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

PubMed Central

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

2009-01-01

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

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

PubMed

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

2009-07-01

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

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

PubMed

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

2002-07-01

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

Community medicine in action: an integrated, fourth-year urban continuity preceptorship.

PubMed

Brill, John R; Jackson, Thomas C; Stearns, Marjorie A

2002-07-01

To provide an opportunity for fourth-year students at the University of Wisconsin Medical School in Madison to immerse in urban community medicine during a 34-week program. This experience enhances the integrity of the fourth year as well as merges medicine and public health perspectives in medical education as called for by the Medicine and Public Health Initiative. A limited number of fourth-year Wisconsin medical students have the opportunity to select a one-year, continuity-based preceptorship at the Milwaukee clinical campus with a focus in one of three domains: family medicine, internal medicine, or women's health. Students participate in the following clinical activities: a one-year, integrated preceptorship (one to three half days per week in a primary preceptor's office), medicine subinternship, senior surgery clerkship, selectives (16-20 weeks of clerkships relevant to preceptorship focus area), and one month of out-of-city electives. Complementing this community-based clinical experience is the opportunity to develop an increased appreciation for urban community health issues and resources by participating in a required urban community medicine clerkship and a mentored student scholarly project focusing on an aspect of urban community medicine and population health. All students begin the year in July with a four-week urban community medicine clerkship, which is based on the St. Luke's family practice residency's community medicine rotation and arranged by residency faculty. They conduct a "windshield survey" of a Milwaukee neighborhood, observing health hazards and identifying assets, and then present these observations to others in the clerkship. During this first month, students are introduced to the work of a variety of social service agencies, the Milwaukee City Health Department, and the Aurora Health Care/UW community clinics, which serve the state's most diverse zip codes. They meet with providers and researchers who share their expertise in infectious disease, preventive medicine, perinatal epidemiology, domestic violence, sexual assault, and disease management. Students develop increased understanding of barriers to health and personal resilience by listening to focus groups conducted with homeless men and undocumented Latino women. They participate in a resident and faculty development retreat on enhancing community medicine knowledge and skills. By August, students select an advisor and outline a project designed to expand understanding in the areas of urban population health research, community health education, professional education, or health intervention planning and evaluation. Faculty members at the Center for Urban Population Health work closely with the students throughout the year, which includes two weeks in the spring that are dedicated to intensive work on the projects. This fourth-year, urban community-based preceptorship is designed to provide students with an alternative fourth year that integrates skill development in clinical and community medicine, offers a continuity primary care experience, and showcases innovative urban health resources and role models. It is hoped that these students will pursue graduate medical education in Milwaukee, incorporate a population perspective in their practice, and choose to work in neighborhoods that are currently underserved.

Translational research: are community-based child obesity treatment programs scalable?

PubMed

Hardy, Louise L; Mihrshahi, Seema; Gale, Joanne; Nguyen, Binh; Baur, Louise A; O'Hara, Blythe J

2015-07-14

Community-based obesity treatment programs have become an important response to address child obesity; however the majority of these programs are small, efficacy trials, few are translated into real-world situations (i.e., dissemination trials). Here we report the short-term impact of a scaled-up, community-based obesity treatment program on children's weight and weight-related behaviours disseminated under real world conditions. Children age 6-15 years with a body mass index (BMI) ≥ 85th percentile with no co-morbidities, and their parents/carers participated in a twice weekly, 10-week after-school child obesity treatment program between 2009 and 2012. Outcome information included measures of weight and weight-related behaviours. Analyses were adjusted for clustering and socio-demographic variables. Overall, 2,812 children participated (54.2% girls; M(age) 10.1 (2.0) years; M(attaendance) 12.9 (5.9) sessions). Beneficial changes among all children included BMI (-0.65 kg/m(2)), BMI-z-score (-0.11), waist circumference (-1.8 cm), and WtHtr (-0.02); self-esteem (+2.7 units), physical activity (+1.2 days/week), screen time (-4.8 h/week), and unhealthy foods index (-2.4 units) (all p < 0.001). Children who completed ≥ 75% of the program were more likely to have beneficial changes in BMI, self-esteem and diet (sugar sweetened beverages, lollies/chocolate, hot chips and takeaways) compared with children completing <75% of the program. This is one of the few studies to report outcomes of a government-funded, program at scale in a real-world setting, and shows that investment in a community-based child obesity treatment program holds potential to produce short-term changes in weight and weight-related behaviours. The findings support government investment in this health priority area, and demonstrate that community-based models of child obesity treatment are a promising adjunctive intervention to health service provision at all levels of care.

Supplementary feeding with locally-produced Ready-to-Use Food (RUF) for mildly wasted children on Nias Island, Indonesia: comparison of daily and weekly program outcomes.

PubMed

Purwestri, Ratna C; Scherbaum, Veronika; Inayati, Dyah A; Wirawan, Nia N; Suryantan, Julia; Bloem, Maurice A; Pangaribuan, Rosnani V; Stuetz, Wolfgang; Hoffmann, Volker; Qaim, Matin; Biesalski, Hans K; Bellows, Anne C

2012-01-01

Ready-to-Use Foods (RUFs) in the form of fortified cereal/nut/legume-based biscuits (±500 kcal and 8-10% protein per 100 g) were tested among mildly wasted children from October 2007 to June 2008, and were labelled as RUF-Nias biscuits. This study reports on a comparison of supplementary feeding program outcomes of mildly wasted children with weight-for-height z-score (WHZ) >=-2 to <-1.5 SD aged >=6 to <60 months old given locally produced RUF-Nias biscuits within daily (in semi-urban areas) and weekly (in rural remote regions) distribution and supervision program settings. In the Church World Service project area, all eligible children were recruited continuously from monthly community-based screening programs and admitted into existing nutrition centers managed by the community on Nias Island, Indonesia. Individual discharge criterion of the programs was WHZ >=-1.5 SD. Of the index children admitted in daily programs (n=51), 80.4% reached target WHZ, which was higher than in weekly programs (72.9%; n=48) by a similar length of stay of about 6 weeks. Weight gain of the children in daily programs was higher (3.1±3.6 g/kg body weight/day) than in weekly programs (2.0±2.1 g/kg body weight/day), and they achieved significantly higher WHZ at discharge. However, the majority of caretakers preferred weekly programs due to lower time constraints. Locally produced RUF in the form of biscuits for treatment of mild wasting among children demonstrated promising results both in daily and weekly community-based intervention programs.

A “Community Fit” Community-Based Participatory Research Program for Family Health, Happiness, and Harmony: Design and Implementation

PubMed Central

Soong, Cissy SS; Wang, Man Ping; Mui, Moses; Viswanath, Kasisomayajula; Chan, Sophia SC

2015-01-01

Background A principal factor in maintaining positive family functioning and well-being, family communication time is decreasing in modern societies such as Hong Kong, where long working hours and indulgent use of information technology are typical. Objective The objective of this paper is to describe an innovative study protocol, “Happy Family Kitchen,” under the project, “FAMILY: A Jockey Club Initiative for a Harmonious Society,” aimed at improving family health, happiness, and harmony (3Hs) through enhancement of family communication. Methods This study employed the community-based participatory research (CBPR) approach, and adopted 5 principles of positive psychology and the traditional Chinese concepts of cooking and dining, as a means to connect family members to promote family health, happiness, and harmony (3Hs). Results In-depth collaboration took place between an academic institution and a large nongovernmental community organization association (NGO association) with 400 social service agency members. Both groups were deeply involved in the project design, implementation, and evaluation of 23 community-based interventions. From 612 families with 1419 individuals’ findings, significant increases in mean communication time per week (from 153.44 to 170.31 minutes, P=.002) at 6 weeks after the intervention and mean communication scores (from 67.18 to 69.56 out of 100, P<.001) at 12 weeks after the intervention were shown. Significant enhancements were also found for mean happiness scores 12 weeks after the intervention (from 7.80 to 7.82 out of 10, P<.001), and mean health scores (from 7.70 to 7.73 out of 10, P<.001) and mean harmony scores (from 7.70 to 8.07 out of 10, P<.001) 6 weeks after the intervention. Conclusions This was the first CBPR study in a Hong Kong Chinese community. The results should be useful in informing collaborative intervention programs and engaging public health researchers and community social service providers, major stakeholders, and community participants in the promotion of family well-being. Furthermore, this study has generated an effective practice model for the improvement of family communication and well-being. Challenges in maintaining research rigor during data collection and program implementation were observed, and should be considered during future program planning. PMID:26510960

Cost-Effectiveness of a Community-Based Exercise Programme in COPD Self-Management.

PubMed

Zwerink, Marlies; Effing, Tanja; Kerstjens, Huib A M; van der Valk, Paul; Brusse-Keizer, Marjolein; Zielhuis, Gerhard; van der Palen, Job

2016-01-01

Information regarding cost-effectiveness of community-based exercise programmes in COPD is scarce. Therefore, we have investigated whether a community-based exercise programme is a cost-effective component of self-management for patients with COPD after 2 years of follow-up. All included COPD patients participated in four self-management sessions. Additionally, patients in the COPE-active group participated in an 11-month community-based exercise programme led by physiotherapists. Patients trained 3 times/week for 6 months and two times/week during the subsequent 5 months. In both periods, one of these weekly training sessions was home-based (unsupervised). No formal physiotherapy sessions were offered to COPE-active patients in the second year. A decision analytical model with a 24-month perspective was used to evaluate cost-effectiveness. Incremental cost-effectiveness ratios (ICER) were calculated and cost-effectiveness planes were created. Data of 77 patients participating in the exercise programme and 76 patients in the control group were analysed. The ICER for an additional patient prevented from deteriorating at least 47.5 meters on the ISWT was €6257. The ICER for an additional patient with a clinically relevant improvement (≥ 500 steps/day) in physical activity was €1564, and the ICER for an additional quality-adjusted life year (QALY) was €10 950. Due to a lack of maintenance of beneficial effects on our primary outcome exercise capacity after 2 years of follow-up and higher costs of the programme, the community-based exercise programme cannot be considered cost-effective compared to self-management programmes only. Nevertheless, the ICERs for the secondary outcomes physical activity and QALY are generally considered acceptable.

The effect of a pedometer-based community walking intervention "Walking for Wellbeing in the West" on physical activity levels and health outcomes: a 12-week randomized controlled trial.

PubMed

Baker, Graham; Gray, Stuart R; Wright, Annemarie; Fitzsimons, Claire; Nimmo, Myra; Lowry, Ruth; Mutrie, Nanette

2008-09-05

Recent systematic reviews have suggested that pedometers may be effective motivational tools to promote walking. However, studies tend to be of a relatively short duration, with small clinical based samples. Further research is required to demonstrate their effectiveness in adequately powered, community based studies. Using a randomized controlled trial design, this study assessed the impact of a 12-week graduated pedometer-based walking intervention on daily step-counts, self-reported physical activity and health outcomes in a Scottish community sample not meeting current physical activity recommendations. Sixty-three women and 16 men (49.2 years +/- 8.8) were randomly assigned to either an intervention (physical activity consultation and 12-week pedometer-based walking program) or control (no action) group. Measures for step-counts, 7-day physical activity recall, affect, quality of life (n = 79), body mass, BMI, % body fat, waist and hip circumference (n = 76), systolic/diastolic blood pressure, total cholesterol and HDL cholesterol (n = 66) were taken at baseline and week 12. Analyses were performed on an intention to treat basis using 2-way mixed factorial analyses of variance for parametric data and Mann Whitney and Wilcoxon tests for non-parametric data. Significant increases were found in the intervention group for step-counts (p < .001), time spent in leisure walking (p = .02) and positive affect (p = .027). Significant decreases were found in this group for time spent in weekday (p = .003), weekend (p = .001) and total sitting (p = .001) with no corresponding changes in the control group. No significant changes in any other health outcomes were found in either group. In comparison with the control group at week 12, the intervention group reported a significantly greater number of minutes spent in leisure time (p = .008), occupational (p = .045) and total walking (p = .03), and significantly fewer minutes in time spent in weekend (p = .003) and total sitting (p = .022). A pedometer-based walking program, incorporating a physical activity consultation, is effective in promoting walking and improving positive affect over 12 weeks in community based individuals. The discussion examines possible explanations for the lack of significant changes in health outcomes. Continued follow-up of this study will examine adherence to the intervention and possible resulting effects on health outcomes.

Outcome Evaluation of a Community Center-Based Program for Mothers at High Psychosocial Risk

ERIC Educational Resources Information Center

Rodrigo, Maria Jose; Maiquez, Maria Luisa; Correa, Ana Delia; Martin, Juan Carlos; Rodriguez, Guacimara

2006-01-01

Objective: This study reported the outcome evaluation of the "Apoyo Personal y Familiar" (APF) program for poorly-educated mothers from multi-problem families, showing inadequate behavior with their children. APF is a community-based multi-site program delivered through weekly group meetings in municipal resource centers. Method: A total…

A randomized controlled trial to promote volunteering in older adults.

PubMed

Warner, Lisa M; Wolff, Julia K; Ziegelmann, Jochen P; Wurm, Susanne

2014-12-01

Volunteering is presumed to confer health benefits, but interventions to encourage older adults to volunteer are sparse. Therefore, a randomized controlled trial with 280 community-dwelling older German adults was conducted to test the effects of a theory-based social-cognitive intervention against a passive waiting-list control group and an active control intervention designed to motivate physical activity. Self-reports of weekly volunteering minutes were assessed at baseline (5 weeks before the intervention) as well as 2 and 6 weeks after the intervention. Participants in the treatment group increased their weekly volunteering minutes to a greater extent than participants in the control groups 6 weeks after the intervention. We conclude that a single, face-to-face group session can increase volunteering among older community-dwelling adults. However, the effects need some time to unfold because changes in volunteering were not apparent 2 weeks after the intervention. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

A pilot evaluation of Arthritis Self-Management Program by lay leaders in patients with chronic inflammatory arthritis in Hong Kong.

PubMed

Leung, Ying-Ying; Kwan, Jackie; Chan, Patsy; Poon, Peter K K; Leung, Christine; Tam, Lai-Shan; Li, Edmund K; Kwok, Anna

2016-04-01

The objectives of this paper are to evaluate the efficacy of a community-based lay-led Arthritis Self-Management Program (ASMP) among patients with chronic inflammatory arthritis and evaluate the effectiveness of "shared care collaboration" between hospital and community. We trained 17 lay leaders and recruited patients with chronic inflammatory arthritis via a new shared-care model between hospital rheumatology centers and community organizations. Participants were allocated to interventional group or a wait list control group. Evaluations were completed before, after (6 weeks), and 3 months after ASMP. We performed analysis of covariance with adjustment with age, sex, marital status, education, employment, duration of illness, and disability at baseline. A total of 65 participants and 32 controls completed the study. The mean (SD) age and duration of illness were 52.0 (11.4) and 5.6 (7.3) years, 90.7 % were female, 80.4 % had rheumatoid arthritis; 25.8, 53.6, and 12.4 % referrals were from hospitals, community organizations, and patient self-help groups, respectively. The interventional group had significantly less pain (p = 0.049 at 6 weeks), used more cognitive coping methods (p = 0.008 at 6 weeks, p = 0.041 at 3 months) and practiced more aerobic exercise (p = 0.049 at 6 weeks, p = 0.008 at 3 months) after adjustment of covariance. The interventional group had a trend of improvement in self-efficacy, fatigue, self-rated health, and health distress. A community-based lay-led ASMP showed positive beneficial effects on participants with chronic inflammatory arthritis. Shared-care collaboration between hospitals, community organizations, and patient self-help groups was demonstrated.

Protocol for disseminating an evidence-based fall prevention program in community senior centers: evaluation of translatability and public health impact via a single group pre-post study.

PubMed

Li, Fuzhong; Harmer, Peter

2014-05-26

Falls are the leading cause of injury death in older adults and present a significant public health problem and a major burden to healthcare. Although there is sufficient evidence from randomized controlled trials to indicate that exercise can prevent falls in older people, few effective, evidence-based fall prevention programs exist in community practice. Thus, there is a pressing need to translate and disseminate evidence-based exercise programs to community providers that serve older adults at increased risk of falling. The current study addresses this public health need by disseminating the evidence-based Tai Ji Quan: Moving for Better Balance (TJQMBB) program through community senior centers. The study uses a single-group design in which the TJQMBB program is being delivered to community-dwelling older adults through collaboration with senior centers in selected counties in Oregon, USA, for 48 weeks, followed by a 24-week post-intervention follow-up. Study process and outcome measures will be evaluated in accordance with the components of the RE-AIM framework that focus on Reach, Effectiveness, Adoption, Implementation and Maintenance. This study will determine whether the evidence-based TJQMBB fall prevention program can be disseminated through a broad spectrum of community-based senior centers that often cater to low-income, underserved community-dwelling older adults at risk of falling. If shown to be both practically implementable and sustainable, the TJQMBB program will provide an effective, potentially low-cost, easy-to-implement intervention that could be used by public health practitioners and community-based organizations to address the problem of falls among older adults. ClinicalTrials.gov Identifier: NCT01854931.

Teaching Community-Based Learning Course in Retailing Management

ERIC Educational Resources Information Center

Rhee, Eddie

2018-01-01

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

Effects of an Aerobic Exercise Program on Community-Based Adults with Mental Retardation.

ERIC Educational Resources Information Center

Pommering, Thomas L.; And Others

1994-01-01

Evaluation of a 10-week aerobic exercise program on 14 community-based adults with mental retardation found a 91.3% attendance rate and significant increases in maximal oxygen consumption, oxygen pulse, maximum ventilation, exercise stress test duration, and flexibility. However, no significant changes were observed in weight or body composition.…

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

PubMed Central

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

2002-01-01

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

A 12-Week Physical and Cognitive Exercise Program Can Improve Cognitive Function and Neural Efficiency in Community-Dwelling Older Adults: A Randomized Controlled Trial.

PubMed

Nishiguchi, Shu; Yamada, Minoru; Tanigawa, Takanori; Sekiyama, Kaoru; Kawagoe, Toshikazu; Suzuki, Maki; Yoshikawa, Sakiko; Abe, Nobuhito; Otsuka, Yuki; Nakai, Ryusuke; Aoyama, Tomoki; Tsuboyama, Tadao

2015-07-01

To investigate whether a 12-week physical and cognitive exercise program can improve cognitive function and brain activation efficiency in community-dwelling older adults. Randomized controlled trial. Kyoto, Japan. Community-dwelling older adults (N = 48) were randomized into an exercise group (n = 24) and a control group (n = 24). Exercise group participants received a weekly dual task-based multimodal exercise class in combination with pedometer-based daily walking exercise during the 12-week intervention phase. Control group participants did not receive any intervention and were instructed to spend their time as usual during the intervention phase. The outcome measures were global cognitive function, memory function, executive function, and brain activation (measured using functional magnetic resonance imaging) associated with visual short-term memory. Exercise group participants had significantly greater postintervention improvement in memory and executive functions than the control group (P < .05). In addition, after the intervention, less activation was found in several brain regions associated with visual short-term memory, including the prefrontal cortex, in the exercise group (P < .001, uncorrected). A 12-week physical and cognitive exercise program can improve the efficiency of brain activation during cognitive tasks in older adults, which is associated with improvements in memory and executive function. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Designing a smoking cessation intervention for the unique needs of homeless persons: a community-based randomized clinical trial.

PubMed

Goldade, Kate; Whembolua, Guy-Lucien; Thomas, Janet; Eischen, Sara; Guo, Hongfei; Connett, John; Des Jarlais, Don; Resnicow, Ken; Gelberg, Lillian; Owen, Greg; Grant, Jon; Ahluwalia, Jasjit S; Okuyemi, Kolawole S

2011-12-01

Although smoking prevalence remains strikingly high in homeless populations (~70% and three times the US national average), smoking cessation studies usually exclude homeless persons. Novel evidence-based interventions are needed for this high-risk subpopulation of smokers. To describe the aims and design of a first-ever smoking cessation clinical trial in the homeless population. The study was a two-group randomized community-based trial that enrolled participants (n = 430) residing across eight homeless shelters and transitional housing units in Minnesota. The study objective was to test the efficacy of motivational interviewing (MI) for enhancing adherence to nicotine replacement therapy (NRT; nicotine patch) and smoking cessation outcomes. Participants were randomized to one of the two groups: active (8 weeks of NRT + 6 sessions of MI) or control (NRT + standard care). Participants attended six in-person assessment sessions and eight retention visits at a location of their choice over 6 months. Nicotine patch in 2-week doses was administered at four visits over the first 8 weeks of the 26-week trial. The primary outcome was cotinine-verified 7-day point-prevalence abstinence at 6 months. Secondary outcomes included adherence to nicotine patch assessed through direct observation and patch counts. Other outcomes included the mediating and/or moderating effects of comorbid psychiatric and substance abuse disorders. Lessons learned from the community-based cessation randomized trial for improving recruitment and retention in a mobile and vulnerable population included: (1) the importance of engaging the perspectives of shelter leadership by forming and convening a Community Advisory Board; (2) locating the study at the shelters for more visibility and easier access for participants; (3) minimizing exclusion criteria to allow enrollment of participants with stable psychiatric comorbid conditions; (4) delaying the baseline visit from the eligibility visit by a week to protect against attrition; and (5) regular and persistent calls to remind participants of upcoming appointments using cell phones and shelter-specific channels of communication. The study's limitations include generalizability due to the sample drawn from a single Midwestern city in the United States. Since inclusion criteria encompassed willingness to use NRT patch, all participants were motivated and were ready to quit smoking at the time of enrollment in the study. Findings from the self-select group will be generalizable only to those motivated and ready to quit smoking. High incentives may limit the degree to which the intervention is replicable. Lessons learned reflect the need to engage communities in the design and implementation of community-based clinical trials with vulnerable populations.

Community-based group aquatic programme for individuals with multiple sclerosis: a pilot study.

PubMed

Salem, Yasser; Scott, Anne Hiller; Karpatkin, Herbert; Concert, George; Haller, Leah; Kaminsky, Eva; Weisbrot, Rivky; Spatz, Eugene

2011-01-01

The purpose of this study was to determine the feasibility of providing a community-based aquatic exercise programme and to examine the effects of a group aquatic exercise programme in individuals with multiple sclerosis. This study illustrates the implementation of a multidisciplinary community-based programme in a university community wellness centre coordinated with a local advocacy group. Eleven subjects with multiple sclerosis participated in a 5-week community-based aquatic exercise programme. Aquatic exercises were held twice weekly for 60 minutes and included aerobic exercises, strength training, flexibility exercises, balance training and walking activities. The 10-Metre Walk test, the Berg Balance Scale (BBS), the 'Timed Up and Go' (TUG) test, grip strength and the Modified Fatigue Impact Scale were used to assess motor function. Analysis of the scores demonstrated improved gait speed, BBS, TUG test and grip strength. The average attendance of the training sessions was good (88%), and no incidence of injuries, no incidence of falls and no adverse effects related to the exercise programme were reported. All participants reported that they enjoyed the programme, and they had improved after the training. A community-based aquatic exercise programme is feasible and resulted in improvement in motor functions of individuals with multiple sclerosis. These findings indicate that an aquatic training programme is appropriate and beneficial for individuals with multiple sclerosis and should be considered to augment the rehabilitation of those individuals. This programme may provide a viable model for a community-based wellness programme for people with disability including individuals with multiple sclerosis.

Youth Risk Behavior Surveillance--Selected Steps Communities, United States, 2007 and Youth Risk Behavior Surveillance--Pacific Island United States Territories, 2007. Morbidity and Mortality Weekly Report. Surveillance Summaries. Volume 57, Number SS-12

ERIC Educational Resources Information Center

Shaw, Frederic E., Ed.

2008-01-01

The "Morbidity and Mortality Weekly Report" ("MMWR") Series is prepared by the Centers for Disease Control and Prevention (CDC). Data in the weekly "MMWR" are provisional, based on weekly reports to CDC by state health departments. This issue of "MMWR" contains the following studies: (1) Youth Risk Behavior…

Proposal for a community-based disaster management curriculum for medical school undergraduates in Saudi Arabia.

PubMed

Bajow, Nidaa; Djalali, Ahmadreza; Ingrassia, Pier Luigi; Ageely, Hussein; Bani, Ibrahim; Della Corte, Francesco

2015-01-01

Health professional preparedness is a key element of disaster response; overall there is a need for increased disaster medicine training worldwide. The objective of this study was to design and develop a curriculum in community-based disaster medicine for Saudi Arabian medical undergraduates. A structured five-step approach was used to develop a curriculum. Expert stakeholders from the Saudi Arabian and international disaster medicine communities were surveyed to determine objectives and content. Learning strategies were carefully considered to maximize participation and retention. Particular attention was paid to equipping learners with the teaching skills required to promote disaster preparedness in their local communities. The course consists of 2 weeks of classroom activities followed by 8 weeks of e-learning structured within five domains of disaster medicine. The curriculum introduces core principles in emergency medicine, public health, and disaster management. Simulations, experiential activities, case studies, and role-playing activities are all used to promote higher levels of cognitive engagement. Special content addresses the adult-learning process, and students design their own community-based seminars in disaster preparedness. The curriculum is designed to promote learning in disaster medicine. Given the paucity of disaster medicine educators in the region, student graduates of this program would be able to improve disaster preparedness in Saudi Arabia by launching their own community-based disaster preparedness initiatives. The program could also be adapted for use throughout the Middle East.

Shall We Dance? The Story of the Radiance Dance Project

ERIC Educational Resources Information Center

Ehrich, Lisa Catherine

2010-01-01

Community workers are often described as unsung heroes who work for, with and alongside others in order to make qualitative differences to the communities they serve. This paper reports on the story of a community-based arts educator, Morgan Jai-Morincome, winner of the ACT Adult Learners Week Award for an outstanding program in 2007. This…

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

PubMed Central

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

2006-01-01

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

A multi-tiered time-series modelling approach to forecasting respiratory syncytial virus incidence at the local level.

PubMed

Spaeder, M C; Fackler, J C

2012-04-01

Respiratory syncytial virus (RSV) is the most common cause of documented viral respiratory infections, and the leading cause of hospitalization, in young children. We performed a retrospective time-series analysis of all patients aged <18 years with laboratory-confirmed RSV within a network of multiple affiliated academic medical institutions. Forecasting models of weekly RSV incidence for the local community, inpatient paediatric hospital and paediatric intensive-care unit (PICU) were created. Ninety-five percent confidence intervals calculated around our models' 2-week forecasts were accurate to ±9·3, ±7·5 and ±1·5 cases/week for the local community, inpatient hospital and PICU, respectively. Our results suggest that time-series models may be useful tools in forecasting the burden of RSV infection at the local and institutional levels, helping communities and institutions to optimize distribution of resources based on the changing burden and severity of illness in their respective communities.

A comparison of home-based exercise programs with and without self-manual therapy in individuals with knee osteoarthritis in community.

PubMed

Cheawthamai, Kornkamon; Vongsirinavarat, Mantana; Hiengkaew, Vimonwan; Saengrueangrob, Sasithorn

2014-07-01

The present study aimed to compare the effectiveness of the treatment programs of home-based exercise with and without self-manual therapy in individuals with knee osteoarthritis (knee OA) in community. Forty-three participants with knee OA were randomly assigned in groups. All participants received the same home-based exercise program with or without self-manual therapy over 12 weeks. Outcome measures were pain intensity, range of motions, six-minute walk test distance, the knee injury and osteoarthritis outcome score (KOOS), short-form 36 (SF-36) and satisfaction. The results showed that the self-manual therapy program significantly decreased pain at 4 weeks, increased flexion and extension at 4 and 12 weeks, and improved the KOOS in pain item and SF-36 in physical function and mental health items. The home-based exercise group showed significant increase of the six-minute walk distance at 4 and 12 weeks, improvements in the KOOS in pain and symptom items and SF-36 in the physical function and role-emotional items. Overall, the results favored a combination of self-manual therapy and home-based exercise for patients with knee OA, which apparently showed superior benefits in decreasing pain and improving active knee range of motions.

A community-based aquatic exercise program to improve endurance and mobility in adults with mild to moderate intellectual disability.

PubMed

Hakim, Renée M; Ross, Michael D; Runco, Wendy; Kane, Michael T

2017-02-01

The purpose of this study was to investigate the impact of a community-based aquatic exercise program on physical performance among adults with mild to moderate intellectual disability (ID). Twenty-two community-dwelling adults with mild to moderate ID volunteered to participate in this study. Participants completed an 8-week aquatic exercise program (2 days/wk, 1 hr/session). Measures of physical performance, which were assessed prior to and following the completion of the aquatic exercise program, included the timed-up-and-go test, 6-min walk test, 30-sec chair stand test, 10-m timed walk test, hand grip strength, and the static plank test. When comparing participants' measures of physical performance prior to and following the 8-week aquatic exercise program, improvements were seen in all measures, but the change in scores for the 6-min walk test, 30-sec chair stand test, and the static plank test achieved statistical significance ( P <0.05). An 8-week group aquatic exercise program for adults with ID may promote improvements in endurance and balance/mobility.

Mobile phone short message service messaging for behaviour modification in a community-based weight control programme in Korea.

PubMed

Joo, Nam-Seok; Kim, Bom-Taeck

2007-01-01

We conducted a community-based anti-obesity programme using mobile phone short message service (SMS) messaging. A total of 927 participants were recruited and visited a public health centre for initial assessment. Mobile phones were used to deliver short messages about diet, exercise and behaviour modification once a week. After a 12-week anti-obesity programme they visited the public health centre again. Four hundred and thirty-three subjects (47%) successfully completed their weight control programme. There were mean reductions of weight, waist circumference and body mass index of 1.6 kg (P < 0.001), 4.3 cm (P < 0.001) and 0.6 kg/m(2) (P < 0.001), respectively. Over two-thirds of the subjects had a reduction in waist circumference of 5-7.5 cm. A post-intervention survey showed that the majority of participants were satisfied with the weekly SMS messages and information brochures delivered by post. SMS messaging may be an effective method of behaviour modification in weight control and anti-obesity health education programmes when promoted by community health centres.

The Impact of a Community Based Exercise Program in Children and Adolescents with Disabilities: A Pilot Study

ERIC Educational Resources Information Center

Oriel, Kathryn N.; George, Cheryl L.; Blatt, Philip J.

2008-01-01

This pilot study sought to determine if participation in an after school community-based exercise program would result in improved fitness, self-concept, and social skills in a heterogeneous sample of children and adolescents with disabilities. Eighteen participants with physical and/or cognitive disabilities were recruited for an 8-week exercise…

MedlinePlus and the challenge of low health literacy: findings from the Colonias project*

PubMed Central

Olney, Cynthia A.; Warner, Debra G.; Reyna, Greysi; Wood, Fred B.; Siegel, Elliot R.

2007-01-01

Objective: To explore the potential of a community-based health information outreach project to overcome problems associated with health literacy in low-income Hispanic communities along the Texas-Mexico border. Methods: Using a train-the-trainer approach, community outreach workers known as promotoras were trained by a health information outreach team to search English and Spanish versions of MedlinePlus. These 15 promotoras submitted written examples on a weekly basis of the topics they helped residents explore on MedlinePlus and the ways in which the residents used the information. These weekly reports, along with verbal interviews with promotoras and others in the communities, allowed development of a database of 161 incidents (“stories”) demonstrating how community residents used MedlinePlus. These stories were thematically analyzed to explore how the program benefited participants. Results: The database of stories included examples of community residents becoming better informed about their illnesses, resolving to visit doctors, making decisions about recommended treatments, reducing their anxiety about health conditions, committing to healthy or preventive behavior, and assisting family members. Conclusion: With the help of paraprofessionals like promotoras, community-based health information outreach projects may improve the ability of community residents to understand their health conditions and to participate actively in their health care. PMID:17252064

Strong Hearts, healthy communities: a rural community-based cardiovascular disease prevention program.

PubMed

Seguin, Rebecca A; Eldridge, Galen; Graham, Meredith L; Folta, Sara C; Nelson, Miriam E; Strogatz, David

2016-01-28

Cardiovascular disease is the leading cause of death in the United States and places substantial burden on the health care system. Rural populations, especially women, have considerably higher rates of cardiovascular disease, influenced by poverty, environmental factors, access to health care, and social and cultural attitudes and norms. This community-based study will be a two-arm randomized controlled efficacy trial comparing a multi-level, community program (Strong Hearts, Healthy Communities) with a minimal intervention control program (Strong Hearts, Healthy Women). Strong Hearts, Healthy Communities was developed by integrating content from three evidence-based programs and was informed by extensive formative research (e.g. community assessments, focus groups, and key informant interviews). Classes will meet twice weekly for one hour for 24 weeks and focus on individual-level skill building and behavior change; social and civic engagement are also core programmatic elements. Strong Hearts, Healthy Women will meet monthly for hour-long sessions over the 24 weeks covering similar content in a general, condensed format. Overweight, sedentary women 40 years of age and older from rural, medically underserved communities (12 in Montana and 4 in New York) will be recruited; sites, pair-matched based on rurality, will be randomized to full or minimal intervention. Data will be collected at baseline, midpoint, intervention completion, and six-month, one-year, and eighteen months post-intervention. The primary outcome is change in body weight; secondary outcomes include physiologic, anthropometric, behavioral, and psychosocial variables. In the full intervention, engagement of participants' friends and family members in partnered activities and community events is an intervention target, hypothesizing that there will be a reciprocal influence of physical activity and diet behavior between participants and their social network. Family members and/or friends will be invited to complete baseline and follow-up questionnaires about their health behaviors and environment, height and weight, and attitudes and beliefs. Strong Hearts, Healthy Communities aims to reduce cardiovascular disease morbidity and mortality, improve quality of life, and reduce cardiovascular disease-related health care burden in underserved rural communities. If successful, the long-term goal is for the program to be nationally disseminated, providing a feasible model to reduce cardiovascular disease in rural settings. ClinicalTrials.gov Identifier: NCT02499731 Registered on July 1, 2015.

Implementing an Evidence-Based Fall Prevention Intervention in Community Senior Centers.

PubMed

Li, Fuzhong; Harmer, Peter; Fitzgerald, Kathleen

2016-11-01

To evaluate the impact of implementing an evidence-based fall prevention intervention in community senior centers. We used a single-group design to evaluate the Tai Ji Quan: Moving for Better Balance (TJQMBB) program's adoption, population reach, implementation, effectiveness, and maintenance among 36 senior centers in 4 Oregon counties between 2012 and 2016. The primary outcome measure, as part of the effectiveness evaluation, was number of falls as ascertained by self-report. Trained TJQMBB instructors delivered the program to community-dwelling older adults for 48 weeks, with a 6-month postintervention follow-up. TJQMBB was adopted by 89% of the senior centers approached and reached 90% of the target population. The program resulted in a 49% reduction in the total number of falls and improved physical performance. Participation was well maintained after the program's completion. The average cost-effectiveness ratio for the 48-week program implementation was $917 per fall prevented and $676 per fall prevented for multiple falls. TJQMBB is an effective public health program that can be broadly implemented in community senior centers for primary prevention of falls among community-dwelling older adults.

Community smoking cessation contests: an effective public health strategy.

PubMed

Leinweber, C E; Macdonald, J M; Campbell, H S

1994-01-01

This report describes the follow-up of a community-sponsored smoking cessation contest. The aims of the evaluation were to describe the characteristics of contestants and the quit rates at six weeks, six months and one year. The "Quit to Win" contest was held as part of a larger cancer prevention program in Medicine Hat, Alberta. In order to be eligible for prizes, contestants were required to be smoke-free for six weeks and have their smoking status verified by a "Buddy". Contestants were contacted by telephone at the end of the contest and again at six months and one year. Seventy-five individuals entered the contest. The quit rates, 56%, 27% and 21% at six weeks, six months and one year respectively, compare favourably with other smoking cessation interventions. This study demonstrates that a community-based program can reach a variety of smokers with a relatively simple intervention.

Appropriate Community Technology: A Training Manual. Training for Development. Peace Corps Information Collection & Exchange Training Manual No. T-28.

ERIC Educational Resources Information Center

Clavaud, Donna; And Others

Based on experience in the field, this training program was developed to help Peace Corps trainers teach appropriate community technology to Peace Corps volunteers and community workers. The 8-week, 104-session training program is organized in six phases that cover the following topics: introduction to training; earthen construction and…

The Impact of a Home-Based Computerized Cognitive Training Intervention on Fall Risk Measure Performance in Community Dwelling Older Adults, a Pilot Study.

PubMed

Blackwood, J; Shubert, T; Fogarty, K; Chase, C

2016-02-01

Cognitive intervention studies have reported improvements in various domains of cognition as well as a transfer effect of improved function post training. Despite the availability of web based cognitive training programs, most intervention studies have been performed under the supervision of researchers. Therefore, the purpose of this study was to first, examine the feasibility of a six week home based computerized cognitive training (CCT) program in a group of community dwelling older adults and, second, to determine if a CCT program which focused on set shifting, attention, and visual spatial ability impacted fall risk measure performance. This pilot study used a pretest/posttest experimental design with randomization by testing site to an intervention or control group. Community dwelling older adults (mean age = 74.6 years) participated in either the control (N=25) or the intervention group (N=19). Intervention group subjects participated in 6 weeks of home based CCT 3x/week for an average of 23 minutes/session, using an online CCT program. Comparisons of mean scores on three measures of physical function (usual gait speed, five times sit to stand, timed up and go) were completed at baseline and week 7. Following the completion of an average of 18 sessions of CCT at home with good adherence (86%) and retention (92%) rates, a statistically significant difference in gait speed was found between groups with an average improvement of 0.14 m/s in the intervention group. A home based CCT program is a feasible approach to targeting cognitive impairments known to influence fall risk and changes in gait in older adults.

Implementing a Science-Based Interdisciplinary Curriculum in the Second Grade: A Community of Practice in Action

ERIC Educational Resources Information Center

Park Rogers, Meredith

2011-01-01

The purpose of this study was to explore the role that a collaborative teaching approach, referred to as a community of practice (CoP), had on a team of four second grade teachers' implementation of a science-based interdisciplinary curriculum. Data was collected in the form of extensive observation notes gathered over 10-weeks of twice weekly…

Los Rios Community College District Office of Institutional Research. Fall 2004 Student Profile. Based upon First Census Data

ERIC Educational Resources Information Center

Glyer-Culver, Betty

2004-01-01

This annual summary provides one in a series of semester-based reports that presents a profile of Los Rios Community College District students enrolled at First Census (taken at the 4th week of classes). The Fall 2004 Student Profile provides the District and its colleges-American River College, Cosumnes River College, Folsom Lake College and…

South-Africa (Goodstart III) trial: community-based maternal and newborn care economic analysis.

PubMed

Daviaud, Emmanuelle; Nkonki, Lungiswa; Ijumba, Petrida; Doherty, Tanya; Lawn, Joy E; Owen, Helen; Jackson, Debra; Tomlinson, Mark

2017-10-01

In light of South Africa's generalized HIV/AIDS epidemic coupled with high infant mortality, we undertook a cluster Randomized Control Trial (2008-10) assessing the effect of Community Health Worker (CHW) antenatal and postnatal home visits on, amongst other indicators, levels of HIV-free survival, and exclusive and appropriate infant feeding at 12 weeks. Cost and time implications were calculated, by assessing the 15 participating CHWs, using financial records, mHealth and interviews. Sustainability and scalability were assessed, enabling identification of health system issues. The majority (96%) of women in the community received an average of 4.1 visits (target seven). The paid, single purpose CHWs spent 13 h/week on the programme. The financial cost per mother amounted to $94 ($23 per home visit). Modelling target coverage (95% mothers, seven visits) and increased efficiency showed that if CHWs spent 25 h/week on the programme, the number of CHWs required would decrease from 15 to 12. The intervention almost doubled exclusive breastfeeding (EBF) at 12 weeks and showed a 6% relative increase in EBF with each additional CHW visit. Home visit programmes improve access and prevention but are not an inexpensive alternative: the observed cost per home visit is twice that of a clinic visit and in target/efficiency scenario decreases to 70% of the cost of a clinic visit. Ensuring sustainability requires optimizing the design of programmes and deployment of human resources, whilst maintaining impact. However, low remuneration of CHWs leads to shorter working hours, low motivation and sub-optimal coverage even in a situation with well-resourced supervision. The community-based care programme in South-Africa is based on multi-purpose CHWs, its cost and impact should be compared with results from this study. Quality of support for multi-purpose CHWs may be the biggest challenge to address to achieving higher efficiency of community-based services. ISRCTN41046462. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Mindfulness-based stress reduction (MBSR) and distress in a community-based sample.

PubMed

Evans, Susan; Ferrando, Stephen; Carr, Corey; Haglin, Dean

2011-01-01

Numerous studies have found Mindfulness-based stress reduction (MBSR) to be useful for a wide range of problems including anxiety, pain and coping with a medical illness. The primary goal of this study was to evaluate the effectiveness of an 8-week MBSR programme in relieving distress in a community based sample. Subjects (n = 14) were participants in the MBSR programme at a major academic medical center and completed the Profile of Mood States (POMS) and the Mindful Attention Awareness Scale (MAAS) prior to starting the class and at the end of the 8-week course. Means and standard deviations were computed for the pre-and post-POMS total and subscale measures and the MAAS. Wilcoxon Signed Ranks Test was conducted. There were significant reductions on multiple dimensions of distress on the POMS as well as a significant increase in mindful awareness as measured by the MAAS. These results suggest that MBSR appears to be associated with a reduction of distress and increased awareness of everyday life experiences in a sample of residents living in a large urban community.  Copyright © 2010 John Wiley & Sons, Ltd.

The DiabetAction Program: Implementation in Community-Based Settings

ERIC Educational Resources Information Center

Mathieu, Marie-Eve; Brochu, Martin; Beliveau, Louise

2009-01-01

Developed for specialists who want to increase the physical activity (PA) level of type 2 diabetic and at-risk individuals, the 10-week DiabetAction program introduced participants to a wide variety of cardiovascular, resistance, balance, and flexibility exercises. Thirty-three of 48 individuals completed the intervention in community-based…

Time development in the early history of social networks: link stabilization, group dynamics, and segregation.

PubMed

Bruun, Jesper; Bearden, Ian G

2014-01-01

Studies of the time development of empirical networks usually investigate late stages where lasting connections have already stabilized. Empirical data on early network history are rare but needed for a better understanding of how social network topology develops in real life. Studying students who are beginning their studies at a university with no or few prior connections to each other offers a unique opportunity to investigate the formation and early development of link patterns and community structure in social networks. During a nine week introductory physics course, first year physics students were asked to identify those with whom they communicated about problem solving in physics during the preceding week. We use these students' self reports to produce time dependent student interaction networks. We investigate these networks to elucidate possible effects of different student attributes in early network formation. Changes in the weekly number of links show that while roughly half of all links change from week to week, students also reestablish a growing number of links as they progress through their first weeks of study. Using the Infomap community detection algorithm, we show that the networks exhibit community structure, and we use non-network student attributes, such as gender and end-of-course grade to characterize communities during their formation. Specifically, we develop a segregation measure and show that students structure themselves according to gender and pre-organized sections (in which students engage in problem solving and laboratory work), but not according to end-of-coure grade. Alluvial diagrams of consecutive weeks' communities show that while student movement between groups are erratic in the beginning of their studies, they stabilize somewhat towards the end of the course. Taken together, the analyses imply that student interaction networks stabilize quickly and that students establish collaborations based on who is immediately available to them and on observable personal characteristics.

Validity of Newborn Clinical Assessment to Determine Gestational Age in Bangladesh

PubMed Central

Mullany, Luke C.; Ladhani, Karima; Uddin, Jamal; Mitra, Dipak; Ahmed, Parvez; Christian, Parul; Labrique, Alain; DasGupta, Sushil K.; Lokken, R. Peter; Quaiyum, Mohammed; Baqui, Abdullah H

2016-01-01

BACKGROUND: Gestational age (GA) is frequently unknown or inaccurate in pregnancies in low-income countries. Early identification of preterm infants may help link them to potentially life-saving interventions. METHODS: We conducted a validation study in a community-based birth cohort in rural Bangladesh. GA was determined by pregnancy ultrasound (<20 weeks). Community health workers conducted home visits (<72 hours) to assess physical/neuromuscular signs and measure anthropometrics. The distribution, agreement, and diagnostic accuracy of different clinical methods of GA assessment were determined compared with early ultrasound dating. RESULTS: In the live-born cohort (n = 1066), the mean ultrasound GA was 39.1 weeks (SD 2.0) and prevalence of preterm birth (<37 weeks) was 11.4%. Among assessed newborns (n = 710), the mean ultrasound GA was 39.3 weeks (SD 1.6) (8.3% preterm) and by Ballard scoring the mean GA was 38.9 weeks (SD 1.7) (12.9% preterm). The average bias of the Ballard was –0.4 weeks; however, 95% limits of agreement were wide (–4.7 to 4.0 weeks) and the accuracy for identifying preterm infants was low (sensitivity 16%, specificity 87%). Simplified methods for GA assessment had poor diagnostic accuracy for identifying preterm births (community health worker prematurity scorecard [sensitivity/specificity: 70%/27%]; Capurro [5%/96%]; Eregie [75%/58%]; Bhagwat [18%/87%], foot length <75 mm [64%/35%]; birth weight <2500 g [54%/82%]). Neonatal anthropometrics had poor to fair performance for classifying preterm infants (areas under the receiver operating curve 0.52–0.80). CONCLUSIONS: Newborn clinical assessment of GA is challenging at the community level in low-resource settings. Anthropometrics are also inaccurate surrogate markers for GA in settings with high rates of fetal growth restriction. PMID:27313070

Validity of Newborn Clinical Assessment to Determine Gestational Age in Bangladesh.

PubMed

Lee, Anne Cc; Mullany, Luke C; Ladhani, Karima; Uddin, Jamal; Mitra, Dipak; Ahmed, Parvez; Christian, Parul; Labrique, Alain; DasGupta, Sushil K; Lokken, R Peter; Quaiyum, Mohammed; Baqui, Abdullah H

2016-07-01

Gestational age (GA) is frequently unknown or inaccurate in pregnancies in low-income countries. Early identification of preterm infants may help link them to potentially life-saving interventions. We conducted a validation study in a community-based birth cohort in rural Bangladesh. GA was determined by pregnancy ultrasound (<20 weeks). Community health workers conducted home visits (<72 hours) to assess physical/neuromuscular signs and measure anthropometrics. The distribution, agreement, and diagnostic accuracy of different clinical methods of GA assessment were determined compared with early ultrasound dating. In the live-born cohort (n = 1066), the mean ultrasound GA was 39.1 weeks (SD 2.0) and prevalence of preterm birth (<37 weeks) was 11.4%. Among assessed newborns (n = 710), the mean ultrasound GA was 39.3 weeks (SD 1.6) (8.3% preterm) and by Ballard scoring the mean GA was 38.9 weeks (SD 1.7) (12.9% preterm). The average bias of the Ballard was -0.4 weeks; however, 95% limits of agreement were wide (-4.7 to 4.0 weeks) and the accuracy for identifying preterm infants was low (sensitivity 16%, specificity 87%). Simplified methods for GA assessment had poor diagnostic accuracy for identifying preterm births (community health worker prematurity scorecard [sensitivity/specificity: 70%/27%]; Capurro [5%/96%]; Eregie [75%/58%]; Bhagwat [18%/87%], foot length <75 mm [64%/35%]; birth weight <2500 g [54%/82%]). Neonatal anthropometrics had poor to fair performance for classifying preterm infants (areas under the receiver operating curve 0.52-0.80). Newborn clinical assessment of GA is challenging at the community level in low-resource settings. Anthropometrics are also inaccurate surrogate markers for GA in settings with high rates of fetal growth restriction. Copyright © 2016 by the American Academy of Pediatrics.

Community-based pulmonary rehabilitation in a non-healthcare facility is feasible and effective.

PubMed

Cecins, Nola; Landers, Holly; Jenkins, Sue

2017-02-01

Pulmonary rehabilitation programs (PRPs) are most commonly provided in hospital settings which present barriers to attendance such as long distances or travel times. Community-based settings have been used in an attempt to alleviate the travel burden. This study evaluated the feasibility and outcomes of a network of community-based PRPs provided in non-healthcare facilities (CPRPs). The CPRPs were established in five venues and comprised two supervised group sessions each week for 8 weeks. Participant inclusion criteria and guidelines for exercise testing and training were developed to reduce the risk of adverse events. Outcome measures included 6-min walk distance (6MWD) and health-related quality of life (chronic respiratory questionnaire (CRQ)). Respiratory-related hospital admission data were collected in the 12 months prior to and following the program. Two hundred and fifty-one participants (79% with chronic obstructive pulmonary disease: mean ± SD FEV 1 49 ± 21%predicted) entered a CPRP of which 166 (66%) completed. Improvements were demonstrated in 6MWD (mean difference (95% CI) 44 m (37-52)) and total CRQ score (0.5 points per item (0.4-0.7)). Fewer participants had a respiratory-related hospital admission following the program (12% vs. 37%, p < 0.0001). Pulmonary rehabilitation is safe, feasible and effective when conducted in community-based non-healthcare facilities.

Enhancing community capacity to support physical activity: the development of a community-based indoor-outdoor walking program.

PubMed

Riley-Jacome, Mary; Gallant, Mary P; Fisher, Brian D; Gotcsik, Frances S; Strogatz, David S

2010-04-01

The University at Albany Prevention Research Center, guided by a needs assessment in two underserved communities (one urban, one rural), initiated a pilot project that opened a public school for community walking in a rural setting. This study examined a 9-week program for potential barriers, benefits, influential factors, and the physical activity levels of program participants. Evaluation was based on daily logs, pedometer diaries, participant surveys, and focus groups. Results indicated that rural schools provide a useful resource for residents and increase participants' physical activity levels. A more comprehensive rural community walking program has been implemented as a result of these findings.

A School at the Center: Study II.

ERIC Educational Resources Information Center

Mid-Continent Regional Educational Lab., Aurora, CO.

This report, which focuses on improving education in rural Nebraska, grew out of a 2-week teachers' institute held in Walthill, Nebraska, in June 1993. "Introduction: The Vision of Community-Based Schools and the Future of Rural Places" (Toni Haas, Paul Nachtigal) examines current civic and social trends in rural communities and the role…

Design and Implementation of a Community Program to Promote Cognitive Vitality among Seniors

ERIC Educational Resources Information Center

Parisien, Manon; Lorthios-Guilledroit, Agathe; Bier, Nathalie; Gilbert, Norma; Nour, Kareen; Guay, Danielle; Langlois, Francis; Fournier, Baptiste; Laforest, Sophie

2016-01-01

Background: Jog Your Mind is a community-based program aiming to enable seniors to maintain their cognitive abilities. It includes stimulating activities, information on aging, mnemonic strategies, and promotion of a healthy lifestyle and is offered over 10 weekly sessions to seniors with no known cognitive impairment. Purpose: This article…

The role of a community coalition in the development of health services for the poor and uninsured.

PubMed

Bibeau, D L; Howell, K A; Rife, J C; Taylor, M L

1996-01-01

Access to primary health care for indigent citizens presents a dilemma for many communities in the United States. In response, communities have developed a variety of strategies to effectively deal with the problem. This article describes the evolution of a small free clinic into a comprehensive primary care clinic developed through the actions of a community-based coalition. The clinic originated within an umbrella organization for indigent residents as free medical service provided at a night shelter by a local physician once a week. Through a coalition of business, religious, medical, hospital, foundation, lay volunteer, county health department, and chamber of commerce representatives, the service was enlarged into a formal clinic operation with a small staff and volunteers providing services for about 3,500 patient visits each year. As the demand for services increased beyond resources, an expanded coalition created HealthServe Medical Center, a comprehensive primary care clinic operating 40 hours per week. The HealthServe Board is currently active in supporting service delivery at the clinic, with plans to serve 24,000 medical and dental visits annually by mid-1995. The evolution process was based upon the characteristics of effective community coalitions and the commitment of individuals from diverse community sectors.

Time Investment in Drug Supply Problems by Flemish Community Pharmacies.

PubMed

De Weerdt, Elfi; Simoens, Steven; Casteels, Minne; Huys, Isabelle

2017-01-01

Introduction: Drug supply problems are a known problem for pharmacies. Community and hospital pharmacies do everything they can to minimize impact on patients. This study aims to quantify the time spent by Flemish community pharmacies on drug supply problems. Materials and Methods: During 18 weeks, employees of 25 community pharmacies filled in a template with the total time spent on drug supply problems. The template stated all the steps community pharmacies could undertake to manage drug supply problems. Results: Considering the median over the study period, the median time spent on drug supply problems was 25 min per week, with a minimum of 14 min per week and a maximum of 38 min per week. After calculating the median of each pharmacy, large differences were observed between pharmacies: about 25% spent less than 15 min per week and one-fifth spent more than 1 h per week. The steps on which community pharmacists spent most time are: (i) "check missing products from orders," (ii) "contact wholesaler/manufacturers regarding potential drug shortages," and (iii) "communicating to patients." These three steps account for about 50% of the total time spent on drug supply problems during the study period. Conclusion: Community pharmacies spend about half an hour per week on drug supply problems. Although 25 min per week does not seem that much, the time spent is not delineated and community pharmacists are constantly confronted with drug supply problems.

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.

Virtual Reality Training With Three-Dimensional Video Games Improves Postural Balance and Lower Extremity Strength in Community-Dwelling Older Adults.

PubMed

Lee, Yongwoo; Choi, Wonjae; Lee, Kyeongjin; Song, Changho; Lee, Seungwon

2017-10-01

Avatar-based three-dimensional technology is a new approach to improve physical function in older adults. The aim of this study was to use three-dimensional video gaming technology in virtual reality training to improve postural balance and lower extremity strength in a population of community-dwelling older adults. The experimental group participated in the virtual reality training program for 60 min, twice a week, for 6 weeks. Both experimental and control groups were given three times for falls prevention education at the first, third, and fifth weeks. The experimental group showed significant improvements not only in static and dynamic postural balance but also lower extremity strength (p < .05). Furthermore, the experimental group was improved to overall parameters compared with the control group (p < .05). Therefore, three-dimensional video gaming technology might be beneficial for improving postural balance and lower extremity strength in community-dwelling older adults.

The Community-based Participatory Intervention Effect of “HIV-RAAP”

PubMed Central

Yancey, Elleen M.; Mayberry, Robert; Armstrong-Mensah, Elizabeth; Collins, David; Goodin, Lisa; Cureton, Shava; Trammell, Ella H.; Yuan, Keming

2012-01-01

Objectives To design and test HIV-RAAP (HIV/AIDS Risk Reduction Among Heterosexually Active African American Men and Women: A Risk Reduction Prevention Intervention) a coeducational, culture- and gender-sensitive community-based participatory HIV risk reduction intervention. Methods A community-based participatory research process included intervention development and implementation of a 7-session coeducational curriculum conducted over 7 consecutive weeks. Results The results indicated a significant intervention effect on reducing sexual behavior risk (P=0.02), improving HIV risk knowledge (P=0.006), and increasing sexual partner conversations about HIV risk reduction (P= 0.001). Conclusions The HIV-RAAP intervention impacts key domains of heterosexual HIV transmission. PMID:22488405

The community-based participatory intervention effect of "HIV-RAAP".

PubMed

Yancey, Elleen M; Mayberry, Robert; Armstrong-Mensah, Elizabeth; Collins, David; Goodin, Lisa; Cureton, Shava; Trammell, Ella H; Yuan, Keming

2012-07-01

To design and test HIV-RAAP (HIV/AIDS Risk Reduction Among Heterosexually Active African American Men and Women: A Risk Reduction Prevention Intervention) a coeducational, culture- and gender-sensitive community-based participatory HIV risk reduction intervention. A community-based participatory research process included intervention development and implementation of a 7-session coeducational curriculum conducted over 7 consecutive weeks. The results indicated a significant intervention effect on reducing sexual behavior risk (P=0.02), improving HIV risk knowledge (P=0.006), and increasing sexual partner conversations about HIV risk reduction (P= 0.001). The HIV-RAAP intervention impacts key domains of heterosexual HIV transmission.

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.

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

PubMed

Prendergast, Michael; Cartier, Jerome J

2008-01-01

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

Bacterial community development in experimental gingivitis.

PubMed

Kistler, James O; Booth, Veronica; Bradshaw, David J; Wade, William G

2013-01-01

Current knowledge of the microbial composition of dental plaque in early gingivitis is based largely on microscopy and cultural methods, which do not provide a comprehensive description of oral microbial communities. This study used 454-pyrosequencing of the V1-V3 region of 16S rRNA genes (approximately 500 bp), and bacterial culture, to characterize the composition of plaque during the transition from periodontal health to gingivitis. A total of 20 healthy volunteers abstained from oral hygiene for two weeks, allowing plaque to accumulate and gingivitis to develop. Plaque samples were analyzed at baseline, and after one and two weeks. In addition, plaque samples from 20 chronic periodontitis patients were analyzed for cross-sectional comparison to the experimental gingivitis cohort. All of the healthy volunteers developed gingivitis after two weeks. Pyrosequencing yielded a final total of 344,267 sequences after filtering, with a mean length of 354 bases, that were clustered into an average of 299 species-level Operational Taxonomic Units (OTUs) per sample. Principal coordinates analysis (PCoA) plots revealed significant shifts in the bacterial community structure of plaque as gingivitis was induced, and community diversity increased significantly after two weeks. Changes in the relative abundance of OTUs during the transition from health to gingivitis were correlated to bleeding on probing (BoP) scores and resulted in the identification of new health- and gingivitis-associated taxa. Comparison of the healthy volunteers to the periodontitis patients also confirmed the association of a number of putative periodontal pathogens with chronic periodontitis. Taxa associated with gingivitis included Fusobacterium nucleatum subsp. polymorphum, Lachnospiraceae [G-2] sp. HOT100, Lautropia sp. HOTA94, and Prevotella oulorum, whilst Rothia dentocariosa was associated with periodontal health. Further study of these taxa is warranted and may lead to new therapeutic approaches to prevent periodontal disease.

Bacterial Community Development in Experimental Gingivitis

PubMed Central

Kistler, James O.; Booth, Veronica; Bradshaw, David J.; Wade, William G.

2013-01-01

Current knowledge of the microbial composition of dental plaque in early gingivitis is based largely on microscopy and cultural methods, which do not provide a comprehensive description of oral microbial communities. This study used 454-pyrosequencing of the V1–V3 region of 16S rRNA genes (approximately 500 bp), and bacterial culture, to characterize the composition of plaque during the transition from periodontal health to gingivitis. A total of 20 healthy volunteers abstained from oral hygiene for two weeks, allowing plaque to accumulate and gingivitis to develop. Plaque samples were analyzed at baseline, and after one and two weeks. In addition, plaque samples from 20 chronic periodontitis patients were analyzed for cross-sectional comparison to the experimental gingivitis cohort. All of the healthy volunteers developed gingivitis after two weeks. Pyrosequencing yielded a final total of 344 267 sequences after filtering, with a mean length of 354 bases, that were clustered into an average of 299 species-level Operational Taxonomic Units (OTUs) per sample. Principal coordinates analysis (PCoA) plots revealed significant shifts in the bacterial community structure of plaque as gingivitis was induced, and community diversity increased significantly after two weeks. Changes in the relative abundance of OTUs during the transition from health to gingivitis were correlated to bleeding on probing (BoP) scores and resulted in the identification of new health- and gingivitis-associated taxa. Comparison of the healthy volunteers to the periodontitis patients also confirmed the association of a number of putative periodontal pathogens with chronic periodontitis. Taxa associated with gingivitis included Fusobacterium nucleatum subsp. polymorphum, Lachnospiraceae [G-2] sp. HOT100, Lautropia sp. HOTA94, and Prevotella oulorum, whilst Rothia dentocariosa was associated with periodontal health. Further study of these taxa is warranted and may lead to new therapeutic approaches to prevent periodontal disease. PMID:23967169

Effect of an integrated community-based package for maternal and newborn care on feeding patterns during the first 12 weeks of life: a cluster-randomized trial in a South African township.

PubMed

Ijumba, Petrida; Doherty, Tanya; Jackson, Debra; Tomlinson, Mark; Sanders, David; Swanevelder, Sonja; Persson, Lars-Åke

2015-10-01

To analyse the effect of community-based counselling on feeding patterns during the first 12 weeks after birth, and to study whether the effect differs by maternal HIV status, educational level or household wealth. Cluster-randomized trial with fifteen clusters in each arm to evaluate an integrated package providing two pregnancy and five postnatal home visits delivered by community health workers. Infant feeding data were collected using 24 h recall of nineteen food and fluid items. A township near Durban, South Africa. Pregnant women (1894 intervention and 2243 control) aged 17 years or more. Twelve weeks after birth, 1629 (intervention) and 1865 (control) mother-infant pairs were available for analysis. Socio-economic conditions differed slightly across intervention groups, which were considered in the analyses. There was no effect on early initiation of breast-feeding. At 12 weeks of age the intervention doubled exclusive breast-feeding (OR=2·29; 95 % CI 1·80, 2·92), increased exclusive formula-feeding (OR=1·70; 95 % CI 1·28, 2·27), increased predominant breast-feeding (OR=1·71; 95 % CI 1·34, 2·19), decreased mixed formula-feeding (OR=0·68; 95 % CI 0·55, 0·83) and decreased mixed breast-feeding (OR=0·54; 95 % CI 0·44, 0·67). The effect on exclusive breast-feeding at 12 weeks was stronger among HIV-negative mothers than HIV-positive mothers (P=0·01), while the effect on mixed formula-feeding was significant only among HIV-positive mothers (P=0·03). The effect on exclusive feeding was not different by household wealth or maternal education levels. A perinatal intervention package delivered by community health workers was effective in increasing exclusive breast-feeding, exclusive formula-feeding and decreasing mixed feeding.

Effect of an integrated community-based package for maternal and newborn care on feeding patterns during the first 12 weeks of life: a cluster-randomized trial in a South African township

PubMed Central

Ijumba, Petrida; Doherty, Tanya; Jackson, Debra; Tomlinson, Mark; Sanders, David; Swanevelder, Sonja; Persson, Lars-Åke

2015-01-01

Objective To analyse the effect of community-based counselling on feeding patterns during the first 12 weeks after birth, and to study whether the effect differs by maternal HIV status, educational level or household wealth. Design Cluster-randomized trial with fifteen clusters in each arm to evaluate an integrated package providing two pregnancy and five postnatal home visits delivered by community health workers. Infant feeding data were collected using 24 h recall of nineteen food and fluid items. Setting A township near Durban, South Africa. Subjects Pregnant women (1894 intervention and 2243 control) aged 17 yearsor more. Results Twelve weeks after birth, 1629 (intervention) and 1865 (control) mother–infant pairs were available for analysis. Socio-economic conditions differed slightly across intervention groups, which were considered in the analyses. There was no effect on early initiation of breast-feeding. At 12 weeks of age the intervention doubled exclusive breast-feeding (OR=2·29; 95 % CI 1·80, 2·92), increased exclusive formula-feeding (OR=1·70; 95 % CI 1·28, 2·27), increased predominant breast-feeding (OR=1·71; 95 % CI 1·34, 2·19), decreased mixed formula-feeding (OR=0·68; 95 % CI 0·55, 0·83) and decreased mixed breast-feeding (OR=0·54; 95 % CI 0·44, 0·67). The effect on exclusive breast-feeding at 12 weeks was stronger among HIV-negative mothers than HIV-positive mothers (P=0·01), while the effect on mixed formula feeding was significant only among HIV-positive mothers (P=0·03). The effect on exclusive feeding was not different by household wealth or maternal education levels. Conclusions A perinatal intervention package delivered by community health workers was effective in increasing exclusive breast-feeding, exclusive formula feeding and decreasing mixed feeding. PMID:25660465

Game-Based Community Cognitive Health Intervention for Minority and Lower Socioeconomic Status Older Adults: A Feasibility Pilot Study.

PubMed

Overman, Amy A; Robbins, Ruth E

2014-10-01

The purpose of this pilot study was to investigate the feasibility of implementing a noncomputerized, game-based, community cognitive health intervention with minority and/or lower socioeconomic status (SES) older adults in order to improve cognitive performance and quality of life. Through partnerships with community organizations, we implemented an innovative pilot 10-week cognitive training intervention. Noncomputerized games were used to combine social interaction and cognitive training that challenged attentional and memory function for 1 hour each week over the span of 10 weeks. One game used in the intervention program was created by adapting a working memory training task into a fun and competitive card game; the other two games were commercially available. The intervention and pre/post assessments were able to be delivered in a community setting. Overall retention was satisfactory, but it dropped in later weeks of the intervention. Older adult participants reported enjoying the games and being invested in their performance. They also reported playing the games with family and friends at home. Older adult participants complied with game rules but were reluctant to comply with instructions to rotate game partners and game types. They preferred their first partners, and they preferred the card game over the existing commercial games. This intervention has the potential to improve quality of life and reduce disparities in cognitive health in older adults because it is an accessible game-based intervention program that motivates older adult participants to engage cognitively and to continue this engagement beyond the formal training sessions. However, in order to carry this out on a larger scale, particular attention must be paid to recruitment, retention, and training procedures. This article discusses the critical need for cognitive training interventions in minority and lower SES older adults, the intended benefits, and the best approaches to conducting this type of intervention.

Time Investment in Drug Supply Problems by Flemish Community Pharmacies

PubMed Central

De Weerdt, Elfi; Simoens, Steven; Casteels, Minne; Huys, Isabelle

2017-01-01

Introduction: Drug supply problems are a known problem for pharmacies. Community and hospital pharmacies do everything they can to minimize impact on patients. This study aims to quantify the time spent by Flemish community pharmacies on drug supply problems. Materials and Methods: During 18 weeks, employees of 25 community pharmacies filled in a template with the total time spent on drug supply problems. The template stated all the steps community pharmacies could undertake to manage drug supply problems. Results: Considering the median over the study period, the median time spent on drug supply problems was 25 min per week, with a minimum of 14 min per week and a maximum of 38 min per week. After calculating the median of each pharmacy, large differences were observed between pharmacies: about 25% spent less than 15 min per week and one-fifth spent more than 1 h per week. The steps on which community pharmacists spent most time are: (i) “check missing products from orders,” (ii) “contact wholesaler/manufacturers regarding potential drug shortages,” and (iii) “communicating to patients.” These three steps account for about 50% of the total time spent on drug supply problems during the study period. Conclusion: Community pharmacies spend about half an hour per week on drug supply problems. Although 25 min per week does not seem that much, the time spent is not delineated and community pharmacists are constantly confronted with drug supply problems. PMID:28878679

Breast cancer survivors' barriers and motives for participating in a group-based physical activity program offered in the community.

PubMed

Wurz, Amanda; St-Aubin, Anik; Brunet, Jennifer

2015-08-01

The purpose of this qualitative study was to explore the barriers and motives experienced by women attending an 8-week group-based physical activity program offered in the community following treatment for breast cancer. Seven women were interviewed during the first and last week of the program. Data were analyzed using thematic analysis. Factors that hindered women's continued participation could be subdivided into situational barriers, which encompassed community (i.e., distance of center and traffic) and institutional factors (i.e., competing roles and responsibilities), and internal barriers, which consisted of cancer-specific limitations. Motives for initial and continued participation were situational (i.e., gaining social support, networking, and being around similar others) and internal (i.e., feeling a sense of personal fulfillment, acquiring health benefits, and recovering from cancer). The findings contribute to a deeper understanding of women's motives to engage in a group-based physical activity program after treatment for breast cancer. Further, they underscore the necessity of considering situational and internal barriers when developing group-based physical activity programs to increase regular participation, optimize adherence, and reduce drop-out.

The feasibility of adapted group-based interpersonal therapy (IPT) for the treatment of depression by community health workers within the context of task shifting in South Africa.

PubMed

Petersen, I; Bhana, A; Baillie, K

2012-06-01

Within the context of a large treatment gap for depression and a scarcity of specialist resources, there is a need for task shifting to scale up mental health services to address this gap in South Africa. This study assessed the feasibility of an adapted manualized version of grouped based Interpersonal Therapy (IPT) for use by supervised community health workers through a pilot study on 60 primary health care clinic users screened as having moderate to severe depression. Retention was good and participants in the group-based IPT intervention showed significant reduction in depressive symptoms on completion of the 12-week intervention as well as 24 weeks post baseline compared to the control group. Qualitative process evaluation suggests that improved social support, individual coping skills and improved personal agency assisted in the reduction of depressive symptoms.

Effect of Community-Based Occupational Therapy on Health-Related Quality of Life and Engagement in Meaningful Activities of Women with Breast Cancer.

PubMed

Petruseviciene, Daiva; Surmaitiene, Deive; Baltaduoniene, Daiva; Lendraitiene, Egle

2018-01-01

We aimed to evaluate the short-term effects of community-based occupational therapy on health-related quality of life and engagement in meaningful activities among women with breast cancer. An open label randomized controlled trial study design was applied. The participants were members of various societies of women with cancer. In total, 22 women have participated in the study. Participants of the experimental group ( n = 11) participated in a 6-week community-based occupational therapy program and the usual activities of various societies, whereas the control group ( n = 11) women participated in the usual activities of the societies only. 1 of the participants withdrew during the course; therefore 21 completed the study successfully. Participants of both groups were assessed for health-related quality of life and the participants of the experimental group were assessed for engagement in meaningful activities. The evaluation was carried out during the nonacute period of the disease-at the beginning of the study and after 6 weeks. Women of the experimental group demonstrated statistically significantly better scores in the global quality of life, role functions, physical, emotional, cognitive, and social functions, fatigue, insomnia, financial impact, systemic therapy side effects, and breast symptoms scales compared to the control group participants ( p < 0.05) after the 6 weeks, as measured by the EORTC QLQ-C30 questionnaire and its breast cancer module QLQ-BR23 . Furthermore, women of the experimental group demonstrated significant greater engagement in meaningful activities when applying community-based occupational therapy ( p < 0.05), as measured by using the Engagement in Meaningful Activities Survey (EMAS). The evaluation of the associations between the women's engagement in meaningful activities and changes in health-related quality of life showed that greater engagement in meaningful activities was associated with better emotional functions and a lower level of insomnia ( p < 0.05). Based on the results of our study, we recommend applying occupational therapy in the field of community healthcare in order to maintain or improve breast cancer patients' health-related quality of life and suggest involving women into meaningful activities during community-based occupational therapy after clarifying which activities are important to them.

Study on community Tai Chi Chuan participants' leisure benefits and well-being: Using Taoyuan City as an example.

PubMed

Lee, Cheng-Jong; Tseng, Chun-Chi; Liu, Mei-Yu

2015-01-01

The aim of this study was to discuss the Research of Community Tai Chi Chuan Participants' Leisure Benefits and Well-being. A questionnaire survey was conducted on the community Tai Chi Chuan participants in Taoyuan city. A total of 500 valid questionnaires were retrieved, and the data were analyzed with SPSS 12.0 and AMOS 7.0 structural equation model analysis (SEM). The findings were as followed: 1) The background variables of the community Tai Chi Chuan participants in Taoyuan City: Gender had no difference in the factor of ``psychological benefit'' of leisure benefits. Occupation, age, education, the number of times a week to participate community Tai Chi Chuan and participation in seniority reached significant difference in leisure benefits. 2) The background variables of the community Tai Chi Chuan participants in Taoyuan City: gender, occupation, age, education, the number of times a week to participate community Tai Chi Chuan, participation in seniority reached significant difference in well-being. 3) The study showed community Tai Chi Chuan participants' leisure benefits had a significant positive correlation in well-being. Based on the findings, suggestions were proposed to related Taiwan Tai Chi Chuan promotion for reference.

Development of a sustainable community-based dental education program.

PubMed

Piskorowski, Wilhelm A; Fitzgerald, Mark; Mastey, Jerry; Krell, Rachel E

2011-08-01

Increasing the use of community-based programs is an important trend in improving dental education to meet the needs of students and the public. To support this trend, understanding the history of programs that have established successful models for community-based education is valuable for the creation and development of new programs. The community-based education model of the University of Michigan School of Dentistry (UMSOD) offers a useful guide for understanding the essential steps and challenges involved in developing a successful program. Initial steps in program development were as follows: raising funds, selecting an outreach clinical model, and recruiting clinics to become partners. As the program developed, the challenges of creating a sustainable financial model with the highest educational value required the inclusion of new clinical settings and the creation of a unique revenue-sharing model. Since the beginning of the community-based program at UMSOD in 2000, the number of community partners has increased to twenty-seven clinics, and students have treated thousands of patients in need. Fourth-year students now spend a minimum of ten weeks in community-based clinical education. The community-based program at UMSOD demonstrates the value of service-based education and offers a sustainable model for the development of future programs.

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.

The radiologic manifestations of Legionnaire's disease. The Ohio Community-Based Pneumonia Incidence Study Group.

PubMed

Tan, M J; Tan, J S; Hamor, R H; File, T M; Breiman, R F

2000-02-01

To study the serial radiographic manifestations of Legionnaire's disease from the initial presentation on admission to recovery using strict criteria for the diagnosis of infection. We prospectively studied the chest radiographs of patients hospitalized with a diagnosis of community-acquired pneumonia in Summit County, Ohio between November 1990 and November 1992. Forty-three patients fulfilled strict criteria for legionellosis. The diagnosis of infection was based on the criteria of "definite" diagnosis as defined by the Ohio Community-Based Pneumonia Incidence Study Group report. The criteria included the isolation of the microorganism, the presence of a significant antibody rise, or the presence of Legionella antigen in the urine. Forty of 43 patients had admission radiographs interpreted as compatible with pneumonia. In spite of appropriate antimicrobial therapy, worsening of the infiltrates was found in more than half of the patients within the first week. Twenty-seven patients were observed to have pleural effusion during the course of hospitalization: 10 effusions were found on admission, another 14 developed during the first week, and 3 new effusions were discovered after the first week. Cavitation was found in only one patient. None of the patients had apical involvement. This study confirms previous reports using less stringent etiologic diagnosis criteria that chest radiographic findings in Legionnaire's disease are not specific. Even with appropriate therapy, more than half of the patients will have worsening of the infiltrates during the first week. Pleural effusion is common among our patients, and it is frequently detected during the serial radiographic studies during the first week of hospitalization. Chest radiography in Legionnaire's disease is useful only for the monitoring of disease progression and not for diagnostic purposes. In addition, worsening of infiltrates and pleural effusion are seen in more than half of the patients in spite of appropriate therapy and clinical improvement.

Telerehabilitation - a new model for community-based stroke rehabilitation.

PubMed

Lai, Jerry C K; Woo, Jean; Hui, Elsie; Chan, W M

2004-01-01

Community resources for stroke clients are underdeveloped in Hong Kong and stroke survivors often face difficulties in community reintegration. We have examined the feasibility of using videoconferencing for community-based stroke rehabilitation. The sample comprised 21 stroke patients living at home. All the subjects participated in an eight-week intervention programme at a community centre for seniors. The intervention, which comprised educational talks, exercise and psychosocial support, was conducted by a physiotherapist via a videoconference link. The Berg Balance Scale (BBS), State Self-Esteem Scale (SSES), Medical Outcomes Study 36-item Short Form (SF-36) and a stroke knowledge test were administered at the start and end of the programme. In addition, at the start of the study the Geriatric Depression Scale 15-item Short Form, the Elderly Mobility Scale and the Lawton Instrumental Activities of Daily Living Scale were used to assess subjects' baseline status, and a focus group was also held at the end of the programme to gather qualitative findings. Nineteen subjects completed the eight-week intervention. The baseline functional status was high, although 52% had symptoms of depression. After the intervention, there were significant improvements in BBS, SSES and knowledge test scores and scores on all subscales of the SF-36. All the subjects accepted the use of videoconferencing for delivery of the intervention. The pilot study demonstrated the feasibility, efficacy and high level of acceptance of telerehabilitation for community-dwelling stroke clients.

Evaluation of an interprofessional educational curriculum pilot course for practitioners working with post-stroke patients.

PubMed

Olaisen, Rho Henry; Mariscal-Hergert, Cheryl; Shaw, Alissa; Macchiavelli, Cecilia; Marsheck, Joanna

2014-03-01

This report describes the design and evaluation of an interprofessional pilot training course aimed at pre-licensure practitioners working with post-stroke patients in community-based settings. The course was developed by community-based practitioners from nine health professions. Course learning activities included traditional methods (lectures) and interactive modules (problem-based learning and exchange-based learning). The study's aim was to assess the program's effectiveness in adapting and incorporating knowledge, skills and self-confidence when delivering tertiary care in therapeutic pool environments; gauge adoption of course principles into practice, and assess overall course satisfaction. Methods of evaluation included conceptual mapping of course format, pre- and post-questionnaires, daily reflection questionnaires, course satisfaction survey and adoption survey, 10 weeks follow-up. Overall, the findings indicate students' knowledge, skills and self-confidence in delivering effective post-stroke care increased following the training. Students reported adopting clinical practices in 10 weeks follow-up. Implications for designing interprofessional curricula are discussed.

Community Wise: paving the way for empowerment in community reentry.

PubMed

Windsor, Liliane Cambraia; Jemal, Alexis; Benoit, Ellen

2014-01-01

Theoretical approaches traditionally applied in mental health and criminal justice interventions fail to address the historical and structural context that partially explains health disparities. Community Wise was developed to address this gap. It is a 12week group intervention informed by Critical Consciousness Theory and designed to prevent substance abuse, related health risk behaviors, psychological distress, and reoffending among individuals with a history of incarceration and substance abuse. This paper reports findings from the first implementation and pilot evaluation of Community Wise in two community-based organizations. This pre-posttest evaluation pilot-tested Community Wise and used findings to improve the intervention. Twenty-six participants completed a phone and clinical screening, baseline, 6- and 12-week follow-ups, and a focus group at the end of the intervention. Measures assessed participants' demographic information, psychological distress, substance use, criminal offending, HIV risk behaviors, community cohesion, community support, civic engagement, critical consciousness, ethnic identification, group cohesion, client satisfaction, and acquired treatment skills. Research methods were found to be feasible and useful in assessing the intervention. Results indicated that while Community Wise is a promising intervention, several changes need to be made in order to enhance the intervention. Community Wise is a new approach where oppressed individuals join in critical dialogue, tap into existing community resources, and devise, implement and evaluate their own community solutions to structural barriers. Copyright © 2014 Elsevier Ltd. All rights reserved.

Meals, Mindfulness, & Moving Forward: A feasibility study to a multi-modal lifestyle approach in early psychosis.

PubMed

Usher, Craigan; Thompson, Andie; Griebeler, Meridith; Senders, Angela; Seibel, Celeste; Ly, Richard; Murchison, Charles; Hagen, Kirsten; Afong, Keith-Allen; Bourdette, Dennis; Ross, Rachel; Borgatti, Alena; Shinto, Lynne

2018-03-07

The primary aim was to demonstrate adherence to a novel 6-week lifestyle intervention program ("Meals, Mindfulness, & Moving Forward" [M 3 ]) designed to help improve lifestyle practices of youth with a history of at least 1 psychotic episode. M 3 used a non-equivalent control group design involving clients from a community early intervention program. Seventeen individuals in the active M 3 program and 16 controls were assessed for secondary outcomes at baseline, 6-weeks, and 12-weeks (6 weeks post-intervention) on cardiometabolic and symptomatic outcomes. The program met its primary aim with 88% (15/17) of participants meeting adherence criteria. Compared with the controls, M 3 participants showed significant improvement in positive psychotic symptoms (P = .002). This pilot study showed that young people involved in a community early intervention program adhered to an activity-based lifestyle program which included mindfulness meditation, yoga and nutrition education, warranting further evaluation with a larger sample size. © 2018 John Wiley & Sons Australia, Ltd.

Prevalence of Physical Inactivity and Recommended Physical Activity in Community-Based Adults with Mental Retardation.

ERIC Educational Resources Information Center

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

2002-01-01

Adults with mental retardation (76 men, 74 women) reported their leisure time physical activity (LTPA). Men and women in community settings were similarly inactive, with 47% to 51% participating in little to no LTPA. Forty-two% to 47% reported participating in moderate to vigorous LTPA five or more times per week. (Contains references.) (Author/CR)

Place-Based Partnerships on Behalf of Children, Families and Communities: Energy Express.

ERIC Educational Resources Information Center

Butera, Gretchen; Richason, Dan; Phillips, Ruthellen

Energy Express is an 8-week summer nutrition and literacy program in low-income West Virginia communities. Multi-age groups of eight children in grades 1-6 work with college student mentors for 3 1/2 hours each day, eating breakfast and lunch served family-style and creating print-rich environments that support their emerging literacy. The program…

Effects of resistance training and dietary changes on physical function and body composition in overweight and obese older adults.

PubMed

Straight, Chad R; Dorfman, Leah R; Cottell, Kathryn E; Krol, Julie M; Lofgren, Ingrid E; Delmonico, Matthew J

2012-08-01

Community-based interventions that incorporate resistance training (RT) and dietary changes have not been extensively studied in overweight and obese older adults. The purpose of this investigation was to determine the effects of a community-based RT and dietary intervention on physical function and body composition in overweight and obese older adults. Ninety-five overweight and obese (BMI=33.4±4.0 kg/m2) older adults aged 55-80 years completed an 8-week RT and dietary intervention at 4 Rhode Island senior centers. Participants performed RT twice-weekly using resistance tubing, dumbbells, and ankle weights. Participants also attended 1 weekly dietary counseling session on a modified Dietary Approaches to Stop Hypertension diet. Outcome measurements included anthropometrics, body composition, and physical function. There were small changes in body mass (-1.0±1.8 kg, P<.001), waist circumference (-5.2±3.8 cm, P<.001), and percent body fat (-0.5±1.4%, P<.001). In addition, significant improvements were observed in knee extensor torque (+7.9±19.1 N-m, P<.001), handgrip strength (+1.2±2.5 kg, P<.001), and 8-foot up-and-go test time (-0.56±0.89 s, P<.001). Community-based RT and dietary modifications can improve body composition, muscle strength, and physical function in overweight and obese older adults. Future investigations should determine if this intervention is effective for long-term changes.

Changes in assembly processes in soil bacterial communities following a wildfire disturbance.

PubMed

Ferrenberg, Scott; O'Neill, Sean P; Knelman, Joseph E; Todd, Bryan; Duggan, Sam; Bradley, Daniel; Robinson, Taylor; Schmidt, Steven K; Townsend, Alan R; Williams, Mark W; Cleveland, Cory C; Melbourne, Brett A; Jiang, Lin; Nemergut, Diana R

2013-06-01

Although recent work has shown that both deterministic and stochastic processes are important in structuring microbial communities, the factors that affect the relative contributions of niche and neutral processes are poorly understood. The macrobiological literature indicates that ecological disturbances can influence assembly processes. Thus, we sampled bacterial communities at 4 and 16 weeks following a wildfire and used null deviation analysis to examine the role that time since disturbance has in community assembly. Fire dramatically altered bacterial community structure and diversity as well as soil chemistry for both time-points. Community structure shifted between 4 and 16 weeks for both burned and unburned communities. Community assembly in burned sites 4 weeks after fire was significantly more stochastic than in unburned sites. After 16 weeks, however, burned communities were significantly less stochastic than unburned communities. Thus, we propose a three-phase model featuring shifts in the relative importance of niche and neutral processes as a function of time since disturbance. Because neutral processes are characterized by a decoupling between environmental parameters and community structure, we hypothesize that a better understanding of community assembly may be important in determining where and when detailed studies of community composition are valuable for predicting ecosystem function.

Changes in assembly processes in soil bacterial communities following a wildfire disturbance

PubMed Central

Ferrenberg, Scott; O'Neill, Sean P; Knelman, Joseph E; Todd, Bryan; Duggan, Sam; Bradley, Daniel; Robinson, Taylor; Schmidt, Steven K; Townsend, Alan R; Williams, Mark W; Cleveland, Cory C; Melbourne, Brett A; Jiang, Lin; Nemergut, Diana R

2013-01-01

Although recent work has shown that both deterministic and stochastic processes are important in structuring microbial communities, the factors that affect the relative contributions of niche and neutral processes are poorly understood. The macrobiological literature indicates that ecological disturbances can influence assembly processes. Thus, we sampled bacterial communities at 4 and 16 weeks following a wildfire and used null deviation analysis to examine the role that time since disturbance has in community assembly. Fire dramatically altered bacterial community structure and diversity as well as soil chemistry for both time-points. Community structure shifted between 4 and 16 weeks for both burned and unburned communities. Community assembly in burned sites 4 weeks after fire was significantly more stochastic than in unburned sites. After 16 weeks, however, burned communities were significantly less stochastic than unburned communities. Thus, we propose a three-phase model featuring shifts in the relative importance of niche and neutral processes as a function of time since disturbance. Because neutral processes are characterized by a decoupling between environmental parameters and community structure, we hypothesize that a better understanding of community assembly may be important in determining where and when detailed studies of community composition are valuable for predicting ecosystem function. PMID:23407312

Feasibility of Group Lifestyle Intervention for Diabetes Prevention in Arab Americans

PubMed Central

Jaber, Linda A.; Pinelli, Nicole R.; Brown, Morton B.; Funnell, Martha M.; Anderson, Robert; Hammad, Adnan; Herman, William H.

2010-01-01

AIMS To assess the feasibility and acceptability of a community-based, culturally-specific, Diabetes Prevention Program (DPP)-adapted, group lifestyle intervention in Arab-Americans. METHODS Overweight (BMI≥27 kg/m2) Arab-Americans aged ≥30 years and without a history of diabetes were recruited to participate in a 24-week group lifestyle intervention. The DPP core-curriculum was culturally rewritten, translated into Arabic, and delivered in weekly sessions over a 12-week period. Follow-up was performed at week-24. The primary goals were to achieve ≥7% weight loss and ≥150 minutes/week of physical activity. An intent-to-treat analysis was performed. RESULTS Of the 71 participants (mean age±SD 47±10 years, 38% males), 44% achieved ≥7% weight loss, 59% achieved ≥5% reduction in weight, and 78% reached the physical activity goal of ≥150-minutes/week. The mean±SD weight loss was 5.2±4.4 kg at week-24 (p<0.0001), Marked reduction in body measurements, daily energy and fat intake were noted. Retention was high with 86% completing the intervention. CONCLUSIONS This trial demonstrates that a culturally-specific, DPP-adapted, group lifestyle intervention implemented in a community setting is feasible and effective in Arab-Americans. PMID:21168232

Community based occupational therapy for patients with dementia and their care givers: randomised controlled trial

PubMed Central

Vernooij-Dassen, Myrra J M; Thijssen, Marjolein; Dekker, Joost; Hoefnagels, Willibrord H L; Rikkert, Marcel G M Olde

2006-01-01

Objective To determine the effectiveness of community based occupational therapy on daily functioning of patients with dementia and the sense of competence of their care givers. Design Single blind randomised controlled trial. Assessors were blinded for treatment allocation. Setting Memory clinic and day clinic of a geriatrics department and participants' homes. Participants 135 patients aged ≥65 with mild to moderate dementia living in the community and their primary care givers. Interventions 10 sessions of occupational therapy over five weeks, including cognitive and behavioural interventions, to train patients in the use of aids to compensate for cognitive decline and care givers in coping behaviours and supervision. Main outcome measures Patients' daily functioning assessed with the assessment of motor and process skills (AMPS) and the performance scale of the interview of deterioration in daily activities in dementia (IDDD). Care giver burden assessed with the sense of competence questionnaire (SCQ). Participants were evaluated at baseline, six weeks, and three months. Results Scores improved significantly relative to baseline in patients and care givers in the intervention group compared with the controls (differences were 1.5 (95% confidence interval 1.3 to 1.7) for the process scale; −11.7 (−13.6 to −9.7) for the performance scale; and (11.0; 9.2 to 12.8) for the competence scale). This improvement was still significant at three months. The number needed to treat to reach a clinically relevant improvement in motor and process skills score was 1.3 (1.2 to 1.4) at six weeks. Effect sizes were 2.5, 2.3, and 1.2, respectively, at six weeks and 2.7, 2.4, and 0.8, respectively, at 12 weeks. Conclusions Occupational therapy improved patients' daily functioning and reduced the burden on the care giver, despite the patients' limited learning ability. Effects were still present at 12 weeks, which justifies implementation of this intervention. Trial registration Clinical Trials NCT00295152. PMID:17114212

EXercising with Computers in Later Life (EXCELL) - pilot and feasibility study of the acceptability of the Nintendo® WiiFit in community-dwelling fallers.

PubMed

Williams, Marie A; Soiza, Roy L; Jenkinson, Alison McE; Stewart, Alison

2010-09-13

Falls management programmes have been instituted to attempt to reduce falls. This pilot study was undertaken to determine whether the Nintendo® WiiFit was a feasible and acceptable intervention in community-dwelling older fallers. Community-dwelling fallers over 70 years were recruited and attended for computer-based exercises (n = 15) or standard care (n = 6). Balance and fear of falling were assessed at weeks 0, 4 and 12. Participants were interviewed on completion of the study to determine whether the intervention was acceptable.Eighty percent of participants attended 75% or more of the exercise sessions. An improvement in Berg Score was seen at four weeks (p = 0.02) and in Wii Age at 12 weeks (p = 0.03) in the intervention group. There was no improvement in balance scores in the standard care group. WiiFit exercise is acceptable in self-referred older people with a history of falls. The WiiFit has the potential to improve balance but further work is required. ClinicalTrials.gov - NCT01082042.

Microbial Extracellular Enzyme Activity and Community Assembly Processes Post Fire Disturbance Amanda Labrado, University of Texas at El Paso; Emily B. Graham, University of Colorado Boulder; Joseph E. Knelman, University of Colorado Boulder; Scott Ferrenberg, University of Colorado Boulder; Diana R. Nemergut, University of Colorado Boulder

NASA Astrophysics Data System (ADS)

Labrdo, A.; Knelman, J. E.; Graham, E. B.; Ferrenberg, S.; Nemergut, D. R.

2013-12-01

Microbes control major biogeochemical cycles and can directly impact the carbon, nitrogen, and phosphorus pools and fluxes of soils. However, many questions remain regarding when and where data on microbial community structure are necessary to accurately predict biogeochemical processes. In particular, it is unknown how shifts in microbial assembly processes may relate to changes in the relationship between community structure and ecosystem function. Here, we examine soil microbial community assembly processes and extracellular enzyme activity (EEA) at 4-weeks and 16-weeks after the Fourmile Canyon Fire in Boulder, CO in order to determine the effects of disturbance on community assembly and EEA. Microbial community structure was determined from 16S rRNA gene pyrosequencing, edaphic properties were determined using standard biogeochemical assays, and extracellular enzyme activity for β-1, 4-glucosidase (BG) and β-1, 4-N-acetylglucosaminidase (NAG) enzymes were determined using fluorimetric assays. Stepwise linear regressions were used to determine the effects of microbial community structure and edaphic factors on EEA. We determined that in 4-week post fire samples EEA was only correlated with microbial predictors. However, we observed a shift with 16-week samples in which EEA was significantly related to edaphic predictors. Null derivation analysis of community assembly revealed that communities in the 4-week samples were more neutrally assembled than communities in the 16-week samples. Together, these results support a conceptual model in which the relationship between edaphic factors and ecosystem processes is somewhat decoupled in more neutrally assembled communities, and data on microbial community structure is important to most accurately predict function.

Design and methods for a community-based intervention to reduce sugar-sweetened beverage consumption among youth: H2GO! study.

PubMed

Wang, Monica L; Lemon, Stephenie C; Clausen, Kristian; Whyte, Julie; Rosal, Milagros C

2016-11-09

Reducing sugar-sweetened beverage (SSB) intake is an important dietary target among underserved children at high risk for obesity and associated morbidities. Community-based approaches to reduce SSB intake are needed. The use of narrative-based approaches (presenting messages within the context of a story) can facilitate connection with target health messages and empower children as behavior change agents within their families. The H 2 GO! program is a community-based behavioral intervention that integrates narrative-based strategies to reduce SSB consumption and promote water intake among school-age youth and parents. Guided by the Social Cognitive Theory and the Social Ecological Model, the H 2 GO! intervention consists of 6 weekly sessions that target beverage knowledge, attitudes, and behaviors through youth-produced messages and narratives to reduce SSB intake and encourage water intake and parent-child activities. To reach underserved youth and families, we identified Boys & Girls Clubs (B&GC) (youth-based community centers that serve an ethnically diverse and predominantly low socioeconomic status population) as a community partner and study setting. Participants (children ages 9-12 years and their parents) will be recruited from B&GC sites in Massachusetts, USA. Intervention efficacy will be assessed through a site-randomized trial (N = 2 youth-based community sites, pair-matched for size and racial/ethnic composition) with 54 parent-child pairs (N = 108) enrolled per site (N = 216 total). The comparison site will carry on with usual practice. Child and parental SSB and water consumption (primary outcomes) and parent and child beverage knowledge and attitudes (secondary outcomes) will be measured via self-report surveys. Additional outcomes include children's anthropometric data, additional dietary behaviors, and physical activity. Measures will be collected at baseline, 2 and 6 months follow-up. With an estimated 20 % dropout rate, the study will have 80 % power to detect a group difference of 3.9 servings of SSBs per week. Community-based approaches hold potential for decreasing SSB consumption among youth and families, particularly among underserved populations who are at greater obesity risk. This article describes the design and methods of a community-based behavioral intervention designed to reduce SSB consumption among youth and parents/caregivers. ClinicalTrials.gov NCT02890056 . Date of Registration: August 31, 2016.

An online community of practice to support evidence-based physiotherapy practice in manual therapy.

PubMed

Evans, Cathy; Yeung, Euson; Markoulakis, Roula; Guilcher, Sara

2014-01-01

The purpose of this study was to explore how a community of practice promoted the creation and sharing of new knowledge in evidence-based manual therapy using Wenger's constructs of mutual engagement, joint enterprise, and shared repertoire as a theoretical framework. We used a qualitative approach to analyze the discussion board contributions of the 19 physiotherapists who participated in the 10-week online continuing education course in evidence-based practice (EBP) in manual therapy. The course was founded on community of practice, constructivism, social, and situated learning principles. The 1436 postings on 9 active discussion boards revealed that the community of practice was a social learning environment that supported strong participation and mutual engagement. Design features such as consistent facilitation, weekly guiding questions, and collaborative assignments promoted the creation and sharing of knowledge. Participants applied research evidence to the contexts in which they worked through reflective comparison of what they were reading to its applicability in their everyday practice. Participants' shared goals contributed to the common ground established in developing collective knowledge about different study designs, how to answer research questions, and the difficulties of conducting sound research. An online longitudinal community of practice utilized as a continuing education approach to deliver an online course based on constructivist and social learning principles allowed geographically dispersed physiotherapists to be mutually engaged in a joint enterprise in evidence-based manual therapy. Advantages included opportunity for reflection, modeling, and collaboration. Future studies should examine the impact of participation on clinical practice. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

Partnering for Health with Nebraska's Latina Immigrant Community Using Design Thinking Process.

PubMed

Ramos, Athena K; Trinidad, Natalia; Correa, Antonia; Rivera, Roy

2016-01-01

The Center for Reducing Health Disparities at the University of Nebraska Medical Center partnered with El Centro de Las Americas, a community-based organization, and various community members to develop a 1-day Spanish-language health conference entitled El Encuentro de La Mujer Sana (Healthy Woman Summit) for immigrant Latinas in Nebraska during May 2013 as part of National Women's Health Week. Design thinking was used to create a meaningful learning experience specifically designed for monolingual Spanish-speaking immigrant Latinas in Nebraska and build a foundation for collaboration between an academic institution, community-based organizational partners, and community members. We used the design thinking methodology to generate ideas for topics and prototyped agendas with community stakeholders that would be relevant and provide culturally and linguistically appropriate health education. By developing community-based health education programs for Latinas with Latinas through a community-engaged co-creation process, organizations and communities build trust, enhance community capacity, and meet identified needs for education and service. Design thinking is a valuable tool that can be used to develop community health education initiatives and enhance civic participation. This method holds promise for health education and public health in becoming more relevant for traditionally marginalized or disenfranchised populations.

How adolescents perceive that community-based exercise improves their well-being.

PubMed

Rourke, Kevin; Wilson, Coralie J

2017-10-01

To determine if adolescents perceive community-based exercise as beneficial to their well-being and in what ways. A New South Wales Police Citizens Youth Club ran a four-week fitness course. The classes involved: 1) sports including basketball and soccer, 2) non-contact boxing drills, and 3) games, both team games such as dodgeball and non-team games such as line tag. Parental consent to offer a survey at the completion of the course was requested during registration. The survey was the Warwick Edinburgh Mental Well-being Scale; it was minimally modified to measure perceived benefit to mental well-being instead of actual benefit. Thirty-one high school adolescents, ages 13-18, completed the survey. As a group, participants reported that they believed their well-being had improved after the course. The mean score for each survey item showed an improvement in every area of mental well-being for this sample of adolescents. Thirty-two per cent of adolescents reported having less energy. Survey scores indicated a statistically significant improvement in perceived well-being ( p<0.0001). The results of this study suggest that four weeks of community-based exercise improves perceived mental well-being in adolescent participants.

Community based study to compare the incidence and health services utilization pyramid for gastrointestinal, respiratory and dermal symptoms.

PubMed

Najnin, Nusrat; Sinclair, Martha; Forbes, Andrew; Leder, Karin

2012-07-23

Gastrointestinal (GI), respiratory and dermal symptoms are common and cause substantial morbidity, although the information on their exact incidence and comparative burden is limited. The aim of this study was to describe the epidemiology and rate these three major symptom complexes in order to improve our understanding of the health burden imposed by these symptoms. We used data from a community based randomised control trial conducted from June 2007 to August 2008 among 277 South Australian families consuming rainwater. Using weekly health diaries, we prospectively collected information on GI (diarrhoea or vomiting), respiratory (sore throat, runny nose or cough) and dermal (rash, generalised itch or dermal infection) symptoms, as well as on relevant GP visits, time off work and/or hospitalisation due to these symptoms. Data were analysed using generalized estimating equations approach taking into account the variable number of weeks of follow-up of each individual and within-family clustering of responses. Over one year, at least one episode of GI symptoms was reported by 54% of participants (95% CI 50%-58%), at least one respiratory episode by 91% (95% CI 88%-93%) and at least one episode of dermal symptoms by 27% (95% CI 24%-30%). The average number of weeks per year during which respiratory symptoms occurred was four times greater than for GI or dermal symptoms (4.9, 1.2 and 1.2 weeks, respectively, p<0.001), with an average number of GP visits per person per year being twice as frequent (0.48, 0.26, 0.19 respectively, p<0.001). However, on a per episode basis, a higher proportion of people saw a GP or were hospitalised for GI symptoms. This first comparative study of three different symptom complexes showed that although respiratory symptoms are most common, GI symptoms cause a greater per episode burden on healthcare resources. Measuring and comparing the community based burden of these symptom complexes will assist evidence-based allocation of resources.

Training community health students to develop community-requested social marketing campaigns: an innovative partnership.

PubMed

Lindsey, Billie J; Hawk, Carol Wetherill

2013-01-01

This paper describes a sustained partnership between a university community health program and local and regional community health agencies. As a key component of the Health Communication and Social Marketing course, the partnership involves undergraduate community health students working for and with community agencies and community members to design social marketing campaigns based on community-identified health needs. The goals of the course are to (1) provide students with the opportunity to work within the community to apply their skills in program planning, evaluation, and communication and (2) provide community agencies with a tailored campaign that can be implemented in their communities. Throughout the 10-week quarter, teams of students follow the principles of community participation in planning a social marketing campaign. These include (1) audience segmentation and formative assessment with the intended audience to determine campaign content and strategies and (2) pretesting and revisions of campaign messages and materials based on community feedback. This partnership contributes to the promotion of health in the local community and it builds the skills and competencies of future health educators. It demonstrates a successful and sustainable combination of community-based participatory research and experiential learning. From 2005 to 2011, 35 campaigns have been developed, many which have been implemented.

Causes and Effects of Fatigue in Experienced Military Aircrew

DTIC Science & Technology

2006-01-01

or corporation , or convey any rights or permission to manufacture, use, or sell any patented invention that may relate to them. The Office of Public...documented in the aviation community since Lindbergh’s solo flight across the Atlantic in 1927 (Berg, 1998; Lindbergh, 1953; National Geographic Home Video...base. It took as little as two weeks in the airlift community to as long as four months in the fighter community . Upon completion of the aircrew member’s

A Preliminary Study on the Efficacy of a Community-Based Physical Activity Intervention on Physical Function-Related Risk Factors for Falls Among Breast Cancer Survivors.

