensive information base for community health assessment and intervention for accountable care that includes the entire population of a geographic area. PMID:24019366

Women of Burma Speak Out: Workshops to Deconstruct Gender-Based Violence and Build Systems of Peace and Justice

ERIC Educational Resources Information Center

Norsworthy, Kathryn L.; Khuankaew, Ouyporn

2004-01-01

Refugee and internally displaced women of Burma examined structural and institutional violence against women within their communities within workshop formats. Group members also discussed strategies for transforming systems supporting gender-based violence into structures of peace and gender justice. The authors describe their methodology, based…

Profiling bacterial communities associated with sediment-based aquaculture bioremediation systems under contrasting redox regimes

NASA Astrophysics Data System (ADS)

Robinson, Georgina; Caldwell, Gary S.; Wade, Matthew J.; Free, Andrew; Jones, Clifford L. W.; Stead, Selina M.

2016-12-01

Deposit-feeding invertebrates are proposed bioremediators in microbial-driven sediment-based aquaculture effluent treatment systems. We elucidate the role of the sediment reduction-oxidation (redox) regime in structuring benthic bacterial communities, having direct implications for bioremediation potential and deposit-feeder nutrition. The sea cucumber Holothuria scabra was cultured on sediments under contrasting redox regimes; fully oxygenated (oxic) and redox stratified (oxic-anoxic). Taxonomically, metabolically and functionally distinct bacterial communities developed between the redox treatments with the oxic treatment supporting the greater diversity; redox regime and dissolved oxygen levels were the main environmental drivers. Oxic sediments were colonised by nitrifying bacteria with the potential to remediate nitrogenous wastes. Percolation of oxygenated water prevented the proliferation of anaerobic sulphate-reducing bacteria, which were prevalent in the oxic-anoxic sediments. At the predictive functional level, bacteria within the oxic treatment were enriched with genes associated with xenobiotics metabolism. Oxic sediments showed the greater bioremediation potential; however, the oxic-anoxic sediments supported a greater sea cucumber biomass. Overall, the results indicate that bacterial communities present in fully oxic sediments may enhance the metabolic capacity and bioremediation potential of deposit-feeder microbial systems. This study highlights the benefits of incorporating deposit-feeding invertebrates into effluent treatment systems, particularly when the sediment is oxygenated.

Profiling bacterial communities associated with sediment-based aquaculture bioremediation systems under contrasting redox regimes

PubMed Central

Robinson, Georgina; Caldwell, Gary S.; Wade, Matthew J.; Free, Andrew; Jones, Clifford L. W.; Stead, Selina M.

2016-01-01

Deposit-feeding invertebrates are proposed bioremediators in microbial-driven sediment-based aquaculture effluent treatment systems. We elucidate the role of the sediment reduction-oxidation (redox) regime in structuring benthic bacterial communities, having direct implications for bioremediation potential and deposit-feeder nutrition. The sea cucumber Holothuria scabra was cultured on sediments under contrasting redox regimes; fully oxygenated (oxic) and redox stratified (oxic-anoxic). Taxonomically, metabolically and functionally distinct bacterial communities developed between the redox treatments with the oxic treatment supporting the greater diversity; redox regime and dissolved oxygen levels were the main environmental drivers. Oxic sediments were colonised by nitrifying bacteria with the potential to remediate nitrogenous wastes. Percolation of oxygenated water prevented the proliferation of anaerobic sulphate-reducing bacteria, which were prevalent in the oxic-anoxic sediments. At the predictive functional level, bacteria within the oxic treatment were enriched with genes associated with xenobiotics metabolism. Oxic sediments showed the greater bioremediation potential; however, the oxic-anoxic sediments supported a greater sea cucumber biomass. Overall, the results indicate that bacterial communities present in fully oxic sediments may enhance the metabolic capacity and bioremediation potential of deposit-feeder microbial systems. This study highlights the benefits of incorporating deposit-feeding invertebrates into effluent treatment systems, particularly when the sediment is oxygenated. PMID:27941918

Community Coalitions' Gender-Aware Policy and Systems Changes to Improve the Health of Women and Girls.

PubMed

Kowalczyk, Shelly; Randolph, Suzanne M; Oravecz, Linda

2017-10-17

Addressing environmental barriers and community conditions through policy and systems change provides the foundation for creating sustainable public health change at the population level. In an effort to influence population-level change that is gender aware, the United States Department of Health and Human Services Office on Women's Health funded the Coalition for a Healthier Community initiative supporting 10 grantees in the implementation of gender-based, public health systems approaches to improve women and girls' health. A national evaluation assessed the extent to which these gender-aware public health systems approaches result in programs and policies that are sustainable and cost effective in addressing health disparities in women and girls. For this paper, a review of policies reported on in grantees' quarterly progress reports was conducted, and policies were categorized based on each policy's status, level, sector affected, and whether it was gender aware. The review revealed 77 policies at varying stages of development or implementation intended to facilitate systems-level change at the coalition, school, organizational, local, or state level. Fifty-one percent of these policies were identified as being gender aware, because they were intended to reduce barriers to or increase facilitators of gender equity. Community coalitions, like the Coalition for a Healthier Community coalitions, can be valuable channels for promoting policy change, as demonstrated by the many policies developed and/or supported by the Coalition for a Healthier Community grantees in their attempt to meet the needs of women and girls. Copyright © 2017. Published by Elsevier Inc.

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

PubMed Central

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

2015-01-01

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

The emergency first aid responder system model: using community members to assist life-threatening emergencies in violent, developing areas of need.

PubMed

Sun, Jared H; Wallis, Lee A

2012-08-01

As many as 90% of all trauma-related deaths occur in developing nations, and this is expected to get worse with modernisation. The current method of creating an emergency care system by modelling after that of a Western nation is too resource-heavy for most developing countries to handle. A cheaper, more community-based model is needed to establish new emergency care systems and to support them to full maturity. A needs assessment was undertaken in Manenberg, a township in Cape Town with high violence and injury rates. Community leaders and successfully established local services were consulted for the design of a first responder care delivery model. The resultant community-based emergency first aid responder (EFAR) system was implemented, and EFARs were tracked over time to determine skill retention and usage. The EFAR system model and training curriculum. Basic EFARs are spread throughout the community with the option of becoming stationed advanced EFARs. All EFARs are overseen by a local organisation and a professional body, and are integrated with the local ambulance response if one exists. On competency examinations, all EFARs tested averaged 28.2% before training, 77.8% after training, 71.3% 4 months after training and 71.0% 6 months after training. EFARs reported using virtually every skill taught them, and further review showed that they had done so adequately. The EFAR system is a low-cost, versatile model that can be used in a developing region both to lay the foundation for an emergency care system or support a new one to maturity.

Supporting community annotation and user collaboration in the integrated microbial genomes (IMG) system

DOE PAGES

Chen, I-Min A.; Markowitz, Victor M.; Palaniappan, Krishna; ...

2016-04-26

Background: The exponential growth of genomic data from next generation technologies renders traditional manual expert curation effort unsustainable. Many genomic systems have included community annotation tools to address the problem. Most of these systems adopted a "Wiki-based" approach to take advantage of existing wiki technologies, but encountered obstacles in issues such as usability, authorship recognition, information reliability and incentive for community participation. Results: Here, we present a different approach, relying on tightly integrated method rather than "Wiki-based" method, to support community annotation and user collaboration in the Integrated Microbial Genomes (IMG) system. The IMG approach allows users to use existingmore » IMG data warehouse and analysis tools to add gene, pathway and biosynthetic cluster annotations, to analyze/reorganize contigs, genes and functions using workspace datasets, and to share private user annotations and workspace datasets with collaborators. We show that the annotation effort using IMG can be part of the research process to overcome the user incentive and authorship recognition problems thus fostering collaboration among domain experts. The usability and reliability issues are addressed by the integration of curated information and analysis tools in IMG, together with DOE Joint Genome Institute (JGI) expert review. Conclusion: By incorporating annotation operations into IMG, we provide an integrated environment for users to perform deeper and extended data analysis and annotation in a single system that can lead to publications and community knowledge sharing as shown in the case studies.« less

Supporting community annotation and user collaboration in the integrated microbial genomes (IMG) system

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

Chen, I-Min A.; Markowitz, Victor M.; Palaniappan, Krishna

Background: The exponential growth of genomic data from next generation technologies renders traditional manual expert curation effort unsustainable. Many genomic systems have included community annotation tools to address the problem. Most of these systems adopted a "Wiki-based" approach to take advantage of existing wiki technologies, but encountered obstacles in issues such as usability, authorship recognition, information reliability and incentive for community participation. Results: Here, we present a different approach, relying on tightly integrated method rather than "Wiki-based" method, to support community annotation and user collaboration in the Integrated Microbial Genomes (IMG) system. The IMG approach allows users to use existingmore » IMG data warehouse and analysis tools to add gene, pathway and biosynthetic cluster annotations, to analyze/reorganize contigs, genes and functions using workspace datasets, and to share private user annotations and workspace datasets with collaborators. We show that the annotation effort using IMG can be part of the research process to overcome the user incentive and authorship recognition problems thus fostering collaboration among domain experts. The usability and reliability issues are addressed by the integration of curated information and analysis tools in IMG, together with DOE Joint Genome Institute (JGI) expert review. Conclusion: By incorporating annotation operations into IMG, we provide an integrated environment for users to perform deeper and extended data analysis and annotation in a single system that can lead to publications and community knowledge sharing as shown in the case studies.« less

Innovation in a Learning Health Care System: Veteran-Directed Home- and Community-Based Services.

PubMed

Garrido, Melissa M; Allman, Richard M; Pizer, Steven D; Rudolph, James L; Thomas, Kali S; Sperber, Nina R; Van Houtven, Courtney H; Frakt, Austin B

2017-11-01

A path-breaking example of the interplay between geriatrics and learning healthcare systems is the Veterans Health Administration's (VHA's) planned roll-out of a program for providing participant-directed home- and community-based services to veterans with cognitive and functional limitations. We describe the design of a large-scale, stepped-wedge, cluster-randomized trial of the Veteran-Directed Home- and Community-Based Services (VD-HCBS) program. From March 2017 through December 2019, up to 77 Veterans Affairs Medical Centers will be randomized to times to begin offering VD-HCBS to veterans at risk of nursing home placement. Services will be provided to community-dwelling participants with support from Aging and Disability Network Agencies. The VHA Partnered Evidence-based Policy Resource Center (PEPReC) is coordinating the evaluation, which includes collaboration from operational stakeholders from the VHA and Administration for Community Living and interdisciplinary researchers from the Center of Innovation in Long-Term Services and Supports and the Center for Health Services Research in Primary Care. For older veterans with functional limitations who are eligible for VD-HCBS, we will evaluate health outcomes (hospitalizations, emergency department visits, nursing home admissions, days at home) and healthcare costs associated with VD-HCBS availability. Learning healthcare systems facilitate diffusion of innovation while enabling rigorous evaluation of effects on patient outcomes. The VHA's randomized rollout of VD-HCBS to veterans at risk of nursing home placement is an example of how to achieve these goals simultaneously. PEPReC's experience designing an evaluation with researchers and operations stakeholders may serve as a framework for others seeking to develop rapid, rigorous, large-scale evaluations of delivery system innovations targeted to older adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Description of data base management systems activities

NASA Technical Reports Server (NTRS)

1983-01-01

One of the major responsibilities of the JPL Computing and Information Services Office is to develop and maintain a JPL plan for providing computing services to the JPL management and administrative community that will lead to improved productivity. The CISO plan to accomplish this objective has been titled 'Management and Administrative Support Systems' (MASS). The MASS plan is based on the continued use of JPL's IBM 3032 Computer system for administrative computing and for the MASS functions. The current candidate administrative Data Base Management Systems required to support the MASS include ADABASE, Cullinane IDMS and TOTAL. Previous uses of administrative Data Base Systems have been applied to specific local functions rather than in a centralized manner with elements common to the many user groups. Limited capacity data base systems have been installed in microprocessor based office automation systems in a few Project and Management Offices using Ashton-Tate dBASE II. These experiences plus some other localized in house DBMS uses have provided an excellent background for developing user and system requirements for a single DBMS to support the MASS program.

Wayfinding the Live 5-2-1-0 Initiative-At the Intersection between Systems Thinking and Community-Based Childhood Obesity Prevention.

PubMed

Amed, Shazhan; Shea, Stephanie; Pinkney, Susan; Wharf Higgins, Joan; Naylor, Patti-Jean

2016-06-21

Childhood obesity is complex and requires a 'systems approach' that collectively engages across multiple community settings. Sustainable Childhood Obesity Prevention through Community Engagement (SCOPE) has implemented Live 5-2-1-0-a multi-sector, multi-component childhood obesity prevention initiative informed by systems thinking and participatory research via an innovative knowledge translation (KT) model (RE-FRAME). This paper describes the protocol for implementing and evaluating RE-FRAME in two 'existing' (>2 years of implementation) and two 'new' Live 5-2-1-0 communities to understand how to facilitate and sustain systems/community-level change. In this mixed-methods study, RE-FRAME was implemented via online resources, webinars, a backbone organization (SCOPE) coordinating the initiative, and a linking system supporting KT. Qualitative and quantitative data were collected using surveys and stakeholder interviews, analyzed using thematic analysis and descriptive statistics, respectively. Existing communities described the consistency of Live 5-2-1-0 and extensive local partnerships/champions as catalysts for synergistic community-wide action; new communities felt that the simplicity of the message combined with the transfer of experiential learning would inform their own strategies and policies/programs to broadly disseminate Live 5-2-1-0. RE-FRAME effectively guided the refinement of the initiative and provided a framework upon which evaluation results described how to implement a community-based systems approach to childhood obesity prevention.

Systems of Care. Factsheet.

ERIC Educational Resources Information Center

Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Center for Mental Health Services.

This fact sheet explains the concept of "systems of care" in meeting the mental health needs of children and adolescents with behavioral, emotional, or mental health problems. Community-based systems of care provide a coordinated range of mental health and related services and supports. Teams representing public and private organizations…

Seasonality, water use and community management of water systems in rural settings: Qualitative evidence from Ghana, Kenya, and Zambia.

PubMed

Kelly, Emma; Shields, Katherine F; Cronk, Ryan; Lee, Kristen; Behnke, Nikki; Klug, Tori; Bartram, Jamie

2018-07-01

The sustainability of rural, community-managed water systems in sub-Saharan Africa depends in part on the ability of local water committees to repair breakdowns and carry out the operation and maintenance (O&M) of the system. Much of sub-Saharan Africa has two distinct seasons that affect the availability of water sources and how people use water. Little is known about how seasonality affects water system management. This qualitative study is based on 320 interviews and focus group discussions and examines the effects of season on community water use and management in Ghana, Kenya and Zambia. Participants revealed that seasonality affects water availability, water system breakdowns, resource mobilization, committee activity, and external support availability. In the rainy season, participants typically reported spending less time and money on water collection because rainwater harvesting and seasonal streams, ponds, wells and reservoirs are available. In the dry season, people used improved groundwater sources more often and spent more money and time collecting water. Although seasonal changes in household water demand and use have been examined previously, our data suggest that seasonality also influences community management through differential water system use, system breakdowns and management characteristics. We found that water committees generally have less money, time and access to external support during the rainy season, making them less able to carry out O&M. Our results suggest that community engagement should take place over a long period of time so that seasonal patterns in management can be understood and incorporated into water committee training. External support actors should make a more targeted effort to understand the cultural and economic patterns in a community in order to train committees with appropriate management strategies. Copyright © 2018 Elsevier B.V. All rights reserved.

Financing Residency Training Redesign.

PubMed

Carney, Patricia A; Waller, Elaine; Green, Larry A; Crane, Steven; Garvin, Roger D; Pugno, Perry A; Kozakowski, Stanley M; Douglass, Alan B; Jones, Samuel; Eiff, M Patrice

2014-12-01

Redesign in the health care delivery system creates a need to reorganize resident education. How residency programs fund these redesign efforts is not known. Family medicine residency program directors participating in the Preparing Personal Physicians for Practice (P(4)) project were surveyed between 2006 and 2011 on revenues and expenses associated with training redesign. A total of 6 university-based programs in the study collectively received $5,240,516 over the entire study period, compared with $4,718,943 received by 8 community-based programs. Most of the funding for both settings came from grants, which accounted for 57.8% and 86.9% of funding for each setting, respectively. Department revenue represented 3.4% of university-based support and 13.1% of community-based support. The total average revenue (all years combined) per program for university-based programs was just under $875,000, and the average was nearly $590,000 for community programs. The vast majority of funds were dedicated to salary support (64.8% in university settings versus 79.3% in community-based settings). Based on the estimated ratio of new funding relative to the annual costs of training using national data for a 3-year program with 7 residents per year, training redesign added 3% to budgets for university-based programs and about 2% to budgets for community-based programs. Residencies undergoing training redesign used a variety of approaches to fund these changes. The costs of innovations marginally increased the estimated costs of training. Federal and local funding sources were most common, and costs were primarily salary related. More research is needed on the costs of transforming residency training.

Community-based organizations in the health sector: A scoping review

PubMed Central

2012-01-01

Community-based organizations are important health system stakeholders as they provide numerous, often highly valued programs and services to the members of their community. However, community-based organizations are described using diverse terminology and concepts from across a range of disciplines. To better understand the literature related to community-based organizations in the health sector (i.e., those working in health systems or more broadly to address population or public health issues), we conducted a scoping review by using an iterative process to identify existing literature, conceptually map it, and identify gaps and areas for future inquiry. We searched 18 databases and conducted citation searches using 15 articles to identify relevant literature. All search results were reviewed in duplicate and were included if they addressed the key characteristics of community-based organizations or networks of community-based organizations. We then coded all included articles based on the country focus, type of literature, source of literature, academic discipline, disease sector, terminology used to describe organizations and topics discussed. We identified 186 articles addressing topics related to the key characteristics of community-based organizations and/or networks of community-based organizations. The literature is largely focused on high-income countries and on mental health and addictions, HIV/AIDS or general/unspecified populations. A large number of different terms have been used in the literature to describe community-based organizations and the literature addresses a range of topics about them (mandate, structure, revenue sources and type and skills or skill mix of staff), the involvement of community members in organizations, how organizations contribute to community organizing and development and how they function in networks with each other and with government (e.g., in policy networks). Given the range of terms used to describe community-based organizations, this scoping review can be used to further map their meanings/definitions to develop a more comprehensive typology and understanding of community-based organizations. This information can be used in further investigations about the ways in which community-based organizations can be engaged in health system decision-making and the mechanisms available for facilitating or supporting their engagement. PMID:23171160

Community-based organizations in the health sector: a scoping review.

PubMed

Wilson, Michael G; Lavis, John N; Guta, Adrian

2012-11-21

Community-based organizations are important health system stakeholders as they provide numerous, often highly valued programs and services to the members of their community. However, community-based organizations are described using diverse terminology and concepts from across a range of disciplines. To better understand the literature related to community-based organizations in the health sector (i.e., those working in health systems or more broadly to address population or public health issues), we conducted a scoping review by using an iterative process to identify existing literature, conceptually map it, and identify gaps and areas for future inquiry.We searched 18 databases and conducted citation searches using 15 articles to identify relevant literature. All search results were reviewed in duplicate and were included if they addressed the key characteristics of community-based organizations or networks of community-based organizations. We then coded all included articles based on the country focus, type of literature, source of literature, academic discipline, disease sector, terminology used to describe organizations and topics discussed. We identified 186 articles addressing topics related to the key characteristics of community-based organizations and/or networks of community-based organizations. The literature is largely focused on high-income countries and on mental health and addictions, HIV/AIDS or general/unspecified populations. A large number of different terms have been used in the literature to describe community-based organizations and the literature addresses a range of topics about them (mandate, structure, revenue sources and type and skills or skill mix of staff), the involvement of community members in organizations, how organizations contribute to community organizing and development and how they function in networks with each other and with government (e.g., in policy networks).Given the range of terms used to describe community-based organizations, this scoping review can be used to further map their meanings/definitions to develop a more comprehensive typology and understanding of community-based organizations. This information can be used in further investigations about the ways in which community-based organizations can be engaged in health system decision-making and the mechanisms available for facilitating or supporting their engagement.

Community, culture and sustainability in multilevel dynamic systems intervention science.

PubMed

Schensul, Jean J

2009-06-01

This paper addresses intertwined issues in the conceptualization, implementation and evaluation of multilevel dynamic systems intervention science (MDSIS). Interventions are systematically planned, conducted and evaluated social science-based cultural products intercepting the lives of people and institutions in the context of multiple additional events and processes (which also may be referred to as interventions) that may speed, slow or reduce change towards a desired outcome. Multilevel interventions address change efforts at multiple social levels in the hope that effects at each level will forge synergistic links, facilitating movement toward desired change. This paper utilizes an ecological framework that identifies macro (policy and regulatory institutions), meso (organizations and agencies with resources, and power) and micro (individuals, families and friends living in communities) interacting directly and indirectly. An MDSIS approach hypothesizes that change toward a goal will occur faster and more effectively when synchronized and supported across levels in a social system. MDSIS approaches by definition involve "whole" communities and cannot be implemented without the establishments of working community partnerships This paper takes a dynamic systems approach to science as conducted in communities, and discusses four concepts that are central to MDSIS--science, community, culture, and sustainability. These concepts are important in community based participatory research and to the targeting, refinement, and adaptation of enduring interventions. Consistency in their meaning and use can promote forward movement in the field of MDSIS, and in community-based prevention science.

Introduction of mobile phones for use by volunteer community health workers in support of integrated community case management in Bushenyi District, Uganda: development and implementation process.

PubMed

Tumusiime, David Katuruba; Agaba, Gad; Kyomuhangi, Teddy; Finch, Jan; Kabakyenga, Jerome; MacLeod, Stuart

2014-01-01

A substantial literature suggests that mobile phones have great potential to improve management and survival of acutely ill children in rural Africa. The national strategy of the Ugandan Ministry of Health calls for employment of volunteer community health workers (CHWs) in implementation of Integrated Community Case Management (iCCM) of common illnesses (diarrhea, acute respiratory infection, pneumonia, fever/malaria) affecting children under five years of age. A mobile phone enabled system was developed within iCCM aiming to improve access by CHWs to medical advice and to strengthen reporting of data on danger signs and symptoms for acutely ill children under five years of age. Herein critical steps in development, implementation, and integration of mobile phone technology within iCCM are described. Mechanisms to improve diagnosis, treatment and referral of sick children under five were defined. Treatment algorithms were developed by the project technical team and mounted and piloted on the mobile phones, using an iterative process involving technical support personnel, health care providers, and academic support. Using a purposefully developed mobile phone training manual, CHWs were trained over an intensive five-day course to make timely diagnoses, recognize clinical danger signs, communicate about referrals and initiate treatment with appropriate essential drugs. Performance by CHWs and the accuracy and completeness of their submitted data was closely monitored post training test period and during the subsequent nine month community trial. In the full trial, the number of referrals and correctly treated children, based on the agreed treatment algorithms, was recorded. Births, deaths, and medication stocks were also tracked. Seven distinct phases were required to develop a robust mobile phone enabled system in support of the iCCM program. Over a nine month period, 96 CHWs were trained to use mobile phones and their competence to initiate a community trial was established through performance monitoring. Local information/communication consultants, working in concert with a university based department of pediatrics, can design and implement a robust mobile phone based system that may be anticipated to contribute to efficient delivery of iCCM by trained volunteer CHWs in rural settings in Uganda.

A strategy to implement and support pre-hospital emergency medical systems in developing, resource-constrained areas of South Africa.

PubMed

Sun, Jared H; Shing, Rachel; Twomey, Michele; Wallis, Lee A

2014-01-01

Resource-constrained countries are in extreme need of pre-hospital emergency care systems. However, current popular strategies to provide pre-hospital emergency care are inappropriate for and beyond the means of a resource-constrained country, and so new ones are needed-ones that can both function in an under-developed area's particular context and be done with the area's limited resources. In this study, we used a two-location pilot and consensus approach to develop a strategy to implement and support pre-hospital emergency care in one such developing, resource-constrained area: the Western Cape province of South Africa. Local community members are trained to be emergency first aid responders who can provide immediate, on-scene care until a Transporter can take the patient to the hospital. Management of the system is done through local Community Based Organizations, which can adapt the model to their communities as needed to ensure local appropriateness and feasibility. Within a community, the system is implemented in a graduated manner based on available resources, and is designed to not rely on the whole system being implemented first to provide partial function. The University of Cape Town's Division of Emergency Medicine and the Western Cape's provincial METRO EMS intend to follow this model, along with sharing it with other South African provinces. Copyright © 2012 Elsevier Ltd. All rights reserved.

Latest Community Coordinated Modeling Center (CCMC) services and innovative tools supporting the space weather research and operational communities.

NASA Astrophysics Data System (ADS)

Mendoza, A. M. M.; Rastaetter, L.; Kuznetsova, M. M.; Mays, M. L.; Chulaki, A.; Shim, J. S.; MacNeice, P. J.; Taktakishvili, A.; Collado-Vega, Y. M.; Weigand, C.; Zheng, Y.; Mullinix, R.; Patel, K.; Pembroke, A. D.; Pulkkinen, A. A.; Boblitt, J. M.; Bakshi, S. S.; Tsui, T.

2017-12-01

The Community Coordinated Modeling Center (CCMC), with the fundamental goal of aiding the transition of modern space science models into space weather forecasting while supporting space science research, has been serving as an integral hub for over 15 years, providing invaluable resources to both space weather scientific and operational communities. CCMC has developed and provided innovative web-based point of access tools varying from: Runs-On-Request System - providing unprecedented global access to the largest collection of state-of-the-art solar and space physics models, Integrated Space Weather Analysis (iSWA) - a powerful dissemination system for space weather information, Advanced Online Visualization and Analysis tools for more accurate interpretation of model results, Standard Data formats for Simulation Data downloads, and Mobile apps to view space weather data anywhere to the scientific community. In addition to supporting research and performing model evaluations, CCMC also supports space science education by hosting summer students through local universities. In this poster, we will showcase CCMC's latest innovative tools and services, and CCMC's tools that revolutionized the way we do research and improve our operational space weather capabilities. CCMC's free tools and resources are all publicly available online (http://ccmc.gsfc.nasa.gov).

A Global Assessment on Climate Research Engaging Indigenous Knowledge Systems and Recommendations for Quality Standards of Research Practice in Indigenous Communities

NASA Astrophysics Data System (ADS)

Davíd-Chavez, D. M.; Gavin, M. C.

2017-12-01

Indigenous communities worldwide have maintained their own knowledge systems for millennia informed through careful observation of dynamics of environmental changes. Withstanding centuries of challenges to their rights to maintain and practice these knowledge systems, Indigenous peoples continually speak to a need for quality standards for research in their communities. Although, international and Indigenous peoples' working groups emphasize Indigenous knowledge systems and the communities who hold them as critical resources for understanding and adapting to climate change, there has yet to be a comprehensive, evidence based analysis into how diverse knowledge systems are integrated in scientific studies. Do current research practices challenge or support Indigenous communities in their efforts to maintain and appropriately apply their knowledge systems? This study addresses this question using a systematic literature review and meta-analysis assessing levels of Indigenous community participation and decision-making in all stages of the research process (initiation, design, implementation, analysis, dissemination). Assessment is based on reported quality indicators such as: outputs that serve the community, ethical guidelines in practice (free, prior, and informed consent and intellectual property rights), and community access to findings. These indicators serve to identify patterns between levels of community participation and quality standards in practice. Meta-analysis indicates most climate studies practice an extractive model in which Indigenous knowledge systems are co-opted with minimal participation or decision-making authority from communities who hold them. Few studies report outputs that directly serve Indigenous communities, ethical guidelines in practice, or community access to findings. Studies reporting the most quality indicators were initiated in mutual agreement between Indigenous communities and outside researchers or by communities themselves. This study also draws from the researcher's experiences as an Indigenous scientist and includes recommendations for quality research practice. This global assessment provides an evidence base to inform our understanding of broader impacts related to research design.

Extending Cancer Prevention to Improve Fruit and Vegetable Consumption

PubMed Central

Freedman, Darcy A.; Peña-Purcell, Ninfa; Friedman, Daniela B.; Ory, Marcia; Flocke, Susan; Barni, Marie T.; Hébert, James R.

2014-01-01

Consuming a diet that is rich in fruits and vegetables is critical for preventing cancer and cancer-related disparities. Food systems approaches that increase spatial-temporal, economic, and social access to fruits and vegetables may ultimately result in improved consumption patterns among Americans. Engaging the triad of Cooperative Extension Services, public health systems, and community health centers may yield maximal public health benefits from food systems interventions. These entities have a mutual interest in promoting health equity and community and economic vitality that provides common ground to (a) implement solutions through the dissemination of evidence-based programs and (b) share resources to foster grassroots support for sustained change. Working together, these systems have an unprecedented opportunity to build on their common ground to implement, evaluate, and disseminate evidence-based food systems interventions in communities and with populations experiencing disparate risk for cancer and cancer-related diseases. PMID:24748060

Systems of care as asset-building communities: implementing strengths-based planning and positive youth development.

PubMed

McCammon, Susan L

2012-06-01

Using a strength-based approach is one of the hallmarks of the system of care (SOC) initiative, and is consistent with the foundations of community psychology. However, while strengths-based planning is recommended and child and family teams often list child and family strengths, the care plans often do not incorporate the strengths in strategies and interventions. The research base regarding strength implementation and effectiveness is summarized, and needed research is outlined. Steps are offered for promoting the use of strengths in SOCS. Implementing programs from the field of positive youth development is advocated as a way that the educational and criminal justice systems could be more actively engaged in implementing strength-based strategies in SOCs. Promoting SOCs to focus more attentively to asset-building (at the child, family, and community level) is compatible with a public health model that addresses mental health concerns in the context of a full range of supports and services so that all children might experience good mental health and realize their potential.

Evaluation of a Telerehabilitation System for Community-Based Rehabilitation

PubMed Central

Schutte, Jamie; Gales, Sara; Filippone, Ashlee; Saptono, Andi; Parmanto, Bambang; McCue, Michael

2012-01-01

The use of web-based portals, while increasing in popularity in the fields of medicine and research, are rarely reported on in community-based rehabilitation programs. A program within the Pennsylvania Office of Vocational Rehabilitation’s Hiram G. Andrews Center, the Cognitive Skills Enhancement Program (CSEP), sought to enhance organization of program and participant information and communication between part- and full-time employees, supervisors and consultants. A telerehabilitation system was developed consisting of (1) a web-based portal to support a variety of clinical activities, and (2) the Versatile Integrated System for Telerehabilitation (VISYTER) video-conferencing system to support the collaboration and delivery of rehabilitation services remotely. This descriptive evaluation examines the usability of the telerehabilitation system incorporating both the portal and VISYTER. Telerehabilitation system users include CSEP staff members from three geographical locations and employed by two institutions. The IBM After-Scenario Questionnaire (ASQ) and Post-Study System Usability Questionnaire (PSSUQ), the Telehealth Usability Questionnaire (TUQ), and two demographic surveys were administered to gather both objective and subjective information. Results showed generally high levels of usability. Users commented that the telerehabilitation system improved communication, increased access to information, improved speed of completing tasks, and had an appealing interface. Areas where users would like to see improvements, including ease of accessing/editing documents and searching for information, are discussed. PMID:25945193

Integrating community-based health promotion programs and primary care: a mixed methods analysis of feasibility.

PubMed

Leppin, Aaron L; Schaepe, Karen; Egginton, Jason; Dick, Sara; Branda, Megan; Christiansen, Lori; Burow, Nicole M; Gaw, Charlene; Montori, Victor M

2018-01-31

Implementation of evidence-based programs (EBPs) for disease self-management and prevention is a policy priority. It is challenging to implement EBPs offered in community settings and to integrate them with healthcare. We sought to understand, categorize, and richly describe key challenges and opportunities related to integrating EBPs into routine primary care practice in the United States. As part of a parent, participatory action research project, we conducted a mixed methods evaluation guided by the PRECEDE implementation planning model in an 11-county region of Southeast Minnesota. Our community-partnered research team interviewed and surveyed 15 and 190 primary care clinicians and 15 and 88 non-clinician stakeholders, respectively. We coded interviews according to pre-defined PRECEDE factors and by participant type and searched for emerging themes. We then categorized survey items-before looking at participant responses-according to their ability to generate further evidence supporting the PRECEDE factors and emerging themes. We statistically summarized data within and across responder groups. When consistent, we merged these with qualitative insight. The themes we found, "Two Systems, Two Worlds," "Not My Job," and "Seeing is Believing," highlighted the disparate nature of prescribed activities that different stakeholders do to contribute to health. For instance, primary care clinicians felt pressured to focus on activities of diagnosis and treatment and did not imagine ways in which EBPs could contribute to either. Quantitative analyses supported aspects of all three themes, highlighting clinicians' limited trust in community-placed activities, and the need for tailored education and system and policy-level changes to support their integration with primary care. Primary care and community-based programs exist in disconnected worlds. Without urgent and intentional efforts to bridge well-care and sick-care, interventions that support people's efforts to be and stay well in their communities will remain outside of-if not at odds with-healthcare.

An exploration of facilitators and challenges in the scale-up of a national, public sector community health worker cadre in Zambia: a qualitative study.

PubMed

Phiri, Sydney Chauwa; Prust, Margaret Lippitt; Chibawe, Caroline Phiri; Misapa, Ronald; van den Broek, Jan Willem; Wilmink, Nikhil

2017-06-24

In 2010 a public sector cadre of community health workers called Community Health Assistants (CHAs) was created in Zambia through the National Community Health Worker Strategy to expand access to health services. This cadre continues to be scaled up to meet the growing demands of Zambia's rural population. We summarize factors that have facilitated the scale-up of the CHA program into a nationwide CHW cadre and the challenges of introducing and institutionalizing the cadre within the Zambian health system. Semi-structured, individual interviews were held across 5 districts with 16 CHAs and 6 CHA supervisors, and 10 focus group discussions were held with 93 community members. Audio recordings of interviews and focus group discussions were transcribed and thematically coded using Dedoose web-based software. The study showed that the CHAs play a critical role in providing a wide range of services at the community level, as described by supervisors and community members. Some challenges still remain, that may inhibit the CHAs ability to provide health services effectively. In particular, the respondents highlighted infrequent supervision, lack of medical and non-medical supplies for outreach services, and challenges with the mobile data reporting system. The study shows that in order to optimize the impact of CHAs or other community health workers, key health-system support structures need to be functioning effectively, such as supervision, community surveillance systems, supplies, and reporting. The Ministry of Health with support from partners are currently addressing these challenges through nationwide supervisor and community data trainings, as well as advocating for adding primary health care as a specific focus area in the new National Health Strategy Plan 2017-2021. This study contributes to the evidence base on the introduction of formalized community health worker cadres in developing countries.

Joining Forces for Families: An Embedded Response to Neighborhood Poverty

ERIC Educational Resources Information Center

Bruce, Michael; Chance, Ron; Meulemans, Laurie

2015-01-01

The authors reflect on how they, as social work practitioners, support the school systems in supporting homeless youth and families. They emphasize the importance of relationships and trust in working with this vulnerable population. The reflexive vignettes highlight the challenges and success of developing community-based programming for homeless…

Toward an evidence-based system for innovation support for implementing innovations with quality: tools, training, technical assistance, and quality assurance/quality improvement.

PubMed

Wandersman, Abraham; Chien, Victoria H; Katz, Jason

2012-12-01

An individual or organization that sets out to implement an innovation (e.g., a new technology, program, or policy) generally requires support. In the Interactive Systems Framework for Dissemination and Implementation, a Support System should work with Delivery Systems (national, state and/or local entities such as health and human service organizations, community-based organizations, schools) to enhance their capacity for quality implementation of innovations. The literature on the Support System [corrected] has been underresearched and under-developedThis article begins to conceptualize theory, research, and action for an evidence-based system for innovation support (EBSIS). EBSIS describes key priorities for strengthening the science and practice of support. The major goal of EBSIS is to enhance the research and practice of support in order to build capacity in the Delivery System for implementing innovations with quality, and thereby, help the Delivery System achieve outcomes. EBSIS is guided by a logic model that includes four key support components: tools, training, technical assistance, and quality assurance/quality improvement. EBSIS uses the Getting To Outcomes approach to accountability to aid the identification and synthesis of concepts, tools, and evidence for support. We conclude with some discussion of the current status of EBSIS and possible next steps, including the development of collaborative researcher-practitioner-funder-consumer partnerships to accelerate accumulation of knowledge on the Support System.

Development of a Community-Based Palliative Care Model for Advance Cancer Patients in Public Health Centers in Busan, Korea.

PubMed

Kim, Sook-Nam; Choi, Soon-Ock; Shin, Seong Hoon; Ryu, Ji-Sun; Baik, Jeong-Won

2017-07-01

A feasible palliative care model for advance cancer patients is needed in Korea with its rapidly aging population and corresponding increase in cancer prevalence. This study describes the process involved in the development of a community-based palliative care (CBPC) model implemented originally in a Busan pilot project. The model development included steps I and II of the pilot project, identification of the service types, a survey exploring the community demand for palliative care, construction of an operational infrastructure, and the establishment of a service delivery system. Public health centers (including Busan regional cancer centers, palliative care centers, and social welfare centers) served as the regional hubs in the development of a palliative care model. The palliative care project included the provision of palliative care, establishment of a support system for the operations, improvement of personnel capacity, development of an educational and promotional program, and the establishment of an assessment system to improve quality. The operational infrastructure included a service management team, provision teams, and a support team. The Busan Metropolitan City CBPC model was based on the principles of palliative care as well as the characteristics of public health centers that implemented the community health projects. The potential use of the Busan CBPC model in Korea should be explored further through service evaluations.

[The regional cooperation of medical services and a nutritional support team].

PubMed

Maruyama, Michio

2006-12-01

"Community NST" is a new concept, which means a cooperation system with the hospital NST and a regional medical service. "Community NST" provides home nutritional care for the patients with nutritional problems. The function of the hospital NST for inpatients has been established in recent years. Now the patients need a continuous nutritional care not only in the hospital but at home. Percutaneous endoscopic gastrostomy (PEG) has been performed on the base of cooperation with the hospital and home care. This PEG system is one of the functions of "Community NST". The author showed several measures of "Community NST", which have been tried in the hospital.

Alternative model for administration and analysis of research-based assessments

NASA Astrophysics Data System (ADS)

Wilcox, Bethany R.; Zwickl, Benjamin M.; Hobbs, Robert D.; Aiken, John M.; Welch, Nathan M.; Lewandowski, H. J.

2016-06-01

Research-based assessments represent a valuable tool for both instructors and researchers interested in improving undergraduate physics education. However, the historical model for disseminating and propagating conceptual and attitudinal assessments developed by the physics education research (PER) community has not resulted in widespread adoption of these assessments within the broader community of physics instructors. Within this historical model, assessment developers create high quality, validated assessments, make them available for a wide range of instructors to use, and provide minimal (if any) support to assist with administration or analysis of the results. Here, we present and discuss an alternative model for assessment dissemination, which is characterized by centralized data collection and analysis. This model provides a greater degree of support for both researchers and instructors in order to more explicitly support adoption of research-based assessments. Specifically, we describe our experiences developing a centralized, automated system for an attitudinal assessment we previously created to examine students' epistemologies and expectations about experimental physics. This system provides a proof of concept that we use to discuss the advantages associated with centralized administration and data collection for research-based assessments in PER. We also discuss the challenges that we encountered while developing, maintaining, and automating this system. Ultimately, we argue that centralized administration and data collection for standardized assessments is a viable and potentially advantageous alternative to the default model characterized by decentralized administration and analysis. Moreover, with the help of online administration and automation, this model can support the long-term sustainability of centralized assessment systems.

Community Health Workers as Support for Sickle Cell Care

PubMed Central

Hsu, Lewis L.; Green, Nancy S.; Ivy, E. Donnell; Neunert, Cindy; Smaldone, Arlene; Johnson, Shirley; Castillo, Sheila; Castillo, Amparo; Thompson, Trevor; Hampton, Kisha; Strouse, John J.; Stewart, Rosalyn; Hughes, TaLana; Banks, Sonja; Smith-Whitley, Kim; King, Allison; Brown, Mary; Ohene-Frempong, Kwaku; Smith, Wally R.; Martin, Molly

2016-01-01

Community health workers are increasingly recognized as useful for improving health care and health outcomes for a variety of chronic conditions. Community health workers can provide social support, navigation of health systems and resources, and lay counseling. Social and cultural alignment of community health workers with the population they serve is an important aspect of community health worker intervention. Although community health worker interventions have been shown to improve patient-centered outcomes in underserved communities, these interventions have not been evaluated with sickle cell disease. Evidence from other disease areas suggests that community health worker intervention also would be effective for these patients. Sickle cell disease is complex, with a range of barriers to multifaceted care needs at the individual, family/friend, clinical organization, and community levels. Care delivery is complicated by disparities in health care: access, delivery, services, and cultural mismatches between providers and families. Current practices inadequately address or provide incomplete control of symptoms, especially pain, resulting in decreased quality of life and high medical expense. The authors propose that care and care outcomes for people with sickle cell disease could be improved through community health worker case management, social support, and health system navigation. This report outlines implementation strategies in current use to test community health workers for sickle cell disease management in a variety of settings. National medical and advocacy efforts to develop the community health workforce for sickle cell disease management may enhance the progress and development of “best practices” for this area of community-based care. PMID:27320471

Community Health Workers as Support for Sickle Cell Care.

PubMed

Hsu, Lewis L; Green, Nancy S; Donnell Ivy, E; Neunert, Cindy E; Smaldone, Arlene; Johnson, Shirley; Castillo, Sheila; Castillo, Amparo; Thompson, Trevor; Hampton, Kisha; Strouse, John J; Stewart, Rosalyn; Hughes, TaLana; Banks, Sonja; Smith-Whitley, Kim; King, Allison; Brown, Mary; Ohene-Frempong, Kwaku; Smith, Wally R; Martin, Molly

2016-07-01

Community health workers are increasingly recognized as useful for improving health care and health outcomes for a variety of chronic conditions. Community health workers can provide social support, navigation of health systems and resources, and lay counseling. Social and cultural alignment of community health workers with the population they serve is an important aspect of community health worker intervention. Although community health worker interventions have been shown to improve patient-centered outcomes in underserved communities, these interventions have not been evaluated with sickle cell disease. Evidence from other disease areas suggests that community health worker intervention also would be effective for these patients. Sickle cell disease is complex, with a range of barriers to multifaceted care needs at the individual, family/friend, clinical organization, and community levels. Care delivery is complicated by disparities in health care: access, delivery, services, and cultural mismatches between providers and families. Current practices inadequately address or provide incomplete control of symptoms, especially pain, resulting in decreased quality of life and high medical expense. The authors propose that care and care outcomes for people with sickle cell disease could be improved through community health worker case management, social support, and health system navigation. This paper outlines implementation strategies in current use to test community health workers for sickle cell disease management in a variety of settings. National medical and advocacy efforts to develop the community health workforce for sickle cell disease management may enhance the progress and development of "best practices" for this area of community-based care. Copyright © 2016 American Journal of Preventive Medicine. All rights reserved.

Preparedness for Protecting the Health of Community-Dwelling Vulnerable Elderly People in Eastern and Western Japan in the Event of Natural Disasters.

PubMed

Tsukasaki, Keiko; Kanzaki, Hatsumi; Kyota, Kaoru; Ichimori, Akie; Omote, Shizuko; Okamoto, Rie; Kido, Teruhiko; Sakakibara, Chiaki; Makimoto, Kiyoko; Nomura, Atsuko; Miyamoto, Yukari

2016-01-01

We clarified the preparedness necessary to protect the health of community-dwelling vulnerable elderly people following natural disasters. We collected data from 304 community general support centres throughout Japan. We found the following in particular to be challenging: availability of disaster-preparedness manuals; disaster countermeasures and management systems; creation of lists of people requiring assistance following a disaster; evacuation support systems; development of plans for health management following disasters; provision of disaster-preparedness guidance and training; disaster-preparedness systems in the community; disaster information management; the preparedness of older people themselves in requiring support; and support from other community residents.

Quantifying Risk of Financial Incapacity and Financial Exploitation in Community-dwelling Older Adults: Utility of a Scoring System for the Lichtenberg Financial Decision-making Rating Scale.

PubMed

Lichtenberg, Peter A; Gross, Evan; Ficker, Lisa J

2018-06-08

This work examines the clinical utility of the scoring system for the Lichtenberg Financial Decision-making Rating Scale (LFDRS) and its usefulness for decision making capacity and financial exploitation. Objective 1 was to examine the clinical utility of a person centered, empirically supported, financial decision making scale. Objective 2 was to determine whether the risk-scoring system created for this rating scale is sufficiently accurate for the use of cutoff scores in cases of decisional capacity and cases of suspected financial exploitation. Objective 3 was to examine whether cognitive decline and decisional impairment predicted suspected financial exploitation. Two hundred independently living, non-demented community-dwelling older adults comprised the sample. Participants completed the rating scale and other cognitive measures. Receiver operating characteristic curves were in the good to excellent range for decisional capacity scoring, and in the fair to good range for financial exploitation. Analyses supported the conceptual link between decision making deficits and risk for exploitation, and supported the use of the risk-scoring system in a community-based population. This study adds to the empirical evidence supporting the use of the rating scale as a clinical tool assessing risk for financial decisional impairment and/or financial exploitation.

Development of an electronic emergency department-based geo-information injury surveillance system in Hong Kong.

PubMed

Chow, C B; Leung, M; Lai, Adela; Chow, Y H; Chung, Joanne; Tong, K M; Lit, Albert

2012-06-01

To describe the experience in the development of an electronic emergency department (ED)-based injury surveillance (IS) system in Hong Kong using data-mining and geo-spatial information technology (IT) for a Safe Community setup. This paper described the phased development of an emergency department-based IS system based on World Health Organization (WHO) injury surveillance Guideline to support safety promotion and injury prevention in a Safe Community in Hong Kong starting 2002. The initial ED data-based only collected data on name, sex, age, address, eight general categories of injury types (traffic, domestic, common assault, indecent assault, batter, industrial, self-harm and sports) and disposal from ED. Phase 1--manual data collection on International Classification of External Causes of Injury pre-event data; Phase 2--manual form was converted to electronic format using web-based data mining technology with built in data quality monitoring mechanism; Phase 3--integration of injury surveillance-data with in-patient hospital information; and Phase 4--geo-spatial information and body mapping were introduced to geo-code exact place of injury in an electronic map and site of injury on body map. It was feasible to develop a geo-spatial IS system at busy ED to collect valuable information for safety promotion and injury prevention at Safe Community setting. The keys for successful development and implementation involves engagement of all stakeholders at design and implementation of the system with injury prevention as ultimate goal, detail workflow planning at front end, support from the management, building on exiting system and appropriate utilisation of modern technology. Copyright © 2011 Elsevier Ltd. All rights reserved.

CDDIS: NASA's Archive of Space Geodesy Data and Products Supporting GGOS

NASA Technical Reports Server (NTRS)

Noll, Carey; Michael, Patrick

2016-01-01

The Crustal Dynamics Data Information System (CDDIS) supports data archiving and distribution activities for the space geodesy and geodynamics community. The main objectives of the system are to store space geodesy and geodynamics related data and products in a central archive, to maintain information about the archival of these data,to disseminate these data and information in a timely manner to a global scientific research community, and provide user based tools for the exploration and use of the archive. The CDDIS data system and its archive is a key component in several of the geometric services within the International Association of Geodesy (IAG) and its observing systemthe Global Geodetic Observing System (GGOS), including the IGS, the International DORIS Service (IDS), the International Laser Ranging Service (ILRS), the International VLBI Service for Geodesy and Astrometry (IVS), and the International Earth Rotation and Reference Systems Service (IERS). The CDDIS provides on-line access to over 17 Tbytes of dataand derived products in support of the IAG services and GGOS. The systems archive continues to grow and improve as new activities are supported and enhancements are implemented. Recently, the CDDIS has established a real-time streaming capability for GNSS data and products. Furthermore, enhancements to metadata describing the contents ofthe archive have been developed to facilitate data discovery. This poster will provide a review of the improvements in the system infrastructure that CDDIS has made over the past year for the geodetic community and describe future plans for the system.

Inspiring health worker motivation with supportive supervision: a survey of lady health supervisor motivating factors in rural Pakistan.

PubMed

Rabbani, Fauziah; Shipton, Leah; Aftab, Wafa; Sangrasi, Kashif; Perveen, Shagufta; Zahidie, Aysha

2016-08-17

Community health worker motivation is an important consideration for improving performance and addressing maternal, newborn, and child health in low and middle-income countries. Therefore, identifying health system interventions that address motivating factors in resource-strained settings is essential. This study is part of a larger implementation research project called Nigraan, which is intervening on supportive supervision in the Lady Health Worker Programme to improve community case management of pneumonia and diarrhea in rural Pakistan. This study explored the motivation of Lady Health Supervisors, a cadre of community health workers, with particular attention to their views on supportive supervision. Twenty-nine lady health supervisors enrolled in Nigraan completed open-ended structured surveys with questions exploring factors that affect their motivation. Thematic analysis was conducted using a conceptual framework categorizing motivating factors at individual, community, and health system levels. Supportive supervision, recognition, training, logistics, and salaries are community and health system motivating factors for lady health supervisors. Lady health supervisors are motivated by both their role in providing supportive supervision to lady health workers and by the supervisory support received from their coordinators and managers. Family support, autonomy, and altruism are individual level motivating factors. Health system factors, including supportive supervision, are crucial to improving lady health supervisor motivation. As health worker motivation influences their performance, evaluating the impact of health system interventions on community health worker motivation is important to improving the effectiveness of community health worker programs.

Developing culturally responsive approaches with Southeast Asian American families experiencing developmental disabilities.

PubMed

Baker, Dian L; Miller, Elizabeth; Dang, Michelle T; Yaangh, Chiem-Seng; Hansen, Robin L

2010-12-01

Southeast Asian American families are underrepresented among recipients of special education and social services for people with developmental disabilities. Our aims were to use a community-based participatory research approach to examine Hmong and Mien families' perceptions of developmental disabilities and understand barriers to and facilitators of service provision among families experiencing developmental disabilities. We describe here a case study of a successful attempt to engage marginalized and underserved communities to understand their needs to improve access and services for persons with developmental disabilities. We conducted 2 focus groups with 11 key informants and 1 focus group with 10 family members of persons with developmental disabilities, as well as in-depth interviews with 3 shamans. Using a thematic analysis approach, we coded notes and transcripts to assess community members' understanding of developmental disabilities, experiences negotiating educational and health care systems, and barriers to high-quality care. A predominant theme was the perception that reliance on governmental support services is not appropriate. Common barriers identified included lack of accurate information, language difficulties, lack of trust, and limited outreach. These perceptions and barriers, combined with limited access to services, interfere with community acceptance and use of available support services. Despite these barriers, participants indicated that with education, outreach, and culturally responsive support, families would likely accept services. Community-based participatory methods are effective for eliciting root causes of health inequities in marginalized communities. Outreach to community-based organizations and an inclusive research practice identified social and cultural reasons for low service uptake and provided a pathway for the community to improve services for persons with developmental disabilities.

Coaching mental health peer advocates for rural LGBTQ people.

PubMed

Willging, Cathleen E; Israel, Tania; Ley, David; Trott, Elise M; DeMaria, Catherine; Joplin, Aaron; Smiley, Verida

Lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) people are affected by mental health disparities, especially in rural communities. We trained peer advocates in rural areas in the fundamentals of mental health, outreach, education, and support for this population. The peer advocates were coached by licensed mental health professionals. We evaluated this process through iterative qualitative analysis of semi-structured interviews and written logs from coaches and advocates. The six major themes comprising the results centered on (1) coaching support, (2) peer advocate skills and preparation, (3) working with help seekers, (4) negotiating diversity, (5) logistical challenges in rural contexts, and (6) systemic challenges. We concluded that peer advocacy for LGBTQ people with mental distress offers an affirmative, community-based strategy to assist the underserved. To be successful, however, peer advocates will likely require ongoing training, coaching, and infrastructural support to negotiate contextual factors that can influence provision of community resources and support to LGBTQ people within rural communities.

Coaching mental health peer advocates for rural LGBTQ people

PubMed Central

Willging, Cathleen E.; Israel, Tania; Ley, David; Trott, Elise M.; DeMaria, Catherine; Joplin, Aaron; Smiley, Verida

2016-01-01

Lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) people are affected by mental health disparities, especially in rural communities. We trained peer advocates in rural areas in the fundamentals of mental health, outreach, education, and support for this population. The peer advocates were coached by licensed mental health professionals. We evaluated this process through iterative qualitative analysis of semi-structured interviews and written logs from coaches and advocates. The six major themes comprising the results centered on (1) coaching support, (2) peer advocate skills and preparation, (3) working with help seekers, (4) negotiating diversity, (5) logistical challenges in rural contexts, and (6) systemic challenges. We concluded that peer advocacy for LGBTQ people with mental distress offers an affirmative, community-based strategy to assist the underserved. To be successful, however, peer advocates will likely require ongoing training, coaching, and infrastructural support to negotiate contextual factors that can influence provision of community resources and support to LGBTQ people within rural communities. PMID:27458498

Empowerment and Social Support: Implications for Practice and Programming Among Minority Women with Substance Abuse and Criminal Justice Histories.

PubMed

Barringer, Alexandra; Hunter, Bronwyn A; Salina, Doreen D; Jason, Leonard A

2017-01-01

Programs for women with substance abuse and criminal justice histories often incorporate empowerment and social support into service delivery systems. Women's empowerment research has focused on the relationship between women's personal identities and the larger sociopolitical context, with an emphasis on how community-based resources are critical for promoting well-being. Social support often protects against negative outcomes for individuals who live with chronic stress. However, few studies have evaluated community resource knowledge and empowerment among marginalized women or how social support might strengthen or weaken this relationship. This study investigated resource knowledge, social support, and empowerment among 200 minority women in substance abuse recovery who had recent criminal justice involvement. Results indicated that resource knowledge was related to empowerment and belonging social support marginally moderated this relationship. In addition, education level increased and current involvement in the criminal justice system decreased empowerment. Implications for research, practice, and policy are discussed.

Empowerment and Social Support: Implications for Practice and Programming among Minority Women with Substance Abuse and Criminal Justice Histories

PubMed Central

Barringer, Alexandra; Hunter, Bronwyn A.; Salina, Doreen; Jason, Leonard A.

2016-01-01

Programs for women with substance abuse and criminal justice histories often incorporate empowerment and social support into service delivery systems. Women’s empowerment research has focused on the relationship between women’s personal identities and the larger sociopolitical context, with an emphasis on how community based resources are critical for promoting well-being. Social support often protects against negative outcomes for individuals who live with chronic stress. However, few studies have evaluated community resource knowledge and empowerment among marginalized women or how social support might strengthen or weaken this relationship. This study investigated resource knowledge, social support and empowerment among 200 minority women in substance abuse recovery who had recent criminal justice involvement. Results indicated that resource knowledge was related to empowerment and belonging social support marginally moderated this relationship. In addition, education level increased and current involvement in the criminal justice system decreased empowerment. Implications for research, practice and policy are discussed. PMID:27084362

Opportunities and Design Considerations for Peer Support in a Hospital Setting.

PubMed

Haldar, Shefali; Mishra, Sonali R; Khelifi, Maher; Pollack, Ari H; Pratt, Wanda

2017-05-01

Although research has demonstrated improved outcomes for outpatients who receive peer support-such as through online health communities, support groups, and mentoring systems-hospitalized patients have few mechanisms to receive such valuable support. To explore the opportunities for a hospital-based peer support system, we administered a survey to 146 pediatric patients and caregivers, and conducted semi-structured interviews with twelve patients and three caregivers in a children's hospital. Our analysis revealed that hospitalized individuals need peer support for five key purposes: (1) to ask about medical details-such as procedures, treatments, and medications; (2) to learn about healthcare providers; (3) to report and prevent medical errors; (4) to exchange emotional support; and (5) to manage their time in the hospital. In this paper, we examine these themes and describe potential barriers to using a hospital-based peer support system. We then discuss the unique opportunities and challenges that the hospital environment presents when designing for peer support in this setting.

A Community-Based, Technology-Supported Health Service for Detecting and Preventing Frailty among Older Adults: A Participatory Design Development Process.

PubMed

van Velsen, Lex; Illario, Maddalena; Jansen-Kosterink, Stephanie; Crola, Catherine; Di Somma, Carolina; Colao, Annamaria; Vollenbroek-Hutten, Miriam

2015-01-01

Frailty is a multifaceted condition that affects many older adults and marks decline on areas such as cognition, physical condition, and nutritional status. Frail individuals are at increased risk for the development of disability, dementia, and falls. There are hardly any health services that enable the identification of prefrail individuals and that focus on prevention of further functional decline. In this paper, we discuss the development of a community-based, technology-supported health service for detecting prefrailty and preventing frailty and further functional decline via participatory design with a wide range of stakeholders. The result is an innovative service model in which an online platform supports the integration of traditional services with novel, Information Communication Technology supported tools. This service is capable of supporting the different phases of screening and offers training services, by also integrating them with community-based services. The service model can be used as a basis for developing similar services within a wide range of healthcare systems. We present the service model, the general functioning of the technology platform, and the different ways in which screening for and prevention of frailty has been localized. Finally, we reflect on the added value of participatory design for creating such health services.

Life concerns of elderly people living at home determined as by Community General Support Center staff: implications for organizing a more effective integrated community care system. The Kurihara Project.

PubMed

Takada, Junko; Meguro, Kenichi; Sato, Yuko; Chiba, Yumiko

2014-09-01

In Japan, the integrated community care system aims to enable people to continue to live in their homes. Based on the concept, one of the activities of a Community General Support Center (CGSC) is to provide preventive intervention based on a Community Support Program. Currently, a Basic Checklist (BC) is sent to elderly people to identify persons appropriate for a Secondary Prevention Program. To find people who had not responded to the BC, CGSC staff evaluated the files of 592 subjects who had participated in the Kurihara Project to identify activities they cannot do that they did in the past, decreased activity levels at home, loss of interaction with people other than their family, and the need for medical interventions. This information was classified, when applicable, into the following categories: (A) 'no life concerns'; (B) 'undecided'; and (C) 'life concerns'. The relationships between these classifications and clinical information, certified need for long-term care, and items on the BC were examined. The numbers of subjects in categories A, B, and C were 291, 42, and 186, respectively. Life concerns were related to scores on the Clinical Dementia Rating, global cognitive function, depressive state, and apathy. Most items on the BC were not associated with classification into category C, but ≥25% of the subjects had life concerns related to these items. Assessment of life concerns by the CGSC staff has clinical validity. The results suggest that there are people who do not respond to the checklist or apply for Long-Term Care Insurance, meaning that they 'hide' in the community, probably due to apathy or depressive state. To organize a more effective integrated community care system, the CGSC staff should focus mainly on preventive care. © 2014 The Authors. Psychogeriatrics © 2014 Japanese Psychogeriatric Society.

MS PHD'S Professional Development Program: A Scientific Renaissance in Cyberspace

NASA Astrophysics Data System (ADS)

Powell, J. M.; Williamson, V. A.; Griess, C. A.; Pyrtle, A. J.

2004-12-01

This study is a component of a four-year investigation of MS PHD'S Professional Development Program's virtual community through the lenses of underrepresented minority students in Earth system science and engineering fields. In this presentation, the development, assessment and projected utilization of the ongoing study will be discussed. The overall goal of this study is to examine the effectiveness of virtual team building methods and understand how the development of a communal cyberinfrastructure acts as an integral part of the emergence of a Scientific Renaissance. The exemplar, Minorities Striving and Pursuing Higher Degrees of Success in Earth System Science (MS PHD'S), provides professional development experiences to facilitate the advancement of students of color achieving outstanding Earth system careers. Undergraduate and graduate students are supported through access to scientific conferences, mentorship and virtual community building. Framed by critical theory, this ethnographic exploration uses a mixed methods research design to record, observe, and analyze both the processes and products of the website, listserv and synchronous web-based dialogue. First, key findings of the formative evaluation and annual reports of the successfully implemented 2003 MS PHD'S Pilot Project are presented. These findings inform future evaluations of the use of technological resources and illustrate how this public space provides peer support and enriched research opportunities. Quantitative methods such as statistical analysis, academic and professional tracking and evaluative tools for scientific content and competency are complimented by qualitative methods that include observations, heuristic case studies and focus group interviews. The findings of this ongoing investigation will provide insight on how national organizations, higher education practitioners, community-based support systems and underrepresented minorities in the sciences promote diversity by developing successful cyberspace programs and networks. Through the examination of the transformation, expansion and democratization of the Earth system science community, new knowledge will be obtained on how a cyber-community fuses science, diversity and technology to form dialectics between creating and analyzing a Scientific Renaissance.

Community-Based Participatory Initiatives to Increase Breastfeeding Rates in Indiana.

PubMed

Friesen, Carol A; Hormuth, Laura J; Cardarelli, Tina L

2015-11-01

In 2012, the Centers for Disease Control and Prevention awarded the Indiana State Department of Health funding for breastfeeding activities. The grant, issued in part in response to the 2011 Surgeon General's Call to Action to Support Breastfeeding, focused on providing funding and technical support to small community-based organizations to address challenges encountered by breastfeeding mothers. Indiana used the funds to develop the Community Breastfeeding Support Initiative (CBSI). The goal was to provide funding and technical support to small community-based organizations to carry out self-selected projects in their communities. The 13 CBSI programs served 1345 individual clients (n = 3664 visits) during the 9-month period. This article provides valuable information about collaboration at the state level and the supporting infrastructure in place to carry out this project. Our findings about the number of clients served, number of visits, community-specific programs and activities, and lessons learned can be used by other organizations as they plan breastfeeding support programs for their community. © The Author(s) 2015.

The Obesity Prevention Initiative: A Statewide Effort to Improve Child Health in Wisconsin.

PubMed

Adams, Alexandra K; Christens, Brian; Meinen, Amy; Korth, Amy; Remington, Patrick L; Lindberg, Sara; Schoeller, Dale

2016-11-01

Obesity rates have increased dramatically, especially among children and disadvantaged populations. Obesity is a complex issue, creating a compelling need for prevention efforts in communities to move from single isolated programs to comprehensive multisystem interventions. To address these issues, we have established a childhood Obesity Prevention Initiative (Initiative) for Wisconsin. This Initiative seeks to test community change frameworks that can support multisystem interventions and provide data for local action as a means for influencing policies, systems, and environments that support individuals’ healthy eating and physical activity. The Initiative is comprised of three components: (1) infrastructure to support a statewide obesity prevention and health promotion network with state- and local-level public messaging and dissemination of evidence-based solutions (healthTIDE); (2) piloting a local, multisetting community-led intervention study in 2 Wisconsin counties; and (3) developing a geocoded statewide childhood obesity and fitness surveillance system. This Initiative is using a new model that involves both coalition action and community organizing to align resources to achieve health improvement at local and state levels. We expect that it will help lead to the implementation of cohesive and sustainable policy, system, and environment health promotion and obesity prevention strategies in communities statewide, and it has the potential to help Wisconsin become a national model for multisetting community interventions to address obesity. Addressing individual-level health through population-level changes ultimately will result in reductions in the prevalence of childhood obesity, current and future health care costs, and chronic disease mortality.

The Obesity Prevention Initiative: A Statewide Effort to Improve Child Health in Wisconsin.

PubMed

Adams, Alexandra K; Christens, Brian; Meinen, Amy; Korth, Amy; Remington, Patrick L; Lindberg, Sara; Schoeller, Dale

2016-11-01

Obesity rates have increased dramatically, especially among children and disadvantaged populations. Obesity is a complex issue, creating a compelling need for prevention efforts in communities to move from single isolated programs to comprehensive multisystem interventions. To address these issues, we have established a childhood Obesity Prevention Initiative (Initiative) for Wisconsin. This Initiative seeks to test community change frameworks that can support multisystem interventions and provide data for local action as a means for influencing policies, systems, and environments that support individuals' healthy eating and physical activity. The Initiative is comprised of three components: (1) infrastructure to support a statewide obesity prevention and health promotion network with state- and local-level public messaging and dissemination of evidence-based solutions (healthTIDE); (2) piloting a local, multisetting community-led intervention study in 2 Wisconsin counties; and (3) developing a geocoded statewide childhood obesity and fitness surveillance system. This Initiative is using a new model that involves both coalition action and community organizing to align resources to achieve health improvement at local and state levels. We expect that it will help lead to the implementation of cohesive and sustainable policy, system, and environment health promotion and obesity prevention strategies in communities statewide, and it has the potential to help Wisconsin become a national model for multisetting community interventions to address obesity. Addressing individual-level health through population-level changes ultimately will result in reductions in the prevalence of childhood obesity, current and future health care costs, and chronic disease mortality.

Fitting Community Based Newborn Care Package into the health systems of Nepal.

PubMed

Pradhan, Y V; Upreti, S R; Kc, N P; Thapa, K; Shrestha, P R; Shedain, P R; Dhakwa, J R; Aryal, D R; Aryal, S; Paudel, D C; Paudel, D; Khanal, S; Bhandari, A; Kc, A

2011-10-01

Community-based strategies for delivering effective newborn interventions are an essential step to avert newborn death, in settings where the health facilities are unable to effectively deliver the interventions and reach their population. Effective implementation of community-based interventions as a large scale program and within the existing health system depends on the appropriate design and planning, monitoring and support systems. This article provides an overview of implementation design of Community-Based Newborn Care Package (CB-NCP) program, its setup within the health system, and early results of the implementation from one of the pilot districts. The evaluation of CB-NCP in one of the pilot districts shows significant improvement in antenatal, intrapartum and post natal care. The implementation design of the CB-NCP has six different health system management functions: i) district planning and orientation, ii) training/human resource development, iii) monitoring and evaluation, iv) logistics and supply chain management, v) communication strategy, and vi) pay for performance. The CB-NCP program embraced the existing system of monitoring with some additional components for the pilot phase to test implementation feasibility, and aligns with existing safe motherhood and child health programs. Though CB-NCP interventions are proven independently in different local and global contexts, they are piloted in 10 districts as a "package" within the national health system settings of Nepal.

The Childhood Obesity Research Demonstration project: a team approach for supporting a multisite, multisector intervention.

PubMed

Williams, Nancy; Dooyema, Carrie A; Foltz, Jennifer L; Belay, Brook; Blanck, Heidi M

2015-02-01

Comprehensive multisector, multilevel approaches are needed to address childhood obesity. This article introduces the structure of a multidisciplinary team approach used to support and guide the multisite, multisector interventions implemented as part of the Childhood Obesity Research Demonstration (CORD) project. This article will describe the function, roles, and lessons learned from the CDC-CORD approach to project management. The CORD project works across multisectors and multilevels in three demonstration communities. Working with principal investigators and their research teams who are engaging multiple stakeholder groups, including community organizations, schools and child care centers, health departments, and healthcare providers, can be a complex endeavor. To best support the community-based research project, scientific and programmatic expertise in a wide range of areas was required. The team was configured based on the skill sets needed to interact with the various levels of staff working with the project. By thoughtful development of the team and processes, an efficient system for supporting the multisite, multisector intervention project sites was developed. The team approach will be formally evaluated at the end of the project period.

RISA progress in the development of drought indicators to support decision making

NASA Astrophysics Data System (ADS)

Close, S.; Simpson, C.

2015-12-01

Communities around the country are increasingly recognizing the need to plan for water shortages and long-term drought. To build preparedness and help communities manage risk, researchers funded by NOAA's National Integrated Drought Information System (NIDIS) Coping with Drought initiative through the Regional Integrated Sciences and Assessments (RISA) program are working to better understand these impacts across the country and work with communities and resource managers to develop adaptation strategies that meet their needs. The Coping with Drought initiative supports research involving the use of climate predictions and forecast information in decision-making across a range of sectors including agriculture, natural and water resources management, and public health. As a component of this initiative, the RISA program supported research and engagement to develop indicators of drought designed to be of most use to managers and planners grappling with severe and in some cases ongoing drought in their regions. Indicators are being developed for coastal ecosystems in the Carolinas, water management in California, and native communities in Arizona. For instance, the California Nevada Applications Program (CNAP) RISA developed a percentile-based indicator system for analyzing historic droughts and characterizing the ongoing California drought. And in the Southwest, the Climate Assessment for the Southwest (CLIMAS) RISA has been working with the Hopi community on drought monitoring and planning to develop the first-ever Hopi Quarterly Drought Status Report which integrates scientific and local knowledge about drought. This presentation will discuss RISA's role in developing drought indicators based on engagement with decision makers and how this work fits into the larger role that RISAs are playing in the development of the NIDIS Regional Drought Early Warning Systems across the U.S.

Community as client: environmental issues in the real world. A SimCity computer simulation.

PubMed

Bareford, C G

2001-01-01

The ability to think critically has become a crucial part of professional practice and education. SimCity, a popular computer simulation game, provides an opportunity to practice community assessment and interventions using a systems approach. SimCity is an interactive computer simulation game in which the player takes an active part in community planning. SimCity is supported on either a Windows 95/98 or a Macintosh platform and is available on CD-ROM at retail stores or at www.simcity.com. Students complete a tutorial and then apply a selected scenario in SimCity. Scenarios consist of hypothetical communities that have varying types and degrees of environmental problems, e.g., traffic, crime, nuclear meltdown, flooding, fire, and earthquakes. In problem solving with the simulated scenarios, students (a) identify systems and subsystems within the community that are critical factors impacting the environmental health of the community, (b) create changes in the systems and subsystems in an effort to solve the environmental health problem, and (c) evaluate the effectiveness of interventions based on the game score, demographic and fiscal data, and amount of community support. Because the consequences of planned intervention are part of the simulation, nursing students are able to develop critical-thinking skills. The simulation provides essential content in community planning in an interesting and interactive format.

Local understandings of conservation in southeastern Mexico and their implications for community-based conservation as an alternative paradigm.

PubMed

Reyes-Garcia, Victoria; Ruiz-Mallen, Isabel; Porter-Bolland, Luciana; Garcia-Frapolli, Eduardo; Ellis, Edward A; Mendez, Maria-Elena; Pritchard, Diana J; Sanchez-Gonzalez, María-Consuelo

2013-08-01

Since the 1990s national and international programs have aimed to legitimize local conservation initiatives that might provide an alternative to the formal systems of state-managed or otherwise externally driven protected areas. We used discourse analysis (130 semistructured interviews with key informants) and descriptive statistics (679 surveys) to compare local perceptions of and experiences with state-driven versus community-driven conservation initiatives. We conducted our research in 6 communities in southeastern Mexico. Formalization of local conservation initiatives did not seem to be based on local knowledge and practices. Although interviewees thought community-based initiatives generated less conflict than state-managed conservation initiatives, the community-based initiatives conformed to the biodiversity conservation paradigm that emphasizes restricted use of and access to resources. This restrictive approach to community-based conservation in Mexico, promoted through state and international conservation organizations, increased the area of protected land and had local support but was not built on locally relevant and multifunctional landscapes, a model that community-based conservation is assumed to advance. © 2013 Society for Conservation Biology.

BioenergyKDF: Enabling Spatiotemporal Data Synthesis and Research Collaboration

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

Myers, Aaron T; Movva, Sunil; Karthik, Rajasekar

2014-01-01

The Bioenergy Knowledge Discovery Framework (BioenergyKDF) is a scalable, web-based collaborative environment for scientists working on bioenergy related research in which the connections between data, literature, and models can be explored and more clearly understood. The fully-operational and deployed system, built on multiple open source libraries and architectures, stores contributions from the community of practice and makes them easy to find, but that is just its base functionality. The BioenergyKDF provides a national spatiotemporal decision support capability that enables data sharing, analysis, modeling, and visualization as well as fosters the development and management of the U.S. bioenergy infrastructure, which ismore » an essential component of the national energy infrastructure. The BioenergyKDF is built on a flexible, customizable platform that can be extended to support the requirements of any user community especially those that work with spatiotemporal data. While there are several community data-sharing software platforms available, some developed and distributed by national governments, none of them have the full suite of capabilities available in BioenergyKDF. For example, this component-based platform and database independent architecture allows it to be quickly deployed to existing infrastructure and to connect to existing data repositories (spatial or otherwise). As new data, analysis, and features are added; the BioenergyKDF will help lead research and support decisions concerning bioenergy into the future, but will also enable the development and growth of additional communities of practice both inside and outside of the Department of Energy. These communities will be able to leverage the substantial investment the agency has made in the KDF platform to quickly stand up systems that are customized to their data and research needs.« less

The diffusion of youth-led participatory research in urban schools: the role of the prevention support system in implementation and sustainability.

PubMed

Ozer, Emily J; Cantor, Jeremy P; Cruz, Gary W; Fox, Brian; Hubbard, Elizabeth; Moret, Lauren

2008-06-01

This article discusses the dissemination of a process of youth-led participatory research in urban secondary schools within the Interactive Systems Framework for Dissemination and Implementation (ISF) developed in collaboration with the CDC and its university partners (Wandersman et al. American Journal of Community Psychology, 41(3-4) 2008). The focus here is on the development of the Prevention Support System with respect to general and innovation-specific capacity building. The specific process under study involves youth-led needs assessment and research to inform the planning of prevention programs and policies to address students' health and developmental needs. The article first briefly describes the youth-led research process, its potential benefits, and a case example in two urban secondary schools. It then describes challenges and responses in providing support for the diffusion of this model in 6 secondary schools. The settings are urban public schools with a majority of students of color from diverse ethnic groups: Asian-American, Latino, and African-American. This project constitutes a collaborative partnership with a university school of public health and community-based organizations (CBOs) to build capacity for long-term, sustainable implementation of this innovative process within the local school system. The perspectives of the university-based researcher and the CBO partners on the development and effectiveness of the Prevention Support System are presented.

Translating a Fall Prevention Intervention Into Practice: A Randomized Community Trial

PubMed Central

Peterson, Donna J.; Christiansen, Ann L.; Mahoney, Jane; Laud, Purushottam; Layde, Peter M.

2015-01-01

Objectives. We examined whether community translation of an effective evidence-based fall prevention program via standard monetary support can produce a community-wide reduction in fall injuries in older adults and evaluated whether an enhanced version with added technical support and capacity building amplified the fall reduction effect. Methods. We completed a randomized controlled community trial among adults aged 65 and older in (1) 10 control communities receiving no special resources or guidance on fall prevention, (2) 5 standard support communities receiving modest funding to implement Stepping On, and (3) 5 enhanced support communities receiving funding and technical support. The primary outcome was hospital inpatient and emergency department discharges for falls, examined with Poisson regression. Results. Compared with control communities, standard and enhanced support communities showed significantly higher community-wide reductions (9% and 8%, respectively) in fall injuries from baseline (2007–2008) to follow-up (2010–2011). No significant difference was found between enhanced and standard support communities. Conclusions. Population-based fall prevention interventions can be effective when implemented in community settings. More research is needed to identify the barriers and facilitators that influence the successful adoption and implementation of fall prevention interventions into broad community practice. PMID:25602891

Translating a Fall Prevention Intervention Into Practice: A Randomized Community Trial.

PubMed

Guse, Clare E; Peterson, Donna J; Christiansen, Ann L; Mahoney, Jane; Laud, Purushottam; Layde, Peter M

2015-07-01

We examined whether community translation of an effective evidence-based fall prevention program via standard monetary support can produce a community-wide reduction in fall injuries in older adults and evaluated whether an enhanced version with added technical support and capacity building amplified the fall reduction effect. We completed a randomized controlled community trial among adults aged 65 and older in (1) 10 control communities receiving no special resources or guidance on fall prevention, (2) 5 standard support communities receiving modest funding to implement Stepping On, and (3) 5 enhanced support communities receiving funding and technical support. The primary outcome was hospital inpatient and emergency department discharges for falls, examined with Poisson regression. Compared with control communities, standard and enhanced support communities showed significantly higher community-wide reductions (9% and 8%, respectively) in fall injuries from baseline (2007-2008) to follow-up (2010-2011). No significant difference was found between enhanced and standard support communities. Population-based fall prevention interventions can be effective when implemented in community settings. More research is needed to identify the barriers and facilitators that influence the successful adoption and implementation of fall prevention interventions into broad community practice.

Community health workers and medicaid managed care in New Mexico.

PubMed

Johnson, Diane; Saavedra, Patricia; Sun, Eugene; Stageman, Ann; Grovet, Dodie; Alfero, Charles; Maynes, Carmen; Skipper, Betty; Powell, Wayne; Kaufman, Arthur

2012-06-01

We describe the impact of community health workers (CHWs) providing community-based support services to enrollees who are high consumers of health resources in a Medicaid managed care system. We conducted a retrospective study on a sample of 448 enrollees who were assigned to field-based CHWs in 11 of New Mexico's 33 counties. The CHWs provided patients education, advocacy and social support for a period up to 6 months. Data was collected on services provided, and community resources accessed. Utilization and payments in the emergency department, inpatient service, non-narcotic and narcotic prescriptions as well as outpatient primary care and specialty care were collected on each patient for a 6 month period before, for 6 months during and for 6 months after the intervention. For comparison, data was collected on another group of 448 enrollees who were also high consumers of health resources but who did not receive CHW intervention. For all measures, there was a significant reduction in both numbers of claims and payments after the community health worker intervention. Costs also declined in the non-CHW group on all measures, but to a more modest degree, with a greater reduction than in the CHW group in use of ambulatory services. The incorporation of field-based, community health workers as part of Medicaid managed care to provide supportive services to high resource-consuming enrollees can improve access to preventive and social services and may reduce resource utilization and cost.

Identification of Job Coach Competencies, Staff Roles and Agency Administrative Patterns. Summary Report from the Community-Based Supported Employment Symposium (St. Cloud, Minnesota, June 10-11, 1986).

ERIC Educational Resources Information Center

Minnesota Association for Rehabilitation, Education, and Training.

A symposium on community-based supported employment for developmentally disabled adults in Minnesota was attended by agency direct service staff who provide job training, executive directors and administrators of agencies, and personnel who refer clients to agencies providing supported work and other types of community-based training and…

An ontology-based system for context-aware and configurable services to support home-based continuous care.

PubMed

Paganelli, Federica; Giuli, Dino

2011-03-01

Continuous care models for chronic diseases pose several technology-oriented challenges for home-based care, where assistance services rely on a close collaboration among different stakeholders, such as health operators, patient relatives, and social community members. This paper describes an ontology-based context model and a related context management system providing a configurable and extensible service-oriented framework to ease the development of applications for monitoring and handling patient chronic conditions. The system has been developed in a prototypal version, and integrated with a service platform for supporting operators of home-based care networks in cooperating and sharing patient-related information and coordinating mutual interventions for handling critical and alarm situations. Finally, we discuss experimentation results and possible further research directions.

A long and winding road: federally qualified health centers, community variation and prospects under reform.

PubMed

Katz, Aaron B; Felland, Laurie E; Hill, Ian; Stark, Lucy B

2011-11-01

Community health centers have evolved from fringe providers to mainstays of many local health care systems. Those designated as federally qualified health centers (FQHCs), in particular, have largely established themselves as key providers of comprehensive, efficient, high-quality primary care services to low-income people, especially Medicaid and uninsured patients. The Center for Studying Health System Change's (HSC's) site visits to 12 nationally representative metropolitan communities since 1996 document substantial growth in FQHC capacity, based on growing numbers of Medicaid enrollees and uninsured people, increased federal support, and improved managerial acumen. At the same time, FQHC development has varied considerably across communities because of several important factors, including local health system characteristics and financial and political support at federal, state and local levels. Some communities--Boston; Syracuse, N.Y.; Miami; and Seattle--have relatively extensive FQHC capacity for their Medicaid and uninsured populations, while other communities--Lansing, Mich.; northern New Jersey; Indianapolis; and Greenville, S.C.--fall in the middle. FQHC growth in Phoenix; Little Rock, Ark.; Cleveland; and Orange County, Calif.; has lagged in comparison. Today, FQHCs seem poised to play a key role in federal health care reform, including coverage expansions and the emphasis on primary care and medical homes.

Payao: a community platform for SBML pathway model curation

PubMed Central

Matsuoka, Yukiko; Ghosh, Samik; Kikuchi, Norihiro; Kitano, Hiroaki

2010-01-01

Summary: Payao is a community-based, collaborative web service platform for gene-regulatory and biochemical pathway model curation. The system combines Web 2.0 technologies and online model visualization functions to enable a collaborative community to annotate and curate biological models. Payao reads the models in Systems Biology Markup Language format, displays them with CellDesigner, a process diagram editor, which complies with the Systems Biology Graphical Notation, and provides an interface for model enrichment (adding tags and comments to the models) for the access-controlled community members. Availability and implementation: Freely available for model curation service at http://www.payaologue.org. Web site implemented in Seaser Framework 2.0 with S2Flex2, MySQL 5.0 and Tomcat 5.5, with all major browsers supported. Contact: kitano@sbi.jp PMID:20371497

Providing Health Sciences Services in a Joint-Use Distributed Learning Library System: An Organizational Case Study.

PubMed

Enslow, Electra; Fricke, Suzanne; Vela, Kathryn

2017-01-01

The purpose of this organizational case study is to describe the complexities librarians face when serving a multi-campus institution that supports both a joint-use library and expanding health sciences academic partnerships. In a system without a centralized health science library administration, liaison librarians are identifying dispersed programs and user groups and collaborating to define their unique service and outreach needs within a larger land-grant university. Using a team-based approach, health sciences librarians are communicating to integrate research and teaching support, systems differences across dispersed campuses, and future needs of a new community-based medical program.

Creating an Integrated Community-Wide Effort to Enhance Diversity in the Geosciences

NASA Astrophysics Data System (ADS)

Manduca, C. A.; Weingroff, M.

2001-05-01

Supporting the development and sustenance of a diverse geoscience workforce and improving Earth system education for the full diversity of students are important goals for our community. There are numerous established programs and many new efforts beginning. However, these efforts can become more powerful if dissemination of opportunities, effective practices, and web-based resources enable synergies to develop throughout our community. The Digital Library for Earth System Education (DLESE; www.dlese.org) has developed a working group and a website to support these goals. The DLESE Diversity Working Group provides an open, virtual community for those interested in enhancing diversity in the geosciences. The working group has focused its initial effort on 1) creating a geoscience community engaged in supporting increased diversity that builds on and is integrated with work taking place in other venues; 2) developing a web resource designed to engage and support members of underrepresented groups in learning about the Earth; and 3) assisting in enhancing DLESE collections and services to better support learning experiences of students from underrepresented groups. You are invited to join the working group and participate in these efforts. The DLESE diversity website provides a mechanism for sharing information and resources. Serving as a community database, the website provides a structure in which community members can post announcements of opportunities, information on programs, and links to resources and services. Information currently available on the site includes links to professional society activities; mentoring opportunities; grant, fellowship, employment, and internship opportunities for students and educators; information on teaching students from underrepresented groups; and professional development opportunities of high interest to members of underrepresented groups. These tools provide a starting point for developing a community wide effort to enhance diversity in the geosciences that builds on our collective experiences, knowledge and resources and the work that is taking place in communities around us.

The evaluation of NIMROD, a community-based service for people with mental handicap: revenue costs.

PubMed

Davies, L; Felce, D; Lowe, K; de Paiva, S

1991-11-01

The cost implications of moving from a system of services for people with mental handicaps centred on large institutions to a network of community-based services are not precisely known. The provision of the NIMROD service in a part of Cardiff, with its aim not only to meet the residential needs of adults comprehensively by providing a number of houses in the community but also to develop a support service to people living in their family home, gave an opportunity to investigate and report the revenue costs of a number of service elements with respect to a defined total population. The residential costs of intensively staffed houses in 1986-87, varying in size from two to six places, were found to range between pounds 16,473 and pounds 23,319 per person per year. With the addition of community support costs, such as the provision of day services, the total costs of care per resident averaged pounds 21,708; range, pounds 18,883-pounds 26,009. These compared to the total costs in a minimally staffed house of pounds 9,678 per resident. The costs of community support services for people living in their family homes averaged pounds 5,614 inclusive of DSS benefits, of which pounds 1,743 was accounted for by the NIMROD domiciliary support service, office base and administrative overheads. The residential costs reported were compared to other cost data in the literature. The study supports previous conclusions that there is little evidence of diseconomy attached to small scale per se but that the way staffing levels and therefore staff costs are determined is critical. No evidence was found in this study to link greater cost to better quality.

An Exploration of the "I Have a Dream" Program and Its Impact on Urban Students' Academic Trajectories

ERIC Educational Resources Information Center

Diamantis, Olga

2012-01-01

The "I Have a Dream" (IHAD) program is a philanthropic, community-based intervention committed to supporting pupils in impoverished and under-resourced school systems. The IHAD program presents disadvantaged youth with an equal opportunity to pursue higher education by providing scholastic and social-emotional supports to promote college…

From Kisiizi to Baltimore: cultivating knowledge brokers to support global innovation for community engagement in healthcare.

PubMed

Ibe, Chidinma A; Basu, Lopa; Gooden, Rachel; Syed, Shamsuzzoha B; Dadwal, Viva; Bone, Lee R; Ephraim, Patti L; Weston, Christine M; Wu, Albert W

2018-02-09

Reverse Innovation has been endorsed as a vehicle for promoting bidirectional learning and information flow between low- and middle-income countries and high-income countries, with the aim of tackling common unmet needs. One such need, which traverses international boundaries, is the development of strategies to initiate and sustain community engagement in health care delivery systems. In this commentary, we discuss the Baltimore "Community-based Organizations Neighborhood Network: Enhancing Capacity Together" Study. This randomized controlled trial evaluated whether or not a community engagement strategy, developed to address patient safety in low- and middle-income countries throughout sub-Saharan Africa, could be successfully applied to create and implement strategies that would link community-based organizations to a local health care system in Baltimore, a city in the United States. Specifically, we explore the trial's activation of community knowledge brokers as the conduit through which community engagement, and innovation production, was achieved. Cultivating community knowledge brokers holds promise as a vehicle for advancing global innovation in the context of health care delivery systems. As such, further efforts to discern the ways in which they may promote the development and dissemination of innovations in health care systems is warranted. Trial Registration Number: NCT02222909 . Trial Register Name: Reverse Innovation and Patient Engagement to Improve Quality of Care and Patient Outcomes (CONNECT). Date of Trial's Registration: August 22, 2014.

Rapid decision support tool based on novel ecosystem service variables for retrofitting of permeable pavement systems in the presence of trees.

PubMed

Scholz, Miklas; Uzomah, Vincent C

2013-08-01

The retrofitting of sustainable drainage systems (SuDS) such as permeable pavements is currently undertaken ad hoc using expert experience supported by minimal guidance based predominantly on hard engineering variables. There is a lack of practical decision support tools useful for a rapid assessment of the potential of ecosystem services when retrofitting permeable pavements in urban areas that either feature existing trees or should be planted with trees in the near future. Thus the aim of this paper is to develop an innovative rapid decision support tool based on novel ecosystem service variables for retrofitting of permeable pavement systems close to trees. This unique tool proposes the retrofitting of permeable pavements that obtained the highest ecosystem service score for a specific urban site enhanced by the presence of trees. This approach is based on a novel ecosystem service philosophy adapted to permeable pavements rather than on traditional engineering judgement associated with variables based on quick community and environment assessments. For an example case study area such as Greater Manchester, which was dominated by Sycamore and Common Lime, a comparison with the traditional approach of determining community and environment variables indicates that permeable pavements are generally a preferred SuDS option. Permeable pavements combined with urban trees received relatively high scores, because of their great potential impact in terms of water and air quality improvement, and flood control, respectively. The outcomes of this paper are likely to lead to more combined permeable pavement and tree systems in the urban landscape, which are beneficial for humans and the environment. Copyright © 2013 Elsevier B.V. All rights reserved.

Data and Models as Social Objects in the HydroShare System for Collaboration in the Hydrology Community and Beyond

NASA Astrophysics Data System (ADS)

Tarboton, D. G.; Idaszak, R.; Horsburgh, J. S.; Ames, D. P.; Goodall, J. L.; Band, L. E.; Merwade, V.; Couch, A.; Hooper, R. P.; Maidment, D. R.; Dash, P. K.; Stealey, M.; Yi, H.; Gan, T.; Castronova, A. M.; Miles, B.; Li, Z.; Morsy, M. M.; Crawley, S.; Ramirez, M.; Sadler, J.; Xue, Z.; Bandaragoda, C.

2016-12-01

How do you share and publish hydrologic data and models for a large collaborative project? HydroShare is a new, web-based system for sharing hydrologic data and models with specific functionality aimed at making collaboration easier. HydroShare has been developed with U.S. National Science Foundation support under the auspices of the Consortium of Universities for the Advancement of Hydrologic Science, Inc. (CUAHSI) to support the collaboration and community cyberinfrastructure needs of the hydrology research community. Within HydroShare, we have developed new functionality for creating datasets, describing them with metadata, and sharing them with collaborators. We cast hydrologic datasets and models as "social objects" that can be shared, collaborated around, annotated, published and discovered. In addition to data and model sharing, HydroShare supports web application programs (apps) that can act on data stored in HydroShare, just as software programs on your PC act on your data locally. This can free you from some of the limitations of local computing capacity and challenges in installing and maintaining software on your own PC. HydroShare's web-based cyberinfrastructure can take work off your desk or laptop computer and onto infrastructure or "cloud" based data and processing servers. This presentation will describe HydroShare's collaboration functionality that enables both public and private sharing with individual users and collaborative user groups, and makes it easier for collaborators to iterate on shared datasets and models, creating multiple versions along the way, and publishing them with a permanent landing page, metadata description, and citable Digital Object Identifier (DOI) when the work is complete. This presentation will also describe the web app architecture that supports interoperability with third party servers functioning as application engines for analysis and processing of big hydrologic datasets. While developed to support the cyberinfrastructure needs of the hydrology community, the informatics infrastructure for programmatic interoperability of web resources has a generality beyond the solution of hydrology problems that will be discussed.

Leaving no one behind: lessons on rebuilding health systems in conflict- and crisis-affected states.

PubMed

Martineau, Tim; McPake, Barbara; Theobald, Sally; Raven, Joanna; Ensor, Tim; Fustukian, Suzanne; Ssengooba, Freddie; Chirwa, Yotamu; Vong, Sreytouch; Wurie, Haja; Hooton, Nick; Witter, Sophie

2017-01-01

Conflict and fragility are increasing in many areas of the world. This context has been referred to as the 'new normal' and affects a billion people. Fragile and conflict-affected states have the worst health indicators and the weakest health systems. This presents a major challenge to achieving universal health coverage. The evidence base for strengthening health systems in these contexts is very weak and hampered by limited research capacity, challenges relating to insecurity and apparent low prioritisation of this area of research by funders. This article reports on findings from a multicountry consortium examining health systems rebuilding post conflict/crisis in Sierra Leone, Zimbabwe, northern Uganda and Cambodia. Across the ReBUILD consortium's interdisciplinary research programme, three cross-cutting themes have emerged through our analytic process: communities, human resources for health and institutions. Understanding the impact of conflict/crisis on the intersecting inequalities faced by households and communities is essential for developing responsive health policies. Health workers demonstrate resilience in conflict/crisis, yet need to be supported post conflict/crisis with appropriate policies related to deployment and incentives that ensure a fair balance across sectors and geographical distribution. Postconflict/crisis contexts are characterised by an influx of multiple players and efforts to support coordination and build strong responsive national and local institutions are critical. The ReBUILD evidence base is starting to fill important knowledge gaps, but further research is needed to support policy makers and practitioners to develop sustainable health systems, without which disadvantaged communities in postconflict and postcrisis contexts will be left behind in efforts to promote universal health coverage.

Rethinking niche evolution: experiments with natural communities of Protozoa in pitcher plants.

PubMed

Miller, Thomas E; Moran, Emma R; terHorst, Casey P

2014-08-01

Classic niche theory predicts that competing species will evolve to use different resources and interact less, whereas recent niche-converge ideas predict that species evolve to use similar resources and interact more. Most data supporting niche evolution are based on observations of contemporary niche use, whereas experimental support is quite sparse. We followed the evolution of four species of Protozoa during succession in the water-filled leaves of the pitcher plant, Sarracenia purpurea, and found that evolution in multispecies systems follows a surprising pattern. Over several hundred generations, weak competitors evolved to be stronger, while strong competitors evolved to become weaker, which does not conform to expectations of either niche divergence or convergence. Evolution in this system appears to occur in response to characteristics of a suite of several competitors in the community, rather than pairwise interactions. Ecologists may need to rethink the roles of competition and evolution in structuring communities.

NextGEOSS: The Next Generation Data Hub For Earth Observations

NASA Astrophysics Data System (ADS)

Lilja Bye, Bente; De Lathouwer, Bart; Catarino, Nuno; Concalves, Pedro; Trijssenaar, Nicky; Grosso, Nuno; Meyer-Arnek, Julian; Goor, Erwin

2017-04-01

The Group on Earth observation embarked on the next 10 year phase with an ambition to streamline and further develop its achievements in building the Global Earth Observing System of Systems (GEOSS). The NextGEOSS project evolves the European vision of GEOSS data exploitation for innovation and business, relying on the three main pillars of engaging communities, delivering technological developments and advocating the use of GEOSS, in order to support the creation and deployment of Earth observation based innovative research activities and commercial services. In this presentation we will present the NextGEOSS concept, a concept that revolves around providing the data and resources to the users communities, together with Cloud resources, seamlessly connected to provide an integrated ecosystem for supporting applications. A central component of NextGEOSS is the strong emphasis put on engaging the communities of providers and users, and bridging the space in between.

Impact of Facility- and Community-Based Peer Support Models on Maternal Uptake and Retention in Malawi's Option B+ HIV Prevention of Mother-to-Child Transmission Program: A 3-Arm Cluster Randomized Controlled Trial (PURE Malawi).

PubMed

Phiri, Sam; Tweya, Hannock; van Lettow, Monique; Rosenberg, Nora E; Trapence, Clement; Kapito-Tembo, Atupele; Kaunda-Khangamwa, Blessings; Kasende, Florence; Kayoyo, Virginia; Cataldo, Fabian; Stanley, Christopher; Gugsa, Salem; Sampathkumar, Veena; Schouten, Erik; Chiwaula, Levison; Eliya, Michael; Chimbwandira, Frank; Hosseinipour, Mina C

2017-06-01

Many sub-Saharan African countries have adopted Option B+, a prevention of mother-to-child transmission approach providing HIV-infected pregnant and lactating women with immediate lifelong antiretroviral therapy. High maternal attrition has been observed in Option B+. Peer-based support may improve retention. A 3-arm stratified cluster randomized controlled trial was conducted in Malawi to assess whether facility- and community-based peer support would improve Option B+ uptake and retention compared with standard of care (SOC). In SOC, no enhancements were made (control). In facility-based and community-based models, peers provided patient education, support groups, and patient tracing. Uptake was defined as attending a second scheduled follow-up visit. Retention was defined as being alive and in-care at 2 years without defaulting. Attrition was defined as death, default, or stopping antiretroviral therapy. Generalized estimating equations were used to estimate risk differences (RDs) in uptake. Cox proportional hazards regression with shared frailties was used to estimate hazard of attrition. Twenty-one facilities were randomized and enrolled 1269 women: 447, 428, and 394 in facilities that implemented SOC, facility-based, and community-based peer support models, respectively. Mean age was 27 years. Uptake was higher in facility-based (86%; RD: 6%, confidence interval [CI]: -3% to 15%) and community-based (90%; RD: 9%, CI: 1% to 18%) models compared with SOC (81%). At 24 months, retention was higher in facility-based (80%; RD: 13%, CI: 1% to 26%) and community-based (83%; RD: 16%, CI: 3% to 30%) models compared with SOC (66%). Facility- and community-based peer support interventions can benefit maternal uptake and retention in Option B+.

New pathways to physics instruction: Blending a MOOC and in-person discussion to train physics graduate students and postdocs in evidence-based teaching

NASA Astrophysics Data System (ADS)

Goldberg, Bennett

A challenge facing physics education is how to encourage and support the adoption of evidence-based instructional practices that decades of physics education research has shown to be effective. Like many STEM departments, physics departments struggle to overcome the barriers of faculty knowledge, motivation and time; institutional cultures and reward systems; and disciplinary traditions. Research has demonstrated successful transformation of department-level approaches to instruction through local learning communities, in-house expertise, and department administrative support. In this talk, I will discuss how physics and other STEM departments can use a MOOC on evidence-based instruction together with in-person seminar discussions to create a learning community of graduate students and postdocs, and how such communities can affect departmental change in teaching and learning. Four university members of the 21-university network working to prepare future faculty to be both excellent researchers and excellent teachers collaborated on an NSF WIDER project to develop and deliver two massive open online courses (MOOCs) in evidence-based STEM instruction. A key innovation is a new blended mode of delivery where groups of participants engaged with the online content and then meet weekly in local learning communities to discuss content, communicate current experiences, and delve deeper into particular techniques of local interest. The MOOC team supported these so-called MOOC-Centered Learning Communities, or MCLCs, with detailed facilitator guides complete with synopses of online content, learning goals and suggested activities for in-person meetings, as well as virtual MCLC communities for sharing and feedback. In the initial run of the first MOOC, 40 MCLCs were created; in the second run this past fall, more than 80 MCLCs formed. Further, target audiences of STEM graduate students and postdocs completed at a 40-50% rate, indicating the value they place in building their knowledge in evidence-based instruction. We will present data on the impact of being in an MCLC on completion and learning outcomes, as well as data on departmental change in physics supported by MCLCs. Work supported by NSF DUE-1347605.

Healthy Families America state systems development: an emerging practice to ensure program growth and sustainability.

PubMed

Friedman, Lori; Schreiber, Lisa

2007-01-01

In an era of fiscal constraints and increased accountability for social service programs, having a centralized and efficient infrastructure is critical. A well-functioning infrastructure helps a state reduce duplication of services, creates economies of scale, coordinates resources, supports high-quality site development and promotes the self-sufficiency and growth of community-based programs. Throughout the Healthy Families America home visitation network, both program growth and contraction have been managed by in-state collaborations, referred to as "state systems." This article explores the research base that supports the rationale for implementing state systems, describes the evolution of state systems for Healthy Families America, and discusses the benefits, challenges and lessons learned of utilizing a systems approach.

75 FR 60467 - Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-30

...). Grant applications for the Active Aging, Supporting Individuals and Enhancing Community-Based Care... on: Active Aging, Supporting Individuals and Enhancing Community-Based Care through Health...

Creating and sharing clinical decision support content with Web 2.0: Issues and examples.

PubMed

Wright, Adam; Bates, David W; Middleton, Blackford; Hongsermeier, Tonya; Kashyap, Vipul; Thomas, Sean M; Sittig, Dean F

2009-04-01

Clinical decision support is a powerful tool for improving healthcare quality and patient safety. However, developing a comprehensive package of decision support interventions is costly and difficult. If used well, Web 2.0 methods may make it easier and less costly to develop decision support. Web 2.0 is characterized by online communities, open sharing, interactivity and collaboration. Although most previous attempts at sharing clinical decision support content have worked outside of the Web 2.0 framework, several initiatives are beginning to use Web 2.0 to share and collaborate on decision support content. We present case studies of three efforts: the Clinfowiki, a world-accessible wiki for developing decision support content; Partners Healthcare eRooms, web-based tools for developing decision support within a single organization; and Epic Systems Corporation's Community Library, a repository for sharing decision support content for customers of a single clinical system vendor. We evaluate the potential of Web 2.0 technologies to enable collaborative development and sharing of clinical decision support systems through the lens of three case studies; analyzing technical, legal and organizational issues for developers, consumers and organizers of clinical decision support content in Web 2.0. We believe the case for Web 2.0 as a tool for collaborating on clinical decision support content appears strong, particularly for collaborative content development within an organization.

The effect of community-based support services on clinical efficacy and health-related quality of life in HIV/AIDS patients in resource-limited settings in sub-Saharan Africa.

PubMed

Kabore, Inoussa; Bloem, Jeanette; Etheredge, Gina; Obiero, Walter; Wanless, Sebastian; Doykos, Patricia; Ntsekhe, Pearl; Mtshali, Nomantshali; Afrikaner, Eric; Sayed, Rauf; Bostwelelo, John; Hani, Andiswa; Moshabesha, Tiisetso; Kalaka, Agnes; Mameja, Jerry; Zwane, Nompumelelo; Shongwe, Nomvuyo; Mtshali, Phangisile; Mohr, Beryl; Smuts, Archie; Tiam, Appolinaire

2010-09-01

Antiretroviral therapy (ART) for HIV/AIDS in developing countries has been rapidly scaled up through directed public and private resources. Data on the efficacy of ART in developing countries are limited, as are operational research studies to determine the effect of selected nonmedical supportive care services on health outcomes in patients receiving ART. We report here on an investigation of the delivery of medical care combined with community-based supportive services for patients with HIV/AIDS in four resource-limited settings in sub-Saharan Africa, carried out between 2005 and 2007. The clinical and health-related quality of life (HRQOL) efficacy of ART combined with community support services was studied in a cohort of 377 HIV-infected patients followed for 18 months, in community-based clinics through patient interviews, clinical evaluations, and questionnaires. Patients exposed to community-based supportive services experienced a more rapid and greater overall increase in CD4 cell counts than unexposed patients. They also had higher levels of adherence, attributed primarily to exposure to home-based care services. In addition, patients receiving home-based care and/or food support services showed greater improvements in selected health-related QOL indicators. This report discusses the feasibility of effective ART in a large number of patients in resource-limited settings and the added value of concomitant community-based supportive care services.

The GLOBAL Learning and Observations to Benefit the Environment (GLOBE) Collaboration System. Building a robust international collaboration environment for teachers, scientists and students.

NASA Astrophysics Data System (ADS)

Overoye, D.; Lewis, C.

2016-12-01

The Global Learning and Observations to Benefit the Environment (GLOBE) Program is a worldwide hands-on, primary and secondary school-based science and education program founded on Earth Day 1995. Implemented in 117 countries, GLOBE promotes the teaching and learning of science, supporting students, teachers and scientists worldwide to collaborate with each other on inquiry-based investigations of the Earth system. As an international platform supporting a large number and variety of stakeholders, the GLOBE Data Information System (DIS) was re-built with the goal of providing users the support needed to foster and develop collaboration between teachers, students and scientists while supporting the collection and visualization of over 50 different earth science investigations (protocols). There have been many challenges to consider as we have worked to prototype and build various tools to support collaboration across the GLOBE community - language, security, time zones, user roles and the Child Online Protection Act (COPA) to name a few. During the last 3 years the re-built DIS has been in operation we have supported user to user collaboration, school to school collaboration, project/campaign to user collaboration and scientist to scientist collaboration. We have built search tools to facilitate finding collaboration partners. The tools and direction continue to evolve based on feedback, evolving needs and changes in technology. With this paper we discuss our approach for dealing with some of the collaboration challenges, review tools built to encourage and support collaboration, and analyze which tools have been successful and which have not. We will review new ideas for collaboration in the GLOBE community that are guiding upcoming development.

Strengthening the role of Community Health Representatives in the Navajo Nation.

PubMed

King, Caroline; Goldman, Alex; Gampa, Vikas; Smith, Casey; Muskett, Olivia; Brown, Christian; Malone, Jamy; Sehn, Hannah; Curley, Cameron; Begay, Mae-Gilene; Nelson, Adrianne Katrina; Shin, Sonya Sunhi

2017-04-21

Strengthening Community Health Worker systems has been recognized to improve access to chronic disease prevention and management efforts in low-resource communities. The Community Outreach and Patient Empowerment (COPE) Program is a Native non-profit organization with formal partnerships with both the Navajo Nation Community Health Representative (CHR) Program and the clinical facilities serving the Navajo Nation. COPE works to better integrate CHRs into the local health care system through training, strengthening care coordination, and a standardized culturally appropriate suite of health promotion materials for CHRs to deliver to high-risk individuals in their homes. The objective of this mixed methods, cross sectional evaluation of a longitudinal cohort study was to explore how the COPE Program has effected CHR teams over the past 6 years. COPE staff surveyed CHRs in concurrent years (2014 and 2015) about their perceptions of and experience working with COPE, including potential effects COPE may have had on communication among patients, CHRs, and hospital-based providers. COPE staff also conducted focus groups with all eight Navajo Nation CHR teams. CHRs and other stakeholders who viewed our results agree that COPE has improved clinic-community linkages, primarily through strengthened collaborations between Public Health Nurses and CHRs, and access to the Electronic Health Records. CHRs perceived that COPE’s programmatic support has strengthened their validity and reputation with providers and clients, and has enhanced their ability to positively effect health outcomes among their clients. CHRs report an improved ability to deliver health coaching to their clients. Survey results show that 80. 2% of CHRs feel strongly positive that COPE trainings are useful, while 44.6% of CHRs felt that communication and teamwork had improved because of COPE. These findings suggest that CHRs have experienced positive benefits from COPE through training. COPE may provide a useful programmatic model on how best to support other Community Health Workers through strengthening clinic-community linkages, standardizing competencies and training support, and structuring home-based interventions for high-risk individuals.

Geospatial information technology: an adjunct to service-based outreach and education.

PubMed

Faruque, Fazlay; Hewlett, Peggy O; Wyatt, Sharon; Wilson, Kaye; Lofton, Susan; Frate, Dennis; Gunn, Jennie

2004-02-01

This exemplar highlights how geospatial information technology was effective in supporting academic practice, faculty outreach, and education initiatives at the University of Mississippi School of Nursing. Using this cutting-edge technology created a community-based prototype for fully integrating point-of-service research, practice, and academics into a cohesive strategy to influence change within the health care delivery system. This exemplar discusses ways this knowledge benefits practice and curriculum development; informs critical decision making affecting the people we serve; underscores the vital role nurses play in linking this technology to practice; and develops community residents as partners in their own health and that of the community.

Using information communication technology in models of integrated community-based primary health care: learning from the iCOACH case studies.

PubMed

Steele Gray, Carolyn; Barnsley, Jan; Gagnon, Dominique; Belzile, Louise; Kenealy, Tim; Shaw, James; Sheridan, Nicolette; Wankah Nji, Paul; Wodchis, Walter P

2018-06-26

Information communication technology (ICT) is a critical enabler of integrated models of community-based primary health care; however, little is known about how existing technologies have been used to support new models of integrated care. To address this gap, we draw on data from an international study of integrated models, exploring how ICT is used to support activities of integrated care and the organizational and environmental barriers and enablers to its adoption. We take an embedded comparative multiple-case study approach using data from a study of implementation of nine models of integrated community-based primary health care, the Implementing Integrated Care for Older Adults with Complex Health Needs (iCOACH) study. Six cases from Canada, three each in Ontario and Quebec, and three in New Zealand, were studied. As part of the case studies, interviews were conducted with managers and front-line health care providers from February 2015 to March 2017. A qualitative descriptive approach was used to code data from 137 interviews and generate word tables to guide analysis. Despite different models and contexts, we found strikingly similar accounts of the types of activities supported through ICT systems in each of the cases. ICT systems were used most frequently to support activities like care coordination by inter-professional teams through information sharing. However, providers were limited in their ability to efficiently share patient data due to data access issues across organizational and professional boundaries and due to system functionality limitations, such as a lack of interoperability. Even in innovative models of care, managers and providers in our cases mainly use technology to enable traditional ways of working. Technology limitations prevent more innovative uses of technology that could support disruption necessary to improve care delivery. We argue the barriers to more innovative use of technology are linked to three factors: (1) information access barriers, (2) limited functionality of available technology, and (3) organizational and provider inertia.

SMARTE: HELPING COMMUNITIES OVERCOME OBSTACLES TO REVITALIZATION (04/23/07)

EPA Science Inventory

Sustainable Management Approaches and Revitalization Tools - electronic (SMARTe), is an open-source, web-based, decision support system for developing and evaluating future reuse scenarios for potentially contaminated land. SMARTe contains information and analysis tools for all a...

GET SMARTE: DECISION TOOLS TO REVITALIZE COMMUNITIES (MAY 2006)

EPA Science Inventory

SMARTe (Sustainable Management Approaches and Revitalization Tools-electronic) is an open-source, web-based, decision-support system for developing and evaluating future use scenarios for potentially contaminated sites (i.e., brownfields). It contains resources and analysis tools...

Using community-based evidence for decentralized health planning: insights from Maharashtra, India.

PubMed

Shukla, Abhay; Khanna, Renu; Jadhav, Nitin

2018-01-01

Health planning is generally considered a technical subject, primarily the domain of health officials with minimal involvement of community representatives. The National Rural Health Mission launched in India in 2005 recognized this gap and mandated mechanisms for decentralized health planning. However, since planning develops in the context of highly unequal power relations, formal spaces for participation are necessary but not sufficient. Hence a project on capacity building for decentralized health planning was implemented in selected districts of Maharashtra, India during 2010-13. This process developed on the platform of officially supported community-based monitoring and planning, a process for community feedback and participation towards health system change. A specific project on capacity building for decentralized planning included a structured learning course and workshops for major stakeholders. An evaluation of the project, including in-depth interviews of various participants and analysis of change in local health planning processes, revealed positive changes in intervention areas, including increased capacity of key stakeholders leading to preparation of evidence-based, innovative planning proposals, significant community oriented changes in utilization of health facility funds, and inclusion of community-based proposals in village, health facility-based block and district plans. Transparency related to planning increased along with responsiveness of health providers to community suggestions. A key lesson is that active facilitation of decentralized health planning and influencing the health system to expand participation, are essential to ensure changes in planning. Effective strategies included: identifying people's health service related priorities through community-based monitoring, capacity building of diverse stakeholders regarding local health planning, and advocacy to enable participation of community-based actors in the planning process. This combination of strategies draws upon the framework of 'empowered participatory governance' which necessitates combining a degree of 'countervailing power' and acceptance of participation by the system, for new forms of governance to emerge. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Persona Development and Educational Needs to Support Informal Caregivers.

PubMed

Al Awar, Zeina; Kuziemsky, Craig

2017-01-01

Informal caregivers are playing an increasing role in community based care delivery. Research is needed that looks at the educational needs of informal caregivers as a precursor to HIT design to support community care delivery. A challenge is informal caregivers have very diverse educational needs. Personas are an approach to describe user characteristics as part of systems design and this approach could be used to understand and categorize the various educational needs of informal caregivers. This paper addresses this research need and provides a method for persona development and the identification of educational needs for informal caregivers.

Family members facilitating community re-integration and return to productivity following traumatic brain injury - motivations, roles and challenges.

PubMed

Gagnon, Alicia; Lin, Jenny; Stergiou-Kita, Mary

2016-01-01

This study explores the experiences of family members in supporting community re-integration and return to productive occupations of the traumatic brain injury (TBI) survivor in order to: (i) describe family members' supportive roles, (ii) determine challenges family members experience in supporting the TBI survivor; and (iii) identify supports that family members require to maintain and enhance their roles. This qualitative descriptive study involved 14 interviews with immediate family members of TBI survivors. Data was analyzed using thematic analysis. Family members expressed strong motivation and engaged in six key roles to support TBI survivors: researcher, case manager, advocate, coach, activities of daily living (ADL)/instrumental ADLs and emotional supporter. Personal and family stressors and challenges navigating the health care system were perceived as challenges in meeting demands of their supportive roles. Stigma also presented a barrier to successful community and vocational re-integration. Subsequently, family members desired more education related to the functional implications of TBI, to be connected to health care and community resources, and sought a greater family-centred care approach. Family members require on-going counseling and community supports to prevent burnout and allow for their continued engagement in their supportive roles. Further education on how to navigate the health care system, access community programs and rights to workplace accommodation is also warranted. Family members are strongly motivated to support survivors' return to productive occupation following a traumatic brain injury, but require counseling and community support to enable their on-going engagement and prevent burnout. Family members can be further empowered through the implementation of family-centred care. Family members requested further education on the long-term functional implications of TBI, how to navigate the health care system, how to access community programs and workers' rights to workplace accommodations.

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

PubMed

Henriques, Justin J; Louis, Garrick E

2011-01-01

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

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

PubMed

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

2008-08-26

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

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

PubMed Central

Gustafsson, Marie; Jontell, Mats; Torgersson, Olof

2008-01-01

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

Opportunities in the Affordable Care Act to Advance Long-Term Services and Supports: The Role of Rehabilitation Counseling

ERIC Educational Resources Information Center

Caldwell, Joe; Alston, Reginald J.

2012-01-01

The Affordable Care Act includes many new provisions for long-term services and supports (LTSS). Among these are several new options, improvements, and incentives within Medicaid to balance service systems and expand access to home and community-based services. This article discusses some of the major provisions, implementations, and implications…

Model-based design of experiments for cellular processes.

PubMed

Chakrabarty, Ankush; Buzzard, Gregery T; Rundell, Ann E

2013-01-01

Model-based design of experiments (MBDOE) assists in the planning of highly effective and efficient experiments. Although the foundations of this field are well-established, the application of these techniques to understand cellular processes is a fertile and rapidly advancing area as the community seeks to understand ever more complex cellular processes and systems. This review discusses the MBDOE paradigm along with applications and challenges within the context of cellular processes and systems. It also provides a brief tutorial on Fisher information matrix (FIM)-based and Bayesian experiment design methods along with an overview of existing software packages and computational advances that support MBDOE application and adoption within the Systems Biology community. As cell-based products and biologics progress into the commercial sector, it is anticipated that MBDOE will become an essential practice for design, quality control, and production. Copyright © 2013 Wiley Periodicals, Inc.

The Community Perinatal Care Study: Home Visiting and Nursing Support for Pregnant Women

ERIC Educational Resources Information Center

Johnston, David; Tough, Suzanne; Siever, Jodi

2006-01-01

This article describes The Community Perinatal Care Study, a community-based study of pregnancy support that was conducted in Calgary, Alberta, Canada, between 2001 and 2004. The study was conducted to learn how to improve community-based pregnancy care and to improve prenatal care and healthy births, particularly for women with increased…

Implementing a low-cost web-based clinical trial management system for community studies: a case study.

PubMed

Geyer, John; Myers, Kathleen; Vander Stoep, Ann; McCarty, Carolyn; Palmer, Nancy; DeSalvo, Amy

2011-10-01

Clinical trials with multiple intervention locations and a single research coordinating center can be logistically difficult to implement. Increasingly, web-based systems are used to provide clinical trial support with many commercial, open source, and proprietary systems in use. New web-based tools are available which can be customized without programming expertise to deliver web-based clinical trial management and data collection functions. To demonstrate the feasibility of utilizing low-cost configurable applications to create a customized web-based data collection and study management system for a five intervention site randomized clinical trial establishing the efficacy of providing evidence-based treatment via teleconferencing to children with attention-deficit hyperactivity disorder. The sites are small communities that would not usually be included in traditional randomized trials. A major goal was to develop database that participants could access from computers in their home communities for direct data entry. Discussed is the selection process leading to the identification and utilization of a cost-effective and user-friendly set of tools capable of customization for data collection and study management tasks. An online assessment collection application, template-based web portal creation application, and web-accessible Access 2007 database were selected and customized to provide the following features: schedule appointments, administer and monitor online secure assessments, issue subject incentives, and securely transmit electronic documents between sites. Each tool was configured by users with limited programming expertise. As of June 2011, the system has successfully been used with 125 participants in 5 communities, who have completed 536 sets of assessment questionnaires, 8 community therapists, and 11 research staff at the research coordinating center. Total automation of processes is not possible with the current set of tools as each is loosely affiliated, creating some inefficiency. This system is best suited to investigations with a single data source e.g., psychosocial questionnaires. New web-based applications can be used by investigators with limited programming experience to implement user-friendly, efficient, and cost-effective tools for multi-site clinical trials with small distant communities. Such systems allow the inclusion in research of populations that are not usually involved in clinical trials.

Putting flow-ecology relationships into practice: A decision-support system to assess fish community response to water-management scenarios

USGS Publications Warehouse

Cartwright, Jennifer M.; Caldwell, Casey; Nebiker, Steven; Knight, Rodney

2017-01-01

This paper presents a conceptual framework to operationalize flow–ecology relationships into decision-support systems of practical use to water-resource managers, who are commonly tasked with balancing multiple competing socioeconomic and environmental priorities. We illustrate this framework with a case study, whereby fish community responses to various water-management scenarios were predicted in a partially regulated river system at a local watershed scale. This case study simulates management scenarios based on interactive effects of dam operation protocols, withdrawals for municipal water supply, effluent discharges from wastewater treatment, and inter-basin water transfers. Modeled streamflow was integrated with flow–ecology relationships relating hydrologic departure from reference conditions to fish species richness, stratified by trophic, reproductive, and habitat characteristics. Adding a hypothetical new water-withdrawal site was predicted to increase the frequency of low-flow conditions with adverse effects for several fish groups. Imposition of new reservoir release requirements was predicted to enhance flow and fish species richness immediately downstream of the reservoir, but these effects were dissipated further downstream. The framework presented here can be used to translate flow–ecology relationships into evidence-based management by developing decision-support systems for conservation of riverine biodiversity while optimizing water availability for human use.

Tailoring and field-testing the use of a knowledge translation peer support shared decision making strategy with First Nations, Inuit and Métis people making decisions about their cancer care: a study protocol.

PubMed

Jull, Janet; Mazereeuw, Maegan; Sheppard, Amanada; Kewayosh, Alethea; Steiner, Richard; Graham, Ian D

2018-01-01

Tailoring and testing a peer support decision making strategy with First Nations, Inuit and Métis people making decisions about their cancer care: A study protocol.First Nations, Inuit and Métis (FNIM) people face higher risks for cancer compared to non-FNIM populations. They also face cultural barriers to health service use. Within non-FNIM populations an approach to health decision making, called shared decision making (SDM), has been found to improve the participation of people in their healthcare. Peer support with SDM further improves these benefits. The purpose of this study is to tailor and test a peer support SDM strategy with community support workers to increase FNIM people's participation in their cancer care.This project has two phases that will be designed and conducted with a Steering Committee that includes members of the FNIM and cancer care communities. First, a peer support SDM strategy will be tailored to meet the needs of cancer system users who are receiving care in urban settings, and training in the SDM strategy developed for community support workers. Three communities will be supported for participation in the study and community support workers who are peers from each community will be trained to use the SDM strategy.Next, each community support worker will work with a community member who has a diagnosis of cancer or who has supported a family member with cancer. Each community support worker and community member pair will use the SDM strategy. The participation and experience of the community support worker and community member will be evaluated.The research will be used to develop strategies to support people who are making decisions about their health. Tailoring and field-testing the use of a knowledge translation peer support shared decision making strategy with First Nations, Inuit and Métis people making decisions about their cancer care: A study protocol Background First Nations, Inuit and Métis ("FNIM") people face increased cancer risks in relation to general populations and experience barriers to health service use. Shared decision making (SDM) has been found to improve peoples' participation and outcomes in healthcare and peer support with SDM further improves these benefits. The purpose of this study is to tailor and then field test, by and with FNIM communities, a peer support SDM strategy for use in cancer care. Methods This project has 2 theory-driven phases and 5 stages (a-e). A core research team that includes members of the Aboriginal Cancer Control Unit of Cancer Care Ontario communities and academic researchers, will work with a Steering Committee. In phase 1 , (stage a) a peer support SDM strategy will be tailored to meet the needs of cancer system users who are receiving care in urban settings and (stage b), training developed that will i) introduce participant communities to SDM, and ii) train community support workers (CSWs) within these communities. Next (stage c), three communities will be approached for voluntary participation in the study. These communities will be introduced to SDM in community meetings, and if in agreement then CSWs from each community will be recruited to participate in the study. One volunteer CSW from each community will be trained to use the peer support SDM strategy to enable phase 2 (field test of the peer support SDM strategy).During phase 2 (stage d), each CSW will be matched to a volunteer community member who has had a diagnosis of cancer or has supported a family member with cancer and is familiar with Ontario cancer systems. Each CSW-community member pair (3 to 4 pairs/community) will use the tailored peer support SDM strategy; their interaction will be audio-recorded and their participation and experience evaluated (total of 9 to 12 interviews). As well (stage e), data will be collected on health systems' factors related to the use of the peer support SDM strategy. Discussion Findings will develop peer support SDM strategies to enhance participation of FNIM people in cancer care decisions, advance knowledge translation science, and support a proposal to conduct a multi-site implementation trial.

Phytophthora database 2.0: update and future direction.

PubMed

Park, Bongsoo; Martin, Frank; Geiser, David M; Kim, Hye-Seon; Mansfield, Michele A; Nikolaeva, Ekaterina; Park, Sook-Young; Coffey, Michael D; Russo, Joseph; Kim, Seong H; Balci, Yilmaz; Abad, Gloria; Burgess, Treena; Grünwald, Niklaus J; Cheong, Kyeongchae; Choi, Jaeyoung; Lee, Yong-Hwan; Kang, Seogchan

2013-12-01

The online community resource Phytophthora database (PD) was developed to support accurate and rapid identification of Phytophthora and to help characterize and catalog the diversity and evolutionary relationships within the genus. Since its release in 2008, the sequence database has grown to cover 1 to 12 loci for ≈2,600 isolates (representing 138 described and provisional species). Sequences of multiple mitochondrial loci were added to complement nuclear loci-based phylogenetic analyses and diagnostic tool development. Key characteristics of most newly described and provisional species have been summarized. Other additions to improve the PD functionality include: (i) geographic information system tools that enable users to visualize the geographic origins of chosen isolates on a global-scale map, (ii) a tool for comparing genetic similarity between isolates via microsatellite markers to support population genetic studies, (iii) a comprehensive review of molecular diagnostics tools and relevant references, (iv) sequence alignments used to develop polymerase chain reaction-based diagnostics tools to support their utilization and new diagnostic tool development, and (v) an online community forum for sharing and preserving experience and knowledge accumulated in the global Phytophthora community. Here we present how these improvements can support users and discuss the PD's future direction.

Atmospheric data access for the geospatial user community

NASA Astrophysics Data System (ADS)

van de Vegte, John; Som de Cerff, Wim-Jan; van den Oord, Gijsbertus H. J.; Sluiter, Raymond; van der Neut, Ian A.; Plieger, Maarten; van Hees, Richard M.; de Jeu, Richard A. M.; Schaepman, Michael E.; Hoogerwerf, Marc R.; Groot, Nikée E.; Domenico, Ben; Nativi, Stefano; Wilhelmi, Olga V.

2007-10-01

Historically the atmospheric and meteorological communities are separate worlds with their own data formats and tools for data handling making sharing of data difficult and cumbersome. On the other hand, these information sources are becoming increasingly of interest outside these communities because of the continuously improving spatial and temporal resolution of e.g. model and satellite data and the interest in historical datasets. New user communities that use geographically based datasets in a cross-domain manner are emerging. This development is supported by the progress made in Geographical Information System (GIS) software. The current GIS software is not yet ready for the wealth of atmospheric data, although the faint outlines of new generation software are already visible: support of HDF, NetCDF and an increasing understanding of temporal issues are only a few of the hints.

"They See Us as Resource": The Role of a Community-Based Youth Center in Supporting the Academic Lives of Low-Income Chinese American Youth

ERIC Educational Resources Information Center

Wong, Nga-Wing Anjela

2008-01-01

Based on a 15-week ethnographic-based research, this article examines the role of a community-based youth center in supporting the academic lives of Chinese American youth from low-income families in an east coast city I call "Harborview." This study demonstrates the significant role that community-based organizations play for low-income immigrant…

Building Communities of Engineers to Share Technical Expertise

NASA Technical Reports Server (NTRS)

Topousis, Daria E.; Dennehy, Cornelius J.; Fesq, Lorraine M.

2012-01-01

Developed by the core community to describe our vision of an approach to ensure a sufficiently technically advanced and affordable AR&D technology base is available to support future NASA missions. The goal of this strategy is to create an environment exploiting reusable technology elements for an AR&D system design and development process which is: a) Lower-Risk. b) More Versatile/Scalable. c) Reliable & Crew-Safe. d) More Affordable.

The Washington experience (evaluation and selection of hardware for automated geo-based information systems)

NASA Technical Reports Server (NTRS)

Harding, R. A.

1981-01-01

A Washington geographic information system is described. The system has thrust from two different angles: the proprietary need for information to support the management of five million acres of thrust lands by the Department of Natural Resources, and the need for data over the entire state because of statewide governmental responsibilities. The data base includes information relevant to agricultural, forest, industrial, business, and community growth with emphasis on assembling information useful in setting intermediate and long-range goals. System selection procedures and system feasibility studies are discussed.

From leaky pipeline to irrigation system: minority education through the lens of community-based participatory research.

PubMed

James, Rosalina; Starks, Helene; Segrest, Valerie Ann; Burke, Wylie

2012-01-01

Higher education has long made efforts to increase underrepresented minority participation in biomedical research and health fields. However, relatively few minority trainees complete advanced degrees or proceed to independent research careers, a loss referred to as the "leaky pipeline." Minority trainees may take alternate pathways to climbing the academic ladder, exiting to pursue multiple disciplinary or community-serving roles. The authors propose a model for understanding minority departures from the education pipeline as a basis for supporting careers that align with community goals for health. Concepts of the traditional pipeline training model are compared with a model that aligns with community-based participatory research (CBPR) principles and practices. The article describes an irrigation model that incorporates informal learning from academic and community knowledge bases to prepare trainees for CBPR and interdisciplinary research. Students serve as agents that foster individual, institutional, and social change needed to address health problems while attending to root causes of disparities. Viewing minority students as agents for community engagement allows institutions to reassess the role training can play in diversifying participation in higher education and research. An irrigation model supports development of an infrastructure that optimizes success at all post-secondary levels, and enhances CBPR capacity wherever trainees live, work, and learn. Linking formal education to informal learning in context of CBPR experiences can also reduce community mistrust of research while nurturing productive research partnerships with communities to address health disparities.

From Leaky Pipeline to Irrigation System: Minority Education through the Lens of Community-Based Participatory Research

PubMed Central

James, Rosalina; Starks, Helene; Segrest, Valerie; Burke, Wylie

2014-01-01

Background Higher education has long made efforts to increase underrepresented minority participation in biomedical research and health fields. However, relatively few minority trainees complete advanced degrees or proceed to independent research careers, a loss referred to as the “leaky pipeline.” Minority trainees may take alternate pathways to climbing the academic ladder, exiting to pursue multiple disciplinary or community-serving roles. Objective The authors propose a model for understanding minority departures from the education pipeline as a basis for nurturing careers that support community goals for health. Methods Concepts of the traditional pipeline training model are compared with a model that aligns with CBPR principles and practices. The article describes an irrigation model that incorporates informal learning from academic and community knowledge bases to prepare trainees for CBPR and interdisciplinary research. Students serve as agents that foster individual, institutional and social change needed to address health problems while attending to root causes of disparities. Conclusions Viewing minority students as agents for community engagement allows institutions to reassess the role training can play in diversifying participation in higher education and research. An irrigation model supports development of an infrastructure that optimizes success at all post-secondary levels, and enhances CBPR capacity wherever trainees live, work, and learn. Linking formal education to informal learning in context of community-based participatory research experiences can also reduce community mistrust of research while nurturing productive research partnerships with communities to address health disparities. PMID:23221293

34 CFR 380.5 - What activities may the Secretary fund under community-based supported employment projects?

Code of Federal Regulations, 2014 CFR

2014-07-01

... development, including work site modification and use of advanced learning technology for skills training. (3...-based supported employment projects? 380.5 Section 380.5 Education Regulations of the Offices of the... the Secretary fund under community-based supported employment projects? (a) Authorized activities. The...

34 CFR 380.5 - What activities may the Secretary fund under community-based supported employment projects?

Code of Federal Regulations, 2012 CFR

2012-07-01

... development, including work site modification and use of advanced learning technology for skills training. (3...-based supported employment projects? 380.5 Section 380.5 Education Regulations of the Offices of the... the Secretary fund under community-based supported employment projects? (a) Authorized activities. The...

34 CFR 380.5 - What activities may the Secretary fund under community-based supported employment projects?

Code of Federal Regulations, 2013 CFR

2013-07-01

... development, including work site modification and use of advanced learning technology for skills training. (3...-based supported employment projects? 380.5 Section 380.5 Education Regulations of the Offices of the... the Secretary fund under community-based supported employment projects? (a) Authorized activities. The...

Segmenting healthcare terminology users: a strategic approach to large scale evolutionary development.

PubMed

Price, C; Briggs, K; Brown, P J

1999-01-01

Healthcare terminologies have become larger and more complex, aiming to support a diverse range of functions across the whole spectrum of healthcare activity. Prioritization of development, implementation and evaluation can be achieved by regarding the "terminology" as an integrated system of content-based and functional components. Matching these components to target segments within the healthcare community, supports a strategic approach to evolutionary development and provides essential product differentiation to enable terminology providers and systems suppliers to focus on end-user requirements.

"Atmospheric Radiation Measurement (ARM) Research Facility at Oliktok Point Alaska"

NASA Astrophysics Data System (ADS)

Helsel, F.; Ivey, M.; Hardesty, J.; Roesler, E. L.; Dexheimer, D.

2017-12-01

Scientific Infrastructure To Support Atmospheric Science, Aerosol Science and UAS's for The Department Of Energy's Atmospheric Radiation Measurement Programs At The Mobile Facility 3 Located At Oliktok Point, Alaska.The Atmospheric Radiation Measurement (ARM) Program's Mobile Facility 3 (AMF3) located at Oliktok Point, Alaska is a U.S. Department of Energy (DOE) site designed to collect data and help determine the impact that clouds and aerosols have on solar radiation. AMF3 provides a scientific infrastructure to support instruments and collect arctic data for the international arctic research community. The infrastructure at AMF3/Oliktok is designed to be mobile and it may be relocated in the future to support other ARM science missions. AMF3's present base line instruments include: scanning precipitation Radars, cloud Radar, Raman Lidar, Eddy correlation flux systems, Ceilometer, Balloon sounding system, Atmospheric Emitted Radiance Interferometer (AERI), Micro-pulse Lidar (MPL) Along with all the standard metrological measurements. In addition AMF3 provides aerosol measurements with a Mobile Aerosol Observing System (MAOS). Ground support for Unmanned Aerial Systems (UAS) and tethered balloon flights. Data from these instruments and systems are placed in the ARM data archives and are available to the international research community. This poster will discuss what instruments and systems are at the ARM Research Facility at Oliktok Point Alaska.

Community Coordinated Modeling Center (CCMC): Using innovative tools and services to support worldwide space weather scientific communities and networks

NASA Astrophysics Data System (ADS)

Mendoza, A. M.; Bakshi, S.; Berrios, D.; Chulaki, A.; Evans, R. M.; Kuznetsova, M. M.; Lee, H.; MacNeice, P. J.; Maddox, M. M.; Mays, M. L.; Mullinix, R. E.; Ngwira, C. M.; Patel, K.; Pulkkinen, A.; Rastaetter, L.; Shim, J.; Taktakishvili, A.; Zheng, Y.

2012-12-01

Community Coordinated Modeling Center (CCMC) was established to enhance basic solar terrestrial research and to aid in the development of models for specifying and forecasting conditions in the space environment. In achieving this goal, CCMC has developed and provides a set of innovative tools varying from: Integrated Space Weather Analysis (iSWA) web -based dissemination system for space weather information, Runs-On-Request System providing access to unique collection of state-of-the-art solar and space physics models (unmatched anywhere in the world), Advanced Online Visualization and Analysis tools for more accurate interpretation of model results, Standard Data formats for Simulation Data downloads, and recently Mobile apps (iPhone/Android) to view space weather data anywhere to the scientific community. The number of runs requested and the number of resulting scientific publications and presentations from the research community has not only been an indication of the broad scientific usage of the CCMC and effective participation by space scientists and researchers, but also guarantees active collaboration and coordination amongst the space weather research community. Arising from the course of CCMC activities, CCMC also supports community-wide model validation challenges and research focus group projects for a broad range of programs such as the multi-agency National Space Weather Program, NSF's CEDAR (Coupling, Energetics and Dynamics of Atmospheric Regions), GEM (Geospace Environment Modeling) and Shine (Solar Heliospheric and INterplanetary Environment) programs. In addition to performing research and model development, CCMC also supports space science education by hosting summer students through local universities; through the provision of simulations in support of classroom programs such as Heliophysics Summer School (with student research contest) and CCMC Workshops; training next generation of junior scientists in space weather forecasting; and educating the general public about the importance and impacts of space weather effects. Although CCMC is organizationally comprised of United States federal agencies, CCMC services are open to members of the international science community and encourages interagency and international collaboration. In this poster, we provide an overview of using Community Coordinated Modeling Center (CCMC) tools and services to support worldwide space weather scientific communities and networks.;

Avoiding institutional outcomes for older adults living with disability: the use of community-based aged care supports.

PubMed

Ellison, Caroline; White, Amy; Chapman, Libby

2011-09-01

Most people with a disability want to remain living in their own home as they age. Without additional support, people with a disability may not be able to avoid moving into residential aged care, attending day programs, or becoming isolated from participation in the wider community. This study examined whether participants perceived access to community-based aged care supports assisted with avoiding receiving more institutional models of service as they age. Qualitative research processes were used to explore the perceptions of 60 individuals with a disability aged 50 years and over, in relation to ageing and the value of community-based aged care. Findings indicated that participants receiving community-based aged care supports reported benefits including opportunities to develop relationships, maintain daily living skills and participate in community activities. Due to a lack of confidence in the availability of access to mainstream community-based aged care services, many participants felt vulnerable or unsure about their future and ability to remain living in their own home. Several participants commented that this meant that an undesired early relocation into residential aged care or congregate disability services appeared inevitable.

Social inclusion and mental health.

PubMed

Cobigo, Virginie; Stuart, Heather

2010-09-01

Recent research on approaches to improving social inclusion for people with mental disabilities is reviewed. We describe four approaches (or tools) that can be used to improve social inclusion for people with mental disabilities: legislation, community-based supports and services, antistigma/antidiscrimination initiatives, and system monitoring and evaluation. While legislative solutions are the most prevalent, and provide an important framework to support social inclusion, research shows that their full implementation remains problematic. Community-based supports and services that are person-centered and recovery-oriented hold considerable promise, but they are not widely available nor have they been widely evaluated. Antistigma and antidiscrimination strategies are gaining in popularity and offer important avenues for eliminating social barriers and promoting adequate and equitable access to care. Finally, in the context of the current human rights and evidence-based health paradigms, systematic evidence will be needed to support efforts to promote social inclusion for people with mental disabilities, highlight social inequities, and develop best practice approaches. Tools that promote social inclusion of persons with mental disabilities are available, though not yet implemented in a way to fully realize the goals of current disability discourse.

The education of physicians: a CDC perspective.

PubMed

Koo, Denise; Thacker, Stephen B

2008-04-01

The Centers for Disease Control and Prevention (CDC) strongly supports integrating population health perspectives into the education of physicians. Physicians with critical-thinking skills, a commitment to the health of a community, and a systems-based approach are critical partners for the agency in its mission to protect and promote the public's health. To cultivate such physicians, integrating population health concepts solely into undergraduate medical education would be inadequate. A multipronged approach that establishes and maintains population health concepts with physicians at all stages of their education is needed: before medical school, during medical school, during residency and fellowship, and in research and practice (particularly for faculty who train the next generation). The authors describe relevant, CDC-conducted or CDC-supported activities that support such physician education during all these stages. Based in part on recent, cutting-edge trends assimilating community health particularly into primary care residencies, the authors also offer ideas for new ways that CDC can participate in the development of physicians who are truly competent at both medicine and population health in an integrated fashion -- physicians who focus on and care for individual patients but who also take a broader population or community perspective and can act effectively in either arena. Physicians who take such a systems approach -- who view and understand medicine and public health as a continuum rather than as distinct arenas -- are sorely needed to help solve the current health system crisis and to contribute to improving health in other ways.

Community based participatory research of breastfeeding disparities in African American women.

PubMed

Kulka, Tamar Ringel; Jensen, Elizabeth; McLaurin, Sue; Woods, Elizabeth; Kotch, Jonathan; Labbok, Miriam; Bowling, Mike; Dardess, Pamela; Baker, Sharon

2011-08-01

OBJECTIVE: Lack of support for breastfeeding mothers has been consistently identified in the literature as a barrier for breastfeeding across racial and ethnic groups. Using a community-based participatory approach, academic and community-based partners conducted an iterative process to assess barriers, facilitators and potential mediating interventions for breastfeeding in the African-American community in Durham, North Carolina. METHODS: Eight focus groups were conducted with African-American mothers, fathers and grandmothers. Researchers transcribed and coded each focus group and analyzed using Atlas ti. 5.2. Patterns and themes that emerged informed the development of community stakeholder interviews; 41 interviews were conducted with community representatives. These findings informed the development of a support group pilot intervention. The pilot support groups were evaluated for increase in knowledge of attendees. RESULTS: Focus group and community interviews indicate that African Americans may disproportionately experience inadequate support for breastfeeding. This lack of support was reported in the home, the workplace, among peers, and from healthcare providers. The pilot support groups resulted in increased knowledge of breastfeeding among group participants OR=3.6 (95% CI: 2.5, 5.2). CONCLUSIONS: The findings from this research underscore the importance of a multi-level approach to breastfeeding support for African American women to address breastfeeding disparities.

Farm Fresh Foods for Healthy Kids (F3HK): An innovative community supported agriculture intervention to prevent childhood obesity in low-income families and strengthen local agricultural economies.

PubMed

Seguin, Rebecca A; Morgan, Emily H; Hanson, Karla L; Ammerman, Alice S; Jilcott Pitts, Stephanie B; Kolodinsky, Jane; Sitaker, Marilyn; Becot, Florence A; Connor, Leah M; Garner, Jennifer A; McGuirt, Jared T

2017-04-08

Childhood obesity persists in the United States and is associated with serious health problems. Higher rates of obesity among children from disadvantaged households may be, in part, attributable to disparities in access to healthy foods such as fruits and vegetables. Community supported agriculture can improve access to and consumption of fresh produce, but the upfront payment structure, logistical barriers, and unfamiliarity with produce items may inhibit participation by low-income families. The aim of this project is to assess the impact of subsidized, or "cost-offset," community supported agriculture participation coupled with tailored nutrition education for low-income families with children. The Farm Fresh Foods for Healthy Kids community-based, randomized intervention trial will build on formative and longitudinal research to examine the impact of cost-offset community supported agriculture on diet and other health behaviors as well as the economic impacts on local economies. The intervention will involve reduced-price community supported agriculture shares which can be paid for on a weekly basis, nine skill-based and seasonally-tailored healthy eating classes, and the provision of basic kitchen tools. Low income families with at least one child aged 2-12 years will be recruited to join existing community supported agriculture programs in New York, North Carolina, Vermont, and Washington. In each program, families will be randomized 1:1 to intervention or delayed intervention groups. Data will be collected at baseline, and in the fall and spring for 3 years. The primary outcomes are children's intake of fruits and vegetables and foods high in sugar and/or (solid) fat, as well as diet quality; secondary outcomes include physical, behavioral, psychosocial, and environmental variables. Cost-effectiveness and economic impact at the farm and community levels also will be assessed. This integrated project will provide important information and contribute to the evidence base regarding the use of local agricultural interventions to improve children's dietary behaviors and weight maintenance. Findings also will inform the development of a toolkit for farmers and education modules related to local food system innovations for undergraduate and graduate students. ClinicalTrials.gov NCT02770196 . Registered 5 April 2016.

A web access script language to support clinical application development.

PubMed

O'Kane, K C; McColligan, E E

1998-02-01

This paper describes the development of a script language to support the implementation of decentralized, clinical information applications on the World Wide Web (Web). The goal of this work is to facilitate construction of low overhead, fully functional clinical information systems that can be accessed anywhere by low cost Web browsers to search, retrieve and analyze stored patient data. The Web provides a model of network access to data bases on a global scale. Although it was originally conceived as a means to exchange scientific documents, Web browsers and servers currently support access to a wide variety of audio, video, graphical and text based data to a rapidly growing community. Access to these services is via inexpensive client software browsers that connect to servers by means of the open architecture of the Internet. In this paper, the design and implementation of a script language that supports the development of low cost, Web-based, distributed clinical information systems for both Inter- and Intra-Net use is presented. The language is based on the Mumps language and, consequently, supports many legacy applications with few modifications. Several enhancements, however, have been made to support modern programming practices and the Web interface. The interpreter for the language also supports standalone program execution on Unix, MS-Windows, OS/2 and other operating systems.

Evidence from the field: Findings on issues related to planning, implementing and evaluating gender-based programs.

PubMed

Kowalczyk, Shelly; Randolph, Suzanne; Stokes, Shereitte; Winston, Stefanie

2015-08-01

An Initiative of the United States Department of Health and Human Services' Office on Women's Health (OWH), Coalition for a Healthier Community (CHC), supports ten grantees across the U.S. in the implementation of gender-based health interventions targeting women and girls. A national evaluation is assessing whether gender-focused public health systems approaches are sustainable and cost effective in addressing health disparities in women and girls. To inform the evaluation, a systematic examination was conducted of literature in both the public and private sector designed to track, assess, understand, and improve women's health, public health systems approaches, and the cost-effectiveness and sustainability of gender-based programs. A two-person team assured the quality of the results following the review of abstracts and full-text articles. Of 123 articles meeting eligibility criteria (See inclusion criteria described in Section 2.2 below), only 18 met inclusion criteria specific to a focus on a systems approach, cost-effectiveness and/or sustainability. Studies assessing systems approaches suggested their effectiveness in changing perceptions and increasing knowledge within a community; increasing involvement of local decision-makers and other community leaders in women's health issues; and increasing community capacity to address women and girls' health. Further evaluation of the cost-effectiveness and sustainability of gender-based approaches is needed. Copyright © 2014 Elsevier Ltd. All rights reserved.

MENTOR: an enabler for interoperable intelligent systems

NASA Astrophysics Data System (ADS)

Sarraipa, João; Jardim-Goncalves, Ricardo; Steiger-Garcao, Adolfo

2010-07-01

A community with knowledge organisation based on ontologies will enable an increase in the computational intelligence of its information systems. However, due to the worldwide diversity of communities, a high number of knowledge representation elements, which are not semantically coincident, have appeared representing the same segment of reality, becoming a barrier to business communications. Even if a domain community uses the same kind of technologies in its information systems, such as ontologies, it doesn't solve its semantics differences. In order to solve this interoperability problem, a solution is to use a reference ontology as an intermediary in the communications between the community enterprises and the outside, while allowing the enterprises to keep their own ontology and semantics unchanged internally. This work proposes MENTOR, a methodology to support the development of a common reference ontology for a group of organisations sharing the same business domain. This methodology is based on the mediator ontology (MO) concept, which assists the semantic transformations among each enterprise's ontology and the referential one. The MO enables each organisation to keep its own terminology, glossary and ontological structures, while providing seamless communication and interaction with the others.

Revenue Generation in the Wake of Welfare Reform: Summary of the Pilot Learning Cluster on Early Childhood Finance.

ERIC Educational Resources Information Center

Finance Project, Washington, DC.

Creating more comprehensive, community-based support systems and reforming early childhood financing systems are critical to advancing the goal of having all children enter school ready to learn. The Finance Project is a national initiative to improve effectiveness, efficiency, and equity of financing for education, children's services, and…

Support for recreational trail development and community attachment: a case of the Soucook River Watershed

Treesearch

Jodi L. Michaud; Robert A. Robertson

2001-01-01

This study was conducted as part of a larger multi-community needs assessment. Data from this study allows for the determination of support for a multiple-use trail system linking communities within the Soucook River Watershed Region in New Hampshire. This study also examines the relationship between support for trail development and community attachment. The results...

Scalable software architectures for decision support.

PubMed

Musen, M A

1999-12-01

Interest in decision-support programs for clinical medicine soared in the 1970s. Since that time, workers in medical informatics have been particularly attracted to rule-based systems as a means of providing clinical decision support. Although developers have built many successful applications using production rules, they also have discovered that creation and maintenance of large rule bases is quite problematic. In the 1980s, several groups of investigators began to explore alternative programming abstractions that can be used to build decision-support systems. As a result, the notions of "generic tasks" and of reusable problem-solving methods became extremely influential. By the 1990s, academic centers were experimenting with architectures for intelligent systems based on two classes of reusable components: (1) problem-solving methods--domain-independent algorithms for automating stereotypical tasks--and (2) domain ontologies that captured the essential concepts (and relationships among those concepts) in particular application areas. This paper highlights how developers can construct large, maintainable decision-support systems using these kinds of building blocks. The creation of domain ontologies and problem-solving methods is the fundamental end product of basic research in medical informatics. Consequently, these concepts need more attention by our scientific community.

The Getting To Outcomes Demonstration and Evaluation: An Illustration of the Prevention Support System

PubMed Central

Hunter, Sarah B.; Ebener, Patricia; Paddock, Susan M.; Stillman, Lindsey; Imm, Pamela; Wandersman, Abraham

2010-01-01

Communities are increasingly being required by state and federal funders to achieve outcomes and be accountable, yet are often not provided the guidance or the tools needed to successfully meet this challenge. To improve the likelihood of achieving positive outcomes, the Getting To Outcomes (GTO) intervention (manual, training, technical assistance) is designed to provide the necessary guidance and tools, tailored to community needs, in order to build individual capacity and program performance. GTO is an example of a Prevention Support System intervention, which as conceptualized by the Interactive Systems Framework, plays a key role in bridging the gap between prevention science (Prevention Synthesis and Translation System) and prevention practice (Prevention Delivery System). We evaluated the impact of GTO on individual capacity and program performance using survey- and interview-based methods. We tracked the implementation of GTO and gathered user feedback about its utility and acceptability. The evaluation of GTO suggests that it can build individual capacity and program performance and as such demonstrates that the Prevention Support System can successfully fulfill its intended role. Lessons learned from the implementation of GTO relevant to illuminating the framework are discussed. PMID:18278551

Feasibility and effectiveness of computer-based therapy in community treatment.

PubMed

Brooks, Adam C; Ryder, Deanna; Carise, Deni; Kirby, Kimberly C

2010-10-01

Computerized therapy approaches may expand the reach of evidence-based treatment; however, it is unclear how to integrate these therapies into community-based treatment. We conducted a two-phase pilot study to explore (a) whether clients' use of the Therapeutic Education System (TES), a Web-based community reinforcement approach (CRA) learning program, would benefit them in the absence of counselor support and (b) whether counselors and clients would use the TES in the absence of tangible research-based reinforcement. In Phase 1, clients in the TES condition (n = 14) demonstrated large improvements in knowledge, F(1, 20) = 8.90, p = .007, d = 1.05, and were significantly more likely to select CRA style coping responses, F (1, 20) = 11.95, p = .002, d = 1.16, relative to the treatment-as-usual group (n = 14). We also detected small, nonsignificant, between-group effects indicating TES decreased cocaine use during treatment. In Phase 2, counselors referred only around 10% of their caseload to the TES, and the modal number of completed modules in the absence of tangible reinforcement was three. Computer-based therapy approaches are viable in community-based treatment but must be integrated with incentive systems to ensure engagement. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Community Palliative Care Nurses' Challenges and Coping Strategies on Delivering Home-Based Pediatric Palliative Care.

PubMed

Chong, LeeAi; Abdullah, Adina

2017-03-01

The aim of this study was to explore the experience of community palliative care nurses providing home care to children. A qualitative study was conducted at the 3 community palliative care provider organizations in greater Kuala Lumpur from August to October 2014. Data were collected with semistructured interviews with 16 nurses who have provided care to children and was analyzed using thematic analysis. Two categories were identified: (1) challenges nurses faced and (2) coping strategies. The themes identified from the categories are (1) communication challenges, (2) inadequate training and knowledge, (3) personal suffering, (4) challenges of the system, (5) intrapersonal coping skills, (6) interpersonal coping strategies, and (7) systemic supports. These results reinforces the need for integration of pediatric palliative care teaching and communication skills training into all undergraduate health care programs. Provider organizational support to meet the specific needs of the nurses in the community can help retain them in their role. It will also be important to develop standards for current and new palliative care services to ensure delivery of quality pediatric palliative care.

Engaging the Community To Support Student Achievement. ERIC Digest.

ERIC Educational Resources Information Center

Cunningham, Chris

School systems have long recognized the need for public support and participation, but now many districts are renewing their commitment to strengthen the ties with their communities. To build community support for schools that facilitates student achievement, school boards are developing communication strategies that routinely reach diverse…

Promoting Social Nurturance and Positive Social Environments to Reduce Obesity in High Risk Youth

PubMed Central

Wilson, Dawn K.; Sweeney, Allison M.; Kitzman-Ulrich, Heather; Gause, Haylee; St. George, Sara M.

2017-01-01

Nurturing environments within the context of families, schools, and communities all play an important role in enhancing youth’s behavioral choices and health outcomes. The increasing prevalence rates of obesity among youth, especially among low income and ethnic minorities, highlight the need to develop effective and innovative intervention approaches that promote positive supportive environments across different contexts for at risk youth. We propose that the integration of Social Cognitive Theory, Family Systems Theory, and Self-Determination Theory offers a useful framework for understanding how individual, family and social-environmental level factors contribute to the development of nurturing environments. In this paper, we summarize evidence-based randomized controlled trials that integrate positive parenting, motivational, and behavioral skills strategies in different contexts, including primary care, home, community, and school-based settings. Taken together, these studies suggest that youth and parents are most likely to benefit when youth receive individual-level behavioral skills, family-level support and communication, and autonomous motivational support from the broader social environment. Future investigators and health care providers should consider integrating these evidence-based approaches that support the effects of positive social climate-based interventions on promoting healthy eating, physical activity, and weight management in youth. PMID:28229248

Promoting Social Nurturance and Positive Social Environments to Reduce Obesity in High-Risk Youth.

PubMed

Wilson, Dawn K; Sweeney, Allison M; Kitzman-Ulrich, Heather; Gause, Haylee; St George, Sara M

2017-03-01

Nurturing environments within the context of families, schools, and communities all play an important role in enhancing youth's behavioral choices and health outcomes. The increasing prevalence rates of obesity among youth, especially among low income and ethnic minorities, highlight the need to develop effective and innovative intervention approaches that promote positive supportive environments across different contexts for at-risk youth. We propose that the integration of Social Cognitive Theory, Family Systems Theory, and Self-Determination Theory offers a useful framework for understanding how individual, family, and social-environmental-level factors contribute to the development of nurturing environments. In this paper, we summarize evidence-based randomized controlled trials that integrate positive parenting, motivational, and behavioral skills strategies in different contexts, including primary care, home, community, and school-based settings. Taken together, these studies suggest that youth and parents are most likely to benefit when youth receive individual-level behavioral skills, family-level support and communication, and autonomous motivational support from the broader social environment. Future investigators and healthcare providers should consider integrating these evidence-based approaches that support the effects of positive social climate-based interventions on promoting healthy eating, physical activity, and weight management in youth.

Expert system verification concerns in an operations environment

NASA Technical Reports Server (NTRS)

Goodwin, Mary Ann; Robertson, Charles C.

1987-01-01

The Space Shuttle community is currently developing a number of knowledge-based tools, primarily expert systems, to support Space Shuttle operations. It is proposed that anticipating and responding to the requirements of the operations environment will contribute to a rapid and smooth transition of expert systems from development to operations, and that the requirements for verification are critical to this transition. The paper identifies the requirements of expert systems to be used for flight planning and support and compares them to those of existing procedural software used for flight planning and support. It then explores software engineering concepts and methodology that can be used to satisfy these requirements, to aid the transition from development to operations and to support the operations environment during the lifetime of expert systems. Many of these are similar to those used for procedural hardware.

An Ontology of Therapies

NASA Astrophysics Data System (ADS)

Eccher, Claudio; Ferro, Antonella; Pisanelli, Domenico M.

Ontologies are the essential glue to build interoperable systems and the talk of the day in the medical community. In this paper we present the ontology of medical therapies developed in the course of the Oncocure project, aimed at building a guideline based decision support integrated with a legacy Electronic Patient Record (EPR). The therapy ontology is based upon the DOLCE top level ontology. It is our opinion that our ontology, besides constituting a model capturing the precise meaning of therapy-related concepts, can serve for several practical purposes: interfacing automatic support systems with a legacy EPR, allowing the automatic data analysis, and controlling possible medical errors made during EPR data input.

Post-Inpatient Brain Injury Rehabilitation Outcomes: Report from the National OutcomeInfo Database.

PubMed

Malec, James F; Kean, Jacob

2016-07-15

This study examined outcomes for intensive residential and outpatient/community-based post-inpatient brain injury rehabilitation (PBIR) programs compared with supported living programs. The goal of supported living programs was stable functioning (no change). Data were obtained for a large cohort of adults with acquired brain injury (ABI) from the OutcomeInfo national database, a web-based database system developed through National Institutes of Health (NIH) Small Business Technology Transfer (STTR) funding for monitoring progress and outcomes in PBIR programs primarily with the Mayo-Portland Adaptability Inventory (MPAI-4). Rasch-derived MPAI-4 measures for cases from 2008 to 2014 from 9 provider organizations offering programs in 23 facilities throughout the United States were examined. Controlling for age at injury, time in program, and time since injury on admission (chronicity), both intensive residential (n = 205) and outpatient/community-based (n = 2781) programs resulted in significant (approximately 1 standard deviation [SD]) functional improvement on the MPAI-4 Total Score compared with supported living (n = 101) programs (F = 18.184, p < 0.001). Intensive outpatient/community-based programs showed greater improvements on MPAI-4 Ability (F = 14.135, p < 0.001), Adjustment (F = 12.939, p < 0.001), and Participation (F = 16.679, p < 0.001) indices than supported living programs; whereas, intensive residential programs showed improvement primarily in Adjustment and Participation. Age at injury and time in program had small effects on outcome; the effect of chronicity was small to moderate. Examination of more chronic cases (>1 year post-injury) showed significant, but smaller (approximately 0.5 SD) change on the MPAI-4 relative to supported living programs (F = 17.562, p < 0.001). Results indicate that intensive residential and outpatient/community-based PIBR programs result in substantial positive functional changes moderated by chronicity.

Post-Inpatient Brain Injury Rehabilitation Outcomes: Report from the National OutcomeInfo Database

PubMed Central

Kean, Jacob

2016-01-01

Abstract This study examined outcomes for intensive residential and outpatient/community-based post-inpatient brain injury rehabilitation (PBIR) programs compared with supported living programs. The goal of supported living programs was stable functioning (no change). Data were obtained for a large cohort of adults with acquired brain injury (ABI) from the OutcomeInfo national database, a web-based database system developed through National Institutes of Health (NIH) Small Business Technology Transfer (STTR) funding for monitoring progress and outcomes in PBIR programs primarily with the Mayo-Portland Adaptability Inventory (MPAI-4). Rasch-derived MPAI-4 measures for cases from 2008 to 2014 from 9 provider organizations offering programs in 23 facilities throughout the United States were examined. Controlling for age at injury, time in program, and time since injury on admission (chronicity), both intensive residential (n = 205) and outpatient/community-based (n = 2781) programs resulted in significant (approximately 1 standard deviation [SD]) functional improvement on the MPAI-4 Total Score compared with supported living (n = 101) programs (F = 18.184, p < 0.001). Intensive outpatient/community-based programs showed greater improvements on MPAI-4 Ability (F = 14.135, p < 0.001), Adjustment (F = 12.939, p < 0.001), and Participation (F = 16.679, p < 0.001) indices than supported living programs; whereas, intensive residential programs showed improvement primarily in Adjustment and Participation. Age at injury and time in program had small effects on outcome; the effect of chronicity was small to moderate. Examination of more chronic cases (>1 year post-injury) showed significant, but smaller (approximately 0.5 SD) change on the MPAI-4 relative to supported living programs (F = 17.562, p < 0.001). Results indicate that intensive residential and outpatient/community-based PIBR programs result in substantial positive functional changes moderated by chronicity. PMID:26414433

Using CDBG to Support Community-Based Youth Programs

ERIC Educational Resources Information Center

Torrico, Roxana

2008-01-01

This brief provides policymakers, stakeholders, community leaders, and program developers working in or with community-based youth programs with a basic understanding of how the Community Development Block Grant (CDBG) is structured, how community-based youth programs fit into CDBG purposes and activities, and how communities nationwide are using…

Perceptions of pharmacogenetic research to guide tobacco cessation by patients, providers and leaders in a tribal healthcare setting

PubMed Central

Avey, Jaedon P; Hiratsuka, Vanessa Y; Beans, Julie A; Trinidad, Susan Brown; Tyndale, Rachel F; Robinson, Renee F

2016-01-01

Aim: Describe patients,’ providers’ and healthcare system leaders’ perceptions of pharmacogenetic research to guide tobacco cessation treatment in an American Indian/Alaska Native primary care setting. Materials & methods: This qualitative study used semistructured interviews with 20 American Indian/Alaska Native current or former tobacco users, 12 healthcare providers and nine healthcare system leaders. Results: Participants supported pharmacogenetic research to guide tobacco cessation treatment provided that a community-based participatory research approach be employed, research closely coordinate with existing tobacco cessation services and access to pharmacogenetic test results be restricted to providers involved in tobacco cessation. Conclusion: Despite a history of mistrust toward genetic research in tribal communities, participants expressed willingness to support pharmacogenetic research to guide tobacco cessation treatment. PMID:26871371

Guiding Principles for Team-Based Pediatric Care.

PubMed

Katkin, Julie P; Kressly, Susan J; Edwards, Anne R; Perrin, James M; Kraft, Colleen A; Richerson, Julia E; Tieder, Joel S; Wall, Liz

2017-07-24

The American Academy of Pediatrics (AAP) recognizes that children's unique and ever-changing needs depend on a variety of support systems. Key components of effective support systems address the needs of the child and family in the context of their home and community and are dynamic so that they reflect, monitor, and respond to changes as the needs of the child and family change. The AAP believes that team-based care involving medical providers and community partners (eg, teachers and state agencies) is a crucial and necessary component of providing high-quality care to children and their families. Team-based care builds on the foundation of the medical home by reaching out to a potentially broad array of participants in the life of a child and incorporating them into the care provided. Importantly, the AAP believes that a high-functioning team includes children and their families as essential partners. The overall goal of team-based care is to enhance communication and cooperation among the varied medical, social, and educational partners in a child's life to better meet the global needs of children and their families, helping them to achieve their best potential. In support of the team-based approach, the AAP urges stakeholders to invest in infrastructure, education, and privacy-secured technology to meet the needs of children. This statement includes limited specific examples of potential team members, including health care providers and community partners, that are meant to be illustrative and in no way represent a complete or comprehensive listing of all team members who may be of importance for a specific child and family. Copyright © 2017 by the American Academy of Pediatrics.

Using an Interactive Systems Framework to Expand Telepsychology Innovations in Underserved Communities

PubMed Central

Alaniz, Angela B.

2016-01-01

Literature indicates that the use of promising innovations in mental health care can be improved. The advancement of telepsychology is one innovation that has been utilized as a method to reduce rural health disparities and increase the number of people with access to mental health services. This paper describes a successful pilot telepsychology program implemented in a rural community to increase access to mental health services and the model's replication and expansion into four additional communities using concepts described in an Interactive Systems Framework. The Interactive Systems Framework highlights how building local capacity specific to organizational functioning and innovations are necessary to support, deliver, and disseminate innovations within new settings. Based on the knowledge gained from this telepsychology innovation, the application of an Interactive Systems Framework and funding mechanisms are discussed. PMID:27403374

Conducting an inventory of informal community-based resources for children with physical disabilities: enhancing access and creating professional linkages.

PubMed

Rosenberg, A E

2000-01-01

This article describes the process involved in conducting a sample inventory of community-based sports, recreation/leisure, and arts resources that include children with physical disabilities in Monroe County, New York. The inventory instrument, Community Resource Inventory for Children with Physical Disabilities, was designed to examine organizational or group capacity to provide activities for children with physical disabilities. The inventory was administered by phone to organizations and groups identified as meeting the definition of a community-based resource. One hundred and six CBR informants were interviewed, each reporting one or two recreational activities provided at their site. The activities included arts, sports, or leisure offerings, with a total of 127 activities identified in the sample. The results of the study support the premise that community-based resources are receptive to providing activities for children with physical disabilities and to potential collaboration with therapists. Numerous barriers exixts, however, including environmental inaccessibility, lack of personnel training, and including environmental inaccesssbility, lack of personnel training, and costs of participation. The results suggest several educational and system-based changes that may promote future collaborative efforts between therapists and community-based organizations.

42 CFR 441.575 - Development and Implementation Council.

Code of Federal Regulations, 2013 CFR

2013-10-01

... and implementing a State plan amendment to provide Community First Choice services and supports. ... SERVICES Home and Community-Based Attendant Services and Supports State Plan Option (Community First Choice...

Community-based parenting and family support interventions and the prevention of drug abuse.

PubMed

Sanders, M R

2000-01-01

This paper presents a model for the development of a comprehensive, multilevel, preventively-oriented parenting and family support strategy to reduce family risk factors associated with drug abuse in young people. If parenting interventions are to make a significant impact at a population level on the prevalence of dysfunctional parenting practices, there is a need for an ecological approach to parenting support. Such an approach needs to target a variety of social contexts that are in a position to provide parents with access to evidence-based parenting interventions. The Triple P-Positive Parenting Program is discussed as an example of such an approach to illustrate the distinguishing features of a population level strategy. The core constructs underpinning the Triple P system include the promotion of parental self-regulation (self-sufficiency, self-efficacy, self-management, personal agency, and problem solving), through making parenting programs of adequate intensity widely available in the community through flexible delivery modalities (individual, group, telephone assisted and self-directed). The system comprises a tiered continuum of increasingly intensive parenting interventions ranging from media interventions with wide reach, to intensive behavioural family interventions with narrow reach for high-risk families where parenting problems are complicated by other factors including marital conflict, parental mood disturbance, and lack of social support. The scientific basis of the system of intervention and possible directions for future research is discussed.

Selecting, Adapting, and Implementing Evidence-based Interventions in Rural Settings: An Analysis of 70 Community Examples.

PubMed

Smith, Tina Anderson; Adimu, Tanisa Foxworth; Martinez, Amanda Phillips; Minyard, Karen

2016-01-01

This paper explores how communities translate evidence-based and promising health practices to rural contexts. A descriptive, qualitative analysis was conducted using data from 70 grantees funded by the Federal Office of Rural Health Policy to implement evidence-based health practices in rural settings. Findings were organized using The Interactive Systems Framework for Dissemination and Implementation. Grantees broadly interpreted evidence-based and promising practices, resulting in the implementation of a patchwork of health-related interventions that fell along a spectrum of evidentiary rigor. The cohort faced common challenges translating recognized practices into rural community settings and reported making deliberate modifications to original models as a result. Opportunities for building a more robust rural health evidence base include investments to incentivize evidence-based programming in rural settings; rural-specific research and theory-building; translation of existing evidence using a rural lens; technical assistance to support rural innovation; and prioritization of evaluation locally.

Cross-Sector Collaboration in the High-Poverty Setting: Qualitative Results from a Community-Based Diabetes Intervention.

PubMed

Tung, Elizabeth L; Gunter, Kathryn E; Bergeron, Nyahne Q; Lindau, Stacy Tessler; Chin, Marshall H; Peek, Monica E

2018-01-22

To characterize the motivations of stakeholders from diverse sectors who engaged in cross-sector collaboration with an academic medical center. Primary qualitative data (2014-2015) were collected from 22 organizations involved in a cross-sector diabetes intervention on the South Side of Chicago. In-depth, semistructured interviews; participants included leaders from all stakeholder organization types (e.g., businesses, community development, faith-based) involved in the intervention. Data were transcribed verbatim from audio and video recordings. Analysis was conducted using the constant comparison method, derived from grounded theory. All stakeholders described collaboration as an opportunity to promote community health in vulnerable populations. Among diverse motivations across organization types, stakeholders described collaboration as an opportunity for: financial support, brand enhancement, access to specialized skills or knowledge, professional networking, and health care system involvement in community-based efforts. Based on our findings, we propose a framework for implementing a working knowledge of stakeholder motivations to facilitate effective cross-sector collaboration. We identified several factors that motivated collaboration across diverse sectors with health care systems to promote health in a high-poverty, urban setting. Understanding these motivations will be foundational to optimizing meaningful cross-sector collaboration and improving diabetes outcomes in the nation's most vulnerable communities. © Health Research and Educational Trust.

Community-based Ontology Development, Annotation and Discussion with MediaWiki extension Ontokiwi and Ontokiwi-based Ontobedia

PubMed Central

Ong, Edison; He, Yongqun

2016-01-01

Hundreds of biological and biomedical ontologies have been developed to support data standardization, integration and analysis. Although ontologies are typically developed for community usage, community efforts in ontology development are limited. To support ontology visualization, distribution, and community-based annotation and development, we have developed Ontokiwi, an ontology extension to the MediaWiki software. Ontokiwi displays hierarchical classes and ontological axioms. Ontology classes and axioms can be edited and added using Ontokiwi form or MediaWiki source editor. Ontokiwi also inherits MediaWiki features such as Wikitext editing and version control. Based on the Ontokiwi/MediaWiki software package, we have developed Ontobedia, which targets to support community-based development and annotations of biological and biomedical ontologies. As demonstrations, we have loaded the Ontology of Adverse Events (OAE) and the Cell Line Ontology (CLO) into Ontobedia. Our studies showed that Ontobedia was able to achieve expected Ontokiwi features. PMID:27570653

The New York City Operations Support Tool: Supporting Water Supply Operations for Millions in an Era of Changing Patterns in Hydrological Extreme Events

NASA Astrophysics Data System (ADS)

Matonse, A. H.; Porter, J. H.; Frei, A.

2015-12-01

Providing an average 1.1 billion gallons (~ 4.2 x 106 cubic meters) of drinking water per day to approximately nine million people in New York City (NYC) and four upstate counties, the NYC water supply is among the world's largest unfiltered systems. In addition to providing a reliable water supply in terms of water quantity and quality, the city has to fulfill other flow objectives to serve downstream communities. At times, such as during extreme hydrological events, water quality issues may restrict water usage for parts of the system. To support a risk-based water supply decision making process NYC has developed the Operations Support Tool (OST). OST combines a water supply systems model with reservoir water quality models, near real time data ingestion, data base management and an ensemble hydrological forecast. A number of reports have addressed the frequency and intensities of extreme hydrological events across the continental US. In the northeastern US studies have indicated an increase in the frequency of extremely large precipitation and streamflow events during the most recent decades. During this presentation we describe OST and, using case studies we demonstrate how this tool has been useful to support operational decisions. We also want to motivate a discussion about how undergoing changes in patterns of hydrological extreme events elevate the challenge faced by water supply managers and the role of the scientific community to integrate nonstationarity approaches in hydrologic forecast and modeling.

Using peer support groups to enhance community integration of veterans in transition.

PubMed

Drebing, Charles E; Reilly, Erin; Henze, Kevin T; Kelly, Megan; Russo, Anthony; Smolinsky, John; Gorman, Jay; Penk, Walter E

2018-05-01

Peer support groups, also known as "self-help groups," provide a unique tool for helping veterans working through the military-to-civilian transition to achieve higher levels of social support and community integration. The number and variety of community-based peer support groups has grown to the point that there are now more visits to these groups each year than to mental health professionals. The focus of these groups on the provision of social support, the number and variety of groups, the lack of cost, and their availability in the community make them a natural transition tool for building community-based social support. A growing literature suggests that these groups are associated with measurable improvements in social support, clinical symptoms, self-efficacy and coping. For clinical populations, the combination of peer support groups and clinical care results in better outcomes than either alone. Given this evidence, we suggest clinical services use active referral strategies to help veterans engage in peer support groups as a means of improving community reintegration and clinical outcomes. Finally, suggestions for identifying appropriate peer support groups and assisting with active referrals are provided. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Learning from Health Information Exchange Technical Architecture and Implementation in Seven Beacon Communities

PubMed Central

McCarthy, Douglas B.; Propp, Karen; Cohen, Alexander; Sabharwal, Raj; Schachter, Abigail A.; Rein, Alison L.

2014-01-01

As health care providers adopt and make “meaningful use” of health information technology (health IT), communities and delivery systems must set up the infrastructure to facilitate health information exchange (HIE) between providers and numerous other stakeholders who have a role in supporting health and care. By facilitating better communication and coordination between providers, HIE has the potential to improve clinical decision-making and continuity of care, while reducing unnecessary use of services. When implemented as part of a broader strategy for health care delivery system and payment reform, HIE capability also can enable the use of analytic tools needed for population health management, patient engagement in care, and continuous learning and improvement. The diverse experiences of seven communities that participated in the three-year federal Beacon Community Program offer practical insight into factors influencing the technical architecture of exchange infrastructure and its role in supporting improved care, reduced cost, and a healthier population. The case studies also document challenges faced by the communities, such as significant time and resources required to harmonize variations in the interpretation of data standards. Findings indicate that their progress developing community-based HIE strategies, while driven by local needs and objectives, is also influenced by broader legal, policy, and market conditions. PMID:25848591

Learning from health information exchange technical architecture and implementation in seven beacon communities.

PubMed

McCarthy, Douglas B; Propp, Karen; Cohen, Alexander; Sabharwal, Raj; Schachter, Abigail A; Rein, Alison L

2014-01-01

As health care providers adopt and make "meaningful use" of health information technology (health IT), communities and delivery systems must set up the infrastructure to facilitate health information exchange (HIE) between providers and numerous other stakeholders who have a role in supporting health and care. By facilitating better communication and coordination between providers, HIE has the potential to improve clinical decision-making and continuity of care, while reducing unnecessary use of services. When implemented as part of a broader strategy for health care delivery system and payment reform, HIE capability also can enable the use of analytic tools needed for population health management, patient engagement in care, and continuous learning and improvement. The diverse experiences of seven communities that participated in the three-year federal Beacon Community Program offer practical insight into factors influencing the technical architecture of exchange infrastructure and its role in supporting improved care, reduced cost, and a healthier population. The case studies also document challenges faced by the communities, such as significant time and resources required to harmonize variations in the interpretation of data standards. Findings indicate that their progress developing community-based HIE strategies, while driven by local needs and objectives, is also influenced by broader legal, policy, and market conditions.

Community-Level Social Support Responses in a Slow-Motion Technological Disaster: The Case of Libby, Montana

PubMed Central

Orom, Heather; Berry-Bobovski, Lisa; Hernandez, Tanis; Black, C. Brad; Schwartz, Ann G.; Ruckdeschel, John C.

2013-01-01

Social support is an important resource for communities experiencing disasters. However, a disaster's nature (rapid- versus slow-onset, natural versus technological) may influence community-level responses. Disaster research on social support focuses primarily on rapid-onset natural disasters and, to a lesser extent, rapid-onset technological disasters. Little research has addressed slow-onset disasters. This study explores social support processes in Libby, MT, a community experiencing a “slow-motion technological disaster” due to widespread amphibole asbestos exposure. A comprehensive social support coding system was applied to focus-group and in-depth-interview transcripts. Results reveal that, although the community has a history of normative supportiveness during community and individual crises, that norm has been violated in the asbestos disaster context. Results are interpreted as a failure to achieve an “emergent altruistic community.” Specifically, community-level conflict appears to interfere with previously established social support patterns. The observed phenomenon can be understood as the deterioration of a previously supportive community. PMID:20526664

Community-level social support responses in a slow-motion technological disaster: the case of Libby, Montana.

PubMed

Cline, Rebecca J W; Orom, Heather; Berry-Bobovski, Lisa; Hernandez, Tanis; Black, C Brad; Schwartz, Ann G; Ruckdeschel, John C

2010-09-01

Social support is an important resource for communities experiencing disasters. However, a disaster's nature (rapid- versus slow-onset, natural versus technological) may influence community-level responses. Disaster research on social support focuses primarily on rapid-onset natural disasters and, to a lesser extent, rapid-onset technological disasters. Little research has addressed slow-onset disasters. This study explores social support processes in Libby, MT, a community experiencing a "slow-motion technological disaster" due to widespread amphibole asbestos exposure. A comprehensive social support coding system was applied to focus-group and in-depth-interview transcripts. Results reveal that, although the community has a history of normative supportiveness during community and individual crises, that norm has been violated in the asbestos disaster context. Results are interpreted as a failure to achieve an "emergent altruistic community." Specifically, community-level conflict appears to interfere with previously established social support patterns. The observed phenomenon can be understood as the deterioration of a previously supportive community.

Community-Based Learning to Support South African Early Group Care

ERIC Educational Resources Information Center

Casper, Virginia; Lamb-Parker, Faith

2012-01-01

The Developing Families Project-South Africa (DFP-SA) is a community-based model of education and training for the care, support and education of vulnerable children birth-to-three and their caregivers, guardians and families in rural and peri-urban townships. The approach fosters interactive learning among community members about early care and…

Protecting Data Privacy in Structured P2P Networks

NASA Astrophysics Data System (ADS)

Jawad, Mohamed; Serrano-Alvarado, Patricia; Valduriez, Patrick

P2P systems are increasingly used for efficient, scalable data sharing. Popular applications focus on massive file sharing. However, advanced applications such as online communities (e.g., medical or research communities) need to share private or sensitive data. Currently, in P2P systems, untrusted peers can easily violate data privacy by using data for malicious purposes (e.g., fraudulence, profiling). To prevent such behavior, the well accepted Hippocratic database principle states that data owners should specify the purpose for which their data will be collected. In this paper, we apply such principles as well as reputation techniques to support purpose and trust in structured P2P systems. Hippocratic databases enforce purpose-based privacy while reputation techniques guarantee trust. We propose a P2P data privacy model which combines the Hippocratic principles and the trust notions. We also present the algorithms of PriServ, a DHT-based P2P privacy service which supports this model and prevents data privacy violation. We show, in a performance evaluation, that PriServ introduces a small overhead.

Tavaxy: integrating Taverna and Galaxy workflows with cloud computing support.

PubMed

Abouelhoda, Mohamed; Issa, Shadi Alaa; Ghanem, Moustafa

2012-05-04

Over the past decade the workflow system paradigm has evolved as an efficient and user-friendly approach for developing complex bioinformatics applications. Two popular workflow systems that have gained acceptance by the bioinformatics community are Taverna and Galaxy. Each system has a large user-base and supports an ever-growing repository of application workflows. However, workflows developed for one system cannot be imported and executed easily on the other. The lack of interoperability is due to differences in the models of computation, workflow languages, and architectures of both systems. This lack of interoperability limits sharing of workflows between the user communities and leads to duplication of development efforts. In this paper, we present Tavaxy, a stand-alone system for creating and executing workflows based on using an extensible set of re-usable workflow patterns. Tavaxy offers a set of new features that simplify and enhance the development of sequence analysis applications: It allows the integration of existing Taverna and Galaxy workflows in a single environment, and supports the use of cloud computing capabilities. The integration of existing Taverna and Galaxy workflows is supported seamlessly at both run-time and design-time levels, based on the concepts of hierarchical workflows and workflow patterns. The use of cloud computing in Tavaxy is flexible, where the users can either instantiate the whole system on the cloud, or delegate the execution of certain sub-workflows to the cloud infrastructure. Tavaxy reduces the workflow development cycle by introducing the use of workflow patterns to simplify workflow creation. It enables the re-use and integration of existing (sub-) workflows from Taverna and Galaxy, and allows the creation of hybrid workflows. Its additional features exploit recent advances in high performance cloud computing to cope with the increasing data size and complexity of analysis.The system can be accessed either through a cloud-enabled web-interface or downloaded and installed to run within the user's local environment. All resources related to Tavaxy are available at http://www.tavaxy.org.

Engaging Scientists in NASA Education and Public Outreach: Higher Education

NASA Astrophysics Data System (ADS)

Meinke, Bonnie K.; Smith, D. A.; Schultz, G. R.; Lawton, B. L.; Bianchi, L.; Blair, W. P.; Buxner, S.; SEPOF Higher Education Working Group; E/PO Community, SMD

2014-01-01

The NASA Science Education and Public Outreach Forums support the NASA Science Mission Directorate (SMD) and its education and public outreach (E/PO) community through a coordinated effort to enhance the coherence and efficiency of SMD-funded E/PO programs. The Forums foster collaboration between scientists with content expertise and educators with pedagogy expertise. We present opportunities for the astronomy community to participate in collaborations supporting the NASA SMD efforts in the Higher Education community. Members of the Higher Education community include instructors, faculty, and students at community colleges and four-year colleges/universities. The Forums’ efforts for the Higher Education community include a literature review, appraisal of instructors’ needs, coordination of audience-based NASA resources and opportunities, and classroom support materials. Learn how to join in our collaborative efforts to support the Higher Education community based upon mutual needs and interests.

The Method for Assigning Priority Levels (MAPLe): A new decision-support system for allocating home care resources

PubMed Central

Hirdes, John P; Poss, Jeff W; Curtin-Telegdi, Nancy

2008-01-01

Background Home care plays a vital role in many health care systems, but there is evidence that appropriate targeting strategies must be used to allocate limited home care resources effectively. The aim of the present study was to develop and validate a methodology for prioritizing access to community and facility-based services for home care clients. Methods Canadian and international data based on the Resident Assessment Instrument – Home Care (RAI-HC) were analyzed to identify predictors for nursing home placement, caregiver distress and for being rated as requiring alternative placement to improve outlook. Results The Method for Assigning Priority Levels (MAPLe) algorithm was a strong predictor of all three outcomes in the derivation sample. The algorithm was validated with additional data from five other countries, three other provinces, and an Ontario sample obtained after the use of the RAI-HC was mandated. Conclusion The MAPLe algorithm provides a psychometrically sound decision-support tool that may be used to inform choices related to allocation of home care resources and prioritization of clients needing community or facility-based services. PMID:18366782

Differing Strategies to Meet Information-Sharing Needs: Publicly Supported Community Health Information Exchanges Versus Health Systems' Enterprise Health Information Exchanges.

PubMed

Vest, Joshua R; Kash, Bita A

2016-03-01

Community health information exchanges have the characteristics of a public good, and they support population health initiatives at the state and national levels. However, current policy equally incentivizes health systems to create their own information exchanges covering more narrowly defined populations. Noninteroperable electronic health records and vendors' expensive custom interfaces are hindering health information exchanges. Moreover, vendors are imposing the costs of interoperability on health systems and community health information exchanges. Health systems are creating networks of targeted physicians and facilities by funding connections to their own enterprise health information exchanges. These private networks may change referral patterns and foster more integration with outpatient providers. The United States has invested billions of dollars to encourage the adoption of and implement the information technologies necessary for health information exchange (HIE), enabling providers to efficiently and effectively share patient information with other providers. Health care providers now have multiple options for obtaining and sharing patient information. Community HIEs facilitate information sharing for a broad group of providers within a region. Enterprise HIEs are operated by health systems and share information among affiliated hospitals and providers. We sought to identify why hospitals and health systems choose either to participate in community HIEs or to establish enterprise HIEs. We conducted semistructured interviews with 40 policymakers, community and enterprise HIE leaders, and health care executives from 19 different organizations. Our qualitative analysis used a general inductive and comparative approach to identify factors influencing participation in, and the success of, each approach to HIE. Enterprise HIEs support health systems' strategic goals through the control of an information technology network consisting of desired trading partners. Community HIEs support obtaining patient information from the broadest set of providers, but with more dispersed benefits to all participants, the community, and patients. Although not an either/or decision, community and enterprise HIEs compete for finite organizational resources like time, skilled staff, and money. Both approaches face challenges due to vendor costs and less-than-interoperable technology. Both community and enterprise HIEs support aggregating clinical data and following patients across settings. Although they can be complementary, community and enterprise HIEs nonetheless compete for providers' attention and organizational resources. Health policymakers might try to encourage the type of widespread information exchange pursued by community HIEs, but the business case for enterprise HIEs clearly is stronger. The sustainability of a community HIE, potentially a public good, may necessitate ongoing public funding and supportive regulation. © 2016 Milbank Memorial Fund.

Celebrating indigenous communities compassionate traditions.

PubMed

Prince, Holly

2018-01-01

Living in a compassionate community is not a new practice in First Nations communities; they have always recognized dying as a social experience. First Nations hold extensive traditional knowledge and have community-based practices to support the personal, familial, and community experiences surrounding end-of-life. However, western health systems were imposed and typically did not support these social and cultural practices at end of life. In fact, the different expectations of western medicine and the community related to end of life care has created stress and misunderstanding for both. One solution is for First Nations communities to develop palliative care programs so that people can receive care at home amongst their family, community and culture. Our research project "Improving End-of-Life Care in First Nations Communities" (EOLFN) was funded by the Canadian Institutes of Health Research [2010-2015] and was conducted in partnership with four First Nations communities in Canada (see www.eolfn.lakeheadu.ca). Results included a community capacity development approach to support Indigenous models of care at end-of-life. The workshop will describe the community capacity development process used to develop palliative care programs in First Nations communities. It will highlight the foundation to this approach, namely, grounding the program in community values and principles, rooted in individual, family, community and culture. Two First Nations communities will share stories about their experiences developing their own palliative care programs, which celebrated cultural capacity in their communities while enhancing medical palliative care services in a way that respected and integrated with their community cultural practices. This workshop shares the experiences of two First Nations communities who developed palliative care programs by building upon community culture, values and principles. The underlying model guiding development is shared.

How Smart Schools Get and Keep Community Support.

ERIC Educational Resources Information Center

Carroll, Susan Rovezzi; Carroll, David

The purpose of this book is to provide public school systems with a fresh and unique approach to building community support. The book suggests that schools must build community support, discusses who the customers segments are, and outlines the diverse ways that public schools can begin to develop strong bonds with each customer segment. It…

ERIC Review: The Impact of Financial Crisis on Access and Support Services in Community Colleges.

ERIC Educational Resources Information Center

Sheldon, Caroline Q.

2003-01-01

Discusses the impact of fiscal contraction on community colleges. Explores how reduced state appropriations have adversely affected community college instruction and student support systems. Research shows that because instruction and student support services suffer when budget is reduced, fiscal contraction can hamper the ability of colleges to…

Individual and community resilience factors among lesbian, gay, bisexual, queer and questioning youth and adults in Israel.

PubMed

Shilo, Guy; Antebi, Nadav; Mor, Zohar

2015-03-01

Drawing on resilience theories, this study examined the individual and community factors of Israeli lesbians, gays, bisexuals, queers, and questioning (LGBQs) that contribute to positive mental health and the degree to which individual and community protective factors mitigate the adverse effect of risk factors for poor mental health. Differences in resilience factors between LGBQ youth and adults were explored. Data were collected on 890 LGBQ youth and adults. Findings emphasize the role of community-level resilience factors in the lives of LGBQs, and that these support systems differ slightly between the two age groups. Among youth, family support was both a strong predictor for well-being and a protective factor for mental distress. Although family support was found as a resilience factor among adults as well, other community-level factors (friends' support, LGBT connectedness and having steady partner) were found as protective factors for poorer mental health. These findings suggest for efforts on fostering familial support for LGBQ youth and a multi-level system that offers support at the familial, peer, relationship and community levels for both LGBQ youth and adults.

Role and outcomes of community health workers in HIV care in sub-Saharan Africa: a systematic review

PubMed Central

Mwai, Grace W; Mburu, Gitau; Torpey, Kwasi; Frost, Peter; Ford, Nathan; Seeley, Janet

2013-01-01

Introduction The provision of HIV treatment and care in sub-Saharan Africa faces multiple challenges, including weak health systems and attrition of trained health workers. One potential response to overcome these challenges has been to engage community health workers (CHWs). Methodology A systematic literature search for quantitative and qualitative studies describing the role and outcomes of CHWs in HIV care between inception and December 2012 in sub-Saharan Africa was performed in the following databases: PubMed, PsychINFO, Embase, Web of Science, JSTOR, WHOLIS, Google Scholar and SAGE journals online. Bibliographies of included articles were also searched. A narrative synthesis approach was used to analyze common emerging themes on the role and outcomes of CHWs in HIV care in sub-Saharan Africa. Results In total, 21 studies met the inclusion criteria, documenting a range of tasks performed by CHWs. These included patient support (counselling, home-based care, education, adherence support and livelihood support) and health service support (screening, referral and health service organization and surveillance). CHWs were reported to enhance the reach, uptake and quality of HIV services, as well as the dignity, quality of life and retention in care of people living with HIV. The presence of CHWs in clinics was reported to reduce waiting times, streamline patient flow and reduce the workload of health workers. Clinical outcomes appeared not to be compromised, with no differences in virologic failure and mortality comparing patients under community-based and those under facility-based care. Despite these benefits, CHWs faced challenges related to lack of recognition, remuneration and involvement in decision making. Conclusions CHWs can clearly contribute to HIV services delivery and strengthen human resource capacity in sub-Saharan Africa. For their contribution to be sustained, CHWs need to be recognized, remunerated and integrated in wider health systems. Further research focusing on comparative costs of CHW interventions and successful models for mainstreaming CHWs into wider health systems is needed. PMID:24029015

Decision support environment for medical product safety surveillance.

PubMed

Botsis, Taxiarchis; Jankosky, Christopher; Arya, Deepa; Kreimeyer, Kory; Foster, Matthew; Pandey, Abhishek; Wang, Wei; Zhang, Guangfan; Forshee, Richard; Goud, Ravi; Menschik, David; Walderhaug, Mark; Woo, Emily Jane; Scott, John

2016-12-01

We have developed a Decision Support Environment (DSE) for medical experts at the US Food and Drug Administration (FDA). The DSE contains two integrated systems: The Event-based Text-mining of Health Electronic Records (ETHER) and the Pattern-based and Advanced Network Analyzer for Clinical Evaluation and Assessment (PANACEA). These systems assist medical experts in reviewing reports submitted to the Vaccine Adverse Event Reporting System (VAERS) and the FDA Adverse Event Reporting System (FAERS). In this manuscript, we describe the DSE architecture and key functionalities, and examine its potential contributions to the signal management process by focusing on four use cases: the identification of missing cases from a case series, the identification of duplicate case reports, retrieving cases for a case series analysis, and community detection for signal identification and characterization. Published by Elsevier Inc.

Distributed Cognition and Process Management Enabling Individualized Translational Research: The NIH Undiagnosed Diseases Program Experience

PubMed Central

Links, Amanda E.; Draper, David; Lee, Elizabeth; Guzman, Jessica; Valivullah, Zaheer; Maduro, Valerie; Lebedev, Vlad; Didenko, Maxim; Tomlin, Garrick; Brudno, Michael; Girdea, Marta; Dumitriu, Sergiu; Haendel, Melissa A.; Mungall, Christopher J.; Smedley, Damian; Hochheiser, Harry; Arnold, Andrew M.; Coessens, Bert; Verhoeven, Steven; Bone, William; Adams, David; Boerkoel, Cornelius F.; Gahl, William A.; Sincan, Murat

2016-01-01

The National Institutes of Health Undiagnosed Diseases Program (NIH UDP) applies translational research systematically to diagnose patients with undiagnosed diseases. The challenge is to implement an information system enabling scalable translational research. The authors hypothesized that similar complex problems are resolvable through process management and the distributed cognition of communities. The team, therefore, built the NIH UDP integrated collaboration system (UDPICS) to form virtual collaborative multidisciplinary research networks or communities. UDPICS supports these communities through integrated process management, ontology-based phenotyping, biospecimen management, cloud-based genomic analysis, and an electronic laboratory notebook. UDPICS provided a mechanism for efficient, transparent, and scalable translational research and thereby addressed many of the complex and diverse research and logistical problems of the NIH UDP. Full definition of the strengths and deficiencies of UDPICS will require formal qualitative and quantitative usability and process improvement measurement. PMID:27785453

COMMUNITY MULTISCALE AIR QUALITY MODELING SYSTEM (ONE ATMOSPHERE)

EPA Science Inventory

This task supports ORD's strategy by providing responsive technical support of EPA's mission and provides credible state of the art air quality models and guidance. This research effort is to develop and improve the Community Multiscale Air Quality (CMAQ) modeling system, a mu...

Community interventions providing care and support to orphans and vulnerable children: a review of evaluation evidence.

PubMed

Schenk, Katie D

2009-07-01

Children affected by HIV in their families and communities face multiple risks to their health, education and psychosocial wellbeing. Community interventions for children who have been orphaned or rendered vulnerable take many forms, including educational assistance, home-based care, legal protection and psychosocial support. Despite a recent influx of funding for programme implementation, there exists little evidence to inform policymakers about whether their investments are improving the lives of vulnerable children and meeting key benchmarks including the Millennium Development Goals. This paper reviews the current evidence base on evaluations of community interventions for orphans and vulnerable children (OVC) in high HIV-prevalence African settings, focusing on studies' methodologies. Sources reviewed include published research studies and evidence from the unpublished programmatic "grey literature" located through database and internet searches. A total of 21 studies, varying in scope and generalisability, were identified. Interventions reviewed address children's wellbeing through various strategies within their communities. Evaluation methodologies reflect quantitative and qualitative approaches, including surveys (with and without baseline or comparison data), costing studies, focus groups, interviews, case studies, and participatory review techniques. Varied study methodologies reflect diverse research questions, various intervention types, and the challenges associated with evaluating complex interventions; highlighting the need to broaden the research paradigm in order to build the evidence base by including quasi-experimental and process evaluation approaches, and seeking further insights through participatory qualitative methodologies and costing studies. Although findings overall indicate the value of community interventions in effecting measurable improvements in child and family wellbeing, the quality and rigour of evidence is varied. A strategic research agenda is urgently needed to inform resource allocation and programme management decisions. Immediate imperatives include building local technical capacity to conduct quantitative and qualitative evaluation research, and strengthening monitoring and evaluation systems to collect process and outcome data (including costing) on key support models. Donors and implementers must support the collection of sound empirical evidence to inform the development and scale-up of OVC programmes.

Assessing the feasibility of using uniaxial accelerometers with an online support platform in the delivery of a community-based exercise referral scheme.

PubMed

Hawkins, Jemma L; Oliver, Emily J; Wyatt-Williams, Jeannie; Scale, Elaine; van Woerden, Hugo C

2014-10-01

Exercise referral schemes are established within community-based health care; however, they have been criticized for failing to evidence long-term behavior change relative to usual care. As such, recent reviews have called for refinement of their delivery with a focus on embedded strategies targeting client motivation. This research letter presents findings from an initial pilot trial conducted within Wales' National Exercise Referral Scheme (NERS), examining the feasibility of using validated physical activity monitoring devices and an accompanying online platform within standard scheme delivery. 30 individuals referred to generic or cardiovascular pathways were offered the system; of these 17 agreed to participate. Common reasons for declining were clustered into lack of technology literacy or access, condition severity, or fear of costs associated with losing the device. Analysis of follow-up interviews after 4 weeks of use indicated that while participants found the monitoring devices practical and informative, only a minority (n = 4) were using the system in full. Crucially, the system element most aligned with contemporary theories of motivation (the online portal) was not used as expected. In addition, feedback from exercise referral professionals indicated that there were demands for support from clients, which might be mitigated by more effective independent system use. Recommendations for larger scale trials using similar systems include consideration of targeted patient groups, equity of access, and providing adequate technological support that is currently beyond the capacity of the NERS system. © The Author(s) 2014.

Impact of community-based support services on antiretroviral treatment programme delivery and outcomes in resource-limited countries: a synthetic review.

PubMed

Wouters, Edwin; Van Damme, Wim; van Rensburg, Dingie; Masquillier, Caroline; Meulemans, Herman

2012-07-09

Task-shifting to lay community health providers is increasingly suggested as a potential strategy to overcome the barriers to sustainable antiretroviral treatment (ART) scale-up in high-HIV-prevalence, resource-limited settings. The dearth of systematic scientific evidence on the contributory role and function of these forms of community mobilisation has rendered a formal evaluation of the published results of existing community support programmes a research priority. We reviewed the relevant published work for the period from November 2003 to December 2011 in accordance with the guidelines for a synthetic review. ISI Web of Knowledge, Science Direct, BioMed Central, OVID Medline, PubMed, Social Services Abstracts, and Sociological Abstracts and a number of relevant websites were searched. The reviewed literature reported an unambiguous positive impact of community support on a wide range of aspects, including access, coverage, adherence, virological and immunological outcomes, patient retention and survival. Looking at the mechanisms through which community support can impact ART programmes, the review indicates that community support initiatives are a promising strategy to address five often cited challenges to ART scale-up, namely (1) the lack of integration of ART services into the general health system; (2) the growing need for comprehensive care, (3) patient empowerment, (4) and defaulter tracing; and (5) the crippling shortage in human resources for health. The literature indicates that by linking HIV/AIDS-care to other primary health care programmes, by providing psychosocial care in addition to the technical-medical care from nurses and doctors, by empowering patients towards self-management and by tracing defaulters, well-organised community support initiatives are a vital part of any sustainable public-sector ART programme. The review demonstrates that community support initiatives are a potentially effective strategy to address the growing shortage of health workers, and to broaden care to accommodate the needs associated with chronic HIV/AIDS. The existing evidence suggests that community support programmes, although not necessarily cheap or easy, remain a good investment to improve coverage of communities with much needed health services, such as ART. For this reason, health policy makers, managers, and providers must acknowledge and strengthen the role of community support in the fight against HIV/AIDS.

Impact of community-based support services on antiretroviral treatment programme delivery and outcomes in resource-limited countries: a synthetic review

PubMed Central

2012-01-01

Background Task-shifting to lay community health providers is increasingly suggested as a potential strategy to overcome the barriers to sustainable antiretroviral treatment (ART) scale-up in high-HIV-prevalence, resource-limited settings. The dearth of systematic scientific evidence on the contributory role and function of these forms of community mobilisation has rendered a formal evaluation of the published results of existing community support programmes a research priority. Methods We reviewed the relevant published work for the period from November 2003 to December 2011 in accordance with the guidelines for a synthetic review. ISI Web of Knowledge, Science Direct, BioMed Central, OVID Medline, PubMed, Social Services Abstracts, and Sociological Abstracts and a number of relevant websites were searched. Results The reviewed literature reported an unambiguous positive impact of community support on a wide range of aspects, including access, coverage, adherence, virological and immunological outcomes, patient retention and survival. Looking at the mechanisms through which community support can impact ART programmes, the review indicates that community support initiatives are a promising strategy to address five often cited challenges to ART scale-up, namely (1) the lack of integration of ART services into the general health system; (2) the growing need for comprehensive care, (3) patient empowerment, (4) and defaulter tracing; and (5) the crippling shortage in human resources for health. The literature indicates that by linking HIV/AIDS-care to other primary health care programmes, by providing psychosocial care in addition to the technical-medical care from nurses and doctors, by empowering patients towards self-management and by tracing defaulters, well-organised community support initiatives are a vital part of any sustainable public-sector ART programme. Conclusions The review demonstrates that community support initiatives are a potentially effective strategy to address the growing shortage of health workers, and to broaden care to accommodate the needs associated with chronic HIV/AIDS. The existing evidence suggests that community support programmes, although not necessarily cheap or easy, remain a good investment to improve coverage of communities with much needed health services, such as ART. For this reason, health policy makers, managers, and providers must acknowledge and strengthen the role of community support in the fight against HIV/AIDS. PMID:22776682

Smart self management: assistive technology to support people with chronic disease.

PubMed

Zheng, Huiru; Nugent, Chris; McCullagh, Paul; Huang, Yan; Zhang, Shumei; Burns, William; Davies, Richard; Black, Norman; Wright, Peter; Mawson, Sue; Eccleston, Christopher; Hawley, Mark; Mountain, Gail

2010-01-01

We have developed a personalised self management system to support self management of chronic conditions with support from health-care professionals. Accelerometers are used to measure gross levels of activity, for example walking around the house, and used to infer higher level activity states, such as standing, sitting and lying. A smart phone containing an accelerometer and a global positioning system (GPS) module can be used to monitor outdoor activity, providing both activity and location based information. Heart rate, blood pressure and weight are recorded and input to the system by the user. A decision support system (DSS) detects abnormal activity and distinguishes life style patterns. The DSS is used to assess the self management process, and automates feedback to the user, consistent with the achievement of their life goals. We have found that telecare and assistive technology is feasible to support self management for chronic conditions within the home and local community environments.

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

PubMed

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

2011-12-01

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

Integrating Behavioral Health Risk Assessment into Centralized Intake for Maternal and Child Health Services.

PubMed

Price, Sarah Kye; Coles, D Crystal; Wingold, Tracey

2017-11-01

Effectively promoting women's health during and around the time of pregnancy requires early, nonstigmatizing identification and assessment of behavioral health risks (such as depression, substance use, smoking, and interpersonal violence) combined with timely linkage to community support and specialized interventions. This article describes an integrated approach to behavioral health risk screening woven into a point of first contact with the health care delivery system: centralized intake for maternal and child health home visiting programs. Behavioral Health Integrated Centralized Intake is a social work-informed, community-designed approach to screening, brief intervention, and service linkage targeting communities at high risk for fetal and infant mortality. Women enrolled in this study were receptive to holistic risk screening as well as guided referral for both home visiting support and specialized mental health interventions. Results from this multi-community study form the foundation for strengths-based, social work-informed enhancements to community health promotion programs. © 2017 National Association of Social Workers.

A hybrid supported employment program for persons with schizophrenia in Japan.

PubMed

Fuller, T R; Oka, M; Otsuka, K; Yokoyama, N; Liberman, R P; Niwa, S I

2000-07-01

INTRODUCTION BY THE COLUMN EDITORS: Because the mental health system in Japan has emphasized hospital-based treatment (1), patients with schizophrenia often remain institutionalized for long periods, even after their symptoms have stabilized. In addition, the introduction of modern community-based methods of treatment and rehabilitation was delayed by an antipsychiatry movement in the 1970s and the ascendance of a reductionistic biological approach to services (2). Lack of adequate outpatient services and community residential care in Japan has been a serious obstacle to destigmatization of mental disorders and has contributed to the heavy burden and stress experienced by families of mentally ill persons (3). More than 80 percent of patients discharged from mental hospitals return to live with their families, who are ill prepared to provide the supportive services required for community tenure. Involvement in work activities can facilitate community reentry for people with serious and persistent mental illness because employment displaces symptoms, provides structure and meaning in daily life, offers socialization with peers, and permits workers to earn income for shelter and food. In this issue's Rehab Rounds column, the authors describe an innovative vocational rehabilitation program for patients with schizophrenia that was designed to overcome obstacles to discharge and community adjustment. The program at Yabuki Prefecture Psychiatric Hospital, in the northern prefecture of Fukushima, Japan, has been successful in training patients for competitive work while capitalizing on the importance of work in Japanese culture and its traditionally supportive employer-employee relationships. The program is termed "hybrid" because it combines elements of transitional employment with supported employment (4).

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

PubMed Central

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

2007-01-01

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

The Impact of Medical/Behavioral Support Needs on the Supports Needed by Adolescents with Intellectual Disability to Participate in Community Life

ERIC Educational Resources Information Center

Seo, Hyojeong; Shogren, Karrie A.; Wehmeyer, Michael L.; Little, Todd D.; Palmer, Susan B.

2017-01-01

As adolescents with intellectual disability (ID) transition to adulthood, there is a need to plan for effective community-based supports that address the post-school life. There is also a need to plan for the impact of factors (e.g., medical/behavioral support needs) on supports needed for community participation. Data from the "Supports…

Adapting an adherence support workers intervention: engaging traditional healers as adherence partners for persons enrolled in HIV care and treatment in rural Mozambique.

PubMed

Audet, Carolyn M; Salato, José; Vermund, Sten H; Amico, K Rivet

2017-04-13

Systematic adaptation of evidence-informed interventions that increase retention in care and improve adherence to antiretroviral therapy (ART) are essential to ending the HIV epidemic in rural sub-Saharan Africa. We selected and adapted an adherence support worker intervention employed in Malawi for use by traditional healers in rural Mozambique. Given the levels of trust and dependence previously expressed by persons living with HIV (PLHIV) for traditional medicine, we adapted the program to engage traditional healers within the allopathic health system. Adaption followed a theoretically driven approach to intervention adaption: the Assessment-Decision-Administration-Production-Topical Experts-Integration-Training-Testing (ADAPT-ITT) model. Three rounds of performance feedback, based on theater presentations of the adapted intervention for stakeholders and idea generation, were completed with 12 groups from March to July 2016 to develop the final model. We offered healer support to 180 newly diagnosed HIV-infected patients. Traditional healers were an acceptable group of community health workers to assist with patient adherence and retention. Traditional healers, clinicians, and interested community members suggested novel strategies to tailor the adherence support worker intervention, revealing a local culture of HIV denialism, aversion to the health system, and dislike of healthcare providers, as well as a preference for traditional treatments. Proposed changes to the intervention included modifications to the training language and topics, expanded community-based activities to support acceptability of an HIV diagnosis and to facilitate partner disclosure, and accompaniment to the health facility by healers to encourage delivery of respectful clinical care. PLHIV, healers, and clinicians deemed the intervention socially acceptable during focus groups. We subsequently recruited 180 newly diagnosed HIV-infected patients into the program: 170 (94%) accepted. Systematic translation of interventions, even between regions with similar social and economic environments, is an important first step to successful program implementation. Efforts previously limited to community health workers can be tailored for use by traditional healers-an underutilized and often maligned health workforce. It proved feasible to use theater-based performances to demonstrate delivery of the intervention in low-literacy populations, generating discussions about social norms, community concerns, and the merits of an acceptable strategy to improve retention and adherence to ART.

Fostering resilience among urban youth exposed to violence: a promising area for interdisciplinary research and practice.

PubMed

Jain, Sonia; Cohen, Alison K

2013-12-01

Most studies to date have examined negative effects of exposure to community violence, in line with the deficit-based perspective. However, given that most youth exposed to community violence demonstrate positive adaptation or resilience over time, we suggest a shift in perspective, practices, and policies across systems toward identifying and building individual, family, and community assets and strengths that may more effectively support youth who have been exposed to community violence and related risks into competent, caring, and thriving adults. In this article, we review how resilience has been conceptualized and operationalized within the context of community violence, highlight gaps in literature, and offer directions for future public health research and practice. We illustrate this review with practice-based examples from public health work in the San Francisco Bay Area. Future multidisciplinary longitudinal studies that identify protective processes and successful trajectories and rigorous evaluations of strength-based policies, programs, and protective processes are needed.

Test Platforms for Model-Based Flight Research

NASA Astrophysics Data System (ADS)

Dorobantu, Andrei

Demonstrating the reliability of flight control algorithms is critical to integrating unmanned aircraft systems into the civilian airspace. For many potential applications, design and certification of these algorithms will rely heavily on mathematical models of the aircraft dynamics. Therefore, the aerospace community must develop flight test platforms to support the advancement of model-based techniques. The University of Minnesota has developed a test platform dedicated to model-based flight research for unmanned aircraft systems. This thesis provides an overview of the test platform and its research activities in the areas of system identification, model validation, and closed-loop control for small unmanned aircraft.

A Smartphone App (AfyaData) for Innovative One Health Disease Surveillance from Community to National Levels in Africa: Intervention in Disease Surveillance

PubMed Central

Sindato, Calvin; Mwabukusi, Mpoki; Teesdale, Scott; Olsen, Jennifer

2017-01-01

Background We describe the development and initial achievements of a participatory disease surveillance system that relies on mobile technology to promote Community Level One Health Security (CLOHS) in Africa. Objective The objective of this system, Enhancing Community-Based Disease Outbreak Detection and Response in East and Southern Africa (DODRES), is to empower community-based human and animal health reporters with training and information and communication technology (ICT)–based solutions to contribute to disease detection and response, thereby complementing strategies to improve the efficiency of infectious disease surveillance at national, regional, and global levels. In this study, we refer to techno-health as the application of ICT-based solutions to enhance early detection, timely reporting, and prompt response to health events in human and animal populations. Methods An EpiHack, involving human and animal health experts as well as ICT programmers, was held in Tanzania in 2014 to identify major challenges facing early detection, timely reporting, and prompt response to disease events. This was followed by a project inception workshop in 2015, which brought together key stakeholders, including policy makers and community representatives, to refine the objectives and implementation plan of the DODRES project. The digital ICT tools were developed and packaged together as the AfyaData app to support One Health disease surveillance. Community health reporters (CHRs) and officials from animal and human health sectors in Morogoro and Ngorongoro districts in Tanzania were trained to use the AfyaData app. The AfyaData supports near- to real-time data collection and submission at both community and health facility levels as well as the provision of feedback to reporters. The functionality of the One Health Knowledge Repository (OHKR) app has been integrated into the AfyaData app to provide health information on case definitions of diseases of humans and animals and to synthesize advice that can be transmitted to CHRs with next step response activities or interventions. Additionally, a WhatsApp social group was made to serve as a platform to sustain interactions between community members, local government officials, and DODRES team members. Results Within the first 5 months (August-December 2016) of AfyaData tool deployment, a total of 1915 clinical cases in livestock (1816) and humans (99) were reported in Morogoro (83) and Ngorongoro (1832) districts. Conclusions These initial results suggest that the DODRES community-level model creates an opportunity for One Health engagement of people in their own communities in the detection of infectious human and animal disease threats. Participatory approaches supported by digital and mobile technologies should be promoted for early disease detection, timely reporting, and prompt response at the community, national, regional, and global levels. PMID:29254916

Reducing Disparities in Cancer Screening and Prevention through Community-Based Participatory Research Partnerships with Local Libraries: A Comprehensive Dynamic Trial.

PubMed

Rapkin, Bruce D; Weiss, Elisa; Lounsbury, David; Michel, Tamara; Gordon, Alexis; Erb-Downward, Jennifer; Sabino-Laughlin, Eilleen; Carpenter, Alison; Schwartz, Carolyn E; Bulone, Linda; Kemeny, Margaret

2017-09-01

Reduction of cancer-related disparities requires strategies that link medically underserved communities to preventive care. In this community-based participatory research project, a public library system brought together stakeholders to plan and undertake programs to address cancer screening and risk behavior. This study was implemented over 48 months in 20 large urban neighborhoods, selected to reach diverse communities disconnected from care. In each neighborhood, Cancer Action Councils were organized to conduct a comprehensive dynamic trial, an iterative process of program planning, implementation and evaluation. This process was phased into neighborhoods in random, stepped-wedge sequence. Population-level outcomes included self-reported screening adherence and smoking cessation, based on street intercept interviews. Event-history regressions (n = 9374) demonstrated that adherence outcomes were associated with program implementation, as were mediators such as awareness of screening programs and cancer information seeking. Findings varied by ethnicity, and were strongest among respondents born outside the U.S. or least engaged in care. This intervention impacted health behavior in diverse, underserved and vulnerable neighborhoods. It has been sustained as a routine library system program for several years after conclusion of grant support. In sum, participatory research with the public library system offers a flexible, scalable approach to reduce cancer health disparities. © Society for Community Research and Action 2017.

Geospatial Data Fusion and Multigroup Decision Support for Surface Water Quality Management

NASA Astrophysics Data System (ADS)

Sun, A. Y.; Osidele, O.; Green, R. T.; Xie, H.

2010-12-01

Social networking and social media have gained significant popularity and brought fundamental changes to many facets of our everyday life. With the ever-increasing adoption of GPS-enabled gadgets and technology, location-based content is likely to play a central role in social networking sites. While location-based content is not new to the geoscience community, where geographic information systems (GIS) are extensively used, the delivery of useful geospatial data to targeted user groups for decision support is new. Decision makers and modelers ought to make more effective use of the new web-based tools to expand the scope of environmental awareness education, public outreach, and stakeholder interaction. Environmental decision processes are often rife with uncertainty and controversy, requiring integration of multiple sources of information and compromises between diverse interests. Fusing of multisource, multiscale environmental data for multigroup decision support is a challenging task. Toward this goal, a multigroup decision support platform should strive to achieve transparency, impartiality, and timely synthesis of information. The latter criterion often constitutes a major technical bottleneck to traditional GIS-based media, featuring large file or image sizes and requiring special processing before web deployment. Many tools and design patterns have appeared in recent years to ease the situation somewhat. In this project, we explore the use of Web 2.0 technologies for “pushing” location-based content to multigroups involved in surface water quality management and decision making. In particular, our granular bottom-up approach facilitates effective delivery of information to most relevant user groups. Our location-based content includes in-situ and remotely sensed data disseminated by NASA and other national and local agencies. Our project is demonstrated for managing the total maximum daily load (TMDL) program in the Arroyo Colorado coastal river basin in Texas. The overall design focuses on assigning spatial information to decision support elements and on efficiently using Web 2.0 technologies to relay scientific information to the nonscientific community. We conclude that (i) social networking, if appropriately used, has great potential for mitigating difficulty associated with multigroup decision making; (ii) all potential stakeholder groups should be involved in creating a useful decision support system; and (iii) environmental decision support systems should be considered a must-have, instead of an optional component of TMDL decision support projects. Acknowledgment: This project was supported by NASA grant NNX09AR63G.

Towards a framework for analyzing determinants of performance of community health workers in malaria prevention and control: a systematic review.

PubMed

Chipukuma, Helen Mwiinga; Zulu, Joseph Mumba; Jacobs, Choolwe; Chongwe, Gershom; Chola, Mumbi; Halwiindi, Hikabasa; Zgambo, Jessy; Michelo, Charles

2018-05-08

Community health workers (CHWs) are an important human resource in improving coverage of and success to interventions aimed at reducing malaria incidence. Evidence suggests that the performance of CHWs in malaria programs varies in different contexts. However, comprehensive frameworks, based on systematic reviews, to guide the analysis of determinants of performance of CHWs in malaria prevention and control programs are lacking. We systematically searched Google Scholar, Science Direct, and PubMed including reference lists that had English language publications. We included 16 full text articles that evaluated CHW performance in malaria control. Search terms were used and studies that had performance as an outcome of interest attributed to community-based interventions done by CHWs were included. Sixteen studies were included in the final review and were mostly on malaria Rapid Diagnosis and Treatment, as well as adherence to referral guidelines. Factors determining performance and effective implementation of CHW malaria programs included health system factors such as nature of training of CHWs; type of supervision including feedback process; availability of stocks, supplies, and job aids; nature of work environment and reporting systems; availability of financial resources and transport systems; types of remuneration; health staff confidence in CHWs; and workload. In addition, community dynamics such as nature of community connectedness and support from the community and utilization of services by the community also influenced performance. Furthermore, community health worker characteristics such marital status, sex, and CHW confidence levels also shaped CHW performance. Effectively analyzing and promoting the performance of CHWs in malaria prevention and control programs may require adopting a framework that considers health systems and community factors as well as community health worker characteristics.

Online Social Support for Patients with Multiple Sclerosis: A Thematic Analysis of Messages Posted to a Virtual Support Community.

PubMed

Shavazi, Masoumeh Abbasi; Morowatisharifabad, Mohammad Ali; Shavazi, Mohammad Taghi Abbasi; Mirzaei, Masoud; Ardekani, Ali Mellat

2016-07-01

Currently with the emergence of the Internet, patients have an opportunity to exchange social support online. However, little attention has been devoted to different dimensions of online social support exchanged in virtual support communities for patients with multiple sclerosis (MS). To provide a rich insight, the aim of this qualitative study was to explore and categorize different dimensions of online social support in messages exchanged in a virtual support community for patients with MS. A total of 548 posted messages created during one year period were selected using purposive sampling to consider the maximum variation sampling. Prior-research-driven thematic analysis was then conducted. In this regard, we used the Cutruna and Suhr's coding system. The messages that could not be categorized with the used coding system were thematically analyzed to explore new additional social support themes. The results showed that various forms of social support including informational, emotional, network, esteem and tangible support were exchanged. Moreover, new additional social support themes including sharing personal experiences, sharing coping strategies and spiritual support emerged in this virtual support community. The wide range of online social support exchanged in the virtual support community can be regarded as a supplementary source of social support for patients with MS. Future researches can examine online social support more comprehensively considering additional social support themes emerging in the present study.

Advances in the Psychosocial Treatment of Addiction

PubMed Central

Dallery, Jesse

2012-01-01

Synopsis The authors present an overview of empirically supported psychosocial interventions for individuals with substance use disorders (SUDs), including recent advances in the field. They also identify barriers to the adoption of evidence-based psychosocial treatments in community-based systems of care, and the promise of leveraging technology (computers, web, mobile phone, and emerging technologies) to markedly enhance the reach of these treatments. Technology-based interventions may provide “on-demand,” ubiquitous access to therapeutic support in diverse settings. A brief discussion of important next steps in developing, refining, and disseminating technology-delivered psychosocial interventions concludes the review. PMID:22640767

Lessons Learned by Community Stakeholders in the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) Project, 2013–2014

PubMed Central

Ganter, Claudia; Aftosmes-Tobio, Alyssa; Chuang, Emmeline; Kwass, Jo-Ann; Land, Thomas

2017-01-01

Introduction Childhood obesity is a multifaceted disease that requires sustainable, multidimensional approaches that support change at the individual, community, and systems levels. The Massachusetts Childhood Obesity Research Demonstration project addressed this need by using clinical and public health evidence-based methods to prevent childhood obesity. To date, little information is known about successes and lessons learned from implementing such large-scale interventions. To address this gap, we examined perspectives of community stakeholders from various sectors on successes achieved and lessons learned during the implementation process. Methods We conducted 39 semistructured interviews with key stakeholders from 6 community sectors in 2 low-income communities from November 2013 through April 2014, during project implementation. Interviews were audio-recorded, transcribed, and analyzed by using the constant comparative method. Data were analyzed by using QSR NVivo 10. Results Successes included increased parental involvement in children’s health and education, increased connections within participating organizations and within the broader community, changes in organizational policies and environments to better support healthy living, and improvements in health behaviors in children, parents, and stakeholders. Lessons learned included the importance of obtaining administrative and leadership support, involving key stakeholders early in the program planning process, creating buffers that allow for unexpected changes, and establishing opportunities for regular communication within and across sectors. Conclusion Study findings indicate that multidisciplinary approaches support health behavior change and provide insight into key issues to consider in developing and implementing such approaches in low-income communities. PMID:28125400

Development of a Smartphone-Enabled Hypertension and Diabetes Mellitus Management Package to Facilitate Evidence-Based Care Delivery in Primary Healthcare Facilities in India: The mPower Heart Project.

PubMed

Ajay, Vamadevan S; Jindal, Devraj; Roy, Ambuj; Venugopal, Vidya; Sharma, Rakshit; Pawar, Abha; Kinra, Sanjay; Tandon, Nikhil; Prabhakaran, Dorairaj

2016-12-21

The high burden of undetected and undertreated hypertension and diabetes mellitus is a major health challenge worldwide. The mPower Heart Project aimed to develop and test a feasible and scalable intervention for hypertension and diabetes mellitus by task-sharing with the use of a mobile phone-based clinical decision support system at Community Health Centers in Himachal Pradesh, India. The development of the intervention and mobile phone-based clinical decision support system was carried out using mixed methods in five Community Health Centers. The intervention was subsequently evaluated using pre-post evaluation design. During intervention, a nurse care coordinator screened, examined, and entered patient parameters into mobile phone-based clinical decision support system to generate a prescription, which was vetted by a physician. The change in systolic blood pressure, diastolic blood pressure, and fasting plasma glucose (FPG) over 18 months of intervention was quantified using generalized estimating equations models. During intervention, 6797 participants were enrolled. Six thousand sixteen participants had hypertension (mean systolic blood pressure: 146.1 mm Hg, 95% CI: 145.7, 146.5; diastolic blood pressure: 89.52 mm Hg, 95% CI: 89.33, 89.72), of which 3152 (52%) subjects were newly detected. Similarly, 1516 participants had diabetes mellitus (mean FPG: 177.9 mg/dL, 95% CI: 175.8, 180.0), of which 450 (30%) subjects were newly detected. The changes in systolic blood pressure, diastolic blood pressure, and FPG observed at 18 months of follow-up were -14.6 mm Hg (95% CI: -15.3, -13.8), -7.6 mm Hg (CI: -8.0, -7.2), and -50.0 mg/dL (95% CI: -54.6, -45.5), respectively, and were statistically significant even after adjusting for age, sex, and Community Health Center. A nurse-facilitated, mobile phone-based clinical decision support system-enabled intervention in primary care was associated with improvements in blood pressure and blood glucose control and has the potential to scale-up in resource poor settings. URL: https://www.clinicaltrials.gov. Unique identifiers: NCT01794052. Clinical Trial Registry-India: CTRI/2013/02/003412. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Establishing a regional, multisite database for quality improvement and service planning in community-based palliative care and hospice.

PubMed

Bull, Janet; Zafar, S Yousuf; Wheeler, Jane L; Harker, Matthew; Gblokpor, Agbessi; Hanson, Laura; Hulihan, Deirdre; Nugent, Rikki; Morris, John; Abernethy, Amy P

2010-08-01

Outpatient palliative care, an evolving delivery model, seeks to improve continuity of care across settings and to increase access to services in hospice and palliative medicine (HPM). It can provide a critical bridge between inpatient palliative care and hospice, filling the gap in community-based supportive care for patients with advanced life-limiting illness. Low capacities for data collection and quantitative research in HPM have impeded assessment of the impact of outpatient palliative care. In North Carolina, a regional database for community-based palliative care has been created through a unique partnership between a HPM organization and academic medical center. This database flexibly uses information technology to collect patient data, entered at the point of care (e.g., home, inpatient hospice, assisted living facility, nursing home). HPM physicians and nurse practitioners collect data; data are transferred to an academic site that assists with analyses and data management. Reports to community-based sites, based on data they provide, create a better understanding of local care quality. The data system was developed and implemented over a 2-year period, starting with one community-based HPM site and expanding to four. Data collection methods were collaboratively created and refined. The database continues to grow. Analyses presented herein examine data from one site and encompass 2572 visits from 970 new patients, characterizing the population, symptom profiles, and change in symptoms after intervention. A collaborative regional approach to HPM data can support evaluation and improvement of palliative care quality at the local, aggregated, and statewide levels.

34 CFR 403.140 - What activities does the Secretary support under the State Assistance for Vocational Education...

Code of Federal Regulations, 2010 CFR

2010-07-01

... State Assistance for Vocational Education Support Programs by Community-Based Organizations? 403.140... Education Support Programs by Community-Based Organizations § 403.140 What activities does the Secretary... Organizations? (a) The State shall provide, in accordance with its State plan, and from its allotment for this...

Birthing Support and the Community-Based Doula

ERIC Educational Resources Information Center

Abramson, Rachel; Breedlove, Ginger K.; Isaacs, Beth

2007-01-01

This article is excerpted from the authors' "The Community-Based Doula: Supporting Families Before, During, and After Childbirth", published in 2006 by "ZERO TO THREE." In the U.S., many new parents are socially isolated and lack access to ongoing caring and support because of poverty, immigration, language barriers, or the growing mobility and…

Community health workers' experiences of mobile device-enabled clinical decision support systems for maternal, newborn and child health in developing countries: a qualitative systematic review protocol.

PubMed

Dzabeng, Francis; Enuameh, Yeetey; Adjei, George; Manu, Grace; Asante, Kwaku Poku; Owusu-Agyei, Seth

2016-09-01

The objective of this review is to synthesize evidence on the experiences of community health workers (CHWs) of mobile device-enabled clinical decision support systems (CDSSs) interventions designed to support maternal newborn and child health (MNCH) in low-and middle-income countries.Specific objectives.

Citizen Science to Support Community-based Flood Early Warning and Resilience Building

NASA Astrophysics Data System (ADS)

Paul, J. D.; Buytaert, W.; Allen, S.; Ballesteros-Cánovas, J. A.; Bhusal, J.; Cieslik, K.; Clark, J.; Dewulf, A.; Dhital, M. R.; Hannah, D. M.; Liu, W.; Nayaval, J. L.; Schiller, A.; Smith, P. J.; Stoffel, M.; Supper, R.

2017-12-01

In Disaster Risk Management, an emerging shift has been noted from broad-scale, top-down assessments towards more participatory, community-based, bottom-up approaches. Combined with technologies for robust and low-cost sensor networks, a citizen science approach has recently emerged as a promising direction in the provision of extensive, real-time information for flood early warning systems. Here we present the framework and initial results of a major new international project, Landslide EVO, aimed at increasing local resilience against hydrologically induced disasters in western Nepal by exploiting participatory approaches to knowledge generation and risk governance. We identify three major technological developments that strongly support our approach to flood early warning and resilience building in Nepal. First, distributed sensor networks, participatory monitoring, and citizen science hold great promise in complementing official monitoring networks and remote sensing by generating site-specific information with local buy-in, especially in data-scarce regions. Secondly, the emergence of open source, cloud-based risk analysis platforms supports the construction of a modular, distributed, and potentially decentralised data processing workflow. Finally, linking data analysis platforms to social computer networks and ICT (e.g. mobile phones, tablets) allows tailored interfaces and people-centred decision- and policy-support systems to be built. Our proposition is that maximum impact is created if end-users are involved not only in data collection, but also over the entire project life-cycle, including the analysis and provision of results. In this context, citizen science complements more traditional knowledge generation practices, and also enhances multi-directional information provision, risk management, early-warning systems and local resilience building.

Preparing the Workforce for Healthy Aging Programs: The Skills for Healthy Aging Resources and Programs (SHARP) Model

ERIC Educational Resources Information Center

Frank, Janet C.; Altpeter, Mary; Damron-Rodriguez, JoAnn; Driggers, Joann; Lachenmayr, Susan; Manning, Colleen; Martinez, Dana M.; Price, Rachel M.; Robinson, Patricia

2014-01-01

Current public health and aging service agency personnel have little training in gerontology, and virtually no training in evidence-based health promotion and disease management programs for older adults. These programs are rapidly becoming the future of our community-based long-term care support system. The purpose of this project was to develop…

The Evolving Urban Community and Military Installations: A Dynamic Spatial Decision Support System for Sustainable Military Communities

DTIC Science & Technology

2007-01-01

focus on identifying growth by income and housing costs. These, and other models are focused on the city itself and deal with growth over the course...2. This model employs a set of econometric models to project future population, household, and employment. The landscape is gridded into one... model in LEAM (LEAMecon) forecasts changes in output, employment and income over time based on changes in the market, technology, productivity and

A Modern Explorer's Journey - using events for innovative multipurpose educational outreach

NASA Astrophysics Data System (ADS)

Lilja Bye, Bente

2014-05-01

Earth observations are important across the specter of geo-sciences. The Group on Earth Observations (GEO) is coordinating efforts to build a Global Earth Observation System of Systems, or GEOSS. The lack of dedicated funding to support specific Science &Technology activities in support of GEOSS is one of the most important obstacles to engaging the Science &Technology communities in its implementation. Finding resources to outreach and capacity building is likewise a challenge. The continuation of GEO and GEOSS rely on political support which again is influenced by public opinions. The GEO Ministerial Summit in 2014 was an event that both needed visibility and represented an opportunity to mobilize the GEO community in producing outreach and educational material. Through the combined resources from two of GEO tasks in the GEO work plan, a multipurpose educational outreach project was planned and executed. This project addressed the following issues: How can the GEO community mobilize resources for its work plan projects in the Societal Benefit Area Water? How can we produce more educational and capacity building material? How can the GEO community support the GEO secretariat related to public relations (material and otherwise) Based on activities described in the GEO work plan, a showcase video and online campaign consisting on a series of webinars were developed and produced. The video and webinars were linked through a common reference: the water cycle. Various aspects of the water cycle ranging from general to more technical and scientific education were covered in the webinars, while the video called A Modern Explorer's Journey focused on story telling with a more emotional appeal. The video was presented to the Ministers at the GEO Ministerial Summit and distributed widely to the GEO community and through social media and articles (as embedded YouTube and more). A discussion of challenges and successes of this event-based educational outreach project will be presented. Continued use of new outreach tools such as web technology and social innovations for more efficient use of limited resources will remain an issue for the scientific community. Lessons learned need to be provided continuously and this project add to this material.

School-Based Mentoring: Big Brothers Big Sisters

ERIC Educational Resources Information Center

Henry, Leon

2009-01-01

Students attacking other students. Students attacking teachers, support staff, and even community members. Disrespectful and threatening language, overwhelmed or inattentive parents, and an administrative system that often appears unable to bring back order in the classroom. These are stories have become an everyday part of teaching in urban…

Learning to Teach Online: Promoting Success through Professional Development

ERIC Educational Resources Information Center

Hinson, Janice M.; LaPrairie, Kimberely N.

2005-01-01

The study reported in this paper examined the types of professional-development activities, support systems, and organizational structures necessary for community college faculty to make transitions from traditional teaching to Web-based teaching. Results indicate that (a) instructional change can by initiated through sustained professional…

Healthy End of Life Project (HELP): a progress report on implementing community guidance on public health palliative care initiatives in Australia.

PubMed

Grindrod, Andrea; Rumbold, Bruce

2018-04-01

Contemporary end of life care policies propose increasing community capacity by developing sustainable skills, policies, structures, and resources to support members of a community in caring for each other at the end of life. Public health approaches to palliative care provide strategies to bring this about. Practical implementation can however be ineffective, principally due to failures to grasp the systemic nature of public health interventions, or to ensure that programs are managed and owned by community members, not the professionals who may have introduced them. This article outlines a comprehensive community development project that identifies local end of life needs and meets them through the efficient use of community resources. The project is the product of a three-phase enquiry. The first phase, carried out in a local community, examined carers' experiences of home-based dying, the networks that supported them during care, and broader community networks with the potential to extend care. Data were collected through in-depth research interviews, focus groups and consultation with a community research reference group. Findings were key issues to be targeted by a local community development strategy. In the second phase, these local findings were compared with other practice accounts to identify themes common to many contexts. A public health palliative care framework was then used to produce an evidence-informed community development model for end of life care. The third phase involves implementing and evaluating this model in different Australian contexts. A major theme emerging in phase one of the enquiry was the reluctance of carers to ask for, or even accept, offers of help from family, friends and community networks despite their evident need for support while providing end of life care at home. Others' willingness to provide support was thus hindered by uncertainty about what to offer, and concern about infringing on people's privacy. To develop community capacity for providing end of life care, these social norms need to change. Phase two brought public health strategies to bear on the themes identified in phase one to develop the Healthy End of Life Project (HELP), a strengths-based sustainable community development project. This provides evidence-based and research-informed resources that equip communities to work cooperatively with carers, family, friends and neighbors in support of residents wishing to receive end-of-life care in their home or a community setting. Services may initiate use of the framework, and will share their expertise on health and death matters, but communities are the experts to lead implementation in their local area. The third part of the article outlines current initiatives to implement and evaluate HELP in several Australian contexts. The substantive outcome of this enquiry is the 'Healthy End of Life Project (HELP); offering and providing, asking and accepting help'.

Management initiatives in a community-based health insurance scheme.

PubMed

Sinha, Tara; Ranson, M Kent; Chatterjee, Mirai; Mills, Anne

2007-01-01

Community-based health insurance (CBHI) schemes have developed in response to inadequacies of alternate systems for protecting the poor against health care expenditures. Some of these schemes have arisen within community-based organizations (CBOs), which have strong links with poor communities, and are therefore well situated to offer CBHI. However, the managerial capacities of many such CBOs are limited. This paper describes management initiatives undertaken in a CBHI scheme in India, in the course of an action-research project. The existing structures and systems at the CBHI had several strengths, but fell short on some counts, which became apparent in the course of planning for two interventions under the research project. Management initiatives were introduced that addressed four features of the CBHI, viz. human resources, organizational structure, implementation systems, and data management. Trained personnel were hired and given clear roles and responsibilities. Lines of reporting and accountability were spelt out, and supportive supervision was provided to team members. The data resources of the organization were strengthened for greater utilization of this information. While the changes that were introduced took some time to be accepted by team members, the commitment of the CBHI's leadership to these initiatives was critical to their success. Copyright (c) 2007 John Wiley & Sons, Ltd.

A Major Force in Economic Development: A Challenge for the North Carolina Community College System.

ERIC Educational Resources Information Center

Lancaster, H. Martin

No other institution has played a more significant role in support of economic development in North Carolina than the North Carolina Community College System. Presented are three challenges that will define the System's future relevance in support of economic development: (1) its ability to stay ahead of the "tidal wave" that is…

The development of specialized palliative care in the community: A qualitative study of the evolution of 15 teams.

PubMed

Seow, Hsien; Bainbridge, Daryl

2018-05-01

Interprofessional specialized palliative care teams at home improve patient outcomes, reduce healthcare costs, and support many patients to die at home. However, practical details about how to develop home-based teams in different regions and health systems are scarce. To examine how a variety of home-based specialized palliative care teams created and grew their team over time and to identify critical steps in their evolution. A qualitative study was designed based on a grounded theory approach, using semi-structured interviews and other documentation. In all, 15 specialized palliative care teams from Ontario, Canada, representing rural and urban areas. Data were collected from core members of the teams, including nurses, physicians, personal support workers, spiritual counselors, and administrators. In all, 122 individuals where interviewed, ranging from 4 to 10 per team. The analysis revealed four stages in team evolution: Inception, Start-up (n = 4 teams), Growth (n = 5), and Mature (n = 6). In the Inception stage, a champion provider was required to leverage existing resources to form the team. Start-up teams were testing and adjusting care processes to solidify their presence in the community. Growth teams had core expertise, relationships with fellow providers, and 24/7 support. Mature teams were fully integrated in the community, but still engaged in continuous quality improvement. Understanding the developmental stages of teams can help to inform the progress of other community-based teams. Appropriate outcome measures at each stage are also critical for team motivation and steady progress.

Differing Strategies to Meet Information‐Sharing Needs: Publicly Supported Community Health Information Exchanges Versus Health Systems’ Enterprise Health Information Exchanges

PubMed Central

KASH, BITA A.

2016-01-01

Policy Points: Community health information exchanges have the characteristics of a public good, and they support population health initiatives at the state and national levels. However, current policy equally incentivizes health systems to create their own information exchanges covering more narrowly defined populations.Noninteroperable electronic health records and vendors’ expensive custom interfaces are hindering health information exchanges. Moreover, vendors are imposing the costs of interoperability on health systems and community health information exchanges.Health systems are creating networks of targeted physicians and facilities by funding connections to their own enterprise health information exchanges. These private networks may change referral patterns and foster more integration with outpatient providers. Context The United States has invested billions of dollars to encourage the adoption of and implement the information technologies necessary for health information exchange (HIE), enabling providers to efficiently and effectively share patient information with other providers. Health care providers now have multiple options for obtaining and sharing patient information. Community HIEs facilitate information sharing for a broad group of providers within a region. Enterprise HIEs are operated by health systems and share information among affiliated hospitals and providers. We sought to identify why hospitals and health systems choose either to participate in community HIEs or to establish enterprise HIEs. Methods We conducted semistructured interviews with 40 policymakers, community and enterprise HIE leaders, and health care executives from 19 different organizations. Our qualitative analysis used a general inductive and comparative approach to identify factors influencing participation in, and the success of, each approach to HIE. Findings Enterprise HIEs support health systems' strategic goals through the control of an information technology network consisting of desired trading partners. Community HIEs support obtaining patient information from the broadest set of providers, but with more dispersed benefits to all participants, the community, and patients. Although not an either/or decision, community and enterprise HIEs compete for finite organizational resources like time, skilled staff, and money. Both approaches face challenges due to vendor costs and less‐than‐interoperable technology. Conclusions Both community and enterprise HIEs support aggregating clinical data and following patients across settings. Although they can be complementary, community and enterprise HIEs nonetheless compete for providers’ attention and organizational resources. Health policymakers might try to encourage the type of widespread information exchange pursued by community HIEs, but the business case for enterprise HIEs clearly is stronger. The sustainability of a community HIE, potentially a public good, may necessitate ongoing public funding and supportive regulation. PMID:26994710

Forging a Frailty-Ready Healthcare System to Meet Population Ageing

PubMed Central

Lim, Wee Shiong; Wong, Sweet Fun; Leong, Ian; Choo, Philip; Pang, Weng Sun

2017-01-01

The beginning of the 21st century has seen health systems worldwide struggling to deliver quality healthcare amidst challenges posed by ageing populations. The increasing prevalence of frailty with older age and accompanying complexities in physical, cognitive, social and psychological dimensions renders the present modus operandi of fragmented, facility-centric, doctor-based, and illness-centered care delivery as clearly unsustainable. In line with the public health framework for action in the World Health Organization’s World Health and Ageing Report, meeting these challenges will require a systemic reform of healthcare delivery that is integrated, patient-centric, team-based, and health-centered. These reforms can be achieved through building partnerships and relationships that engage, empower, and activate patients and their support systems. To meet the challenges of population ageing, Singapore has reorganised its public healthcare into regional healthcare systems (RHSs) aimed at improving population health and the experience of care, and reducing costs. This paper will describe initiatives within the RHS frameworks of the National Health Group (NHG) and the Alexandra Health System (AHS) to forge a frailty-ready healthcare system across the spectrum, which includes the well healthy (“living well”), the well unhealthy (“living with illness”), the unwell unhealthy (“living with frailty”), and the end-of-life (EoL) (“dying well”). For instance, the AHS has adopted a community-centered population health management strategy in older housing estates such as Yishun to build a geographically-based care ecosystem to support the self-management of chronic disease through projects such as “wellness kampungs” and “share-a-pot”. A joint initiative by the Lien Foundation and Khoo Teck Puat Hospital aims to launch dementia-friendly communities across the island by building a network comprising community partners, businesses, and members of the public. At the National Healthcare Group, innovative projects to address the needs of the frail elderly have been developed in the areas of: (a) admission avoidance through joint initiatives with long-term care facilities, nurse-led geriatric assessment at the emergency department and geriatric assessment clinics; (b) inpatient care, such as the Framework for Inpatient care of the Frail Elderly, orthogeriatric services, and geriatric surgical services; and (c) discharge to care, involving community transitional care teams and the development of community infrastructure for post-discharge support; and an appropriate transition to EoL care. In the area of EoL care, the National Strategy for Palliative Care has been developed to build an integrated system to: provide care for frail elderly with advance illnesses, develop advance care programmes that respect patients’ choices, and equip healthcare professionals to cope with the challenges of EoL care. PMID:29186782

Forging a Frailty-Ready Healthcare System to Meet Population Ageing.

PubMed

Lim, Wee Shiong; Wong, Sweet Fun; Leong, Ian; Choo, Philip; Pang, Weng Sun

2017-11-24

The beginning of the 21st century has seen health systems worldwide struggling to deliver quality healthcare amidst challenges posed by ageing populations. The increasing prevalence of frailty with older age and accompanying complexities in physical, cognitive, social and psychological dimensions renders the present modus operandi of fragmented, facility-centric, doctor-based, and illness-centered care delivery as clearly unsustainable. In line with the public health framework for action in the World Health Organization's World Health and Ageing Report, meeting these challenges will require a systemic reform of healthcare delivery that is integrated, patient-centric, team-based, and health-centered. These reforms can be achieved through building partnerships and relationships that engage, empower, and activate patients and their support systems. To meet the challenges of population ageing, Singapore has reorganised its public healthcare into regional healthcare systems (RHSs) aimed at improving population health and the experience of care, and reducing costs. This paper will describe initiatives within the RHS frameworks of the National Health Group (NHG) and the Alexandra Health System (AHS) to forge a frailty-ready healthcare system across the spectrum, which includes the well healthy ("living well"), the well unhealthy ("living with illness"), the unwell unhealthy ("living with frailty"), and the end-of-life (EoL) ("dying well"). For instance, the AHS has adopted a community-centered population health management strategy in older housing estates such as Yishun to build a geographically-based care ecosystem to support the self-management of chronic disease through projects such as "wellness kampungs" and "share-a-pot". A joint initiative by the Lien Foundation and Khoo Teck Puat Hospital aims to launch dementia-friendly communities across the island by building a network comprising community partners, businesses, and members of the public. At the National Healthcare Group, innovative projects to address the needs of the frail elderly have been developed in the areas of: (a) admission avoidance through joint initiatives with long-term care facilities, nurse-led geriatric assessment at the emergency department and geriatric assessment clinics; (b) inpatient care, such as the Framework for Inpatient care of the Frail Elderly, orthogeriatric services, and geriatric surgical services; and (c) discharge to care, involving community transitional care teams and the development of community infrastructure for post-discharge support; and an appropriate transition to EoL care. In the area of EoL care, the National Strategy for Palliative Care has been developed to build an integrated system to: provide care for frail elderly with advance illnesses, develop advance care programmes that respect patients' choices, and equip healthcare professionals to cope with the challenges of EoL care.

Building net-centric data strategies in support of a transformational MIW capability

NASA Astrophysics Data System (ADS)

Cramer, M. A.; Stack, J.

2010-04-01

The Mine Warfare (MIW) Community of Interest (COI) was established to develop data strategies in support of a future information-based architecture for naval MIW. As these strategies are developed and deployed, the ability for these datafocused efforts to enable technology insertion is becoming increasingly evident. This paper explores and provides concrete examples as to the ways in which these data strategies are supporting the technology insertion process for software-based systems and ultimately contribute to the establishment of an Open Business Model virtual environment. It is through the creation of such a collaborative research platform that a truly transformation MIW capability can be realized.

Extravehicular Activity System Sizing Analysis Tool (EVAS_SAT)

NASA Technical Reports Server (NTRS)

Brown, Cheryl B.; Conger, Bruce C.; Miranda, Bruno M.; Bue, Grant C.; Rouen, Michael N.

2007-01-01

An effort was initiated by NASA/JSC in 2001 to develop an Extravehicular Activity System Sizing Analysis Tool (EVAS_SAT) for the sizing of Extravehicular Activity System (EVAS) architecture and studies. Its intent was to support space suit development efforts and to aid in conceptual designs for future human exploration missions. Its basis was the Life Support Options Performance Program (LSOPP), a spacesuit and portable life support system (PLSS) sizing program developed for NASA/JSC circa 1990. EVAS_SAT estimates the mass, power, and volume characteristics for user-defined EVAS architectures, including Suit Systems, Airlock Systems, Tools and Translation Aids, and Vehicle Support equipment. The tool has undergone annual changes and has been updated as new data have become available. Certain sizing algorithms have been developed based on industry standards, while others are based on the LSOPP sizing routines. The sizing algorithms used by EVAS_SAT are preliminary. Because EVAS_SAT was designed for use by members of the EVA community, subsystem familiarity on the part of the intended user group and in the analysis of results is assumed. The current EVAS_SAT is operated within Microsoft Excel 2003 using a Visual Basic interface system.

Engaging Scientists in NASA Education and Public Outreach: K - 12 Formal Education

NASA Astrophysics Data System (ADS)

Bartolone, Lindsay; Smith, D. A.; Eisenhamer, B.; Lawton, B. L.; Universe Professional Development Collaborative, Multiwavelength; NASA Data Collaborative, Use of; SEPOF K-12 Formal Education Working Group; E/PO Community, SMD

2014-01-01

The NASA Science Education and Public Outreach Forums support the NASA Science Mission Directorate (SMD) and its education and public outreach (E/PO) community through a coordinated effort to enhance the coherence and efficiency of SMD-funded E/PO programs. The Forums foster collaboration between scientists with content expertise and educators with pedagogy expertise. We present opportunities for the astronomy community to participate in collaborations supporting the NASA SMD efforts in the K - 12 Formal Education community. Members of the K - 12 Formal Education community include classroom educators, homeschool educators, students, and curriculum developers. The Forums’ efforts for the K - 12 Formal Education community include a literature review, appraisal of educators’ needs, coordination of audience-based NASA resources and opportunities, professional development, and support with the Next Generation Science Standards. Learn how to join in our collaborative efforts to support the K - 12 Formal Education community based upon mutual needs and interests.

Current Directions in Adding Value to Earth Observation Products for Decision Support

NASA Astrophysics Data System (ADS)

Ryker, S. J.

2015-12-01

Natural resource managers and infrastructure planners face increasingly complex challenges, given competing demands for resources and changing conditions due to climate and land use change. These pressures create demand for high-quality, timely data; for both one-time decision support and long-term monitoring; and for techniques to articulate the value of resources in monetary and nonmonetary terms. To meet the need for data, the U.S. government invests several billion dollars per year in Earth observations collected from satellite, airborne, terrestrial, and ocean-based systems. Earth observation-based decision support is coming of age; user surveys show that these data are used in an increasing variety of analyses. For example, since the U.S. Department of the Interior/U.S. Geological Survey's (USGS) 2008 free and open data policy for the Landsat satellites, downloads from the USGS archive have increased from 20,000 Landsat scenes per year to 10 million per year and climbing, with strong growth in both research and decision support fields. However, Earth observation-based decision support still poses users a number of challenges. Many of those Landsat downloads support a specialized community of remote sensing scientists, though new technologies promise to increase the usability of remotely sensed data for the larger GIS community supporting planning and resource management. Serving this larger community also requires supporting the development of increasingly interpretive products, and of new approaches to host and update products. For example, automating updates will add value to new essential climate variable products such as surface water extent and wildfire burned area extent. Projections of future urbanization in the southeastern U.S. are most useful when long-term land cover trends are integrated with street-level community data and planning tools. The USGS assessment of biological carbon sequestration in vegetation and shallow soils required a significant research investment in satellite and in situ measurements and biogeochemical and climate modeling, and is already providing decision support at a variety of scales; once operationalized, it will be a tool for adaptive management from field-scale soil and wetland conservation projects to national-scale policy.

Asthma patient education opportunities in predominantly minority urban communities.

PubMed

Zayas, Luis E; McLean, Don

2007-12-01

Disenfranchised ethnic minority communities in the urban United States experience a high burden of asthma. Conventional office-based patient education often is insufficient to promote proper asthma management and coping practices responsive to minority patients' environments. This paper explores existing and alternative asthma information and education sources in three urban minority communities in western New York State to help design other practical educational interventions. Four focus groups (n = 59) and four town hall meetings (n = 109) were conducted in one Hispanic and two black communities. Focus groups included adult asthmatics or caretakers of asthmatics, and town meetings were open to all residents. A critical theory perspective informed the study. Asthma information and education sources, perceptions of asthma and ways of coping were elicited through semi-structured interviews. Data analysis followed a theory-driven immersion-crystallization approach. Several asthma education and information resources from the health care system, media, public institutions and communities were identified. Intervention recommendations highlighted asthma workshops that recognize participants as teachers and learners, offer social support, promote advocacy, are culturally appropriate and community-based and include health care professionals. Community-based, group health education couched on people's experiences and societal conditions offers unique opportunities for patient asthma care empowerment in minority urban communities.

Multi-Sector Sustainability Browser (MSSB) User Manual: A ...

EPA Pesticide Factsheets

EPA’s Sustainable and Healthy Communities (SHC) Research Program is developing methodologies, resources, and tools to assist community members and local decision makers in implementing policy choices that facilitate sustainable approaches in managing their resources affecting the built environment, natural environment, and human health. In order to assist communities and decision makers in implementing sustainable practices, EPA is developing computer-based systems including models, databases, web tools, and web browsers to help communities decide upon approaches that support their desired outcomes. Communities need access to resources that will allow them to achieve their sustainability objectives through intelligent decisions in four key sustainability areas: • Land Use • Buildings and Infrastructure • Transportation • Materials Management (i.e., Municipal Solid Waste [MSW] processing and disposal) The Multi-Sector Sustainability Browser (MSSB) is designed to support sustainable decision-making for communities, local and regional planners, and policy and decision makers. Document is an EPA Technical Report, which is the user manual for the Multi-Sector Sustainability Browser (MSSB) tool. The purpose of the document is to provide basic guidance on use of the tool for users

Ecologists can enable communities to implement malaria vector control in Africa

PubMed Central

Mukabana, W Richard; Kannady, Khadija; Kiama, G Michael; Ijumba, Jasper N; Mathenge, Evan M; Kiche, Ibrahim; Nkwengulila, Gamba; Mboera, Leonard; Mtasiwa, Deo; Yamagata, Yoichi; van Schayk, Ingeborg; Knols, Bart GJ; Lindsay, Steven W; de Castro, Marcia Caldas; Mshinda, Hassan; Tanner, Marcel; Fillinger, Ulrike; Killeen, Gerry F

2006-01-01

Background Integrated vector management (IVM) for malaria control requires ecological skills that are very scarce and rarely applied in Africa today. Partnerships between communities and academic ecologists can address this capacity deficit, modernize the evidence base for such approaches and enable future scale up. Methods Community-based IVM programmes were initiated in two contrasting settings. On Rusinga Island, Western Kenya, community outreach to a marginalized rural community was achieved by University of Nairobi through a community-based organization. In Dar es Salaam, Tanzania, Ilala Municipality established an IVM programme at grassroots level, which was subsequently upgraded and expanded into a pilot scale Urban Malaria Control Programme with support from national academic institutes. Results Both programmes now access relevant expertise, funding and policy makers while the academic partners benefit from direct experience of community-based implementation and operational research opportunities. The communities now access up-to-date malaria-related knowledge and skills for translation into local action. Similarly, the academic partners have acquired better understanding of community needs and how to address them. Conclusion Until sufficient evidence is provided, community-based IVM remains an operational research activity. Researchers can never directly support every community in Africa so community-based IVM strategies and tactics will need to be incorporated into undergraduate teaching programmes to generate sufficient numbers of practitioners for national scale programmes. Academic ecologists at African institutions are uniquely positioned to enable the application of practical environmental and entomological skills for malaria control by communities at grassroots level and should be supported to fulfil this neglected role. PMID:16457724

The GEOSS Science and Technology Stakeholder Network and Service Suite: Linking S&T Communities and GEOSS

NASA Astrophysics Data System (ADS)

Plag, Hans-Peter; Jules-Plag, Shelley

2015-04-01

The Global Earth Observation System of Systems (GEOSS) developed by the Group on Earth Observations (GEO) aims to provide practice-relevant knowledge in support of decision making in a wide range of societal benefit areas. Generating this practice-relevant knowledge based on Earth observations, socio-economic data and models often depends on research, and utilization of the societal benefits of EOs requires the involvement of science and research communities. Building a GEOSS responding to the needs of a wide range of users necessitates contributions from many science and technology (S&T) communities. In particular, a strong engagement of science and technology (S&T) communities in both the development and use of GEOSS is necessary to address the complex issues associated with the on-going transition out of the Holocene. S&T support is needed to improve interoperability between global observing, modeling, and information systems; to enable data integration across disciplinary boundaries; to facilitate data sharing, archiving, dissemination, and reanalysis; to optimize the recording of observations, assimilation of data into models, and generation of data products; to enhance the value of observations from individual observing systems through their integration in the SBAs; and to harmonize well-calibrated, highly accurate, stable, sustained in-situ and satellite observations of the same variable recorded by different sensors and different agencies. Consequently, the GEO Work Plan includes several Tasks focusing on outreach to S&T communities, and most of the GEO Community of Practice have a strong S&T component. The GEOSS S&T Stakeholder Network facilitates input from S&T communities to GEO. Infrastructure serving and linking S&T users communities and GEOSS has been developed and is integrated into a GEOSS S&T Service Suite (GSTSS). The GSTSS has several outreach components for the demonstration of GEOSS and its value for S&T communities, and for services supporting S&T communities in their linkage to, and use of GEOSS. At the core of the GSTSS, the GEOSS S&T Portfolio includes examples showing GEOSS at work for S&T communities and provides an avenue for S&T groups to feature their contribution to GEOSS. The assessment of datasets is supported through an extensive feedback system. The User Requirements Registry (URR) allows users to publish what they do, how they do it, and what information and observations they need to do it. The URR is currently transitioned into a Socio-Economic and Environmental Information Needs Knowledge Base (SEE IN KB), which focuses on the linkage between societal goals and benefits on the one side and essential earth observations on the other side. The S&T Meeting Web Portal provides a workspace to coordinate and document GEO and GEOSS participation, side events, and presentations at relevant S&T meetings. The GEOSS S&T Stakeholder Network provides an umbrella for all S&T user and provider communities. The idea of a Stakeholder Network bringing together relevant S&T communities was developed by the EC-funded EGIDA project, and the underlying concept assumes that successful outreach to S&T communities requires demonstration of a benefit for these communities. The mission of the GEOSS S&T Stakeholder Network is twofold: to provide a voice for the needs and guidance of S&T communities to GEO, and to promote the use of GEOSS in these stakeholder communities. Workshops of the GEOSS S&T Stakeholder Network are organized within the GSTSS, among others with the goal to link societal goals, such as the Millennium Development Goals and the Sustainable Development Goals, and associated targets to a metric that then can be tied to essential variables to be provided by GEOSS.

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

PubMed

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

2014-07-22

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

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

PubMed Central

2014-01-01

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

Citizen Support for Northern Ohio Community College Funding Initiatives during an Economic Recession Recovery

ERIC Educational Resources Information Center

Flores, Patricia

2013-01-01

The current research, "Citizen Support for Northern Ohio Community College Funding Initiatives during an Economic Recession Recovery", asks the question: Do the citizens of Northern Ohio support community college funding during difficult economic times? Based on the theory of Stakeholder Analysis, the purpose of this concurrent,…

An assessment of PKI and networked electronic patient record system: lessons learned from real patient data exchange at the platform of OCHIS (Osaka Community Healthcare Information System).

PubMed

Takeda, Hiroshi; Matsumura, Yasushi; Kuwata, Shigeki; Nakano, Hirohiko; Shanmai, Ji; Qiyan, Zhang; Yufen, Chen; Kusuoka, Hideo; Matsuoka, Masaki

2004-03-31

To enhance medical cooperation between the hospitals and clinics around Osaka local area, the healthcare network system, named Osaka Community Healthcare Information System (OCHIS), was established with support of a supplementary budget from the Japanese government in fiscal year 2002. Although the system has been based on healthcare public key infrastructure (PKI), there remain security issues to be solved technically and operationally. An experimental study was conducted to elucidate the central and the local function in terms of a registration authority and a time stamp authority in contract with the Japanese Medical Information Systems Organization (MEDIS) in 2003. This paper describes the experimental design and the results of the study concerning message security.

Sustainability of a community-based anti-retroviral care delivery model - a qualitative research study in Tete, Mozambique.

PubMed

Rasschaert, Freya; Decroo, Tom; Remartinez, Daniel; Telfer, Barbara; Lessitala, Faustino; Biot, Marc; Candrinho, Baltazar; Van Damme, Wim

2014-01-01

To overcome patients' reported barriers to accessing anti-retroviral therapy (ART), a community-based delivery model was piloted in Tete, Mozambique. Community ART Groups (CAGs) of maximum six patients stable on ART offered cost- and time-saving benefits and mutual psychosocial support, which resulted in better adherence and retention outcomes. To date, Médecins Sans Frontières has coordinated and supported these community-driven activities. To better understand the sustainability of the CAG model, we developed a conceptual framework on sustainability of community-based programmes. This was used to explore the data retrieved from 16 focus group discussions and 24 in-depth interviews with different stakeholder groups involved in the CAG model and to identify factors influencing the sustainability of the CAG model. We report the findings according to the framework's five components. (1) The CAG model was designed to overcome patients' barriers to ART and was built on a concept of self-management and patient empowerment to reach effective results. (2) Despite the progressive Ministry of Health (MoH) involvement, the daily management of the model is still strongly dependent on external resources, especially the need for a regulatory cadre to form and monitor the groups. These additional resources are in contrast to the limited MoH resources available. (3) The model is strongly embedded in the community, with patients taking a more active role in their own healthcare and that of their peers. They are considered as partners in healthcare, which implies a new healthcare approach. (4) There is a growing enabling environment with political will and general acceptance to support the CAG model. (5) However, contextual factors, such as poverty, illiteracy and the weak health system, influence the community-based model and need to be addressed. The community embeddedness of the model, together with patient empowerment, high acceptability and progressive MoH involvement strongly favour the future sustainability of the CAG model. The high dependency on external resources for the model's daily management, however, can potentially jeopardize its sustainability. Further reflections are required on possible solutions to solve these challenges, especially in terms of human resources.

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.

Removing a barrier to computer-based outbreak and disease surveillance--the RODS Open Source Project.

PubMed

Espino, Jeremy U; Wagner, M; Szczepaniak, C; Tsui, F C; Su, H; Olszewski, R; Liu, Z; Chapman, W; Zeng, X; Ma, L; Lu, Z; Dara, J

2004-09-24

Computer-based outbreak and disease surveillance requires high-quality software that is well-supported and affordable. Developing software in an open-source framework, which entails free distribution and use of software and continuous, community-based software development, can produce software with such characteristics, and can do so rapidly. The objective of the Real-Time Outbreak and Disease Surveillance (RODS) Open Source Project is to accelerate the deployment of computer-based outbreak and disease surveillance systems by writing software and catalyzing the formation of a community of users, developers, consultants, and scientists who support its use. The University of Pittsburgh seeded the Open Source Project by releasing the RODS software under the GNU General Public License. An infrastructure was created, consisting of a website, mailing lists for developers and users, designated software developers, and shared code-development tools. These resources are intended to encourage growth of the Open Source Project community. Progress is measured by assessing website usage, number of software downloads, number of inquiries, number of system deployments, and number of new features or modules added to the code base. During September--November 2003, users generated 5,370 page views of the project website, 59 software downloads, 20 inquiries, one new deployment, and addition of four features. Thus far, health departments and companies have been more interested in using the software as is than in customizing or developing new features. The RODS laboratory anticipates that after initial installation has been completed, health departments and companies will begin to customize the software and contribute their enhancements to the public code base.

System flexibility in the rehabilitation process of mentally disabled persons in a hostel that bridges between the hospital and the community.

PubMed

Baloush-Kleinman, Vered; Schneidman, Michael

2003-01-01

Deinstitutionalization and community mental health services have become the focus of mental health care in the United States, Italy and England, and now in Israel. Tirat Carmel MHC developed an intervention model of organizational change implemented in a rehabilitation hostel. It is an interim service based on graduated transition from maintenance care to a transitional Half-way House, followed by a Transitional Living Skills Center oriented for independent community living. Of 205 rehabilitees who resided in the hostel since the beginning of the project, 138 were discharged to community residential settings: 67 patients were discharged to reinforced community hostels; 27 to sheltered housing and 23 to independent residential quarters; 7 patients were discharged to comprehensive hostels, 3 to old-age homes and 11 returned home to their families. In terms of employment, 79 were placed in sheltered employment facilities, 24 work in the open market and 3 returned to school; 22 work in therapeutic occupational settings and 10 patients discharged to comprehensive hostels and old-age homes are engaged in sheltered employment programs in those settings. The system flexibility model and the rehabilitation processes anchored in normalization supported the relocation of hospitalized psychiatric patients to community-based settings and enabled the rehabilitees to cope with readjustment to community life.

Commercial insurance vs community-based health plans: time for a policy option with clinical emphasis to address the cost spiral.

PubMed

Amundson, Bruce

2005-01-01

The nation continues its ceaseless struggle with the spiraling cost of health care. Previous efforts (regulation, competition, voluntary action) have included almost every strategy except clinical. Insurers have largely failed in their cost-containment efforts. There is a strong emerging body of literature that demonstrates the relationship between various clinical strategies and reductions in utilization and costs. This article describes the organization of health services, including integration of delivery and financing systems, at the community level as a model that effectively addresses the critical structural flaws that have frustrated control of costs. Community-based health plans (CHPs) have been developed and have demonstrated viability. The key elements of CHPs are a legal organizational structure, a full provider network, advanced care-management systems, and the ability to assume financial risk. Common misconceptions regarding obstacles to CHP development are the complexity of the undertaking, difficulty assuming the insurance function, and insured pools that are too small to be viable. The characteristics of successful CHPs and 2 case studies are described, including the types of advanced care-management systems that have resulted in strong financial performance. The demonstrated ability of CHPs to establish financial viability with small numbers of enrollees challenges the common assumption that there is a fixed relationship between health plan enrollment size and financial performance. Organizing the health system at the community/regional level provides an attractive alternative model in the health-reform debate. There is an opportunity for clinical systems and state and federal leaders to support the development of community-based integrated delivery and financing system models that, among other advantages, have significant potential to modulate the pernicious cost spiral.

The fourth delay and community-driven solutions to reduce maternal mortality in rural Haiti: a community-based action research study.

PubMed

MacDonald, Tonya; Jackson, Suzanne; Charles, Marie-Carmèle; Periel, Marius; Jean-Baptiste, Marie-Véna; Salomon, Alex; Premilus, Éveillard

2018-06-20

In Haiti, the number of women dying in pregnancy, during childbirth and the weeks after giving birth remains unacceptably high. The objective of this research was to explore determinants of maternal mortality in rural Haiti through Community-Based Action Research (CBAR), guided by the delays that lead to maternal death. This paper focuses on socioecological determinants of maternal mortality from the perspectives of women of near-miss maternal experiences and community members, and their solutions to reduce maternal mortality in their community. The study draws on five semi-structured Individual Interviews with women survivors of near-misses, and on four Focus Group Discussions with Community Leaders and with Traditional Birth Attendants. Data collection took place in July 2013. A Community Research Team within a resource-limited rural community in Haiti undertook the research. The methods and analysis process were guided by participatory research and CBAR. Participants identified three delays that lead to maternal death but also described a fourth delay with respect to community responsibility for maternal mortality. They included women being carried from the community to a healthcare facility as a special example of the fourth delay. Women survivors of near-miss maternal experiences and community leaders suggested solutions to reduce maternal death that centered on prevention and community infrastructure. Most of the strategies for action were related to the fourth delay and include: community mobilization by way of the formation of Neighbourhood Maternal Health/Well-being Committees, and community support through the provision/sharing of food for undernourished women, offering monetary support and establishment of a communication relay/transport system in times of crisis. Finding sustainable ways to reduce maternal mortality requires a community-based/centred and community-driven comprehensive approach to maternal health/well-being. This includes engagement of community members that is dependent upon community knowledge, political will, mobilization, accountability and empowerment. An engaged/empowered community is one that is well placed to find ways that work in their community to reduce the fourth delay and in turn, maternal death. Potentially, community ownership of challenges and solutions can lead to more sustainable improvements in maternal health/well-being in Haiti.

The Organization of Mental Health Services in Cuba.

ERIC Educational Resources Information Center

Camayd-Freixas, Yohel; Uriarte, Miren

1980-01-01

Reviews the status and organization of the Cuban mental health system. Focuses on the deliberate and systematic interdependence of mental health, public health, and socio-political structures; inpatient treatment modes and rehabilitation programs; use of social networks to support discharged patients; community-based care; and primary to tertiary…

The Learning Enrichment Service: A Triad-Based Secondary School Model for Enrichment Programming.

ERIC Educational Resources Information Center

Smyth, Elizabeth; And Others

1983-01-01

Three secondary teachers describe a school-wide support system for meeting the needs of gifted students in and beyond the regular classroom. A management team coordinates enrichment within the school and community while a computerized data bank of enrichment resources is accessible to all learners. (CL)

Is rhizosphere remediation sufficient for sustainable revegetation of mine tailings?

PubMed

Huang, Longbin; Baumgartl, Thomas; Mulligan, David

2012-07-01

Revegetation of mine tailings (fine-grained waste material) starts with the reconstruction of root zones, consisting of a rhizosphere horizon (mostly topsoil and/or amended tailings) and the support horizon beneath (i.e. equivalent to subsoil - mostly tailings), which must be physically and hydro-geochemically stable. This review aims to discuss key processes involved in the development of functional root zones within the context of direct revegetation of tailings and introduces a conceptual process of rehabilitating structure and function in the root zones based on a state transition model. Field studies on the revegetation of tailings (from processing base metal ore and bauxite residues) are reviewed. Particular focus is given to tailings' properties that limit remediation effectiveness. Aspects of root zone reconstruction and vegetation responses are also discussed. When reconstructing a root zone system, it is critical to restore physical structure and hydraulic functions across the whole root zone system. Only effective and holistically restored systems can control hydro-geochemical mobility of acutely and chronically toxic factors from the underlying horizon and maintain hydro-geochemical stability in the rhizosphere. Thereafter, soil biological capacity and ecological linkages (i.e. carbon and nutrient cycling) may be rehabilitated to integrate the root zones with revegetated plant communities into sustainable plant ecosystems. A conceptual framework of system transitions between the critical states of root zone development has been proposed. This will illustrate the rehabilitation process in root zone reconstruction and development for direct revegetation with sustainable plant communities. Sustainable phytostabilization of tailings requires the systematic consideration of hydro-geochemical interactions between the rhizosphere and the underlying supporting horizon. It further requires effective remediation strategies to develop hydro-geochemically stable and biologically functional root zones, which can facilitate the recovery of the microbial community and ecological linkages with revegetated plant communities.

Adapting to psychiatric disability and needs for home- and community-based care.

PubMed

Green, Carla A; Vuckovic, Nancy H; Firemark, Alison J

2002-03-01

The objective of the study was to describe adaptation strategies and use of formal and informal support by individuals with psychiatric disabilities, to delineate remaining needs, and to determine how home- and community-based services might address those needs. Using in-depth interviews and structured questionnaires, we examined functional status, adaptation, and needs for home- and community-based care among 33 severely mentally ill members of a large health maintenance organization. Despite success in community living, participants had significant functional deficits (physical and emotional), relied heavily on only one or two key informal caregivers, and often needed significant support from mental health professionals. Limited numbers of caregivers and social isolation placed participants at risk of negative outcomes if informal support resources were to be lost. Home- and community-based care interventions that attempt to increase informal support networks and provide instrumental help (cooking, cleaning, transport) on short notice during flare-ups could augment existing (but limited) informal caregiving, help severely mentally ill individuals remain independent, and reduce the likelihood that loss of an informal caregiver would result in unwanted outcomes.

A New Framework for Addressing Adverse Childhood and Community Experiences: The Building Community Resilience Model.

PubMed

Ellis, Wendy R; Dietz, William H

We propose a transformative approach to foster collaboration across child health, public health, and community-based agencies to address the root causes of toxic stress and childhood adversity and to build community resilience. Physicians, members of social service agencies, and experts in toxic stress and adverse childhood experiences (ACEs) were interviewed to inform development of the Building Community Resilience (BCR) model. Through a series of key informant interviews and focus groups, we sought to understand the role of BCR for child health systems and their partners to reduce toxic stress and build community resilience to improve child health outcomes. Key informants indicated the intentional approach to ACEs and toxic stress through continuous quality improvement (data-driven decisions and program development, partners testing and adapting to changes to their needs, and iterative development and testing) which provides a mechanism by which social determinants or a population health approach could be introduced to physicians and community partners as part of a larger effort to build community resilience. Structured interviews also reveal a need for a framework that provides guidance, structure, and support for child health systems and community partners to develop collective goals, shared work plans, and a means for data-sharing to reinforce the components that will contribute to community resilience. Key informant interviews and focus group dialogues revealed a deep understanding of the factors related to toxic stress and ACEs. Respondents endorsed the BCR approach as a means to explore capacity issues, reduce fragmented health care delivery, and facilitate integrated systems across partners in efforts to build community resilience. Current financing models are seen as a potential barrier, because they often do not support restructured roles, partnership development, and the work to sustain upstream efforts to address toxic stress and community resilience. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Dynamics of sustained use and abandonment of clean cooking systems: lessons from rural India

NASA Astrophysics Data System (ADS)

Chalise, Nishesh; Kumar, Praveen; Priyadarshini, Pratiti; Yadama, Gautam N.

2018-03-01

Clean cooking technologies—ranging from efficient cookstoves to clean fuels—are widely deployed to reduce household air pollution and alleviate adverse health and climate consequences. Although much progress has been made on the technical aspects, sustained and proper use of clean cooking technologies by populations with the most need has been problematic. Only by understanding how clean cooking as an intervention is embedded within complex community processes can we ensure its sustained implementation. Using a community-based system dynamics approach, we engaged two rural communities in co-creating a dynamic model to explain the processes influencing the uptake and transition to sustained use of biogas (an anaerobic methane digester), a clean fuel and cooking technology. The two communities provided contrasting cases: one abandoned biogas while the other continues to use it. We present a system dynamics simulation model, associated analyses, and experiments to understand what factors drive transition and sustained use. A central insight of the model is community processes influencing the capacity to solve technical issues. Model analysis shows that families begin to abandon the technology when it takes longer to solve problems. The momentum in the community then shifts from a determination to address issues with the cooking technology toward caution in further adhering to it. We also conducted experiments using the simulation model to understand the impact of interventions aimed at renewing the use of biogas. A combination of theoretical interventions, including repair of non-functioning biogas units and provision of embedded technical support in communities, resulted in a scenario where the community can continue using the technology even after support is retracted. Our study also demonstrates the utility of a systems approach for engaging local stakeholders in delineating complex community processes to derive significant insights into the dynamic feedback mechanisms involved in the sustained use of biogas by the poor.

Collective efficacy in Denver, Colorado: Strengthening neighborhoods and health through community gardens.

PubMed

Teig, Ellen; Amulya, Joy; Bardwell, Lisa; Buchenau, Michael; Marshall, Julie A; Litt, Jill S

2009-12-01

Community gardens are viewed as a potentially useful environmental change strategy to promote active and healthy lifestyles but the scientific evidence base for gardens is limited. As a step towards understanding whether gardens are a viable health promotion strategy for local communities, we set out to examine the social processes that might explain the connection between gardens, garden participation and health. We analyzed data from semi-structured interviews with community gardeners in Denver. The analysis examined social processes described by community gardeners and how those social processes were cultivated by or supportive of activities in community gardens. After presenting results describing these social processes and the activities supporting them, we discuss the potential for the place-based social processes found in community gardens to support collective efficacy, a powerful mechanism for enhancing the role of gardens in promoting health.

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

PubMed

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

2017-01-17

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

RIMS: Resource Information Management System

NASA Technical Reports Server (NTRS)

Symes, J.

1983-01-01

An overview is given of the capabilities and functions of the resource management system (RIMS). It is a simple interactive DMS tool which allows users to build, modify, and maintain data management applications. The RIMS minimizes programmer support required to develop/maintain small data base applications. The RIMS also assists in bringing the United Information Services (UIS) budget system work inhouse. Information is also given on the relationship between the RIMS and the user community.

Integrating into the Mental Health System from the Criminal Justice System: Jail Aftercare Services for Persons with a Severe Mental Illness

ERIC Educational Resources Information Center

Davis, Kristin; Fallon, John; Vogel, Sue; Teachout, Alexandra

2008-01-01

This article describes a mental health evidence based practice, Assertive Community Treatment (ACT). While ACT has scientific support, it has not been rigorously tested for persons with a severe mental illness and repeated forensic involvement. This article provides preliminary evidence that ACT is best suited for reentry into the mental health…

The networked health enterprise: a vision for 2008.

PubMed

Stead, W W

1998-01-01

Informatics and information technology hold the promise of a consumer-centered health enterprise--one that provides quality care at a cost society is willing to pay; one where need-based, adaptive, competency-based learning results in cost-effectiveness of health education; one where team-based health and learning on demand, coupled with monitoring of process outcomes and network access to expertise, guarantee quality. The barriers to this promise are the professional guilds, the cross-subsidies that support the health enterprise of 1998, and the lack of respect for privacy. Collectively, the informatics community needs to develop a compelling vision that will galvanize the health community to action. If the health community does not step up to this challenge, consumers will take advantage of disintermediation. Empowered by the network, they will go outside the system into hands that meet their needs.

Defense AT and L. Volume 44, Number 3

DTIC Science & Technology

2015-06-01

CommunityBrowser.aspx?id=527436 Product Support Key References https://acc.dau.mil/productsupport CLL 011 Performance-Based Life Cycle Product Support (PBL...http://icatalog.dau.mil/onlinecatalog/courses.aspx?crs_id=269 CLL 031 PBL Contracting Strategies http://icatalog.dau.mil/onlinecatalog/courses.aspx...CommunityBrowser.aspx?id=527436 Product Support Key References https://acc.dau.mil/productsupport CLL 011 Performance-Based Life Cycle Product Support (PBL) http

Online Social Support for Patients with Multiple Sclerosis: A Thematic Analysis of Messages Posted to a Virtual Support Community

PubMed Central

Shavazi, Masoumeh Abbasi; Morowatisharifabad, Mohammad Ali; Shavazi, Mohammad Taghi Abbasi; Mirzaei, Masoud; Ardekani, Ali Mellat

2016-01-01

Background: Currently with the emergence of the Internet, patients have an opportunity to exchange social support online. However, little attention has been devoted to different dimensions of online social support exchanged in virtual support communities for patients with multiple sclerosis (MS). Methods: To provide a rich insight, the aim of this qualitative study was to explore and categorize different dimensions of online social support in messages exchanged in a virtual support community for patients with MS. A total of 548 posted messages created during one year period were selected using purposive sampling to consider the maximum variation sampling. Prior-research-driven thematic analysis was then conducted. In this regard, we used the Cutruna and Suhr’s coding system. The messages that could not be categorized with the used coding system were thematically analyzed to explore new additional social support themes. Results: The results showed that various forms of social support including informational, emotional, network, esteem and tangible support were exchanged. Moreover, new additional social support themes including sharing personal experiences, sharing coping strategies and spiritual support emerged in this virtual support community. Conclusion: The wide range of online social support exchanged in the virtual support community can be regarded as a supplementary source of social support for patients with MS. Future researches can examine online social support more comprehensively considering additional social support themes emerging in the present study. PMID:27382585

Practice Parameter on Child and Adolescent Mental Health Care in Community Systems of Care

ERIC Educational Resources Information Center

Journal of the American Academy of Child and Adolescent Psychiatry, 2007

2007-01-01

This parameter presents overarching principles and practices for child and adolescent mental health care in community systems of care. Community systems of care are defined broadly as comprising the wide array of child-serving agencies, programs, and practitioners (both public and private), in addition to natural community supports such as…

Derivation and validation of the Personal Support Algorithm: an evidence-based framework to inform allocation of personal support services in home and community care.

PubMed

Sinn, Chi-Ling Joanna; Jones, Aaron; McMullan, Janet Legge; Ackerman, Nancy; Curtin-Telegdi, Nancy; Eckel, Leslie; Hirdes, John P

2017-11-25

Personal support services enable many individuals to stay in their homes, but there are no standard ways to classify need for functional support in home and community care settings. The goal of this project was to develop an evidence-based clinical tool to inform service planning while allowing for flexibility in care coordinator judgment in response to patient and family circumstances. The sample included 128,169 Ontario home care patients assessed in 2013 and 25,800 Ontario community support clients assessed between 2014 and 2016. Independent variables were drawn from the Resident Assessment Instrument-Home Care and interRAI Community Health Assessment that are standardised, comprehensive, and fully compatible clinical assessments. Clinical expertise and regression analyses identified candidate variables that were entered into decision tree models. The primary dependent variable was the weekly hours of personal support calculated based on the record of billed services. The Personal Support Algorithm classified need for personal support into six groups with a 32-fold difference in average billed hours of personal support services between the highest and lowest group. The algorithm explained 30.8% of the variability in billed personal support services. Care coordinators and managers reported that the guidelines based on the algorithm classification were consistent with their clinical judgment and current practice. The Personal Support Algorithm provides a structured yet flexible decision-support framework that may facilitate a more transparent and equitable approach to the allocation of personal support services.

Behavioral health support and online peer communities: international experiences

PubMed Central

Harding, Claire

2016-01-01

Online peer support communities play an important part in many people’s experience of healthcare. They can be particularly significant in behavioral health/mental health due to the difficulties that people may experience in accessing face to face care for these conditions. There is considerable diversity of practice in service management, target group, and moderation practices of online peer support communities. People using the communities also appear to have diverse aims and experiences. This heterogeneity contributes to a relative lack of data about the value and effectiveness of online peer support in behavioral health, although there is significant research into some aspects of these communities. The digital behavioral health service Big White Wall was launched in the UK in 2007, and in the US in 2015, and is focused on delivering moderated peer support. There are considerable differences in health systems between the two countries, and this has been reflected in different experiences of implementation. The value of online peer support could be maximized if systemic challenges to implementation and adoption were addressed more effectively. PMID:28293613

Mental health and psychosocial support in humanitarian settings: linking practice and research

PubMed Central

Tol, Wietse A; Barbui, Corrado; Galappatti, Ananda; Silove, Derrick; Betancourt, Theresa S; Souza, Renato; Golaz, Anne; van Ommeren, Mark

2014-01-01

This review links practice, funding, and evidence for interventions for mental health and psychosocial wellbeing in humanitarian settings. We studied practice by reviewing reports of mental health and psychosocial support activities (2007–10); funding by analysis of the financial tracking service and the creditor reporting system (2007–09); and interventions by systematic review and meta-analysis. In 160 reports, the five most commonly reported activities were basic counselling for individuals (39%); facilitation of community support of vulnerable individuals (23%); provision of child-friendly spaces (21%); support of community-initiated social support (21%); and basic counselling for groups and families (20%). Most interventions took place and were funded outside national mental health and protection systems. 32 controlled studies of interventions were identified, 13 of which were randomised controlled trials (RCTs) that met the criteria for meta-analysis. Two studies showed promising effects for strengthening community and family supports. Psychosocial wellbeing was not included as an outcome in the meta-analysis, because its definition varied across studies. In adults with symptoms of post-traumatic stress disorder (PTSD), meta-analysis of seven RCTs showed beneficial effects for several interventions (psychotherapy and psychosocial supports) compared with usual care or waiting list (standardised mean difference [SMD] −0.38, 95% CI −0.55 to −0.20). In children, meta-analysis of four RCTs failed to show an effect for symptoms of PTSD (−0.36, −0.83 to 0.10), but showed a beneficial effect of interventions (group psychotherapy, school-based support, and other psychosocial support) for internalising symptoms (six RCTs; SMD −0.24, −0.40 to −0.09). Overall, research and evidence focuses on interventions that are infrequently implemented, whereas the most commonly used interventions have had little rigorous scrutiny. PMID:22008428

Exploration of the Factors That Support Learning: Web-Based Activity and Testing Systems in Community College Algebra [Conference Long Paper

ERIC Educational Resources Information Center

Hauk, Shandy; Matlen, Bryan J.

2017-01-01

This is an extended conference proceedings report [Long Paper] based on a shorter contributed report at the same conference. A variety of computerized learning platforms exist. In mathematics, most include sets of problems to complete. Feedback to users ranges from a single word like "Correct!" to offers of hints and partially- to…

Using Satellite-Based Earth Science Data in a Public Health Decision-Support System to Track and Forecast Pollen Events

NASA Astrophysics Data System (ADS)

Hudspeth, W. B.; Budge, A.

2013-12-01

There is widespread recognition within the public health community that ongoing changes in climate are expected to increasingly pose threats to human health. Environmentally induced health risks to populations with respiratory illnesses are a growing concern globally. Of particular concern are dust and smoke events carrying PM2.5 and PM10 particle sizes, ozone, and pollen. There is considerable interest in documenting the precise linkages between changing patterns in the climate and how these shifts impact the prevalence of respiratory illnesses. The establishment of these linkages can drive the development of early warning and forecasting systems to alert health care professionals of impending air-quality events. As a component of a larger NASA-funded project on Integration of Airborne Dust Prediction Systems and Vegetation Phenology to Track Pollen for Asthma Alerts in Public Health Decision Support Systems, the Earth Data Analysis Center (EDAC) at the University of New Mexico, is developing web-based visualization and analysis services for forecasting pollen concentration data. This decision-support system, New Mexico's Environmental Public Health Tracking System (NMEPHTS), funded by the Centers for Disease Control (CDC) Environmental Public Health Tracking Network (EPHTN), aims to improve health awareness and services by linking health effects data with levels and frequency of environmental exposure. The forecast of atmospheric events with high pollen concentrations has employed a modified version of the DREAM (Dust Regional Atmospheric Model, a verified model for atmospheric dust transport modeling. In this application, PREAM (Pollen Regional Atmospheric Model) models pollen emission using a MODIS-derived phenology of Juniperus spp. communities. Model outputs are verified and validated with ground-based records of pollen release timing and quantities. Outputs of the PREAM model are post-processed and archived in EDAC's Geographic Storage, Transformation, and Retrieval Engine (GStore) database. The GStore geospatial services platform provides general purpose web services based upon the REST service model, and is capable of data discovery, access, and publication functions, metadata delivery functions, data transformation, and auto-generated OGC services for those data products that can support those services. These services are in turn ingested by New Mexico's EPHTN where end users in the public health community can then assess environmental-pubic health data associations. Advances in web mapping and related technologies open new doors for data providers and users that can deliver data and information in near-real time. In the public health community these technologies are being used to enhance disease and syndromic surveillance systems, visualize environmentally-related events such as pollen and dust events, and to provide focused mapping and analysis capabilities on the desktop. Here we present the current results of the project, and will focus on the challenges encountered in providing reliable and accurate forecast of pollen concentrations, as well as the experience of integrating output results and services into end user applications that can provide timely and meaningful alerts and forecasts.

42 CFR 441.590 - Increased Federal financial participation.

Code of Federal Regulations, 2013 CFR

2013-10-01

... SERVICES Home and Community-Based Attendant Services and Supports State Plan Option (Community First Choice... the State will be increased by 6 percentage points, for the provision of Community First Choice services and supports, under an approved State plan amendment. ...

42 CFR 441.590 - Increased Federal financial participation.

Code of Federal Regulations, 2014 CFR

2014-10-01

... SERVICES Home and Community-Based Attendant Services and Supports State Plan Option (Community First Choice... the State will be increased by 6 percentage points, for the provision of Community First Choice services and supports, under an approved State plan amendment. ...

QCloud: A cloud-based quality control system for mass spectrometry-based proteomics laboratories

PubMed Central

Chiva, Cristina; Olivella, Roger; Borràs, Eva; Espadas, Guadalupe; Pastor, Olga; Solé, Amanda

2018-01-01

The increasing number of biomedical and translational applications in mass spectrometry-based proteomics poses new analytical challenges and raises the need for automated quality control systems. Despite previous efforts to set standard file formats, data processing workflows and key evaluation parameters for quality control, automated quality control systems are not yet widespread among proteomics laboratories, which limits the acquisition of high-quality results, inter-laboratory comparisons and the assessment of variability of instrumental platforms. Here we present QCloud, a cloud-based system to support proteomics laboratories in daily quality assessment using a user-friendly interface, easy setup, automated data processing and archiving, and unbiased instrument evaluation. QCloud supports the most common targeted and untargeted proteomics workflows, it accepts data formats from different vendors and it enables the annotation of acquired data and reporting incidences. A complete version of the QCloud system has successfully been developed and it is now open to the proteomics community (http://qcloud.crg.eu). QCloud system is an open source project, publicly available under a Creative Commons License Attribution-ShareAlike 4.0. PMID:29324744

Community-based efforts to prevent obesity: Australia-wide survey of projects.

PubMed

Nichols, Melanie S; Reynolds, Rebecca C; Waters, Elizabeth; Gill, Timothy; King, Lesley; Swinburn, Boyd A; Allender, Steven

2013-08-01

Community-based programs that affect healthy environments and policies have emerged as an effective response to high obesity levels in populations. Apart from limited individual reports, little is currently known about these programs, limiting the potential to provide effective support, to promote effective practice, prevent adverse outcomes and disseminate intervention results and experience. The aim of the present study was to identify the size and reach of current community-based obesity prevention projects in Australia and to examine their characteristics, program features (e.g. intervention setting), capacity and approach to obesity prevention. Detailed survey completed by representatives from community-based obesity prevention initiatives in Australia. There was wide variation in funding, capacity and approach to obesity prevention among the 78 participating projects. Median annual funding was Au$94900 (range Au$2500-$4.46 million). The most common intervention settings were schools (39%). Forty per cent of programs focused on a population group of ≥50000 people. A large proportion of respondents felt that they did not have sufficient resources or staff training to achieve project objectives. Community-based projects currently represent a very large investment by both government and non-government sectors for the prevention of obesity. Existing projects are diverse in size and scope, and reach large segments of the population. Further work is needed to identify the full extent of existing community actions and to monitor their reach and future 'scale up' to ensure that future activities aim for effective integration into systems, policies and environments. SO WHAT? Community-based programs make a substantial contribution to the prevention of obesity and promotion of healthy lifestyles in Australia. A risk of the current intervention landscape is that effective approaches may go unrecognised due to lack of effective evaluations or limitations in program design, duration or size. Policy makers and researchers must recognise the potential contribution of these initiatives, to both public health and knowledge generation, and provide support for strong evaluation and sustainable intervention designs.

The AMPATH Nutritional Information System: Designing a Food Distribution Electronic Record System in Rural Kenya

PubMed Central

Lim, Jason LitJeh; Yih, Yuehwern; Gichunge, Catherine; Tierney, William M.; Le, Tung H.; Zhang, Jun; Lawley, Mark A.; Petersen, Tomeka J.; Mamlin, Joseph J.

2009-01-01

Objective The AMPATH program is a leading initiative in rural Kenya providing healthcare services to combat HIV. Malnutrition and food insecurity are common among AMPATH patients and the Nutritional Information System (NIS) was designed, with cross-functional collaboration between engineering and medical communities, as a comprehensive electronic system to record and assist in effective food distribution in a region with poor infrastructure. Design The NIS was designed modularly to support the urgent need of a system for the growing food distribution program. The system manages the ordering, storage, packing, shipping, and distribution of fresh produce from AMPATH farms and dry food supplements from the World Food Programme (WFP) and U.S. Agency for International Development (USAID) based on nutritionists' prescriptions for food supplements. Additionally, the system also records details of food distributed to support future studies. Measurements Patients fed weekly, patient visits per month. Results With inception of the NIS, the AMPATH food distribution program was able to support 30,000 persons fed weekly, up from 2,000 persons. Patient visits per month also saw a marked increase. Conclusion The NIS' modular design and frequent, effective interactions between developers and users has positively affected the design, implementation, support, and modifications of the NIS. It demonstrates the success of collaboration between engineering and medical communities, and more importantly the feasibility for technology readily available in a modern country to contribute to healthcare delivery in developing countries like Kenya and other parts of sub-Saharan Africa. PMID:19717795

Community Participation in Health Systems Research: A Systematic Review Assessing the State of Research, the Nature of Interventions Involved and the Features of Engagement with Communities.

PubMed

George, Asha S; Mehra, Vrinda; Scott, Kerry; Sriram, Veena

2015-01-01

Community participation is a major principle of people centered health systems, with considerable research highlighting its intrinsic value and strategic importance. Existing reviews largely focus on the effectiveness of community participation with less attention to how community participation is supported in health systems intervention research. To explore the extent, nature and quality of community participation in health systems intervention research in low- and middle-income countries. We searched for peer-reviewed, English language literature published between January 2000 and May 2012 through four electronic databases. Search terms combined the concepts of community, capability/participation, health systems research and low- and middle-income countries. The initial search yielded 3,092 articles, of which 260 articles with more than nominal community participation were identified and included. We further excluded 104 articles due to lower levels of community participation across the research cycle and poor description of the process of community participation. Out of the remaining 160 articles with rich community participation, we further examined 64 articles focused on service delivery and governance within health systems research. Most articles were led by authors in high income countries and many did not consistently list critical aspects of study quality. Articles were most likely to describe community participation in health promotion interventions (78%, 202/260), even though they were less participatory than other health systems areas. Community involvement in governance and supply chain management was less common (12%, 30/260 and 9%, 24/260 respectively), but more participatory. Articles cut across all health conditions and varied by scale and duration, with those that were implemented at national scale or over more than five years being mainstreamed by government. Most articles detailed improvements in service availability, accessibility and acceptability, with fewer efforts focused on quality, and few designs able to measure impact on health outcomes. With regards to participation, most articles supported community's in implementing interventions (95%, n = 247/260), in contrast to involving communities in identifying and defining problems (18%, n = 46/260). Many articles did not discuss who in communities participated, with just over a half of the articles disaggregating any information by sex. Articles were largely under theorized, and only five mentioned power or control. Majority of the articles (57/64) described community participation processes as being collaborative with fewer describing either community mobilization or community empowerment. Intrinsic individual motivations, community-level trust, strong external linkages, and supportive institutional processes facilitated community participation, while lack of training, interest and information, along with weak financial sustainability were challenges. Supportive contextual factors included decentralization reforms and engagement with social movements. Despite positive examples, community participation in health systems interventions was variable, with few being truly community directed. Future research should more thoroughly engage with community participation theory, recognize the power relations inherent in community participation, and be more realistic as to how much communities can participate and cognizant of who decides that.

Disaster Mental Health and Community-Based Psychological First Aid: Concepts and Education/Training.

PubMed

Jacobs, Gerard A; Gray, Brandon L; Erickson, Sara E; Gonzalez, Elvira D; Quevillon, Randal P

2016-12-01

Any community can experience a disaster, and many traumatic events occur without warning. Psychologists can be an important resource assisting in psychological support for individuals and communities, in preparation for and in response to traumatic events. Disaster mental health and the community-based model of psychological first aid are described. The National Preparedness and Response Science Board has recommended that all mental health professionals be trained in disaster mental health, and that first responders, civic officials, emergency managers, and the general public be trained in community-based psychological first aid. Education and training resources in these two fields are described to assist psychologists and others in preparing themselves to assist their communities in difficult times and to help their communities learn to support one another. © 2016 Wiley Periodicals, Inc.

Exploring the Solar System in the Classroom: A Hands-On Approach

NASA Technical Reports Server (NTRS)

Coombs, Cassandra R.

2000-01-01

This final report discusses the development and implementation of several educational products for K-16 teachers and students. Specifically, I received support for: (A) three K-12 Teacher workshops, Exploring the Solar System in the Classroom: A Hands-On Approach, and minimal Support to finish two computer-based tutorials. (B) Contact Light: An Interactive CD-ROM, and (C) Another Look at Taurus Littrow: An Interactive GIS Database. Each of these projects directly supports NASA's Strategic Plan to: "Involve the education community in our endeavors to inspire America's students, create learning opportunities, enlighten inquisitive minds", and, to "communicate widely the content, relevancy, and excitement of NASA's missions and discoveries to inspire and to increase understanding and the broad application of science and technology." Attachment: Appendix A. And also article: "Aristarchus plateau: as potential lunar base site."

Dementia RED (Respect Empathy Dignity): Collaborating to build dementia supportive communities in North Wales--reporting on a pilot project (innovative practice).

PubMed

Chalk, Annabel; Page, Sean

2016-03-01

There is increasing interest in developing dementia supportive communities world wide. Dementia RED (Respect Empathy Dignity) is a unique example from North Wales which is based on the twin concepts of people living with dementia as citizens in their community and developing 'bottom up' rather than 'top down' approaches to dementia supportive communities. Most people with dementia prefer to live at home thus making community connectivity key to maintaining healthy relationships and wellbeing. For those living with dementia, the community plays a pivotal role in providing value, meaning, purpose and acceptance. Building dementia supportive communities helps to raise awareness about dementia in the community through engagement and from identifying champions in the locality to voice issues. Dementia RED is an initiative and service which helps to develop such a philosophy in creating a dementia supportive community. © The Author(s) 2014.

[Development of the community mental health system and activities of the community mental health team in Kawasaki City].

PubMed

Ito, Masato

2012-01-01

Since the 1960s, Kawasaki City has been leading the nation in its efforts regarding community mental health practices. Public institutions such as the Psychiatric Rehabilitation Center in the central area of the city and the Mental Health and Welfare Center in the southern area have mainly developed the psychiatric rehabilitation system. However, since 2000, new mental health needs have emerged, as the target of mental health and welfare services has been diversified to include people with developmental disorders, higher brain dysfunction, or social withdrawal, in addition to those with schizophrenia. Therefore, Kawasaki City's plan for community-based rehabilitation was drawn up, which makes professional support available for individuals with physical, intellectual, and mental disabilities. As the plan was being implemented, in 2008, the Northern Community Rehabilitation Center was established by both the public and private sectors in partnership. After the community mental health teams were assigned to both southern and northern areas of the city, the community partnership has been developed not only for individual support but also for other objectives that required the partnership. Takeshima pointed out that the local community should be inclusive of the psychiatric care in the final stage of community mental health care in Japan. Because of the major policies regarding people with disabilities, the final stage has been reached in the northern area of Kawasaki City. This also leads to improvement in measures for major issues in psychiatry, such as suicide prevention and intervention in psychiatric disease at an early stage.

Next Generation Community Based Unified Global Modeling System Development and Operational Implementation Strategies at NCEP

NASA Astrophysics Data System (ADS)

Tallapragada, V.

2017-12-01

NOAA's Next Generation Global Prediction System (NGGPS) has provided the unique opportunity to develop and implement a non-hydrostatic global model based on Geophysical Fluid Dynamics Laboratory (GFDL) Finite Volume Cubed Sphere (FV3) Dynamic Core at National Centers for Environmental Prediction (NCEP), making a leap-step advancement in seamless prediction capabilities across all spatial and temporal scales. Model development efforts are centralized with unified model development in the NOAA Environmental Modeling System (NEMS) infrastructure based on Earth System Modeling Framework (ESMF). A more sophisticated coupling among various earth system components is being enabled within NEMS following National Unified Operational Prediction Capability (NUOPC) standards. The eventual goal of unifying global and regional models will enable operational global models operating at convective resolving scales. Apart from the advanced non-hydrostatic dynamic core and coupling to various earth system components, advanced physics and data assimilation techniques are essential for improved forecast skill. NGGPS is spearheading ambitious physics and data assimilation strategies, concentrating on creation of a Common Community Physics Package (CCPP) and Joint Effort for Data Assimilation Integration (JEDI). Both initiatives are expected to be community developed, with emphasis on research transitioning to operations (R2O). The unified modeling system is being built to support the needs of both operations and research. Different layers of community partners are also established with specific roles/responsibilities for researchers, core development partners, trusted super-users, and operations. Stakeholders are engaged at all stages to help drive the direction of development, resources allocations and prioritization. This talk presents the current and future plans of unified model development at NCEP for weather, sub-seasonal, and seasonal climate prediction applications with special emphasis on implementation of NCEP FV3 Global Forecast System (GFS) and Global Ensemble Forecast System (GEFS) into operations by 2019.

Use of Community Health Workers and Patient Navigators to Improve Cancer Outcomes Among Patients Served by Federally Qualified Health Centers: A Systematic Literature Review

PubMed Central

Roland, Katherine B.; Milliken, Erin L.; Rohan, Elizabeth A.; DeGroff, Amy; White, Susan; Melillo, Stephanie; Rorie, William E.; Signes, Carmita-Anita C.; Young, Paul A.

2017-01-01

Abstract Introduction: In the United States, disparities in cancer screening, morbidity, and mortality are well documented, and often are related to race/ethnicity and socioeconomic indicators including income, education, and healthcare access. Public health approaches that address social determinants of health have the greatest potential public health benefit, and can positively impact health disparities. As public health interventions, community health workers (CHWs), and patient navigators (PNs) work to address disparities and improve cancer outcomes through education, connecting patients to and navigating them through the healthcare system, supporting patient adherence to screening and diagnostic services, and providing social support and linkages to financial and community resources. Clinical settings, such as federally qualified health centers (FQHCs) are mandated to provide care to medically underserved communities, and thus are also valuable in the effort to address health disparities. We conducted a systematic literature review to identify studies of cancer-related CHW/PN interventions in FQHCs, and to describe the components and characteristics of those interventions in order to guide future intervention development and evaluation. Method: We searched five databases for peer-reviewed CHW/PN intervention studies conducted in partnership with FQHCs with a focus on cancer, carried out in the United States, and published in English between January 1990 and December 2013. Results: We identified 24 articles, all reporting positive outcomes of CHW/PNs interventions in FQHCs. CHW/PN interventions most commonly promoted breast, cervical, or colorectal cancer screening and/or referral for diagnostic resolution. Studies were supported largely through federal funding. Partnerships with academic institutions and community-based organizations provided support and helped develop capacity among FQHC clinic leadership and community members. Discussion: Both the FQHC system and CHW/PNs were borne from the need to address persistent, complex health disparities among medically underserved communities. Our findings support the effectiveness of CHW/PN programs to improve completion and timeliness of breast, cervical, and colorectal cancer screening in FQHCs, and highlight intervention components useful to design and sustainability. PMID:28905047

Condition of karangkepatihan village community balong district ponorogo regency in supporting development of community based tourism

NASA Astrophysics Data System (ADS)

Sutedjo, A.; Prasetyo, K.; Sudaryono, L.

2018-01-01

In Karangkepatihan village, it can be found some attractions that have the potential to develop. Some attractions have been developed by involving the community in its management, but its development has not been as expected. The purpose of this research is to know the attitude of the community and the level of human resources of the community of Karangkepatihan village in supporting the development of community-based tourism and the right strategy for its development. Subjects in this study were the head of the family and the physical condition of tourist objects, with a sample of 100 family heads taken randomly. Research data which are knowledge, understanding, participation, support to the development of tourism and level of education and skill obtained by interview while observation is done to get potential data of tourism object. The data obtained are analyzed by using scoring technique and SWOT analysis. The results show that community attitudes are positive in supporting community-based tourism development, but have not been shown to participate in developing tourism in Karangkepatihan village. The level of human resources in Karangkepatihan village to support the development of tourism is low so that the development of tourism is slow. An appropriate strategy for developing tourism development in Karangkepatihan village is to grow and build. Improving the skills of the community to fill the job opportunities in the field of tourism, increase the participation or involvement of the community in tourism activities, increasing the accessibility of tourism objects, increasing the facilities and infrastructure of tourism needs to be done.

Competency-Based Training and Worker Turnover in Community Supports for People with IDD: Results from a Group Randomized Controlled Study

ERIC Educational Resources Information Center

Bogenschutz, Matthew; Nord, Derek; Hewitt, Amy

2015-01-01

Turnover among direct support professionals (DSPs) in community support settings for individuals with intellectual and developmental disabilities (IDD) has been regarded as a challenge since tracking of this workforce began in the 1980s. This study utilized a group randomized controlled design to test the effects of a competency-based training…

[Development of a nurse-led family counseling program for families of the elderly: the first cycle of a Community-Based Action Research Project (CBPR)].

PubMed

Mahrer-Imhof, Romy; Hediger, Hannele; Naef, Rahel; Bruylands, Michelle

2014-08-01

With the support of family members many elderly people can live an independent life at home. Accepting support respectively providing support might be a challenge for both elder and family member. Families often have little professional support to manage those challenges. Therefore, a nurse-led counseling program for families of the elders has been established. The counseling program was developed with community-based participatory research (CBPR) methodology using individual and focus group interviews, as well as a written survey and tested in a pilot study. Managing disease in everyday life, helpful means of support at home, changes in family relations, information about services as well as information how to navigate the healthcare system have been themes to discuss in the counseling sessions. Participants in the pilot study showed a statistically not significant increase in well-being, and preparedness for care and were highly satisfied with the counseling program. Families of the elderly could actively participate in developing and researching a nurse-led family counseling program. Several family members still engage as co-researcher in the program and participate to improve the new service.

Perceptions of health managers and professionals about mental health and primary care integration in Rio de Janeiro: a mixed methods study.

PubMed

Athié, Karen; Menezes, Alice Lopes do Amaral; da Silva, Angela Machado; Campos, Monica; Delgado, Pedro Gabriel; Fortes, Sandra; Dowrick, Christopher

2016-09-30

Community-based primary mental health care is recommended in low and middle-income countries. The Brazilian Health System has been restructuring primary care by expanding its Family Health Strategy. Due to mental health problems, psychosocial vulnerability and accessibility, Matrix Support teams are being set up to broaden the professional scope of primary care. This paper aims to analyse the perceptions of health professionals and managers about the integration of primary care and mental health. In this mixed-method study 18 health managers and 24 professionals were interviewed from different primary and mental health care services in Rio de Janeiro. A semi-structured survey was conducted with 185 closed questions ranging from 1 to 5 and one open-ended question, to evaluate: access, gateway, trust, family focus, primary mental health interventions, mental health records, mental health problems, team collaboration, integration with community resources and primary mental health education. Two comparisons were made: health managers and professionals' (Mann-Whitney non-parametric test) and health managers' perceptions (Kruskall-Wallis non parametric-test) in 4 service designs (General Traditional Outpatients, Mental Health Specialised Outpatients, Psychosocial Community Centre and Family Health Strategy)(SPSS version 17.0). Qualitative data were subjected to Framework Analysis. Firstly, health managers and professionals' perceptions converged in all components, except the health record system. Secondly, managers' perceptions in traditional services contrasted with managers' perceptions in community-based services in components such as mental health interventions and team collaboration, and converged in gateway, trust, record system and primary mental health education. Qualitative data revealed an acceptance of mental health and primary care integration, but a lack of communication between institutions. The Mixed Method demonstrated that interviewees consider mental health and primary care integration as a requirement of the system, while their perceptions and the model of work produced by the institutional culture are inextricably linked. There is a gap between health managers' and professionals' understanding of community-based primary mental health care. The integration of different processes of work entails both rethinking workforce actions and institutional support to help make changes.

Whole of Systems Trial of Prevention Strategies for Childhood Obesity: WHO STOPS Childhood Obesity.

PubMed

Allender, Steven; Millar, Lynne; Hovmand, Peter; Bell, Colin; Moodie, Marj; Carter, Rob; Swinburn, Boyd; Strugnell, Claudia; Lowe, Janette; de la Haye, Kayla; Orellana, Liliana; Morgan, Sue

2016-11-16

Background : Community-based initiatives show promise for preventing childhood obesity. They are characterized by community leaders and members working together to address complex local drivers of energy balance. Objectives : To present a protocol for a stepped wedge cluster randomized trial in ten communities in the Great South Coast Region of Victoria, Australia to test whether it is possible to: (1) strengthen community action for childhood obesity prevention, and (2) measure the impact of increased action on risk factors for childhood obesity. Methods: The WHO STOPS intervention involves a facilitated community engagement process that: creates an agreed systems map of childhood obesity causes for a community; identifies intervention opportunities through leveraging the dynamic aspects of the system; and, converts these understandings into community-built, systems-oriented action plans. Ten communities will be randomized (1:1) to intervention or control in year one and all communities will be included by year three. The primary outcome is childhood obesity prevalence among grade two (ages 7-8 y), grade four (9-10 y) and grade six (11-12 y) students measured using our established community-led monitoring system (69% school and 93% student participation rate in government and independent schools). An additional group of 13 external communities from other regions of Victoria with no specific interventions will provide an external comparison. These communities will also allow us to assess diffusion of the intervention to control communities during the first three years of the trial. Conclusion : This trial will test effectiveness, over a five-year period, of community-owned, -supported and -led strategies designed to address complex and dynamic causes of childhood obesity.

Whole of Systems Trial of Prevention Strategies for Childhood Obesity: WHO STOPS Childhood Obesity

PubMed Central

Allender, Steven; Millar, Lynne; Hovmand, Peter; Bell, Colin; Moodie, Marj; Carter, Rob; Swinburn, Boyd; Strugnell, Claudia; Lowe, Janette; de la Haye, Kayla; Orellana, Liliana; Morgan, Sue

2016-01-01

Background: Community-based initiatives show promise for preventing childhood obesity. They are characterized by community leaders and members working together to address complex local drivers of energy balance. Objectives: To present a protocol for a stepped wedge cluster randomized trial in ten communities in the Great South Coast Region of Victoria, Australia to test whether it is possible to: (1) strengthen community action for childhood obesity prevention, and (2) measure the impact of increased action on risk factors for childhood obesity. Methods: The WHO STOPS intervention involves a facilitated community engagement process that: creates an agreed systems map of childhood obesity causes for a community; identifies intervention opportunities through leveraging the dynamic aspects of the system; and, converts these understandings into community-built, systems-oriented action plans. Ten communities will be randomized (1:1) to intervention or control in year one and all communities will be included by year three. The primary outcome is childhood obesity prevalence among grade two (ages 7–8 y), grade four (9–10 y) and grade six (11–12 y) students measured using our established community-led monitoring system (69% school and 93% student participation rate in government and independent schools). An additional group of 13 external communities from other regions of Victoria with no specific interventions will provide an external comparison. These communities will also allow us to assess diffusion of the intervention to control communities during the first three years of the trial. Conclusion: This trial will test effectiveness, over a five-year period, of community-owned, -supported and -led strategies designed to address complex and dynamic causes of childhood obesity. PMID:27854354

The Feasibility of Establishing Operational Water Hyacinth-Based Systems at the Treatment Facilities of Existing Cities. [in Florida and Texas

NASA Technical Reports Server (NTRS)

1977-01-01

The wastewater treatment facilities of three communities in southern Florida and two in southern Texas areas having populations of 20,000 or fewer persons were surveyed to determine: (1) their performance characteristics and the nature of their customers; (2) facility upgrading requirements needed to meet current and future EPA and State standards; (3) their adaptability to water hyacinth utilization and harvested plant disposal; and (4) the level of community support. Guidelines for site selection were established and applied to five cities in Texas and four in Florida. An evaluation of the prospective sites reveals that the Florida locations are generally unsuitable for implementation of water hyacinth based systems because of regulatory philosophy. All five Texas sites have excellent potential.

The UNH Earth Systems Observatory: A Regional Application in Support of GEOSS Global-Scale Objectives

NASA Astrophysics Data System (ADS)

Vorosmarty, C. J.; Braswell, B.; Fekete, B.; Glidden, S.; Hartmann, H.; Magill, A.; Prusevich, A.; Wollheim, W.; Blaha, D.; Justice, D.; Hurtt, G.; Jacobs, J.; Ollinger, S.; McDowell, W.; Rock, B.; Rubin, F.; Schloss, A.

2006-12-01

The Northeast corridor of the US is emblematic of the many changes taking place across the nation's and indeed the world's watersheds. Because ecosystem and watershed change occurs over many scales and is so multifaceted, transferring scientific knowledge to applications as diverse as remediation of local ground water pollution, setting State-wide best practices for non-point source pollution control, enforcing regional carbon sequestration treaties, or creating public/private partnerships for protecting ecosystem services requires a new generation of integrative environmental surveillance systems, information technology, and information transfer to the user community. Geographically complex ecosystem interactions justify moving toward more integrative, regionally-based management strategies to deal with issues affecting land, inland waterways, and coastal waterways. A unified perspective that considers the full continuum of processes which link atmospheric forcings, terrestrial responses, watershed exports along drainage networks, and the final delivery to the coastal zone, nearshore, and off shore waters is required to adequately support the management challenge. A recent inventory of NOAA-supported environmental surveillance systems, IT resources, new sensor technologies, and management-relevant decision support systems shows the community poised to formulate an integrated and operational picture of the environment of New England. This paper presents the conceptual framework and early products of the newly-created UNH Earth Systems Observatory. The goal of the UNH Observatory is to serve as a regionally-focused yet nationally-prominent platform for observation-based, integrative science and management of the New England/Gulf of Maine's land, air, and ocean environmental systems. Development of the UNH Observatory is being guided by the principles set forth under the Global Earth Observation System of Systems and is cast as an end-to-end prototype for GEOSS, targeting the monitoring in near real time of regional ecosystem state. The UNH Earth Systems Observatory consists of five interacting components. These "pillars" include (1) the Observatory data holdings themselves, (2) IT informatics backbone with standards-compliant data and map services, (3) community engagement through User Working Groups (UWGs), (4) an Advisory Board (drawn from local, regional, and national entities), and (5) education and public outreach. The structure is designed to capitalize on "operations-ready" capabilities, to identify emerging opportunities for new data integration, and to use the Observatory as a regional "launchpad" from which data-intensive science and management activities can be tested and implemented operationally.

Cultivated vaginal microbiomes alter HIV-1 infection and antiretroviral efficacy in colonized epithelial multilayer cultures.

PubMed

Pyles, Richard B; Vincent, Kathleen L; Baum, Marc M; Elsom, Barry; Miller, Aaron L; Maxwell, Carrie; Eaves-Pyles, Tonyia D; Li, Guangyu; Popov, Vsevolod L; Nusbaum, Rebecca J; Ferguson, Monique R

2014-01-01

There is a pressing need for modeling of the symbiotic and at times dysbiotic relationship established between bacterial microbiomes and human mucosal surfaces. In particular clinical studies have indicated that the complex vaginal microbiome (VMB) contributes to the protection against sexually-transmitted pathogens including the life-threatening human immunodeficiency virus (HIV-1). The human microbiome project has substantially increased our understanding of the complex bacterial communities in the vagina however, as is the case for most microbiomes, very few of the community member species have been successfully cultivated in the laboratory limiting the types of studies that can be completed. A genetically controlled ex vivo model system is critically needed to study the complex interactions and associated molecular dialog. We present the first vaginal mucosal culture model that supports colonization by both healthy and dysbiotic VMB from vaginal swabs collected from routine gynecological patients. The immortalized vaginal epithelial cells used in the model and VMB cryopreservation methods provide the opportunity to reproducibly create replicates for lab-based evaluations of this important mucosal/bacterial community interface. The culture system also contains HIV-1 susceptible cells allowing us to study the impact of representative microbiomes on replication. Our results show that our culture system supports stable and reproducible colonization by VMB representing distinct community state types and that the selected representatives have significantly different effects on the replication of HIV-1. Further, we show the utility of the system to predict unwanted alterations in efficacy or bacterial community profiles following topical application of a front line antiretroviral.

Cultivated Vaginal Microbiomes Alter HIV-1 Infection and Antiretroviral Efficacy in Colonized Epithelial Multilayer Cultures

PubMed Central

Pyles, Richard B.; Vincent, Kathleen L.; Baum, Marc M.; Elsom, Barry; Miller, Aaron L.; Maxwell, Carrie; Eaves-Pyles, Tonyia D.; Li, Guangyu; Popov, Vsevolod L.; Nusbaum, Rebecca J.; Ferguson, Monique R.

2014-01-01

There is a pressing need for modeling of the symbiotic and at times dysbiotic relationship established between bacterial microbiomes and human mucosal surfaces. In particular clinical studies have indicated that the complex vaginal microbiome (VMB) contributes to the protection against sexually-transmitted pathogens including the life-threatening human immunodeficiency virus (HIV-1). The human microbiome project has substantially increased our understanding of the complex bacterial communities in the vagina however, as is the case for most microbiomes, very few of the community member species have been successfully cultivated in the laboratory limiting the types of studies that can be completed. A genetically controlled ex vivo model system is critically needed to study the complex interactions and associated molecular dialog. We present the first vaginal mucosal culture model that supports colonization by both healthy and dysbiotic VMB from vaginal swabs collected from routine gynecological patients. The immortalized vaginal epithelial cells used in the model and VMB cryopreservation methods provide the opportunity to reproducibly create replicates for lab-based evaluations of this important mucosal/bacterial community interface. The culture system also contains HIV-1 susceptible cells allowing us to study the impact of representative microbiomes on replication. Our results show that our culture system supports stable and reproducible colonization by VMB representing distinct community state types and that the selected representatives have significantly different effects on the replication of HIV-1. Further, we show the utility of the system to predict unwanted alterations in efficacy or bacterial community profiles following topical application of a front line antiretroviral. PMID:24676219

Semantic mediation in the national geologic map database (US)

USGS Publications Warehouse

Percy, D.; Richard, S.; Soller, D.

2008-01-01

Controlled language is the primary challenge in merging heterogeneous databases of geologic information. Each agency or organization produces databases with different schema, and different terminology for describing the objects within. In order to make some progress toward merging these databases using current technology, we have developed software and a workflow that allows for the "manual semantic mediation" of these geologic map databases. Enthusiastic support from many state agencies (stakeholders and data stewards) has shown that the community supports this approach. Future implementations will move toward a more Artificial Intelligence-based approach, using expert-systems or knowledge-bases to process data based on the training sets we have developed manually.

Effective collaborative learning in biomedical education using a web-based infrastructure.

PubMed

Wu, Yunfeng; Zheng, Fang; Cai, Suxian; Xiang, Ning; Zhong, Zhangting; He, Jia; Xu, Fang

2012-01-01

This paper presents a feature-rich web-based system used for biomedical education at the undergraduate level. With the powerful groupware features provided by the wiki system, the instructors are able to establish a community-centered mentoring environment that capitalizes on local expertise to create a sense of online collaborative learning among students. The web-based infrastructure can help the instructors effectively organize and coordinate student research projects, and the groupware features may support the interactive activities, such as interpersonal communications and data sharing. The groupware features also provide the web-based system with a wide range of additional ways of organizing collaboratively developed materials, which makes it become an effective tool for online active learning. Students are able to learn the ability to work effectively in teams, with an improvement of project management, design collaboration, and technical writing skills. With the fruitful outcomes in recent years, it is positively thought that the web-based collaborative learning environment can perform an excellent shift away from the conventional instructor-centered teaching to community- centered collaborative learning in the undergraduate education.

Technical assistance from state health departments for communities engaged in policy, systems, and environmental change: the ACHIEVE Program.

PubMed

Hefelfinger, Jenny; Patty, Alice; Ussery, Ann; Young, Walter

2013-10-24

This study assessed the value of technical assistance provided by state health department expert advisors and by the staff of the National Association of Chronic Disease Directors (NACDD) to community groups that participated in the Action Communities for Health, Innovation, and Environmental Change (ACHIEVE) Program, a CDC-funded health promotion program. We analyzed quantitative and qualitative data reported by community project coordinators to assess the nature and value of technical assistance provided by expert advisors and NACDD staff and the usefulness of ACHIEVE resources in the development and implementation of community action plans. A grounded theory approach was used to analyze and categorize phrases in text data provided by community coordinators. Open coding placed conceptual labels on text phrases. Frequency distributions of the quantitative data are described and discussed. The most valuable technical assistance and program support resources were those determined to be in the interpersonal domain (ie, interactions with state expert advisors, NACDD staff, and peer-to-peer support). The most valuable technical assistance events were action institutes, coaches' meetings, webinars, and technical assistance conference calls. This analysis suggests that ACHIEVE communities valued the management and training assistance provided by expert advisors and NACDD staff. State health department expert advisors provided technical guidance and support, including such skills or knowledge-based services as best-practice strategies, review and discussion of community assessment data, sustainability planning, and identification of possible funding opportunities. NACDD staff led development and implementation of technical assistance events.

Rosidal K: a short-stretch compression bandage system.

PubMed

Williams, C

Management of venous leg ulcers account for a large proportion of the work of healthcare professionals, especially for those who are community based. Multilayer and long-stretch bandage systems have been used successfully for many years in venous leg ulcer management. Rosidal K, a short-stretch bandage, is now also becoming more widely accepted in this country as an effective and cost-effective bandage system. This product focus looks at bandage systems and examines the research supporting the use of short-stretch bandages and Rosidal K.

Enhancing Access to Land Remote Sensing Data through Mainstream Social Media Channels

NASA Astrophysics Data System (ADS)

Sohre, T.; Maiersperger, T.

2011-12-01

Social media tools are changing the way that people discover information, communicate, and collaborate. Government agencies supporting the Land Remote Sensing user community have begun taking advantage of standard social media tools and capabilities. National Aeronautics and Space Administration (NASA) Earth Observing System (EOS) data centers have started providing outreach utilizing services including Facebook, Twitter, and YouTube videos. Really Simple Syndication (RSS) Feeds have become more standard means of sharing information, and a DataCasting tool was created as a NASA Technology Infusion effort to make RSS-based technology for accessing Earth Science information available. The United States Geological Survey (USGS) has also started using social media to allow the community access to news feeds and real-time earthquake alerts; listen to podcasts; get updates on new USGS publications, videos, and photographs; and more. Twitter feeds have been implemented in 2011 for the USGS Land Cover and Landsat user communities. In early 2011, the NASA Land Processes Distributed Active Archive Center (LP DAAC) user working group suggested the investigation of concepts for creating and distributing "bundles" of data, which would aggregate theme-based data sets from multiple sources. The LP DAAC is planning to explore the use of standard social bookmarking tools to support community developed bundles through the use of tools such as Delicious, Digg, or StumbleUpon. This concept would allow science users to organize and discover common links to data resources based on community developed tags, or a folksonomy. There are challenges that will need to be addressed such as maintaining the quality of tags but a social bookmarking system may have advantages over traditional search engines or formal ontologies for identifying and labeling various data sets relevant to a theme. As classification is done by the community of scientists who understand the data, the tagged data sets will result in a growing inventory of useful bundles.

Decision support systems for clinical radiological practice — towards the next generation

PubMed Central

Stivaros, S M; Gledson, A; Nenadic, G; Zeng, X-J; Keane, J; Jackson, A

2010-01-01

The huge amount of information that needs to be assimilated in order to keep pace with the continued advances in modern medical practice can form an insurmountable obstacle to the individual clinician. Within radiology, the recent development of quantitative imaging techniques, such as perfusion imaging, and the development of imaging-based biomarkers in modern therapeutic assessment has highlighted the need for computer systems to provide the radiological community with support for academic as well as clinical/translational applications. This article provides an overview of the underlying design and functionality of radiological decision support systems with examples tracing the development and evolution of such systems over the past 40 years. More importantly, we discuss the specific design, performance and usage characteristics that previous systems have highlighted as being necessary for clinical uptake and routine use. Additionally, we have identified particular failings in our current methodologies for data dissemination within the medical domain that must be overcome if the next generation of decision support systems is to be implemented successfully. PMID:20965900

Climate change adaptation among Tibetan pastoralists: challenges in enhancing local adaptation through policy support.

PubMed

Fu, Yao; Grumbine, R Edward; Wilkes, Andreas; Wang, Yun; Xu, Jian-Chu; Yang, Yong-Ping

2012-10-01

While researchers are aware that a mix of Local Ecological Knowledge (LEK), community-based resource management institutions, and higher-level institutions and policies can facilitate pastoralists' adaptation to climate change, policy makers have been slow to understand these linkages. Two critical issues are to what extent these factors play a role, and how to enhance local adaptation through government support. We investigated these issues through a case study of two pastoral communities on the Tibetan Plateau in China employing an analytical framework to understand local climate adaptation processes. We concluded that LEK and community-based institutions improve adaptation outcomes for Tibetan pastoralists through shaping and mobilizing resource availability to reduce risks. Higher-level institutions and policies contribute by providing resources from outside communities. There are dynamic interrelationships among these factors that can lead to support, conflict, and fragmentation. Government policy could enhance local adaptation through improvement of supportive relationships among these factors. While central government policies allow only limited room for overt integration of local knowledge/institutions, local governments often have some flexibility to buffer conflicts. In addition, government policies to support market-based economic development have greatly benefited adaptation outcomes for pastoralists. Overall, in China, there are still questions over how to create innovative institutions that blend LEK and community-based institutions with government policy making.

The influence of hazard models on GIS-based regional risk assessments and mitigation policies

USGS Publications Warehouse

Bernknopf, R.L.; Rabinovici, S.J.M.; Wood, N.J.; Dinitz, L.B.

2006-01-01

Geographic information systems (GIS) are important tools for understanding and communicating the spatial distribution of risks associated with natural hazards in regional economies. We present a GIS-based decision support system (DSS) for assessing community vulnerability to natural hazards and evaluating potential mitigation policy outcomes. The Land Use Portfolio Modeler (LUPM) integrates earth science and socioeconomic information to predict the economic impacts of loss-reduction strategies. However, the potential use of such systems in decision making may be limited when multiple but conflicting interpretations of the hazard are available. To explore this problem, we conduct a policy comparison using the LUPM to test the sensitivity of three available assessments of earthquake-induced lateral-spread ground failure susceptibility in a coastal California community. We find that the uncertainty regarding the interpretation of the science inputs can influence the development and implementation of natural hazard management policies. Copyright ?? 2006 Inderscience Enterprises Ltd.

The Path to Far-IR Interferometry in Space: Recent Developments, Plans, and Prospects

NASA Technical Reports Server (NTRS)

Leisawitz, David T.; Rinehart, Stephen A.

2012-01-01

The far-IR astrophysics community is eager to follow up Spitzer and Herschel observations with sensitive, highresolution imaging and spectroscopy, for such measurements are needed to understand merger-driven star formation and chemical enrichment in galaxies, star and planetary system formation, and the development and prevalence of waterbearing planets. The community is united in its support for a space-based interferometry mission. Through concerted efforts worldwide, the key enabling technologies are maturing. Two balloon-borne far-IR interferometers are presently under development. This paper reviews recent technological and programmatic developments, summarizes plans, and offers a vision for space-based far-IR interferometry involving international collaboration.

NASA's Global Imagery Browse Services - Technologies for Visualizing Earth Science Data

NASA Astrophysics Data System (ADS)

Cechini, M. F.; Boller, R. A.; Baynes, K.; Schmaltz, J. E.; Thompson, C. K.; Roberts, J. T.; Rodriguez, J.; Wong, M. M.; King, B. A.; King, J.; De Luca, A. P.; Pressley, N. N.

2017-12-01

For more than 20 years, the NASA Earth Observing System (EOS) has collected earth science data for thousands of scientific parameters now totaling nearly 15 Petabytes of data. In 2013, NASA's Global Imagery Browse Services (GIBS) formed its vision to "transform how end users interact and discover [EOS] data through visualizations." This vision included leveraging scientific and community best practices and standards to provide a scalable, compliant, and authoritative source for EOS earth science data visualizations. Since that time, GIBS has grown quickly and now services millions of daily requests for over 500 imagery layers representing hundreds of earth science parameters to a broad community of users. For many of these parameters, visualizations are available within hours of acquisition from the satellite. For others, visualizations are available for the entire mission of the satellite. The GIBS system is built upon the OnEarth and MRF open source software projects, which are provided by the GIBS team. This software facilitates standards-based access for compliance with existing GIS tools. The GIBS imagery layers are predominantly rasterized images represented in two-dimensional coordinate systems, though multiple projections are supported. The OnEarth software also supports the GIBS ingest pipeline to facilitate low latency updates to new or updated visualizations. This presentation will focus on the following topics: Overview of GIBS visualizations and user community Current benefits and limitations of the OnEarth and MRF software projects and related standards GIBS access methods and their in/compatibilities with existing GIS libraries and applications Considerations for visualization accuracy and understandability Future plans for more advanced visualization concepts including Vertical Profiles and Vector-Based Representations Future plans for Amazon Web Service support and deployments

A rural, community-based suicide awareness and intervention program.

PubMed

Jones, Sharon; Walker, Coralanne; Miles, Alison C J; De Silva, Eve; Zimitat, Craig

2015-01-01

Suicide is a prominent public health issue in rural Australia and specifically in Tasmania, which has one of the highest suicide rates in the country. The Community Response to Eliminating Suicide (CORES) program was developed in rural Tasmania in response to a significant number of suicides over a short period of time. CORES is unique in that it is both a community-based and gatekeeper education model. CORES aims to build and empower communities to take ownership of suicide prevention strategies. It also aims to increase the individual community member's interpersonal skills and awareness of suicide risks, while building peer support and awareness of suicide prevention support services within the community itself. Pre- and post-test surveys after the CORES 1-day suicide awareness and intervention program (SAIP) showed significant increases in levels of comfort and confidence in discussing suicide with those who may be contemplating that action. CORES builds community capital through establishing new connections within communities. Establishment of local executive groups, funding and SAIP are key activities of successful CORES programs in communities around Australia. Over half of the initial leaders are still actively involved after a decade, which reflects positively on the quality and outcomes of the program. This study supports CORES as a beneficial and feasible community-based suicide intervention program for rural communities.

A Smartphone App (AfyaData) for Innovative One Health Disease Surveillance from Community to National Levels in Africa: Intervention in Disease Surveillance.

PubMed

Karimuribo, Esron Daniel; Mutagahywa, Eric; Sindato, Calvin; Mboera, Leonard; Mwabukusi, Mpoki; Kariuki Njenga, M; Teesdale, Scott; Olsen, Jennifer; Rweyemamu, Mark

2017-12-18

We describe the development and initial achievements of a participatory disease surveillance system that relies on mobile technology to promote Community Level One Health Security (CLOHS) in Africa. The objective of this system, Enhancing Community-Based Disease Outbreak Detection and Response in East and Southern Africa (DODRES), is to empower community-based human and animal health reporters with training and information and communication technology (ICT)-based solutions to contribute to disease detection and response, thereby complementing strategies to improve the efficiency of infectious disease surveillance at national, regional, and global levels. In this study, we refer to techno-health as the application of ICT-based solutions to enhance early detection, timely reporting, and prompt response to health events in human and animal populations. An EpiHack, involving human and animal health experts as well as ICT programmers, was held in Tanzania in 2014 to identify major challenges facing early detection, timely reporting, and prompt response to disease events. This was followed by a project inception workshop in 2015, which brought together key stakeholders, including policy makers and community representatives, to refine the objectives and implementation plan of the DODRES project. The digital ICT tools were developed and packaged together as the AfyaData app to support One Health disease surveillance. Community health reporters (CHRs) and officials from animal and human health sectors in Morogoro and Ngorongoro districts in Tanzania were trained to use the AfyaData app. The AfyaData supports near- to real-time data collection and submission at both community and health facility levels as well as the provision of feedback to reporters. The functionality of the One Health Knowledge Repository (OHKR) app has been integrated into the AfyaData app to provide health information on case definitions of diseases of humans and animals and to synthesize advice that can be transmitted to CHRs with next step response activities or interventions. Additionally, a WhatsApp social group was made to serve as a platform to sustain interactions between community members, local government officials, and DODRES team members. Within the first 5 months (August-December 2016) of AfyaData tool deployment, a total of 1915 clinical cases in livestock (1816) and humans (99) were reported in Morogoro (83) and Ngorongoro (1832) districts. These initial results suggest that the DODRES community-level model creates an opportunity for One Health engagement of people in their own communities in the detection of infectious human and animal disease threats. Participatory approaches supported by digital and mobile technologies should be promoted for early disease detection, timely reporting, and prompt response at the community, national, regional, and global levels. ©Esron Daniel Karimuribo, Eric Mutagahywa, Calvin Sindato, Leonard Mboera, Mpoki Mwabukusi, M Kariuki Njenga, Scott Teesdale, Jennifer Olsen, Mark Rweyemamu. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 18.12.2017.

Community-Based Breastfeeding Support With the Tiger Babies Breastfeeding Support Tent.

PubMed

Lambert, Ann W; Harris, Laurie C; Wang, Chih-Hsuan; Tzeng, Shu-Wen

2018-04-01

The Tiger Babies Breastfeeding Support Tent was established by a baccalaureate nursing program in southeastern Alabama to increase community awareness of the importance of breastfeeding and to provide a clean, convenient, and private location for nursing mothers during community events. Local advertising was distributed before community events to promote awareness and support of the project. Survey results indicate that 80% of mothers who used the tent's services would recommend the tent to their friends and family members. © 2018 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

Community Action for Health in India's National Rural Health Mission: One policy, many paths.

PubMed

Gaitonde, Rakhal; San Sebastian, Miguel; Muraleedharan, V R; Hurtig, Anna-Karin

2017-09-01

Community participation as a strategy for health system strengthening and accountability is an almost ubiquitous policy prescription. In 2005, with the election of a new Government in India, the National Rural Health Mission was launched. This was aimed at 'architectural correction' of the health care system, and enshrined 'communitization' as one of its pillars. The mission also provided unique policy spaces and opportunity structures that enabled civil society groups to attempt to bring on to the policy agenda as well as implement a more collective action and social justice based approach to community based accountability. Despite receiving a lot of support and funding from the central ministry in the pilot phase, the subsequent roll out of the process, led in the post-pilot phase by the individual state governments, showed very varied outcomes. This paper using both documentary and interview based data is the first study to document the roll out of this ambitious process. Looking critically at what varied and why, the paper attempts to derive lessons for future implementation of such contested concepts. Copyright © 2017 Elsevier Ltd. All rights reserved.

Improving Health Promotion Using Quality Improvement Techniques in Australian Indigenous Primary Health Care

PubMed Central

Percival, Nikki; O’Donoghue, Lynette; Lin, Vivian; Tsey, Komla; Bailie, Ross Stewart

2016-01-01

Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years. Baseline assessments showed suboptimal health center systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health center systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence-based health promotion by engaging front line health practitioners in decision-making processes about the design/redesign of health center systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff, and members of the local community to address organizational and policy level barriers. PMID:27066470

Improving Health Promotion Using Quality Improvement Techniques in Australian Indigenous Primary Health Care.

PubMed

Percival, Nikki; O'Donoghue, Lynette; Lin, Vivian; Tsey, Komla; Bailie, Ross Stewart

2016-01-01

Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years. Baseline assessments showed suboptimal health center systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health center systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence-based health promotion by engaging front line health practitioners in decision-making processes about the design/redesign of health center systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff, and members of the local community to address organizational and policy level barriers.

Status of the DIRAC Project

NASA Astrophysics Data System (ADS)

Casajus, A.; Ciba, K.; Fernandez, V.; Graciani, R.; Hamar, V.; Mendez, V.; Poss, S.; Sapunov, M.; Stagni, F.; Tsaregorodtsev, A.; Ubeda, M.

2012-12-01

The DIRAC Project was initiated to provide a data processing system for the LHCb Experiment at CERN. It provides all the necessary functionality and performance to satisfy the current and projected future requirements of the LHCb Computing Model. A considerable restructuring of the DIRAC software was undertaken in order to turn it into a general purpose framework for building distributed computing systems that can be used by various user communities in High Energy Physics and other scientific application domains. The CLIC and ILC-SID detector projects started to use DIRAC for their data production system. The Belle Collaboration at KEK, Japan, has adopted the Computing Model based on the DIRAC system for its second phase starting in 2015. The CTA Collaboration uses DIRAC for the data analysis tasks. A large number of other experiments are starting to use DIRAC or are evaluating this solution for their data processing tasks. DIRAC services are included as part of the production infrastructure of the GISELA Latin America grid. Similar services are provided for the users of the France-Grilles and IBERGrid National Grid Initiatives in France and Spain respectively. The new communities using DIRAC started to provide important contributions to its functionality. Among recent additions can be mentioned the support of the Amazon EC2 computing resources as well as other Cloud management systems; a versatile File Replica Catalog with File Metadata capabilities; support for running MPI jobs in the pilot based Workload Management System. Integration with existing application Web Portals, like WS-PGRADE, is demonstrated. In this paper we will describe the current status of the DIRAC Project, recent developments of its framework and functionality as well as the status of the rapidly evolving community of the DIRAC users.

Moral Learning in the Space between Places: The Potential of Community-Based Moral Education.

ERIC Educational Resources Information Center

Schweigert, Francis J.

This paper presents the results of a heuristic and interpretive study of a public policy experiment in the criminal justice system, victim offender mediation conferencing. Conferences typically include the victim, the offender, their supporters and family members, and one or more conference facilitators. Participants report high levels of…

Issues in Putting Outcome-Based Education into Practice at the District Level: A Panel Discussion.

ERIC Educational Resources Information Center

Norton, Deborah

This conference presentation describes the AUEN (Addressing Unique Education Needs) system of assessing educational outcomes which is used by the Rochester (Michigan) Community Schools to help establish accountable and effective special education support programs and services. The AUEN provides an innovative and practical approach to assessment,…

Policy, Planning and Management of Education in Small States.

ERIC Educational Resources Information Center

Lillis, Kevin M., Ed.

This book offers a range of original perspectives on issues of planning and managing education in small systems. It is based on the proceedings of a conference held at the University of London's Institute for Education, supported by the European Community Directorate General for Development. The conference addressed a range of themes relevant to…

Evaluation of a Knowledge Translation and Exchange Platform to Advance Non-Communicable Disease Prevention

ERIC Educational Resources Information Center

Pettman, Tahna Lee; Armstrong, Rebecca; Waters, Elizabeth; Allender, Steven; Love, Penelope; Gill, Tim; Coveney, John; Boylan, Sinead; Booth, Sue; Bolton, Kristy; Swinburn, Boyd

2016-01-01

Coordinated systems are required to ensure evidence-informed practice and evaluation of community-based interventions (CBIs). Knowledge translation and exchange (KTE) strategies show promise, but these require evaluation. This paper describes implementation and evaluation of COOPS, a national KTE platform to support best practice in obesity…

Preparing the workforce for healthy aging programs: the Skills for Healthy Aging Resources and Programs (SHARP) model.

PubMed

Frank, Janet C; Altpeter, Mary; Damron-Rodriguez, JoAnn; Driggers, Joann; Lachenmayr, Susan; Manning, Colleen; Martinez, Dana M; Price, Rachel M; Robinson, Patricia

2014-10-01

Current public health and aging service agency personnel have little training in gerontology, and virtually no training in evidence-based health promotion and disease management programs for older adults. These programs are rapidly becoming the future of our community-based long-term care support system. The purpose of this project was to develop and test a model community college career technical education program, Skills for Healthy Aging Resources and Programs (SHARP), for undergraduate college students, current personnel in aging service and community organizations, and others interested in retraining. A multidisciplinary cross-sector team from disciplines of public health, sociology, gerontology and nursing developed four competency-based courses that focus on healthy aging, behavior change strategies, program management, an internship, and an option for leader training in the Chronic Disease Self-Management Program. To enhance implementation and fidelity, intensive faculty development training was provided to all instructors and community agency partners. Baseline and postprogram evaluation of competencies for faculty and students was conducted. Process evaluation for both groups focused on satisfaction with the curricula and suggestions for program improvement. SHARP has been piloted five times at two community colleges. Trainees (n = 113) were primarily community college students (n = 108) and current aging service personnel (n = 5). Statistically significant improvements in all competencies were found for both faculty and students. Process evaluation outcomes identified the needed logical and component adaptations to enhance the feasibility of program implementation, dissemination, and student satisfaction. The SHARP program provides a well-tested, evidence-based effective model for addressing workforce preparation in support of healthy aging service program expansion and delivery. © 2014 Society for Public Health Education.

United States Air Force Graduate Student Summer Support Program (1987). Program Management Report.

DTIC Science & Technology

1987-12-01

were briefed on the benefits and research opportunities of the SFRP. The targeted groups within the University community were faculty of the...Effects on Fine Mary C. Robinson Motor Skill and Decoding Tasks 78 Design of a Mechanism to Control Wind Filiberto Santiago Tunnel Turbulence 79 Low...Systems 81 The Integration of Decision Support Jon A. Shupe Problems into Feature Modeling Based Design 89 r 0 82 Optimal Control of the Wing

Common IED exploitation target set ontology

NASA Astrophysics Data System (ADS)

Russomanno, David J.; Qualls, Joseph; Wowczuk, Zenovy; Franken, Paul; Robinson, William

2010-04-01

The Common IED Exploitation Target Set (CIEDETS) ontology provides a comprehensive semantic data model for capturing knowledge about sensors, platforms, missions, environments, and other aspects of systems under test. The ontology also includes representative IEDs; modeled as explosives, camouflage, concealment objects, and other background objects, which comprise an overall threat scene. The ontology is represented using the Web Ontology Language and the SPARQL Protocol and RDF Query Language, which ensures portability of the acquired knowledge base across applications. The resulting knowledge base is a component of the CIEDETS application, which is intended to support the end user sensor test and evaluation community. CIEDETS associates a system under test to a subset of cataloged threats based on the probability that the system will detect the threat. The associations between systems under test, threats, and the detection probabilities are established based on a hybrid reasoning strategy, which applies a combination of heuristics and simplified modeling techniques. Besides supporting the CIEDETS application, which is focused on efficient and consistent system testing, the ontology can be leveraged in a myriad of other applications, including serving as a knowledge source for mission planning tools.

Toward a Community School: A Model for Organizing Community Based Educational Support Services. Publication Series No. 10.

ERIC Educational Resources Information Center

Bartelt, David W.

This paper focuses on how to develop a community-based educational intervention when community apathy is present, or where the isolation between school and community makes partnership more difficult. The key elements for this model are three steps: (1) determining the school-community relationship, establishing that a condition of isolation…

Evidence-based treatment and supervision practices for co-occurring mental and substance use disorders in the criminal justice system.

PubMed

Peters, Roger H; Young, M Scott; Rojas, Elizabeth C; Gorey, Claire M

2017-07-01

Over seven million persons in the United States are supervised by the criminal justice system, including many who have co-occurring mental and substance use disorders (CODs). This population is at high risk for recidivism and presents numerous challenges to those working in the justice system. To provide a contemporary review of the existing research and examine key issues and evidence-based treatment and supervision practices related to CODs in the justice system. We reviewed COD research involving offenders that has been conducted over the past 20 years and provide an analysis of key findings. Several empirically supported frameworks are available to guide services for offenders who have CODs, including Integrated Dual Disorders Treatment (IDDT), the Risk-Need-Responsivity (RNR) model, and Cognitive-Behavioral Therapy (CBT). Evidence-based services include integrated assessment that addresses both sets of disorders and the risk for criminal recidivism. Although several evidence-based COD interventions have been implemented at different points in the justice system, there remains a significant gap in services for offenders who have CODs. Existing program models include Crisis Intervention Teams (CIT), day reporting centers, specialized community supervision teams, pre- and post-booking diversion programs, and treatment-based courts (e.g., drug courts, mental health courts, COD dockets). Jail-based COD treatment programs provide stabilization of acute symptoms, medication consultation, and triage to community services, while longer-term prison COD programs feature Modified Therapeutic Communities (MTCs). Despite the availability of multiple evidence-based interventions that have been implemented across diverse justice system settings, these services are not sufficiently used to address the scope of treatment and supervision needs among offenders with CODs.

Pathways to high and low performance: factors differentiating primary care facilities under performance-based financing in Nigeria

PubMed Central

Mabuchi, Shunsuke; Sesan, Temilade; Bennett, Sara C

2018-01-01

Abstract The determinants of primary health facility performance in developing countries have not been well studied. One of the most under-researched areas is health facility management. This study investigated health facilities under the pilot performance-based financing (PBF) scheme in Nigeria, and aimed to understand which factors differentiated primary health care centres (PHCCs) which had performed well, vs those which had not, with a focus on health facility management practices. We used a multiple case study where we compared two high-performing PHCCs and two low-performing PHCCs for each of the two PBF target states. Two teams of two trained local researchers spent 1 week at each PHCC and collected semi-structured interview, observation and documentary data. Data from interviews were transcribed, translated and coded using a framework approach. The data for each PHCC were synthesized to understand dynamic interactions of different elements in each case. We then compared the characteristics of high and low performers. The areas in which critical differences between high and low-performers emerged were: community engagement and support; and performance and staff management. We also found that (i) contextual and health system factors particularly staffing, access and competition with other providers; (ii) health centre management including community engagement, performance management and staff management; and (iii) community leader support interacted and drove performance improvement among the PHCCs. Among them, we found that good health centre management can overcome some contextual and health system barriers and enhance community leader support. This study findings suggest a strong need to select capable and motivated health centre managers, provide long-term coaching in managerial skills, and motivate them to improve their practices. The study also highlights the need to position engagement with community leaders as a key management practice and a central element of interventions to improve PHCC performance. PMID:29077844

The Role of Community Development Employment Projects in Rural and Remote Communities. Support Document

ERIC Educational Resources Information Center

Misko, Josie

2006-01-01

This document was produced by the author(s) based on their research for the report, "The Role of Community Development Employment Projects in Rural and Remote Communities," (ED495158) and is an added resource for further information. The contents of this support docment include: (1) Regional Council--Roma; (2) Regional Council--Tennant…

Experiences of Community-Living Older Adults Receiving Integrated Care Based on the Chronic Care Model: A Qualitative Study

PubMed Central

Spoorenberg, Sophie L. W.; Wynia, Klaske; Fokkens, Andrea S.; Slotman, Karin; Kremer, Hubertus P. H.; Reijneveld, Sijmen A.

2015-01-01

Background Integrated care models aim to solve the problem of fragmented and poorly coordinated care in current healthcare systems. These models aim to be patient-centered by providing continuous and coordinated care and by considering the needs and preferences of patients. The objective of this study was to evaluate the opinions and experiences of community-living older adults with regard to integrated care and support, along with the extent to which it meets their health and social needs. Methods Semi-structured interviews were conducted with 23 older adults receiving integrated care and support through “Embrace,” an integrated care model for community-living older adults that is based on the Chronic Care Model and a population health management model. Embrace is currently fully operational in the northern region of the Netherlands. Data analysis was based on the grounded theory approach. Results Responses of participants concerned two focus areas: 1) Experiences with aging, with the themes “Struggling with health,” “Increasing dependency,” “Decreasing social interaction,” “Loss of control,” and “Fears;” and 2) Experiences with Embrace, with the themes “Relationship with the case manager,” “Interactions,” and “Feeling in control, safe, and secure”. The prospect of becoming dependent and losing control was a key concept in the lives of the older adults interviewed. Embrace reinforced the participants’ ability to stay in control, even if they were dependent on others. Furthermore, participants felt safe and secure, in contrast to the fears of increasing dependency within the standard care system. Conclusion The results indicate that integrated care and support provided through Embrace met the health and social needs of older adults, who were coping with the consequences of aging. PMID:26489096

Experiences of Community-Living Older Adults Receiving Integrated Care Based on the Chronic Care Model: A Qualitative Study.

PubMed

Spoorenberg, Sophie L W; Wynia, Klaske; Fokkens, Andrea S; Slotman, Karin; Kremer, Hubertus P H; Reijneveld, Sijmen A

2015-01-01

Integrated care models aim to solve the problem of fragmented and poorly coordinated care in current healthcare systems. These models aim to be patient-centered by providing continuous and coordinated care and by considering the needs and preferences of patients. The objective of this study was to evaluate the opinions and experiences of community-living older adults with regard to integrated care and support, along with the extent to which it meets their health and social needs. Semi-structured interviews were conducted with 23 older adults receiving integrated care and support through "Embrace," an integrated care model for community-living older adults that is based on the Chronic Care Model and a population health management model. Embrace is currently fully operational in the northern region of the Netherlands. Data analysis was based on the grounded theory approach. Responses of participants concerned two focus areas: 1) Experiences with aging, with the themes "Struggling with health," "Increasing dependency," "Decreasing social interaction," "Loss of control," and "Fears;" and 2) Experiences with Embrace, with the themes "Relationship with the case manager," "Interactions," and "Feeling in control, safe, and secure". The prospect of becoming dependent and losing control was a key concept in the lives of the older adults interviewed. Embrace reinforced the participants' ability to stay in control, even if they were dependent on others. Furthermore, participants felt safe and secure, in contrast to the fears of increasing dependency within the standard care system. The results indicate that integrated care and support provided through Embrace met the health and social needs of older adults, who were coping with the consequences of aging.

New directions in capacity building: incorporating cultural competence into the interactive systems framework.

PubMed

Gregory, Henry; Van Orden, Onna; Jordan, Lisa; Portnoy, Galina A; Welsh, Elena; Betkowski, Jennifer; Charles, Jade Wolfman; DiClemente, Carlo C

2012-12-01

The UMBC Psychology Department's Center for Community Collaboration (CCC) provides training and support for capacity building to promote substance abuse and mental health treatment as well as adherence improvement in community agencies funded through the Ryan White Act serving persons living with HIV/AIDS. This article describes an approach to dissemination of Evidence Based Practices (EBPs) for these services that uses the Interactive Systems Framework (ISF) and incorporates a collaborative process involving trainer cultural competence, along with a comprehensive assessment of organizational needs, culture, and climate that culminates in tailored training and ongoing collaboration. This article provides: (1) an overview of the CCC's expanded ISF for the effective dissemination of two EBPs-motivational interviewing and the stages of change perspective; (2) an examination of the role of trainer cultural competence within the ISF framework, particularly attending to organizational culture and climate; and (3) case examples to demonstrate this approach for both general and innovation-specific capacity building in two community based organizations.

Integrating molecular markers into the World Health Organization classification of CNS tumors: a survey of the neuro-oncology community.

PubMed

Aldape, Kenneth; Nejad, Romina; Louis, David N; Zadeh, Gelareh

2017-03-01

Molecular markers provide important biological and clinical information related to the classification of brain tumors, and the integration of relevant molecular parameters into brain tumor classification systems has been a widely discussed topic in neuro-oncology over the past decade. With recent advances in the development of clinically relevant molecular signatures and the 2016 World Health Organization (WHO) update, the views of the neuro-oncology community on such changes would be informative for implementing this process. A survey with 8 questions regarding molecular markers in tumor classification was sent to an email list of Society for Neuro-Oncology members and attendees of prior meetings (n=5065). There were 403 respondents. Analysis was performed using whole group response, based on self-reported subspecialty. The survey results show overall strong support for incorporating molecular knowledge into the classification and clinical management of brain tumors. Across all 7 subspecialty groups, ≥70% of respondents agreed to this integration. Interestingly, some variability is seen among subspecialties, notably with lowest support from neuropathologists, which may reflect their roles in implementing such diagnostic technologies. Based on a survey provided to the neuro-oncology community, we report strong support for the integration of molecular markers into the WHO classification of brain tumors, as well as for using an integrated "layered" diagnostic format. While membership from each specialty showed support, there was variation by specialty in enthusiasm regarding proposed changes. The initial results of this survey influenced the deliberations underlying the 2016 WHO classification of tumors of the central nervous system. © The Author(s) 2017. Published by Oxford University Press on behalf of the Society for Neuro-Oncology.

Building community capacity using web-supported work-based learning.

PubMed

Pearson, Pauline; Young-Murphy, Lesley; Yaseen, Jonathan; Shiel, Gillian

2013-02-01

Health visitors are a central component of policy to create strong, stable families and communities. The programme which is described here is intended to facilitate existing health visitors to gain confidence and extend or renew their skills in building community capacity (BCC). Networking and relationships are essential to effective community development. These are key skills for the health visitor, which along with professional principles support community capacity building. Learning in this programme is self-directed, supported by web-based resources over a 24 week period. Learning mainly takes place in practice. It involves carrying out a work based project through to completion. Participants register online, and follow a series of six phases. Evaluation of the pilot took place during 2011. Three main areas for improvement were identified: reflective software; signposting access to resources; and dealing with workload pressures. Community engagement for health improvement remains an important element of the vision for health visiting. The programme described is a core resource through which health visitors can build the skills and confidence of community groups and staff in other agencies to make a difference to health and wellbeing.

Indigenous health: effective and sustainable health services through continuous quality improvement.

PubMed

Bailie, Ross S; Si, Damin; O'Donoghue, Lyn; Dowden, Michelle

2007-05-21

The Australian government's Healthy for Life program is supporting capacity development in Indigenous primary care using continuous quality improvement (CQI) techniques. An important influence on the Healthy for Life program has been the ABCD research project. The key features contributing to the success of the project are described. The ABCD research project: uses a CQI approach, with an ongoing cycle of gathering data on how well organisational systems are functioning, and developing and then implementing improvements; is guided by widely accepted principles of community-based research, which emphasise participation; and adheres to the principles and values of Indigenous health research and service delivery. The potential for improving health outcomes in Aboriginal and Torres Strait Islander communities using a CQI approach should be strengthened by clear clinical and managerial leadership, supporting service organisations at the community level, and applying participatory-action principles.

Enhancing project-oriented learning by joining communities of practice and opening spaces for relatedness

NASA Astrophysics Data System (ADS)

Pascual, R.

2010-03-01

This article describes an extension to project-oriented learning to increase social construction of knowledge and learning. The focus is on: (a) maximising opportunities for students to share their knowledge with practitioners by joining communities of practice, and (b) increasing their intrinsic motivation by creating conditions for student's relatedness. The case study considers a last year capstone course in Mechanical Engineering. The work addresses innovative practices of active learning and beyond project-oriented learning through: (a) the development of a web-based decision support system, (b) meetings between the communities of students, maintenance engineers and academics, and (c) new off-campus group instances. The author hypothesises that this multi-modal approach increases deep learning and social impact of the educational process. Surveys to the actors support a successful achievement of the educational goals. The methodology can easily be extended to further improve the learning process.

Identifying community healthcare supports for the elderly and the factors affecting their aging care model preference: evidence from three districts of Beijing.

PubMed

Liu, Tianyang; Hao, Xiaoning; Zhang, Zhenzhong

2016-11-15

The Chinese tradition of filial piety, which prioritized family-based care for the elderly, is transitioning and elders can no longer necessarily rely on their children. The purpose of this study was to identify community support for the elderly, and analyze the factors that affect which model of old-age care elderly people dwelling in communities prefer. We used the database "Health and Social Support of Elderly Population in Community". Questionnaires were issued in 2013, covering 3 districts in Beijing. A group of 1036 people over 60 years in age were included in the study. The respondents' profile variables were organized in Andersen's Model and community healthcare resource factors were added. A multinomial logistic model was applied to analyze the factors associated with the desired aging care models. Cohabiting with children and relying on care from family was still the primary desired aging care model for seniors (78 %), followed by living in institutions (14.8 %) and living at home independently while relying on community resources (7.2 %). The regression result indicated that predisposing, enabling and community factors were significantly associated with the aging care model preference. Specifically, compared with those who preferred to cohabit with children, those having higher education, fewer available family and friend helpers, and shorter distance to healthcare center were more likely to prefer to live independently and rely on community support. And compared with choosing to live in institutions, those having fewer available family and friend helpers and those living alone were more likely to prefer to live independently and rely on community. Need factors (health and disability condition) were not significantly associated with desired aging care models, indicating that desired aging care models were passive choices resulted from the balancing of family and social caring resources. In Beijing, China, aging care arrangement preference is the result of balancing family care resources, economic and social status, and the accessibility of community resources. Community facilities and services supporting elderly were found to be insufficient. For China's future health system, efforts should be made to improve community capacity to provide integrated services to senior citizens.

Community Health Workers Promote Civic Engagement and Organizational Capacity to Impact Policy.

PubMed

Sabo, Samantha; Flores, Melissa; Wennerstrom, Ashley; Bell, Melanie L; Verdugo, Lorena; Carvajal, Scott; Ingram, Maia

2017-12-01

Community health workers (CHW) have historically served to link structurally vulnerable populations to broad support systems. Emerging evidence suggests that CHWs engage in various forms of advocacy to promote policy and systems change. We assessed the impact of CHW community advocacy on community change, defined as civic engagement, organizational capacity and policy and systems change. Data are drawn from the 2014 National Community Health Worker Advocacy Survey (N = 1776) aimed to identify the state of the CHW profession, and their impact on health disparities through community advocacy and policy engagement. Our primary analysis used multiple linear regression to assess the association between CHW advocacy and community change. As predicted, there was a significant, positive association between CHW advocacy and change in community conditions. Additionally, both adjusted and sensitivity models had similar standardized beta estimates for advocacy, and adjusted R 2 statistics. CHW advocacy predicts positive change in community conditions and further advances the CHW Community Advocacy Framework designed to support and monitor CHW community advocacy to reduce health disparities through advocacy and policy change.

Education for Community-based Family Medicine: A Social Need in the Real World

PubMed Central

Taniguchi, Shin-ichi; Park, Daeho; Inoue, Kazuoki; Hamada, Toshihiro

2017-01-01

One of the most critical social problems in Japan is the remarkable increase in the aging population. Elderly patients with a variety of complications and issues other than biomedical problems such as dementia and life support with nursing care have been also increasing. Ever since the Japanese economy started to decline after the economic bubble burst of 1991 and the Lehman Brothers bankruptcy in 2008, how we can resolve health problems of the elderly at a lower cost has become one of our most challenging social issues. On the other hand, the appropriate supply of medical and welfare resources is also a fundamental problem. The disparity of physician distribution leads to a marked lack of medical services especially in remote and rural areas of Japan. The government has been attempting to recruit physicians into rural areas through a regional quota system. Based on this background, the medical field pays a great amount of attention to community-based family medicine (CBFM). CBFM requires basic knowledge of community health and family medicine. The main people involved in CBFM are expected to be a new type of general practitioner that cares for residents in targeted communities. To improve the performance of CBFM doctors, we need to establish a better CBFM education system and assess it appropriately when needed. Here, we review the background of CBFM development and propose an effective education system. PMID:28701889

Education for Community-based Family Medicine: A Social Need in the Real World.

PubMed

Taniguchi, Shin-Ichi; Park, Daeho; Inoue, Kazuoki; Hamada, Toshihiro

2017-06-01

One of the most critical social problems in Japan is the remarkable increase in the aging population. Elderly patients with a variety of complications and issues other than biomedical problems such as dementia and life support with nursing care have been also increasing. Ever since the Japanese economy started to decline after the economic bubble burst of 1991 and the Lehman Brothers bankruptcy in 2008, how we can resolve health problems of the elderly at a lower cost has become one of our most challenging social issues. On the other hand, the appropriate supply of medical and welfare resources is also a fundamental problem. The disparity of physician distribution leads to a marked lack of medical services especially in remote and rural areas of Japan. The government has been attempting to recruit physicians into rural areas through a regional quota system. Based on this background, the medical field pays a great amount of attention to community-based family medicine (CBFM). CBFM requires basic knowledge of community health and family medicine. The main people involved in CBFM are expected to be a new type of general practitioner that cares for residents in targeted communities. To improve the performance of CBFM doctors, we need to establish a better CBFM education system and assess it appropriately when needed. Here, we review the background of CBFM development and propose an effective education system.

Why high tech needs high touch: Supporting continuity of community primary health care.

PubMed

Meyer, Ellenore D; Hugo, Johannes F M; Marcus, Tessa S; Molebatsi, Rebaone; Komana, Kabelo

2018-06-21

 Integrated care through community-oriented primary care (COPC) deployed through municipal teams of community health workers (CHWs) has been part of health reform in South Africa since 2011. The role of COPC and integration of information and communication technology (ICT) information to improve patient health and access to care, require a better understanding of patient social behaviour. Aim: The study sought to understand how COPC with CHWs visiting households offering health education can support antenatal follow-up and what the barriers for access to care would be. Method: A mixed methodological approach was followed. Quantitative patient data were recorded on an electronic health record-keeping system. Qualitative data collection was performed through interviews of the COPC teams at seven health posts in Mamelodi and telephonic patient interviews. Interviews were analysed according to themes and summarised as barriers to access care from a social and community perspective. Results: An integrated COPC approach increased the number of traceable pregnant women followed up at home from 2016 - 2017. Wrong addresses or personal identification were given at the clinic because of fear of being denied care. Allocating patients correctly to a ward-based outreach team (WBOT) proved to be a challenge as many patients did not know their street address. Conclusion: Patient health data available to a health worker on a smartphone as part of COPC improve patient traceability and follow-up at home making timely referral possible. Health system developments that support patient care on community level could strengthen patient health access and overall health.

Aging and Elder Care in Japan: A Call for Empowerment-Oriented Community Development.

PubMed

Inaba, Miyuki

This article provides a brief overview of the situation of the elderly and their caregivers in Japan, including demographic changes in Japan, development and changes in long-term care policy that have targeted the poorly integrated community care system, and other challenges that the elderly and family caregivers face. Policy direction designed to address these issues is increasingly targeting care by the community versus support care by society (which was initially the main strategy). The potential of empowerment-oriented community development intervention strategies to decrease the gap between available institutional and formal community-based services and the needs of the elderly and their families in their efforts to meet late life challenges is described. The need for an increased role of social workers in community development interventions is explored and strategies are suggested.

INTAROS: Development of an integrated Arctic observation system under Horizon 2020

NASA Astrophysics Data System (ADS)

Beszczynska-Möller, Agnieszka; Sandven, Stein; Sagen, Hanne

2017-04-01

INTAROS is a research and innovation action funded under the H2020-BG-09 call for the five-year period 2016-2021. INTAROS will develop an integrated Arctic Observation System (iAOS) by extending, improving and unifying existing systems in the different regions of the Arctic. INTAROS will have a strong multidisciplinary focus, with tools for integration of data from atmosphere, ocean, cryosphere and terrestrial sciences, provided by institutions in Europe, North America and Asia. Satellite earth observation (EO) data plays an increasingly important role in such observing systems, because the amount of EO data for observing the global climate and environment grows year by year. EO data will therefore be integrated into iAOS based on existing products and databases. In situ observing systems are much more limited due to logistical constraints and cost limitations. The sparseness of in situ data is therefore the largest gap in the overall observing system. INTAROS will assess strengths and weaknesses of existing Arctic observing systems and contribute with innovative solutions to fill some of the critical gaps in the selected networks. INTAROS will develop a platform, iAOS, to search for and access data from distributed databases. The evolution into a sustainable Arctic observing system requires coordination, mobilization and cooperation between the existing European and international infrastructures (in-situ and remote, including space-based), the modeling communities and relevant stakeholder groups. INTAROS will include development of community-based observing systems, where local knowledge is merged with scientific data. Multidisciplinary data integrated under INTAROS will contribute to better understanding of interactions and coupling in the complex Arctic ice-ocean-land-atmosphere system. An integrated Arctic Observation System will enable better-informed decisions and better-documented processes within key sectors (e.g. local communities, shipping, tourism, fishing), in order to strengthen the societal and economic role of the Arctic region and support the EU strategy for the Arctic and related maritime and environmental policies. Following the SAON goal, INTAROS will support and strengthen the EU engagement in developing the sustained and coordinated pan-Arctic observing and data sharing systems.

Social support systems as determinants of self-management and quality of life of people with diabetes across Europe: study protocol for an observational study.

PubMed

Koetsenruijter, Jan; van Lieshout, Jan; Vassilev, Ivaylo; Portillo, Mari Carmen; Serrano, Manuel; Knutsen, Ingrid; Roukova, Poli; Lionis, Christos; Todorova, Elka; Foss, Christina; Rogers, Anne; Wensing, Michel

2014-03-04

Long-term conditions pose major challenges for healthcare systems. Optimizing self-management of people with long-term conditions is an important strategy to improve quality of life, health outcomes, patient experiences in healthcare, and the sustainability of healthcare systems. Much research on self-management focuses on individual competencies, while the social systems of support that facilitate self-management are underexplored. The presented study aims to explore the role of social systems of support for self-management and quality of life, focusing on the social networks of people with diabetes and community organisations that serve them. The protocol concerns a cross-sectional study in 18 geographic areas in six European countries, involving a total of 1800 individuals with diabetes and 900 representatives of community organisations. In each country, we include a deprived rural area, a deprived urban area, and an affluent urban area. Individuals are recruited through healthcare practices in the targeted areas. A patient questionnaire comprises measures for quality of life, self-management behaviours, social network and social support, as well as individual characteristics. A community organisations' survey maps out interconnections between community and voluntary organisations that support patients with chronic illness and documents the scope of work of the different types of organisations. We first explore the structure of social networks of individuals and of community organisations. Then linkages between these social networks, self-management and quality of life will be examined, taking deprivation and other factors into account. This study will provide insight into determinants of self-management and quality of life in individuals with diabetes, focusing on the role of social networks and community organisations.

A new perspective: a vulnerable population framework to guide research and practice for persons with traumatic brain injury.

PubMed

Bay, Esther; Kreulen, Grace J; Shavers, Clarissa Agee; Currier, Connie

2006-01-01

Recovery from traumatic brain injury (TBI) can be a tumultuous lifelong and expensive process. Guided therapies for community integration within community systems are a focus of treating therapists around the world, yet there are no published discussions concerning the most fitting community context. We propose a theoretical approach for practice and research using Flaskerud and Winslow's conceptual model of vulnerable populations. Using the model constructs of health status, resource availability, and increased relative risk, we offer empirical support for proposed construct relationships applied to persons with traumatic brain injury. We then propose that interventions for health promotion, acute care, and rehabilitation or chronic disease management have a community focus, and we identify relevant goals for community-based practice and research.

The Cancer Prevention and Control Research Network: An Interactive Systems Approach to Advancing Cancer Control Implementation Research and Practice

PubMed Central

Fernández, María E.; Melvin, Cathy L.; Leeman, Jennifer; Ribisl, Kurt M.; Allen, Jennifer D.; Kegler, Michelle C.; Bastani, Roshan; Ory, Marcia G.; Risendal, Betsy C.; Hannon, Peggy A.; Kreuter, Matthew W.; Hebert, James R.

2018-01-01

Background Although cancer research has advanced at a rapid pace, a gap remains between what is known about how to improve cancer prevention and control (CPC) and what is implemented as best practices within health care systems and communities. The Cancer Prevention and Control Research Network (CPCRN), with more than 10 years of dissemination and implementation research experience, aims to accelerate the uptake and use of evidence-based CPC interventions. Methods The collective work of the CPCRN has facilitated the analysis and categorization of research and implementation efforts according to the Interactive Systems Framework for Dissemination and Implementation (ISF), providing a useful heuristic for bridging the gap between prevention research and practice. The ISF authors have called for examples of its application as input to help refine the model. Results We provide examples of how the collaborative activities supported by the CPCRN, using community-engaged processes, accelerated the synthesis and translation of evidence, built both general and innovation-specific capacity, and worked with delivery systems to advance cancer control research and practice. Conclusions The work of the CPCRN has provided real-world examples of the application of the ISF and demonstrated that synthesizing and translating evidence can increase the potential that evidence-based CPC programs will be used and that capacity building for both the support system and the delivery system is crucial for the successful implementation and maintenance of evidence-based cancer control. Impact Adoption and implementation of CPC can be enhanced by better understanding ISF systems and intervening to improve them. PMID:25155759

Coupling plant growth and waste recycling systems in a controlled life support system (CELSS)

NASA Technical Reports Server (NTRS)

Garland, Jay L.

1992-01-01

The development of bioregenerative systems as part of the Controlled Ecological Life Support System (CELSS) program depends, in large part, on the ability to recycle inorganic nutrients, contained in waste material, into plant growth systems. One significant waste (resource) stream is inedible plant material. This research compared wheat growth in hydroponic solutions based on inorganic salts (modified Hoagland's) with solutions based on the soluble fraction of inedible wheat biomass (leachate). Recycled nutrients in leachate solutions provided the majority of mineral nutrients for plant growth, although additions of inorganic nutrients to leachate solutions were necessary. Results indicate that plant growth and waste recyling systems can be effectively coupled within CELSS based on equivalent wheat yield in leachate and Hoagland solutions, and the rapid mineralization of waste organic material in the hydroponic systems. Selective enrichment for microbial communities able to mineralize organic material within the leachate was necessary to prevent accumulation of dissolved organic matter in leachate-based solutions. Extensive analysis of microbial abundance, growth, and activity in the hydroponic systems indicated that addition of soluble organic material from plants does not cause excessive microbial growth or 'biofouling', and helped define the microbially-mediated flux of carbon in hydroponic solutions.

Tavaxy: Integrating Taverna and Galaxy workflows with cloud computing support

PubMed Central

2012-01-01

Background Over the past decade the workflow system paradigm has evolved as an efficient and user-friendly approach for developing complex bioinformatics applications. Two popular workflow systems that have gained acceptance by the bioinformatics community are Taverna and Galaxy. Each system has a large user-base and supports an ever-growing repository of application workflows. However, workflows developed for one system cannot be imported and executed easily on the other. The lack of interoperability is due to differences in the models of computation, workflow languages, and architectures of both systems. This lack of interoperability limits sharing of workflows between the user communities and leads to duplication of development efforts. Results In this paper, we present Tavaxy, a stand-alone system for creating and executing workflows based on using an extensible set of re-usable workflow patterns. Tavaxy offers a set of new features that simplify and enhance the development of sequence analysis applications: It allows the integration of existing Taverna and Galaxy workflows in a single environment, and supports the use of cloud computing capabilities. The integration of existing Taverna and Galaxy workflows is supported seamlessly at both run-time and design-time levels, based on the concepts of hierarchical workflows and workflow patterns. The use of cloud computing in Tavaxy is flexible, where the users can either instantiate the whole system on the cloud, or delegate the execution of certain sub-workflows to the cloud infrastructure. Conclusions Tavaxy reduces the workflow development cycle by introducing the use of workflow patterns to simplify workflow creation. It enables the re-use and integration of existing (sub-) workflows from Taverna and Galaxy, and allows the creation of hybrid workflows. Its additional features exploit recent advances in high performance cloud computing to cope with the increasing data size and complexity of analysis. The system can be accessed either through a cloud-enabled web-interface or downloaded and installed to run within the user's local environment. All resources related to Tavaxy are available at http://www.tavaxy.org. PMID:22559942

Impact of Family Support Systems on Children's Academic and Social Functioning after Parental Divorce.

ERIC Educational Resources Information Center

Guidubaldi, John; Cleminshaw, Helen

To determine whether support systems ameliorated the impact of divorce on family stress and child adjustment, the present study examined the availability to divorced families of various support systems, including the extended family, church, work, and community groups. Specifically, the study addressed the impact of parental support systems on…

Cold Weather Wind Turbines: A Joint NASA/NSF/DOE Effort in Technology Transfer and Commercialization

NASA Technical Reports Server (NTRS)

Flynn, Michael; Bubenheim, David; Chiang, Erick; Goldman, Peter; Kohout, Lisa; Norton, Gary; Kliss, Mark (Technical Monitor)

1997-01-01

Renewable energy sources and their integration with other power sources to support remote communities is of interest for Mars applications as well as Earth communities. The National Science Foundation (NSF), NASA, and the Department of Energy (DOE) have been jointly supporting development of a 100 kW cold weather wind turbine through grants and SBIRs independently managed by each agency but coordinated by NASA. The NSF grant addressed issues associated with the South Pole application and a 3 kW direct drive unit is being tested there in anticipation of the 100 kW unit operation. The DOE-NREL contract focused on development of the 100 kW direct drive generator. The NASA SBIR focused on the development of the 100 kW direct drive wind turbine. The success of this effort has required coordination and team involvement of federal agencies and the industrial partners. Designs of the wind turbine and component performance testing results will be presented. Plans for field testing of wind turbines, based on this design, in village energy systems in Alaska and in energy production at the South Pole Station will be discussed. Also included will be a discussion of terrestrial and space use of hybrid energy systems, including renewable energy sources, such as the wind turbine, to support remote communities.

[Medical treatment support to tuberculous patients--from the standpoint of community support].

PubMed

2001-11-01

A symposium with "Medical Treatment Support to Tuberculous Patients--From the standpoint of community support" as its theme was held at the 76th Annual Meeting of the Japanese Society for Tuberculosis (April 20, 2001). "Once, It is infected with tuberculosis, one have to complete medication with a sensitive antituberculosis drug by observing the prescribed dose and duration for successful treatment". For this to be promoted community, it is necessary that (1) to manage patient's medication by medical facilities, (2) to support patient's medication by health center and (3) to support patient's living by welfare offices. Not that each facilities takes such responsibilities alone, but various community must fulfill them continuously in liaison with one another. On what measures should be taken to that end, reports based on practical examples from Nagoya City, Yokohama City and Kanagawa Prefecture have been compiled as follows. 1. It was in-office liaison by conference that supported the DOTS activities of health nurses. 2. It is cooperating, without health, medical treatment, and welfare going out, as follows. (1) A system for hospitals and clinics to carry out DOTS treatment consistently has been kept in good condition. (2) For a patient to take a drug in front of a nurse has become common, causing the patients to be motivated. (3) Assignment of MSW and nurses in charge of DOTS sent from hospitals has make it possible to offer or exchange information smoothly among those concerned. (4) A system for many persons concerned to support patients timely has been kept in good condition. This resulted in an increase in the cure rate of tuberculosis in the areas which have day laborers' lodgings. 3. By DOTS for in-patients, the number of self-discharges has decreased by 1/3, and the treatment completion rate was 94%. 4. In promotion of DOTS for the patients who have health problems other than tuberculosis, the role MSW plays is great. 5. As conditions for supporting DOTS promotion, it is necessary to create a system by which to stabilize the living of the patient himself, guarantee earnings to support it and dissolve the living problem faced by the patient. 6. Introduction of the "early guidance system for the patients in whom the treatment of tuberculosis" was discontinued has strengthened the liaison between health offices and medical facilities, has led to early detection in persons yet to receive medical treatment and resumption of medical treatment, making it possible to deal with problem cases effectively on a priority basis. It has been confirmed that liaison between health, medical service and welfare for community support of the treatment of tuberculous patients who live in that community resulted in improvement of clinical results of tuberculous patients. In this connection, Dr. Shirai advised "For a tuberculous patient to form a habit of taking a drug wherever he lives needs to be recognized as a major subject". He presented the forcible yell. "Any local government office has the homeless. I want you to make efforts so that DOTS be given to all the tuberculous persons. If there is any problem, I am ready to give advice."

The space shuttle ascent vehicle aerodynamic challenges configuration design and data base development

NASA Technical Reports Server (NTRS)

Dill, C. C.; Young, J. C.; Roberts, B. B.; Craig, M. K.; Hamilton, J. T.; Boyle, W. W.

1985-01-01

The phase B Space Shuttle systems definition studies resulted in a generic configuration consisting of a delta wing orbiter, and two solid rocket boosters (SRB) attached to an external fuel tank (ET). The initial challenge facing the aerodynamic community was aerodynamically optimizing, within limits, this configuration. As the Shuttle program developed and the sensitivities of the vehicle to aerodynamics were better understood the requirements of the aerodynamic data base grew. Adequately characterizing the vehicle to support the various design studies exploded the size of the data base to proportions that created a data modeling/management challenge for the aerodynamicist. The ascent aerodynamic data base originated primarily from wind tunnel test results. The complexity of the configuration rendered conventional analytic methods of little use. Initial wind tunnel tests provided results which included undesirable effects from model support tructure, inadequate element proximity, and inadequate plume simulation. The challenge to improve the quality of test results by determining the extent of these undesirable effects and subsequently develop testing techniques to eliminate them was imposed on the aerodynamic community. The challenges to the ascent aerodynamics community documented are unique due to the aerodynamic complexity of the Shuttle launch. Never before was such a complex vehicle aerodynamically characterized. The challenges were met with innovative engineering analyses/methodology development and wind tunnel testing techniques.

A primary care-public health partnership addressing homelessness, serious mental illness, and health disparities.

PubMed

Weinstein, Lara Carson; Lanoue, Marianna D; Plumb, James D; King, Hannah; Stein, Brianna; Tsemberis, Sam

2013-01-01

People with histories of homelessness and serious mental illness experience profound health disparities. Housing First is an evidenced-based practice that is working to end homelessness for these individuals through a combination of permanent housing and community-based supports. The Jefferson Department of Family and Community Medicine and a Housing First agency, Pathways to Housing-PA, has formed a partnership to address multiple levels of health care needs for this group. We present a preliminary program evaluation of this partnership using the framework of the patient-centered medical home and the "10 Essential Public Health Services." Preliminary program evaluation results suggest that this partnership is evolving to function as an integrated person-centered health home and an effective local public health monitoring system. The Pathways to Housing-PA/Jefferson Department of Family and Community Medicine partnership represents a community of solution, and multiple measures provide preliminary evidence that this model is feasible and can address the "grand challenges" of integrated community health services.

Examining the Highs and Lows of the Collaborative Relationship Between Technical Assistance Providers and Prevention Implementers.

PubMed

Chilenski, Sarah M; Welsh, Janet; Olson, Jonathan; Hoffman, Lesa; Perkins, Daniel F; Feinberg, Mark E

2018-02-01

The PROSPER model uses a three-tiered community partnership, university researcher, and Cooperative Extension-based technical assistance system to support the delivery of evidence-based interventions in communities. This study examines the trajectory and predictors of the collaborative relationship between technical assistance providers and community teams across the three phases of organization, implementation, and sustainability. Members of 14 PROmoting School-university-community Partnerships to Enhance Resilience (PROSPER) community teams and directors of local agencies rated communities' levels of readiness and adolescent substance use norms. Technical assistance providers rated their collaborative relationship with their teams at 14 occasions across 4.5 years. Results from mixed models show that levels of collaboration were stable until the sustainability phase, when they increased significantly. Team differences in change were significant during the implementation phase. Community readiness predicted levels of the collaborative relationship over time: high community readiness was associated with a high level of collaboration during organization, but a decline in collaboration during implementation. These results provide a more nuanced understanding of the relationship between technical assistance provision and community prevention teams and lead to recommendations to improve dissemination models to achieve a greater public health impact.

"Kicked out into the real world": prostate cancer patients' experiences with transitioning from hospital-based supervised exercise to unsupervised exercise in the community.

PubMed

Schmidt, Mette L K; Østergren, Peter; Cormie, Prue; Ragle, Anne-Mette; Sønksen, Jens; Midtgaard, Julie

2018-06-21

Regular exercise is recommended to mitigate the adverse effects of androgen deprivation therapy in men with prostate cancer. The purpose of this study was to explore the experience of transition to unsupervised, community-based exercise among men who had participated in a hospital-based supervised exercise programme in order to propose components that supported transition to unsupervised exercise. Participants were selected by means of purposive, criteria-based sampling. Men undergoing androgen deprivation therapy who had completed a 12-week hospital-based, supervised, group exercise intervention were invited to participate. The programme involved aerobic and resistance training using machines and included a structured transition to a community-based fitness centre. Data were collected by means of semi-structured focus group interviews and analysed using thematic analysis. Five focus group interviews were conducted with a total of 29 men, of whom 25 reported to have continued to exercise at community-based facilities. Three thematic categories emerged: Development and practice of new skills; Establishing social relationships; and Familiarising with bodily well-being. These were combined into an overarching theme: From learning to doing. Components suggested to support transition were as follows: a structured transition involving supervised exercise sessions at a community-based facility; strategies to facilitate peer support; transferable tools including an individual exercise chart; and access to 'check-ups' by qualified exercise specialists. Hospital-based, supervised exercise provides a safe learning environment. Transferring to community-based exercise can be experienced as a confrontation with the real world and can be eased through securing a structured transition, having transferable tools, sustained peer support and monitoring.

A national survey on health department capacity for community engagement in emergency preparedness.

PubMed

Schoch-Spana, Monica; Selck, Frederic W; Goldberg, Lisa A

2015-01-01

Limited systematic knowledge exists about how public health practitioners and policy makers can best strengthen community engagement in public health emergency preparedness ("CE-PHEP"), a top priority for US national health security. To investigate local health department (LHD) adoption of federally recommended participatory approaches to PHEP and to identify LHD organizational characteristics associated with more intense CE-PHEP. National survey in 2012 of LHDs using a self-administered Web-based questionnaire regarding LHD practices and resources for CE-PHEP ("The Community Engagement for Public Health Emergency Preparedness Survey"). Differences in survey responses were examined, and a multivariate analysis was used to test whether LHD organizational characteristics were associated with differences in CE-PHEP intensity. A randomized sample of 754 LHDs drawn from the 2565 LHDs that had been invited to participate in the 2010 National Profile of LHDs. Sample selection was stratified by the size of population served and geographic location. Emergency preparedness coordinators reporting on their respective LHDs. CE-PHEP intensity as measured with a scoring system that rated specific CE-PHEP practices by LHD according to the relative degrees of public participation and community capacity they represented. Survey response rate was 61%. The most common reported CE-PHEP activity was disseminating personal preparedness materials (90%); the least common was convening public forums on PHEP planning (22%). LHD characteristics most strongly associated with more intense CE-PHEP were having a formal CE-PHEP policy, allocating funds for CE-PHEP, having strong support from community-based organizations, and employing a coordinator with prior CE experience. Promising ways to engage community partners more fully in the PHEP enterprise are institutionalizing CE-PHEP objectives, employing sufficient and skilled staff, leveraging current community-based organization support, and aligning budgets with the value of CE-PHEP to US national health security.

Progress in European CELSS activities

NASA Technical Reports Server (NTRS)

Skoog, A. I.

1987-01-01

The European Controlled Ecological Life Support System (CELSS) activities started in the late 1970's with system analysis and feasibility studies of Biological Life Support Systems (BLSS). The initiation for CELSS came from the industry side in Europe, but since then planning and hardware feasibility analyses have been initiated also from customer/agency side. Despite this, it is still too early to state that a CELSS program as a concerted effort has been agreed upon in Europe. However, the general CELSS objectives were accepted as planning and possible development goals for the European effort for manned space activities, and as experimental planning topics in the life sciences community for the next decades. It is expected that ecological life support systems can be tested and implemented on a space station towards the end of this century or early in the next. For the European activities a possible scenario can be projected based on ongoing life support system development activities and the present life sciences goals.

“Respect the way I need to communicate with you”: Healthcare experiences of adults on the autism spectrum

PubMed Central

Nicolaidis, Christina; Raymaker, Dora M.; McDonald, Katherine E.; Baggs, W. Amelia E.V.; Dern, Sebastian; Kapp, Steven K.; Weiner, Michael; Boisclair, Cody; Ashkenazy, Elesia

2016-01-01

Our objective was to obtain an in-depth understanding of autistic adults’ experiences with healthcare and their recommendations for improving care. Our academic-community partnership used a community based participatory research (CBPR) approach to conduct semi-structured, open-ended interviews with 39 autistic adults and 16 people who had experience supporting autistic adults in healthcare settings. Participants identified patient-level, autism-related factors that impact healthcare interactions, including verbal communication skills, sensory sensitivities, challenges with body awareness, slow processing speed, atypical non-verbal communication, and challenges with organization. However, the success of healthcare interactions largely depended on the interplay between patient- and provider-level factors, as well as on the larger context in which patients were receiving care. Provider-level factors included providers’ knowledge about autism in adults, incorrect assumptions about individual patients, willingness to allow written communication, use of accessible language, openness to providing other accommodations, and skill in appropriately incorporating supporters. System-level factors included the availability of supporters, complexity of the healthcare system, accessibility of healthcare facilities, and stigma about autism. Further efforts are needed to empower patients, adequately train providers, increase the accessibility of the healthcare system, and decrease discrimination. PMID:25882392

Geodetic Infrastructure, Data, Education and Community Engagement in Response to Earthquakes and Other Geophysical Events: An Overview of UNAVCO Support Resources Plus Highlights from Recent Event Response

NASA Astrophysics Data System (ADS)

Phillips, D. A.; Meertens, C. M.; Mattioli, G. S.; Miller, M. M.; Charlevoix, D. J.; Maggert, D.; Hodgkinson, K. M.; Henderson, D. B.; Puskas, C. M.; Bartel, B. A.; Baker, S.; Blume, F.; Normandeau, J.; Feaux, K.; Galetzka, J.; Williamson, H.; Pettit, J.; Crosby, C. J.; Boler, F. M.

2015-12-01

UNAVCO responds to community requests for support during and following significant geophysical events such as earthquakes, volcanic activity, landslides, glacial and ice-sheet movements, unusual uplift or subsidence, extreme meteorological events, or other hazards. UNAVCO can also respond proactively to events in anticipation of community demand for relevant data, data products or other services. Recent major events to which UNAVCO responded include the 2015 M7.8 Nepal EQ, the 2014 M6.0 American Canyon (Napa) EQ, the 2014 M8.2 Chile EQ, the 2011 M9.0 Tohoku, Japan EQ and tsunami, the 2010 M8.8 Maule, Chile EQ, and the 2010 M7.0 Haiti EQ. UNAVCO provided geophysical event response support for 15 events in 2014 alone. UNAVCO event response resources include geodetic infrastructure, data, and education and community engagement. Specific support resources include: field engineering personnel; continuous and campaign GNSS/GPS station deployment; real-time and/or high rate field GNSS/GPS station upgrades or deployment; data communications and power systems deployment; tiltmeter, strainmeter, and borehole seismometer deployments; terrestrial laser scanning (TLS a.k.a. ground-based LiDAR); InSAR data support; education and community engagement assistance or products; data processing services; generation of custom GNSS/GPS or borehole data sets and products; equipment shipping and logistics coordination; and assistance with RAPID proposal preparation, budgeting, and submission. The most critical aspect of a successful event response is effective and efficient communication. To facilitate such communication, UNAVCO creates event response web pages describing the event and the support being provided, and in the case of major events also provides an online event response forum. These resources are shared broadly with the geophysical community through multiple dissemination strategies including social media of UNAVCO and partner organizations. We will provide an overview of resources available to the community from UNAVCO in response to events. We will also highlight examples of the infrastructure, data and data products, and education and community engagement support provided by UNAVCO for major recent events.

Supporting Shared Resource Usage for a Diverse User Community: the OSG Experience and Lessons Learned

NASA Astrophysics Data System (ADS)

Garzoglio, Gabriele; Levshina, Tanya; Rynge, Mats; Sehgal, Chander; Slyz, Marko

2012-12-01

The Open Science Grid (OSG) supports a diverse community of new and existing users in adopting and making effective use of the Distributed High Throughput Computing (DHTC) model. The LHC user community has deep local support within the experiments. For other smaller communities and individual users the OSG provides consulting and technical services through the User Support area. We describe these sometimes successful and sometimes not so successful experiences and analyze lessons learned that are helping us improve our services. The services offered include forums to enable shared learning and mutual support, tutorials and documentation for new technology, and troubleshooting of problematic or systemic failure modes. For new communities and users, we bootstrap their use of the distributed high throughput computing technologies and resources available on the OSG by following a phased approach. We first adapt the application and run a small production campaign on a subset of “friendly” sites. Only then do we move the user to run full production campaigns across the many remote sites on the OSG, adding to the community resources up to hundreds of thousands of CPU hours per day. This scaling up generates new challenges - like no determinism in the time to job completion, and diverse errors due to the heterogeneity of the configurations and environments - so some attention is needed to get good results. We cover recent experiences with image simulation for the Large Synoptic Survey Telescope (LSST), small-file large volume data movement for the Dark Energy Survey (DES), civil engineering simulation with the Network for Earthquake Engineering Simulation (NEES), and accelerator modeling with the Electron Ion Collider group at BNL. We will categorize and analyze the use cases and describe how our processes are evolving based on lessons learned.

Using metagenomic and metatranscriptomic observations to test a thermodynamic-based model of community metabolic expression over time and space

NASA Astrophysics Data System (ADS)

Vallino, J. J.; Huber, J. A.

2016-02-01

Marine biogeochemistry is orchestrated by a complex and dynamic community of microorganisms that attempt to maximize their own fecundity through a combination of competition and cooperation. At a systems level, the community can be described as a distributed metabolic network, where different species contribute their own unique set of metabolic capabilities. Our current project attempts to understand the governing principles that describe amplification or attenuation of metabolic pathways within the network through a combination of modeling and metagenomic, metatranscriptomic and biogeochemical observations. We will describe and present results from our thermodynamic-based model that determines optimal pathway expression from available resources based on the principle of maximum entropy production (MEP); that is, based on the hypothesis that non-equilibrium systems organize to maximize energy dissipation. The MEP model currently predicts metabolic pathway expression over time, and one spatial dimension. Model predictions will be compared to biogeochemical observations and gene presence and expression from samples collected over time and space from a costal meromictic basin (Siders Pond) located in Falmouth MA, US. Siders Pond permanent stratification, caused by occasional seawater intrusion, results in steep chemoclines and redox gradients, which supports both aerobic and anaerobic phototrophs as well as sulfur, Fe and Mn redox cycles. The diversity of metabolic capability and expression we have observed over depth makes it an ideal system to test our thermodynamic-based model.

Community health navigators for breast- and cervical-cancer screening among Cambodian and Laotian women: intervention strategies and relationship-building processes.

PubMed

Ngoc Nguyen, Tu-Uyen; Tanjasiri, Sora Park; Kagawa-Singer, Marjorie; Tran, Jacqueline H; Foo, Mary Anne

2008-10-01

In recent years, there has been a growing number of programs employing health navigators to assist underserved individuals in overcoming barriers to obtaining regular and quality health care. This article describes the perspectives and experiences of community-based health navigators in the Cambodian and Laotian communities involved in a REACH 2010 project to reduce health disparities in breast and cervical cancer among Pacific Islander and Southeast Asian communities in California. These community health navigators, who have extensive training and knowledge about the cultural, historical, and structural needs and resources of their communities, are well equipped to build trusting relationships with community members traditionally ignored by the mainstream medical system. By comparing the different social support roles and intervention strategies employed by community health navigators in diverse communities, we can better understand how these valuable change agents of the health workforce are effective in improving health access and healthy behaviors for underserved communities.

Towards Critical Justice: Exploring Intersectionality in Community-Based STEM-Rich Making with Youth from Non-Dominant Communities

ERIC Educational Resources Information Center

Tan, Edna; Calabrese Barton, Angela

2018-01-01

We investigated how community ethnography as a pedagogy approach to STEM-rich making supported youth makers from two low-income urban communities engaged in sustained STEM-rich making towards making a difference in their communities. Data is drawn from two-year long ethnographic data across two community-based, youth making programs. We highlight…

Drug Free Communities Support Program. Prevention Update

ERIC Educational Resources Information Center

Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention, 2012

2012-01-01

Administered by the Office of National Drug Control Policy (ONDCP), in partnership with the Substance Abuse and Mental Health Services Administration (SAMHSA), the Drug Free Communities Support Program (DFC) is a federal grant program that provides funding to community-based coalitions that organize to prevent youth substance use. Since the…

XML Based Scientific Data Management Facility

NASA Technical Reports Server (NTRS)

Mehrotra, Piyush; Zubair, M.; Ziebartt, John (Technical Monitor)

2001-01-01

The World Wide Web consortium has developed an Extensible Markup Language (XML) to support the building of better information management infrastructures. The scientific computing community realizing the benefits of HTML has designed markup languages for scientific data. In this paper, we propose a XML based scientific data management facility, XDMF. The project is motivated by the fact that even though a lot of scientific data is being generated, it is not being shared because of lack of standards and infrastructure support for discovering and transforming the data. The proposed data management facility can be used to discover the scientific data itself, the transformation functions, and also for applying the required transformations. We have built a prototype system of the proposed data management facility that can work on different platforms. We have implemented the system using Java, and Apache XSLT engine Xalan. To support remote data and transformation functions, we had to extend the XSLT specification and the Xalan package.

XML Based Scientific Data Management Facility

NASA Technical Reports Server (NTRS)

Mehrotra, P.; Zubair, M.; Bushnell, Dennis M. (Technical Monitor)

2002-01-01

The World Wide Web consortium has developed an Extensible Markup Language (XML) to support the building of better information management infrastructures. The scientific computing community realizing the benefits of XML has designed markup languages for scientific data. In this paper, we propose a XML based scientific data management ,facility, XDMF. The project is motivated by the fact that even though a lot of scientific data is being generated, it is not being shared because of lack of standards and infrastructure support for discovering and transforming the data. The proposed data management facility can be used to discover the scientific data itself, the transformation functions, and also for applying the required transformations. We have built a prototype system of the proposed data management facility that can work on different platforms. We have implemented the system using Java, and Apache XSLT engine Xalan. To support remote data and transformation functions, we had to extend the XSLT specification and the Xalan package.

Enhancing the Supervision of Community Health Workers With WhatsApp Mobile Messaging: Qualitative Findings From 2 Low-Resource Settings in Kenya.

PubMed

Henry, Jade Vu; Winters, Niall; Lakati, Alice; Oliver, Martin; Geniets, Anne; Mbae, Simon M; Wanjiru, Hannah

2016-06-20

An estimated half of all mobile phone users in Kenya use WhatsApp, an instant messaging platform that provides users an affordable way to send and receive text messages, photos, and other media at the one-to-one, one-to-many, many-to-one, or many-to-many levels. A mobile learning intervention aimed at strengthening supervisory support for community health workers (CHWs) in Kibera and Makueni, Kenya, created a WhatsApp group for CHWs and their supervisors to support supervision, professional development, and team building. We analyzed 6 months of WhatsApp chat logs (from August 19, 2014, to March 1, 2015) and conducted interviews with CHWs and their supervisors to understand how they used this instant messaging tool. During the study period, 1,830 posts were made by 41participants. Photos were a key component of the communication among CHWs and their supervisors: 430 (23.4%) of all posts contained photos or other media. Of the remaining 1,400 text-based posts, 87.6% (n = 1,227) related to at least 1 of 3 defined supervision objectives: (1) quality assurance, (2) communication and information, or (3) supportive environment. This supervision took place in the context of posts about the roll out of the new mobile learning intervention and the delivery of routine health care services, as well as team-building efforts and community development. Our preliminary investigation demonstrates that with minimal training, CHWs and their supervisors tailored the multi-way communication features of this mobile instant messaging technology to enact virtual one-to-one, group, and peer-to-peer forms of supervision and support, and they switched channels of communication depending on the supervisory objectives. We encourage additional research on how health workers incorporate mobile technologies into their practices to develop and implement effective supervisory systems that will safeguard patient privacy, strengthen the formal health system, and create innovative forms of community-based, digitally supported professional development for CHWs. © Henry et al.

Enhancing the Supervision of Community Health Workers With WhatsApp Mobile Messaging: Qualitative Findings From 2 Low-Resource Settings in Kenya

PubMed Central

Henry, Jade Vu; Winters, Niall; Lakati, Alice; Oliver, Martin; Geniets, Anne; Mbae, Simon M; Wanjiru, Hannah

2016-01-01

ABSTRACT An estimated half of all mobile phone users in Kenya use WhatsApp, an instant messaging platform that provides users an affordable way to send and receive text messages, photos, and other media at the one-to-one, one-to-many, many-to-one, or many-to-many levels. A mobile learning intervention aimed at strengthening supervisory support for community health workers (CHWs) in Kibera and Makueni, Kenya, created a WhatsApp group for CHWs and their supervisors to support supervision, professional development, and team building. We analyzed 6 months of WhatsApp chat logs (from August 19, 2014, to March 1, 2015) and conducted interviews with CHWs and their supervisors to understand how they used this instant messaging tool. During the study period, 1,830 posts were made by 41participants. Photos were a key component of the communication among CHWs and their supervisors: 430 (23.4%) of all posts contained photos or other media. Of the remaining 1,400 text-based posts, 87.6% (n = 1,227) related to at least 1 of 3 defined supervision objectives: (1) quality assurance, (2) communication and information, or (3) supportive environment. This supervision took place in the context of posts about the roll out of the new mobile learning intervention and the delivery of routine health care services, as well as team-building efforts and community development. Our preliminary investigation demonstrates that with minimal training, CHWs and their supervisors tailored the multi-way communication features of this mobile instant messaging technology to enact virtual one-to-one, group, and peer-to-peer forms of supervision and support, and they switched channels of communication depending on the supervisory objectives. We encourage additional research on how health workers incorporate mobile technologies into their practices to develop and implement effective supervisory systems that will safeguard patient privacy, strengthen the formal health system, and create innovative forms of community-based, digitally supported professional development for CHWs. PMID:27353623

Community Participation in Health Systems Research: A Systematic Review Assessing the State of Research, the Nature of Interventions Involved and the Features of Engagement with Communities

PubMed Central

George, Asha S.; Mehra, Vrinda; Scott, Kerry; Sriram, Veena

2015-01-01

Background Community participation is a major principle of people centered health systems, with considerable research highlighting its intrinsic value and strategic importance. Existing reviews largely focus on the effectiveness of community participation with less attention to how community participation is supported in health systems intervention research. Objective To explore the extent, nature and quality of community participation in health systems intervention research in low- and middle-income countries. Methodology We searched for peer-reviewed, English language literature published between January 2000 and May 2012 through four electronic databases. Search terms combined the concepts of community, capability/participation, health systems research and low- and middle-income countries. The initial search yielded 3,092 articles, of which 260 articles with more than nominal community participation were identified and included. We further excluded 104 articles due to lower levels of community participation across the research cycle and poor description of the process of community participation. Out of the remaining 160 articles with rich community participation, we further examined 64 articles focused on service delivery and governance within health systems research. Results Most articles were led by authors in high income countries and many did not consistently list critical aspects of study quality. Articles were most likely to describe community participation in health promotion interventions (78%, 202/260), even though they were less participatory than other health systems areas. Community involvement in governance and supply chain management was less common (12%, 30/260 and 9%, 24/260 respectively), but more participatory. Articles cut across all health conditions and varied by scale and duration, with those that were implemented at national scale or over more than five years being mainstreamed by government. Most articles detailed improvements in service availability, accessibility and acceptability, with fewer efforts focused on quality, and few designs able to measure impact on health outcomes. With regards to participation, most articles supported community’s in implementing interventions (95%, n = 247/260), in contrast to involving communities in identifying and defining problems (18%, n = 46/260). Many articles did not discuss who in communities participated, with just over a half of the articles disaggregating any information by sex. Articles were largely under theorized, and only five mentioned power or control. Majority of the articles (57/64) described community participation processes as being collaborative with fewer describing either community mobilization or community empowerment. Intrinsic individual motivations, community-level trust, strong external linkages, and supportive institutional processes facilitated community participation, while lack of training, interest and information, along with weak financial sustainability were challenges. Supportive contextual factors included decentralization reforms and engagement with social movements. Conclusion Despite positive examples, community participation in health systems interventions was variable, with few being truly community directed. Future research should more thoroughly engage with community participation theory, recognize the power relations inherent in community participation, and be more realistic as to how much communities can participate and cognizant of who decides that. PMID:26496124

Mental Health Collaborative Care and Its Role in Primary Care Settings

PubMed Central

Goodrich, David E.; Kilbourne, Amy M.; Nord, Kristina M.; Bauer, Mark S.

2013-01-01

Collaborative care models (CCMs) provide a pragmatic strategy to deliver integrated mental health and medical care for persons with mental health conditions served in primary care settings. CCMs are team-based intervention to enact system-level redesign by improving patient care through organizational leadership support, provider decision support, and clinical information systems as well as engaging patients in their care through self-management support and linkages to community resources. The model is also a cost-efficient strategy for primary care practices to improve outcomes for a range of mental health conditions across populations and settings. CCMs can help achieve integrated care aims under healthcare reform yet organizational and financial issues may affect adoption into routine primary care. Notably, successful implementation of CCMs in routine care will require alignment of financial incentives to support systems redesign investments, reimbursements for mental health providers, and adaptation across different practice settings and infrastructure to offer all CCM components. PMID:23881714

Mental health collaborative care and its role in primary care settings.

PubMed

Goodrich, David E; Kilbourne, Amy M; Nord, Kristina M; Bauer, Mark S

2013-08-01

Collaborative care models (CCMs) provide a pragmatic strategy to deliver integrated mental health and medical care for persons with mental health conditions served in primary care settings. CCMs are team-based intervention to enact system-level redesign by improving patient care through organizational leadership support, provider decision support, and clinical information systems, as well as engaging patients in their care through self-management support and linkages to community resources. The model is also a cost-efficient strategy for primary care practices to improve outcomes for a range of mental health conditions across populations and settings. CCMs can help achieve integrated care aims underhealth care reform yet organizational and financial issues may affect adoption into routine primary care. Notably, successful implementation of CCMs in routine care will require alignment of financial incentives to support systems redesign investments, reimbursements for mental health providers, and adaptation across different practice settings and infrastructure to offer all CCM components.

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

PubMed

Prendergast, Michael; Cartier, Jerome J

2008-01-01

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

Implementing Research-Based Substance Abuse Prevention in Communities: Effects of a Coalition-Based Prevention Initiative in Vermont

ERIC Educational Resources Information Center

Flewelling, Robert L.; Austin, David; Hale, Kelly; LaPlante, Marcia; Liebig, Melissa; Piasecki, Linda; Uerz, Lori

2005-01-01

Despite the popularity and perceived potential effectiveness of community-based coalitions in helping to prevent and reduce adolescent substance use, empirical evidence supporting this approach is sparse. Many reasons have been suggested for why coalition-based prevention initiatives, and community-level interventions in general, have not…

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

NASA Astrophysics Data System (ADS)

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

2013-11-01

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

Neuro-Fuzzy Support of Knowledge Management in Social Regulation

NASA Astrophysics Data System (ADS)

Petrovic-Lazarevic, Sonja; Coghill, Ken; Abraham, Ajith

2002-09-01

The aim of the paper is to demonstrate the neuro-fuzzy support of knowledge management in social regulation. Knowledge could be understood for social regulation purposes as explicit and tacit. Explicit knowledge relates to the community culture indicating how things work in the community based on social policies and procedures. Tacit knowledge is ethics and norms of the community. The former could be codified, stored and transferable in order to support decision making, while the latter being based on personal knowledge, experience and judgments is difficult to codify and store. Tacit knowledge expressed through linguistic information can be stored and used to support knowledge management in social regulation through the application of fuzzy and neuro-fuzzy logic.

A decision support system for telemedicine through the mobile telecommunications platform.

PubMed

Eren, Ali; Subasi, Abdulhamit; Coskun, Osman

2008-02-01

In this paper we have discussed the application of artificial intelligence in telemedicine using mobile device. The main goal of our research is to develop methods and systems to collect, analyze, distribute and use medical diagnostics information from multiple knowledge sources and areas of expertise. Physicians may collect and analyze information obtained from experts worldwide with the help of a medical decision support system. In this information retrieval system, modern communication tools such as computers and mobile phones can be used efficiently. In this work we propose a medical decision support system using the general packet radio service (GPRS). GPRS, a data extension of the mobile telephony standard Global system for mobile communications (GSM) is emerging as the first true packet-switched architecture to allow mobile subscribers to benefit from high-speed transmission rates and run JAVA based applications from their mobile terminals. An academic prototype of a medical decision support system using mobile device was implemented. The results reveal that the system could find acceptance from the medical community and it could be an effective means of providing quality health care in developing countries.

Active Rehabilitation-a community peer-based approach for persons with spinal cord injury: international utilisation of key elements.

PubMed

Divanoglou, A; Tasiemski, T; Augutis, M; Trok, K

2017-06-01

Active Rehabilitation (AR) is a community peer-based approach that started in Sweden in 1976. As a key component of the approach, AR training camps provide intensive, goal-oriented, intentional, group-based, customised training and peer-support opportunities in a community environment for individuals with spinal cord injury. Prospective cross-sectional study. To describe the profile of the organisations that use components of the AR approach, and to explore the characteristics and the international variations of the approach. Twenty-two organisations from 21 countries from Europe, Asia and Africa reported using components of the AR approach during the past 10 years. An electronic survey was developed and distributed through a personalised email. Sampling involved a prospective identification of organisations that met the inclusion criteria and snowball strategies. While there were many collaborating links between the organisations, RG Active Rehabilitation from Sweden and Motivation Charitable Trust from the United Kingdom were identified as key supporting organisations. The 10 key elements of the AR approach were found to be used uniformly across the participating organisations. Small variations were associated with variations in country income and key supporting organisation. This is the first study to describe the key elements and international variations of the AR approach. This will provide the basis for further studies exploring the effectiveness of the approach, it will likely facilitate international collaboration on research and operational aspects and it could potentially support higher integration in the health-care system and long-term funding of these programmes.

Identifying consumer's needs of health information technology through an innovative participatory design approach among English- and Spanish-speaking urban older adults.

PubMed

Lucero, R; Sheehan, B; Yen, P; Velez, O; Nobile-Hernandez, D; Tiase, V

2014-01-01

We describe an innovative community-centered participatory design approach, Consumer-centered Participatory Design (C2PD), and the results of applying C2PD to design and develop a web-based fall prevention system. We conducted focus groups and design sessions with English- and Spanish-speaking community-dwelling older adults. Focus group data were summarized and used to inform the context of the design sessions. Descriptive content analysis methods were used to develop categorical descriptions of design session informant's needs related to information technology. The C2PD approach enabled the assessment and identification of informant's needs of health information technology (HIT) that informed the development of a falls prevention system. We learned that our informants needed a system that provides variation in functions/content; differentiates between actionable/non-actionable information/structures; and contains sensory cues that support wide-ranging and complex tasks in a varied, simple, and clear interface to facilitate self-management. The C2PD approach provides community-based organizations, academic researchers, and commercial entities with a systematic theoretically informed approach to develop HIT innovations. Our community-centered participatory design approach focuses on consumer's technology needs while taking into account core public health functions.

Identifying Consumer’s Needs of Health Information Technology through an Innovative Participatory Design Approach among English- and Spanish-speaking Urban Older Adults

PubMed Central

Sheehan, B.; Yen, P.; Velez, O.; Nobile-Hernandez, D.; Tiase, V.

2014-01-01

Summary Objectives We describe an innovative community-centered participatory design approach, Consumer-centered Participatory Design (C2PD), and the results of applying C2PD to design and develop a web-based fall prevention system. Methods We conducted focus groups and design sessions with English- and Spanish-speaking community-dwelling older adults. Focus group data were summarized and used to inform the context of the design sessions. Descriptive content analysis methods were used to develop categorical descriptions of design session informant’s needs related to information technology. Results The C2PD approach enabled the assessment and identification of informant’s needs of health information technology (HIT) that informed the development of a falls prevention system. We learned that our informants needed a system that provides variation in functions/content; differentiates between actionable/non-actionable information/structures; and contains sensory cues that support wide-ranging and complex tasks in a varied, simple, and clear interface to facilitate self-management. Conclusions The C2PD approach provides community-based organizations, academic researchers, and commercial entities with a systematic theoretically informed approach to develop HIT innovations. Our community-centered participatory design approach focuses on consumer’s technology needs while taking into account core public health functions. PMID:25589909

Ecological influences of sexuality on early adolescent African American females.

PubMed

Aronowitz, Teri; Rennells, Rachel E; Todd, Erin

2006-01-01

African Americans make up the greater proportion of AIDS cases in adolescent girls but little is understood about the development of sexual risk behaviors during the early adolescent years. This article will explore ecological factors influencing adolescent sexual risk behaviors. In the focus groups, which were conducted using 28 African American mothers and their early adolescent daughters, 2 major themes emerged: exposure and support systems. Mothers described the impact community had on their daughters and how monitoring and support systems worked together to control exposure. The girls detailed the different ways they were impacted by the community. Attitudes the girls adopted from their exposures resulted in risk-taking behaviors or a determination to positively impact the community. Community was shown to be the context of the acquisition of sexual knowledge and attitudes. These findings support the development of interventions to address the impact of community on the participation of sexual risk behaviors.

Homicide in childhood: a public health problem in need of attention.

PubMed Central

Christoffel, K K

1984-01-01

Homicide is now among the five leading causes of death in childhood, accounting for 1/20 deaths of those less than 18 years of age. Based on childrens' changing developmental vulnerabilities, it is possible to characterize three subtypes of child homicide--infanticide, fatal child abuse and neglect after infancy, and homicide in the community. Specific approaches to primary prevention include measures to strengthen families and their community support systems, and to educate adults and children concerning appropriate behaviors of children at different ages. PMID:6689845

Looking Similar Promotes Group Stability in a Game-Based Virtual Community.

PubMed

Lortie, Catherine L; Guitton, Matthieu J

2012-08-01

Online support groups are popular Web-based resources that provide tailored information and peer support through virtual communities and fulfill the users' needs for empowerment and belonging. However, the therapeutic potential of online support groups is at present limited by the lack of systematic research on the cognitive mechanisms underlying social group cohesion in virtual communities. We might increase the benefits of participation in online support groups if we gain more insight into the factors that promote long-term commitment to peer support. One approach to foster the therapeutic potential of online support groups could be to increase social selection based on visual similarity. We performed a case study using the popular virtual setting of "World of Warcraft" (Blizzard Entertainment, Irvine, CA). We monitored the social dynamics of a virtual community composed of avatars whose appearance was identical during a period of 3 months, biweekly, for a total of 24 measures. We observed that this homogeneous community displayed a very high level of group stability over time in terms of the total number of members, the number of members that stayed the same, and the number of arrivals and departures, despite the fact that belonging to a heterogeneous group typically favors the success of the group with respect to game progression. Our results confirm that appearance can trigger social selection in online virtual communities. Displaying a similar appearance could be one way to strengthen social bonds among peers who share various health and well-being issues. Thus, the therapeutic potential of online support groups could be promoted through visual cohesion.

Driving with roadmaps and dashboards: using information resources to structure the decision models in service organizations.

PubMed

Chorpita, Bruce F; Bernstein, Adam; Daleiden, Eric L

2008-03-01

This paper illustrates the application of design principles for tools that structure clinical decision-making. If the effort to implement evidence-based practices in community services organizations is to be effective, attention must be paid to the decision-making context in which such treatments are delivered. Clinical research trials commonly occur in an environment characterized by structured decision making and expert supports. Technology has great potential to serve mental health organizations by supporting these potentially important contextual features of the research environment, through organization and reporting of clinical data into interpretable information to support decisions and anchor decision-making procedures. This article describes one example of a behavioral health reporting system designed to facilitate clinical and administrative use of evidence-based practices. The design processes underlying this system-mapping of decision points and distillation of performance information at the individual, caseload, and organizational levels-can be implemented to support clinical practice in a wide variety of settings.

Evaluating Community Readiness to Implement Environmental and Policy-Based Alcohol Abuse Prevention Strategies in Wisconsin

ERIC Educational Resources Information Center

Paltzer, Jason; Black, Penny; Moberg, D. Paul

2013-01-01

Background: Matching evidence-based alcohol prevention strat- egies with a community's readiness to support those strategies is the basis for the Tri-Ethnic Community Readiness Model (CRM). The purpose of this evaluation was to assess the association of a community's readiness to address alcohol abuse in their community with the implementation of…

Community-managed Data Sharing, Curation, and Publication: SEN on SEAD

NASA Astrophysics Data System (ADS)

Martin, R. L.; Myers, J.; Hsu, L.

2017-12-01

While data publication in support of reuse and scientific reproducibility is increasingly being recognized as a key aspect of modern research practice, best practices are still to be developed at the level of scientific communities. Often, such practices are discussed in the abstract - as community standards for data plans or as requirements for yet-to-be-built software - with no clear path to community adoption. In contrast, the Sediment Experimentalist Network, supported through the National Science Foundation's (NSF) EarthCube initiative, has encouraged an iterative, practice-based approach within its community that has resulted in the publication of dozens of datasets, comprised of millions of files totaling more than 4 TB in size, and the documentation of more than 100 experimental procedures, instruments, and facilities, by multiple research teams. A key element of SEN's approach has been to leverage cloud-based data services that provide robust core capabilities with community-based management and customization capabilities. These services - data sharing, curation, and publication services developed through the NSF-supported Sustainable Environment - Actionable Data (SEAD) project and the wiki-based SEN Knowledge Base (KB) - have allowed the SEN team to ground discussions in reality and leverage the practical questions arising as researchers publish data to drive discussion and evolve towards better practices. In this presentation we summarize how SEN interacts with researchers, the best practices that have been developed, and the capabilities of SEAD and the SEN KB that support them. We also describe issues that have arisen in the community - related, for example, to recommended and required metadata, individual, project and community branding, and data version and derivation relationships - and describe how SEN's outreach activities, collaboration with the SEAD team, and the flexible design of the data services themselves have, in combination, been able to provide rapid incremental solutions to support researchers needs while also helping the community align with broader semantic and data publication standards. We conclude with thoughts on how this approach could be applied in other communities as a way to drive progress towards data reuse and reproducible research.

Developing strategic systems supporting communities of practice in the Georgia Department of Transportation.

DOT National Transportation Integrated Search

2011-12-01

This study is designed to explore strategies through which the Georgia Department of : Transportation (GDOT) can develop communities of practice to help employees facilitate critical : exchanges of knowledge, support organizational learning, and ulti...

Person-Centeredness in Home- and Community-Based Services and Supports: Domains, Attributes, and Assisted Living Indicators.

PubMed

Zimmerman, Sheryl; Love, Karen; Cohen, Lauren W; Pinkowitz, Jackie; Nyrop, Kirsten A

2014-01-01

As a result of the Centers for Medicare & Medicaid Services (CMS) interest in creating a unifying definition of "community living" for its Medicaid Home and Community Based Services and Support (HCBS) programs, it needed clarifying descriptors of person-centered (PC) practices in assisted living to distinguish them from institutional ones. Additionally, CMS's proposed language defining "community living" had the unintended potential to exclude many assisted living communities and disadvantage residents who receive Medicaid. This manuscript describes the consensus process through which clarifying language for "community living" and a framework for HCBS PC domains, attributes, and indicators specific to assisted living were developed. It examines the validity of those domains based on literature review, surveys, and stakeholder focus groups, and identifies nine domains and 43 indicators that provide a foundation for defining and measuring PC practice in assisted living. Ongoing efforts using community-based participatory research methods are further refining and testing PC indicators for assisted living to advance knowledge, operational policies, practices, and quality outcomes.

Integrating Parenting Support Within and Beyond the Pediatric Medical Home.

PubMed

Linton, Julie M; Stockton, Maria Paz; Andrade, Berta; Daniel, Stephanie

2018-01-01

Positive parenting programs, developmental support services, and evidence-based home visiting programs can effectively provide parenting support and improve health and developmental outcomes for at-risk children. Few models, however, have integrated referrals for on-site support and home visiting programs into the provision of routine pediatric care within a medical home. This article describes an innovative approach, through partnership with a community-based organization, to deliver on-site and home visiting support services for children and families within and beyond the medical home. Our model offers a system of on-site services, including parenting, behavior, and/or development support, with optional intensive home visiting services. Assessment included description of the population served, delineation of services provided, and qualitative identification of key themes of the impact of services, illustrated by case examples. This replicable model describes untapped potential of the pediatric medical home as a springboard to mitigate risk and optimize children's health and development.

Principles of strengths-based nursing leadership for strengths-based nursing care: a new paradigm for nursing and healthcare for the 21st century.

PubMed

Gottlieb, Laurie N; Gottlieb, Bruce; Shamian, Judith

2012-06-01

The current healthcare system is slowly evolving into a new system built on a vision of health promotion, primary care and community-based home care, with hospitals still being a core pillar of the healthcare system but not its primary service. This transformation requires a new approach to practice, namely, Strengths-Based Nursing Care (SBC). SBC is about mobilizing, capitalizing and developing a person's strengths to promote health and facilitate healing. For nurses to practise SBNC requires strong nursing leadership that creates conditions to enable them to do so. Strengths-Based Nursing Leadership complements and acts in synergy with, SBNC. This paper describes eight principles of Strengths-Based Nursing Leadership to support SBNC.

A study of human resource competencies required to implement community rehabilitation in less resourced settings.

PubMed

Gilmore, Brynne; MacLachlan, Malcolm; McVeigh, Joanne; McClean, Chiedza; Carr, Stuart; Duttine, Antony; Mannan, Hasheem; McAuliffe, Eilish; Mji, Gubela; Eide, Arne H; Hem, Karl-Gerhard; Gupta, Neeru

2017-09-22

It is estimated that over one billion persons worldwide have some form of disability. However, there is lack of knowledge and prioritisation of how to serve the needs and provide opportunities for people with disabilities. The community-based rehabilitation (CBR) guidelines, with sufficient and sustained support, can assist in providing access to rehabilitation services, especially in less resourced settings with low resources for rehabilitation. In line with strengthening the implementation of the health-related CBR guidelines, this study aimed to determine what workforce characteristics at the community level enable quality rehabilitation services, with a focus primarily on less resourced settings. This was a two-phase review study using (1) a relevant literature review informed by realist synthesis methodology and (2) Delphi survey of the opinions of relevant stakeholders regarding the findings of the review. It focused on individuals (health professionals, lay health workers, community rehabilitation workers) providing services for persons with disabilities in less resourced settings. Thirty-three articles were included in this review. Three Delphi iterations with 19 participants were completed. Taken together, these produced 33 recommendations for developing health-related rehabilitation services. Several general principles for configuring the community rehabilitation workforce emerged: community-based initiatives can allow services to reach more vulnerable populations; the need for supportive and structured supervision at the facility level; core skills likely include case management, social protection, monitoring and record keeping, counselling skills and mechanisms for referral; community ownership; training in CBR matrix and advocacy; a tiered/teamwork system of service delivery; and training should take a rights-based approach, include practical components, and involve persons with disabilities in the delivery and planning. This research can contribute to implementing the WHO guidelines on the interaction between the health sector and CBR, particularly in the context of the Framework for Action for Strengthening Health Systems, in which human resources is one of six components. Realist syntheses can provide policy makers with detailed and practical information regarding complex health interventions, which may be valuable when planning and implementing programmes.

Operating Budget Appropriation and Supporting Technical Data for the Illinois Public Community College System, Fiscal Year 2002.

ERIC Educational Resources Information Center

Illinois Community Coll. Board, Springfield.

This document provides detailed tables of the operating budget appropriation for the Illinois public community college system for fiscal year 2002. This document reflects final audited data and revised decision criteria affecting the appropriation for the community college system. Figures detailed in this report include basic instruction resource…

Spatial distribution and deployment of community-based distributors implementing integrated community case management (iCCM): Geographic information system (GIS) mapping study in three South Sudan states.

PubMed

Pratt, Abigail; Dale, Martin; Olivi, Elena; Miller, Jane

2014-12-01

In late 2012 and in conjunction with South Sudan's Ministry of Health - National Malaria Control Program, PSI (Population Services International) conducted a comprehensive mapping exercise to assess geographical coverage of its integrated community case management (iCCM) program and consider scope for expansion. The operational research was designed to provide evidence and support for low-cost mapping and monitoring systems, demonstrating the use of technology to enhance the quality of programming and to allow for the improved allocation of resources through appropriate and need-based deployment of community-based distributors (CBDs). The survey took place over the course of three months and program staff gathered GPS (global positioning system) data, along with demographic data, for over 1200 CBDs and 111 CBD supervisors operating in six counties in South Sudan. Data was collated, cleaned and quality assured, input into an Excel database, and subsequently uploaded to geographic information system (GIS) for spatial analysis and map production. The mapping results showed that over three-quarters of CBDs were deployed within a five kilometer radius of a health facility or another CBD, contrary to program planning and design. Other characteristics of the CBD and CBD supervisor profiles (age, gender, literacy) were more closely matched with other regional programs. The results of this mapping exercise provided a valuable insight into the contradictions found between a program "deployment plan" and the realities observed during field implementation. It also highlighted an important need for program implementers and national-level strategy makers to consider the natural and community-driven diffusion of CBDs, and take into consideration the strength of the local health facilities when developing a deployment plan.

Response to External Peer Review comments regarding the C ...

EPA Pesticide Factsheets

This report documents the external peer review of the C-PORT Tool. C-PORT is intended to provide users with the capability to estimate changes in the concentration of air pollutants in the community resulting from changes in emissions from traffic and port activities. C-PORT is an EPA web-based, easy-to-use modeling system, that allows users to visualize and evaluate different planning scenarios under consideration, helping them identify the best alternatives for making long-term decisions that protect community health and sustainability. In addition, C-PORT is designed to identify local hotspots, focus on specific populations and locations, and inform citizen science and data collection activities. The model is not intended to support or replace any regulatory models or programs. Peer Review report to be posted on Community Modeling and Analysis System (CMAS) along with C-PORT model

Linking vegetable preferences, health and local food systems through community-supported agriculture.

PubMed

Wilkins, Jennifer L; Farrell, Tracy J; Rangarajan, Anusuya

2015-09-01

The objective of the present study was to explore the influence of participation in community-supported agriculture (CSA) on vegetable exposure, vegetable intake during and after the CSA season, and preference related to locally produced vegetables acquired directly from CSA growers. Quantitative surveys were administered at three time points in two harvest seasons to four groups of CSA participants: new full-paying, returning full-paying, new subsidized and returning subsidized members. Questionnaires included a vegetable frequency measure and measures of new and changed vegetable preference. Comparisons were made between new and returning CSA members and between those receiving subsidies and full-paying members. The research was conducted in a rural county in New York, USA. CSA members who agreed to participate in the study. Analysis was based on 151 usable questionnaires. CSA participants reported higher intake of eleven different vegetables during the CSA season, with a sustained increase in some winter vegetables. Over half of the respondents reported trying at least one, and up to eleven, new vegetables. Sustained preferences for CSA items were reported. While those who choose to join a CSA may be more likely to acquire new and expanded vegetable preferences than those who do not, the CSA experience has the potential to enhance vegetable exposure, augment vegetable preference and increase overall vegetable consumption. Dietary patterns encouraged through CSA participation can promote preferences and consumer demand that support local production and seasonal availability. Emphasis on fresh and fresh stored locally produced vegetables is consistent with sustainable community-based food systems.

"Working with COW": Social Work Supporting Older Women Living in the Community.

PubMed

Rawsthorne, Margot; Ellis, Kayleigh; de Pree, Alison

2017-01-01

Australia, like all developed Western countries, is experiencing a demographic shift resulting in an increasing proportion of the population being over the age of 65 years. Contrary to stereotypes, the vast majority of older people live independently in communities. This article explores the potential of social work practice informed by community development principles to enable socially disadvantaged older women to live in vibrant and supportive communities, in which they feel safe and are able to access the support services they need. It argues that participation in social action not only builds older women's well-being but also enables them to become (or continue to be) agents for social change in local communities. Adopting a community-based research methodology, this article draws on a decade of community development practice with the Concerned Older Women's (COW) Group. This data suggests that community development practice based on participation, empowerment, and social action founded on respectful relationships may accrue significant benefits to individuals and the broader community. This social work practice creates the social conditions to facilitate older women's capacity to work collectively to achieve social change, challenging ageist stereotypes.

Teen Pregnancy Prevention: Implementation of a Multicomponent, Community-Wide Approach.

PubMed

Mueller, Trisha; Tevendale, Heather D; Fuller, Taleria R; House, L Duane; Romero, Lisa M; Brittain, Anna; Varanasi, Bala

2017-03-01

This article provides an overview and description of implementation activities of the multicomponent, community-wide initiatives of the Teenage Pregnancy Prevention Program initiated in 2010 by the Office of Adolescent Health and the Centers for Disease Control and Prevention. The community-wide initiatives applied the Interactive Systems Framework for dissemination and implementation through training and technical assistance on the key elements of the initiative: implementation of evidence-based teen pregnancy prevention (TPP) interventions; enhancing quality of and access to youth-friendly reproductive health services; educating stakeholders about TPP; working with youth in communities most at risk of teen pregnancy; and mobilizing the community to garner support. Of nearly 12,000 hours of training and technical assistance provided, the majority was for selecting, implementing, and evaluating an evidence-based TPP program. Real-world implementation of a community-wide approach to TPP takes time and effort. This report describes implementation within each of the components and shares lessons learned during planning and implementation phases of the initiative. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Guided preparedness planning with lay communities: enhancing capacity of rural emergency response through a systems-based partnership.

PubMed

McCabe, O Lee; Perry, Charlene; Azur, Melissa; Taylor, Henry G; Gwon, Howard; Mosley, Adrian; Semon, Natalie; Links, Jonathan M

2013-02-01

Community disaster preparedness plans, particularly those with content that would mitigate the effects of psychological trauma on vulnerable rural populations, are often nonexistent or underdeveloped. The purpose of the study was to develop and evaluate a model of disaster mental health preparedness planning involving a partnership among three, key stakeholders in the public health system. A one-group, post-test, quasi-experimental design was used to assess outcomes as a function of an intervention designated Guided Preparedness Planning (GPP). The setting was the eastern-, northern-, and mid-shore region of the state of Maryland. Partner participants were four local health departments (LHDs), 100 faith-based organizations (FBOs), and one academic health center (AHC)-the latter, collaborating entities of the Johns Hopkins University and the Johns Hopkins Health System. Individual participants were 178 community residents recruited from counties of the above-referenced geographic area. Effectiveness of GPP was based on post-intervention assessments of trainee knowledge, skills, and attitudes supportive of community disaster mental health planning. Inferences about the practicability (feasibility) of the model were drawn from pre-defined criteria for partner readiness, willingness, and ability to participate in the project. Additional aims of the study were to determine if LHD leaders would be willing and able to generate post-project strategies to perpetuate project-initiated government/faith planning alliances (sustainability), and to develop portable methods and materials to enhance model application and impact in other health jurisdictions (scalability). The majority (95%) of the 178 lay citizens receiving the GPP intervention and submitting complete evaluations reported that planning-supportive objectives had been achieved. Moreover, all criteria for inferring model feasibility, sustainability, and scalability were met. Within the span of a six-month period, LHDs, FBOs, and AHCs can work effectively to plan, implement, and evaluate what appears to be an effective, practical, and durable model of capacity building for public mental health emergency planning.

NASA's Earth Observing Data and Information System

NASA Technical Reports Server (NTRS)

Mitchell, Andrew E.; Behnke, Jeanne; Lowe, Dawn; Ramapriyan, H. K.

2009-01-01

NASA's Earth Observing System Data and Information System (EOSDIS) has been a central component of NASA Earth observation program for over 10 years. It is one of the largest civilian science information system in the US, performing ingest, archive and distribution of over 3 terabytes of data per day much of which is from NASA s flagship missions Terra, Aqua and Aura. The system supports a variety of science disciplines including polar processes, land cover change, radiation budget, and most especially global climate change. The EOSDIS data centers, collocated with centers of science discipline expertise, archive and distribute standard data products produced by science investigator-led processing systems. Key to the success of EOSDIS is the concept of core versus community requirements. EOSDIS supports a core set of services to meet specific NASA needs and relies on community-developed services to meet specific user needs. EOSDIS offers a metadata registry, ECHO (Earth Observing System Clearinghouse), through which the scientific community can easily discover and exchange NASA s Earth science data and services. Users can search, manage, and access the contents of ECHO s registries (data and services) through user-developed and community-tailored interfaces or clients. The ECHO framework has become the primary access point for cross-Data Center search-and-order of EOSDIS and other Earth Science data holdings archived at the EOSDIS data centers. ECHO s Warehouse Inventory Search Tool (WIST) is the primary web-based client for discovering and ordering cross-discipline data from the EOSDIS data centers. The architecture of the EOSDIS provides a platform for the publication, discovery, understanding and access to NASA s Earth Observation resources and allows for easy integration of new datasets. The EOSDIS also has developed several methods for incorporating socioeconomic data into its data collection. Over the years, we have developed several methods for determining needs of the user community including use of the American Customer Satisfaction Index and a broad metrics program.

Effectiveness of community-based peer support for mothers to improve their breastfeeding practices: A systematic review and meta-analysis

PubMed Central

Koyama, Momoko; Rai, Sarju Sing; Miyaguchi, Moe; Dhakal, Sumi; Sandy, Su; Sunguya, Bruno Fokas; Jimba, Masamine

2017-01-01

Breastfeeding is associated with reduced mortality in children aged less than 5 years. We conducted a systematic review and meta-analysis (registered as PROSPERO 2015: CRD42015019105) to examine the effectiveness of community-based peer support for mothers on their breastfeeding practices as compared to mothers who have not received such a support. Methods We searched for evidence regarding community-based peer support for mothers in databases, such as PubMed/MEDLINE, the Cochrane Library, CINAHL, Web of Science, SocINDEX, and PsycINFO. We selected three outcome variables for breastfeeding practices, namely, exclusive breastfeeding duration, breastfeeding within the first hour of life, and prelacteal feeding. We conducted meta-analyses of the included randomized controlled trials and quasi-experimental studies. Results For our review, we selected 47 articles for synthesis out of 1,855 retrieved articles. In low- and middle-income countries, compared to usual care, community-based peer support increased exclusive breastfeeding at 3 months (RR: 1.90, 95% CI: 1.62–2.22), at 5 months (RR: 9.55, 95% CI: 6.65–13.70) and at 6 months (RR: 3.53, 95% CI: 2.49–5.00). In high-income countries, compared to usual care, peer support increased exclusive breastfeeding at 3 months (RR: 2.61, 95% CI: 1.15–5.95). In low- and middle-income countries, compared to usual care, peer support increased the initiation of breastfeeding within the first hour of life (RR: 1.51, 95% CI: 1.04–2.21) and decreased the risk of prelacteal feeding (RR: 0.38, 95% CI: 0.33–0.45). Conclusions Community-based peer support for mothers is effective in increasing the duration of exclusive breastfeeding, particularly for infants aged 3–6 months in low- and middle-income countries. Such support also encourages mothers to initiate breastfeeding early and prevents newborn prelacteal feeding. PMID:28510603

Breastfeeding knowledge, attitudes and training amongst Australian community pharmacists.

PubMed

Ryan, Morgan; Smith, Julie

2016-07-01

Pharmacists are one of the most accessible and trusted professionals in the Australian health care system and can have a large impact in supporting and encouraging breastfeeding. This study aimed to research the knowledge, attitudes and training satisfaction of Australian pharmacists in the area of infant nutrition and breastfeeding. The mixed method study involved quantitative data collection via an online survey and qualitative data collected via separate semi-structured interviews. All registered pharmacists in the Australian Capital Territory and surrounding regional areas were eligible. Participants were recruited via emailed information sheets and individual onsite recruitment. Positive attitudes towards and a desire to support and advocate for breastfeeding by pharmacists were hampered by a lack of knowledge, confidence, training and education. Government or other non-profit organisations can enhance community-based support for breastfeeding, including developing new education and training programs for pharmacy students and pharmacists.

Expert System Shells for Rapid Clinical Decision Support Module Development: An ESTA Demonstration of a Simple Rule-Based System for the Diagnosis of Vaginal Discharge

PubMed Central

2012-01-01

Objectives This study demonstrates the feasibility of using expert system shells for rapid clinical decision support module development. Methods A readily available expert system shell was used to build a simple rule-based system for the crude diagnosis of vaginal discharge. Pictures and 'canned text explanations' are extensively used throughout the program to enhance its intuitiveness and educational dimension. All the steps involved in developing the system are documented. Results The system runs under Microsoft Windows and is available as a free download at http://healthcybermap.org/vagdisch.zip (the distribution archive includes both the program's executable and the commented knowledge base source as a text document). The limitations of the demonstration system, such as the lack of provisions for assessing uncertainty or various degrees of severity of a sign or symptom, are discussed in detail. Ways of improving the system, such as porting it to the Web and packaging it as an app for smartphones and tablets, are also presented. Conclusions An easy-to-use expert system shell enables clinicians to rapidly become their own 'knowledge engineers' and develop concise evidence-based decision support modules of simple to moderate complexity, targeting clinical practitioners, medical and nursing students, as well as patients, their lay carers and the general public (where appropriate). In the spirit of the social Web, it is hoped that an online repository can be created to peer review, share and re-use knowledge base modules covering various clinical problems and algorithms, as a service to the clinical community. PMID:23346475

School-based approaches to reducing the duration of untreated psychosis.

PubMed

Schiffman, Jason; Stephan, Sharon Hoover; Hong, L Elliot; Reeves, Gloria

2015-04-01

Students with emerging psychosis often experience delays in diagnosis and treatment that impact mental health and academic outcomes. School systems have tremendous potential to improve early identification and treatment of adolescent psychosis. As a community-based resource, schools can support outreach, education, and screening for adolescents with psychosis and engage identified students and their families for treatment. The concept of duration of untreated psychosis (DUP; the gap between symptom onset and treatment initiation) in adolescent psychosis and the potential role of schools in reducing DUP are reviewed. Future directions for clinical care and research needed to support school-based interventions are proposed. Copyright © 2015 Elsevier Inc. All rights reserved.

Technical Assistance From State Health Departments for Communities Engaged in Policy, Systems, and Environmental Change: The ACHIEVE Program

PubMed Central

Hefelfinger, Jenny; Patty, Alice; Ussery, Ann

2013-01-01

Introduction This study assessed the value of technical assistance provided by state health department expert advisors and by the staff of the National Association of Chronic Disease Directors (NACDD) to community groups that participated in the Action Communities for Health, Innovation, and Environmental Change (ACHIEVE) Program, a CDC-funded health promotion program. Methods We analyzed quantitative and qualitative data reported by community project coordinators to assess the nature and value of technical assistance provided by expert advisors and NACDD staff and the usefulness of ACHIEVE resources in the development and implementation of community action plans. A grounded theory approach was used to analyze and categorize phrases in text data provided by community coordinators. Open coding placed conceptual labels on text phrases. Frequency distributions of the quantitative data are described and discussed. Results The most valuable technical assistance and program support resources were those determined to be in the interpersonal domain (ie, interactions with state expert advisors, NACDD staff, and peer-to-peer support). The most valuable technical assistance events were action institutes, coaches’ meetings, webinars, and technical assistance conference calls. Conclusion This analysis suggests that ACHIEVE communities valued the management and training assistance provided by expert advisors and NACDD staff. State health department expert advisors provided technical guidance and support, including such skills or knowledge-based services as best-practice strategies, review and discussion of community assessment data, sustainability planning, and identification of possible funding opportunities. NACDD staff led development and implementation of technical assistance events. PMID:24157078

An Update on the CDDIS

NASA Technical Reports Server (NTRS)

Noll, Carey; Michael, Patrick; Dube, Maurice P.; Pollack, N.

2012-01-01

The Crustal Dynamics Data Inforn1ation System (CoorS) supports data archiving and distribution activities for the space geodesy and geodynamics community. The main objectives of the system are to store space geodesy and geodynamics related data products in a central data bank, to maintain infom1ation about the archival of these data, and to disseminate these data and information in a timely mam1er to a global scientific research community. The archive consists of GNSS, laser ranging, VLBI, and OORIS data sets and products derived from these data. The coors is one of NASA's Earth Observing System Oata and Infom1ation System (EOSorS) distributed data centers; EOSOIS data centers serve a diverse user community and are tasked to provide facilities to search and access science data and products. The coors data system and its archive have become increasingly important to many national and international science communities, in pal1icular several of the operational services within the International Association of Geodesy (lAG) and its project the Global Geodetic Observing System (GGOS), including the International OORIS Service (IDS), the International GNSS Service (IGS), the International Laser Ranging Service (ILRS), the International VLBI Service for Geodesy and Astrometry (IVS), and the International Earth Rotation Service (IERS). The coors has recently expanded its archive to supp011 the IGS Multi-GNSS Experiment (MGEX). The archive now contains daily and hourly 3D-second and subhourly I-second data from an additional 35+ stations in RINEX V3 fOm1at. The coors will soon install an Ntrip broadcast relay to support the activities of the IGS Real-Time Pilot Project (RTPP) and the future Real-Time IGS Service. The coors has also developed a new web-based application to aid users in data discovery, both within the current community and beyond. To enable this data discovery application, the CDDIS is currently implementing modifications to the metadata extracted from incoming data and product files pushed to its archive. This poster will include background information about the system and its user communities, archive contents and updates, enhancements for data discovery, new system architecture, and future plans.

Using a multi-state Learning Community as an implementation strategy for immediate postpartum long-acting reversible contraception.

PubMed

DeSisto, Carla L; Estrich, Cameron; Kroelinger, Charlan D; Goodman, David A; Pliska, Ellen; Mackie, Christine N; Waddell, Lisa F; Rankin, Kristin M

2017-11-21

Implementation strategies are imperative for the successful adoption and sustainability of complex evidence-based public health practices. Creating a learning collaborative is one strategy that was part of a recently published compilation of implementation strategy terms and definitions. In partnership with the Centers for Disease Control and Prevention and other partner agencies, the Association of State and Territorial Health Officials recently convened a multi-state Learning Community to support cross-state collaboration and provide technical assistance for improving state capacity to increase access to long-acting reversible contraception (LARC) in the immediate postpartum period, an evidence-based practice with the potential for reducing unintended pregnancy and improving maternal and child health outcomes. During 2015-2016, the Learning Community included multi-disciplinary, multi-agency teams of state health officials, payers, clinicians, and health department staff from 13 states. This qualitative study was conducted to better understand the successes, challenges, and strategies that the 13 US states in the Learning Community used for increasing access to immediate postpartum LARC. We conducted telephone interviews with each team in the Learning Community. Interviews were semi-structured and organized by the eight domains of the Learning Community. We coded transcribed interviews for facilitators, barriers, and implementation strategies, using a recent compilation of expert-defined implementation strategies as a foundation for coding the latter. Data analysis showed three ways that the activities of the Learning Community helped in policy implementation work: structure and accountability, validity, and preparing for potential challenges and opportunities. Further, the qualitative data demonstrated that the Learning Community integrated six other implementation strategies from the literature: organize clinician implementation team meetings, conduct educational meetings, facilitation, promote network weaving, provide ongoing consultation, and distribute educational materials. Convening a multi-state learning collaborative is a promising approach for facilitating the implementation of new reimbursement policies for evidence-based practices complicated by systems challenges. By integrating several implementation strategies, the Learning Community serves as a meta-strategy for supporting implementation.

The role of information technology in the development of community pharmacy services: visions and strategic views of international experts.

PubMed

Westerling, Anna M; Haikala, Veikko; Airaksinen, Marja

2011-12-01

Community pharmacy's strategic vision has been to extend practice responsibilities beyond dispensing and provide patient care services. Few studies have evaluated the strategic and long-term development of information technology (IT) systems to support this vision. The objective of this study was to explore international experts' visions and strategic views on IT development needs in relation to service provision in community pharmacies. Semistructured interviews were conducted with a purposive sample of 14 experts from 8 countries in 2007-2008. These experts had expertise in the development of community pharmacy services and IT. The interviews were content analyzed using a constant comparison approach and a SWOT (strengths, weaknesses, opportunities, threats) analysis was undertaken. Most of the experts shared the vision for community pharmacy adopting a patient care orientation; supported by IT-based documentation, new technological solutions, access to information, and shared patient data. Opportunities to achieve this vision included IT solutions, professional skills, and interprofessional collaboration. Threats included costs, pharmacists' attitude, and the absence of IT solutions. Those responsible for IT development in community pharmacy sector should create long-term IT development strategies that are in line with community pharmacy service development strategies. Copyright © 2011 Elsevier Inc. All rights reserved.

They Lift My Spirit Up: Stakeholders' Perspectives on Support Teams for African Americans Facing Serious Illness

ERIC Educational Resources Information Center

Jackson, LeRon C.; Hanson, Laura C.; Hayes, Michelle; Green, Melissa; Peacock, Stacie; Corbie-Smith, Giselle

2014-01-01

Background: Active social and spiritual support for persons with cancer and other serious illnesses has been shown to improve psychological adjustment to illness and quality of life. Objective: To evaluate a community-based support team intervention within the African American community using stakeholder interviews. Methods: Support team members…

HKHC Community Dashboard: design, development, and function of a Web-based performance monitoring system.

PubMed

Bors, Philip A; Kemner, Allison; Fulton, John; Stachecki, Jessica; Brennan, Laura K

2015-01-01

As part of Robert Wood Johnson Foundation's Healthy Kids, Healthy Communities (HKHC) national grant program, a technical assistance team designed the HKHC Community Dashboard, an online progress documentation and networking system. The Dashboard was central to HKHC's multimethod program evaluation and became a communication interface for grantees and technical assistance providers. The Dashboard was designed through an iterative process of identifying needs and priorities; designing the user experience, technical development, and usability testing; and applying visual design. The system was created with an open-source content management system and support for building an online community of users. The site developer trained technical assistance providers at the national program office and evaluators, who subsequently trained all 49 grantees. Evaluators provided support for Dashboard users and populated the site with the bulk of its uploaded tools and resource documents. The system tracked progress through an interactive work plan template, regular documentation by local staff and partners, and data coding and analysis by the evaluation team. Other features included the ability to broadcast information to Dashboard users via e-mail, event calendars, discussion forums, private messaging, a resource clearinghouse, a technical assistance diary, and real-time progress reports. The average number of Dashboard posts was 694 per grantee during the grant period. Technical assistance providers and grantees uploaded a total of 1304 resource documents. The Dashboard functions with the highest grantee satisfaction were its interfaces for sharing and progress documentation. A majority of Dashboard users (69%) indicated a preference for continued access to the Dashboard's uploaded resource documents. The Dashboard was a useful and innovative tool for participatory evaluation of a large national grant program. While progress documentation added some burden to local project staff, the system proved to be a useful resource-sharing technology.

The Potential of Community Libraries in Supporting Literate Environments and Sustaining Literacy Skills

ERIC Educational Resources Information Center

Shrestha, Sanjana; Krolak, Lisa

2015-01-01

This article shows how community libraries can create and support literate environments, which are essential for building and sustaining literacy skills in local communities. The paper begins with a subject analysis reviewing available background materials and literature on the topic. Next, relevant issues are considered based on experiences and…

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…

Coordinated Strategies to Help the Whole Child: Examining the Contributions of Full-Service Community Schools

ERIC Educational Resources Information Center

Biag, Manuelito; Castrechini, Sebastian

2016-01-01

Full-service community schools are designed to increase students, and families' access to comprehensive and coordinated supports, services, and programs such as medical care, food aid, and enrichment activities. Despite widespread support, the research base documenting the efficacy of community schools is still emerging. Analyzing longitudinal…

Use of formative research and social network theory to develop a group walking intervention: Sumter County on the Move!

PubMed

Forthofer, Melinda; Burroughs-Girardi, Ericka; Stoisor-Olsson, Liliana; Wilcox, Sara; Sharpe, Patricia A; Pekuri, Linda M

2016-10-01

Although social support is a frequently cited enabler of physical activity, few studies have examined how to harness social support in interventions. This paper describes community-based formative research to design a walking program for mobilizing naturally occurring social networks to support increases in walking behavior. Focus group methods were used to engage community members in discussions about desired walking program features. The research was conducted with underserved communities in Sumter County, South Carolina. The majority of focus group participants were women (76%) and African American (92%). Several important themes emerged from the focus group results regarding attitudes toward walking, facilitators of and barriers to walking, ideal walking program characteristics, and strategies for encouraging community members to walk. Most noteably, the role of existing social networks as a supportive influence on physical activity was a recurring theme in our formative research and a gap in the existing evidence base. The resulting walking program focused on strategies for mobilizing, supporting and reinforcing existing social networks as mechanisms for increasing walking. Our approach to linking theory, empirical evidence and community-based formative research for the development of a walking intervention offers an example for practitioners developing intervention strategies for a wide range of behaviors. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cardiovascular risk outcome and program evaluation of a cluster randomised controlled trial of a community-based, lay peer led program for people with diabetes.

PubMed

Riddell, M A; Dunbar, J A; Absetz, P; Wolfe, R; Li, H; Brand, M; Aziz, Z; Oldenburg, B

2016-08-24

The 2013 Global Burden of Disease Study demonstrated the increasing burden of diabetes and the challenge it poses to the health systems of all countries. The chronic and complex nature of diabetes requires active self-management by patients in addition to clinical management in order to achieve optimal glycaemic control and appropriate use of available clinical services. This study is an evaluation of a "real world" peer support program aimed at improving the control and management of type 2 diabetes (T2DM) in Australia. The trial used a randomised cluster design with a peer support intervention and routine care control arms and 12-month follow up. Participants in both arms received a standardised session of self-management education at baseline. The intervention program comprised monthly community-based group meetings over 12 months led by trained peer supporters and active encouragement to use primary health care and other community resources and supports related to diabetes. Clinical, behavioural and other measures were collected at baseline, 6 and 12 months. The primary outcome was the predicted 5 year cardiovascular disease risk using the United Kingdom Prospective Diabetes Study (UKPDS) Risk Equation at 12 months. Secondary outcomes included clinical measures, quality of life, measures of support, psychosocial functioning and lifestyle measures. Eleven of 12 planned groups were successfully implemented in the intervention arm. Both the usual care and the intervention arms demonstrated a small reduction in 5 year UKPDS risk and the mean values for biochemical and anthropometric outcomes were close to target at 12 months. There were some small positive changes in self-management behaviours. The positive changes in self-management behaviours among intervention participants were not sufficient to reduce cardiovascular risk, possibly because approximately half of the study participants already had quite well controlled T2DM at baseline. Future research needs to address how to enhance community based programs so that they reach and benefit those most in need of resources and supports to improve metabolic control and associated clinical outcomes. Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12609000469213 . Registered 16 June 2009.

Intelligent Systems Technologies for Ops

NASA Technical Reports Server (NTRS)

Smith, Ernest E.; Korsmeyer, David J.

2012-01-01

As NASA supports International Space Station assembly complete operations through 2020 (or later) and prepares for future human exploration programs, there is additional emphasis in the manned spaceflight program to find more efficient and effective ways of providing the ground-based mission support. Since 2006 this search for improvement has led to a significant cross-fertilization between the NASA advanced software development community and the manned spaceflight operations community. A variety of mission operations systems and tools have been developed over the past decades as NASA has operated the Mars robotic missions, the Space Shuttle, and the International Space Station. NASA Ames Research Center has been developing and applying its advanced intelligent systems research to mission operations tools for both unmanned Mars missions operations since 2001 and to manned operations with NASA Johnson Space Center since 2006. In particular, the fundamental advanced software development work under the Exploration Technology Program, and the experience and capabilities developed for mission operations systems for the Mars surface missions, (Spirit/Opportunity, Phoenix Lander, and MSL) have enhanced the development and application of advanced mission operation systems for the International Space Station and future spacecraft. This paper provides an update on the status of the development and deployment of a variety of intelligent systems technologies adopted for manned mission operations, and some discussion of the planned work for Autonomous Mission Operations in future human exploration. We discuss several specific projects between the Ames Research Center and the Johnson Space Centers Mission Operations Directorate, and how these technologies and projects are enhancing the mission operations support for the International Space Station, and supporting the current Autonomous Mission Operations Project for the mission operation support of the future human exploration programs.

Health Maintenance System (HMS) Hardware Research, Design, and Collaboration

NASA Technical Reports Server (NTRS)

Gonzalez, Stefanie M.

2010-01-01

The Space Life Sciences division (SLSD) concentrates on optimizing a crew member's health. Developments are translated into innovative engineering solutions, research growth, and community awareness. This internship incorporates all those areas by targeting various projects. The main project focuses on integrating clinical and biomedical engineering principles to design, develop, and test new medical kits scheduled for launch in the Spring of 2011. Additionally, items will be tagged with Radio Frequency Interference Devices (RFID) to keep track of the inventory. The tags will then be tested to optimize Radio Frequency feed and feed placement. Research growth will occur with ground based experiments designed to measure calcium encrusted deposits in the International Space Station (ISS). The tests will assess the urine calcium levels with Portable Clinical Blood Analyzer (PCBA) technology. If effective then a model for urine calcium will be developed and expanded to microgravity environments. To support collaboration amongst the subdivisions of SLSD the architecture of the Crew Healthcare Systems (CHeCS) SharePoint site has been redesigned for maximum efficiency. Community collaboration has also been established with the University of Southern California, Dept. of Aeronautical Engineering and the Food and Drug Administration (FDA). Hardware disbursements will transpire within these communities to support planetary surface exploration and to serve as an educational tool demonstrating how ground based medicine influenced the technological development of space hardware.

A state-wide partnership to promote safe and supportive schools: the PBIS Maryland Initiative.

PubMed

Bradshaw, Catherine P; Pas, Elise T; Bloom, Jerry; Barrett, Susan; Hershfeldt, Patricia; Alexander, Andrea; McKenna, Milton; Chafin, Ann E; Leaf, Philip J

2012-07-01

Schools continue to be an important context for preventive interventions targeting a range of behavioral and mental health problems. Yet competing demands on teachers and shifting priorities in response to federal legislation have posed some unique challenges to prevention researchers working in school settings. This paper summarizes an approach to prevention partnerships developed over a decade and centered on the three-tiered Positive Behavioral Interventions and Supports (PBIS) model. A state-wide initiative was formed and led through a partnership between the Maryland State Department of Education, Sheppard Pratt Health System, and Johns Hopkins University, which focused on implementing evidence-based practices and conducting prevention research in Maryland public schools. Drawing on a community-based participatory research framework for developing research partnerships, we highlight the importance of forming and sustaining authentic relationships to support school-based prevention research and implementation of evidence-based programs. We also discuss how these relationships have been used to disseminate PBIS and rigorously test its effectiveness. We describe some lessons learned from the partnership and identify potential areas for future research on the prevention partnership model. We conclude with a discussion of the implications for both researchers and community partners engaged in translational research in school settings.

Wyoming Community College Commission Annual Report, 2010

ERIC Educational Resources Information Center

Wyoming Community College Commission, 2010

2010-01-01

The Wyoming Community College Commission (WCCC) serves the system of Wyoming's seven community colleges. Wyoming's seven community colleges provide affordable, accessible and lifelong education. The Wyoming Community College Commission supports the colleges through advocacy, coordination and collaboration. In partnership with the colleges, the…