Coaching in Community Settings: A Review.

ERIC Educational Resources Information Center

Nettles, Saundra Murray

Coaching is a means of instruction that combines elements of mentoring and tutoring in natural community environments. Coach and student characteristics, processes of coaching, and outcomes of coaching in varied community settings and across different developmental levels are examined. Programs utilizing adults and peers from the community in…

Use of GIS to identify optimal settings for cancer prevention and control in African American communities

PubMed Central

Alcaraz, Kassandra I.; Kreuter, Matthew W.; Bryan, Rebecca P.

2009-01-01

Objective Rarely have Geographic Information Systems (GIS) been used to inform community-based outreach and intervention planning. This study sought to identify community settings most likely to reach individuals from geographically localized areas. Method An observational study conducted in an urban city in Missouri during 2003–2007 placed computerized breast cancer education kiosks in seven types of community settings: beauty salons, churches, health fairs, neighborhood health centers, Laundromats, public libraries and social service agencies. We used GIS to measure distance between kiosk users’ (n=7,297) home ZIP codes and the location where they used the kiosk. Mean distances were compared across settings. Results Mean distance between individuals’ home ZIP codes and the location where they used the kiosk varied significantly (p<0.001) across settings. The distance was shortest among kiosk users in Laundromats (2.3 miles) and public libraries (2.8 miles) and greatest among kiosk users at health fairs (7.6 miles). Conclusion Some community settings are more likely than others to reach highly localized populations. A better understanding of how and where to reach specific populations can complement the progress already being made in identifying populations at increased disease risk. PMID:19422844

Research Foundations and Problems Regarding Counseling in the Community.

ERIC Educational Resources Information Center

Campbell, Robert E.

Research foundations and problems for counseling in the community are discussed. Research implications are outlined around Sarason's three challenges to community health; (1) extending therapeutic outreach, (2) studying those situations, settings, or forces in the community that set the stage for problems; and (3) efforts toward prevention.…

Parent-Child Interaction Therapy in a Community Setting: Examining Outcomes, Attrition, and Treatment Setting

ERIC Educational Resources Information Center

Lanier, Paul; Kohl, Patrica L.; Benz, Joan; Swinger, Dawn; Moussette, Pam; Drake, Brett

2011-01-01

Objectives: The purpose of this study was to evaluate Parent-Child Interaction Therapy (PCIT) deployed in a community setting comparing in-home with the standard office-based intervention. Child behavior, parent stress, parent functioning, and attrition were examined. Methods: Using a quasi-experimental design, standardized measures at three time…

The NCI Community Oncology Research Program: what every clinician needs to know.

PubMed

McCaskill-Stevens, Worta; Lyss, Alan P; Good, Marge; Marsland, Thomas; Lilenbaum, Rogerio

2013-01-01

Research in the community setting is essential for the translation of advances in cancer research into practice and improving cancer care for all populations. The National Cancer Institute is proposing a new community-based program, NCI Community Oncology Research Program (NCORP), which is the alignment of two existing programs, the Community Clinical Oncology Program, Minority-Based Community Clinical Oncology Program, and their Research Bases, and the National Cancer Institute's Community Cancer Centers Program. NCROP will support cancer control, prevention, treatment, and screening clinical trials and expand its research scope to include cancer care delivery research. Cancer disparities research will be integrated into studies across the continuum of NCORP research. Input from current NCI-funded community investigators provides critical insight into the challenges faced by oncology practices within various organizational structures. Furthermore, these investigators identify the resources, both administrative and clinical, that will be required in the community setting to support cancer care delivery research and to meet the requirements for a new generation of clinical research. The American Society for Clinical Oncology (ASCO) has initiated a forum to focus on the conduct of clinical research in the community setting. Resources are being developed to help practices in managing cancer care in community settings.

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

PubMed

Liu, Jingfang; Zhang, Pengzhu; Lu, Yingjie

2014-11-01

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

Health Care Human Factors/Ergonomics Fieldwork in Home and Community Settings

PubMed Central

Valdez, Rupa S.; Holden, Richard J.

2017-01-01

Feature at a glance Designing innovations aligned with patients’ needs and workflow requires human factors and ergonomics (HF/E) fieldwork in home and community settings. Fieldwork in these extra-institutional settings is challenged by a need to balance the occasionally competing priorities of patient and informal caregiver participants, study team members, and the overall project. We offer several strategies that HF/E professionals can use before, during, and after home and community site visits to optimize fieldwork and mitigate challenges in these settings. Strategies include interacting respectfully with participants, documenting the visit, managing the study team-participant relationship, and engaging in dialogue with institutional review boards. PMID:28781512

Financing and systems barriers to seasonal influenza vaccine delivery in community settings.

PubMed

Penfold, Robert B; Rusinak, Donna; Lieu, Tracy A; Shefer, Abigail; Messonnier, Mark; Lee, Grace M

2011-12-06

Recommendations for annual seasonal influenza vaccination have expanded to now include >300 million children and adults each year. Community settings have become increasingly important venues for influenza vaccination. We sought to identify barriers to and solutions for expanding influenza vaccination in community settings. Semi-structured telephone interviews were conducted from 01/09 to 06/10 with a range of stakeholders involved in influenza vaccination, including health plans, medical services firms, retail based clinics, pharmacies, schools, and state and local public health immunization programs. Participants (n=65) were asked about barriers and feasible solutions to influenza vaccine delivery to children and adults in community settings. Key themes were identified through iterative coding using a grounded theory approach. Stakeholders identified specific financial barriers to influenza vaccine delivery in 3 major areas: purchase and distribution, delivery, and reimbursement. Limited purchasing power, the uncertain nature of public demand, and unpredictable timing of influenza vaccine supply were important barriers to enhance delivery in community settings. Barriers to delivery included complexities in running off-site clinics, especially in school settings, the need to manage publicly vs. privately purchased vaccines separately, and state-to-state variability in requirements for credentialing, physician oversight, and reporting. Reimbursement barriers included a protracted credentialing process, the need to determine insurance eligibility at point-of-service, and lack of a billing infrastructure in off-site clinics. Opportunities to mitigate financial barriers to influenza vaccine delivery in community settings focused on coordination across providers and the role of public health as a "trusted broker" to overcome existing challenges. Financial and systems barriers hamper the optimal use of community settings to effectively deliver influenza vaccines. Public health partners at the federal, state, and local levels are well-positioned to facilitate the engagement of all stakeholders in this important and complex vaccine delivery system. Copyright © 2011 Elsevier Ltd. All rights reserved.

Asthma and mental health among youth in high-risk service settings.

PubMed

Goodwin, Renee D; Hottinger, Kate; Pena, Lillian; Chacko, Anil; Feldman, Jonathan; Wamboldt, Marianne Z; Hoven, Christina

2014-08-01

To investigate the prevalence of asthma and mental health problems among representative samples of youth in high-risk service settings and the community, and to examine the relationship between asthma and mental health in these groups. Data were drawn from the Alternative Service Use Patterns of Youth with Serious Emotional Disturbance Study (SED) (n = 1181), a combined representative, cross-sectional sample of youth in various clinical settings and the community. Multiple logistic regression analyses were used to examine the association between asthma and mental disorders. Demographic characteristics were investigated as potential confounders. Asthma was common among 15.2% of youth in service settings and 18.8% of youth in the community. The prevalence of mental disorders was extremely high among youth with and without asthma in all service settings, and asthma was associated with increased prevalence of mental disorders among youth in the community, but not among youth in service settings. The relationship between asthma and internalizing disorders among youth in the community does not appear entirely attributable to confounding by demographics. Findings are consistent with and extend previous data by showing that both asthma and mental disorders are disproportionately common among youth in high-risk service settings. Almost half of youth with asthma in service settings meet diagnostic criteria for a mental disorder. Clinicians and policy makers who are responsible for the health care of youth in these high-risk groups should be aware that asthma is common, and that the prevalence of internalizing disorders are especially common among those with asthma.

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

PubMed

Merritt, Alan; Boogaerts, Marina

2014-01-01

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

Mixed method evaluation of a community-based physical activity program using the RE-AIM framework: practical application in a real-world setting.

PubMed

Koorts, Harriet; Gillison, Fiona

2015-11-06

Communities are a pivotal setting in which to promote increases in child and adolescent physical activity behaviours. Interventions implemented in these settings require effective evaluation to facilitate translation of findings to wider settings. The aims of this paper are to i) present findings from a RE-AIM evaluation of a community-based physical activity program, and ii) review the methodological challenges faced when applying RE-AIM in practice. A single mixed-methods case study was conducted based on a concurrent triangulation design. Five sources of data were collected via interviews, questionnaires, archival records, documentation and field notes. Evidence was triangulated within RE-AIM to assess individual and organisational-level program outcomes. Inconsistent availability of data and a lack of robust reporting challenged assessment of all five dimensions. Reach, Implementation and setting-level Adoption were less successful, Effectiveness and Maintenance at an individual and organisational level were moderately successful. Only community-level Adoption was highly successful, reflecting the key program goal to provide community-wide participation in sport and physical activity. This research highlighted important methodological constraints associated with the use of RE-AIM in practice settings. Future evaluators wishing to use RE-AIM may benefit from a mixed-method triangulation approach to offset challenges with data availability and reliability.

Play Therapy for Bereaved Children: Adapting Strategies to Community, School, and Home Settings

ERIC Educational Resources Information Center

Webb, Nancy Boyd

2011-01-01

Play therapy is a highly adaptable treatment method that can be modified according to children's ages, circumstances, and settings in which counseling occurs. Play therapy may be used in schools, community settings, and homes to help children following the death of a significant other. After reviewing basic developmental factors that affect…

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

PubMed

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

1995-11-01

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

Pragmatic Applications of RE-AIM for Health Care Initiatives in Community and Clinical Settings

PubMed Central

Estabrooks, Paul E.

2018-01-01

The RE-AIM (Reach Effectiveness Adoption Implementation Maintenance) planning and evaluation framework has been applied broadly, but users often have difficulty in applying the model because of data collection needs across multiple domains and sources. Questions in the more common “who, what, where, how, when, and why” format may be an effective guide to ensure that individual participants, organization staff, and the perspectives of the setting are considered in planning and evaluation. Such a format can also help users in typical community and clinical settings to identify which outcomes are most valued and to focus limited measurement resources. Translations of RE-AIM that are easy to understand and apply are needed for application in real-world community and clinical settings where research and evaluation resources are limited. The purpose of this article is to provide simplified, pragmatic, user-centered and stakeholder-centered recommendations to increase the use of RE-AIM in community and clinical settings and in translational research. PMID:29300695

Cost differential by site of service for cancer patients receiving chemotherapy.

PubMed

Hayes, Jad; Hoverman, Russell J; Brow, Matthew E; Dilbeck, Dana C; Verrilli, Diana K; Garey, Jody; Espirito, Janet L; Cardona, Jorge; Beveridge, Roy

2015-03-01

To compare the costs of: 1) chemotherapy treatment across clinical, demographic, and geographic variables; and 2) various cancer care-related cost categories between patients receiving chemotherapy in a community oncology versus a hospital outpatient setting. Data from the calendar years 2008 to 2010 from the Truven Health Analytics MarketScan Commercial Claims and Encounters Database were analyzed. During 2010, the data set contained approximately 45 million unique commercially insured patients with 70,984 cancer patients receiving chemotherapy. These patients were assigned to cohorts depending on whether they received chemotherapy at a community oncology or hospital outpatient setting. Cost data for 9 common cancer types were extracted from the database and analyzed on a per member per month basis to normalize costs; costs included amounts paid by the payer and patient payment. Community oncology and hospital outpatient setting chemotherapy treatment costs were categorized and examined according to cancer diagnosis, patient demographics, and geographic location. Patients receiving chemotherapy treatment in the community oncology clinic had a 20% to 39% lower mean per member per month cost of care, depending on diagnosis, compared with those receiving chemotherapy in the hospital outpatient setting. This cost differential was consistent across cancer type, geographic location, patient age, and number of chemotherapy sessions. Various cost categories examined were also higher for those treated in the hospital outpatient setting. The cost of care for patients receiving chemotherapy was consistently lower in the community oncology clinic compared with the hospital outpatient setting, controlling for the clinical, demographic, and geographic variables analyzed.

Quality indicators for pharmaceutical care: a comprehensive set with national scores for Dutch community pharmacies.

PubMed

Teichert, Martina; Schoenmakers, Tim; Kylstra, Nico; Mosk, Berend; Bouvy, Marcel L; van de Vaart, Frans; De Smet, Peter A G M; Wensing, Michel

2016-08-01

Background The quality of pharmaceutical care in community pharmacies in the Netherlands has been assessed annually since 2008. The initial set has been further developed with pharmacists and patient organizations, the healthcare inspectorate, the government and health insurance companies. The set over 2012 was the first set of quality indicators for community pharmacies which was validated and supported by all major stakeholders. The aims of this study were to describe the validated set of quality indicators for community pharmacies and to report their scores over 2012. In subanalyses the score development over 5 years was described for those indicators, that have been surveyed before and remained unchanged. Methods Community pharmacists in the Netherlands were invited in 2013 to provide information for the set of 2012. Quality indicators were mapped by categories relevant for pharmaceutical care and defined for structures, processes and dispensing outcomes. Scores for categorically-measured quality indicators were presented as the percentage of pharmacies reporting the presence of a quality aspect. For numerical quality indicators, the mean of all reported scores was expressed. In subanalyses for those indicators that had been questioned previously, scores were collected from earlier measurements for pharmacies providing their scores in 2012. Multilevel analysis was used to assess the consistency of scores within one pharmacy over time by the intra-class correlation coefficient (ICC). Results For the set in 2012, 1739 Dutch community pharmacies (88 % of the total) provided information for 66 quality indicators in 10 categories. Indicator scores on the presence of quality structures showed relatively high quality levels. Scores for processes and dispensing outcomes were lower. Subanalyses showed that overall indicators scores improved within pharmacies, but this development differed between pharmacies. Conclusions A set of validated quality indicators provided insight into the quality of pharmaceutical care in the Netherlands. The quality of pharmaceutical care improved over time. As of 2012 quality structures were present in at least 80 % of the community pharmacies. Variation in scores on care processes and outcomes between individual pharmacies and over time can initiate future research to better understand and facilitate quality improvement in community pharmacies.

About the Community Oncology and Prevention Trials Research Group | Division of Cancer Prevention

Cancer.gov

The Community Oncology and Prevention Trials Research Group supports clinical oncology trials in cancer prevention and control in community settings. The group also supports investigator-initiated research projects in supportive, palliative and end-of-life care, and coordinates clinical oncology research projects with other NCI programs to be done in the community setting. |

Irish set dancing classes for people with Parkinson's disease: The needs of participants and dance teachers.

PubMed

Shanahan, Joanne; Bhriain, Orfhlaith Ní; Morris, Meg E; Volpe, Daniele; Clifford, Amanda M

2016-08-01

As the number of people diagnosed with Parkinson's disease increases, there is a need to develop initiatives that promote health and wellbeing and support self-management. Additionally, as exercise may slow physical decline, there is a need to develop methods that facilitate greater engagement with community-based exercise. The aim of this study is to examine the needs of (1) people with Parkinson's disease and (2) set dancing teachers to enable the development of participant-centred community set dance classes. A mixed methods study design was used. Two consensus group discussions using nominal group technique were held to (1) identify factors pertaining to the needs of people with Parkinson's disease from a set dance class and (2) the educational needs of set dancing teachers to enable them to teach set dancing to people with Parkinson's disease. Group discussions began with silent generation of ideas. A round-robin discussion and grouping of ideas into broader topic areas followed. Finally, participants ranked, by order of priority (1-5), the topic areas developed. Final data analysis involved summation of participants' ranking scores for each topic area. Rich information on the needs of people with Parkinson's disease from a dance class and the educational guidance sought by set dancing teachers was gathered. Topic areas developed include "teaching method" for set dances and "class environment". Accessing community exercise programmes is important for this population. The results of this study will inform the development of an educational resource on Parkinson's disease for set dancing teachers. This resource may facilitate a larger number of teachers to establish sustainable community set dancing classes for people with Parkinson's disease. Copyright © 2016 Elsevier Ltd. All rights reserved.

An algorithm for designing minimal microbial communities with desired metabolic capacities

PubMed Central

Eng, Alexander; Borenstein, Elhanan

2016-01-01

Motivation: Recent efforts to manipulate various microbial communities, such as fecal microbiota transplant and bioreactor systems’ optimization, suggest a promising route for microbial community engineering with numerous medical, environmental and industrial applications. However, such applications are currently restricted in scale and often rely on mimicking or enhancing natural communities, calling for the development of tools for designing synthetic communities with specific, tailored, desired metabolic capacities. Results: Here, we present a first step toward this goal, introducing a novel algorithm for identifying minimal sets of microbial species that collectively provide the enzymatic capacity required to synthesize a set of desired target product metabolites from a predefined set of available substrates. Our method integrates a graph theoretic representation of network flow with the set cover problem in an integer linear programming (ILP) framework to simultaneously identify possible metabolic paths from substrates to products while minimizing the number of species required to catalyze these metabolic reactions. We apply our algorithm to successfully identify minimal communities both in a set of simple toy problems and in more complex, realistic settings, and to investigate metabolic capacities in the gut microbiome. Our framework adds to the growing toolset for supporting informed microbial community engineering and for ultimately realizing the full potential of such engineering efforts. Availability and implementation: The algorithm source code, compilation, usage instructions and examples are available under a non-commercial research use only license at https://github.com/borenstein-lab/CoMiDA. Contact: elbo@uw.edu Supplementary information: Supplementary data are available at Bioinformatics online. PMID:27153571

A Question of Community: Quality of Life and Integration in "Small Residential Units" and Other Residential Settings.

ERIC Educational Resources Information Center

Lutfiyya, Zana Marie; And Others

This report examines the quality of life for individuals with mental retardation who live in a range of residential service settings in New York, and explores issues related to the provision of housing and appropriate supports. Five settings were studied: (1) an intentional Christian community where three individuals with mental retardation live…

RE-AIM in Clinical, Community, and Corporate Settings: Perspectives, Strategies, and Recommendations to Enhance Public Health Impact

PubMed Central

Harden, Samantha M.; Smith, Matthew Lee; Ory, Marcia G.; Smith-Ray, Renae L.; Estabrooks, Paul A.; Glasgow, Russell E.

2018-01-01

The RE-AIM Framework is a planning and evaluation model that has been used in a variety of settings to address various programmatic, environmental, and policy innovations for improving population health. In addition to the broad application and diverse use of the framework, there are lessons learned and recommendations for the future use of the framework across clinical, community, and corporate settings. The purposes of this article are to: (A) provide a brief overview of the RE-AIM Framework and its pragmatic use for planning and evaluation; (B) offer recommendations to facilitate the application of RE-AIM in clinical, community, and corporate settings; and (C) share perspectives and lessons learned about employing RE-AIM dimensions in the planning, implementation, and evaluation phases within these different settings. In this article, we demonstrate how the RE-AIM concepts and elements within each dimension can be applied by researchers and practitioners in diverse settings, among diverse populations and for diverse health topics. PMID:29623270

Reexamining free flap breast reconstruction in the community and university setting: is there a difference?

PubMed

Nelson, Jonas A; Stransky, Carrie A; Fischer, John P; Fosnot, Joshua; Serletti, Joseph M; Wu, Liza C

2014-12-01

This study aimed to compare free flap breast reconstruction outcomes in community and university settings to determine whether the latter is necessary for successful performance of this complex procedure. Free tissue transfer procedures for breast reconstruction from 1 university and 1 community hospital performed between 2005 and 2011 were included. Procedures were performed by the same 2 surgeons at both institutions. Demographics and outcome measures were evaluated. Of the 1293 free tissue breast reconstructions performed, 99 (7.7%) were performed in a community hospital and 1194 (92.3%) were performed in a university center. No differences were noted in demographics, comorbidities, or type of free flap reconstruction. However, a number of perioperative characteristics differed. In the community setting, operative time was less (7.3 vs 8.3 hours, P < 0.0001), estimated blood loss was higher (330 vs 248 mL, P < 0.0001), and blood transfusions were more prevalent (24.6% vs 8.3%, P < 0.0001). Furthermore, no significant differences were noted in overall postoperative complications, although a higher rate of abdominal wound infections was noted in the community setting (7.2% vs 2.6%, P = 0.03). The mean number of hospital days was similar between the community and the university (should include value P = 0.44). Although slight differences were noted in a number of perioperative variables and wound complications, we conclude that the key to a successful free tissue transfer reconstruction is in the expertise of the surgeon and not the setting in which it is performed. Despite its complexity, free flap breast reconstruction can be safely and successfully performed in the community setting.

Effects of Short-Term Set-Aside Management Practices on Soil Microorganism and Enzyme Activity in China.

PubMed

Li, Guangyu; Wu, Cifang

2017-08-14

Set-aside farmland can effectively improve the self-rehabilitation of arable soil. Long-term set-asides however cannot satisfy provisionment, therefore the use of short-term set-asides to restore cultivated soil is a better option. Few studies have compared short-term set-aside patterns, and the effects of set-asides on soil microbial community and enzyme enzymes. We analyzed the bacterial structure, microbial biomass carbon/nitrogen and enzyme activity of farmland soil under different set-aside regimes in the Yellow River Delta of China. Bacterial alpha diversity was relatively lower under only irrigation, and farmyard manure applications showed clear advantages. Set-asides should consider their influence on soil organic carbon and nitrogen, which were correlated with microbial community structure. Nitrospira (0.47-1.67%), Acidobacteria Gp6 (8.26-15.91%) and unclassified Burkholderiales (1.50-2.81%) were significantly altered ( p < 0.01). Based on functions of these genera, some set-aside patterns led to a relative balance in nitrogen and carbon turnover. Partial treatments showed a deficiency in organic matter. In addition, farmyard manure may lead to the increased consumption of organic matter, with the exception of native plants set-asides. Conventional farming (control group) displayed a significant enzyme activity advantage. Set-aside management practices guided soil microbial communities to different states. Integrated soil microbiota and the content of carbon and nitrogen, native plants with farmyard manure showed an equilibrium state relatively, which would be helpful to improve land quality in the short-term.

Development of a measure of sense of community for individuals with serious mental illness residing in community settings.

PubMed

Townley, Greg; Kloos, Bret

2009-03-03

The psychological sense of community is one of the most commonly investigated constructs in community psychology. Sense of community may be particularly important for individuals with serious mental illness (SMI) because they often face societal barriers to participation in community living, including stigma and discrimination. To date, no published studies have investigated the psychometric qualities of sense of community measures among individuals with SMI. The current study tested a series of confirmatory factor analyses using the Brief Sense of Community Index (BSCI, Long & Perkins, 2003) in a sample of 416 persons with SMI living in community settings to suggest a model of sense of community for individuals with SMI and other disabilities. The resulting scale, the Brief Sense of Community Index- Disability (BSCI-D), demonstrated good model fit and construct validity. Implications are discussed for how this scale may be used in research investigating community integration and adaptive functioning in community settings.

Development of a measure of sense of community for individuals with serious mental illness residing in community settings

PubMed Central

Townley, Greg; Kloos, Bret

2008-01-01

The psychological sense of community is one of the most commonly investigated constructs in community psychology. Sense of community may be particularly important for individuals with serious mental illness (SMI) because they often face societal barriers to participation in community living, including stigma and discrimination. To date, no published studies have investigated the psychometric qualities of sense of community measures among individuals with SMI. The current study tested a series of confirmatory factor analyses using the Brief Sense of Community Index (BSCI, Long & Perkins, 2003) in a sample of 416 persons with SMI living in community settings to suggest a model of sense of community for individuals with SMI and other disabilities. The resulting scale, the Brief Sense of Community Index- Disability (BSCI-D), demonstrated good model fit and construct validity. Implications are discussed for how this scale may be used in research investigating community integration and adaptive functioning in community settings. PMID:19305637

The Geriatric ICF Core Set reflecting health-related problems in community-living older adults aged 75 years and older without dementia: development and validation.

PubMed

Spoorenberg, Sophie L W; Reijneveld, Sijmen A; Middel, Berrie; Uittenbroek, Ronald J; Kremer, Hubertus P H; Wynia, Klaske

2015-01-01

The aim of the present study was to develop a valid Geriatric ICF Core Set reflecting relevant health-related problems of community-living older adults without dementia. A Delphi study was performed in order to reach consensus (≥70% agreement) on second-level categories from the International Classification of Functioning, Disability and Health (ICF). The Delphi panel comprised 41 older adults, medical and non-medical experts. Content validity of the set was tested in a cross-sectional study including 267 older adults identified as frail or having complex care needs. Consensus was reached for 30 ICF categories in the Delphi study (fourteen Body functions, ten Activities and Participation and six Environmental Factors categories). Content validity of the set was high: the prevalence of all the problems was >10%, except for d530 Toileting. The most frequently reported problems were b710 Mobility of joint functions (70%), b152 Emotional functions (65%) and b455 Exercise tolerance functions (62%). No categories had missing values. The final Geriatric ICF Core Set is a comprehensive and valid set of 29 ICF categories, reflecting the most relevant health-related problems among community-living older adults without dementia. This Core Set may contribute to optimal care provision and support of the older population. Implications for Rehabilitation The Geriatric ICF Core Set may provide a practical tool for gaining an understanding of the relevant health-related problems of community-living older adults without dementia. The Geriatric ICF Core Set may be used in primary care practice as an assessment tool in order to tailor care and support to the needs of older adults. The Geriatric ICF Core Set may be suitable for use in multidisciplinary teams in integrated care settings, since it is based on a broad range of problems in functioning. Professionals should pay special attention to health problems related to mobility and emotional functioning since these are the most prevalent problems in community-living older adults.

Community-Acquired Methicillin-Resistant "Staphylococcus aureus": Considerations for School Nurses

ERIC Educational Resources Information Center

Alex, Aniltta; Letizia, MariJo

2007-01-01

Methicillin-resistant "Staphylococcus aureus" (MRSA) is a disease-causing organism that has been present in hospital settings since the 1960s. However, a genetically distinct strain of MRSA, called community-acquired methicillin-resistant "Staphylococcus aureus" (CA-MRSA), has emerged in recent years in community settings among healthy…

A Comparison of the Wellbeing of Orphans and Abandoned Children Ages 6–12 in Institutional and Community-Based Care Settings in 5 Less Wealthy Nations

PubMed Central

Whetten, Kathryn; Ostermann, Jan; Whetten, Rachel A.; Pence, Brian W.; O'Donnell, Karen; Messer, Lynne C.; Thielman, Nathan M.

2009-01-01

Background Leaders are struggling to care for the estimated 143,000,000 orphans and millions more abandoned children worldwide. Global policy makers are advocating that institution-living orphans and abandoned children (OAC) be moved as quickly as possible to a residential family setting and that institutional care be used as a last resort. This analysis tests the hypothesis that institutional care for OAC aged 6–12 is associated with worse health and wellbeing than community residential care using conservative two-tail tests. Methodology The Positive Outcomes for Orphans (POFO) study employed two-stage random sampling survey methodology in 6 sites across 5 countries to identify 1,357 institution-living and 1,480 community-living OAC ages 6–12, 658 of whom were double-orphans or abandoned by both biological parents. Survey analytic techniques were used to compare cognitive functioning, emotion, behavior, physical health, and growth. Linear mixed-effects models were used to estimate the proportion of variability in child outcomes attributable to the study site, care setting, and child levels and institutional versus community care settings. Conservative analyses limited the community living children to double-orphans or abandoned children. Principal Findings Health, emotional and cognitive functioning, and physical growth were no worse for institution-living than community-living OAC, and generally better than for community-living OAC cared for by persons other than a biological parent. Differences between study sites explained 2–23% of the total variability in child outcomes, while differences between care settings within sites explained 8–21%. Differences among children within care settings explained 64–87%. After adjusting for sites, age, and gender, institution vs. community-living explained only 0.3–7% of the variability in child outcomes. Conclusion This study does not support the hypothesis that institutional care is systematically associated with poorer wellbeing than community care for OAC aged 6–12 in those countries facing the greatest OAC burden. Much greater variability among children within care settings was observed than among care settings type. Methodologically rigorous studies must be conducted in those countries facing the new OAC epidemic in order to understand which characteristics of care promote child wellbeing. Such characteristics may transcend the structural definitions of institutions or family homes. PMID:20020037

Social settings and addiction relapse.

PubMed

Walton, M A; Reischl, T M; Ramanthan, C S

1995-01-01

Despite addiction theorists' acknowledgment of the impact of environmental factors on relapse, researchers have not adequately investigated these influences. Ninety-six substance users provided data regarding their perceived risk for relapse, exposure to substances, and involvement in reinforcing activities. These three setting attributes were assessed in their home, work, and community settings. Reuse was assessed 3 months later. When controlling for confounding variables, aspects of the home settings significantly distinguished abstainers from reusers; perceived risk for relapse was the strongest predictor of reuse. Exposure to substances and involvement in reinforcing activities were not robust reuse indicators. The work and community settings were not significant determinants of reuse. These findings offer some initial support for the utility of examining social settings to better understand addiction relapse and recovery. Identification of setting-based relapse determinants provides concrete targets for relapse prevention interventions.

Trust, Responsiveness and Communities of Care: An Ethnographic Study of the Significance and Development of Parent-Caregiver Relationships in Irish Early Years Settings

ERIC Educational Resources Information Center

Garrity, Sheila; Canavan, John

2017-01-01

Conceptualising early years settings as "communities of care" reflects the narrative arising from recent ethnographic research conducted in the West and Midlands areas of Ireland. Drawing on the ethic of care as an underpinning theoretical framework, this article outlines the potential of early years settings to represent reliable,…

Integrating cultural community psychology: activity settings and the shared meanings of intersubjectivity.

PubMed

O'Donnell, Clifford R; Tharp, Roland G

2012-03-01

Cultural and community psychology share a common emphasis on context, yet their leading journals rarely cite each other's articles. Greater integration of the concepts of culture and community within and across their disciplines would enrich and facilitate the viability of cultural community psychology. The contextual theory of activity settings is proposed as one means to integrate the concepts of culture and community in cultural community psychology. Through shared activities, participants develop common experiences that affect their psychological being, including their cognitions, emotions, and behavioral development. The psychological result of these experiences is intersubjectivity. Culture is defined as the shared meanings that people develop through their common historic, linguistic, social, economic, and political experiences. The shared meanings of culture arise through the intersubjectivity developed in activity settings. Cultural community psychology presents formidable epistemological challenges, but overcoming these challenges could contribute to the transformation and advancement of community psychology.

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.

Community-partnered evaluation of depression services for clients of community-based agencies in under-resourced communities in Los Angeles.

PubMed

Miranda, Jeanne; Ong, Michael K; Jones, Loretta; Chung, Bowen; Dixon, Elizabeth L; Tang, Lingqi; Gilmore, Jim; Sherbourne, Cathy; Ngo, Victoria K; Stockdale, Susan; Ramos, Esmeralda; Belin, Thomas R; Wells, Kenneth B

2013-10-01

As medical homes are developing under health reform, little is known regarding depression services need and use by diverse safety-net populations in under-resourced communities. For chronic conditions like depression, primary care services may face new opportunities to partner with diverse community service providers, such as those in social service and substance abuse centers, to support a collaborative care model of treating depression. To understand the distribution of need and current burden of services for depression in under-resourced, diverse communities in Los Angeles. Baseline phase of a participatory trial to improve depression services with data from client screening and follow-up surveys. Of 4,440 clients screened from 93 programs (primary care, mental health, substance abuse, homeless, social and other community services) in 50 agencies, 1,322 were depressed according to an eight-item Patient Health Questionnaire (PHQ-8) and gave contact information; 1,246 enrolled and 981 completed surveys. Ninety-three programs, including 17 primary care/public health, 18 mental health, 20 substance abuse, ten homeless services, and 28 social/other community services, participated. Comparisons by setting in 6-month retrospective recall of depression services use. Depression prevalence ranged from 51.9 % in mental health to 17.2 % in social-community programs. Depressed clients used two settings on average to receive depression services; 82 % used any setting. More clients preferred counseling over medication for depression treatment. Need for depression care was high, and a broad range of agencies provide depression care. Although most participants had contact with primary care, most depression services occurred outside of primary care settings, emphasizing the need to coordinate and support the quality of community-based services across diverse community settings.

A Mixed-Methods Study Examining the Role of the Instructional Coach within a Professional Learning Community

ERIC Educational Resources Information Center

Jorgensen, Christie L.

2016-01-01

Although instructional coaching and professional learning communities provide ongoing, job-embedded support and professional learning, little is known about what role the instructional coach serves within the setting of the professional learning community or what coaching skills teachers find most helpful within this setting. Research examining…

Community Rehabilitation: "Home versus Centre" Guidelines for Choosing the Optimal Treatment Location

ERIC Educational Resources Information Center

Barker, Lauren N.; Ziino, Carlo

2010-01-01

This study aimed to produce indicators and guidelines for clinician use in determining whether individual therapy sessions for community rehabilitation services should be delivered in a home/community-based setting or centre-based setting within a flexible service delivery model. Concept mapping techniques as described by Tochrim and Kane (2005)…

Building up STEM education professional learning community in school setting: Case of Khon Kaen Wittayayon School

NASA Astrophysics Data System (ADS)

Thana, Aduldej; Siripun, Kulpatsorn; Yuenyong, Chokchai

2018-01-01

The STEM education is new issue of teaching and learning in school setting. Building up STEM education professional learning community may provide some suggestions for further collaborative work of STEM Education from grounded up. This paper aimed to clarify the building up STEM education learning community in Khon Kaen Wittayayon (KKW) School setting. Participants included Khon Kaen University researchers, Khon Kaen Wittayayon School administrators and teachers. Methodology regarded interpretative paradigm. The tools of interpretation included participant observation, interview and document analysis. Data was analyzed to categories of condition for building up STEM education professional learning community. The findings revealed that the actions of developing STEM learning activities and research showed some issues of KKW STEM community of inquiry and improvement. The paper will discuss what and how the community learns about sharing vision of STEM Education, supportive physical and social conditions of KKW, sharing activities of STEM, and good things from some key STEM teachers' ambition. The paper may has implication of supporting STEM education in Thailand school setting.

How Settings Change People: Applying Behavior Setting Theory to Consumer-Run Organizations

ERIC Educational Resources Information Center

Brown, Louis D.; Shepherd, Matthew D.; Wituk, Scott A.; Meissen, Greg

2007-01-01

Self-help initiatives stand as a classic context for organizational studies in community psychology. Behavior setting theory stands as a classic conception of organizations and the environment. This study explores both, applying behavior setting theory to consumer-run organizations (CROs). Analysis of multiple data sets from all CROs in Kansas…

Effectiveness of Ebola treatment units and community care centers - Liberia, September 23-October 31, 2014.

PubMed

Washington, Michael L; Meltzer, Martin L

2015-01-30

Previous reports have shown that an Ebola outbreak can be slowed, and eventually stopped, by placing Ebola patients into settings where there is reduced risk for onward Ebola transmission, such as Ebola treatment units (ETUs) and community care centers (CCCs) or equivalent community settings that encourage changes in human behaviors to reduce transmission risk, such as making burials safe and reducing contact with Ebola patients. Using cumulative case count data from Liberia up to August 28, 2014, the EbolaResponse model previously estimated that without any additional interventions or further changes in human behavior, there would have been approximately 23,000 reported Ebola cases by October 31, 2014. In actuality, there were 6,525 reported cases by that date. To estimate the effectiveness of ETUs and CCCs or equivalent community settings in preventing greater Ebola transmission, CDC applied the EbolaResponse model to the period September 23-October 31, 2014, in Liberia. The results showed that admitting Ebola patients to ETUs alone prevented an estimated 2,244 Ebola cases. Having patients receive care in CCCs or equivalent community settings with a reduced risk for Ebola transmission prevented an estimated 4,487 cases. Having patients receive care in either ETUs or CCCs or in equivalent community settings, prevented an estimated 9,100 cases, apparently as the result of a synergistic effect in which the impact of the combined interventions was greater than the sum of the two interventions. Caring for patients in ETUs, CCCs, or in equivalent community settings with reduced risk for transmission can be important components of a successful public health response to an Ebola epidemic.

Comparison of Clostridium difficile Ribotypes Circulating in Australian Hospitals and Communities.

PubMed

Furuya-Kanamori, Luis; Riley, Thomas V; Paterson, David L; Foster, Niki F; Huber, Charlotte A; Hong, Stacey; Harris-Brown, Tiffany; Robson, Jenny; Clements, Archie C A

2017-01-01

Clostridium difficile infection (CDI) is becoming less exclusively a health care-associated CDI (HA-CDI). The incidence of community-associated CDI (CA-CDI) has increased over the past few decades. It has been postulated that asymptomatic toxigenic C. difficile (TCD)-colonized patients may play a role in the transfer of C. difficile between the hospital setting and the community. Thus, to investigate the relatedness of C. difficile across the hospital and community settings, we compared the characteristics of symptomatic and asymptomatic host patients and the pathogens from these patients in these two settings over a 3-year period. Two studies were simultaneously conducted; the first study enrolled symptomatic CDI patients from two tertiary care hospitals and the community in two Australian states, while the second study enrolled asymptomatic TCD-colonized patients from the same tertiary care hospitals. A total of 324 patients (96 with HA-CDI, 152 with CA-CDI, and 76 colonized with TCD) were enrolled. The predominant C. difficile ribotypes isolated in the hospital setting corresponded with those isolated in the community, as it was found that for 79% of the C. difficile isolates from hospitals, an isolate with a matching ribotype was isolated in the community, suggesting that transmission between these two settings is occurring. The toxigenic C. difficile strains causing symptomatic infection were similar to those causing asymptomatic infection, and patients exposed to antimicrobials prior to admission were more likely to develop a symptomatic infection (odds ratio, 2.94; 95% confidence interval, 1.20 to 7.14). Our findings suggest that the development of CDI symptoms in a setting without establishment of hospital epidemics with binary toxin-producing C. difficile strains may be driven mainly by host susceptibility and exposure to antimicrobials, rather than by C. difficile strain characteristics. Copyright © 2016 American Society for Microbiology.

Effects of Short-Term Set-Aside Management Practices on Soil Microorganism and Enzyme Activity in China

PubMed Central

Wu, Cifang

2017-01-01

Set-aside farmland can effectively improve the self-rehabilitation of arable soil. Long-term set-asides however cannot satisfy provisionment, therefore the use of short-term set-asides to restore cultivated soil is a better option. Few studies have compared short-term set-aside patterns, and the effects of set-asides on soil microbial community and enzyme enzymes. We analyzed the bacterial structure, microbial biomass carbon/nitrogen and enzyme activity of farmland soil under different set-aside regimes in the Yellow River Delta of China. Bacterial alpha diversity was relatively lower under only irrigation, and farmyard manure applications showed clear advantages. Set-asides should consider their influence on soil organic carbon and nitrogen, which were correlated with microbial community structure. Nitrospira (0.47–1.67%), Acidobacteria Gp6 (8.26–15.91%) and unclassified Burkholderiales (1.50–2.81%) were significantly altered (p < 0.01). Based on functions of these genera, some set-aside patterns led to a relative balance in nitrogen and carbon turnover. Partial treatments showed a deficiency in organic matter. In addition, farmyard manure may lead to the increased consumption of organic matter, with the exception of native plants set-asides. Conventional farming (control group) displayed a significant enzyme activity advantage. Set-aside management practices guided soil microbial communities to different states. Integrated soil microbiota and the content of carbon and nitrogen, native plants with farmyard manure showed an equilibrium state relatively, which would be helpful to improve land quality in the short-term. PMID:28805737

Mapping the rehabilitation interventions of a community stroke team to the extended International Classification of Functioning, Disability and Health Core Set for Stroke.

PubMed

Evans, Melissa; Hocking, Clare; Kersten, Paula

2017-12-01

This study aim was to evaluate whether the Extended International Classification of Functioning, Disability and Health Core Set for Stroke captured the interventions of a community stroke rehabilitation team situated in a large city in New Zealand. It was proposed that the results would identify the contribution of each discipline, and the gaps and differences in service provision to Māori and non-Māori. Applying the Extended International Classification of Functioning, Disability and Health Core Set for Stroke in this way would also inform whether this core set should be adopted in New Zealand. Interventions were retrospectively extracted from 18 medical records and linked to the International Classification of Functioning, Disability and Health and the Extended International Classification of Functioning, Disability and Health Core Set for Stroke. The frequencies of linked interventions and the health discipline providing the intervention were calculated. Analysis revealed that 98.8% of interventions provided by the rehabilitation team could be linked to the Extended International Classification of Functioning, Disability and Health Core Set for Stroke, with more interventions for body function and structure than for activities and participation; no interventions for emotional concerns; and limited interventions for community, social and civic life. Results support previous recommendations for additions to the EICSS. The results support the use of the Extended International Classification of Functioning, Disability and Health Core Set for Stroke in New Zealand and demonstrates its use as a quality assurance tool that can evaluate the scope and practice of a rehabilitation service. Implications for Rehabilitation The Extended International Classification of Functioning Disability and Health Core Set for Stroke appears to represent the stroke interventions of a community stroke rehabilitation team in New Zealand. As a result, researchers and clinicians may have increased confidence to use this core set in research and clinical practice. The Extended International Classification of Functioning Disability and Health Core Set for Stroke can be used as a quality assurance tool to establish whether a community stroke rehabilitation team is meeting the functional needs of its stroke population.

Study unique artistic lopburi province for design brass tea set of bantahkrayang community

NASA Astrophysics Data System (ADS)

Pliansiri, V.; Seviset, S.

2017-07-01

The objectives of this study were as follows: 1) to study the production process of handcrafted Brass Tea Set; and 2) to design and develop the handcrafted of Brass Tea Set. The process of design was started by mutual analytical processes and conceptual framework for product design, Quality Function Deployment, Theory of Inventive Problem Solving, Principles of Craft Design, and Principle of Reverse Engineering. The experts in field of both Industrial Product Design and Brass Handicraft Product, have evaluated the Brass Tea Set design and created prototype of Brass tea set by the sample of consumers who have ever bought the Brass Tea Set of Bantahkrayang Community on this research. The statistics methods used were percentage, mean ({{{\\overline X}} = }) and standard deviation (S.D.) 3. To assess consumer satisfaction toward of handcrafted Brass tea set was at the high level.

Providing Tobacco Treatment in a Community Mental Health Setting: A Pilot Study.

PubMed

Okoli, Chizimuzo T C; Mason, Dia A; Brumley-Shelton, Angela; Robertson, Heather

Individuals with mental illnesses (MIs) are disproportionately affected by tobacco-related disease burden because of higher tobacco use prevalence and poor tobacco treatment outcomes. This pilot study examines the outcomes of delivering an evidence-based tobacco treatment program (the Cooper-Clayton program) in a community mental health setting. A prospective nonequivalent group design was used to assess outcomes. This study included 47 participants, of which 19 were in a community mental health setting and 28 were from two non-mental-health settings. Information on sociodemographic (gender, age, educational level, and current life stressors) and medical, MI, substance use, and tobacco use and cessation histories were obtained. Program completion and smoking cessation at the end of treatment (verified with expired carbon monoxide monitoring) were assessed. The program consists of combining behavioral counseling with nicotine replacement therapy for 12 weeks. Participants from the mental health setting were significantly less educated, had greater medical comorbidities, had greater psychiatric and mental health histories, and had greater perceived secondhand tobacco smoke exposure as compared with those from the non-mental-health settings. Thirty-two percent of the participants (6/19) completed the program in the mental health site as compared with 68% (19/28) from the non-mental-health site. None of those from the mental health site achieved cessation as compared with 68% of those from non-mental-health sites. The differential outcomes of evidence-based tobacco treatment programs in non-mental-health versus mental health settings may suggest the need to modify existing tobacco treatment approaches for those with MIs in community settings.

42 CFR 441.710 - State plan home and community-based services under section 1915(i)(1) of the Act.

Code of Federal Regulations, 2014 CFR

2014-10-01

... section. (1) Home and community-based settings must have all of the following qualities, and such other qualities as the Secretary determines to be appropriate, based on the needs of the individual as indicated... work in competitive integrated settings, engage in community life, control personal resources, and...

Exploring the Meso-System: The Roles of Community, Family, and Peers in Adolescent Delinquency and Positive Youth Development

ERIC Educational Resources Information Center

Smith, Emilie Phillips; Faulk, Monique; Sizer, Monteic A.

2016-01-01

Community contexts are important ecological settings related to problem behavior and positive youth development (PYD). While substantial work has focused on neighborhood disadvantage, the current study explores the role of community assets, specifically linkages to important institutional resources and people in those settings. These concepts are…

Adapting Evidence-Based Mental Health Treatments in Community Settings: Preliminary Results from a Partnership Approach

ERIC Educational Resources Information Center

Southam-Gerow, Michael A.; Hourigan, Shannon E.; Allin, Robert B., Jr.

2009-01-01

This article describes the application of a university-community partnership model to the problem of adapting evidence-based treatment approaches in a community mental health setting. Background on partnership research is presented, with consideration of methodological and practical issues related to this kind of research. Then, a rationale for…

Re-Imagining Competencies in North Carolina Community Colleges: Integrating Certifications into Academic Programs at Two Community Colleges

ERIC Educational Resources Information Center

Vester, Jonathan Steven

2017-01-01

Once a community college graduate completes an associate's degree, the institution is committing to the public that the graduate possesses a prescriptive set of knowledge, skills, and abilities either gained through, or enhanced by, their college attendance. At most institutions, these skill sets are assessed almost exclusively through internal…

Characteristics of Children with Autistic Spectrum Disorders Served in Comprehensive Community-Based Mental Health Settings

ERIC Educational Resources Information Center

Mandell, David S.; Walrath, Christine M.; Manteuffel, Brigitte; Sgro, Gina; Pinto-Martin, Jennifer

2005-01-01

This study describes the characteristics of children with autistic spectrum disorders (ASD) receiving treatment in community mental health settings. Data from a national community mental health initiative was used to identify children who had received a primary diagnosis of ASD. These children were compared with children with other diagnoses on…

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.

Successes and Lessons Learned From Implementing Community Health Worker Programs in Community-Based and Clinical Settings: Insights From the Gulf Coast.

PubMed

Sherman, Mya; Covert, Hannah; Fox, Laila; Lichtveld, Maureen

Community health workers (CHWs) are an increasingly viable component of the American health system. While organizations may be interested in incorporating CHWs into the health care workforce, there are challenges to doing so. This study characterizes the successes and lessons learned from implementing new CHW programs in clinical and community-based settings in 4 US Gulf states. Semistructured interviews were conducted with CHWs and their supervisors. Interviews were conducted with participants in 16 community-based organizations and federally qualified health centers located in coastal counties and parishes of Louisiana, Florida, Alabama, and Mississippi. Study participants consisted of 22 CHWs and 17 CHW supervisors. Although most challenges and strategies were reported by participants working in both clinical and community-based settings, some were workplace-specific. Participants from predominantly clinical settings described the importance of strengthening organizational cohesion and coordination, whereas participants from community-based participants discussed the need for specialized training for CHWs. In both work environments, participants indicated that CHW functioning was constrained by limited organizational resources, difficulty accessing the client population, and limited knowledge regarding the CHW's scope of practice. Strategies to improve CHW functioning in both settings included investing in local partnerships, streamlining resources, prioritizing strong communication and outreach, and establishing explicit operating procedures. The majority of participants noted that challenges lessened over time. Evaluating successes and lessons learned in CHW work is critical to maximize CHWs' abilities to address clients' health needs and promote health in underserved communities. This study provides important insights into how to successfully integrate CHWs into the public health workforce.

Development of the Policy Indicator Checklist: A Tool to Identify and Measure Policies for Calorie-Dense Foods and Sugar-Sweetened Beverages Across Multiple Settings

PubMed Central

Hallett, Allen M.; Parker, Nathan; Kudia, Ousswa; Kao, Dennis; Modelska, Maria; Rifai, Hanadi; O’Connor, Daniel P.

2015-01-01

Objectives. We developed the policy indicator checklist (PIC) to identify and measure policies for calorie-dense foods and sugar-sweetened beverages to determine how policies are clustered across multiple settings. Methods. In 2012 and 2013 we used existing literature, policy documents, government recommendations, and instruments to identify key policies. We then developed the PIC to examine the policy environments across 3 settings (communities, schools, and early care and education centers) in 8 communities participating in the Childhood Obesity Research Demonstration Project. Results. Principal components analysis revealed 5 components related to calorie-dense food policies and 4 components related to sugar-sweetened beverage policies. Communities with higher youth and racial/ethnic minority populations tended to have fewer and weaker policy environments concerning calorie-dense foods and healthy foods and beverages. Conclusions. The PIC was a helpful tool to identify policies that promote healthy food environments across multiple settings and to measure and compare the overall policy environments across communities. There is need for improved coordination across settings, particularly in areas with greater concentration of youths and racial/ethnic minority populations. Policies to support healthy eating are not equally distributed across communities, and disparities continue to exist in nutrition policies. PMID:25790397

Development of the policy indicator checklist: a tool to identify and measure policies for calorie-dense foods and sugar-sweetened beverages across multiple settings.

PubMed

Lee, Rebecca E; Hallett, Allen M; Parker, Nathan; Kudia, Ousswa; Kao, Dennis; Modelska, Maria; Rifai, Hanadi; O'Connor, Daniel P

2015-05-01

We developed the policy indicator checklist (PIC) to identify and measure policies for calorie-dense foods and sugar-sweetened beverages to determine how policies are clustered across multiple settings. In 2012 and 2013 we used existing literature, policy documents, government recommendations, and instruments to identify key policies. We then developed the PIC to examine the policy environments across 3 settings (communities, schools, and early care and education centers) in 8 communities participating in the Childhood Obesity Research Demonstration Project. Principal components analysis revealed 5 components related to calorie-dense food policies and 4 components related to sugar-sweetened beverage policies. Communities with higher youth and racial/ethnic minority populations tended to have fewer and weaker policy environments concerning calorie-dense foods and healthy foods and beverages. The PIC was a helpful tool to identify policies that promote healthy food environments across multiple settings and to measure and compare the overall policy environments across communities. There is need for improved coordination across settings, particularly in areas with greater concentration of youths and racial/ethnic minority populations. Policies to support healthy eating are not equally distributed across communities, and disparities continue to exist in nutrition policies.

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

PubMed

Prescott, Sarah; Fleming, Jennifer; Doig, Emmah

2017-06-11

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

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

PubMed

Robinson, Lance W; Makupa, Enock

2015-11-01

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

Data publication with the structural biology data grid supports live analysis

DOE PAGES

Meyer, Peter A.; Socias, Stephanie; Key, Jason; ...

2016-03-07

Access to experimental X-ray diffraction image data is fundamental for validation and reproduction of macromolecular models and indispensable for development of structural biology processing methods. Here, we established a diffraction data publication and dissemination system, Structural Biology Data Grid (SBDG; data.sbgrid.org), to preserve primary experimental data sets that support scientific publications. Data sets are accessible to researchers through a community driven data grid, which facilitates global data access. Our analysis of a pilot collection of crystallographic data sets demonstrates that the information archived by SBDG is sufficient to reprocess data to statistics that meet or exceed the quality of themore » original published structures. SBDG has extended its services to the entire community and is used to develop support for other types of biomedical data sets. In conclusion, it is anticipated that access to the experimental data sets will enhance the paradigm shift in the community towards a much more dynamic body of continuously improving data analysis.« less

Data publication with the structural biology data grid supports live analysis

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

Meyer, Peter A.; Socias, Stephanie; Key, Jason

Access to experimental X-ray diffraction image data is fundamental for validation and reproduction of macromolecular models and indispensable for development of structural biology processing methods. Here, we established a diffraction data publication and dissemination system, Structural Biology Data Grid (SBDG; data.sbgrid.org), to preserve primary experimental data sets that support scientific publications. Data sets are accessible to researchers through a community driven data grid, which facilitates global data access. Our analysis of a pilot collection of crystallographic data sets demonstrates that the information archived by SBDG is sufficient to reprocess data to statistics that meet or exceed the quality of themore » original published structures. SBDG has extended its services to the entire community and is used to develop support for other types of biomedical data sets. In conclusion, it is anticipated that access to the experimental data sets will enhance the paradigm shift in the community towards a much more dynamic body of continuously improving data analysis.« less

Job frustration in substance abuse counselors working with offenders in prisons versus community settings.