PubMed

Lee, C Ellen; Warden, Stuart J; Szuck, Beth; Lau, Y K James

2016-08-01

The aim of this study was to examine the effects of a 6-week community-based physical activity (PA) intervention on physical function-related risk factors for falls among 56 breast cancer survivors (BCS) who had completed treatments. This was a single-group longitudinal study. The multimodal PA intervention included aerobic, strengthening, and balance components. Physical function outcomes based on the 4-meter walk, chair stand, one-leg stance, tandem walk, and dynamic muscular endurance tests were assessed at 6-week pre-intervention (T1), baseline (T2), and post-intervention (T3). T1 to T2 and T2 to T3 were the control and intervention periods, respectively. All outcomes, except the tandem walk test, significantly improved after the intervention period (P < 0.05), with no change detected after the control period (P > 0.05). Based on the falls risk criterion in the one-leg stance test, the proportion at risk for falls was significantly lower after the intervention period (P = 0.04), but not after the control period. A community-based multimodal PA intervention for BCS may be efficacious in improving physical function-related risk factors for falls, and lowering the proportion of BCS at risk for falls based on specific physical function-related falls criteria. Further larger trials are needed to confirm these preliminary findings.

Evaluation of an Internet-based monitoring system for influenza-like illness in Sweden.

PubMed

Rehn, Moa; Carnahan, AnnaSara; Merk, Hanna; Kühlmann-Berenzon, Sharon; Galanis, Ilias; Linde, Annika; Nyrén, Olof

2014-01-01

To complement traditional influenza surveillance with data on disease occurrence not only among care-seeking individuals, the Swedish Institute for Communicable Disease Control (SMI) has tested an Internet-based monitoring system (IMS) with self-recruited volunteers submitting weekly on-line reports about their health in the preceding week, upon weekly reminders. We evaluated IMS acceptability and to which extent participants represented the Swedish population. We also studied the agreement of data on influenza-like illness (ILI) occurrence from IMS with data from a previously evaluated population-based system (PBS) with an actively recruited random sample of the population who spontaneously report disease onsets in real-time via telephone/Internet, and with traditional general practitioner based sentinel and virological influenza surveillance, in the 2011-2012 and 2012-2013 influenza seasons. We assessed acceptability by calculating the participation proportion in an invited IMS-sample and the weekly reporting proportion of enrolled self-recruited IMS participants. We compared distributions of socio-demographic indicators of self-recruited IMS participants to the general Swedish population using chi-square tests. Finally, we assessed the agreement of weekly incidence proportions (%) of ILI in IMS and PBS with cross-correlation analyses. Among 2,511 invited persons, 166 (6.6%) agreed to participate in the IMS. In each season, 2,552 and 2,486 self-recruited persons participated in the IMS respectively. The weekly reporting proportion among self-recruited participants decreased from 87% to 23% (2011-2012) and 82% to 45% (2012-2013). Women, highly educated, and middle-aged persons were overrepresented among self-recruited IMS participants (p<0.01). IMS (invited and self-recruited) and PBS weekly incidence proportions correlated strongest when no lags were applied (r = 0.71 and r = 0.69, p<0.05). This evaluation revealed socio-demographic misrepresentation and limited compliance among the self-recruited IMS participants. Yet, IMS offered a reasonable representation of the temporal ILI pattern in the community overall during the 2011-2012 and 2012-2013 influenza seasons and could be a simple tool for collecting community-based ILI data.

Hexavalent chromium reduction under fermentative conditions with lactate stimulated native microbial communities.

PubMed

Somenahally, Anil C; Mosher, Jennifer J; Yuan, Tong; Podar, Mircea; Phelps, Tommy J; Brown, Steven D; Yang, Zamin K; Hazen, Terry C; Arkin, Adam P; Palumbo, Anthony V; Van Nostrand, Joy D; Zhou, Jizhong; Elias, Dwayne A

2013-01-01

Microbial reduction of toxic hexavalent chromium (Cr(VI)) in-situ is a plausible bioremediation strategy in electron-acceptor limited environments. However, higher [Cr(VI)] may impose stress on syntrophic communities and impact community structure and function. The study objectives were to understand the impacts of Cr(VI) concentrations on community structure and on the Cr(VI)-reduction potential of groundwater communities at Hanford, WA. Steady state continuous flow bioreactors were used to grow native communities enriched with lactate (30 mM) and continuously amended with Cr(VI) at 0.0 (No-Cr), 0.1 (Low-Cr) and 3.0 (High-Cr) mg/L. Microbial growth, metabolites, Cr(VI), 16S rRNA gene sequences and GeoChip based functional gene composition were monitored for 15 weeks. Temporal trends and differences in growth, metabolite profiles, and community composition were observed, largely between Low-Cr and High-Cr bioreactors. In both High-Cr and Low-Cr bioreactors, Cr(VI) levels were below detection from week 1 until week 15. With lactate enrichment, native bacterial diversity substantially decreased as Pelosinus spp., and Sporotalea spp., became the dominant groups, but did not significantly differ between Cr concentrations. The Archaea diversity also substantially decreased after lactate enrichment from Methanosaeta (35%), Methanosarcina (17%) and others, to mostly Methanosarcina spp. (95%). Methane production was lower in High-Cr reactors suggesting some inhibition of methanogens. Several key functional genes were distinct in Low-Cr bioreactors compared to High-Cr. Among the Cr resistant microbes, Burkholderia vietnamiensis, Comamonas testosterone and Ralstonia pickettii proliferated in Cr amended bioreactors. In-situ fermentative conditions facilitated Cr(VI) reduction, and as a result 3.0 mg/L Cr(VI) did not impact the overall bacterial community structure.

Evaluating a multi-component, community-based program to improve adherence and retention in care among adolescents living with HIV in Zimbabwe: study protocol for a cluster randomized controlled trial.

PubMed

Mavhu, Webster; Willis, Nicola; Mufuka, Juliet; Mangenah, Collin; Mvududu, Kudzanayi; Bernays, Sarah; Mangezi, Walter; Apollo, Tsitsi; Araya, Ricardo; Weiss, Helen A; Cowan, Frances M

2017-10-20

World Health Organization (WHO) adolescent HIV-testing and treatment guidelines recommend community-based interventions to support antiretroviral therapy (ART) adherence and retention in care, while acknowledging that the evidence to support this recommendation is weak. This cluster randomized controlled trial aims to evaluate the effectiveness and cost-effectiveness of a psychosocial, community-based intervention on HIV-related and psychosocial outcomes. We are conducting the trial in two districts. Sixteen clinics were randomized to either enhanced ART-adherence support or standard of care. Eligible individuals (HIV-positive adolescents aged 13-19 years and eligible for ART) in both arms receive ART and adherence support provided by adult counselors and nursing staff. Adolescents in the intervention arm additionally attend a monthly support group, are allocated to a designated community adolescent treatment supporter, and followed up through a short message service (SMS) and calls plus home visits. The type and frequency of contact is determined by whether the adolescent is "stable" or in need of enhanced support. Stable adolescents receive a monthly home visit plus a weekly, individualized SMS. An additional home visit is conducted if participants miss a scheduled clinic appointment or support-group meeting. Participants in need of further, enhanced, support receive bi-weekly home visits, weekly phone calls and daily SMS. Caregivers of adolescents in the intervention arm attend a caregiver support group. Trial outcomes are assessed through a clinical, behavioral and psychological assessment conducted at baseline and after 48 and 96 weeks. The primary outcome is the proportion who have died or have virological failure (viral load ≥1000 copies/ml) at 96 weeks. Secondary outcomes include virological failure at 48 weeks, retention in care (proportion of missed visits) and psychosocial outcomes at both time points. Statistical analyses will be conducted and reported in line with CONSORT guidelines for cluster randomized trials, including a flowchart. This study provides a unique opportunity to generate evidence of the impact of the on-going Zvandiri program, for adolescents living with HIV, on virological failure and psychosocial outcomes as delivered in a real-world setting. If found to reduce rates of treatment failure, this would strengthen support for further scale-up across Zimbabwe and likely the region more widely. Pan African Clinical Trial Registry database, registration number PACTR201609001767322 (the Zvandiri trial). Retrospectively registered on 5 September 2016.

Planning for the Rheumatologist Workforce: Factors Associated With Work Hours and Volumes.

PubMed

Barber, Claire E H; Nasr, Mina; Barnabe, Cheryl; Badley, Elizabeth M; Lacaille, Diane; Pope, Janet; Cividino, Alfred; Yacyshyn, Elaine; Baillie, Cory; Mosher, Dianne; Thomson, John G; Charnock, Christine; Thorne, J Carter; Zummer, Michel; Brophy, Julie; Ruban, Thanu Nadarajah; Ahluwalia, Vandana; McDougall, Robert; Marshall, Deborah A

2018-05-25

The aim of this study was to evaluate factors associated with rheumatologists' clinical work hours and patient volumes based on a national workforce survey in rheumatology. Adult rheumatologists who participated in a 2015 workforce survey were included (n = 255). Univariate analysis evaluated the relationship between demographics (sex, age, academic vs. community practice, billing fee for service vs. other plan, years in practice, retirement plans) and workload (total hours and number of ½-day clinics per week) or patient volumes (number of new and follow-up consults per week). Multiple linear regression models were used to evaluate the relationship between practice type, sex, age, and working hours or clinical volumes. Male rheumatologists had more ½-day clinics (P = 0.05) and saw more new patients per week (P = 0.001) compared with females. Community rheumatologists had more ½-day clinics and new and follow-up visits per week (all P < 0.01). Fee-for-service rheumatologists reported more ½-day clinics per week (P < 0.001) and follow-ups (P = 0.04). Workload did not vary by age, years in practice, or retirement plans. In multivariate analysis, community practice remained independently associated with higher patient volumes and more clinics per week. Female rheumatologists reported fewer clinics and fewer follow-up patients per week than males, but this did not affect the duration of working hours or new consultations. Age was not associated with work volumes or hours. Practice type and rheumatologist sex should be considered when evaluating rheumatologist workforce needs, as the proportion of female rheumatologists has increased over time and alternative billing practices have been introduced in many centers.

"Bigger than Hip-Hop?" Impact of a Community-Based Physical Activity Program on Youth Living in a Disadvantaged Neighborhood in Canada

ERIC Educational Resources Information Center

Beaulac, Julie; Kristjansson, Elizabeth; Calhoun, Melissa

2011-01-01

This study explored whether a hip-hop dance program was associated with improved well-being for adolescents living in a multicultural, socio-economically disadvantaged urban community in Ottawa. Sixty-seven youths between 11 and 16 years of age participated in a 13-week program. A primarily qualitative approach was used to assess perceived impact…

Linking High Risk Postpartum Women with a Technology Enabled Health Coaching Program to Reduce Diabetes Risk and Improve Wellbeing: Program Description, Case Studies, and Recommendations for Community Health Coaching Programs

PubMed Central

Thomas, Melanie; Delgadillo-Duenas, Adriana T.; Leong, Karen; Najmabadi, Adriana; Harleman, Elizabeth; Rios, Christina; Quan, Judy; Soria, Catalina; Handley, Margaret A.

2016-01-01

Background. Low-income minority women with prior gestational diabetes mellitus (pGDM) or high BMIs have increased risk for chronic illnesses postpartum. Although the Diabetes Prevention Program (DPP) provides an evidence-based model for reducing diabetes risk, few community-based interventions have adapted this program for pGDM women. Methods. STAR MAMA is an ongoing randomized control trial (RCT) evaluating a hybrid HIT/Health Coaching DPP-based 20-week postpartum program for diabetes prevention compared with education from written materials at baseline. Eligibility includes women 18–39 years old, ≥32 weeks pregnant, and GDM or BMI > 25. Clinic- and community-based recruitment in San Francisco and Sonoma Counties targets 180 women. Sociodemographic and health coaching data from a preliminary sample are presented. Results. Most of the 86 women included to date (88%) have GDM, 80% were identified as Hispanic/Latina, 78% have migrant status, and most are Spanish-speaking. Women receiving the intervention indicate high engagement, with 86% answering 1+ calls. Health coaching callbacks last an average of 9 minutes with range of topics discussed. Case studies presented convey a range of emotional, instrumental, and health literacy-related supports offered by health coaches. Discussion. The DPP-adapted HIT/health coaching model highlights the possibility and challenge of delivering DPP content to postpartum women in community settings. This trial is registered with ClinicalTrials.gov NCT02240420. PMID:27830157

Linking High Risk Postpartum Women with a Technology Enabled Health Coaching Program to Reduce Diabetes Risk and Improve Wellbeing: Program Description, Case Studies, and Recommendations for Community Health Coaching Programs.

PubMed

Athavale, Priyanka; Thomas, Melanie; Delgadillo-Duenas, Adriana T; Leong, Karen; Najmabadi, Adriana; Harleman, Elizabeth; Rios, Christina; Quan, Judy; Soria, Catalina; Handley, Margaret A

2016-01-01

Background . Low-income minority women with prior gestational diabetes mellitus (pGDM) or high BMIs have increased risk for chronic illnesses postpartum. Although the Diabetes Prevention Program (DPP) provides an evidence-based model for reducing diabetes risk, few community-based interventions have adapted this program for pGDM women. Methods . STAR MAMA is an ongoing randomized control trial (RCT) evaluating a hybrid HIT/Health Coaching DPP-based 20-week postpartum program for diabetes prevention compared with education from written materials at baseline. Eligibility includes women 18-39 years old, ≥32 weeks pregnant, and GDM or BMI > 25. Clinic- and community-based recruitment in San Francisco and Sonoma Counties targets 180 women. Sociodemographic and health coaching data from a preliminary sample are presented. Results . Most of the 86 women included to date (88%) have GDM, 80% were identified as Hispanic/Latina, 78% have migrant status, and most are Spanish-speaking. Women receiving the intervention indicate high engagement, with 86% answering 1+ calls. Health coaching callbacks last an average of 9 minutes with range of topics discussed. Case studies presented convey a range of emotional, instrumental, and health literacy-related supports offered by health coaches. Discussion . The DPP-adapted HIT/health coaching model highlights the possibility and challenge of delivering DPP content to postpartum women in community settings. This trial is registered with ClinicalTrials.gov NCT02240420.

[Effects of community-based comprehensive fall prevention program on muscle strength, postural balance and fall efficacy in elderly people].

PubMed

Bae, Jeongyee; Cho, Seong Il

2014-12-01

The purposes of this study was to develop a comprehensive community-based fall prevention program and to test the effects of the program on the muscle strength, postural balance and fall efficacy for elderly people. The design of this study was a nonequivalent control group pretest-posttest design. There were 28 participants in the experimental group and 29 in the control group. The program consisted of balance exercises, elastic resistance exercises and prevention education. The program was provided five times a week for 8 weeks and each session lasted 90 minutes. Data were analyzed using χ²-test, independent t-test and paired t-test using the SPSS program. Muscle strength of the lower extremities, postural balance and fall efficacy scores significantly improved in the experimental group compared to the control group. These results suggest that this program can improve lower extremity muscle strength, postural balance and fall efficacy in elders. Therefore, this program is recommended for use in fall prevention programs for elders living in the community.

Outcomes and lessons from a pilot RCT of a community-based HIV prevention multi-session group intervention for gay men.

PubMed

Harding, R; Bensley, J; Corrigan, N; Franks, L; Stratman, J; Waller, Z; Warner, J

2004-07-01

This paper presents the first outcome evaluation of multi-session groupwork for HIV prevention among gay men in the UK. This community-based RCT recruited 50 men, of whom 42% were HIV-positive or untested, and 32% reported status unknown or serodiscordant UAI in the previous 12 months. No knowledge, skills, attitudinal or behavioural differences were detected between intervention and control at baseline. At eight weeks, those attending the group reported significant gains over their control in making sexual choices, physical safety, HIV and STI transmission knowledge, and sexual negotiation skills. At 20 weeks, significant differences remained for HIV and STI transmission knowledge and comfort with sexual choices. Although no behavioural differences were detected, the aims of the National Prevention Strategy were met. This pilot RCT is appraised in the light of modest sample size and attrition, and recommendations for establishing behavioural outcomes are presented. This study has demonstrated that high-risk community samples can be recruited to multi-session interventions, and has provided feasibility data for future rigorous evaluation designs.

Effect of Tai Chi on physical function, fall rates and quality of life among older stroke survivors.

PubMed

Taylor-Piliae, Ruth E; Hoke, Tiffany M; Hepworth, Joseph T; Latt, L Daniel; Najafi, Bijan; Coull, Bruce M

2014-05-01

To examine the effect of a 12-week Tai Chi (TC) intervention on physical function and quality of life. Single-blind, randomized controlled trial. General community. Community-dwelling survivors of stroke (N=145; 47% women; mean age, 70y; time poststroke: 3y; ischemic stroke: 66%; hemiparesis: 73%) who were aged ≥50 years and were ≥3 months poststroke. Yang style 24-posture short-form TC (n=53), strength and range of movement exercises (SS) (n=44), or usual care (UC) (n=48) for 12 weeks. The TC and SS groups attended a 1-hour class 3 times per week, whereas the UC group had weekly phone calls. Physical function: Short Physical Performance Battery, fall rates, and 2-minute step test; quality of life: Medical Outcomes Study 36-Item Short-Form Health Survey, Center for Epidemiologic Studies Depression Scale, and Pittsburgh Sleep Quality Index. During the intervention, TC participants had two thirds fewer falls (5 falls) than the SS (14 falls) and UC (15 falls) groups (χ(2)=5.6, P=.06). There was a significant group by time interaction for the 2-minute step test (F2,142=4.69, P<.01). Post hoc tests indicated that the TC (t53=2.45, P=.02) and SS (t44=4.63, P<.01) groups had significantly better aerobic endurance over time, though not in the UC group (t48=1.58, P=.12). Intervention adherence rates were 85%. TC and SS led to improved aerobic endurance, and both are suitable community-based programs that may aid in stroke recovery and community reintegration. Our data suggest that a 12-week TC intervention was more effective in reducing fall rates than SS or UC interventions. Future studies examining the effectiveness of TC as a fall prevention strategy for community-dwelling survivors of stroke are recommended. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

A Population-Based Assessment of Heartburn in Urban Black Americans

PubMed Central

Friedenberg, Frank K.; Makipour, Kian; Palit, Amiya; Shah, Sweetang; Vanar, Vishwas; Richter, Joel E.

2013-01-01

Background Prevalence data for heartburn in the urban Black American community is lacking. In order to estimate prevalence for this community we analyzed data from an ongoing cohort study in progress at our hospital. Comprehensive interviews allowed for exploration of factors associated with heartburn. Methods Complex, stratified sampling design. Survey invitations are hand delivered to random blocks in a single zip code tabulation area. One member per eligible household is invited to complete a computer-based survey. Heartburn was defined as ≥ 3 days/week of symptoms as defined by the Montreal Definition and Classification of GERD. Scaling and weighting factors were utilized to estimate population-level prevalence. Multivariate logistic regression was used to identify independent predictor variables for heartburn. Results Enrolled 379 participants corresponding to a weighted sample size of 22,409 (20,888–23,930) citizens. Demographic characteristics of the sample closely matched those of the entire targeted population. Overall, the weighted prevalence of heartburn ≥ 3 times per week was 17.6% (16.4%–18.8%). Variables independently associated with heartburn were BMI, daily caloric and fat intake, diabetes mellitus (OR=2.95; 2.59–3.36), cigarette smoking, and alcohol consumption (OR=2.55; 2.25–2.89). Factors inversely associated included illicit drug use and increased physical activity. Waist: hip ratio showed no relationship. Conclusions The prevalence of heartburn ≥ 3 times per week is high in the Black American community. Adverse lifestyle behaviors showed particularly important associations. Our study needs to be replicated in other communities with similar demographics. PMID:23237330

Introducing a means of quantifying community reputation: the print media as a data source.

PubMed

McLaren, Lindsay; Perry, Rosemary; Carruthers, Lesley; Hawe, Penelope

2005-06-01

A community's reputation may have implications for self-esteem, morale, or other health outcomes of residents. In this study, we introduce a means of quantifying the reputation of communities in Calgary, Canada based on their portrayal in the daily citywide newspaper. Publication dates were selected from an 8.5-year period using constructed week sampling. For communities designated as high or low in well-being, sampled references were rated as positive, negative, or neutral in topic, by two independent raters who were blind to community identity. Findings suggest that the print media represent a convenient and discriminating data source for characterising some aspects of community reputation.

A study protocol of a randomised controlled trial to investigate if a community based strength training programme improves work task performance in young adults with Down syndrome.

PubMed

Shields, Nora; Taylor, Nicholas F; Fernhall, Bo

2010-03-25

Muscle strength is important for young people with Down syndrome as they make the transition to adulthood, because their workplace activities typically emphasise physical rather than cognitive skills. Muscle strength is reduced up to 50% in people with Down syndrome compared to their peers without disability. Progressive resistance training improves muscle strength and endurance in people with Down syndrome. However, there is no evidence on whether it has an effect on work task performance or physical activity levels. The aim of this study is to investigate if a student-led community-based progressive resistance training programme can improve these outcomes in adolescents and young adults with Down syndrome. A randomised controlled trial will compare progressive resistance training with a control group undertaking a social programme. Seventy adolescents and young adults with Down syndrome aged 14-22 years and mild to moderate intellectual disability will be randomly allocated to the intervention or control group using a concealed method. The intervention group will complete a 10-week, twice a week, student-led progressive resistance training programme at a local community gymnasium. The student mentors will be undergraduate physiotherapy students. The control group will complete an arts/social programme with a student mentor once a week for 90 minutes also for 10 weeks to control for the social aspect of the intervention. Work task performance (box stacking, pail carry), muscle strength (1 repetition maximum for chest and leg press) and physical activity (frequency, duration, intensity over 7-days) will be assessed at baseline (Week 0), following the intervention (Week 11), and at 3 months post intervention (Week 24) by an assessor blind to group allocation. Data will be analysed using ANCOVA with baseline measures as covariates. This paper outlines the study protocol for a randomised controlled trial on the effects of progressive resistance training on work task performance and physical activity for adolescents and young adults with Down syndrome. The intervention addresses the impairment of muscle weakness which may improve work task performance and help to increase physical activity levels. Australian New Zealand Clinical Trials Registry ACTRN12609000938202.

Building community capacity using web-supported work-based learning.

PubMed

Pearson, Pauline; Young-Murphy, Lesley; Yaseen, Jonathan; Shiel, Gillian

2013-02-01

Health visitors are a central component of policy to create strong, stable families and communities. The programme which is described here is intended to facilitate existing health visitors to gain confidence and extend or renew their skills in building community capacity (BCC). Networking and relationships are essential to effective community development. These are key skills for the health visitor, which along with professional principles support community capacity building. Learning in this programme is self-directed, supported by web-based resources over a 24 week period. Learning mainly takes place in practice. It involves carrying out a work based project through to completion. Participants register online, and follow a series of six phases. Evaluation of the pilot took place during 2011. Three main areas for improvement were identified: reflective software; signposting access to resources; and dealing with workload pressures. Community engagement for health improvement remains an important element of the vision for health visiting. The programme described is a core resource through which health visitors can build the skills and confidence of community groups and staff in other agencies to make a difference to health and wellbeing.

Linking urban families to community resources in the context of pediatric primary care.

PubMed

Garg, Arvin; Sarkar, Sonia; Marino, Mark; Onie, Rebecca; Solomon, Barry S

2010-05-01

Pediatric guidelines emphasize the importance for healthcare providers to view children in the context of family and community, and promote community resources at visits. In 2006, a Family Help Desk (FHD) was established in an urban academic-based clinic in Baltimore, MD to assist healthcare providers in educating families about available community-based resources. A longitudinal cohort pilot study was conducted during a 6-week period in 2007 to evaluate the impact of the FHD in connecting at-risk families to community resources. Overall, 6% of parents (n=59) who brought their child for a scheduled clinic visit accessed the FHD. Parents had a mean of 1.7 social needs, including after-school programs and childcare (29%), employment (13%), housing (12%), and food (11%). Most parents who utilized the FHD (64%) contacted a community resource or service within 6 months of their clinic visit. Nineteen parents (32%) who utilized the FHD enrolled in community programs. A clinic-based multi-disciplinary model can empower families to connect with community-based resources for basic social needs. The Family Help Desk model has great potential for addressing family psychosocial needs, and educating families about community resources within the context of pediatric primary care. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

Community occupational therapy for people with dementia and family carers (COTiD-UK) versus treatment as usual (Valuing Active Life in Dementia [VALID] programme): study protocol for a randomised controlled trial.

PubMed

Wenborn, Jennifer; Hynes, Sinéad; Moniz-Cook, Esme; Mountain, Gail; Poland, Fiona; King, Michael; Omar, Rumana; Morris, Steven; Vernooij-Dassen, Myrra; Challis, David; Michie, Susan; Russell, Ian; Sackley, Catherine; Graff, Maud; O'Keeffe, Aidan; Crellin, Nadia; Orrell, Martin

2016-02-03

A community-based occupational therapy intervention for people with mild to moderate dementia and their family carers (Community Occupational Therapy in Dementia (COTiD)) was found clinically and cost effective in the Netherlands but not in Germany. This highlights the need to adapt and implement complex interventions to specific national contexts. The current trial aims to evaluate the United Kingdom-adapted occupational therapy intervention for people with mild to moderate dementia and their family carers living in the community (COTiD-UK) compared with treatment as usual. This study is a multi-centre, parallel-group, pragmatic randomised trial with internal pilot. We aim to allocate 480 pairs, with each pair comprising a person with mild to moderate dementia and a family carer, who provides at least 4 hours of practical support per week, at random between COTiD-UK and treatment as usual. We shall assess participants at baseline, 12 and 26 weeks, and by telephone at 52 and 78 weeks (first 40% of recruits only) after randomisation. The primary outcome measure is the Bristol Activities of Daily Living Scale (BADLS) at 26 weeks. Secondary outcome measures will include quality of life, mood, and resource use. To assess intervention delivery, and client experience, we shall collect qualitative data via audio recordings of COTiD-UK sessions and conduct semi-structured interviews with pairs and occupational therapists. COTiD-UK is an evidence-based person-centred intervention that reflects the current priority to enable people with dementia to remain in their own homes by improving their capabilities whilst reducing carer burden. If COTiD-UK is clinically and cost effective, this has major implications for the future delivery of dementia services across the UK. Current Controlled Trials ISRCTN10748953 Date of registration: 18 September 2014.

Developing a nationwide K-12 outreach model: Physiology Understanding (PhUn) Week 10 years later.

PubMed

Stieben, Margaret; Halpin, Patricia A; Matyas, Marsha Lakes

2017-09-01

Since 2005, nearly 600 Physiology Understanding Week (PhUn Week) events have taken place across the U.S., involving American Physiological Society (APS) members in K-12 outreach. The program seeks to build student understanding of physiology and physiology careers, assist teachers in recognizing physiology in their standards-based curriculum, and involve more physiologists in K-12 outreach. Formative goals included program growth (sites, participants, and leaders), diversification of program models, and development of a community of practice of physiologists and trainees involved in outreach. Eleven years of member-provided data indicate that the formative goals are being met. Nearly 100,000 K-12 students have been reached during the last decade as an increasing pool of physiologists took part in a growing number of events, including a number of international events. The number and types of PhUn Week events have steadily increased as a community of practice has formed to support the program. Future program goals include targeting regional areas for PhUn Week participation, establishing research collaboratives to further explore program impacts, and providing on-demand training for physiologists. Copyright © 2017 the American Physiological Society.

A randomized trial to measure the impact of a community-based cognitive training intervention on balance and gait in cognitively intact Black older adults.

PubMed

Smith-Ray, Renae L; Makowski-Woidan, Beth; Hughes, Susan L

2014-10-01

Fall prevention is important for maintaining mobility and independence into old age. Approaches for reducing falls include exercise, tai chi, and home modifications; however, causes of falling are multifactorial and include not just physical but cognitive factors. Cognitive decline occurs with age, but older adults with the greatest declines in executive function experience more falls. The purpose of this study was twofold: to demonstrate the feasibility of a community-based cognitive training program for cognitively intact Black older adults and to analyze its impact on gait and balance in this population. This pilot study used a pretest/posttest randomized trial design with assignment to an intervention or control group. Participants assigned to the intervention completed a computer-based cognitive training class that met 2 days a week for 60 min over 10 weeks. Classes were held at senior/community centers. Primary outcomes included balance as measured by the Berg Balance Scale (BBS), 10-meter gait speed, and 10-meter gait speed under visuospatial dual-task condition. All measures were assessed at baseline and immediately post-intervention. Participants were community-dwelling Black adults with a mean age of 72.5 and history of falls (N = 45). Compared to controls, intervention participants experienced statistically significant improvements in BBS and gait speed. Mean performance on distracted gait speed also improved more for intervention participants compared to controls. Findings from this pilot randomized trial demonstrate the feasibility of a community-based cognitive training intervention. They provide initial evidence that cognitive training may be an efficacious approach toward improving balance and gait in older adults known to have a history of falls. © 2014 Society for Public Health Education.

Genome resolved analysis of a premature infant gut microbial community reveals a Varibaculum cambriense genome and a shift towards fermentation-based metabolism during the third week of life.

PubMed

Brown, Christopher T; Sharon, Itai; Thomas, Brian C; Castelle, Cindy J; Morowitz, Michael J; Banfield, Jillian F

2013-12-17

The premature infant gut has low individual but high inter-individual microbial diversity compared with adults. Based on prior 16S rRNA gene surveys, many species from this environment are expected to be similar to those previously detected in the human microbiota. However, the level of genomic novelty and metabolic variation of strains found in the infant gut remains relatively unexplored. To study the stability and function of early microbial colonizers of the premature infant gut, nine stool samples were taken during the third week of life of a premature male infant delivered via Caesarean section. Metagenomic sequences were assembled and binned into near-complete and partial genomes, enabling strain-level genomic analysis of the microbial community.We reconstructed eleven near-complete and six partial bacterial genomes representative of the key members of the microbial community. Twelve of these genomes share >90% putative ortholog amino acid identity with reference genomes. Manual curation of the assembly of one particularly novel genome resulted in the first essentially complete genome sequence (in three pieces, the order of which could not be determined due to a repeat) for Varibaculum cambriense (strain Dora), a medically relevant species that has been implicated in abscess formation.During the period studied, the microbial community undergoes a compositional shift, in which obligate anaerobes (fermenters) overtake Escherichia coli as the most abundant species. Other species remain stable, probably due to their ability to either respire anaerobically or grow by fermentation, and their capacity to tolerate fluctuating levels of oxygen. Metabolic predictions for V. cambriense suggest that, like other members of the microbial community, this organism is able to process various sugar substrates and make use of multiple different electron acceptors during anaerobic respiration. Genome comparisons within the family Actinomycetaceae reveal important differences related to respiratory metabolism and motility. Genome-based analysis provided direct insight into strain-specific potential for anaerobic respiration and yielded the first genome for the genus Varibaculum. Importantly, comparison of these de novo assembled genomes with closely related isolate genomes supported the accuracy of the metagenomic methodology. Over a one-week period, the early gut microbial community transitioned to a community with a higher representation of obligate anaerobes, emphasizing both taxonomic and metabolic instability during colonization.

Genome resolved analysis of a premature infant gut microbial community reveals a Varibaculum cambriense genome and a shift towards fermentation-based metabolism during the third week of life

PubMed Central

2013-01-01

Background The premature infant gut has low individual but high inter-individual microbial diversity compared with adults. Based on prior 16S rRNA gene surveys, many species from this environment are expected to be similar to those previously detected in the human microbiota. However, the level of genomic novelty and metabolic variation of strains found in the infant gut remains relatively unexplored. Results To study the stability and function of early microbial colonizers of the premature infant gut, nine stool samples were taken during the third week of life of a premature male infant delivered via Caesarean section. Metagenomic sequences were assembled and binned into near-complete and partial genomes, enabling strain-level genomic analysis of the microbial community. We reconstructed eleven near-complete and six partial bacterial genomes representative of the key members of the microbial community. Twelve of these genomes share >90% putative ortholog amino acid identity with reference genomes. Manual curation of the assembly of one particularly novel genome resulted in the first essentially complete genome sequence (in three pieces, the order of which could not be determined due to a repeat) for Varibaculum cambriense (strain Dora), a medically relevant species that has been implicated in abscess formation. During the period studied, the microbial community undergoes a compositional shift, in which obligate anaerobes (fermenters) overtake Escherichia coli as the most abundant species. Other species remain stable, probably due to their ability to either respire anaerobically or grow by fermentation, and their capacity to tolerate fluctuating levels of oxygen. Metabolic predictions for V. cambriense suggest that, like other members of the microbial community, this organism is able to process various sugar substrates and make use of multiple different electron acceptors during anaerobic respiration. Genome comparisons within the family Actinomycetaceae reveal important differences related to respiratory metabolism and motility. Conclusions Genome-based analysis provided direct insight into strain-specific potential for anaerobic respiration and yielded the first genome for the genus Varibaculum. Importantly, comparison of these de novo assembled genomes with closely related isolate genomes supported the accuracy of the metagenomic methodology. Over a one-week period, the early gut microbial community transitioned to a community with a higher representation of obligate anaerobes, emphasizing both taxonomic and metabolic instability during colonization. PMID:24451181

Results of the Alternative Calendar Survey: A Survey of Faculty, Classified Staff and Administrators at California Community Colleges That Have Moved from an 18-Week Semester to a Compressed Calendar.

ERIC Educational Resources Information Center

Beachler, Judith

From December 2002 through February 2003, Los Rios Community College District (LRCCD), California, administrators invited key faculty members, classified staff, and administrators of California community colleges that have moved from an 18 week semester to a compressed 15- or 16-week semester to share their colleges' experiences through the…

High-throughput nucleotide sequence analysis of diverse bacterial communities in leachates of decomposing pig carcasses

PubMed Central

Yang, Seung Hak; Lim, Joung Soo; Khan, Modabber Ahmed; Kim, Bong Soo; Choi, Dong Yoon; Lee, Eun Young; Ahn, Hee Kwon

2015-01-01

The leachate generated by the decomposition of animal carcass has been implicated as an environmental contaminant surrounding the burial site. High-throughput nucleotide sequencing was conducted to investigate the bacterial communities in leachates from the decomposition of pig carcasses. We acquired 51,230 reads from six different samples (1, 2, 3, 4, 6 and 14 week-old carcasses) and found that sequences representing the phylum Firmicutes predominated. The diversity of bacterial 16S rRNA gene sequences in the leachate was the highest at 6 weeks, in contrast to those at 2 and 14 weeks. The relative abundance of Firmicutes was reduced, while the proportion of Bacteroidetes and Proteobacteria increased from 3–6 weeks. The representation of phyla was restored after 14 weeks. However, the community structures between the samples taken at 1–2 and 14 weeks differed at the bacterial classification level. The trend in pH was similar to the changes seen in bacterial communities, indicating that the pH of the leachate could be related to the shift in the microbial community. The results indicate that the composition of bacterial communities in leachates of decomposing pig carcasses shifted continuously during the study period and might be influenced by the burial site. PMID:26500442

Dual-energy x-ray absorptiometry to measure the influence of a 16-week community-based swim training program on body fat in children and adolescents with intellectual disabilities.

PubMed

Casey, Amanda Faith; Rasmussen, Roy; Mackenzie, Sasho J; Glenn, Jillian

2010-07-01

To use dual-energy x-ray absorptiometry (DXA) to measure the effects of a 16-week community-based swim training program on percent body fat in children and adolescents with intellectual disability (ID). Convenience sample. University sport complex and exercise science laboratory. Children and adolescents (n=8; mean age +/- SD, 13.1 +/- 3.4 y), 2 girls and 6 boys with ID, of varying fat levels (11%-35%). A swim training program lasting for the duration of 16 weeks with three 1-hour sessions held at a 25-m pool each week. Assessing percent body fat at pretest and posttest through the use of DXA. After the 16-week exercise training program, we observed a 1.2% median increase in body fat percentage with a range from -0.3% to 4.5%. Wilcoxon matched-pairs signed-ranks tests suggest that these results are statistically significant (P=.039; exact). Exercise training alone proved ineffectual in reducing percent body fat in 8 children and adolescents with ID. Further research should consider implementing a combined diet and exercise program. To gauge the effectiveness of intervention programs, valid methods and complex measurement tools such as DXA should be used to assess changes in percent body fat in such a heterogeneous population. Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Bioretention column study of bacteria community response to salt-enriched artificial stormwater.

PubMed

Endreny, Theodore; Burke, David J; Burchhardt, Kathleen M; Fabian, Mark W; Kretzer, Annette M

2012-01-01

Cold climate cities with green infrastructure depend on soil bacteria to remove nutrients from road salt-enriched stormwater. Our research examined how bacterial communities in laboratory columns containing bioretention media responded to varying concentrations of salt exposure from artificial stormwater and the effect of bacteria and salt on column effluent concentrations. We used a factorial design with two bacteria treatments (sterile, nonsterile) and three salt concentrations (935, 315, and 80 ppm), including a deionized water control. Columns were repeatedly saturated with stormwater or deionized and then drained throughout 5 wk, with the last week of effluent analyzed for water chemistry. To examine bacterial communities, we extracted DNA from column bioretention media at time 0 and at week 5 and used molecular profiling techniques to examine bacterial community changes. We found that bacterial community taxa changed between time 0 and week 5 and that there was significant separation between taxa among salt treatments. Bacteria evenness was significantly affected by stormwater treatment, but there were no differences in bacterial richness or diversity. Soil bacteria and salt treatments had a significant effect on the effluent concentration of NO, PO, Cu, Pb, and Zn based on ANOVA tests. The presence of bacteria reduced effluent NO and Zn concentrations by as much as 150 and 25%, respectively, while having a mixed effect on effluent PO concentrations. Our results demonstrate how stormwater can affect bacterial communities and how the presence of soil bacteria improves pollutant removal by green infrastructure. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

Chronic Disease Risk Reduction with a Community-Based Lifestyle Change Programme

ERIC Educational Resources Information Center

Merrill, Ray M; Aldana, Steven G; Greenlaw, Roger L; Salberg, Audrey; Englert, Heike

2008-01-01

Objective To assess whether reduced health risks resulting from the Coronary Health Improvement Project (CHIP) persist through 18 months. Methods: The CHIP is a four-week health education course designed to help individuals reduce cardiovascular risk by improving nutrition and physical activity behaviors. Analyses were based on 211 CHIP enrollees,…

77 FR 56745 - Patriot Day and National Day of Service and Remembrance, 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-13

... helped our Nation rebuild and recover long after the dust had settled, donating and volunteering and... compassion by serving their communities in the days and weeks ahead. From volunteering with a faith-based...

3 CFR 8363 - Proclamation 8363 of April 21, 2009. National Volunteer Week, 2009

Code of Federal Regulations, 2010 CFR

2010-01-01

... in our schools. The law also creates a Social Innovation Fund. This fund looks for new ideas in communities and leverages private, nonprofit, and faith-based support to invest in local innovation. The fund...

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.

Self-management improvement program combined with community involvement in Thai hypertensive population: an action research.

PubMed

Srichairattanakull, Jeamjai; Kaewpan, Wonpen; Powattana, Arpaporn; Pichayapinyo, Panan

2014-04-01

To investigate the effectiveness of a program that utilizes community involvement to improve the self-management strategies among people living with hypertension. Forty-four subjects, aged 35 to 59-year-old, with hypertension in Nakhon Pathom Province, Thailand, were randomly allocated to either an experimental group (n = 22) or a control group (n = 20). The experimental group attended a program to improve self-management methods based on social cognitive theory (SCT). The program lasted 12 weeks, consisted of 1 1/2 hours meeting once a week, including group meetings and home visit monitoring. Mann-Whitney U test and Friedman test were employed to analyze the program's effectiveness. After the program, the mean rank of the perceived self-efficacy for the self-management strategies was statistically different between the two groups (p = 0.023). In the experimental group, after the twelve week, the mean rank of perceived self-efficacy and outcome expectancy increased and diastolic blood pressure decreased after the eight week. The program applied social cognitive theory (SCT) to promote self-management techniques, increased the health promoting behavior among hypertensive people.

An Attachment-Based Home Visiting Program for Distressed Mothers of Young Infants

ERIC Educational Resources Information Center

Kaitz, Marsha; Tessler, Naomi; Chriki, Miriam

2012-01-01

Mom2Mom is an attachment-based home visiting project for distressed mothers of young infants, based in Israel. Home visitors, who are volunteer mothers from the community, are trained and supervised by professionals. Home visits occur weekly for 1-2 hours and continue until the infant is 1 year old. The project was founded in Jerusalem in year…

Effects of low-volume high-intensity interval training in a community setting: a pilot study.

PubMed

Reljic, Dejan; Wittmann, Felix; Fischer, Joachim E

2018-06-01

High-intensity interval training (HIIT) is emerging as an effective and time-efficient exercise strategy for health promotion. However, most HIIT studies are conducted in laboratory settings and evidence regarding the efficacy of time-efficient "low-volume" HIIT is based mainly on demanding "all-out" protocols. Thus, the aim of this pilot study was to assess the feasibility and efficacy of two low-volume (≤ 30 min time-effort/week), non-all-out HIIT protocols, performed 2 ×/week over 8 weeks in a community-based fitness centre. Thirty-four sedentary men and women were randomised to either 2 × 4-min HIIT (2 × 4-HIIT) or 5 × 1-min HIIT (5 × 1-HIIT) at 85-95% maximal heart rate (HR max ), or an active control group performing moderate-intensity continuous training (MICT, 76 min/week) at 65-75% HR max . The exercise protocols were well tolerated and no adverse events occurred. 2 × 4-HIIT and 5 × 1-HIIT exhibited lower dropout rates (17 and 8 vs. 30%) than MICT. All training modes improved VO 2max (2 × 4-HIIT: + 20%, P < 0.01; 5 × 1-HIIT: + 27%, P < 0.001; MICT: + 16%, P < 0.05), but the HIIT protocols required 60% less time commitment. Both HIIT protocols and MICT had positive impact on cholesterol profiles. Only 5 × 1-HIIT significantly improved waist circumference (P < 0.05) and subjective work ability (P < 0.05). The present study indicates that low-volume HIIT can be feasibly implemented in a community-based setting. Moreover, our data suggest that practical (non-all-out) HIIT that requires as little as 30 min/week, either performed as 2 × 4-HIIT or 5 × 1-HIIT, may induce significant improvements in VO 2max and cardiometabolic risk markers.

Study Protocol for a Randomized, Double-Blind, Community-Based Efficacy Trial of Various Doses of Zinc in Micronutrient Powders or Tablets in Young Bangladeshi Children

PubMed Central

Islam, M. Munirul; McDonald, Christine M.; Krebs, Nancy F.; Westcott, Jamie; Rahman, Ahmed Ehsanur; El Arifeen, Shams; Ahmed, Tahmeed; King, Janet C.; Black, Robert E.

2018-01-01

Zinc is essential to supporting growth in young children especially for tissues undergoing rapid cellular differentiation and turnover, such as those in the immune system and gastrointestinal tract. Therapeutic zinc supplementation has been initiated in low-income countries as part of diarrhea treatment programs to support these needs for young children, but the effects of preventive supplemental zinc as a tablet or as a multiple micronutrient powder (MNP) on child growth and diarrheal disease are mixed and pose programmatic uncertainties. Thus, a randomized, double-blind community-based efficacy trial of five different doses, forms, and frequencies of preventive zinc supplementation vs. a placebo was designed for a study in children aged 9–11 months in an urban community in Dhaka, Bangladesh. The primary outcomes of this 24-week study are incidence of diarrheal disease and linear growth. Study workers will conduct in-home morbidity checks twice weekly; anthropometry will be measured at baseline, 12 weeks and 24 weeks. Serum zinc and other related biomarkers will be measured in a subsample along with an estimate of the exchangeable zinc pool size using stable isotope techniques in a subgroup. Therapeutic zinc will be provided as part of diarrhea treatment, in accordance with Bangladesh’s national policy. Therefore, the proposed study will determine the additional benefit of a preventive zinc supplementation intervention. The protocol has been approved by the Institutional Review Boards (IRBs) of icddr,b and Children’s Hospital Oakland Research Institute (CHORI). The IRB review process is underway at the University of Colorado Denver as well.

Effects of Community-Based Exercise in Children with Severe Burns: A Randomized Trial

PubMed Central

Peña, Raquel; Ramirez, Leybi L.; Crandall, Craig G.; Wolf, Steven; Herndon, David N.; Suman, Oscar E.

2015-01-01

Objective To counteract long-lasting muscle break down, muscle weakness, and poor physical fitness resulting from severe burns, we recommend a 12-week in-hospital exercise training rehabilitation program. Unfortunately, this in-hospital training program requires time away from home, family, school or work). This study was undertaken to evaluate an alternative exercise rehabilitation strategy involving a 12-week community-based exercise training rehabilitation program (COMBEX) carried out at or near the patient and caretaker’s home. Study Design and Participants Pediatric patients (7–18 years) with ≥ 30% of the total body surface area (TBSA) burns were randomized to participate in COMBEX (N=12) or an outpatient exercise program (EX) at the hospital (N=22). Both programs were started after hospital discharge and consisted of 12 weeks of progressive resistive and aerobic exercise. COMBEX was performed in community fitness centers near the patients’ home. Endpoints were assessed at discharge (pre-exercise) and after the 12-week program. Primary endpoints were lean body mass (dual energy x-ray absorptiometry), muscle strength (isokinetic dynamometry), and peak aerobic capacity (indirect calorimetry). Results Demographics, length of hospitalization, and TBSA burned were comparable between groups (p>0.05). Both groups exhibited a significant (p≤0.01 for all) increase (mean ± SEM) in lean muscle mass (EX: 6.9 ± 1.7%; COMBEX: 6.5 ± 1.1%), muscle strength (EX: 67.1 ± 7.0%; COMBEX: 49.9 ± 6.8%), and peak aerobic capacity (EX: 35.5 ± 4.0%; COMBEX: 46.9 ± 7.7%). Furthermore, the magnitude of these increases were not different between groups (P>0.12). Conclusions Both EX and COMBEX are efficacious in improving lean mass, strength, and cardiopulmonary capacity in severely burned children. PMID:26643401

A Preliminary Study on the Efficacy of a Community-Based Physical Activity Intervention on Physical Function-Related Risk Factors for Falls among Breast Cancer Survivors

PubMed Central

Lee, C. Ellen; Warden, Stuart J.; Szuck, Beth; Lau, Y.K. James

2015-01-01

Objective The aim of this study was to examine the effects of a 6-week community-based physical activity (PA) intervention on physical function-related risk factors for falls among 56 breast cancer survivors (BCS) who had completed treatments. Design This was a single-group longitudinal study. The multimodal PA intervention included aerobic, strengthening and balance components. Physical function outcomes based on the 4-meter walk, chair stand, one-leg stance, tandem walk, and dynamic muscular endurance tests were assessed at 6-week pre-intervention (T1), baseline (T2), and post-intervention (T3). T1-T2 and T2-T3 were the control and intervention periods, respectively. Results All outcomes, except the tandem walk test, significantly improved after the intervention period (p < 0.05), with no change detected after the control period (p > 0.05). Based on the falls risk criterion in the one-leg stance test, the proportion at risk for falls was significantly lower after the intervention period (p = 0.04), but not after the control period. Conclusions A community-based multimodal PA intervention for BCS may be efficacious in improving physical function-related risk factors for falls, and lowering the proportion of BCS at risk for falls based on specific physical function-related falls criteria. Further larger trials are needed to confirm these preliminary findings. PMID:26829081

Community-based advocacy training: applying asset-based community development in resident education.

PubMed

Hufford, Laura; West, Daniel C; Paterniti, Debora A; Pan, Richard J

2009-06-01

Communities and Physicians Together (CPT) at University of California, Davis Health System provides a novel approach to teaching residents to be effective community advocates. Founded in 1999, CPT is a partnership between a pediatric residency program, five community collaboratives located in diverse neighborhoods, and a grassroots child advocacy organization. Using the principles of Asset-Based Community Development, the program emphasizes establishing partnerships with community members and organizations to improve child health and identifies community assets and building capacity. Community members function as the primary faculty for CPT.The authors describe the CPT curriculum, which teaches residents to build partnerships with their assigned community. Residents have three, two-week blocks each year for CPT activities and maintain a longitudinal relationship with their community. In the first year, collaborative coordinators from each community orient residents to their community. Residents identify community assets and perform activities designed to provide them with a community member's perspective. In the second and third years, residents partner with community members and organizations to implement a project to improve the health of children in that community. CPT also provides faculty development to community partners including a workshop on medical culture and resident life. A qualitative evaluation demonstrated residents' attitudes of their role as pediatricians in the community changed with CPT.CPT is unique because it provides a model of service learning that emphasizes identifying and utilizing strengths and building capacity. This approach differs from the traditional medical model, which emphasizes deficits and needs.

Evaluating a community-based exercise intervention with adults living with HIV: protocol for an interrupted time series study

PubMed Central

O'Brien, Kelly K; Bayoumi, Ahmed M; Solomon, Patricia; Tang, Ada; Murzin, Kate; Chan Carusone, Soo; Zobeiry, Mehdi; Nayar, Ayesha; Davis, Aileen M

2016-01-01

Introduction Our aim was to evaluate a community-based exercise (CBE) intervention with the goal of reducing disability and enhancing health for community-dwelling people living with HIV (PLWH). Methods and analysis We will use a mixed-methods implementation science study design, including a prospective longitudinal interrupted time series study, to evaluate a CBE intervention with PLWH in Toronto, Canada. We will recruit PLWH who consider themselves medically stable and safe to participate in exercise. In the baseline phase (0–8 months), participants will be monitored bimonthly. In the intervention phase (8–14 months), participants will take part in a 24-week CBE intervention that includes aerobic, resistance, balance and flexibility exercise at the YMCA 3 times per week, with weekly supervision by a fitness instructor, and monthly educational sessions. In the follow-up phase (14–22 months), participants will be encouraged to continue to engage in unsupervised exercise 3 times per week. Quantitative assessment: We will assess cardiopulmonary fitness, strength, weight, body composition and flexibility outcomes followed by the administration of self-reported questionnaires to assess disability and contextual factor outcomes (coping, mastery, stigma, social support) bimonthly. We will use time series regression analysis to determine the level and trend of outcomes across each phase in relation to the intervention. Qualitative assessment: We will conduct a series of face-to-face interviews with a subsample of participants and recreation providers at initiation, midpoint and completion of the 24-week CBE intervention. We will explore experiences and anticipated benefits with exercise, perceived impact of CBE for PLWH and the strengths and challenges of implementing a CBE intervention. Interviews will be audio recorded and analysed thematically. Ethics and dissemination Protocol approved by the University of Toronto HIV/AIDS Research Ethics Board. Knowledge translation will occur with stakeholders in the form of presentations and publications in open access peer-reviewed journals. Trial registration number NCT02794415; Pre-results. PMID:27798038

Efficacy of community-based physiotherapy networks for patients with Parkinson's disease: a cluster-randomised trial.

PubMed

Munneke, Marten; Nijkrake, Maarten J; Keus, Samyra Hj; Kwakkel, Gert; Berendse, Henk W; Roos, Raymund Ac; Borm, George F; Adang, Eddy M; Overeem, Sebastiaan; Bloem, Bastiaan R

2010-01-01

Many patients with Parkinson's disease are treated with physiotherapy. We have developed a community-based professional network (ParkinsonNet) that involves training of a selected number of expert physiotherapists to work according to evidence-based recommendations, and structured referrals to these trained physiotherapists to increase the numbers of patients they treat. We aimed to assess the efficacy of this approach for improving health-care outcomes. Between February, 2005, and August, 2007, we did a cluster-randomised trial with 16 clusters (defined as community hospitals and their catchment area). Clusters were randomly allocated by use of a variance minimisation algorithm to ParkinsonNet care (n=8) or usual care (n=8). Patients were assessed at baseline and at 8, 16, and 24 weeks of follow-up. The primary outcome was a patient preference disability score, the patient-specific index score, at 16 weeks. Health secondary outcomes were functional mobility, mobility-related quality of life, and total societal costs over 24 weeks. Analysis was by intention to treat. This trial is registered, number NCT00330694. We included 699 patients. Baseline characteristics of the patients were comparable between the ParkinsonNet clusters (n=358) and usual-care clusters (n=341). The primary endpoint was similar for patients within the ParkinsonNet clusters (mean 47.7, SD 21.9) and control clusters (48.3, 22.4). Health secondary endpoints were also similar for patients in both study groups. Total costs over 24 weeks were lower in ParkinsonNet clusters compared with usual-care clusters (difference euro727; 95% CI 56-1399). Implementation of ParkinsonNet networks did not change health outcomes for patients living in ParkinsonNet clusters. However, health-care costs were reduced in ParkinsonNet clusters compared with usual-care clusters. ZonMw; Netherlands Organisation for Scientific Research; Dutch Parkinson's Disease Society; National Parkinson Foundation; Stichting Robuust. Copyright 2010 Elsevier Ltd. All rights reserved.

Hemodynamic responses to a community-based Tai Chi exercise intervention in ethnic Chinese adults with cardiovascular disease risk factors.

PubMed

Taylor-Piliae, Ruth E; Haskell, William L; Froelicher, Erika Sivarajan

2006-06-01

Cardiovascular disease (CVD) is the leading cause of death among older adults worldwide, including Europe, Asia, and North America. In the United States (US), CVD is also the leading cause of death among Asian-Americans. Physical activity has been shown to reduce CVD risk factors. Reduction in blood pressure (BP) in response to Tai Chi (TC) exercise in persons with CVD risk factors have been reported, though not in ethnic Chinese living in the US. Hemodynamic responses to a 12-week community-based TC exercise intervention among ethnic Chinese with CVD risk factors were examined. Quasi-experimental design. Ethnic Chinese > 45 years old with at least 1 major CVD risk factor, living in the San Francisco Bay Area, attended a TC intervention three times a week for 12 weeks. A 2-min step-in-place test assessed aerobic endurance. BP and heart rate were measured at rest, and within 1-min after the step-test. Data were collected at baseline, 6 and 12 weeks. A total of 39 subjects (69% women), 66 +/- 8.3 years old, with hypertension (92%), hypercholesteremia (49%), and/or diabetes (21%), and 1 current smoker participated. Adherence to the intervention was high (87%). Subjects were sedentary at baseline, though had a statistically significant improvement in aerobic endurance over-time (eta2 = 0.39). At baseline, the average BP at rest was 150/86, while BP in response to the step-test was 178/99. Clinically and statistically significant reductions in BP at rest (131/77), and in response to the step-test (164/82) were found over 12 weeks of TC (p < 0.01). No significant change in heart rate was observed. This innovative, culturally relevant, community-based 12-week TC exercise intervention, appealed to Chinese adults with CVD risk factors, with significant reductions in BP and improvement in aerobic endurance. Given the number of persons estimated to have HTN and other CVD risk factors, the identification of new approaches to improve health, combined with risk factor reduction is needed. This is particularly important, given the rise in HTN among adults in the US and the associated public health burden of HTN. TC has the potential to reduce expenditures associated with CVD by facilitating a lifestyle that promotes physical activity, while remaining a low-tech, low-cost alternative to exercise.

Impact of a community-based intervention on serving and intake of vegetables among low-income, rural Appalachian families.

PubMed

Wenrich, Tionni R; Brown, J Lynne; Wilson, Robin Taylor; Lengerich, Eugene J

2012-01-01

To evaluate the effectiveness of a community-based intervention promoting the serving and eating of deep-orange, cruciferous, and dark-green leafy vegetables. Randomized, parallel-group, community-based intervention with a baseline/postintervention/3-month follow-up design. Low-income food preparers (n = 50) and their partners (n = 50) in rural Appalachia Pennsylvania. Experimental food preparers attended 8 weekly interactive lessons; control food preparers received 8 weekly mailings that included similar recipes and handouts. Target vegetable intake and frequency of serving by experimental and control treatment groups and by high and low meal diary scores, a measure of recipe acceptability. Linear mixed-model analysis with repeated measures. No significant differences resulted between the original experimental and control treatment groups. When grouped by high and low meal diary scores, more experimental families had high scores than in controls. High scores were associated with significant changes in frequency of serving and intake of the target vegetables. Meal diary use may foster food preparer negotiation with partners and children to become involved in vegetable dish evaluation. Tools to help the trained food preparer draw family members into recipe evaluation, such as the meal diary, are useful and needed. Copyright © 2012 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

INTERDEM Academy special section -  Digging for Dementia: Exploring the experience of community gardening from the perspectives of people with dementia.

PubMed

Noone, Sarah; Jenkins, Nicholas

2017-10-25

The study sought to explore the lived experiences of people with dementia who participate in community-based gardening programmes. A collaborative gardening project was conducted over six weeks at a day centre for people with dementia. Six participants were recruited from the centre's attendees. Each session was co-designed by participants. Semi-structured group interviews were conducted each week, and researcher observations were documented. Semi-structured interviews were also conducted with the centre's staff to explore their views and to contextualise gardening participants' experiences. Data were analysed inductively using thematic analysis. This paper focuses upon three of the study's emergent themes: identity, agency, and community. The findings revealed that for people with dementia, gardening is not merely a matter of enjoying time outdoors; it is a forum for the articulation of identity and selfhood and expression of agency, and can facilitate the development of new social bonds based upon shared interests, rather than a shared diagnosis. Gardening-based interventions can offer more than simply facilitating outdoor engagement and promoting social interaction. When conditions are right, gardening can be an effective vehicle for the promotion of social citizenship and expression of selfhood and agency in dementia.

Place Based STEM: Leveraging Local Resources to Engage K-12 Teachers in Teaching Integrated STEM and for Addressing the Local STEM Pipeline

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

Dr. Louis Nadelson; Anne Louise Seifert; Meagan McKinney

Business, industry, parks, nature settings, government infrastructure, and people, can be invaluable resources for connecting STEM curriculum within context which results in conditions ideal for promoting purposeful learning of authentic STEM content. Thus, community-based STEM resources offer ideal context for teaching STEM content. A benefit of focusing teacher attention on these contextual, content aligned resources is that they are in every community; making place-based STEM education a possibility, regardless of the location of STEM teaching and learning. Further, associating STEM teaching and learning with local resources addresses workforce development and the STEM pipeline by exposing students to STEM careers andmore » applications in their local communities. The desire to align STEM teaching and learning with local STEM related resources guided the design of our week-long integrated STEM K-12 teacher professional development (PD) program, i-STEM. We have completed four years of our i-STEM PD program and have made place-based STEM a major emphasis of our curriculum. This report focuses on the data collected in the fourth year of our program. Our week-long i-STEM PD served over 425 educators last summer (2013), providing them with in depth theme-based integrated STEM short courses which were limited to an average of 15 participants and whole group plenary sessions focused around placed based integrated STEM, inquiry, engineering design, standards and practices of Common Core and 21st Century skills. This state wide PD was distributed in five Idaho community colleges and took place over two weeks. The STEM short courses included topics on engineering for sustainability, using engineering to spark interest in STEM, municipal water systems, health, agriculture, food safety, mining, forestry, energy, and others. Integral to these short courses were field trips designed to connect the K-12 educators to the resources in their local communities that could be leveraged for teaching integrated STEM and provide a relevant context for teaching STEM content. Workplace presentations made by place-based STEM experts and provided teachers field trips to place-base STEM industries and business such as manufacturing plants, waste water treatment systems, mines, nature parks, food processing plants, research, hospitals, and laboratory facilities. We researched the 425 participants’ conceptions of place-based STEM prior to and after their taking part in the summer institutes, which included fieldtrips. Our findings revealed substantial increase in our participants’ knowledge, interest, and plans to use place-based resources for teaching integrated STEM. We detail the data analysis and provide a theoretical foundation and justification for the importance of place-based STEM to address the STEM pipeline for the future workforce.« less

Happy Family Kitchen: A community-based research for enhancing family communication and well-being in Hong Kong.

PubMed

Ho, Henry C Y; Mui, Moses; Wan, Alice; Ng, Yin-Lam; Stewart, Sunita M; Yew, Carol; Lam, Tai Hing; Chan, Sophia S

2016-09-01

Urban families worldwide are often characterized by busy working lives which leave little time for family gatherings and communication. The Happy Family Kitchen project, which emphasized cooking and dining with family members, was conducted in a deprived district in Hong Kong. We hypothesized that the community-based family intervention, derived from a positive psychology framework, can improve family communication, family well-being, and subjective happiness. Twenty-three social service units organized and delivered the intervention programs for 1,419 individuals from 612 families. The core intervention was developed with emphasis on 1 of 5 positive psychology themes: gratitude, flow, happiness, health, and savoring. Intervention outcomes were assessed at preintervention, immediate postintervention, and 6 weeks and 12 weeks postintervention. Results showed that family communication, family well-being, and subjective happiness improved with small effect sizes which were sustained up to 12 weeks. The gratitude intervention improved all of the outcome measures. Qualitative data provided additional evidence for effectiveness with in-depth insights into family dynamics. We concluded that this brief intervention was a low-cost and simple approach to improve family communication and well-being. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Developing leadership practices in hospital-based nurse educators in an online learning community.

PubMed

Stutsky, Brenda J; Spence Laschinger, Heather K

2014-01-01

Hospital-based nurse educators are in a prime position to mentor future nurse leaders; however, they need to first develop their own leadership practices. The goal was to establish a learning community where hospital-based nurse educators could develop their own nursing leadership practices within an online environment that included teaching, cognitive, and social presence. Using a pretest/posttest-only nonexperimental design, 35 nurse educators from three Canadian provinces engaged in a 12-week online learning community via a wiki where they learned about exemplary leadership practices and then shared stories about their own leadership practices. Nurse educators significantly increased their own perceived leadership practices after participation in the online community, and teaching, cognitive, and social presence was determined to be present in the online community. It was concluded that leadership development can be enhanced in an online learning community using a structured curriculum, multimedia presentations, and the sharing and analysis of leadership stories. Educators who participated should now be better equipped to role model exemplary leadership practices and mentor our nurse leaders of the future.

A randomized pilot study of a community-based weight loss intervention for African-American women: Rationale and study design of Doing Me! Sisters Standing Together for a Healthy Mind and Body.

PubMed

Springfield, Sparkle; Buscemi, Joanna; Fitzgibbon, Marian L; Stolley, Melinda R; Zenk, Shannon N; Schiffer, Linda; Sampson, Jameika; Jones, Quiana; Murdock, Tanine; Davis, Iona; Holland, Loys; Watkins, April; Odoms-Young, Angela

2015-07-01

Despite the high prevalence of obesity among African-American women and modest success in behavioral weight loss interventions, the development and testing of weight management interventions using a community-based participatory research (CBPR) approach have been limited. Doing Me!: Sisters Standing Together for Healthy Mind and Body (Doing Me!) is an intervention adapted from an evidence-based behavioral obesity intervention using a CBPR approach. The purpose of Doing Me! is to test the feasibility and acceptability of this adapted intervention and determine its efficacy in achieving improvements in anthropometrics, diet, and physical activity. Sixty African-American women, from a low-income, urban community, aged 30-65 years will be randomized to one of two arms: 16-week Doing Me! (n = 30) or waitlist control (n = 30). Doing Me! employs CBPR methodology to involve community stakeholders and members during the planning, development, implementation, and evaluation phases of the intervention. There will be thirty-two 90-minute sessions incorporating 45 min of instruction on diet, physical activity, and/or weight management plus 45 min of physical activity. Data will be collected at baseline and post-intervention (16 weeks). Doing Me! is one of the first CBPR studies to examine the feasibility/acceptability of an adapted evidence-based behavioral weight loss intervention designed for obese African-American women. CBPR may be an effective strategy for implementing a weight management intervention among this high-risk population. Copyright © 2015 Elsevier Inc. All rights reserved.

Population-based assessment of heartburn in urban Black Americans.

PubMed

Friedenberg, F K; Makipour, K; Palit, A; Shah, S; Vanar, V; Richter, J E

2013-08-01

Prevalence data for heartburn in the urban Black American community is lacking. In order to estimate prevalence for this community, we analyzed data from an ongoing cohort study in progress at our hospital. Comprehensive interviews allowed for exploration of factors associated with heartburn. Complex, stratified sampling design was the method used. Survey invitations are hand-delivered to random blocks in a single zip code tabulation area. One member per eligible household is invited to complete a computer-based survey. Heartburn was defined as ≥ 3 days/week of symptoms as defined by the Montreal Definition and Classification of gastroesophageal reflux disease. Scaling and weighting factors were utilized to estimate population level prevalence. Multivariate logistic regression was used to identify independent predictor variables for heartburn. Enrolled 379 participants corresponding to a weighted sample size of 22,409 (20,888-23,930) citizens. Demographic characteristics of the sample closely matched those of the entire targeted population. Overall, the weighted prevalence of heartburn ≥ 3 times per week was 17.6% (16.4-18.8%). Variables independently associated with heartburn were body mass index, daily caloric and fat intake, diabetes mellitus (odds ratio = 2.95; 2.59-3.36), cigarette smoking, and alcohol consumption (odds ratio = 2.55; 2.25-2.89). Factors inversely associated included illicit drug use and increased physical activity. Waist : hip ratio showed no relationship. The prevalence of heartburn ≥ 3 times per week is high in the Black American community. Adverse lifestyle behaviors showed particularly important associations. Our study needs to be replicated in other communities with similar demographics. © 2012 Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.

Community Based Psychosocial Education Can Improve Mood Disturbance in Breast Cancer Survivors at Various Stages of Their Recovery.

PubMed

Kokavec, Anna

2016-11-01

Psychosocial distress can contribute to avoidance, refusal, or discontinuation of cancer treatment, which could impact recovery and survival. The aim of the present study was to evaluate the effectiveness of a community based psychosocial program on alleviating mood disturbance in breast cancer survivors at different stages of their breast cancer journey. A total of 37 women participated in an 8-week psychosocial program at their local community centre. The weekly 3-hour program was delivered in a small group format. Program components included health education, behavioural training, cognitive behavioural therapy, art therapy and stress-management. Questionnaires aimed at assessing psychiatric morbidity and mood adjustment were administered at the beginning of the program (Pre) and at the completion of the program (Post). Group data revealed a significant reduction in psychiatric morbidity and improved psychological adjustment. When participants were divided into degree of psychiatric morbidity (mild, moderate, severe, very severe) a significant reduction in the reporting of anxiety symptoms in the mild, moderate, severe and very severe groups was reported; depression symptoms in the severe and very severe groups were noted, and anger, confusion and somatic symptoms in the mild group were noted. The level of activity was also significantly improved in the very severe group. A structured community based psychosocial program is beneficial to women struggling to come to terms with the emotional consequences of breast cancer at all stages of recovery.

Promoting nutritional well-being in seniors: feasibility study of a nutrition information series.

PubMed

Manafò, Elizabeth; Jose, Katrina; Silverberg, Dena

2013-01-01

Better Living Health and Community Services developed a 12-week community-based nutrition information series (NIS) for people aged 55 or older. The purpose of this feasibility study was to describe briefly the process of developing and implementing the 12-week NIS and to identify the practicality and plausibility of the program in terms of its process and content attributes, using Thorncliffe Park community as the test site. A pre- and post-test design was used to identify changes in participants' perception of their nutritional and overall well-being. Twenty-four participants who completed at least four sessions participated in the post-evaluation follow-up. Only participants' perception of their eating habits demonstrated a significant, positive improvement (t24=2.1, P<0.05). The results suggest that the NIS has the potential to promote the health and well-being of community-living seniors. The development and implementation of the NIS provided considerations for program practicality. However, additional work is needed to examine the plausibility of the program in meeting its stated objective to promote awareness of nutrition as an important concept for healthy aging. Community-practising dietitians are instrumental in providing credible nutrition information to facilitate healthy eating in older Canadians.

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…

The Pros and Cons of Getting Engaged in an Online Social Community Embedded Within Digital Cognitive Behavioral Therapy for Insomnia: Survey Among Users.

PubMed

Coulson, Neil S; Smedley, Richard; Bostock, Sophie; Kyle, Simon D; Gollancz, Rosie; Luik, Annemarie I; Hames, Peter; Espie, Colin A

2016-04-25

Sleepio is a proven digital sleep improvement program based on cognitive behavioral therapy techniques. Users have the option to join an online community that includes weekly expert discussions, peer-to-peer discussion forums, and personal message walls. The aim of this study was to conduct an online survey to (1) explore the reasons for deciding to engage with the Sleepio online community, (2) explore the potential benefits arising from engagement with the online community, and (3) identify and describe any problematic issues related to use of the online community. We developed an online survey and posted an invitation to the community discussion forum inviting users to participate. In addition, we sent an email invitation to 970 individuals who had previously or were currently working through the Sleepio program to participate in this study. In total, 100 respondents (70/100, 70% female; mean age 51 years, range 26-82 years) completed the online survey. Most respondents had started Sleepio with chronic sleep problems (59/100, 59% up to 10 years; 35/100, 35% >10 years) and had actively engaged with the online community (85/100, 85%) had made a discussion or wall post). At the time of the survey, respondents had used Sleepio for a median of 12 weeks (range from 3 weeks to 2 years). We analyzed responses to the open-ended questions using thematic analysis. This analysis revealed 5 initial drivers for engagement: (1) the desire to connect with people facing similar issues, (2) seeking personalized advice, (3) curiosity, (4) being invited by other members, and (5) wanting to use all available sleep improvement tools. Advantages of engagement included access to continuous support, a reduced sense of isolation, being part of a nonjudgmental community, personalized advice, positive comparisons with others, encouragement to keep going, and altruism. We found 5 potential disadvantages: design and navigation issues, uncertain quality of user-generated content, negative comparisons with others, excessive time commitments, and data privacy concerns. Participants related their community experiences to engagement with the Sleepio program, with many stating it had supported their efforts to improve their sleep, as well as helping with adherence and commitment to the program. Despite some concerns, members regarded the Sleepio community as a valuable resource. Online communities may be a useful means through which to support long-term engagement with Web-based therapy for insomnia.

The Pros and Cons of Getting Engaged in an Online Social Community Embedded Within Digital Cognitive Behavioral Therapy for Insomnia: Survey Among Users

PubMed Central

Smedley, Richard; Bostock, Sophie; Kyle, Simon D; Gollancz, Rosie; Luik, Annemarie I; Hames, Peter; Espie, Colin A

2016-01-01

Background Sleepio is a proven digital sleep improvement program based on cognitive behavioral therapy techniques. Users have the option to join an online community that includes weekly expert discussions, peer-to-peer discussion forums, and personal message walls. Objective The aim of this study was to conduct an online survey to (1) explore the reasons for deciding to engage with the Sleepio online community, (2) explore the potential benefits arising from engagement with the online community, and (3) identify and describe any problematic issues related to use of the online community. Methods We developed an online survey and posted an invitation to the community discussion forum inviting users to participate. In addition, we sent an email invitation to 970 individuals who had previously or were currently working through the Sleepio program to participate in this study. Results In total, 100 respondents (70/100, 70% female; mean age 51 years, range 26–82 years) completed the online survey. Most respondents had started Sleepio with chronic sleep problems (59/100, 59% up to 10 years; 35/100, 35% >10 years) and had actively engaged with the online community (85/100, 85%) had made a discussion or wall post). At the time of the survey, respondents had used Sleepio for a median of 12 weeks (range from 3 weeks to 2 years). We analyzed responses to the open-ended questions using thematic analysis. This analysis revealed 5 initial drivers for engagement: (1) the desire to connect with people facing similar issues, (2) seeking personalized advice, (3) curiosity, (4) being invited by other members, and (5) wanting to use all available sleep improvement tools. Advantages of engagement included access to continuous support, a reduced sense of isolation, being part of a nonjudgmental community, personalized advice, positive comparisons with others, encouragement to keep going, and altruism. We found 5 potential disadvantages: design and navigation issues, uncertain quality of user-generated content, negative comparisons with others, excessive time commitments, and data privacy concerns. Participants related their community experiences to engagement with the Sleepio program, with many stating it had supported their efforts to improve their sleep, as well as helping with adherence and commitment to the program. Despite some concerns, members regarded the Sleepio community as a valuable resource. Conclusions Online communities may be a useful means through which to support long-term engagement with Web-based therapy for insomnia. PMID:27113540

Efficacy of Wii-Fit on Static and Dynamic Balance in Community Dwelling Older Veterans: A Randomized Controlled Pilot Trial

PubMed Central

Dubbert, Patricia M.

2017-01-01

Background/Objectives. Balance problems are well-established modifiable risk factors for falls, which are common in older adults. The objective of this study was to establish the efficacy of a Wii-Fit interactive video-game-led physical exercise program to improve balance in older Veterans. Methods. A prospective randomized controlled parallel-group trial was conducted at Veterans Affairs Medical Center. Thirty community dwelling Veterans aged 68 (±6.7) years were randomized to either the exercise or control groups. The exercise group performed Wii-Fit program while the control group performed a computer-based cognitive program for 45 minutes, three days per week for 8-weeks. The primary (Berg Balance Scale (BBS)) and secondary outcomes (fear of falling, physical activity enjoyment, and quality of life) were measured at baseline, 4 weeks, and 8 weeks. Results. Of 30 randomized subjects, 27 completed all aspects of the study protocol. There were no study-related adverse events. Intent-to-treat analysis showed a significantly greater improvement in BBS in the exercise group (6.0; 95% CI, 5.1–6.9) compared to the control group (0.5; 95% CI, −0.3–1.3) at 8 weeks (average intergroup difference (95% CI), 5.5 (4.3–6.7), p < 0.001) after adjusting for baseline. Conclusion. This study establishes that the Wii-Fit exercise program is efficacious in improving balance in community dwelling older Veterans. This trial is registered with ClinicalTrials.gov Identifier NCT02190045. PMID:28261500

Local-food-based complementary feeding for the nutritional status of children ages 6–36 months in rural areas of Indonesia

PubMed Central

Syahrul; Sulistyorini, Lantin; Rondhianto; Yudisianto, Alfi

2017-01-01

Purpose This study aimed to evaluate a pilot project of the Nursing Feeding Center “Posyandu Plus” (NFCPP) through local food-based complementary feeding (LFCF) program designed to improve the nutritional status of children aged 6–36 months at community health centers in Indonesia. Methods A quasi-experimental design was used to obtain data regarding the nutritional status of 109 children who participated in the project from 6 rural areas. The NFCPP was conducted for 9 weeks, comprising 2 weeks of preintervention, 6 weeks of intervention, and one week of postintervention. The LFCF intervention consisted of 12 sets of recipes to be made by mothers and given to their children 4 times daily over 6 weeks. The weight-for-age z score (WAZ), height-for-age z score (HAZ), weight-for-height z score (WHZ), and body mass index-for-age z score (BAZ) were calculated using World Health Organization Anthro Plus version 1.0.3. Results LFCF intervention significantly increased WHZ, WAZ, and BAZ scores but decreased HAZ scores (P<0.001). Average scores of WHZ (0.96±0.97) and WAZ (0.45±0.72) increased; BAZ increased (1.12±0.93) after 6 weeks of LFCF. WAZ scores postintervention were 50.5% of normal, and WHZ scores were 77.1% of normal. However, the HAZ score decreased by 0.53±0.52, which indicated 57.8% had short stature. Conclusion The NFCPP program with LFCF intervention can improve the nutritional status of children in rural areas. It should be implemented as a sustained program for better provision of complementary feeding during the period of lactation using local food made available at community health centers. PMID:29158766

Brief Video-Module Administered Mindfulness Program for Physicians: A Pilot Study.

PubMed

Pflugeisen, Bethann Mangel; Drummond, Dike; Ebersole, Drew; Mundell, Kate; Chen, David

2016-01-01

The purpose of this study was to evaluate the feasibility of implementing a video-module-based mindfulness pilot program intended to reduce stress, improve well-being, and develop mindfulness skills in physicians in a community hospital setting. Preliminary findings are presented. Using a single-sample, pre-post study design, we administered an eight-week mindfulness training offered as part of a wellness initiative for medical staff in a suburban community hospital. Participants enrolled on a first-come, first-served basis. Participants engaged in three 90-min in-person trainings, weekly online video-module trainings, and weekly teleconference coaching calls. Video-module trainings were available at all times, to be accessed at the participants׳ convenience. Journals and a guided meditation audio library were also provided. Physician stress, well-being (emotional exhaustion, depersonalization of patients, and sense of personal accomplishment), and mindfulness skills (observing, describing, acting with awareness, and accepting without judgment) were evaluated at baseline, end-of-program, and eight weeks post-intervention using well-validated instruments. A total of 23 physicians enrolled and 19 completed the program. Compared to baseline, statistically significant decreases in stress, personal accomplishment, and emotional exhaustion were observed at end-of-program and eight weeks post-intervention (all P < .05). Significant increases in all mindfulness skills were observed at end-of-program; these increases persisted for describing, acting with awareness, and accepting without judgment at eight weeks post-intervention (all P < .05). This study provides preliminary evidence that a flexible, video-module-based mindfulness program can decrease stress, increase well-being, and develop lasting mindfulness skills in physicians. Copyright © 2016 Elsevier Inc. All rights reserved.

Body-Mind-Spirit Practice for Healthy Aging

ERIC Educational Resources Information Center

Lee, Eun-Kyoung Othelia; Yoon, Hyunsook; Lee, Jungui; Yoon, Jiyoung; Chang, Eunjin

2012-01-01

This community-based, health promotion intervention for seniors provided a comprehensive review of the effect of body-mind-spirit (BMS) interventions on health behaviors. The 12-week curriculum offered sessions on exercise, nutrition, sexuality, leisure, stress management, cognitive behavioral therapy, forgiveness, and happiness. Gerontological…

Efficacy of Nintendo Wii training on mechanical leg muscle function and postural balance in community-dwelling older adults: a randomized controlled trial.

PubMed

Jorgensen, Martin G; Laessoe, Uffe; Hendriksen, Carsten; Nielsen, Ole Bruno Faurholt; Aagaard, Per

2013-07-01

Older adults show increased risk of falling and major risk factors include impaired lower extremity muscle strength and postural balance. However, the potential positive effect of biofeedback-based Nintendo Wii training on muscle strength and postural balance in older adults is unknown. This randomized controlled trial examined postural balance and muscle strength in community-dwelling older adults (75±6 years) pre- and post-10 weeks of biofeedback-based Nintendo Wii training (WII, n = 28) or daily use of ethylene vinyl acetate copolymer insoles (controls [CON], n = 30). Primary end points were maximal muscle strength (maximal voluntary contraction) and center of pressure velocity moment during bilateral static stance. Intention-to-treat analysis with adjustment for age, sex, and baseline level showed that the WII group had higher maximal voluntary contraction strength (18%) than the control group at follow up (between-group difference = 269 N, 95% CI = 122; 416, and p = .001). In contrast, the center of pressure velocity moment did not differ (1%) between WII and CON at follow-up (between-group difference = 0.23 mm(2)/s, 95% CI = -4.1; 4.6, and p = .92). For secondary end points, pre-to-post changes favoring the WII group were evident in the rate of force development (p = .03), Timed Up and Go test (p = .01), short Falls Efficacy Scale-International (p = .03), and 30-second repeated Chair Stand Test (p = .01). Finally, participants rated the Wii training highly motivating at 5 and 10 weeks into the intervention. Biofeedback-based Wii training led to marked improvements in maximal leg muscle strength (maximal voluntary contraction; rate of force development) and overall functional performance in community-dwelling older adults. Unexpectedly, static bilateral postural balance remained unaltered with Wii training. The high level of participant motivation suggests that biofeedback-based Wii exercise may ensure a high degree of compliance to home- and/or community-based training in community-dwelling older adults.

Effects of a 12 week self-managed stretching program among Korean-Chinese female migrant workers in Korea: a randomized trial.

PubMed

Lee, Hyeonkyeong; Chae, Duckhee; Wilbur, JoEllen; Miller, Arlene; Lee, Kyongeun; Jin, Hwaeun

2014-04-01

The purpose of this study was to assess the efficacy of a 12 week, self-managed, community-based stretching program on musculoskeletal fitness, musculoskeletal symptoms, and acculturative stress, in Korean-Chinese female migrant workers in Korea. This was a randomized controlled trial with random assignment of eligible full-time Korean-Chinese female migrant workers to a stretching exercise intervention (n=40) or an enhanced stretching exercise intervention (n=40) condition. Both conditions received a 6 min stretching exercise program that included an orientation and three work-related musculoskeletal disorder (WMSD) educational classes. Between educational classes, the enhanced stretching exercise condition also received mobile phone text messaging and telephone counseling to increase self-efficacy (confidence in overcoming barriers) and provide social support. Flexibility, muscle strength, musculoskeletal symptoms, and acculturative stress were assessed at baseline and 12 weeks. Significant increase in flexibility was noted for both conditions, but acculturative stress was significantly reduced only in the standard intervention condition. Muscle strength and WMSD symptoms had no significant changes at the 12 week follow up in both conditions. The 12 week, self-managed, community-based, stretching exercise program was effective to increase flexibility. The standard stretching intervention without any enhancements may be a more cost-effective way to increase flexibility. Longitudinal studies, however, are needed to see if the long-term effects are greater in the enhanced intervention for the migrant worker population. © 2013 The Authors. Japan Journal of Nursing Science © 2013 Japan Academy of Nursing Science.

Mindfulness meditation for the treatment of chronic low back pain in older adults: A randomized controlled pilot study

PubMed Central

Morone, Natalia E.; Greco, Carol M.; Weiner, Debra K.

2008-01-01

The objectives of this pilot study were to assess the feasibility of recruitment and adherence to an eight-session mindfulness meditation program for community-dwelling older adults with chronic low back pain (CLBP) and to develop initial estimates of treatment effects. It was designed as a randomized, controlled clinical trial. Participants were 37 community-dwelling older adults aged 65 years and older with CLBP of moderate intensity occurring daily or almost every day. Participants were randomized to an 8-week mindfulness-based meditation program or to a wait-list control group. Baseline, 8-week and 3-month follow-up measures of pain, physical function, attention, and quality of life were assessed. Eighty-nine older adults were screened and 37 found to be eligible and randomized within a 6-month period. The mean age of the sample was 74.9 years, 21/37 (57%) of participants were female and 33/37 (89%) were white. At the end of the intervention 30/37 (81%) participants completed 8-week assessments. Average class attendance of the intervention arm was 6.7 out of 8. They meditated an average of 4.3 days a week and the average minutes per day was 31.6. Compared to the control group, the intervention group displayed significant improvement in the Chronic Pain Acceptance Questionnaire Total Score and Activities Engagement subscale (P = .008, P = .004) and SF-36 Physical Function (P = .03). An 8-week mindfulness-based meditation program is feasible for older adults with CLBP. The program may lead to improvement in pain acceptance and physical function. PMID:17544212

Feasibility of an experiential community garden and nutrition programme for youth living in public housing.

PubMed

Grier, Karissa; Hill, Jennie L; Reese, Felicia; Covington, Constance; Bennette, Franchennette; MacAuley, Lorien; Zoellner, Jamie

2015-10-01

Few published community garden studies have focused on low socio-economic youth living in public housing or used a community-based participatory research approach in conjunction with youth-focused community garden programmes. The objective of the present study was to evaluate the feasibility (i.e. demand, acceptability, implementation and limited-effectiveness testing) of a 10-week experiential theory-based gardening and nutrition education programme targeting youth living in public housing. In this mixed-methods feasibility study, demand and acceptability were measured using a combination of pre- and post-programme surveys and interviews. Implementation was measured via field notes and attendance. Limited-effectiveness was measured quantitatively using a pre-post design and repeated-measures ANOVA tests. Two public housing sites in the Dan River Region of south central Virginia, USA. Forty-three youth (primarily African American), twenty-five parents and two site leaders. The positive demand and acceptability findings indicate the high potential of the programme to be used and be suitable for the youth, parents and site leaders. Field notes revealed numerous implementation facilitators and barriers. Youth weekly attendance averaged 4·6 of 10 sessions. Significant improvements (P<0·05) were found for some (e.g. fruit and vegetable asking self-efficacy, overall gardening knowledge, knowledge of MyPlate recommendations), but not all limited-effectiveness measures (e.g. willingness to try fruits and vegetables, fruit and vegetable eating self-efficacy). This community-based participatory research study demonstrates numerous factors that supported and threatened the feasibility of a gardening and nutrition programme targeting youth in public housing. Lessons learned are being used to adapt and strengthen the programme for future efforts targeting fruit and vegetable behaviours.

Current Realities of Delivering Mammography Services in the Community: Do Challenges with Staffing and Scheduling Exist?

PubMed Central

D'Orsi, Carl; Tu, Shin-Ping; Nakano, Connie; Carney, Patricia A.; Abraham, Linn A.; Taplin, Stephen H.; Hendrick, R. Edward; Cutter, Gary R.; Berns, Eric; Barlow, William E.; Elmore, Joann G.

2011-01-01

PURPOSE To evaluate the current (2001–2002) capacity of community-based mammography facilities to deliver screening and diagnostic services in the United States. MATERIALS AND METHODS Institutional review board approvals and patient consent were obtained. A mailed survey was sent to 53 eligible mammography facilities in three states (Washington, New Hampshire, and Colorado). Survey questions assessed equipment and staffing availability, as well as appointment waiting times for screening and diagnostic mammography services. Criterion-related content and construct validity were obtained first by means of a national advisory committee of academic, scientific, and clinical colleagues in mammography that reviewed literature on existing surveys and second by pilot testing a series of draft surveys among community mammography facilities not inclusive of the study facilities. The final survey results were independently double entered into a relational database with programmed data checks. The data were sent encrypted by means of file transfer protocol to a central analytical center at Group Health Cooperative. A two-sided P value with α = .05 was considered to show statistical significance in all analyses. RESULTS Forty-five of 53 eligible mammography facilities (85%) returned the survey. Shortages of radiologists relative to the mammographic volume were found in 44% of mammography facilities overall, with shortages of radiologists higher in not-for-profit versus for-profit facilities (60% vs 28% reported). Shortages of Mammography Quality Standards Act–qualified technologists were reported by 20% of facilities, with 46% reporting some level of difficulty in maintaining qualified technologists. Waiting times for diagnostic mammography ranged from less than 1 week to 4 weeks, with 85% performed within 1 week. Waiting times for screening mammography ranged from less than 1 week to 8 weeks, with 59% performed between 1 week and 4 weeks. Waiting times for both diagnostic and screening services were two to three times higher in high-volume compared with low-volume facilities. CONCLUSION Survey results show shortages of radiologists and certified mammography technologists. PMID:15798153

Teaching geriatric medicine at the Queen's University of Belfast.

PubMed

Stout, R W

1983-01-01

Undergraduate teaching at the Queen's University, Belfast, takes place in the fourth year of a five year curriculum. It lasts three weeks and this is divided into two parts. First, held within the university department, is topic-based teaching including seminars, discussions, case histories and visits. The second phase of two weeks consists of attachment of two to four students to geriatric medical units both in and outside Belfast. The whole of this module is situated within a combined course involving community medicine, general practice, geriatric medicine and mental health lasting 12 weeks and involving one-third of the year of 150 students each time. In addition to the three weeks teaching in geriatrics, joint discussion groups are held.

Ibobbly mobile health intervention for suicide prevention in Australian Indigenous youth: a pilot randomised controlled trial

PubMed Central

Shand, Fiona; Ridani, Rebecca; Mackinnon, Andrew; De La Mata, Nicole; Christensen, Helen

2017-01-01

Objectives Rates of youth suicide in Australian Indigenous communities are 4 times the national youth average and demand innovative interventions. Historical and persistent disadvantage is coupled with multiple barriers to help seeking. Mobile phone applications offer the opportunity to deliver therapeutic interventions directly to individuals in remote communities. The pilot study aimed to evaluate the effectiveness of a self-help mobile app (ibobbly) targeting suicidal ideation, depression, psychological distress and impulsivity among Indigenous youth in remote Australia. Setting Remote and very remote communities in the Kimberley region of North Western Australia. Participants Indigenous Australians aged 18–35 years. Interventions 61 participants were recruited and randomised to receive either an app (ibobbly) which delivered acceptance-based therapy over 6 weeks or were waitlisted for 6 weeks and then received the app for the following 6 weeks. Primary and secondary outcome measures The primary outcome was the Depressive Symptom Inventory—Suicidality Subscale (DSI-SS) to identify the frequency and intensity of suicidal ideation in the previous weeks. Secondary outcomes were the Patient Health Questionnaire 9 (PHQ-9), The Kessler Psychological Distress Scale (K10) and the Barratt Impulsivity Scale (BIS-11). Results Although preintervention and postintervention changes on the (DSI-SS) were significant in the ibobbly arm (t=2.40; df=58.1; p=0.0195), these differences were not significant compared with the waitlist arm (t=1.05; df=57.8; p=0.2962). However, participants in the ibobbly group showed substantial and statistically significant reductions in PHQ-9 and K10 scores compared with waitlist. No differences were observed in impulsivity. Waitlist participants improved after 6 weeks of app use. Conclusions Apps for suicide prevention reduce distress and depression but do not show significant reductions on suicide ideation or impulsivity. A feasible and acceptable means of lowering symptoms for mental health disorders in remote communities is via appropriately designed self-help apps. Trial registration number ACTRN12613000104752. PMID:28132007

Developing a student-led health and wellbeing clinic in an underserved community: collaborative learning, health outcomes and cost savings.

PubMed

Stuhlmiller, Cynthia M; Tolchard, Barry

2015-01-01

The University of New England (UNE), Australia decided to develop innovative placement opportunities for its increasing numbers of nursing students. Extensive community and stakeholder consultation determined that a community centre in rural New South Wales was the welcomed site of the student-led clinic because it fit the goals of the project-to increase access to health care services in an underserved area while providing service learning for students. Supported by a grant from Health Workforce Australia and in partnership with several community organisations, UNE established a student-led clinic in a disadvantaged community using an engaged scholarship approach which joins academic service learning with community based action research. The clinic was managed and run by the students, who were supervised by university staff and worked in collaboration with residents and local health and community services. Local families, many of whom were Indigenous Australians, received increased access to culturally appropriate health services. In the first year, the clinic increased from a one day per week to a three day per week service and offered over 1000 occasions of care and involved 1500 additional community members in health promotion activities. This has led to improved health outcomes for the community and cost savings to the health service estimated to be $430,000. The students learned from members of the community and community members learned from the students, in a collaborative process. Community members benefited from access to drop in help that was self-determined. The model of developing student-led community health and wellbeing clinics in underserved communities not only fulfils the local, State Government, Federal Government and international health reform agenda but it also represents good value for money. It offers free health services in a disadvantaged community, thereby improving overall health and wellbeing. The student-led clinic is an invaluable and sustainable link between students, health care professionals, community based organisations, the university, and the community. The community benefits from the clinic by learning to self-manage health and wellbeing issues. The benefits for students are that they gain practical experience in an interdisciplinary setting and through exposure to a community with unique and severe needs.

Community Engagement to Optimize the Use of Web-Based and Wearable Technology in a Cardiovascular Health and Needs Assessment Study: A Mixed Methods Approach.

PubMed

Yingling, Leah R; Brooks, Alyssa T; Wallen, Gwenyth R; Peters-Lawrence, Marlene; McClurkin, Michael; Cooper-McCann, Rebecca; Wiley, Kenneth L; Mitchell, Valerie; Saygbe, Johnetta N; Johnson, Twanda D; Curry, Rev Kendrick E; Johnson, Allan A; Graham, Avis P; Graham, Lennox A; Powell-Wiley, Tiffany M

2016-04-25

Resource-limited communities in Washington, D.C. have high rates of obesity-related cardiovascular disease in addition to inadequate physical activity (PA) facilities and limited Internet access. Engaging community members in the design and implementation of studies to address these health disparities is essential to the success of community-based PA interventions. The objective of the study was to use qualitative and quantitative methods to evaluate the feasibility and acceptability of PA-monitoring wristbands and Web-based technology by predominantly African American, church-based populations in resource-limited Washington, D.C. neighborhoods. To address cardiovascular health in at-risk populations in Washington, D.C., we joined community leaders to establish a community advisory board, the D.C. Cardiovascular Health and Obesity Collaborative (D.C. CHOC). As their first initiative, the Washington, D.C. Cardiovascular Health and Needs Assessment intends to evaluate cardiovascular health, social determinants of health, and PA-monitoring technologies. At the recommendation of D.C. CHOC members, we conducted a focus group and piloted the proposed PA-monitoring system with community members representing churches that would be targeted by the Cardiovascular Health and Needs Assessment. Participants (n=8) agreed to wear a PA-monitoring wristband for two weeks and to log cardiovascular health factors on a secure Internet account. Wristbands collected accelerometer-based data that participants uploaded to a wireless hub at their church. Participants agreed to return after two weeks to participate in a moderated focus group to share experiences using this technology. Feasibility was measured by Internet account usage, wristband utilization, and objective PA data. Acceptability was evaluated through thematic analysis of verbatim focus group transcripts. Study participants (5 males, 3 females) were African American and age 28-70 years. Participant wristbands recorded data on 10.1±1.6 days. Two participants logged cardiovascular health factors on the website. Focus group transcripts revealed that participants felt positively about incorporating the device into their church-based populations, given improvements were made to device training, hub accessibility, and device feedback. PA-monitoring wristbands for objectively measuring PA appear to be a feasible and acceptable technology in Washington, D.C., resource-limited communities. User preferences include immediate device feedback, hands-on device training, explicit instructions, improved central hub accessibility, and designation of a church member as a trained point-of-contact. When implementing technology-based interventions in resource-limited communities, engaging the targeted community may aid in early identification of issues, suggestions, and preferences. ClinicalTrials.gov NCT01927783; https://clinicaltrials.gov/ct2/show/NCT01927783 (Archived by WebCite at http://www.webcitation.org/6f8wL117u).

Evaluation of Experimental Four-Day Week Class Schedule, January Through April 1974 at Lake City Community College.

ERIC Educational Resources Information Center

Hardman, Clark

Due to the energy disturbance during the fall and winter of 1973-74, Lake City Community College experimented with a 4-days-per-week schedule of classes. a student evaluation of the 4-day week was completed by 58 percent of the full-time students. Fifty-one percent of the total student sample preferred the 4-day week, and 30 percent preferred the…

WV Walks: replication with expanded reach.

PubMed

Reger-Nash, Bill; Bauman, Adrian; Cooper, Linda; Chey, Tien; Simon, Kenneth J; Brann, Maria; Leyden, Kevin M

2008-01-01

WV Walks replicated the Wheeling Walks community-wide campaign methodology to promote physical activity. A social marketing intervention promoted walking among insufficiently active 40- to 65-year-olds throughout the television media market in north-central West Virginia. The intervention included participatory planning, an 8-week mass media-based campaign, and policy and environmental activities. Pre and post random-digit-dial cohort telephone surveys were conducted at baseline and immediately postcampaign in intervention and comparison regions. The campaign resulted in maximal message awareness in north-central WV and demonstrated a significant increase in walking behavior represented by an absolute shift of 12% of the target population from insufficiently active to active (> or = 30 minutes, 5 days per week), versus the comparison community (adjusted odds ratio 1.82, CI: 1.05-3.17). Policy and environmental changes were also evident. This replication study increases our confidence that the initial effects observed in the Wheeling Walks intervention are generalizable to other similar rural communities.

Las mujeres saludables: reaching Latinas for breast, cervical and colorectal cancer prevention and screening.

PubMed

Larkey, Linda

2006-02-01

Community health advisors have effectively promoted breast and cervical cancer prevention and screening among low-income Latina women. Specific elements of such programs, such as enhanced social support, may explain successes. Promotion of colorectal cancer screening has been less studied. Promotoras de Salud (i.e., Latina health advisors) implemented a 12-week program among women recruited from community-based organizations. The program educated 366 Latinas in breast, cervical and colorectal cancer prevention and screening and emphasized social support among class members. Pre- and post-intervention assessments demonstrated significant increases for fruit and vegetable consumption (3.05 to 3.60 servings/day), and physical activity (65.15 to 122.40 minutes/week). Of women previously non-compliant, 39 percent, 31 percent and 4 percent received Pap tests, mammography, and fecal occult blood test (FOBT), respectively. A culturally aligned education program using community health advisors and emphasizing social support among participants may improve prevention and selected screening behaviors, but more intensive interventions may be required for colorectal cancer screening compliance.

Effectiveness of a community-based program for suicide prevention among elders with early-stage dementia: A controlled observational study.

PubMed

Kim, Jong-Pill; Yang, Jinhyang

The purpose of this study was to develop a small-group-focused suicide prevention program for elders with early-stage dementia and to assess its effects. This was a quasi-experimental study with a control group pretest-posttest design. A total of 62 elders diagnosed with early-stage dementia who were receiving care services at nine daycare centers in J City Korea participated in this study. The experimental group participated in the suicide prevention program twice a week for 5 weeks with a pretest and two posttests The developed suicide prevention program had a significant effect on the perceived health status, social support, depression, and suicidal ideation of elders with early-stage dementia. Nurses should integrate risk factors such as depression and protective factors such as health status and social support into a suicide prevention program. This community-based program in geriatric nursing practice can be effective in preventing suicide among elders with early-stage dementia. Copyright © 2016 Elsevier Inc. All rights reserved.

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

PubMed

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

2015-02-01

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

Sing Your Lungs Out—a community singing group for chronic obstructive pulmonary disease: a 1-year pilot study

PubMed Central

McNaughton, Amanda; Weatherall, Mark; Williams, Mathew; McNaughton, Harry; Aldington, Sarah; Williams, Gayle; Beasley, Richard

2017-01-01

Objective Singing group participation may benefit patients with chronic obstructive pulmonary disease (COPD). Previous studies are limited by small numbers of participants and short duration of generally hospital-based singing group intervention. This study examines the feasibility of long-term participation in a community singing group for patients with COPD who had completed pulmonary rehabilitation (PR). Methods This was a feasibility cohort study. Patients with COPD who had completed PR and were enrolled in a weekly community exercise group were recruited to a new community-based singing group which met weekly for over 1 year. Measurements at baseline, 4 months and 1 year comprised comprehensive pulmonary function tests including lung volumes, 6 min walk test (6MWT), Clinical COPD Questionnaire (CCQ), Hospital Anxiety and Depression Scale (HADS) and hospital admission days for acute exacerbation of COPD (AECOPD) for 1 year before and after the first singing group session. Findings There were 28 participants with chronic lung disease recruited from 140 people approached. Five withdrew in the first month. 21 participants meeting Global Initiative for Chronic Obstructive Lung Disease criteria for COPD completed 4-month and 18 completed 1-year assessments. The mean attendance was 85%. For the prespecified primary outcome measure, total HADS score, difference between baseline and 12 months was −0.9, 95% CI −3.0 to 1.2, p=0.37. Of the secondary measures, a significant reduction was observed for HADS anxiety score after 1 year of −0.9 (95% CI −1.8 to −0.1) points, p=0.038 and an increase in the 6MWT at 1 year, of 65 (95% CI 35 to 99) m compared with baseline p<0.001. Conclusions Our findings support the feasibility of long-term participation in a community singing group for adults with COPD who have completed PR and are enrolled in a weekly community exercise group and provide evidence of improved exercise capacity and a reduction in anxiety. Trial registration number ACTRN12615000736549; Results. PMID:28119393

Translating Evidence for Low Back Pain Management into a Consumer-Focussed Resource for Use in Community Pharmacies: A Cluster-Randomised Controlled Trial

PubMed Central

2013-01-01

Background This cluster-randomised controlled trial determined the effectiveness of an evidence-based, pamphlet intervention in improving low back pain (LBP)-related beliefs among pharmacy consumers. Methods Thirty five community pharmacies were randomised to three groups: pamphlet+education intervention [n = 11]; pamphlet only intervention [n = 11]; control: usual care [n = 13]. Eligibility requirements for clusters included: community-based pharmacies and proprietor participation consent. Pharmacy consumers (N = 317) aged 18–65 years currently experiencing LBP participated. Intervention group allocation depended on the pharmacy attended. Individual-level outcomes were measured at pre-intervention (T0), at two (T1) and eight (T2) weeks post-intervention and included beliefs about LBP [Back Pain Beliefs Questionnaire (BBQ); Fear Avoidance Beliefs Questionnaire (FABQ)]. Secondary outcomes included pain severity, activity impairment and pamphlet perceived usefulness. Blinding to group allocation included primary investigators, outcome assessors and the statistician. Pharmacy staff and consumers were un-blinded. Results Of 35 pharmacies recruited (317 consumers), no clusters were lost to follow-up. Follow-up was available for n = 24 at 2 weeks only; n = 38 at 8 weeks only; n = 148 at both time points, with n = 148+24+38 = 210 analysed (107 excluded: no follow up). Adjusting for baseline scores demonstrated no significant differences in beliefs (2 or at 8 weeks) between pamphlet (with or without education) versus control, or between ‘pamphlet with’ versus ‘without’ education. Work-related fear (FABQ) was significantly lower in consumers receiving pamphlet (with or without education) versus control (difference −2.3, 95%CI: −4.4 to −0.2). There was no significant difference between “pamphlet with” versus “pamphlet without” groups. Consumers receiving the “pamphlet with” reported greater perceived usefulness than consumers receiving the “pamphlet without” (difference 0.9 (95%CI: 0.0 to 1.8)). Conclusion Community pharmacies provided a feasible primary care portal for implementing evidence-based information. The associated improvement in work-related LBP-beliefs for consumers receiving the pamphlet suggests this simple intervention may be a useful component of care. Trial Registration ACTR.org.au ACTRN12611000053921 PMID:23977178

A community based prevention of weight gain intervention (Mothers In Motion) among young low-income overweight and obese mothers: design and rationale.

PubMed

Chang, Mei-Wei; Nitzke, Susan; Brown, Roger; Resnicow, Ken

2014-03-25

Over 45% of American women 20-39 years old are at risk for type 2 diabetes, cardiovascular disease, and other health conditions because they are overweight or obese. The prevalence of overweight and obesity is disproportionately high among low-income women. This paper describes the study design and rationale of a community based intervention (Mothers In Motion, MIM) aimed to prevent weight gain among low-income overweight and obese mothers 18-39 years old by promoting stress management, healthy eating, and physical activity. Peer recruiters approach participants from 5 Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Michigan. The MIM delivers theory-based, culturally-sensitive intervention messages via a combination of DVDs and peer support group teleconferences (PSGTs). The DVD features African American and white overweight and obese WIC mothers who participated in a healthy lifestyle intervention patterned after MIM. The PSGTs are led by paraprofessionals from Michigan State University Extension and WIC providers in Michigan who are trained in motivational interviewing and group facilitation skills. Participants are randomly assigned to an intervention (n=350) or comparison group (n=175). The intervention group receives a 16-week intervention on a weekly or bi-weekly basis. Participants are asked to watch 10 MIM DVD chapters at home and join 10 PSGT sessions by phone. The comparison group receives printed educational materials. The primary outcome is body weight. Secondary outcomes include dietary fat, fruit, and vegetable intake; physical activity; stress, and affect. Mediators are self-efficacy, emotional coping response, social support, and autonomous motivation. Telephone interviews and in-person data collection at WIC offices occur at 3 time points: baseline, immediately, and 3 months after the 16-week intervention. If MIM shows effectiveness, it could have a favorable impact on public health and community programs. The DVDs and PSGTs will be disseminated in WIC, Extension, clinical practice that promote healthy lifestyles for similar target audiences to make a broad contribution to the prevention of weight gain in low-income mothers. Also, our methodology can be adapted by researchers and community stakeholders to help other low-income populations prevent weight gain. Clinical Trials Number: NCT01839708.

Leveraging Mobile Technology in a School-Based Participatory Asthma Intervention: Findings from the Student Media-Based Asthma Research Team (SMART) Study

ERIC Educational Resources Information Center

Warren, Christopher M.; Dyer, Ashley; Blumenstock, Jesse; Gupta, Ruchi S.

2016-01-01

Background: Asthma places a heavy burden on Chicago's schoolchildren, particularly in low-income, minority communities. Recently, our group developed a 10-week afterschool program, the Student Asthma Research Team (START), which successfully engaged high school youth in a Photovoice investigation of factors impacting their asthma at school and in…

Comprehensive, Individualized, Person-Centered Management of Community-Residing Persons with Moderate-to-Severe Alzheimer Disease: A Randomized Controlled Trial.

PubMed

Reisberg, Barry; Shao, Yongzhao; Golomb, James; Monteiro, Isabel; Torossian, Carol; Boksay, Istvan; Shulman, Melanie; Heller, Sloane; Zhu, Zhaoyin; Atif, Ayesha; Sidhu, Jaskirat; Vedvyas, Alok; Kenowsky, Sunnie

2017-01-01

The aim was to examine added benefits of a Comprehensive, Individualized, Person-Centered Management (CI-PCM) program to memantine treatment. This was a 28-week, clinician-blinded, randomized, controlled, parallel-group study, with a similar study population, similar eligibility criteria, and a similar design to the memantine pivotal trial of Reisberg et al. [N Engl J Med 2003;348:1333-1341]. Twenty eligible community-residing Alzheimer disease (AD) subject-caregiver dyads were randomized to the CI-PCM program (n = 10) or to usual community care (n = 10). Primary outcomes were the New York University Clinician's Interview-Based Impression of Change Plus Caregiver Input (NYU-CIBIC-Plus), assessed by one clinician set, and an activities of daily living inventory, assessed by a separate clinician set at baseline and at weeks 4, 12, and 28. Primary outcomes showed significant benefits of the CI-PCM program at all post-baseline evaluations. Improvement on the NYU-CIBIC-Plus in the management group at 28 weeks was 2.9 points over the comparator group. The memantine 2003 trial showed an improvement of 0.3 points on this global measure in memantine-treated versus placebo-randomized subjects at 28 weeks. Hence, globally, the management program intervention benefits were 967% greater than memantine treatment alone. These results are approximately 10 times those usually observed with both nonpharmacological and pharmacological treatments and indicate substantial benefits with the management program for advanced AD persons. © 2017 S. Karger AG, Basel.

Effects of lower-cost incentives on stimulant abstinence in methadone maintenance treatment: a National Drug Abuse Treatment Clinical Trials Network study.

PubMed

Peirce, Jessica M; Petry, Nancy M; Stitzer, Maxine L; Blaine, Jack; Kellogg, Scott; Satterfield, Frank; Schwartz, Marion; Krasnansky, Joe; Pencer, Eileen; Silva-Vazquez, Lolita; Kirby, Kimberly C; Royer-Malvestuto, Charlotte; Roll, John M; Cohen, Allan; Copersino, Marc L; Kolodner, Ken; Li, Rui

2006-02-01

Contingency management interventions that provide tangible incentives based on objective indicators of drug abstinence have improved treatment outcomes of substance abusers, but have not been widely implemented in community drug abuse treatment settings. To compare outcomes achieved when a lower-cost prize-based contingency management treatment is added to usual care in community methadone hydrochloride maintenance treatment settings. Random assignment to usual care with (n = 198) or without (n = 190) abstinence incentives during a 12-week trial. Six community-based methadone maintenance drug abuse treatment clinics in locations across the United States. Three hundred eighty-eight stimulant-abusing patients enrolled in methadone maintenance programs for at least 1 month and no more than 3 years. Participants submitting stimulant- and alcohol-negative samples earned draws for a chance to win prizes; the number of draws earned increased with continuous abstinence time. Total number of stimulant- and alcohol-negative samples provided, percentage of stimulant- and alcohol-negative samples provided, longest duration of abstinence, retention, and counseling attendance. Submission of stimulant- and alcohol-negative samples was twice as likely for incentive as for usual care group participants (odds ratio, 1.98; 95% confidence interval, 1.42-2.77). Achieving 4 or more, 8 or more, and 12 weeks of continuous abstinence was approximately 3, 9, and 11 times more likely, respectively, for incentive vs usual care participants. Groups did not differ on study retention or counseling attendance. The average cost of prizes was 120 dollars per participant. An abstinence incentive approach that paid 120 dollars in prizes per participant effectively increased stimulant abstinence in community-based methadone maintenance treatment clinics.

Effects of home-based tele-exercise on sarcopenia among community-dwelling elderly adults: Body composition and functional fitness.

PubMed

Hong, Jeeyoung; Kim, Jeongeun; Kim, Suk Wha; Kong, Hyoun-Joong

2017-01-01

This study aims to develop a form of tele-exercise that would enable real-time interactions between exercise instructors and community-dwelling elderly people and to investigate its effects on improvement of sarcopenia-related factors of body composition and functional fitness among the elderly. Randomized, controlled trial, with a 12-week intervention period. Community-dwelling senior citizens in Gangseo-gu, Seoul, South Korea. The participants were 23 elderly individuals (tele-exercise group: 11, control group: 12), aged 69 to 93years. The tele-exercise program was developed utilizing a 15-in. all-in-one PC and video conferencing software (Skype™), with broadband Internet connectivity. The tele-exercise group performed supervised resistance exercise at home for 20-40min a day three times per week for 12weeks. The remote instructor provided one-on-one instruction to each participant during the intervention. The control group maintained their lifestyles without any special intervention. The sarcopenia-related factors of body composition and functional fitness were examined prior to, as well as following, a 12-week intervention period. The data were analyzed with a two-way repeated measures ANOVA. There were significant improvements in lower limb muscle mass (p=0.017), appendicular lean soft tissue (p=0.032), total muscle mass (p=0.033), and chair sit-and-reach length (p=0.019) for the tele-exercise group compared to the control group. No group×time interaction effects were detected for the 2-min step, chair stand, and time effects (p<0.05). Video conferencing-based supervised resistance exercise had positive effects on sarcopenia-related factors such as total-body skeletal muscle mass, appendicular lean soft tissue, lower limb muscle mass, and the chair sit-and-reach scores among community-dwelling elderly adults. These results imply that tele-exercise can be a new and effective intervention method for increasing skeletal muscle mass and the physical functioning of the lower limbs from the perspective of sarcopenia improvement among the elderly. Copyright © 2016 Elsevier Inc. All rights reserved.

Effects of Parent-Implemented Early Start Denver Model Intervention on Chinese Toddlers with Autism Spectrum Disorder: A Non-Randomized Controlled Trial.

PubMed

Zhou, Bingrui; Xu, Qiong; Li, Huiping; Zhang, Ying; Wang, Yi; Rogers, Sally J; Xu, Xiu

2018-04-01

To evaluate the effects of a 26-week, high-intensity, parent-implemented Early Start Denver Model (P-ESDM) intervention on developmental outcomes, severity of autism spectrum disorder (ASD), and parental stress of ASD toddlers in China. Subjects in P-ESDM group (n = 23) were recruited from 1.5- to 2.5-year-old toddlers who were screened positive in Xuhui and Minhang Districts and were diagnosed with ASD. A community (comparison) group of age-matched toddlers with ASD (n = 20) was recruited from other areas. Subjects of the P-ESDM group attended 1.5-hr parent coaching per week for 26 weeks, and those in the community group received interventions available from communities. Assessments were conducted at baseline (T1) and 26 weeks later (T2). After adjusting for baseline differences between the two groups, P-ESDM group demonstrated greater improvement than the community group in general development, especially in Language domain. Neither group demonstrated significant change in ASD severity, but the P-ESDM group showed greater improvement in social affect, parent-reported social communication and symbolic play than community group did. Finally, parents in P-ESDM group experienced decreased parenting stress while those in community group showed an opposite trend, though the differences did not reach significant association with the P-ESDM intervention. Chinese toddlers with ASD receiving 26 weeks of P-ESDM via regular coaching sessions showed significant greater improvement than those receiving community interventions in multiple aspects of development including social communications. These findings add support to the importance of providing early screening, diagnosis, and immediate referral for evidence-based interventions to improve outcome of young children with ASD. Autism Res 2018, 11: 654-666. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. The development of early screening and diagnosis of autism spectrum disorder (ASD) in China has highlighted the importance of early intervention for young children with ASD. Our current study demonstrated that parent-implemented Early Start Denver Model (P-ESDM) via coaching from professionals improved developmental outcomes, especially in the language domain, and social communicational behaviors of Chinese toddlers with ASD. P-ESDM may help parents in China provide effective early intervention to their children with ASD via improving their skills when they are still at a waiting list for services or lack access to intervention, and has the potential to alleviate their parenting stress. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

Successional colonization of temporary streams: An experimental approach using aquatic insects

NASA Astrophysics Data System (ADS)

Godoy, Bruno Spacek; Queiroz, Luciano Lopes; Lodi, Sara; Nascimento de Jesus, Jhonathan Diego; Oliveira, Leandro Gonçalves

2016-11-01

The metacommunity concept studies the processes that structure communities on local and regional scales. This concept is useful to assess spatial variability. However, temporal patterns (e.g., ecological succession and colonization) are neglected in metacommunity studies, since such patterns require temporally extensive, and hard to execute studies. We used experimental habitats in temporary streams located within the Brazilian Cerrado to evaluate the importance of succession for the aquatic insect metacommunity. Five artificial habitats consisting of wrapped crushed rock were set transversally to the water flow in five streams. The habitats were sampled weekly to assess community composition, and replaced after sampling to identify new potential colonizers. We analyzed the accumulation of new colonizers after each week using a logistic model. We selected pairs of experimental habitats and estimated the Bray-Curtis dissimilarity index to assess the community composition trajectory during the experiment. We used the dissimilarity values in ANOVA tests, identifying the importance of time and space for the community. The number of new taxa stabilized in the third week, and we estimated a weekly increase of 1.61 new taxa in the community after stabilization. The overall pattern was a small change on community composition, but one stream had a higher weekly turnover. Our results showed a relevant influence of time in the initial communities of aquatic insects of temporary streams. However, we must observe the temporal pattern in a spatial context, once different streams have different successional history regarding number of taxa and community turnover. We highlight the importance of aerial dispersal and movement to seek oviposition sites as an important factor in determining colonization patterns.

Home-based walking improves cardiopulmonary function and health-related QOL in community-dwelling adults.

PubMed

Okamoto, N; Nakatani, T; Morita, N; Saeki, K; Kurumatani, N

2007-12-01

The objective of our study was to investigate the effects of a home-based walking program on physical fitness and QOL among community residents. Subjects (n = 200, mean age: 64.2 years, range: 42 - 75 years) who participated in the 32-week trial were randomly allocated to one of two groups: an exercise (E) group and a control (C) group. The E group was instructed to increase the number of steps a day that they walked and to perform aerobic walking at a target heart rate for 20 minutes or more daily, 2 or more days a week. The C group was told to continue their normal level of activity. Outcome measures were the 3-minute shuttle stamina walk test (SSWT), 30-second chair-stand test (CS-30), and SF-36. Increases in SSWT values were significantly greater in the E group than in the C group (men 24.1 m vs. 6.3 m; women 8.8 m vs. 2.4 m), as were increases in CS-30 values (men 5.9 vs. 2.6; women 4.5 vs. - 0.1). On the SF-36, the scores in the E group for vitality and mental health increased significantly. Home-based walking is considered to be an effective and feasible method to improve physical fitness and QOL among community residents.

Benefits of mother goose: influence of a community-based program on parent-child attachment relationships in typical families.

PubMed

Scharfe, Elaine

2011-01-01

An estimated 50 to 60% of children from typical families develop secure attachment relationships with their parents (Ainsworth, Blehar, Waters, & Wall, 1978; Van IJzendoorn & Kroonenberg, 1988); however, intervention research has focused primarily on interventions for high-risk clinical samples (Berlin, Zeanah, & Lieberman, 2008). In this project, the influence of a popular community-based parent-child program was assessed in a non-clinical sample of families. Families participating in a 10-week Parent-Child Mother Goose Program (n.d.) and families on the waitlist for the program were asked to complete questionnaires to assess parenting efficacy and satisfaction as well as parents' perception of their own and their child's attachment styles at the beginning of the program, the end of the program, and six months later. Mothers in the program group reported significantly more positive change in their reports of parenting efficacy over time and also reported significantly more change in their children's attachment category. Specifically, children in the program group were significantly more likely to be classified as secure over time (55% at T1 to 81% at T3) as compared to the waitlist participants (45% at T1 to 62% at T2). In this popular 10-week, community-based program, parents learned skills that continued to influence their relationship with their children six months after the conclusion of the program.

Happy Family Kitchen II: A Cluster Randomized Controlled Trial of a Community-Based Family Intervention for Enhancing Family Communication and Well-being in Hong Kong

PubMed Central

Ho, Henry C. Y.; Mui, Moses; Wan, Alice; Ng, Yin-Lam; Stewart, Sunita M.; Yew, Carol; Lam, Tai Hing; Chan, Sophia S.

2016-01-01

Long working hours and stressful urban lifestyles pose major challenges to family communication and well-being in Hong Kong. A community-based family intervention derived from a positive psychology framework, by using cooking and dining as a platform, was developed for improving family communication and well-being. Social workers and teachers from 31 social service units and schools in collaboration with an academic partner organized and conducted the intervention programs for 2,070 individuals from 973 families in a deprived district in Hong Kong. The participants were randomly assigned into the intervention or control group in a cluster randomized controlled trial (cRCT). The core intervention covered one of five positive psychology themes: joy, gratitude, flow, savoring, and listening. Assessments at pre-intervention, immediate post-intervention, and 4 and 12 weeks post-intervention showed improved family communication and well-being with sustainable effects up to 12 weeks. Positive changes in family happiness and family health were greater in the intervention group than in the control group. The savoring intervention had the most improved outcomes among the five themes. We concluded that this large-scale brief cRCT developed and conducted in real-world settings provided evidence for the feasibility and effectiveness of a community-based family intervention. This study was registered under ClinicalTrials.gov (NCT01796275). PMID:27199864

Translating the Diabetes Prevention Program into practice: a review of community interventions.

PubMed

Jackson, Lindsey

2009-01-01

The purpose of this review is to summarize community interventions based on the National Institutes of Health (NIH) Diabetes Prevention Program (DPP) curriculum and to describe differences in curriculum and its effect on outcome measurements. A keyword search of PubMed and review of citation lists of relevant articles yielded 161 articles. Primary outcomes of interest were achievement of the DPP study goals: 5% to 7% loss of body weight and increased moderate physical activity to at least 150 minutes per week. A secondary outcome of improvement in metabolic syndrome components was also included. Inclusion criteria included application of a DPP-based curriculum to a community setting and publication in English. Seven articles were included in the review. Interventions were conducted across a variety of settings. All showed a significant amount of weight loss immediately following a DPP-based curriculum, varying in length from 6 to 24 weeks. Three held significance by 12 months. Two articles reported on physical activity improvements. Two articles reported improvement in metabolic syndrome components. Although the most effective intervention for type 2 diabetes prevention may not yet be identified, DPP-based interventions show promise for long-term sustainability. The DPP intervention is effective in treating overweight and obesity across a variety of settings and thus may prevent chronic diseases in which overweight and obesity are risk factors. Public health practitioners can use this successful intervention to help individuals lead healthier lives.

Safe sleep practices in a New Zealand community and development of a Sudden Unexpected Death in Infancy (SUDI) risk assessment instrument.

PubMed

Galland, Barbara C; Gray, Andrew; Sayers, Rachel M; Heath, Anne-Louise M; Lawrence, Julie; Taylor, Rachael; Taylor, Barry J

2014-10-13

Interventions to prevent sudden unexpected death in infancy (SUDI) have generally been population wide interventions instituted after case-control studies identified specific childcare practices associated with sudden death. While successful overall, in New Zealand (NZ), the rates are still relatively high by international comparison. This study aims to describe childcare practices related to SUDI prevention messages in a New Zealand community, and to develop and explore the utility of a risk assessment instrument based on international guidelines and evidence. Prospective longitudinal study of 209 infants recruited antenatally. Participant characteristics and infant care data were collected by questionnaire at: baseline (third trimester), and monthly from infant age 3 weeks through 23 weeks. Published meta-analyses data were used to estimate individual risk ratios for 6 important SUDI risk factors which, when combined, yielded a "SUDI risk score". Most infants were at low risk for SUDI with 72% at the lowest or slightly elevated risk (combined risk ratio ≤1.5). There was a high prevalence of the safe practices: supine sleeping (86-89% over 3-19 weeks), mother not smoking (90-92% over 3-19 weeks), and not bed sharing at a young age (87% at 3 weeks). Five independent predictors of a high SUDI risk score were: higher parity (P =0.028), younger age (P =0.030), not working or caring for other children antenatally (P =0.031), higher depression scores antenatally (P =0.036), and lower education (P =0.042). Groups within the community identified as priorities for education about safe sleep practices beyond standard care are mothers who are young, have high parity, low educational levels, and have symptoms of depression antenatally. These findings emphasize the importance of addressing maternal depression as a modifiable risk factor in pregnancy.

Factors associated with differences in quit rates between "specialist" and "community" stop-smoking practitioners in the english stop-smoking services.

PubMed

McDermott, Máirtín S; Beard, Emma; Brose, Leonie S; West, Robert; McEwen, Andy

2013-07-01

Behavioral support improves smokers' chances of quitting, but quit rates are typically lower for smokers supported by "community practitioners" for whom smoking cessation is a small part of their job than for those supported by "specialist practitioners" for whom it is the main role. This article examined the factors that might contribute to this. A total of 573 specialist practitioners and 466 community practitioners completed a 42-item online survey that covered demographic and employment information, current practices, levels of training, and 4-week CO-verified quit rates. Responses were compared for community and specialist practitioners. Mediation analysis was undertaken to assess how far "structural" and "modifiable" variables account for the difference in quit rates. Specialist practitioners reported higher 4-week CO-verified quit rates than community practitioners (63.6% versus 50.4%, p < .001). Practitioners also differed significantly in employment variables, evidence-based practices, and levels of training. Six "modifiable" variables (proportion of clients using an "abrupt" quit model, duration of first session, always advising on medications, number of days training received, number of sessions observed when starting work, and number of sessions having been observed in practice and received feedback) mediated the association between practitioners' role and quit rates over and above the "structural" variables, explaining 14.3%-35.7% of the variance in the total effect. "Specialist" practitioners in the English stop-smoking services report higher success rates than "community" practitioners and this is at least in part attributable to more extensive training and supervision and greater adherence to evidence-based practice including advising on medication usage and promoting abrupt rather than gradual quitting.

Comparison of Microbial Communities in Swine Manure at Various Temperatures and storage times.

PubMed

Lim, Joung-Soo; Yang, Seung Hak; Kim, Bong-Soo; Lee, Eun Young

2018-01-26

This study was designed to investigate the effects of temperature and storage time on the evolution of bacterial communities in swine manure. Manure was stored at -20°C, 4°C, 20°C, or 37°C and sampled at 7-day intervals over 28 days of storage, for a total of 5 time points. To assess the bacterial species present, 16S ribosomal RNA gene sequences were analyzed using pyrosequencing. After normalization, 113,934 sequence reads were obtained, with an average length of 466.6 ± 4.4 bp. The diversity indices of the communities reduced as temperature and storage time increased, and the slopes of rarefaction curves decreased from the second week in samples stored at -20 °C and 4 °C. These results indicate that the richness of the bacterial community in the manure reduced as temperature and storage time increased. Firmicutes were the dominant phylum in all samples examined, ranging from 89.3% to 98.8% of total reads, followed by Actinobacteria, which accounted for 0.6% to 7.9%. A change in community composition was observed in samples stored at 37 °C during the first 7 days, indicating that temperature plays an important role in determining the microbiota of swine manure. Clostridium, Turicibacter, Streptococcus, and Lactobacillus within Firmicutes, and Corynebacterium within Actinobacteria were the most dominant genera in fresh manure and all stored samples. Based on our findings, we propose Clostridium as an indicator genus of swine manure decomposition in an anaerobic environment. The proportions of dominant genera changed in samples stored at 20 °C and 37 °C during the fourth week. Based on these results, it was concluded that the microbial communities of swine manure change rapidly as storage time and temperature increase.

Claim More™: Empowering African American Women to Make Healthy Choices.

PubMed

Tkatch, Rifky; Musich, Shirley; Draklellis, Jennifer; Hetzel, Marla; Banks, Jo; Dugan, Jessica; Thompson, Kaylene; Hawkins, Kevin

2018-03-01

Diabetes is a serious issue for African American women. The purpose of this project was to develop and test the feasibility of a culturally appropriate and faith-based healthy eating program for African American women at risk for developing diabetes. At total of 30 women from two churches completed a 12-week, faith-based program using a community-based approach with lay health educators in the church setting. Participants set healthy eating goals, attended weekly education classes, and received daily text messaging reminders related to their goals. Outcomes included high levels of social support, frequent engagement with the program, and improved healthy eating. This program demonstrated the ability to target African American women at risk for diabetes and engage them in a health-related program.

Scale-out of a community-based behavioral intervention for childhood obesity: pilot implementation evaluation.

PubMed

Heerman, William J; Schludnt, David; Harris, Dawn; Teeters, Leah; Apple, Rachel; Barkin, Shari L

2018-04-13

Expanding the use of evidence-based behavioral interventions in community settings has met with limited success in various health outcomes as fidelity and dose of clinical interventions are often diluted when translated to communities. We conducted a pilot implementation study to examine adoption of the rigorously evaluated Healthier Families Program by Parks and Recreation centers in 3 cities across the country (MI, GA, NV) with diverse socio-cultural environments. Using the RE-AIM framework, we evaluated the program both quantitatively (pre/post surveys of health behavior change; attendance & fidelity) and qualitatively (interviews with Parks and Recreation staff and participants following the program). The 3 partner sites recruited a total of 26 parent-child pairs. Among the 24 participants who completed pre/post surveys, 62.5% were 25-34 years old, and average child age was 3.6 (SD 0.7) years. The distribution of self-reported race/ethnicity was 54% non-Hispanic White, 38% non-Hispanic Black, and 8% Latino. Qualitative interviews with participants demonstrated increased use of the built environment for physical activity and continued use of key strategies for health behavior change. Three of five (60%) collaborating sites proceeded with implementation of the program. The average attendance for the 12-week program was 7.6 (SD 3.9) sessions, with 71% attending > 50% of sessions. Average fidelity for the 12 weekly sessions was 25.2 (SD 1.2; possible range 9-27). All 3 partner sites continued offering the program after grant funding was complete. This pilot is among the first attempts to scale-out an evidence-based childhood obesity intervention in community Parks and Recreation centers. While this pilot was not intended to confirm the efficacy of the original trial on Body Mass Index (BMI) reduction, the effective and sustained behavior change among a geographically and ethnically diverse population with high attendance and fidelity demonstrates an effective approach on which to base future large-scale implementation efforts to reduce childhood obesity in community settings.

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

Measuring spatial and temporal trends of nicotine and alcohol consumption in Australia using wastewater-based epidemiology.

PubMed

Lai, Foon Yin; Gartner, Coral; Hall, Wayne; Carter, Steve; O'Brien, Jake; Tscharke, Benjamin J; Been, Frederic; Gerber, Cobus; White, Jason; Thai, Phong; Bruno, Raimondo; Prichard, Jeremy; Kirkbride, K Paul; Mueller, Jochen F

2018-06-01

Tobacco and alcohol consumption remain priority public health issues world-wide. As participation in population-based surveys has fallen, it is increasingly challenging to estimate accurately the prevalence of alcohol and tobacco use. Wastewater-based epidemiology (WBE) is an alternative approach for estimating substance use at the population level that does not rely upon survey participation. This study examined spatio-temporal patterns in nicotine (a proxy for tobacco) and alcohol consumption in the Australian population via WBE. Daily wastewater samples (n = 164) were collected at 18 selected wastewater treatment plants across Australia, covering approximately 45% of the total population. Nicotine and alcohol metabolites in the samples were measured using liquid chromatography-tandem mass spectrometry. Daily consumption of nicotine and alcohol and its associated uncertainty were computed using Monte Carlo simulations. Nation-wide daily average and weekly consumption of these two substances were extrapolated using ordinary least squares and mixed-effect models. Nicotine and alcohol consumption was observed in all communities. Consumption of these substances in rural towns was three to four times higher than in urban communities. The spatial consumption pattern of these substances was consistent across the monitoring periods in 2014-15. Nicotine metabolites significantly reduced by 14-25% (P = 0.001-0.008) (2014-15) in some catchments. Alcohol consumption remained constant over the studied periods. Strong weekly consumption patterns were observed for alcohol but not nicotine. Nation-wide, the daily average consumption per person (aged 15-79 years) was estimated at approximately 2.5 cigarettes and 1.3-2.0 standard drinks (weekday-weekend) of alcohol. These estimates were close to the sale figure and apparent consumption, respectively. Wastewater-based epidemiology is a feasible method for objectively evaluating the geographic, temporal and weekly profiles of nicotine and alcohol consumption in different communities nationally. © 2018 Society for the Study of Addiction.

The family series workshop: a community-based psychoeducational intervention.

PubMed

Llanque, Sarah M; Enriquez, Maithe; Cheng, An-Lin; Doty, Leilani; Brotto, Marco A; Kelly, Patricia J; Niedens, Michelle; Caserta, Michael S; Savage, Lynette M

2015-09-01

This study describes an evaluation of a community-based psychoeducational intervention, called The Family Series Workshop, for caregivers of community-dwelling persons with Alzheimer's disease or related dementias (ADRD). In a one-group pretest-posttest design, participants (n = 35) attended six weekly sessions. Caregiver stress, coping, and caregiving competence were evaluated along with demographic characteristics of participants. There was a significant improvement found for caregiving competence, and a marginally significant increase in coping with humor. Using regression analysis we also found that coping with humor, along with stress, were significant predictors of caregiving competence. These findings indicate that it is possible to increase caregiving competence utilizing a "grassroots" approach and that it is feasible to hold educational, group discussions on a plethora of challenging caregiving topics. © The Author(s) 2015.

The Family Series Workshop: A Community-Based Psychoeducational Intervention

PubMed Central

Llanque, Sarah M.; Enriquez, Maithe; Cheng, An-Lin; Doty, Leilani; Brotto, Marco A.; Kelly, Patricia J.; Niedens, Michelle; Caserta, Michael S.; Savage, Lynette M.

2015-01-01

This study describes an evaluation of a community-based psychoeducational intervention, called The Family Series Workshop, for caregivers of community-dwelling persons with Alzheimer’s disease or related dementias (ADRD). In a one-group pretest–posttest design, participants (n = 35) attended six weekly sessions. Caregiver stress, coping, and caregiving competence were evaluated along with demographic characteristics of participants. There was a significant improvement found for caregiving competence, and a marginally significant increase in coping with humor. Using regression analysis we also found that coping with humor, along with stress, were significant predictors of caregiving competence. These findings indicate that it is possible to increase caregiving competence utilizing a “grassroots” approach and that it is feasible to hold educational, group discussions on a plethora of challenging caregiving topics. PMID:25609602

Bacterial Communities Associated with Surfaces of Leafy Greens: Shift in Composition and Decrease in Richness over Time

PubMed Central

Lysøe, Erik; Nordskog, Berit; Brurberg, May Bente

2014-01-01

The phyllosphere is colonized by a wide variety of bacteria and fungi; it harbors epiphytes, as well as plant-pathogenic bacteria and even human pathogens. However, little is known about how the bacterial community composition on leafy greens develops over time. The bacterial community of the leafy-green phyllosphere obtained from two plantings of rocket salad (Diplotaxis tenuifolia) and three plantings of lettuce (Lactuca sativa) at two farms in Norway were profiled by an Illumina MiSeq-based approach. We found that the bacterial richness of the L. sativa samples was significantly greater shortly (3 weeks) after planting than at harvest (5 to 7 weeks after planting) for plantings 1 and 3 at both farms. For the second planting, the bacterial diversity remained consistent at the two sites. This suggests that the effect on bacterial colonization of leaves, at least in part must, be seasonally driven rather than driven solely by leaf maturity. The distribution of phyllosphere communities varied between D. tenuifolia and L. sativa at harvest. The variability between these species at the same location suggests that the leaf-dwelling bacteria are not only passive inhabitants but interact with the host, which shapes niches favoring the growth of particular taxa. This work contributes to our understanding of host plant-specific microbial community structures and shows how these communities change throughout plant development. PMID:25527554

A community-wide media campaign to promote walking in a Missouri town.

PubMed

Wray, Ricardo J; Jupka, Keri; Ludwig-Bell, Cathy

2005-10-01

Engaging in moderate physical activity for 30 minutes five or more times per week substantially reduces the risk of coronary heart disease, stroke, colon cancer, diabetes, high blood pressure, and obesity, and walking is an easy and accessible way to achieve this goal. A theory-based mass media campaign promoted walking and local community-sponsored wellness initiatives through four types of media (billboard, newspaper, radio, and poster advertisements) in St Joseph, Mo, over 5 months during the summer of 2003. The Walk Missouri campaign was conducted in four phases: 1) formative research, 2) program design and pretesting, 3) implementation, and 4) impact assessment. Using a postcampaign-only, cross-sectional design, a telephone survey (N = 297) was conducted in St Joseph to assess campaign impact. Study outcomes were pro-walking beliefs and behaviors. One in three survey respondents reported seeing or hearing campaign messages on one or more types of media. Reported exposure to the campaign was significantly associated with two of four pro-walking belief scales (social and pleasure benefits) and with one of three community-sponsored activities (participation in a community-sponsored walk) controlling for demographic, health status, and environmental factors. Exposure was also significantly associated with one of three general walking behaviors (number of days per week walking) when controlling for age and health status but not when beliefs were introduced into the model, consistent with an a priori theoretical mechanism: the mediating effect of pro-walking beliefs on the exposure-walking association. These results suggest that a media campaign can enhance the success of community-based efforts to promote pro-walking beliefs and behaviors.

Effect of Saccharomyces boulardii and Mode of Delivery on the Early Development of the Gut Microbial Community in Preterm Infants.

PubMed

Zeber-Lubecka, Natalia; Kulecka, Maria; Ambrozkiewicz, Filip; Paziewska, Agnieszka; Lechowicz, Milosz; Konopka, Ewa; Majewska, Urszula; Borszewska-Kornacka, Maria; Mikula, Michal; Cukrowska, Bozena; Ostrowski, Jerzy

2016-01-01

Recent advances in culture-independent approaches have enabled insights into the diversity, complexity, and individual variability of gut microbial communities. To examine the effect of oral administration of Saccharomyces (S.) boulardii and mode of delivery on the intestinal microbial community in preterm infants. Stool samples were collected from preterm newborns randomly divided into two groups: a probiotic-receiving group (n = 18) or a placebo group (n = 21). Samples were collected before probiotic intake (day 0), and after 2 and 6 weeks of supplementation. The composition of colonizing bacteria was assessed by 16S ribosomal RNA (rRNA) gene sequencing of fecal samples using the Ion 16S Metagenomics Kit and the Ion Torrent Personal Genome Machine platform. A total of 11932257 reads were generated, and were clustered into 459, 187, and 176 operational taxonomic units at 0 days, 2 weeks, and 6 weeks, respectively. Of the 17 identified phyla, Firmicutes Actinobacteria, Proteobacteria, and Bacteroidetes were universal. The microbial community differed at day 0 compared with at 2 weeks and 6 weeks. There was a tendency for increased bacterial diversity at 2 weeks and 6 weeks compared with day 0, and infants with a gestational age of 31 weeks or higher presented increased bacterial diversity prior to S. boulardii administration. Firmicutes and Proteobacteria remained stable during the observation period, whereas Actinobacteria and Bacteroidetes increased in abundance, the latter particularly more sharply in vaginally delivered infants. While the mode of delivery may influence the development of a microbial community, this study had not enough power to detect statistical differences between cohorts supplemented with probiotics, and in a consequence, to speculate on S. boulardii effect on gut microbiome composition in preterm newborns.

Effect of Saccharomyces boulardii and Mode of Delivery on the Early Development of the Gut Microbial Community in Preterm Infants

PubMed Central

Zeber-Lubecka, Natalia; Kulecka, Maria; Ambrozkiewicz, Filip; Paziewska, Agnieszka; Lechowicz, Milosz; Konopka, Ewa; Majewska, Urszula; Borszewska-Kornacka, Maria; Mikula, Michal; Cukrowska, Bozena; Ostrowski, Jerzy

2016-01-01

Background Recent advances in culture-independent approaches have enabled insights into the diversity, complexity, and individual variability of gut microbial communities. Objectives To examine the effect of oral administration of Saccharomyces (S.) boulardii and mode of delivery on the intestinal microbial community in preterm infants. Study Design Stool samples were collected from preterm newborns randomly divided into two groups: a probiotic-receiving group (n = 18) or a placebo group (n = 21). Samples were collected before probiotic intake (day 0), and after 2 and 6 weeks of supplementation. The composition of colonizing bacteria was assessed by 16S ribosomal RNA (rRNA) gene sequencing of fecal samples using the Ion 16S Metagenomics Kit and the Ion Torrent Personal Genome Machine platform. Results A total of 11932257 reads were generated, and were clustered into 459, 187, and 176 operational taxonomic units at 0 days, 2 weeks, and 6 weeks, respectively. Of the 17 identified phyla, Firmicutes Actinobacteria, Proteobacteria, and Bacteroidetes were universal. The microbial community differed at day 0 compared with at 2 weeks and 6 weeks. There was a tendency for increased bacterial diversity at 2 weeks and 6 weeks compared with day 0, and infants with a gestational age of 31 weeks or higher presented increased bacterial diversity prior to S. boulardii administration. Firmicutes and Proteobacteria remained stable during the observation period, whereas Actinobacteria and Bacteroidetes increased in abundance, the latter particularly more sharply in vaginally delivered infants. Conclusion While the mode of delivery may influence the development of a microbial community, this study had not enough power to detect statistical differences between cohorts supplemented with probiotics, and in a consequence, to speculate on S. boulardii effect on gut microbiome composition in preterm newborns. PMID:26918330

Community-based randomized controlled trial of diabetes prevention study for high-risk individuals of type 2 diabetes: lifestyle intervention using web-based system.

PubMed

Cha, Seon-Ah; Lim, Sun-Young; Kim, Kook-Rye; Lee, Eun-Young; Kang, Borami; Choi, Yoon-Hee; Yoon, Kun-Ho; Ahn, Yu-Bae; Lee, Jin-Hee; Ko, Seung-Hyun

2017-05-05

The trend of increasing numbers of patients with type 2 diabetes emphasizes the need for active screening of high-risk individuals and intensive lifestyle modification (LSM). The community-based Korean Diabetes Prevention Study (C-KDPS) is a randomized controlled clinical trial to prevent type 2 diabetes by intensive LSM using a web-based program. The two public healthcare centers in Korea are involved, and 420 subjects are being recruited for 6 months and will be followed up for 22 months. The participants are allocated randomly to intensive LSM (18 individual sessions for 24 weeks) and usual care (control group). The major goals of the C-KDPS lifestyle intervention program are: 1) a minimum of 5-7% loss of initial body weight in 6 months and maintenance of this weight loss, 2) increased physical activity (≥ 150 min/week of moderate intensity activity), 3) balanced healthy eating, and 4) quitting smoking and alcohol with stress management. The web-based program includes education contents, video files, visit schedules, and inter-communicable keeping track sites. Primary outcomes are the diagnoses of newly developed diabetes. A 75-g oral glucose tolerance test with hemoglobin A1c level determination and cardiovascular risk factor assessment is scheduled at 6, 12, 18, and 22 months. Active screening of high-risk individuals and an effective LSM program are an essential prerequisite for successful diabetes prevention. We hope that our C-KDPS program can reduce the incidence of newly developed type 2 diabetes and be implemented throughout the country, merging community-based public healthcare resources and a web-based system. Clinical Research Information Service (CRIS), Republic of Korea (No. KCT0001981 ). Date of registration; July 28, 2016.

Social networking technologies as an emerging tool for HIV prevention: a cluster randomized trial.

PubMed

Young, Sean D; Cumberland, William G; Lee, Sung-Jae; Jaganath, Devan; Szekeres, Greg; Coates, Thomas

2013-09-03

Social networking technologies are an emerging tool for HIV prevention. To determine whether social networking communities can increase HIV testing among African American and Latino men who have sex with men (MSM). Randomized, controlled trial with concealed allocation. (ClinicalTrials.gov: NCT01701206). Online. 112 MSM based in Los Angeles, more than 85% of whom were African American or Latino. Sixteen peer leaders were randomly assigned to deliver information about HIV or general health to participants via Facebook groups over 12 weeks. After participants accepted a request to join the group, participation was voluntary. Group participation and engagement were monitored. Participants could request a free, home-based HIV testing kit and completed questionnaires at baseline and 12-week follow-up. Participant acceptance of and engagement in the intervention and social network participation, rates of home-based HIV testing, and sexual risk behaviors. Almost 95% of intervention participants and 73% of control participants voluntarily communicated using the social platform. Twenty-five of 57 intervention participants (44%) requested home-based HIV testing kits compared with 11 of 55 control participants (20%) (difference, 24 percentage points [95% CI, 8 to 41 percentage points]). Nine of the 25 intervention participants (36%) who requested the test took it and mailed it back compared with 2 of the 11 control participants (18%) who requested the test. Retention at study follow-up was more than 93%. Only 2 Facebook communities were included for each group. Social networking communities are acceptable and effective tools to increase home-based HIV testing among at-risk populations. National Institute of Mental Health.

Outcomes of Stay Strong, Stay Healthy in community settings.

PubMed

Ball, Stephen; Gammon, Robin; Kelly, Patricia J; Cheng, An-Lin; Chertoff, Keyna; Kaume, Lydia; Abreu, Eduardo L; Brotto, Marco

2013-12-01

Loss of muscle strength, flexibility, and balance are strong predictors of falls in the elderly. The goal of this research was to investigate the effectiveness of a 10-week, strength-based exercise program delivered by Extension professionals. Matched pair t tests were used to compare differences in five measures of fitness collected from 808 participants (mean age = 65.4 years) at the start and finish of the exercise program. Following programming, participants significantly improved strength, flexibility, and balance. Results indicate that an evidence-based program can be translated into a community Extension program that is able to improve the fitness level of seniors.

Are 11 Weeks Weak? A Conversation with Instructors

ERIC Educational Resources Information Center

Sarkaria, Gagan; Schuster, Toni M.

2008-01-01

Undergraduate programs in the United States range from locally funded, two-year community colleges, to state and federally funded universities, as well as private, tuition-based institutions. Assumingly most programs attempt to facilitate a relevant and balanced curriculum that prepares students for the general and perhaps specific obstacles that…

Interventional Audiology to Address Hearing Health Care Disparities: Oyendo Bien Pilot Study

PubMed Central

Marrone, Nicole; Ingram, Maia; Somoza, Maria; Jacob, Daisey Sánchez; Sanchez, Adriana; Adamovich, Stephanie; Harris, Frances P.

2017-01-01

Interventional audiology, specifically community-based outreach, can connect people with the hearing health care system. Community-based participatory research methods were applied in two phases of research to: (1) investigate the needs of families affected by hearing loss in a rural Arizona community on the U.S.–Mexico border; and (2) evaluate an outreach program on hearing health. The needs assessment included interviews with persons with hearing loss and focus groups with family members and the greater community. The needs assessment revealed that despite perceived severity of hearing loss, help-seeking for audiologic care was limited due to barriers, stigma, and low self-efficacy. Results informed development of a community-based pilot study conducted as part of an academic-community partnership between audiology, public health, and community health workers of a federally qualified health center. An outreach program, Oyendo Bien (hearing wellness), a 5-week, Spanish-language health education program for older adults (n = 21) incorporated communication strategies and behavioral change techniques. Postprogram focus groups revealed increased self-efficacy and decreased stigma. After 1 year, 7 of 9 participants with hearing loss contacted for follow-up had sought some form of hearing-related health care. Future research should further investigate interventional audiology approaches to address health disparities. PMID:28522894

Evaluating a community-based exercise intervention with adults living with HIV: protocol for an interrupted time series study.

PubMed

O'Brien, Kelly K; Bayoumi, Ahmed M; Solomon, Patricia; Tang, Ada; Murzin, Kate; Chan Carusone, Soo; Zobeiry, Mehdi; Nayar, Ayesha; Davis, Aileen M

2016-10-20

Our aim was to evaluate a community-based exercise (CBE) intervention with the goal of reducing disability and enhancing health for community-dwelling people living with HIV (PLWH). We will use a mixed-methods implementation science study design, including a prospective longitudinal interrupted time series study, to evaluate a CBE intervention with PLWH in Toronto, Canada. We will recruit PLWH who consider themselves medically stable and safe to participate in exercise. In the baseline phase (0-8 months), participants will be monitored bimonthly. In the intervention phase (8-14 months), participants will take part in a 24-week CBE intervention that includes aerobic, resistance, balance and flexibility exercise at the YMCA 3 times per week, with weekly supervision by a fitness instructor, and monthly educational sessions. In the follow-up phase (14-22 months), participants will be encouraged to continue to engage in unsupervised exercise 3 times per week. Quantitative assessment: We will assess cardiopulmonary fitness, strength, weight, body composition and flexibility outcomes followed by the administration of self-reported questionnaires to assess disability and contextual factor outcomes (coping, mastery, stigma, social support) bimonthly. We will use time series regression analysis to determine the level and trend of outcomes across each phase in relation to the intervention. Qualitative assessment: We will conduct a series of face-to-face interviews with a subsample of participants and recreation providers at initiation, midpoint and completion of the 24-week CBE intervention. We will explore experiences and anticipated benefits with exercise, perceived impact of CBE for PLWH and the strengths and challenges of implementing a CBE intervention. Interviews will be audio recorded and analysed thematically. Protocol approved by the University of Toronto HIV/AIDS Research Ethics Board. Knowledge translation will occur with stakeholders in the form of presentations and publications in open access peer-reviewed journals. NCT02794415; Pre-results. 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/.

Effect of thiram and of a hydrocarbon mixture on freshwater macroinvertebrate communities in outdoor stream and pond mesocosms: I. Study design, chemicals fate and structural responses.

PubMed

Bayona, Yannick; Roucaute, Marc; Cailleaud, Kevin; Lagadic, Laurent; Bassères, Anne; Caquet, Thierry

2015-11-01

Higher-tier ecological risk assessment (ERA) in mesocosms is commonly performed in lotic or lentic experimental systems. These systems differ in their physico-chemical and hydrological properties, leading to differences in chemical fate, community characteristics and potential recovery. This raises the issue of the relevance and sensitivity of community-level endpoints in different types of mesocosms. In this study, macroinvertebrate abundance and biomass estimates were used to assess the effects of a dithiocarbamate fungicide, thiram (35 and 170 µg l(-1)), and a petroleum middle distillate (PMD; 0.01, 0.4, 2 and 20 mg l(-1)) in outdoor stream and pond mesocosms. Streams were continuously treated during 3 weeks followed by a 2-month long post-treatment period. Ponds were treated weekly for 4 weeks, followed by a 10-month long post-treatment period. Taxonomic structure of macroinvertebrate communities was characterized using the α, β and γ components of taxa richness, Shannon and Gini-Simpson indices. Computations were based either on abundance or biomass data. Results clearly highlighted that the effects of chemicals depended on the exposure regime (for thiram) and type of system (for the PMD). Causes of the differences between streams and ponds in the magnitude and nature of effects include differential sensitivity of taxa dwelling in lentic and lotic systems and the influence of hydrology (e.g., drift from upstream) and mesocosm connectivity on recovery dynamics. This study also showed complementarities in the use of both types of mesocosms to improve the characterization of chemical effects on communities in ERA.

Evaluating the effectiveness of a home-based exercise programme delivered through a tablet computer for preventing falls in older community-dwelling people over 2 years: study protocol for the Standing Tall randomised controlled trial

PubMed Central

Delbaere, K; Valenzuela, T; Woodbury, A; Davies, T; Yeong, J; Steffens, D; Miles, L; Pickett, L; Zijlstra, G A R; Clemson, L; Close, J C T; Howard, K; Lord, S R

2015-01-01

Introduction In order to prevent falls, older people should exercise for at least 2 h per week for 6 months, with a strong focus on balance exercises. This article describes the design of a randomised controlled trial to evaluate the effectiveness of a home-based exercise programme delivered through a tablet computer to prevent falls in older people. Methods and analysis Participants aged 70 years or older, living in the community in Sydney will be recruited and randomly allocated to an intervention or control group. The intervention consists of a tailored, home-based balance training delivered through a tablet computer. Intervention participants will be asked to complete 2 h of exercises per week for 2 years. Both groups will receive an education programme focused on health-related information relevant to older adults, delivered through the tablet computer via weekly fact sheets. Primary outcome measures include number of fallers and falls rate recorded in weekly fall diaries at 12 months. A sample size of 500 will be necessary to see an effect on falls rate. Secondary outcome measures include concern about falling, depressive symptoms, health-related quality of life and physical activity levels (in all 500 participants); and physiological fall risk, balance, functional mobility, gait, stepping and cognitive performance (in a subsample of 200 participants). Adherence, acceptability, usability and enjoyment will be recorded in intervention group participants over 2 years. Data will be analysed using the intention-to-treat principle. Secondary analyses are planned in people with greater adherence. Economic analyses will be assessed from a health and community care provider perspective. Ethics and dissemination Ethical approval was obtained from UNSW Ethics Committee in December 2014 (ref number HC#14/266). Outcomes will be disseminated through publication in peer-reviewed journals and presentations at international conferences. Trial registration number Australian New Zealand Clinical Trials Registry (ACTRN)12615000138583. PMID:26493461

Evaluating the effectiveness of a home-based exercise programme delivered through a tablet computer for preventing falls in older community-dwelling people over 2 years: study protocol for the Standing Tall randomised controlled trial.

PubMed

Delbaere, K; Valenzuela, T; Woodbury, A; Davies, T; Yeong, J; Steffens, D; Miles, L; Pickett, L; Zijlstra, G A R; Clemson, L; Close, J C T; Howard, K; Lord, S R

2015-10-22

In order to prevent falls, older people should exercise for at least 2 h per week for 6 months, with a strong focus on balance exercises. This article describes the design of a randomised controlled trial to evaluate the effectiveness of a home-based exercise programme delivered through a tablet computer to prevent falls in older people. Participants aged 70 years or older, living in the community in Sydney will be recruited and randomly allocated to an intervention or control group. The intervention consists of a tailored, home-based balance training delivered through a tablet computer. Intervention participants will be asked to complete 2 h of exercises per week for 2 years. Both groups will receive an education programme focused on health-related information relevant to older adults, delivered through the tablet computer via weekly fact sheets. Primary outcome measures include number of fallers and falls rate recorded in weekly fall diaries at 12 months. A sample size of 500 will be necessary to see an effect on falls rate. Secondary outcome measures include concern about falling, depressive symptoms, health-related quality of life and physical activity levels (in all 500 participants); and physiological fall risk, balance, functional mobility, gait, stepping and cognitive performance (in a subsample of 200 participants). Adherence, acceptability, usability and enjoyment will be recorded in intervention group participants over 2 years. Data will be analysed using the intention-to-treat principle. Secondary analyses are planned in people with greater adherence. Economic analyses will be assessed from a health and community care provider perspective. Ethical approval was obtained from UNSW Ethics Committee in December 2014 (ref number HC#14/266). Outcomes will be disseminated through publication in peer-reviewed journals and presentations at international conferences. Australian New Zealand Clinical Trials Registry (ACTRN)12615000138583. 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/

Dance-based therapy in a program of all-inclusive care for the elderly: an integrative approach to decrease fall risk.

PubMed

Krampe, Jean; Rantz, Marilyn J; Dowell, Laura; Schamp, Richard; Skubic, Marjorie; Abbott, Carmen

2010-01-01

Loss of balance and diminished gait are major fall risk factors in older persons. Literature suggests that physical activity based on dance may improve balance and gait. The aim of this pilot study was to determine whether dance-based therapy affects the balance/gait of community-based frail seniors. The Roy Adaptation Model and Environmental Press Theory were used as joint frameworks. Eleven participants were recruited from a Program of All-inclusive Care for the Elderly (PACE). Inclusion criteria were (1) Mini-Mental State Examination score of 23 or more, (2) attending PACE on Monday, Wednesday, and Friday, and (3) able to stand with or without assistance. A Lebed Method dance intervention was conducted using a longitudinal design 3 times a week for 6 weeks. Functional Reach and Timed Get Up and Go were measured at baseline, 6 weeks after the start of the intervention, and 6 weeks postintervention and repeated to estimate the persistence of the effect. Graphs were compared looking for functional trends; postintervention interviews were conducted with each subject. Dance therapy results in positive functional trends, suggesting that further study using dance-based therapy will be useful to decrease fall risks in older persons.

Sensitivity of a computer adaptive assessment for measuring functional mobility changes in children enrolled in a community fitness programme.

PubMed

Haley, Stephen M; Fragala-Pinkham, Maria; Ni, Pengsheng

2006-07-01

To examine the relative sensitivity to detect functional mobility changes with a full-length parent questionnaire compared with a computerized adaptive testing version of the questionnaire after a 16-week group fitness programme. Prospective, pre- and posttest study with a 16-week group fitness intervention. Three community-based fitness centres. Convenience sample of children (n = 28) with physical or developmental disabilities. A 16-week group exercise programme held twice a week in a community setting. A full-length (161 items) paper version of a mobility parent questionnaire based on the Pediatric Evaluation of Disability Inventory, but expanded to include expected skills of children up to 15 years old was compared with a 15-item computer adaptive testing version. Both measures were administered at pre- and posttest intervals. Both the full-length Pediatric Evaluation of Disability Inventory and the 15-item computer adaptive testing version detected significant changes between pre- and posttest scores, had large effect sizes, and standardized response means, with a modest decrease in the computer adaptive test as compared with the 161-item paper version. Correlations between the computer adaptive and paper formats across pre- and posttest scores ranged from r = 0.76 to 0.86. Both functional mobility test versions were able to detect positive functional changes at the end of the intervention period. Greater variability in score estimates was generated by the computerized adaptive testing version, which led to a relative reduction in sensitivity as defined by the standardized response mean. Extreme scores were generally more difficult for the computer adaptive format to estimate with as much accuracy as scores in the mid-range of the scale. However, the reduction in accuracy and sensitivity, which did not influence the group effect results in this study, is counterbalanced by the large reduction in testing burden.

Effects of interactive video-game based system exercise on the balance of the elderly.

PubMed

Lai, Chien-Hung; Peng, Chih-Wei; Chen, Yu-Luen; Huang, Ching-Ping; Hsiao, Yu-Ling; Chen, Shih-Ching

2013-04-01

This study evaluated the effects of interactive video-game based (IVGB) training on the balance of older adults. The participants of the study included 30 community-living persons over the age of 65. The participants were divided into 2 groups. Group A underwent IVGB training for 6 weeks and received no intervention in the following 6 weeks. Group B received no intervention during the first 6 weeks and then participated in training in the following 6 weeks. After IVGB intervention, both groups showed improved balance based on the results from the following tests: the Berg Balance Scale (BBS), Modified Falls Efficacy Scale (MFES), Timed Up and Go (TUG) test, and the Sway Velocity (SV) test (assessing bipedal stance center pressure with eyes open and closed). Results from the Sway Area (SA) test (assessing bipedal stance center pressure with eyes open and closed) revealed a significant improvement in Group B after IVGB training. Group A retained some training effects after 6 weeks without IVGB intervention. Additionally, a moderate association emerged between the Xavix measured step system stepping tests and BBS, MFES, Unipedal Stance test, and TUG test measurements. In conclusion, IVGB training improves balance after 6 weeks of implementation, and the beneficial effects partially remain after training is complete. Further investigation is required to determine if this training is superior to traditional physical therapy. Copyright © 2012 Elsevier B.V. All rights reserved.

Community-Level and Phenological Responses of Emerging Aquatic Insects Exposed To Three Neonicotinoid Insecticides: An In Situ Wetland Limnocorral Approach.

PubMed

Cavallaro, Michael C; Liber, Karsten; Headley, John V; Peru, Kerry M; Morrissey, Christy A

2018-06-07

Seasonal aquatic insect emergence represents a critical subsidy link between aquatic and terrestrial ecosystems. Early and late instar larvae developing in wetlands near neonicotinoid-treated cropland are at risk of chronic insecticide exposure. An in situ wetland limnocorral experiment compared emergent insect community responses to imidacloprid, clothianidin, and thiamethoxam. Over 15 weeks, 21 limnocorrals were dosed weekly for 9 weeks to target peak nominal doses of 0.0, 0.05 or 0.5 µg/L, followed by a 6-week recovery period. Thirty-nine aquatic insect taxa were recorded but 11 taxa groups made up 97% of the community composition. Principal response curves indicated that during the dosing period, community composition among the treatments resembled the controls. During the 6-week recovery period, significant deviance was observed in the high imidacloprid treatment with similar trends in the clothianidin treatment, suggesting that community effects from neonicotinoid exposure can be delayed. Non-biting midges (Diptera: Chironomidae) and damselflies (Odonata: Zygoptera) also emerged 18 to 25 days earlier in the imidacloprid and clothianidin neonicotinoid treatments, relative to controls. These data suggest that phenology and subtle community effects can occur at measured neonicotinoid concentrations of 0.045 µg/L (imidacloprid) and 0.038 µg/L (clothianidin) under chronic repeated exposure conditions. Synchronization and community dynamics are critical to aquatic insects and consumers; thus, neonicotinoids may have broad implications for wetland ecosystem function. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Preliminary evaluation of the effect of a dynamic preferential runway system upon community noise disturbance

NASA Technical Reports Server (NTRS)

Patterson, H. P.; Edmiston, R. P.; Connor, W. K.

1972-01-01

A dynamic preferential runway system (DPRS) was developed for John F. Kennedy International Airport for the purpose of controlling short term noise exposure in the neighboring communities. The DPRS is a computer-aided procedure for optimum selection of runways from the standpoint of noise and is based upon a community disturbance model which takes into account flyover levels, size of exposed populations, time of day and week, and persistence of overflights. A preliminary evaluation of the DPRS is presented on the basis of social survey data and telephone complaint records, for the trial period of August and September, 1971. Comparative use is made of data taken in a previous survey of the same community areas in 1969.

Nuevo Amanecer: results of a randomized controlled trial of a community-based, peer-delivered stress management intervention to improve quality of life in Latinas with breast cancer.

PubMed

Nápoles, Anna María; Ortíz, Carmen; Santoyo-Olsson, Jasmine; Stewart, Anita L; Gregorich, Steven; Lee, Howard E; Durón, Ysabel; McGuire, Peggy; Luce, Judith

2015-07-01

We evaluated a community-based, translational stress management program to improve health-related quality of life in Spanish-speaking Latinas with breast cancer. We adapted a cognitive-behavioral stress management program integrating evidence-based and community best practices to address the needs of Latinas with breast cancer. Spanish-speaking Latinas with breast cancer were randomly assigned to an intervention or usual-care control group. Trained peers delivered the 8-week intervention between February 2011 and February 2014. Primary outcomes were breast cancer-specific quality of life and distress, and general symptoms of distress. Of 151 participants, 95% were retained at 6 months (between May 2011 and May 2014). Improvements in quality of life from baseline to 6 months were greater for the intervention than the control group on physical well-being, emotional well-being, breast cancer concerns, and overall quality of life. Decreases from baseline to 6 months were greater for the intervention group on depression and somatization. Results suggest that translation of evidence-based programs can reduce psychosocial health disparities in Latinas with breast cancer. Integration of this program into community-based organizations enhances its dissemination potential.

Does Self-Assessment Improve the Effectiveness of Grand Rounds Lectures in a Community-Based Teaching Hospital?

PubMed

Winton, Lisa M; Ferguson, Elizabeth M N; Hsu, Chiu-Hsieh; Agee, Neal; Eubanks, Ryan D; O'Neill, Patrick J; Goldberg, Ross F; Kopelman, Tammy R; Nodora, Jesse N; Caruso, Daniel M; Komenaka, Ian K

To determine whether use of self-assessment (SA) questions affects the effectiveness of weekly didactic grand rounds presentations. From 26 consecutive grand rounds presentations from August 2013 to April 2014, a 52-question multiple-choice test was administered based on 2 questions from each presentation. Community teaching institution. General surgery residents, students, and attending physicians. The test was administered to 66 participants. The mean score was 41.8%. There was no difference in test score based on experience with similar scores for junior residents, senior residents, and attending surgeons (43%, 46%, and 44%; p = 0.13). Most participants felt they would be most interested in presentations directly related to their surgical specialty. Participants, however, did not score differently on topics which were the focus of the program (40% vs. 42%; p = 0.85). Journal club presentations (39% vs. others 42%; p = 0.33) also did not affect the score. The Pearson correlation coefficient for attendance was 0.49 (p < 0.0001) demonstrated that attendance was very important. Participation in the weekly SA was significantly associated with improved score as those who participated in SA scored over 20% higher than those who did not (59% vs. 38%; p < 0.0001). Based on multiple linear regression for mean score, SA explained the variation in score more than attendance. The current study found that without preparation approximately 40% of material presented is retained after 10 months. Participation in weekly SA significantly improved retention of information from grand rounds presentations. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

High-Risk Sexual Behavior at Social Venues in Madagascar

PubMed Central

KHAN, MARIA R.; RASOLOFOMANANA, JUSTIN R.; McCLAMROCH, KRISTI J.; RALISIMALALA, ANDRIAMAMPIANINA; ZAFIMANJAKA, MAURICE G.; BEHETS, FRIEDA; WEIR, SHARON S.

2018-01-01

Background Persistent high levels of sexually transmitted infection (STI) in Madagascar indicate current prevention strategies are inadequate. STI/HIV prevention based in social venues may play an important role in reaching individuals at risk of infection. We identified venues where people meet sexual partners and measured the need and potential for venue-based prevention. Methods Interviews were conducted in 7 Madagascar towns with 1) community informants to identify social venues, 2) individuals socializing at a sample of venues to assess sexual behavior among venue patrons, and 3) venue representatives to assess the potential for venue-based intervention. Results Community informants identified numerous venues (range: 67–211 venues, depending on the town); streets, bars, and hotels were most commonly reported. Among 2982 individuals socializing at venues, 78% of men and 74% of women reported new sexual partnership or sex trade for money, goods, or services in the past 4 weeks and 19% of men and 18% of women reported symptoms suggestive of STI in the past 4 weeks. STI symptom levels were disproportionately high among respondents reporting either sex trade or new sexual partnership in the past 4 weeks. Twenty-eight percent of men and 41% of women reported condom use during the last sex act with a new partner. Although 24% to 45% of venues had hosted STI/HIV interventions, interventions were deemed possible at 73% to 90% venues according to 644 interviews with venue representatives. Conclusions Venue-based intervention is possible and would reach a spectrum of populations vulnerable to STI/HIV including sex workers, their clients, and other high-risk populations. PMID:18496471

Bringing the Community to Campus: An Oral History of Women's Week at Ball State University

ERIC Educational Resources Information Center

Jarrett, Courtney

2012-01-01

This dissertation examined the annual Women's Week events hosted by Ball State's Women's and Gender Studies Program. It served to paint a historical picture of how the local Muncie community has been linked with the academic community at Ball State through events about women's issues. The program began when a group of people wanting to broaden the…

Does exposure to opioid substitution treatment in prison reduce the risk of death after release? A national prospective observational study in England.

PubMed

Marsden, John; Stillwell, Garry; Jones, Hayley; Cooper, Alisha; Eastwood, Brian; Farrell, Michael; Lowden, Tim; Maddalena, Nino; Metcalfe, Chris; Shaw, Jenny; Hickman, Matthew

2017-08-01

People with opioid use disorder (OUD) in prison face an acute risk of death after release. We estimated whether prison-based opioid substitution treatment (OST) reduces this risk. Prospective observational cohort study using prison health care, national community drug misuse treatment and deaths registers. Recruitment at 39 adult prisons in England (32 male; seven female) accounting for 95% of OST treatment in England during study planning. Adult prisoners diagnosed with OUD (recruited: September 2010-August 2013; first release: September 2010; last release: October 2014; follow-up to February 2016; n = 15 141 in the risk set). At release, participants were classified as OST exposed (n = 8645) or OST unexposed (n = 6496). The OST unexposed group did not receive OST, or had been withdrawn, or had a low dose. Primary outcome: all-cause mortality (ACM) in the first 4 weeks. drug-related poisoning (DRP) deaths in the first 4 weeks; ACM and DRP mortality after 4 weeks to 1 year; admission to community drug misuse treatment in the first 4 weeks. Unadjusted and adjusted Cox regression models (covariates: sex, age, drug injecting, problem alcohol use, use of benzodiazepines, cocaine, prison transfer and admission to community treatment), tested difference in mortality rates and community treatment uptake. During the first 4 weeks after prison release there were 24 ACM deaths: six in the OST exposed group and 18 in the OST unexposed group [mortality rate 0.93 per 100 person-years (py) versus 3.67 per 100 py; hazard ratio (HR) = 0.25; 95% confidence interval (CI) = 0.10-0.64]. There were 18 DRP deaths: OST exposed group mortality rate 0.47 per 100 py versus 3.06 per 100 py in the OST unexposed group (HR = 0.15; 95% CI = 0.04-0.53). There was no group difference in mortality risk after the first month. The OST exposed group was more likely to enter drug misuse treatment in the first month post-release (odds ratio 2.47, 95% CI = 2.31-2.65). The OST mortality protective effect on ACM and DRP mortality risk was not attenuated by demographic, overdose risk factors, prison transfer or community treatment (fully adjusted HR = 0.25; 95% CI = 0.09-0.64 and HR = 0.15; 95% CI = 0.04-0.52, respectively). In an English national study, prison-based opioid substitution therapy was associated with a 75% reduction in all-cause mortality and an 85% reduction in fatal drug-related poisoning in the first month after release. © 2017 Society for the Study of Addiction.

Use of an Internet-based community surveillance network to predict seasonal communicable disease morbidity.

PubMed

Hammond, Lucinda; Papadopoulos, Spyridon; Johnson, Candice F; MaWhinney, Samantha; Nelson, Bernard; Todd, James K

2002-03-01

We designed an Internet-based surveillance network that linked community clinic diagnoses with viral isolation rates and admission patterns at a related children's hospital. We hypothesized that community surveillance would successfully predict subsequent hospital admissions and laboratory viral isolations. Secondarily, we expected the network to monitor trends in disease and that posting this information on a Web site would be useful to physicians in daily practice. Data were collected from December 1999 through August 2000. Information was summarized and posted weekly on a Web site. Active public piloting of the site took place during August 2000, after which the project was evaluated through an electronic mail survey. The predictive ability of the community surveillance data was evaluated by multivariate linear regression. Increases in the community diagnosis of most syndromes under surveillance, including lower respiratory infections (adjusted R(2) = 0.7086) and gastroenteritis (adjusted R(2) = 0.6532) successfully predicted an increase in subsequent hospital admissions. Community surveillance also successfully predicted laboratory isolation of associated viral organisms. Physicians completing the evaluation (N = 11) indicated that the site provided information useful in daily practice for both physician and parent education. An Internet-based surveillance network linking a hospital with community physicians is beneficial to the hospital in predicting waves of severe cases requiring admission and reciprocally provides useful information to physicians in daily practice regarding the incidence and cause of seasonal disease in the community.

Use of 16S rRNA sequencing and quantitative PCR to correlate venous leg ulcer bacterial bioburden dynamics with wound expansion, antibiotic therapy, and healing

PubMed Central

Sprockett, Daniel D.; Ammons, Christine G.; Tuttle, Marie S.

2016-01-01

Clinical diagnosis of infection in chronic wounds is currently limited to subjective clinical signs and culture-based methods that underestimate the complexity of wound microbial bioburden as revealed by DNA-based microbial identification methods. Here, we use 16S rRNA next generation sequencing and quantitative polymerase chain reaction to characterize weekly changes in bacterial load, community structure, and diversity associated with a chronic venous leg ulcer over the 15-week course of treatment and healing. Our DNA-based methods and detailed sampling scheme reveal that the bacterial bioburden of the wound is unexpectedly dynamic, including changes in the bacterial load and community structure that correlate with wound expansion, antibiotic therapy, and healing. We demonstrate that these multidimensional changes in bacterial bioburden can be summarized using swabs taken prior to debridement, and therefore, can be more easily collected serially than debridement or biopsy samples. Overall, this case illustrates the importance of detailed clinical indicators and longitudinal sampling to determine the pathogenic significance of chronic wound microbial dynamics and guide best use of antimicrobials for improvement of healing outcomes. PMID:25902876

Translating effective web-based self-help for problem drinking into the real world.

PubMed

Riper, Heleen; Kramer, Jeannet; Conijn, Barbara; Smit, Filip; Schippers, Gerard; Cuijpers, Pim

2009-08-01

Drinking Less (DL) is a 24/7 free-access anonymous interactive web-based self-help intervention without therapeutic guidance for adult problem drinkers in the community. In a randomized controlled trial (referred to here as DL-RCT), DL has been shown effective in reducing risky alcohol consumption. To assess whether the findings of DL-RCT are generalizable to a naturalistic setting (DL-RW) in terms of ability to reach the target group and alcohol treatment response. Pretest-posttest study with 6-month follow-up. An online survey was conducted of 378 of the 1,625 people who used DL-RW from May to November 2007. Primary outcome measures were (1) problem drinking, defined as alcohol consumption in the previous 4 weeks averaging >21 or >14 standard units (male/female) per week or >or=6 or >or=4 units (m/f) on 1 or more days per week; and (2) mean weekly alcohol consumption. DL-RW and DL-RCT data were compared and pooled. Intention-to-treat (ITT) analysis was performed to analyze and compare changes in drinking from baseline to follow-up. In the DL-RW group, 18.8% (n = 71) were drinking successfully within the limits of the Dutch guideline for low-risk drinking (p < 0.001) 6 months after baseline (ITT). The DL-RW group also decreased its mean weekly alcohol intake by 7.4 units, t(377) = 6.67, p < 0.001, d = 0.29. Drinking reduction in DL-RW was of a similar magnitude to that in the DL-RCT condition in terms of drinking within the guideline [chi(2)(1) = 1.83, CI: 0.82-3.00, p = 0.18, RD = 0.05, OR = 1.55] and mean weekly consumption (a negligible difference of d = 0.03 in favor of DL-RW group). The results from DL-RCT and DL-RW were similar, and they demonstrate that web-based self-help without therapeutic guidance is feasible, well accepted, and effective for curbing adult problem drinking in the community.

Combined exercise is more effective than aerobic exercise in the improvement of fall risk factors: a randomized controlled trial in community-dwelling older men.

PubMed

Sousa, Nelson; Mendes, Romeu; Silva, André; Oliveira, José

2017-04-01

To compare the long-term effects of two community-based exercise programs on fall risk factors, such as balance, postural control, mobility and leg strength, in community-dwelling older men. Single-blinded randomized controlled trial, comparing three groups, with follow-ups at eight, 16, 24 and 32 weeks. Older men independent-living residing in Maia city, Portugal. A total of 66 older men (aged 69.0 ±4.9 years) were randomly assigned to an aerobic exercise group ( n = 22), a combined aerobic and resistance exercise group ( n = 22) or a control group ( n = 22). Both community-based exercise programs consisted of three sessions each week for 32 consecutive weeks and were planned for moderate-to-vigorous intensity. The control group had no exercise intervention. Main outcomes were measured by the Timed Up and Go Test, functional reach test, 30-second chair stand test and 6-minute walk test, on five different occasions. Repeated measures of analysis of covariance revealed significant main effects between time × group interaction in all outcomes over time (Timed Up and Go Test: p < 0.001; functional reach test: p = 0.002; 30-second chair stand: p = 0.001; 6-minute walk test: p < 0.001). Both exercise groups reported improvements; however, better performance was identified in the combined aerobic and resistance exercise group compared with the aerobic exercise group (-20.3% vs. -9.1% on the Timed Up and Go Test, +27.5% vs. +10.9% on the functional reach test, +20.8% vs. +7.3% on 30-second chair stand, +10.9% vs. +3.5% on 6-minute walk test). Adding resistance exercise to aerobic exercise improves factors associated with an increased risk of falls. However, both exercise regimes, combined or aerobic alone, are more effective than no exercise in the reduction of fall risk factors. ClinicalTrials.org #NCT01874132.

An Investigation of Participation in Weekly Music Workshops and Its Relationship to Academic Self-Concept and Self-Esteem of Middle School Students in Low-Income Communities

ERIC Educational Resources Information Center

Shin, Jihae

2011-01-01

The purpose of this study was to examine how I Am A Dreamer Musician Program (IDMP) affected academic self-concept and self-esteem of middle school students in low-income communities. During the seven weeks of the weekly music workshops, students participated in different musical activities including playing percussion instruments, singing,…

An online community improves adherence in an internet-mediated walking program. Part 1: results of a randomized controlled trial.

PubMed

Richardson, Caroline R; Buis, Lorraine R; Janney, Adrienne W; Goodrich, David E; Sen, Ananda; Hess, Michael L; Mehari, Kathleen S; Fortlage, Laurie A; Resnick, Paul J; Zikmund-Fisher, Brian J; Strecher, Victor J; Piette, John D

2010-12-17

Approximately half of American adults do not meet recommended physical activity guidelines. Face-to-face lifestyle interventions improve health outcomes but are unlikely to yield population-level improvements because they can be difficult to disseminate, expensive to maintain, and inconvenient for the recipient. In contrast, Internet-based behavior change interventions can be disseminated widely at a lower cost. However, the impact of some Internet-mediated programs is limited by high attrition rates. Online communities that allow participants to communicate with each other by posting and reading messages may decrease participant attrition. Our objective was to measure the impact of adding online community features to an Internet-mediated walking program on participant attrition and average daily step counts. This randomized controlled trial included sedentary, ambulatory adults who used email regularly and had at least 1 of the following: overweight (body mass index [BMI] ≥ 25), type 2 diabetes, or coronary artery disease. All participants (n = 324) wore enhanced pedometers throughout the 16-week intervention and uploaded step-count data to the study server. Participants could log in to the study website to view graphs of their walking progress, individually-tailored motivational messages, and weekly calculated goals. Participants were randomized to 1 of 2 versions of a Web-based walking program. Those randomized to the "online community" arm could post and read messages with other participants while those randomized to the "no online community" arm could not read or post messages. The main outcome measures were participant attrition and average daily step counts over 16 weeks. Multiple regression analyses assessed the effect of the online community access controlling for age, sex, disease status, BMI, and baseline step counts. Both arms significantly increased their average daily steps between baseline and the end of the intervention period, but there were no significant differences in increase in step counts between arms using either intention-to-treat or completers analysis. In the intention-to-treat analysis, the average step count increase across both arms was 1888 ± 2400 steps. The percentage of completers was 13% higher in the online community arm than the no online community arm (online community arm, 79%, no online community arm, 66%, P = .02). In addition, online community arm participants remained engaged in the program longer than no online community arm participants (hazard ratio = 0.47, 95% CI = 0.25 - 0.90, P = .02). Participants with lower baseline social support posted more messages to the online community (P < .001) and viewed more posts (P < .001) than participants with higher baseline social support. Adding online community features to an Internet-mediated walking program did not increase average daily step counts but did reduce participant attrition. Participants with low baseline social support used the online community features more than those with high baseline social support. Thus, online communities may be a promising approach to reducing attrition from online health behavior change interventions, particularly in populations with low social support. NCT00729040; http://clinicaltrials.gov/ct2/show/NCT00729040 (Archived by WebCite at http://www.webcitation.org/5v1VH3n0A).

Claim More™: Empowering African American Women to Make Healthy Choices

PubMed Central

Tkatch, Rifky; Musich, Shirley; Draklellis, Jennifer; Hetzel, Marla; Banks, Jo; Dugan, Jessica; Thompson, Kaylene; Hawkins, Kevin

2017-01-01

Diabetes is a serious issue for African American women. The purpose of this project was to develop and test the feasibility of a culturally appropriate and faith-based healthy eating program for African American women at risk for developing diabetes. At total of 30 women from two churches completed a 12-week, faith-based program using a community-based approach with lay health educators in the church setting. Participants set healthy eating goals, attended weekly education classes, and received daily text messaging reminders related to their goals. Outcomes included high levels of social support, frequent engagement with the program, and improved healthy eating. This program demonstrated the ability to target African American women at risk for diabetes and engage them in a health-related program. PMID:29172987

A cyber-linked undergraduate research experience in computational biomolecular structure prediction and design

PubMed Central

Alford, Rebecca F.; Dolan, Erin L.

2017-01-01

Computational biology is an interdisciplinary field, and many computational biology research projects involve distributed teams of scientists. To accomplish their work, these teams must overcome both disciplinary and geographic barriers. Introducing new training paradigms is one way to facilitate research progress in computational biology. Here, we describe a new undergraduate program in biomolecular structure prediction and design in which students conduct research at labs located at geographically-distributed institutions while remaining connected through an online community. This 10-week summer program begins with one week of training on computational biology methods development, transitions to eight weeks of research, and culminates in one week at the Rosetta annual conference. To date, two cohorts of students have participated, tackling research topics including vaccine design, enzyme design, protein-based materials, glycoprotein modeling, crowd-sourced science, RNA processing, hydrogen bond networks, and amyloid formation. Students in the program report outcomes comparable to students who participate in similar in-person programs. These outcomes include the development of a sense of community and increases in their scientific self-efficacy, scientific identity, and science values, all predictors of continuing in a science research career. Furthermore, the program attracted students from diverse backgrounds, which demonstrates the potential of this approach to broaden the participation of young scientists from backgrounds traditionally underrepresented in computational biology. PMID:29216185

A cyber-linked undergraduate research experience in computational biomolecular structure prediction and design.

PubMed

Alford, Rebecca F; Leaver-Fay, Andrew; Gonzales, Lynda; Dolan, Erin L; Gray, Jeffrey J

2017-12-01

Computational biology is an interdisciplinary field, and many computational biology research projects involve distributed teams of scientists. To accomplish their work, these teams must overcome both disciplinary and geographic barriers. Introducing new training paradigms is one way to facilitate research progress in computational biology. Here, we describe a new undergraduate program in biomolecular structure prediction and design in which students conduct research at labs located at geographically-distributed institutions while remaining connected through an online community. This 10-week summer program begins with one week of training on computational biology methods development, transitions to eight weeks of research, and culminates in one week at the Rosetta annual conference. To date, two cohorts of students have participated, tackling research topics including vaccine design, enzyme design, protein-based materials, glycoprotein modeling, crowd-sourced science, RNA processing, hydrogen bond networks, and amyloid formation. Students in the program report outcomes comparable to students who participate in similar in-person programs. These outcomes include the development of a sense of community and increases in their scientific self-efficacy, scientific identity, and science values, all predictors of continuing in a science research career. Furthermore, the program attracted students from diverse backgrounds, which demonstrates the potential of this approach to broaden the participation of young scientists from backgrounds traditionally underrepresented in computational biology.

An Imaginary Community--Hotel.

ERIC Educational Resources Information Center

Allan, Jan

1969-01-01

An English class at Newtyle Secondary School, Scotland, spent four periods a week for 6 weeks on an anthological project entitled "hotel". Students assumed roles in an imaginary hotel community, wrote advertisements, brochures, and business letters, and participated in interviews, discussions, and dramatizations of specific hotel problems. Besides…

A pilot study on community-based outpatient treatment for patients with chronic psychotic disorders in Somalia: Change in symptoms, functioning and co-morbid khat use

PubMed Central

2012-01-01

Background In Low and Middle Income Countries, mental health services are often poorly developed due to the lack of resources and trained personnel. In order to overcome these challenges, new ways of care have been suggested such as a focus on community-based services. In Somalia, the consumption of the natural stimulant khat is highly prevalent, aggravating mental illness. At the same time, mental health care is largely unavailable to the vast majority of the population. In a pilot project, we tested possibilities for effective measures in community-based out-patient mental health care. Methods Thirty-five male patients with chronic psychotic disorders and their carers were involved in a 10-months follow-up study. All of them abused khat. Seventeen outpatients experiencing acute psychotic episodes were recruited from the community and received an intensive six week home-based treatment package. Additionally eighteen patients with chronic psychotic disorders in remission were recruited either following hospital discharge or from the community. In a second phase of the study, both groups received community-based relapse prevention that differed in the degree of the family’s responsibility for the treatment. The treatment package was comprised of psycho-education, low-dose neuroleptic treatment, monthly home visits and counseling. The Brief Psychiatric Rating Scale (BPRS) was applied three times. Additionally, we assessed functioning, khat use and other outcomes. Results Of the 35 patients enrolled in the study, 33 participated in the 10-month follow-up. Outpatients improved significantly in the first six weeks of treatment and did not differ from remitted patients at the start of the second treatment phase. In the preventive treatment phase, we find heterogeneous outcomes that diverge between symptom and functioning domains. With the exception of depressive symptoms, symptoms in all patients tended to worsen. The outpatient group had higher BPRS positive and negative symptom scores compared to the remitted group. Levels of functioning in 20 out of 33 patients significantly improved, with small differences between groups. Most patients experienced improvements in basic functioning, such as communication, self-care etc. Khat use could only be reduced in the group of outpatients. Conclusions Community-based out-patient mental health treatment for chronic psychotic disorders has demonstrated positive effects in Somalia and is both feasible and practical, despite facing formidable challenges, e.g. controlling khat intake. PMID:22747911

Screening for acute childhood malnutrition during the National Nutrition Week in mali increases treatment referrals.

PubMed

Nyirandutiye, Daniele H; Ag Iknane, Akory; Fofana, Amadou; Brown, Kenneth H

2011-01-01

To evaluate a pilot intervention designed to integrate mid-upper arm circumference (MUAC) screening for acute malnutrition into the semi-annual Child Nutrition Week (Semaine d'Intensification des Activités de Nutrition, or "SIAN") activities carried out in June 2008. A cross-sectional survey was conducted in Kolokani and Nara, two health districts in the Koulikoro region of Mali, 4-5 months after the SIAN, using a population-proportionate, multi-stage random sample of: 1) health centers, and 2) households in communities linked to each of the selected health centers. Caregivers of 1543 children who were 6-59 months of age at the time of the SIAN, 17 community-based volunteers and 45 health center staff members were interviewed. A total of 1278 children 6-59 months (83% of those studied) reportedly participated in SIAN. Of the participating children, 1258 received vitamin A (98% of SIAN participants; 82% of all eligible children), 945 received anti-helminth tablets (84% of participants; 71% of eligibles), and 669 were screened for acute malnutrition (52% of participants; 43% of eligibles). 186 of the children screened (27%) were reportedly identified as acutely malnourished. SIAN screening covered a significantly greater proportion of children than were examined in both community-based (22% of children) and health center-based screening activities (5% of children) combined during the 4-5 months after the SIAN (P<0.0001). In general, community volunteers and health personnel positively evaluated their experience adding MUAC screening to SIAN. Integrating MUAC screening for acute malnutrition in SIAN permits the assessment of a large number of children for acute malnutrition, and should be continued.

Screening for Acute Childhood Malnutrition during the National Nutrition Week in Mali Increases Treatment Referrals

PubMed Central

Nyirandutiye, Daniele H.; Ag Iknane, Akory; Fofana, Amadou; Brown, Kenneth H.

2011-01-01

Objective To evaluate a pilot intervention designed to integrate mid-upper arm circumference (MUAC) screening for acute malnutrition into the semi-annual Child Nutrition Week (Semaine d'Intensification des Activités de Nutrition, or “SIAN”) activities carried out in June 2008. Design A cross-sectional survey was conducted in Kolokani and Nara, two health districts in the Koulikoro region of Mali, 4–5 months after the SIAN, using a population-proportionate, multi-stage random sample of: 1) health centers, and 2) households in communities linked to each of the selected health centers. Caregivers of 1543 children who were 6–59 months of age at the time of the SIAN, 17 community-based volunteers and 45 health center staff members were interviewed. Results A total of 1278 children 6–59 months (83% of those studied) reportedly participated in SIAN. Of the participating children, 1258 received vitamin A (98% of SIAN participants; 82% of all eligible children), 945 received anti-helminth tablets (84% of participants; 71% of eligibles), and 669 were screened for acute malnutrition (52% of participants; 43% of eligibles). 186 of the children screened (27%) were reportedly identified as acutely malnourished. SIAN screening covered a significantly greater proportion of children than were examined in both community-based (22% of children) and health center-based screening activities (5% of children) combined during the 4-5 months after the SIAN (P<0.0001). In general, community volunteers and health personnel positively evaluated their experience adding MUAC screening to SIAN. Conclusion Integrating MUAC screening for acute malnutrition in SIAN permits the assessment of a large number of children for acute malnutrition, and should be continued. PMID:21731602

Adherence with physical activity monitoring wearable devices in a community-based population: observations from the Washington, D.C., Cardiovascular Health and Needs Assessment.

PubMed

Yingling, Leah R; Mitchell, Valerie; Ayers, Colby R; Peters-Lawrence, Marlene; Wallen, Gwenyth R; Brooks, Alyssa T; Troendle, James F; Adu-Brimpong, Joel; Thomas, Samantha; Henry, JaWanna; Saygbe, Johnetta N; Sampson, Dana M; Johnson, Allan A; Graham, Avis P; Graham, Lennox A; Wiley, Kenneth L; Powell-Wiley, Tiffany

2017-12-01

Wearable mobile health (mHealth) technologies offer approaches for targeting physical activity (PA) in resource-limited, community-based interventions. We sought to explore user characteristics of PA tracking, wearable technology among a community-based population within a health and needs assessment. In 2014-2015, we conducted the Washington, D.C., Cardiovascular Health and Needs Assessment in predominantly African-American churches among communities with higher obesity rates and lower household incomes. Participants received a mHealth PA monitor and wirelessly uploaded PA data weekly to church data collection hubs. Participants (n = 99) were 59 ± 12 years, 79% female, and 99% African-American, with a mean body mass index of 33 ± 7 kg/m 2 . Eighty-one percent of participants uploaded PA data to the hub and were termed "PA device users." Though PA device users were more likely to report lower household incomes, no differences existed between device users and non-users for device ownership or technology fluency. Findings suggest that mHealth systems with a wearable device and data collection hub may feasibly target PA in resource-limited communities.

Comparison of DNA preservation methods for environmental bacterial community samples

USGS Publications Warehouse

Gray, Michael A.; Pratte, Zoe A.; Kellogg, Christina A.

2013-01-01

Field collections of environmental samples, for example corals, for molecular microbial analyses present distinct challenges. The lack of laboratory facilities in remote locations is common, and preservation of microbial community DNA for later study is critical. A particular challenge is keeping samples frozen in transit. Five nucleic acid preservation methods that do not require cold storage were compared for effectiveness over time and ease of use. Mixed microbial communities of known composition were created and preserved by DNAgard™, RNAlater®, DMSO–EDTA–salt (DESS), FTA® cards, and FTA Elute® cards. Automated ribosomal intergenic spacer analysis and clone libraries were used to detect specific changes in the faux communities over weeks and months of storage. A previously known bias in FTA® cards that results in lower recovery of pure cultures of Gram-positive bacteria was also detected in mixed community samples. There appears to be a uniform bias across all five preservation methods against microorganisms with high G + C DNA. Overall, the liquid-based preservatives (DNAgard™, RNAlater®, and DESS) outperformed the card-based methods. No single liquid method clearly outperformed the others, leaving method choice to be based on experimental design, field facilities, shipping constraints, and allowable cost.

Falls and age in patients with Alzheimer's disease.

PubMed

Bassiony, Medhat M; Rosenblatt, Adam; Baker, Alva; Steinberg, Martin; Steele, Cynthia D; Sheppard, Jeanie-Marie E; Lyketsos, Constantine G

2004-08-01

The study's objective was to estimate the prevalence of falls in community-residing patients with Alzheimer's disease (AD) and to investigate the relationship between falls and age in AD. This was a study of 326 community-residing patients with AD according to National Institute of Neurological and Communicative Disorders and Stroke and Alzheimer's Disease and Related Disorders Association criteria. The patients and their caregivers were asked about falls, behavioral disturbances, and medication use within the last 2 weeks. The patients were also rated on standardized measures of cognitive impairment, stage of dementia, depression, daily activities, general health, and extrapyramidal symptoms. Falls occurred in 24 (7.4%) patients with AD during the last 2 weeks. Using multiple logistic regression analyses, falls were independently associated with old age (odds ratio = 1.2; p = .03; 95% confidence interval = 1.0 to 1.4) but not with other variables examined. The authors conclude that falls in community-residing patients with AD are significantly associated with old age. Population-based prospective studies are needed to investigate further the risk factors for falls in AD.

JPRS Report China.

DTIC Science & Technology

1988-08-29

Moscow Summit 1 U.S.-Philippine Talks on Military Bases Analyzed 3 SOVIET UNION Gorbachev’s ’New Thinking ’ Soviet Policy Toward Eastern Europe...Unprecedented Era of Dialogues." People noticed that, a week after the Moscow summit, the European Economic Community and the Council of Mutual Eco- nomic...forceful impetus to the Afro-Asian peoples ’ liberation movements. Talks with the United States on a revision of the agreement on military bases achieved

Report on Staffing and Salaries, Fall 1988. Report Number 89-2.

ERIC Educational Resources Information Center

California Community Colleges, Sacramento. Office of the Chancellor.

This report presents fall 1989 demographic, staffing, salary, and workload information on all California community college employees, based on data from 69 of the 71 districts in the state. First, tables present the total number of district employees by primary occupational activity; full-time equivalency; type of assignment; weekly faculty…

Multi-component access to a community-based weight loss program: 12 week results

USDA-ARS?s Scientific Manuscript database

The current study examined weight loss between a comprehensive lifestyle modification program (Weight Watchers PointsPlus program) that included three ways to access and a self-help (SH) condition. A total of 293 participants were randomized to either a Weight Watchers condition (WW) (n=148) or a SH...

Toddlers' Scientific Explorations: Encounters with Insects

ERIC Educational Resources Information Center

Shaffer, Lauren Foster; Hall, Ellen; Lynch, Mary

2009-01-01

This article features Boulder Journey School, located in Boulder, Colorado, a full-day, year-round school that welcomes over 200 young children, ages 6 weeks to 6 years, and their families. The school community is committed to a culture based on children as curious and competent individuals capable of coconstructing knowledge. In Boulder Journey…

Engaging Overweight Adolescents in a Health and Fitness Program Using Wearable Activity Trackers.

PubMed

Wilson, Marian; Ramsay, Samantha; Young, Kimberly J

Our objectives were to (a) examine feasibility and receptivity of overweight adolescents joining a community-based group fitness program and (b) test preliminary efficacy of a 12-week pilot intervention designed to promote health, fitness, and self-efficacy for the identified teens. The 12-week fitness program for overweight adolescents was developed and included planned physical activities, nutrition classes, and goal-setting sessions. A one-group pre-/posttest study design evaluated 20 participants from grades 10 through 12 who enrolled in the program pilot study. Participants were given a wearable activity tracker that captured data using an Internet-based platform. Outcome measures included body mass index, screen time, fitness, and cardiovascular measures. A community fitness program for overweight adolescents was successfully implemented. High school students were receptive to the intervention and reported high program satisfaction. Positive effects included measurements of strength, systolic blood pressure, weight, and screen time behaviors. This study provides evidence to support the feasibility, acceptance, and preliminary effects of the pilot program with overweight adolescents. Copyright © 2017 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

Challenger Center's Window on the Universe

NASA Astrophysics Data System (ADS)

Livengood, T. A.; Goldstein, J. J.; Smith, S.; Bobrowsky, M.; Radnofsky, M.; Perelmuter, J.-M.; Jaggar, L.

2001-11-01

Challenger Center for Space Science Education's Window on the Universe program aims to create a network of under-served communities across the nation dedicated to sustained science, math, and technology education. Window communities presently include Broken Arrow, OK; Muncie, IN; Moscow, ID; Nogales, AZ; Tuskegee, AL; Marquette, MI; Altamont, KS; Washington, D.C.; and other emerging sites. Window uses themes of human space flight and the space sciences as interdisciplinary means to inspire entire communities. Practicing scientists and engineers engaged in these disciplines are invited to volunteer to become a part of these communities for a week, each visitor reaching roughly 2000 K-12 students through individual classroom visits and Family Science Night events during an intense Window on the Universe Week. In the same Window Week, Challenger Center scientists and educators present a workshop for local educators to provide training in the use of a K-12 educational module built around a particular space science and exploration theme. Window communities follow a 3-year development: Year 1, join the network, experience Window Week presented by Challenger Center and visiting researchers; Year 2, same as Year 1 plus workshop on partnering with local organizations to develop sources of visiting researchers and to enhance connections with local resources; Year 3 and subsequent, the community stages its own Window Week, with Challenger Center providing new education modules and training workshops for "master educators" from the Window community, after which the master educators return home to conduct training workshops of their own. Challenger Center remains a resource and clearinghouse for Window communities to acquire experience, technical information, and opportunities for distance collaboration with other Window communities. Window on the Universe is dedicated to assessing degree of success vs. failure in each program component and as a whole, using pre- and post-assessment questionnaires to develop a sound basis for continual improvement. Window on the Universe is funded by NASA's Office of Space Flight and the Office of Space Science.

Maintenance of Geobacter-dominated biofilms in microbial fuel cells treating synthetic wastewater.

PubMed

Commault, Audrey S; Lear, Gavin; Weld, Richard J

2015-12-01

Geobacter-dominated biofilms can be selected under stringent conditions that limit the growth of competing bacteria. However, in many practical applications, such stringent conditions cannot be maintained and the efficacy and stability of these artificial biofilms may be challenged. In this work, biofilms were selected on low-potential anodes (-0.36 V vs Ag/AgCl, i.e. -0.08 V vs SHE) in minimal acetate or ethanol media. Selection conditions were then relaxed by transferring the biofilms to synthetic wastewater supplemented with soil as a source of competing bacteria. We tracked community succession and functional changes in these biofilms. The Geobacter-dominated biofilms showed stability in their community composition and electrochemical properties, with Geobacter sp. being still electrically active after six weeks in synthetic wastewater with power densities of 100±19 mW·m(-2) (against 74±14 mW·m(-2) at week 0) for all treatments. After six weeks, the ethanol-selected biofilms, despite their high taxon richness and their efficiency at removing the chemical oxygen demand (0.8 g·L(-1) removed against the initial 1.3 g·L(-1) injected), were the least stable in terms of community structure. These findings have important implications for environmental microbial fuel cells based on Geobacter-dominated biofilms and suggest that they could be stable in challenging environments. Copyright © 2015 Elsevier B.V. All rights reserved.

Translation of a Motor Learning Walking Rehabilitation Program Into a Group-Based Exercise Program for Community-Dwelling Older Adults.

PubMed

Brach, Jennifer S; Francois, Sara J; VanSwearingen, Jessie M; Gilmore, Sandra; Perera, Subashan; Studenski, Stephanie A

2016-06-01

Traditional exercise programs for older adults, which focus on aerobic and strength training, have had only modest effects on walking. Recently, a motor learning exercise program was shown to have greater effects on walking compared with a traditional exercise program. Translating this novel motor learning exercise program into a group exercise program would allow it to be offered as an evidence-based, community-based program for older adults. To translate a walking rehabilitation program based on motor learning theory from one-on-one to group delivery (On the Move) and evaluate multiple aspects of implementation in older adults with impaired mobility. The translation process involved multiple iterations, including meetings of experts in the field (Phase I), focus groups (Phase II), and implementation of the newly developed program (Phase III). Phase III was based on a one-group model of intervention development for feasibility, safety, potential effects, and acceptability. Community sites, including 2 independent living facilities, an apartment building, and a community center. Adults 65 years of age or older who could ambulate independently and who were medically stable. Thirty-one adults, mean age 82.3 ± 5.6 years, were eligible to participate. The group exercise program was held twice a week for 12 weeks. Acceptability of the program was determined by retention and adherence rates and a satisfaction survey. Risk was measured by adverse events and questions on perceived challenge and safety. Mobility was assessed pre- and postintervention by gait speed, Figure of 8 Walk Test, and 6-minute walk test. Modifications to the program included adjustments to format/length, music, education, and group interaction. The 12-week program was completed by 24 of 31 entrants (77%). Adherence was high, with participants attending on average 83% of the classes. Safety was excellent, with only 1 subject experiencing a controlled, noninjurious fall. There was preliminary evidence for improved mobility after the intervention: gait speed improved from 0.76 ± 0.21 to 0.81 ± 0.22 m/s, P = .06; Figure of 8 Walk Test from 13.0 ± 3.9 to 12.0 ± 3.9 seconds, P = .07; and 6-minute walk test from 246 ± 75 to 281 ± 67 m, P = .02. The group-based program was safe and acceptable to older adults with impaired mobility and resulted in potentially clinically meaningful improvements in mobility. Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Efficacy of a Student-Led, Community-Based, Multifactorial Fall Prevention Program: Stay in Balance.

PubMed

Der Ananian, Cheryl A; Mitros, Melanie; Buman, Matthew Paul

2017-01-01

Falls are a major public health concern in older adults. Recent fall prevention guidelines recommend the use of multifactorial fall prevention programs (FPPs) that include exercise for community-dwelling older adults; however, the availability of sustainable, community-based FPPs is limited. We conducted a 24-week quasi-experimental study to evaluate the efficacy of a community-based, multifactorial FPP [Stay in Balance (SIB)] on dynamic and functional balance and muscular strength. The SIB program was delivered by allied health students and included a health education program focused on fall risk factors and a progressive exercise program emphasizing lower-extremity strength and balance. All participants initially received the 12-week SIB program, and participants were non-randomly assigned at baseline to either continue the SIB exercise program at home or as a center-based program for an additional 12 weeks. Adults aged 60 and older ( n  = 69) who were at-risk of falling (fall history or 2+ fall risk factors) were recruited to participate. Mixed effects repeated measures using Statistical Application Software Proc Mixed were used to examine group, time, and group-by-time effects on dynamic balance (8-Foot Up and Go), functional balance (Berg Balance Scale), and muscular strength (30 s chair stands and 30 s arm curls). Non-normally distributed outcome variables were log-transformed. After adjusting for age, gender, and body mass index, 8-Foot Up and Go scores, improved significantly over time [ F (2,173)  = 8.92, p  = 0.0; T0 - T2 diff = 1.2 (1.0)]. Berg Balance Scores [ F (2,173)  = 29.0, p  < 0.0001; T0 - T2 diff = 4.96 (0.72)], chair stands [ F (2,171)  = 10.17, p  < 0.0001; T0 - T2 diff = 3.1 (0.7)], and arm curls [ F (2,171)  = 12.7, p  < 0.02; T0 - T2 diff = 2.7 (0.6)] also all improved significantly over time. There were no significant group-by-time effects observed for any of the outcomes. The SIB program improved dynamic and functional balance and muscular strength in older adults at-risk for falling. Our findings indicate continuing home-based strength and balance exercises at home after completion of a center-based FPP program may be an effective and feasible way to maintain improvements in balance and strength parameters.

A Hospice Rotation for Military Medical Residents: A Mixed Methods, Multi-Perspective Program Evaluation

PubMed Central

Boyden, Jackelyn Y.; Kalish, Virginia B.; Muir, J. Cameron; Richardson, Suzanne; Connor, Stephen R.

2016-01-01

Abstract Background: An estimated 6,000 to 18,000 additional hospice and palliative medicine (HPM) physicians are needed in the United States. A source could be the military graduate medical education system where 15% of U.S. medical residents are trained. A community-based hospice and palliative care organization created a one-week rotation for military residents including participation in interdisciplinary group visits at patients' homes, facilities, and an inpatient hospice unit. Objective: Our goal was to evaluate the effectiveness of a one-week community HPM rotation for military medical residents. Methods: A mixed-methods, multi-stakeholder perspective program evaluation model was used for program years 2011 to 2013. Data were managed and analyzed using Microsoft Excel and Atlas.ti. Participants in the rotation were residents training at two local military hospitals. Program evaluation data were collected from residents, military program liaisons, and hospice clinical preceptors. Quantitative data included pre- and post-tests based on Accreditation Council for Graduate Medical Education competencies completed by residents. Qualitative data included resident essays and semi-structured interviews with hospice preceptors and military program liaisons. Results: Quantitative and qualitative data suggested that the rotation increased military residents' knowledge, attitudes, and comfort level with HPM. Quantitative analysis of test scores indicated improvements from pre- to post-tests in each of five areas of learning. Qualitative data indicated the rotation created a greater appreciation for the overall importance of HPM and increased understanding of eligibility and methods for pain and symptom management. Conclusions: A one-week community hospice rotation for medical military residents impacts participant's knowledge of and attitudes toward HPM. PMID:27139524

Ibobbly mobile health intervention for suicide prevention in Australian Indigenous youth: a pilot randomised controlled trial.

PubMed

Tighe, Joseph; Shand, Fiona; Ridani, Rebecca; Mackinnon, Andrew; De La Mata, Nicole; Christensen, Helen

2017-01-27

Rates of youth suicide in Australian Indigenous communities are 4 times the national youth average and demand innovative interventions. Historical and persistent disadvantage is coupled with multiple barriers to help seeking. Mobile phone applications offer the opportunity to deliver therapeutic interventions directly to individuals in remote communities. The pilot study aimed to evaluate the effectiveness of a self-help mobile app (ibobbly) targeting suicidal ideation, depression, psychological distress and impulsivity among Indigenous youth in remote Australia. Remote and very remote communities in the Kimberley region of North Western Australia. Indigenous Australians aged 18-35 years. 61 participants were recruited and randomised to receive either an app (ibobbly) which delivered acceptance-based therapy over 6 weeks or were waitlisted for 6 weeks and then received the app for the following 6 weeks. The primary outcome was the Depressive Symptom Inventory-Suicidality Subscale (DSI-SS) to identify the frequency and intensity of suicidal ideation in the previous weeks. Secondary outcomes were the Patient Health Questionnaire 9 (PHQ-9), The Kessler Psychological Distress Scale (K10) and the Barratt Impulsivity Scale (BIS-11). Although preintervention and postintervention changes on the (DSI-SS) were significant in the ibobbly arm (t=2.40; df=58.1; p=0.0195), these differences were not significant compared with the waitlist arm (t=1.05; df=57.8; p=0.2962). However, participants in the ibobbly group showed substantial and statistically significant reductions in PHQ-9 and K10 scores compared with waitlist. No differences were observed in impulsivity. Waitlist participants improved after 6 weeks of app use. Apps for suicide prevention reduce distress and depression but do not show significant reductions on suicide ideation or impulsivity. A feasible and acceptable means of lowering symptoms for mental health disorders in remote communities is via appropriately designed self-help apps. ACTRN12613000104752. 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/.

Dark Skies, Bright Kids Year 8

NASA Astrophysics Data System (ADS)

Bittle, Lauren E.; Wenger, Trey; Johnson, Kelsey E.; Angell, Dylan; Burkhardt, Andrew; Davis, Blair; Firebaugh, Ariel; Hancock, Danielle; Richardson, Whitney; Rochford Hayes, Christian; Linden, Sean; Liss, Sandra; Matthews, Allison; McNair, Shunlante; Prager, Brian; Pryal, Matthew; Troup, Nicholas William

2017-01-01

We present activities from the eighth year of Dark Skies Bright Kids (DSBK), an entirely volunteer-run outreach organization based out of the Department of Astronomy at the University of Virginia. Our core mission is to enhance elementary science education and literacy in Central Virginia through fun, hands-on activities that introduce basic Astronomy concepts. Over the past seven years, our primary focus has been hosting an 8-10 week after-school astronomy club at underserved elementary and middle schools, and over the past several years, we have partnered with local businesses to host our Annual Central Virginia Star Party, a free event open to the community featuring star-gazing and planetarium shows. This past summer we expanded our reach through a new initiative to bring week-long summer day camps to south and southwest Virginia, home to some of the most underserved communities in the commonwealth.

Culturally Specific Dance to Reduce Obesity in African American Women

PubMed Central

Murrock, Carolyn J.; Gary, Faye A.

2013-01-01

This article provides evidence of a culturally specific dance intervention to decrease obesity as measured by body fat and body mass index (BMI) in African American women. A community partnership was formed with two African American churches to develop an intervention to address the issue of obesity. The culturally specific dance intervention was delivered two times per week for 8 weeks, choreographed to gospel music selected by the experimental group participants, and taught by an African American woman. Body fat and BMI were assessed at three time points and revealed significant differences between the two groups. Attending a minimum of 7 classes was enough to show an observed dose effect and the intervention was found to be culturally specific by understanding their roles as African American women. This community partnership was an effective way to promote a church-based, culturally specific dance intervention to improve the health of African American women. PMID:19098267

Culturally specific dance to reduce obesity in African American women.

PubMed

Murrock, Carolyn J; Gary, Faye A

2010-07-01

This article provides evidence of a culturally specific dance intervention to decrease obesity as measured by body fat and body mass index (BMI) in African American women. A community partnership was formed with two African American churches to develop an intervention to address the issue of obesity. The culturally specific dance intervention was delivered two times per week for 8 weeks, choreographed to gospel music selected by the experimental group participants, and taught by an African American woman. Body fat and BMI were assessed at three time points and revealed significant differences between the two groups. Attending a minimum of 7 classes was enough to show an observed dose effect and the intervention was found to be culturally specific by understanding their roles as African American women. This community partnership was an effective way to promote a church-based, culturally specific dance intervention to improve the health of African American women.

A Study Comparing Typewriting Achievement of Students Attending Class Three and Five Days a Week in Beginning Typewriting at the Community College Level. Final Report.

ERIC Educational Resources Information Center

Ziemer, Adelle W.

The purpose of this study was to determine (1) whether beginning typewriting on the community college level should be taught in a five-day-a-week pattern or in a reduced three-day-a-week pattern; (2) what, if any, relationship existed between the achievement level in beginning college typewriting and the following student characteristics: Locus of…

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

Environmental perceptions and objective walking trail audits inform a community-based participatory research walking intervention

PubMed Central

2012-01-01

Background Given the documented physical activity disparities that exist among low-income minority communities and the increased focused on socio-ecological approaches to address physical inactivity, efforts aimed at understanding the built environment to support physical activity are needed. This community-based participatory research (CBPR) project investigates walking trails perceptions in a high minority southern community and objectively examines walking trails. The primary aim is to explore if perceived and objective audit variables predict meeting recommendations for walking and physical activity, MET/minutes/week of physical activity, and frequency of trail use. Methods A proportional sampling plan was used to survey community residents in this cross-sectional study. Previously validated instruments were pilot tested and appropriately adapted and included the short version of the validated International Physical Activity Questionnaire, trail use, and perceptions of walking trails. Walking trails were assessed using the valid and reliable Path Environmental Audit Tool which assesses four content areas including: design features, amenities, maintenance, and pedestrian safety from traffic. Analyses included Chi-square, one-way ANOVA's, multiple linear regression, and multiple logistic models. Results Numerous (n = 21) high quality walking trails were available. Across trails, there were very few indicators of incivilities and safety features rated relatively high. Among the 372 respondents, trail use significantly predicted meeting recommendations for walking and physical activity, and MET/minutes/week. While controlling for other variables, significant predictors of trail use included proximity to trails, as well as perceptions of walking trail safety, trail amenities, and neighborhood pedestrian safety. Furthermore, while controlling for education, gender, and income; for every one time per week increase in using walking trails, the odds for meeting walking recommendations increased 1.27 times, and the odds for meeting PA recommendation increased 3.54 times. Perceived and objective audit variables did not predict meeting physical activity recommendations. Conclusions To improve physical activity levels, intervention efforts are needed to maximize the use of existing trails, as well as improve residents' perceptions related to incivilities, safety, conditions of trail, and amenities of the walking trails. This study provides important insights for informing development of the CBPR walking intervention and informing local recreational and environmental policies in this southern community. PMID:22289653

Effects of a mutual recovery intervention on mental health in depressed elderly community-dwelling adults: a pilot study.

PubMed

Wang, Chao; Hua, Yujie; Fu, Hua; Cheng, Longfeng; Qian, Wen; Liu, Junyang; Crawford, Paul; Dai, Junming

2017-01-03

The prevalence of depression in the elderly is growing worldwide, and the population aging in China makes depression a major health problem for the elderly adults and a tremendous burden to the society. Effective interventions should be determined to provide an approach solving the problem and improving the situation. This study examined the effectiveness of a mutual recovery program intervention on depressive symptom, sleep quality, and well-being in community-dwelling elderly adults with depressive symptom in Shanghai. Recruitment was performed between July 2012 and August 2012. Using a cluster randomized wait-list controlled design, we randomized 6 communities (n = 237) into either the intervention group (3 communities, n = 105) or to a wait-list control group (3 communities, n = 132). All participants met the inclusion criteria for depression, which were defined by The Geriatric Depression Scale (GDS-15). From March to May of 2013, participants in the intervention group underwent a 2-month mutual recovery program intervention. The intervention included seven 90-min, weekly sessions that were based on a standardized self-designed schedule. Depression was used as primary outcome at three measurement moments: baseline (T1), before intervention at 24 weeks (T2), and immediately after intervention at 32 weeks (T3). Well-being and sleep quality were used as the secondary outcomes, and were evaluated based on the WHO-5 Well-being Index (WHO-5) and the Self-administered Sleep Questionnaire (SSQ). Finally, a total of 225 participants who completed all the sessions and the three measurements entered the final analysis. Mixed-model repeated measures ANOVAs were performed to estimate the intervention effects. There was no significant difference in gender, marriage, age structure, post-work type, and education background between the intervention and control group at baseline. Multivariate ANOVAs showed that there was no significant difference within the groups in terms of sleep, well-being, and depression at baseline and before the intervention. Mixed-model repeated measures ANOVAs detected a group × time interaction on depression, sleep, and well-being and showed a favorable intervention effect within groups immediately after the intervention. The mutual recovery program could be a creative and effective approach to improve mental health in older community-dwelling adults with depressive symptom.

Sing Your Lungs Out-a community singing group for chronic obstructive pulmonary disease: a 1-year pilot study.

PubMed

McNaughton, Amanda; Weatherall, Mark; Williams, Mathew; McNaughton, Harry; Aldington, Sarah; Williams, Gayle; Beasley, Richard

2017-01-24

Singing group participation may benefit patients with chronic obstructive pulmonary disease (COPD). Previous studies are limited by small numbers of participants and short duration of generally hospital-based singing group intervention. This study examines the feasibility of long-term participation in a community singing group for patients with COPD who had completed pulmonary rehabilitation (PR). This was a feasibility cohort study. Patients with COPD who had completed PR and were enrolled in a weekly community exercise group were recruited to a new community-based singing group which met weekly for over 1 year. Measurements at baseline, 4 months and 1 year comprised comprehensive pulmonary function tests including lung volumes, 6 min walk test (6MWT), Clinical COPD Questionnaire (CCQ), Hospital Anxiety and Depression Scale (HADS) and hospital admission days for acute exacerbation of COPD (AECOPD) for 1 year before and after the first singing group session. There were 28 participants with chronic lung disease recruited from 140 people approached. Five withdrew in the first month. 21 participants meeting Global Initiative for Chronic Obstructive Lung Disease criteria for COPD completed 4-month and 18 completed 1-year assessments. The mean attendance was 85%. For the prespecified primary outcome measure, total HADS score, difference between baseline and 12 months was -0.9, 95% CI -3.0 to 1.2, p=0.37. Of the secondary measures, a significant reduction was observed for HADS anxiety score after 1 year of -0.9 (95% CI -1.8 to -0.1) points, p=0.038 and an increase in the 6MWT at 1 year, of 65 (95% CI 35 to 99) m compared with baseline p<0.001. Our findings support the feasibility of long-term participation in a community singing group for adults with COPD who have completed PR and are enrolled in a weekly community exercise group and provide evidence of improved exercise capacity and a reduction in anxiety. ACTRN12615000736549; Results. 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/.

PM 10 levels in communities close to and away from opencast coal mining sites in Northeast England

NASA Astrophysics Data System (ADS)

Pless-Mulloli, Tanja; King, Andrew; Howel, Denise; Stone, Ian; Merefield, John

Concerns about levels of particulate matter of less than 10 μm (PM 10) and their potential health effects have been raised by residents living near opencast coal mining sites in the UK. PM 10 levels were measured by TEOM in 5 matched pairs of communities in northeast England, 5 near active opencast sites and 5 further away, to characterise the PM 10 exposure of residents. 14 609 paired 30-min TEOM readings, and weather data were collected during 1996-97, over 6 weeks each in four pairs and for 24 weeks in one pair. Co-located samplers collected PM 10 on an approximately weekly basis and samples were analysed using scanning electron microscopy with energy dispersive analysis (SEM-EDS). The patterns of PM 10 levels over time were similar in Opencast and Control Communities and were mostly similar to readings from nearby automated urban network stations. This suggested regional influences on PM 10 levels. The geometric mean PM 10 was 17.0 μg m -3 in Opencast and 14.9 μg m -3 in Control Communities (arithmetic mean 22.1 μg m -3 in Opencast 18.2 μg m -3 in Control Communities): Opencast Communities thus had 14% higher PM 10 levels than Control Communities on average. While the size distribution and proportion of shale particles indicated the opencast site as contributor to the PM 10 load in adjacent communities, elevated PM 10 levels in Opencast Communities were not positively linked with permitted working hours or wind direction being from the site to the community. No consistent relationship was found between PM 10 levels and wind speed or day of the week.

"Kicked out into the real world": prostate cancer patients' experiences with transitioning from hospital-based supervised exercise to unsupervised exercise in the community.

PubMed

Schmidt, Mette L K; Østergren, Peter; Cormie, Prue; Ragle, Anne-Mette; Sønksen, Jens; Midtgaard, Julie

2018-06-21

Regular exercise is recommended to mitigate the adverse effects of androgen deprivation therapy in men with prostate cancer. The purpose of this study was to explore the experience of transition to unsupervised, community-based exercise among men who had participated in a hospital-based supervised exercise programme in order to propose components that supported transition to unsupervised exercise. Participants were selected by means of purposive, criteria-based sampling. Men undergoing androgen deprivation therapy who had completed a 12-week hospital-based, supervised, group exercise intervention were invited to participate. The programme involved aerobic and resistance training using machines and included a structured transition to a community-based fitness centre. Data were collected by means of semi-structured focus group interviews and analysed using thematic analysis. Five focus group interviews were conducted with a total of 29 men, of whom 25 reported to have continued to exercise at community-based facilities. Three thematic categories emerged: Development and practice of new skills; Establishing social relationships; and Familiarising with bodily well-being. These were combined into an overarching theme: From learning to doing. Components suggested to support transition were as follows: a structured transition involving supervised exercise sessions at a community-based facility; strategies to facilitate peer support; transferable tools including an individual exercise chart; and access to 'check-ups' by qualified exercise specialists. Hospital-based, supervised exercise provides a safe learning environment. Transferring to community-based exercise can be experienced as a confrontation with the real world and can be eased through securing a structured transition, having transferable tools, sustained peer support and monitoring.

Testing the effectiveness of in-home behavioral economics strategies to increase vegetable intake, liking, and variety among children residing in households that receive food assistance.

PubMed

Leak, Tashara M; Swenson, Alison; Vickers, Zata; Mann, Traci; Mykerezi, Elton; Redden, Joseph P; Rendahl, Aaron; Reicks, Marla

2015-01-01

To test the effectiveness of behavioral economics strategies for increasing vegetable intake, variety, and liking among children residing in homes receiving food assistance. A randomized controlled trial with data collected at baseline, once weekly for 6 weeks, and at study conclusion. Family homes. Families with a child (9-12 years) will be recruited through community organizations and randomly assigned to an intervention (n = 36) or control (n = 10) group. The intervention group will incorporate a new behavioral economics strategy during home dinner meal occasions each week for 6 weeks. Strategies are simple and low-cost. The primary dependent variable will be child's dinner meal vegetable consumption based on weekly reports by caregivers. Fixed independent variables will include the strategy and week of strategy implementation. Secondary dependent variables will include vegetable liking and variety of vegetables consumed based on data collected at baseline and study conclusion. Mean vegetable intake for each strategy across families will be compared using a mixed-model analysis of variance with a random effect for child. In additionally, overall mean changes in vegetable consumption, variety, and liking will be compared between intervention and control groups. Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

The Violence Prevention Community Meeting: A Multi-Site Study.

PubMed

Lanza, Marilyn; Ridenour, Marilyn; Hendricks, Scott; Rierdan, Jill; Zeiss, Robert; Schmidt, Satu; Lovelace, Jeff; Amandus, Harlan

2016-06-01

The Violence Prevention Community Meeting (VPCM) is a specialized form of community meeting in which avoiding violence and promoting non-violent problem solving and interpersonal civility are focal points. A nationwide study to assess the VPCM as an effective intervention to reduce workplace violence was undertaken. Seven acute locked psychiatric units of the Veterans Health Administration (VHA) throughout the United States participated in the study. All patients and all staff on the seven in-patient locked psychiatry units participated in the intervention (VPCM) or as a control (treatment as usual). The study was 21weeks at each site. The three time periods were pre-treatment weeks 1-3, treatment weeks 4-18, and post-treatment weeks 19-21. The VPCM was conducted during the treatment weeks. Overall rates of aggression declined by 0.6% (95% CI: -5.6%, 6.5%; nonsignificant) per week in the intervention hospitals and by 5.1% (95% CI: 0.4%, 9.6%; significant) per week for the control hospitals. Aggression decreased for both the intervention and control hospitals which could be due to enrollment in a research study and thus being more aware of their ability to address workplace violence at their site. Published by Elsevier Inc.

Results of the First Year of Active for Life: Translation of 2 Evidence-Based Physical Activity Programs for Older Adults Into Community Settings

PubMed Central

Wilcox, Sara; Dowda, Marsha; Griffin, Sarah F.; Rheaume, Carol; Ory, Marcia G.; Leviton, Laura; King, Abby C.; Dunn, Andrea; Buchner, David M.; Bazzarre, Terry; Estabrooks, Paul A.; Campbell-Voytal, Kimberly; Bartlett-Prescott, Jenny; Dowdy, Diane; Castro, Cynthia M.; Carpenter, Ruth Ann; Dzewaltowski, David A.; Mockenhaupt, Robin

2006-01-01

Objectives. Translating efficacious interventions into practice within community settings is a major public health challenge. We evaluated the effects of 2 evidence-based physical activity interventions on self-reported physical activity and related outcomes in midlife and older adults. Methods. Four community-based organizations implemented Active Choices, a 6-month, telephone-based program, and 5 implemented Active Living Every Day, a 20-week, group-based program. Both programs emphasize behavioral skills necessary to become more physically active. Participants completed pretest and posttest surveys. Results. Participants (n=838) were aged an average of 68.4 ±9.4 years, 80.6% were women, and 64.1% were non-Hispanic White. Seventy-two percent returned posttest surveys. Intent-to-treat analyses found statistically significant increases in moderate-to-vigorous physical activity and total physical activity, decreases in depressive symptoms and stress, increases in satisfaction with body appearance and function, and decreases in body mass index. Conclusions. The first year of Active for Life demonstrated that Active Choices and Active Living Every Day, 2 evidence-based physical activity programs, can be successfully translated into community settings with diverse populations. Further, the magnitudes of change in outcomes were similar to those reported in the efficacy trials. PMID:16735619

Promoting Physical Activity through Hand-Held Computer Technology

PubMed Central

King, Abby C.; Ahn, David K.; Oliveira, Brian M.; Atienza, Audie A.; Castro, Cynthia M.; Gardner, Christopher D.

2009-01-01

Background Efforts to achieve population-wide increases in walking and similar moderate-intensity physical activities potentially can be enhanced through relevant applications of state-of-the-art interactive communication technologies. Yet few systematic efforts to evaluate the efficacy of hand-held computers and similar devices for enhancing physical activity levels have occurred. The purpose of this first-generation study was to evaluate the efficacy of a hand-held computer (i.e., personal digital assistant [PDA]) for increasing moderate intensity or more vigorous (MOD+) physical activity levels over 8 weeks in mid-life and older adults relative to a standard information control arm. Design Randomized, controlled 8-week experiment. Data were collected in 2005 and analyzed in 2006-2007. Setting/Participants Community-based study of 37 healthy, initially underactive adults aged 50 years and older who were randomized and completed the 8-week study (intervention=19, control=18). Intervention Participants received an instructional session and a PDA programmed to monitor their physical activity levels twice per day and provide daily and weekly individualized feedback, goal setting, and support. Controls received standard, age-appropriate written physical activity educational materials. Main Outcome Measure Physical activity was assessed via the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire at baseline and 8 weeks. Results Relative to controls, intervention participants reported significantly greater 8-week mean estimated caloric expenditure levels and minutes per week in MOD+ activity (p<0.04). Satisfaction with the PDA was reasonably high in this largely PDA-naive sample. Conclusions Results from this first-generation study indicate that hand-held computers may be effective tools for increasing initial physical activity levels among underactive adults. PMID:18201644

Social networking technologies as emerging tools for HIV prevention: A Cluster Randomized Trial

PubMed Central

Young, Sean D.; Cumberland, William G.; Lee, Sung-Jae; Jaganath, Devan; Szekeres, Greg; Coates, Thomas

2013-01-01

Background Social networking technologies are an emerging tool for HIV prevention. Objective To determine whether social networking communities can increase HIV testing among African American and Latino men who have sex with men (MSM). Design Randomized; controlled trial with concealed allocation (ClinicalTrials.gov: NCT01701206). Setting Online. Patients 112 MSM based in Los Angeles, more than 85% of whom were African American or Latino. Intervention Sixteen peer leaders were randomly assigned to deliver information about HIV or general health to participants via Facebook groups over 12 weeks. After participants accepted a request to join the group, participation was voluntary. Group participation and engagement was monitored. Participants could request a free home-based HIV testing kit and completed questionnaires at baseline and 12-week follow-up. Measurements Participant acceptance of and engagement in the intervention and social network participation, rates of home-based HIV testing, and sexual risk behaviors. Results Almost 95% of intervention participants and 73% of control participants voluntarily communicated using the social platform. Twenty-five of the 57 intervention participants (44%) requested home-based HIV testing kits compared with 11 of 55 control participants (20%) (difference, 24 percentage points [95% CI, 8 to 41 percentage points]). Nine of the 25 intervention participants (36%) who requested the test took it and mailed it back compared with 2 of the 11 control participants (18%) who requested the test. Retention at study follow-up was more 93%. Limitations Only 2 Facebook communities were included for each group. Conclusions Social networking communities are acceptable and effective tools to increase home-based HIV testing among at-risk populations. Primary funding source National Institute of Mental Health ClinicalTrials.gov Identifier (NCT01701206) PMID:24026317

Outcomes in a Community-Based Intensive Cardiac Rehabilitation Program: Comparison with Hospital-Based and Academic Programs.

PubMed

Katzenberg, Charles; Silva, Edna; Young, M Jean; Gilles, Greg

2018-04-13

The purpose of this study was to test the hypothesis that a community-based intensive cardiac rehabilitation program could produce positive changes in risk factor profile and outcomes in an at-risk population. Participants seeking either primary or secondary coronary artery disease prevention voluntarily enrolled in the 12-week intensive cardiac rehabilitation program. Data were obtained at baseline and 6-12 months after completion of the program. A total of 142 individuals, mean age 69 years, completed the Heart Series between 2012 and 2016. Follow-up data were available in 105 participants (74%). Participants showed statistically significant improvements in mean weight (165 to 162 lbs, P = .0005), body mass index (26 to 25 kg/m 2 , P = .001), systolic blood pressure (126 to 122 mm Hg, P = .01), diastolic blood pressure (73 to 70 mm Hg, P = .0005), total cholesterol (175 to 168 mg/dL, P = .03), low-density lipoprotein cholesterol (LDL-C) (100 to 93 mg/dL, P = .005), LDL-C/high-density lipoprotein cholesterol (HDL-C) ratio (1.8 to 1.6, P = .005), and cholesterol/HDL-C ratio (3.2 to 3.0, P = .003). Changes in HDL-C, triglycerides, and fasting blood glucose did not reach statistical significance, but all trended in favorable directions. Adverse cardiovascular disease outcomes were rare (one stent placement, no deaths). A total of 105 participants completed our 12-week community-based intensive cardiac rehabilitation program and showed significant positive changes in several measures of cardiac risk, with only 1 adverse event. These results compare favorably with those of hospital-based and academic institutional programs. Copyright © 2018 Elsevier Inc. All rights reserved.

Binge Eating, Purging, or Both: Eating Disorder Psychopathology Findings from an Internet Community Survey

PubMed Central

Roberto, Christina A.; Grilo, Carlos M.; Masheb, Robin M.; White, Marney A.

2010-01-01

Objective This study aimed to compare bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD) on clinically significant variables and examine the utility of once versus twice-weekly diagnostic thresholds for disturbed eating behaviors. Method 234 women with BN, BED, or PD were identified through self-report measures via an online survey and categorized based on either once-weekly or twice-weekly disturbed eating behaviors. Results BN emerged as a more severe disorder than BED and PD. The three groups differed significantly in self-reported restraint and disinhibition and the BN and BED groups reported higher levels of depression than PD. For BN, those engaging in behaviors twice-weekly versus once-weekly were more symptomatic. Discussion The BN, BED, and PD groups differed in clinically meaningful ways. Future research need to clarify the relationship between mood disturbances and eating behaviors. Reducing the twice-weekly behavior threshold for BN would capture individuals with clinically significant eating disorders, though the twice-weekly threshold may provide important information about disorder severity for both BN and BED. PMID:19862702

Reach Out Churches: A Community-Based Participatory Research Pilot Trial to Assess the Feasibility of a Mobile Health Technology Intervention to Reduce Blood Pressure Among African Americans.

PubMed

Skolarus, Lesli E; Cowdery, Joan; Dome, Mackenzie; Bailey, Sarah; Baek, Jonggyu; Byrd, James Brian; Hartley, Sarah E; Valley, Staci C; Saberi, Sima; Wheeler, Natalie C; McDermott, Mollie; Hughes, Rebecca; Shanmugasundaram, Krithika; Morgenstern, Lewis B; Brown, Devin L

2017-06-01

Innovative strategies are needed to reduce the hypertension epidemic among African Americans. Reach Out was a faith-collaborative, mobile health, randomized, pilot intervention trial of four mobile health components to reduce high blood pressure (BP) compared to usual care. It was designed and tested within a community-based participatory research framework among African Americans recruited and randomized from churches in Flint, Michigan. The purpose of this pilot study was to assess the feasibility of the Reach Out processes. Feasibility was assessed by willingness to consent (acceptance of randomization), proportion of weeks participants texted their BP readings (intervention use), number lost to follow-up (retention), and responses to postintervention surveys and focus groups (acceptance of intervention). Of the 425 church members who underwent BP screening, 94 enrolled in the study and 73 (78%) completed the 6-month outcome assessment. Median age was 58 years, and 79% were women. Participants responded with their BPs on an average of 13.7 (SD = 10.7) weeks out of 26 weeks that the BP prompts were sent. All participants reported satisfaction with the intervention. Reach Out, a faith-collaborative, mobile health intervention was feasible. Further study of the efficacy of the intervention and additional mobile health strategies should be considered.

Home-based neurologic music therapy for arm hemiparesis following stroke: results from a pilot, feasibility randomized controlled trial.

PubMed

Street, Alexander J; Magee, Wendy L; Bateman, Andrew; Parker, Michael; Odell-Miller, Helen; Fachner, Jorg

2018-01-01

To assess the feasibility of a randomized controlled trial to evaluate music therapy as a home-based intervention for arm hemiparesis in stroke. A pilot feasibility randomized controlled trial, with cross-over design. Randomization by statistician using computer-generated, random numbers concealed in opaque envelopes. Participants' homes across Cambridgeshire, UK. Eleven people with stroke and arm hemiparesis, 3-60 months post stroke, following discharge from community rehabilitation. Each participant engaged in therapeutic instrumental music performance in 12 individual clinical contacts, twice weekly for six weeks. Feasibility was estimated by recruitment from three community stroke teams over a 12-month period, attrition rates, completion of treatment and successful data collection. Structured interviews were conducted pre and post intervention to establish participant tolerance and preference. Action Research Arm Test and Nine-hole Peg Test data were collected at weeks 1, 6, 9, 15 and 18, pre and post intervention by a blinded assessor. A total of 11 of 14 invited participants were recruited (intervention n = 6, waitlist n = 5). In total, 10 completed treatment and data collection. It cannot be concluded whether a larger trial would be feasible due to unavailable data regarding a number of eligible patients screened. Adherence to treatment, retention and interview responses might suggest that the intervention was motivating for participants. ClinicalTrials.gov identifier NCT 02310438.

Social support and education groups for single mothers: a randomized controlled trial of a community-based program.

PubMed

Lipman, Ellen L; Boyle, Michael H

2005-12-06

Members of families headed by single mothers are at increased risk of psychosocial disadvantage and mental health problems. We assessed the effect of a community-based program of social support and education groups for single mothers of young children on maternal well-being and parenting. We recruited 116 single mothers of children 3 to 9 years old through community advertisements. Eligible mothers were randomly assigned either to participate in a 10-week program of group sessions (1.5 hours per week) offering social support and education, with a parallel children's activity group, or to receive a standard list of community resources and the option to participate in group sessions at the end of the follow-up period. Interviewers blinded to the randomization collected assessment data from all mothers at baseline and at 3 follow-up visits (immediately after the intervention and at 3 and 6 months after the intervention). Outcome measures were self-reported mood, self-esteem, social support and parenting. Between February 2000 and April 2003, the program was offered to 9 groups of single mothers. Most of the mothers in the trial reported high levels of financial and mental health problems. In the short term (after the intervention), mothers in the intervention group had improved scores for mood (p < 0.01, standardized effect = 0.55) and self-esteem (p < 0.05, standardized effect = 0.29) compared with mothers in the control group; scores for the other 2 measures did not differ between the groups. Growth curve analysis of program effects over the follow-up period showed improvement in all 4 outcomes, with no significant difference between the intervention and control groups. This community-based program of group sessions offering social support and education to low-income single mothers had positive short-term effects on mood and self-esteem but not on social support and parenting. Longer follow-up showed attenuation of these effects.

Rapid determination of soil quality and earthworm impacts on soil microbial communities using fluorescence-based respirometry

NASA Astrophysics Data System (ADS)

Prendergast-Miller, Miranda T.; Thurston, Josh; Taylor, Joe; Helgason, Thorunn; Ashauer, Roman; Hodson, Mark E.

2017-04-01

We applied a fluorescence-based respirometry method currently devised for aquatic ecotoxicology studies to rapidly measure soil microbial oxygen consumption as a function of soil quality. In this study, soil was collected from an arable wheat field and the field margin. These two soil habitats are known to differ in their soil quality due to differences in their use and management as well as plant, microbial and earthworm community. The earthworm Lumbricus terrestris was incubated in arable or margin soil for three weeks. After this initial phase, a transfer experiment was then conducted to test the hypothesis that earthworm 'migration' alters soil microbial community function and diversity. In this transfer experiment, earthworms incubated in margin soil were transferred to arable soil. The converse transfer (i.e. earthworms incubated in arable soil) was also conducted. Soils of each type with no earthworms were also incubated as controls. After a further four week incubation, the impact of earthworm migration on the soil microbial community was tested by measuring oxygen consumption. Replicated soil slurry subsamples were aliquoted into individual respirometer wells (600 μl volume) on a glass 24-well microplate (Loligo Systems, Denmark) fitted with non-invasive, reusable oxygen sensor spots. The sealed microplate was then attached to an oxygen fluorescence sensor (SDR SensorDish Reader, PreSens, Germany). Oxygen consumption was measured in real-time over a 2 hr period following standard operating procedures. Soil microbial activity was measured with and without an added carbon source (glucose or cellulose, 50 mg C L-1). Using this system, we were able to differentiate between soil type, earthworm treatment and C source. Earthworm-driven impacts on soil microbial oxygen consumption were also supported by changes in soil microbial community structure and diversity revealed using DNA-based sequencing techniques. This method provides a simple and rapid system for measuring soil quality and has the potential for use in a variety of scenarios investigating impacts on soil microbial function.

Usage, adherence and attrition: how new mothers engage with a nurse-moderated web-based intervention to support maternal and infant health. A 9-month observational study

PubMed Central

Sawyer, Michael G; Reece, Christy E; Bowering, Kerrie; Jeffs, Debra; Sawyer, Alyssa C P; Peters, Jacqueline D; Mpundu-Kaambwa, Christine; Clark, Jennifer J; McDonald, Denise; Mittinty, Murthy N; Lynch, John W

2016-01-01

Objectives To identify factors predicting use, adherence and attrition with a nurse-moderated web-based group intervention designed to support mothers of infants aged 0–6 months. Design 9-Month observational study. Setting Community maternal and child health service. Participants 240 mothers attending initial postnatal health checks at community clinics who were randomly assigned to the intervention arm of a pragmatic preference randomised trial (total randomised controlled trial, n=819; response rate=45%). Intervention In the first week (phase I), mothers were assisted with their first website login by a research assistant. In weeks 2–7 (phase II), mothers participated in the web-based intervention with an expectation of weekly logins. The web-based intervention was comparable to traditional face-to-face new mothers’ groups. During weeks 8–26 (phase III), mothers participated in an extended programme at a frequency of their choosing. Primary outcome measures Number of logins and posted messages. Standard self-report measures assessed maternal demographic and psychosocial characteristics. Results In phase II, the median number of logins was 9 logins (IQR=1–25), and in phase III, it was 10 logins (IQR=0–39). Incident risk ratios from multivariable analyses indicated that compared to mothers with the lowest third of logins in phase I, those with the highest third had 6.43 times as many logins in phase II and 7.14 times in phase III. Fifty per cent of mothers logged-in at least once every 30 days for 147 days after phase I and 44% logged-in at least once in the last 30 days of the intervention. Frequency of logins during phase I was a stronger predictor of mothers’ level of engagement with the intervention than their demographic and psychosocial characteristics. Conclusions Mothers’ early use of web-based interventions could be employed to customise engagement protocols to the circumstances of individual mothers with the aim of improving adherence and reducing attrition with web-based interventions. Trial registration number ACTRN12613000204741; Results. PMID:27496227

Evaluating the potential of group singing to enhance the well-being of older people.

PubMed

Davidson, Jane W; McNamara, Beverley; Rosenwax, Lorna; Lange, Andrea; Jenkins, Sue; Lewin, Gill

2014-06-01

To evaluate the effect of a singing program developed specifically for older community-dwelling people on measures of health and well-being. An eight-week singing program was developed and evaluated using standardised measures of health and well-being, measures designed to examine specific singing program outcomes, and semi-structured interviews. Participants aged 70 years and older were recruited through a home care service provider (n = 17) and an advertisement in a community newspaper (n = 19). Standard outcome measures indicated that the program had little effect on health and well-being. However, study-specific measures indicated that many participants had positive gains. Those in the home care group required more assistance to attend and continue in the program than those in the general community. Participants reported that the community-based singing facilitator was essential to the program's success. Well-structured community-based singing programs have the potential to impact positively upon the well-being of older people, but program viability depends on support with recruitment, transport and funding. © 2013 The Authors. Australasian Journal on Ageing © 2013 ACOTA.

Perspectives on Past and Present Waste Disposal Practices: A Community-Based Participatory Research Project in Three Saskatchewan First Nations Communities

PubMed Central

Zagozewski, Rebecca; Judd-Henrey, Ian; Nilson, Suzie; Bharadwaj, Lalita

2011-01-01

The impact of current and historical waste disposal practices on the environment and human health of Indigenous people in First Nations communities has yet to be adequately addressed. Solid waste disposal has been identified as a major environmental threat to First Nations Communities. A community-based participatory research project (CBPR) was initiated by the Saskatoon Tribal Council Health and Family Services Incorporated to investigate concerns related to waste disposal in three Saskatchewan First Nations Communities. Utilizing a qualitative approach, we aimed to gain an understanding of past and present waste disposal practices and to identify any human and environmental health concerns related to these practices. One to one interviews and sharing circles were conducted with Elders. Elders were asked to share their perspectives on past and present waste disposal practices and to comment on the possible impacts these practices may have on the environment and community health. Historically waste disposal practices were similar among communities. The homeowner generated small volumes of waste, was exclusively responsible for disposal and utilized a backyard pit. Overtime waste disposal evolved to weekly pick-up of un-segregated garbage with waste disposal and open trash burning in a community dump site. Dump site locations and open trash burning were identified as significant health issues related to waste disposal practices in these communities. This research raises issues of inequity in the management of waste in First Nations Communities. It highlights the need for long-term sustainable funding to support community-based waste disposal and management strategies and the development of First Nations centered and delivered educational programs to encourage the adoption and implementation of waste reduction, reutilization and recycling activities in these communities. PMID:21573032

Reaching out: medical students leading in local communities.

PubMed

Bannon, Aidan; O'Hare, Niamh; Corr, Michael; Sterling, Margaret; Gormley, Gerard J

2015-06-01

Queen's University Red Cross is a medical student-led volunteer group with a key aim of promoting social change within local communities and empowering young people to aspire to higher education. We describe 'The Personal Development Certificate', a 12-week community development programme devised by third-year medical students at Queen's University Belfast to target young people who are lacking educational motivation, are disengaged at home or are marginalised through social circumstances. Community-based education is of increasing importance within undergraduate and postgraduate medical education in the UK, and further afield. We evaluated the perceived improvements in key skills such as teamwork, leadership, communication, and problem solving in students following participation in this programme, and the extent to which their attitude and appreciation of community-based medicine changed. [Students] appreciated the opportunity to translate a series of classroom-learned skills to real-life environments Following facilitation of this community-based initiative, all students reported a perceived improvement in the acquired skill sets. Students made strong links from this programme to previous clinical experiences and appreciated the opportunity to translate a series of classroom-learned skills to real-life environments and interactions. The students' appreciation and understanding of community-based medicine was the single most improved area of our evaluation. We have demonstrated that medical students possess the skills to develop and facilitate their own educational projects. Non-clinical, student-led community projects have the potential to be reproduced using recognised frameworks and guidelines to complement the current undergraduate medical curriculum. © 2015 John Wiley & Sons Ltd.

Nasal saline for chronic sinonasal symptoms: a randomized controlled trial.

PubMed

Pynnonen, Melissa A; Mukerji, Shraddha S; Kim, H Myra; Adams, Meredith E; Terrell, Jeffrey E

2007-11-01

To determine if isotonic sodium chloride (hereinafter "saline") nasal irrigations performed with large volume and delivered with low positive pressure are more effective than saline sprays at improving quality of life and decreasing medication use. A prospective, randomized controlled trial. Community. A total of 127 adults with chronic nasal and sinus symptoms. Patients were randomly assigned to irrigation performed with large volume and delivered with low positive pressure (n = 64) or spray (n = 63) for 8 weeks. Change in symptom severity measured by mean 20-Item Sino-Nasal Outcome Test (SNOT-20) score; change in symptom frequency measured with a global question; and change in medication use. A total of 121 patients were evaluable. The irrigation group achieved lower SNOT-20 scores than the spray group at all 3 time points: 4.4 points lower at 2 weeks (P = .02); 8.2 points lower at 4 weeks (P < .001); and 6.4 points lower at 8 weeks (P = .002). When symptom frequency was analyzed, 40% of subjects in the irrigation group reported symptoms "often or always" at 8 weeks compared with 61% in the spray group (absolute risk reduction, 0.2; 95% confidence interval, 0.02-0.38 (P = .01). No significant differences in sinus medication use were seen between groups. Nasal irrigations performed with large volume and delivered with low positive pressure are more effective than saline sprays for treatment of chronic nasal and sinus symptoms in a community-based population.

Reflections on Serving Remote Mountain Communities: Mobile Hospitals and Women's and Children's Health Care in Northern Haiti.

PubMed

Chierici, Rose-Marie; Voltaire, Thony Michelet

2016-12-01

In 2003 Alyans Sante Borgne's (ASB) conducted the first week-long mobile hospital in Molas, a poor mountain community a 10-h walk from the main hospital in the town of Borgne in North Haiti. ASB is a partnership between Haiti Outreach-Pwoje Espwa (H.O.P.E.), a US-based NGO, and Haiti's Ministry of Health. The paper reflects on this first experience and the evolution of an indigenous model of health care delivery, Sante Nan Lakou (SNL)/Health at the Extended Family Level, a model that prioritizes the needs of patients over those of the institution. It highlights the challenges of providing quality care to a much neglected segment of our population and documents the impact of this event for the community and for ASB. Lessons learned during that week shaped ASB's response to the root causes of women and children's poor health in the commune of Borgne. The response is articulated in a holistic grassroots program called Sante/Health, Edikasyon/Education, Ekonomi/Economy for Fanm/Women (SEE Fanm). SEE Fanm is a constellation of programs and initiatives that together brings quality care to women and seeks to empower them to take charge of their health and wellbeing and, by extension, that of their families and communities.

The effect of a VR exercise program on falls and depression in the elderly with mild depression in the local community.

PubMed

Yang, Jong-Eun; Lee, Tac-Young; Kim, Jin-Kyung

2017-12-01

[Purpose] The purpose of this study is to explore the effect of a VR exercise program on falls and depression in the elderly with mild depression who reside in the local community. [Subjects and Methods] This study was performed by targeting 15 elderly subjects with mild depression who resided in the local community. The targeted subjects voluntarily selected 3 VR exercise programs (each lasting 10 minutes) among 4 activities, and a resting time of 5 minutes was given for an interval after each activity. The VR exercise program was performed for total 12 weeks (36 times), 3 times a week, 45 minutes per session. [Results] After exercise, scores of static balance test (anteroposterior), Falls Efficacy Scale, and the Activities-specific Balance Confidence Scale in the test subjects were improved and depression and internal stress scores were significantly decreased after the intervention. [Conclusion] It can be concluded that the VR exercise program exerts a positive effect not only on the physical factor but also on the mental factor of the elderly subjects with mild depression who reside in the local community. It is expected that based on the VR exercise program, diversified home programs for the elderly should be developed in the future.

Exercise leads to faster postural reflexes, improved balance and mobility, and fewer falls in older persons with chronic stroke.

PubMed

Marigold, Daniel S; Eng, Janice J; Dawson, Andrew S; Inglis, J Timothy; Harris, Jocelyn E; Gylfadóttir, Sif

2005-03-01

To determine the effect of two different community-based group exercise programs on functional balance, mobility, postural reflexes, and falls in older adults with chronic stroke. A randomized, clinical trial. Community center. Sixty-one community-dwelling older adults with chronic stroke. Participants were randomly assigned to an agility (n=30) or stretching/weight-shifting (n=31) exercise group. Both groups exercised three times a week for 10 weeks. Participants were assessed before, immediately after, and 1 month after the intervention for Berg Balance, Timed Up and Go, step reaction time, Activities-specific Balance Confidence, and Nottingham Health Profile. Testing of standing postural reflexes and induced falls evoked by a translating platform was also performed. In addition, falls in the community were tracked for 1 year from the start of the interventions. Although exercise led to improvements in all clinical outcome measures for both groups, the agility group demonstrated greater improvement in step reaction time and paretic rectus femoris postural reflex onset latency than the stretching/weight-shifting group. In addition, the agility group experienced fewer induced falls on the platform. Group exercise programs that include agility or stretching/weight shifting exercises improve postural reflexes, functional balance, and mobility and may lead to a reduction of falls in older adults with stroke.

Comparison between smartphone pedometer applications and traditional pedometers for improving physical activity and body mass index in community-dwelling older adults

PubMed Central

Fong, Shirley S.M.; Ng, Shamay S.M.; Cheng, Yoyo T.Y.; Zhang, Joni; Chung, Louisa M.Y.; Chow, Gary C.C.; Chak, Yvonne T.C.; Chan, Ivy K.Y.; Macfarlane, Duncan J.

2016-01-01

[Purpose] The effectiveness of a smartphone pedometer application was compared with that of a traditional pedometer for improving the physical activity and weight status of community-dwelling older adults. [Subjects and Methods] This study had a nonequivalent pretest-posttest control group design. Ninety-seven older adults (mean age ± SD, 60.1 ± 5.5 years) joined the smartphone pedometer group and underwent a 2-week walking intervention based on a smartphone pedometer application. Fifty-four older adults (mean age ± SD, 65.3 ± 8.7 years) joined the traditional pedometer group and underwent a 2-week walking intervention based on a traditional pedometer. The participants’ physical activity was evaluated using the International Physical Activity Questionnaire–Short Form, and their weight status was quantified by calculating the body mass index. The daily pedometer count was also documented. [Results] No significant time, group, or time-by-group interaction effects were found for any of the outcome variables. However, trends of improvement in physical activity and body mass index were seen only in the smartphone pedometer group. [Conclusion] A smartphone pedometer application might be more favorable than a traditional pedometer in improving physical activity and body mass index in community-dwelling older adults. However, further experimental studies are necessary to confirm the results. PMID:27313391

Comparison between smartphone pedometer applications and traditional pedometers for improving physical activity and body mass index in community-dwelling older adults.

PubMed

Fong, Shirley S M; Ng, Shamay S M; Cheng, Yoyo T Y; Zhang, Joni; Chung, Louisa M Y; Chow, Gary C C; Chak, Yvonne T C; Chan, Ivy K Y; Macfarlane, Duncan J

2016-05-01

[Purpose] The effectiveness of a smartphone pedometer application was compared with that of a traditional pedometer for improving the physical activity and weight status of community-dwelling older adults. [Subjects and Methods] This study had a nonequivalent pretest-posttest control group design. Ninety-seven older adults (mean age ± SD, 60.1 ± 5.5 years) joined the smartphone pedometer group and underwent a 2-week walking intervention based on a smartphone pedometer application. Fifty-four older adults (mean age ± SD, 65.3 ± 8.7 years) joined the traditional pedometer group and underwent a 2-week walking intervention based on a traditional pedometer. The participants' physical activity was evaluated using the International Physical Activity Questionnaire-Short Form, and their weight status was quantified by calculating the body mass index. The daily pedometer count was also documented. [Results] No significant time, group, or time-by-group interaction effects were found for any of the outcome variables. However, trends of improvement in physical activity and body mass index were seen only in the smartphone pedometer group. [Conclusion] A smartphone pedometer application might be more favorable than a traditional pedometer in improving physical activity and body mass index in community-dwelling older adults. However, further experimental studies are necessary to confirm the results.

Impact of a community-based prevention marketing intervention to promote physical activity among middle-aged women.

PubMed

Sharpe, Patricia A; Burroughs, Ericka L; Granner, Michelle L; Wilcox, Sara; Hutto, Brent E; Bryant, Carol A; Peck, Lara; Pekuri, Linda

2010-06-01

A physical activity intervention applied principles of community-based participatory research, the community-based prevention marketing framework, and social cognitive theory. A nonrandomized design included women ages 35 to 54 in the southeastern United States. Women (n = 430 preprogram, n = 217 postprogram) enrolled in a 24-week behavioral intervention and were exposed to a media campaign. They were compared to cross-sectional survey samples at pre- (n = 245) and postprogram (n = 820) from the media exposed county and a no-intervention county (n = 234 pre, n = 822 post). Women in the behavioral intervention had statistically significant positive changes on physical activity minutes, walking, park and trail use, knowledge of mapped routes and exercise partner, and negative change on exercise self-efficacy. Media exposed women had statistically significant pre- to postprogram differences on knowledge of mapped routes. No-intervention women had significant pre- to postprogram differences on physical activity minutes, walking, and knowledge of mapped routes.

Peginterferon alfa-2b and weight-based or flat-dose ribavirin in chronic hepatitis C patients: a randomized trial.

PubMed

Jacobson, Ira M; Brown, Robert S; Freilich, Bradley; Afdhal, Nezam; Kwo, Paul Y; Santoro, John; Becker, Scott; Wakil, Adil E; Pound, David; Godofsky, Eliot; Strauss, Robert; Bernstein, David; Flamm, Steven; Pauly, Mary Pat; Mukhopadhyay, Pabak; Griffel, Louis H; Brass, Clifford A

2007-10-01

This prospective, multicenter, community-based and academic-based, open-label, investigator-initiated, U.S. study evaluated efficacy and safety of pegylated interferon (PEG-IFN) alfa-2b plus a flat or weight-based dose of ribavirin (RBV) in adults with chronic hepatitis C. Patients (n = 5027) were randomly assigned to receive PEG-IFN alfa-2b 1.5 microg/kg/week plus flat-dose (800 mg/day) or weight-based (800-1400 mg/day) RBV for 48 weeks (patients with genotype 1, 4, 5, or 6) and for 24 or 48 weeks (genotype 2/3 patients). Primary end point was sustained virologic response (undetectable [<125 IU/mL] serum hepatitis C virus RNA at 24-week follow-up). Sustained virologic response, but not end-of-treatment, rates were significantly higher with weight-based than with flat-dose RBV (44.2% versus 40.5%; P = 0.008). Sustained virologic response rates by intention-to-treat analysis were 34.0% and 28.9%, respectively, in genotype 1 patients (P = 0.005) and 31.2% and 26.7%, respectively, in genotype 1 patients with high baseline viral load (P = 0.056). In genotype 2/3 patients, rates were not significantly different (61.8% and 59.5%, respectively) regardless of treatment duration. Besides greater hemoglobin reductions with weight-based RBV, safety profiles were similar across RBV dosing groups, including the 1400-mg/day group. PEG-IFN alfa-2b plus weight-based RBV is more effective than flat-dose RBV, particularly in genotype 1 patients, providing equivalent efficacy across all weight groups. RBV 1400 mg/day is appropriate for patients 105 to 125 kg. For genotype 2/3 patients, 24 weeks of treatment with flat-dose RBV is adequate; no evidence of additional benefit of extending treatment to 48 weeks was demonstrated.

Feasibility and acceptability of two incentive-based implementation strategies for mental health therapists implementing cognitive-behavioral therapy: a pilot study to inform a randomized controlled trial.

PubMed

Beidas, Rinad S; Becker-Haimes, Emily M; Adams, Danielle R; Skriner, Laura; Stewart, Rebecca E; Wolk, Courtney Benjamin; Buttenheim, Alison M; Williams, Nathaniel J; Inacker, Patricia; Richey, Elizabeth; Marcus, Steven C

2017-12-15

Informed by our prior work indicating that therapists do not feel recognized or rewarded for implementation of evidence-based practices, we tested the feasibility and acceptability of two incentive-based implementation strategies that seek to improve therapist adherence to cognitive-behavioral therapy for youth, an evidence-based practice. This study was conducted over 6 weeks in two community mental health agencies with therapists (n = 11) and leaders (n = 4). Therapists were randomized to receive either a financial or social incentive if they achieved a predetermined criterion on adherence to cognitive-behavioral therapy. In the first intervention period (block 1; 2 weeks), therapists received the reward they were initially randomized to if they achieved criterion. In the second intervention period (block 2; 2 weeks), therapists received both rewards if they achieved criterion. Therapists recorded 41 sessions across 15 unique clients over the project period. Primary outcomes included feasibility and acceptability. Feasibility was assessed quantitatively. Fifteen semi-structured interviews were conducted with therapists and leaders to assess acceptability. Difference in therapist adherence by condition was examined as an exploratory outcome. Adherence ratings were ascertained using an established and validated observational coding system of cognitive-behavioral therapy. Both implementation strategies were feasible and acceptable-however, modifications to study design for the larger trial will be necessary based on participant feedback. With respect to our exploratory analysis, we found a trend suggesting the financial reward may have had a more robust effect on therapist adherence than the social reward. Incentive-based implementation strategies can be feasibly administered in community mental health agencies with good acceptability, although iterative pilot work is essential. Larger, fully powered trials are needed to compare the effectiveness of implementation strategies to incentivize and enhance therapists' adherence to evidence-based practices such as cognitive-behavioral therapy.

Preliminary Findings on Gender Based Fear Reactions in Communication Apprehension Writings.

ERIC Educational Resources Information Center

Stowell, Jessica; Furlong, Cathy

A study examined some of the reasons behind communication apprehension. The participants were 240 students (120 men and 120 women) from a southern community college enrolled in the basic public speaking course. Their writings were collected over a period of 7 years and selected randomly for analysis. The second week of the semester, students were…

Increase in Teachers' Knowledge about ADHD after a Week-Long Training Program: A Pilot Study

ERIC Educational Resources Information Center

Syed, Ehsan Ullah; Hussein, Sajida Abdul

2010-01-01

Objectives: ADHD affects 3% to 5% of school-age children. Clinical and community based epidemiological studies in Pakistan have shown a high prevalence of ADHD among school going children. A thorough review of literature shows that no studies of teachers' training programs regarding ADHD have been published in Pakistani research literature. The…

Implementation Issues: A "FRIENDS for Life" Course in a Mainstream Secondary School

ERIC Educational Resources Information Center

Green, Sarah L.; Atkinson, Sarah

2016-01-01

"FRIENDS for life" is a manualised, 10 week, Cognitive Behavioural Therapy (CBT) based programme designed to be run in school and community settings. The aim of this study was to evaluate the impact of "FRIENDS for life" when implemented in a mainstream secondary school by school staff. Data regarding implementation of the…

The Application of a Residential Treatment Evaluation Model.

ERIC Educational Resources Information Center

Nelson, Ronald H.; And Others

This study applied a model for the evaluation of a children's residential treatment center. The conclusions are based on data collected for 22 children at four key points: a community baseline relating to families and prior agency contacts, a residential baseline dealing with the child's reported behavior during the first six weeks at the center,…

Mediating Parent Learning to Promote Social Communication for Toddlers with Autism: Effects from a Randomized Controlled Trial

ERIC Educational Resources Information Center

Schertz, Hannah H.; Odom, Samuel L.; Baggett, Kathleen M.; Sideris, John H.

2018-01-01

A randomized controlled trial was conducted to evaluate effects of the Joint Attention Mediated Learning (JAML) intervention. Toddlers with autism spectrum disorders (ASD) aged 16-30 months (n = 144) were randomized to intervention and community control conditions. Parents, who participated in 32 weekly home-based sessions, followed a mediated…

Evaluation of a Peer-Led, Low-Intensity Physical Activity Program for Older Adults

ERIC Educational Resources Information Center

Werner, Danilea; Teufel, James; Brown, Stephen L.

2014-01-01

Background: Physical inactivity is a primary contributor to decreasing functional physical fitness and increasing chronic disease in older adults. Purpose: This study assessed the health-related benefits of ExerStart for Lay Leaders, a 20-week, community based, peer-led, low-impact exercise program for older adults. ExerStart focuses on aerobic…

Specialized Apprentice-Level Training Programs for Industry.

ERIC Educational Resources Information Center

Edling, Walter

Lorain County Community College (LCCC) has provided training programs for the employees of the United States Steel Corporation since 1969 and for the Lorain Telephone Company since 1977. These training programs are campus-based, and the students attend classes for four or five week periods at a time. An effort has been made to adhere as closely as…

Temporal changes in the bacterial community of animal feces and their correlation with stable fly oviposition, larval development, and adult fitness

PubMed Central

Albuquerque, Thais A.; Zurek, Ludek

2014-01-01

Stable flies are blood-feeding insects with a great negative impact on animals world wide. Larvae develop primarily in animal manure and bacteria are essential for larval development; however, the principle of this dependence is not understood. We hypothesized that as the microbial community of animal manure changes over time, it plays an important role in stable fly fitness. Two-choice bioassays were conducted using 2 week old horse manure (control) and aging horse manure (fresh to 5 week old) to evaluate the effect of manure age on stable fly oviposition. Our data showed that fresh feces did not stimulate oviposition and that the attractiveness increased as manure aged but started to decline after 3 weeks. Bioassays assessing the effect of manure age at the time of oviposition on larval development demonstrated that 1–3 week old manure supported larval development significantly better than fresh, 4, and 5 week old manure. In addition, adult fitness (body size) was significantly higher in flies from 1 and 2 week old manure comparing to that of all other treatments. Analysis of the bacterial community of aging horse manure by 454-pyrosequencing of 16S rDNA revealed a great reduction in bacterial diversity and richness from fresh to 1–5 week old manure and a major shift from strict anaerobes in fresh manure to facultative anaerobes and strict aerobes in aged manure. Overall, the microbial community of 2 and 3 week old horse manure with its dominant bacterial taxa Rhizobium, Devosia, and Brevundimonas stimulated stable fly oviposition the most and provided a suitable habitat for larval development. These bacteria represent the candidates for studies focused on better understanding of stable fly – microbial interactions. PMID:25426108

Community-based exercise training for people with chronic respiratory and chronic cardiac disease: a mixed-methods evaluation.

PubMed

McNamara, Renae J; McKeough, Zoe J; Mo, Laura R; Dallimore, Jamie T; Dennis, Sarah M

2016-01-01

Poor uptake and adherence are problematic for hospital-based pulmonary and heart failure rehabilitation programs, often because of access difficulties. The aims of this mixed-methods study were to determine the feasibility of a supervised exercise training program in a community gymnasium in people with chronic respiratory and chronic cardiac disease, to explore the experiences of participants and physiotherapists and to determine if a community venue improved access and adherence to rehabilitation. Adults with chronic respiratory and/or chronic cardiac disease referred to a hospital-based pulmonary and heart failure rehabilitation program were screened to determine their suitability to exercise in a community venue. Eligible patients were offered the opportunity to attend supervised exercise training for 8 weeks in a community gymnasium. Semi-structured interviews were conducted with participants and physiotherapists at the completion of the program. Thirty-one people with chronic respiratory and chronic cardiac disease (34% males, mean [standard deviation] age 72 [10] years) commenced the community-based exercise training program. Twenty-two (71%) completed the program. All participants who completed the program, and the physiotherapists delivering the program, were highly satisfied, with reports of the community venue being well-equipped, convenient, and easily accessible. Using a community gymnasium promoted a sense of normality and instilled confidence in some to continue exercising at a similar venue post rehabilitation. However, factors such as cost and lack of motivation continue to be barriers. The convenience and accessibility of a community venue for rehabilitation contributed to high levels of satisfaction and a positive experience for people with chronic respiratory and chronic cardiac disease and physiotherapists.

A capacity building approach to increase sports participation in disadvantaged urban communities: a multilevel analysis.

PubMed

Marlier, Mathieu; Cardon, Greet; De Bourdeaudhuij, Ilse; Willem, Annick

2014-12-01

Recent evidence showed that community capacity building is one of the key methods to reach health improvements within disadvantaged communities. Physical activity and sports participation are important means to reach health improvements. This study investigates a capacity building method which aims at increasing sports participation in the community, especially for individuals at higher risk of sports deprivation. The main aims of the present study, are the following: (1) to examine differences in sports participation between individuals living in communities implementing a sports-based capacity building program and individuals living in communities without such capacity building program and (2) to investigate if the community sports program reaches the individuals known to experience higher barriers to engage in sports. In Flanders, Belgium, five disadvantaged urban communities implementing the community capacity building program (program communities) and four without (control communities) were selected based on similarity of sociodemographic and environmental characteristics. Two hundred adults (aged 18-56 years) per community were randomly selected and visited at home to fill out a questionnaire on sociodemographics, sports participation, and the community sports program. A sample of 414 adults participated in the study. Results showed that adults from program communities reported on average 96 min/week more participation in sports than their counterparts living in control communities. Furthermore, 61.3% of the individuals of program communities indicated to engage in sports, whereas in control communities, this was only 42.4%. Respondents at higher risk of sports deprivation also engaged in significantly more sports participation in program communities than those in control communities. This difference was also noted for groups that are not related with sports deprivation. These results are promising and plead for a community capacity building approach to increase sports participation in disadvantaged communities.

Association of alcohol use and loneliness frequency among middle-aged and older adult drinkers

PubMed Central

Canham, Sarah L.; Mauro, Pia M.; Kaufmann, Christopher N.; Sixsmith, Andrew

2015-01-01

Objectives We examined the association between alcohol use, at-risk drinking, and binge drinking, and loneliness in a sample of middle-aged and older adults. Methods We studied participants aged 50+ years from the 2008 wave of the Health and Retirement Study who reported alcohol use. We ran separate multinomial logistic regressions to assess the association of three alcohol use outcomes (i.e., weekly alcohol consumption, at-risk drinking, and binge drinking) and loneliness. Results After adjusting for covariates, being lonely was associated with reduced odds of weekly alcohol consumption 4–7 days per week, but not 1–3 days per week, compared to average alcohol consumption 0 days per week in the last 3 months. No association was found between at-risk drinking or binge drinking and loneliness. Discussion Results suggest that among a sample of community-based adults aged 50+, loneliness was associated with reduced alcohol use frequency, but not with at-risk or binge drinking. PMID:26082130

Microblogging to Foster Connections and Community in a Weekly Graduate Seminar Course

ERIC Educational Resources Information Center

Domizi, Denise P.

2013-01-01

This study investigated the use of microblogs to enhance content learning and to foster community between participants in a weekly multidisciplinary graduate seminar on teaching and pedagogy. Data included students' and instructor's Twitter posts, an initial reaction paper, and an end-of-semester survey to determine if and how students' attitudes…

3 CFR 8523 - Proclamation 8523 of May 20, 2010. National Hurricane Preparedness Week, 2010

Code of Federal Regulations, 2011 CFR

2011-01-01

... coastal and inland communities face the danger of these powerful storms. From high winds and storm surges... Preparedness Week, I urge individuals, families, communities, and businesses to take time to plan for the storm season before it begins. While hurricane forecasting has improved, storms may still develop with little...

COMMUNITY RESOURCES POOL, SOUTH ORANGETOWN CENTRAL SCHOOL DISTRICT 1.

ERIC Educational Resources Information Center

FRIEDAN, BETTY

IN OCTOBER, 1962, 250 STUDENTS IN 14 SEMINAR GROUPS, FIFTH GRADERS THROUGH HIGH SCHOOL SENIORS, BECAME SATURDAY "APPRENTICES" TO PROFESSIONAL RESOURCE PERSONS FROM THE COMMUNITY. STUDENTS WITH HIGH INTEREST AND POTENTIAL ATTENDED THE SEMINARS FOR 8 WEEKS IN THE FALL SEMESTER. A SECOND 8-WEEK SERIES WAS PRESENTED IN THE SPRING. THE…

The impact of community-based palliative care on acute hospital use in the last year of life is modified by time to death, age and underlying cause of death. A population-based retrospective cohort study

PubMed Central

Rosenwax, Lorna; Arendts, Glenn; Semmens, James B.

2017-01-01

Objective Community-based palliative care is known to be associated with reduced acute care health service use. Our objective was to investigate how reduced acute care hospital use in the last year of life varied temporally and by patient factors. Methods A retrospective cohort study of the last year of life of 12,763 Western Australians who died from cancer or one of seven non-cancer conditions. Outcome measures were rates of hospital admissions and mean length of hospital stays. Multivariate analyses involved time-to-event and population averaged log-link gamma models. Results There were 28,939 acute care overnight hospital admissions recorded in the last year of life, an average of 2.3 (SD 2.2) per decedent and a mean length of stay of 9.2 (SD 10.3) days. Overall, the rate of hospital admissions was reduced 34% (95%CI 1–66) and the mean length of stay reduced 6% (95%CI 2–10) during periods of time decedents received community-based palliative care compared to periods of time not receiving this care. Decedents aged <70 years receiving community-based palliative care showed a reduced rate of hospital admission around five months before death, whereas for older decedents the reduction in hospital admissions was apparent a year before death. All decedents who were receiving community-based palliative care tended towards shorter hospital stays in the last month of life. Decedents with neoplasms had a mean length of stay three weeks prior to death while not receiving community-based palliative care of 9.6 (95%CI 9.3–9.9) days compared to 8.2 (95% CI 7.9–8.7) days when receiving community-based palliative care. Conclusion Rates of hospital admission during periods of receiving community-based palliative care were reduced with benefits evident five months before death and even earlier for older decedents. The mean length of hospital stay was also reduced while receiving community-based palliative care, mostly in the last month of life. PMID:28934324

The impact of community-based palliative care on acute hospital use in the last year of life is modified by time to death, age and underlying cause of death. A population-based retrospective cohort study.

PubMed

Spilsbury, Katrina; Rosenwax, Lorna; Arendts, Glenn; Semmens, James B

2017-01-01

Community-based palliative care is known to be associated with reduced acute care health service use. Our objective was to investigate how reduced acute care hospital use in the last year of life varied temporally and by patient factors. A retrospective cohort study of the last year of life of 12,763 Western Australians who died from cancer or one of seven non-cancer conditions. Outcome measures were rates of hospital admissions and mean length of hospital stays. Multivariate analyses involved time-to-event and population averaged log-link gamma models. There were 28,939 acute care overnight hospital admissions recorded in the last year of life, an average of 2.3 (SD 2.2) per decedent and a mean length of stay of 9.2 (SD 10.3) days. Overall, the rate of hospital admissions was reduced 34% (95%CI 1-66) and the mean length of stay reduced 6% (95%CI 2-10) during periods of time decedents received community-based palliative care compared to periods of time not receiving this care. Decedents aged <70 years receiving community-based palliative care showed a reduced rate of hospital admission around five months before death, whereas for older decedents the reduction in hospital admissions was apparent a year before death. All decedents who were receiving community-based palliative care tended towards shorter hospital stays in the last month of life. Decedents with neoplasms had a mean length of stay three weeks prior to death while not receiving community-based palliative care of 9.6 (95%CI 9.3-9.9) days compared to 8.2 (95% CI 7.9-8.7) days when receiving community-based palliative care. Rates of hospital admission during periods of receiving community-based palliative care were reduced with benefits evident five months before death and even earlier for older decedents. The mean length of hospital stay was also reduced while receiving community-based palliative care, mostly in the last month of life.

Effects of a resistance training program performed with an interocclusal splint for community-dwelling older adults: a randomized controlled trial

PubMed Central

Hirase, Tatsuya; Inokuchi, Shigeru; Matsusaka, Nobuou; Nakahara, Kazumi; Okita, Minoru

2016-01-01

[Purpose] To examine whether resistance training for elderly community-dwellers performed with an interocclusal splint resulted in greater lower extremity muscle strength and better balance than resistance training performed without an interocclusal splint. [Subjects and Methods] Eighty-eight elderly persons using Japanese community day centers were randomly divided into two groups: an intervention group (n=45), which performed resistance training with an interocclusal splint; and a control group (n=43), which performed resistance training without an interocclusal splint. The resistance training program comprised a 40-min session performed twice a week for 12 weeks. Outcome measures were the chair stand test (CST), timed up and go test (TUG), and one-leg standing test (OLST). Assessments were conducted before the intervention and every 2 weeks after the start of the intervention. [Results] There was a significant group × time interaction for the OLST, with the intervention group showing significant improvement from 8 to 12 weeks compared to the control group. For the CST and TUG, no significant differences were found between the two groups throughout the 12 weeks. [Conclusion] Resistance training with an interocclusal splint improved the balance ability of elderly community-dwellers more effectively than resistance training without an interocclusal splint. PMID:27313359

Effects of a resistance training program performed with an interocclusal splint for community-dwelling older adults: a randomized controlled trial.

PubMed

Hirase, Tatsuya; Inokuchi, Shigeru; Matsusaka, Nobuou; Nakahara, Kazumi; Okita, Minoru

2016-05-01

[Purpose] To examine whether resistance training for elderly community-dwellers performed with an interocclusal splint resulted in greater lower extremity muscle strength and better balance than resistance training performed without an interocclusal splint. [Subjects and Methods] Eighty-eight elderly persons using Japanese community day centers were randomly divided into two groups: an intervention group (n=45), which performed resistance training with an interocclusal splint; and a control group (n=43), which performed resistance training without an interocclusal splint. The resistance training program comprised a 40-min session performed twice a week for 12 weeks. Outcome measures were the chair stand test (CST), timed up and go test (TUG), and one-leg standing test (OLST). Assessments were conducted before the intervention and every 2 weeks after the start of the intervention. [Results] There was a significant group × time interaction for the OLST, with the intervention group showing significant improvement from 8 to 12 weeks compared to the control group. For the CST and TUG, no significant differences were found between the two groups throughout the 12 weeks. [Conclusion] Resistance training with an interocclusal splint improved the balance ability of elderly community-dwellers more effectively than resistance training without an interocclusal splint.

Cervical Cancer Prevention in HIV-infected Women Using the “See and Treat” Approach in Botswana

PubMed Central

Ramogola-Masire, Doreen; de Klerk, Ronny; Monare, Barati; Ratshaa, Bakgaki; Friedman, Harvey M.; Zetola, Nicola M.

2013-01-01

Background Cervical cancer is a major public health problem in resource-limited settings, particularly among HIV-infected women. Given the challenges of cytology-based approaches, the efficiency of new screening programs need to be assessed. Setting Community and hospital-based clinics in Gaborone, Botswana. Objective To determine the feasibility, and efficiency of the “See and Treat” approach using Visual Inspection Acetic Acid (VIA) and Enhanced Digital Imaging (EDI) for cervical cancer prevention in HIV-infected women. Methods A two-tier community-based cervical cancer prevention program was implemented. HIV-infected women were screened by nurses at the community using the VIA/EDI approach. Low-grade lesions were treated with cryotherapy on the same visit. Women with complex lesions were referred to our second tier, specialized clinic for evaluation. Weekly quality control assessments were performed by a specialist in collaboration with the nurses on all pictures taken. Results From March 2009 through January 2011, 2,175 patients were screened for cervical cancer at our community-based clinic. 253 (11.6%) were found to have low-grade lesions and received same-day cryotherapy. 1,347 (61.9%) women were considered to have a normal examination and 575 (27.3%) were referred for further evaluation and treatment. Of the 1,347 women initially considered to have normal exams, 267 (19.8%) were recalled based on weekly quality control assessments. 210 (78.6%) of the 267 recalled women and 499 (86.8%) of the 575 referred women were seen at the referral clinic. Of these 709 women, 506 (71.4%) required additional treatment. Overall, 264 CIN stage 2 or 3 were identified and treated, and six micro-invasive cancers identified were referred for further management. Conclusions Our “See and Treat” cervical cancer prevention program using the VIA/EDI approach is a feasible, high-output and high-efficiency program, worthy of considering as an additional cervical cancer screening method in Botswana, especially for women with limited access to the current cytology-based screening services. PMID:22134146

Cervical cancer prevention in HIV-infected women using the "see and treat" approach in Botswana.

PubMed

Ramogola-Masire, Doreen; de Klerk, Ronny; Monare, Barati; Ratshaa, Bakgaki; Friedman, Harvey M; Zetola, Nicola M

2012-03-01

Cervical cancer is a major public health problem in resource-limited settings, particularly among HIV-infected women. Given the challenges of cytology-based approaches, the efficiency of new screening programs need to be assessed. Community and hospital-based clinics in Gaborone, Botswana. To determine the feasibility and efficiency of the "see and treat" approach using visual inspection acetic acid (VIA) and enhanced digital imaging (EDI) for cervical cancer prevention in HIV-infected women. A 2-tier community-based cervical cancer prevention program was implemented. HIV-infected women were screened by nurses at the community using the VIA/EDI approach. Low-grade lesions were treated with cryotherapy on the same visit. Women with complex lesions were referred to our second tier specialized clinic for evaluation. Weekly quality control assessments were performed by a specialist in collaboration with the nurses on all pictures taken. From March 2009 through January 2011, 2175 patients were screened for cervical cancer at our community-based clinic. Two hundred fifty-three patients (11.6%) were found to have low-grade lesions and received same-day cryotherapy. One thousand three hundred forty-seven (61.9%) women were considered to have a normal examination, and 575 (27.3%) were referred for further evaluation and treatment. Of the 1347 women initially considered to have normal exams, 267 (19.8%) were recalled based on weekly quality control assessments. Two hundred ten (78.6%) of the 267 recalled women, and 499 (86.8%) of the 575 referred women were seen at the referral clinic. Of these 709 women, 506 (71.4%) required additional treatment. Overall, 264 cervical intraepithelial neoplasia stage 2 or 3 were identified and treated, and 6 microinvasive cancers identified were referred for further management. Our "see and treat" cervical cancer prevention program using the VIA/EDI approach is a feasible, high-output and high-efficiency program, worthy of considering as an additional cervical cancer screening method in Botswana, especially for women with limited access to the current cytology-based screening services.

The American Indian Summer Institute in Earth System Science (AISESS) at UC Irvine: A Two-Week Residential Summer Program for High School Students

NASA Astrophysics Data System (ADS)

Johnson, K. R.; Polequaptewa, N.; Leon, Y.

2012-12-01

Native Americans remain severely underrepresented in the geosciences, despite a clear need for qualified geoscience professionals within Tribal communities to address critical issues such as natural resource and land management, water and air pollution, and climate change. In addition to the need for geoscience professionals within Tribal communities, increased participation of Native Americans in the geosciences would enhance the overall diversity of perspectives represented within the Earth science community and lead to improved Earth science literacy within Native communities. To address this need, the Department of Earth System Science and the American Indian Resource Program at the University California have organized a two-week residential American Indian Summer Institute in Earth System Science (AISESS) for high-school students (grades 9-12) from throughout the nation. The format of the AISESS program is based on the highly-successful framework of a previous NSF Funded American Indian Summer Institute in Computer Science (AISICS) at UC Irvine and involves key senior personnel from the AISICS program. The AISESS program, however, incorporates a week of camping on the La Jolla Band of Luiseño Indians reservation in Northern San Diego County, California. Following the week of camping and field projects, the students spend a week on the campus of UC Irvine participating in Earth System Science lectures, laboratory activities, and tours. The science curriculum is closely woven together with cultural activities, native studies, and communication skills programs The program culminates with a closing ceremony during which students present poster projects on environmental issues relevant to their tribal communities. The inaugural AISESS program took place from July 15th-28th, 2012. We received over 100 applications from Native American high school students from across the nation. We accepted 40 students for the first year, of which 34 attended the program. The objective of the program is to introduce students to Earth System Science and, hopefully, inspire them to pursue Earth or Environmental Science degrees. Towards this end, we developed a fairly broad curriculum which will be presented here. Evaluation planning was conducted during the first quarter of 2012 during recruitment. A longitudinal database was established for the project to track college preparatory course-taking, GPA, school attendance, participation in earth science activities, and attitudes and interest in attending college and completing a degree after high school. Based on attendance during AISESS, schools and students will be selected as descriptive case studies. A pre-post design for evaluating the Summer Institute includes a survey about student background, attitudes, and knowledge about preparing to complete high school and attend college after graduation and focus groups of participants immediately after the Institute to capture qualitative data about their experiences in the field and at the University. Initial evaluation results will be presented here.

Community partnership to address snack quality and cost in after-school programs.

PubMed

Beets, Michael W; Tilley, Falon; Turner-McGrievy, Gabrielle; Weaver, Robert G; Jones, Sonya

2014-08-01

Policies call on after-school programs (ASPs) to serve more nutritious snacks. A major barrier for improving snack quality is cost. This study describes the impact on snack quality and expenditures from a community partnership between ASPs and local grocery stores. Four large-scale ASPs (serving ˜500 children, aged 6-12 years, each day) and a single local grocery store chain participated in this study. The nutritional quality of snacks served was recorded preintervention (18 weeks spring/fall 2011) and postintervention (7 weeks spring 2012) via direct observation, along with cost/child/snack/day. Preintervention snacks were low-nutrient-density salty snacks (eg, chips, 3.0 servings/week), sugar-sweetened beverages (eg, powdered-lemonade, 1.9 servings/week), and desserts (eg, cookies, 2.1 servings/week), with only 0.4 servings/week of fruits and no vegetables. By postintervention, fruits (3.5 servings/week) and vegetables (1.2 servings/week) were increased, whereas sugar-sweetened beverages and desserts were eliminated. Snack expenditures were $0.26 versus $0.24 from preintervention to postintervention. Partnership savings versus purchasing snacks at full retail cost was 24.5% or $0.25/serving versus $0.34/serving. This innovative partnership can serve as a model in communities where ASPs seek to identify low-cost alternatives to providing nutritious snacks. © 2014, American School Health Association.

Community Partnership to Address Snack Quality and Cost in Afterschool Programs

PubMed Central

Tilley, Falon; Turner-McGrievy, Gabrielle; Weaver, Robert Glenn; Jones, Sonya

2014-01-01

Background Policies call on afterschool programs (ASPs) to serve more nutritious snacks. A major barrier for improving snack quality is cost. This study describes the impact on snack quality and expenditures from a community-partnership between ASPs and local grocery stores. Methods Four large-scale ASPs (serving ∼500 children aged 6-12 years each day) and a single local grocery store chain participated in the study. The nutritional quality of snacks served was recorded pre-intervention (18 weeks spring/fall 2011) and post-intervention (7 weeks spring 2012) via direct observation, along with cost/child/snack/day. Results Pre-intervention snacks were low-nutrient-density salty snacks (eg, chips, 3.0 servings/week), sugar-sweetened beverages (eg, powdered-lemonade, 1.9 servings/week), and desserts (eg, cookies, 2.1servings/week), with only 0.4 servings/week of fruits and no vegetables. By post-intervention, fruits (3.5 servings/week) and vegetables (1.2 servings/week) increased, while sugar-sweetened beverages and desserts were eliminated. Snack expenditures were $0.26 versus $0.24 from pre-intervention to post-intervention. Partnership savings versus purchasing snacks at full retail cost was 24.5% or $0.25/serving versus $0.34/serving. Conclusions This innovative partnership can serve as a model in communities where ASPs seek to identify low-cost alternatives to providing nutritious snacks. PMID:25040123

Investigation of the microbial communities colonizing prepainted steel used for roofing and walling.

PubMed

Huynh, Tran T; Jamil, Ili; Pianegonda, Nicole A; Blanksby, Stephen J; Barker, Philip J; Manefield, Mike; Rice, Scott A

2017-04-01

Microbial colonization of prepainted steel, commonly used in roofing applications, impacts their aesthetics, durability, and functionality. Understanding the relevant organisms and the mechanisms by which colonization occurs would provide valuable information that can be subsequently used to design fouling prevention strategies. Here, next-generation sequencing and microbial community finger printing (T-RFLP) were used to study the community composition of microbes colonizing prepainted steel roofing materials at Burrawang, Australia and Kapar, Malaysia over a 52-week period. Community diversity was low and was dominated by Bacillus spp., cyanobacteria, actinobacteria, Cladosporium sp., Epicoccum nigrum, and Teratosphaeriaceae sp. Cultivation-based methods isolated approximately 20 different fungi and bacteria, some of which, such as E. nigrum and Cladosporium sp., were represented in the community sequence data. Fluorescence in situ hybridization imaging showed that fungi were the most dominant organisms present. Analysis of the sequence and T-RFLP data indicated that the microbial communities differed significantly between locations and changed significantly over time. The study demonstrates the utility of molecular ecology tools to identify and characterize microbial communities associated with the fouling of painted steel surfaces and ultimately can enable the targeted development of control strategies based on the dominant species responsible for fouling. © 2016 The Authors. MicrobiologyOpen published by John Wiley & Sons Ltd.

A Community-based Healthy Living Promotion Program Improved Self-esteem Among Minority Children.

PubMed

Wong, William W; Ortiz, Christina L; Stuff, Janice E; Mikhail, Carmen; Lathan, Debra; Moore, Louis A; Alejandro, Mercedes E; Butte, Nancy F; Smith, Elliot O'Brian

2016-07-01

Improving self-esteem, dietary habits, and physical activity is essential for long-term success in childhood obesity prevention. The aim is to evaluate the effects of a healthy living promotion program, Healthy Kids-Houston, on BMI, dietary habits, self-esteem, and physical activity among minority children. The after-school program was implemented at community centers in low-income neighborhoods with close proximity to public schools. The program consisted of 3 6-week sessions. Each week, children attended 2 2-hour sessions. Each 2-hour session in the intervention included 90 minutes of structured physical activities and 30 minutes of nutrition and healthy habit lessons. The control group received typical enrichment programs. Outcomes were measured before the intervention and at the end of each 6-week session. We enrolled 877 children (age 10.2 ± 0.1 years (mean ± SE); body mass index z score: 1.49 ± 0.1; 52.0% boys; 72.6% Hispanic) in the program with 524 children received the intervention at 14 community centers and 353 children served as control at 10 community centers. The intervention led to no improvements in BMI z score (P = 0.78) and dietary habits (P = 0.46). Significant improvements (P ≤ 0.02) were detected in the amount of exercise that a child perceived to be required to offset a large meal and in several key self-esteem scores. No improvements were detected in physical activities (P ≥ 0.21). The improvement in some key self-esteem scores and nutrition knowledge may act as a mediator to motivate these children to adopt a healthier lifestyle in the future.

The role of community pharmacists in supporting self-management in patients with psoriasis.

PubMed

Tucker, Rod; Stewart, Derek

2017-04-01

The majority of patients with psoriasis have mild to moderate disease which can be managed in primary care with topical therapies. The supportive role of pharmacists for patients with long-term dermatological conditions is largely unknown. To assess the impact of an educational intervention delivered by community pharmacists to improve self-management for people with psoriasis. The study involved a pre- and post-intervention design. Seven community pharmacies were selected based on their location (urban, rural etc.) and the pharmacists recruited via local comprehensive research networks. Patients with mild to moderate psoriasis were recruited either opportunistically or via a letter of invite by pharmacists who undertook a face-to-face consultation with one follow-up visit after 6 weeks. The primary outcome was the change in person-centred dermatology self-care index (PEDESI) score and secondary outcomes were the self-assessed psoriasis and severity index (SAPASI), measuring disease severity and the dermatology quality of life index (DLQI). A total of 47 patients were recruited. At 6 weeks, 42/47 (89.3%) patients completed the follow-up consultation. There was a significant increase in mean PEDESI scores (25.15 versus 17.78, P < 0.001) at 6 weeks compared to baseline. Similarly, SAPASI (11.60 versus 7.74, P < 0.001) and DLQI (7.21 versus 4.14, P < 0.001) scores improved significantly. Pharmacist-assisted support for patients with psoriasis improved knowledge, reduced disease severity and the impact on quality of life. These results suggest that community pharmacists might have an important role to play in facilitating self-management for patients with psoriasis. © 2016 Royal Pharmaceutical Society.

Internet-delivered treatment: its potential as a low-intensity community intervention for adults with symptoms of depression: protocol for a randomized controlled trial

PubMed Central

2014-01-01

Background Depression is a high prevalence disorder, displaying high rates of lifetime incidence, early age onset, high chronicity, and role impairment. In Ireland 12-month prevalence of depression has been reported to be 10.3%. A large percentage of affected individuals have no medical diagnosis nor seek treatment. Cognitive Behavior Therapy (CBT) has established itself as an option for the treatment of depression. Many Irish adults with depression find it difficult to access evidence-based CBT, this is due to several factors, like stigma and costs. However, systematic factors including the shortage of trained professionals and the relative underdevelopment of services also make access difficult. Stepped-care can increase access to evidence-based CBT. One option is tailored internet-delivered treatment programs. Preliminary research from Ireland needs now to include large-scale studies on effectiveness. Thus the current study seeks to examine the potential of an internet-delivered low-intensity treatment for symptoms of depression in an Irish adult community sample. Method/Design The study is a randomized controlled trial of an online CBT (iCBT) program for the treatment of adults with depressive symptoms. The trial will include an active treatment group and a waiting-list control group. The active condition will consist of 8 weekly modules of iCBT, with post-session feedback support. Participants in the waiting list will receive access to the treatment at week 8. Participants will complete the Beck Depression Inventory (BDI-II) and eligibility criteria will also apply. Primary outcomes are depressive symptoms. Secondary outcomes include quality of life indicators, significant events and satisfaction with online treatment. Data will be collected at baseline and at post-treatment, week 8, and at follow-up week 20 (3-months) and week 32 (6-months). Analysis will be conducted on the intention-to-treat basis. Discussion The study seeks to evaluate the effectiveness of an online delivered treatment for depression in a community sample of Irish adults with symptoms of depression. The study will be a first contribution and depending on the sample recruited the results may be generalizable to people with similar difficulties in Ireland and may therefore give insight into the potential of low-intensity interventions for Irish people with depressive symptoms. Trial registration number Current Controlled Trials ISRCTN03704676. DOI: 10.1186/ISRCTN03704676 PMID:24886179

Vivir Con Un Corazón Saludable: a Community-Based Educational Program Aimed at Increasing Cardiovascular Health Knowledge in High-Risk Hispanic Women.

PubMed

Romero, Daniela C; Sauris, Aileen; Rodriguez, Fátima; Delgado, Daniela; Reddy, Ankita; Foody, JoAnne M

2016-03-01

Hispanic women suffer from high rates of cardiometabolic risk factors and an increasingly disproportionate burden of cardiovascular disease (CVD). Particularly, Hispanic women with limited English proficiency suffer from low levels of CVD knowledge associated with adverse CVD health outcomes. Thirty-two predominantly Spanish-speaking Hispanic women completed, Vivir Con un Corazón Saludable (VCUCS), a culturally tailored Spanish language-based 6-week intensive community program targeting CVD health knowledge through weekly interactive health sessions. A 30-question CVD knowledge questionnaire was used to assess mean changes in CVD knowledge at baseline and postintervention across five major knowledge domains including CVD epidemiology, dietary knowledge, medical information, risk factors, and heart attack symptoms. Completion of the program was associated with a statistically significant (p < 0.001) increase in total mean CVD knowledge scores from 39 % (mean 11.7/30.0) to 66 % (mean 19.8/30.0) postintervention consistent with a 68 % increase in overall mean CVD scores. There was a statistically significant (p < 0.001) increase in mean knowledge scores across all five CVD domains. A culturally tailored Spanish language-based health program is effective in increasing CVD awareness among high CVD risk Hispanic women with low English proficiency and low baseline CVD knowledge.

Motor imagery group practice for gait rehabilitation in individuals with post-stroke hemiparesis: a pilot study.

PubMed

Dickstein, Ruth; Levy, Sandra; Shefi, Sara; Holtzman, Sarit; Peleg, Sara; Vatine, Jean-Jacques

2014-01-01

Stroke is the leading cause of adult disability, with walking impairment being a devastating indicator of chronic post-stroke hemiparesis. Limited resources exist for individual treatments; therefore, the delivery of safe group exercise therapy is highly desired. To examine whether the application of group-based motor imagery practice to community-dwelling individuals with chronic hemiparesis improves gait. Sixteen individuals with chronic hemiparesis from two community centers participated in the study, with eight from each center. Four participants in each center received five weeks of the experimental intervention, consisting of group-based motor imagery exercises of gait tasks, followed by five weeks of control treatment of motor imagery exercises for the affected upper extremity. Four other subjects in each center received the same treatments in reverse order. Pre- and post intervention measurements included clinical and biomechanical gait parameters. Comparisons within (pre- vs. post) and between treatments (experimental vs. control) indicated no significant change in any gait variable. Nevertheless, the verbal reports of most participants alluded to satisfaction with the experimental intervention and to an increase in self-confidence. Despite the lack of evidence for the effectiveness of group-based motor imagery practice in improving gait among individuals with chronic hemiparesis, the contrast between the measured outcomes and the positive verbal reports merits further inquiry.

Targeting smoking cessation to high prevalence communities: outcomes from a pilot intervention for gay men.

PubMed

Harding, Richard; Bensley, James; Corrigan, Nick

2004-09-30

Cigarette smoking prevalence among gay men is twice that of population levels. A pilot community-level intervention was developed and evaluated aiming to meet UK Government cessation and cancer prevention targets. Four 7-week withdrawal-oriented treatment groups combined nicotine replacement therapy with peer support. Self-report and carbon monoxide register data were collected at baseline and 7 weeks. N = 98 gay men were recruited through community newspapers and organisations in London UK. At 7 weeks, n = 44 (76%) were confirmed as quit using standard UK Government National Health Service monitoring forms. In multivariate analysis the single significant baseline variable associated with cessation was previous number of attempts at quitting (OR 1.48, p = 0.04). This tailored community-level intervention successfully recruited a high-prevalence group, and the outcome data compares very favourably to national monitoring data (which reports an average of 53% success). Implications for national targeted services are considered.

A Dietary Intervention in Urban African Americans

PubMed Central

Miller, Edgar R.; Cooper, Lisa A.; Carson, Kathryn A.; Wang, Nae-Yuh; Appel, Lawrence J.; Gayles, Debra; Charleston, Jeanne; White, Karen; You, Na; Weng, Yingjie; Martin-Daniels, L. Michelle; Bates-Hopkins, Barbara; Robb, Inez; Franz, Whitney K.; Brown, Emily L.; Halbert, Jennifer P.; Albert, Michael C.; Dalcin, Arlene T.; Yeh, Hsin-Chieh

2015-01-01

Introduction Unhealthy diets, often low in potassium, likely contribute to racial disparities in blood pressure. We tested the effectiveness of providing weekly dietary advice, assistance with selection of higher potassium grocery items, and a $30 per week food allowance on blood pressure and other outcomes in African American adults with hypertension. Design We conducted an 8-week RCT with two parallel arms between May 2012 and November 2013. Setting/participants We randomized 123 African Americans with controlled hypertension from an urban primary care clinic in Baltimore, Maryland and implemented the trial in partnership with a community supermarket and the Baltimore City Health Department. Mean (SD) age was 58.6 (9.5) years, 71% were female, blood pressure was 131.3 (14.7)/77.2 (10.5) mmHg, BMI was 34.5 (8.2) kg/m2, and 28% had diabetes. Intervention Participants randomized to the active intervention group (Dietary Approaches to Stop Hypertension [DASH]-Plus) received coach-directed dietary advice and assistance with weekly online ordering and purchasing of high-potassium foods ($30/week) delivered by a community supermarket to a neighborhood library. Participants in the control group received a printed DASH diet brochure along with debit account of equivalent value to that of the DASH-Plus group. Main outcome measures The primary outcome was blood pressure change. Analyses were conducted in January to October 2014. Results Compared with the control group, the DASH-Plus group increased self-reported consumption of fruits and vegetables (mean=1.4, 95% CI=0.7, 2.1 servings/day), estimated intake of potassium (mean=0.4, 95% CI=0.1, 0.7 grams/day), and urine potassium excretion (mean=19%, 95% CI=1%, 38%). There was no significant effect on blood pressure. Conclusions A program providing dietary advice, assistance with grocery ordering, and $30/week of high-potassium foods in African American patients with controlled hypertension in a community-based clinic did not reduce BP. However, the intervention increased consumption of fruits, vegetables, and urinary excretion of potassium. PMID:26321012

A Dietary Intervention in Urban African Americans: Results of the "Five Plus Nuts and Beans" Randomized Trial.

PubMed

Miller, Edgar R; Cooper, Lisa A; Carson, Kathryn A; Wang, Nae-Yuh; Appel, Lawrence J; Gayles, Debra; Charleston, Jeanne; White, Karen; You, Na; Weng, Yingjie; Martin-Daniels, Michelle; Bates-Hopkins, Barbara; Robb, Inez; Franz, Whitney K; Brown, Emily L; Halbert, Jennifer P; Albert, Michael C; Dalcin, Arlene T; Yeh, Hsin-Chieh

2016-01-01

Unhealthy diets, often low in potassium, likely contribute to racial disparities in blood pressure. We tested the effectiveness of providing weekly dietary advice, assistance with selection of higher potassium grocery items, and a $30 per week food allowance on blood pressure and other outcomes in African American adults with hypertension. We conducted an 8-week RCT with two parallel arms between May 2012 and November 2013. We randomized 123 African Americans with controlled hypertension from an urban primary care clinic in Baltimore, Maryland, and implemented the trial in partnership with a community supermarket and the Baltimore City Health Department. Mean (SD) age was 58.6 (9.5) years; 71% were female; blood pressure was 131.3 (14.7)/77.2 (10.5) mmHg; BMI was 34.5 (8.2); and 28% had diabetes. Participants randomized to the active intervention group (Dietary Approaches to Stop Hypertension [DASH]-Plus) received coach-directed dietary advice and assistance with weekly online ordering and purchasing of high-potassium foods ($30/week) delivered by a community supermarket to a neighborhood library. Participants in the control group received a printed DASH diet brochure along with a debit account of equivalent value to that of the DASH-Plus group. The primary outcome was blood pressure change. Analyses were conducted in January to October 2014. Compared with the control group, the DASH-Plus group increased self-reported consumption of fruits and vegetables (mean=1.4, 95% CI=0.7, 2.1 servings/day); estimated intake of potassium (mean=0.4, 95% CI=0.1, 0.7 grams/day); and urine potassium excretion (mean=19%, 95% CI=1%, 38%). There was no significant effect on blood pressure. A program providing dietary advice, assistance with grocery ordering, and $30/week of high-potassium foods in African American patients with controlled hypertension in a community-based clinic did not reduce BP. However, the intervention increased consumption of fruits, vegetables, and urinary excretion of potassium. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Randomised controlled trial of informal team sports for cardiorespiratory fitness and health benefit in Pacific adults.

PubMed

Biddle, Mark G; Vincent, Grace; McCambridge, Alana; Britton, Gabrielle; Dewes, Ofa; Elley, C Raina; Moyes, Simon A; Edge, Johann

2011-12-01

Rates of obesity, Type 2 diabetes and cardiovascular disease are high among Pacific people in New Zealand. Physical activity is recommended in the prevention and management of these conditions. Community-based, 'small-sided game' group activities may be an effective and culturally appropriate way to promote physical activity within Pacific communities. To assess the effectiveness of small-sided games-based exercise on fitness and health parameters among Pacific adults over four weeks. Twenty untrained (13 female) Pacific adults were randomised to intervention or control. Intervention participants were offered 45 minutes of small-sided games three times per week for four weeks. Control participants were offered one-month gym membership after the trial. Primary outcomes included cardiorespiratory fitness (VO₂peak) and leg strength (maximal concentric force of quadriceps at 60°/second) measured at baseline and four weeks. Secondary outcomes included glycaemia, lipid profile, blood pressure (BP), and inflammatory markers. Multivariable regression models were used to assess differences between groups, adjusting for baseline values, age and gender. At baseline, mean age was 34.8 years (SD 12.6), BMI 36.3 (6.7), systolic BP 127.7 mmHg (12.1), HbA1c 6.1% (1.9), VO₂peak 2.5 L/min (0.6) and leg strength 170.0 N.m (57.4). Sixteen participants completed the trial. Change in outcomes were greater in intervention than control participants in absolute VO₂peak (0.9 L/min (p=0.003)), leg strength (17.8 N.m (p=0.04)) and HDL (0.12 mmol/L (p=0.02)). There were no other significant differences. Small-sided games appear to be a promising means for improving the health and cardiorespiratory fitness and reducing the risk of diabetes and cardiovascular disease in Pacific adults.

Comparison of DNA preservation methods for environmental bacterial community samples.

PubMed

Gray, Michael A; Pratte, Zoe A; Kellogg, Christina A

2013-02-01

Field collections of environmental samples, for example corals, for molecular microbial analyses present distinct challenges. The lack of laboratory facilities in remote locations is common, and preservation of microbial community DNA for later study is critical. A particular challenge is keeping samples frozen in transit. Five nucleic acid preservation methods that do not require cold storage were compared for effectiveness over time and ease of use. Mixed microbial communities of known composition were created and preserved by DNAgard(™), RNAlater(®), DMSO-EDTA-salt (DESS), FTA(®) cards, and FTA Elute(®) cards. Automated ribosomal intergenic spacer analysis and clone libraries were used to detect specific changes in the faux communities over weeks and months of storage. A previously known bias in FTA(®) cards that results in lower recovery of pure cultures of Gram-positive bacteria was also detected in mixed community samples. There appears to be a uniform bias across all five preservation methods against microorganisms with high G + C DNA. Overall, the liquid-based preservatives (DNAgard(™), RNAlater(®), and DESS) outperformed the card-based methods. No single liquid method clearly outperformed the others, leaving method choice to be based on experimental design, field facilities, shipping constraints, and allowable cost. © 2012 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.

Effects of WiiActive exercises on fear of falling and functional outcomes in community-dwelling older adults: a randomised control trial.

PubMed

Kwok, Boon Chong; Pua, Yong Hao

2016-09-01

the study compares the effects of a Nintendo Wii exercise programme and a standard Gym-based exercise intervention on fear of falling, knee strength, physical function and falls rate in older adults. eighty community-dwelling adults aged 60 years and above with short physical performance battery score of 5-9 points and modified falls efficacy scale (MFES) score of ≤9 points participated in the parallel-group randomised trial. Each intervention arm involved an hour of intervention per week, totalling 12 sessions over 12 weeks. Besides 1-year fall incidence, the participants were evaluated on MFES, knee extensor strength (KES), timed-up-and-go test, gait speed, 6-minute walk test and narrow corridor walk test at weeks 13 and 24. at week 13, between interventions, the effect of MFES changes did not reach statistical significance (difference = -0.07 point, 95% CI -0.56 to 0.42, P = 0.78); at week 24, the Wii group showed statistically significant effects over the Gym group (difference = 0.8 point, 95% CI 0.27 to 1.29, P < 0.01). For KES, the two groups did not differ statistically at week 13 (difference = -2.0%, 95% CI -5.6 to -1.7, P = 0.29); at week 24, the Gym group had greater strength gains than the Wii group (difference = -5.1%, 95% CI -8.7 to -1.5, P < 0.01). No between-group differences were observed for other outcome measures. on completion of a 12-week Nintendo Wii exercise programme, there was no significant benefit seen on fear of falling when compared to a standard Gym-based exercise intervention; however, post-intervention there was an apparent reduction in fear of falling in the group allocated to Wii training, despite knee strength apparently improving more in those allocated to the Gym. It is possible that long-term gains after using the Wii might be due to a carry-over effect. Australian New Zealand Clinical Trials Registry, ACTRN12610000576022. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Iterative design, implementation and evaluation of a supplemental feeding program for underweight children ages 6-59 months in Western Uganda.

PubMed

Jilcott, Stephanie B; Ickes, Scott B; Ammerman, Alice S; Myhre, Jennifer A

2010-03-01

In this paper we describe the development, implementation, evaluation, and subsequent improvements of a supplemental feeding program that provides community-based care to underweight children in a rural East African setting, using a locally-sourced and produced ready-to-use food (RUF). Production teams were trained to grind soybeans and groundnuts (peanuts), which were then mixed with moringa oleifera leaf powder to form an energy-dense supplemental food, designed for use as an RUF. Eligible children (based on low weight-for-age or mid-upper-arm circumference < 12 cm) received RUF of approximately 682 kcal per day for five weeks. Weekly growth monitoring and caregiver education were provided by trained health center staff and community volunteers. The program was evaluated by examining RUF nutrient composition, weight gain velocity, and qualitative data from key-informant interviews and home feeding observations. Locally-produced RUF had similar energy density but higher protein content than commercial RUTF (ready-to-use therapeutic food). Mean weight gain of children was 2.5 g/kg/day (range 0.9-6.0). Feeding observations revealed that caregivers were diluting the RUF fed to children. Production team members desired increased financial compensation for their work but were enthusiastic about the program as helpful to malnourished children. Locally-produced RUF is a promising strategy for community-based care of moderately malnourished children. Through the production team's entrepreneurship, a small business was formed, whereby financial incentives encouraged continued RUF production. Future efforts are needed to educate caregivers on correct RUF use and improve commercial viability in local markets.

Haiti and the politics of governance and community responses to Hurricane Matthew

PubMed Central

Marcelin, Louis Herns; Cela, Toni; Shultz, James M.

2016-01-01

ABSTRACT This article examines disaster preparedness and community responses to Hurricane Matthew in semi-urban and rural towns and villages in Grande-Anse, Haiti. Based on an ethnographic study conducted in the department of Grande-Anse one week after the hurricane made landfall in Haiti, the article focuses on the perspectives of citizens, community-based associations and local authorities in the affected areas. Sixty-three (63) interviews and 8 community meetings (focus groups) were conducted in 11 impacted sites in 8 communes. Results suggest that preexisting conditions in impacted communities, rather than deliberate and coordinated disaster management strategies, shaped levels of preparedness for and response to the disaster. Affected populations relied primarily on family networks and local forms of solidarity to attend to basic needs such as shelter, health and food. The main argument presented is that Haiti, by virtue of its geographic location, lack of resources, institutional fragility and vulnerability, must systematically integrate community-based assets and capacities in its responses to and management of disasters. Further, it is critical for the government, Haitian institutions, and society to apply integrated risk reduction and management and disaster preparedness measures in all aspects of life, if the country is to survive the many disasters to come in a time of climate change. These measures should be embedded in recovery and reconstruction efforts after Hurricane Matthew. PMID:28321361

76 FR 25525 - National Charter Schools Week, 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-05

... Charter Schools Week, 2011 By the President of the United States of America A Proclamation In communities... of students, parents, teachers, and administrators. During National Charter Schools Week, we... Charter School Week. I commend our Nation's charter schools, teachers, and administrators, and I call on...

The Four Day School Week. Research Brief

ERIC Educational Resources Information Center

Muir, Mike

2013-01-01

Can four-day school weeks help districts save money? How do districts overcome the barriers of moving to a four-day week? What is the effect of a four-day week on students, staff and the community? This paper enumerates the benefits for students and teachers of four-day school weeks. Recommendations for implementation of a four-day week are also…

Perceived access to fruits and vegetables associated with increased consumption.

PubMed

Caldwell, Erin M; Miller Kobayashi, M; DuBow, W M; