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.

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.

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…

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…

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…

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…

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.

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.

School and Community, Community and School: A Case Study of a Rural Missouri Setting

ERIC Educational Resources Information Center

Franklin, Melia K.

2011-01-01

How do a school and a community interact? This question guided this dissertation examining one rural school and community. The purpose of this case study was to investigate the relationship between the rural Marceline R-V School District (a K-12 school system) and its community, Marceline, Missouri. The framework for this study included the…

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.

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…

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

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.

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…

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…

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

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.

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.

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.

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

PubMed Central

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

2014-01-01

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

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

PubMed

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

2014-07-01

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

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

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.

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…

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…

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,…

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.

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

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.

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.

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…

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…

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.

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.

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

ERIC Educational Resources Information Center

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

2014-01-01

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

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.

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.

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.

Cardiovascular risk assessment of South Asian populations in religious and community settings: a qualitative study.

PubMed

Eastwood, Sophie V; Rait, Greta; Bhattacharyya, Mimi; Nair, Devaki R; Walters, Kate

2013-08-01

Cardiovascular disease (CVD) is a leading cause of mortality, and South Asian groups experience worse outcomes than the general population in the UK. Regular screening for CVD risk factors is recommended, but we do not know the best settings in which to deliver this for ethnically diverse populations. Health promotion in religious and community settings may reduce inequalities in access to cardiovascular preventative health care. To use stakeholders' and attendees' experiences to explore the feasibility and potential impact of cardiovascular risk assessment targeting South Asian groups at religious and community venues and how health checks in these settings might compare with general practice assessments. Qualitative semi-structured interviews were used. The settings were two Hindu temples, one mosque and one Bangladeshi community centre in central and north-west London. Twenty-four participants (12 stakeholders and 12 attendees) were purposively selected for interview. Interviews were recorded and transcribed verbatim. Themes from the data were generated using thematic framework analysis. All attendees reported positive experiences of the assessments. All reported making lifestyle changes after the check, particularly to diet and exercise. Barriers to lifestyle change, e.g. resistance to change from family members, were identified. Advantages of implementing assessments in religious and community settings compared with general practice included accessibility and community encouragement. Disadvantages included reduced privacy, organizational difficulties and lack of follow-up care. Cardiovascular risk assessment in religious and community settings has the potential to trigger lifestyle change in younger participants. These venues should be considered for future health promotional activities.

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.

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.

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.

What Factors Are Important in Smoking Cessation Amongst Deprived Communities?: A Qualitative Study

ERIC Educational Resources Information Center

Henderson, Hazel J.; Memon, Anjum; Lawson, Kate; Jacobs, Barbara; Koutsogeorgou, Eleni

2011-01-01

Objective: There is limited evidence regarding effective smoking cessation interventions in deprived communities. This study explored what factors are considered most important in smoking cessation, from the perspective of a group of NHS Stop Smoking Service users from a deprived community. Design: A qualitative study. Setting: A deprived…

Improving School Practices Through Public Communication.

ERIC Educational Resources Information Center

Gleason, Thomas P.; Rankine, Fred C.

The principal objectives of this study were to assist school personnel and community members in the Botwood School zone to assess perceived problems, and to study and clarify communication networks existing between school and community. Two isolated, semirural, coastal communities in central Newfoundland, Canada, provided the experimental 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…

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

PubMed Central

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

2018-01-01

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

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

PubMed

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

2018-01-01

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

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.

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.

Using Geospatial Research Methods to Examine Resource Accessibility and Availability as it Relates to Community Participation of Individuals with Serious Mental Illnesses.

PubMed

Townley, Greg; Brusilovskiy, Eugene; Snethen, Gretchen; Salzer, Mark S

2018-03-01

Greater community participation among individuals with serious mental illnesses is associated with better psychosocial and health outcomes. Typically, studies examining community participation have utilized self-report measures and been conducted in limited settings. The introduction of methodological advances to examining community participation of individuals with serious mental illnesses has the potential to advance the science of community mental health research and invigorate the work of community psychologists in this area. This study employed an innovative geospatial approach to examine the relationship between community participation and resource accessibility (i.e., proximity) and availability (i.e., concentration) among 294 individuals utilizing community mental health services throughout the United States. Findings suggest small but significant associations between community participation and the accessibility and availability of resources needed for participation. Furthermore, findings demonstrate the importance of car access for individuals residing in both urban and non-urban settings. The methods and results presented in this study have implications for community mental health research and services and provide an illustration of ways that geospatial methodologies can be used to investigate environmental factors that impact community inclusion and participation of individuals with serious mental illnesses. © Society for Community Research and Action 2017.

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…

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

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.

NASA Ocean Altimeter Pathfinder Project. Report 2; Data Set Validation

NASA Technical Reports Server (NTRS)

Koblinsky, C. J.; Ray, Richard D.; Beckley, Brian D.; Bremmer, Anita; Tsaoussi, Lucia S.; Wang, Yan-Ming

1999-01-01

The NOAA/NASA Pathfinder program was created by the Earth Observing System (EOS) Program Office to determine how existing satellite-based data sets can be processed and used to study global change. The data sets are designed to be long time-series 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. Details are currently presented in two technical reports: Report# 1: Data Processing Handbook Report #2: Data Set Validation This report describes the validation of the data sets against a global network of high quality tide gauge measurements and provides an estimate of the error budget. The first report describes the processing schemes used to produce the geodetic consistent data set comprised of SEASAT, GEOSAT, ERS-1, TOPEX/ POSEIDON, and ERS-2 satellite observations.

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…

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…

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…

Securing the Future: Retention Models in Community Colleges--Study of Community College Structures for Student Success (SCCSSS)

ERIC Educational Resources Information Center

College Board Advocacy & Policy Center, 2012

2012-01-01

The Study of Community College Structures for Student Success (SCCSSS) was launched in 2010 with three goals at its center: (1) To explore a set of promising institutional practices and organizational structures identified through theory and research as having the potential to support community college student success; (2) To present a synthesized…

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.

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

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.

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.

Exploring provision of Innovative Community Education Placements (ICEPs) for junior doctors in training: a qualitative study.

PubMed

Griffin, Ann; Jones, Melvyn M; Khan, Nada; Park, Sophie; Rosenthal, Joe; Chrysikou, Vasiliki

2016-02-09

Medical education in community settings is an essential ingredient of doctors' training and a key factor in recruiting general practitioners (GP). Health Education England's report 'Broadening the Foundation' recommends foundation doctors complete 4-month community placements. While Foundation GP schemes exist; other community settings, are not yet used for postgraduate training. The objective of this study was to explore how community-based training of junior doctors might be expanded into possible 'innovative community education placements' (ICEPs), examining opportunities and barriers to these developments. A qualitative study where semistructured interviews were undertaken and themes were generated deductively from the research questions, and iteratively from transcripts. UK community healthcare. Stakeholders from UK Community healthcare providers and undergraduate GP and community educators. Nine participants were interviewed; those experienced in delivering community-based undergraduate education, and others working in community settings that had not previously trained doctors. Themes identified were practicalities such as 'finance and governance', 'communication and interaction', 'delivery of training' and 'perceptions of community'. ICEPs were willing to train Foundation doctors. However, concerns were raised that large numbers and inadequate resources could undermine the quality of educational opportunities, and even cause reputational damage. Organisation was seen as a challenge, which might be best met by placing some responsibility with trainees to manage their placements. ICEP providers agreed that defined service contribution by trainees was required to make placements sustainable, and enhance learning. ICEPs stated the need for positive articulation of the learning value of placements to learners and stakeholders. This study highlighted the opportunities for foundation doctors to gain specialist and generalist knowledge in ICEPs from diverse clinical teams and patients. We recommend in conclusion ways of dealing with some of the perceived barriers to training. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Variability of community interaction networks in marine reserves and adjacent exploited areas

USGS Publications Warehouse

Montano-Moctezuma, G.; Li, H.W.; Rossignol, P.A.

2008-01-01

Regional and small-scale local oceanographic conditions can lead to high variability in community structure even among similar habitats. Communities with identical species composition can depict distinct networks due to different levels of disturbance as well as physical and biological processes. In this study we reconstruct community networks in four different areas off the Oregon Coast by matching simulated communities with observed dynamics. We compared reserves with harvested areas. Simulations suggested that different community networks, but with the same species composition, can represent each study site. Differences were found in predator-prey interactions as well as non-predatory interactions between community members. In addition, each site can be represented as a set of models, creating alternative stages among sites. The set of alternative models that characterize each study area depicts a sequence of functional responses where each specific model or interaction structure creates different species composition patterns. Different management practices, either in the past or of the present, may lead to alternative communities. Our findings suggest that management strategies should be analyzed at a community level that considers the possible consequences of shifting from one community scenario to another. This analysis provides a novel conceptual framework to assess the consequences of different management options for ecological communities. ?? 2008 Elsevier B.V. All rights reserved.

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

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.

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…

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…

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…

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.

Exploring the Disjunctures between Theory and Practice in Community College Visual Arts Programs

ERIC Educational Resources Information Center

Holland, Arnold

2012-01-01

This study explored the perceptions of ten community college visual arts faculty in five different community college settings with regard to the theory and practice disjunctures they were experiencing in their roles as instructors teaching foundational level courses within visual arts programs. The study illuminated the responses of community…

Gender and Transportation Access among Community-Dwelling Seniors

ERIC Educational Resources Information Center

Dupuis, Josette; Weiss, Deborah R.; Wolfson, Christina

2007-01-01

Purpose: This study estimates the prevalence of problems with transportation in a sample of community-dwelling seniors residing in an urban setting and investigates the role that gender plays in the ability of seniors to remain mobile in their communities. Design and Methods: Data collected as part of a study assessing the prevalence and…

Community Engaged Service-Learning: The Effect on University Students and Community Partners

ERIC Educational Resources Information Center

Steele, Susan C.

2012-01-01

The notion that an ethic of service can be fostered through participation in an academic community engaged service-learning program was the underlying premise for this program evaluation study. The purpose of this program evaluation study, using both quantitative and qualitative measures in a thoughtfully organized setting of university and…

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.

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.

A systematic review on US-based community health navigator (CHN) interventions for cancer screening promotion--comparing community- versus clinic-based navigator models.

PubMed

Hou, Su-I; Roberson, Kiersten

2015-03-01

This study synthesized lessons learned from US-based community and clinic health navigator (CHN) interventions on cancer screening promotion to identify characteristics of models and approaches for addressing cancer disparities. The combination terms "cancer screening" and "community health workers or navigators" or "patient navigators" were used in searching Medline, CINAHL, and PsycInfo. A total of 27 articles published during January 2005∼April 2014 were included. Two CHN models were identified: community-based (15 studies) and clinic/hospital-based (12 studies). While both models used the term "navigators," most community-based programs referred them as community health workers/navigators/advisors, whereas clinic-based programs often called them patient navigators. Most community-based CHN interventions targeted specific racial/ethnic minority or rural groups, while clinic-based programs mostly targeted urban low income or mixed ethnic groups. Most community-based CHN programs outreached members from community networks, while clinic-based programs commonly worked with pre-identified in-service clients. Overall, regardless model type, CHNs had similar roles and responsibilities, and interventions demonstrated effective outcomes. Our review identified characteristics of CHN interventions with attention to different settings. Lessons learned have implication on the dissemination and implementation of CHN interventions for cancer screening promotion across setting and target groups.

Sense of Belonging among Adult Community College Women: An Exploratory Study in Southeastern North Carolina

ERIC Educational Resources Information Center

Gilmore, W. Tamikka

2017-01-01

This mixed method study offered an examination of the construct of sense of belonging among adult, community college women in the community college setting and its role on student success. Using academic data from women who met the criteria for the study at the conclusion of Fall 2016, results showed that neither group of women…

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.

Religious networking organizations and social justice: an ethnographic case study.

PubMed

Todd, Nathan R

2012-09-01

The current study provides an innovative examination of how and why religious networking organizations work for social justice in their local community. Similar to a coalition or community coordinating council, religious networking organizations are formal organizations comprised of individuals from multiple religious congregations who consistently meet to organize around a common goal. Based on over a year and a half of ethnographic participation in two separate religious networking organizations focused on community betterment and social justice, this study reports on the purpose and structure of these organizations, how each used networking to create social capital, and how religion was integrated into the organizations' social justice work. Findings contribute to the growing literature on social capital, empowering community settings, and the unique role of religious settings in promoting social justice. Implications for future research and practice also are discussed.

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.

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

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…

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…

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,…

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.

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

ERIC Educational Resources Information Center

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

2012-01-01

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

Treatment of Individuals with Borderline Personality Disorder Using Dialectical Behavior Therapy in a Community Mental Health Setting: Clinical Application and a Preliminary Investigation

ERIC Educational Resources Information Center

Ben-Porath, Denise D.; Peterson, Gregory A.; Smee, Jacqueline

2004-01-01

This article describes an effort to implement and examine dialectical behavior therapy's (DBT) effectiveness in a community mental health setting. Modifications made to address unique aspects of community mental health settings are described. Barriers encountered in implementation of DBT treatment in community mental health settings, such as staff…

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.

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

Contextual variations in costs for a community health strategy implemented in rural, peri-urban and nomadic sites in Kenya.

PubMed

Wafula, Charles Ouma; Edwards, Nancy; Kaseje, Dan C O

2017-02-28

Many low and middle income countries have developed community health strategies involving lay health workers, to complement and strengthen public health services. This study explores variations in costing parameters pertinent to deployment of community health volunteers across different contexts outlining considerations for costing program scale-up. The study used quasi experimental study design and employed both quantitative and qualitative methods to explore community health unit implementation activities and costs and compare costs across purposively selected sites that differed socially, economically and ecologically. Data were collected from November 2010 to December 2013 through key informant interviews and focus group discussions. We interviewed 16 key informants (eight District community health strategy focal persons, eight frontline field officers), and eight focus group discussions (four with community health volunteers and four with community health committee) and 560 sets of monthly cost data. Cost data were tabulated using Microsoft Excel. Qualitative data were transcribed and coded using a content analysis framework. Four critical elements: attrition rates for community health volunteers, geography and population density, livelihood opportunity costs and benefits, and social opportunity benefits, drove cost variations across the three sites. Attrition rate was highest in peri-urban site where population is highly mobile and lowest in nomadic site. More households were covered by community health workers in the peri-urban area making per capita costs considerably less than in the nomadic settings where long distances had to be covered to reach sparsely distributed households. Livelihood opportunity costs for Community Health Volunteers were highest in nomadic setting, while peri-urban ones reported substantial employability benefits resulting from training. Social opportunity benefits were highest in rural site. Results show that costs of implementing community health strategy varied due to different area contextual factors in Kenya. This study identified four critical elements that drive cost variations: attrition rates for community health volunteers, geography and population density, livelihood opportunity costs and benefits, and social opportunity benefits. Health programme managers and policy-makers need to pay attention to details of contextual factors in costing for effective implementation of community health strategies.

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2016-01-01

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

Two-Year Community: Tools for Success--A Study of the Resources and Study Habits of General Chemistry I Students at Two Community Colleges

ERIC Educational Resources Information Center

Bruck, Laura B.; Bruck, Aaron D.

2018-01-01

Recruitment and retention in the sciences is both difficult and crucial, especially in the community college setting. In this study, the resources used by General Chemistry I students at two different public, predominantly two-year colleges in two states were studied via surveys for a semester. Data were analyzed with respect to student attitudes…

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.

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.

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.

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

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.

The Study of Collective Actions in a University Anchored Community Wireless Network

ERIC Educational Resources Information Center

Kuchibhotla, Hari N.

2012-01-01

The emergence of wireless devices and the ease in setting up wireless devices has created opportunities for various entities, and in particular to universities, by partnering with their local communities in the form of a university anchored community wireless network. This provides opportunities for students to be part of the community-based…

Pipelines to Leadership: Aspirations of Faculty in the Community College, Kentucky Community and Technical College System

ERIC Educational Resources Information Center

Tipton, Erin Courtney

2016-01-01

Community colleges are challenged to find their next set of leaders who can respond to the diverse challenges of leading the institution. This study examined the impact of institutional and personal factors on faculty aspirations to leadership roles within the community college through the utilization of the Social Cognitive Career Theory…

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.

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.

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…

Training Community Mental Health Therapists to Deliver a Package of Evidence-Based Practice Strategies for School-Age Children with Autism Spectrum Disorders: A Pilot Study

ERIC Educational Resources Information Center

Brookman-Frazee, Lauren I.; Drahota, Amy; Stadnick, Nicole

2012-01-01

Research on moving evidence-based practice (EBP) intervention strategies to community service settings for children with autism spectrum disorders (ASD) is urgently needed. The current pilot study addresses this need by examining the feasibility, acceptability and preliminary outcomes of training therapists practicing in community mental health…

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.

"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.

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.

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.

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.

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.

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.

Use of technology for note taking and therapeutic alliance.

PubMed

Wiarda, Nicholas R; McMinn, Mark R; Peterson, Mary A; Gregor, Joel A

2014-09-01

Is psychotherapeutic alliance helped or harmed by using an iPad or computer during an intake session? Two studies are reported where psychotherapists use one of three different technologies in semistructured initial interviews: paper and pen, iPad, or a computer. The studies were conducted at a Primary Care Clinic and a Community Mental Health Clinic to provide a broader context to account for recent behavioral health integration into medical settings in addition to a traditional psychotherapy setting. The Primary Care Study consisted of 60 participants from a behavioral health service at a primary care clinic. The Community Mental Health Study involved 55 participants from a community mental health clinic in semirural Oregon. No differences were found for the three technologies in either study. Practice and training implications are offered. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Flexible Bilingualism through Multimodal Practices: Studying K-12 Community Languages Online

ERIC Educational Resources Information Center

Nordstrom, Janica

2015-01-01

Community language schools are complementary schools set up and run by minority communities in Australia. They aim to assist in intergenerational language and identity transmission, but previous research has indicated that these schools position their students in monolingual ways that contradicts how bilingual speakers use their language in…

Ready, Set, Succeed! Growth Mindset Instruction in a Community College Success Class

ERIC Educational Resources Information Center

Brysacz, Lynn M.

2017-01-01

The purpose of this action research study was to explore the relationship between growth mindset instruction in a community college success class with student academic effort and achievement, among students enrolled in a developmental reading class. Community college students, especially those testing into developmental classes, face numerous…

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.

A Novel Method to Evaluate the Community Built Environment Using Photographs – Environmental Profile of a Community Health (EPOCH) Photo Neighbourhood Evaluation Tool

PubMed Central

Chow, Clara K.; Corsi, Daniel J.; Lock, Karen; Madhavan, Manisha; Mackie, Pam; Li, Wei; Yi, Sun; Wang, Yang; Swaminathan, Sumathi; Lopez-Jaramillo, Patricio; Gomez-Arbelaez, Diego; Avezum, Álvaro; Lear, Scott A.; Dagenais, Gilles; Teo, Koon; McKee, Martin; Yusuf, Salim

2014-01-01

Background Previous research has shown that environments with features that encourage walking are associated with increased physical activity. Existing methods to assess the built environment using geographical information systems (GIS) data, direct audit or large surveys of the residents face constraints, such as data availability and comparability, when used to study communities in countries in diverse parts of the world. The aim of this study was to develop a method to evaluate features of the built environment of communities using a standard set of photos. In this report we describe the method of photo collection, photo analysis instrument development and inter-rater reliability of the instrument. Methods/Principal Findings A minimum of 5 photos were taken per community in 86 communities in 5 countries according to a standard set of instructions from a designated central point of each community by researchers at each site. A standard pro forma derived from reviewing existing instruments to assess the built environment was developed and used to score the characteristics of each community. Photo sets from each community were assessed independently by three observers in the central research office according to the pro forma and the inter-rater reliability was compared by intra-class correlation (ICC). Overall 87% (53 of 60) items had an ICC of ≥0.70, 7% (4 of 60) had an ICC between 0.60 and 0.70 and 5% (3 of 60) items had an ICC ≤0.50. Conclusions/Significance Analysis of photos using a standardized protocol as described in this study offers a means to obtain reliable and reproducible information on the built environment in communities in very diverse locations around the world. The collection of the photographic data required minimal training and the analysis demonstrated high reliability for the majority of items of interest. PMID:25369366

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.

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…

Systematic review: handwashing behaviour in low- to middle-income countries: outcome measures and behaviour maintenance.

PubMed

Vindigni, Stephen M; Riley, Patricia L; Jhung, Michael

2011-04-01

To describe global approaches to handwashing research in low- and middle-income communities, schools and health care settings using behavioural outcome measurement and temporal study design. Peer-reviewed and grey literature was screened for handwashing studies that evaluated behaviour change. Relevant articles were assessed by their research approach, including the investigator's selected outcome measure and time frame of various study components (e.g., formative research, intervention and evaluation). The initial search yielded 527 relevant articles. After application of exclusion criteria, we identified 27 unique studies (30 total articles). Of the 27 articles, most were focused in the community setting. Fifteen (56%) documented observed handwashing behaviour, while 18 (67%) used proxy measures (e.g., soap presence, diarrhoea) and 14 (52%) used self-reported behaviour. Several studies used multiple outcome measures. While all studies had an evaluation of behaviour change, there was a dearth of studies that evaluated long-term maintenance of behaviour change after the intervention's conclusion. While the literature is replete with a variety of handwashing studies in community, school and health care settings, none have been able to definitively document long-term behaviour change, thereby challenging the sustainability of various interventions. Additionally, there is a need to better understand which research approach is most effective in promoting long-term behaviour compliance in global low- and middle-income settings. © 2011 Blackwell Publishing Ltd.

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.

Community pharmacy-delivered interventions for public health priorities: a systematic review of interventions for alcohol reduction, smoking cessation and weight management, including meta-analysis for smoking cessation

PubMed Central

Brown, Tamara J; Todd, Adam; O'Malley, Claire; Moore, Helen J; Husband, Andrew K; Bambra, Clare; Kasim, Adetayo; Sniehotta, Falko F; Steed, Liz; Smith, Sarah; Nield, Lucie; Summerbell, Carolyn D

2016-01-01

Objectives To systematically review the effectiveness of community pharmacy-delivered interventions for alcohol reduction, smoking cessation and weight management. Design Systematic review and meta-analyses. 10 electronic databases were searched from inception to May 2014. Eligibility criteria for selecting studies Study design: randomised and non-randomised controlled trials; controlled before/after studies, interrupted times series. Intervention: any relevant intervention set in a community pharmacy, delivered by the pharmacy team. No restrictions on duration, country, age, or language. Results 19 studies were included: 2 alcohol reduction, 12 smoking cessation and 5 weight management. Study quality rating: 6 ‘strong’, 4 ‘moderate’ and 9 ‘weak’. 8 studies were conducted in the UK, 4 in the USA, 2 in Australia, 1 each in 5 other countries. Evidence from 2 alcohol-reduction interventions was limited. Behavioural support and/or nicotine replacement therapy are effective and cost-effective for smoking cessation: pooled OR was 2.56 (95% CI 1.45 to 4.53) for active intervention vs usual care. Pharmacy-based interventions produced similar weight loss compared with active interventions in other primary care settings; however, weight loss was not sustained longer term in a range of primary care and commercial settings compared with control. Pharmacy-based weight management interventions have similar provider costs to those delivered in other primary care settings, which are greater than those delivered by commercial organisations. Very few studies explored if and how sociodemographic or socioeconomic variables moderated intervention effects. Insufficient information was available to examine relationships between effectiveness and behaviour change strategies, implementation factors, or organisation and delivery of interventions. Conclusions Community pharmacy-delivered interventions are effective for smoking cessation, and demonstrate that the pharmacy is a feasible option for weight management interventions. Given the potential reach, effectiveness and associated costs of these interventions, commissioners should consider using community pharmacies to help deliver public health services. PMID:26928025

A capping case study : integrating freight rail into a community setting.

DOT National Transportation Integrated Search

2011-11-01

"This investigation seeks to explore specific design solutions that could potentially enhance the capabilities of heavy rail facilities while increasing : their safety and reducing their environmental and community impacts. : Using Portland's Brookly...

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.

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.

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.

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

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.

Exploring the Benefits of Respite Services to Family Caregivers: Methodological Issues and Current Findings

PubMed Central

Zarit, Steven H.; Liu, Yin; Bangerter, Lauren R.; Rovine, Michael J.

2017-01-01

Objectives There is growing emphasis on empirical validation of the efficacy of community-based services for older people and their families, but research on services such as respite care faces methodological challenges that have limited the growth of outcome studies. We identify problems associated with the usual research approaches for studying respite care, with the goal of stimulating use of novel and more appropriate research designs that can lead to improved studies of community-based services. Method Using the concept of research validity, we evaluate the methodological approaches in the current literature on respite services, including adult day services, in-home respite and overnight respite. Results Although randomized control trials (RCTs) are possible in community settings, validity is compromised by practical limitations of randomization and other problems. Quasi-experimental and interrupted time series designs offer comparable validity to RCTs and can be implemented effectively in community settings. Conclusion An emphasis on RCTs by funders and researchers is not supported by scientific evidence. Alternative designs can lead to development of a valid body of research on community services such as respite. PMID:26729467

Exploring the benefits of respite services to family caregivers: methodological issues and current findings.

PubMed

Zarit, Steven H; Bangerter, Lauren R; Liu, Yin; Rovine, Michael J

2017-03-01

There is growing emphasis on empirical validation of the efficacy of community-based services for older people and their families, but research on services such as respite care faces methodological challenges that have limited the growth of outcome studies. We identify problems associated with the usual research approaches for studying respite care, with the goal of stimulating use of novel and more appropriate research designs that can lead to improved studies of community-based services. Using the concept of research validity, we evaluate the methodological approaches in the current literature on respite services, including adult day services, in-home respite and overnight respite. Although randomized control trials (RCTs) are possible in community settings, validity is compromised by practical limitations of randomization and other problems. Quasi-experimental and interrupted time series designs offer comparable validity to RCTs and can be implemented effectively in community settings. An emphasis on RCTs by funders and researchers is not supported by scientific evidence. Alternative designs can lead to development of a valid body of research on community services such as respite.

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.

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.

Changing Communities, Community Satisfaction, and Quality of Life: A View of Multiple Perceived Indicators

ERIC Educational Resources Information Center

Matarrita-Cascante, David

2010-01-01

The relationship between a community's services and conditions, satisfaction, and overall quality of life were examined in this study. As these relationships respond to specific contextual and cultural settings, qualitative methods were used to account for their complexity and depth. Key informant interviews were conducted in two rural communities…

The AACC Competencies and the PhD Completion Project: Practical Implications

ERIC Educational Resources Information Center

Sinady, Chantal; Floyd, Deborah L.; Mulder, Anne E.

2010-01-01

The American Association of Community Colleges (AACC) has identified a set of six competencies essential to effective community college leadership. Studies have been conducted to test the validity and usefulness of these competencies in such ways as by surveying community college professionals and to examine the effectiveness of graduate programs…

Learning as Community Service: Thinking with New Media

ERIC Educational Resources Information Center

Hughes, Janette; Gadanidis, George

2010-01-01

This paper is exploratory in nature and our research goal is to develop a conceptualization of "learning as community service" in a new media context. The setting for the study is an after-school program involving middle school children in a First Nations community. In the after-school program, children developed knowledge about (1) their…

Modifiable Risk Factors for Attempted Suicide in Australian Clinical and Community Samples

ERIC Educational Resources Information Center

Carter, Gregory L.; Page, Andrew; Clover, Kerrie; Taylor, Richard

2007-01-01

Modifiable risk factors for suicide attempt require identification in clinical and community samples. The aim of this study was to determine if similar social and psychiatric factors are associated with suicide attempts in community and clinical settings and whether the magnitude of effect is greater in clinical populations. Two case-control…

The Impact of Innovation

ERIC Educational Resources Information Center

O'Banion, Terry; Weidner, Laura; Wilson, Cynthia

2012-01-01

With funding from MetLife Foundation, the League for Innovation in the Community College engaged in a yearlong study in 2009 of the nature of innovation in the community college. Using recipients of the League's Innovation of the Year Award at 19 community colleges during the period from 1999 through 2008 as a data set, the authors used document…

Evaluation of a Research Mentorship Program in Community Care

ERIC Educational Resources Information Center

Ploeg, Jenny; de Witt, Lorna; Hutchison, Brian; Hayward, Lynda; Grayson, Kim

2008-01-01

This article describes the results of a qualitative case study evaluating a research mentorship program in community care settings in Ontario, Canada. The purpose of the program was to build evaluation and research capacity among staff of community care agencies through a mentorship program. Data were collected through in-depth, semi-structured…

Evolution properties of the community members for dynamic networks

NASA Astrophysics Data System (ADS)

Yang, Kai; Guo, Qiang; Li, Sheng-Nan; Han, Jing-Ti; Liu, Jian-Guo

2017-03-01

The collective behaviors of community members for dynamic social networks are significant for understanding evolution features of communities. In this Letter, we empirically investigate the evolution properties of the new community members for dynamic networks. Firstly, we separate data sets into different slices, and analyze the statistical properties of new members as well as communities they joined in for these data sets. Then we introduce a parameter φ to describe community evolution between different slices and investigate the dynamic community properties of the new community members. The empirical analyses for the Facebook, APS, Enron and Wiki data sets indicate that both the number of new members and joint communities increase, the ratio declines rapidly and then becomes stable over time, and most of the new members will join in the small size communities that is s ≤ 10. Furthermore, the proportion of new members in existed communities decreases firstly and then becomes stable and relatively small for these data sets. Our work may be helpful for deeply understanding the evolution properties of community members for social networks.

Opening Doors to Student Success: A Synthesis of Findings from an Evaluation at Six Community Colleges. Policy Brief

ERIC Educational Resources Information Center

Scrivener, Susan; Coghlan, Erin

2011-01-01

Only one-third of all students who enter community colleges with the intent to earn a degree or certificate actually meet this goal within six years. MDRC launched the Opening Doors Demonstration in 2003--the first large-scale random assignment study in a community college setting--to tackle this problem. Partnering with six community colleges,…

The Convergence of Institutional Logics on the Community College Sector and the Normalization of Emotional Labor: A New Theoretical Approach for Considering the Community College Faculty Labor Expectations

ERIC Educational Resources Information Center

Gonzales, Leslie D.; Ayers, David F.

2018-01-01

Little empirical research has systematically focused on, or interrogated, the labor expectations set forth for community college faculty. Thus, in this paper, we present a theoretical argument, which we formed by (re) reading several community college focused studies through various theoretical lenses. Ultimately, we merged two…

A Native American Community's Involvement and Empowerment to Guide Their Children's Development in the School Setting

ERIC Educational Resources Information Center

Rivera, Hector H.; Tharp, Roland G.

2006-01-01

This study provides an empirical description of the dimensions of community values, beliefs, and opinions through a survey conducted in the Pueblo Indian community of Zuni in New Mexico. The sample was composed of 200 randomly chosen community members ranging from 21 to 103 years old. A principal component factor analysis was conducted, as well as…

Meeting stroke survivors' perceived needs: a qualitative study of a community-based exercise and education scheme.

PubMed

Reed, Mary; Harrington, Rachel; Duggan, Aine; Wood, Victorine A

2010-01-01

A qualitative study using a phenomenological approach, to explore stroke survivors' needs and their perceptions of whether a community stroke scheme met these needs. Semi-structured in-depth interviews of 12 stroke survivors, purposively selected from participants attending a new community stroke scheme. Interpretative phenomenological analysis of interviews by two researchers independently. Participants attending the community stroke scheme sought to reconstruct their lives in the aftermath of their stroke. To enable this they needed internal resources of confidence and sense of purpose to 'create their social self', and external resources of 'responsive services' and an 'informal support network', to provide direction and encouragement. Participants felt the community stroke scheme met some of these needs through exercise, goal setting and peer group interaction, which included social support and knowledge acquisition. Stroke survivors need a variety of internal and external resources so that they can rebuild their lives positively post stroke. A stroke-specific community scheme, based on exercise, life-centred goal setting, peer support and knowledge acquisition, is an external resource that can help with meeting some of the stroke survivor's needs.

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

PubMed

Sudfeld, C R; Halsey, N A

2009-11-01

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

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.

A small-area analysis of inequalities in chronic disease prevalence across urban and non-urban communities in the Province of Nova Scotia, Canada, 2007-2011.

PubMed

Terashima, Mikiko; Rainham, Daniel G C; Levy, Adrian R

2014-05-13

Small-area studies of health inequalities often have an urban focus, and may be limited in their translatability to non-urban settings. Using small-area units representing communities, this study assessed the influence of living in different settlement types (urban, town and rural) on the prevalence of four chronic diseases (heart disease, cancer, diabetes and stroke) and compared the degrees of associations with individual-level and community-level factors among the settlement types. The associations between community-level and individual-level characteristics and prevalence of the chronic diseases were assessed using logistic regression (multilevel and non-multilevel) models. Individual-level data were extracted from the Canadian Community Health Survey (2007-2011). Indices of material deprivation and social isolation and the settlement type classification were created using the Canadian Census. Respondents living in towns were 21% more likely to report one of the diseases than respondents living in urban communities even after accounting for individual-level and community-level characteristics. Having dependent children appeared to have protective effects in towns, especially for males (OR: 0.49 (95% CI 0.27 to 0.90)). Unemployment had a strong association for all types of communities, but being unemployed appeared to be particularly damaging to health of males in urban communities (OR: 2.48 (95% CI 1.43 to 4.30)). The study showed that those living in non-urban settings, particularly towns, experience extra challenges in maintaining health above and beyond the socioeconomic condition and social isolation of the communities, and individual demographic, behavioural and socioeconomic attributes. Our findings also suggest that health inequality studies based on urban-only settings may underestimate the risks by some factors. Ways to devise meaningful small-area units comparable in all settlement types are necessary to help plan effective provision of chronic disease-related health services and programmes on a regional scale. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Community perceptions of mental distress in a post-conflict setting: a qualitative study in Burundi.

PubMed

Familiar, Itziar; Sharma, Sonali; Ndayisaba, Herman; Munyentwari, Norbert; Sibomana, Seleus; Bass, Judith K

2013-01-01

There is scant documentation of the mental health characteristics of low-income communities recovering from armed conflict. To prepare for quantitative health surveys and health service planning in Burundi, we implemented a qualitative study to explore concepts related to mental distress and coping among adults. Mental distress was defined as problems related to feelings, thinking, behaviour and physical stress. Using free listing and key informant interviews with a range of community members, we triangulated data to identify salient issues. Thirty-eight free list respondents and 23 key informants were interviewed in 5 rural communities in Burundi using 2 interview guides from the WHO Toolkit for Mental Health Assessment in Humanitarian Settings. Based on these interviews, we identified four locally defined idioms/terms relating to mental distress: ihahamuka (anxiety spectrum illnesses), ukutiyemera (a mix of depression and anxiety-like syndrome), akabonge (depression/grief-like syndrome) and kwamana ubwoba burengeje (anxiety-like syndrome). Mental distress terms were perceived as important problems impacting community development. Affected individuals sought help from several sources within the community, including community leaders and traditional healers. We discuss how local expressions of distress can be used to tailor health research and service integration from the bottom up.

Dissemination of Evidence-Based Practice: Can We Train Therapists from a Distance?

ERIC Educational Resources Information Center

Vismara, Laurie A.; Young, Gregory S.; Stahmer, Aubyn C.; Griffith, Elizabeth McMahon; Rogers, Sally J.

2009-01-01

Although knowledge about the efficacy of behavioral interventions for children with ASD is increasing, studies of effectiveness and transportability to community settings are needed. The current study conducted an effectiveness trial to compare distance learning vs. live instruction for training community-based therapists to implement the Early…

A Double Shot of Information Literacy Instruction at a Community College

ERIC Educational Resources Information Center

Henry, Jo; Glauner, Dana; Lefoe, Grant

2015-01-01

This study analyzes the effectiveness of implementing four information literacy sessions within two different English classes in a community college setting. The study found significant improvement in the comfort level of students starting, researching, and writing papers. Additionally, students showed an increased understanding in areas of…

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

PubMed Central

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

2015-01-01

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

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.

The effectiveness of oral health education conducted at a rural community market setting.

PubMed

Lawal, F B; Nasiru, W O; Taiwo, J O

2013-01-01

The workplace is one of the avenues for educating the public about their oral health in developing countries; particularly in rural communities where the workplace plays a major role in communal living. It is therefore necessary to find out if the market is appropriate for achieving the set aim of improving oral health awareness among the populace in rural communities. The aim of this study was to determine the effectiveness of oral health education conducted in a market in a rural community by comparing the oral health practices of market women involved in the oral health education programme to those not involved in the programme. A prospective study. A rural community in South-western Nigeria. A prospective interventional study was conducted among market women in Igboora, a rural community in South-western Nigeria. The intervention was oral health education differentiating between the intervention group and the control group. Structured interviewer administered questionnaires were used to obtain information from the participants on their oral hygiene measures, fluoride use, dental attendance and the demographics of the participants. Data collected was analyzed using SPSS and p-value set at <0.05. Two hundred market women participated in the study with a mean age of 45.2 ± 17 years. The interventional group was made up of 106 market women while the control group was made up of 94 market women. There were no significant differences in the sociodemographic characteristics of women in both the intervention and control groups. Women in the intervention group engaged in more frequent cleaning of their teeth and tongue than those in the control group (p < 0.001). Market women who had participated in the oral health education subsequently visited the dentist more often than those in the control group (p = 0.010). The study showed that oral health education conducted at a market was effective in improving some oral health practices of participants. It is recommended that oral health practices be extended to major markets in our communities.

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

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

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.

State highways as main streets : a study of community design and visioning.

DOT National Transportation Integrated Search

2009-10-01

The objectives for this project were to explore community transportation design policy to improve collaboration when state highways serve as local main streets, determine successful approaches to meet the federal requirements for visioning set forth ...

Understanding low colorectal cancer screening uptake in South Asian faith communities in England--a qualitative study.

PubMed

Palmer, Cecily K; Thomas, Mary C; McGregor, Lesley M; von Wagner, Christian; Raine, Rosalind

2015-10-01

Colorectal cancer screening uptake within the South Asian population in England is approximately half that of the general population (33 % vs 61 %), and varies by Muslim (31.9 %), Sikh (34.6 %) and Hindu (43.7 %) faith background. This study sought to explore reasons for low uptake of CRC screening in South Asian communities and for the variability of low uptake between three faith communities; and to identify strategies by which uptake might be improved. We interviewed 16 'key informants' representing communities from the three largest South Asian faith backgrounds (Islam, Hinduism and Sikhism) in London, England. Reasons for low colorectal cancer screening uptake were overwhelmingly shared across South Asian faith groups. These were: limitations posed by written English; limitations posed by any written language; reliance on younger family members; low awareness of colorectal cancer and screening; and difficulties associated with faeces. Non-written information delivered verbally and interactively within faith or community settings was preferred across faith communities. Efforts to increase accessibility to colorectal cancer screening in South Asian communities should use local language broadcasts on ethnic media and face-to-face approaches within community and faith settings to increase awareness of colorectal cancer and screening, and address challenges posed by written materials.

Factors in creating sustainable intersectoral community mobilization for prevention of heart and lung disease.

PubMed

Bourdages, Josée; Sauvageau, Lyne; Lepage, Céline

2003-06-01

This paper describes factors facilitating and working against successful community mobilization in the implementation of an integrated prevention programme for cardiovascular disease and lung cancer in four community settings in Québec, Canada. Implementation evaluation data from several sources showed that over the 3-year period, mobilization was partly achieved in all four communities, although the degree of success varied. The data support those of previous studies showing that several factors are key to effective intersectoral community mobilization: (i) involvement of concerned and influential community members with a commitment to shared goals and a visible community focus; (ii) formation of multi-organization systems among appropriate organizations, recognizing their strengths, resources and competencies, and preserving both their autonomy and interdependence with an appreciation of divergent perspectives; (iii) development of decision-making mechanisms through the setting up of formal structural arrangements to facilitate decisions with clear leadership; (iv) clear definition of objectives, tasks, roles and responsibilities; and (v) official support and legitimization from participating agencies, government authorities, and organizations with adequate resources devoted to partnership building. This study also replicated a number of barriers to the creation of sustainable intersectoral community mobilization, notably the potentially destructive role of power conflicts among the key institutional partners.

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.

42 CFR 441.530 - Home and Community-Based Setting.

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...

Determinants and Outcomes of Employee Participation in a Strategic Community of Practice: A Mixed-Method Approach

ERIC Educational Resources Information Center

Chang, Joohee; Jacobs, Ronald L.

2012-01-01

Despite increasing investment in building, supporting, and managing communities of practice that meet the strategic business needs of the organization, the literature indicates that little is known about strategic communities of practice in organizational work settings. The purpose of this study was to investigate determinants and outcomes of…

Using the School Setting to Map Community Languages: A Pilot Study in Manchester, England

ERIC Educational Resources Information Center

Matras, Yaron; Robertson, Alex; Jones, Charlotte

2016-01-01

Recording the home languages of schoolchildren has long been acknowledged as a useful way of mapping community multilingualism. However, the need to process large quantities of data on many different languages has meant that in order to assess the vitality of community languages, researchers have had to rely on schoolchildren's self-reported…

Sense of Community, Inclusion, and Religious Pluralism: A Comparison of Two Catholic Universities

ERIC Educational Resources Information Center

Ferrari, Joseph R.; Bottom, Todd L.; Matteo, Elizabeth

2014-01-01

For decades researchers assessed sense of community (SOC), inclusion, and pluralism within academic settings. In the present study, 2,220 undergraduate students (1,442 women, 778 men; M age = 23.42 years; SD = 7.84) at two Catholic universities responded to perceived levels of school sense of community, inclusion, and religious pluralism. Analyses…

Estimating Survival Rates in Engineering for Community College Transfer Students Using Grades in Calculus and Physics

ERIC Educational Resources Information Center

Laugerman, Marcia; Shelley, Mack; Rover, Diane; Mickelson, Steve

2015-01-01

This study uses a unique synthesized set of data for community college students transferring to engineering by combining several cohorts of longitudinal data along with transcript-level data, from both the Community College and the University, to measure success rates in engineering. The success rates are calculated by developing Kaplan-Meier…

Organizing for Change: A Case Study of Grassroots Leadership at a Kentucky Community College

ERIC Educational Resources Information Center

Borregard, Andrea Rae

2016-01-01

Community colleges constitute a special type of higher education organization: their complex mission, dynamics, personnel structures, and values require a distinct set of understandings and skills to lead and manage them well. Most of the research on leadership in community colleges focuses on leaders in positions of power (presidents, provosts,…

Education/Connection/Action: Community Literacies and Shared Knowledges as Creative Productions for Social Justice

ERIC Educational Resources Information Center

Licona, Adela C.; Gonzales, J. Sarah

2013-01-01

This article highlights Education/Connection/Action (ECA), a locally developed community pedagogy deployed at a youth activism summer camp that served as a site for a community/academic teaching and research collaboration. Youth considered connections between a set of issues, including a local ban on Ethnic Studies, the School-to-Prison Pipeline,…

Theorizing E-Learning Participation: A Study of the HRD Online Communities in the USA

ERIC Educational Resources Information Center

Wang, Greg G.

2010-01-01

Purpose: This study sets out to investigate the e-learning participation and completion phenomenon in the US corporate HRD online communities and to explore determinants of e-learning completion. Design/methodology/approach: Based on the HRD Learning Participation Theory (LPT), this study takes a two-stage approach. Stage one adopts an interview…

Community-Based Financial Literacy Education in a Cultural Context: A Study of Teacher Beliefs and Pedagogical Practice

ERIC Educational Resources Information Center

Tisdell, Elizabeth J.; Taylor, Edward W.; Forte, Karin Sprow

2013-01-01

This article presents the findings related to teaching beliefs and pedagogical practices of a study that examined how financial literacy educators educate adults from underserved population groups in community-based settings. The study is theoretically framed in the teaching beliefs and culturally responsive education literature. Findings reveal a…

‘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

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

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.

An Ethnographic Meta-Synthesis of Three Southwestern Rural Studies.

PubMed

Averill, Jennifer B

2016-01-01

The objectives were to synthesize cumulative findings across three critical ethnographic, community-partnered studies in the southwestern United States and to describe the process of meta-ethnography for that analysis. The meta-ethnography followed the design of Noblit and Hare for constructing an analysis of composite data, informed by community-based participatory research and Stringer's ethnographic strategies of Look-Think-Act. The three studies occurred in rural settings of Colorado and New Mexico, engaging 129 total participants, along with community organizations and agencies as partners. Methods consisted of detailed review of each original study, mapping of major concepts and themes, and general analysis, interpretation, and synthesis across the studies. Overall themes were: health is the capacity to care for oneself and do work, meaningful relationships are key in health care interactions, patterns of discrimination persist in rural settings, poor literacy and health literacy are barriers, and food insecurity is a growing concern for older rural adults. Resolutions involve practice, policy, and research and must incorporate all stakeholder groups in rural settings; a participatory approach is critical to prioritize and impact existing inequities; and work is needed to extend education and understanding of multiple cultures, groups, customs, and rural contexts. © 2015 Wiley Periodicals, Inc.

The challenges of quantitative evaluation of a multi-setting, multi-strategy community-based childhood obesity prevention programme: lessons learnt from the eat well be active Community Programs in South Australia.

PubMed

Wilson, Annabelle M; Magarey, Anthea M; Dollman, James; Jones, Michelle; Mastersson, Nadia

2010-08-01

To describe the rationale, development and implementation of the quantitative component of evaluation of a multi-setting, multi-strategy, community-based childhood obesity prevention project (the eat well be active (ewba) Community Programs) and the challenges associated with this process and some potential solutions. ewba has a quasi-experimental design with intervention and comparison communities. Baseline data were collected in 2006 and post-intervention measures will be taken from a non-matched cohort in 2009. Schoolchildren aged 10-12 years were chosen as one litmus group for evaluation purposes. Thirty-nine primary schools in two metropolitan and two rural communities in South Australia. A total of 1732 10-12-year-old school students completed a nutrition and/or a physical activity questionnaire and 1637 had anthropometric measures taken; 983 parents, 286 teachers, thirty-six principals, twenty-six canteen and thirteen out-of-school-hours care (OSHC) workers completed Program-specific questionnaires developed for each of these target groups. The overall child response rate for the study was 49 %. Sixty-five per cent, 43 %, 90 %, 90 % and 68 % of parent, teachers, principals, canteen and OSHC workers respectively, completed and returned questionnaires. A number of practical, logistical and methodological challenges were experienced when undertaking this data collection. Learnings from the process of quantitative baseline data collection for the ewba Community Programs can provide insights for other researchers planning similar studies with similar methods, particularly those evaluating multi-strategy programmes across multiple settings.

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.

Aligning Community Engagement With Traditional Authority Structures in Global Health Research: A Case Study From Northern Ghana

PubMed Central

Tindana, Paulina O.; Rozmovits, Linda; Boulanger, Renaud F.; Bandewar, Sunita V. S.; Aborigo, Raymond A.; Hodgson, Abraham V. O.; Kolopack, Pamela

2011-01-01

Despite the recognition of its importance, guidance on community engagement practices for researchers remains underdeveloped, and there is little empirical evidence of what makes community engagement effective in biomedical research. We chose to study the Navrongo Health Research Centre in northern Ghana because of its well-established community engagement practices and because of the opportunity it afforded to examine community engagement in a traditional African setting. Our findings suggest that specific preexisting features of the community have greatly facilitated community engagement and that using traditional community engagement mechanisms limits the social disruption associated with research conducted by outsiders. Finally, even in seemingly ideal, small, and homogeneous communities, cultural issues exist, such as gender inequities, that may not be effectively addressed by traditional practices alone. PMID:21852635

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

PubMed

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

2017-03-01

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

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

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

PubMed

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

2010-09-01

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

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.

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.

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.

[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.

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

PubMed

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

2017-04-01

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

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…

An assessment of community health workers' ability to screen for cardiovascular disease risk with a simple, non-invasive risk assessment instrument in Bangladesh, Guatemala, Mexico, and South Africa: an observational study.

PubMed

Gaziano, Thomas A; Abrahams-Gessel, Shafika; Denman, Catalina A; Montano, Carlos Mendoza; Khanam, Masuma; Puoane, Thandi; Levitt, Naomi S

2015-09-01

Cardiovascular disease contributes substantially to the non-communicable disease (NCD) burden in low-income and middle-income countries, which also often have substantial health personnel shortages. In this observational study we investigated whether community health workers could do community-based screenings to predict cardiovascular disease risk as effectively as could physicians or nurses, with a simple, non-invasive risk prediction indicator in low-income and middle-income countries. This observation study was done in Bangladesh, Guatemala, Mexico, and South Africa. Each site recruited at least ten to 15 community health workers based on usual site-specific norms for required levels of education and language competency. Community health workers had to reside in the community where the screenings were done and had to be fluent in that community's predominant language. These workers were trained to calculate an absolute cardiovascular disease risk score with a previously validated simple, non-invasive screening indicator. Community health workers who successfully finished the training screened community residents aged 35-74 years without a previous diagnosis of hypertension, diabetes, or heart disease. Health professionals independently generated a second risk score with the same instrument and the two sets of scores were compared for agreement. The primary endpoint of this study was the level of direct agreement between risk scores assigned by the community health workers and the health professionals. Of 68 community health worker trainees recruited between June 4, 2012, and Feb 8, 2013, 42 were deemed qualified to do fieldwork (15 in Bangladesh, eight in Guatemala, nine in Mexico, and ten in South Africa). Across all sites, 4383 community members were approached for participation and 4049 completed screening. The mean level of agreement between the two sets of risk scores was 96·8% (weighted κ=0·948, 95% CI 0·936-0·961) and community health workers showed that 263 (6%) of 4049 people had a 5-year cardiovascular disease risk of greater than 20%. Health workers without formal professional training can be adequately trained to effectively screen for, and identify, people at high risk of cardiovascular disease. Using community health workers for this screening would free up trained health professionals in low-resource settings to do tasks that need high levels of formal, professional training. Copyright © 2015 Gaziano et al. Open Access article published under the terms of CC BY-NC-ND 4.0. Published by Elsevier Ltd.. All rights reserved.

Diagnosis of Autism Spectrum Disorders in 2-Year-Olds: A Study of Community Practice

ERIC Educational Resources Information Center

Corsello, Christina M.; Akshoomoff, Natacha; Stahmer, Aubyn C.

2013-01-01

Background: Longitudinal research studies have demonstrated that experienced clinicians using standardized assessment measures can make a reliable diagnosis of autism spectrum disorders (ASDs) in children under age 3. Limited data are available regarding the sensitivity and specificity of these measures in community settings. The aims of this…

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.

Feedback Mechanisms in Learning Virtual Community Settings

ERIC Educational Resources Information Center

Colazzo, Luigi; Comai, Alessio; Davi, Filippo; Molinari, Andrea; Villa, Nicola

2010-01-01

This paper introduces a set of services for the creation of on-line surveys, questionnaires, exams and self-assessment tests within a virtual community system used in e-learning settings. The system, called "Online Communities", is a dynamic web application used as platform for blended learning activities by the Faculty of Economics of…

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.

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.

Implementing community-based provider participation in research: an empirical study.

PubMed

Teal, Randall; Bergmire, Dawn M; Johnston, Matthew; Weiner, Bryan J

2012-05-08

Since 2003, the United States National Institutes of Health (NIH) has sought to restructure the clinical research enterprise in the United States by promoting collaborative research partnerships between academically-based investigators and community-based physicians. By increasing community-based provider participation in research (CBPPR), the NIH seeks to advance the science of discovery by conducting research in clinical settings where most people get their care, and accelerate the translation of research results into everyday clinical practice. Although CBPPR is seen as a promising strategy for promoting the use of evidence-based clinical services in community practice settings, few empirical studies have examined the organizational factors that facilitate or hinder the implementation of CBPPR. The purpose of this study is to explore the organizational start-up and early implementation of CBPPR in community-based practice. We used longitudinal, case study research methods and an organizational model of innovation implementation to theoretically guide our study. Our sample consisted of three community practice settings that recently joined the National Cancer Institute's (NCI) Community Clinical Oncology Program (CCOP) in the United States. Data were gathered through site visits, telephone interviews, and archival documents from January 2008 to May 2011. The organizational model for innovation implementation was useful in identifying and investigating the organizational factors influencing start-up and early implementation of CBPPR in CCOP organizations. In general, the three CCOP organizations varied in the extent to which they achieved consistency in CBPPR over time and across physicians. All three CCOP organizations demonstrated mixed levels of organizational readiness for change. Hospital management support and resource availability were limited across CCOP organizations early on, although they improved in one CCOP organization. As a result of weak IPPs, all three CCOPs created a weak implementation climate. Patient accrual became concentrated over time among those groups of physicians for whom CBPPR exhibited a strong innovation-values fit. Several external factors influenced innovation use, complicating and enriching our intra-organizational model of innovation implementation. Our results contribute to the limited body of research on the implementation of CBPPR. They inform policy discussions about increasing and sustaining community clinician involvement in clinical research and expand on theory about organizational determinants of implementation effectiveness.

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.

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.

A study of human resource competencies required to implement community rehabilitation in less resourced settings.

PubMed

Gilmore, Brynne; MacLachlan, Malcolm; McVeigh, Joanne; McClean, Chiedza; Carr, Stuart; Duttine, Antony; Mannan, Hasheem; McAuliffe, Eilish; Mji, Gubela; Eide, Arne H; Hem, Karl-Gerhard; Gupta, Neeru

2017-09-22

It is estimated that over one billion persons worldwide have some form of disability. However, there is lack of knowledge and prioritisation of how to serve the needs and provide opportunities for people with disabilities. The community-based rehabilitation (CBR) guidelines, with sufficient and sustained support, can assist in providing access to rehabilitation services, especially in less resourced settings with low resources for rehabilitation. In line with strengthening the implementation of the health-related CBR guidelines, this study aimed to determine what workforce characteristics at the community level enable quality rehabilitation services, with a focus primarily on less resourced settings. This was a two-phase review study using (1) a relevant literature review informed by realist synthesis methodology and (2) Delphi survey of the opinions of relevant stakeholders regarding the findings of the review. It focused on individuals (health professionals, lay health workers, community rehabilitation workers) providing services for persons with disabilities in less resourced settings. Thirty-three articles were included in this review. Three Delphi iterations with 19 participants were completed. Taken together, these produced 33 recommendations for developing health-related rehabilitation services. Several general principles for configuring the community rehabilitation workforce emerged: community-based initiatives can allow services to reach more vulnerable populations; the need for supportive and structured supervision at the facility level; core skills likely include case management, social protection, monitoring and record keeping, counselling skills and mechanisms for referral; community ownership; training in CBR matrix and advocacy; a tiered/teamwork system of service delivery; and training should take a rights-based approach, include practical components, and involve persons with disabilities in the delivery and planning. This research can contribute to implementing the WHO guidelines on the interaction between the health sector and CBR, particularly in the context of the Framework for Action for Strengthening Health Systems, in which human resources is one of six components. Realist syntheses can provide policy makers with detailed and practical information regarding complex health interventions, which may be valuable when planning and implementing programmes.

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…

Mental health recovery, goal setting and working alliance in an Australian community-managed organisation.

PubMed

Rose, Grenville; Smith, Lorraine

2018-01-01

This article examines the relationships between goal setting and achievement, working alliance and recovery in an Australian mental health community-managed organisation. The study gathered data over a 14-month period after the introduction of routine outcome measures. Both goal achievement and the strength of the working alliance were shown to have a positive effect on the personal recovery of the clients in the study. Both working alliance and goal achievement are robustly supportive at whatever point a person is on in the recovery journey. The brief goals card used is a useful adjunct to other tools.

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 Priorities for Healthy Eating in Older Adults.

PubMed

Jiang, Qianzhi; Cohen, Nancy L; Marra, Melissa Ventura; Woolf, Kathleen; Gilbride, Judith; Francis, Sarah L

2017-01-01

Community planners such as policymakers and health care and nutrition service providers can create an "age-friendly" environment to support healthy eating in older residents by addressing the highest priorities that enable older adults to improve their dietary intake through different food-related community settings. To identify and prioritize these factors that facilitate behavioral change (enablers) and behavioral settings important for older adult nutrition based on the social ecological model, nutrition and aging professionals (n = 30) from two rural (West Virginia, Iowa) and two urban (Massachusetts, New York) city/county regions (communities) participated in an online or live focus group discussion and completed an analytic hierarchy process survey online. Overall, the most important perceived enablers were accessibility and cost, followed by transportation and social support, but their relative importance varied by community. Participants from all communities considered congregate meal sites and food banks among the most important behavioral settings. Participants from most communities considered food stores to be important and also highlighted other settings unique to the area, such as senior housing, neighborhood, and farmers' markets. By targeting interventions to address the most notable enablers and behavioral settings specific to their community, planning groups can enhance their older residents' ability to achieve optimal nutritional health.

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.

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

Patterns of protective factors in an intervention for the prevention of suicide and alcohol abuse with Yup'ik Alaska Native youth.

PubMed

Henry, David; Allen, James; Fok, Carlotta Ching Ting; Rasmus, Stacy; Charles, Bill

2012-09-01

Community-based participatory research (CBPR) with American Indian and Alaska Native communities creates distinct interventions, complicating cross-setting comparisons. The objective of this study is to develop a method for quantifying intervention exposure in CBPR interventions that differ in their forms across communities, permitting multi-site evaluation. Attendance data from 195 youth from three Yup'ik communities were coded for the specific protective factor exposure of each youth, based on information from the intervention manual. The coded attendance data were then submitted to latent class analysis to obtain participation patterns. Five patterns of exposure to protective factors were obtained: Internal, External, Limits, Community/family, and Low Protection. Patterns differed significantly by community and youth age. Standardizing interventions by the functions an intervention serves (protective factors promoted) instead of their forms or components (specific activities) can assist in refining CBPR interventions and evaluating effects in culturally distinct settings.

When micro meets macro: microbial lipid analysis and ecosystem ecology

NASA Astrophysics Data System (ADS)

Balser, T.; Gutknecht, J.

2008-12-01

There is growing interest in linking soil microbial community composition and activity with large-scale field studies of nutrient cycling or plant community response to disturbances. And while analysis of microbial communities has moved rapidly in the past decade from culture-based to non-culture based techniques, still it must be asked what have we gained from the move? How well does the necessarily micro-scale of microbial analysis allow us to address questions of interest at the macro-scale? Several challenges exist in bridging the scales, and foremost is the question of methodological feasibility. Past microbiological methodologies have not been readily adaptable to the large sample sizes necessary for ecosystem-scale research. As a result, it has been difficult to generate compatible microbial and ecosystem data sets. We describe the use of a modified lipid extraction method to generate microbial community data sets that allow us to match landscape-scale or long-term ecological studies with microbial community data. We briefly discuss the challenges and advantages associated with lipid analysis as an approach to addressing ecosystem ecological studies, and provide examples from our research in ecosystem restoration and recovery following disturbance and climate change.

Influence of flooding and landform properties on riparian plant communities in an old-growth northern hardwood watershed

Treesearch

P. Charles Goebel; Kurt S. Pregitzer; Brian J. Palik

2012-01-01

In most forested landscapes, the organization of plant communities across stream valleys is thought to be regulated by a complex set of interactions including flooding, landform properties, and vegetation. However, few studies have directly examined the relative influence of frequent and infrequent flooding, as well as landform properties, on riparian plant community...

Leading Edge Technologies in a Community College Library Setting: Identifying Disconnects of Academic Libraries and Their Users

ERIC Educational Resources Information Center

Stanley, Theresa C.

2010-01-01

The intent of this research was to discover what, if any, disconnect exists between community college students' library perceptions and technology use. The researcher studied how students at a very-large southwestern community college are using the physical and virtual college library, and their overall technology and library technology use. The…

The Relative Influence of Formal Learning Opportunities versus Indicators of Professional Community on Changes in Science Teaching in Urban Schools

ERIC Educational Resources Information Center

McGee, Steven

2016-01-01

Previous research has shown that professional communities have the potential to be a powerful lever for continuous improvement in school settings. This research seeks to extend previous research by investigating the indicators of professional community that influence science teaching practice. This study took place in a network of urban…

Knowledge, Attitudes and Practice Relating to Hazardous Alcohol Use across the Continuum of Care in a Community Healthcare Centre

ERIC Educational Resources Information Center

Kishore, Vimal; Lynch, Sara; Pichon, Jamilia; Theall, Katherine; Johnson, Sandy; Roberson, Emily; Hinton, Susan

2011-01-01

Alcohol screening and intervention in community health settings places a great time demand on practitioners. Thus, implementation of practitioner-delivered intervention is challenging. Aims: The aim of this study was to assess the feasibility of incorporating a brief alcohol intervention into daily practices of a community health care centre by…

Heritage tourism development in rural Russia: A case study in collaborative tourism planning in an international setting

Treesearch

Roy Ramthun; Susan Williams; Vladimir Shalaev; Svetlana Guseva; Irina Polinkova; Sofia Chervakova; Svetlana Ivanova; Anna Pahkmutova; Anastasia Shalaev

2010-01-01

In the United States, advisers from such organizations as universities and extension services often assist rural communities with community planning and development efforts. These outside groups typically facilitate communication and discussion among stakeholders and help to lay out a process by which the community may proceed towards its shared goals. Faculty members...

A Portraiture of Six Hispanic Women's Academic Pursuit in a Community College Setting: A Qualitative Study

ERIC Educational Resources Information Center

Artiaga, Maria D.

2013-01-01

Community colleges in the United States serve as social, cultural, and intellectual hubs that take the role as gatekeepers by committing to opening up the doors of opportunity to the public (Vaughan, 2006). Community colleges prepare their students for the workforce by providing credit or non-credit courses, certifications, or degrees. Depending…

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

ERIC Educational Resources Information Center

Lewis, Lisa Scandale

2016-01-01

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

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.

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

Microbial community composition of a multi-stage moving bed biofilm reactor and its interaction with kinetic model parameters estimation.

PubMed

Wang, Xiaodong; Bi, Xuejun; Hem, Lars John; Ratnaweera, Harsha

2018-07-15

Microbial community diversity determines the function of each chamber of multi-stage moving bed biofilm reactor (MBBR) systems. How the microbial community data can be further used to serve wastewater treatment process modelling and optimization has been rarely studied. In this study, a MBBR system was set up to investigate the microbial community diversity of biofilm in each functional chamber. The compositions of microbial community of biofilm from different chambers of MBBR were quantified by high-throughput sequencing. Significantly higher proportion of autotrophs were found in the second aerobic chamber (15.4%), while 4.3% autotrophs were found in the first aerobic chamber. Autotrophs in anoxic chamber were negligible. Moreover, ratios of active heterotrophic biomass and autotrophic biomass (X H /X A ) were obtained by performing respiration tests. By setting heterotroph/autotroph ratios obtained from sequencing analysis equal to X H /X A , a novel approach for kinetic model parameters estimation was developed. This work not only investigated microbial community of MBBR system, but also it provided an approach to make further use of molecular microbiology analysis results. Copyright © 2018 Elsevier Ltd. All rights reserved.

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…

Pre-Creating the HyperNews Classroom Community: (Not)Speaking, (Not)Writing the Subtext.

ERIC Educational Resources Information Center

Satie, Stephanie

As two groups of teachers met to set up a HyperNews network for a grant project, it became clear that politics cannot be kept out of the classroom. In creating a community of diverse writers via HyperNews, six composition classes were linked for online discourse among departments: Asian American Studies, Chicano Studies, Pan African Studies, and…

Volunteering as a community mother--a pathway to lifelong learning.

PubMed

Molloy, Mary

2007-05-01

This paper describes a study that was undertaken to investigate the effects of participating in a community volunteering programme (the Community Mothers Programme) on volunteers (Community Mothers). The aim of the study was to investigate if volunteering in this programme acted as a pathway to lifelong learning; did the volunteers recognise the learning of new knowledge and/or skills, and did their participation in the programme trigger them to progress to further education in other settings? A self-administered questionnaire method was used for data collection: 115 questionnaires being distributed to volunteers, with a response rate of eighty-two (71 per cent). Findings show that the majority of the respondents cited the learning of new knowledge and/or skills as a result of their participation in the Community Mothers Programme. Learning appeared to stem from the various training and activities, suggesting an educational process within the volunteer setting. Findings also show that the majority of respondents had progressed to further education. In this instance, therefore, volunteering did appear to act as a pathway to lifelong learning.

Approaches for building community participation: A qualitative case study of Canadian food security programs.

PubMed

Hyett, Nerida; Kenny, Amanda; Dickson-Swift, Virginia

2017-10-01

There is increasing opportunity and support for occupational therapists to expand their scope of practice in community settings. However, evidence is needed to increase occupational therapists' knowledge, confidence, and capacity with building community participation and adopting community-centered practice roles. The purpose of this study is to improve occupational therapists' understanding of an approach to building community participation, through case study of a network of Canadian food security programs. Qualitative case study was utilized. Data were semistructured interviews, field observations, documents, and online social media. Thematic analysis was used to identify and describe four themes that relate to processes used to build community participation. The four themes were use of multiple methods, good leaders are fundamental, growing participation via social media, and leveraging outcomes. Occupational therapists can utilize an approach for building community participation that incorporates resource mobilization. Challenges of sustainability and social exclusion must be addressed.

An assessment of community health workers’ ability to screen for cardiovascular disease risk with a simple, non-invasive risk assessment instrument in Bangladesh, Guatemala, Mexico, and South Africa: an observational study

PubMed Central

Gaziano, Thomas A; Abrahams-Gessel, Shafika; Denman, Catalina A; Montano, Carlos Mendoza; Khanam, Masuma; Puoane, Thandi; Levitt, Naomi S

2016-01-01

Summary Background Cardiovascular disease contributes substantially to the non-communicable disease (NCD) burden in low-income and middle-income countries, which also often have substantial health personnel shortages. In this observational study we investigated whether community health workers could do community-based screenings to predict cardiovascular disease risk as effectively as could physicians or nurses, with a simple, non-invasive risk prediction indicator in low-income and middle-income countries. Methods This observation study was done in Bangladesh, Guatemala, Mexico, and South Africa. Each site recruited at least ten to 15 community health workers based on usual site-specific norms for required levels of education and language competency. Community health workers had to reside in the community where the screenings were done and had to be fluent in that community’s predominant language. These workers were trained to calculate an absolute cardiovascular disease risk score with a previously validated simple, non-invasive screening indicator. Community health workers who successfully finished the training screened community residents aged 35–74 years without a previous diagnosis of hypertension, diabetes, or heart disease. Health professionals independently generated a second risk score with the same instrument and the two sets of scores were compared for agreement. The primary endpoint of this study was the level of direct agreement between risk scores assigned by the community health workers and the health professionals. Findings Of 68 community health worker trainees recruited between June 4, 2012, and Feb 8, 2013, 42 were deemed qualified to do fieldwork (15 in Bangladesh, eight in Guatemala, nine in Mexico, and ten in South Africa). Across all sites, 4383 community members were approached for participation and 4049 completed screening. The mean level of agreement between the two sets of risk scores was 96 8% (weighted κ =0 948, 95% CI 0 936–0 961) and community health workers showed that 263 (6%) of 4049 people had a 5-year cardiovascular disease risk of greater than 20%. Interpretation Health workers without formal professional training can be adequately trained to effectively screen for, and identify, people at high risk of cardiovascular disease. Using community health workers for this screening would free up trained health professionals in low-resource settings to do tasks that need high levels of formal, professional training. Funding US National Heart, Lung, and Blood Institute and National Institutes of Health, UnitedHealth Chronic Disease Initiative. PMID:26187361

Community Involvement among Behaviourally Bisexual Men in the Midwestern USA: Experiences and Perceptions across Communities

PubMed Central

Dodge, Brian; Schnarrs, Phillip W.; Reece, Michael; Goncalves, Gabriel; Martinez, Omar; Nix, Ryan; Malebranche, David; Van Der Pol, Barbara; Murray, Maresa; Fortenberry, J. Dennis

2012-01-01

Limited research exists regarding community involvement and social support among behaviourally bisexual men. Previous studies suggest that bisexual men experience high levels of social stigma in both heterosexual and homosexual community settings. Research focusing on social support has demonstrated that individuals with limited access to similar individuals experience greater risk for negative health outcomes. Using a community-based research design, participants were recruited using multiple methods in Indianapolis, Indiana, USA. Researchers conducted in-depth, semi-structured interviews with 75 men who reported having engaged in bisexual behaviour within the past six months. Interviews elucidated the experiences of behaviourally bisexual men in heterosexual and homosexual settings, as well as their perceptions of the existence of a bisexual community or bisexual spaces. All participants perceived a lack of a visible bisexual community and expressed difficulty with being comfortable, or feeling belonging, within a variety of heterosexual and homosexual community spaces. Findings suggest the need for interventions focused on community building among, as well as creating spaces specifically designed for, bisexual men in order to increase perceived social support and decrease isolation and possible negative health outcomes. PMID:22978551

The South Asian heart lifestyle intervention (SAHELI) study to improve cardiovascular risk factors in a community setting: Design and methods

PubMed Central

Kandula, Namratha R.; Patel, Yasin; Dave, Swapna; Seguil, Paola; Kumar, Santosh; Baker, David W.; Spring, Bonnie; Siddique, Juned

2013-01-01

Disseminating and implementing evidence-based, cardiovascular disease (CVD) prevention lifestyle interventions in community settings and in ethnic minority populations is a challenge. We describe the design and methods for the South Asian heart lifestyle intervention (SAHELI) study, a pilot study designed to determine the feasibility and initial efficacy of a culturally-targeted, community-based lifestyle intervention to improve physical activity and diet behaviors among medically underserved South Asians (SAs). Participants with at least one CVD risk factor will be randomized to either a lifestyle intervention or a control group. Participants in both groups will be screened in a community setting and receive a primary care referral after randomization. Intervention participants will receive 6 weeks of group classes, followed by 12 weeks of individual telephone support where they will be encouraged to initiate and maintain a healthy lifestyle goal. Control participants will receive their screening results and monthly mailings on CVD prevention. Primary outcomes will be changes in moderate/vigorous physical activity and saturated fat intake between baseline, 3-, and 6-month follow-up. Secondary outcomes will be changes in weight, clinical risk factors, primary care visits, self-efficacy, and social support. This study will be one of the first to pilot-test a lifestyle intervention for SAs, one of the fastest growing racial/ethnic groups in the U.S. and one with disparate CVD risk. Results of this pilot study will provide preliminary data about the efficacy of a lifestyle intervention on CVD risk in SAs and inform community-engaged CVD prevention efforts in an increasingly diverse U.S. population. PMID:24060673

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.

Similarity between community structures of different online social networks and its impact on underlying community detection

NASA Astrophysics Data System (ADS)

Fan, W.; Yeung, K. H.

2015-03-01

As social networking services are popular, many people may register in more than one online social network. In this paper we study a set of users who have accounts of three online social networks: namely Foursquare, Facebook and Twitter. Community structure of this set of users may be reflected in these three online social networks. Therefore, high correlation between these reflections and the underlying community structure may be observed. In this work, community structures are detected in all three online social networks. Also, we investigate the similarity level of community structures across different networks. It is found that they show strong correlation with each other. The similarity between different networks may be helpful to find a community structure close to the underlying one. To verify this, we propose a method to increase the weights of some connections in networks. With this method, new networks are generated to assist community detection. By doing this, value of modularity can be improved and the new community structure match network's natural structure better. In this paper we also show that the detected community structures of online social networks are correlated with users' locations which are identified on Foursquare. This information may also be useful for underlying community detection.

Building an evidence base for community health: a review of the quality of program evaluations.

PubMed

Jolley, Gwyn M; Lawless, Angela P; Baum, Fran E; Hurley, Catherine J; Fry, Denise

2007-11-01

An assessment of the quality of program evaluations conducted in South Australian community health services investigated how effective evaluation reporting is in producing an evidence base for community health. Evaluation reports were assessed by a team of reviewers. Practitioner workshops allowed an understanding of the uses of evaluation and what promotes or acts as a barrier to undertaking evaluations. Community health services do undertake a good deal of evaluation. However, reports were not generally explicit in dealing with the principles that underpin community health. Few engaged with program theory or rationale. Typically, reports were of short-term projects with uncertain futures so there may seem little point in considering issues of long-term health outcomes and transferability to other settings. The most important issue from our study is the lack of investment in applied health services research of the sort that will be required to produce the evidence for practice that policy makers desire. The current lack of evidence for community health reflects failure of the system to invest in research and evaluation that is adequately resourced and designed for complex community settings.

Change Management Model for Implementing an Effective First-Year Experience Program in the Community College Setting

ERIC Educational Resources Information Center

Tucker, Joy C.

2015-01-01

This study provides evidence that systematic management of change can facilitate the implementation of first-year experience programming that leads to improved results in retention and student success for community college students. The study includes four major themes: (a) first-year experience, (b) change management, (c) change leadership, and…

Peer Interaction and Social Network Analysis of Online Communities with the Support of Awareness of Different Contexts

ERIC Educational Resources Information Center

Lin, Jian-Wei; Mai, Li-Jung; Lai, Yung-Cheng

2015-01-01

Although several studies related to social-context awareness (SA) and knowledge-context awareness (KA) argued that each (SA or KA) can individually enhance peer interaction in an online learning community, other studies reached opposite conclusions. These conflicting findings likely stem from different experimental settings. Most importantly, few…

Labor Market Returns to Sub-Baccalaureate Credentials: How Much Does a Community College Degree or Certificate Pay?

ERIC Educational Resources Information Center

Dadgar, Mina; Trimble, Madeline Joy

2015-01-01

This study provides one of the first estimates of the returns to different types of community college credentials--short-term certificates, long-term certificates, and associate degrees--across different fields of study. We exploit a rich data set that includes matched, longitudinal college transcripts and Unemployment Insurance records for…

Student Plagiarism and the Use of a Plagiarism Detection Tool by Community College Faculty

ERIC Educational Resources Information Center

Thurmond, Bradley H.

2010-01-01

This study sought to better inform community college administrators and faculty regarding possible factors that contribute to higher levels of student plagiarism and to suggest appropriate preventative or responsive interventions. The specific purpose of the study was to investigate a set of faculty related factors that may be associated with…

Effect of a fall prevention program on balance maintenance using a quasi-experimental design in real-world settings.

PubMed

Robitaille, Yvonne; Fournier, Michel; Laforest, Sophie; Gauvin, Lise; Filiatrault, Johanne; Corriveau, Hélène

2012-08-01

To examine the effect of a fall prevention program offered under real-world conditions on balance maintenance several months after the program. To explore the program's impact on falls. A quasi-experimental study was conducted among community-dwelling seniors, with pre- and postintervention measures of balance performance and self-reported falls. Ten community-based organizations offered the intervention (98 participants) and 7 recruited participants to the study's control arm (102 participants). An earlier study examined balance immediately after the 12-week program. The present study focuses on the 12-month effect. Linear regression (balance) and negative binomial regression (falls) procedures were performed.falls. During the 12-month study period, experimental participants improved and maintained their balance as reflected by their scores on three performance tests. There was no evidence of an effect on falls.falls. Structured group exercise programs offered in community-based settings can maintain selected components of balance for several months after the program's end.

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

PubMed

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

2012-01-01

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

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.

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

Effective recruitment strategies and community-based participatory research: Community Networks Program Centers’ recruitment in cancer prevention studies

PubMed Central

Greiner, K. Allen; Friedman, Daniela B.; Adams, Swann Arp; Gwede, Clement K.; Cupertino, Paula; Engelman, Kimberly K.; Meade, Cathy D.; Hébert, James R.

2014-01-01

Background Community-based participatory research (CBPR) approaches that involve community and academic partners in activities ranging from protocol design through dissemination of study findings can increase recruitment of medically underserved and underrepresented racial/ethnic minority populations into biomedical research. Settings/Methods Five cancer screening and prevention trials in three NCI-funded Community Networks Program Centers (CNPCs); in Florida, Kansas and South Carolina, were conducted across diverse populations. Data were collected on total time period of recruitment, ratios of participants enrolled over potential participants approached, selected CBPR strategies, capacity-building development, and systematic procedures for community stakeholder involvement. Findings Community-engaged approaches employed included establishing co-learning opportunities, participatory procedures for community-academic involvement, and community and clinical capacity building. A relatively large proportion of individuals identified for recruitment were actually approached (between 50% and 100%). The proportion of subjects who were eligible among all those approached ranged from 25% to over 70% (in the community setting). Recruitment rates were very high (78%–100% of eligible individuals approached) and the proportion who refused or who were not interested among those approached was very low (5%–11%). Conclusions Recruitment strategies used by the CNPCs were associated with low refusal and high enrollment ratios of potential subjects. Adherence to CBPR principles in the spectrum of research activities; from strategic planning to project implementation has significant potential to increase involvement in biomedical research and improve our ability to make appropriate recommendations for cancer prevention and control programming in underrepresented diverse populations. Impact CBPR strategies should be more widely implemented to enhance study recruitment. PMID:24609851

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.

Project Coach: A Case Study of a College-Community Partnerships as a Venture in Social Entrepreneurship

ERIC Educational Resources Information Center

Intrator, Sam M.; Siegel, Donald

2010-01-01

Project Coach is an after school program developed and directed by the authors. The program, which is set in a high-need urban community in Springfield, Massachusetts, teaches high school and middle school students to be sport coaches and then to run youth sport leagues for elementary-aged youth in underserved neighborhoods in their own community.…

Course and Short-Term Outcomes of Separation Anxiety Disorder in a Community Sample of Twins.

ERIC Educational Resources Information Center

Foley, Debra L.; Pickles, Andrew; Maes, Hermine M.; Silberg, Judy L.; Eaves, Lindon J.

2004-01-01

Objective: To assess the course and short-term outcomes associated with separation anxiety disorder (SAD) in a community setting. Method: The subjects were 161 of 2,061 8- to 17-year-old twins with SAD from a community-based twin study. Subjects were born between 1974 and 1983. Subjects and parents were personally interviewed about the subject's…

A Case Study That Examines the Community School Model in Elementary School Settings in West Tennessee

ERIC Educational Resources Information Center

Clark, LaWanda M.

2016-01-01

If schools are to succeed, children must be provided with more support than a school can accomplish alone (Barbour et al., 2001). The need to involve community in the educational process to offer services that make students successful and to have these services within the school building are all critical aspects of the community school model…

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.

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

Parent perceptions of an adapted evidence-based practice for toddlers with autism in a community setting

PubMed Central

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

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-implemented early intervention programs have not been well studied. Using both qualitative and quantitative data to examine parent perspectives and the perceived feasibility of parent training by community providers, 13 families were followed as they received training in the Naturalistic Developmental Behavioral Intervention, Project ImPACT. Data indicate that parent training by community providers is feasible and well received, and parents find value in participating in intervention and perceive benefit for their children. Recommendations for adaptation of program elements and future research are discussed. PMID:27121242

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

Evaluating the Real-World Effectiveness of Cognitive-Behavior Therapy Efficacy Research on Eating Disorders: A Case Study from a Community-based Clinical Setting

PubMed Central

Lowe, Michael R.; Bunnell, Douglas W.; Neeren, Amy M.; Chernyak, Yelena; Greberman, Laurel

2009-01-01

Objective There is a growing consensus that there is a need to test the real-world effectiveness of eating disorder therapies that show promise in efficacy research. The current paper provides a narrative account of an NIMH-funded study that attempted to apply efficacy findings from CBT research to an Intensive Outpatient Program (IOP) at the largest community-based eating disorder program in the United States. Method We describe the study as originally envisioned as well as the various challenges that the researchers and the IOP staff encountered in implementing this study. Results The different training, assumptions, and “ways of knowing” of the research team and the treatment staff in regard to the nature of eating disorders and their treatment created multiple challenges for both groups during the study period. We describe valuable lessons learned about how to - and how not to -implement effectiveness designs in clinical settings that are relatively unfamiliar with empirically-based research findings. Discussion It is hoped that our experience in attempting to apply efficacy-based research findings on eating disorders treatment in a community-based clinical setting will prove helpful to other researchers and service providers engaging in such translational research. PMID:20063375

Investigating the potential for students to provide dental services in community settings.

PubMed

Huynh-Vo, Linda; Rosenbloom, Joel M; Aslanyan, Garry; Leake, James L

2002-01-01

Some dental educational institutions in North America have incorporated community-oriented programs into their curriculum. The purpose of this study was to investigate the potential for the clinical placement of Ontario's dental and dental hygiene students in community-based settings. Key informant interviews were used to collect data. The study group consisted of 15 key informants from 9 potential placement sites and 4 educational institutions in Toronto and London, Ontario. The textual data were analyzed qualitatively to identify important issues regarding a clinical placement program. Results showed that there is strong support for the placement of students in community-based clinics; however, the degree to which health centres can accommodate students varies. The majority would not set any limit on the types of dental services that students could provide as long as the services were within the students' competencies. Funding was identified as a barrier to the implementation of such a program, with most of the organizations not able to contribute financially. None would be able to provide sufficient supervision without additional funding. These results indicate that a clinical placement program would be a welcome addition to the training of dental and dental hygiene students, but that external funding for supervision and operational expenses must be available before a program can be instituted.

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.

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

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

Promoting Entrepreneurship Studies in the Community College Setting.

ERIC Educational Resources Information Center

Watts, Karen Southall

This document examines the current promotional methods used by North Carolina community colleges to advance entrepreneurship education and identifies practical strategies for improving promotional efforts and outcomes. The observations, interviews, and anecdotal information presented in the paper are based on the author's three years of community…

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

ERIC Educational Resources Information Center

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

2017-01-01

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

Comparison of Primer Sets for Use in Automated Ribosomal Intergenic Spacer Analysis of Aquatic Bacterial Communities: an Ecological Perspective▿

PubMed Central

Jones, Stuart E.; Shade, Ashley L.; McMahon, Katherine D.; Kent, Angela D.

2007-01-01

Two primer sets for automated ribosomal intergenic spacer analysis (ARISA) were used to assess the bacterial community composition (BCC) in Lake Mendota, Wisconsin, over 3 years. Correspondence analysis revealed differences in community profiles generated by different primer sets, but overall ecological patterns were conserved in each case. ARISA is a powerful tool for evaluating BCC change through space and time, regardless of the specific primer set used. PMID:17122397

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

PubMed

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

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

Mental health recovery, goal setting and working alliance in an Australian community-managed organisation

PubMed Central

Rose, Grenville; Smith, Lorraine

2018-01-01

This article examines the relationships between goal setting and achievement, working alliance and recovery in an Australian mental health community-managed organisation. The study gathered data over a 14-month period after the introduction of routine outcome measures. Both goal achievement and the strength of the working alliance were shown to have a positive effect on the personal recovery of the clients in the study. Both working alliance and goal achievement are robustly supportive at whatever point a person is on in the recovery journey. The brief goals card used is a useful adjunct to other tools. PMID:29785279

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

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.

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.

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

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

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

PubMed

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

2008-07-01

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

Comparison of Final Grades between a Traditional Classroom and Learning Community Classroom at Northeast Wisconsin Technical College.

ERIC Educational Resources Information Center

Van Beek, Dianne

This study examines courses in the marketing program at Northeast Wisconsin Technical College to compare the academic performance of students in traditional and learning community classroom settings. Two sections of students, a traditional 17-week course and a block scheduled 5-week course, served as the sample in the study. The block scheduling…

Effectiveness of Written Materials in a Rehabilitative Program for Female Offenders: A Case Study at the Montana Women's Prison

ERIC Educational Resources Information Center

Dillon, Laura; Colling, Kyle

2010-01-01

This case study of the Therapeutic Community Program at Montana Women's Prison investigates the relationship between inmate reading levels and the self-help materials used for rehabilitative purposes within prison settings. The Therapeutic Community Handbook, published by the Montana Department of Corrections, is used as the primary method of…

Competency-Based Training and Worker Turnover in Community Supports for People with IDD: Results from a Group Randomized Controlled Study

ERIC Educational Resources Information Center

Bogenschutz, Matthew; Nord, Derek; Hewitt, Amy

2015-01-01

Turnover among direct support professionals (DSPs) in community support settings for individuals with intellectual and developmental disabilities (IDD) has been regarded as a challenge since tracking of this workforce began in the 1980s. This study utilized a group randomized controlled design to test the effects of a competency-based training…

Topologies of an Effective Mentoring Model: At the Intersection of Community Colleges, Underrepresented Students, and Completion

ERIC Educational Resources Information Center

Leslie, Janet Lee

2012-01-01

This evidenced-based study was conducted using a systemic review of the literature to verify scholarly consensus about the effectiveness of mentoring as an intervention to impact college completion for underrepresented students in a community college setting. The study explored the impact of having access to mentors for the target population:…

Communities of Practice as a Technical Assistance Strategy: A Single-Case Study of State Systems Change

ERIC Educational Resources Information Center

Linehan, Patrice Cunniff

2010-01-01

This study examined how one state approached the integration of policy and practice by forming communities of practice (CoP), defined as groups of people who share a set of problems and interact regularly to solve them (Wenger, McDermott, & Snyder, 2002). Policymakers have created strategies known as technical assistance (TA) to bridge the…

Interplay of diverse environmental settings and their influence on the plankton community off Myanmar during the Spring Intermonsoon

NASA Astrophysics Data System (ADS)

Jyothibabu, R.; Win, Ni Ni; Shenoy, D. M.; Swe, U. Tint; Pratik, M.; Thwin, Swe; Jagadeesan, L.

2014-11-01

The northern Andaman Sea including the Myanmar waters is one of the least studied regions of the northern Indian Ocean. The freshwater and suspended sediments carried by Ayeyawady/Irrawaddy, the peculiar surface circulation, coastline morphology and shallow bathymetry in the Gulf of Mottama facilitate several diverse environmental settings in the study region. In order to understand the environmental settings and their linkages to the plankton community in the study region, this paper combined in situ data of 'First India-Myanmar Joint Oceanographic Expedition' with satellite oceanography observations. The study period was the Spring Intermonsoon (March-May), which was characterized by high tidal activity in the Gulf of Mottama region (tidal height 6-8 m) causing strong tidal currents and re-suspension of sediments. The tidal currents and eastward advection of Ayeyawady influx caused the lowest salinity, highest concentration of nutrients, suspended sediments and chlorophyll a in the Gulf of Mottama region. Conversely, high salinity, highest temperature, lowest nutrients and suspended sediments prevalent in the offshore waters of the northern Andaman Sea induced a massive bloom of Trichodesmium erythraeum, which was mostly in the declining phase during the observation. The in situ and satellite remote sensing data clearly showed that the T. erythraeum bloom observed in the offshore waters was closely linked to a warm core eddy. The decomposition of the bloom favored swarms of siphonophores and hydromedusae through a trophic link involving copepods and appendicularians. Aided by satellite remote sensing data and multivariate statistical tools, five diverse environmental settings have been identified in the study domain. The analysis showed a close coupling between phytoplankton biomass and nutrients with their higher values in the Gulf of Mottama, off Rakhine, Ayeyawady and Thanintharyi region as compared to the offshore waters in the northern Andaman Sea. The zooplankton community dominated by copepods and chaetognaths preferred regions with high salinity, chlorophyll, deep mixed layer and low suspended sediments as existed off Rakhine, Ayeyawady and Thanintharyi regions. The study evidences, for the first time, the spatial segregation of environmental settings and its linkages to the plankton community off Myanmar during the Spring Intermonsoon.

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. |

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.

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

PubMed

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

2006-01-01

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

Seasonality and vertical structure of microbial communities in an ocean gyre.

PubMed

Treusch, Alexander H; Vergin, Kevin L; Finlay, Liam A; Donatz, Michael G; Burton, Robert M; Carlson, Craig A; Giovannoni, Stephen J

2009-10-01

Vertical, seasonal and geographical patterns in ocean microbial communities have been observed in many studies, but the resolution of community dynamics has been limited by the scope of data sets, which are seldom up to the task of illuminating the highly structured and rhythmic patterns of change found in ocean ecosystems. We studied vertical and temporal patterns in the microbial community composition in a set of 412 samples collected from the upper 300 m of the water column in the northwestern Sargasso Sea, on cruises between 1991 and 2004. The region sampled spans the extent of deep winter mixing and the transition between the euphotic and the upper mesopelagic zones, where most carbon fixation and reoxidation occurs. A bioinformatic pipeline was developed to de-noise, normalize and align terminal restriction fragment length polymorphism (T-RFLP) data from three restriction enzymes and link T-RFLP peaks to microbial clades. Non-metric multidimensional scaling statistics resolved three microbial communities with distinctive composition during seasonal stratification: a surface community in the region of lowest nutrients, a deep chlorophyll maximum community and an upper mesopelagic community. A fourth microbial community was associated with annual spring blooms of eukaryotic phytoplankton that occur in the northwestern Sargasso Sea as a consequence of winter convective mixing that entrains nutrients to the surface. Many bacterial clades bloomed in seasonal patterns that shifted with the progression of stratification. These richly detailed patterns of community change suggest that highly specialized adaptations and interactions govern the success of microbial populations in the oligotrophic ocean.

Michigan's "Higher-Education Mall" Viewed as a Model for Other Communities.

ERIC Educational Resources Information Center

Cage, Mary Crystal

1990-01-01

An innovative, cooperative Michigan program involves a higher education center built by the community in which 5 4-year institutions within the state offer a total of 11 degree programs. Most students will be able to complete studies without setting foot on a 4-year college campus. (MSE)

The Managerial Roles of Community College Chief Academic Officers.

ERIC Educational Resources Information Center

Anderson, Philip Wayne

This study utilized Mintzberg's taxonomy of managerial roles to examine the roles performed by community college chief academic officers (CAOs). Mintzberg's taxonomy defines managerial roles as a set of behaviors and identifies 10 distinct roles: (1) figurehead; (2) leader; (3) liaison; (4) monitor; (5) disseminator; (6) spokesperson; (7)…

People with an Intellectual Disability Living in an Intentional Community

ERIC Educational Resources Information Center

Randell, M.; Cumella, S.

2009-01-01

Background: Hospital closure programmes in England have generally sought to attain a fulfilling life for people with an intellectual disability by locating them in domestic-style housing in urban settings. Few have been placed in intentional or "village" communities. Yet comparative studies of different housing types have found that…

Determining Developmental Education Effectiveness in Math

ERIC Educational Resources Information Center

May, Joseph E.

2017-01-01

One of the most problematic issues facing community colleges is developmental education. In the last decade, more research has been conducted examining developmental education. The purpose of this study was to evaluate the effectiveness of developmental math in a rural community college setting. Is developmental math an effective intervention?…

Suicide Prevention and Community-Level Indicators

ERIC Educational Resources Information Center

Hourani, Laurel L.; Davidson, Lucy; Clinton-Sherrod, Monique; Patel, Nita; Marshall, Maureen; Crosby, Alex E.

2006-01-01

This study sought to develop a set of easily obtainable, relevant measures of a community's condition that could be used to guide its suicide prevention efforts. Existing data were gathered across 159 Georgia counties for nine potential social indicators (rates of net migration, divorce, unemployment, violent crimes reported, driving under the…

Measuring Capacities for Community Resilience

ERIC Educational Resources Information Center

Sherrieb, Kathleen; Norris, Fran H.; Galea, Sandro

2010-01-01

The purpose of this study was to measure the sets of adaptive capacities for Economic Development and Social Capital in the Norris et al. (2008) community resilience model with publicly accessible population indicators. Our approach involved five steps. First, we conducted a literature review on measurements of the capacities. Second, we created…

Internships as a Bridge from Community College into a Career

ERIC Educational Resources Information Center

Rogers, John Mark

2017-01-01

Internships, externships, apprenticeships and co-operative education programs are all forms of experiential learning in a workplace setting that community colleges sponsor to enhance learning and career outcomes for their graduates. Previous studies have examined wage gains associated with co-op participation at the baccalaureate level, but no…

Conflict Management Styles in an HBCU HSI Community College Setting

ERIC Educational Resources Information Center

Schmittou, Natasha P.

2012-01-01

The purpose of this quantitative study is to investigate the conflict management styles in an HBCU and HSI community college and how gender, power position, age, educational level, and ethnicity influence conflict management. A convenience sample of 80 administrators and 220 subordinates completed an electronic demographic survey and the…

Community-Clinic-Based Parent Intervention Addressing Noncompliance in Children with Attention-Deficit/Hyperactivity Disorder

ERIC Educational Resources Information Center

Canu, Will H.; Bearman, Sarah Kate

2011-01-01

The current study tested whether an abbreviated version of "Defiant Children" (Barkley, 1987), an efficacious parent training program to address the behavioral noncompliance often associated with disruptive behavior disorders, could be implemented successfully within a community mental health clinic setting by master's-level therapists. Ethnically…

Interventions for tobacco cessation in the dental setting.

PubMed

Carr, Alan B; Ebbert, Jon

2012-06-13

Tobacco use has significant adverse effects on oral health. Oral health professionals in the dental office or community setting have a unique opportunity to increase tobacco abstinence rates among tobacco users. This review assesses the effectiveness of interventions for tobacco cessation delivered by oral health professionals and offered to cigarette smokers and smokeless tobacco users in the dental office or community setting. We searched the Cochrane Tobacco Addiction Group Specialized Register (CENTRAL), MEDLINE (1966-November 2011), EMBASE (1988-November 2011), CINAHL (1982-November 2011), Healthstar (1975-November 2011), ERIC (1967-November 2011), PsycINFO (1984-November 2011), National Technical Information Service database (NTIS, 1964-November 2011), Dissertation Abstracts Online (1861-November 2011), Database of Abstract of Reviews of Effectiveness (DARE, 1995-November 2011), and Web of Science (1993-November 2011). We included randomized and pseudo-randomized clinical trials assessing tobacco cessation interventions conducted by oral health professionals in the dental office or community setting with at least six months of follow-up. Two authors independently reviewed abstracts for potential inclusion and abstracted data from included trials. Disagreements were resolved by consensus. The primary outcome was abstinence from smoking or all tobacco use (for users of smokeless tobacco) at the longest follow-up, using the strictest definition of abstinence reported. The effect was summarised as an odds ratio, with correction for clustering where appropriate. Heterogeneity was assessed using the I² statistic and where appropriate a pooled effect was estimated using an inverse variance fixed-effect model. Fourteen clinical trials met the criteria for inclusion in this review. Included studies assessed the efficacy of interventions in the dental office or in a community school or college setting. Six studies evaluated the effectiveness of interventions among smokeless tobacco (ST) users, and eight studies evaluated interventions among cigarette smokers, six of which involved adult smokers in dental practice settings. All studies employed behavioral interventions and only one required pharmacotherapy as an interventional component. All studies included an oral examination component. Pooling all 14 studies suggested that interventions conducted by oral health professionals can increase tobacco abstinence rates (odds ratio [OR] 1.71, 95% confidence interval [CI] 1.44 to 2.03) at six months or longer, but there was evidence of heterogeneity (I² = 61%). Within the subgroup of interventions for smokers, heterogeneity was smaller (I² = 51%), but was largely attributable to a large study showing no evidence of benefit. Within this subgroup there were five studies which involved adult smokers in dental practice settings. Pooling these showed clear evidence of benefit and minimal heterogeneity (OR 2.38, 95% CI 1.70 to 3.35, 5 studies, I² = 3%) but this was a posthoc subgroup analysis. Amongst the studies in smokeless tobacco users the heterogeneity was also attributable to a large study showing no sign of benefit, possibly due to intervention spillover to control colleges; the other five studies indicated that interventions for ST users were effective (OR 1.70; 95% CI 1.36 to 2.11). Available evidence suggests that behavioral interventions for tobacco cessation conducted by oral health professionals incorporating an oral examination component in the dental office or community setting may increase tobacco abstinence rates among both cigarette smokers and smokeless tobacco users. Differences between the studies limit the ability to make conclusive recommendations regarding the intervention components that should be incorporated into clinical practice, however, behavioral counselling (typically brief) in conjunction with an oral examination was a consistent intervention component that was also provided in some control groups.

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

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).

Community pharmacy-delivered interventions for public health priorities: a systematic review of interventions for alcohol reduction, smoking cessation and weight management, including meta-analysis for smoking cessation.

PubMed

Brown, Tamara J; Todd, Adam; O'Malley, Claire; Moore, Helen J; Husband, Andrew K; Bambra, Clare; Kasim, Adetayo; Sniehotta, Falko F; Steed, Liz; Smith, Sarah; Nield, Lucie; Summerbell, Carolyn D

2016-02-29

To systematically review the effectiveness of community pharmacy-delivered interventions for alcohol reduction, smoking cessation and weight management. Systematic review and meta-analyses. 10 electronic databases were searched from inception to May 2014. randomised and non-randomised controlled trials; controlled before/after studies, interrupted times series. any relevant intervention set in a community pharmacy, delivered by the pharmacy team. No restrictions on duration, country, age, or language. 19 studies were included: 2 alcohol reduction, 12 smoking cessation and 5 weight management. Study quality rating: 6 'strong', 4 'moderate' and 9 'weak'. 8 studies were conducted in the UK, 4 in the USA, 2 in Australia, 1 each in 5 other countries. Evidence from 2 alcohol-reduction interventions was limited. Behavioural support and/or nicotine replacement therapy are effective and cost-effective for smoking cessation: pooled OR was 2.56 (95% CI 1.45 to 4.53) for active intervention vs usual care. Pharmacy-based interventions produced similar weight loss compared with active interventions in other primary care settings; however, weight loss was not sustained longer term in a range of primary care and commercial settings compared with control. Pharmacy-based weight management interventions have similar provider costs to those delivered in other primary care settings, which are greater than those delivered by commercial organisations. Very few studies explored if and how sociodemographic or socioeconomic variables moderated intervention effects. Insufficient information was available to examine relationships between effectiveness and behaviour change strategies, implementation factors, or organisation and delivery of interventions. Community pharmacy-delivered interventions are effective for smoking cessation, and demonstrate that the pharmacy is a feasible option for weight management interventions. Given the potential reach, effectiveness and associated costs of these interventions, commissioners should consider using community pharmacies to help deliver public health services. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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

The Structural Transformation of the Public Sphere on the Internet: Focused on New Media Literacy and Collectivity of Online Communities

ERIC Educational Resources Information Center

Shin, Jiwon

2013-01-01

Through the case of one online disputant, Minerva, this study intended to see the possibilities of online communities as the public sphere. Minerva's postings and comments were analyzed using discourse analysis and ground theory. It was found that the online community did act as the public sphere at that time, such as setting agenda and developing…

Determining suitability for home versus community-based ambulatory therapy services for adults with arthritis.

PubMed

Rothman, L M; Badley, E M

1996-02-01

A survey of clients seen by a community-based arthritis therapy service was conducted to investigate how characteristics of clients might provide information to assist in the development of guidelines for services delivered in the home versus in a community-based ambulatory setting. Clients completed a self-administered questionnaire, which included the Health Assessment Questionnaire, and a mobility handicap measure. Two indicator variables selected as criteria for suitability for ambulatory therapy were the therapists' rating of client suitability and the clients' report of going out more than once weekly. Based on these indicator variables, 60-76% of clients currently receiving home therapy by this service could potentially receive services in a community-based ambulatory setting. The results demonstrate the usefulness of considering client characteristics when deciding whether clients need to be seen at home. This study emphasizes the need to determine the most efficient and effective methods of providing services to people in the community with chronic conditions.

“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.

Native Transformations in the Pacific Northwest: A strength-based model of protection against substance use disorder.

PubMed

Rasmus, Stacy; Allen, James; Connor, William; Freeman, William; Skewes, Monica

2016-01-01

This paper presents findings from the Native Transformations Project, an exploratory community-based participatory research study that aims to identify sources of strength and protection against substance use disorder in three tribal communities in the coastal Pacific Northwest. Preliminary results from the study describe the specific settings, acts, and behaviors that build strengths and provide protection at the family, community, individual, and spiritual levels within coastal Pacific Northwest local tribal cultures. Findings from this study give voice to stated community preferences for grassroots Native intervention programs based in local cultural knowledge, worldviews, values, and theories of change, that operate at the local level on their own terms.

NATIVE TRANSFORMATIONS IN THE PACIFIC NORTHWEST: A STRENGTH-BASED MODEL OF PROTECTION AGAINST SUBSTANCE USE DISORDER

PubMed Central

Rasmus, Stacy; Allen, James; Connor, William; Freeman, William; Skewes, Monica

2016-01-01

This paper presents findings from the Native Transformations Project, an exploratory community-based participatory research study that aims to identify sources of strength and protection against substance use disorder in three tribal communities in the coastal Pacific Northwest. Preliminary results from the study describe the specific settings, acts, and behaviors that build strengths and provide protection at the family, community, individual, and spiritual levels within coastal Pacific Northwest local tribal cultures. Findings from this study give voice to stated community preferences for grassroots Native intervention programs based in local cultural knowledge, worldviews, values, and theories of change, that operate at the local level on their own terms. PMID:27383091

Power, fairness and trust: understanding and engaging with vaccine trial participants and communities in the setting up the EBOVAC-Salone vaccine trial in Sierra Leone.

PubMed

Enria, Luisa; Lees, Shelley; Smout, Elizabeth; Mooney, Thomas; Tengbeh, Angus F; Leigh, Bailah; Greenwood, Brian; Watson-Jones, Deborah; Larson, Heidi

2016-11-08

This paper discusses the establishment of a clinical trial of an Ebola vaccine candidate in Kambia District, Northern Sierra Leone during the epidemic, and analyses the role of social science research in ensuring that lessons from the socio-political context, the recent experience of the Ebola outbreak, and learning from previous clinical trials were incorporated in the development of community engagement strategies. The paper aims to provide a case study of an integrated social science and communications system in the start-up phase of the clinical trial. The paper is based on qualitative research methods including ethnographic observation, interviews with trial participants and key stakeholder interviews. Through the case study of EBOVAC Salone, the paper suggests ways in which research can be used to inform communication strategies before and during the setting up of the trial. It explores notions of power, fairness and trust emerging from analysis of the Sierra Leonean context and through ethnographic research, to reflect on three situations in which social scientists and community liaison officers worked together to ensure successful community engagement. Firstly, a section on "power" considers the pitfalls of considering communities as homogeneous and shows the importance of understanding intra-community power dynamics when engaging communities. Secondly, a section on "fairness" shows how local understandings of what is fair can help inform the design of volunteer recruitment strategies. Finally, a section on "trust" highlights how historically rooted rumours can be effectively addressed through active dialogue rather than through an approach focused on correcting misinformation. The paper firstly emphasises the value of social science in the setting up of clinical trials, in terms of providing an in depth understanding of context and social dynamics. Secondly, the paper suggests the importance of a close collaboration between research and community engagement to effectively confront political and social dynamics, especially in the context of an epidemic.

The relationship between observational scale and explained variance in benthic communities

PubMed Central

Flood, Roger D.; Frisk, Michael G.; Garza, Corey D.; Lopez, Glenn R.; Maher, Nicole P.

2018-01-01

This study addresses the impact of spatial scale on explaining variance in benthic communities. In particular, the analysis estimated the fraction of community variation that occurred at a spatial scale smaller than the sampling interval (i.e., the geographic distance between samples). This estimate is important because it sets a limit on the amount of community variation that can be explained based on the spatial configuration of a study area and sampling design. Six benthic data sets were examined that consisted of faunal abundances, common environmental variables (water depth, grain size, and surficial percent cover), and sonar backscatter treated as a habitat proxy (categorical acoustic provinces). Redundancy analysis was coupled with spatial variograms generated by multiscale ordination to quantify the explained and residual variance at different spatial scales and within and between acoustic provinces. The amount of community variation below the sampling interval of the surveys (< 100 m) was estimated to be 36–59% of the total. Once adjusted for this small-scale variation, > 71% of the remaining variance was explained by the environmental and province variables. Furthermore, these variables effectively explained the spatial structure present in the infaunal community. Overall, no scale problems remained to compromise inferences, and unexplained infaunal community variation had no apparent spatial structure within the observational scale of the surveys (> 100 m), although small-scale gradients (< 100 m) below the observational scale may be present. PMID:29324746

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.

Reading Quizzes Improve Exam Scores for Community College Students.

PubMed

Pape-Lindstrom, Pamela; Eddy, Sarah; Freeman, Scott

2018-06-01

To test the hypothesis that adding course structure may encourage self-regulated learning skills resulting in an increase in student exam performance in the community college setting, we added daily preclass online, open-book reading quizzes to an introductory biology course. We compared three control terms without reading quizzes and three experimental terms with online, open-book reading quizzes; the instructor of record, class size, and instructional time did not vary. Analyzing the Bloom's taxonomy level of a random sample of exam questions indicated a similar cognitive level of high-stakes assessments across all six terms in the study. To control for possible changes in student preparation or ability over time, we calculated each student's grade point average in courses other than biology during the term under study and included it as a predictor variable in our regression models. Our final model showed that students in the experimental terms had significantly higher exam scores than students in the control terms. This result shows that online reading quizzes can boost achievement in community college students. We also comment on the importance of discipline-based education research in community college settings and the structure of our community college/4-year institution collaboration.

Implementing community-based provider participation in research: an empirical study

PubMed Central

2012-01-01

Background Since 2003, the United States National Institutes of Health (NIH) has sought to restructure the clinical research enterprise in the United States by promoting collaborative research partnerships between academically-based investigators and community-based physicians. By increasing community-based provider participation in research (CBPPR), the NIH seeks to advance the science of discovery by conducting research in clinical settings where most people get their care, and accelerate the translation of research results into everyday clinical practice. Although CBPPR is seen as a promising strategy for promoting the use of evidence-based clinical services in community practice settings, few empirical studies have examined the organizational factors that facilitate or hinder the implementation of CBPPR. The purpose of this study is to explore the organizational start-up and early implementation of CBPPR in community-based practice. Methods We used longitudinal, case study research methods and an organizational model of innovation implementation to theoretically guide our study. Our sample consisted of three community practice settings that recently joined the National Cancer Institute’s (NCI) Community Clinical Oncology Program (CCOP) in the United States. Data were gathered through site visits, telephone interviews, and archival documents from January 2008 to May 2011. Results The organizational model for innovation implementation was useful in identifying and investigating the organizational factors influencing start-up and early implementation of CBPPR in CCOP organizations. In general, the three CCOP organizations varied in the extent to which they achieved consistency in CBPPR over time and across physicians. All three CCOP organizations demonstrated mixed levels of organizational readiness for change. Hospital management support and resource availability were limited across CCOP organizations early on, although they improved in one CCOP organization. As a result of weak IPPs, all three CCOPs created a weak implementation climate. Patient accrual became concentrated over time among those groups of physicians for whom CBPPR exhibited a strong innovation-values fit. Several external factors influenced innovation use, complicating and enriching our intra-organizational model of innovation implementation. Conclusion Our results contribute to the limited body of research on the implementation of CBPPR. They inform policy discussions about increasing and sustaining community clinician involvement in clinical research and expand on theory about organizational determinants of implementation effectiveness. PMID:22568935

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.

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.

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.

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.

Stability of Playfulness across Environmental Settings: A Pilot Study

ERIC Educational Resources Information Center

Rigby, Patricia; Gaik, Sandy

2007-01-01

The Test of Playfulness (ToP) was used in this pilot study to examine the stability of playfulness of 16 children with cerebral palsy (CP), aged 4-8 years, across three environmental settings: home, community, and school. Each videotaped play segment was scored using the ToP. The ANOVA statistic demonstrated a significant variance (p less than…

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.

Dissemination of colorectal cancer screening by Filipino American community health advisors: a feasibility study.

PubMed

Maxwell, Annette E; Danao, Leda L; Bastani, Roshan

2013-07-01

Filipino Americans underutilize life-saving screening tests for colorectal cancer, resulting in late stage of diagnosis and poor survival relative to other racial/ethnic groups. Education regarding colorectal cancer screening and distribution of free fecal occult blood test (FOBT) kits are evidence-based interventions that can significantly increase screening. However, this community will only benefit if the intervention is broadly disseminated. We assessed the feasibility of promoting colorectal cancer screening in Filipino American community settings working with community health advisors, and the practicality of conducting one-on-one or small group education, in addition to passing out free FOBT kits. Twenty community health advisors from 4 organizations engaged in recruitment and education activities with 132 participants. Community health advisors consistently completed screening questionnaires to establish eligibility and kept logs of FOBT distribution. However, they did not consistently record eligible participants who did not consent to participate. Process checklists that indicated what information was covered in each educational session and postsession follow-up logs were partially completed. Almost all participants reported receipt of intervention components and receipt of screening at 4-month follow-up and reported high acceptability of the program. The pilot study established the feasibility of working with community health advisors to promote colorectal cancer screening in Filipino American community settings. Findings informed the design of a dissemination trial that is currently ongoing with regards to monitoring recruitment, intervention implementation and follow-up and allowing flexibility regarding one-on-one or small group education.

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…

Research partnerships with local communities: two case studies from Papua New Guinea and Australia

NASA Astrophysics Data System (ADS)

Almany, G. R.; Hamilton, R. J.; Williamson, D. H.; Evans, R. D.; Jones, G. P.; Matawai, M.; Potuku, T.; Rhodes, K. L.; Russ, G. R.; Sawynok, B.

2010-09-01

Partnerships between scientists and local communities can increase research capacity and data delivery while improving management effectiveness through enhanced community participation. To encourage such collaboration, this study demonstrates how these partnerships can be formed, drawing on two case studies in coral reef ecosystems in very different social settings (Papua New Guinea and Australia). In each case, steps towards successfully engaging communities in research were similar. These included: (1) early engagement by collaborating organizations to build trust, (2) ensuring scientific questions have direct relevance to the community, (3) providing appropriate incentives for participation, and (4) clear and open communication. Community participants engaged in a variety of research activities, including locating and capturing fishes, collecting and recording data (weight, length and sex), applying external tags, and removing otoliths (ear bones) for ageing and elemental analysis. Research partnerships with communities enhanced research capacity, reduced costs and, perhaps more importantly, improved the likelihood of long-term community support for marine protected areas (MPAs).

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.

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.

What Online User Innovation Communities Can Teach Us about Capturing the Experiences of Patients Living with Chronic Health Conditions. A Scoping Review

PubMed Central

Amann, Julia; Zanini, Claudia; Rubinelli, Sara

2016-01-01

Background In order to adapt to societal changes, healthcare systems need to switch from a disease orientation to a patient-centered approach. Virtual patient networks are a promising tool to favor this switch and much can be learned from the open and user innovation literature where the involvement of online user communities in the innovation process is well-documented. Objectives The objectives of this study were 1) to describe the use of online communities as a tool to capture and harness innovative ideas of end users or consumers; and 2) to point to the potential value and challenges of these virtual platforms to function as a tool to inform and promote patient-centered care in the context of chronic health conditions. Methods A scoping review was conducted. A total of seven databases were searched for scientific articles published in English between 1995 and 2014. The search strategy was refined through an iterative process. Results A total of 144 studies were included in the review. Studies were coded inductively according to their research focus to identify groupings of papers. The first set of studies focused on the interplay of factors related to user roles, motivations, and behaviors that shape the innovation process within online communities. Studies of the second set examined the role of firms in online user innovation initiatives, identifying different organizational strategies and challenges. The third set of studies focused on the idea selection process and measures of success with respect to online user innovation initiatives. Finally, the findings from the review are presented in the light of the particularities and challenges discussed in current healthcare research. Conclusion The present paper highlights the potential of virtual patient communities to inform and promote patient-centered care, describes the key challenges involved in this process, and makes recommendations on how to address them. PMID:27272912

What Online User Innovation Communities Can Teach Us about Capturing the Experiences of Patients Living with Chronic Health Conditions. A Scoping Review.

PubMed

Amann, Julia; Zanini, Claudia; Rubinelli, Sara

2016-01-01

In order to adapt to societal changes, healthcare systems need to switch from a disease orientation to a patient-centered approach. Virtual patient networks are a promising tool to favor this switch and much can be learned from the open and user innovation literature where the involvement of online user communities in the innovation process is well-documented. The objectives of this study were 1) to describe the use of online communities as a tool to capture and harness innovative ideas of end users or consumers; and 2) to point to the potential value and challenges of these virtual platforms to function as a tool to inform and promote patient-centered care in the context of chronic health conditions. A scoping review was conducted. A total of seven databases were searched for scientific articles published in English between 1995 and 2014. The search strategy was refined through an iterative process. A total of 144 studies were included in the review. Studies were coded inductively according to their research focus to identify groupings of papers. The first set of studies focused on the interplay of factors related to user roles, motivations, and behaviors that shape the innovation process within online communities. Studies of the second set examined the role of firms in online user innovation initiatives, identifying different organizational strategies and challenges. The third set of studies focused on the idea selection process and measures of success with respect to online user innovation initiatives. Finally, the findings from the review are presented in the light of the particularities and challenges discussed in current healthcare research. The present paper highlights the potential of virtual patient communities to inform and promote patient-centered care, describes the key challenges involved in this process, and makes recommendations on how to address them.

Occupancy in community-level studies

USGS Publications Warehouse

MacKenzie, Darryl I.; Nichols, James; Royle, Andy; Pollock, Kenneth H.; Bailey, Larissa L.; Hines, James

2018-01-01

Another type of multi-species studies, are those focused on community-level metrics such as species richness. In this chapter we detail how some of the single-species occupancy models described in earlier chapters have been applied, or extended, for use in such studies, while accounting for imperfect detection. We highlight how Bayesian methods using MCMC are particularly useful in such settings to easily calculate relevant community-level summaries based on presence/absence data. These modeling approaches can be used to assess richness at a single point in time, or to investigate changes in the species pool over time.

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.

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.

Prevalence of wounds in a community care setting in Ireland.

PubMed

McDermott-Scales, L; Cowman, S; Gethin, G

2009-10-01

To establish the prevalence of wounds and their management in a community care setting. A multi-site, census point prevalence wound survey was conducted in the following areas: intellectual disability, psychiatry, GP practices, prisons, long-term care private nursing homes, long-term care, public nursing homes and the community/public health (district) nursing services on one randomly selected day. Acute services were excluded. Formal ethical approval was obtained. Data were collected using a pre-piloted questionnaire. Education was provided to nurses recording the tool (n=148). Descriptive statistical analysis was performed. A 97.2% response rate yielded a crude prevalence rate of 15.6% for wounds across nursing disciplines (290/1,854 total census) and 0.2% for the community area (290/133,562 population statistics for the study area). Crude point prevalence ranged from 2.7% in the prison services (7/262 total prison population surveyed) to 33.5% in the intellectual disability services (72/215 total intellectual disability population surveyed). The most frequent wounds recorded were pressure ulcers (crude point prevalence 4%, 76/1,854 total census; excluding category l crude point prevalence was 2.6%, 49/1,854 total census), leg ulcers (crude point prevalence 2.9%, 55/1,854 total census), self-inflicted superficial abrasions (crude point prevalence 2.2%, 41/1,854 total census) and surgical wounds (crude point prevalence 1.7%, 32/1,854 total census). These results support previous international research in that they identify a high prevalence of wounds in the community. The true community prevalence of wounds is arguably much higher, as this study identified only wounds known to the nursing services and excluded acute settings and was conducted on one day.

Attitude of Academic Community towards Physically Challenged Students in the University of Maiduguri: Implications for Financing Inclusive Education for Sustainable Development

ERIC Educational Resources Information Center

Bamiteko, Racheal Modupe; Ibi, Mustapha Baba; Bukar, Ibrahim Bulama

2017-01-01

This study examined the attitude of academic community towards physically challenged students in the University of Maiduguri as it affect the financing of inclusive education for sustainable development in Nigeria. Four objectives, two research questions and two hypotheses were set and tested for the study. Descriptive survey was adopted as a…

Leading Change: A Case Study of Leadership Practices from the Development of the Niagara County Community College Culinary Institute

ERIC Educational Resources Information Center

Caton, Jazmin; Mistriner, Mark

2016-01-01

The purpose of this case study was to evaluate the lessons learned from the development of a project that set out to revitalize an economically depressed area with an innovative approach to workforce development through partnerships. The focus was to utilize the development of the Niagara County Community College Culinary Institute as an example…

A Case Study Examining How Students Make Meaning out of Using Facebook as a Virtual Learning Community at a Midwestern University

ERIC Educational Resources Information Center

Hilscher, Jerome

2013-01-01

The purpose of this qualitative case study was to explore how peer mentors make meaning out of using Facebook as a virtual learning community. With the prevalence of Facebook usage by college students, and the introduction of Facebook into academic settings by educators, program facilitators, administrators, and recruiters, researchers have begun…

African American Students in a California Community College: Perceptions of Cultural Congruity and Academic Self-Concept within a Black Culture Center

ERIC Educational Resources Information Center

James, Tenisha Celita

2017-01-01

This study focused on the cultural congruity and academic self-concept of African American students in a community college setting who participated in a Black Culture Center. The purpose of this quantitative correlational study was to examine the relationship between cultural congruity and academic self-concept through the following two research…

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.

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.

Neonatal sepsis in rural India: timing, microbiology, and antibiotic resistance in a population-based prospective study in the community setting

PubMed Central

Panigrahi, Pinaki; Chandel, Dinesh S.; Hansen, Nellie I.; Sharma, Nidhi; Kandefer, Sarah; Parida, Sailajanandan; Satpathy, Radhanath; Pradhan, Lingaraj; Mohapatra, Arjit; Mohapatra, Subhranshu S.; Misra, Pravas R.; Banaji, Nandita; Johnson, Judith A.; Morris, John Glenn; Gewolb, Ira H.; Chaudhry, Rama

2017-01-01

Objective To examine the timing and microbiology of neonatal sepsis in a population-based surveillance in the Indian community setting. Study Design All live born infants in 223 villages of Odisha state were followed at home for 60 days. Suspect sepsis cases were referred to study hospitals for further evaluation including blood culture. Results Of 12,622 births, 842 were admitted with suspected sepsis of whom 95% were 4–60 days old. Culture confirmed incidence of sepsis was 6.7/1000 births with 51% Gram negatives (Klebsiella predominating) and 26% Gram positives (mostly Staphylococcus aureus). A very high level of resistance to penicillin and ampicillin, moderate resistance to cephalosporins, and extremely low resistance to Gentamicin and Amikacin was observed. Conclusion The bacterial burden of sepsis in the Indian community is not high. Judicious choice of empiric antibiotics, antibiotic stewardship, and alternate modalities should be considered for the management or prevention of neonatal sepsis in India. PMID:28492525

Study protocol for a cluster randomized trial of the Community of Voices choir intervention to promote the health and well-being of diverse older adults.

PubMed

Johnson, Julene K; Nápoles, Anna M; Stewart, Anita L; Max, Wendy B; Santoyo-Olsson, Jasmine; Freyre, Rachel; Allison, Theresa A; Gregorich, Steven E

2015-10-13

Older adults are the fastest growing segment of the United States population. There is an immediate need to identify novel, cost-effective community-based approaches that promote health and well-being for older adults, particularly those from diverse racial/ethnic and socioeconomic backgrounds. Because choral singing is multi-modal (requires cognitive, physical, and psychosocial engagement), it has the potential to improve health outcomes across several dimensions to help older adults remain active and independent. The purpose of this study is to examine the effect of a community choir program (Community of Voices) on health and well-being and to examine its costs and cost-effectiveness in a large sample of diverse, community-dwelling older adults. In this cluster randomized controlled trial, diverse adults age 60 and older were enrolled at Administration on Aging-supported senior centers and completed baseline assessments. The senior centers were randomly assigned to either start the choir immediately (intervention group) or wait 6 months to start (control). Community of Voices is a culturally tailored choir program delivered at the senior centers by professional music conductors that reflects three components of engagement (cognitive, physical, and psychosocial). We describe the nature of the study including the cluster randomized trial study design, sampling frame, sample size calculation, methods of recruitment and assessment, and primary and secondary outcomes. The study involves conducting a randomized trial of an intervention as delivered in "real-world" settings. The choir program was designed using a novel translational approach that integrated evidence-based research on the benefits of singing for older adults, community best practices related to community choirs for older adults, and the perspective of the participating communities. The practicality and relatively low cost of the choir intervention means it can be incorporated into a variety of community settings and adapted to diverse cultures and languages. If successful, this program will be a practical and acceptable community-based approach for promoting health and well-being of older adults. ClinicalTrials.gov NCT01869179 registered 9 January 2013.

An evidence-based approach to the prevention and initial management of skin tears within the aged community setting: a best practice implementation project.

PubMed

Beechey, Rebekah; Priest, Laura; Peters, Micah; Moloney, Clint

2015-06-12

Maintaining skin integrity in a community setting is an ongoing issue, as research suggests that the prevalence of skin tears within the community is greater than that in an institutional setting. While skin tear prevention and management principles in these settings are similar to those in an acute care setting, consideration of the environmental and psychological factors of the client is pivotal to prevention in a community setting. Evidence suggests that home environment assessment, education for clients and care givers, and being proactive in improving activities of daily living in a community setting can significantly reduce the risk of sustaining skin tears. The aim of this implementation project was to assess and review current skin tear prevention and management practices within the community setting, and from this, to implement an evidence-based approach in the education of clients and staff on the prevention of skin tears. As well. the project aims to implement evidence-based principles to guide clinical practice in relation to the initial management of skin tears, and to determine strategies to overcome barriers and non-compliance. The project utilized the Joanna Brigg's Institute Practical Application of Clinical Evidence System audit tool for promoting changes in the community health setting. The implementation of this particular project is based in a region within Anglicare Southern Queensland. A small team was established and a baseline audit carried out. From this, multiple strategies were implemented to address non-compliance which included education resources for clients and caregivers, staff education sessions, and creating skin integrity kits to enable staff members to tend to skin tears, and from this a follow-up audit undertaken. Baseline audit results were slightly varied, from good to low compliance. From this, the need for staff and client education was highlighted. There were many improvements in the audit criteria following client and staff education sessions and staff self-directed learning packages. Future strategies required to sustain improvements in practice and make further progress are to introduce a readily available Anglicare Skin Integrity Assessment Tool to the nursing staff for undertaking new client admissions over 65 years, and to provide ongoing education to staff members, clients and care givers in order to reduce the prevalence of skin tears in the community setting. This implementation project demonstrated the importance of education of personal care workers, clients and their caregivers for prevention of skin tears in the community setting. This in turn created autonomy and empowered clients to take control of their health. The Joanna Briggs Institute.

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

PubMed

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

2006-11-01

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

Tailored Case Management for Diabetes and Hypertension (TEACH-DM) in a community population: study design and baseline sample characteristics.

PubMed

Crowley, Matthew J; Bosworth, Hayden B; Coffman, Cynthia J; Lindquist, Jennifer H; Neary, Alice M; Harris, Amy C; Datta, Santanu K; Granger, Bradi B; Pereira, Katherine; Dolor, Rowena J; Edelman, David

2013-09-01

Despite recognition of the benefits associated with well-controlled diabetes and hypertension, control remains suboptimal. Effective interventions for these conditions have been studied within academic settings, but interventions targeting both conditions have rarely been tested in community settings. We describe the design and baseline results of a trial evaluating a behavioral intervention among community patients with poorly-controlled diabetes and comorbid hypertension. Tailored Case Management for Diabetes and Hypertension (TEACH-DM) is a 24-month randomized, controlled trial evaluating a telephone-delivered behavioral intervention for diabetes and hypertension versus attention control. The study recruited from nine community practices. The nurse-administered intervention targets 3 areas: 1) cultivation of healthful behaviors for diabetes and hypertension control; 2) provision of fundamentals to support attainment of healthful behaviors; and 3) identification and correction of patient-specific barriers to adopting healthful behaviors. Hemoglobin A1c and blood pressure measured at 6, 12, and 24 months are co-primary outcomes. Secondary outcomes include self-efficacy, self-reported medication adherence, exercise, and cost-effectiveness. Of 377 randomized patients, 193 were allocated to the intervention and 184 to attention control. The cohort is balanced in terms of gender, race, education level, and income. The cohort's mean baseline hemoglobin A1c and blood pressure are above goal, and mean baseline body mass index falls in the obese range. Baseline self-reported non-adherence is high for diabetes and hypertension medications. Trial results are pending. If effective, the TEACH-DM intervention's telephone-based delivery strategy and nurse administration make it well-suited for rapid implementation and broad dissemination in community settings. © 2013.

Community health workers and mobile technology: a systematic review of the literature.

PubMed

Braun, Rebecca; Catalani, Caricia; Wimbush, Julian; Israelski, Dennis

2013-01-01

In low-resource settings, community health workers are frontline providers who shoulder the health service delivery burden. Increasingly, mobile technologies are developed, tested, and deployed with community health workers to facilitate tasks and improve outcomes. We reviewed the evidence for the use of mobile technology by community health workers to identify opportunities and challenges for strengthening health systems in resource-constrained settings. We conducted a systematic review of peer-reviewed literature from health, medical, social science, and engineering databases, using PRISMA guidelines. We identified a total of 25 unique full-text research articles on community health workers and their use of mobile technology for the delivery of health services. Community health workers have used mobile tools to advance a broad range of health aims throughout the globe, particularly maternal and child health, HIV/AIDS, and sexual and reproductive health. Most commonly, community health workers use mobile technology to collect field-based health data, receive alerts and reminders, facilitate health education sessions, and conduct person-to-person communication. Programmatic efforts to strengthen health service delivery focus on improving adherence to standards and guidelines, community education and training, and programmatic leadership and management practices. Those studies that evaluated program outcomes provided some evidence that mobile tools help community health workers to improve the quality of care provided, efficiency of services, and capacity for program monitoring. Evidence suggests mobile technology presents promising opportunities to improve the range and quality of services provided by community health workers. Small-scale efforts, pilot projects, and preliminary descriptive studies are increasing, and there is a trend toward using feasible and acceptable interventions that lead to positive program outcomes through operational improvements and rigorous study designs. Programmatic and scientific gaps will need to be addressed by global leaders as they advance the use and assessment of mobile technology tools for community health workers.

Goal setting practice in services delivering community-based stroke rehabilitation: a United Kingdom (UK) wide survey.

PubMed

Scobbie, Lesley; Duncan, Edward A; Brady, Marian C; Wyke, Sally

2015-01-01

We investigated the nature of services providing community-based stroke rehabilitation across the UK, and goal setting practice used within them, to inform evaluation of a goal setting and action planning (G-AP) framework. We designed, piloted and electronically distributed a survey to health professionals working in community-based stroke rehabilitation settings across the UK. We optimised recruitment using a multi-faceted strategy. Responses were analysed from 437 services. Services size, composition and input was highly variable; however, most were multi-disciplinary (82%; n = 335/407) and provided input to a mixed diagnostic group of patients (71%; n = 312/437). Ninety one percent of services (n = 358/395) reported setting goals with "all" or "most" stroke survivors. Seventeen percent (n = 65/380) reported that no methods were used to guide goal setting practice; 47% (n = 148/315) reported use of informal methods only. Goal setting practice varied, e.g. 98% of services (n = 362/369) reported routinely asking patients about goal priorities; 39% (n = 141/360) reported routinely providing patients with a copy of their goals. Goal setting is embedded within community-based stroke rehabilitation; however, practice varies and is potentially sub-optimal. Further evaluation of the G-AP framework is warranted to inform optimal practice. Evaluation design will take account of the diverse service models that exist. Implications for Rehabilitation Community-based stroke rehabilitation services across the UK are diverse and tend to see a mixed diagnostic group of patients. Goal setting is implemented routinely within community-based stroke rehabilitation services; however, practice is variable and potentially sub-optimal. Further evaluation of the G-AP framework is warranted to assess its effectiveness in practice.

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.

Employment Status, Teaching Load, and Student Performance in Online Community College Courses

ERIC Educational Resources Information Center

Salley, Witt; Shaw, Melanie

2015-01-01

A continued need exists for community college administrators to develop and implement strategies to ensure sufficient staffing to meet demand for online courses and promote student success. The problem this study addressed was threefold. First, online instructors in the local setting are overextended and are consequently unable to implement best…

Cross-Cultural Communities of Practice for College Readiness

ERIC Educational Resources Information Center

Leonard, Jack

2014-01-01

College readiness is a social construct requiring both student and adult preparedness. This paper used a case study methodology to explore how teaching in an early college program might promote adult college readiness in the instructors. A community of practice, enhanced by a co-teaching model, in two separate high school settings under one early…

Using Community Radio in a Rural Women's Post-Literacy Programme in Nepal

ERIC Educational Resources Information Center

Nagaoka, Chizuko; Karki, Manohar

2014-01-01

This paper examines the literacy and post-literacy needs of rural women in Nepal, describes a pilot study in using community radio to supplement a classroom-based post-literacy programme for these women, analyses the findings of this intervention and considers the implications for similar programmes in other settings.

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

ERIC Educational Resources Information Center

VanOra, Jason

2012-01-01

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

Storytelling Dramas as a Community Building Activity in an Early Childhood Classroom

ERIC Educational Resources Information Center

Wright, Cheryl; Diener, Marissa L.; Kemp, Jacqueline Lindsay

2013-01-01

Healthy social-emotional development is promoted by building a safe, secure and respectful environment in an early childhood setting with positive and consistent relationships among adults, children, and their peers. This study explored storytelling dramas as an opportunity to build community within the context of one early childhood classroom.…

Vouchers Versus Prizes: Contingency Management Treatment of Substance Abusers in Community Settings

ERIC Educational Resources Information Center

Petry, Nancy M.; Alessi, Sheila M.; Marx, Jacqueline; Austin, Mark; Tardif, Michelle

2005-01-01

Contingency management (CM) interventions usually use vouchers as reinforcers, but a new technique awards chances of winning prizes. This study compares these approaches. In community treatment centers, 142 cocaine- or heroin-dependent outpatients were randomly assigned to standard treatment (ST), ST with vouchers, or ST with prizes for 12 weeks.…

Infant Feeding Practices: Perceptions of Native American Mothers and Health Paraprofessionals

ERIC Educational Resources Information Center

Horodynski, Mildred A; Calcatera, Mary; Carpenter, Amanda

2012-01-01

Objective: To ascertain infant feeding practices and to explore the feasibility of an in-home feeding intervention with Native American Indian (NAI) mothers in six Native American communities in the United States (US). Design: Qualitative focus group study. Setting: Six Native American communities in the Midwest region of the United States.…

HEALTH C.H.I.P.s: Opportunistic Community Use of Computerized Health Information Programs

ERIC Educational Resources Information Center

Radvan, Deborah; Wiggers, John; Hazell, Trevor

2004-01-01

Computerized health information programs have been shown to have potential to improve knowledge, attitudes and behavior. However, relatively little is known regarding their capacity to engage the public for opportunistic, spontaneous use in community settings. Two studies were undertaken to provide insight to this practical issue. An intercept…

Tobacco Sales in Community Pharmacies: Remote Decisions and Demographic Targets

ERIC Educational Resources Information Center

Morton, Cory M.; Peterson, N. Andrew; Schneider, John E.; Smith, Brian J.; Armstead, Theresa L.

2010-01-01

This study applied multilevel modeling procedures with data from 678 community pharmacies and 382 residential census tracts in a Midwestern U.S. state to determine if two sets of variables: retail type (e.g., remotely owned, independently owned) and population demographics of the tracts in which outlets were located were associated with retail…

Measuring the Accountability of CTE Programs: Factors that Influence Postcollege Earnings among Community College Students

ERIC Educational Resources Information Center

Maguire, Kenneth J.; Starobin, Soko S.; Laanan, Frankie Santos; Friedel, Janice N.

2012-01-01

In this study specific factors were examined to determine their ability to influence fifth-year earnings of community college students in the Manufacturing/Science, Technology, Engineering and Math (STEM) career cluster and the Arts/Audiovisual/Technology/ Communication career cluster. State and national data sets from Iowa's Management…

Current Developments in Community College Performance Funding

ERIC Educational Resources Information Center

D'Amico, Mark M.; Friedel, Janice N.; Katsinas, Stephen G.; Thornton, Zoë M.

2014-01-01

Since the initiation of performance funding in Tennessee in the late 1970s, approximately 30 states have, at some point, attempted a funding model that includes performance on a set of indicators. The purpose of the present study was to capture the current status of performance funding in public statewide community college systems and to assess…

44 CFR 66.5 - Responsibilities for consultation and coordination.

Code of Federal Regulations, 2014 CFR

2014-10-01

... study or restudy. Such information to the community will include the data set forth in paragraph (e) of... investigation shall be encouraged so that interested parties will have an opportunity to bring relevant data to... data obtained. The community shall be informed in writing if any of the six preceding items are or will...

44 CFR 66.5 - Responsibilities for consultation and coordination.

Code of Federal Regulations, 2012 CFR

2012-10-01

... study or restudy. Such information to the community will include the data set forth in paragraph (e) of... investigation shall be encouraged so that interested parties will have an opportunity to bring relevant data to... data obtained. The community shall be informed in writing if any of the six preceding items are or will...

44 CFR 66.5 - Responsibilities for consultation and coordination.

Code of Federal Regulations, 2011 CFR

2011-10-01

... study or restudy. Such information to the community will include the data set forth in paragraph (e) of... investigation shall be encouraged so that interested parties will have an opportunity to bring relevant data to... data obtained. The community shall be informed in writing if any of the six preceding items are or will...

44 CFR 66.5 - Responsibilities for consultation and coordination.

Code of Federal Regulations, 2010 CFR

2010-10-01

... study or restudy. Such information to the community will include the data set forth in paragraph (e) of... investigation shall be encouraged so that interested parties will have an opportunity to bring relevant data to... data obtained. The community shall be informed in writing if any of the six preceding items are or will...

44 CFR 66.5 - Responsibilities for consultation and coordination.

Code of Federal Regulations, 2013 CFR

2013-10-01

... study or restudy. Such information to the community will include the data set forth in paragraph (e) of... investigation shall be encouraged so that interested parties will have an opportunity to bring relevant data to... data obtained. The community shall be informed in writing if any of the six preceding items are or will...

Leveraging Alumni and Business Community Relations to Assess the Information Systems Curriculum

ERIC Educational Resources Information Center

Plice, Robert K.; Reinig, Bruce A.

2009-01-01

A recent Association to Advance Collegiate Schools of Business (2006) task force called for increased interaction between business schools and the business community to identify essential skill sets and help with the curriculum-management process. An information systems curriculum-assessment study solicited input from recent alumni working in the…

Psychological Conditions of Engagement among Community College Maintenance Employees: A Cross-Sectional Study

ERIC Educational Resources Information Center

Franks, Tammy T.

2017-01-01

This dissertation examined the relationship between employee engagement and the factors that may influence the three psychological conditions of engagement: meaningfulness, safety, and availability for the sector of employees classified as maintenance, grounds, and custodial employees in a community college setting. The factors for each of the…

Use of the Child Behavior Checklist as a Diagnostic Screening Tool in Community Mental Health

ERIC Educational Resources Information Center

Rishel, Carrie W.; Greeno, Catherine; Marcus, Steven C.; Shear, M. Katherine; Anderson, Carol

2005-01-01

Objective: This study examines whether the Child Behavior Checklist (CBCL) can be used as an accurate psychiatric screening tool for children in community mental health settings. Method: Associations, logistic regression models, and receiver operating characteristic (ROC) analysis were used to test the predictive relationship between the CBCL and…

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

ERIC Educational Resources Information Center

Fitzpatrick, Kate R.

2014-01-01

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

Revisiting a Meta-Analysis of Helpful Aspects of Therapy in a Community Counselling Service

ERIC Educational Resources Information Center

Quick, Emma L; Dowd, Claire; Spong, Sheila

2018-01-01

This small scale mixed methods study examines helpful events in a community counselling setting, categorising impacts of events according to Timulak's [(2007). Identifying core categories of client-identified impact of helpful events in psychotherapy: A qualitative meta-analysis. "Psychotherapy Research," 17, 305-314] meta-synthesis of…

Supporting Veteran Transitions to the Academic Setting: VA on Campus

ERIC Educational Resources Information Center

O'Connor, Ashley; Herbst, Ellen; McCaslin, Shannon; Armstrong, Keith; Leach, Bridget; Jersky, Brandina

2018-01-01

In this case study, we assessed academic functioning, service satisfaction, and needs of student veterans at a community college who had accessed the Veterans Health Administration (VHA) Student Veteran Health Program (SVHP) (n = 36). The SVHP provides outreach and behavioral health services directly on a large community college campus to overcome…

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)

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

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

NCBI GEO: archive for functional genomics data sets--10 years on.

PubMed

Barrett, Tanya; Troup, Dennis B; Wilhite, Stephen E; Ledoux, Pierre; Evangelista, Carlos; Kim, Irene F; Tomashevsky, Maxim; Marshall, Kimberly A; Phillippy, Katherine H; Sherman, Patti M; Muertter, Rolf N; Holko, Michelle; Ayanbule, Oluwabukunmi; Yefanov, Andrey; Soboleva, Alexandra

2011-01-01

A decade ago, the Gene Expression Omnibus (GEO) database was established at the National Center for Biotechnology Information (NCBI). The original objective of GEO was to serve as a public repository for high-throughput gene expression data generated mostly by microarray technology. However, the research community quickly applied microarrays to non-gene-expression studies, including examination of genome copy number variation and genome-wide profiling of DNA-binding proteins. Because the GEO database was designed with a flexible structure, it was possible to quickly adapt the repository to store these data types. More recently, as the microarray community switches to next-generation sequencing technologies, GEO has again adapted to host these data sets. Today, GEO stores over 20,000 microarray- and sequence-based functional genomics studies, and continues to handle the majority of direct high-throughput data submissions from the research community. Multiple mechanisms are provided to help users effectively search, browse, download and visualize the data at the level of individual genes or entire studies. This paper describes recent database enhancements, including new search and data representation tools, as well as a brief review of how the community uses GEO data. GEO is freely accessible at http://www.ncbi.nlm.nih.gov/geo/.

Becoming a Physicist: How Identities and Practices Shape Physics Trajectories

NASA Astrophysics Data System (ADS)

Quan, Gina M.

This dissertation studies the relationships and processes which shape students' participation within the discipline of physics. Studying this early disciplinary participation gives insight to how students are supported in or pushed out of physics, which is an important step in cultivating a diverse set of physics students. This research occurs within two learning environments that we co-developed: a physics camp for high school girls and a seminar for undergraduate physics majors to get started in physics research. Using situated learning theory, we conceptualized physics learning to be intertwined with participation in physics practices and identity development. This theoretical perspective draws our attention to relationships between students and the physics community. Specifically, we study how students come to engage in the practices of the community and who they are within the physics community. We find that students' interactions with faculty and peers impact the extent to which students engage in authentic physics practices. These interactions also impact the extent to which students develop identities as physicists. We present implications of these findings for the design of physics learning spaces. Understanding this process of how students become members of the physics community will provide valuable insights into fostering a diverse set of successful trajectories in physics.

'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.

A Multi-Center Diabetes Eye Screening Study in Community Settings: Study Design and Methodology.

PubMed

Murchison, Ann P; Friedman, David S; Gower, Emily W; Haller, Julia A; Lam, Byron L; Lee, David J; McGwin, Gerald; Owsley, Cynthia; Saaddine, Jinan; Insight Study Group

2016-01-01

Diabetes is the leading cause of new cases of blindness among adults aged 20-74 years within the United States. The Innovative Network for Sight Research group (INSIGHT) designed the Diabetic Eye Screening Study (DESS) to examine the feasibility and short-term effectiveness of non-mydriatic diabetic retinopathy (DR) screening for adults with diabetes in community-based settings. Study enrollment began in December 2011 at four sites: an internal medicine clinic at a county hospital in Birmingham, Alabama; a Federally-qualified community healthcare center in Miami-Dade County, Florida; a university-affiliated outpatient pharmacy in Philadelphia, Pennsylvania; and a medical home in Winston-Salem, North Carolina. People 18 years or older with previously diagnosed diabetes were offered free DR screening using non-mydriatic retinal photography that was preceded by a brief questionnaire addressing demographic information and previous eye care use. Visual acuity was also measured for each eye. Images were evaluated at a telemedicine reading center by trained evaluators using the National Health System DR grading classification. Participants and their physicians were sent screening report results and telephoned for a follow-up survey 3 months post-screening to determine whether participants had sought follow-up comprehensive eye care and their experiences with the screening process. Target enrollment at each site was a minimum of 500 persons. Three of the four sites met this enrollment goal. The INSIGHT/DESS is intended to establish the feasibility and short-term effectiveness of DR screening using non-mydriatic retinal photography in persons with diabetes who seek services in community-based clinic and pharmacy settings.

Impact of safe community program on motorcyclists' safety with focus on helmet usage in 14 cities of IR Iran.

PubMed

Moghisi, Alireza; Mohammadi, Reza; Svanström, Leif

2014-01-01

The aim of this study was to evaluate the effectiveness of safe community interventions on motorcyclists' safety. Two cross sectional observations were conducted in 14 cities (five safe community practicing and nine safe community non-practicing cities) independently on 2005 and 2007. Ten percent of registered motorcycles were observed and interviewed (n=1114 in each observation). 87.9% used motorcycle for commercial purposes. All motorcyclists were male and mostly aged 18-29 years old. Death rate significantly rose from 122 to 254 per 100000 motorcyclists in Fars province since the first observation (p < 0.0001). Helmet usage rate was constant (13%). Recorded crashes increased from 16.4% to 23.1% in safe community setting (p < 0.0001). 11% carried more than one pillion. Heat disturbances, embarrassment, hearing blockage, and negligence were the most mentioned excuses for not using helmet. Law enforcement, public education, accessibility to helmets on discount rate, new legislation and, finally, access to new designed helmet were the most suggestions made by motorcyclists to promote helmet usage. No significant effect was noticed between two settings except in injury registration system in safe community. Community involvement in the safety programs could ensure sustainability of initiatives and continuity of interventions in safe communities.

Community-based psychosocial interventions for people with schizophrenia in low and middle-income countries: systematic review and meta-analysis.

PubMed

Asher, Laura; Patel, Vikram; De Silva, Mary J

2017-10-30

There is consensus that the treatment of schizophrenia should combine anti-psychotic medication and psychosocial interventions in order to address complex social, economic and health needs. It is recommended that family therapy or support; community-based rehabilitation; and/or self-help and support groups should be provided for people with schizophrenia in low and middle-income countries. The effectiveness of community-based psychosocial interventions in these settings is unclear. Studies evaluating community-based psychosocial interventions for people with schizophrenia were identified through database searching up to April 2016. Randomised controlled trials were included if they compared the intervention group with a control group receiving treatment as usual including medication. Only studies set in low and middle-income countries were included. Random effects meta-analyses were performed separately for each intervention type. Eleven randomised controlled trials in five middle-income countries were identified, with a total of 1580 participants. The content of included interventions varied from single-faceted psychoeducational interventions, to multi-component rehabilitation-focused interventions, to case management interventions. A third of the included studies did not incorporate any community involvement in the intervention. The quality of evidence was often low. Amongst the seven studies that reported on symptom severity up to 18 months post intervention, the pooled standardised mean difference (SMD) across all intervention types was 0.95 (95% CI 0.28, 1.61; P 0.005; I 2  = 95%; n = 862), representing a strong effect. A strong effect on symptom severity remained after excluding two studies with a high risk of bias (SMD 0.80; 95% CI 0.07, 1.53; P 0.03; I 2  = 94%; n = 676). Community-based psychosocial interventions may also have beneficial impacts on functioning (SMD 1.12; 95% CI 0.25, 2.00; P 0.01; I 2  = 94%; n = 511) and reducing hospital readmissions (SMD 0.68; 95% CI 0.27, 1.09; P 0.001; I 2  = 33%; n = 167). The limited evidence from low and middle-income countries supports the feasibility and effectiveness of community-based psychosocial interventions for schizophrenia, even in the absence of community mobilisation. Community-based psychosocial interventions should therefore be provided in these settings as an adjuvant service in addition to facility-based care for people with schizophrenia.

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…

Cardiology or primary care for heart failure in the community setting: process of care and clinical outcomes.

PubMed

Philbin, E F; Weil, H F; Erb, T A; Jenkins, P L

1999-08-01

Severity of illness, treatment choices, and clinical outcomes may vary with physician training. This study was performed to determine whether such differences exist among patients with congestive heart failure (CHF) treated by cardiologists and by noncardiologists in the community hospital setting. Prospective cohort study. Ten acute-care community hospitals. PATIENTS, MEASUREMENTS, AND RESULTS: Two thousand four hundred fifty-four patients with CHF were identified and followed up for 6 months after hospital discharge. Patients who were not treated by a cardiologist (group I; n = 977) were compared with patients whose attending physician was a cardiologist (group II; n = 419) and patients who received consultative care from a cardiologist (group III; n = 1,058). When compared with group I patients, group II patients were more likely to receive the recommended diagnostic tests and treatment strategies, although some of these differences could be explained by variations in the case mix. Group II patients had higher hospital charges, but lower CHF readmission rates and better postdischarge quality-of-life measures. No differences in adjusted mortality rates were observed. In the community-hospital setting, the clinical practices of cardiologists are more compatible with published treatment guidelines than the clinical practices of other physicians. The benefits of cardiology specialty care include lower CHF readmission rates and better postdischarge quality-of-life measures, rather than lower mortality rates, fewer hospital charges, or shorter length of stay.

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

PubMed

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

2015-07-02

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

Wearable accelerometry-based technology capable of assessing functional activities in neurological populations in community settings: a systematic review

PubMed Central

2014-01-01

Background Integrating rehabilitation services through wearable systems has the potential to accurately assess the type, intensity, duration, and quality of movement necessary for procuring key outcome measures. Objectives This review aims to explore wearable accelerometry-based technology (ABT) capable of assessing mobility-related functional activities intended for rehabilitation purposes in community settings for neurological populations. In this review, we focus on the accuracy of ABT-based methods, types of outcome measures, and the implementation of ABT in non-clinical settings for rehabilitation purposes. Data sources Cochrane, PubMed, Web of Knowledge, EMBASE, and IEEE Xplore. The search strategy covered three main areas, namely wearable technology, rehabilitation, and setting. Study selection Potentially relevant studies were categorized as systems either evaluating methods or outcome parameters. Methods Methodological qualities of studies were assessed by two customized checklists, depending on their categorization and rated independently by three blinded reviewers. Results Twelve studies involving ABT met the eligibility criteria, of which three studies were identified as having implemented ABT for rehabilitation purposes in non-clinical settings. From the twelve studies, seven studies achieved high methodological quality scores. These studies were not only capable of assessing the type, quantity, and quality measures of functional activities, but could also distinguish healthy from non-healthy subjects and/or address disease severity levels. Conclusion While many studies support ABT’s potential for telerehabilitation, few actually utilized it to assess mobility-related functional activities outside laboratory settings. To generate more appropriate outcome measures, there is a clear need to translate research findings and novel methods into practice. PMID:24625308

Measuring teamwork and taskwork of community-based “teams” delivering life-saving health interventions in rural Zambia: a qualitative study

PubMed Central

2013-01-01

Background The use of teams is a well-known approach in a variety of settings, including health care, in both developed and developing countries. Team performance is comprised of teamwork and task work, and ascertaining whether a team is performing as expected to achieve the desired outcome has rarely been done in health care settings in resource-limited countries. Measuring teamwork requires identifying dimensions of teamwork or processes that comprise the teamwork construct, while taskwork requires identifying specific team functions. Since 2008 a community-based project in rural Zambia has teamed community health workers (CHWs) and traditional birth attendants (TBAs), supported by Neighborhood Health Committees (NHCs), to provide essential newborn and continuous curative care for children 0–59 months. This paper describes the process of developing a measure of teamwork and taskwork for community-based health teams in rural Zambia. Methods Six group discussions and pile-sorting sessions were conducted with three NHCs and three groups of CHW-TBA teams. Each session comprised six individuals. Results We selected 17 factors identified by participants as relevant for measuring teamwork in this rural setting. Participants endorsed seven functions as important to measure taskwork. To explain team performance, we assigned 20 factors into three sub-groups: personal, community-related and service-related. Conclusion Community and culturally relevant processes, functions and factors were used to develop a tool for measuring teamwork and taskwork in this rural community and the tool was quite unique from tools used in developed countries. PMID:23802766

Family, Community and Clinic Collaboration to Treat Overweight and Obese Children: Stanford GOALS -- a Randomized Controlled Trial of a Three-Year, Multi-Component, Multi-Level, Multi-Setting Intervention

PubMed Central

Robinson, Thomas N.; Matheson, Donna; Desai, Manisha; Wilson, Darrell M.; Weintraub, Dana L.; Haskell, William L.; McClain, Arianna; McClure, Samuel; Banda, Jorge; Sanders, Lee M.; Haydel, K. Farish; Killen, Joel D.

2013-01-01

Objective To test the effects of a three-year, community-based, multi-component, multi-level, multi-setting (MMM) approach for treating overweight and obese children. Design Two-arm, parallel group, randomized controlled trial with measures at baseline, 12, 24, and 36 months after randomization. Participants Seven through eleven year old, overweight and obese children (BMI ≥ 85th percentile) and their parents/caregivers recruited from community locations in low-income, primarily Latino neighborhoods in Northern California. Interventions Families are randomized to the MMM intervention versus a community health education active-placebo comparison intervention. Interventions last for three years for each participant. The MMM intervention includes a community-based after school team sports program designed specifically for overweight and obese children, a home-based family intervention to reduce screen time, alter the home food/eating environment, and promote self-regulatory skills for eating and activity behavior change, and a primary care behavioral counseling intervention linked to the community and home interventions. The active-placebo comparison intervention includes semi-annual health education home visits, monthly health education newsletters for children and for parents/guardians, and a series of community-based health education events for families. Main Outcome Measure Body mass index trajectory over the three-year study. Secondary outcome measures include waist circumference, triceps skinfold thickness, accelerometer-measured physical activity, 24-hour dietary recalls, screen time and other sedentary behaviors, blood pressure, fasting lipids, glucose, insulin, hemoglobin A1c, C-reactive protein, alanine aminotransferase, and psychosocial measures. Conclusions The Stanford GOALS trial is testing the efficacy of a novel community-based multi-component, multi-level, multi-setting treatment for childhood overweight and obesity in low-income, Latino families. PMID:24028942

Family, community and clinic collaboration to treat overweight and obese children: Stanford GOALS-A randomized controlled trial of a three-year, multi-component, multi-level, multi-setting intervention.

PubMed

Robinson, Thomas N; Matheson, Donna; Desai, Manisha; Wilson, Darrell M; Weintraub, Dana L; Haskell, William L; McClain, Arianna; McClure, Samuel; Banda, Jorge A; Sanders, Lee M; Haydel, K Farish; Killen, Joel D

2013-11-01

To test the effects of a three-year, community-based, multi-component, multi-level, multi-setting (MMM) approach for treating overweight and obese children. Two-arm, parallel group, randomized controlled trial with measures at baseline, 12, 24, and 36 months after randomization. Seven through eleven year old, overweight and obese children (BMI ≥ 85th percentile) and their parents/caregivers recruited from community locations in low-income, primarily Latino neighborhoods in Northern California. Families are randomized to the MMM intervention versus a community health education active-placebo comparison intervention. Interventions last for three years for each participant. The MMM intervention includes a community-based after school team sports program designed specifically for overweight and obese children, a home-based family intervention to reduce screen time, alter the home food/eating environment, and promote self-regulatory skills for eating and activity behavior change, and a primary care behavioral counseling intervention linked to the community and home interventions. The active-placebo comparison intervention includes semi-annual health education home visits, monthly health education newsletters for children and for parents/guardians, and a series of community-based health education events for families. Body mass index trajectory over the three-year study. Secondary outcome measures include waist circumference, triceps skinfold thickness, accelerometer-measured physical activity, 24-hour dietary recalls, screen time and other sedentary behaviors, blood pressure, fasting lipids, glucose, insulin, hemoglobin A1c, C-reactive protein, alanine aminotransferase, and psychosocial measures. The Stanford GOALS trial is testing the efficacy of a novel community-based multi-component, multi-level, multi-setting treatment for childhood overweight and obesity in low-income, Latino families. © 2013 Elsevier Inc. All rights reserved.

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.

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

PubMed

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

2017-02-01

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

Citizenship for All in the Literate Community: An Ethnography of Young Children with Significant Disabilities in Inclusive Early Childhood Settings

ERIC Educational Resources Information Center

Kliewer, Christopher; Fitzgerald, Linda May; Meyer-Mork, Jodi; Hartman, Patresa; English-Sand, Pat; Raschke, Donna

2004-01-01

In this study, Christopher Kliewer, Linda Fitzgerald, Jodi Meyer-Mork, Patresa Hartman, Pat English-Sand, and Donna Raschke use ethnographic methods to explore literacy development in young children considered to have significant disabilities. The study settings included nine preschool and kindergarten classrooms across five programs, all of which…

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

PubMed

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

2015-01-01

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. Cross-sectional study. Four Midwestern cities in the United States in August through October 2009. 28 community-based pharmacists practicing in 17 pharmacies. Interviews. Opinions of participants about roles of specialty and nonspecialty pharmacists in caring for patients living with HIV infections. 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. 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.

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…

"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…

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…

Adapting a Technology-Based Implementation Support Tool for Community Mental Health: Challenges and Lessons Learned.

PubMed

Livet, Melanie; Fixsen, Amanda

2018-01-01

With mental health services shifting to community-based settings, community mental health (CMH) organizations are under increasing pressure to deliver effective services. Despite availability of evidence-based interventions, there is a gap between effective mental health practices and the care that is routinely delivered. Bridging this gap requires availability of easily tailorable implementation support tools to assist providers in implementing evidence-based intervention with quality, thereby increasing the likelihood of achieving the desired client outcomes. This study documents the process and lessons learned from exploring the feasibility of adapting such a technology-based tool, Centervention, as the example innovation, for use in CMH settings. Mixed-methods data on core features, innovation-provider fit, and organizational capacity were collected from 44 CMH providers. Lessons learned included the need to augment delivery through technology with more personal interactions, the importance of customizing and integrating the tool with existing technologies, and the need to incorporate a number of strategies to assist with adoption and use of Centervention-like tools in CMH contexts. This study adds to the current body of literature on the adaptation process for technology-based tools and provides information that can guide additional innovations for CMH settings.

Increasing Pap smear rates at an urban Aboriginal Community Controlled Health Service through translational research and continuous quality improvement.

PubMed

Dorrington, Melanie S; Herceg, Ana; Douglas, Kirsty; Tongs, Julie; Bookallil, Marianne

2015-01-01

This article describes translational research (TR) and continuous quality improvement (CQI) processes used to identify and address barriers and facilitators to Pap smear screening within an urban Aboriginal Community Controlled Health Service (ACCHS). Rapid Plan-Do-Study-Act (PDSA) cycles were conducted, informed by client surveys, a data collection tool, focus groups and internal research. There was a statistically significant increase in Pap smear numbers during PDSA cycles, continuing at 10 months follow up. The use of TR with CQI appears to be an effective and acceptable way to affect Pap smear screening. Community and service collaboration should be at the core of research in Aboriginal and Torres Strait Islander health settings. This model is transferrable to other settings and other health issues.

Influence of culture and community perceptions on birth and perinatal care of immigrant women: doulas' perspective.

PubMed

Kang, Hye-Kyung

2014-01-01

A qualitative study examined the perceptions of doulas practicing in Washington State regarding the influence of cultural and community beliefs on immigrant women's birth and perinatal care, as well as their own cultural beliefs and values that may affect their ability to work interculturally. The findings suggest that doulas can greatly aid immigrant mothers in gaining access to effective care by acting as advocates, cultural brokers, and emotional and social support. Also, doulas share a consistent set of professional values, including empowerment, informed choice, cultural relativism, and scientific/evidence-based practice, but do not always recognize these values as culturally based. More emphasis on cultural self-awareness in doula training, expanding community doula programs, and more integration of doula services in health-care settings are recommended.

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

DOE Data Explorer

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

2017-01-01

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

Wearable accelerometry-based technology capable of assessing functional activities in neurological populations in community settings: a systematic review.

PubMed

Steins, Dax; Dawes, Helen; Esser, Patrick; Collett, Johnny

2014-03-13

Integrating rehabilitation services through wearable systems has the potential to accurately assess the type, intensity, duration, and quality of movement necessary for procuring key outcome measures. This review aims to explore wearable accelerometry-based technology (ABT) capable of assessing mobility-related functional activities intended for rehabilitation purposes in community settings for neurological populations. In this review, we focus on the accuracy of ABT-based methods, types of outcome measures, and the implementation of ABT in non-clinical settings for rehabilitation purposes. Cochrane, PubMed, Web of Knowledge, EMBASE, and IEEE Xplore. The search strategy covered three main areas, namely wearable technology, rehabilitation, and setting. Potentially relevant studies were categorized as systems either evaluating methods or outcome parameters. Methodological qualities of studies were assessed by two customized checklists, depending on their categorization and rated independently by three blinded reviewers. Twelve studies involving ABT met the eligibility criteria, of which three studies were identified as having implemented ABT for rehabilitation purposes in non-clinical settings. From the twelve studies, seven studies achieved high methodological quality scores. These studies were not only capable of assessing the type, quantity, and quality measures of functional activities, but could also distinguish healthy from non-healthy subjects and/or address disease severity levels. While many studies support ABT's potential for telerehabilitation, few actually utilized it to assess mobility-related functional activities outside laboratory settings. To generate more appropriate outcome measures, there is a clear need to translate research findings and novel methods into practice.

Extensive diversity in the allelic frequency of Plasmodium falciparum merozoite surface proteins and glutamate-rich protein in rural and urban settings of southwestern Nigeria.

PubMed

Funwei, Roland I; Thomas, Bolaji N; Falade, Catherine O; Ojurongbe, Olusola

2018-01-02

Nigeria carries a high burden of malaria which makes continuous surveillance for current information on genetic diversity imperative. In this study, the merozoite surface proteins (msp-1, msp-2) and glutamate-rich protein (glurp) of Plasmodium falciparum collected from two communities representing rural and urban settings in Ibadan, southwestern Nigeria were analysed. A total of 511 febrile children, aged 3-59 months, whose parents/guardians provided informed consent, were recruited into the study. Capillary blood was obtained for malaria rapid diagnostic test, thick blood smears for parasite count and blood spots on filter paper for molecular analysis. Three-hundred and nine samples were successfully genotyped for msp-1, msp-2 and glurp genes. The allelic distribution of the three genes was not significantly different in the rural and urban communities. R033 and 3D7 were the most prevalent alleles in both rural and urban communities for msp-1 and msp-2, respectively. Eleven of glurp RII region genotypes, coded I-XII, with sizes ranging from 500 to 1100 base pairs were detected in the rural setting. Genotype XI (1000-1050 bp) had the highest prevalence of 41.5 and 38.5% in rural and urban settings, respectively. Overall, 82.1 and 70.0% of samples had multiclonal infection with msp-1 gene resulting in a mean multiplicity of infection (MOI) of 2.8 and 2.6 for rural and urban samples, respectively. Msp-1 and msp-2 genes displayed higher levels of diversity and higher MOI rates than the glurp gene. Significant genetic diversity was observed between rural and urban parasite populations in Ibadan, southwestern Nigeria. The results of this study show that malaria transmission intensity in these regions is still high. No significant difference was observed between rural and urban settings, except for a completely different msp-1 allele, compared to previous reports, thereby confirming the changing face of malaria transmission in these communities. This study provides important baseline information required for monitoring the impact of malaria elimination efforts in this region and data points useful in revising current protocols.

"I Don't Know What Literacy Is": Uncovering Hidden Literacies in a Community Library Using Ecological and Participatory Research Methodologies with Children

ERIC Educational Resources Information Center

Pahl, Kate; Allan, Chloe

2011-01-01

This article describes an ecological study in Eastside, a particular area of Rotherham, a town in the north of England, UK. The purpose of the study was to collect information about literacy practices in a community setting, focusing on a library. The researchers used an ecological approach to data collection. The methodology included approaches…

Characterization of Chemosynthetic Microbial Mats Associated with Intertidal Hydrothermal Sulfur Vents in White Point, San Pedro, CA, USA

PubMed Central

Miranda, Priscilla J.; McLain, Nathan K.; Hatzenpichler, Roland; Orphan, Victoria J.; Dillon, Jesse G.

2016-01-01

The shallow-sea hydrothermal vents at White Point (WP) in Palos Verdes on the southern California coast support microbial mats and provide easily accessed settings in which to study chemolithoautotrophic sulfur cycling. Previous studies have cultured sulfur-oxidizing bacteria from the WP mats; however, almost nothing is known about the in situ diversity and activity of the microorganisms in these habitats. We studied the diversity, micron-scale spatial associations and metabolic activity of the mat community via sequence analysis of 16S rRNA and aprA genes, fluorescence in situ hybridization (FISH) microscopy and sulfate reduction rate (SRR) measurements. Sequence analysis revealed a diverse group of bacteria, dominated by sulfur cycling gamma-, epsilon-, and deltaproteobacterial lineages such as Marithrix, Sulfurovum, and Desulfuromusa. FISH microscopy suggests a close physical association between sulfur-oxidizing and sulfur-reducing genotypes, while radiotracer studies showed low, but detectable, SRR. Comparative 16S rRNA gene sequence analyses indicate the WP sulfur vent microbial mat community is similar, but distinct from other hydrothermal vent communities representing a range of biotopes and lithologic settings. These findings suggest a complete biological sulfur cycle is operating in the WP mat ecosystem mediated by diverse bacterial lineages, with some similarity with deep-sea hydrothermal vent communities. PMID:27512390

Potential effectiveness of Community Health Strategy to promote exclusive breastfeeding in urban poor settings in Nairobi, Kenya: a quasi-experimental study.

PubMed

Kimani-Murage, E W; Norris, S A; Mutua, M K; Wekesah, F; Wanjohi, M; Muhia, N; Muriuki, P; Egondi, T; Kyobutungi, C; Ezeh, A C; Musoke, R N; McGarvey, S T; Madise, N J; Griffiths, P L

2016-04-01

Early nutrition is critical for later health and sustainable development. We determined potential effectiveness of the Kenyan Community Health Strategy in promoting exclusive breastfeeding (EBF) in urban poor settings in Nairobi, Kenya. We used a quasi-experimental study design, based on three studies [Pre-intervention (2007-2011; n=5824), Intervention (2012-2015; n=1110) and Comparison (2012-2014; n=487)], which followed mother-child pairs longitudinally to establish EBF rates from 0 to 6 months. The Maternal, Infant and Young Child Nutrition (MIYCN) study was a cluster randomized trial; the control arm (MIYCN-Control) received standard care involving community health workers (CHWs) visits for counselling on antenatal and postnatal care. The intervention arm (MIYCN-Intervention) received standard care and regular MIYCN counselling by trained CHWs. Both groups received MIYCN information materials. We tested differences in EBF rates from 0 to 6 months among four study groups (Pre-intervention, MIYCN-Intervention, MIYCN-Control and Comparison) using a χ(2) test and logistic regression. At 6 months, the prevalence of EBF was 2% in the Pre-intervention group compared with 55% in the MIYCN-Intervention group, 55% in the MIYCN-Control group and 3% in the Comparison group (P<0.05). After adjusting for baseline characteristics, the odds ratio for EBF from birth to 6 months was 66.9 (95% CI 45.4-96.4), 84.3 (95% CI 40.7-174.6) and 3.9 (95% CI 1.8-8.4) for the MIYCN-Intervention, MIYCN-Control and Comparison group, respectively, compared with the Pre-intervention group. There is potential effectiveness of the Kenya national Community Health Strategy in promoting EBF in urban poor settings where health care access is limited.

The Mobile story: data-driven community efforts to raise graduation rates.

PubMed

Newell, Jeremiah; Akers, Carolyn

2010-01-01

Through sustained community organizing and strategic partnerships, the Mobile (Alabama) County Public School System is improving achievement and creating beat-the-odds schools that set and achieve high academic expectations despite the challenges of poverty and racial disparity. The authors chart how Mobile's Research Alliance for Multiple Pathways, funded through the U.S. Department of Labor's Multiple Pathways Blueprint Initiative, is identifying gaps in services throughout the community, analyzing the data about dropouts, benchmarking other communities, studying best practices, and mobilizing the community to expect and demand higher graduation rates. These activities are resulting in early identification of off-track students and coordination of school- and community-based reforms.

Coastal oceanography sets the pace of rocky intertidal community dynamics.

PubMed

Menge, B A; Lubchenco, J; Bracken, M E S; Chan, F; Foley, M M; Freidenburg, T L; Gaines, S D; Hudson, G; Krenz, C; Leslie, H; Menge, D N L; Russell, R; Webster, M S

2003-10-14

The structure of ecological communities reflects a tension among forces that alter populations. Marine ecologists previously emphasized control by locally operating forces (predation, competition, and disturbance), but newer studies suggest that inputs from large-scale oceanographically modulated subsidies (nutrients, particulates, and propagules) can strongly influence community structure and dynamics. On New Zealand rocky shores, the magnitude of such subsidies differs profoundly between contrasting oceanographic regimes. Community structure, and particularly the pace of community dynamics, differ dramatically between intermittent upwelling regimes compared with relatively persistent down-welling regimes. We suggest that subsidy rates are a key determinant of the intensity of species interactions, and thus of structure in marine systems, and perhaps also nonmarine communities.

A Pilot Study of a Novel Method of Measuring Stigma about Depression Developed for Latinos in the Faith-Based Setting.

PubMed

Caplan, Susan

2016-08-01

In order to understand the effects of interventions designed to reduce stigma about mental illness, we need valid measures. However, the validity of commonly used measures is compromised by social desirability bias. The purpose of this pilot study was to test an anonymous method of measuring stigma in the community setting. The method of data collection, Preguntas con Cartas (Questions with Cards) used numbered playing cards to conduct anonymous group polling about stigmatizing beliefs during a mental health literacy intervention. An analysis of the difference between Preguntas con Cartas stigma votes and corresponding face-to-face individual survey results for the same seven stigma questions indicated that there was a statistically significant differences in the distributions between the two methods of data collection (χ(2) = 8.27, p = 0.016). This exploratory study has shown the potential effectiveness of Preguntas con Cartas as a novel method of measuring stigma in the community-based setting.

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.

Exploration of an allied health workforce redesign model: quantifying the work of allied health assistants in a community workforce.

PubMed

Somerville, Lisa; Davis, Annette; Milne, Sarah; Terrill, Desiree; Philip, Kathleen

2017-07-25

The Victorian Assistant Workforce Model (VAWM) enables a systematic approach for the identification and quantification of work that can be delegated from allied health professionals (AHPs) to allied health assistants (AHAs). The aim of the present study was to explore the effect of implementation of VAWM in the community and ambulatory health care setting. Data captured using mixed methods from allied health professionals working across the participating health services enabled the measurement of opportunity for workforce redesign in the community and ambulatory allied health workforce. A total of 1112 AHPs and 135 AHAs from the 27 participating organisations took part in the present study. AHPs identified that 24% of their time was spent undertaking tasks that could safely be delegated to an appropriately qualified and supervised AHA. This equates to 6837h that could be redirected to advanced and expanded AHP practice roles or expanded patient-centred service models. The VAWM demonstrates potential for more efficient implementation of assistant workforce roles across allied health. Data outputs from implementation of the VAWM are vital in informing strategic planning and sustainability of workforce change. A more efficient and effective workforce promotes service delivery by the right person, in the right place, at the right time. What is known about this topic? There are currently workforce shortages that are predicted to grow across the allied health workforce. Ensuring that skill mix is optimal is one way to address these shortages. Matching the right task to right worker will also enable improved job satisfaction for both allied health assistants and allied health professionals. Workforce redesign efforts are more effective when there is strong data to support the redesign. What does this paper add? This paper builds on a previous paper by Somerville et al. with a case study applying the workforce redesign model to a community and ambulatory health care setting. It provides evidence that this workforce redesign model enables data to be collected to identify the opportunity for redesign in the allied health workforce in this clinical setting. What are the implications for practitioners? There are career pathways and opportunity for growth in the allied health assistant workforce in the community and ambulatory health care setting. These opportunities will need to be coupled with the development of supervision and delegation skills in the allied health professional workforce to ensure that an integrated workforce is built to provide optimal clinical care in the community and ambulatory setting.

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

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.

What childhood obesity prevention programmes work? A systematic review and meta-analysis

PubMed Central

Wang, Y.; Cai, L.; Wu, Y.; Wilson, R. F.; Weston, C.; Fawole, O.; Bleich, S. N.; Cheskin, L. J.; Showell, N. N.; Lau, B. D.; Chiu, D. T.; Zhang, A.; Segal, J.

2015-01-01

Summary Previous reviews of childhood obesity prevention have focused largely on schools and findings have been inconsistent. Funded by the US Agency for Healthcare Research and Quality (AHRQ) and the National Institutes of Health, we systematically evaluated the effectiveness of childhood obesity prevention programmes conducted in high-income countries and implemented in various settings. We searched MEDLINE®, Embase, PsycINFO, CINAHL®, ClinicalTrials.gov and the Cochrane Library from inception through 22 April 2013 for relevant studies, including randomized controlled trials, quasi-experimental studies and natural experiments, targeting diet, physical activity or both, and conducted in children aged 2–18 in high-income countries. Two reviewers independently abstracted the data. The strength of evidence (SOE) supporting interventions was graded for each study setting (e.g. home, school). Meta-analyses were performed on studies judged sufficiently similar and appropriate to pool using random effect models. This paper reported our findings on various adiposity-related outcomes. We identified 147 articles (139 intervention studies) of which 115 studies were primarily school based, although other settings could have been involved. Most were conducted in the United States and within the past decade. SOE was high for physical activity-only interventions delivered in schools with home involvement or combined diet–physical activity interventions delivered in schools with both home and community components. SOE was moderate for school-based interventions targeting either diet or physical activity, combined interventions delivered in schools with home or community components or combined interventions delivered in the community with a school component. SOE was low for combined interventions in childcare or home settings. Evidence was insufficient for other interventions. In conclusion, at least moderately strong evidence supports the effectiveness of school-based interventions for preventing childhood obesity. More research is needed to evaluate programmes in other settings or of other design types, especially environmental, policy and consumer health informatics-oriented interventions. PMID:25893796

A cross-cultural study of eating attitudes in adolescent South African females

PubMed Central

Szabo, Christopher Paul; Allwood, Clifford W

2004-01-01

Eating disorders were first described in black females in South Africa in 1995. A subsequent community based study of eating attitudes amongst adolescent females in an urban setting suggested that there would be increasing numbers of sufferers from within the black community. The current study sought to extend these findings using a larger, more representative urban sample. The results support those of the preliminary study. The underlying basis for the emerging phenomenon is discussed PMID:16633453

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.

SNOWMASS (DPF Community Summer Study)

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

Cronin-Hennessy, et al, Daniel

2013-08-06

The 2013 Community Summer Study, known as Snowmass," brought together nearly 700 physicists to identify the critical research directions for the United States particle physics program. Commissioned by the American Physical Society, this meeting was the culmination of intense work over the past year by more than 1000 physicists that defined the most important questions for this field and identified the most promising opportunities to address them. This Snowmass study report is a key resource for setting priorities in particle physics.

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

PubMed

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

2016-12-01

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

Community walking programs for treatment of peripheral artery disease

PubMed Central

Mays, Ryan J.; Rogers, R. Kevin; Hiatt, William R.; Regensteiner, Judith G.

2013-01-01

Background Supervised walking programs offered at medical facilities for patients with peripheral artery disease (PAD) and intermittent claudication (IC), while effective, are often not utilized due to barriers including lack of reimbursement and the need to travel to specialized locations for the training intervention. Walking programs for PAD patients that occur in community settings, such as those outside of supervised settings, may be a viable treatment option, as they are convenient and potentially bypass the need for supervised walking. This review evaluated the various methodologies and outcomes of community walking programs for PAD. Methods A literature review using appropriate search terms was conducted within PubMed/Medline and the Cochrane databases to identify studies in the English language employing community walking programs to treat PAD patients with IC. Search results were reviewed, and relevant articles were identified that form the basis of this review. The primary outcome was peak walking performance on the treadmill. Results Randomized controlled trials (n=10) examining peak walking outcomes in 558 PAD patients demonstrated that supervised exercise programs were more effective than community walking studies that consisted of general recommendations for patients with IC to walk at home. Recent community trials that incorporated more advice and feedback for PAD patients in general resulted in similar outcomes with no differences in peak walking time compared to supervised walking exercise groups. Conclusions Unstructured recommendations for patients with symptomatic PAD to exercise in the community are not efficacious. Community walking programs with more feedback and monitoring offer improvements in walking performance for patients with claudication and may bypass some obstacles associated with facility-based exercise programs. PMID:24103409

Evidence-Based Implementation: The Role of Sustained Community-Based Practice and Research Partnerships

PubMed Central

Kilbourne, Amy M.; Neumann, Mary Spink; Waxmonsky, Jeanette; Bauer, Mark S.; Kim, Hyungin Myra; Pincus, Harold Alan; Thomas, Marshall

2017-01-01

This column describes a process for adapting an evidence-based practice in community clinics in which researchers and community providers participated and the resulting framework for implementation of the practice—Replicating Effective Programs–Facilitation. A two-day meeting for the Recovery-Oriented Collaborative Care study was conducted to elicit input from more than 50 stakeholders, including community providers, health care administrators, and implementation researchers. The process illustrates an effective researcher-community partnership in which stakeholders worked together not only to adapt the evidence-based practice to the needs of the clinical settings but also to develop the implementation strategy. PMID:22388527

Sexuality in a Community Based Sample of Adults with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Gilmour, Laura; Schalomon, P. Melike; Smith, Veronica

2012-01-01

Few studies have examined the sexual attitudes and behaviours of individuals with high functioning autism spectrum disorders (ASDs) living in community settings. A total of 82 (55 female and 17 male) adults with autism were contrasted with 282 members of the general population on their responses to an online survey of sexual knowledge and…

Assessing Riverside Community College Nursing Student Attitudes toward Exposure to AIDS/HIV-Positive Patients.

ERIC Educational Resources Information Center

Kross, Carolyn Sue

In fall 1990, a study was conducted to assess the attitudes of nursing students who were attending Riverside Community College (RCC), in California, toward exposure to Acquired Immune Deficiency Syndrome/Human Immunodeficiency Virus (AIDS/HIV) positive patients in a hospital setting. All students enrolled in RCC's associate degree nursing program…

Life Satisfaction: The Richard Cory Syndrome.

ERIC Educational Resources Information Center

Gatz, Margaret; And Others

This study of life satisfaction and competence was part of the Individual and Community Competence Project (Gatz and others, 1976). It included two groups of people, community workers (N=21) and non-workers (N=22), from each of two settings, Model Neighborhoods Areas (MNA) and Central Area (CNA). The MNA is a black area, while the CNA is a white…

Responses to Islam in the Classroom: A Case of Muslim Girls from Minority Communities of Interpretation

ERIC Educational Resources Information Center

Merchant, Natasha Hakimali

2016-01-01

Coinciding with the rise of "Islamophobia" in the United States is a small but growing set of educational scholarship around the curricular impact of and response to Islamophobia. The qualitative case study discussed in this manuscript aims to contribute to this conversation by investigating how Muslim girls from minority communities of…

Adolescents' Educational Outcomes in a Social Ecology of Parenting, Family, and Community Risks in Northern Ireland

ERIC Educational Resources Information Center

Goeke-Morey, Marcie C.; Taylor, Laura K.; Merrilees, Christine E.; Cummings, E. Mark; Cairns, Ed; Shirlow, Peter

2013-01-01

This study examines the influence of social ecological risks within the domains of parenting, family environment, and community in the prediction of educational outcomes for 770 adolescents (49% boys, 51% girls, "M"?=?13.6 years, "SD"?=?2.0) living in a setting of protracted political conflict, specifically working class areas…

Diabetes Prevention and Management among Minority Ethnic Groups in Nicaragua: Findings from Phase 2 of a Community-Based Participatory Research Study

ERIC Educational Resources Information Center

Newlin Lew, Kelley; Mitchell, Emma McKim; Mclean, Yolanda

2016-01-01

Objectives: To (1) describe barriers to diabetes prevention and self-management, (2) explore how religious beliefs inform diabetes prevention and self-management and (3) describe community action strategies to address the problem of diabetes locally. Design: Qualitative, descriptive design. Setting: Three Moravian Churches located, respectively,…

An Expanded Role for the Community College and its Counseling Center.

ERIC Educational Resources Information Center

Heiner, Harold

This study examines, expecially for the rural district, ways to increase the effectiveness of college counseling for the whole community. The counselor often wants to refer an individual to a more specialized agency. Such referral is hard to make even in an urban setting, where the existing agencies are usually overcrowded, and worse in a rural…

Transportability of Multisystemic Therapy to Community Settings: Can a Program Sustain Outcomes without MST Services Oversight?

ERIC Educational Resources Information Center

Smith-Boydston, Julianne M.; Holtzman, Rochelle J.; Roberts, Michael C.

2014-01-01

Background: Multisystemic therapy (MST) has been shown to be effective in treating delinquent behavior in youth. However, some community agencies with MST programs are unable to afford the ongoing costs of licensure and quality assurance oversight provided by MST services. Objective: The present study utilized retrospective archival analyses of…

Novel Setting for Addressing Tobacco-Related Disparities: A Survey of Community Welfare Organization Smoking Policies, Practices and Attitudes

ERIC Educational Resources Information Center

Bonevski, B.; O'Brien, J.; Frost, S.; Yiow, L.; Oakes, W.; Barker, D.

2013-01-01

Research in the United States and Australia acknowledges the potential of non-government social and community service organizations (SCSOs) for reaching socially disadvantaged smokers. This study aimed to describe SCSO smoking policies and practices, and attitudes of senior staff towards smoking and cessation. It also investigated factors…

Scale Development of a Measure to Assess Community-Based and Clinical Intervention Group Environments

ERIC Educational Resources Information Center

Wilson, Patrick A.; Hansen, Nathan B.; Tarakeshwar, Nalini; Neufeld, Sharon; Kochman, Arlene; Sikkema, Kathleen J.

2008-01-01

Though group interventions are widely used in community-based and clinical settings, there are few brief instruments for assessing the group environment. Two studies on the development of a brief measure to assess intervention group environments are described, and psychometric properties of the new scale are presented. The new measure is based on…

Nurse Education and Communities of Practice. Researching Professional Education Research Reports Series.

ERIC Educational Resources Information Center

Burkitt, Ian; Husband, Charles; Mackenzie, Jennifer; Torn, Alison

The processes whereby nurses develop the skills and knowledge required to deliver individualized and holistic care were examined in a 2-year study of nurses in a range of clinical settings and a university department of nursing in England. Members of two research teams of qualified nurses joined various communities of nursing practice as…

Establishing an Online Community of Inquiry at the Distance Education Centre, Victoria

ERIC Educational Resources Information Center

Jackson, Luke C.; Jackson, Alun C.; Chambers, Dianne

2013-01-01

This pilot intervention focused on three courses that were redesigned to utilize the online environment to establish an online community of inquiry (CoI). The setting for this research study was the Distance Education Centre, Victoria (DECV), an Australian co-educational school with approximately 3000 students who, for a variety of reasons, are…

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.

Comparative Initial and Sustained Engagement in Web-based Training by Behavioral Healthcare Providers in New York State.

PubMed

Talley, Rachel; Chiang, I-Chin; Covell, Nancy H; Dixon, Lisa

2018-06-01

Improved dissemination is critical to implementation of evidence-based practice in community behavioral healthcare settings. Web-based training modalities are a promising strategy for dissemination of evidence-based practice in community behavioral health settings. Initial and sustained engagement of these modalities in large, multidisciplinary community provider samples is not well understood. This study evaluates comparative engagement and user preferences by provider type in a web-based training platform in a large, multidisciplinary community sample of behavioral health staff in New York State. Workforce make-up among platform registrants was compared to the general NYS behavioral health workforce. Training completion by functional job type was compared to characterize user engagement and preferences. Frequently completed modules were classified by credit and requirement incentives. High initial training engagement across professional role was demonstrated, with significant differences in initial and sustained engagement by professional role. The most frequently completed modules across functional job types contained credit or requirement incentives. The analysis demonstrated that high engagement of a web-based training in a multidisciplinary provider audience can be achieved without tailoring content to specific professional roles. Overlap between frequently completed modules and incentives suggests a role for incentives in promoting engagement of web-based training. These findings further the understanding of strategies to promote large-scale dissemination of evidence-based practice in community behavioral health settings.

Breastfeeding patterns in the rural community of Hilo, Hawai'i: an exploration of existing data sets.

PubMed

Flood, Jeanie L

2013-03-01

Before any breastfeeding promotion effort, an understanding of the existing breastfeeding patterns is essential. Hawai'i County is a rural, ethnically diverse, medically underserved community. The purpose of this study was to describe the breastfeeding patterns of women living in Hilo, Hawai'i. Data from several existing national, state, and local data sets were accessed to identify and describe the breastfeeding patterns of women in this community. Available breastfeeding data about women in Hilo was obtained from the Hawai'i WIC program and includes initiation, duration, exclusivity of breastfeeding, and reasons for not breastfeeding. These data were compared to data from published reports available at the county, state, and national level. The State of Hawai'i and Hilo exceed national targets for breastfeeding initiation; however, rates soon drop following delivery, and mixed feedings of infants is common. The highest percentage of mothers weaned their infants within the first four weeks postpartum. The reasons the majority of the mothers gave for weaning were tied to breastfeeding situations that are amenable to skilled lactation support (eg, milk supply issues and latch or sucking problems). While available data sets offer valuable information on the breastfeeding patterns in this rural community, there are limitations to their usefulness, primarily due to the inconsistent operational definitions of infant feeding variables used in the surveys, and the lack of availability of community level data.

Breastfeeding Patterns in the Rural Community of Hilo, Hawai‘i: An Exploration of Existing Data Sets

PubMed Central

2013-01-01

Before any breastfeeding promotion effort, an understanding of the existing breastfeeding patterns is essential. Hawai‘i County is a rural, ethnically diverse, medically underserved community. The purpose of this study was to describe the breastfeeding patterns of women living in Hilo, Hawai‘i. Data from several existing national, state, and local data sets were accessed to identify and describe the breastfeeding patterns of women in this community. Available breastfeeding data about women in Hilo was obtained from the Hawai‘i WIC program and includes initiation, duration, exclusivity of breastfeeding, and reasons for not breastfeeding. These data were compared to data from published reports available at the county, state, and national level. The State of Hawai‘i and Hilo exceed national targets for breastfeeding initiation; however, rates soon drop following delivery, and mixed feedings of infants is common. The highest percentage of mothers weaned their infants within the first four weeks postpartum. The reasons the majority of the mothers gave for weaning were tied to breastfeeding situations that are amenable to skilled lactation support (eg, milk supply issues and latch or sucking problems). While available data sets offer valuable information on the breastfeeding patterns in this rural community, there are limitations to their usefulness, primarily due to the inconsistent operational definitions of infant feeding variables used in the surveys, and the lack of availability of community level data. PMID:23520565

Comparison of community and hospital pharmacists' attitudes and behaviors on medication error disclosure to the patient: A pilot study.

PubMed

Kim, ChungYun; Mazan, Jennifer L; Quiñones-Boex, Ana C

To determine pharmacists' attitudes and behaviors on medication errors and their disclosure and to compare community and hospital pharmacists on such views. An online questionnaire was developed from previous studies on physicians' disclosure of errors. Questionnaire items included demographics, environment, personal experiences, and attitudes on medication errors and the disclosure process. An invitation to participate along with the link to the questionnaire was electronically distributed to members of two Illinois pharmacy associations. A follow-up reminder was sent 4 weeks after the original message. Data were collected for 3 months, and statistical analyses were performed with the use of IBM SPSS version 22.0. The overall response rate was 23.3% (n = 422). The average employed respondent was a 51-year-old white woman with a BS Pharmacy degree working in a hospital pharmacy as a clinical staff member. Regardless of practice settings, pharmacist respondents agreed that medication errors were inevitable and that a disclosure process is necessary. Respondents from community and hospital settings were further analyzed to assess any differences. Community pharmacist respondents were more likely to agree that medication errors were inevitable and that pharmacists should address the patient's emotions when disclosing an error. Community pharmacist respondents were also more likely to agree that the health care professional most closely involved with the error should disclose the error to the patient and thought that it was the pharmacists' responsibility to disclose the error. Hospital pharmacist respondents were more likely to agree that it was important to include all details in a disclosure process and more likely to disagree on putting a "positive spin" on the event. Regardless of practice setting, responding pharmacists generally agreed that errors should be disclosed to patients. There were, however, significant differences in their attitudes and behaviors depending on their particular practice setting. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Self-perceived health status and sleep quality of older adults living in community after elastic band exercises.

PubMed

Chan, Shu-Ya; Chen, Kuei-Min

2017-07-01

To test the effectiveness of a six-month senior elastic band exercise programme on the self-perceived health status and sleep quality of older adults living in community settings. Health issues common among older adults living in community settings include poor physical and mental health conditions and sleep quality. Engagement in appropriate exercise programmes facilitates alleviating these health issues among older adults. A quasi-experimental design was applied. A convenience sample of older adults was drawn from six senior-citizen activity centres in southern Taiwan. Participants were assigned to either an experimental group (three centres, n = 97) or a control group (three centres, n = 102) based on the senior-citizen activity centres they attended. The participants in the experimental group carried out the Senior Elastic Band exercise programme for six months (three times per week and 40 minutes per session) in addition to their daily activities. The participants in the control group maintained their daily activities. The participants' self-perceived health status and sleep quality were examined at the baseline, three-month interval and six-month interval. In total, 169 participants completed the six-month study: 84 constituted the experimental group and 85 constituted the control group. At the three-month interval, the participants in the experimental group had greater improvements in self-perceived physical health, overall sleep quality, sleep latency and sleep duration compared with those in the control group; these significant changes continued throughout the six-month study. The Senior Elastic Band exercise programme showed promising effects in improving the self-perceived physical health and sleep quality of older adults living in community settings. Healthcare professionals can incorporate the Senior Elastic Band exercise programme as one of the health promotion activities for older adults living in community settings. © 2016 John Wiley & Sons Ltd.

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.

Structural and functional diversity of Nematoda in relation with environmental variables in the Setúbal and Cascais canyons, Western Iberian Margin

NASA Astrophysics Data System (ADS)

Ingels, Jeroen; Billett, David S. M.; Kiriakoulakis, Konstadinos; Wolff, George A.; Vanreusel, Ann

2011-12-01

Samples collected at two different depths (ca. 3200 and ca. 4200 m) in the Setúbal and Cascais canyons off the Portuguese coast, during the HERMES RRS Charles Darwin cruise CD179, were analysed for (1) sediment biogeochemistry (TOC, TN) and (2) composition, and structural and trophic diversity of nematode communities. Multivariate PERMANOVA analysis on the nematode community data revealed differences between sediment layers that were greater than differences between canyons, water depths, and stations. This suggests that biogeochemical gradients along the vertical sediment profile are crucial in determining nematode community structure. The interaction between canyon conditions and the nematode community is illustrated by biogeochemical patterns in the sediment and the prevalence of nematode genera that are able to persist in disturbed sediments. Trophic analysis of the nematode community indicated that non-selective deposit feeders are dominant, presumably because of their non-selective feeding behaviour compared to other feeding types, which gives them a competitive advantage in exploiting lower-quality food resources. This study presents a preliminary conceptual scheme for interactions between canyon conditions and the resident fauna.

Self-Efficacy and Nutrition Education: A Study of the Effect of an Intervention with Faith Community Nurses.

PubMed

Gotwals, Beth

2018-02-01

The faith community provides an important access point for practice focused on population health at a time when health issues such as obesity and overweight are affecting large number of Americans. The purpose of this study was to examine faith community nurses' self-efficacy perceptions following a nutrition educational intervention. A convenience sample of 92 faith community nurses were randomly assigned to experimental and control groups. The t-distribution analysis revealed significant differences between the nutrition knowledge self-efficacy (p = .016) and nutrition counseling self-efficacy (p = .010) post-test scores for the experimental and control groups. This type of educational intervention provides a model to be used with faith community nurses as they integrate faith and health in this setting.

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.

Think locally, act locally: detection of small, medium-sized, and large communities in large networks.

PubMed

Jeub, Lucas G S; Balachandran, Prakash; Porter, Mason A; Mucha, Peter J; Mahoney, Michael W

2015-01-01

It is common in the study of networks to investigate intermediate-sized (or "meso-scale") features to try to gain an understanding of network structure and function. For example, numerous algorithms have been developed to try to identify "communities," which are typically construed as sets of nodes with denser connections internally than with the remainder of a network. In this paper, we adopt a complementary perspective that communities are associated with bottlenecks of locally biased dynamical processes that begin at seed sets of nodes, and we employ several different community-identification procedures (using diffusion-based and geodesic-based dynamics) to investigate community quality as a function of community size. Using several empirical and synthetic networks, we identify several distinct scenarios for "size-resolved community structure" that can arise in real (and realistic) networks: (1) the best small groups of nodes can be better than the best large groups (for a given formulation of the idea of a good community); (2) the best small groups can have a quality that is comparable to the best medium-sized and large groups; and (3) the best small groups of nodes can be worse than the best large groups. As we discuss in detail, which of these three cases holds for a given network can make an enormous difference when investigating and making claims about network community structure, and it is important to take this into account to obtain reliable downstream conclusions. Depending on which scenario holds, one may or may not be able to successfully identify "good" communities in a given network (and good communities might not even exist for a given community quality measure), the manner in which different small communities fit together to form meso-scale network structures can be very different, and processes such as viral propagation and information diffusion can exhibit very different dynamics. In addition, our results suggest that, for many large realistic networks, the output of locally biased methods that focus on communities that are centered around a given seed node (or set of seed nodes) might have better conceptual grounding and greater practical utility than the output of global community-detection methods. They also illustrate structural properties that are important to consider in the development of better benchmark networks to test methods for community detection.

Think locally, act locally: Detection of small, medium-sized, and large communities in large networks

NASA Astrophysics Data System (ADS)

Jeub, Lucas G. S.; Balachandran, Prakash; Porter, Mason A.; Mucha, Peter J.; Mahoney, Michael W.

2015-01-01

It is common in the study of networks to investigate intermediate-sized (or "meso-scale") features to try to gain an understanding of network structure and function. For example, numerous algorithms have been developed to try to identify "communities," which are typically construed as sets of nodes with denser connections internally than with the remainder of a network. In this paper, we adopt a complementary perspective that communities are associated with bottlenecks of locally biased dynamical processes that begin at seed sets of nodes, and we employ several different community-identification procedures (using diffusion-based and geodesic-based dynamics) to investigate community quality as a function of community size. Using several empirical and synthetic networks, we identify several distinct scenarios for "size-resolved community structure" that can arise in real (and realistic) networks: (1) the best small groups of nodes can be better than the best large groups (for a given formulation of the idea of a good community); (2) the best small groups can have a quality that is comparable to the best medium-sized and large groups; and (3) the best small groups of nodes can be worse than the best large groups. As we discuss in detail, which of these three cases holds for a given network can make an enormous difference when investigating and making claims about network community structure, and it is important to take this into account to obtain reliable downstream conclusions. Depending on which scenario holds, one may or may not be able to successfully identify "good" communities in a given network (and good communities might not even exist for a given community quality measure), the manner in which different small communities fit together to form meso-scale network structures can be very different, and processes such as viral propagation and information diffusion can exhibit very different dynamics. In addition, our results suggest that, for many large realistic networks, the output of locally biased methods that focus on communities that are centered around a given seed node (or set of seed nodes) might have better conceptual grounding and greater practical utility than the output of global community-detection methods. They also illustrate structural properties that are important to consider in the development of better benchmark networks to test methods for community detection.

Short-Term Cognitive-Behavioural Group Treatment for Hoarding Disorder: A Naturalistic Treatment Outcome Study.

PubMed

Moulding, Richard; Nedeljkovic, Maja; Kyrios, Michael; Osborne, Debra; Mogan, Christopher

2017-01-01

The study aim was to test whether a 12-week publically rebated group programme, based upon Steketee and Frost's Cognitive Behavioural Therapy-based hoarding treatment, would be efficacious in a community-based setting. Over a 3-year period, 77 participants with clinically significant hoarding were recruited into 12 group programmes. All completed treatment; however, as this was a community-based naturalistic study, only 41 completed the post-treatment assessment. Treatment included psychoeducation about hoarding, skills training for organization and decision making, direct in-session exposure to sorting and discarding, and cognitive and behavioural techniques to support out-of-session sorting and discarding, and nonacquiring. Self-report measures used to assess treatment effect were the Savings Inventory-Revised (SI-R), Savings Cognition Inventory, and the Depression, Anxiety and Stress Scales. Pre-post analyses indicated that after 12 weeks of treatment, hoarding symptoms as measured on the SI-R had reduced significantly, with large effect sizes reported in total and across all subscales. Moderate effect sizes were also reported for hoarding-related beliefs (emotional attachment and responsibility) and depressive symptoms. Of the 41 participants who completed post-treatment questionnaires, 14 (34%) were conservatively calculated to have clinically significant change, which is considerable given the brevity of the programme judged against the typical length of the disorder. The main limitation of the study was the moderate assessment completion rate, given its naturalistic setting. This study demonstrated that a 12-week group treatment for hoarding disorders was effective in reducing hoarding and depressive symptoms in an Australian clinical cohort and provides evidence for use of this treatment approach in a community setting. Copyright © 2016 John Wiley & Sons, Ltd. A 12-week group programme delivered in a community setting was effective for helping with hoarding symptoms with a large effect size. Hoarding beliefs (emotional attachment and responsibility) and depression were reduced, with moderate effect sizes. A third of all participants who completed post-treatment questionnaires experienced clinically significant change. Suggests that hoarding CBT treatment can be effectively translated into real-world settings and into a brief 12-session format, albeit the study had a moderate assessment completion rate. Copyright © 2016 John Wiley & Sons, Ltd.

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

PubMed

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

2013-01-01

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

Community views and public health priority setting: how do health department priorities, community views, and health indicator data compare?

PubMed

Earle-Richardson, Giulia; Scribani, Melissa; Wyckoff, Lynae; Strogatz, David; May, John; Jenkins, Paul

2015-01-01

New York, like many other states, provides county-level health statistics for use in local priority settings but does not provide any data on public views about priority health issues. This study assessed whether health department priorities are notably different from community concerns about health, and how both groups' priorities compare with local health statistics. Data from a 2009 rural survey on community health concerns were compared to priorities named by the seven area county health departments, and to local health indicator data. Health care/insurance cost (60%), obesity (53%), and prescription cost (41%) were leading community concerns, regardless of age, education, sex, or Internet in the home. Six of seven county health departments selected access to quality health care (which includes health care/insurance cost) as a leading public health priority, but only three identified obesity. The following leading local health issues were suggested by health indicators: Physical activity and nutrition, Smoking, and Unintentional injury. Health departments diverged from community priorities, from health indicator data, and from one another in choosing priorities. Adding a question about community health priorities to existing state telephone surveys on health behavior and lifestyle would provide an important tool to local health departments. © 2014 Society for Public Health Education.

A taxonomy for community-based care programs focused on HIV/AIDS prevention, treatment, and care in resource-poor settings

PubMed Central

Rachlis, Beth; Sodhi, Sumeet; Burciul, Barry; Orbinski, James; Cheng, Amy H.Y.; Cole, Donald

2013-01-01

Community-based care (CBC) can increase access to key services for people affected by HIV/AIDS through the mobilization of community interests and resources and their integration with formal health structures. Yet, the lack of a systematic framework for analysis of CBC focused on HIV/AIDS impedes our ability to understand and study CBC programs. We sought to develop taxonomy of CBC programs focused on HIV/AIDS in resource-limited settings in an effort to understand their key characteristics, uncover any gaps in programming, and highlight the potential roles they play. Our review aimed to systematically identify key CBC programs focused on HIV/AIDS in resource-limited settings. We used both bibliographic database searches (Medline, CINAHL, and EMBASE) for peer-reviewed literature and internet-based searches for gray literature. Our search terms were ‘HIV’ or ‘AIDS’ and ‘community-based care’ or ‘CBC’. Two co-authors developed a descriptive taxonomy through an iterative, inductive process using the retrieved program information. We identified 21 CBC programs useful for developing taxonomy. Extensive variation was observed within each of the nine categories identified: region, vision, characteristics of target populations, program scope, program operations, funding models, human resources, sustainability, and monitoring and evaluation strategies. While additional research may still be needed to identify the conditions that lead to overall program success, our findings can help to inform our understanding of the various aspects of CBC programs and inform potential logic models for CBC programming in the context of HIV/AIDS in resource-limited settings. Importantly, the findings of the present study can be used to develop sustainable HIV/AIDS-service delivery programs in regions with health resource shortages. PMID:23594416

A taxonomy for community-based care programs focused on HIV/AIDS prevention, treatment, and care in resource-poor settings.

PubMed

Rachlis, Beth; Sodhi, Sumeet; Burciul, Barry; Orbinski, James; Cheng, Amy H Y; Cole, Donald

2013-04-16

Community-based care (CBC) can increase access to key services for people affected by HIV/AIDS through the mobilization of community interests and resources and their integration with formal health structures. Yet, the lack of a systematic framework for analysis of CBC focused on HIV/AIDS impedes our ability to understand and study CBC programs. We sought to develop taxonomy of CBC programs focused on HIV/AIDS in resource-limited settings in an effort to understand their key characteristics, uncover any gaps in programming, and highlight the potential roles they play. Our review aimed to systematically identify key CBC programs focused on HIV/AIDS in resource-limited settings. We used both bibliographic database searches (Medline, CINAHL, and EMBASE) for peer-reviewed literature and internet-based searches for gray literature. Our search terms were 'HIV' or 'AIDS' and 'community-based care' or 'CBC'. Two co-authors developed a descriptive taxonomy through an iterative, inductive process using the retrieved program information. We identified 21 CBC programs useful for developing taxonomy. Extensive variation was observed within each of the nine categories identified: region, vision, characteristics of target populations, program scope, program operations, funding models, human resources, sustainability, and monitoring and evaluation strategies. While additional research may still be needed to identify the conditions that lead to overall program success, our findings can help to inform our understanding of the various aspects of CBC programs and inform potential logic models for CBC programming in the context of HIV/AIDS in resource-limited settings. Importantly, the findings of the present study can be used to develop sustainable HIV/AIDS-service delivery programs in regions with health resource shortages.

A community-based health education analysis of an infectous disease control program in Nigeria.

PubMed

Adeyanju, O M

1987-01-01

This descriptive study utilized the strategy of primary health care in program development-especially a community-based health education intervention approach-in the control of guinea-worm in rural communities of Nigeria. Two closely related rural communities in two states served as target groups. Committee system approach, nominal group process, interview methods, audio-visual aids, and health care volunteer trainingship were the educational strategies employed in a control and experimental set up. The PRECEDE model was applied in the analysis. Results show a significant control action on guinea-worm infestation in the experimental community and a tremendous achievement in preventive health education interventions through organized community participation/involvement and ultimate self-reliance and individual responsibility. A positive increase in health knowledge and attitude examined through interview method, and observable changes in health behavior were noticed. Wells were provided, drinking water treated, while personal and community health promotion strategies were encouraged by all. The study has shown the effectiveness/efficacy of a community-based effort facilitated by a health educator.

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.

Data collection challenges in community settings: Insights from two field studies of patients with chronic disease

PubMed Central

Holden, Richard J.; McDougald Scott, Amanda M.; Hoonakker, Peter L.T.; Hundt, Ann S.; Carayon, Pascale

2014-01-01

Purpose Collecting information about health and disease directly from patients can be fruitfully accomplished using contextual approaches, ones that combine more and less structured methods in home and community settings. This paper's purpose is to describe and illustrate a framework of the challenges of contextual data collection. Methods A framework is presented based on prior work in community-based participatory research and organizational science, comprised of ten types of challenges across four broader categories. Illustrations of challenges and suggestions for addressing them are drawn from two mixed-method, contextual studies of patients with chronic disease in two regions of the US. Results The first major category of challenges was concerned with the researcher-participant partnership, for example, the initial lack of mutual trust and understanding between researchers, patients, and family members. The second category concerned patient characteristics such as cognitive limitations and a busy personal schedule that created barriers to successful data collection. The third concerned research logistics and procedures such as recruitment, travel distances, and compensation. The fourth concerned scientific quality and interpretation, including issues of validity, reliability, and combining data from multiple sources. The two illustrative studies faced both common and diverse research challenges and used many different strategies to address them. Conclusion Collecting less structured data from patients and others in the community is potentially very productive but requires the anticipation, avoidance, or negotiation of various challenges. Future work is necessary to better understand these challenges across different methods and settings, as well as to test and identify strategies to address them. PMID:25154464

Medicine shortages in Australia: causes, impact and management strategies in the community setting.

PubMed

Tan, Yee Xi; Moles, Rebekah J; Chaar, Betty B

2016-10-01

Background Medicine shortages are an ongoing global problem. The Therapeutic Goods Administration (TGA) dedicated a website for monitoring of medicine shortages in Australia in May 2014, as part of the Medicine Shortage Information Initiative. This study aimed to explore the views of pharmacists regarding medicine shortages in the community setting and the impact of the TGA website in Australia. Setting Community pharmacies in New South Wales, Australia. Method Twenty semi-structured interviews were conducted with community pharmacists. Data collected were analysed thematically utilising the framework analysis method. Main outcome measure Qualitative analysis conducted using the framework approach. Results Findings clearly indicated that medicine shortages were experienced on a regular basis, but most participants were unaware of the TGA website. Medicine shortages reportedly impacted both pharmacists and consumers; and various workarounds were undertaken to manage the issue. The "price disclosure policy" was found to be a prominent contributing factor in emerging shortages. Suggestions were made for ways to improve the growing occurrence of shortages. Conclusion Overall, the study found that there was a lack of familiarity with the TGA website, despite experiencing regular shortages of medicines in practice. Also highlighted, was the importance of pharmacists prioritising patient care over business decisions. To reduce prescribing of out-of-stock medicines notifying doctors about shortages was also considered important, to allow for early action to be taken at higher levels of the supply chain. Findings of this study may help direct future policy-making around the world, as medicine shortages is a problem shared by healthcare providers in most countries around the world.

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...

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…

Economic Evaluation of Combined Diet and Physical Activity Promotion Programs to Prevent Type 2 Diabetes Among Persons at Increased Risk: A Systematic Review for the Community Preventive Services Task Force

PubMed Central

Li, Rui; Qu, Shuli; Zhang, Ping; Chattopadhyay, Sajal; Gregg, Edward W.; Albright, Ann; Hopkins, David; Pronk, Nicolaas P.

2016-01-01

Background Diabetes is a highly prevalent and costly disease. Studies indicate that combined diet and physical activity promotion programs can prevent type 2 diabetes among persons at increased risk. Purpose To systematically evaluate the evidence on cost, cost-effectiveness, and cost-benefit estimates of diet and physical activity promotion programs. Data Sources Cochrane Library, EMBASE, MEDLINE, PsycINFO, Sociological Abstracts, Web of Science, EconLit, and CINAHL through 7 April 2015. Study Selection English-language studies from high-income countries that provided data on cost, cost-effectiveness, or cost-benefit ratios of diet and physical activity promotion programs with at least 2 sessions over at least 3 months delivered to persons at increased risk for type 2 diabetes. Data Extraction Dual abstraction and assessment of relevant study details. Data Synthesis Twenty-eight studies were included. Costs were expressed in 2013 U.S. dollars. The median program cost per participant was $653. Costs were lower for group-based programs (median, $417) and programs implemented in community or primary care settings (median, $424) than for the U.S. DPP (Diabetes Prevention Program) trial and the DPP Outcomes Study ($5881). Twenty-two studies assessed the incremental cost-effectiveness ratios (ICERs) of the programs. From a health system perspective, 16 studies reported a median ICER of $13 761 per quality-adjusted life-year (QALY) saved. Group-based programs were more cost-effective (median, $1819 per QALY) than those that used individual sessions (median, $15 846 per QALY). No cost-benefit studies were identified. Limitation Information on recruitment costs and cost-effectiveness of translational programs implemented in community and primary care settings was limited. Conclusion Diet and physical activity promotion programs to prevent type 2 diabetes are cost-effective among persons at increased risk. Costs are lower when programs are delivered to groups in community or primary care settings. Primary Funding Source None. PMID:26167962

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

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

Study participants incentives, compensation and reimbursement in resource-constrained settings.

PubMed

Mduluza, Takafira; Midzi, Nicholas; Duruza, Donold; Ndebele, Paul

2013-01-01

Controversies still exists within the research fraternity on the form and level of incentives, compensation and reimbursement to study participants in resource-constrained settings. While most research activities contribute significantly to advancement of mankind, little has been considered in rewarding directly the research participants from resource-constrained areas. A study was conducted in Zimbabwe to investigate views and expectations of various stakeholders on study participation incentives, compensation and reimbursement issues. Data was collected using various methods including a survey of about 1,008 parents/guardians of school children participating in various immunological cohort studies and parasitology surveys. Community advisory boards (CABs) at 9 of the sites were also consulted. Further, information was gathered during discussions held at a basic research ethics training workshop. The workshop had 45 participants that including 40 seasoned Zimbabwean researchers and 5 international research collaborators. About 90% (907) of the study participants and guardians expected compensation of reasonable value, in view of the researchers' value and comparison to other sites regardless of economic status of the community. During discussion with researchers at a basic ethics training workshop, about 80% (32) believed that decisions on level of compensation should be determined by the local research ethics committees. While, the few international research collaborators were of the opinion that compensation should be in accordance with local guidelines, and incentives should be in line with funding. Both the CAB members and study participants expressed that there should be a clear distinction between study incentive and compensation accorded to individual and community expectations on benefits from studies. However, CABs expressed that their suggestions on incentives and compensation are often moderated by the regulatory authorities who cite fear of unknown concerns. Overall, both personal and community benefits need to be considered collectively in future studies to be conducted in resource-constrained communities. There is projected fear that recruitment in future may be a challenge, now that almost every community, has somehow been reached and participated in some form of studies. A major concern on reimbursement, compensation or incentives should be internationally pegged regardless of different economic status of the individuals or communities where the study is to be conducted.

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.

Involving patients in setting priorities for healthcare improvement: a cluster randomized trial.

PubMed

Boivin, Antoine; Lehoux, Pascale; Lacombe, Réal; Burgers, Jako; Grol, Richard

2014-02-20

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. Cluster randomized controlled trial. Local communities were randomized in intervention (priority setting with patient involvement) and control sites (no patient involvement). 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. Patients were consulted in writing, before participating in face-to-face deliberation with professionals. Professionals established priorities among themselves, without patient involvement. A total of 172 individuals from six communities participated in the study, including 83 chronic disease patients, and 89 health professionals. 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. 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. 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. The Netherlands National Trial Register #NTR2496.

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

PubMed

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

2011-10-01

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

Effectiveness and Feasibility of the Early Start Denver Model Implemented in a Group-Based Community Childcare Setting

ERIC Educational Resources Information Center

Vivanti, Giacomo; Paynter, Jessica; Duncan, Ed; Fothergill, Hannah; Dissanayake, Cheryl; Rogers, Sally J.

2014-01-01

A recent study documented the efficacy of the Early Start Denver Model (ESDM) delivered in a 1:1 fashion. In the current study we investigated the effectiveness and feasibility of the ESDM in the context of a long-day care community service, with a child-staff ratio of 1:3. Outcomes of 27 preschoolers with ASD undergoing 15-25 h per week of ESDM…

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.

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…

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

ERIC Educational Resources Information Center

Kanyengo, Brendah Kakulwa; Kanyengo, Christine Wamunyima

2011-01-01

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

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

ERIC Educational Resources Information Center

Sindberg, Laura K.

2014-01-01

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

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…

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…

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.…

Globalization, neo-liberalism and community psychology.

PubMed

Nafstad, Hilde Eileen; Blakar, Rolv Mikkel; Carlquist, Erik; Phelps, Joshua Marvle; Rand-Hendriksen, Kim

2009-03-01

A longitudinal analysis (1984-2005) of media language in Norway is presented, demonstrating how the current globalized capitalist market ideology is now permeating this long-established Scandinavian welfare state. This ideological shift carries powerful implications for community psychology, as traditional welfare state values of equal services based on a universalistic principle are set aside, and social and material inequalities are increasingly accepted. The methodology developed in the present study may serve as a "barometer of community changes", to borrow a metaphor used by Sarason (2000).

Laparoscopic versus robotic-assisted Roux-en-Y gastric bypass: a retrospective, single-center study of early perioperative outcomes at a community hospital.

PubMed

Ahmad, Arif; Carleton, Jared D; Ahmad, Zoha F; Agarwala, Ashish

2016-09-01

The purpose of this study was to compare the operative and early perioperative outcomes of laparoscopic versus robotic-assisted Roux-en-Y gastric bypass procedures performed in a community hospital setting. The study was a chart review and analysis of the early perioperative outcomes of a total of 345 Roux-en-Y gastric bypass procedures performed by a single surgeon in a community hospital setting from January 2011 to October 2014. Of these, 173 procedures were performed laparoscopically and 172 were performed with robotic assistance utilizing the daVinci(®) surgical platform. Factors such as baseline patient characteristics, operative time, estimated blood loss (EBL), conversions to open procedure, complication rates, adverse events, length of stay (LOS), and return to the operating room for the two groups were retrospectively analyzed from a prospectively maintained database. Student's t test with unequal variances was used for statistical analysis, and a p value <0.05 was used for significance. There were no statistically significant differences in complication rates, EBL, or LOS between the two groups. There was a significant difference between the total operative times (135.30 ± 37.60 min for the laparoscopic procedure versus 154.84 ± 38.44 min for the robotic procedure, p < 0.05). There were no adverse intraoperative events, conversions to open procedures, leaks, strictures, returns to the operating room within 30 days, or mortalities in either group. Our study, which is the first of its kind to analyze the operative and early perioperative outcomes between laparoscopic and robotic-assisted Roux-en-Y gastric bypass procedures in the US community hospital setting, indicates that both are comparable in terms of safety, efficacy, and operative and early perioperative outcomes.

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

PubMed

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

2013-01-01

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

Rural Health Networks and Care Coordination: Health Care Innovation in Frontier Communities to Improve Patient Outcomes and Reduce Health Care Costs

PubMed Central

Conway, Pat; Favet, Heidi; Hall, Laurie; Uhrich, Jenny; Palcher, Jeanette; Olimb, Sarah; Tesch, Nathan; York-Jesme, Margaret; Bianco, Joe

2017-01-01

Rural residents’ health is challenged by high health care costs, chronic diseases, and policy decisions affecting rural health care. This single-case, embedded design study, guided by community-based participatory research principles and using mixed methods, describes outcomes of implementation of a community care team (CCT) and care coordination to improve outcomes of patients living in a frontier community. Seventeen organizations and 165 adults identified as potential care coordination candidates constituted the target populations. Following CCT development, collaboration and cohesion increased among organizations. Patients who participated in care coordination reported similar physical and lower emotional health quality of life than national counterparts; emergency department use decreased following care coordination. Key components identified as successful in urban settings seem applicable in rural settings, with emphasis on the key role of team facilitators; need for intense care coordination for people with complex health needs, especially behavioral health needs; and access to specialty care through technology. PMID:27818417

A Finnish validation study of the SCL-90.

PubMed

Holi, M M; Sammallahti, P R; Aalberg, V A

1998-01-01

The Symptom Check-List-90 (SCL-90) is a widely used psychiatric questionnaire which has not yet been validated in Finland. We investigated the utility of the translated version of the SCL-90 in the Finnish population, and set community norms for it. The internal consistency of the original subscales was checked and found to be good. Discriminant function analysis, based on the nine original subscales, showed that the power of the SCL-90 to discriminate between patients and the community is good. Factor analysis of the items of the questionnaire yielded a very strong unrotated first factor, suggesting that a general factor may be present. This together with the fact that high intercorrelations were found between the nine original subscales suggests that the instrument is not multidimensional. The SCL-90 may be useful in a research setting as an instrument for measuring the change in symptomatic distress, or as a screening instrument. The American community norms should be used with caution, as the Finnish community sample scored consistently higher on all subscales.

Improving the Nutritional Resource Environment for Healthy Living Through Community-based Participatory Research

PubMed Central

Sloane, David C; Diamant, Allison L; Lewis, LaVonna B; Yancey, Antronette K; Flynn, Gwendolyn; Nascimento, Lori Miller; McCarthy, William J; Guinyard, Joyce Jones; Cousineau, Michael R

2003-01-01

OBJECTIVES To build health promotion capacity among community residents through a community-based participatory model, and to apply this model to study the nutritional environment of an urban area to better understand the role of such resources in residents' efforts to live a healthy life. DESIGN A multiphase collaborative study that inventoried selected markets in targeted areas of high African-American concentration in comparison with markets in a contrasting wealthier area with fewer African Americans. SETTING A community study set in the Los Angeles metropolitan area. PARTICIPANTS African-American community organizations and community residents in the target areas. INTERVENTIONS Two surveys of market inventories were conducted. The first was a single-sheet form profiling store conditions and the availability of a small selection of healthy foods. The second provided detailed information on whether the store offered fruit, vegetables, low-fat dairy products, dried goods and other items necessary for residents to consume a nutritious diet. RESULTS The targeted areas were significantly less likely to have important items for living a healthier life. The variety and quality of fresh fruit and vegetable produce was significantly lower in the target areas. Such products as 1% milk, skim milk, low-fat and nonfat cheese, soy milk, tofu, whole grain pasta and breads, and low-fat meat and poultry items were sig-nificantly less available. CONCLUSIONS Healthy food products were significantly less available in the target areas. The authors conclude from these results that the health disparities experienced by African-American communities have origins that extend beyond the health delivery system and individual behaviors inasmuch as adherence to the healthy lifestyle associated with low chronic disease risk is more difficult in resource-poor neighborhoods than in resource-rich ones. PMID:12848840

The Effect of Treating Institution on Outcomes in Head and Neck Cancer

PubMed Central

Lassig, Amy Anne D.; Joseph, Anne M.; Lindgren, Bruce R.; Fernandes, Patricia; Cooper, Sarah; Schotzko, Chelsea; Khariwala, Samir; Reynolds, Margaret; Yueh, Bevan

2017-01-01

Objective Factors leading patients with head and neck cancer (HNCA) to seek radiation or chemoradiation in an academic center versus the community are incompletely understood, as are the effects of site of treatment on treatment completion and survival. Study Design Historical cohort study. Setting Tertiary academic center, community practices. Methods A historical cohort study was completed of patients with mucosal HNCA identified by International Classification of Disease, Ninth Revision (ICD-9) codes receiving consultation at the authors’ institution from 2003 to 2008. Patients who received primary and adjuvant radiation at an academic center or in the community were included. The authors compared treatment completion rates and performed univariate and multivariate analyses of treatment outcomes. Results Of 388 patients, 210 completed treatment at an academic center and 145 at a community center (33 excluded, location unknown). Patients with HNCA undergoing radiation at an academic site had more advanced disease (P = .024) and were more likely to receive concurrent chemotherapy. Academic hospitals had a higher percentage of noncurrent smokers, higher median income, and higher percentage of oropharyngeal tumors. There was no significant difference in the rate of planned treatment completion between community and academic centers (93.7% vs 94.7%, P > .81) or rate of treatment breaks (22.4% vs 28.4%, P > .28). On Kaplan-Meier analysis, the 5-year survival rate was 53.2% (95% confidence interval [CI], 45.3%–61.1%) for academic centers and 32.8% (95% CI, 22.0%–43.6%) for community hospitals (P <.001). Conclusion In this cohort, although treatment completion and treatment breaks were similar between academic and community centers, survival rates were higher in patients treated in an academic setting. PMID:22875780

Pay-for-performance in a community substance abuse clinic

PubMed Central

Vandrey, Ryan; Stitzer, Maxine L.; Acquavita, Shauna P.; Quinn-Stabile, Patricia

2011-01-01

Pay-for-performance (P4P) strategies improve employee productivity and morale in business settings and are increasingly being implemented in medical care settings. This study investigated whether P4P could improve treatment utilization and retention at a community drug treatment clinic. Counselors had the opportunity to earn cash bonuses based on therapy attendance rates of individual clients as well as the quarterly retention rates of their caseload. Using a pre-post study design, average therapy sessions attended during the first month of treatment increased from 4.6 sessions prior to the intervention to 5.5 sessions per client during the intervention. The 90-day client retention rate increased from 40% to 53%. Additional analyses suggest that the improvement in 90-day retention was mediated by the increase in attendance during the first month of treatment. This project demonstrates that implementing a P4P incentive program in community drug abuse treatment clinics is feasible and effective at improving utilization and retention. PMID:21489739

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

The impact of socio-political environment on the perception of science - a comparative study of German and Israeli approaches to science education

NASA Astrophysics Data System (ADS)

Schneider, S.; Rabinowitz, D.

2017-12-01

At the interface of environmental anthropology, social science, education research, and Earth Sciences, this presentation will look at Earth science education in school and out-of-school settings in Germany and Israel. We will focus on divergent cultural concepts of nature and science within the four-columned societal system in Israel: the secular Israeli community, which is oriented on western standards and concepts, the orthodox community with a stronger focus on merging scientific and religious approaches to understanding the Earth system, the Arabian community in Israel, which is strongly influenced by the Arabian science tradition as well as by confined monetary resources, and the ultra-orthodox community where science education seems to be totally abandoned in favor of Thora-studies. These environments, alongside a more homogeneous Germany educational system, resample an experimental setting with differences in a manageable number of parameters. We will analyze educational material used by the different communities in terms of the presented functions and services of the Earth sciences as well as in respect to the image of Earth sciences constructed by educational material of the observed communities. The aim of this project is to look for evidence that allows to attribute significant differences in education concepts to formal socio-political settings in the observed communities. The term Socio-political environment as used in this project proposal describes the context that is predetermined by cultural, political, and religious traditions. It described the pre-conditions in which communication takes place. Within this presentation, we will discuss the concept of socio-political environments. One of our hypothesis is, that the intensity of differences in Earth science community will be associated with differences in the socio-political environment. Influences of cultural, political, and religious boundary conditions will provide an insight into alterations within the effectiveness of standardized education and communication concepts. Similar observations where recently made in analyzing the media representation of Earth science research in respect to parameters from structural geology. These findings demand for similar analysis in respect to Earth science education as well.

Challenges and benefits of conducting environmental justice research in a school setting.

PubMed

Guidry, Virginia T; Lowman, Amy; Hall, Devon; Baron, Dothula; Wing, Steve

2014-01-01

Environmental justice (EJ) research requires attention to consequences for research participants beyond those typically considered by institutional review boards. The imbalance of power between impacted communities and those who create and regulate pollution creates challenges for participation, yet research can also benefit those involved. Our community-academic partnership designed the Rural Air Pollutants and Children's Health (RAPCH) study to provide positive impacts while measuring health effects at three low-resource public middle schools near concentrated animal feeding operations (CAFOs) in North Carolina. We evaluated perceived benefits and challenges of study involvement by interviewing school staff and community liaisons who facilitated data collection. Reported benefits included enhancement of students' academic environment and increased community environmental awareness; challenges were associated mainly with some participants' immaturity. Leadership from a strong community-based organization was crucial to recruitment, yet our approach entailed minimal focus on EJ, which may have limited opportunities for community education or organizing for environmental health.

Exploring an increased role for Australian community pharmacy in mental health professional service delivery: evaluation of the literature.

PubMed

Hattingh, H Laetitia; Scahill, Shane; Fowler, Jane L; Wheeler, Amanda J

2016-12-01

Australian general practitioners primarily treat mental health problems by prescribing medication dispensed by community pharmacists. Pharmacists therefore have regular interactions with mental health consumers and carers. This narrative review explored the potential role of community pharmacy in mental health services. Medline, CINAHL, ProQuest, Emerald, PsycINFO, Science Direct, PubMed, Web of Knowledge and IPA were utilised. The Cochrane Library as well as grey literature and "lay" search engines such as GoogleScholar were also searched. Four systematic reviews and ten community pharmacy randomised controlled trials were identified. Various relevant reviews outlining the impact of community pharmacy based disease state or medicines management services were also identified. International studies involving professional service interventions for mental health consumers could be contextualised for the Australian setting. Australian studies of pharmacy professional services for chronic physical health conditions provided further guidance for the expansion of community pharmacy mental health professional services.

To dance or not to dance? A comparison of balance, physical fitness and quality of life in older Irish set dancers and age-matched controls.

PubMed

Shanahan, J; Coman, L; Ryan, F; Saunders, J; O'Sullivan, K; Ni Bhriain, O; Clifford, A M

2016-12-01

The objective of this study is to determine if older adults regularly participating in Irish set dancing have superior balance, physical fitness and quality of life compared to age-matched controls. This study used a community-based, observational cross-sectional design. Regular set dancers (n = 39) and age-matched controls (n = 33) were recruited. Participants were assessed using the physical activity scale for the elderly (physical activity levels), mini-BESTest (balance) and senior fitness test (battery of functional fitness tests). Quality of life was also assessed using the EuroQol EQ visual analogue scale. When controlling for between-group differences in levels of physical activity (ANCOVA analysis), the dancers had significantly better balance, functional capacity and quality of life (all P < 0.05) compared to controls. No differences between the groups were observed in other measures of functional fitness. The findings of this study suggest regular participation in set dancing is associated with health benefits for older adults. These results may inform future studies prospectively examining the role of set dancing for falls prevention, emotional well-being and cognitive function in community-dwelling older adults. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

An assessment of the impact of entrepreneurial skills of community pharmacists on pharmaceutical business performance in Jos metropolis, Nigeria.

PubMed

Asieba, Iyeseun O; Nmadu, Teresa M

2018-01-01

Community pharmacy has been a lucrative area of practice for pharmacists in Jos, Nigeria, until about the turn of the millennium where a decline in viability of the business has been observed. This study assessed the entrepreneurial skills of community pharmacists, the business performance of community pharmacies and the impact of their entrepreneurial skills on business performance. A cross sectional survey was conducted by administering a pretested questionnaire to 30 community pharmacists in Jos. An adaptation of the Bernelli model and the expanded Katz (1974)/Herron (1990) Skill Typology Model was used to assess nine entrepreneurial skills - product, organizational, industry, networking, leadership, executive, entrepreneurial, marketing and money skills; while sales growth, net profit and stock growth were used to assess business performance. Frequency distribution of results was presented, with further analysis done with the Epi-Info software using the chi square test of association. The results from this study showed that community pharmacies in Jos do possess requisite entrepreneurial skills, but to varying extents. Product skills ranked highest while money skills and entrepreneurial skills ranked least, portraying a need for skills enhancement in these areas. Business performance was suboptimal, being rated as average or poor by 56.6% of respondents. However, most respondents (90%) still assessed their businesses as profitable. Money skills had a significant impact on business performance (P=0.03) and stock growth (P=0.04); while stock growth was significantly affected by leadership skills (P=0.002) and entrepreneurial skills (0.02). Net profit was significantly affected by industry skills (P=0.008). Community pharmacy business is still a profitable business venture in Jos though business performance is sub optimal. The entrepreneurial skills set of a community pharmacist set has an impact on business performance with money skills, leadership skills and entrepreneurial skills being most significant. This study recommended that entrepreneurial skills of community pharmacists in Nigeria are further developed to improve pharmaceutical business performance.

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

PubMed

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

2018-02-01

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

76 FR 23825 - Study Methodologies for Diagnostics in the Postmarket Setting; Public Workshop

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-28

... community on issues related to the studies and methodological approaches examining diagnostics in the... discuss a large number of methodological concerns at the workshop, including, but not limited to the...

Coproduction of Research Questions and Research Evidence in Public Health: The Study to Prevent Teen Drinking Parties.

PubMed

Wolfson, Mark; Wagoner, Kimberly G; Rhodes, Scott D; Egan, Kathleen L; Sparks, Michael; Ellerbee, Dylan; Song, Eunyoung Y; Debinski, Beata; Terrillion, Albert; Vining, Judi; Yang, Evelyn

2017-01-01

Community-based participatory research (CBPR) provides a set of principles and practices intended to foster coproduction of knowledge. However, CBPR often has shortcomings when applied to population-level policy and practice interventions, including a focus on single communities and a lack of focus on policy change. At the same time, community trials focused on policy have shortcomings, including lack of stakeholder involvement in framing research questions and modest engagement in study implementation and interpretation and dissemination of results. We describe an attempt to hybridize CBPR and community trials by creating a partnership that included a national membership organization, a coalition advisory board, intervention and delayed intervention communities, and an academic study team, which collaborated on a study of community strategies to prevent underage drinking parties. We use qualitative and quantitative data to critically assess the partnership. Areas where the partnership was effective included (1) identifying a research question with high public health significance, (2) enhancing the intervention, and (3) improving research methods. Challenges included community coalition representatives' greater focus on their own communities rather than the production of broader scientific knowledge. This model can be applied in future attempts to narrow the gap between research, policy, and practice.

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.

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.

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.

Comparing community and specialty provider-based recruitment in a randomized clinical trial: clinical trial in fecal incontinence.

PubMed

Whitebird, Robin R; Bliss, Donna Zimmaro; Savik, Kay; Lowry, Ann; Jung, Hans-Joachim G

2010-12-01

Recruitment of participants to clinical trials remains a significant challenge, especially for research addressing topics of a sensitive nature such as fecal incontinence (FI). In the Fiber Study, a randomized controlled trial on symptom management for FI, we successfully enrolled 189 community-living adults through collaborations with specialty-based and community-based settings, each employing methods tailored to the organizational characteristics of their site. Results show that using the two settings increased racial and ethnic diversity of the sample and inclusion of informal caregivers. There were no differential effects on enrollment, final eligibility, or completion of protocol by site. Strategic collaborations with complementary sites can achieve sample recruitment goals for clinical trials on topics that are sensitive or known to be underreported. Copyright © 2010 Wiley Periodicals, Inc.

Influence of Culture and Community Perceptions on Birth and Perinatal Care of Immigrant Women: Doulas’ Perspective

PubMed Central

Kang, Hye-Kyung

2014-01-01

A qualitative study examined the perceptions of doulas practicing in Washington State regarding the influence of cultural and community beliefs on immigrant women’s birth and perinatal care, as well as their own cultural beliefs and values that may affect their ability to work interculturally. The findings suggest that doulas can greatly aid immigrant mothers in gaining access to effective care by acting as advocates, cultural brokers, and emotional and social support. Also, doulas share a consistent set of professional values, including empowerment, informed choice, cultural relativism, and scientific/evidence-based practice, but do not always recognize these values as culturally based. More emphasis on cultural self-awareness in doula training, expanding community doula programs, and more integration of doula services in health-care settings are recommended. PMID:24453465

A panchayat level primary-care approach for adolescent services.

PubMed

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

2012-01-01

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

[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.

The healthy men study: design and recruitment considerations for environmental epidemiologic studies in male reproductive health

EPA Science Inventory

Study Objective: To describe study conduct and response and participant characteristics. Design: Prospective cohort study. Setting: Participants were male partners of women enrolled in a community-based study of drinking water disinfection by-products and pregnancy healt...

Exploring the Position of Community-Based Nursing in Iran: A Qualitative Study.

PubMed

Heydari, Heshmatolah; Rahnavard, Zahra; Ghaffari, Fatemeh

2017-10-01

Community-based nursing focuses on providing health services to families and communities in the second and third levels of prevention and this can improve the individuals, families and communities' quality of life, and reduce the healthcare costs. The aim of this study was to explore the status of community-based nursing in Iran. This qualitative study was conducted from March to November 2015, in Tehran, Iran, using the content analysis approach. The study setting consisted of Iran and Tehran Faculties of Nursing and Midwifery, Tehran, Iran. The purposive sampling method was used. Twenty faculty members and Master's and PhD students were interviewed by using the face-to-face semi-structured interview method. Moreover, two focus groups were conducted for complementing and enriching the study data. The data were analyzed using the Graneheim and Lundman's approach to content analysis. The trustworthiness of the study findings was maintained by employing the Lincoln and Guba's criteria of credibility, dependability, and confirmability. In total, 580 codes were generated and categorized into three main categories of conventional services, the necessity for creating infrastructures, and multidimensional outcomes of community-based nursing. Introducing community-based nursing into nursing education curricula and creating ample job opportunities for community-based nurses seem clearly essential.