PubMed

Perkins, Elizabeth B; Oser, Carrie B

2014-06-01

Substance abuse counselors who work with offenders are facing increasing caseloads, which puts them at higher risk of job frustration. The purpose of this study was to explore differences between substance abuse counselors employed in prison versus community settings in terms of level of organizational support and job frustration. This study also investigated whether organizational support was associated with job frustration after controlling for counselor characteristics and workplace setting. This was accomplished utilizing data that were collected from 267 counselors as part of the Criminal Justice Drug Abuse Treatment Studies research cooperative. Results indicated that counselors employed in community settings, as compared with those employed in prisons, are more likely to report higher levels of perceived organizational support. In addition, ordinal logistic regression results reveal that counselors who are non-White and have greater levels of organizational support have less job frustration, after controlling for counselor characteristics and workplace setting. The researches to practice implications are discussed.

Job Frustration in Substance Abuse Counselors Working with Offenders in Prisons Versus Community Settings

PubMed Central

Perkins, Elizabeth B.; Oser, Carrie B.

2014-01-01

Substance abuse counselors who work with offenders are facing increasing caseloads which puts them at higher risk for job frustration. The purpose of this study was to explore differences between substance abuse counselors employed in prison versus community settings in terms of level of organizational support and job frustration. This study also investigated whether organizational support was associated with job frustration after controlling for counselor characteristics and workplace setting. This was accomplished utilizing data that was collected from 267 counselors as part of the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) research cooperative. Results indicated that counselors employed in community settings, as compared to those employed in prisons, are more likely to report higher levels of perceived organizational support. In addition, ordinal logistic regression results reveal that counselors who are non-white and have greater levels of organizational support have less job frustration, after controlling for counselor characteristics and workplace setting. The research to practice implications are discussed. PMID:23525175

Data publication with the structural biology data grid supports live analysis.

PubMed

Meyer, Peter A; Socias, Stephanie; Key, Jason; Ransey, Elizabeth; Tjon, Emily C; Buschiazzo, Alejandro; Lei, Ming; Botka, Chris; Withrow, James; Neau, David; Rajashankar, Kanagalaghatta; Anderson, Karen S; Baxter, Richard H; Blacklow, Stephen C; Boggon, Titus J; Bonvin, Alexandre M J J; Borek, Dominika; Brett, Tom J; Caflisch, Amedeo; Chang, Chung-I; Chazin, Walter J; Corbett, Kevin D; Cosgrove, Michael S; Crosson, Sean; Dhe-Paganon, Sirano; Di Cera, Enrico; Drennan, Catherine L; Eck, Michael J; Eichman, Brandt F; Fan, Qing R; Ferré-D'Amaré, Adrian R; Fromme, J Christopher; Garcia, K Christopher; Gaudet, Rachelle; Gong, Peng; Harrison, Stephen C; Heldwein, Ekaterina E; Jia, Zongchao; Keenan, Robert J; Kruse, Andrew C; Kvansakul, Marc; McLellan, Jason S; Modis, Yorgo; Nam, Yunsun; Otwinowski, Zbyszek; Pai, Emil F; Pereira, Pedro José Barbosa; Petosa, Carlo; Raman, C S; Rapoport, Tom A; Roll-Mecak, Antonina; Rosen, Michael K; Rudenko, Gabby; Schlessinger, Joseph; Schwartz, Thomas U; Shamoo, Yousif; Sondermann, Holger; Tao, Yizhi J; Tolia, Niraj H; Tsodikov, Oleg V; Westover, Kenneth D; Wu, Hao; Foster, Ian; Fraser, James S; Maia, Filipe R N C; Gonen, Tamir; Kirchhausen, Tom; Diederichs, Kay; Crosas, Mercè; Sliz, Piotr

2016-03-07

Access to experimental X-ray diffraction image data is fundamental for validation and reproduction of macromolecular models and indispensable for development of structural biology processing methods. Here, we established a diffraction data publication and dissemination system, Structural Biology Data Grid (SBDG; data.sbgrid.org), to preserve primary experimental data sets that support scientific publications. Data sets are accessible to researchers through a community driven data grid, which facilitates global data access. Our analysis of a pilot collection of crystallographic data sets demonstrates that the information archived by SBDG is sufficient to reprocess data to statistics that meet or exceed the quality of the original published structures. SBDG has extended its services to the entire community and is used to develop support for other types of biomedical data sets. It is anticipated that access to the experimental data sets will enhance the paradigm shift in the community towards a much more dynamic body of continuously improving data analysis.

Data publication with the structural biology data grid supports live analysis

PubMed Central

Meyer, Peter A.; Socias, Stephanie; Key, Jason; Ransey, Elizabeth; Tjon, Emily C.; Buschiazzo, Alejandro; Lei, Ming; Botka, Chris; Withrow, James; Neau, David; Rajashankar, Kanagalaghatta; Anderson, Karen S.; Baxter, Richard H.; Blacklow, Stephen C.; Boggon, Titus J.; Bonvin, Alexandre M. J. J.; Borek, Dominika; Brett, Tom J.; Caflisch, Amedeo; Chang, Chung-I; Chazin, Walter J.; Corbett, Kevin D.; Cosgrove, Michael S.; Crosson, Sean; Dhe-Paganon, Sirano; Di Cera, Enrico; Drennan, Catherine L.; Eck, Michael J.; Eichman, Brandt F.; Fan, Qing R.; Ferré-D'Amaré, Adrian R.; Christopher Fromme, J.; Garcia, K. Christopher; Gaudet, Rachelle; Gong, Peng; Harrison, Stephen C.; Heldwein, Ekaterina E.; Jia, Zongchao; Keenan, Robert J.; Kruse, Andrew C.; Kvansakul, Marc; McLellan, Jason S.; Modis, Yorgo; Nam, Yunsun; Otwinowski, Zbyszek; Pai, Emil F.; Pereira, Pedro José Barbosa; Petosa, Carlo; Raman, C. S.; Rapoport, Tom A.; Roll-Mecak, Antonina; Rosen, Michael K.; Rudenko, Gabby; Schlessinger, Joseph; Schwartz, Thomas U.; Shamoo, Yousif; Sondermann, Holger; Tao, Yizhi J.; Tolia, Niraj H.; Tsodikov, Oleg V.; Westover, Kenneth D.; Wu, Hao; Foster, Ian; Fraser, James S.; Maia, Filipe R. N C.; Gonen, Tamir; Kirchhausen, Tom; Diederichs, Kay; Crosas, Mercè; Sliz, Piotr

2016-01-01

Access to experimental X-ray diffraction image data is fundamental for validation and reproduction of macromolecular models and indispensable for development of structural biology processing methods. Here, we established a diffraction data publication and dissemination system, Structural Biology Data Grid (SBDG; data.sbgrid.org), to preserve primary experimental data sets that support scientific publications. Data sets are accessible to researchers through a community driven data grid, which facilitates global data access. Our analysis of a pilot collection of crystallographic data sets demonstrates that the information archived by SBDG is sufficient to reprocess data to statistics that meet or exceed the quality of the original published structures. SBDG has extended its services to the entire community and is used to develop support for other types of biomedical data sets. It is anticipated that access to the experimental data sets will enhance the paradigm shift in the community towards a much more dynamic body of continuously improving data analysis. PMID:26947396

Respiratory isolation for tuberculosis: the experience of Indigenous peoples on the Canadian prairies.

PubMed

Mayan, M; Robinson, T; Gokiert, R; Tremblay, M; Abonyi, S; Long, R

2017-12-21

Setting: The Prairie provinces of Canada. Objective: To understand how Indigenous peoples with infectious pulmonary tuberculosis living in different community settings in the Prairie provinces of Canada experience respiratory isolation. Design: Using an exploratory qualitative approach, we interviewed participants living in urban centres, non-remote reserve settings and remote and isolated reserve settings. Results: Through qualitative content analysis of 48 interviews, we determined that participants experienced feelings of confinement regardless of the community setting in which they lived. Participants also experienced family and social disconnect, but the experience was more potent for the remote and isolated reserve participants, who were required to be flown out of their home communities to receive treatment, and for those urban centre and non-remote reserve participants who lacked social connections. The roles of past experiences with sanitoria and of family in providing social support are discussed. Conclusions: The conclusions of this study focus on examining isolation policies and improving the hospital isolation experience.

Community Exchange Systems. What They Are. How They Work. How to Set One Up.

ERIC Educational Resources Information Center

Page, Leslie

This booklet explains the concept of a community exchange system (CES), or barter system, for the exchange of goods and services and describes how to set one up. The booklet is concerned only with nonprofit, voluntary organizations. The booklet is organized in four sections. The first section introduces the community exchange systems idea and…

The Effectiveness of Distance Education across Virginia's Community Colleges: Evidence from Introductory College-Level Math and English Courses

ERIC Educational Resources Information Center

Xu, Di; Jaggars, Shanna Smith

2011-01-01

Although online learning is rapidly expanding in the community college setting, there is little evidence regarding its effectiveness among community college students. In the current study, the authors used a statewide administrative data set to estimate the effects of taking one's first college-level math or English course online rather than face…

Preparing new nurse graduates for practice in multiple settings: a community-based academic-practice partnership model.

PubMed

West, Nikki; Berman, Audrey; Karshmer, Judith; Prion, Susan; Van, Paulina; Wallace, Jonalyn

2014-06-01

Responding to local and national concerns about the nursing workforce, the California Institute for Nursing and Health Care worked with private and public funders and community health care partners to establish community-based transition-to-practice programs for new RN graduates unable to secure nursing positions in the San Francisco Bay Area. The goals were to retain new RN graduates in nursing and further develop their skills and competencies to increase their employability. Leaders from academic and inpatient, ambulatory, and community-based practice settings, as well as additional community partners, collaboratively provided four 12- to 16-week pilot transition programs in 2010-2011. A total of 345 unemployed new nurse graduates enrolled. Eighty-four percent of 188 respondents to a post-program survey were employed in inpatient and community settings 3 months after completion. Participants and clinical preceptors also reported increases in confidence and competence. Copyright 2014, SLACK Incorporated.

Impact of an Elective Course in Community and Ambulatory Care Pharmacy Practices on Student Perception of Patient Care

PubMed Central

Maguire, Michelle; Bennett, Marialice S.

2015-01-01

Objective. To determine the impact of an elective course on students’ perception of opportunities and of their preparedness for patient care in community and ambulatory pharmacy settings. Design. Each course meeting included a lecture and discussion to introduce concepts and active-learning activities to apply concepts to patient care or practice development in a community or ambulatory pharmacy setting. Assessment. A survey was administered to students before and after the course. Descriptive statistics were used to assess student responses to survey questions, and Wilcoxon signed rank tests were used to analyze the improvement in student responses with an alpha level set at 0.05. Students felt more prepared to provide patient care, develop or improve a clinical service, and effectively communicate recommendations to other health care providers after course completion. Conclusion. This elective course equipped students with the skills necessary to increase their confidence in providing patient care services in community and ambulatory settings. PMID:27168617

A comparison of participation outcome measures and the International Classification of Functioning, Disability and Health Core Sets for traumatic brain injury.

PubMed

Chung, Pearl; Yun, Sarah Jin; Khan, Fary

2014-02-01

To compare the contents of participation outcome measures in traumatic brain injury with the International Classification of Functioning, Disability and Health (ICF) Core Sets for traumatic brain injury. A systematic search with an independent review process selected relevant articles to identify outcome measures in participation in traumatic brain injury. Instruments used in two or more studies were linked to the ICF categories, which identified categories in participation for comparison with the ICF Core Sets for traumatic brain injury. Selected articles (n = 101) identified participation instruments used in two or more studies (n = 9): Community Integration Questionnaire, Craig Handicap Assessment and Reporting Technique, Mayo-Portland Adaptability Inventory-4 Participation Index, Sydney Psychosocial Reintegration Scale Version-2, Participation Assessment with Recombined Tool-Objective, Community Integration Measure, Participation Objective Participation Subjective, Community Integration Questionnaire-2, and Quality of Community Integration Questionnaire. Each instrument was linked to 4-35 unique second-level ICF categories, of which 39-100% related to participation. Instruments addressed 86-100% and 50-100% of the participation categories in the Comprehensive and Brief ICF Core Sets for traumatic brain injury, respectively. Participation measures in traumatic brain injury were compared with the ICF Core Sets for traumatic brain injury. The ICF Core Sets for traumatic brain injury could contribute to the development and selection of participation measures.

Improved Selection of Internal Transcribed Spacer-Specific Primers Enables Quantitative, Ultra-High-Throughput Profiling of Fungal Communities

PubMed Central

Bokulich, Nicholas A.

2013-01-01

Ultra-high-throughput sequencing (HTS) of fungal communities has been restricted by short read lengths and primer amplification bias, slowing the adoption of newer sequencing technologies to fungal community profiling. To address these issues, we evaluated the performance of several common internal transcribed spacer (ITS) primers and designed a novel primer set and work flow for simultaneous quantification and species-level interrogation of fungal consortia. Primer comparison and validation were predicted in silico and by sequencing a “mock community” of mixed yeast species to explore the challenges of amplicon length and amplification bias for reconstructing defined yeast community structures. The amplicon size and distribution of this primer set are smaller than for all preexisting ITS primer sets, maximizing sequencing coverage of hypervariable ITS domains by very-short-amplicon, high-throughput sequencing platforms. This feature also enables the optional integration of quantitative PCR (qPCR) directly into the HTS preparatory work flow by substituting qPCR with these primers for standard PCR, yielding quantification of individual community members. The complete work flow described here, utilizing any of the qualified primer sets evaluated, can rapidly profile mixed fungal communities and capably reconstructed well-characterized beer and wine fermentation fungal communities. PMID:23377949

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.

Leisure activities, friendships, and quality of life of persons with intellectual disability: foster homes vs community residential settings.

PubMed

Duvdevany, Ilana; Arar, Efrat

2004-12-01

Living in the community does not, in itself, guarantee social integration and inclusion for persons with intellectual disability. Friendships and leisure participation can indicate the beginning of such a process and their impact on quality of life. The present study investigated the quality of life, friendships and leisure activities of persons with intellectual disability who live in community settings or in foster families. Three hypotheses were examined: 1. Persons with intellectual disability who live in foster families have more friends than do those who live in community residential settings. 2. Persons with intellectual disability who live in community residential settings participate in more leisure activities than those who live in foster families. 3. The more friendships and leisure activities in which one is involved, the higher the quality of one's life. The sample consisted of 85 adults with intellectual disability, ranging in age from 18 to 55 years. Forty-five live in community residential settings and 40 live in foster families in Israel. Five questionnaires were used: 1) a demographic questionnaire; 2) Quality of Life Questionnaire, 1990); 3) the Revised UCLA Loneliness Scale; 4) Social Relationships List; and 5) Leisure Activities List. The main findings show no significant differences between the two groups in the number of friendships or feelings of loneliness. Foster residents were more involved and more independent in their leisure activities than were those who live in community residences. An association between friendships, leisure activities and quality of life was partly confirmed. The need for intervention programs and leisure education programs is discussed.

Evaluation of the suitability of root cause analysis frameworks for the investigation of community-acquired pressure ulcers: a systematic review and documentary analysis.

PubMed

McGraw, Caroline; Drennan, Vari M

2015-02-01

To evaluate the suitability of root cause analysis frameworks for the investigation of community-acquired pressure ulcers. The objective was to identify the extent to which these frameworks take account of the setting where the ulcer originated as being the person's home rather than a hospital setting. Pressure ulcers involving full-thickness skin loss are increasingly being regarded as indicators of nursing patient safety failure, requiring investigation using root cause analysis frameworks. Evidence suggests that root cause analysis frameworks developed in hospital settings ignore the unique dimensions of risk in home healthcare settings. A systematic literature review and documentary analysis of frameworks used to investigate community-acquired grade three and four pressure ulcers by home nursing services in England. No published papers were identified for inclusion in the review. Fifteen patient safety investigative frameworks were collected and analysed. Twelve of the retrieved frameworks were intended for the investigation of community-acquired pressure ulcers; seven of which took account of the setting where the ulcer originated as being the patient's home. This study provides evidence to suggest that many of the root cause analysis frameworks used to investigate community-acquired pressure ulcers in England are unsuitable for this purpose. This study provides researchers and practitioners with evidence of the need to develop appropriate home nursing root cause analysis frameworks to investigate community-acquired pressure ulcers. © 2014 John Wiley & Sons Ltd.

Primer selection impacts specific population abundances but not community dynamics in a monthly time-series 16S rRNA gene amplicon analysis of coastal marine bacterioplankton.

PubMed

Wear, Emma K; Wilbanks, Elizabeth G; Nelson, Craig E; Carlson, Craig A

2018-03-09

Primers targeting the 16S small subunit ribosomal RNA marker gene, used to characterize bacterial and archaeal communities, have recently been re-evaluated for marine planktonic habitats. To investigate whether primer selection affects the ecological interpretation of bacterioplankton populations and community dynamics, amplicon sequencing with four primer sets targeting several hypervariable regions of the 16S rRNA gene was conducted on both mock communities constructed from cloned 16S rRNA genes and a time-series of DNA samples from the temperate coastal Santa Barbara Channel. Ecological interpretations of community structure (delineation of depth and seasonality, correlations with environmental factors) were similar across primer sets, while population dynamics varied. We observed substantial differences in relative abundances of taxa known to be poorly resolved by some primer sets, such as Thaumarchaeota and SAR11, and unexpected taxa including Roseobacter clades. Though the magnitude of relative abundances of common OTUs differed between primer sets, the relative abundances of the OTUs were nonetheless strongly correlated. We do not endorse one primer set but rather enumerate strengths and weaknesses to facilitate selection appropriate to a system or experimental goal. While 16S rRNA gene primer bias suggests caution in assessing quantitative population dynamics, community dynamics appear robust across studies using different primers. © 2018 The Authors. Environmental Microbiology published by Society for Applied Microbiology and John Wiley & Sons Ltd.

Translation of lifestyle modification programs focused on physical activity and dietary habits delivered in community settings.

PubMed

Stoutenberg, Mark; Stanzilis, Katie; Falcon, Ashley

2015-06-01

Lifestyle modification programs (LMPs) can provide individuals with behavioral skills to sustain long-term changes to their physical activity (PA) levels and dietary habits. Yet, there is much work to be done in the translation of these programs to community settings. This review identified LMPs that focused on changing both PA and dietary behaviors and examined common features and barriers faced in their translation to community settings. A search of multiple online databases was conducted to identify LMPs that included participants over the age of 18 who enrolled in LMPs, offered in community settings, and had the goal of improving both PA and dietary behaviors. Data were extracted on participant demographics, study design characteristics, and study outcome variables including changes in PA, dietary habits, body weight, and clinical outcomes. We identified 27 studies that met inclusion criteria. Despite high levels of retention and adherence to the interventions, varying levels of success were observed in increasing PA levels, improving dietary habits, reducing body weight, and improving clinic outcomes. LMPs addressing issues of PA and dietary habits can be successfully implemented in a community setting. However, inconsistent reporting of key components in the translation of these studies (participant recruitment, utilization of behavioral strategies) may limit their replication and advancement of future programs. Future efforts should better address issues such as identifying barriers to participation and program implementation, utilization of community resources, and evaluating changes across multiple health behaviors.

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

PubMed

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

2016-06-01

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

Behavioral Analytic Approach to Placement of Patients in Community Settings.

ERIC Educational Resources Information Center

Glickman, Henry S.; And Others

Twenty adult psychiatric outpatients were assessed by their primary therapists on the Current Behavior Inventory prior to placing them in community settings. The diagnoses included schizophrenia, major affective disorder, dysthymic disorder, and atypical paranoid disorder. The inventory assessed behaviors in four areas: independent community…

Tornado Preparedness Planning.

ERIC Educational Resources Information Center

National Oceanic and Atmospheric Administration (DOC), Rockville, MD. National Weather Service.

This pamphlet contains a set of guidelines for community leaders interested in developing preparedness plans for tornadoes and severe thunderstorms. Included in the guide is a list of the types of officials and agencies which should be involved in planning meetings. A set of suggestions for developing a community communications network and…

Surveying Unstructured Time of Adults with Mental Retardation Living in Two Community Settings: A Search for Normalization.

ERIC Educational Resources Information Center

Pierce, Thomas B., Jr.; And Others

1990-01-01

A survey assessed time spent in the community and/or on unstructured activities by randomly selected individuals in Intermediate Care Facilities for the Mentally Retarded (ICF/MR) (N=20) or minigroup home settings (N=20). Individuals in ICF/MR homes spent more time in the community with staff and made fewer choices of unstructured activities.…

Knowledge Contribution in a Non-Formal Virtual Setting through a Social Constructionist Approach: A Case Study of an Online Learning Community

ERIC Educational Resources Information Center

Moses, Myra Gail

2012-01-01

This study explored an online learning community in a non-formal educational setting and the process participants used in order to share, create, and construct knowledge through their interactions in the online community. Participants in the study were college interns who were part of a grant that focused on providing professional development for…

Grip strength and its determinants among older people in different healthcare settings

PubMed Central

Roberts, Helen C; Syddall, Holly; Butchart, Joe; Sparkes, Jonathan; Ritchie, Jan; Kerr, Alastair; Cooper, Cyrus; Sayer, Avan Aihie

2013-01-01

Background Low muscle strength is central to geriatric syndromes including sarcopenia and frailty. It is well described in community dwelling older people but the epidemiology of grip strength of older people in rehabilitation or long term care has been little explored. Objective To describe grip strength of older people in rehabilitation and nursing home settings. Design Cross-sectional epidemiological study. Setting 3 healthcare settings in one town. Subjects 101 inpatients on a rehabilitation ward, 47 community rehabilitation referrals and 100 nursing home residents. Methods Grip strength, age, height, weight, body mass index, number of co-morbidities and medications, Barthel score, mini mental state examination (MMSE), nutritional status, and number of falls in the last year were recorded. Results Grip strength differed substantially between healthcare settings for both men and women (p<0.0001). Nursing home residents had the lowest age-adjusted mean grip strength and community rehabilitation referrals the highest. Broadly higher grip strength was associated in univariate analyses with younger age, greater height and weight, fewer comorbidities, higher Barthel score, higher MMSE score, better nutritional status and fewer falls. However after mutual adjustment for these factors, the difference in grip strength between settings remained significant. Barthel score was the characteristic most strongly associated with grip strength. Conclusions Older people in rehabilitation and care home settings had lower grip strength than reported for those living at home. Furthermore grip strength varied widely between healthcare settings independent of known major influences. Further research is required to ascertain whether grip strength may help identify people at risk of adverse health outcomes within these settings. PMID:23926093

BEHAVIORAL INTERVENTION TO TREAT SELECTIVE MUTISM ACROSS MULTIPLE SOCIAL SITUATIONS AND COMMUNITY SETTINGS

PubMed Central

Lang, Russell; Regester, April; Mulloy, Austin; Rispoli, Mandy; Botout, Amanda

2011-01-01

We evaluated a behavioral intervention for a 9-year-old girl with selective mutism. The intervention consisted of role play and video self-modeling. The frequency of spoken initiations, responses to questions, and communication breakdowns was measured during three social situations (i.e., ordering in a restaurant, meeting new adults, and playing with new children) and in three community settings. Results demonstrated increases in spoken initiations and responses and decreases in communication breakdowns across all situations and settings. PMID:21941394

Behavioral intervention to treat selective mutism across multiple social situations and community settings.

PubMed

Lang, Russell; Regester, April; Mulloy, Austin; Rispoli, Mandy; Botout, Amanda

2011-01-01

We evaluated a behavioral intervention for a 9-year-old girl with selective mutism. The intervention consisted of role play and video self-modeling. The frequency of spoken initiations, responses to questions, and communication breakdowns was measured during three social situations (i.e., ordering in a restaurant, meeting new adults, and playing with new children) and in three community settings. Results demonstrated increases in spoken initiations and responses and decreases in communication breakdowns across all situations and settings.

Nurses' experiences providing palliative care to individuals living in rural communities: aspects of the physical residential setting.

PubMed

Kaasalainen, S; Brazil, K; Williams, A; Wilson, D; Willison, K; Marshall, D; Taniguchi, A; Phillips, C

2014-01-01

Efforts are needed to improve palliative care in rural communities, given the unique characteristics and inherent challenges with respect to working within the physical aspects of residential settings. Nurses who work in rural communities play a key role in the delivery of palliative care services. Hence, the purpose of this study was to explore nurses' experiences of providing palliative care in rural communities, with a particular focus on the impact of the physical residential setting. This study was grounded in a qualitative approach utilizing an exploratory descriptive design. Individual telephone interviews were conducted with 21 community nurses. Data were analyzed by thematic content analysis. Nurses described the characteristics of working in a rural community and how it influences their perception of their role, highlighting the strong sense of community that exists but how system changes over the past decade have changed the way they provide care. They also described the key role that they play, which was often termed a 'jack of all trades', but focused on providing emotional, physical, and spiritual care while trying to manage many challenges related to transitioning and working with other healthcare providers. Finally, nurses described how the challenges of working within the physical constraints of a rural residential setting impeded their care provision to clients who are dying in the community, specifically related to the long distances that they travel while dealing with bad weather. These study findings contribute to our understanding of the experiences of nurses working in rural communities in terms of the provision of palliative care and the influence of the physical residential setting that surrounds them. These findings are important since nurses play a major role in caring for community-dwelling clients who are dying, but they are confronted with many obstacles. As such, these results may help inform future decisions about how to best improve access to important services and ways to support them while providing palliative care to rural individuals.

Use of Computer Kiosks for Breast Cancer Education in Five Community Settings

ERIC Educational Resources Information Center

Kreuter, Matthew W.; Black, Wynona J.; Friend, LaBraunna; Booker, Angela C.; Klump, Paula; Bobra, Sonal; Holt, Cheryl L.

2006-01-01

Finding ways to bring effective computer-based behavioral interventions to those with limited access to technology is a continuing challenge for health educators. Computer kiosks placed in community settings may help reach such populations. The "Reflections of You" kiosk generates individually tailored magazines on breast cancer and…

An Evaluation of a Community Living Initiative in Ireland

ERIC Educational Resources Information Center

Sheerin, Fintan; Griffiths, Colin; de Vries, Jan; Keenan, Paul

2015-01-01

One of the central principles underpinning Irish intellectual disability policy is that of decongregation. Allied to this is the belief that life in community settings offers greater opportunities and richer experiences than does life in institutional settings. This study explores the experiences of a group of adults with intellectual disabilities…

Parent Perceptions of an Adapted Evidence-Based Practice for Toddlers with Autism in a Community Setting

ERIC Educational Resources Information Center

Stahmer, Aubyn C.; Brookman-Frazee, Lauren; Rieth, Sarah R.; Stoner, Julia Trigeiro; Feder, Joshua D.; Searcy, Karyn; Wang, Tiffnay

2016-01-01

Although data from parent-implemented Naturalistic Developmental Behavioral Interventions have shown positive effects on decreasing core symptoms of autism, there has been limited examination of the effectiveness of Naturalistic Developmental Behavioral Interventions in community settings. In addition, parent perspectives of their involvement in…

Parent Perceptions of an Adapted Evidence-Based Practice for Toddlers with Autism in a Community Setting

ERIC Educational Resources Information Center

Stahmer, Aubyn C.; Brookman-Frazee, Lauren; Rieth, Sarah R.; Stoner, Julia Trigeiro; Feder, Joshua D.; Searcy, Karyn; Wang, Tiffany

2017-01-01

Although data from parent-implemented Naturalistic Developmental Behavioral Interventions have shown positive effects on decreasing core symptoms of autism, there has been limited examination of the effectiveness of Naturalistic Developmental Behavioral Interventions in community settings. In addition, parent perspectives of their involvement in…

3 N.J. Community Colleges Set Up New Programs as Part of State's Plans for Welfare Reform.

ERIC Educational Resources Information Center

Jaschik, Scott

1987-01-01

Bergen Community College, Middlesex County College, and Union County College are setting up (1) counseling programs to help welfare recipients determine their job interests and skills, (2) job-training courses, and (3) day-care centers for participants children. (MLW)

Training Instructional Skills with Paraprofessional Service Providers at a Community-Based Habilitation Setting

ERIC Educational Resources Information Center

Wood, Amanda L.; Luiselli, James K.; Harchik, Alan E.

2007-01-01

The present study evaluates a training program with paraprofessional service providers at a community-based habilitation setting. Four staff were taught to implement alternative and augmentative communication instruction with an adult who had autism and mental retardation through a combination of instruction, demonstration, behavior rehearsal, and…

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

PubMed Central

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

2016-01-01

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

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.

Community perspectives on roles and responsibilities for strengthening primary health care in rural Ethiopia.

PubMed

Curry, Leslie A; Alpern, Rachelle; Webster, Tashonna R; Byam, Patrick; Zerihun, Abraham; Tarakeshwar, Nalini; Cherlin, Emily J; Bradley, Elizabeth H

2012-01-01

Government-community partnerships are central to developing effective, sustainable models of primary health care in low-income countries; however, evidence about the nature of partnerships lacks the perspective of community members. Our objective was to characterise community perspectives regarding the respective roles and responsibilities of government and the community in efforts to strengthen primary health care in low-income settings. We conducted a qualitative study using focus groups (n=14 groups in each of seven primary health care units in Amhara and Oromia, Ethiopia, with a total of 140 participants) in the context of the Ethiopian Millennium Rural Initiative. Results indicated that community members defined important roles and responsibilities for both communities and governments. Community roles included promoting recommended health behaviours; influencing social norms regarding health; and contributing resources as feasible. Government roles included implementing oversight of health centres; providing human resources, infrastructure, equipment, medication and supplies; and demonstrating support for community health workers, who are seen as central to the rural health system. Renewed efforts in health system strengthening highlight the importance of community participation in initiatives to improve primary health care in rural settings. Community perspectives provide critical insights to defining, implementing and sustaining partnerships in these settings.

[Screening of sexually transmitted diseases in clinical and non-clinical settings in Salvador, Bahia, Brazil].

PubMed

de Codes, José Santiago; Cohen, Deborah Ann; de Melo, Neli Almeida; Teixeira, Guilherme Gonzaga; Leal, Alexandre dos Santos; Silva, Tiago de Jesus; de Oliveira, Miucha Pereira Rios

2006-02-01

The objectives were to study: (1) acceptance of STD screening in non-clinical settings for asymptomatic individuals; (2) risk factors and STD prevalence among individuals in non-clinical and clinical settings; and (3) non-clinical screening of asymptomatic populations as a feasible method for STD control. We recruited 139 males and 486 females between 18 and 30 years of age from a family planning clinic, schools, and community centers in low-income neighborhoods. We asked about STD symptoms and STD/HIV risk behaviors and tested the individuals for gonorrhea, Chlamydia, syphilis, and HIV. Except for HIV, women recruited directly from the community had higher STD rates than those who came in for care at the clinic. Screening in non-clinical settings in Brazil is feasible and has a high yield among young adults in low-income communities. Infected participants would likely never have otherwise sought care or been tested or treated. STD control efforts could be implemented in any site that can reach populations at risk and become a routine procedure in health care settings where people report for problems unrelated to STDs.

Resilience and Professional Quality of Life in Staff Working with People with Intellectual Disabilities and Offending Behavior in Community Based and Institutional Settings.

PubMed

Søndenaa, Erik; Lauvrud, Christian; Sandvik, Marita; Nonstad, Kåre; Whittington, Richard

2013-01-02

Staff in forensic services for people with intellectual disabilities (ID) are expected to deal with a wide range of emotional challenges when providing care. The potential impact of this demanding work has not been systematically explored previously. This article explores the professional quality of life (QoL) and the resilience (hardiness) of the staff in this setting. The Professional QoL questionnaire and the Disposional Resilience Scale were completed by staff (n=85, 80% response rate) in the Norwegian forensic service for ID offenders. Responses from staff working in institutional settings were compared to those from staff in local community services. Staff in the local community services had higher resilience scores compared to the staff in the institutional setting, (t=2.19; P<0.05). However in the other QoL and resilience domains there were no differences between the staff in the two settings. The greater sense of resilient control among community staff may be a function of both the number of service users they work with and the institutional demands they face. Even though these participants worked with relatively high risk clients, they did not report significantly impaired quality of life compared to other occupations.

The conduct and process of mental capacity assessments in home health care settings.

PubMed

Cliff, Charlotte; McGraw, Caroline

2016-11-02

The assessment of capacity to consent to treatment is key to shared practitioner-patient decision-making. It is the responsibility of the person closest to the decision being made to carry out the assessment. The aim was to examine the factors that influence mental capacity assessments in home health care settings and identify the facilitators and inhibitors to the conduct and process of assessments as perceived and experienced by non-medical health practitioners providing generalist community services. Semi-structured interviews with a purposive sample of community nurses, community physiotherapists and community occupational therapists in one NHS Trust in London. Data were analysed thematically. The main themes were issues relating to: intrinsic patient factors and behaviours; recognising, managing and utilising the influence of the family; practitioner motivation and competence; working together as a team to optimise shared decision making, and; the importance of place. While some issues appear germane to both hospital and home health care settings, others are unique to - or manifest very differently in - home health care settings. The findings suggest that the influence of family members, long-term practitioner-patient relationships and physical distance from co-workers make the conduct and process of mental capacity assessments in home health care settings an inherently complex endeavour.

Self-Reported Physical Activity in Medically Underserved Adults With Type 2 Diabetes in Clinical and Community Settings.

PubMed

Cooper, John; Stetson, Barbara; Bonner, Jason; Spille, Sean; Krishnasamy, Sathya; Mokshagundam, Sri Prakash

2015-07-01

This study assessed physical activity (PA) in community dwelling adults with Type 2 diabetes, using multiple instruments reflecting internationally normed PA and diabetes-specific self-care behaviors. Two hundred and fifty-three Black (44.8%) and White (55.2%) Americans [mean age = 57.93; 39.5% male] recruited at low-income clinic and community health settings. Participants completed validated PA self-report measures developed for international comparisons (International Physical Activity Questionnaire Short Form), characterization of diabetes self-care (Summary of Diabetes Self-Care Activities Measure; SDSCA) and exercise-related domains including provider recommendations and PA behaviors and barriers (Personal Diabetes Questionnaire; PDQ). Self-reported PA and PA correlates differed by instrument. BMI was negatively correlated with PA level assessed by the PDQ in both genders, and assessed with SDSCA activity items in females. PA levels were low, comparable to previous research with community and diabetes samples. Pain was the most frequently reported barrier; females reported more frequent PA barriers overall. When using self-report PA measures for PA evaluation of adults with diabetes in clinical settings, it is critical to consider population and setting in selecting appropriate tools. PA barriers may be an important consideration when interpreting PA levels and developing interventions. Recommendations for incorporating these measures in clinical and research settings are discussed.

Risky decision-making predicts short-term outcome of community but not residential treatment for opiate addiction. Implications for case management.

PubMed

Passetti, F; Clark, L; Davis, P; Mehta, M A; White, S; Checinski, K; King, M; Abou-Saleh, M

2011-10-01

Opiate addiction is associated with decision-making deficits and we previously showed that the extent of these impairments predicts aspects of treatment outcome. Here we aimed to establish whether measures of decision-making performance might be used to inform placement matching. Two groups of opiate dependent individuals, one receiving treatment in a community setting (n=48) and one in a residential setting (n=32) were administered computerised tests of decision-making, impulsivity and planning shortly after the beginning of treatment, to be followed up three months into each programme. In the community sample, performance on the decision-making tasks at initial assessment predicted abstinence from illicit drugs at follow-up. In contrast, in the residential sample there was no relationship between decision-making and clinical outcome. Intact decision-making processes appear to be necessary for upholding a resolve to avoid taking drugs in a community setting, but the importance of these mechanisms may be attenuated in a residential treatment setting. The results support the placement matching hypothesis, suggesting that individuals with more prominent decision-making deficits may particularly benefit from treatment in a residential setting and from the inclusion of aspects of cognitive rehabilitation in their treatment programme. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Resilience and Professional Quality of Life in Staff Working with People with Intellectual Disabilities and Offending Behavior in Community Based and Institutional Settings

PubMed Central

Søndenaa, Erik; Lauvrud, Christian; Sandvik, Marita; Nonstad, Kåre; Whittington, Richard

2013-01-01

Staff in forensic services for people with intellectual disabilities (ID) are expected to deal with a wide range of emotional challenges when providing care. The potential impact of this demanding work has not been systematically explored previously. This article explores the professional quality of life (QoL) and the resilience (hardiness) of the staff in this setting. The Professional QoL questionnaire and the Disposional Resilience Scale were completed by staff (n=85, 80% response rate) in the Norwegian forensic service for ID offenders. Responses from staff working in institutional settings were compared to those from staff in local community services. Staff in the local community services had higher resilience scores compared to the staff in the institutional setting, (t=2.19; P<0.05). However in the other QoL and resilience domains there were no differences between the staff in the two settings. The greater sense of resilient control among community staff may be a function of both the number of service users they work with and the institutional demands they face. Even though these participants worked with relatively high risk clients, they did not report significantly impaired quality of life compared to other occupations. PMID:26973892

Public-academic partnerships: research in community mental health settings: a practicum experience for researchers.

PubMed

Miller, Alexander L; Lopez, Linda; Gonzalez, Jodi M; Dassori, Albana; Bond, Gary; Velligan, Dawn

2008-11-01

Applying research findings to community mental health practices is slowed by provider concerns that research participants often differ from community populations in duration of illness, comorbid conditions, and illness severity. Selecting participants from community settings makes research results demonstrably relevant, but researchers and community providers can be mistrustful of one another, feeling that the other has little understanding of their needs and work. This mistrust impedes patient referrals for research. This column describes a program to increase researcher knowledge of community clinic procedures through structured interactions with clinic personnel. Follow-up interviews indicate improved attitudes and cooperation of researchers and community providers.

The ReproGenomics Viewer: an integrative cross-species toolbox for the reproductive science community

PubMed Central

Darde, Thomas A.; Sallou, Olivier; Becker, Emmanuelle; Evrard, Bertrand; Monjeaud, Cyril; Le Bras, Yvan; Jégou, Bernard; Collin, Olivier; Rolland, Antoine D.; Chalmel, Frédéric

2015-01-01

We report the development of the ReproGenomics Viewer (RGV), a multi- and cross-species working environment for the visualization, mining and comparison of published omics data sets for the reproductive science community. The system currently embeds 15 published data sets related to gametogenesis from nine model organisms. Data sets have been curated and conveniently organized into broad categories including biological topics, technologies, species and publications. RGV's modular design for both organisms and genomic tools enables users to upload and compare their data with that from the data sets embedded in the system in a cross-species manner. The RGV is freely available at http://rgv.genouest.org. PMID:25883147

Does community health care require different competencies from physicians and nurses?

PubMed Central

2014-01-01

Background Recently competency approach in Health Professionals’ Education (HPE) has become quite popular and for an effective competency based HPE, it is important to design the curriculum around the health care needs of the population to be served and on the expected roles of the health care providers. Unfortunately, in community settings roles of health providers tend to be described less clearly, particularly at the Primary Health Care (PHC) level where a multidisciplinary and appropriately prepared health team is generally lacking. Moreover, to tailor the education on community needs there is no substantial evidence on what specific requirements the providers must be prepared for. Methods This study has explored specific tasks of physicians and nurses employed to work in primary or secondary health care units in a context where there is a structural scarcity of community health care providers. In-depth Interviews of 11 physicians and 06 nurses working in community settings of Pakistan were conducted along with review of their job descriptions. Results At all levels of health settings, physicians’ were mostly engaged with diagnosing and prescribing medical illness of patients coming to health center and nurses depending on their employer were either providing preventive health care activities, assisting physicians or occupied in day to day management of health center. Geographical location or level of health facility did not have major effect on the roles being expected or performed, however the factors that determined the roles performed by health providers were employer expectations, preparation of health providers for providing community based care, role clarity and availability of resources including health team at health facilities. Conclusions Exploration of specific tasks of physicians and nurses working in community settings provide a useful framework to map competencies, and can help educators revisit the curricula and instructional designs accordingly. Furthermore, in community settings there are many synergies between the roles of physicians and nurses which could be simulated as learning activities; at the same time these two groups of health providers offer distinct sets of services, which must be harnessed to build effective, non-hierarchal, collaborative health teams. PMID:24387322

Building capacity for cognitive behavioral therapy delivery for depression in disaster-impacted contexts.

PubMed

Ngo, Victoria K; Centanni, Angela; Wong, Eunice; Wennerstrom, Ashley; Miranda, Jeanne

2011-01-01

Numerous challenges exist in implementing evidence-based practices, such as cognitive behavioral therapy, in resource poor, ethnic minority, and/or disaster-affected communities with disparities in mental health. Community-academic participatory partnerships are a promising approach to addressing disparities by implementing community-appropriate, evidence-based depression care. A community-academic collaborative was formed in New Orleans after Hurricane Katrina to expand resources for effective depression care, including cognitive behavioral therapy. In this article, we: 1) describe our model of building capacity to deliver cognitive behavioral therapy for depression in post-disaster community-based settings; 2) discuss the impact of this training program on therapist reported practice; and 3) share lessons learned regarding disseminating and sustaining evidence-based interventions in the context of a disaster impacted community. Using a mixed methods approach, we found that this model was feasible, acceptable, and disseminated knowledge about cognitive behavioral therapy in community settings. Over the course of two years, community providers demonstrated the feasibility of implementing evidence-based practice and potential for local community leadership. The lessons learned from this model of implementation may help address barriers to disseminating evidence-based interventions in other low-resource, disaster-impacted community settings.

Assessment of central haemomodynamics from a brachial cuff in a community setting

PubMed Central

2012-01-01

Background Large artery stiffening and wave reflections are independent predictors of adverse events. To date, their assessment has been limited to specialised techniques and settings. A new, more practical method allowing assessment of central blood pressure from waveforms recorded using a conventional automated oscillometric monitor has recently been validated in laboratory settings. However, the feasibility of this method in a community based setting has not been assessed. Methods One-off peripheral and central haemodynamic (systolic and diastolic blood pressure (BP) and pulse pressure) and wave reflection parameters (augmentation pressure (AP) and index, AIx) were obtained from 1,903 volunteers in an Austrian community setting using a transfer-function like method (ARCSolver algorithm) and from waveforms recorded with a regular oscillometric cuff. We assessed these parameters for known differences and associations according to gender and age deciles from <30 years to >80 years in the whole population and a subset with a systolic BP < 140 mmHg. Results We obtained 1,793 measures of peripheral and central BP, PP and augmentation parameters. Age and gender associations with central haemodynamic and augmentation parameters reflected those previously established from reference standard non-invasive techniques under specialised settings. Findings were the same for patients with a systolic BP below 140 mmHg (i.e. normotensive). Lower values for AIx in the current study are possibly due to differences in sampling rates, detection frequency and/or averaging procedures and to lower numbers of volunteers in younger age groups. Conclusion A novel transfer-function like algorithm, using brachial cuff-based waveform recordings, provides robust and feasible estimates of central systolic pressure and augmentation in community-based settings. PMID:22734820

Hand hygiene to reduce community transmission of influenza and acute respiratory tract infection: a systematic review

PubMed Central

Warren‐Gash, Charlotte; Fragaszy, Ellen; Hayward, Andrew C.

2012-01-01

Please cite this paper as: Warren‐Gash et al. (2012) Hand hygiene to reduce community transmission of influenza and acute respiratory tract infection: a systematic review. Influenza and Other Respiratory Viruses DOI: 10.1111/irv.12015. Hand hygiene may be associated with modest protection against some acute respiratory tract infections, but its specific role in influenza transmission in different settings is unclear. We aimed to review evidence that improving hand hygiene reduces primary and secondary transmission of (i) influenza and (ii) acute respiratory tract infections in community settings. We searched Medline, Embase, Global Health and Cochrane databases up to 13 February 2012 for reports in any language of original research investigating the effect of hand hygiene on influenza or acute respiratory tract infection where aetiology was unspecified in community settings including institutions such as schools, and domestic residences. Data were presented and quality rated across outcomes according to the Grading of Recommendations Assessment, Development and Evaluation system. Sixteen articles met inclusion criteria. There was moderate to low‐quality evidence of a reduction in both influenza and respiratory tract infection with hand hygiene interventions in schools, greatest in a lower–middle‐income setting. There was high‐quality evidence of a small reduction in respiratory infection in childcare settings. There was high‐quality evidence for a large reduction in respiratory infection with a hand hygiene intervention in squatter settlements in a low‐income setting. There was moderate‐ to high‐quality evidence of no effect on secondary transmission of influenza in households that had already experienced an index case. While hand hygiene interventions have potential to reduce transmission of influenza and acute respiratory tract infections, their effectiveness varies depending on setting, context and compliance. PMID:23043518

Bringing Planetary Data into Learning Environments: A Community Effort

NASA Astrophysics Data System (ADS)

Shipp, S.; Higbie, M.; Lowes, L.

2005-12-01

Recognizing the need to communicate scientific findings, and the power of using real planetary data in educational settings to engage students in Earth and space science in meaningful ways, the South Central Organization of Researchers and Educators and the Solar System Exploration Education Forum, part of NASA's Science Mission Directorate's Support Network, have established the Planetary Data in Education (PDE) Initiative. The Initiative strives to: 1) Establish a collaborative community of educators, education specialists, curriculum developers, tool developers, learning technologists, scientists, and data providers to design and develop educationally appropriate products; 2) Build awareness in the broader educational and scientific community of existing programs, products, and resources; 3) Address issues hindering the effective use of planetary data in formal and informal educational settings; and 4) Encourage partnerships that leverage the community's expertise The PDE community has hosted two conferences exploring issues in using data in educational settings. The community recognizes that data are available through venues such as the Planetary Data Systems (PDS), but not in a format that the end-user in a formal or informal educational setting can digest; these data are intended for the scientific audience. Development of meaningful educational programs using planetary data requires design of appropriate learner interfaces and involvement of data providers, product developers, learning technologists, scientists, and educators. The PDE community will participate in the development of Earth Exploration Toolbooks during the DLESE Data Services Workshop and will host a workshop in the summer of 2006 to bring together small groups of educators, data providers, and learning technologists, and scientists to design and develop products that bring planetary data into educational settings. In addition, the PDE community hosts a Web site that presents elements identified as needed by the community, including examples of planetary data use in education, recommendations for program development, links to data providers, opportunities for collaboration, pertinent research, and a Web portal to access educational resources using planetary data on the DLESE Web site.

Stability of Initial Autism Spectrum Disorder Diagnoses in Community Settings

ERIC Educational Resources Information Center

Daniels, Amy M.; Rosenberg, Rebecca E.; Law, J. Kiely; Lord, Catherine; Kaufmann, Walter E.; Law, Paul A.

2011-01-01

The study's objectives were to assess diagnostic stability of initial autism spectrum disorder (ASD) diagnoses in community settings and identify factors associated with diagnostic instability using data from a national Web-based autism registry. A Cox proportional hazards model was used to assess the relative risk of change in initial ASD…

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

ERIC Educational Resources Information Center

Kastner, Theodore; And Others

1992-01-01

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

Blogging the Field: An Emergent Continuum for Urban Teacher Development

ERIC Educational Resources Information Center

Domine, Vanessa

2012-01-01

Preparing teachers to work in urban settings poses unique challenges, as urban communities are complex and require systemic understanding of students and their families, culture, and community. Pre-service teachers often harbor misconceptions about what it means to work in urban settings and many bring to their teacher education program minimal…

Using a Comprehensive Leadership Framework as a Scholarship and Teaching Tool

ERIC Educational Resources Information Center

Boyce, Kim

2006-01-01

Educators who work in community settings often encounter participants with a wide array of individual leadership beliefs, attitudes, and experiences. Given this situation, one of the challenges we face is to identify effective methods and tools to teach leadership in community and organizational settings. As an educator, it is important to…

Building a Community of Experience.

ERIC Educational Resources Information Center

Matthews, Kelly

2002-01-01

Discusses how field trips can build a community of experience in preschool settings. Focuses on what to consider when planning field trips, how to reduce field trip costs, adjustments to be made during the trip, and ways to bring the trip to the preschool setting. Suggests activities after the field trip, and destinations related to the arts,…

Social Behavior of Mentally Handicapped Clients in Different Community Settings.

ERIC Educational Resources Information Center

Romer, Daniel; Berkson, Gershon

To study the influence that community settings have upon peer relationships and social behavior, 81 mentally disabled (retarded and emotionally disturbed retarded) adults were observed in their intermediate care residential facility and in one of four workshop programs. In summary, Ss tended to have more extensive affiliation and to aggregate more…

Cooperative Learning in a Community College Setting: Developmental Coursework in Mathematics

ERIC Educational Resources Information Center

Rivera, Natalie

2013-01-01

This action research study, set in a community college in the southwestern United States, was designed to investigate the effects of implementing cooperative learning strategies in a developmental mathematics course. Introductory algebra was formerly taught in a lecture based format, and as such regularly had a low course completion rate. To…

A Community Information Network.

ERIC Educational Resources Information Center

Consumers' Association of Canada, Ottawa (Ontario).

The possibility of creating in Canada a non-profit community information network (a set of linked data banks containing information for use by the general public) should be explored. A network to link together a set of data banks containing information for general public use would have the following merits: (1) By its effect on household…

Toward Integrated Family Services in Rural Settings: A Summary of Research and Practice. Program Report.

ERIC Educational Resources Information Center

Stoops, Jack W.; Hull, Janis L.

This report synthesizes research findings with observations of three Pacific Northwest sites attempting service integration in rural settings. At case-study sites in Washington and Oregon, rural schools, communities, and service providers collaborate to deliver services to students and community members suffering from high unemployment, alcohol…

Dietary Intake of Adults with Mental Retardation Who Reside in Community Settings

ERIC Educational Resources Information Center

Draheim, Christopher C.; Stanish, Heidi I.; Williams, Daniel P.; McCubbin, Jeffrey A.

2007-01-01

The dietary intake of adults with mental retardation among three different community residential settings was described and compared. Two dietary screeners were administered to 325 adults. The women's Fruit and Vegetable Screener scores from group homes were significantly higher than scores from those with family members and in semi-independent…

Case Management in Community Corrections: Current Status and Future Directions

ERIC Educational Resources Information Center

Day, Andrew; Hardcastle, Lesley; Birgden, Astrid

2012-01-01

Case management is commonly regarded as the foundation of effective service provision across a wide range of human service settings. This article considers the case management that is offered to clients of community corrections, identifying the distinctive features of case management in this particular setting, and reviewing the empirical evidence…

It Takes a Village to Prevent Falls: Reconceptualizing Fall Prevention and Management for Older Adults

PubMed Central

Ganz, David A.; Alkema, Gretchen E.; Wu, Shinyi

2013-01-01

Systematic evidence reviews support the efficacy of physical activity programs and multifactorial strategies for fall prevention. However, community settings where fall prevention programs occur often differ substantially from the research settings in which efficacy was first demonstrated. Because of these differences, alternative approaches are needed to judge the adequacy of fall prevention activities occurring as part of standard medical care or community efforts. This paper uses the World Health Organization Innovative Care for Chronic Conditions (ICCC) framework to rethink how fall prevention programs might be implemented routinely in both medical and community settings. We highlight examples of innovative programs and policies that provide fall prevention strategies consistent with the ICCC framework, and provide evidence where available on the effects of these strategies on processes and outcomes of care. We close by proposing a “no wrong door” approach to fall prevention and management, in which older adults who are found to be at risk for falls in either a medical or community setting are linked to a standard fall risk evaluation across three domains (physical activity, medical risks and home safety). PMID:18676787

Characteristics of Smartphone Applications for Nutrition Improvement in Community Settings: A Scoping Review1234

PubMed Central

Brimblecombe, Julie; Wycherley, Thomas Philip

2017-01-01

Smartphone applications are increasingly being used to support nutrition improvement in community settings. However, there is a scarcity of practical literature to support researchers and practitioners in choosing or developing health applications. This work maps the features, key content, theoretical approaches, and methods of consumer testing of applications intended for nutrition improvement in community settings. A systematic, scoping review methodology was used to map published, peer-reviewed literature reporting on applications with a specific nutrition-improvement focus intended for use in the community setting. After screening, articles were grouped into 4 categories: dietary self-monitoring trials, nutrition improvement trials, application description articles, and qualitative application development studies. For mapping, studies were also grouped into categories based on the target population and aim of the application or program. Of the 4818 titles identified from the database search, 64 articles were included. The broad categories of features found to be included in applications generally corresponded to different behavior change support strategies common to many classic behavioral change models. Key content of applications generally focused on food composition, with tailored feedback most commonly used to deliver educational content. Consumer testing before application deployment was reported in just over half of the studies. Collaboration between practitioners and application developers promotes an appropriate balance of evidence-based content and functionality. This work provides a unique resource for program development teams and practitioners seeking to use an application for nutrition improvement in community settings. PMID:28298274

Analysis of large 16S rRNA Illumina data sets: Impact of singleton read filtering on microbial community description.

PubMed

Auer, Lucas; Mariadassou, Mahendra; O'Donohue, Michael; Klopp, Christophe; Hernandez-Raquet, Guillermina

2017-11-01

Next-generation sequencing technologies give access to large sets of data, which are extremely useful in the study of microbial diversity based on 16S rRNA gene. However, the production of such large data sets is not only marred by technical biases and sequencing noise but also increases computation time and disc space use. To improve the accuracy of OTU predictions and overcome both computations, storage and noise issues, recent studies and tools suggested removing all single reads and low abundant OTUs, considering them as noise. Although the effect of applying an OTU abundance threshold on α- and β-diversity has been well documented, the consequences of removing single reads have been poorly studied. Here, we test the effect of singleton read filtering (SRF) on microbial community composition using in silico simulated data sets as well as sequencing data from synthetic and real communities displaying different levels of diversity and abundance profiles. Scalability to large data sets is also assessed using a complete MiSeq run. We show that SRF drastically reduces the chimera content and computational time, enabling the analysis of a complete MiSeq run in just a few minutes. Moreover, SRF accurately determines the actual community diversity: the differences in α- and β-community diversity obtained with SRF and standard procedures are much smaller than the intrinsic variability of technical and biological replicates. © 2017 John Wiley & Sons Ltd.

Gym-based exoskeleton walking: A preliminary exploration of non-ambulatory end-user perspectives.

PubMed

Cahill, Aoife; Ginley, Orna Mc; Bertrand, Courtney; Lennon, Olive

2018-07-01

Robotic walking devices (RWD) have shown many physical benefits in Spinal Cord Injury (SCI) rehabilitation. No study to date has explored end-user perceptions of these devices or gained insight into the use of these devices in a gym-based setting. This preliminary study explores the perspectives of four non-ambulatory individuals with SCI on using an exoskeleton walking device in a gym-based community setting. In-depth, semi-structured interviews were conducted with four SCI individuals living in the community. Interviews were audio-recorded and transcribed verbatim. Inductive thematic analysis established common overarching themes and subthemes. Four primary themes emerged addressing "The Psychological Adjustments Around Using RWDs with Respect to Disability", "Perceived Physical, Social and Psychological Benefits of Using an Exoskeleton", "The Role of External Influences", and "A Wellness Model to Health". A fully integrated gym setting was found to provide a positive and encouraging space to utilise the device. In addition, both the ability to set training goals and the positive attitude of robotic trainers were deemed to be important factors. This preliminary study provides detailed perspectives of four non-ambulatory individuals with SCI on utilising an exoskeleton walking device in a community setting. It suggests that gym-based RWDs impact positively on the users' lives and enhance their perceived wellbeing and sense of community integration. Enabling access to similar, community-based facilities should be prioritised for those with longstanding SCI disability. Copyright © 2018 Elsevier Inc. All rights reserved.

Characteristics of Smartphone Applications for Nutrition Improvement in Community Settings: A Scoping Review.

PubMed

Tonkin, Emma; Brimblecombe, Julie; Wycherley, Thomas Philip

2017-03-01

Smartphone applications are increasingly being used to support nutrition improvement in community settings. However, there is a scarcity of practical literature to support researchers and practitioners in choosing or developing health applications. This work maps the features, key content, theoretical approaches, and methods of consumer testing of applications intended for nutrition improvement in community settings. A systematic, scoping review methodology was used to map published, peer-reviewed literature reporting on applications with a specific nutrition-improvement focus intended for use in the community setting. After screening, articles were grouped into 4 categories: dietary self-monitoring trials, nutrition improvement trials, application description articles, and qualitative application development studies. For mapping, studies were also grouped into categories based on the target population and aim of the application or program. Of the 4818 titles identified from the database search, 64 articles were included. The broad categories of features found to be included in applications generally corresponded to different behavior change support strategies common to many classic behavioral change models. Key content of applications generally focused on food composition, with tailored feedback most commonly used to deliver educational content. Consumer testing before application deployment was reported in just over half of the studies. Collaboration between practitioners and application developers promotes an appropriate balance of evidence-based content and functionality. This work provides a unique resource for program development teams and practitioners seeking to use an application for nutrition improvement in community settings. © 2017 American Society for Nutrition.

Programa de fortalecimiento de capacidades: reflections on a case study of community-based teacher education set in rural northern Peru

NASA Astrophysics Data System (ADS)

Alsop, Steve; Ames, Patricia; Arroyo, Graciela Cordero; Dippo, Don

2010-12-01

This article explores distinctive features of a 5-year international education development project set in rural northern Peru (PROMEB, the Proyecto de Mejoramiento de la Educación Básica). Grounded within a partnership between teacher educators from Peru, Mexico and Canada, and rural Peruvian teachers, students and their communities, we offer reflections on a teacher education initiative which sought to support action-orientated inquiries as a mechanism for school/community development. Set against a background of poverty, hunger, isolation and an "educational crisis", we outline our pedagogy and describe two projects. We then reflect on the influences of our engagements and on associated tensions and ambiguities in our methods. We hope that such discussions might offer insights for others involved in international school/community development projects of this type.

From "Water Boiling in a Peruvian Town" to "Letting them Die": culture, community intervention, and the metabolic balance between patience and zeal.

PubMed

Trickett, Edison J

2011-03-01

While the concept of culture has long been central to community psychology research and intervention, it has most frequently referred to the communities in which such work occurs. The purpose of this paper is to reframe this discussion by viewing community interventions as instances of intercultural contact between the culture of science, reflected in community intervention research, and the culture of the communities in which those interventions occur. Following a brief discussion of the complexities of culture as a concept, two illustrative stories of failed community interventions are provided to highlight the centrality of cultural and contextual understanding as prelude to community intervention. These stories, set 50 years apart, reflect the depth and pervasive influence of both the culture of science and the culture of communities. Next, a series of propositions about the culture of social science as a partial reflection of the broader culture of the United States are offered, and their implications for the conduct of community interventions drawn. The paper concludes with a series of recommendations which, together, provide an ecological mind-set for taking culture seriously in community interventions. Central to this mind set are the importance of focusing on communities rather than programs and emphasizing the intervention goal of choice over change.

Community-based violence awareness.

PubMed

Kelly, Patricia J; Lesser, Janna; Peralez-Dieckmann, Esther; Castilla, Martha

2007-03-01

Violence against women is a major influence on women's mental health. We used popular education techniques to train 14 Spanish-speaking women as promotoras (community health workers) to increase awareness about violence against women in low income Texas communities. These women then conducted over 80 presentations in Spanish in local community settings. The impact of the program on the promotoras and on women attending the presentations was evaluated using qualitative methods. This research lends support to the idea that nurses working in community mental health settings must use innovative primary prevention strategies and evaluation mechanisms to change awareness about violence against women.

Evaluation of different PCR primers for denaturing gradient gel electrophoresis (DGGE) analysis of fungal community structure in traditional fermentation starters used for Hong Qu glutinous rice wine.

PubMed

Lv, Xu-Cong; Jiang, Ya-Jun; Liu, Jie; Guo, Wei-Ling; Liu, Zhi-Bin; Zhang, Wen; Rao, Ping-Fan; Ni, Li

2017-08-16

Denaturing gradient gel electrophoresis (DGGE) has become a widely used tool to examine microbial community structure. However, when DGGE is applied to evaluate the fungal community of traditional fermentation starters, the choice of hypervariable ribosomal RNA gene regions is still controversial. In the current study, several previously published fungal PCR primer sets were compared and evaluated using PCR-DGGE, with the purpose of screening a suitable primer set to study the fungal community of traditional fermentation starters for Hong Qu glutinous rice wine. Firstly, different primer sets were used to amplify different hypervariable regions from pure fungal cultures. Except NS1/FR1+ and ITS1fGC/ITS4, other primer sets (NL1+/LS2R, NL3A/NL4GC, FF390/FR1+, NS1/GCFung, NS3+/YM951r and ITS1fGC/ITS2r) amplified the target DNA sequences successfully. Secondly, the selected primer sets were further evaluated based on their resolution to distinguish different fungal cultures through DGGE fingerprints. Three primer sets (NL1+/LS2R, NS1/GCFung and ITS1fGC/ITS2r) were finally selected for investigating the fungal community structure of different traditional fermentation starters for Hong Qu glutinous rice wine. The internal transcribed spacer (ITS) region amplified by ITS1fGC/ITS2r, which is more hypervariable than the 18S rRNA gene and 26S rRNA gene, provides an excellent tool to separate amplification products of different fungal species. Results indicated that PCR-DGGE profile using ITS1fGC/ITS2r showed more abundant fungal species than that using NL1+/LS2R and NS1/GCFung. Therefore, ITS1fGC/ITS2r is the most suitable primer set for PCR-DGGE analysis of fungal community structure in traditional fermentation starters for Hong Qu glutinous rice wine. DGGE profiles based on ITS1fGC/ITS2r revealed the presence of twenty-four fungal species in traditional fermentation starter. A significant difference of fungal community can be observed directly from DGGE fingerprints and principal component analysis. The statistical analysis results based on the band intensities of fungal DGGE profile showed that Saccharomyces cerevisiae, Saccharomycopsis fibuligera, Rhizopus oryzae, Monascus purpureus and Aspergillus niger were the dominant fungal species. In conclusion, the comparison of several primer sets for fungal PCR-DGGE would be useful to enrich our knowledge of the fungal community structures associated with traditional fermentation starters, which may facilitate the development of better starter cultures for manufacturing Chinese Hong Qu glutinous rice wine. Copyright © 2017 Elsevier B.V. All rights reserved.

[Applying a teaching programme in community-based medical education].

PubMed

Al-Faisal, W

2006-01-01

A community-based medical education programme at Damascus University was applied in a local setting from 2 to 12 July 2004 to assess the advantages and disadvantages. Three families and 10 medical students participated. The programme included teaching objectives, health education and approaches to application and evaluation. The design of the programme was appropriate for the community setting, but it needed a longer period to run and for contact between the students and the community. The students agreed with the structure of the programme and the role of the tutor and community, but were concerned about difficulties in implementation. Community members were enthusiastic about the programme.

Improving Participants' Retention in a Smoking Cessation Intervention Using a Community-based Participatory Research Approach.

PubMed

Estreet, Anthony; Apata, Jummai; Kamangar, Farin; Schutzman, Christine; Buccheri, Jane; O'Keefe, Anne-Marie; Wagner, Fernando; Sheikhattari, Payam

2017-01-01

This study compares participant' sretention in three phases of smoking cessation interventions, one provided in a health clinic and the subsequent two in community-based settings. Smoking cessation interventions were conducted in three phases from 2008 to 2015 in two underserved urban communities with low socioeconomic profiles and high rates of smoking ( n = 951). Phase I was conducted in a clinic; Phases II and III were conducted in community venues. In Phases II and III, incremental changes were made based on lessons learned from the previous phases. Retention (attending six or more sessions) was the primary predictor of cessation and was analyzed while controlling for associated factors including age, gender, race, employment, education, and nicotine dependence. Retention increased substantially over the three phases, with rates for attending six or more sessions of 13.8%, 51.9%, and 67.9% in Phases I, II, and III, respectively. Retention was significantly higher in community settings than in the clinic setting (adjusted odds ratio [OR] = 6.7; 95% confidence intervals [CI] = 4.6, 9.8). In addition to the intervention in community venues, predictors of retention included age and unemployment. Higher retention was significantly associated with higher quit rates (adjusted OR = 2.4; 95% CI = 1.5, 3.8). Conducting the intervention in community settings using trained peer motivators rather than health-care providers resulted in significantly higher retention and smoking cessation rates. This was due in part to the ability to tailor cessation classes in the community for specific populations and improving the quality of the intervention based on feedback from participants and community partners.

The rural community care gerontologic nurse entrepreneur: role development strategies.

PubMed

Caffrey, Rosalie A

2005-10-01

Rural elderly individuals are an underserved population with limited access to health care. There is an increasing need for independent community care nurses to provide assistance to home-based elderly individuals with chronic illnesses to prevent unnecessary medical and placement decisions and, thus, allow them to maintain independence and quality of life. This article describes the rural setting and why community care nurses are needed, and explores strategies for implementing the role of the independent nurse entrepreneur in caring for community-based elderly individuals in rural settings.

Climbing the walls: prison mental health and community engagement.

PubMed

Caie, Jude

Until recently, treatment for mental health conditions has focused on medical and psychological therapy. The role and significance of social and community interventions and initiatives in fostering recovery, resilience and a sense of 'flourishing' is now being recognised. This paper seeks to explore how these principles, which are usually community-based, can be successfully applied within a prison setting, and how such interventions may have a positive effect on the mental health of prisoners through successfully engaging them with the communities they are set to return to after release while still in custody.

7 CFR 1778.13 - Set-aside.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Set-aside. 1778.13 Section 1778.13 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) EMERGENCY AND IMMINENT COMMUNITY WATER ASSISTANCE GRANTS § 1778.13 Set-aside. (a) At least 70...

Implementing a framework for goal setting in community based stroke rehabilitation: a process evaluation.

PubMed

Scobbie, Lesley; McLean, Donald; Dixon, Diane; Duncan, Edward; Wyke, Sally

2013-05-24

Goal setting is considered 'best practice' in stroke rehabilitation; however, there is no consensus regarding the key components of goal setting interventions or how they should be optimally delivered in practice. We developed a theory-based goal setting and action planning framework (G-AP) to guide goal setting practice. G-AP has 4 stages: goal negotiation, goal setting, action planning & coping planning and appraisal & feedback. All stages are recorded in a patient-held record. In this study we examined the implementation, acceptability and perceived benefits of G-AP in one community rehabilitation team with people recovering from stroke. G-AP was implemented for 6 months with 23 stroke patients. In-depth interviews with 8 patients and 8 health professionals were analysed thematically to investigate views of its implementation, acceptability and perceived benefits. Case notes of interviewed patients were analysed descriptively to assess the fidelity of G-AP implementation. G-AP was mostly implemented according to protocol with deviations noted at the planning and appraisal and feedback stages. Each stage was felt to make a useful contribution to the overall process; however, in practice, goal negotiation and goal setting merged into one stage and the appraisal and feedback stage included an explicit decision making component. Only two issues were raised regarding G-APs acceptability: (i) health professionals were concerned about the impact of goal non-attainment on patient's well-being (patients did not share their concerns), and (ii) some patients and health professionals found the patient-held record unhelpful. G-AP was felt to have a positive impact on patient goal attainment and professional goal setting practice. Collaborative partnerships between health professionals and patients were apparent throughout the process. G-AP has been perceived as both beneficial and broadly acceptable in one community rehabilitation team; however, implementation of novel aspects of the framework was inconsistent. The regulatory function of goal non-attainment and the importance of creating flexible partnerships with patients have been highlighted. Further development of the G-AP framework, training package and patient held record is required to address the specific issues highlighted by this process evaluation. Further evaluation of G-AP is required across diverse community rehabilitation settings.

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

NASA Technical Reports Server (NTRS)

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

1998-01-01

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

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

ERIC Educational Resources Information Center

Cannon, Anneliese; Blair, Alissa

2014-01-01

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

The Prevalence of Behavior Problems among People with Intellectual Disability Living in Community Settings

ERIC Educational Resources Information Center

Myrbakk, Even; Von Tetzchner, Stephen

2008-01-01

With the desegregation processes of services for people with intellectual disability (ID) that is taking place in most Western countries there is a need for more knowledge related to the prevalence of behavior problems among people living in community settings. This study investigates the prevalence of behavior problems among 140 adolescents and…

Caught in the Shadows: Immigrant Educational Access -- The Amnesty Population.

ERIC Educational Resources Information Center

Spicer, Scot L.; Sanchez, Jorge R.

A study was conducted by Glendale Community College (California) in 1991 to obtain information about amnesty applicants participating in programs offered by the California community colleges. Two sets of data were used for the study. The first set was collected as part of a spring 1989 needs assessment survey in English as a Second Language…

How Working Poor Maya Migrant Families Acculturate to an Urban Setting--Daily Routines and Adaptation Strategies

ERIC Educational Resources Information Center

Tovote, Katrin Erika

2012-01-01

Globally, an increasing number of people migrate from their rural communities to large cities. Despite the pervasive thinking that indigenous communities are solidified in space and strictly conserve cultural traditions, indigenous individuals and families increasingly leave their homelands to set up a new life in an urban environment mostly…

Implementation of a Contingency Management-Based Intervention in a Community Supervision Setting: Clinical Issues and Recommendations

ERIC Educational Resources Information Center

Trotman, Adria J.; Taxman, Faye S.

2011-01-01

A cognitive-behaviorally based substance abuse treatment program was implemented within a community supervision setting. This program included a goals group that used a contingency management component and included the probation agent as a part of the treatment. In this article, the authors describe the contingency management component of the…

Measuring Efficiency in the Community College Sector. CCRC Working Paper No. 43

ERIC Educational Resources Information Center

Belfield, Clive R.

2012-01-01

Community colleges are increasingly being pressed to demonstrate efficiency and improve productivity even as these concepts are not clearly defined and require a significant set of assumptions to determine. This paper sets out a preferred economic definition of efficiency: fiscal and social cost per degree. It then assesses the validity of using…

From out of the Fields: Migrant Student Success in a Post-Secondary Community College Setting

ERIC Educational Resources Information Center

Alaniz, Monica Jean

2010-01-01

This study examines factors that contribute to migrant student success while navigating a post-secondary community college setting. While the majority of studies dealing with migrant education use a deficit approach--concentrating on the factors that inhibit student success--this study asks why certain migrant students at South Texas College in…

Teaching Social Skills to Enhance Work Performance in a Child Care Setting

ERIC Educational Resources Information Center

Gear, Sabra; Bobzien, Jonna; Judge, Sharon; Raver, Sharon A.

2011-01-01

Adults with intellectual disabilities face difficulty seeking employment in the community workforce. Using a single-subject design, this study examined the utility of role playing and self-management strategies to enhance work performance by promoting the social skills of a young woman with Down syndrome working in a community child care setting.…

The Efficacy of Conjoint Behavioral Consultation in the Home Setting: Outcomes and Mechanisms in Rural Communities

ERIC Educational Resources Information Center

Sheridan, Susan M.; Witte, Amanda L.; Holmes, Shannon; Wu, ChaoRong; Bhatia, Sonya A.; Angell, Samantha

2017-01-01

This study reports the results of a randomized controlled trial examining the effect of Conjoint Behavioral Consultation (CBC), a family-school partnership intervention, on children's behaviors, parents' skills, and parent-teacher relationships in rural community and town settings. Participants were 267 children, 267 parents, and 152 teachers in…

Designing for expansive science learning and identification across settings

NASA Astrophysics Data System (ADS)

Stromholt, Shelley; Bell, Philip

2017-10-01

In this study, we present a case for designing expansive science learning environments in relation to neoliberal instantiations of standards-based implementation projects in education. Using ethnographic and design-based research methods, we examine how the design of coordinated learning across settings can engage youth from non-dominant communities in scientific and engineering practices, resulting in learning experiences that are more relevant to youth and their communities. Analyses highlight: (a) transformative moments of identification for one fifth-grade student across school and non-school settings; (b) the disruption of societal, racial stereotypes on the capabilities of and expectations for marginalized youth; and (c) how youth recognized themselves as members of their community and agents of social change by engaging in personally consequential science investigations and learning.

Supporting breast-feeding when a woman is homeless.

PubMed

Crespo-Fierro, Michele; Lunney, Margaret

2011-01-01

This case study demonstrates use of standardized nursing languages in the care of new mothers in community settings. The author collected data from clinical practice as an instructor in a baccalaureate nursing program and from the research literature. The appropriate nursing diagnoses, outcomes, and interventions were identified in partnership with the new mother. This case shows that NANDA International (NANDA-I), the Nursing Outcomes Classification (NOC), and the Nursing Interventions Classification (NIC) are useful to direct nursing care in community settings. When teaching nursing students in a baccalaureate program, nurse faculty can use NANDA-I, NOC, and NIC classifications to guide the growing practice of nursing students in community settings. © 2011, The Authors. International Journal of Nursing Terminologies and Classifications © 2011, NANDA International.

Pharmacogenomics in diverse practice settings: implementation beyond major metropolitan areas

PubMed Central

Dorfman, Elizabeth H; Trinidad, Susan Brown; Morales, Chelsea T; Howlett, Kevin; Burke, Wylie; Woodahl, Erica L

2015-01-01

Aim The limited formal study of the clinical feasibility of implementing pharmacogenomic tests has thus far focused on providers at large medical centers in urban areas. Our research focuses on small metropolitan, rural and tribal practice settings. Materials & methods We interviewed 17 healthcare providers in western Montana regarding pharmacogenomic testing. Results Participants were optimistic about the potential of pharmacogenomic tests, but noted unique barriers in small and rural settings including cost, adherence, patient acceptability and testing timeframe. Participants in tribal settings identified heightened sensitivity to genetics and need for community leadership approval as additional considerations. Conclusion Implementation differences in small metropolitan, rural and tribal communities may affect pharmacogenomic test adoption and utilization, potentially impacting many patients. PMID:25712186

Emergency ultrasound usage among recent emergency medicine residency graduates of a convenience sample of 14 residencies.

PubMed

Dean, Anthony J; Breyer, Michael J; Ku, Bon S; Mills, Angela M; Pines, Jesse M

2010-02-01

Emergency Medicine (EM) residency graduates are trained to perform Emergency Medicine bedside ultrasound (EMBU). However, the degree to which they use this skill in their practice after graduation is unknown. We sought to test the amount and type of usage of EMBU among recent residency graduates, and how usage and barriers vary among various types of EM practice settings. Graduates from 14 EM residency programs in 2003-2005 were surveyed on their current practice setting and use of EMBU. There were 252 (73%) graduates who completed the survey. Of the 73% of respondents reporting access to EMBU, 98% had used it within the past 3 months. Access to EMBU was higher in academic (97%) vs. community teaching (79%) vs. community non-teaching settings (62%) (p < 0.001), and in Emergency Departments (EDs) where yearly census exceeded 60,000 visits (87% vs. 65%, p < 0.001). Physicians in academic settings reported "high use" of EMBU more frequently than those in community settings for most modalities. FAST (focused assessment by sonography in trauma) was the most common high-use application and the most useful in practice. The greatest impediment to EMBU use was "not enough time" (61%). Ultrasound usage among recent EM residency graduates is significantly higher in teaching than in community settings and in high-volume EDs. Its use is more widespread than in previous reports in all types of practice. There is a wide range of utilization of ultrasound in the various applications in emergency practice, with the evaluation of trauma being the most common. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Community-based interventions to promote increased physical activity: a primer.

PubMed

Bopp, Melissa; Fallon, Elizabeth

2008-01-01

Current recommendations, based on an abundance of empirical data documenting the impact of physical activity (PA) on preventing morbidity and mortality associated with common chronic diseases, indicate that adults should accumulate 30 minutes of moderate-intensity PA > or =5 days per week. However, worldwide rates of PA remain low, indicating a great need for large-scale implementation of evidence-based PA interventions. We briefly present practical aspects of intervention planning, implementation and evaluation within common community settings. The first stage of intervention planning is formative research, which allows for a better understanding of the elements needed for a successful intervention. Partnering with community settings (schools, worksites, faith-based organizations and healthcare organizations) offers many benefits and the opportunity to reach specific populations. Setting-based approaches allow for multilevel strategies, ranging from individual-based programmes and educational initiatives to physical and social environmental changes. Various settings such as healthcare, worksite, and school- and community-based settings are discussed. Intervention delivery methods and strategies can range, depending on the population and setting targeted, from small-group approaches to mediated methods (e.g. print, telephone, electronic). The final phase of intervention planning and implementation is evaluation. Several objective and subjective methods of PA assessment are available to determine the effectiveness of the intervention. We have highlighted the need for process evaluation of intervention implementation to provide valuable information for the dissemination and sustainability of successful interventions. Although there are numerous considerations for the design, implementation, assessment and evaluation of PA interventions, the potential for positive impact on the overall health of the public indicates the necessity for programmes designed to increase PA.

Understanding facilitators and barriers to reengineering the clinical research enterprise in community-based practice settings.

PubMed

Kukafka, Rita; Allegrante, John P; Khan, Sharib; Bigger, J Thomas; Johnson, Stephen B

2013-09-01

Solutions are employed to support clinical research trial tasks in community-based practice settings. Using the IT Implementation Framework (ITIF), an integrative framework intended to guide the synthesis of theoretical perspectives for planning multi-level interventions to enhance IT use, we sought to understand the barriers and facilitators to clinical research in community-based practice settings preliminary to implementing new informatics solutions for improving clinical research infrastructure. The studies were conducted in practices within the Columbia University Clinical Trials Network. A mixed-method approach, including surveys, interviews, time-motion studies, and observations was used. The data collected, which incorporates predisposing, enabling, and reinforcing factors in IT use, were analyzed according to each phase of ITIF. Themes identified in the first phase of ITIF were 1) processes and tools to support clinical trial research and 2) clinical research peripheral to patient care processes. Not all of the problems under these themes were found to be amenable to IT solutions. Using the multi-level orientation of the ITIF, we set forth strategies beyond IT solutions that can have an impact on reengineering clinical research tasks in practice-based settings. Developing strategies to target enabling and reinforcing factors, which focus on organizational factors, and the motivation of the practice at large to use IT solutions to integrate clinical research tasks with patient care processes, is most challenging. The ITIF should be used to consider both IT and non-IT solutions concurrently for reengineering of clinical research in community-based practice settings. © 2013.

Epidemic spreading on complex networks with community structures

PubMed Central

Stegehuis, Clara; van der Hofstad, Remco; van Leeuwaarden, Johan S. H.

2016-01-01

Many real-world networks display a community structure. We study two random graph models that create a network with similar community structure as a given network. One model preserves the exact community structure of the original network, while the other model only preserves the set of communities and the vertex degrees. These models show that community structure is an important determinant of the behavior of percolation processes on networks, such as information diffusion or virus spreading: the community structure can both enforce as well as inhibit diffusion processes. Our models further show that it is the mesoscopic set of communities that matters. The exact internal structures of communities barely influence the behavior of percolation processes across networks. This insensitivity is likely due to the relative denseness of the communities. PMID:27440176

Communitarian claims and community capabilities: furthering priority setting?

PubMed

Mooney, Gavin

2005-01-01

Priority setting in health care is generally not done well. This paper draws on ideas from Amartya Sen and Martha Nussbaum and adds some communitarian underpinnings to provide a way of improving on current uses of program budgeting and marginal analysis (PBMA) in priority setting. The paper suggests that shifting to a communitarian base for priority setting alters the distribution of property rights over health service decision making and increases the probability that recommendations from PBMA exercises will be implemented. The approach is built on a paradigm which departs from three tenets of welfarism as it is normally conceived: (i) individuals qua individuals seek to maximise their individual utility/well-being; (ii) individuals want to do this; and (iii) it is the values of individuals qua individuals that count. Some of the problems of PBMA, as it has been applied to date, are highlighted. It is argued that these are due largely to a lack of 'credible commitment'. Bringing in the community and communitarian values to PBMA priority setting exercises can help to overcome some of the barriers to getting PBMA recommendations implemented. The approach has the merit of reflecting Sen's concept of capabilities (but extending that to a community level). It avoids the often consequentialist base of a conventional welfarist framework, and it allows community values as opposed to individual values to come to the fore. How to elicit communitarian values is explored.

Community Psychology and the Capabilities Approach

PubMed Central

2016-01-01

What makes for a good life? The capabilities approach to this question has much to offer community psychology, particularly with respect to marginalized groups. Capabilities are freedoms to engage in valued social activities and roles—what people can do and be given both their capacities, and environmental opportunities and constraints. Economist Amartya Sen’s focus on freedoms and agency resonates with psychological calls for empowerment, and philosopher Martha Nussbaum’s specification of requirements for a life that is fully human provides an important guide for social programs. Community psychology’s focus on mediating structures has much to offer the capabilities approach. Parallels between capabilities, as enumerated by Nussbaum, and settings that foster positive youth development, as described in a National Research Council Report (Eccles and Gootman (Eds) in Community programs to promote youth development. National Academy Press, Washington, 2002) suggest extensions of the approach to children. Community psychologists can contribute to theory about ways to create and modify settings to enhance capabilities as well as empowerment and positive youth development. Finally, capabilities are difficult to measure, because they involve freedoms to choose but only choices actually made or enacted can be observed. The variation in activities or goals across members of a setting provides a measure of the capabilities that the setting fosters. PMID:25822113

Community psychology and the capabilities approach.

PubMed

Shinn, Marybeth

2015-06-01

What makes for a good life? The capabilities approach to this question has much to offer community psychology, particularly with respect to marginalized groups. Capabilities are freedoms to engage in valued social activities and roles-what people can do and be given both their capacities, and environmental opportunities and constraints. Economist Amartya Sen's focus on freedoms and agency resonates with psychological calls for empowerment, and philosopher Martha Nussbaum's specification of requirements for a life that is fully human provides an important guide for social programs. Community psychology's focus on mediating structures has much to offer the capabilities approach. Parallels between capabilities, as enumerated by Nussbaum, and settings that foster positive youth development, as described in a National Research Council Report (Eccles and Gootman (Eds) in Community programs to promote youth development. National Academy Press, Washington, 2002) suggest extensions of the approach to children. Community psychologists can contribute to theory about ways to create and modify settings to enhance capabilities as well as empowerment and positive youth development. Finally, capabilities are difficult to measure, because they involve freedoms to choose but only choices actually made or enacted can be observed. The variation in activities or goals across members of a setting provides a measure of the capabilities that the setting fosters.

More Needed for Coherent System

ERIC Educational Resources Information Center

Field, John

2004-01-01

From a learner's standpoint, Scotland's education system often looks less like a neat set of pathways than a tangled jungle. Since devolution, Scottish policymakers and the education community have set out to create a coherent and transparent set of opportunities for adult learners, of a quality to match Scotland's oft-praised unified system of…

Parent Involvement in Early Intervention: What Role Does Setting Play?

ERIC Educational Resources Information Center

Kellar-Guenther, Yvonne; Rosenberg, Steven A.; Block, Stephen R.; Robinson, Cordelia C.

2014-01-01

This study compared levels of parent involvement in early intervention services for children under three which were delivered in community settings (children's homes and child care programs) and specialized settings (early intervention centers and provider offices) in the USA. Respondents reported the highest levels of parental involvement in the…

Making User-Generated Content Communities Work in Higher Education - The Importance of Setting Incentives

NASA Astrophysics Data System (ADS)

Vom Brocke, Jan; White, Cynthia; Walker, Ute; Vom Brocke, Christina

The concept of User-Generated Content (UGC) offers impressive potential for innovative learning and teaching scenarios in higher education. Examples like Wikipedia and Facebook illustrate the enormous effects of multiple users world-wide contributing to a pool of shared resources, such as videos and pictures and also lexicographical descriptions. Apart from single examples, however, the systematic use of these virtual technologies in higher education still needs further exploration. Only few examples display the successful application of UGC Communities at university scenarios. We argue that a major reason for this can be seen in the fact that the organizational dimension of setting up UGC Communities has widely been neglected so far. In particular, we indicate the need for incentive setting to actively involve students and achieve specific pedagogical objectives. We base our study on organizational theories and derive strategies for incentive setting that have been applied in a practical e-Learning scenario involving students from Germany and New Zealand.

Automated large-scale file preparation, docking, and scoring: evaluation of ITScore and STScore using the 2012 Community Structure-Activity Resource benchmark.

PubMed

Grinter, Sam Z; Yan, Chengfei; Huang, Sheng-You; Jiang, Lin; Zou, Xiaoqin

2013-08-26

In this study, we use the recently released 2012 Community Structure-Activity Resource (CSAR) data set to evaluate two knowledge-based scoring functions, ITScore and STScore, and a simple force-field-based potential (VDWScore). The CSAR data set contains 757 compounds, most with known affinities, and 57 crystal structures. With the help of the script files for docking preparation, we use the full CSAR data set to evaluate the performances of the scoring functions on binding affinity prediction and active/inactive compound discrimination. The CSAR subset that includes crystal structures is used as well, to evaluate the performances of the scoring functions on binding mode and affinity predictions. Within this structure subset, we investigate the importance of accurate ligand and protein conformational sampling and find that the binding affinity predictions are less sensitive to non-native ligand and protein conformations than the binding mode predictions. We also find the full CSAR data set to be more challenging in making binding mode predictions than the subset with structures. The script files used for preparing the CSAR data set for docking, including scripts for canonicalization of the ligand atoms, are offered freely to the academic community.

Community reinforcement approach plus vouchers for cocaine dependence in a community setting in Spain: six-month outcomes.

PubMed

Secades-Villa, Roberto; García-Rodríguez, Olaya; Higgins, Stephen T; Fernández-Hermida, José R; Carballo, José L

2008-03-01

The aim of this study was to assess the efficacy of the community reinforcement approach (CRA) plus vouchers treatment in achieving cocaine abstinence and treatment retention among patients enrolled in an outpatient program for cocaine dependence in Spain. Forty-three patients were randomly assigned to one of two treatment conditions in a community setting: CRA plus vouchers or standard care. Of the patients who received the CRA plus vouchers program, 73% completed 24 weeks of treatment, as compared with 42% of the patients who received standard care who did. In the CRA plus vouchers group, 40% of the patients achieved 24 weeks of continuous cocaine abstinence, as compared with 21% of the patients in the standard care group who did. These results support the effectiveness and generalizability of the CRA plus vouchers treatment in a community setting outside of the United States. Further follow-up is required to confirm the long-term maintenance of the results.

Facilitating knowledge translation in the "real world" of community psychiatry.

PubMed

Goldie, Catherine L; Malchy, Leslie; Johnson, Joy L

2010-11-01

Tobacco use disproportionately affects the well-being of individuals with mental illness. In community psychiatric settings, there are culturally embedded attitudes and behaviors regarding smoking that enable practitioners to remain ambivalent about their clients' tobacco use. Given these cultural norms, the authors aimed to introduce evidence-informed smoking cessation interventions to a variety of interdisciplinary mental health care providers by using an innovative approach to knowledge translation. The authors used a case study design in which six community psychiatric settings were targeted. The organizational culture related to smoking was examined at each site before tailored tobacco reduction interventions were delivered. The study design was guided by the knowledge-to-action (KTA) process and two supplementary approaches to change: motivational interviewing (MI) and appreciative inquiry (AI). The principles of the KTA process, MI, and AI helped the authors to meaningfully engage with practice groups and change the organizational culture surrounding tobacco use in several community psychiatric settings.

Obtaining and providing health information in the community pharmacy setting.

PubMed

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

2006-06-15

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

Obtaining and Providing Health Information in the Community Pharmacy Setting

PubMed Central

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

2006-01-01

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

Bridging informatics and implementation science: evaluating a framework to assess electronic health record implementations in community settings.

PubMed

Richardson, Joshua E; Abramson, Erika L; Pfoh, Elizabeth R; Kaushal, Rainu

2012-01-01

Effective electronic health record (EHR) implementations in community settings are critical to promoting safe and reliable EHR use as well as mitigating provider dissatisfaction that often results. The implementation challenge is compounded given the scale and scope of EHR installations that are occurring and will continue to occur over the next five years. However, when compared to EHR evaluations relatively few biomedical informatics researchers have published on evaluating EHR implementations. Fewer still have evaluated EHR implementations in community settings. We report on the methods we used to achieve a novel application of an implementation science framework in informatics to qualitatively evaluate community-based EHR implementations. We briefly provide an overview of the implementation science framework, our methods for adapting it to informatics, the effects the framework had on our qualitative methods of inquiry and analysis, and discuss its potential value for informatics research.

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

PubMed

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

2015-11-23

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

Community-based outbreaks of tuberculosis.

PubMed

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

1996-05-27

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

Local community detection as pattern restoration by attractor dynamics of recurrent neural networks.

PubMed

Okamoto, Hiroshi

2016-08-01

Densely connected parts in networks are referred to as "communities". Community structure is a hallmark of a variety of real-world networks. Individual communities in networks form functional modules of complex systems described by networks. Therefore, finding communities in networks is essential to approaching and understanding complex systems described by networks. In fact, network science has made a great deal of effort to develop effective and efficient methods for detecting communities in networks. Here we put forward a type of community detection, which has been little examined so far but will be practically useful. Suppose that we are given a set of source nodes that includes some (but not all) of "true" members of a particular community; suppose also that the set includes some nodes that are not the members of this community (i.e., "false" members of the community). We propose to detect the community from this "imperfect" and "inaccurate" set of source nodes using attractor dynamics of recurrent neural networks. Community detection by the proposed method can be viewed as restoration of the original pattern from a deteriorated pattern, which is analogous to cue-triggered recall of short-term memory in the brain. We demonstrate the effectiveness of the proposed method using synthetic networks and real social networks for which correct communities are known. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Comparison of gait performance on different environmental settings for patients with chronic spinal cord injury.

PubMed

Olmos, L E; Freixes, O; Gatti, M A; Cozzo, D A; Fernandez, S A; Vila, C J; Agrati, P E; Rubel, I F

2008-05-01

Observational cross-section study. The objective of our study was to determine if the influence of a community environment would impact on ASIA D spinal cord injured (SCI) gait performance patients. Our main hypothesis is that an outdoor community environment may influence gait speed and endurance on community ambulating patients. Ten-Meter Walking (10MWT) and Six-Minute Walking (6MWT) tests were performed on community ambulating SCI research participants (n=18) in two different environmental conditions: (1) Experimental (indoors Gymnasium) and (2) Natural (community setting). Average gait speed and endurance values were obtained for the two different conditions and analyzed for statistical significance on the nonparametric two-tailed Wilcoxon signed rank test. While no difference was observed on the 10MWT we found an improvement on gait performance on the 6 MWT on a community setting. Our study showed mixed results on environmental influence on gait speed and endurance on ASIA D patient population. While there is no difference on the 10 MWT, there is an improvement on gait performance on the communitary 6MWT.

Recommendations for scale-up of community-based misoprostol distribution programs.

PubMed

Robinson, Nuriya; Kapungu, Chisina; Carnahan, Leslie; Geller, Stacie

2014-06-01

Community-based distribution of misoprostol for prevention of postpartum hemorrhage (PPH) in resource-poor settings has been shown to be safe and effective. However, global recommendations for prenatal distribution and monitoring within a community setting are not yet available. In order to successfully translate misoprostol and PPH research into policy and practice, several critical points must be considered. A focus on engaging the community, emphasizing the safe nature of community-based misoprostol distribution, supply chain management, effective distribution, coverage, and monitoring plans are essential elements to community-based misoprostol program introduction, expansion, or scale-up. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Community Health Workers-Promotores de Salud in Mexico: History and Potential for Building Effective Community Actions.

PubMed

Balcazar, Hector; Perez-Lizaur, Ana Bertha; Izeta, Ericka Escalante; Villanueva, Maria Angeles

2016-01-01

This article takes a historical perspective combining 3 illustrative examples of the origins of the community health worker (CHW) model in Mexico, as a community-based participatory strategy. Three examples were identified from the sparse literature about CHWs in Mexico emphasizing their key roles and functions in various community settings. The CHW models illustrate what is known of training-development and planning, implementation, and evaluation of the CHWs model in different settings addressing cardiovascular disease and risk factors. The potential exists for integrating CHW projects to expand the health promotion model with new emphasis on municipality and regional participation.

Creating Employable Graduates in Career and Technical Education: Defining the Partnership between Business and the Community College

ERIC Educational Resources Information Center

Thomes, Norbert Joseph

2012-01-01

The skill set required to attain quality employment is not being fully addressed in the community colleges. This disconnect produces laborers with skill sets that do not meet the needs of employers. Ironically, while the need for employees with increased skills rises annually, many graduates have difficulty finding employment in their career…

Concussion Assessment in California Community College Football: Athletic Trainers' Strides toward a Safer Return to Play

ERIC Educational Resources Information Center

Chinn, Nancy Resendes

2010-01-01

The purpose of this mixed method study was to compare current practices of athletic trainers in the management of concussion in football at California Community Colleges (CCC) with the concussion management guidelines set forth by the National Athletic Trainers Association (NATA). The study also set out to gain understanding of why some athletic…

Portable and Accessible Video Modeling: Teaching a Series of Novel Skills within School and Community Settings

ERIC Educational Resources Information Center

Taber-Doughty, Teresa; Miller, Bridget; Shurr, Jordan; Wiles, Benjamin

2013-01-01

This study examined the effectiveness of self-operated video models on the skill acquisition of a series of novel tasks taught in community-based settings. In addition, the percent of independent task transitions and the duration at which four secondary students with a moderate intellectual disability transitioned between tasks was also examined.…

Influence of Risk and Community Setting on Kindergarten Children's Development. R2Ed Working Paper 2015-2

ERIC Educational Resources Information Center

Holmes, Shannon R.; Sheridan, Susan M.; Witte, Amanda L.; Bhatia, Sonya A.; Coutts, Michael J.

2015-01-01

This study examined differences in kindergarten children's behavioral functioning across rural and non-rural communities, as well as explored the effect of risk in each setting (i.e., rural, nonrural) on these children's behavior. Data from 116 kindergarten students and their parents and teachers was analyzed. Multileveling modeling was used to…

Staff Stress and Morale in Community-Based Settings for People with Intellectual Disabilities and Challenging Behaviour: A Brief Report

ERIC Educational Resources Information Center

Robertson, Janet; Hatton, Chris; Felce, David; Meek, Andrea; Carr, Deborah; Knapp, Martin; Hallam, Angela; Emerson, Eric; Pinkney, Lisa; Caesar, Emma; Lowe, Kathy

2005-01-01

Background: There are no studies that have compared outcomes for staff in different types of supported accommodation for people with intellectual disabilities and challenging behaviour. This study looked at stress, morale and intended job turnover in staff in two types of community-based residential supports: non-congregate settings where the…

A Model Process for Institutional Goals-Setting. A Module of the Needs Assessment Project.

ERIC Educational Resources Information Center

King, Maxwell C.; And Others

A goals-setting model for the community/junior college that would interface with the community needs assessment model was developed, using as the survey instrument the Institutional Goals Inventory (I.G.I.) developed by the Educational Testing Service. The nine steps in the model are: Establish Committee on College Goals and Identify Goals Project…

Development of Guidelines Related to Riverside Community College Nursing Student Mandatory Assignment to AIDS Patients in the Clinical Setting.

ERIC Educational Resources Information Center

Kross, Carolyn Sue

The purpose of this study was to develop Associate Degree nursing program guidelines for Riverside Community College (RCC), in California, regarding mandatory nursing student assignment to Acquired Immune Deficiency Syndrome (AIDS) patients, and student refusal of such assignments in a clinical setting. During the 1990 fall semester, RCC's Nursing…

Doing More with Less: Innovative Program Building in ABA and Special Education in a Rural Setting

ERIC Educational Resources Information Center

Bethune, Keri S.; Kiser, Ansley

2017-01-01

There is a need for both special education teachers and Board Certified Behavior Analysts (BCBAs) who are trained to work in rural school settings with students with disabilities and problem behaviors. The specific challenges presented by rural communities, such as diminished access to resources and fewer community partners, can make it difficult…

The effect of healthcare environments on a pandemic influenza outbreak.

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

Cannon, Daniel C.; Davey, Victoria J.; Glass, Robert John, Jr.

The objectives of this presentation are: (1) To determine if healthcare settings serve as intensive transmission environments for influenza epidemics, increasing effects on communities; (2) To determine which mitigation strategies are best for use in healthcare settings and in communities to limit influenza epidemic effects; and (3) To determine which mitigation strategies are best to prevent illness in healthcare workers.

Framework for Understanding Intercultural Perspective Taking in Operational Settings

DTIC Science & Technology

2016-02-01

Child Development , 42, 1721-1734. Selmeski, B. R. (2007). Military cross-cultural competence: Core concepts and individual development . Centre for...community and can also serve as a common reference for the development community to direct training and assessment initiatives. 15. SUBJECT TERMS...research effort was to develop an understanding of intercultural perspective taking (IPT) in operational settings. To represent this understanding, a

Programa de Fortalecimiento de Capacidades: Reflections on a Case Study of Community-Based Teacher Education Set in Rural Northern Peru

ERIC Educational Resources Information Center

Alsop, Steve; Ames, Patricia; Arroyo, Graciela Cordero; Dippo, Don

2010-01-01

This article explores distinctive features of a 5-year international education development project set in rural northern Peru (PROMEB, the "Proyecto de Mejoramiento de la Educacion Basica"). Grounded within a partnership between teacher educators from Peru, Mexico and Canada, and rural Peruvian teachers, students and their communities,…

An Invitation To Discuss Standards in Public Schools: A Preliminary Policy Statement of the Rural Challenge.

ERIC Educational Resources Information Center

Rural Challenge News, 1998

1998-01-01

Strong local communities are the best habitat for excellence in education, and education is the responsibility of the whole community. Setting high academic standards and achieving against those standards is an important educational objective, but the quest for higher standards can be exploited to serve other purposes. This statement sets out the…

Improving Participants’ Retention in a Smoking Cessation Intervention Using a Community-based Participatory Research Approach

PubMed Central

Estreet, Anthony; Apata, Jummai; Kamangar, Farin; Schutzman, Christine; Buccheri, Jane; O’Keefe, Anne-Marie; Wagner, Fernando; Sheikhattari, Payam

2017-01-01

Background: This study compares participant’ sretention in three phases of smoking cessation interventions, one provided in a health clinic and the subsequent two in community-based settings. Methods: Smoking cessation interventions were conducted in three phases from 2008 to 2015 in two underserved urban communities with low socioeconomic profiles and high rates of smoking (n = 951). Phase I was conducted in a clinic; Phases II and III were conducted in community venues. In Phases II and III, incremental changes were made based on lessons learned from the previous phases. Retention (attending six or more sessions) was the primary predictor of cessation and was analyzed while controlling for associated factors including age, gender, race, employment, education, and nicotine dependence. Results: Retention increased substantially over the three phases, with rates for attending six or more sessions of 13.8%, 51.9%, and 67.9% in Phases I, II, and III, respectively. Retention was significantly higher in community settings than in the clinic setting (adjusted odds ratio [OR] = 6.7; 95% confidence intervals [CI] = 4.6, 9.8). In addition to the intervention in community venues, predictors of retention included age and unemployment. Higher retention was significantly associated with higher quit rates (adjusted OR = 2.4; 95% CI = 1.5, 3.8). Conclusions: Conducting the intervention in community settings using trained peer motivators rather than health-care providers resulted in significantly higher retention and smoking cessation rates. This was due in part to the ability to tailor cessation classes in the community for specific populations and improving the quality of the intervention based on feedback from participants and community partners. PMID:29416835

The conduct of practice-based research in community clinics compared to private practices: similarities, differences, and challenges

PubMed Central

Gillette, Jane; Cunha-Cruz, Joana; Gilbert, Ann; Speed-McIntyre, Pollene; Zhou, Lingmei; DeRouen, Timothy

2013-01-01

Practice-based research should be performed in all practice settings if the results are to be applied to all settings. However, some practice settings, such as community clinics, have unique features that may make the conduct of such research more challenging. The purpose of this article is to describe and compare the similarities and unique challenges related to conducting research in community clinics compared to private practices within the Northwest Practice-Based REsearch Collaborative in Evidence-Based DENTistry (PRECEDENT) network. Information was obtained from meetings with general dentists, a survey of general dentists (N = 253), and a clinical examination and record review of a systemic random sample of patients visiting community clinics and private practices. (N = 1903)—all part of a dental practice-based research network. The processes of conducting research, the dentist and patient sociodemographic characteristics, the prevalence of oral diseases, and the dental treatments received in community clinics and private practices were compared. Both community clinics and private practices have the clinical treatment of the patients as their priority and have time constraints on research. The processes of research training, obtaining informed consent, and collecting, transmitting, and securely maintaining research data are also similar. The patient populations and treatment needs differ substantially between community clinics and private practices, with a higher prevalence of dental caries and higher restorative treatment needs in the community clinic patients. The process of study participant selection and follow-up for research and the dentist and staff work arrangements also vary between the two practice settings. Although community clinic patients and their dental healthcare providers have different research needs and challenges than their counterparts in private practice, practice-based research can be successfully PMID:25429251

44 CFR 60.2 - Minimum compliance with flood plain management criteria.

Code of Federal Regulations, 2012 CFR

2012-10-01

... period of six months from the date the Federal Insurance Administrator provides the data set forth in... for eligibility directly under the standards set forth in § 60.3(b). Thereafter, the community will be given a period of six months from the date the Federal Insurance Administrator provides the data set...

44 CFR 60.2 - Minimum compliance with flood plain management criteria.

Code of Federal Regulations, 2014 CFR

2014-10-01

... period of six months from the date the Federal Insurance Administrator provides the data set forth in... for eligibility directly under the standards set forth in § 60.3(b). Thereafter, the community will be given a period of six months from the date the Federal Insurance Administrator provides the data set...

44 CFR 60.2 - Minimum compliance with flood plain management criteria.

Code of Federal Regulations, 2011 CFR

2011-10-01

... period of six months from the date the Federal Insurance Administrator provides the data set forth in... for eligibility directly under the standards set forth in § 60.3(b). Thereafter, the community will be given a period of six months from the date the Federal Insurance Administrator provides the data set...

44 CFR 60.2 - Minimum compliance with flood plain management criteria.

Code of Federal Regulations, 2010 CFR

2010-10-01

... period of six months from the date the Federal Insurance Administrator provides the data set forth in... for eligibility directly under the standards set forth in § 60.3(b). Thereafter, the community will be given a period of six months from the date the Federal Insurance Administrator provides the data set...

44 CFR 60.2 - Minimum compliance with flood plain management criteria.

Code of Federal Regulations, 2013 CFR

2013-10-01

... period of six months from the date the Federal Insurance Administrator provides the data set forth in... for eligibility directly under the standards set forth in § 60.3(b). Thereafter, the community will be given a period of six months from the date the Federal Insurance Administrator provides the data set...

Towards a Science of Community Stakeholder Engagement in Biomedical HIV Prevention Trials: An Embedded Four-Country Case Study.

PubMed

Newman, Peter A; Rubincam, Clara; Slack, Catherine; Essack, Zaynab; Chakrapani, Venkatesan; Chuang, Deng-Min; Tepjan, Suchon; Shunmugam, Murali; Roungprakhon, Surachet; Logie, Carmen; Koen, Jennifer; Lindegger, Graham

2015-01-01

Broad international guidelines and studies in the context of individual clinical trials highlight the centrality of community stakeholder engagement in conducting ethically rigorous HIV prevention trials. We explored and identified challenges and facilitators for community stakeholder engagement in biomedical HIV prevention trials in diverse global settings. Our aim was to assess and deepen the empirical foundation for priorities included in the GPP guidelines and to highlight challenges in implementation that may merit further attention in subsequent GPP iterations. From 2008-2012 we conducted an embedded, multiple case study centered in Thailand, India, South Africa and Canada. We conducted in-depth interviews and focus groups with respondents from different trial-related subsystems: civil society organization representatives, community advocates, service providers, clinical trialists/researchers, former trial participants, and key HIV risk populations. Interviews/focus groups were recorded, and coded using thematic content analysis. After intra-case analyses, we conducted cross-case analysis to contrast and synthesize themes and sub-themes across cases. Lastly, we applied the case study findings to explore and assess UNAIDS/AVAC GPP guidelines and the GPP Blueprint for Stakeholder Engagement. Across settings, we identified three cross-cutting themes as essential to community stakeholder engagement: trial literacy, including lexicon challenges and misconceptions that imperil sound communication; mistrust due to historical exploitation; and participatory processes: engaging early; considering the breadth of "community"; and, developing appropriate stakeholder roles. Site-specific challenges arose in resource-limited settings and settings where trials were halted. This multiple case study revealed common themes underlying community stakeholder engagement across four country settings that largely mirror GPP goals and the GPP Blueprint, as well as highlighting challenges in the implementation of important guidelines. GPP guidance documents could be strengthened through greater focus on: identifying and addressing the community-specific roots of mistrust and its impact on trial literacy activities; achieving and evaluating representativeness in community stakeholder groups; and addressing the impact of power and funding streams on meaningful engagement and independent decision-making.

Making a success of providing NHS Health Checks in community pharmacies across the Tees Valley: a qualitative study

PubMed Central

2011-01-01

Background In England and Wales, the Department of Health introduced a primary prevention programme, NHS Health Checks, to provide screening for cardiovascular risk amongst people aged 40-74. The aim of this programme is to offer treatment and advice to those identified with an increased risk of cardiovascular diseases (CVD). The North East of England has some of the highest rates of CVD in the UK and prevention is therefore a priority. NHS Tees funded this programme of work under the local branding of Healthy Heart Checks (HHC). These were initially implemented principally through GP practices from October 2008 but, in order to mitigate the possibility that some hard to reach communities would be reluctant to engage with some primary care settings, plans were also developed to deliver the programme through workplace settings and through community pharmacies. This paper reports specifically on the findings from the evaluation in respect of the setting up of HHCs in community pharmacies and aims to offer some lessons for other service settings where this option is seen as a way of providing low threshold services which will minimise inequalities in intervention uptake. Methods In assessing the community pharmacy component of HHCs, a selection of staff having direct involvement in the process was invited to take part in the evaluation. Interviews were carried out with representatives from community pharmacy, staff members from the commissioning Primary Care Trusts and with Local Pharmaceutical Committee members. Results Evaluation and analysis identified challenges which should be anticipated and addressed in initiating HHC in community pharmacies. These have been categorised into four main themes for discussion in this paper: (1) establishing and maintaining pharmacy Healthy Heart Checks, (2) overcoming IT barriers, (3) developing confident, competent staff and (4) ensuring volume and through flow in pharmacy. Conclusions Delivering NHS health checks through community pharmacies can be a complex process, requiring meticulous planning, and may incur higher than expected costs. Findings from our evaluation provide insight into possible barriers to setting up services in pharmacies which may help other commissioning bodies when considering community pharmacy as a location for primary prevention interventions in future. PMID:21929809

Hand hygiene to reduce community transmission of influenza and acute respiratory tract infection: a systematic review.

PubMed

Warren-Gash, Charlotte; Fragaszy, Ellen; Hayward, Andrew C

2013-09-01

Hand hygiene may be associated with modest protection against some acute respiratory tract infections, but its specific role in influenza transmission in different settings is unclear. We aimed to review evidence that improving hand hygiene reduces primary and secondary transmission of (i) influenza and (ii) acute respiratory tract infections in community settings. We searched Medline, Embase, Global Health and Cochrane databases up to 13 February 2012 for reports in any language of original research investigating the effect of hand hygiene on influenza or acute respiratory tract infection where aetiology was unspecified in community settings including institutions such as schools, and domestic residences. Data were presented and quality rated across outcomes according to the Grading of Recommendations Assessment, Development and Evaluation system. Sixteen articles met inclusion criteria. There was moderate to low-quality evidence of a reduction in both influenza and respiratory tract infection with hand hygiene interventions in schools, greatest in a lower-middle-income setting. There was high-quality evidence of a small reduction in respiratory infection in childcare settings. There was high-quality evidence for a large reduction in respiratory infection with a hand hygiene intervention in squatter settlements in a low-income setting. There was moderate- to high-quality evidence of no effect on secondary transmission of influenza in households that had already experienced an index case. While hand hygiene interventions have potential to reduce transmission of influenza and acute respiratory tract infections, their effectiveness varies depending on setting, context and compliance. © 2012 John Wiley & Sons Ltd.

Implementing managed alcohol programs in hospital settings: A review of academic and grey literature.

PubMed

Brooks, Hannah L; Kassam, Shehzad; Salvalaggio, Ginetta; Hyshka, Elaine

2018-04-01

People with severe alcohol use disorders are at increased risk of poor acute-care outcomes, in part due to difficulties maintaining abstinence from alcohol while hospitalised. Managed alcohol programs (MAP), which administer controlled doses of beverage alcohol to prevent withdrawal and stabilise drinking patterns, are one strategy for increasing adherence to treatment, and improving health outcomes for hospital inpatients with severe alcohol use disorders. Minimal research has examined the implementation of MAPs in hospital settings. We conducted a scoping review to describe extant literature on MAPs in community settings, as well as the therapeutic provision of alcohol to hospital inpatients, to assess the feasibility of implementing formal MAPs in hospital settings and identify knowledge gaps requiring further study. Four academic and 10 grey literature databases were searched. Evidence was synthesised using quantitative and qualitative approaches. Forty-two studies met review inclusion criteria. Twenty-eight examined the administration of alcohol to hospital inpatients, with most reporting positive outcomes related to prevention or treatment of alcohol withdrawal. Fourteen studies examined MAPs in the community and reported that they help stabilise drinking patterns, reduce alcohol-related harms and facilitate non-judgemental health and social care. MAPs in the community have been well described and research has documented effective provision of alcohol in hospital settings for addressing withdrawal. Implementing MAPs as a harm reduction approach in hospital settings is potentially feasible. However, there remains a need to build off extant literature and develop and evaluate standardised MAP protocols tailored to acute-care settings. © 2018 Australasian Professional Society on Alcohol and other Drugs.

Comparison of macroinvertebrate community structure between two riffle-based sampling protocols in Wyoming, Colorado, and Montana, 2000-2001

USGS Publications Warehouse

Peterson, David A.; Zumberge, Jeremy R.

2006-01-01

Samples of benthic macroinvertebrates were collected side-by-side from riffles at 12 stream sites in Wyoming, Colorado, and Montana during 2000-2001, following protocols established by the U.S. Geological Survey National Water-Quality Assessment (NAWQA) Program and the U.S. Environmental Protection Agency Environmental Monitoring and Assessment Program (EMAP). Samples from riffles were collected following NAWQA protocols, using a sampler with 425-micron net mesh-opening size from a total area of 1.25 m2 per sample in multiple riffles. Samples also were collected following EMAP protocols, using a sampler with 500-micron net mesh-opening size from a total area of 0.72 m2 per sample in multiple riffles. The taxonomic identification and enumeration of the samples followed procedures established for each program. Benthic macroinvertebrate community structure was compared between the data sets using individual metrics, a multimetric index, and multivariate analysis. Comparisons between the macroinvertebrate community structures were made after sequentially adjusting both data sets for: (1) ambiguous taxa, (2) taxonomic inconsistencies, and (3) differences in laboratory subsampling. After removal of ambiguous taxa, pair-wise differences in total taxa richness and Ephemeroptera taxa richness were statistically significant (p < 0.05). Differences between the data sets generally were not significant for richness of other taxa, tolerant taxa, semi-voltine taxa, functional feeding groups, diversity, and dominance. Sample scores calculated using the Wyoming Stream Integrity Index were not significantly different between the two data sets. After reconciling both data sets for taxonomic inconsistencies, total taxa richness and Ephemeroptera taxa richness remained significantly different between the data sets. After adjusting the data for differences in laboratory subsampling, the differences in taxa richness were no longer significant. Bray-Curtis similarity coefficients and non-metric multi-dimensional scaling were used to examine macroinvertebrate community structure. Similarity in community structure between sites was affected to a greater extent by taxa reconciliation than by adjustment for subsampling.

Metabolic control in a nationally representative diabetic elderly sample in Costa Rica: patients at community health centers vs. patients at other health care settings

PubMed Central

Brenes-Camacho, Gilbert; Rosero-Bixby, Luis

2008-01-01

Background Costa Rica, like other developing countries, is experiencing an increasing burden of chronic conditions such as diabetes mellitus (DM), especially among its elderly population. This article has two goals: (1) to assess the level of metabolic control among the diabetic population age ≥ 60 years old in Costa Rica, and (2) to test whether diabetic elderly patients of community health centers differ from patients in other health care settings in terms of the level of metabolic control. Methods Data come from the project CRELES, a nationally representative study of people aged 60 and over in Costa Rica. This article analyzes a subsample of 542 participants in CRELES with self-reported diagnosis of diabetes mellitus. Odds ratios of poor levels of metabolic control at different health care settings are computed using logistic regressions. Results Lack of metabolic control among elderly diabetic population in Costa Rica is described as follows: 37% have glycated hemoglobin ≥ 7%; 78% have systolic blood pressure ≥ 130 mmHg; 66% have diastolic blood pressure ≥ 80 mmHg; 48% have triglycerides ≥ 150 mg/dl; 78% have LDL ≥ 100 mg/dl; 70% have HDL ≤ 40 mg/dl. Elevated levels of triglycerides and LDL were higher in patients of community health centers than in patients of other clinical settings. There were no statistical differences in the other metabolic control indicators across health care settings. Conclusion Levels of metabolic control among elderly population with DM in Costa Rica are not that different from those observed in industrialized countries. Elevated levels of triglycerides and LDL at community health centers may indicate problems of dyslipidemia treatment among diabetic patients; these problems are not observed in other health care settings. The Costa Rican health care system should address this problem, given that community health centers constitute a means of democratizing access to primary health care to underserved and poor areas. PMID:18447930

Cover Your Cough

MedlinePlus

... KB] Spanish [153 KB] Cover Your Cough, Flyer & Poster for Health Care Settings Flyer : English Portuguese [268 ... KB] Chinese [246 KB] Cover Your Cough, Flyer & Poster for Community and Public Settings Flyer : English Portuguese [ ...

A cross-sectional evaluation of community pharmacists' perceptions of intermediate care and medicines management across the healthcare interface.

PubMed

Millar, Anna; Hughes, Carmel; Devlin, Maria; Ryan, Cristín

2016-12-01

Background Despite the importance placed on the concept of the multidisciplinary team in relation to intermediate care (IC), little is known about community pharmacists' (CPs) involvement. Objective To determine CPs' awareness of and involvement with IC services, perceptions of the transfer of patients' medication information between healthcare settings and views of the development of a CP-IC service. Setting Community pharmacies in Northern Ireland. Methods A postal questionnaire, informed by previous qualitative work was developed and piloted. Main outcome measure CPs' awareness of and involvement with IC. Results The response rate was 35.3 % (190/539). Under half (47.4 %) of CPs 'agreed/strongly agreed' that they understood the term 'intermediate care'. Three quarters of respondents were either not involved or unsure if they were involved with providing services to IC. A small minority (1.2 %) of CPs reported that they received communication regarding medication changes made in hospital or IC settings 'all of the time'. Only 9.5 and 0.5 % of respondents 'strongly agreed' that communication from hospital and IC, respectively, was sufficiently detailed. In total, 155 (81.6 %) CPs indicated that they would like to have greater involvement with IC services. 'Current workload' was ranked as the most important barrier to service development. Conclusion It was revealed that CPs had little awareness of, or involvement with, IC. Communication of information relating to patients' medicines between settings was perceived as insufficient, especially between IC and community pharmacy settings. CPs demonstrated willingness to be involved with IC and services aimed at bridging the communication gap between healthcare settings.

Building community resilience to climate change through public health planning.

PubMed

Bajayo, Rachael

2012-04-01

Nillumbik Shire Council, in partnership with La Trobe University, used the Municipal Public Health Planning process to develop an approach for building the resilience of local communities to climate-related stressors. The objective was to define an approach for building community resilience to climate change and to integrate this approach with the 'Environments for Health' framework. Key published papers and reports by leading experts the field were reviewed. Literature was selected based on its relevance to the subjects of community resilience and climate change and was derived from local and international publications, the vast majority published within the past two decades. Review of literature on community resilience revealed that four principal resource sets contribute to the capacity of communities to adapt in times of stress, these being: economic development; social capital; information and communication; and community competence. On the strength of findings, a framework for building each resilience resource set within each of the Environments for Health was constructed. This paper introduces the newly constructed 'Community Resilience Framework', which describes how each one of the four resilience resource sets can be developed within social, built, natural and economic environments. The Community Resilience Framework defines an approach for simultaneously creating supportive environments for health and increasing community capacity for adaptation to climate-related stressors. As such, it can be used by Municipal Public Health Planners as a guide in building community resilience to climate change.

Validation and Application of a PCR Primer Set to Quantify Fungal Communities in the Soil Environment by Real-Time Quantitative PCR

PubMed Central

Chemidlin Prévost-Bouré, Nicolas; Christen, Richard; Dequiedt, Samuel; Mougel, Christophe; Lelièvre, Mélanie; Jolivet, Claudy; Shahbazkia, Hamid Reza; Guillou, Laure; Arrouays, Dominique; Ranjard, Lionel

2011-01-01

Fungi constitute an important group in soil biological diversity and functioning. However, characterization and knowledge of fungal communities is hampered because few primer sets are available to quantify fungal abundance by real-time quantitative PCR (real-time Q-PCR). The aim in this study was to quantify fungal abundance in soils by incorporating, into a real-time Q-PCR using the SYBRGreen® method, a primer set already used to study the genetic structure of soil fungal communities. To satisfy the real-time Q-PCR requirements to enhance the accuracy and reproducibility of the detection technique, this study focused on the 18S rRNA gene conserved regions. These regions are little affected by length polymorphism and may provide sufficiently small targets, a crucial criterion for enhancing accuracy and reproducibility of the detection technique. An in silico analysis of 33 primer sets targeting the 18S rRNA gene was performed to select the primer set with the best potential for real-time Q-PCR: short amplicon length; good fungal specificity and coverage. The best consensus between specificity, coverage and amplicon length among the 33 sets tested was the primer set FR1 / FF390. This in silico analysis of the specificity of FR1 / FF390 also provided additional information to the previously published analysis on this primer set. The specificity of the primer set FR1 / FF390 for Fungi was validated in vitro by cloning - sequencing the amplicons obtained from a real time Q-PCR assay performed on five independent soil samples. This assay was also used to evaluate the sensitivity and reproducibility of the method. Finally, fungal abundance in samples from 24 soils with contrasting physico-chemical and environmental characteristics was examined and ranked to determine the importance of soil texture, organic carbon content, C∶N ratio and land use in determining fungal abundance in soils. PMID:21931659

Day Care for All Children: Integrating Children with Special Needs into Community Child Care Settings. A Resource and Consultation Manual.

ERIC Educational Resources Information Center

Gaumer, Nancy; And Others

This manual provides guidance on using the consultation method to help meet the needs of families of children with disabilities in integrated community-based day care settings. The introductory section provides an overview, a statement of philosophy, the history of the day care consultation program in Illinois, and instructions for using the…

"Shaping Communities" as a Christian Practice and Popular Religion: Their Implications for Latina/o Religious Education in the United States

ERIC Educational Resources Information Center

Lee, Michael G.

2008-01-01

This article sets Dorothy Bass' Christian practices movement in critical dialogue with U.S. Latina/o popular religion in order to explore ways that these distinctive sets of practices could enrich one another. Then, it focuses on "shaping communities" as a Christian practice and correlates it with the U.S. Latina/o popular religious…

Using Needs Assessment to Develop Curricula for Screening, Brief Intervention, and Referral to Treatment (SBIRT) in Academic and Community Health Settings

ERIC Educational Resources Information Center

Satre, Derek D.; McCance-Katz, Elinore F.; Moreno-John, Gina; Julian, Katherine A.; O'Sullivan, Patricia S.; Satterfield, Jason M.

2012-01-01

This article describes the use of a brief needs assessment survey in the development of alcohol and drug screening, brief intervention, and referral to treatment (SBIRT) curricula in 2 health care settings in the San Francisco Bay Area. The samples included university medical center faculty (n = 27) and nonphysician community health and social…

Diagnostic Stability of Autism Spectrum Disorder in Toddlers Prospectively Identified in a Community-Based Setting: Behavioural Characteristics and Predictors of Change over Time

ERIC Educational Resources Information Center

Barbaro, Josephine; Dissanayake, Cheryl

2017-01-01

Autism spectrum disorder diagnoses in toddlers have been established as accurate and stable across time in high-risk siblings and clinic-referred samples. Few studies have investigated diagnostic stability in children prospective identified in community-based settings. Furthermore, there is a dearth of evidence on the individual behaviours that…

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

PubMed

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

2009-01-01

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

FIM motor scores for classifying community discharge after inpatient rehabilitation for hip fracture.

PubMed

Wang, Ching-Yi; Graham, James E; Karmarkar, Amol M; Reistetter, Timothy A; Protas, Elizabeth J; Ottenbacher, Kenneth J

2014-06-01

To assess the utility of functional status in classifying patients by discharge setting after inpatient rehabilitation for hip fracture. Retrospective cohort study. A total of 1257 inpatient rehabilitation facilities in the United States. Medicare beneficiaries (N = 117,168) receiving inpatient rehabilitation for hip fracture from 2007 to 2009. Receiver operating characteristic curve analyses to assess the overall discriminatory ability of functional status scores (Functional Independence Measure [FIM] total, FIM cognition, and FIM motor) and to identify the functioning threshold that best differentiates patients by discharge setting. Discharge setting (community versus institutional). Approximately 68% of patients were discharged to the community after inpatient rehabilitation for hip fracture. Receiver operating characteristic curve analyses indicate that discharge FIM motor ratings (area under the curve: 0.84) alone are as effective as a multivariable model (area under the curve: 0.85), including sociodemographic and clinical factors, in discriminating patients discharged to the community from those discharged to an institution. A discharge FIM motor rating of 58 yielded the best balance in sensitivity and specificity for classifying patients by discharge setting. Discharge FIM motor ratings demonstrated good discriminatory ability for classifying discharge setting. An FIM motor rating of 58 may serve as a clinical tool to guide treatment plans and/or as additional information in complex discharge planning decisions for patients with hip fracture. Copyright © 2014 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Funding women's health work -- no easy answers.

PubMed

Ikeda, J

1998-01-01

This article discusses a community's solution to improving women's health in Guatemala. Indigenous women from the highland community of Cajola formed the Asociacion Pro-Bienestar de la Mujer Mam (APBMM). The APBMM identified a need for women health promoters and good, low-cost medicines. The Instituto de Educacion Integral para la Salud y el Desarrollo (IDEI) helped train 16 women as health communicators or promoters in 1996. The health communicators learned about setting up community medicine distribution. The mayor bypassed APBMM's efforts to set up medicine distribution and set up a community pharmacy himself. Someone else opened a private pharmacy. The 200-member group was frustrated and redirected their energies to making natural herbal medicines, such as eucalyptus rub. The group set up a community medicine chest in the IDEI medical clinic and sold modern medicine, homemade vapor rubs, and syrups. The group was joined by midwives and other volunteers and began educating mothers about treatment of diarrhea and respiratory diseases. The Drogueria Estatal, which distributes medicines nationally to nongovernmental groups, agreed to sell high quality, low cost medicine to the medicine chest, which was renamed Venta Social de Medicamentos (VSM). The health communicators are working on three potential income generation projects: VSM, the production and sale of traditional medicines and educational materials, and an experimental greenhouse to grow medicinal plants and research other crops that can be grown in the highlands.

An examination of public school safety measures across geographic settings.

PubMed

Shelton, Andrea J; Owens, Emiel W; Song, Holim

2009-01-01

Violence at a school can have a negative impact on the health of students, teachers, administrators, and others associated with the school and surrounding community. The use of weapons in school buildings or on school grounds accounts for the majority of violent deaths, particularly among males. This national trend suggests the need for a more concerted effort to improve safety and prevent violence. This article reports the use of 13 safety measures in US public schools in 4 geographic regions (Northeast, Midwest, South, and West) and 3 community settings (urban, suburban, and rural). Data representing 16,000 schools reported in the Educational Longitudinal Survey of 2002-2004 were analyzed. Data were self-reported by school administrators. Of the various safety measures assessed, fire alarms and extinguishers were consistently reported regardless of the geographic region or community setting of the school. Other than measures for fire safety, schools throughout the country routinely used exterior light and student lockers as safety measures. There was a significant difference by geographic region and community setting in the use of safety measures that required specific personnel, namely a security guard and an adult to direct a guest to sign in. Recognizing the patterns of violence at public high schools, administrators working with students, other school personnel, and community partners may consider more combinations of the safety measures within their institutions together with local resources and services to improve safety and reduce violence.

Advancing understanding of the sustainability of lay health advisor (LHA) programs for African-American women in community settings.

PubMed

Shelton, Rachel C; Charles, Thana-Ashley; Dunston, Sheba King; Jandorf, Lina; Erwin, Deborah O

2017-09-01

Lay health advisor (LHA) programs have made strong contributions towards the elimination of health disparities and are increasingly being implemented to promote health and prevent disease. Developed in collaboration with African-American survivors, the National Witness Project (NWP) is an evidence-based, community-led LHA program that improves cancer screening among African-American women. NWP has been successfully disseminated, replicated, and implemented nationally in over 40 sites in 22 states in diverse community settings, reaching over 15,000 women annually. We sought to advance understanding of barriers and facilitators to the long-term implementation and sustainability of LHA programs in community settings from the viewpoint of the LHAs, as well as the broader impact of the program on African-American communities and LHAs. In the context of a mixed-methods study, in-depth telephone interviews were conducted among 76 African-American LHAs at eight NWP sites at baseline and 12-18 months later, between 2010 and 2013. Qualitative data provides insight into inner and outer contextual factors (e.g., community partnerships, site leadership, funding), implementation processes (e.g., training), as well as characteristics of the intervention (e.g., perceived need and fit in African-American community) and LHAs (e.g., motivations, burnout) that are perceived to impact the continued implementation and sustainability of NWP. Factors at the contextual levels and related to motivations of LHAs are critical to the sustainability of LHA programs. We discuss how findings are used to inform (1) the development of the LHA Sustainability Framework and (2) strategies to support the continued implementation and sustainability of evidence-based LHA interventions in community settings.

Ancillary care in public health intervention research in low-resource settings: researchers' practices and decision-making.

PubMed

Taylor, Holly A; Merritt, Maria W; Mullany, Luke C

2011-09-01

Little is known about researchers' practices regarding the provision of ancillary care (AC) in public health intervention studies they have conducted and the factors that influence their decisions about whether to provide ancillary care in low-resource settings. We conducted 52 in-person in-depth interviews with public health researchers. Data analysis was iterative and led to the identification of themes and patterns among themes. We found that researchers who conduct their research in the community setting are more likely to identify and plan for the AC needs of potential research subjects before a study begins, whereas those affiliated with a permanent facility are more likely to deliver AC to research subjects on an ad hoc basis. Our findings suggest that on the whole, at least for public health intervention research in low-resource settings, researchers conducting research in the community setting confront more complex ethical and operational challenges in their decision-making about AC than do researchers conducting facility-based studies.

Salud Para Su Corazon (health for your heart) community health worker model: community and clinical approaches for addressing cardiovascular disease risk reduction in Hispanics/Latinos.

PubMed

Balcazar, H; Alvarado, M; Ortiz, G

2011-01-01

This article describes 6 Salud Para Su Corazon (SPSC) family of programs that have addressed cardiovascular disease risk reduction in Hispanic communities facilitated by community health workers (CHWs) or Promotores de Salud (PS). A synopsis of the programs illustrates the designs and methodological approaches that combine community-based participatory research for 2 types of settings: community and clinical. Examples are provided as to how CHWs can serve as agents of change in these settings. A description is presented of a sustainability framework for the SPSC family of programs. Finally, implications are summarized for utilizing the SPSC CHW/PS model to inform ambulatory care management and policy.

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

PubMed

Taylor, Holly A; Merritt, Maria W

2012-12-01

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

Implementing a framework for goal setting in community based stroke rehabilitation: a process evaluation

PubMed Central

2013-01-01

Background Goal setting is considered ‘best practice’ in stroke rehabilitation; however, there is no consensus regarding the key components of goal setting interventions or how they should be optimally delivered in practice. We developed a theory-based goal setting and action planning framework (G-AP) to guide goal setting practice. G-AP has 4 stages: goal negotiation, goal setting, action planning & coping planning and appraisal & feedback. All stages are recorded in a patient-held record. In this study we examined the implementation, acceptability and perceived benefits of G-AP in one community rehabilitation team with people recovering from stroke. Methods G-AP was implemented for 6 months with 23 stroke patients. In-depth interviews with 8 patients and 8 health professionals were analysed thematically to investigate views of its implementation, acceptability and perceived benefits. Case notes of interviewed patients were analysed descriptively to assess the fidelity of G-AP implementation. Results G-AP was mostly implemented according to protocol with deviations noted at the planning and appraisal and feedback stages. Each stage was felt to make a useful contribution to the overall process; however, in practice, goal negotiation and goal setting merged into one stage and the appraisal and feedback stage included an explicit decision making component. Only two issues were raised regarding G-APs acceptability: (i) health professionals were concerned about the impact of goal non-attainment on patient’s well-being (patients did not share their concerns), and (ii) some patients and health professionals found the patient-held record unhelpful. G-AP was felt to have a positive impact on patient goal attainment and professional goal setting practice. Collaborative partnerships between health professionals and patients were apparent throughout the process. Conclusions G-AP has been perceived as both beneficial and broadly acceptable in one community rehabilitation team; however, implementation of novel aspects of the framework was inconsistent. The regulatory function of goal non-attainment and the importance of creating flexible partnerships with patients have been highlighted. Further development of the G-AP framework, training package and patient held record is required to address the specific issues highlighted by this process evaluation. Further evaluation of G-AP is required across diverse community rehabilitation settings. PMID:23705824

Evaluation of a train-the-trainer program for stable coronary artery disease management in community settings: A pilot study.

PubMed

Shen, Zhiyun; Jiang, Changying; Chen, Liqun

2018-02-01

To evaluate the feasibility and effectiveness of conducting a train-the-trainer (TTT) program for stable coronary artery disease (SCAD) management in community settings. The study involved two steps: (1) tutors trained community nurses as trainers and (2) the community nurses trained patients. 51 community nurses attended a 2-day TTT program and completed questionnaires assessing knowledge, self-efficacy, and satisfaction. By a feasibility and non-randomized control study, 120 SCAD patients were assigned either to intervention group (which received interventions from trained nurses) or control group (which received routine management). Pre- and post-intervention, patients' self-management behaviors and satisfaction were assessed to determine the program's overall impact. Community nurses' knowledge and self-efficacy improved (P<0.001), as did intervention group patients' self-management behaviors (P<0.001). The satisfaction of community nurses and patients was all very positive after training. The TTT program for SCAD management in community settings in China was generally feasible and effective, but many obstacles remain including patients' noncompliance, nurses' busy work schedules, and lack of policy supports. Finding ways to enhance the motivation of community nurses and patients with SCAD are important in implementing community-based TTT programs for SCAD management; further multicenter and randomized control trials are needed. Copyright © 2017 Elsevier B.V. All rights reserved.

Salud Para Su Corazon (Health for Your Heart) Community Health Worker Model

PubMed Central

Balcazar, H.; Alvarado, M.; Ortiz, G.

2012-01-01

This article describes 6 Salud Para Su Corazon (SPSC) family of programs that have addressed cardiovascular disease risk reduction in Hispanic communities facilitated by community health workers (CHWs) or Promotores de Salud (PS). A synopsis of the programs illustrates the designs and methodological approaches that combine community-based participatory research for 2 types of settings: community and clinical. Examples are provided as to how CHWs can serve as agents of change in these settings. A description is presented of a sustainability framework for the SPSC family of programs. Finally, implications are summarized for utilizing the SPSC CHW/PS model to inform ambulatory care management and policy. PMID:21914992

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

PubMed Central

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

2018-01-01

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

Creating a sustainable, participatory palliative care programme in an urban slum in Dhaka, Bangladesh.

PubMed

Ahmad, Nezamuddin

2018-01-01

The Centre for Palliative Care, based at the only medical university [Bangabandhu Sheikh Mujib Medical University (BSMMU)] in Dhaka, Bangladesh, in collaboration with Worldwide Hospice Palliative Care Alliance, piloted a one-year project focussed on improving the quality of life of 100 older people and their families in two slum settings in Dhaka. This project was developed following the identification of significant palliative care needs of older people in the slum settings. In addition, the project was formed in response to the absence of programmes delivering palliative care to the poorest and most marginalised in poor urban settings, in a sustainable manner within the context of the low development of palliative care and the human and financial resource limitations in Bangladesh. The programme was developed using a participatory approach which focussed on engaging members of the community in the delivery of the project through the identification and training of 8 palliative care assistants from the slum setting itself, who delivered basic care supported by health professionals, the development of palliative care activists within the community and the engagement of the slum community leadership. The impact of the project showed improved quality of life for the target population and the potential for further development as a sustainable, community owned model over a further 2 years, which could be translated into other urban settings. This presentation will highlight lessons learned from the development and implementation of the project, and findings from the independent evaluation completed in December 2016, overseen by Glasgow University. The presentation will outline the successes and challenges of developing a participatory, community owned palliative care service within a slum in Dhaka, Bangladesh for older people and their families.

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

PubMed

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

2018-01-01

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

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

PubMed

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

2014-09-01

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

Community detection for networks with unipartite and bipartite structure

NASA Astrophysics Data System (ADS)

Chang, Chang; Tang, Chao

2014-09-01

Finding community structures in networks is important in network science, technology, and applications. To date, most algorithms that aim to find community structures only focus either on unipartite or bipartite networks. A unipartite network consists of one set of nodes and a bipartite network consists of two nonoverlapping sets of nodes with only links joining the nodes in different sets. However, a third type of network exists, defined here as the mixture network. Just like a bipartite network, a mixture network also consists of two sets of nodes, but some nodes may simultaneously belong to two sets, which breaks the nonoverlapping restriction of a bipartite network. The mixture network can be considered as a general case, with unipartite and bipartite networks viewed as its limiting cases. A mixture network can represent not only all the unipartite and bipartite networks, but also a wide range of real-world networks that cannot be properly represented as either unipartite or bipartite networks in fields such as biology and social science. Based on this observation, we first propose a probabilistic model that can find modules in unipartite, bipartite, and mixture networks in a unified framework based on the link community model for a unipartite undirected network [B Ball et al (2011 Phys. Rev. E 84 036103)]. We test our algorithm on synthetic networks (both overlapping and nonoverlapping communities) and apply it to two real-world networks: a southern women bipartite network and a human transcriptional regulatory mixture network. The results suggest that our model performs well for all three types of networks, is competitive with other algorithms for unipartite or bipartite networks, and is applicable to real-world networks.

Development of a Measure to Assess Youth Self-Reported Experiences of Activity Settings (SEAS)

ERIC Educational Resources Information Center

King, Gillian; Batorowicz, Beata; Rigby, Patty; McMain-Klein, Margot; Thompson, Laura; Pinto, Madhu

2014-01-01

There is a need for psychometrically sound measures of youth experiences of community/home leisure activity settings. The 22-item Self-Reported Experiences of Activity Settings (SEAS) captures the following experiences of youth with a Grade 3 level of language comprehension or more: Personal Growth, Psychological Engagement, Social Belonging,…

Barriers and Facilitators to Implementing Functional Family Therapy in a Community Setting: Client and Practitioner Perspectives.

PubMed

McPherson, Kerri E; Kerr, Susan; Casey, Beth; Marshall, John

2017-10-01

While Functional Family Therapy (FFT) is known to be effective in addressing adolescent behavioral problems, there has been little exploration of issues relevant to its transport from the tightly controlled setting of clinical trials into routine service delivery. This study sought the views of key stakeholders, clients, and practitioners, on barriers and facilitators to the successful implementation of FFT. Undertaken in a community setting in Scotland, interviews were carried out with 12 adolescents, 14 parents/caregivers, and 6 practitioners. Results focus on: Referral process and pre-intervention contact; Engagement of families; Structure and delivery; Organizational factors. Although barriers to engagement were identified, FFT was viewed as an acceptable, appropriate and feasible intervention with the potential to improve adolescent wellbeing in 'real-world' settings. © 2017 American Association for Marriage and Family Therapy.

Transcultural healthcare immersion: a unique interprofessional experience poised to influence collaborative practice in cultural settings.

PubMed

Morton, Jennifer

2012-01-01

This paper describes a model for interprofessional and transcultural learning established by the author and supported by the University of New England and Ghana Health Mission, Inc. The model for interprofessional immersion in cultural settings represents a guiding framework predicated on a conceptual "brick and mortar" process for building cultural proficiency among individuals and within teams. It encompasses social, clinical and behavioral components (brick) and personal desire, cultural humility and values (mortar). The ``bounty'' aspect of the model is achieved by way of successful student learning outcomes, positive interprofessional and community-based collaborations, and finally, and to be measured over time, favorable patient and population (programmatic) outcomes. In partnership with the Ghana Health Mission, Inc and local community health workers, students and faculty from a range of health professions took part in a cultural-clinical experience known as Transcultural Immersion in Healthcare. The goal of the experience was to advance cultural proficiency and knowledge through intensive cultural immersion. An urban setting in Ghana, located in West Africa served as the setting for this unique experience. The transcultural immersion in healthcare experience achieved its ``bounty'' as seen in the enhanced cultural proficiency of students and faculty, seamless interprofessional communication and collaboration, and provision of primary care and related services to patients and the Ghanaian community. Future research is in development to test the Model for Interprofessional Immersion in Cultural Settings (MIICS) in a variety of other settings and with a cross section of health disciplines.

Teaching Health Center Graduate Medical Education Locations Predominantly Located in Federally Designated Underserved Areas.

PubMed

Barclift, Songhai C; Brown, Elizabeth J; Finnegan, Sean C; Cohen, Elena R; Klink, Kathleen

2016-05-01

Background The Teaching Health Center Graduate Medical Education (THCGME) program is an Affordable Care Act funding initiative designed to expand primary care residency training in community-based ambulatory settings. Statute suggests, but does not require, training in underserved settings. Residents who train in underserved settings are more likely to go on to practice in similar settings, and graduates more often than not practice near where they have trained. Objective The objective of this study was to describe and quantify federally designated clinical continuity training sites of the THCGME program. Methods Geographic locations of the training sites were collected and characterized as Health Professional Shortage Area, Medically Underserved Area, Population, or rural areas, and were compared with the distribution of Centers for Medicare and Medicaid Services (CMS)-funded training positions. Results More than half of the teaching health centers (57%) are located in states that are in the 4 quintiles with the lowest CMS-funded resident-to-population ratio. Of the 109 training sites identified, more than 70% are located in federally designated high-need areas. Conclusions The THCGME program is a model that funds residency training in community-based ambulatory settings. Statute suggests, but does not explicitly require, that training take place in underserved settings. Because the majority of the 109 clinical training sites of the 60 funded programs in 2014-2015 are located in federally designated underserved locations, the THCGME program deserves further study as a model to improve primary care distribution into high-need communities.

Patient perspectives on care received at community acupuncture clinics: a qualitative thematic analysis.

PubMed

Tippens, Kimberly M; Chao, Maria T; Connelly, Erin; Locke, Adrianna

2013-10-29

Community acupuncture is a recent innovation in acupuncture service delivery in the U.S. that aims to improve access to care through low-cost treatments in group-based settings. Patients at community acupuncture clinics represent a broader socioeconomic spectrum and receive more frequent treatments compared to acupuncture users nationwide. As a relatively new model of acupuncture in the U.S., little is known about the experiences of patients at community acupuncture clinics and whether quality of care is compromised through this high-volume model. The aim of this study was to assess patients' perspectives on the care received through community acupuncture clinics. The investigators conducted qualitative, thematic analysis of written comments from an observational, cross-sectional survey of clients of the Working Class Acupuncture clinics in Portland, Oregon. The survey included an open-ended question for respondents to share comments about their experiences with community acupuncture. Comments were received from 265 community acupuncture patients. Qualitative analysis of written comments identified two primary themes that elucidate patients' perspectives on quality of care: 1) aspects of health care delivery unique to community acupuncture, and 2) patient engagement in health care. Patients identified unique aspects of community acupuncture, including structures that facilitate access, processes that make treatments more comfortable and effective and holistic outcomes including physical improvements, enhanced quality of life, and empowerment. The group setting, community-based locations, and low cost were highlighted as aspects of this model that allow patients to access acupuncture. Patients' perspectives on the values and experiences unique to community acupuncture offer insights on the quality of care received in these settings. The group setting, community-based locations, and low cost of this model potentially reduce access barriers for those who might not otherwise consider using acupuncture. In addition, the community acupuncture model may offer individuals the opportunity for increased frequency of treatments, which raises pertinent questions about the dose-response relationship of acupuncture and health outcomes. This study provides preliminary data for future evaluations of the quality and effectiveness of community acupuncture. Future studies should include the perspectives of patients who initiated, and subsequently, discontinued community acupuncture treatment.

Towards a Science of Community Stakeholder Engagement in Biomedical HIV Prevention Trials: An Embedded Four-Country Case Study

PubMed Central

Newman, Peter A.; Rubincam, Clara; Slack, Catherine; Essack, Zaynab; Chakrapani, Venkatesan; Chuang, Deng-Min; Tepjan, Suchon; Shunmugam, Murali; Roungprakhon, Surachet; Logie, Carmen; Koen, Jennifer; Lindegger, Graham

2015-01-01

Objectives Broad international guidelines and studies in the context of individual clinical trials highlight the centrality of community stakeholder engagement in conducting ethically rigorous HIV prevention trials. We explored and identified challenges and facilitators for community stakeholder engagement in biomedical HIV prevention trials in diverse global settings. Our aim was to assess and deepen the empirical foundation for priorities included in the GPP guidelines and to highlight challenges in implementation that may merit further attention in subsequent GPP iterations. Methods From 2008–2012 we conducted an embedded, multiple case study centered in Thailand, India, South Africa and Canada. We conducted in-depth interviews and focus groups with respondents from different trial-related subsystems: civil society organization representatives, community advocates, service providers, clinical trialists/researchers, former trial participants, and key HIV risk populations. Interviews/focus groups were recorded, and coded using thematic content analysis. After intra-case analyses, we conducted cross-case analysis to contrast and synthesize themes and sub-themes across cases. Lastly, we applied the case study findings to explore and assess UNAIDS/AVAC GPP guidelines and the GPP Blueprint for Stakeholder Engagement. Results Across settings, we identified three cross-cutting themes as essential to community stakeholder engagement: trial literacy, including lexicon challenges and misconceptions that imperil sound communication; mistrust due to historical exploitation; and participatory processes: engaging early; considering the breadth of “community”; and, developing appropriate stakeholder roles. Site-specific challenges arose in resource-limited settings and settings where trials were halted. Conclusions This multiple case study revealed common themes underlying community stakeholder engagement across four country settings that largely mirror GPP goals and the GPP Blueprint, as well as highlighting challenges in the implementation of important guidelines. GPP guidance documents could be strengthened through greater focus on: identifying and addressing the community-specific roots of mistrust and its impact on trial literacy activities; achieving and evaluating representativeness in community stakeholder groups; and addressing the impact of power and funding streams on meaningful engagement and independent decision-making. PMID:26295159

Partnering with libraries to promote walking among community-dwelling adults: a Kingston gets active pilot pedometer-lending project.

PubMed

Ryder, Holly H; Faloon, Kathryn J; Lévesque, Lucie; McDonald, Deanna

2009-10-01

Most adults do not walk enough to obtain health benefits. Pedometers have been successfully utilized to motivate and increase walking. Given that libraries are a place where community members seek health resources, they are a logical setting for increasing community accessibility to pedometers. The purpose was to examine the feasibility of lending pedometers to library patrons to increase walking. In five Canadian public libraries, 90 pedometers were made available for 6 months. A total of 41 library patrons (33 women, 8 men, age range 18 to 65 or older) completed a survey about their walking patterns and pedometer use. More than 330 loans were made. Chisquare analysis found significant associations between walking and motivation to walk more (p < .05), walking and goal setting (p < .05), and motivation to walk more and setting a walking goal (p < .001). Results provide preliminary evidence that lending pedometers through local libraries is an effective, low-cost approach to enhance walking in community members.

‘The dangers attending these conditions are evident’: Public Health and the Working Environment of Lancashire Textile Communities, c.1870–1939

PubMed Central

Greenlees, Janet

2013-01-01

This article examines the position of the working environment within public health priorities and as a contributor to the health of a community. Using two Lancashire textile towns (Burnley and Blackburn) as case studies and drawing on a variety of sources, it highlights how, while legislation set the industry parameters for legal enforcement of working conditions, local public health priorities were pivotal in setting codes of practice. The complexities entwined with identifying the working environment as a cause of ill health and with improving it were entangled within the local community health context. In addition, the multiple understandings of Medical Officers of Health surrounding the remit of their responsibilities impacted the local health context. These did not always parallel national regulations. Indeed, it was these local, community specific forces that set the public health agenda, determined its path and the place of the working environment within this. PMID:24771979

Quantitative phylogenetic assessment of microbial communities in diverse environments.

PubMed

von Mering, C; Hugenholtz, P; Raes, J; Tringe, S G; Doerks, T; Jensen, L J; Ward, N; Bork, P

2007-02-23

The taxonomic composition of environmental communities is an important indicator of their ecology and function. We used a set of protein-coding marker genes, extracted from large-scale environmental shotgun sequencing data, to provide a more direct, quantitative, and accurate picture of community composition than that provided by traditional ribosomal RNA-based approaches depending on the polymerase chain reaction. Mapping marker genes from four diverse environmental data sets onto a reference species phylogeny shows that certain communities evolve faster than others. The method also enables determination of preferred habitats for entire microbial clades and provides evidence that such habitat preferences are often remarkably stable over time.

Active-Reserve Force Cost Model

DTIC Science & Technology

2015-01-01

structure to be maintained for a given level of expenditure. We have developed this methodology and set of associated computer-based tools to...rotational, and deployed units or systems • Attain acceptable steady state operational or presence levels , as measured by the number of units a...at the community level . By community, we mean the set of units of a given type: mission, platform, or capability. We do this because AC-RC force-mix

Conditional Reliability and the Identification of Communities

DTIC Science & Technology

2009-11-09

screening is needed to find the factors and interactions that may be relevant. This problem arises in numerous different settings : screening using D...related to the core communities than to each other. and 4. Develop a set of computational methods for conditional reliability. A report describing...resilience address the question: What is the probability that k nodes can communicate? The difference is that for k-terminal reliability, the k communicating

Feasibility of Training Early Childhood Educators in a Community Child Care Setting Using a Caregiver-Mediated Intervention for Toddlers with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Brian, Jessica; Bernardi, Kate; Dowds, Erin; Easterbrook, Rachel; MacWilliam, Stacey; Bryson, Susan

2017-01-01

Parent-mediated intervention programs have demonstrated benefits for toddlers with autism spectrum disorder (ASD). Interest is emerging in other community-level models, such as those that can be integrated into child care settings. These programs have the potential to reach a wide range of high-risk toddlers who spend the majority of their day in…

An Exploratory Factor Analysis and Construct Validity of the Resident Choice Assessment Scale with Paid Carers of Adults with Intellectual Disabilities and Challenging Behavior in Community Settings

ERIC Educational Resources Information Center

Ratti, Victoria; Vickerstaff, Victoria; Crabtree, Jason; Hassiotis, Angela

2017-01-01

Introduction: The Resident Choice Assessment Scale (RCAS) is used to assess choice availability for adults with intellectual disabilities (ID). The aim of the study was to explore the factor structure, construct validity, and internal consistency of the measure in community settings to further validate this tool. Method: 108 paid carers of adults…

Reproduction of Amorpha canescens (Fabaceae) and diversity of its bee community in a fragmented landscape.

PubMed

Slagle, Malinda W; Hendrix, Stephen D

2009-10-01

Loss of insect pollinators due to habitat fragmentation often results in negative effects on plant reproduction, but few studies have simultaneously examined variation in the bee community, site characteristics and plant community characteristics to evaluate their relative effects on plant reproduction in a fragmented habitat. We examined the reproduction of a common tallgrass prairie forb, Amorpha canescens (Fabaceae), in large (>40 ha) and small (<2 ha) prairie remnants in Iowa and Minnesota in relation to the diversity and abundance of its bee visitors, plant population size, and species density of the forb flowering community. We found significant positive effects of the diversity of bees visiting A. canescens on percent fruit set at a site in both years of the study and in 2002 an additional significant positive effect of plant species density. Abundance of bees visiting A. canescens had a significant positive effect on percent fruit set in 2002, but was only marginally significant in 2003. In 2003 but not 2002, the plant species density at the sites had a significant negative effect on the diversity and abundance of bees visiting A. canescens, indicating community-level characteristics can influence the bee community visiting any one species. Site size, a common predictor of plant reproduction in fragmented habitats did not contribute to any models of fruit set and was only marginally related to bee diversity one year. Andrena quintilis, one of the three oligolectic bee species associated with A. canescens, was abundant at all sites, suggesting it has not been significantly affected by fragmentation. Our results show that the diversity of bees visiting A. canescens is important for maintaining fruit set and that bee visitation is still sufficient for at least some fruit set in all populations, suggesting these small remnants act as floral resource oases for bees in landscapes often dominated by agriculture.

Barriers to promote cardiovascular health in community pharmacies: a systematic review.

PubMed

Alonso-Perales, María Del Mar; Lasheras, Berta; Beitia, Guadalupe; Beltrán, Idoia; Marcos, Beatriz; Núñez-Córdoba, Jorge M

2017-06-01

Community pharmacists play an important role in the provision of health promotion services, and community pharmacies are considered as a potentially ideal site for cardiovascular health promotion. Information based on a systematic review of barriers to promoting cardiovascular health in community pharmacy is currently lacking. We have sought to identify the most important barriers to cardiovascular health promotion in the community pharmacy. We have systematically searched PubMed and International Pharmaceutical Abstracts for a period of 15 years from 1 April 1998 to 1 April 2013, contacted subject experts and hand-searched bibliographies. We have included peer-reviewed articles, with English abstracts in the analysis, if they reported community pharmacists' perceptions of the barriers to cardiovascular health promotion activities in a community pharmacy setting. Two reviewers have independently extracted study characteristics and data. We identified 24 studies that satisfy the eligibility criteria. The main barriers to cardiovascular health promotion in the community pharmacy included pharmacist-related factors; practice site factors; financial factors; legal factors; and patient-related factors. This review will help to provide reliable evidence for health promotion practitioners of the barriers to promoting cardiovascular health in the community pharmacy setting. This knowledge is valuable for the improvement of cardiovascular health promotion in this setting and guiding future research. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

NASA Astrophysics Data System (ADS)

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

2017-11-01

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

47 CFR 73.611 - Reference points and distance computations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... as set forth in the FCC's authorization therefor and the coordinates of the other community as set... separations between the proposed stations in the respective cities have been met. (c) In measuring assignment...

Three Cs of Translating Evidence-Based Programs for Youth and Families to Practice Settings

ERIC Educational Resources Information Center

Freire, Kimberley E.; Perkinson, Leah; Morrel-Samuels, Susan; Zimmerman, Marc A.

2015-01-01

Despite the growing number of evidence-based programs (EBPs) for youth and families, few are well-integrated in service systems or widely adopted by communities. One set of challenges to widespread adoption of EBPs relates to the transfer of programs from research and development to practice settings. This is often because program developers have…

Transition Services for Students with Significant Disabilities in College and Community Settings: Strategies for Planning, Implementation, and Evaluation

ERIC Educational Resources Information Center

Grigal, Meg; Neubert, Debra, A.; Moon, M., Sherril

2005-01-01

Traditionally, students with significant disabilities, such as autism, mental retardation, or multiple disabilities, receive transition services in a public high school setting until they are 21 or 22 years old. While this is an appropriate setting for students with these disabilities during ages 14-18, it may be neither an appropriate nor…

Building a citywide, all-payer, hospital claims database to improve health care delivery in a low-income, urban community.

PubMed

Gross, Kennen; Brenner, Jeffrey C; Truchil, Aaron; Post, Ernest M; Riley, Amy Henderson

2013-01-01

Developing data-driven local solutions to address rising health care costs requires valid and reliable local data. Traditionally, local public health agencies have relied on birth, death, and specific disease registry data to guide health care planning, but these data sets provide neither health information across the lifespan nor information on local health care utilization patterns and costs. Insurance claims data collected by local hospitals for administrative purposes can be used to create valuable population health data sets. The Camden Coalition of Healthcare Providers partnered with the 3 health systems providing emergency and inpatient care within Camden, New Jersey, to create a local population all-payer hospital claims data set. The combined claims data provide unique insights into the health status, health care utilization patterns, and hospital costs on the population level. The cross-systems data set allows for a better understanding of the impact of high utilizers on a community-level health care system. This article presents an introduction to the methods used to develop Camden's hospital claims data set, as well as results showing the population health insights obtained from this unique data set.

Current status of the Essential Variables as an instrument to assess the Earth Observation Networks in Europe

NASA Astrophysics Data System (ADS)

Blonda, Palma; Maso, Joan; Bombelli, Antonio; Plag, Hans Peter; McCallum, Ian; Serral, Ivette; Nativi, Stefano Stefano

2016-04-01

ConnectinGEO (Coordinating an Observation Network of Networks EnCompassing saTellite and IN-situ to fill the Gaps in European Observations" is an H2020 Coordination and Support Action with the primary goal of linking existing Earth Observation networks with science and technology (S&T) communities, the industry sector, the Group on Earth Observations (GEO), and Copernicus. The project will end in February 2017. Essential Variables (EVs) are defined by ConnectinGEO as "a minimal set of variables that determine the system's state and developments, are crucial for predicting system developments, and allow us to define metrics that measure the trajectory of the system". . Specific application-dependent characteristics, such as spatial and temporal resolution of observations and data quality thresholds, are not generally included in the EV definition. This definition and the present status of EV developments in different societal benefit areas was elaborated at the ConnectinGEO workshop "Towards a sustainability process for GEOSS Essential Variables (EVs)," which was held in Bari on June 11-12, 2015 (http://www.gstss.org/2015_Bari/). Presentations and reports contributed by a wide range of communities provided important inputs from different sectors for assessing the status of the EV development. In most thematic areas, the development of sets of EVs is a community process leading to an agreement on what is essential for the goals of the community. While there are many differences across the communities in the details of the criteria, methodologies and processes used to develop sets of EVs, there is also a considerable common core across the communities, particularly those with a more advanced discussion. In particular, there is some level of overlap in different topics (e.g., Climate and Water), and there is a potential to develop an integrated set of EVs common to several thematic areas as well as specific ones that satisfy only one community. The thematic areas with a more mature development of EV lists are Climate (ECV), Ocean (EOV) and Biodiversity (EBV). Water is also developing a set of EVs in GEOSS. Agriculture is working with a common set of variables that can be considered essential to them such as Crop Area, Crop Type, Crop Condition, etc.. More work is required for an agreement on other sets of EVs for Disasters, Health and Ecosystems. Being cross-domain topics, these areas can make use of existing sets of EVs (such as ECVs, EOVs and EBVs) complemented by socioeconomic variables that can help to characterize services (e.g., ecosystem services) to human societies. Renewable energy also makes use of the ECVs but there is a need for additional ones: solar surface irradiance and wind at different heights are good candidates to explore. ConnectinGEO will link with Climate, Ocean and Biodiversity communities and support Water, Agriculture, Renewable Energy, Health, Disasters and Ecosystems to make progress in the EV development by stimulating the debate in their respective international forums (mainly in GEOSS). The final objective is to foster EV extraction from the integrated use of in-situ and satellite Earth Observation data.

Breast cancer treatment across health care systems: linking electronic medical records and state registry data to enable outcomes research.

PubMed

Kurian, Allison W; Mitani, Aya; Desai, Manisha; Yu, Peter P; Seto, Tina; Weber, Susan C; Olson, Cliff; Kenkare, Pragati; Gomez, Scarlett L; de Bruin, Monique A; Horst, Kathleen; Belkora, Jeffrey; May, Suepattra G; Frosch, Dominick L; Blayney, Douglas W; Luft, Harold S; Das, Amar K

2014-01-01

Understanding of cancer outcomes is limited by data fragmentation. In the current study, the authors analyzed the information yielded by integrating breast cancer data from 3 sources: electronic medical records (EMRs) from 2 health care systems and the state registry. Diagnostic test and treatment data were extracted from the EMRs of all patients with breast cancer treated between 2000 and 2010 in 2 independent California institutions: a community-based practice (Palo Alto Medical Foundation; "Community") and an academic medical center (Stanford University; "University"). The authors incorporated records from the population-based California Cancer Registry and then linked EMR-California Cancer Registry data sets of Community and University patients. The authors initially identified 8210 University patients and 5770 Community patients; linked data sets revealed a 16% patient overlap, yielding 12,109 unique patients. The percentage of all Community patients, but not University patients, treated at both institutions increased with worsening cancer prognostic factors. Before linking the data sets, Community patients appeared to receive less intervention than University patients (mastectomy: 37.6% vs 43.2%; chemotherapy: 35% vs 41.7%; magnetic resonance imaging: 10% vs 29.3%; and genetic testing: 2.5% vs 9.2%). Linked Community and University data sets revealed that patients treated at both institutions received substantially more interventions (mastectomy: 55.8%; chemotherapy: 47.2%; magnetic resonance imaging: 38.9%; and genetic testing: 10.9% [P < .001 for each 3-way institutional comparison]). Data linkage identified 16% of patients who were treated in 2 health care systems and who, despite comparable prognostic factors, received far more intensive treatment than others. By integrating complementary data from EMRs and population-based registries, a more comprehensive understanding of breast cancer care and factors that drive treatment use was obtained. © 2013 American Cancer Society.

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

PubMed

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

2017-07-11

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

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

PubMed

Khurshid, Anjum; Brown, Lisanne

2014-01-01

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

Are community-based pharmacists underused in the care of persons living with HIV? A need for structural and policy changes

PubMed Central

Kibicho, Jennifer; Pinkerton, Steven D.; Owczarzak, Jill; Mkandawire–Valhmu, Lucy; Kako, Peninnah M.

2016-01-01

Objectives To describe community pharmacists' perceptions on their current role in direct patient care services, an expanded role for pharmacists in providing patient care services, and changes needed to optimally use pharmacists' expertise to provide high-quality direct patient care services to people living with human immunodeficiency virus (HIV) infections. Design Cross-sectional study. Setting Four Midwestern cities in the United States in August through October 2009. Participants 28 community-based pharmacists practicing in 17 pharmacies. Interventions Interviews. Main Outcome Measures Opinions of participants about roles of specialty and nonspecialty pharmacists in caring for patients living with human immunodeficiency virus infections. Results Pharmacists noted that although challenges in our health care system characterized by inaccessible health professionals presented opportunities for a greater pharmacist role, there were missed opportunities for greater level of patient care services in many community-based nonspecialty settings. Many pharmacists in semispecialty and nonspecialty pharmacies expressed a desire for an expanded role in patient care congruent with their pharmacy education and training. Conclusion Structural-level policy changes needed to transform community-based pharmacy settings to patient-centered medical homes include recognizing pharmacists as important players in the multidisciplinary health care team, extending the health information exchange highway to include pharmacist-generated electronic therapeutic records, and realigning financial incentives. Comprehensive policy initiatives are needed to optimize the use of highly trained pharmacists in enhancing the quality of health care to an ever-growing number of Americans with chronic conditions who access care in community-based pharmacy settings. PMID:25575148

NASA SMD E/PO Community Addresses the needs of the Higher Ed Community: Introducing Slide sets for the Introductory Earth and Space Science Instructor

NASA Astrophysics Data System (ADS)

Buxner, S.; Meinke, B. K.; Brain, D.; Schneider, N. M.; Schultz, G. R.; Smith, D. A.; Grier, J.; Shipp, S. S.

2014-12-01

The NASA Science Mission Directorate (SMD) Science Education and Public Outreach (E/PO) community and Forums work together to bring the cutting-edge discoveries of NASA Astrophysics and Planetary Science missions to the introductory astronomy college classroom. These mission- and grant-based E/PO programs are uniquely poised to foster collaboration between scientists with content expertise and educators with pedagogy expertise. We present two new opportunities for college instructors to bring the latest NASA discoveries in Space Science into their classrooms. The NASA Science Mission Directorate (SMD) Astrophysics Education and Public Outreach Forum is coordinating the development of a pilot series of slide sets to help Astronomy 101 instructors incorporate new discoveries in their classrooms. The "Astro 101 slide sets" are presentations 5-7 slides in length on a new development or discovery from a NASA Astrophysics mission relevant to topics in introductory astronomy courses. We intend for these slide sets to help Astronomy 101 instructors include new developments (discoveries not yet in their textbooks) into the broader context of the course. In a similar effort to keep the astronomy classroom apprised of the fast moving field of planetary science, the Division of Planetary Sciences (DPS) has developed the Discovery slide sets, which are 3-slide presentations that can be incorporated into college lectures. The slide sets are targeted at the Introductory Astronomy undergraduate level. Each slide set consists of three slides which cover a description of the discovery, a discussion of the underlying science, and a presentation of the big picture implications of the discovery, with a fourth slide includes links to associated press releases, images, and primary sources. Topics span all subdisciplines of planetary science, and sets are available in Farsi and Spanish. The NASA SMD Planetary Science Forum has recently partnered with the DPS to continue producing the Discovery slides and connect them to NASA mission science.

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

PubMed

Holder, H D; Reynolds, R I

1997-06-01

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

The Basic Structure of Community Early Intervention Programs for Children with Autism: Provider Descriptions

PubMed Central

Stahmer, Aubyn C.

2007-01-01

Autism researchers have identified a set of common effective practice elements for early intervention (EI) (e.g., intensive programming). The current study examined the reported about use of common elements of effective interventions in community EI settings. Eighty EI providers reported about their programs. The majority of participants reported using common effective elements, however, the depth and quality of the use of these elements was highly variable. Taking community program structure into account in future research will facilitate the development of methodologies, which immediately fit into the context of community programming rather than requiring program adaptation for use in the real world. Recommendations for using current community program structure to improve use of evidence-based practices are discussed. PMID:17086438

Nonpareil 3: Fast Estimation of Metagenomic Coverage and Sequence Diversity.

PubMed

Rodriguez-R, Luis M; Gunturu, Santosh; Tiedje, James M; Cole, James R; Konstantinidis, Konstantinos T

2018-01-01

Estimations of microbial community diversity based on metagenomic data sets are affected, often to an unknown degree, by biases derived from insufficient coverage and reference database-dependent estimations of diversity. For instance, the completeness of reference databases cannot be generally estimated since it depends on the extant diversity sampled to date, which, with the exception of a few habitats such as the human gut, remains severely undersampled. Further, estimation of the degree of coverage of a microbial community by a metagenomic data set is prohibitively time-consuming for large data sets, and coverage values may not be directly comparable between data sets obtained with different sequencing technologies. Here, we extend Nonpareil, a database-independent tool for the estimation of coverage in metagenomic data sets, to a high-performance computing implementation that scales up to hundreds of cores and includes, in addition, a k -mer-based estimation as sensitive as the original alignment-based version but about three hundred times as fast. Further, we propose a metric of sequence diversity ( N d ) derived directly from Nonpareil curves that correlates well with alpha diversity assessed by traditional metrics. We use this metric in different experiments demonstrating the correlation with the Shannon index estimated on 16S rRNA gene profiles and show that N d additionally reveals seasonal patterns in marine samples that are not captured by the Shannon index and more precise rankings of the magnitude of diversity of microbial communities in different habitats. Therefore, the new version of Nonpareil, called Nonpareil 3, advances the toolbox for metagenomic analyses of microbiomes. IMPORTANCE Estimation of the coverage provided by a metagenomic data set, i.e., what fraction of the microbial community was sampled by DNA sequencing, represents an essential first step of every culture-independent genomic study that aims to robustly assess the sequence diversity present in a sample. However, estimation of coverage remains elusive because of several technical limitations associated with high computational requirements and limiting statistical approaches to quantify diversity. Here we described Nonpareil 3, a new bioinformatics algorithm that circumvents several of these limitations and thus can facilitate culture-independent studies in clinical or environmental settings, independent of the sequencing platform employed. In addition, we present a new metric of sequence diversity based on rarefied coverage and demonstrate its use in communities from diverse ecosystems.

Developing a Set of Uniform Outcome Measures for Adult Day Services.

PubMed

Anderson, Keith A; Geboy, Lyn; Jarrott, Shannon E; Missaelides, Lydia; Ogletree, Aaron M; Peters-Beumer, Lisa; Zarit, Steven H

2018-06-01

Adult day services (ADS) provide care to adults with physical, functional, and/or cognitive limitations in nonresidential, congregate, community-based settings. ADS programs have emerged as a growing and affordable approach within the home and community-based services sector. Although promising, the growth of ADS has been hampered by a lack of uniform outcome measures and data collection protocols. In this article, the authors detail a recent effort by leading researchers and practitioners in ADS to develop a set of uniform outcome measures. Based upon three recent efforts to develop outcome measures, selection criteria were established and an iterative process was conducted to debate the merits of outcome measures across three domains-participant well-being, caregiver well-being, and health care utilization. The authors conclude by proposing a uniform set of outcome measures to (a) standardize data collection, (b) aid in the development of programming, and (c) facilitate the leveraging of additional funding for ADS.

Hospital preparedness in community measles outbreaks—challenges and recommendations for low-resource settings

PubMed Central

Shakoor, Sadia; Mir, Fatima; Zaidi, Anita K. M.; Zafar, Afia

2015-01-01

We have reviewed various strategies involved in containment of measles in healthcare facilities during community outbreaks. The strategies that are more applicable to resource-poor settings, such as natural ventilation, mechanical ventilation with heating and air-conditioning systems allowing unidirectional air-flow, and protection of un-infected patients and healthcare workers (HCWs), have been examined. Ventilation methods need innovative customization for resource-poor settings followed by validation and post-implementation analysis for impact. Mandatory vaccination of all HCWs with two doses of measles-containing vaccine, appropriate post-exposure prophylaxis of immunocompromised inpatients, and stringent admission criteria for measles cases can contribute toward reduction of nosocomial and secondary transmission within facilities. PMID:25882388

The Social Value of Knowledge and International Clinical Research.

PubMed

Wenner, Danielle M

2015-08-01

In light of the growth in the conduct of international clinical research in developing populations, this paper seeks to explore what is owed to developing world communities who host international clinical research. Although existing paradigms for assigning and assessing benefits to host communities offer valuable insight, I criticize their failure to distinguish between those benefits which can justify the conduct of research in a developing world setting and those which cannot. I argue that the justification for human subjects research is fundamentally grounded in the social value of knowledge, and that this value is context-dependent in a manner which should inform our ethical evaluation of the conduct of research in specific settings. I propose a new framework for the assessment of research benefits assigned to developing world host communities, a natural implication of which is to limit the types of research projects which may permissibly be conducted in developing world settings. © 2013 John Wiley & Sons Ltd.

Mechanisms of change in cognitive therapy for major depressive disorder in the community mental health setting.

PubMed

Crits-Christoph, Paul; Gallop, Robert; Diehl, Caroline K; Yin, Seohyun; Gibbons, Mary Beth Connolly

2017-06-01

This study examined the relation of change in theory-relevant cognitive variables to depressive symptom change over the course of cognitive therapy, as well as the specificity of change mechanisms to cognitive therapy as compared with dynamic therapy. There were 237 adult outpatients who were randomized to either cognitive (n = 119) or dynamic (n = 118) therapy for major depressive disorder in a community mental health setting. Assessments of compensatory skills (Ways of Responding Community Version and Self-Report Version), dysfunctional attitudes (Dysfunctional Attitudes Scale), and depressogenic schemas (Psychological Distance Scaling Task) were obtained at baseline and months 1, 2, and 5 following baseline. Primary outcome was measured using the Hamilton Rating Scale for Depression. Across both therapy conditions, change in all 3 cognitive domains was associated with concurrent change in depressive symptoms. After controlling for other cognitive variables, increased interconnectedness of the positive achievement-related schema was significantly associated with concurrent symptom change in cognitive (rp = .26, p < .001) but not dynamic therapy (rp = .08, p = .29). Increases in positive compensatory skills were associated with subsequent change in depressive symptoms in cognitive therapy (rp = -.36, p = .003), but not in dynamic therapy (rp = .11, p = .386). Results provide support for the compensatory skills model of cognitive therapy (CT) within a community mental health setting. Additional research is necessary to understand other possible mechanisms of change in CT in the community setting. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

A community-based trial of educational interventions with fecal immunochemical tests for colorectal cancer screening uptake among blacks in community settings.

PubMed

Christy, Shannon M; Davis, Stacy N; Williams, Kimberly R; Zhao, Xiuhua; Govindaraju, Swapomthi K; Quinn, Gwendolyn P; Vadaparampil, Susan T; Lin, Hui-Yi; Sutton, Steven K; Roethzeim, Richard R; Shibata, David; Meade, Cathy D; Gwede, Clement K

2016-11-15

Intervention studies among individuals in diverse community settings are needed to reduce health disparities in colorectal cancer (CRC) screening and mortality rates. The current study compared the efficacy of 2 intervention conditions promoting CRC screening among black individuals. Black individuals ages 50 to 75 years (N = 330) were recruited in community settings in 4 Tampa Bay counties. After obtaining consent and conducting a baseline interview to assess sociodemographic and health-related variables, participants received either a culturally targeted CRC photonovella booklet plus a fecal immunochemical test (FIT) kit or a standard CRC screening brochure plus an FIT kit. The primary outcome was FIT kit screening uptake. FIT screening uptake at 6 months was 86.7% overall (90.3% in the brochure group and 81.9% in the photonovella group). Controlling for baseline between-group differences, there was no influence of intervention on FIT kit uptake (P = .756). Significant predictors of not returning an FIT kit included being unable to work (P = .010), having higher religious belief scores (P = .015), and living farther from the cancer center (P = .015). Providing FIT kits and educational print materials to black individuals in community settings resulted in high rates of CRC screening. The study also identified subgroups of participants who were less likely to return an FIT kit and provides insight for future interventions. Cancer 2016;122:3288-3296. © 2016 American Cancer Society. © 2016 American Cancer Society.

A randomized controlled trial of a community health worker intervention in a population of patients with multiple chronic diseases: Study design and protocol

PubMed Central

Kangovi, Shreya; Mitra, Nandita; Turr, Lindsey; Huo, Hairong; Grande, David; Long, Judith A.

2017-01-01

Upstream interventions – e.g. housing programs and community health worker interventions-address socioeconomic and behavioral factors that influence health outcomes across diseases. Studying these types of interventions in clinical trials raises a methodological challenge: how should researchers measure the effect of an upstream intervention in a sample of patients with different diseases? This paper addresses this question using an illustrative protocol of a randomized controlled trial of collaborative-goal setting versus goal-setting plus community health worker support among patients multiple chronic diseases: diabetes, obesity, hypertension and tobacco dependence. At study enrollment, patients met with their primary care providers to select one of their chronic diseases to focus on during the study, and to collaboratively set a goal for that disease. Patients randomly assigned to a community health worker also received six months of support to address socioeconomic and behavioral barriers to chronic disease control. The primary hypothesis was that there would be differences in patients’ selected chronic disease control as measured by HbA1c, body mass index, systolic blood pressure and cigarettes per day, between the goal-setting alone and community health worker support arms. To test this hypothesis, we will conduct a stratum specific multivariate analysis of variance which allows all patients (regardless of their selected chronic disease) to be included in a single model for the primary outcome. Population health researchers can use this approach to measure clinical outcomes across diseases. PMID:27965180

Evaluating the variation in the projected benefit of community-wide mass treatment for schistosomiasis: Implications for future economic evaluations.

PubMed

Turner, Hugo C; Truscott, James E; Bettis, Alison A; Farrell, Sam H; Deol, Arminder K; Whitton, Jane M; Fleming, Fiona M; Anderson, Roy M

2017-04-28

The majority of schistosomiasis control programmes focus on targeting school-aged children. Expanding the use of community-wide mass treatment to reach more adults is under consideration. However, it should be noted that this would require a further increase in programmatic resources, international aid, and commitment for the provision of praziquantel. Consequently, it is important to understand (i) where a change of strategy would have the greatest benefit, and (ii) how generalisable the conclusions of field trials and analytical studies based on mathematical models investigating the impact of community-wide mass treatment, are to a broad range of settings. In this paper, we employ a previously described deterministic fully age-structured schistosomiasis transmission model and evaluate the benefit of community-wide mass treatment both in terms of controlling morbidity and eliminating transmission for Schistosoma mansoni, across a wide range of epidemiological settings and programmatic scenarios. This included variation in the baseline relative worm pre-control burden in adults, the overall level of transmission in defined settings, choice of effectiveness metric (basing morbidity calculations on prevalence or intensity), the level of school enrolment and treatment compliance. Community-wide mass treatment was found to be more effective for controlling the transmission of schistosome parasites than using a school-based programme only targeting school-aged children. However, in the context of morbidity control, the potential benefit of switching to community-wide mass treatment was highly variable across the different scenarios analysed. In contrast, for areas where the goal is to eliminate transmission, the projected benefit of community-wide mass treatment was more consistent. Whether community-wide mass treatment is appropriate will depend on the local epidemiological setting (i.e. the relative pre-control burden in adults and transmission intensity), and whether the goal is morbidity control or eliminating transmission. This has important implications regarding the generalisability of cost-effectiveness analyses of schistosomiasis interventions. Our results indicate that areas with poor school-enrolment/coverage could benefit more from community-wide treatment of praziquantel and should potentially be prioritised for any change in strategy. This work highlights the importance of not over-generalising conclusions and policy in this area, but of basing decisions on high quality epidemiological data and quantitative analyses of the impact of interventions in a range of settings.

Implementation of evidence-based practice by nurses working in community settings and their strategies to mentor student nurses to develop evidence-based practice: A qualitative study.

PubMed

Brooke, Joanne Mary; Mallion, Jaimee

2016-08-01

The aim of the study was to explore how community nurses apply the best available evidence to their practice, and how they mentor student nurses to conceptualize and implement evidence-based practice in community settings. In the UK, the expansion of health-care provision in the community has supported the development of highly skilled community nurses. However, there is limited literature regarding the strategies used by community nurses to implement evidence-based practice and mentor student nurses to conceptualize evidence-based practice in community placements. An exploratory qualitative approach applying inductive reasoning to focus group data was used. As a result, nurses working for a community NHS Foundation Trust in South England with a mentor qualification were invited to participate in one of the seven focus groups, 33 nurses participated. Data were analyzed with thematic analysis. The themes discussed in this paper are: 'our practice is evidence-based' as guidelines and policies provided structure, but occasionally stifled autonomous clinical decision-making, and 'time' as a barrier and facilitator to mentoring student nurses in community settings. In conclusion, nurses need to develop the ability to incorporate patients' needs and wishes within evidence-based care. Time was a facilitator for some community mentors, but protected time is required to complete the necessary practice documentation of student nurses. © 2016 John Wiley & Sons Australia, Ltd.

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

PubMed

Matsushita, Ryo

2016-01-01

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

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

PubMed Central

Maree, Jacobus G.

2017-01-01

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

Training Volunteers in Community Education: A Manual for Staff Members in Community Decision-Making Settings.

ERIC Educational Resources Information Center

Slotnik, William J.; And Others

Methods for encouraging community involvement and training community volunteers for decision making positions in community schools are described. The functions of community schools are to provide a broad diversity of learning opportunities and to involve citizens in assessing community needs, evaluating services, and advocating…

Northern nursing practice in a primary health care setting.

PubMed

Vukic, Adele; Keddy, Barbara

2002-12-01

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

An assessment of priority setting process and its implication on availability of emergency obstetric care services in Malindi District, Kenya.

PubMed

Nyandieka, Lilian Nyamusi; Kombe, Yeri; Ng'ang'a, Zipporah; Byskov, Jens; Njeru, Mercy Karimi

2015-01-01

In spite of the critical role of Emergency Obstetric Care in treating complications arising from pregnancy and childbirth, very few facilities are equipped in Kenya to offer this service. In Malindi, availability of EmOC services does not meet the UN recommended levels of at least one comprehensive and four basic EmOC facilities per 500,000 populations. This study was conducted to assess priority setting process and its implication on availability, access and use of EmOC services at the district level. A qualitative study was conducted both at health facility and community levels. Triangulation of data sources and methods was employed, where document reviews, in-depth interviews and focus group discussions were conducted with health personnel, facility committee members, stakeholders who offer and/ or support maternal health services and programmes; and the community members as end users. Data was thematically analysed. Limitations in the extent to which priorities in regard to maternal health services can be set at the district level were observed. The priority setting process was greatly restricted by guidelines and limited resources from the national level. Relevant stakeholders including community members are not involved in the priority setting process, thereby denying them the opportunity to contribute in the process. The findings illuminate that consideration of all local plans in national planning and budgeting as well as the involvement of all relevant stakeholders in the priority setting exercise is essential in order to achieve a consensus on the provision of emergency obstetric care services among other health service priorities.

Training instructional skills with paraprofessional service providers at a community-based habilitation setting.

PubMed

Wood, Amanda L; Luiselli, James K; Harchik, Alan E

2007-11-01

The present study evaluates a training program with paraprofessional service providers at a community-based habilitation setting. Four staff were taught to implement alternative and augmentative communication instruction with an adult who had autism and mental retardation through a combination of instruction, demonstration, behavior rehearsal, and performance feedback. Training was conducted under natural conditions at the adult's group home residence. Three of the four staff were able to maintain near-100% instructional accuracy following initial training. The results add to the limited research literature concerning community-based training of direct-care personnel.

Supporting Inclusive Care and Education for Young Children with Special Needs and Their Families; an International Perspective

ERIC Educational Resources Information Center

Frankel, Elaine B.

2004-01-01

Inclusion, as a value, supports the right of all children, regardless of abilities, to participate actively in natural settings within their communities. Natural settings are those in which the child would spend time had he or she not had a disability. These settings include, but are not limited to, home, preschool, nursery schools, Head Start…

The Planetary Data System— Archiving Planetary Data for the use of the Planetary Science Community

NASA Astrophysics Data System (ADS)

Morgan, Thomas H.; McLaughlin, Stephanie A.; Grayzeck, Edwin J.; Vilas, Faith; Knopf, William P.; Crichton, Daniel J.

2014-11-01

NASA’s Planetary Data System (PDS) archives, curates, and distributes digital data from NASA’s planetary missions. PDS provides the planetary science community convenient online access to data from NASA’s missions so that they can continue to mine these rich data sets for new discoveries. The PDS is a federated system consisting of nodes for specific discipline areas ranging from planetary geology to space physics. Our federation includes an engineering node that provides systems engineering support to the entire PDS.In order to adequately capture complete mission data sets containing not only raw and reduced instrument data, but also calibration and documentation and geometry data required to interpret and use these data sets both singly and together (data from multiple instruments, or from multiple missions), PDS personnel work with NASA missions from the initial AO through the end of mission to define, organize, and document the data. This process includes peer-review of data sets by members of the science community to ensure that the data sets are scientifically useful, effectively organized, and well documented. PDS makes the data in PDS easily searchable so that members of the planetary community can both query the archive to find data relevant to specific scientific investigations and easily retrieve the data for analysis. To ensure long-term preservation of data and to make data sets more easily searchable with the new capabilities in Information Technology now available (and as existing technologies become obsolete), the PDS (together with the COSPAR sponsored IPDA) developed and deployed a new data archiving system known as PDS4, released in 2013. The LADEE, MAVEN, OSIRIS REx, InSight, and Mars2020 missions are using PDS4. ESA has adopted PDS4 for the upcoming BepiColumbo mission. The PDS is actively migrating existing data records into PDS4 and developing tools to aid data providers and users. The PDS is also incorporating challenge-based competitions to rapidly and economically develop new tools for both users and data providers.Please visit our User Support Area at the meeting (Booth #114) if you have questions accessing our data sets or providing data to the PDS.

Results from a Community-Wide Pilot Program to Standardize COPD Education for Patients Across Healthcare Settings in Rhode Island.

PubMed

Pelland, Kimberly; Youssef, Rouba; Calandra, Kathleen; Cellar, Jennifer; Thiesen, Jennifer; Gardner, Rebekah

2017-07-05

Chronic obstructive pulmonary disease (COPD) is associated with significant morbidity, decreased quality of life, and burdensome hospital admissions. Therefore, patients with COPD interact with clinicians in a number of healthcare settings. A coalition of healthcare practitioners in Rhode Island, in partnership with the local Quality Improvement Organization, designed and implemented a standardized, COPD education program for use across multiple healthcare settings. More than 60 organizations participated, producing 140 Master Trainers, who trained 634 staff members at their facilities from October 2015 through June 2016. Master Trainers were satisfied with the training, and we observed significant increases in knowledge scores post-training among all participants, which remained significant when stratified by setting. These results demonstrate that implementation of a community-based program to disseminate patient-centered, standardized COPD education in multiple healthcare settings is feasible. We hope this program will ultimately improve patient outcomes and serve as the foundation for expanding standardized education for other chronic conditions. [Full article available at http://rimed.org/rimedicaljournal-2017-07.asp].

Characterization of a Methanogenic Community within an Algal Fed Anaerobic Digester

PubMed Central

Ellis, Joshua T.; Tramp, Cody; Sims, Ronald C.; Miller, Charles D.

2012-01-01

The microbial diversity and metabolic potential of a methanogenic consortium residing in a 3785-liter anaerobic digester, fed with wastewater algae, was analyzed using 454 pyrosequencing technology. DNA was extracted from anaerobic sludge material and used in metagenomic analysis through PCR amplification of the methyl-coenzyme M reductase α subunit (mcrA) gene using primer sets ML, MCR, and ME. The majority of annotated mcrA sequences were assigned taxonomically to the genera Methanosaeta in the order Methanosarcinales. Methanogens from the genus Methanosaeta are obligate acetotrophs, suggesting this genus plays a dominant role in methane production from the analyzed fermentation sample. Numerous analyzed sequences within the algae fed anaerobic digester were unclassified and could not be assigned taxonomically. Relative amplicon frequencies were determined for each primer set to determine the utility of each in pyrosequencing. Primer sets ML and MCR performed better quantitatively (representing the large majority of analyzed sequences) than primer set ME. However, each of these primer sets was shown to provide a quantitatively unique community structure, and thus they are of equal importance in mcrA metagenomic analysis. PMID:23724331

A Step towards a Sharable Community Knowledge Base for WRF Settings -Developing a WRF Setting Methodology based on a case study in a Torrential Rainfall Event

NASA Astrophysics Data System (ADS)

CHU, Q.; Xu, Z.; Zhuo, L.; Han, D.

2016-12-01

Increased requirements for interactions between different disciplines and readily access to the numerical weather forecasting system featured with portability and extensibility have made useful contribution to the increases of downstream model users in WRF over recent years. For these users, a knowledge base classified by the representative events would be much helpful. This is because the determination of model settings is regarded as the most important steps in WRF. However, such a process is generally time-consuming, even if with a high computational platform. As such, we propose a sharable proper lookup table on WRF domain settings and corresponding procedures based on a representative torrential rainfall event in Beijing, China. It has been found that WRF's simulations' drift away from the input lateral boundary conditions can be significantly reduced with the adjustment of the domain settings. Among all the impact factors, the placement of nested domain can not only affect the moving speed and angle of the storm-center, but also the location and amount of heavy-rain-belt which can only be detected with adjusted spatial resolutions. Spin-up time is also considered in the model settings, which is demonstrated to have the most obvious influence on the accuracy of the simulations. This conclusion is made based on the large diversity of spatial distributions of precipitation, in terms of the amount of heavy rain varied from -30% to 58% among each experiment. After following all the procedures, the variations of domain settings have minimal effect on the modeling and show the best correlation (larger than 0.65) with fusion observations. So the model settings, including domain size covering the greater Beijing area, 1:5:5 downscaling ratio, 57 vertical levels with top of 50hpa and 60h spin-up time, are found suitable for predicting the similar convective torrential rainfall event in Beijing area. We hope that the procedure for building the community WRF knowledge base in this paper would be helpful to peer-researchers and operational communities by saving them from repeating each other's work. More importantly, the results by studying different events and locations could enrich this community knowledge base to benefit WRF users around the world in the future.

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

PubMed

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

2017-01-01

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

Central On-Line Data Directory

NASA Technical Reports Server (NTRS)

Thieman, J.

1986-01-01

The National Space Science Data Center (NSSDC) Central On-Line Data Directory (CODD), which allows the general scientist remote access to information about data sets available not only at NSSDC, but throughout the scientific community, is discussed. A user may search for data set information within CODD by specifying spacecraft name, experiment name, investigator name, and/or keywords. CODD will include information on atmospheric science data sets contained not only within the PCDS, but also within other data sets that are deemed important. Keywords to be used in locating these data sets are currently being formulated. The main type of keyword to be used for categorization of data sets will be discipline related. The primary discipline keyword for PCDS-type data sets would be ATMOSPHERIC SCIENCE. A good set of subdiscipline keywords is needed under this discipline to subdivide the data sets. A sheet containing a strawman set of subdiscipline keywords was distributed, and a request was made for the knowledgeable scientists to modify or replace the proposed keywords.

The essence of 'community' within community nursing: a district nursing perspective.

PubMed

McGarry, Julie

2003-09-01

Over the past decade or so, there has been a marked shift in the location and nature of nursing care from the hospital setting to primary and community care. The past decade has also witnessed the development of a number of policy initiatives which indicate that the drive towards the community as a key location of nursing care is set to continue. Although notions of community have been explored extensively within the literature from a number of perspectives, there is an absence of a clear definition, and more particularly for the purposes of the present study, one from a nursing perspective. This lack of conceptual clarity is further compounded when notions of community and the place of nursing within the community are considered contemporaneously. The present pilot study, which was based on semi-structured interviews with district nurses, seeks to address this deficit and explore how district nurses define the nature of their role, both in terms of providing nursing care within the community and also in terms of defining community within the context of their work. The study illuminates the principal position of the home in defining the essence of community within community nursing and notions surrounding the nature of relationships which exist within this setting. This is highlighted through the identification of emerging themes: the maintenance of personal-professional boundaries, notions of holistic care and professional definitions of community. These observations raise important questions regarding the extent to which the location of care and the taken-for-granted assumptions surrounding community-based nursing care have been translated into practice to date. This also raises key issues regarding the tensions which exist for nurses trying to balance notions of community and community-based care within the parameters of organisational and professional boundaries.

Mobile crisis management teams as part of an effective crisis management system for rural communities.

PubMed

Trantham, Doug; Sherry, Anne

2012-01-01

Mobile crisis management teams provide crisis prevention and intervention services in community settings. The Appalachian Community Services crisis management program shows how such teams can be used to effectively serve rural communities.

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

PubMed

Shepherd, Andrew; Sanders, Caroline; Shaw, Jenny

2017-08-01

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

A multidomain approach to understanding risk for underage drinking: converging evidence from 5 data sets.

PubMed

Jones, Damon E; Feinberg, Mark E; Cleveland, Michael J; Cooper, Brittany Rhoades

2012-11-01

We examined the independent and combined influence of major risk and protective factors on youths' alcohol use. Five large data sets provided similar measures of alcohol use and risk or protective factors. We carried out analyses within each data set, separately for boys and girls in 8th and 10th grades. We included interaction and curvilinear predictive terms in final models if results were robust across data sets. We combined results using meta-analytic techniques. Individual, family, and peer risk factors and a community protective factor moderately predicted youths' alcohol use. Family and school protective factors did not predict alcohol use when combined with other factors. Youths' antisocial attitudes were more strongly associated with alcohol use for those also reporting higher levels of peer or community risk. For certain risk factors, the association with alcohol use varied across different risk levels. Efforts toward reducing youths' alcohol use should be based on robust estimates of the relative influence of risk and protective factors across adolescent environment domains. Public health advocates should focus on context (e.g., community factors) as a strategy for curbing underage alcohol use.

The Eco-Behavioral Approach to Surveys and Social Accounts for Rural Communities: Exploratory Analyses and Interpretations of Roger G. Barker's Microdata from the Behavior Setting Survey of Midwest, Kansas in 1963-64.

ERIC Educational Resources Information Center

Fox, Karl A.

The concept of behavior settings--the environments shaping individual behavior--was originated by Roger Barker in 1950 in connection with his community surveys in a small Kansas town, code-named Midwest. This book seeks to provide rural social scientists with an understanding of Barker's eco-behavioral approach and proposed adaptations of it to…

Implementation of Lifestyle Modification Program Focusing on Physical Activity and Dietary Habits in a Large Group, Community-Based Setting.

PubMed

Stoutenberg, Mark; Falcon, Ashley; Arheart, Kris; Stasi, Selina; Portacio, Francia; Stepanenko, Bryan; Lan, Mary L; Castruccio-Prince, Catarina; Nackenson, Joshua

2017-06-01

Lifestyle modification programs improve several health-related behaviors, including physical activity (PA) and nutrition. However, few of these programs have been expanded to impact a large number of individuals in one setting at one time. Therefore, the purpose of this study was to determine whether a PA- and nutrition-based lifestyle modification program could be effectively conducted using a large group format in a community-based setting. One hundred twenty-one participants enrolled in a 16-week, community-based lifestyle modification program and separated in small teams of 13 to 17 individuals. Height, weight, fruit and vegetable (FAV) consumption, physical fitness, and several psychosocial measures were assessed before and after the program. Significant improvements in 6-minute walk distance (+68.3 m; p < .001), chair stands (+6.7 repetitions; p < .001), FAV servings (+1.8 servings/day; p < .001), body weight (-3.2 lbs; p < .001), as well as PA social support and eating habits self-efficacy were observed. Our lifestyle modification program was also successful in shifting participants to higher levels of stages of change for nutrition and PA, increasing overall levels of self-efficacy for healthy eating, and improving levels of social support for becoming more active. A lifestyle modification program can be successfully implemented in a community setting using a large group format to improve PA and FAV attitudes and behaviors.

Translating evidence into practice in low resource settings: cervical cancer screening tests are only part of the solution in rural India.

PubMed

Isaac, Rita; Finkel, Madelon; Olver, Ian; Annie, I K; Prashanth, H R; Subhashini, J; Viswanathan, P N; Trevena, Lyndal J

2012-01-01

The majority of women in rural India have poor or no access to cervical cancer screening services, although one-quarter of all cervical cancers in the world occur there. Several large trials have proven the efficacy of low-tech cervical cancer screening methods in the Indian context but none have documented the necessary components and processes of implementing this evidence in a low-resource setting. This paper discusses a feasible model of implementation of cervical cancer screening programme in low-resource settings developed through a pilot research project carried out in rural Tamilnadu, India. The programme used visual inspection of cervix after acetic acid application (VIA) as a screening tool, nurses in the primary care centres as the primary screeners and peer educators within Self-Help Women groups to raise community awareness. The uptake of screening was initially low despite the access to a screening programme. However, the programme witnessed an incremental increase in the number of women accessing screening with increasing community awareness. The investigators recommend 4 key components to programme implementation in low-resource setting: 1) Evidence-based, cost-effective test and treatment available within the reach of the community; 2) Appropriate referral pathways; 3) Skilled health workers and necessary equipment; and 4) Optimisation of health literacy, beliefs, attitudes of the community.

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

PubMed

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

2008-01-01

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

The community reintegration project: occupational therapy at work in a county jail.

PubMed

Eggers, Mila; Muñoz, Jaime Phillip; Sciulli, John; Crist, Patricia Ann Hickerson

2006-01-01

The incarcerated population in U.S jails has more than doubled in the last thirty years while prison populations have quintupled. Over half of those released from incarceration return to correctional systems within one year of release. One of the reasons for these high rates of recidivism is that many inmates lack the community living skills necessary for community reintegration. Successful community reintegration for ex-offenders requires a skill set that occupational therapists have long addressed in their domain of practice. Compared to practitioners in the United Kingdom and Australia, U.S. practitioners have been slow to develop occupational therapy programming in correctional settings. This article describes a community reintegration program for jail inmates built through a collaborative partnership between a university occupational therapy program, community non-profit organizations and a county jail.

Pharmacist and Technician Perceptions of Tech-Check-Tech in Community Pharmacy Practice Settings.

PubMed

Frost, Timothy P; Adams, Alex J

2018-04-01

Tech-check-tech (TCT) is a practice model in which pharmacy technicians with advanced training can perform final verification of prescriptions that have been previously reviewed for appropriateness by a pharmacist. Few states have adopted TCT in part because of the common view that this model is controversial among members of the profession. This article aims to summarize the existing research on pharmacist and technician perceptions of community pharmacy-based TCT. A literature review was conducted using MEDLINE (January 1990 to August 2016) and Google Scholar (January 1990 to August 2016) using the terms "tech* and check," "tech-check-tech," "checking technician," and "accuracy checking tech*." Of the 7 studies identified we found general agreement among both pharmacists and technicians that TCT in community pharmacy settings can be safely performed. This agreement persisted in studies of theoretical TCT models and in studies assessing participants in actual community-based TCT models. Pharmacists who had previously worked with a checking technician were generally more favorable toward TCT. Both pharmacists and technicians in community pharmacy settings generally perceived TCT to be safe, in both theoretical surveys and in surveys following actual TCT demonstration projects. These perceptions of safety align well with the actual outcomes achieved from community pharmacy TCT studies.

Utility of functional status for classifying community versus institutional discharges after inpatient rehabilitation for stroke.

PubMed

Reistetter, Timothy A; Graham, James E; Deutsch, Anne; Granger, Carl V; Markello, Samuel; Ottenbacher, Kenneth J

2010-03-01

To evaluate the ability of patient functional status to differentiate between community and institutional discharges after rehabilitation for stroke. Retrospective cross-sectional design. Inpatient rehabilitation facilities contributing to the Uniform Data System for Medical Rehabilitation. Patients (N=157,066) receiving inpatient rehabilitation for stroke from 2006 and 2007. Not applicable. Discharge FIM rating and discharge setting (community vs institutional). Approximately 71% of the sample was discharged to the community. Receiver operating characteristic curve analyses revealed that FIM total performed as well as or better than FIM motor and FIM cognition subscales in differentiating discharge settings. Area under the curve for FIM total was .85, indicating very good ability to identify persons discharged to the community. A FIM total rating of 78 was identified as the optimal cut point for distinguishing between positive (community) and negative (institution) tests. This cut point yielded balanced sensitivity and specificity (both=.77). Discharge planning is complex, involving many factors. Identifying a functional threshold for classifying discharge settings can provide important information to assist in this process. Additional research is needed to determine if the risks and benefits of classification errors justify shifting the cut point to weight either sensitivity or specificity of FIM ratings. Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Sustainability Tools Inventory - Initial Gaps Analysis | Science ...

EPA Pesticide Factsheets

This report identifies a suite of tools that address a comprehensive set of community sustainability concerns. The objective is to discover whether "gaps" exist in the tool suite’s analytic capabilities. These tools address activities that significantly influence resource consumption, waste generation, and hazard generation including air pollution and greenhouse gases. In addition, the tools have been evaluated using four screening criteria: relevance to community decision making, tools in an appropriate developmental stage, tools that may be transferrable to situations useful for communities, and tools with requiring skill levels appropriate to communities. This document provides an initial gap analysis in the area of community sustainability decision support tools. It provides a reference to communities for existing decision support tools, and a set of gaps for those wishing to develop additional needed tools to help communities to achieve sustainability. It contributes to SHC 1.61.4

Effects of community-based, videotape, and flash card instruction of community-referenced sight words on students with mental retardation.

PubMed Central

Cuvo, A J; Klatt, K P

1992-01-01

Community-referenced sight words and phrases were taught to adolescents with mild and moderate mental retardation using three instructional methods in two locations. Words were presented on flash cards in a school setting, on videotape recordings in a school setting, and on naturally occurring signs in the community. During each session, participants were taught one third of the words in each of these conditions and were then tested at the community sites. A constant prompt delay procedure was used to promote stimulus control to the experimenter's cue initially and then to transfer control to the textual stimuli used for training. A multiple baseline across participants design was employed. Results showed rapid acquisition of the community-referenced sight words in all three training conditions and generalization from the flash card and videotape conditions to the community sites. PMID:1378827

Annotated Bibliography for Adult Educators in Institutional Settings.

ERIC Educational Resources Information Center

Elwyn Inst., PA.

This annotated bibliography of instructional materials for adult educators in institutional settings lists materials available in fourteen areas: basic skills, citizenship education, community services, consumer education, health and safety, mathematics, meal planning, money management, personal information/general life skills, pre-employment…

Communication as Part of the Engineering Skills Set

ERIC Educational Resources Information Center

Lappalainen, Pia

2009-01-01

Engineering graduates are facing changing requirements regarding their competencies, as interdisciplinarity and globalization have transformed engineering communities into collaboration arenas extending beyond uniform national, cultural, contextual and disciplinary settings and structures. Engineers no longer manage their daily tasks with plain…

[Discipline: Three Views.

ERIC Educational Resources Information Center

Turnbaugh, Ann

1986-01-01

This resource bulletin provides an overview of creative disciplinary programs in rural, suburban, and urban school settings through interviews conducted with administrators in 1986. Principals interviewed in urban settings expressed concern about student gangs and safety. In rural schools, administrators stated that community cohesion and…

Student nurses' perceived use of NANDA-I nursing diagnoses in the community setting.

PubMed

Ogunfowokan, Adesola A; Oluwatosin, Abimbola O; Olajubu, Aanuoluwapo O; Alao, Olujide A; Faremi, Adenike F

2013-02-01

Study explored knowledge and perception of student nurses on the use of NANDA-I nursing diagnoses in the community setting. Study adopted cross-sectional design. Convenient sampling method was used to select 290 nursing students. Data analysis was by descriptive and inferential statistics. A majority (81.3%) of the participants considered NANDA-I nursing diagnoses to be useful in the community. Significant association existed in the perception and level of education of the students (χ(2) = 8.257, d.f. = 1, p= .04). Knowledge and perception of the participants about the use of NANDA-I nursing diagnoses in the community is satisfactory. Use of NANDA-I nursing diagnoses should be encouraged among community health nurses. © 2012, The Authors. International Journal of Nursing Knowledge © 2012, NANDA International.

The Trial Using Motivational Interviewing and Positive Affect and Self-Affirmation in African-Americans with Hypertension (TRIUMPH): From Theory to Clinical Trial Implementation

PubMed Central

Boutin-Foster, Carla; Scott, Ebony; Rodriguez, Anna; Ramos, Rosio; Kanna, Balavenkatesh; Michelen, Walid; Charlson, Mary; Gbenga, Ogedegbe

2014-01-01

This paper describes the application of a translational research model in developing The Trial Using Motivational Interviewing and Positive Affect and Self-Affirmation in African-Americans with Hypertension (TRIUMPH), a theoretically-based, randomized controlled trial. TRIUMPH targets blood pressure control among African-Americans with hypertension in a community health center and public hospital setting. TRIUMPH applies positive affect, self-affirmation, and motivational interviewing as strategies to increase medication adherence and blood pressure control. A total of 220 participants were recruited in TRIUMPH and are currently being followed. This paper provides a detailed description of the theoretical framework and study design of TRIUMPH and concludes with a critical reflection of the lessons learned in the process of implementing a health behavior intervention in a community-based setting. TRIUMPH provides a model for incorporating the translational science research paradigm to conducting pragmatic behavioral trials in a real-world setting in a vulnerable population. Lessons learned through interactions with our community partners reinforce the value of community engagement in research. PMID:23403073

Romidepsin for the treatment of relapsed/refractory cutaneous T-cell lymphoma (mycosis fungoides/Sézary syndrome): Use in a community setting.

PubMed

Reddy, Sunil A

2016-10-01

Cutaneous T-cell lymphoma (CTCL) is a heterogeneous group of rare non-Hodgkin lymphomas that arise in the skin. In advanced stages, CTCL becomes systemic and is associated with poor prognosis. Diagnosis of CTCL and treatment of early-stage disease with topical therapies often occurs under the care of a dermatologist. Community oncologists see few patients with CTCL due to direct referrals from dermatologists to academic or lymphoma specialty centers. However, some patients will continue to be managed in a community setting. Currently there is no evidence-based stepwise algorithm for treatment of patients with CTCL, and guidelines suggest a wide range of systemic therapies, including biologics, targeted agents, and more traditional chemotherapies. To provide optimal care in a community setting, oncologists must become familiar with newer nonchemotherapeutic treatment options. This review highlights romidepsin, a histone deacetylase inhibitor approved for the treatment of patients with CTCL who have received ≥1 prior systemic therapy. Copyright © 2016 The Author. Published by Elsevier Ireland Ltd.. All rights reserved.

Moving Forward in Fall Prevention: An Intervention to Improve Balance Among Older Adults in Real-World Settings

PubMed Central

Robitaille, Yvonne; Laforest, Sophie; Fournier, Michel; Gauvin, Lise; Parisien, Manon; Corriveau, Hélène; Trickey, Francine; Damestoy, Nicole

2005-01-01

Objectives. We investigated the effectiveness of a group-based exercise intervention to improve balancing ability among older adults delivered in natural settings by staff in local community organizations. Methods. The main component of the intervention consisted of biweekly group-based exercise sessions conducted over 12 weeks by a professional, coupled with home-based exercises. In a quasiexperimental design, 10 community organizations working with older adults offered the intervention to groups of 5 to 15 persons concerned about falls, while 7 organizations recruited similar groups to participate in the control arm of the study. Participants (98 experimental and 102 control) underwent balance assessments by a physiotherapist at registration and 3 months later. Results. Eighty-nine percent of participants attended the 3-month measurement session (n=177). A linear regression analysis showed that after adjusting for baseline levels of balance and demographic and health characteristics, the intervention significantly improved static balance and mobility. Conclusion. Structured, group-based exercise programs offered by community organizations in natural settings can successfully increase balancing ability among community-dwelling older adults concerned about falls. PMID:16195514

Leader behaviors, group cohesion, and participation in a walking group program

PubMed Central

Izumi, Betty T.; Schulz, Amy J.; Mentz, Graciela; Israel, Barbara A.; Sand, Sharon L.; Reyes, Angela G.; Hoston, Bernadine; Richardson, Dawn; Gamboa, Cindy; Rowe, Zachary; Diaz, Goya

2015-01-01

Background Fewer than half of all U.S. adults meet the 2008 Physical Activity Guidelines. Leader behaviors and group cohesion have been associated with increased participation or adherence in sports team and exercise class settings. Physical activity interventions in community settings that encompass these factors may enhance intervention adherence. Purpose To examine the impact of Community Health Promoter leader behaviors and group cohesion on participation in a walking group intervention among racially/ethnically diverse adults in low-to-moderate income communities in Detroit, Mich. Design Data for the current study were drawn from the Walk Your Heart to Health (WYHH) data set. WYHH was a multi-site cluster randomized controlled study with a lagged intervention and outcome measurements at baseline, four, eight, and 32 weeks. Pooled survey data from both intervention arms is used for the current study. Data were analyzed between August 2013 and October 2014. Setting/participants A total of 603 non-Hispanic Black, non-Hispanic White, and Hispanic adults across five cohorts that began the 32-week WYHH intervention between March 2009 and October 2011. Intervention A 32-week long walking group program hosted by community- and faith-based organizations and facilitated by Community Health Promoters. Walking groups met three times per week for 90-minutes per session. To promote participation in or adherence to WYHH, Community Health Promoters used evidence-based strategies to facilitate group cohesion. Group members assumed increasing leadership responsibility for facilitating sessions over time. Main outcome measures Participation in WYHH as measured by consistency of attendance. Results Community Health Promoter leader behaviors were positively associated with participation in WYHH. Social but not task cohesion was significantly associated with consistent participation. Social cohesion may mediate the relationship between leader behaviors and walking group participation. Conclusions Providing leaders with training to build socially cohesive groups may help motivate individuals to continue participation in community-based physical activity programs. PMID:26094226

Abundance fluctuations among benthic invertebrates in two pacific estuaries

USGS Publications Warehouse

Nichols, Frederic H.

1985-01-01

Long-term studies were used to examine (1) contrasting time scales and mechanisms of structural variations within two benthic communities and (2) the usefulness of long data sets for evaluating human impact. A 10-year study of a San Francisco Bay mudflat, the details of which are reported elsewhere, has revealed large short-term (on the order of months) variations in species abundances within a community composed predominantly of opportunistic species. The study site, located in a highly urbanized estuary, is subject to the influence of a nearby sewage-treatment facility. However, rapid changes in population size of the common species, in part due to periodic natural habitat disturbance, impedes the detection of anthropogenic influences on community composition. Only a very long-term data set may provide evidence of progressive change. Data collected for a 20-year period on the benthic community at 200 m depth in the main basin of Puget Sound, an environment subject to little apparent habitat disturbance show that numerical abundance of the common species can also change markedly. Here, however, numerical dominance shifts from one species to another at irregular, multiyear intervals. Recent increases in two heretofore rare species, and a significant increase in total numbers of individuals suggest that long-term changes may be occurring in this community. These two long-term data sets demonstrate the importance of measuring both the amplitude and the periodicity of fluctuations in population size of aquatic species as well as long-term fluctuations and patterns in environmental factors before attempting to demonstrate the effect of anthropogenic influences on aquatic communities. The results of these studies also demonstrate the usefulness of long-term data sets for revealing the potential importance of interactions among species in determining abundance patterns in the soft-bottom benthos.

If we offer it, will children buy it? Sales of healthy foods mirrored their availability in a community sport, commercial setting in Alberta, Canada.

PubMed

Olstad, Dana Lee; Goonewardene, Laksiri A; McCargar, Linda J; Raine, Kim D

2015-04-01

Community sports settings are often sources of unhealthy foods for children. Many managers in these settings are reluctant to increase availability of healthy food options because they perceive that healthy foods are not profitable. This study assessed the independent contribution of increased availability of healthy foods to their sales in a community sport, commercial context. Change in revenues per patron was also examined. The availability of healthy items was increased from 9.1% at baseline (35 days) to 25.0% during the intervention period (40 days), returning to 9.1% postintervention (6 days). Purchases of all patrons who bought foods/beverages (n=17,262 items sold) from two concessions at an outdoor community pool were assessed from baseline to postintervention. Chi-square analyses assessed differences in the proportion of healthy and unhealthy items sold, as well as in the proportion of total revenues per patron across periods. A trained observer also recorded qualitative observations pertaining to a subset of patrons' (n=221) dietary behaviors and activities. Healthy items represented 7.7%, 22.7%, and 9.8% of sales during the preintervention, intervention, and postintervention periods, respectively (p<0.01). Sales of healthy beverages exceeded sales of all other product types. The proportion of total revenues per patron did not differ by period. Food availability was an important environmental determinant of food purchasing behaviors in this community commercial context, given that sales of healthy foods closely mirrored their availability. Increased availability of healthy foods in community and commercial settings is important because concurrent changes within multiple environments will be required to improve children's dietary behaviors.

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

PubMed Central

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

2016-01-01

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

Participatory methods for research prioritization in primary care: an analysis of the World Café approach in Ireland and the USA.

PubMed

MacFarlane, Anne; Galvin, Rose; O'Sullivan, Madeleine; McInerney, Chris; Meagher, Eoghan; Burke, Daniel; LeMaster, Joseph W

2017-06-01

There are increasing imperatives for patients and members of the public to engage as partners in identifying health research priorities. The use of participatory methods to engage stakeholders in health care in research prioritization is not commonly reported. This article analyses the use of World Cafés as a participatory method for research prioritization with marginalized communities in Ireland and the USA. The principles of purposeful and snowball sampling were followed in both settings and a diverse range of community and health care stakeholders participated (n = 63 Ireland and n = 55 USA). The principles for a classic World Café were employed but there were novel features in each setting as well. Stewart et al.'s (Patients' and clinicians' research priorities. Health Expect 2011; 14: 439-48, conceptual framework for patient engagement was adapted and used to comparatively analyse the strengths and weaknesses of the World Cafés, focusing on agenda setting, engagement with research processes, interactional features and outputs. Design principles for World Cafés were found to align with high-quality patient engagement for research prioritization in both settings. They served to facilitate meaningful collaboration among stakeholder groups in research prioritization (research agenda setting) and explored research priorities (engagement with research). The café ambience, emphasis on hospitality and self-facilitation created an environment for dialogues within and across participating groups (interactional features). There was a commitment to follow-up actions with reference to possible subsequent research (outputs). The World Café is a valuable, participatory, flexible method that can be used with community and health care stakeholders for research prioritization with marginalized communities. © The Author 2016. Published by Oxford University Press.

Temporal trends in the occurrence and outcomes of atrial fibrillation in patients with acute myocardial infarction (from the Atherosclerosis Risk in Communities Surveillance Study).

PubMed

Bengtson, Lindsay G S; Chen, Lin Y; Chamberlain, Alanna M; Michos, Erin D; Whitsel, Eric A; Lutsey, Pamela L; Duval, Sue; Rosamond, Wayne D; Alonso, Alvaro

2014-09-01

Atrial fibrillation (AF) frequently coexists in the setting of myocardial infarction (MI), being associated with increased mortality. Nonetheless, temporal trends in the occurrence of AF complicating MI and in the prognosis of these patients are not well described. We examined temporal trends in prevalence of AF in the setting of MI and the effect of AF on prognosis in the community. We studied a population-based sample of 20,049 validated first-incident nonfatal hospitalized MIs among 35- to 74-year old residents of 4 communities in the Atherosclerosis Risk in Communities (ARIC) Study from 1987 through 2009. Prevalence of AF in the setting of MI increased from 11% to 15% during the 23-year study period. The multivariable adjusted odds ratio for prevalent AF, per 5-year increment, was 1.11 (95% confidence interval 1.04 to 1.19). Overall, in patients with MI, AF was associated with increased 1-year case fatality (odds ratio 1.47, 95% confidence interval 1.07 to 2.01) compared with those without AF. However, there was no evidence that the impact of AF on MI survival changed over time or differed over time by sex, race, or MI classification (all p values >0.10). In conclusion, co-occurrence of AF in MI slightly increased between 1987 and 2009. The adverse impact of AF on survival in the setting of MI was consistent throughout. In the setting of MI, co-occurrence of AF should be viewed as a critical clinical event, and treatment needs unique to this population should be explored further. Copyright © 2014 Elsevier Inc. All rights reserved.

Employing continuous quality improvement in community-based substance abuse programs.

PubMed

Chinman, Matthew; Hunter, Sarah B; Ebener, Patricia

2012-01-01

This article aims to describe continuous quality improvement (CQI) for substance abuse prevention and treatment programs in a community-based organization setting. CQI (e.g., plan-do-study-act cycles (PDSA)) applied in healthcare and industry was adapted for substance abuse prevention and treatment programs in a community setting. The authors assessed the resources needed, acceptability and CQI feasibility for ten programs by evaluating CQI training workshops with program staff and a series of three qualitative interviews over a nine-month implementation period with program participants. The CQI activities, PDSA cycle progress, effort, enthusiasm, benefits and challenges were examined. Results indicated that CQI was feasible and acceptable for community-based substance abuse prevention and treatment programs; however, some notable resource challenges remain. Future studies should examine CQI impact on service quality and intended program outcomes. The study was conducted on a small number of programs. It did not assess CQI impact on service quality and intended program outcomes. Practical implications- This project shows that it is feasible to adapt CQI techniques and processes for community-based programs substance abuse prevention and treatment programs. These techniques may help community-based program managers to improve service quality and achieve program outcomes. This is one of the first studies to adapt traditional CQI techniques for community-based settings delivering substance abuse prevention and treatment programs.

Using community-level metrics to monitor the effects of marine protected areas on biodiversity.

PubMed

Soykan, Candan U; Lewison, Rebecca L

2015-06-01

Marine protected areas (MPAs) are used to protect species, communities, and their associated habitats, among other goals. Measuring MPA efficacy can be challenging, however, particularly when considering responses at the community level. We gathered 36 abundance and 14 biomass data sets on fish assemblages and used meta-analysis to evaluate the ability of 22 distinct community diversity metrics to detect differences in community structure between MPAs and nearby control sites. We also considered the effects of 6 covariates-MPA size and age, MPA size and age interaction, latitude, total species richness, and level of protection-on each metric. Some common metrics, such as species richness and Shannon diversity, did not differ consistently between MPA and control sites, whereas other metrics, such as total abundance and biomass, were consistently different across studies. Metric responses derived from the biomass data sets were more consistent than those based on the abundance data sets, suggesting that community-level biomass differs more predictably than abundance between MPA and control sites. Covariate analyses indicated that level of protection, latitude, MPA size, and the interaction between MPA size and age affect metric performance. These results highlight a handful of metrics, several of which are little known, that could be used to meet the increasing demand for community-level indicators of MPA effectiveness. © 2015 Society for Conservation Biology.

Environmental influences on physical activity in rural adults: the relative contributions of home, church and work settings.

PubMed

Kegler, Michelle C; Swan, Deanne W; Alcantara, Iris; Wrensford, Louise; Glanz, Karen

2012-09-01

This study examines the relative contribution of social (eg, social support) and physical (eg, programs and facilities) aspects of worksite, church, and home settings to physical activity levels among adults in rural communities. Data are from a cross-sectional survey of 268 African American and Caucasian adults, ages 40-70, living in southwest Georgia. Separate regression models were developed for walking, moderate, vigorous, and total physical activity as measured in METs-minutes-per-week. Social support for physical activity was modest in all 3 settings (mean scores 1.5-1.9 on a 4-point scale). Participants reported limited (<1) programs and facilities for physical activity at their worksites and churches. An interaction of physical and social aspects of the home setting was observed for vigorous and moderate physical activity and total METs. There were also interactions between gender and social support at church for vigorous activity among women, and between race and the physical environment at church for moderate physical activity. A cross-over interaction was found between home and church settings for vigorous physical activity. Social support at church was associated with walking and total METs. Homes and churches may be important behavioral settings for physical activity among adults in rural communities.

Patient Safety: Moving the Bar in Prison Health Care Standards

PubMed Central

Greifinger, Robert B.; Mellow, Jeff

2010-01-01

Improvements in community health care quality through error reduction have been slow to transfer to correctional settings. We convened a panel of correctional experts, which recommended 60 patient safety standards focusing on such issues as creating safety cultures at organizational, supervisory, and staff levels through changes to policy and training and by ensuring staff competency, reducing medication errors, encouraging the seamless transfer of information between and within practice settings, and developing mechanisms to detect errors or near misses and to shift the emphasis from blaming staff to fixing systems. To our knowledge, this is the first published set of standards focusing on patient safety in prisons, adapted from the emerging literature on quality improvement in the community. PMID:20864714

The role of exercise in fall prevention for older adults.

PubMed

Rose, Debra J; Hernandez, Danielle

2010-11-01

This article reviews the evidence for the effectiveness of stand-alone exercise interventions and multifactorial intervention strategies that include exercise in lowering fall incidence rates and/or fall risk among older adults residing in the community, acute, subacute, and long-term care settings. Stand-alone exercise programs that emphasize multiple exercise categories are effective in reducing fall rates and fall risk in community-residing older adults, and may also be effective when conducted for a sufficient duration with older adult patients in subacute settings. In contrast, multifactorial fall risk reduction programs that include exercise as a component and are delivered by a multidisciplinary team are more effective in lowering fall rates in long-term care settings. Copyright © 2010 Elsevier Inc. All rights reserved.

Exploring empowerment in settings: mapping distributions of network power.

PubMed

Neal, Jennifer Watling

2014-06-01

This paper brings together two trends in the empowerment literature-understanding empowerment in settings and understanding empowerment as relational-by examining what makes settings empowering from a social network perspective. Specifically, extending Neal and Neal's (Am J Community Psychol 48(3/4):157-167, 2011) conception of network power, an empowering setting is defined as one in which (1) actors have existing relationships that allow for the exchange of resources and (2) the distribution of network power among actors in the setting is roughly equal. The paper includes a description of how researchers can examine distributions of network power in settings. Next, this process is illustrated in both an abstract example and using empirical data on early adolescents' peer relationships in urban classrooms. Finally, implications for theory, methods, and intervention related to understanding empowering settings are explored.

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

PubMed Central

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

2013-01-01

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

Stakeholders understanding of the concept of benefit sharing in health research in Kenya: a qualitative study.

PubMed

Lairumbi, Geoffrey M; Parker, Michael; Fitzpatrick, Raymond; Mike, English C

2011-10-03

The concept of benefit sharing to enhance the social value of global health research in resource poor settings is now a key strategy for addressing moral issues of relevance to individuals, communities and host countries in resource poor settings when they participate in international collaborative health research.The influence of benefit sharing framework on the conduct of collaborative health research is for instance evidenced by the number of publications and research ethics guidelines that require prior engagement between stakeholders to determine the social value of research to the host communities. While such efforts as the production of international guidance on how to promote the social value of research through such strategies as benefit sharing have been made, the extent to which these ideas and guidelines have been absorbed by those engaged in global health research especially in resource poor settings remains unclear. We examine this awareness among stakeholders involved in health related research in Kenya. We conducted in-depth interviews with key informants drawn from within the broader health research system in Kenya including researchers from the mainstream health research institutions, networks and universities, teaching hospitals, policy makers, institutional review boards, civil society organisations and community representative groups. Our study suggests that although people have a sense of justice and the moral aspects of research, this was not articulated in terms used in the literature and the guidelines on the ethics of global health research. This study demonstrates that while in theory several efforts can be made to address the moral issues of concern to research participants and their communities in resource poor settings, quick fixes such as benefit sharing are not going to be straightforward. We suggest a need to pay closer attention to the processes through which ethical principles are enacted in practice and distil lessons on how best to involve individuals and communities in promoting ethical conduct of global health research in resource poor settings.

Stakeholders understanding of the concept of benefit sharing in health research in Kenya: a qualitative study

PubMed Central

2011-01-01

Background The concept of benefit sharing to enhance the social value of global health research in resource poor settings is now a key strategy for addressing moral issues of relevance to individuals, communities and host countries in resource poor settings when they participate in international collaborative health research. The influence of benefit sharing framework on the conduct of collaborative health research is for instance evidenced by the number of publications and research ethics guidelines that require prior engagement between stakeholders to determine the social value of research to the host communities. While such efforts as the production of international guidance on how to promote the social value of research through such strategies as benefit sharing have been made, the extent to which these ideas and guidelines have been absorbed by those engaged in global health research especially in resource poor settings remains unclear. We examine this awareness among stakeholders involved in health related research in Kenya. Methods We conducted in-depth interviews with key informants drawn from within the broader health research system in Kenya including researchers from the mainstream health research institutions, networks and universities, teaching hospitals, policy makers, institutional review boards, civil society organisations and community representative groups. Results Our study suggests that although people have a sense of justice and the moral aspects of research, this was not articulated in terms used in the literature and the guidelines on the ethics of global health research. Conclusion This study demonstrates that while in theory several efforts can be made to address the moral issues of concern to research participants and their communities in resource poor settings, quick fixes such as benefit sharing are not going to be straightforward. We suggest a need to pay closer attention to the processes through which ethical principles are enacted in practice and distil lessons on how best to involve individuals and communities in promoting ethical conduct of global health research in resource poor settings. PMID:21961798

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.

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

PubMed Central

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

2012-01-01

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

Implementing rapid HIV testing in outreach and community settings: results from an advancing HIV prevention demonstration project conducted in seven U.S. cities.

PubMed

Bowles, Kristina E; Clark, Hollie A; Tai, Eric; Sullivan, Patrick S; Song, Binwei; Tsang, Jenny; Dietz, Craig A; Mir, Julita; Mares-DelGrasso, Azul; Calhoun, Cindy; Aguirre, Daisy; Emerson, Cicily; Heffelfinger, James D

2008-01-01

The goals of this project were to assess the feasibility of conducting rapid human immunodeficiency virus (HIV) testing in outreach and community settings to increase knowledge of HIV serostatus among groups disproportionately affected by HIV and to identify effective nonclinical venues for recruiting people in the targeted populations. Community-based organizations (CBOs) in seven U.S. cities conducted rapid HIV testing in outreach and community settings, including public parks, homeless shelters, and bars. People with reactive preliminary positive test results received confirmatory testing, and people confirmed to be HIV-positive were referred to health-care and prevention services. A total of 23,900 people received rapid HIV testing. Of the 267 people (1.1%) with newly diagnosed HIV infection, 75% received their confirmatory test results and 64% were referred to care. Seventy-six percent were from racial/ethnic minority groups, and 58% identified themselves as men who have sex with men, 72% of whom reported having multiple sex partners in the past year. Venues with the highest proportion of new HIV diagnoses were bathhouses, social service organizations, and needle-exchange programs. The acceptance rate for testing was 60% among sites collecting this information. Findings from this demonstration project indicate that offering rapid HIV testing in outreach and community settings is a feasible approach for reaching members of minority groups and people at high risk for HIV infection. The project identified venues that would be important to target and offered lessons that could be used by other CBOs to design and implement similar programs in the future.

How Informed Are Informal Educators?

ERIC Educational Resources Information Center

Lederman, Norman G.; Niess, Margaret L.

1998-01-01

Explores current reforms in both mathematics and science education that emphasize the importance of learning in informal settings. Suggests that informal education must include planned and purposeful attempts to facilitate students' understanding of mathematics and science in community settings other than the local school. (Author/CCM)

[Better coordination between primary care, community settings and diabetes outpatient clinic for patients with type 2 diabetes].

PubMed

Gjessing, Hans Jørgen; Jørgensen, Ulla Linding; Møller, Charlotte Chrois; Huge, Lis; Dalgaard, Anne Mette; Nielsen, Kristian Wendelboe; Thomsen, Lis; Buch, Martin Sandberg

2014-06-02

Integrated care programmes for patients with type 2 diabetes can be successfully implemented by planning the programmes in coordination between the sectors primary care, community settings and diabetes outpatient clinic, and with involvement of leaders and employees. Our project has resulted in: 1) more patients with type 2 diabetes receiving diabetes management courses, 2) improved diabetes management of primary care, and 3) improved confidence and respect between sectors involved in diabetes care.

Clinical supervision in a community setting.

PubMed

Evans, Carol; Marcroft, Emma

Clinical supervision is a formal process of professional support, reflection and learning that contributes to individual development. First Community Health and Care is committed to providing clinical supervision to nurses and allied healthcare professionals to support the provision and maintenance of high-quality care. In 2012, we developed new guidelines for nurses and AHPs on supervision, incorporating a clinical supervision framework. This offers a range of options to staff so supervision accommodates variations in work settings and individual learning needs and styles.

Treating asthma with a self-management model of illness behaviour in an Australian community pharmacy setting.

PubMed

Smith, Lorraine; Bosnic-Anticevich, Sinthia Z; Mitchell, Bernadette; Saini, Bandana; Krass, Ines; Armour, Carol

2007-04-01

Asthma affects a considerable proportion of the population worldwide and presents a significant health problem in Australia. Given its chronic nature, effective asthma self-management approaches are important. However, despite research and interventions targeting its treatment, the management of asthma remains problematic. This study aimed to develop, from a theoretical basis, an asthma self-management model and implement it in an Australian community pharmacy setting in metropolitan Sydney, using a controlled, parallel-groups repeated-measures design. Trained pharmacists delivered a structured, step-wise, patient-focused asthma self-management program to adult participants over a 9-month period focusing on identification of asthma problems, goal setting and strategy development. Data on process- clinical- and psychosocial-outcome measures were gathered. Results showed that participants set an average of four new goals and six repeated goals over the course of the intervention. Most common goal-related themes included asthma triggers, asthma control and medications. An average of nine strategies per participant was developed to achieve the set goals. Common strategies involved visiting a medical practitioner for review of medications, improving adherence to medications and using medications before exercise. Clinical and psychosocial outcomes indicated significant improvements over time in asthma symptom control, asthma-related self-efficacy and quality of life, and negative affect. These results suggest that an asthma self-management model of illness behaviour has the potential to provide patients with a range of process skills for self-management, and deliver improvements in clinical and psychosocial indicators of asthma control. The results also indicate the capacity for the effective delivery of such an intervention by pharmacists in Australian community pharmacy settings.

“Violence. Enough already”: findings from a global participatory survey among women living with HIV

PubMed Central

Orza, Luisa; Bewley, Susan; Chung, Cecilia; Crone, E Tyler; Nagadya, Hajjarah; Vazquez, Marijo; Welbourn, Alice

2015-01-01

Introduction Women living with HIV are vulnerable to gender-based violence (GBV) before and after diagnosis, in multiple settings. This study's aim was to explore how GBV is experienced by women living with HIV, how this affects women's sexual and reproductive health (SRH) and human rights (HR), and the implications for policymakers. Methods A community-based, participatory, user-led, mixed-methods study was conducted, with women living with HIV from key affected populations. Simple descriptive frequencies were used for quantitative data. Thematic coding of open qualitative responses was performed and validated with key respondents. Results In total, 945 women living with HIV from 94 countries participated in the study. Eighty-nine percent of 480 respondents to an optional section on GBV reported having experienced or feared violence, either before, since and/or because of their HIV diagnosis. GBV reporting was higher after HIV diagnosis (intimate partner, family/neighbours, community and health settings). Women described a complex and iterative relationship between GBV and HIV occurring throughout their lives, including breaches of confidentiality and lack of SRH choice in healthcare settings, forced/coerced treatments, HR abuses, moralistic and judgemental attitudes (including towards women from key populations), and fear of losing child custody. Respondents recommended healthcare practitioners and policymakers address stigma and discrimination, training, awareness-raising, and HR abuses in healthcare settings. Conclusions Respondents reported increased GBV with partners and in families, communities and healthcare settings after their HIV diagnosis and across the life-cycle. Measures of GBV must be sought and monitored, particularly within healthcare settings that should be safe. Respondents offered policymakers a comprehensive range of recommendations to achieve their SRH and HR goals. Global guidance documents and policies are more likely to succeed for the end-users if lived experiences are used. PMID:26643458

"Violence. Enough already": findings from a global participatory survey among women living with HIV.

PubMed

Orza, Luisa; Bewley, Susan; Chung, Cecilia; Crone, E Tyler; Nagadya, Hajjarah; Vazquez, Marijo; Welbourn, Alice

2015-01-01

Women living with HIV are vulnerable to gender-based violence (GBV) before and after diagnosis, in multiple settings. This study's aim was to explore how GBV is experienced by women living with HIV, how this affects women's sexual and reproductive health (SRH) and human rights (HR), and the implications for policymakers. A community-based, participatory, user-led, mixed-methods study was conducted, with women living with HIV from key affected populations. Simple descriptive frequencies were used for quantitative data. Thematic coding of open qualitative responses was performed and validated with key respondents. In total, 945 women living with HIV from 94 countries participated in the study. Eighty-nine percent of 480 respondents to an optional section on GBV reported having experienced or feared violence, either before, since and/or because of their HIV diagnosis. GBV reporting was higher after HIV diagnosis (intimate partner, family/neighbours, community and health settings). Women described a complex and iterative relationship between GBV and HIV occurring throughout their lives, including breaches of confidentiality and lack of SRH choice in healthcare settings, forced/coerced treatments, HR abuses, moralistic and judgemental attitudes (including towards women from key populations), and fear of losing child custody. Respondents recommended healthcare practitioners and policymakers address stigma and discrimination, training, awareness-raising, and HR abuses in healthcare settings. Respondents reported increased GBV with partners and in families, communities and healthcare settings after their HIV diagnosis and across the life-cycle. Measures of GBV must be sought and monitored, particularly within healthcare settings that should be safe. Respondents offered policymakers a comprehensive range of recommendations to achieve their SRH and HR goals. Global guidance documents and policies are more likely to succeed for the end-users if lived experiences are used.

Estimating climate resilience for conservation across geophysical settings.

PubMed

Anderson, Mark G; Clark, Melissa; Sheldon, Arlene Olivero

2014-08-01

Conservationists need methods to conserve biological diversity while allowing species and communities to rearrange in response to a changing climate. We developed and tested such a method for northeastern North America that we based on physical features associated with ecological diversity and site resilience to climate change. We comprehensively mapped 30 distinct geophysical settings based on geology and elevation. Within each geophysical setting, we identified sites that were both connected by natural cover and that had relatively more microclimates indicated by diverse topography and elevation gradients. We did this by scoring every 405 ha hexagon in the region for these two characteristics and selecting those that scored >SD 0.5 above the mean combined score for each setting. We hypothesized that these high-scoring sites had the greatest resilience to climate change, and we compared them with sites selected by The Nature Conservancy for their high-quality rare species populations and natural community occurrences. High-scoring sites captured significantly more of the biodiversity sites than expected by chance (p < 0.0001): 75% of the 414 target species, 49% of the 4592 target species locations, and 53% of the 2170 target community locations. Calcareous bedrock, coarse sand, and fine silt settings scored markedly lower for estimated resilience and had low levels of permanent land protection (average 7%). Because our method identifies-for every geophysical setting-sites that are the most likely to retain species and functions longer under a changing climate, it reveals natural strongholds for future conservation that would also capture substantial existing biodiversity and correct the bias in current secured lands. © 2014 The Authors. Conservation Biology published by Wiley Periodicals, Inc., on behalf of the Society for Conservation Biology.

Antibacterial cleaning and hygiene products as an emerging risk factor for antibiotic resistance in the community.

PubMed

Aiello, Allison E; Larson, Elaine

2003-08-01

Antibiotic resistance within the community setting is an emerging public-health concern. Infection with antibiotic-resistant organisms in the community among people lacking traditional risk factors has been reported. In addition, prevalence studies have identified individuals carrying antibiotic-resistant organisms in the absence of known risk factors. These studies strongly suggest the presence of contributing factors that have yet to be identified. In this paper we review the burden of antibiotic resistance and known risk factors within the community setting, assess the potential role of antibacterial cleaning and hygiene products containing triclosan in the emergence of resistance, and recommend future research on the assessment of household cleaning and hygiene products containing triclosan.

Clinical and Community Delivery Systems for Preventive Care

PubMed Central

Krist, Alex H.; Shenson, Douglas; Woolf, Steven H.; Bradley, Cathy; Liaw, Winston R.; Rothemich, Stephen F.; Slonim, Amy; Benson, William; Anderson, Lynda A.

2015-01-01

Although clinical preventive services (CPS)—screening tests, immunizations, health behavior counseling, and preventive medications—can save lives, Americans receive only half of recommended services. This "prevention gap," if closed, could substantially reduce morbidity and mortality. Opportunities to improve delivery of CPS exist in both clinical and community settings, but these activities are rarely coordinated across these settings, resulting in inefficiencies and attenuated benefits. Through a literature review, semi-structured interviews with 50 national experts, field observations of 53 successful programs, and a national stakeholder meeting, a framework to fully integrate CPS delivery across clinical and community care delivery systems was developed. The framework identifies the necessary participants, their role in care delivery, and the infrastructure, support, and policies necessary to ensure success. Essential stakeholders in integration include clinicians; community members and organizations; spanning personnel and infrastructure; national, state, and local leadership; and funders and purchasers. Spanning personnel and infrastructure are essential to bring clinicians and communities together and to help patients navigate across care settings. The specifics of clinical–community integrations vary depending on the services addressed and the local context. Although broad establishment of effective clinical–community integrations will require substantial changes, existing clinical and community models provide an important starting point. The key policies and elements of the framework are often already in place or easily identified. The larger challenge is for stakeholders to recognize how integration serves their mutual interests and how it can be financed and sustained over time. PMID:24050428

Building community resilience through mental health infrastructure and training in post-Katrina New Orleans.

PubMed

Springgate, Benjamin F; Wennerstrom, Ashley; Meyers, Diana; Allen, Charles E; Vannoy, Steven D; Bentham, Wayne; Wells, Kenneth B

2011-01-01

To describe a disaster recovery model focused on developing mental health services and capacity-building within a disparities-focused, community-academic participatory partnership framework. Community-based participatory, partnered training and services delivery intervention in a post-disaster setting. Post-Katrina Greater New Orleans community. More than 400 community providers from more than 70 health and social services agencies participated in the trainings. Partnered development of a training and services delivery program involving physicians, therapists, community health workers, and other clinical and non-clinical personnel to improve access and quality of care for mental health services in a post-disaster setting. Services delivery (outreach, education, screening, referral, direct treatment); training delivery; satisfaction and feedback related to training; partnered development of training products. Clinical services in the form of outreach, education, screening, referral and treatment were provided in excess of 110,000 service units. More than 400 trainees participated in training, and provided feedback that led to evolution of training curricula and training products, to meet evolving community needs over time. Participant satisfaction with training generally scored very highly. This paper describes a participatory, health-focused model of community recovery that began with addressing emerging, unmet mental health needs using a disparities-conscious partnership framework as one of the principle mechanisms for intervention. Population mental health needs were addressed by investment in infrastructure and services capacity among small and medium sized non-profit organizations working in disaster-impacted, low resource settings.

AACC-ACCT Community College Agenda for the 105th Congress.

ERIC Educational Resources Information Center

Association of Community College Trustees, Washington, DC.

Focusing on legislation expected to be addressed by the 105th Congress, this booklet sets forth an agenda for the nation's community colleges, developed by the American Association of Community Colleges (AACC) and the Association of Community College Trustees (ACCT). An introductory section provides background on community colleges, indicating…

Bounded Community: Designing and Facilitating Learning Communities in Formal Courses

ERIC Educational Resources Information Center

Wilson, Brent G.; Ludwig-Hardman, Stacey; Thornam, Christine L.; Dunlap, Joanna C.

2004-01-01

Learning communities can emerge spontaneously when people find common learning goals and pursue projects and tasks together in pursuit of those goals. "Bounded" learning communities (BLCs) are groups that form within a structured teaching or training setting, typically a course. Unlike spontaneous communities, BLCs develop in direct response to…

'By seeing with our own eyes, it can remain in our mind': qualitative evaluation findings suggest the ability of participatory video to reduce gender-based violence in conflict-affected settings.

PubMed

Gurman, Tilly A; Trappler, Regan M; Acosta, Angela; McCray, Pamella A; Cooper, Chelsea M; Goodsmith, Lauren

2014-08-01

Gender-based violence is pervasive and poses unique challenges in conflict-affected settings, with women and girls particularly vulnerable to its sequelae. Furthermore, widespread stigmatization of gender-based violence promotes silence among survivors and families, inhibiting access to services. Little evidence exists regarding effective gender-based violence prevention interventions in these settings. Through Our Eyes, a multi-year participatory video project, addressed gender-based violence by stimulating community dialogue and action in post-conflict settings in South Sudan, Uganda, Thailand, Liberia and Rwanda. The present qualitative analysis of project evaluation data included transcripts from 18 focus group discussions (n = 125) and key informant interviews (n = 76). Study participants included project team members, representatives from partner agencies, service providers and community members who either participated in video production or attended video screenings. Study findings revealed that the video project contributed to a growing awareness of women's rights and gender equality. The community dialogue helped to begin dismantling the culture of silence gender-based violence, encouraging survivors to access health and law enforcement services. Furthermore, both men and women reported attitude and behavioral changes related to topics such as wife beating, gender-based violence reporting and girls' education. Health education professionals should employ participatory video to address gender-based violence within conflict-affected settings. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Public and private prenatal care providers in urban Mexico: how does their quality compare?

PubMed

Barber, Sarah L

2006-08-01

To evaluate variations in prenatal care quality by public and private clinical settings and by household wealth. The study uses 2003 data detailing retrospective reports of 12 prenatal care procedures received that correspond to clinical guidelines. The 12 procedures are summed up, and prenatal care quality is described as the average procedures received by clinical setting, provider qualifications, and household wealth. Low-income communities in 17 states in urban Mexico. A total of 1253 women of reproductive age who received prenatal care within 1 year of the survey. The mean of the 12 prenatal care procedures received, reported as unadjusted and adjusted for individual, household, and community characteristics. Women received significantly more procedures in public clinical settings [80.7, 95% confidence interval (CI) = 79.3-82.1; P < or = 0.05] compared with private (60.2, 95% CI = 57.8-62.7; P < or = 0.05). Within private clinical settings, an increase in household wealth is associated with an increase in procedures received. Care from medical doctors is associated with significantly more procedures (78.8, 95% CI = 77.5-80.1; P < or = 0.05) compared with non-medical doctors (50.3, 95% CI = 46.7-53.9; P < or = 0.05). These differences are independent of individual, household, and community characteristics that affect health-seeking behavior. Significant differences in prenatal care quality exist across clinical settings, provider qualifications, and household wealth in urban Mexico. Strategies to improve quality include quality reporting, training, accreditation, regulation, and franchising.

Priority setting and economic appraisal: whose priorities--the community or the economist?

PubMed

Green, A; Barker, C

1988-01-01

Scarce resources for health require a process for setting priorities. The exact mechanism chosen has important implications for the type of priorities and plans set, and in particular their relationship to the principles of primary health care. One technique increasingly advocated as an aid to priority setting is economic appraisal. It is argued however that economic appraisal is likely to reinforce a selective primary health care approach through its espousal of a technocratic medical model and through its hidden but implicit value judgements. It is suggested that urgent attention is needed to develop approaches to priority setting that incorporate the strengths of economic appraisal, but that are consistent with comprehensive primary health care.

From Controlled Trial to Community Adoption: The Multisite Translational Community Trial

PubMed Central

Murimi, Mary; Gonzalez, Anjelica; Njike, Valentine; Green, Lawrence W.

2011-01-01

Methods for translating the findings of controlled trials, such as the Diabetes Prevention Program, into real-world community application have not been clearly defined. A standardized research methodology for making and evaluating such a transition is needed. We introduce the multisite translational community trial (mTCT) as the research analog to the multisite randomized controlled trial. The mTCT is adapted to incorporate the principles and practices of community-based participatory research and the increased relevance and generalizability gained from diverse community settings. The mTCT is a tool designed to bridge the gap between what a clinical trial demonstrates can work in principle and what is needed to make it workable and effective in real-world settings. Its utility could be put to the test, in particular with practice-based research networks such as the Prevention Research Centers. PMID:21680935

An Advanced Professional Pharmacy Experience in a Community Setting Using an Experiential Manual

PubMed Central

Lee, Karen W.; Machado, Matthew R.; Wenzel, Marie M.; Gagnon, James M.; Calomo, Joseph M.

2006-01-01

Objectives To determine the usefulness of a teaching and learning tool used to create structure for advanced pharmacy practice experiences (APPEs) in community pharmacy settings, and to identify differences between respondents' perspectives on the relevance and practicality of implementing specific community pharmacy-related topics during the experience. Design Community practice faculty members designed a manual that outlined a week-by-week schedule of student activities, consistent with the Center for the Advancement of Pharmaceutical Education (CAPE) outcome-based goals, and included associated teaching, documentation, and assessment tools. The manual was distributed to site preceptors and students. Assessment Eighty-six PharmD students responded to a questionnaire upon completion of their community APPE. Student feedback concerning the impact of the manual relative to interactions with site preceptors and their overall learning experience was relatively positive. Conclusion The manual was an effective teaching and learning tool for students completing a community APPE. PMID:17149421

A Potential Natural Treatment for Attention-Deficit/Hyperactivity Disorder: Evidence From a National Study

PubMed Central

Kuo, Frances E.; Faber Taylor, Andrea

2004-01-01

Objectives. We examined the impact of relatively “green” or natural settings on attention-deficit/hyperactivity disorder (ADHD) symptoms across diverse subpopulations of children. Methods. Parents nationwide rated the aftereffects of 49 common after-school and weekend activities on children’s symptoms. Aftereffects were compared for activities conducted in green outdoor settings versus those conducted in both built outdoor and indoor settings. Results. In this national, nonprobability sample, green outdoor activities reduced symptoms significantly more than did activities conducted in other settings, even when activities were matched across settings. Findings were consistent across age, gender, and income groups; community types; geographic regions; and diagnoses. Conclusions. Green outdoor settings appear to reduce ADHD symptoms in children across a wide range of individual, residential, and case characteristics. PMID:15333318

34 CFR 363.6 - What definitions apply?

Code of Federal Regulations, 2011 CFR

2011-07-01

...) Integrated setting means a setting typically found in the community in which an individual with the most... to by the individual and the rehabilitation counselor and established in the individualized written rehabilitation program, before an individual with the most severe disabilities makes the transition to extended...

Learning Partnerships in Rural Early Childhood Settings.

ERIC Educational Resources Information Center

Coombe, Kennece; Lubawy, Joy

A study examined six aspects of learning communities in early childhood settings in rural New South Wales (Australia). These aspects are reflection, individual development, diversity, conversation, caring, and shared responsibility. Surveys of 15 directors of early childhood programs indicated that the reflective component of the learning…

Natural Setting and Vegetation of the Florida Panhandle. An Account of the Environments and Plant Communities of Northern Florida, West of the Suwannee River.

DTIC Science & Technology

1986-01-01

interpreting vegetational processes, then the predictions of environmental impacts with regard to proposed land uses or resource management may be in error...34 Cotton Era........................................ 37 4. LAND USE AND LAN~D MANAGEMENT ............................ 40 Grazing...Setting; Vegetatio1Tt~lants; Eco logy;. 7 ommunities; *History; Land ’ Use ; Enviro mental Setting; Geology; rIhysiography; Rivers; Lakes; Aquifers;.Soils

Group‐Based Trajectory Models: Assessing Adherence to Antihypertensive Medication in Older Adults in a Community Pharmacy Setting

PubMed Central

Stewart, Derek; Smith, Susan M.; Gallagher, Paul; Cousins, Gráinne

2017-01-01

Antihypertensive medication nonadherence is highly prevalent, leading to uncontrolled blood pressure. Methods that facilitate the targeting and tailoring of adherence interventions in clinical settings are required. Group‐Based Trajectory Modeling (GBTM) is a newer method to evaluate adherence using pharmacy dispensing (refill) data that has advantages over traditional refill adherence metrics (e.g. Proportion of Days Covered) by identifying groups of patients who may benefit from adherence interventions, and identifying patterns of adherence behavior over time that may facilitate tailoring of an adherence intervention. We evaluated adherence to antihypertensive medication in 905 patients over a 12‐month period in a community pharmacy setting using GBTM, identifying three subgroups of adherence patterns: 52.8%, 40.7%, and 6.5% had very high, high, and low adherence, respectively. However, GBTM failed to demonstrate predictive validity with blood pressure at 12 months. Further research on the validity of adherence measures that facilitate interventions in clinical settings is required. PMID:28875569

Is Irish set dancing feasible for people with Parkinson's disease in Ireland?

PubMed

Shanahan, Joanne; Morris, Meg E; Bhriain, Orfhlaith Ni; Volpe, Daniele; Richardson, Margaret; Clifford, Amanda M

2015-02-01

To investigate if community-based Irish set dancing is feasible in Irish adults with Parkinson's disease. Over an eight week period, ten participants attended one set dancing class per week and completed a home programme in parallel. Feasibility was assessed by monitoring adverse effects, participants' verbal feedback, compliance rates and feedback from an exit questionnaire. Participants were assessed using the Berg balance scale, 6-min walk test, UPDRS-3 and PDQ-39, before and after the intervention. No adverse effects were detected. Attendance at classes was 86%. Compliance with the home programme was 67%. Findings from the exit questionnaire showed participants enjoyed participating and reported improvements in aspects of health including balance. Quality of life improved with the dance programme and there was a trend toward improvement on the UPDRS-3. These findings suggest community-based Irish set dancing is a feasible form of exercise that can positively influence quality of life. Copyright © 2014 Elsevier Ltd. All rights reserved.

Use of simulated data sets to evaluate the fidelity of metagenomic processing methods

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

Mavromatis, K; Ivanova, N; Barry, Kerrie

2007-01-01

Metagenomics is a rapidly emerging field of research for studying microbial communities. To evaluate methods presently used to process metagenomic sequences, we constructed three simulated data sets of varying complexity by combining sequencing reads randomly selected from 113 isolate genomes. These data sets were designed to model real metagenomes in terms of complexity and phylogenetic composition. We assembled sampled reads using three commonly used genome assemblers (Phrap, Arachne and JAZZ), and predicted genes using two popular gene-finding pipelines (fgenesb and CRITICA/GLIMMER). The phylogenetic origins of the assembled contigs were predicted using one sequence similarity-based ( blast hit distribution) and twomore » sequence composition-based (PhyloPythia, oligonucleotide frequencies) binning methods. We explored the effects of the simulated community structure and method combinations on the fidelity of each processing step by comparison to the corresponding isolate genomes. The simulated data sets are available online to facilitate standardized benchmarking of tools for metagenomic analysis.« less

Use of simulated data sets to evaluate the fidelity of Metagenomicprocessing methods

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

Mavromatis, Konstantinos; Ivanova, Natalia; Barry, Kerri

2006-12-01

Metagenomics is a rapidly emerging field of research for studying microbial communities. To evaluate methods presently used to process metagenomic sequences, we constructed three simulated data sets of varying complexity by combining sequencing reads randomly selected from 113 isolate genomes. These data sets were designed to model real metagenomes in terms of complexity and phylogenetic composition. We assembled sampled reads using three commonly used genome assemblers (Phrap, Arachne and JAZZ), and predicted genes using two popular gene finding pipelines (fgenesb and CRITICA/GLIMMER). The phylogenetic origins of the assembled contigs were predicted using one sequence similarity--based (blast hit distribution) and twomore » sequence composition--based (PhyloPythia, oligonucleotide frequencies) binning methods. We explored the effects of the simulated community structure and method combinations on the fidelity of each processing step by comparison to the corresponding isolate genomes. The simulated data sets are available online to facilitate standardized benchmarking of tools for metagenomic analysis.« less

HIV testing in correctional institutions: evaluating existing strategies, setting new standards.

PubMed

Basu, Sanjay; Smith-Rohrberg, Duncan; Hanck, Sarah; Altice, Frederick L

2005-01-01

Before introducing an HIV testing protocol into correctional facilities, the unique nature of these environments must be taken into account. We analyze three testing strategies that have been used in correctional settings--mandatory, voluntary, and routine "opt out" testing--and conclude that routine testing is most likely beneficial to inmates, the correctional system, and the outside community. The ethics of pre-release testing, and the issues surrounding segregation, confidentiality, and linking prisoners with community-based care, also play a role in determining how best to establish HIV testing strategies in correctional facilities. Testing must be performed in a manner that is not simply beneficial to public health, but also enhances the safety and health status of individual inmates. Longer-stay prison settings provide ample opportunities not just for testing but also for in-depth counseling, mental health and substance abuse treatment, and antiretroviral therapy. Jails present added complexities because of their shorter stay with respect to prisons, and testing, treatment, and counseling policies must be adapted to these settings.

Inclusive Livable Communities for People with Psychiatric Disabilities

ERIC Educational Resources Information Center

National Council on Disability, 2008

2008-01-01

Two reports of the National Council on Disability (NCD), Livable Communities for Adults with Disabilities and Creating Livable Communities, set forth a livable community framework. These reports propose necessary changes in public policies regarding housing; transportation that is reliable and accessible; environments that are physically…

Linking Knowledge and Action: PRI's Community Consultant.

ERIC Educational Resources Information Center

Spencer, Gregory P.

Within the Partnership for Rural Improvement (PRI), community consultants operate within three complex sets of relationships: client groups, the organizational structure of PRI, and the local operational base. Community consultants are responsible for developing and facilitating rural development and for providing assistance in community and…

Community psychology practice: expanding the impact of psychology's work.

PubMed

Wolff, Tom

2014-11-01

This article introduces the reader to community psychology practice by defining the field and its key principles and then illustrating through brief case stories what community psychology practice looks like in various employment settings. An exploration of the development of the field includes a review of the competencies of community psychology practice. Finally, the emerging opportunities for community psychology practice for psychologists are outlined. Well-publicized issues such as health disparities give psychologists an opportunity to bring social problems such as racism, sexism, homophobia, and income inequality to the forefront and to create community-wide efforts to improve the ways in which people live. Community psychology practice offers psychologists a format and a set of competencies for moving forward on this work by focusing on approaches that are ecological, community centered, population based, preventive, focused on systems change and empowerment, and multidisciplinary and that bring those most affected by the issues to the heart of the decision making. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Design and evaluation of a drama-based intervention to promote voluntary counseling and HIV testing in a South African community.

PubMed

Middelkoop, Keren; Myer, Landon; Smit, Joalida; Wood, Robin; Bekker, Linda-Gail

2006-08-01

Voluntary counseling and testing (VCT) services are a major component of HIV prevention and treatment efforts. We developed a drama-based intervention to promote VCT services in a peri-urban community in South Africa. Young adults from the community received training in HIV/AIDS and drama, and developed sketches to address perceived barriers to VCT. Over 12 months, 80 performances were held in busy community settings. The intervention was evaluated through changes in VCT uptake at the local clinic compared with comparable communities nearby. After the start of the intervention in August 2003, a 172% increase in the uptake of VCT services was observed in the intervention community. This was significantly greater than demand for VCT in either of the control communities during the same period (P < 0.0001). A structured, community-based education program based on drama can lead to substantial increases in the demand for VCT services in resource-limited settings.

Uncovering the features of negotiation in developing the patient-nurse relationship.

PubMed

Stoddart, Kathleen; Bugge, Carol

2012-02-01

This article describes a study that set out to explore the interaction between patients and nurses in community practice settings, in order to understand the social meanings and understandings brought to the interaction and at play within it. The study used a grounded theory methodology with traditional procedures. Driven by constant comparative analysis, data were collected by non-participant observation and informal and semi-structured interviews in four community health centres. Eighteen patients and 18 registered practice nurses participated. Negotiation was found to be a fundamental process in patient- nurse interaction. Navigation, socio-cultural characteristics and power and control were found to be key properties of negotiation. The negotiation processes for developing understanding required patients and nurses to draw upon social meanings and understandings generated from within and beyond their current interaction. Social meanings and understandings created within and beyond the health-care setting influence negotiation. The developmental nature of negotiation in interaction is an important dimension of the patient- nurse relationship in community practice.

Use of Web-based library resources by medical students in community and ambulatory settings*

PubMed Central

Tannery, Nancy Hrinya; Foust, Jill E.; Gregg, Amy L.; Hartman, Linda M.; Kuller, Alice B.; Worona, Paul; Tulsky, Asher A.

2002-01-01

Purpose: The purpose was to evaluate the use of Web-based library resources by third-year medical students. Setting/Participants/Resources: Third-year medical students (147) in a twelve-week multidisciplinary primary care rotation in community and ambulatory settings. Methodology: Individual user surveys and log file analysis of Website were used. Results/Outcomes: Twenty resource topics were compiled into a Website to provide students with access to electronic library resources from any community-based clerkship location. These resource topics, covering subjects such as hypertension and back pain, linked to curriculum training problems, full-text journal articles, MEDLINE searches, electronic book chapters, and relevant Websites. More than half of the students (69%) accessed the Website on a daily or weekly basis. Over 80% thought the Website was a valuable addition to their clerkship. Discussion/Conclusion: Web-based information resources can provide curriculum support to students for whom access to the library is difficult and time consuming. PMID:12113515

Challenges Facing Families at the End of Life in Three Settings

PubMed Central

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

2010-01-01

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

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

Aurich, Maike K.; Fleming, Ronan M. T.; Thiele, Ines

Metabolomic data sets provide a direct read-out of cellular phenotypes and are increasingly generated to study biological questions. Previous work, by us and others, revealed the potential of analyzing extracellular metabolomic data in the context of the metabolic model using constraint-based modeling. With the MetaboTools, we make our methods available to the broader scientific community. The MetaboTools consist of a protocol, a toolbox, and tutorials of two use cases. The protocol describes, in a step-wise manner, the workflow of data integration, and computational analysis. The MetaboTools comprise the Matlab code required to complete the workflow described in the protocol. Tutorialsmore » explain the computational steps for integration of two different data sets and demonstrate a comprehensive set of methods for the computational analysis of metabolic models and stratification thereof into different phenotypes. The presented workflow supports integrative analysis of multiple omics data sets. Importantly, all analysis tools can be applied to metabolic models without performing the entire workflow. Taken together, the MetaboTools constitute a comprehensive guide to the intra-model analysis of extracellular metabolomic data from microbial, plant, or human cells. In conclusion, this computational modeling resource offers a broad set of computational analysis tools for a wide biomedical and non-biomedical research community.« less

Application of eco-friendly tools and eco-bio-social strategies to control dengue vectors in urban and peri-urban settings in Thailand

PubMed Central

Kittayapong, Pattamaporn; Thongyuan, Suporn; Olanratmanee, Phanthip; Aumchareoun, Worawit; Koyadun, Surachart; Kittayapong, Rungrith; Butraporn, Piyarat

2012-01-01

Background Dengue is considered one of the most important vector-borne diseases in Thailand. Its incidence is increasing despite routine implementation of national dengue control programmes. This study, conducted during 2010, aimed to demonstrate an application of integrated, community-based, eco-bio-social strategies in combination with locally-produced eco-friendly vector control tools in the dengue control programme, emphasizing urban and peri-urban settings in eastern Thailand. Methodology Three different community settings were selected and were randomly assigned to intervention and control clusters. Key community leaders and relevant governmental authorities were approached to participate in this intervention programme. Ecohealth volunteers were identified and trained in each study community. They were selected among active community health volunteers and were trained by public health experts to conduct vector control activities in their own communities using environmental management in combination with eco-friendly vector control tools. These trained ecohealth volunteers carried out outreach health education and vector control during household visits. Management of public spaces and public properties, especially solid waste management, was efficiently carried out by local municipalities. Significant reduction in the pupae per person index in the intervention clusters when compared to the control ones was used as a proxy to determine the impact of this programme. Results Our community-based dengue vector control programme demonstrated a significant reduction in the pupae per person index during entomological surveys which were conducted at two-month intervals from May 2010 for the total of six months in the intervention and control clusters. The programme also raised awareness in applying eco-friendly vector control approaches and increased intersectoral and household participation in dengue control activities. Conclusion An eco-friendly dengue vector control programme was successfully implemented in urban and peri-urban settings in Thailand, through intersectoral collaboration and practical action at household level, with a significant reduction in vector densities. PMID:23318236

Application of eco-friendly tools and eco-bio-social strategies to control dengue vectors in urban and peri-urban settings in Thailand.

PubMed

Kittayapong, Pattamaporn; Thongyuan, Suporn; Olanratmanee, Phanthip; Aumchareoun, Worawit; Koyadun, Surachart; Kittayapong, Rungrith; Butraporn, Piyarat

2012-12-01

Dengue is considered one of the most important vector-borne diseases in Thailand. Its incidence is increasing despite routine implementation of national dengue control programmes. This study, conducted during 2010, aimed to demonstrate an application of integrated, community-based, eco-bio-social strategies in combination with locally-produced eco-friendly vector control tools in the dengue control programme, emphasizing urban and peri-urban settings in eastern Thailand. Three different community settings were selected and were randomly assigned to intervention and control clusters. Key community leaders and relevant governmental authorities were approached to participate in this intervention programme. Ecohealth volunteers were identified and trained in each study community. They were selected among active community health volunteers and were trained by public health experts to conduct vector control activities in their own communities using environmental management in combination with eco-friendly vector control tools. These trained ecohealth volunteers carried out outreach health education and vector control during household visits. Management of public spaces and public properties, especially solid waste management, was efficiently carried out by local municipalities. Significant reduction in the pupae per person index in the intervention clusters when compared to the control ones was used as a proxy to determine the impact of this programme. Our community-based dengue vector control programme demonstrated a significant reduction in the pupae per person index during entomological surveys which were conducted at two-month intervals from May 2010 for the total of six months in the intervention and control clusters. The programme also raised awareness in applying eco-friendly vector control approaches and increased intersectoral and household participation in dengue control activities. An eco-friendly dengue vector control programme was successfully implemented in urban and peri-urban settings in Thailand, through intersectoral collaboration and practical action at household level, with a significant reduction in vector densities.

The bias associated with amplicon sequencing does not affect the quantitative assessment of bacterial community dynamics.

PubMed

Ibarbalz, Federico M; Pérez, María Victoria; Figuerola, Eva L M; Erijman, Leonardo

2014-01-01

The performance of two sets of primers targeting variable regions of the 16S rRNA gene V1-V3 and V4 was compared in their ability to describe changes of bacterial diversity and temporal turnover in full-scale activated sludge. Duplicate sets of high-throughput amplicon sequencing data of the two 16S rRNA regions shared a collection of core taxa that were observed across a series of twelve monthly samples, although the relative abundance of each taxon was substantially different between regions. A case in point was the changes in the relative abundance of filamentous bacteria Thiothrix, which caused a large effect on diversity indices, but only in the V1-V3 data set. Yet the relative abundance of Thiothrix in the amplicon sequencing data from both regions correlated with the estimation of its abundance determined using fluorescence in situ hybridization. In nonmetric multidimensional analysis samples were distributed along the first ordination axis according to the sequenced region rather than according to sample identities. The dynamics of microbial communities indicated that V1-V3 and the V4 regions of the 16S rRNA gene yielded comparable patterns of: 1) the changes occurring within the communities along fixed time intervals, 2) the slow turnover of activated sludge communities and 3) the rate of species replacement calculated from the taxa-time relationships. The temperature was the only operational variable that showed significant correlation with the composition of bacterial communities over time for the sets of data obtained with both pairs of primers. In conclusion, we show that despite the bias introduced by amplicon sequencing, the variable regions V1-V3 and V4 can be confidently used for the quantitative assessment of bacterial community dynamics, and provide a proper qualitative account of general taxa in the community, especially when the data are obtained over a convenient time window rather than at a single time point.

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

PubMed

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

2015-08-01

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

User guide to the Magellan synthetic aperture radar images

NASA Technical Reports Server (NTRS)

Wall, Stephen D.; Mcconnell, Shannon L.; Leff, Craig E.; Austin, Richard S.; Beratan, Kathi K.; Rokey, Mark J.

1995-01-01

The Magellan radar-mapping mission collected a large amount of science and engineering data. Now available to the general scientific community, this data set can be overwhelming to someone who is unfamiliar with the mission. This user guide outlines the mission operations and data set so that someone working with the data can understand the mapping and data-processing techniques used in the mission. Radar-mapping parameters as well as data acquisition issues are discussed. In addition, this user guide provides information on how the data set is organized and where specific elements of the set can be located.

Developing a framework for community-based sexual health interventions for youth in the rural setting: protocol for a participatory action research study

PubMed Central

Heslop, Carl William; Burns, Sharyn; Lobo, Roanna; McConigley, Ruth

2017-01-01

Introduction There is limited research examining community-based or multilevel interventions that address the sexual health of young people in the rural Australian context. This paper describes the Participatory Action Research (PAR) project that will develop and validate a framework that is effective for planning, implementing and evaluating multilevel community-based sexual health interventions for young people aged 16–24 years in the Australian rural setting. Methods and analysis To develop a framework for sexual health interventions with stakeholders, PAR will be used. Three PAR cycles will be conducted, using semistructured one-on-one interviews, focus groups, community mapping and photovoice to inform the development of a draft framework. Cycle 2 and Cycle 3 will use targeted Delphi studies to gather evaluation and feedback on the developed draft framework. All data collected will be reviewed and analysed in detail and coded as concepts become apparent at each stage of the process. Ethics and dissemination This protocol describes a supervised doctoral research project. This project seeks to contribute to the literature regarding PAR in the rural setting and the use of the Delphi technique within PAR projects. The developed framework as a result of the project will provide a foundation for further research testing the application of the framework in other settings and health areas. This research has received ethics approval from the Curtin University Human Research and Ethics Committee (HR96/2015). PMID:28559453

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

PubMed

Linden, Mark; Kavanagh, Rory

2012-06-01

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

A Tool for Tracking and Assessing Chronic Illness Care in Prison (ACIC-P)

PubMed Central

Wang, Emily A.; Aminawung, Jenerius A.; Ferguson, Warren; Trestman, Robert; Wagner, Edward H.; Bova, Carol

2014-01-01

Chronic disease care is being transformed in correctional settings, given an aging inmate population, ongoing quality improvement efforts, litigation, and rising costs. The Chronic Care Model, established for chronic disease care in the community, might be a suitable framework to transform chronic disease care in prison, but it has not been systematically adapted for the correctional health care setting. We employed cognitive interviewing to adapt an extant survey used to measure the delivery of chronic illness care in the community, Assessment of Chronic Illness Care, for a prison setting. Results from the cognitive interviews and the modified Assessment of Chronic Illness Care–Prison (ACIC-P) instrument are presented in this article. Future studies will need to test the reliability and psychometric properties of the adapted ACIC-P. PMID:25117427

Associations between the settings of exercise habits and health-related outcomes in community-dwelling older adults

PubMed Central

Makino, Keitaro; Ihira, Hikaru; Mizumoto, Atsushi; Shimizu, Kotaro; Ishida, Toyoaki; Furuna, Taketo

2015-01-01

[Purpose] The purpose of this study was to examine the associations between the settings of exercise habits and health-related outcomes in community-dwelling older adults. [Subjects] A total of 304 Japanese community-dwelling older adults (70.3 ± 4.1 years; 113 males and 191 females) participated in this study. [Methods] Demographic characteristics, medical conditions, exercise habits, and health-related outcomes were assessed by face-to-face interviews and self-reported questionnaires. Older adults who had exercise habits were classified into two groups: individual- and group-based exercise habits groups, and the health-related outcomes were compared between groups. [Results] The scores for the Geriatric Depression Scale, exercise self-efficacy, and dietary variety of older adults who had group-based exercise habits were better than those of older adults who had individual-based exercise habits. In addition, the exercise settings (individual- and group-based) were significantly associated with scores for the Geriatric Depression Scale (odds ratio = 0.76) and exercise self-efficacy (odds ratio = 1.26), even after adjusting for age and gender. [Conclusion] These results implied that habitual exercise in group settings may have an effective role in promoting exercise self-efficacy and mental health. PMID:26311955

Pilot evaluation of parent-child interaction therapy delivered in an Australian community early childhood clinic setting.

PubMed

Phillips, Jane; Morgan, Susan; Cawthorne, Karen; Barnett, Bryanne

2008-08-01

Parent-child interaction therapy (PCIT) is a short-term, evidence-based parent training intervention used widely in the treatment of behaviourally disordered preschool-aged children. Outcome studies have shown PCIT to be associated with lasting improvements in child and sibling behaviours and in the interactional styles, stress levels, confidence, and psychological functioning of parents. To date, however, all outcome studies have been conducted in university research clinic settings, and therefore understanding about the effectiveness of PCIT applied in a real-world setting has been limited. The present study evaluated the effectiveness of PCIT delivered to families in an Australian community-based early childhood clinic. Participants included 43 families with children aged 19-52 months who were referred for treatment of disruptive child behaviours and who completed PCIT treatment at the Karitane Toddler Clinic, in Sydney, Australia. Parents provided pre- and post-treatment ratings of child behaviours, parental stress, parental psychopathology and parental attitudes to therapy. At the end of the programme, clinically and statistically significant improvements were seen in child behaviours and parental well-being, and parents reported high levels of satisfaction with treatment. Implications for the implementation of PCIT programmes in community-based settings are discussed and areas of further research are identified.

Integrating the hospital library with patient care, teaching and research: model and Web 2.0 tools to create a social and collaborative community of clinical research in a hospital setting.

PubMed

Montano, Blanca San José; Garcia Carretero, Rafael; Varela Entrecanales, Manuel; Pozuelo, Paz Martin

2010-09-01

Research in hospital settings faces several difficulties. Information technologies and certain Web 2.0 tools may provide new models to tackle these problems, allowing for a collaborative approach and bridging the gap between clinical practice, teaching and research. We aim to gather a community of researchers involved in the development of a network of learning and investigation resources in a hospital setting. A multi-disciplinary work group analysed the needs of the research community. We studied the opportunities provided by Web 2.0 tools and finally we defined the spaces that would be developed, describing their elements, members and different access levels. WIKINVESTIGACION is a collaborative web space with the aim of integrating the management of all the hospital's teaching and research resources. It is composed of five spaces, with different access privileges. The spaces are: Research Group Space 'wiki for each individual research group', Learning Resources Centre devoted to the Library, News Space, Forum and Repositories. The Internet, and most notably the Web 2.0 movement, is introducing some overwhelming changes in our society. Research and teaching in the hospital setting will join this current and take advantage of these tools to socialise and improve knowledge management.

Implementation of the power to prevent diabetes prevention educational curriculum into rural African American communities: a feasibility study.

PubMed

Cené, Crystal W; Haymore, Laura Beth; Ellis, Danny; Whitaker, Shaketa; Henderson, Stacey; Lin, Feng-Chang; Corbie-Smith, Giselle

2013-01-01

The purpose of this study was to describe the feasibility of using a community-based participatory research (CBPR) approach to implement the Power to Prevent (P2P) diabetes prevention education curriculum in rural African American (AA) settings. Trained community health workers facilitated the 12-session P2P curriculum across 3 community settings. Quantitative (based on the pre- and post-curriculum questionnaires and changes in blood glucose, blood pressure [BP], and weight at baseline and 6 months) and qualitative data (based on semi-structured interviews with facilitators) were collected. Indicators of feasibility included: demand, acceptability, implementation fidelity, and limited efficacy testing. Across 3 counties, 104 AA participants were recruited; 43% completed ≥ 75% of the sessions. There was great demand for the program. Fifteen community health ambassadors (CHAs) were trained, and 4 served as curriculum facilitators. Content and structure of the intervention was acceptable to facilitators but there were challenges to implementing the program as designed. Improvements were seen in diabetes knowledge and the impact of healthy eating and physical activity on diabetes prevention, but there were no significant changes in blood glucose, BP, or weight. While it is feasible to use a CBPR approach to recruit participants and implement the P2P curriculum in AA community settings, there are significant challenges that must be overcome.

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

PubMed Central

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

2014-01-01

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

Clustering network layers with the strata multilayer stochastic block model.

PubMed

Stanley, Natalie; Shai, Saray; Taylor, Dane; Mucha, Peter J

2016-01-01

Multilayer networks are a useful data structure for simultaneously capturing multiple types of relationships between a set of nodes. In such networks, each relational definition gives rise to a layer. While each layer provides its own set of information, community structure across layers can be collectively utilized to discover and quantify underlying relational patterns between nodes. To concisely extract information from a multilayer network, we propose to identify and combine sets of layers with meaningful similarities in community structure. In this paper, we describe the "strata multilayer stochastic block model" (sMLSBM), a probabilistic model for multilayer community structure. The central extension of the model is that there exist groups of layers, called "strata", which are defined such that all layers in a given stratum have community structure described by a common stochastic block model (SBM). That is, layers in a stratum exhibit similar node-to-community assignments and SBM probability parameters. Fitting the sMLSBM to a multilayer network provides a joint clustering that yields node-to-community and layer-to-stratum assignments, which cooperatively aid one another during inference. We describe an algorithm for separating layers into their appropriate strata and an inference technique for estimating the SBM parameters for each stratum. We demonstrate our method using synthetic networks and a multilayer network inferred from data collected in the Human Microbiome Project.

Characterizing implementation strategies using a systems engineering survey and interview tool: a comparison across 10 prevention programs for drug abuse and HIV sexual risk behavior.

PubMed

Czaja, Sara J; Valente, Thomas W; Nair, Sankaran N; Villamar, Juan A; Brown, C Hendricks

2016-05-17

Although many behavioral interventions have proven to be efficacious, new methodologies are required beyond efficacy trials to understand how to adopt, implement with fidelity, and sustain behavioral interventions in community settings. In this paper, we present a new approach, based on systems engineering concepts and methods, for characterizing implementation strategies that are used to deliver evidence-based behavioral interventions in health and social service settings. We demonstrate the use of this approach with implementation strategies, used or being used for broader dissemination of 10 evidence-based prevention program projects focused on the prevention of drug or HIV sex risk behaviors. The results indicate that there are wide variations in intervention approaches and that there are challenges in program implementation including maintaining program fidelity, serving community needs, and adequate resources. The results also indicate that implementation requires a committed partnership between the program developers, implementation researchers, and community partners. In addition, there is a need for adaptability within programs to meet community needs, resources, and priorities while maintaining program fidelity. Our methodological approach enabled us to highlight challenges associated with the community implementation of health risk prevention interventions. We also demonstrate how comprehensive descriptions of interventions facilitate understanding of the requirements of program implementation and decisions about the feasibility of implementing a program in community settings.

Effect of preventive dentistry training program for caregivers in community facilities on caregiver and client behavior and client oral hygiene.

PubMed

Glassman, Paul; Miller, Christine Ernst

2006-01-01

The influx of persons with developmental disabilities into community-based programs has required the development, expansion and improved integration of community-based services. The role of caregivers in these community settings has become pivotal. However, with regard to daily activities, oral hygiene is often a low priority. Few attempts have been made to study caregiver participation in oral disease prevention and practices. This study evaluated the effects of an indirect training program, where caregivers were trained but the ultimate effects were demonstrated in adult clients. In addition, these effects were demonstrated in community care settings. A multiple baseline design, across three group homes, included 11 adult clients with developmental disabilities. This study evaluated the effects of training, instruction to use training and coaching on the presence of caregivers during oral hygiene sessions, the duration of toothbrushing and plaque scores of the clients. The results of this investigation demonstrated that there was an increase in caregiver presence and duration of brushing with a concurrent decrease in plaque scores. Caregivers responding to social validation questionnaires believed that 8 out of 11 clients had increased skills. This study demonstrates that caregiver training, combined with specific instructions to use training information and coaching of caregivers, can have a positive impact on the oral health of individuals with developmental disabilities living in community settings.

An improved method to set significance thresholds for β diversity testing in microbial community comparisons.

PubMed

Gülay, Arda; Smets, Barth F

2015-09-01

Exploring the variation in microbial community diversity between locations (β diversity) is a central topic in microbial ecology. Currently, there is no consensus on how to set the significance threshold for β diversity. Here, we describe and quantify the technical components of β diversity, including those associated with the process of subsampling. These components exist for any proposed β diversity measurement procedure. Further, we introduce a strategy to set significance thresholds for β diversity of any group of microbial samples using rarefaction, invoking the notion of a meta-community. The proposed technique was applied to several in silico generated operational taxonomic unit (OTU) libraries and experimental 16S rRNA pyrosequencing libraries. The latter represented microbial communities from different biological rapid sand filters at a full-scale waterworks. We observe that β diversity, after subsampling, is inflated by intra-sample differences; this inflation is avoided in the proposed method. In addition, microbial community evenness (Gini > 0.08) strongly affects all β diversity estimations due to bias associated with rarefaction. Where published methods to test β significance often fail, the proposed meta-community-based estimator is more successful at rejecting insignificant β diversity values. Applying our approach, we reveal the heterogeneous microbial structure of biological rapid sand filters both within and across filters. © 2014 Society for Applied Microbiology and John Wiley & Sons Ltd.

Clustering network layers with the strata multilayer stochastic block model

PubMed Central

Stanley, Natalie; Shai, Saray; Taylor, Dane; Mucha, Peter J.

2016-01-01

Multilayer networks are a useful data structure for simultaneously capturing multiple types of relationships between a set of nodes. In such networks, each relational definition gives rise to a layer. While each layer provides its own set of information, community structure across layers can be collectively utilized to discover and quantify underlying relational patterns between nodes. To concisely extract information from a multilayer network, we propose to identify and combine sets of layers with meaningful similarities in community structure. In this paper, we describe the “strata multilayer stochastic block model” (sMLSBM), a probabilistic model for multilayer community structure. The central extension of the model is that there exist groups of layers, called “strata”, which are defined such that all layers in a given stratum have community structure described by a common stochastic block model (SBM). That is, layers in a stratum exhibit similar node-to-community assignments and SBM probability parameters. Fitting the sMLSBM to a multilayer network provides a joint clustering that yields node-to-community and layer-to-stratum assignments, which cooperatively aid one another during inference. We describe an algorithm for separating layers into their appropriate strata and an inference technique for estimating the SBM parameters for each stratum. We demonstrate our method using synthetic networks and a multilayer network inferred from data collected in the Human Microbiome Project. PMID:28435844

What works in Indigenous tobacco control? The perceptions of remote Indigenous community members and health staff.

PubMed

Johnston, Vanessa; Thomas, David P

2010-04-01

To explore the perceptions of remote Indigenous community members and health staff regarding the acceptability and effectiveness of different tobacco control health promotion interventions. Qualitative methods were used for this exploratory study, including interviews with remote Indigenous community members and health staff, as well as observations of the delivery of different tobacco control activities in three remote communities in the Northern Territory (NT). Several tobacco control interventions for which there is strong evidence in other settings were generally perceived as acceptable and efficacious in the remote Indigenous setting. Primary care interventions, such as brief advice and pharmaceutical quitting aids, when available and accessible, were perceived as important and effective strategies to help people quit, as were the promotion of smokefree areas. By contrast unmodified Quit programs were perceived to have questionable application in this context and there were conflicting findings regarding taxation increases on tobacco and social marketing campaigns. Several evidence-based 'mainstream' activities are perceived to be acceptable to this population, but we may also need to address the concerns raised by health staff and community members about the acceptability of some unmodified activities. Additionally, organisational barriers within the health system may be contributing to the reduced effectiveness of tobacco control in this setting.

Evaluation of complex community-based childhood obesity prevention interventions.

PubMed

Karacabeyli, D; Allender, S; Pinkney, S; Amed, S

2018-05-16

Multi-setting, multi-component community-based interventions have shown promise in preventing childhood obesity; however, evaluation of these complex interventions remains a challenge. The objective of the study is to systematically review published methodological approaches to outcome evaluation for multi-setting community-based childhood obesity prevention interventions and synthesize a set of pragmatic recommendations. MEDLINE, CINAHL and PsycINFO were searched from inception to 6 July 2017. Papers were included if the intervention targeted children ≤18 years, engaged at least two community sectors and described their outcome evaluation methodology. A single reviewer conducted title and abstract scans, full article review and data abstraction. Directed content analysis was performed by three reviewers to identify prevailing themes. Thirty-three studies were included, and of these, 26 employed a quasi-experimental design; the remaining were randomized control trials. Body mass index was the most commonly measured outcome, followed by health behaviour change and psychosocial outcomes. Six themes emerged, highlighting advantages and disadvantages of active vs. passive consent, quasi-experimental vs. randomized control trials, longitudinal vs. repeat cross-sectional designs and the roles of process evaluation and methodological flexibility in evaluating complex interventions. Selection of study designs and outcome measures compatible with community infrastructure, accompanied by process evaluation, may facilitate successful outcome evaluation. © 2018 World Obesity Federation.

Low prevalence of methicillin-resistant Staphylococcus aureus nasal carriage in urban and rural community settings in Bolivia and Peru.

PubMed

Bartoloni, Alessandro; Pallecchi, Lucia; Fernandez, Connie; Mantella, Antonia; Riccobono, Eleonora; Magnelli, Donata; Mannini, Dario; Strohmeyer, Marianne; Bartalesi, Filippo; Segundo, Higinio; Monasterio, Joaquin; Rodriguez, Hugo; Cabezas, César; Gotuzzo, Eduardo; Rossolini, Gian Maria

2013-05-01

To investigate the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage in rural and urban community settings of Bolivia and Peru. MRSA nasal carriage was investigated in 585 individuals living in rural and urban areas of Bolivia and Peru (one urban area, one small rural village, and two native communities, one of which was highly isolated). MRSA isolates were subjected to molecular analysis for the detection of virulence genes, characterization of the staphylococcal cassette chromosome mec (SCCmec), and genotyping (multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE)). An overall very low prevalence of MRSA nasal carriage was observed (0.5%), with MRSA carriers being detected only in a small rural village of the Bolivian Chaco. The three MRSA isolates showed the characteristics of community-associated MRSA (being susceptible to all non-beta-lactam antibiotics and harboring the SCCmec type IV), were clonally related, and belonged to ST1649. This study provides an insight into the epidemiology of MRSA in community settings of Bolivia and Peru. Reliable, time-saving, and low-cost methods should be implemented to encourage continued surveillance of MRSA dissemination in resource-limited countries. Copyright © 2012 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Pharmacy patronage: identifying key factors in the decision making process using the determinant attribute approach.

PubMed

Franic, Duska M; Haddock, Sarah M; Tucker, Leslie Tootle; Wooten, Nathan

2008-01-01

To use the determinant attribute approach, a research method commonly used in marketing to identify the wants of various consumer groups, to evaluate consumer pharmacy choice when having a prescription order filled in different pharmacy settings. Cross sectional. Community independent, grocery store, community chain, and discount store pharmacies in Georgia between April 2005 and April 2006. Convenience sample of adult pharmacy consumers (n = 175). Survey measuring consumer preferences on 26 attributes encompassing general pharmacy site features (16 items), pharmacist characteristics (5 items), and pharmacy staff characteristics (5 items). 26 potential determinant attributes for pharmacy selection. 175 consumers were surveyed at community independent (n = 81), grocery store (n = 44), community chain (n = 27), or discount store (n = 23) pharmacy settings. The attributes of pharmacists and staff at all four pharmacy settings were shown to affect pharmacy patronage motives, although consumers frequenting non-community independent pharmacies were also motivated by secondary convenience factors, e.g., hours of operation, and prescription coverage. Most consumers do not perceive pharmacies as merely prescription-distribution centers that vary only by convenience. Prescriptions are not just another economic good. Pharmacy personnel influence pharmacy selection; therefore, optimal staff selection and training is likely the greatest asset and most important investment for ensuring pharmacy success.

Using Multiattribute Utility Theory as a Priority-Setting Tool in Human Services Planning.

ERIC Educational Resources Information Center

Camasso, Michael J.; Dick, Janet

1993-01-01

The feasibility of applying multiattribute utility theory to the needs assessment and priority-setting activities of human services planning councils was studied in Essex County (New Jersey). Decision-making and information filtering processes are explored in the context of community planning. (SLD)

A Guide to Monitoring Residential Settings.

ERIC Educational Resources Information Center

Taylor, Steven J.

The guide provides some basic strategies and tools for monitoring residential settings--both institutions and community residences--for the quality of services provided to persons with developmental disabilities. An introductory chapter explains the purpose and layout of the document. Chapter II describes how to find and understand public…

Pedestrian Safety Training Curriculum for Persons with Developmental Disabilities.

ERIC Educational Resources Information Center

Illinois State Office of the Secretary of State, Springfield.

This manual provides a suggested curriculum, intended for use in the natural environment, for individualized instruction on street travel skills for adults with developmental disabilities. Suggestions are given for instruction in home or classroom; the community; vocational settings; recreational settings; and special pedestrian situations (for…

Continuity of Treatment: Toilet Training in Multiple Community Settings.

ERIC Educational Resources Information Center

Dunlap, Glen; And Others

1984-01-01

Results showed no consistent trends toward acquisition when training for severely disabled autistic Ss (5-7 years old) was provided in only some settings. However, the continuity approach which coordinated all of the children's daily activities produced immediate and steady gains in successful toileting. (Author)

Conversational Competence in Academic Settings

ERIC Educational Resources Information Center

Bowman, Richard F.

2014-01-01

Conversational competence is a process, not a state. Ithaca does not exist, only the voyage to Ithaca. Vibrant campuses are a series of productive conversations. At its core, communicative competence in academic settings mirrors a collective search for meaning regarding the purpose and direction of a campus community. Communicative competence…

Representing Young Children with Disabilities in Classroom Environments.

ERIC Educational Resources Information Center

Favazza, Paddy C.; LaRoe, Joyce; Phillipsen, Leslie; Kumar, Poonam

2000-01-01

The "Inventory of Disability Representation" was administered to 92 teachers representing kindergarten, community child care, or preschool settings. Low scores across settings indicated that classrooms typically do not have materials that represent or depict children with diverse abilities. Reasons cited by teachers are noted as are benefits…

Bridging Community Development and Environmental Education: Rural Water Conservation in Jordan

ERIC Educational Resources Information Center

Hansen, Lexine Tallis

2010-01-01

International community development is a fertile area of research for environmental education scholars and practitioners. Although the community development field is well established, there is relatively little focus on education and learning in community development literature, especially in developing country settings. Particularly,…

Learning Community Assessment 101--Best Practices

ERIC Educational Resources Information Center

Huerta, Juan Carlos; Hansen, Michele J.

2013-01-01

Good assessment is part of all good learning communities, and this article provides a useful set of best practices for learning community assessment planning: (1) articulating agreed-upon learning community program goals; (2) identifying the purpose of assessment (e.g., summative or formative); (3) employing qualitative and quantitative assessment…

Caregivers' compliance with referral advice: evidence from two studies introducing mRDTs into community case management of malaria in Uganda.

PubMed

Lal, Sham; Ndyomugenyi, Richard; Paintain, Lucy; Alexander, Neal D; Hansen, Kristian S; Magnussen, Pascal; Chandramohan, Daniel; Clarke, Siân E

2018-05-02

Several malaria endemic countries have implemented community health worker (CHW) programmes to increase access to populations underserved by health care. There is considerable evidence on CHW adherence to case management guidelines, however, there is limited evidence on the compliance to referral advice and the outcomes of children under-5 referred by CHWs. This analysis examined whether caregivers complied with CHWs referral advice. Data from two cluster (village) randomised trials, one in a moderate-to-high malaria transmission setting, another in a low-transmission setting conducted between January 2010-July 2011 were analysed. CHW were trained to recognise signs and symptoms that required referral to a health centre. CHW in the intervention arm also had training on; malaria rapid diagnostic tests (mRDT) and administering artemisinin based combination therapy (ACT); CHW in the control arm were trained to treat malaria with ACTs based on fever symptoms. Caregivers' referral forms were linked with CHW treatment forms to determine whether caregivers complied with the referral advice. Factors associated with compliance were examined with logistic regression. CHW saw 18,497 child visits in the moderate-to-high transmission setting and referred 15.2% (2815/18,497) of all visits; in the low-transmission setting, 35.0% (1135/3223) of all visits were referred. Compliance to referral was low, in both settings < 10% of caregivers complied with referral advice. In the moderate-to-high transmission setting compliance was higher if children were tested with mRDT compared to children who were not tested with mRDT. In both settings, nearly all children treated with pre-referral rectal artesunate failed to comply with referral and compliance was independently associated with factors such as health centre distance and day of referral by a CHW. In the moderate-to-high transmission setting, time of presentation, severity of referral were also associated with compliance, whilst in the low-transmission setting, compliance was low if an ACT was prescribed. This analysis suggests there are several barriers to comply with CHWs referral advice by caregivers. This is concerning for children who received rectal artesunate. As CHW programmes continue scale-up, barriers to referral compliance need to be addressed to ensure a continuum of care from the community to the health centre. The study was registered with ClinicalTrials.gov. Identifier NCT01048801 , 13th January 2010.

An Essay on Academic Disciplines, Faithfulness, and the Christian Scholar

ERIC Educational Resources Information Center

Gould, Paul

2014-01-01

Christian scholars inhabit at least two communities: the community of Christians and the community of scholars. Each community has its own distinctive set of beliefs, practices, and criteria for membership. To avoid incoherence, the Christian scholar seeks to understand the relationship between the two communities. The Christian, we are told, must…

Community College Presidents' Understanding of Spirituality as Part of a Community College Institution

ERIC Educational Resources Information Center

Beemer, Angela Rice

2013-01-01

This study explored how community college presidents understood spirituality as part of a community college institution. Using a purposive criterion sample, five community college presidents were interviewed in the natural setting of their individual colleges. The interviews took place over a thirteen month period of time. A phenomenological…

Photovoice for Healthy Relationships: Community-Based Participatory HIV Prevention in a Rural American Indian Community

ERIC Educational Resources Information Center

Markus, Susan F.

2012-01-01

This article provides an example of a culturally responsive, community-based project for addressing social determinants of health in rural American Indian (AI) communities through: 1) empowering youth and community voices to set directions for HIV, sexually transmitted infections, and unintended pregnancy prevention and education efforts; 2) using…

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

PubMed

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

2013-01-01

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

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

PubMed Central

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

2015-01-01

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

Knowledge and pharmacological management of Alzheimer's disease by managing community pharmacists: a nationwide study.

PubMed

Zerafa, Natalie; Scerri, Charles

2016-12-01

Background Managing community pharmacists can play a leading role in supporting community dwelling individuals with Alzheimer's disease and their caregivers. Objective The main purpose of this study was to assess knowledge of managing community pharmacists towards Alzheimer's disease and its pharmacological management. Setting Community pharmacies in the Maltese islands. Method A nationwide survey was conducted with full-time managing community pharmacists in possession of a tertiary education degree in pharmacy studies. The level of knowledge was investigated using the Alzheimer's Disease Knowledge Scale and the Alzheimer's Disease Pharmacotherapy Measure. Participants were also asked to rate a number of statements related to disease management. Results Maltese managing community pharmacists (57 % response rate) had inadequate knowledge on risk factors, caregiving issues and pharmacological management of Alzheimer's disease. Age and number of years working in a community pharmacy setting were found to be negatively correlated with increased knowledge. Conclusion The findings highlight the need of providing training and continued educational support to managing community pharmacists in order to provide quality advice to individuals with dementia and their caregivers in the community.

Social capital in ethnic communities and mental health: a study of older Korean immigrants.

PubMed

Jang, Yuri; Park, Nan Sook; Chiriboga, David A; Yoon, Hyunwoo; An, Sok; Kim, Miyong T

2015-06-01

This study examined how social capital in ethnic communities (e.g., social cohesion, community support, community participation, and negative interaction) influences depressive symptoms of older Korean immigrants. Using survey data from 209 participants in Central Texas (M(age)  = 69.6, SD = 7.50), hierarchical regression models of depressive symptoms were examined with the following sets of predictors: (1) demographics, (2) physical health, (3) sociocultural factors, and (4) ethnic community factors. After controlling for the multiple sets of individual-level variables previously known to be important predictors of mental health, ethnic community factors made a substantial contribution. Higher levels of depressive symptoms were observed among individuals who received lower levels of community support (β = -0.14, p < 0.05), had limited participation in ethnic community events and activities (β = -0.15, p < 0.05), and reported more frequent negative interactions with ethnic community members (β = 0.12, p < 0.05). Findings highlight the importance of social capital in ethnic communities and hold implications for improving older ethnic immigrants' mental well-being.

Achieving Results through Community School Partnerships: How District and Community Leaders Are Building Effective, Sustainable Relationships

ERIC Educational Resources Information Center

Blank, Martin J.; Jacobson, Reuben; Melaville, Atelia

2012-01-01

A community school is a place and a set of partnerships connecting a school, the families of students, and the surrounding community. A community school is distinguished by an integrated focus on academics, youth development, family support, health and social services, and community development. The community school strategy is central to efforts…

Youth–adult partnership: exploring contributions to empowerment, agency and community connections in Malaysian youth programs.

PubMed

Krauss, Steven Eric; Collura, Jessica; Zeldin, Shepherd; Ortega, Adriana; Abdullah, Haslinda; Sulaiman, Abdul Hadi

2014-09-01

Youth–adult partnership (Y–AP) has emerged as a key practice for enacting two features of effective developmental settings: supportive adult relationships and support for efficacy and mattering. Previous studies have shown that when youth, supported by adults, actively participate in organizational and community decision making they are likely to show greater confidence and agency, empowerment and critical consciousness, and community connections. Most of the extant research on Y–AP is limited to qualitative studies and the identification of organizational best practices. Almost all research focuses on Western sociocultural settings. To address these gaps, 299 youth, age 15 to 24, were sampled from established afterschool and community programs in Malaysia to explore the contribution of Y–AP (operationalized as having two components: youth voice in decision-making and supportive adult relationships) to empowerment, agency and community connections. As hypothesized, hierarchical regressions indicated that program quality (Y–AP, safe environment and program engagement) contributed to agency, empowerment and community connections beyond the contribution of family, school and religion. Additionally, the Y–AP measures contributed substantially more variance than the other measures of program quality on each outcome. Interaction effects indicated differences by age for empowerment and agency but not for community connections. The primary findings in this inquiry replicate those found in previous interview and observational-oriented studies. The data suggests fertile ground for future research while demonstrating that Y–AP may be an effective practice for positive youth development outside of Western settings.

Relation of physical and chemical characteristics of streams to fish communities in the Red River of the North basin, Minnesota and North Dakota, 1993-95

USGS Publications Warehouse

Goldstein, R.M.; Stauffer, J.C.; Larson, P.R.; Lorenz, D.L.

1996-01-01

Within the instream habitat data set, measures of habitat volume (channel width and depth) and habitat diversity were most significant in explaining the variability of the fish communities. The amount of nonagricultural land and riparian zone integrity from the terrestrial habitat data set were also useful in explaining fish community composition. Variability of mean monthly discharge and the frequency of high and low discharge events during the three years prior to fish sampling were the most influential of the hydrologic variables.The first two axes of the canonical correspondence analysis accounted for 43.3 percent of the variation in the fish community and 52.5 percent of the variation in the environmental-species relation. Water-quality indicators such as the percent of fine material in suspended sediment, minimum dissolved oxygen concentrations, minimum concentrations of dissolved organic carbon, and the range of concentrations of major ions and nutrients were the variables that were most important in the canonical correspondence analysis of water-quality data with fish. No single environmental variable or data set appeared to be more important than another in explaining variation in the fish community. The environmental factors affecting the fish communities of the Red River of the North are interrelated. For the most part, instream environmental conditions (instream habitat, hydrology, and water chemistry) appear to be more important in explaining variability in fish community composition than factors related to the agricultural nature of the basin.

Explanatory power does not equal clinical importance: study of the use of the Brief ICF Core Sets for Spinal Cord Injury with a purely statistical approach.

PubMed

Ballert, C; Oberhauser, C; Biering-Sørensen, F; Stucki, G; Cieza, A

2012-10-01

Psychometric study analyzing the data of a cross-sectional, multicentric study with 1048 persons with spinal cord injury (SCI). To shed light on how to apply the Brief Core Sets for SCI of the International Classification of Functioning, Disability and Health (ICF) by determining whether the ICF categories contained in the Core Sets capture differences in overall health. Lasso regression was applied using overall health, rated by the patients and health professionals, as dependent variables and the ICF categories of the Comprehensive ICF Core Sets for SCI as independent variables. The ICF categories that best capture differences in overall health refer to areas of life such as self-care, relationships, economic self-sufficiency and community life. Only about 25% of the ICF categories of the Brief ICF Core Sets for the early post-acute and for long-term contexts were selected in the Lasso regression and differentiate, therefore, among levels of overall health. ICF categories such as d570 Looking after one's health, d870 Economic self-sufficiency, d620 Acquisition of goods and services and d910 Community life, which capture changes in overall health in patients with SCI, should be considered in addition to those of the Brief ICF Core Sets in clinical and epidemiological studies in persons with SCI.

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

PubMed Central

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

2013-01-01

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

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

PubMed

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

2013-12-01

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

Does integration matter? A holistic model for building community resilience in Pakistan.

PubMed

Kanta Kafle, Shesh

2017-01-01

This paper analyses an integrated communitybased risk reduction model adopted by the Pakistan Red Crescent. The paper analyses the model's constructs and definitions, and provides a conceptual framework and a set of practical recommendations for building community resilience. The study uses the process of outcome-based resilience index to assess the effectiveness of the approach. The results indicate that the integrated programming approach is an effective way to build community resilience as it offers a number of tangible and longlasting benefits, including effective and efficient service delivery, local ownership, sustainability of results, and improved local resilience with respect to the shock and stress associated with disaster. The paper also outlines a set of recommendations for the effective and efficient use of the model for building community resilience in Pakistan.

Community resilience as a metaphor, theory, set of capacities, and strategy for disaster readiness.

PubMed

Norris, Fran H; Stevens, Susan P; Pfefferbaum, Betty; Wyche, Karen F; Pfefferbaum, Rose L

2008-03-01

Communities have the potential to function effectively and adapt successfully in the aftermath of disasters. Drawing upon literatures in several disciplines, we present a theory of resilience that encompasses contemporary understandings of stress, adaptation, wellness, and resource dynamics. Community resilience is a process linking a network of adaptive capacities (resources with dynamic attributes) to adaptation after a disturbance or adversity. Community adaptation is manifest in population wellness, defined as high and non-disparate levels of mental and behavioral health, functioning, and quality of life. Community resilience emerges from four primary sets of adaptive capacities--Economic Development, Social Capital, Information and Communication, and Community Competence--that together provide a strategy for disaster readiness. To build collective resilience, communities must reduce risk and resource inequities, engage local people in mitigation, create organizational linkages, boost and protect social supports, and plan for not having a plan, which requires flexibility, decision-making skills, and trusted sources of information that function in the face of unknowns.

Professional relationships and power dynamics between urban community-based nurses and social work case managers: advocacy in action.

PubMed

Young, Staci

2009-01-01

The purpose of this study was to explore how community-based case managers interface with their clients' healthcare providers and other community organizations as a function within their advocacy efforts. Case managers previously defined advocacy as occurring at individual, organizational, and community levels. The relationships they attempt to develop and maintain are consistent with case management ideology, yet this is a complex process to ensure care for vulnerable populations with many medical and socioeconomic needs. Community-based case management settings. In-depth qualitative interviews with a total of 20 nurse and social work case managers working in public housing, university-affiliated community nursing centers, local parishes, and community ministry. The case managers in this study reflected on how they interface with their clients, other healthcare providers, and community organizations on behalf of their clients. They reflect on the importance of trust and communication to facilitate this process. The advocacy work of case managers is influenced by the setting, others' perceptions of their knowledge and expertise, and power dynamics. Their ability to effectively advocate is greatly influenced by the strength of the relationships they forge. Advocacy for vulnerable clients is influenced by the existing relationship between case managers and their clients' healthcare providers. Case managers need to be persistent in their interactions with other providers to ensure that their clients have access to valuable community resources. Clear lines of communication should be established between case managers so that there is clarity around roles and expectations in service provision. Case managers should also participate in the mentoring of future health professions students so they may learn the application of advocacy work in community settings.

Removing barriers to rehabilitation: Theory-based family intervention in community settings after brain injury.

PubMed

Stejskal, Taryn M

2012-01-01

Rehabilitation professionals have become increasingly aware that family members play a critical role in the recovery process of individuals after brain injury. In addition, researchers have begun to identify a relationship between family member caregivers' well-being and survivors' outcomes. The idea of a continuum of care or following survivors from inpatient care to community reintegration has become an important model of treatment across many hospital and community-based settings. In concert with the continuum of care, present research literature indicates that family intervention may be a key component to successful rehabilitation after brain injury. Yet, clinicians interacting with family members and survivors often feel confounded about how exactly to intervene with the broader family system beyond the individual survivor. Drawing on the systemic nature of the field of marriage and family therapy (MFT), this article provides information to assist clinicians in effectively intervening with families using theory-based interventions in community settings. First, a rationale for the utilization of systems-based, as opposed to individual-based, therapies will be uncovered. Second, historically relevant publications focusing on family psychotherapy and intervention after brain injury are reviewed and their implications discussed. Recommendations for the utilization of systemic theory-based principles and strategies, specifically cognitive behavioral therapy (CBT), narrative therapy (NT), and solution-focused therapy (SFT) will be examined. Descriptions of common challenges families and couples face will be presented along with case examples to illustrate how these theoretical frameworks might be applied to these special concerns postinjury. Finally, the article concludes with an overview of the ideas presented in this manuscript to assist practitioners and systems of care in community-based settings to more effectively intervene with the family system as a whole after brain injury.

Health-related physical fitness assessment in a community-based cancer rehabilitation setting.

PubMed

Kirkham, Amy A; Neil-Sztramko, Sarah E; Morgan, Joanne; Hodson, Sara; Weller, Sarah; McRae, Tasha; Campbell, Kristin L

2015-09-01

Assessment of physical fitness is important in order to set goals, appropriately prescribe exercise, and monitor change over time. This study aimed to determine the utility of a standardized physical fitness assessment for use in cancer-specific, community-based exercise programs. Tests anticipated to be feasible and suitable for a community setting and a wide range of ages and physical function were chosen to measure body composition, aerobic fitness, strength, flexibility, and balance. Cancer Exercise Trainers/Specialists at cancer-specific, community-based exercise programs assessed new clients (n = 60) at enrollment, designed individualized exercise programs, and then performed a re-assessment 3-6 months later (n = 34). Resting heart rate, blood pressure, body mass index, waist circumference, handgrip strength, chair stands, sit-and-reach, back scratch, single-leg standing, and timed up-and-go tests were considered suitable and feasible tests/measures, as they were performed in most (≥88 %) participants. The ability to capture change was also noted for resting blood pressure (-7/-5 mmHg, p = 0.02), chair stands (+4, p < 0.01), handgrip strength (+2 kg, p < 0.01), and sit-and-reach (+3 cm, p = 0.03). While the submaximal treadmill test captured a meaningful improvement in aerobic fitness (+62 s, p = 0.17), it was not completed in 33 % of participants. Change in mobility, using the timed up-and-go was nominal and was not performed in 27 %. Submaximal treadmill testing, handgrip dynamometry, chair stands, and sit-and-reach tests were feasible, suitable, and provided meaningful physical fitness information in a cancer-specific, community-based, exercise program setting. However, a shorter treadmill protocol and more sensitive balance and upper body flexibility tests should be investigated.

Analysis of residents' willingness to pay to reduce air pollution to improve children's health in community and hospital settings in Shanghai, China.

PubMed

Wang, Keran; Wu, Jinyi; Wang, Rui; Yang, Yingying; Chen, Renjie; Maddock, Jay E; Lu, Yuanan

2015-11-15

Shanghai, along with many major cities in China, faces deterioration of air quality and increases in air pollution-related respiratory diseases (RDs) in children due to rapid industrialization and urbanization. The Contingent Valuation Method (CVM) was used to qualitatively and quantitatively measure the willingness to pay (WTP) for reducing children's RDs through air quality improvement. Between April and May, 2014, 975 face-to-face interviews were collected from parents in a community-based and a hospital-setting in Shanghai. Multiple imputation and the Probit model were used to determine the relationship between the WTP and the related environmental factors, child health factors and the socio-economic status. Most respondents reported being willing to make a financial contribution to improve air quality in both the community (52.6%) and hospital (70.2%) samples. Those in the hospital setting were willing to pay significantly more ¥504 (USD$80.7) compared to the community sample ¥428 ($68.5) as expected. Reasons for those not being willing to pay included lack of disposable income and believing that responsibility of the air quality was a community issue. These did not differ by sample. Annual household income and education were related to WTP. This study indicated that parents in Shanghai would be willing to pay for improved air quality. Children's health can be the incentive for the citizens' participation and support in the air quality improvement, therefore, hospital settings may present unique places to improve education about air quality and enhance advocacy efforts. This study also suggested that future environmental policies be addressed more rigorously for targeted populations. Copyright © 2015 Elsevier B.V. All rights reserved.

Three models of community mental health services In low-income countries

PubMed Central

2011-01-01

Objective To compare and contrast three models of community mental health services in low-income settings. Data Sources/Study Setting Primary and secondary data collected before, during, and after site visits to mental health programs in Nigeria, the Philippines, and India. Study Design Qualitative case study methodology. Data Collection Data were collected through interviews and observations during site visits to the programs, as well as from reviews of documentary evidence. Principal Findings A set of narrative topics and program indicators were used to compare and contrast three community mental health programs in low-income countries. This allowed us to identify a diversity of service delivery models, common challenges, and the strengths and weaknesses of each program. More definitive evaluations will require the establishment of data collection methods and information systems that provide data about the clinical and social outcomes of clients, as well as their use of services. Conclusions Community mental health programs in low-income countries face a number of challenges. Using a case study methodology developed for this purpose, it is possible to compare programs and begin to assess the effectiveness of diverse service delivery models. PMID:21266051

Assessing Health Promotion Interventions: Limitations of Traditional Research Methods in Community-Based Studies.

PubMed

Dressel, Anne; Schneider, Robert; DeNomie, Melissa; Kusch, Jennifer; Welch, Whitney; Sosa, Mirtha; Yeldell, Sally; Maida, Tatiana; Wineberg, Jessica; Holt, Keith; Bernstein, Rebecca

2017-09-01

Most low-income Americans fail to meet physical activity recommendations. Inactivity and poor diet contribute to obesity, a risk factor for multiple chronic diseases. Health promotion activities have the potential to improve health outcomes for low-income populations. Measuring the effectiveness of these activities, however, can be challenging in community settings. A "Biking for Health" study tested the impact of a bicycling intervention on overweight or obese low-income Latino and African American adults to reduce barriers to cycling and increase physical activity and fitness. A randomized controlled trial was conducted in Milwaukee, Wisconsin, in summer 2015. A 12-week bicycling intervention was implemented at two sites with low-income, overweight, or obese Latino and African American adults. We found that randomized controlled trial methodology was suboptimal for use in this small pilot study and that it negatively affected participation. More discussion is needed about the effectiveness of using traditional research methods in community settings to assess the effectiveness of health promotion interventions. Modifications or alternative methods may yield better results. The aim of this article is to discuss the effectiveness and feasibility of using traditional research methods to assess health promotion interventions in community-based settings.

Cost-effectiveness of finding new HIV diagnoses using rapid HIV testing in community-based organizations.

PubMed

Shrestha, Ram K; Clark, Hollie A; Sansom, Stephanie L; Song, Binwei; Buckendahl, Holly; Calhoun, Cindy B; Hutchinson, Angela B; Heffelfinger, James D

2008-01-01

We assessed the cost-effectiveness of determining new human immunodeficiency virus (HIV) diagnoses using rapid HIV testing performed by community-based organizations (CBOs) in Kansas City, Missouri, and Detroit, Michigan. The CBOs performed rapid HIV testing during April 2004 through March 2006. In Kansas City, testing was performed in a clinic and in outreach settings. In Detroit, testing was performed in outreach settings only. Both CBOs used mobile testing vans. Measures of effectiveness were the number of HIV tests performed and the number of people notified of new HIV diagnoses, based on rapid tests. We retrospectively collected program costs, including those for personnel, test kits, mobile vans, and facility space. The CBO in Kansas City tested a mean of 855 people a year in its clinic and 703 people a year in outreach settings. The number of people notified of new HIV diagnoses was 19 (2.2%) in the clinic and five (0.7%) in outreach settings. The CBO in Detroit tested 976 people a year in outreach settings, and the number notified of new HIV diagnoses was 15 (1.5%). In Kansas City, the cost per person notified of a new HIV diagnosis was $3,637 in the clinic and $16,985 in outreach settings. In the Detroit outreach settings, the cost per notification was $13,448. The cost of providing a new HIV diagnosis was considerably higher in the outreach settings than in the clinic. The variation can be largely explained by differences in the number of undiagnosed infections among the people tested and by the costs of purchasing and operating a mobile van.

Research-Practice Integration in Real Practice Settings: Issues and Suggestions

ERIC Educational Resources Information Center

Cheung, Monit; Ma, Anny K.; Thyer, Bruce A.; Webb, Ann E.

2015-01-01

At the National Bridging the Research and Practice Gap Symposium to discuss evidence-based practice (EBP) in social work, 150 participants attended five breakout groups to address real practice setting applications. These participants from social work academia and practice communities addressed issues and looked for solutions to promote…

SETTING EXPECTATIONS FOR THE OHIO RIVER FISH INDEX BASED ON IN-STREAM HABITAT

EPA Science Inventory

The use of habitat criteria for setting fish community assessment expectations is common for streams, but a standard approach for great rivers remains largely undeveloped. We developed assessment expectations for the Ohio River Fish Index (ORFIN) based on measures of in-stream h...

Preservice Teacher Mobile Investigation and Interpretation of Everyday Mathematics across Settings

ERIC Educational Resources Information Center

Kalir, Jeremiah

2016-01-01

This study reports upon design-based research that enacted mobile mathematics learning for preservice teachers across classroom, community, and online settings. The integration of mobile learning within mathematics teacher education is understudied, and it is necessary to better understand mobile technology affordances when locating disciplinary…

An Ethics Challenge for School Counselors

ERIC Educational Resources Information Center

Froeschle, Janet G.; Crews, Charles

2010-01-01

Ethical issues arise more often for school counselors than for those who work in other settings (Remley, 2002). The challenge of working not only with minors but also with other stakeholders including parents, teachers, school administrators, and community members sets the stage for potential legal and ethical dilemmas. Awareness and adherence to…

Learning from Learners: Family and Consumer Sciences Professionals in International Settings

ERIC Educational Resources Information Center

Keino, Leah C.

2007-01-01

Family and consumer sciences professionals' contribute to the well-being of individuals, families, and communities through work in and support of international efforts. However, limited literature is available on professionals' challenges when working in such settings. In this article, the author offers one professional's insights into working…

Telling Different Tales: Possible Childhoods in Children's Literature

ERIC Educational Resources Information Center

Sreenivas, Deepa

2011-01-01

This article draws on the insights/questions that emerged while putting together a set of stories for children published in a series named "Different Tales." These stories, set in Dalit and other minority communities, problematize the normative grids through which we view "childhood" as they depict the complex ways in which…

Managed Hearts? Emotional Labour and the Applied Theatre Facilitator in Urban Settings

ERIC Educational Resources Information Center

Prestona, Sheila

2013-01-01

This paper reflects on Arlie Hochschild's concept of "Emotional Labour" to investigate the emotion work undertaken by artists facilitating participatory arts in urban community settings. The discussion seeks to capture the emotional cost of "managing" feelings to understand the resilient practitioner in wider political…

Cultivating a Community of Effective Special Education Teachers: Local Special Education Administrators' Roles

ERIC Educational Resources Information Center

Bettini, Elizabeth; Benedict, Amber; Thomas, Rachel; Kimerling, Jenna; Choi, Nari; McLeskey, James

2017-01-01

Evidence of the powerful impact teachers have on student achievement has led to an intensive focus on cultivating effective teachers, including special education teachers (SETs). Local special education administrators (LSEAs) share responsibility for cultivating effective SETs throughout their districts. However, the roles LSEAs play in this…

"Clubcasting": Educational Uses of Podcasting in Multicultural Settings

ERIC Educational Resources Information Center

Beilke, Jayne R.; Stuve, Matthew J.; Williams-Hawkins, Maria A.

2008-01-01

Purpose: This article aims to provide a case study example of the uses of podcasting in a multicultural educational setting. Design/methodology/approach: Pre-service undergraduate teaching majors collaborated with graduate students enrolled in an educational technology course and clients of a community agency service minority, low-income youth to…

What Your Board Wants: School Board Expectations for Business Officials.

ERIC Educational Resources Information Center

Shannon, Thomas A.

1993-01-01

The essential elements of school board governance involve four dimensions: (1) setting the vision for what the community wants the public school program to be; (2) ensuring that districts have a solid staff infrastructure to achieve the vision; (3) setting standards; and (4) advocating for schools. (MLF)

Imperfect/I'm Perfect: Bodies/Embodiment in Post-Secondary and Elementary Settings

ERIC Educational Resources Information Center

Winters, Kari-Lynn; Code, Mary

2017-01-01

Using researched perspectives of bodies and embodiment, alongside dramatic structures, where bodies are foregrounded, this article looks closely at bodies and embodiment inside of school settings. Specifically, it investigates a community in Southern Ontario and the perceived, affective, relational, and critical ways that study participants story…

Community Schools: What We Know and What We Need to Know

ERIC Educational Resources Information Center

Heers, Marieke; Van Klaveren, Chris; Groot, Wim; Maassen van den Brink, Henriëtte

2016-01-01

Community schools offer children an integrated set of educational and social services, but sound scientific evidence on their effectiveness is lacking. Therefore, this study reviews the literature on community schools. First, we characterize community schools and find that their key activities are cooperating with other institutions, involving…

Motivations for Parent Involvement within a Community School Setting

ERIC Educational Resources Information Center

Mercanti-Anthony, Michael-Joseph

2012-01-01

Increasingly, education reform advocates have pointed to the growing community school movement as a partial answer to the myriad challenges facing urban public education. Rooted in the ideas of John Dewey, community schools are generally defined as localized community hubs of partnerships--often serving as sources of service distribution and…

Learning Communities Faculty Scholars: An Online, Targeted Faculty Development Course to Promote Scholarly Teaching

ERIC Educational Resources Information Center

Steiner, Hillary H.

2016-01-01

Many learning communities instructors seek professional development opportunities that foster their growth as teacher-scholars. Learning communities programs, therefore, have an opportunity to provide targeted, "just in time" training that allows for the immediate application of knowledge to a learning community setting, maximizing…

Introducing OTUshuff and DwOdum: A new set of tools for estimating beta diversity for under-sampled communities

USDA-ARS?s Scientific Manuscript database

Characterization of complex microbial communities by DNA sequencing has become a standard technique in microbial ecology. Yet, particular features of this approach render traditional methods of community comparison problematic. In particular, a very low proportion of community members are typically ...

Toward a Definition of a Community Choir

ERIC Educational Resources Information Center

Bell, Cindy L.

2008-01-01

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

Proposing Community-Based Learning in the Marketing Curriculum

ERIC Educational Resources Information Center

Cadwallader, Susan; Atwong, Catherine; Lebard, Aubrey

2013-01-01

Community service and service learning (CS&SL) exposes students to the business practice of giving back to society while reinforcing classroom learning in an applied real-world setting. However, does the CS&SL format provide a better means of instilling the benefits of community service among marketing students than community-based…

Listening: Implications for Qualitative Research.

ERIC Educational Resources Information Center

Enos, Anya Dozier

Pueblo communities want local research to be linked to community needs. To address this requirement, university research must shift from a set agenda that addresses personal or professional goals to a flexible design that moves toward a community-based goal. This can be achieved through collaboration with the Pueblo community. Key to developing…

A reference data set of hillslope rainfall-runoff response, Panola Mountain Research Watershed, United States

USGS Publications Warehouse

Tromp-van, Meerveld; James, A.L.; McDonnell, Jeffery J.; Peters, N.E.

2008-01-01

Although many hillslope hydrologic investigations have been conducted in different climate, topographic, and geologic settings, subsurface stormflow remains a poorly characterized runoff process. Few, if any, of the existing data sets from these hillslope investigations are available for use by the scientific community for model development and validation or conceptualization of subsurface stormflow. We present a high-resolution spatial and temporal rainfall-runoff data set generated from the Panola Mountain Research Watershed trenched experimental hillslope. The data set includes surface and subsurface (bedrock surface) topographic information and time series of lateral subsurface flow at the trench, rainfall, and subsurface moisture content (distributed soil moisture content and groundwater levels) from January to June 2002. Copyright 2008 by the American Geophysical Union.

Understanding the environmental issues in diabetes self-management education research: a reexamination of 8 studies in community-based settings.

PubMed

Jack, Leonard; Liburd, Leandris; Spencer, Tirzah; Airhihenbuwa, Collins O

2004-06-01

Eight studies included in a recent systematic review of the efficacy of diabetes self-management education were qualitatively reexamined to determine the presence of theoretical frameworks, methods used to ensure cultural appropriateness, and the quality of the instrument. Theoretical frameworks that help to explain complex pathways that produce health outcomes were lacking; culture indices were not incorporated into diabetes self-management education; and the instruments used to measure outcomes were inadequate. We provide recommendations to improve research on diabetes self-management education in community settings through use of a contextual framework that encourages targeting multiple levels of influence--individual, family, organizational, community, and policy.

Instalacion necesaria para montar una pequena central electrica (plant requirements to set up and operate a small-community electric system)

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

Not Available

1965-04-30

The manual serves as a guide to the important factors to consider in establishing a small-scale community electric system. Financial requirements include labor costs, machinery, equipment, utilities and administrative costs, raw materials (for diesel fuel to run the generators). Tables on cost estimates are given, with a blank column for actual cost statements; the summary provides questions that will help the planner decide what is necessary for setting up the plant and whether the requirements can be met.

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

PubMed

Tuoriniemi, Pamela; Schott-Baer, Darlene

2008-01-01

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

Local structuring factors of invertebrate communities in ephemeral freshwater rock pools and the influence of more permanent water bodies in the region

USGS Publications Warehouse

Jocque, M.; Graham, T.; Brendonck, L.

2007-01-01

We used three isolated clusters of small ephemeral rock pools on a sandstone flat in Utah to test the importance of local structuring processes on aquatic invertebrate communities. In the three clusters we characterized all ephemeral rock pools (total: 27) for their morphometry, and monitored their water quality, hydrology and community assemblage during a full hydrocycle. In each cluster we also sampled a set of more permanent interconnected freshwater systems positioned in a wash, draining the water from each cluster of rock pools. This design allowed additional testing for the potential role of more permanent water bodies in the region as source populations for the active dispersers and the effect on the community structure in the rock pools. Species richness and community composition in the rock pools correlated with level of permanence and the ammonia concentration. The length of the rock pool inundation cycle shaped community structure, most probably by inhibiting colonization by some taxa (e.g. tadpoles and insect larvae) through developmental constraints. The gradient in ammonia concentrations probably reflects differences in primary production. The more permanent water bodies in each wash differed both environmentally and in community composition from the connected set of rock pools. A limited set of active dispersers was observed in the rock pools. Our findings indicate that aquatic invertebrate communities in the ephemeral rock pools are mainly structured through habitat permanence, possibly linked with biotic interactions and primary production. ?? 2007 Springer Science+Business Media B.V.

Implementation of the IDEFICS intervention across European countries: perceptions of parents and relationship with BMI.

PubMed

De Bourdeaudhuij, I; Verbestel, V; De Henauw, S; Maes, L; Mårild, S; Moreno, L A; Barba, G; Siani, A; Kovács, E; Konstabel, K; Tornaritis, M; Pigeot, I; Ahrens, W

2015-12-01

The primary aim of the present study was to obtain insight into parents' perception of the IDEFICS intervention at the school or preschool/kindergarten and community levels and whether they received specific materials related to the intervention. The secondary aim was to analyse whether parents who reported higher levels of exposure to the IDEFICS intervention had children with more favourable changes in body mass index (BMI) z-scores between baseline and after 2 years of intervention. Process evaluation of the IDEFICS intervention investigated the implementation of the 2-year intervention in the intervention communities. Intervention group parents (n = 4,180) in seven countries (Belgium, Cyprus, Estonia, Germany, Italy, Spain and Sweden) answered questions about their exposure to the IDEFICS study. To analyse the relationship between exposure and BMI z-score, a composite score was calculated for exposure at the setting and at the community levels. The frequency of parental exposure to the IDEFICS messages not only through the community but also through the (pre)school/kindergarten was lower than what was intended and planned. The dose received by the parents was considerably higher through the (pre)school/kindergarten settings than that through the community in all countries. Efforts by the settings or communities related to fruit and vegetable consumption (range 69% to 97%), physical activity promotion (range 67% to 91%) and drinking water (range 49% to 93%) were more visible and also realized more parental involvement than those related to TV viewing, sleep duration and spending time with the family (below 50%). Results showed no relation of parental exposure at the setting or the community level on more favourable changes in children's BMI z-scores for the total sample. Country-specific analyses for parental exposure at the setting level showed an expected positive effect in German girls and an unexpected negative effect in Italian boys. Parental exposure and involvement in the IDEFICS intervention in all countries was much less than aimed for, which might be due to the diverse focus (six key messages) and high intensity and duration of the intervention. It may also be that the human resources invested in the implementation and maintenance of intervention activities by the study centres, the caretakers and the community stakeholders were not sufficient. Higher levels of parental exposure were not related to more favourable changes in BMI z-scores. © 2015 World Obesity.

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

PubMed

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

2005-08-01

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

Predictors of firearm violence in urban communities: A machine-learning approach.

PubMed

Goin, Dana E; Rudolph, Kara E; Ahern, Jennifer

2018-05-01

Interpersonal firearm violence is a leading cause of death and injuries in the United States. Identifying community characteristics associated with firearm violence is important to improve confounder selection and control in health research, to better understand community-level factors that are associated with firearm violence, and to enhance community surveillance and control of firearm violence. The objective of this research was to use machine learning to identify an optimal set of predictors for urban interpersonal firearm violence rates using a broad set of community characteristics. The final list of 18 predictive covariates explain 77.8% of the variance in firearm violence rates, and are publicly available, facilitating their inclusion in analyses relating violence and health. This list includes the black isolation and segregation indices, rates of educational attainment, marital status, indicators of wealth and poverty, longitude, latitude, and temperature. Copyright © 2018 Elsevier Ltd. All rights reserved.

Strong Lens Time Delay Challenge. I. Experimental Design

NASA Astrophysics Data System (ADS)

Dobler, Gregory; Fassnacht, Christopher D.; Treu, Tommaso; Marshall, Phil; Liao, Kai; Hojjati, Alireza; Linder, Eric; Rumbaugh, Nicholas

2015-02-01

The time delays between point-like images in gravitational lens systems can be used to measure cosmological parameters. The number of lenses with measured time delays is growing rapidly; the upcoming Large Synoptic Survey Telescope (LSST) will monitor ~103 strongly lensed quasars. In an effort to assess the present capabilities of the community, to accurately measure the time delays, and to provide input to dedicated monitoring campaigns and future LSST cosmology feasibility studies, we have invited the community to take part in a "Time Delay Challenge" (TDC). The challenge is organized as a set of "ladders," each containing a group of simulated data sets to be analyzed blindly by participating teams. Each rung on a ladder consists of a set of realistic mock observed lensed quasar light curves, with the rungs' data sets increasing in complexity and realism. The initial challenge described here has two ladders, TDC0 and TDC1. TDC0 has a small number of data sets, and is designed to be used as a practice set by the participating teams. The (non-mandatory) deadline for completion of TDC0 was the TDC1 launch date, 2013 December 1. The TDC1 deadline was 2014 July 1. Here we give an overview of the challenge, we introduce a set of metrics that will be used to quantify the goodness of fit, efficiency, precision, and accuracy of the algorithms, and we present the results of TDC0. Thirteen teams participated in TDC0 using 47 different methods. Seven of those teams qualified for TDC1, which is described in the companion paper.

Diabetes Screening and Prevention in a High-Risk, Medically Isolated Border Community.

PubMed

Millard, Ann V; Graham, Margaret A; Mier, Nelda; Moralez, Jesus; Perez-Patron, Maria; Wickwire, Brian; May, Marlynn L; Ory, Marcia G

2017-01-01

A project in a Texas border community setting, Prevention Organized against Diabetes and Dialysis with Education and Resources (POD 2 ER), offered diabetes prevention information, screening, and medical referrals. The setting was a large, longstanding flea market that functions as a shopping mall for low-income people. The priority population included medically underserved urban and rural Mexican Americans. Components of the program addressed those with diabetes, prediabetes, and accompanying relatives and friends. People living in the Lower Rio Grande Valley (LRGV) face challenges of high rates of type 2 diabetes, lack of knowledge about prevention, and inadequate access to medical care. Recent statistics from actual community-wide screenings indicate a high diabetes prevalence, 30.7% among adults in the LRGV compared with 12.3% nationwide. A diverse team composed of public health faculty, students, a physician, a community health worker, and community volunteers conceived and developed the project with a focus on cultural and economic congruence and a user-friendly atmosphere. The program provided screening for prediabetes and diabetes with a hemoglobin A1c test. Screening was offered to those who were at least 25 years of age and not pregnant. When results indicated diabetes, a test for kidney damage was offered (urinary albumin-to-creatinine ratio). A medical appointment at a community clinic within a week was provided to those who tested positive for diabetes and lacked a medical home. Health education modules addressed all family members. The project was successful in recruiting 2,332 high-risk people in 26 months in a community setting, providing clinic referrals to those without a doctor, introducing them to treatment, and providing diabetes prevention information to all project participants. Implications for research and practice are highlighted. This study shows that a regular access point in a place frequented by large numbers of medically marginalized people in a program designed to eliminate cultural and economic barriers can succeed in providing a hard-to-reach community with diabetes prevention services. Aspects of this program can serve as a model for other service provision for similar populations and settings.

Through the eyes of a child: preschoolers' identification of emotional expressions from the child affective facial expression (CAFE) set.

PubMed

LoBue, Vanessa; Baker, Lewis; Thrasher, Cat

2017-08-10

Researchers have been interested in the perception of human emotional expressions for decades. Importantly, most empirical work in this domain has relied on controlled stimulus sets of adults posing for various emotional expressions. Recently, the Child Affective Facial Expression (CAFE) set was introduced to the scientific community, featuring a large validated set of photographs of preschool aged children posing for seven different emotional expressions. Although the CAFE set was extensively validated using adult participants, the set was designed for use with children. It is therefore necessary to verify that adult validation applies to child performance. In the current study, we examined 3- to 4-year-olds' identification of a subset of children's faces in the CAFE set, and compared it to adult ratings cited in previous research. Our results demonstrate an exceptionally strong relationship between adult ratings of the CAFE photos and children's ratings, suggesting that the adult validation of the set can be applied to preschool-aged participants. The results are discussed in terms of methodological implications for the use of the CAFE set with children, and theoretical implications for using the set to study the development of emotion perception in early childhood.

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

ERIC Educational Resources Information Center

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

2016-01-01

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

Resilience, Community, and Resilient Communities: Conditioning Contexts and Collective Action

ERIC Educational Resources Information Center

Chaskin, Robert J.

2008-01-01

This article explores the idea of community as it relates to the concept of resilience. It focuses on community both as context (local environments providing a set of risk and protective factors that have an influence on the well-being of community members) and as collective actors that can exhibit resilience in themselves by organizing and acting…

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

PubMed

Dawood, Mary

2012-08-01

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

PERICLES: a knowledge management programme applied to solar data from International Space Station-Columbus

NASA Astrophysics Data System (ADS)

Muller, Christian; PERICLES Consortium

2017-06-01

The FP-7 (Framework Programme 7 of the European Union) PERICLES project addresses the life-cycle of large and complex data sets to cater for the evolution of context of data sets and user communities, including groups unanticipated when the data was created. Semantics of data sets are thus also expected to evolve and the project includes elements which could address the reuse of data sets at periods where the data providers and even their institutions are not available any more. This paper presents the PERICLES science case with the example of the SOLAR (SOLAR monitoring observatory) payload on International Space Station-Columbus.

"Birth Control can Easily Take a Back Seat": Challenges Providing IUDs in Community Health Care Settings.

PubMed

Biggs, M Antonia; Kaller, Shelly; Harper, Cynthia C; Freedman, Lori; Mays, Aisha R

2018-01-01

To assess community health centers' (CHCs) capacity to offer streamlined intrauterine devices (IUDs) services. Prior to implementing a contraceptive training project, we surveyed health care staff (N=97) from 11 CHC sites that offer IUDs onsite. Twenty interviews with clinicians explored more deeply their challenges offering IUDs in the CHC setting. Most practices required multiple visits for IUD placement, most (66%) clinician survey respondents had placed an IUD and 19% had placed an IUD as emergency contraception. Need for screening tests, scheduling challenges, pressures to meet patient quotas, and lack of priority given to women's health hindered streamlined IUD provision. Although access to IUDs has increased, significant barriers to provision in CHC settings persist. Clinic policies may need to address a variety of system and provider-level barriers to meet the needs of patients.

A tool for tracking and assessing chronic illness care in prison (ACIC-P).

PubMed

Wang, Emily A; Aminawung, Jenerius A; Ferguson, Warren; Trestman, Robert; Wagner, Edward H; Bova, Carol

2014-10-01

Chronic disease care is being transformed in correctional settings, given an aging inmate population, ongoing quality improvement efforts, litigation, and rising costs. The Chronic Care Model, established for chronic disease care in the community, might be a suitable framework to transform chronic disease care in prison, but it has not been systematically adapted for the correctional health care setting. We employed cognitive interviewing to adapt an extant survey used to measure the delivery of chronic illness care in the community, Assessment of Chronic Illness Care, for a prison setting. Results from the cognitive interviews and the modified Assessment of Chronic Illness Care-Prison (ACIC-P) instrument are presented in this article. Future studies will need to test the reliability and psychometric properties of the adapted ACIC-P. © The Author(s) 2014.

The economic and social benefits of an aquaponic system for the integrated production of fish and water plants

NASA Astrophysics Data System (ADS)

Rizal, A.; Dhahiyat, Y.; Zahidah; Andriani, Y.; Handaka, A. A.; Sahidin, A.

2018-04-01

Aquaponics is an evolving closed-system food production technology that integrates recirculating aquaculture with hydroponics. In this paper we give a brief literature overview of the benefit aspects of aquaponics by discussing its social, environmental, and economic impacts in different potential settings. The technology might be applied to commercial or community based urban food production, industrial scale production in rural areas, small scale farming in developing countries or as systems for education and decoration inside buildings. We concluded that due to the different potential applications and settings for installing the technology, benefit impacts need to be considered separately and that due the complexity, communities, urban and rural infrastructure and policy settings, further research and data acquisition is needed to be able to assess all benefit aspects.

Violence in the School Setting: A School Nurse Perspective.

PubMed

King, Kate K

2014-01-31

Violence in schools has become a significant public health risk and is not limited to violent acts committed in the school setting. Violence in homes, neighborhoods, and communities also affects the learning and behaviors of children while at school. School violence, such as shootings, weapons in schools, assaults, fights, bullying; other witnessed violence in non-school settings; and violence as a cultural norm of problem solving can all impact the ability of children to function in school. School nurses serve on the front-line of problem identification and intervene to diminish the effects of violence on both school children as individuals and on populations in schools and the community. This article describes ways in which school nurses deal with violence and concludes with discussion of potential responses to violence, including the school nurse response to violence and implications for other healthcare professionals.

Factors shaping interactions among community health workers in rural Ethiopia: rethinking workplace trust and teamwork.

PubMed

Dynes, Michelle M; Stephenson, Rob; Hadley, Craig; Sibley, Lynn M

2014-01-01

Worldwide, a shortage of skilled health workers has prompted a shift toward community-based health workers taking on greater responsibility in the provision of select maternal and newborn health services. Research in mid- and high-income settings suggests that coworker collaboration increases productivity and performance. A major gap in this research, however, is the exploration of factors that influence teamwork among diverse community health worker cadres in rural, low-resource settings. The purpose of this study is to examine how sociodemographic and structural factors shape teamwork among community-based maternal and newborn health workers in Ethiopia. A cross-sectional survey was conducted with health extension workers, community health development agents, and traditional birth attendants in 3 districts of the West Gojam Zone in the Amhara region of Ethiopia. Communities were randomly selected from Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) sites; health worker participants were recruited using a snowball sampling strategy. Fractional logit modeling and average marginal effects analyses were carried out to identify the influential factors for frequency of work interactions with each cadre. One hundred and ninety-four health workers participated in the study. A core set of factors-trust in coworkers, gender, and cadre-were influential for teamwork across groups. Greater geographic distance and perception of self-interested motivations were barriers to interactions with health extension workers, while greater food insecurity (a proxy for wealth) was associated with increased interactions with traditional birth attendants. Interventions that promote trust and gender sensitivity and improve perceptions of health worker motivations may help bridge the gap in health services delivery between low- and high-resource settings. Inter-cadre training may be one mechanism to increase trust and respect among diverse health workers, thereby increasing collaboration. Large-scale, longitudinal research is needed to understand how changes in trust, gender norms, and perceptions of motivations influence teamwork over time. © 2014 by the American College of Nurse-Midwives.

A web-based training program to support chronic kidney disease screening by community pharmacists.

PubMed

Gheewala, Pankti A; Peterson, Gregory M; Zaidi, Syed Tabish R; Bereznicki, Luke; Jose, Matthew D; Castelino, Ronald L

2016-10-01

Background Community pharmacists' role in screening of several chronic diseases has been widely explored. The global health burden of chronic kidney disease is high; however, the progression and adverse outcomes can be prevented or delayed by detecting and treating the disease in its initial stages 1-3. Therefore, a web-based training program was developed to enhance pharmacists' knowledge and skills required to perform a chronic kidney disease screening service in a community setting. Objective The aim of this study was to evaluate the impact of a web-based training program on community pharmacists' knowledge and skills associated with chronic kidney disease screening. As secondary aim, pharmacists' satisfaction with the training program was assessed. Setting Community pharmacy practice. Method A web-based training program was developed by four pharmacists and a nephrologist. Quantitative data was collected by employing a self-administered, web-based questionnaire, which comprised a set of five multiple-choice knowledge questions and one clinical vignette to assess skills. A nine-item Likert scale was used to determine pharmacists' satisfaction with the training program. Main outcome measure Pharmacists' knowledge and skills scores at pre and post-training, reliability of the Likert scale, and the proportion of responses to the individual nine items of the satisfaction survey. Results Fifty pharmacists participated in the pre-questionnaire and 38 pharmacists completed the web-based training and post-questionnaire. Significant differences were observed in the knowledge scores (p < 0.001) and skills scores (p < 0.001) at pre- and post-training. Cronbach's alpha for the nine-item satisfaction scale was 0.73 and the majority pharmacists (92.1-100 %) were satisfied with the various aspects of the training program. Conclusion The web-based training program positively enhanced pharmacists' knowledge and skills associated with chronic kidney disease screening. These findings support further development and widespread implementation of the training program to facilitate health promotion and early identification of chronic kidney disease in a community setting.

Priority setting for health in the context of devolution in Kenya: implications for health equity and community-based primary care

PubMed Central

McCollum, Rosalind; Theobald, Sally; Otiso, Lilian; Martineau, Tim; Karuga, Robinson; Barasa, Edwine; Molyneux, Sassy; Taegtmeyer, Miriam

2018-01-01

Abstract Devolution changes the locus of power within a country from central to sub-national levels. In 2013, Kenya devolved health and other services from central government to 47 new sub-national governments (known as counties). This transition seeks to strengthen democracy and accountability, increase community participation, improve efficiency and reduce inequities. With changing responsibilities and power following devolution reforms, comes the need for priority-setting at the new county level. Priority-setting arises as a consequence of the needs and demand for healthcare resources exceeding the resources available, resulting in the need for some means of choosing between competing demands. We sought to explore the impact of devolution on priority-setting for health equity and community health services. We conducted key informant and in-depth interviews with health policymakers, health providers and politicians from 10 counties (n = 269 individuals) and 14 focus group discussions with community members based in 2 counties (n = 146 individuals). Qualitative data were analysed using the framework approach. We found Kenya’s devolution reforms were driven by the need to demonstrate responsiveness to county contexts, with positive ramifications for health equity in previously neglected counties. The rapidity of the process, however, combined with limited technical capacity and guidance has meant that decision-making and prioritization have been captured and distorted for political and power interests. Less visible community health services that focus on health promotion, disease prevention and referral have been neglected within the prioritization process in favour of more tangible curative health services. The rapid transition in power carries a degree of risk of not meeting stated objectives. As Kenya moves forward, decision-makers need to address the community health gap and lay down institutional structures, processes and norms which promote health equity for all Kenyans. PMID:29846599

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

Tracking and unpacking rapid Arctic change: Indicators of community health and sustainability in northern Alaska and links to cryospheric change

NASA Astrophysics Data System (ADS)

Eicken, H.; Sam, J. M.; Mueller-stoffels, M.; Lovecraft, A. L.; Fresco, N. L.

2017-12-01

Tracking and responding to rapid Arctic change benefits from time series of indicator variables that describe the state of the system and can inform anticipatory action. A key challenge is to identify and monitor sets of indicators that capture relevant variability, trends, and transitions in social-environmental systems. We present findings from participatory scenarios focused on community health and sustainability in northern Alaska. In a series of workshops in 2015 and 2016 (Kotzebue workshop photo shown below), over 50 experts, mostly local, identified determinants of community health and sustainability by 2040 in the Northwest Arctic and North Slope Boroughs, Alaska. Drawing on further research, an initial set of factors and uncertainties was refined and prioritized into a total of 20 key drivers, ranging from governance issues to socio-economic and environmental factors. The research team then developed sets of future projections that describe plausible outcomes by mid-century for each of these drivers. A plausibility and consistency analysis of all pairwise combinations of these projections (following Mueller-Stoffels and Eicken, In: North by 2020 - Perspectives on Alaska's Changing Social-Ecological Systems, University of Alaska Press, 2011) resulted in the identification of robust scenarios. The latter were further reviewed by workshop participants, and a set of indicator variables, including indicators of relevant cryospheric change, was identified to help track trajectories towards plausible future states. Publically accessible recorded data only exist for a subset of the more than 70 indicators, reaching back a few years to several decades. For several indicators, the sampling rate or time series length are insufficient for tracking of and response to change. A core set of variables has been identified that meets indicator requirements and can serve as a tool for Alaska Arctic communities in adapting to or mitigating rapid change affecting community health and sustainability. The study provides guidance on Arctic observing system design, highlighting the importance of knowledge co-production to capture those aspects of climate, cryospheric and environmental change that are relevant in the context of broader responses to rapid Arctic change.

Involving patients in setting priorities for healthcare improvement: a cluster randomized trial

PubMed Central

2014-01-01

Background Patients are increasingly seen as active partners in healthcare. While patient involvement in individual clinical decisions has been extensively studied, no trial has assessed how patients can effectively be involved in collective healthcare decisions affecting the population. The goal of this study was to test the impact of involving patients in setting healthcare improvement priorities for chronic care at the community level. Methods Design: Cluster randomized controlled trial. Local communities were randomized in intervention (priority setting with patient involvement) and control sites (no patient involvement). Setting: Communities in a canadian region were required to set priorities for improving chronic disease management in primary care, from a list of 37 validated quality indicators. Intervention: Patients were consulted in writing, before participating in face-to-face deliberation with professionals. Control: Professionals established priorities among themselves, without patient involvement. Participants: A total of 172 individuals from six communities participated in the study, including 83 chronic disease patients, and 89 health professionals. Outcomes: The primary outcome was the level of agreement between patients’ and professionals’ priorities. Secondary outcomes included professionals’ intention to use the selected quality indicators, and the costs of patient involvement. Results Priorities established with patients were more aligned with core generic components of the Medical Home and Chronic Care Model, including: access to primary care, self-care support, patient participation in clinical decisions, and partnership with community organizations (p < 0.01). Priorities established by professionals alone placed more emphasis on the technical quality of single disease management. The involvement intervention fostered mutual influence between patients and professionals, which resulted in a 41% increase in agreement on common priorities (95%CI: +12% to +58%, p < 0.01). Professionals’ intention to use the selected quality indicators was similar in intervention and control sites. Patient involvement increased the costs of the prioritization process by 17%, and required 10% more time to reach consensus on common priorities. Conclusions Patient involvement can change priorities driving healthcare improvement at the population level. Future research should test the generalizability of these findings to other contexts, and assess its impact on patient care. Trial registration The Netherlands National Trial Register #NTR2496. PMID:24555508

DOE Research Set-Aside Areas of the Savannah River Site

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

Davis, C.E.; Janecek, L.L.

1997-08-31

Designated as the first of seven National Environmental Research Parks (NERPs) by the Atomic Energy Commission (now the Department of Energy), the Savannah River Site (SRS) is an important ecological component of the Southeastern Mixed Forest Ecoregion located along the Savannah River south of Aiken, South Carolina. Integral to the Savannah River Site NERP are the DOE Research Set-Aside Areas. Scattered across the SRS, these thirty tracts of land have been set aside for ecological research and are protected from public access and most routine Site maintenance and forest management activities. Ranging in size from 8.5 acres (3.44 ha) tomore » 7,364 acres (2,980 ha), the thirty Set-Aside Areas total 14,005 acres (5,668 ha) and comprise approximately 7% of the Site`s total area. This system of Set-Aside Areas originally was established to represent the major plant communities and habitat types indigenous to the SRS (old-fields, sandhills, upland hardwood, mixed pine/hardwood, bottomland forests, swamp forests, Carolina bays, and fresh water streams and impoundments), as well as to preserve habitats for endangered, threatened, or rare plant and animal populations. Many long-term ecological studies are conducted in the Set-Asides, which also serve as control areas in evaluations of the potential impacts of SRS operations on other regions of the Site. The purpose of this document is to give an historical account of the SRS Set-Aside Program and to provide a descriptive profile of each of the Set-Aside Areas. These descriptions include a narrative for each Area, information on the plant communities and soil types found there, lists of sensitive plants and animals documented from each Area, an account of the ecological research conducted in each Area, locator and resource composition maps, and a list of Site-Use permits and publications associated with each Set-Aside.« less

Strengthening fairness, transparency and accountability in health care priority setting at district level in Tanzania

PubMed Central

Maluka, Stephen Oswald

2011-01-01

Health care systems are faced with the challenge of resource scarcity and have insufficient resources to respond to all health problems and target groups simultaneously. Hence, priority setting is an inevitable aspect of every health system. However, priority setting is complex and difficult because the process is frequently influenced by political, institutional and managerial factors that are not considered by conventional priority-setting tools. In a five-year EU-supported project, which started in 2006, ways of strengthening fairness and accountability in priority setting in district health management were studied. This review is based on a PhD thesis that aimed to analyse health care organisation and management systems, and explore the potential and challenges of implementing Accountability for Reasonableness (A4R) approach to priority setting in Tanzania. A qualitative case study in Mbarali district formed the basis of exploring the sociopolitical and institutional contexts within which health care decision making takes place. The study also explores how the A4R intervention was shaped, enabled and constrained by the contexts. Key informant interviews were conducted. Relevant documents were also gathered and group priority-setting processes in the district were observed. The study revealed that, despite the obvious national rhetoric on decentralisation, actual practice in the district involved little community participation. The assumption that devolution to local government promotes transparency, accountability and community participation, is far from reality. The study also found that while the A4R approach was perceived to be helpful in strengthening transparency, accountability and stakeholder engagement, integrating the innovation into the district health system was challenging. This study underscores the idea that greater involvement and accountability among local actors may increase the legitimacy and fairness of priority-setting decisions. A broader and more detailed analysis of health system elements, and socio-cultural context is imperative in fostering sustainability. Additionally, the study stresses the need to deal with power asymmetries among various actors in priority-setting contexts. PMID:22072991

Facemasks for the prevention of infection in healthcare and community settings.

PubMed

MacIntyre, C Raina; Chughtai, Abrar Ahmad

2015-04-09

Facemasks are recommended for diseases transmitted through droplets and respirators for respiratory aerosols, yet recommendations and terminology vary between guidelines. The concepts of droplet and airborne transmission that are entrenched in clinical practice have recently been shown to be more complex than previously thought. Several randomised clinical trials of facemasks have been conducted in community and healthcare settings, using widely varying interventions, including mixed interventions (such as masks and handwashing), and diverse outcomes. Of the nine trials of facemasks identified in community settings, in all but one, facemasks were used for respiratory protection of well people. They found that facemasks and facemasks plus hand hygiene may prevent infection in community settings, subject to early use and compliance. Two trials in healthcare workers favoured respirators for clinical respiratory illness. The use of reusable cloth masks is widespread globally, particularly in Asia, which is an important region for emerging infections, but there is no clinical research to inform their use and most policies offer no guidance on them. Health economic analyses of facemasks are scarce and the few published cost effectiveness models do not use clinical efficacy data. The lack of research on facemasks and respirators is reflected in varied and sometimes conflicting policies and guidelines. Further research should focus on examining the efficacy of facemasks against specific infectious threats such as influenza and tuberculosis, assessing the efficacy of cloth masks, investigating common practices such as reuse of masks, assessing compliance, filling in policy gaps, and obtaining cost effectiveness data using clinical efficacy estimates. © BMJ Publishing Group Ltd 2015.

Experienced HIV-Related Stigma in Health Care and Community Settings: Mediated Associations With Psychosocial and Health Outcomes.

PubMed

Kay, Emma S; Rice, Whitney S; Crockett, Kaylee B; Atkins, Ghislaine C; Batey, David Scott; Turan, Bulent

2018-03-01

There are multiple dimensions of HIV-related stigma that can compromise the mental and physical health of people living with HIV. We focused on the dimension of experienced stigma, defined as exposure to acts of discrimination, devaluation, and prejudice, and investigated its relationship with HIV health and psychosocial outcomes. We examined associations between experienced stigma in the community and health care settings and psychosocial and health outcomes for people living with HIV (N = 203) receiving care at an urban HIV clinic in the Southeastern United States. We also investigated whether those effects are unique to experienced stigma or are mediated by other dimensions of HIV-related stigma. Experienced stigma was associated with suboptimal clinical outcomes such as viral nonsuppression, as well as poor affective, cognitive, and mental health outcomes (self-esteem, depressive symptoms, avoidance coping, and blame coping) and interpersonal outcomes such as social support and physician trust. Furthermore, serial mediation models suggested significant indirect effects of experienced stigma through internalized stigma and anticipated stigma from various theoretically expected sources of stigma (eg, community members, friends and family, and health care workers), with varying effects depending on the source. These findings suggest nuanced mechanisms for the effects of experienced HIV-related stigma, especially in health care settings, and may be used to inform stigma-reduction interventions. Interventions designed to address experienced stigma in health care settings might be more tailored to specific outcomes, such as depression and physician trust, than interventions designed to address experienced stigma in the community.

Community-based interventions to optimize early childhood development in low resource settings.

PubMed

Maulik, P K; Darmstadt, G L

2009-08-01

Interventions targeting the early childhood period (0 to 3 years) help to improve neuro-cognitive functioning throughout life. Some of the more low cost, low resource-intensive community practices for this age-group are play, reading, music and tactile stimulation. This research was conducted to summarize the evidence regarding the effectiveness of such strategies on child development, with particular focus on techniques that may be transferable to developing countries and to children at risk of developing secondary impairments. PubMed, PsycInfo, Embase, ERIC, CINAHL and Cochrane were searched for studies involving the above strategies for early intervention. Reference lists of these studies were scanned and other studies were incorporated based on snow-balling. Overall, 76 articles corresponding to 53 studies, 24 of which were randomized controlled trials, were identified. Sixteen of those studies were from low- and middle-income countries. Play and reading were the two commonest interventions and showed positive impact on intellectual development of the child. Music was evaluated primarily in intensive care settings. Kangaroo Mother Care, and to a lesser extent massage, also showed beneficial effects. Improvement in parent-child interaction was common to all the interventions. Play and reading were effective interventions for early childhood interventions in low- and middle-income countries. More research is needed to judge the effectiveness of music. Kangaroo Mother Care is effective for low birth weight babies in resource poor settings, but further research is needed in community settings. Massage is useful, but needs more rigorous research prior to being advocated for community-level interventions.

Carnegie's New Community Engagement Classification: Affirming Higher Education's Role in Community

ERIC Educational Resources Information Center

Driscoll, Amy

2009-01-01

In 2005, the Carnegie Foundation for the Advancement of Teaching (CFAT) stirred the higher education world with the announcement of a new classification for institutions that engage with community. The classification, community engagement, is the first in a set of planned classification schemes resulting from the foundation's reexamination of the…

The Impact of Human Capital and Selected Job Rewards on Community College Faculty Job Satisfaction

ERIC Educational Resources Information Center

Lyons, Frankie W.; Akroyd, Duane

2014-01-01

Community colleges accommodate nearly half of all United States college students. Increased reliance upon community colleges is driven by the current economic downturn, rising costs of higher education, and changing expectations for today's workforce requiring advanced skill sets. Community colleges offer more affordable options for broader…

Ranking Institutional Settings Based on Publications in Community Psychology Journals

ERIC Educational Resources Information Center

Jason, Leonard A.; Pokorny, Steven B.; Patka, Mazna; Adams, Monica; Morello, Taylor

2007-01-01

Two primary outlets for community psychology research, the "American Journal of Community Psychology" and the "Journal of Community Psychology", were assessed to rank institutions based on publication frequency and scientific influence of publications over a 32-year period. Three specific periods were assessed (1973-1983, 1984-1994, 1995-2004).…

Promoting Physical Activity among Youth through Community-Based Prevention Marketing

ERIC Educational Resources Information Center

Bryant, Carol A.; Courtney, Anita H.; McDermott, Robert J.; Alfonso, Moya L.; Baldwin, Julie A.; Nickelson, Jen; Brown, Kelli R. McCormack; DeBate, Rita D.; Phillips, Leah M.; Thompson, Zachary; Zhu, Yiliang

2010-01-01

Background: Community-based prevention marketing (CBPM) is a program planning framework that blends community-organizing principles with a social marketing mind-set to design, implement, and evaluate public health interventions. A community coalition used CBPM to create a physical activity promotion program for tweens (youth 9-13 years of age)…

Building Partnerships: CBOs...CETA...Voc Ed. Research and Development Series No 209.

ERIC Educational Resources Information Center

Campbell-Thrane, Lucille; Jahnke, Jessica Jo

Based upon interviews in a number of community-based organizations in several states, this report describes community-based organizations from several perspectives. The report begins with a discussion of the origins of community-based organizations. This historical perspective sets the background for a discussion of the nature of community-based…

Achieving Community Membership through Community Rehabilitation Provider Services: Are We There Yet?

ERIC Educational Resources Information Center

Metzel, Deborah S.; Boeltzig, Heike; Butterworth, John; Sulewski, Jennifer Sullivan; Gilmore, Dana Scott

2007-01-01

Findings from an analysis of the characteristics and services of community rehabilitation providers (CRPs) in the early years of the 21st century are presented. Services provided by CRPs can be categorized along two dimensions: purpose (work, nonwork) and setting (facility-based, community). The number of individuals with disabilities present…

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

ERIC Educational Resources Information Center

Wilson, Walter C.; Thompson, Donald D.

1983-01-01

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

Body dysmorphic disorder in different settings: A systematic review and estimated weighted prevalence.

PubMed

Veale, David; Gledhill, Lucinda J; Christodoulou, Polyxeni; Hodsoll, John

2016-09-01

Our aim was to systematically review the prevalence of body dysmorphic disorder (BDD) in a variety of settings. Weighted prevalence estimate and 95% confidence intervals in each study were calculated. The weighted prevalence of BDD in adults in the community was estimated to be 1.9%; in adolescents 2.2%; in student populations 3.3%; in adult psychiatric inpatients 7.4%; in adolescent psychiatric inpatients 7.4%; in adult psychiatric outpatients 5.8%; in general cosmetic surgery 13.2%; in rhinoplasty surgery 20.1%; in orthognathic surgery 11.2%; in orthodontics/cosmetic dentistry settings 5.2%; in dermatology outpatients 11.3%; in cosmetic dermatology outpatients 9.2%; and in acne dermatology clinics 11.1%. Women outnumbered men in the majority of settings but not in cosmetic or dermatological settings. BDD is common in some psychiatric and cosmetic settings but is poorly identified. Copyright © 2016 Elsevier Ltd. All rights reserved.

SigReannot-mart: a query environment for expression microarray probe re-annotations.

PubMed

Moreews, François; Rauffet, Gaelle; Dehais, Patrice; Klopp, Christophe

2011-01-01

Expression microarrays are commonly used to study transcriptomes. Most of the arrays are now based on oligo-nucleotide probes. Probe design being a tedious task, it often takes place once at the beginning of the project. The oligo set is then used for several years. During this time period, the knowledge gathered by the community on the genome and the transcriptome increases and gets more precise. Therefore re-annotating the set is essential to supply the biologists with up-to-date annotations. SigReannot-mart is a query environment populated with regularly updated annotations for different oligo sets. It stores the results of the SigReannot pipeline that has mainly been used on farm and aquaculture species. It permits easy extraction in different formats using filters. It is used to compare probe sets on different criteria, to choose the set for a given experiment to mix probe sets in order to create a new one.

Structural Ecosystems Therapy for HIV+ African-American women and drug abuse relapse.

PubMed

Feaster, Daniel J; Burns, Myron J; Brincks, Ahnalee M; Prado, Guillermo; Mitrani, Victoria B; Mauer, Megaly H; Szapocznik, Jose

2010-06-01

This report examines the effect of Structural Ecosystems Therapy (SET) for (n=143) HIV+ African-American women on rate of relapse to substance use relative to both a person-centered approach (PCA) to therapy and a community control (CC) group. A prior report has shown SET to decrease psychological distress and family hassles relative to these 2 comparison groups. In new analyses, SET and CC had a significant protective effect against relapse as compared with PCA. There is evidence that SET's protective effect on relapse was related to reductions in family hassles, whereas there was not a direct impact of change in psychological distress on rates of relapse. Lower retention in PCA, perhaps caused by the lack of a directive component to PCA, may have put these women at greater risk for relapse. Whereas SET did not specifically address substance abuse, SET indirectly protected at-risk women from relapse through reductions in family hassles.

Finding and testing network communities by lumped Markov chains.

PubMed

Piccardi, Carlo

2011-01-01

Identifying communities (or clusters), namely groups of nodes with comparatively strong internal connectivity, is a fundamental task for deeply understanding the structure and function of a network. Yet, there is a lack of formal criteria for defining communities and for testing their significance. We propose a sharp definition that is based on a quality threshold. By means of a lumped Markov chain model of a random walker, a quality measure called "persistence probability" is associated to a cluster, which is then defined as an "α-community" if such a probability is not smaller than α. Consistently, a partition composed of α-communities is an "α-partition." These definitions turn out to be very effective for finding and testing communities. If a set of candidate partitions is available, setting the desired α-level allows one to immediately select the α-partition with the finest decomposition. Simultaneously, the persistence probabilities quantify the quality of each single community. Given its ability in individually assessing each single cluster, this approach can also disclose single well-defined communities even in networks that overall do not possess a definite clusterized structure.

Modeling evolution of spatially distributed bacterial communities: a simulation with the haploid evolutionary constructor

PubMed Central

2015-01-01

Background Multiscale approaches for integrating submodels of various levels of biological organization into a single model became the major tool of systems biology. In this paper, we have constructed and simulated a set of multiscale models of spatially distributed microbial communities and study an influence of unevenly distributed environmental factors on the genetic diversity and evolution of the community members. Results Haploid Evolutionary Constructor software http://evol-constructor.bionet.nsc.ru/ was expanded by adding the tool for the spatial modeling of a microbial community (1D, 2D and 3D versions). A set of the models of spatially distributed communities was built to demonstrate that the spatial distribution of cells affects both intensity of selection and evolution rate. Conclusion In spatially heterogeneous communities, the change in the direction of the environmental flow might be reflected in local irregular population dynamics, while the genetic structure of populations (frequencies of the alleles) remains stable. Furthermore, in spatially heterogeneous communities, the chemotaxis might dramatically affect the evolution of community members. PMID:25708911

MetaboTools: A comprehensive toolbox for analysis of genome-scale metabolic models

DOE PAGES

Aurich, Maike K.; Fleming, Ronan M. T.; Thiele, Ines

2016-08-03

Metabolomic data sets provide a direct read-out of cellular phenotypes and are increasingly generated to study biological questions. Previous work, by us and others, revealed the potential of analyzing extracellular metabolomic data in the context of the metabolic model using constraint-based modeling. With the MetaboTools, we make our methods available to the broader scientific community. The MetaboTools consist of a protocol, a toolbox, and tutorials of two use cases. The protocol describes, in a step-wise manner, the workflow of data integration, and computational analysis. The MetaboTools comprise the Matlab code required to complete the workflow described in the protocol. Tutorialsmore » explain the computational steps for integration of two different data sets and demonstrate a comprehensive set of methods for the computational analysis of metabolic models and stratification thereof into different phenotypes. The presented workflow supports integrative analysis of multiple omics data sets. Importantly, all analysis tools can be applied to metabolic models without performing the entire workflow. Taken together, the MetaboTools constitute a comprehensive guide to the intra-model analysis of extracellular metabolomic data from microbial, plant, or human cells. In conclusion, this computational modeling resource offers a broad set of computational analysis tools for a wide biomedical and non-biomedical research community.« less

Integrated Experiential Education: Definitions and a Conceptual Model

ERIC Educational Resources Information Center

Fenton, Lara; Gallant, Karen

2016-01-01

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

Student Affairs and Academic Affairs Collaborations in the Community College Setting

ERIC Educational Resources Information Center

Gulley, Needham Yancey; Mullendore, Richard H.

2014-01-01

The relationship between academic affairs and student affairs units in higher education settings has traditionally and historically been troubled by the divergent understandings of each other's institutional role and the systematic division of labor between the two. However, for a variety of reasons, not the least of which is a desire to…

The Little Brain That Could: Understanding Executive Function in Early Childhood

ERIC Educational Resources Information Center

Blasco, Patricia M.; Saxton, Sage; Gerrie, Mary

2014-01-01

Executive functions (EFs) involve a number of interconnected systems that, when compromised, can result in difficulties that affect a child's ability to perform tasks across early childhood settings, including the home and community-based settings. In retrospective research studies, researchers have found that a young child's…

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

ERIC Educational Resources Information Center

Hess, Steven Timothy Michael

2012-01-01

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

Getting through to Difficult Kids and Parents: Uncommon Sense for Child Professionals.

ERIC Educational Resources Information Center

Taffel, Ron

Intended to enhance the work of therapists, guidance counselors, teachers, clergy, pediatricians, and others who work with children and their parents, this book sets out a wise and practical framework for more effective interventions with challenging children and resistant parents in school, community, or health care settings. The book offers…

Provision of Auricular Acupuncture and Acupressure in a University Setting

ERIC Educational Resources Information Center

Oyola-Santiago, Tamara; Knopf, Rachel; Robin, Tracy; Harvey, Kristen

2013-01-01

Auricular acupuncture using the National Acupuncture Detoxification Association (NADA) protocol stimulates 5 points in each ear--the Shen Men, sympathetic nervous system, liver, kidney, and lung. This protocol is also known as Acu Detox, and has been used for recovery in community-based settings and drug use treatment programs. It has also been…

Extending Participation in Standard Setting: An Online Judging Proposal

ERIC Educational Resources Information Center

MacCann, Robert G.; Stanley, Gordon

2010-01-01

In order for standard setting to retain public confidence, it will be argued there are two important requirements. One is that the judges' allocation of students to performance bands would yield results broadly consistent with the expectation of the wider educational community. Secondly, in the absence of any change in educational performance,…

Transition of Youth and Young Adults with Emotional or Behavioral Difficulties: An Evidence-Supported Handbook

ERIC Educational Resources Information Center

Clark, Hewitt B., Ed.; Unruh, Deanne K., Ed.

2009-01-01

This comprehensive professional handbook will help transition specialists, general and special educators, school psychologists, and administrators support youth and young adults in setting goals and achieving positive outcomes across employment, education, and community settings. Through up-to-date research and in-depth analyses of five successful…

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

ERIC Educational Resources Information Center

Kanyengo, Brendah Kakulwa; Kanyengo, Christine Wamunyima

2011-01-01

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

Boundary Crossings: Using Participatory Theatre as a Site for Deepening Learning

ERIC Educational Resources Information Center

Kumrai, Rajni Rani; Chauhan, Vipin; Hoy, Jane

2011-01-01

Amongst the academic community there has been an increasing acceptance that knowledge and learning is no longer situated solely within academic settings and that workplace settings are also legitimate spaces for reflecting on practice in order to enhance professional capabilities. Learners are uniquely placed to draw on their workplace experiences…

Knowing One's Community through Language Rights

ERIC Educational Resources Information Center

Chiasson, Maurice

2016-01-01

French-language schools in minority settings are set apart from other schools by their twofold mission: the educational success of students and the building of their Francophone identity. As a result, there are few French-language school boards or schools that do not underline the importance of the French-language culture in their mission. The…

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

ERIC Educational Resources Information Center

Sindberg, Laura K.

2014-01-01

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

The Rewards of Teaching Music in Urban Settings

ERIC Educational Resources Information Center

Bernard, Rhoda

2010-01-01

A great deal has been written about the challenges facing music educators who work in urban settings. The scarcity of instruments, textbooks, and other resources; a lack of parental and administrative support; and difficulties with classroom management are just a few of the issues that confront music teachers who work in urban communities.…

Rural Compared to Urban Home Community Settings as Predictors of First-Year Students' Adjustment to University

ERIC Educational Resources Information Center

Ames, Megan E.; Wintre, Maxine G.; Prancer, S. Mark; Pratt, Michael W.; Birnie-Lefcovitch, Shelly; Polivy, Janet; Adams, Gerald R.

2014-01-01

Undergraduates (N = 2,823) at 6 universities were surveyed longitudinally to examine the relevance of student home setting on the transition to university. Preliminary results indicated that rural students seem less likely to attend large, ethnically diverse universities. Hierarchical linear models revealed that "proximal rural" students…

Implementing and Preparing for Home Visits

ERIC Educational Resources Information Center

McWilliam, R. A.

2012-01-01

The most common setting for early intervention services for infants and toddlers with disabilities and their families is the home. This article discusses home- and community-based early intervention and how the routines-based interview (RBI) can set the stage for successful home visits. It also addresses what has been learned about home visiting,…

Evaluating the Effectiveness of the Family Employment Awareness Training in Kansas: A Pilot Study

ERIC Educational Resources Information Center

Francis, Grace; Gross, Judith M. S.; Turnbull, Rud; Parent-Johnson, Wendy

2013-01-01

Working in competitive employment (employment in community settings with nondisabled peers for minimum wage or higher) has many positive benefits for people with disabilities who have individualized support needs (Johannesen, McGrew, Griss, & Born, 2007). Nonetheless, many of these individuals work in segregated settings or are unemployed…

Creative Living: Inside a Community for Children with Autism

ERIC Educational Resources Information Center

Schapiro, Judith

2009-01-01

Children with autism spectrum disorders face a complex set of challenges when they enter the school system. Inspired by the work of D.W. Winnicott and Carl Rogers, the author suggests that facilitative educational settings for these children are those that stimulate creativity, honor a child's strengths, trust the developmental process, and…

Bringing Nature into Social Work Settings: Mother Earth's Presence

ERIC Educational Resources Information Center

Gana, Carolina

2011-01-01

In an urban location in the downtown core of Toronto, Ontario, the author provides both individual and group counselling to women impacted by trauma in a community-based setting. Various modalities and theoretical frameworks that include feminism and anti-oppressive methods inform her counselling practice. The approach that the author takes in the…

The Differential Effects of Forms and Settings of Exposure to Violence on Adolescents' Adjustment

ERIC Educational Resources Information Center

Ho, Man Yee; Cheung, Fanny M.

2010-01-01

This study investigated the link between exposure to violence and psychosocial adjustment for 442 Chinese secondary school students in Form 1-3. The students completed an inventory assessing exposure to violence through witnessing and through direct victimization in different settings (community, school, and home). Multiple measures and informants…

The Education of Juveniles in Detention: Policy Considerations and Infrastructure Development

ERIC Educational Resources Information Center

Geib, Catherine Foley; Chapman, John F.; D'Amaddio, Amy H.; Grigorenko, Elena L.

2011-01-01

This article presents a discussion of the state of affairs pertaining to educating juvenile justice-involved youth. It summarizes general observations regarding the schooling of juveniles in pre-trial and post-trial incarceration settings, as well as, juveniles on probation or in community settings. The article selectively presents relevant…

Workplace Violence in Early Childhood Settings: A Counter Narrative.

ERIC Educational Resources Information Center

Sumsion, Jennifer

Noting that portrayals of early childhood settings as communities of care distinguish them from other education contexts, this paper presents a counter-narrative that focuses on workplace tensions experienced by an Australian preschool teacher. The counter-narrative was informed by informal interviews held 4 times yearly over a period of 7 years…

Sources of Variation in Consequences of Everyday Activity Settings on Child and Parent Functioning

ERIC Educational Resources Information Center

Trivette, Carol; Dunst, Carl; Hamby, Deborah

2004-01-01

Relationships between acculturation and enculturation, parent beliefs about child learning methods and parenting roles in children's learning, children's participation in family and community activity settings, and a variety of child, parent and family outcomes were examined in a sample of 203 parents. Information received from these parents…

Student Self-Determination: A Preliminary Investigation of the Role of Participation in Inclusive Settings

ERIC Educational Resources Information Center

Hughes, Carolyn; Cosgriff, Joseph C.; Agran, Martin; Washington, Barbara H.

2013-01-01

Little is known about the effects of participation in inclusive settings on student self-determination. In this exploratory study, we examined the association between students' inclusive school and community activities and the self-determination skills of active involvement in IEP activities and use of selected self-determination strategies.…

Median Middle School: Striving to Rise above Average

ERIC Educational Resources Information Center

Moon, Jodi Saxton

2016-01-01

This case was developed for use with future school leaders in an educational setting. There are several topics of discussion that can be developed, including but not limited to policy implementation, the efficacy of professional learning communities, and improving student learning outcomes. The setting is a solidly performing middle school in the…

Child Care Centers in Park Settings.

ERIC Educational Resources Information Center

Giegerich & Associates, Inc., Rockville, MD.

One of three studies of child care which addressed a variety of planning and site planning issues of concern to the Montgomery County Planning Board in Silver Spring, Maryland, this study reports findings related to the location of child care facilities in park settings. Principal purposes of the study were to: (1) analyze the community impact of…

Developing a social enterprise through right to request.

PubMed

Parker, Nicola

2010-10-01

The 'right to request' the authority to run healthcare services was introduced by the previous government so that staff can respond to the needs of local communities by setting up social enterprises. This article explains how the right to request works in practice by describing how a social enterprise was set up in Bromley, Kent.

Restorative Practices in the Collegiate Student Conduct Process: A Qualitative Analysis of Student Conduct Administrators' Perspectives

ERIC Educational Resources Information Center

Mikus, Robert L.

2014-01-01

Restorative justice philosophy and practices have been utilized in a variety of settings. Legislative reform prompted their application in the criminal and juvenile justice systems. They have also been utilized in employment, education, civic, human services and community settings. While their integration in elementary, intermediate and secondary…

Interventions to prevent skin cancer by reducing exposure to ultraviolet radiation: a systematic review.

PubMed

Saraiya, Mona; Glanz, Karen; Briss, Peter A; Nichols, Phyllis; White, Cornelia; Das, Debjani; Smith, S Jay; Tannor, Bernice; Hutchinson, Angela B; Wilson, Katherine M; Gandhi, Nisha; Lee, Nancy C; Rimer, Barbara; Coates, Ralph C; Kerner, Jon F; Hiatt, Robert A; Buffler, Patricia; Rochester, Phyllis

2004-12-01

The relationship between skin cancer and ultraviolet radiation is well established. Behaviors such as seeking shade, avoiding sun exposure during peak hours of radiation, wearing protective clothing, or some combination of these behaviors can provide protection. Sunscreen use alone is not considered an adequate protection against ultraviolet radiation. This report presents the results of systematic reviews of effectiveness, applicability, other harms or benefits, economic evaluations, and barriers to use of selected interventions to prevent skin cancer by reducing exposure to ultraviolet radiation. The Task Force on Community Preventive Services found that education and policy approaches to increasing sun-protective behaviors were effective when implemented in primary schools and in recreational or tourism settings, but found insufficient evidence to determine effectiveness when implemented in other settings, such as child care centers, secondary schools and colleges, and occupational settings. They also found insufficient evidence to determine the effectiveness of interventions oriented to healthcare settings and providers, media campaigns alone, interventions oriented to parents or caregivers of children, and community-wide multicomponent interventions. The report also provides suggestions for areas for future research.

Assessing Community Quality of Health Care.

PubMed

Herrin, Jeph; Kenward, Kevin; Joshi, Maulik S; Audet, Anne-Marie J; Hines, Stephen J

2016-02-01

To determine the agreement of measures of care in different settings-hospitals, nursing homes (NHs), and home health agencies (HHAs)-and identify communities with high-quality care in all settings. Publicly available quality measures for hospitals, NHs, and HHAs, linked to hospital service areas (HSAs). We constructed composite quality measures for hospitals, HHAs, and nursing homes. We used these measures to identify HSAs with exceptionally high- or low-quality of care across all settings, or only high hospital quality, and compared these with respect to sociodemographic and health system factors. We identified three dimensions of hospital quality, four HHA dimensions, and two NH dimensions; these were poorly correlated across the three care settings. HSAs that ranked high on all dimensions had more general practitioners per capita, and fewer specialists per capita, than HSAs that ranked highly on only the hospital measures. Higher quality hospital, HHA, and NH care are not correlated at the regional level; regions where all dimensions of care are high differ systematically from regions which score well on only hospital measures and from those which score well on none. © Health Research and Educational Trust.

Integrating children with psychiatric disorders in the classroom: a systematic review.

PubMed

Cossu, Giulia; Cantone, Elisa; Pintus, Mirra; Cadoni, Michela; Pisano, Anna; Otten, Roy; Kuijpers, Rowella; Pintus, Elisa; Sancassiani, Federica; Moro, Maria Francesca; Holzinger, Anita; Mereu, Alessandra; Preti, Antonio; Carta, Mauro Giovanni

2015-01-01

The school setting may be the optimal context for early screening of and intervention on child mental health problems, because of its large reach and intertwinement with various participants (child, teacher, parent, other community services). But this setting also exposes children to the risk of stigma, peer rejection and social exclusion. This systematic literature review investigates the efficacy of mental health interventions addressed to children and adolescents in school settings, and it evaluates which programs explicitly take into account social inclusion indicators. Only randomized controlled trials conducted on clinical populations of students and carried out in school settings were selected: 27 studies overall. Most studies applied group Cognitive Behavioural Therapy or Interpersonal Psychotherapy. Findings were suggestive of the effectiveness of school-based intervention programs in reducing symptoms of most mental disorders. Some evidence was found about the idea that effective studies on clinical populations may promote the social inclusion of children with an ongoing mental disorder and avoid the risk of being highly stigmatized. School programs are still needed that implement standardized models with verifiable and evidence-based practices involving the whole school community.

Quantifying Transmission of Clostridium difficile within and outside Healthcare Settings

PubMed Central

Olsen, Margaret A.; Dubberke, Erik R.; Galvani, Alison P.; Townsend, Jeffrey P.

2016-01-01

To quantify the effect of hospital and community-based transmission and control measures on Clostridium difficile infection (CDI), we constructed a transmission model within and between hospital, community, and long-term care-facility settings. By parameterizing the model from national databases and calibrating it to C. difficile prevalence and CDI incidence, we found that hospitalized patients with CDI transmit C. difficile at a rate 15 (95% CI 7.2–32) times that of asymptomatic patients. Long-term care facility residents transmit at a rate of 27% (95% CI 13%–51%) that of hospitalized patients, and persons in the community at a rate of 0.1% (95% CI 0.062%–0.2%) that of hospitalized patients. Despite lower transmission rates for asymptomatic carriers and community sources, these transmission routes have a substantial effect on hospital-onset CDI because of the larger reservoir of hospitalized carriers and persons in the community. Asymptomatic carriers and community sources should be accounted for when designing and evaluating control interventions. PMID:26982504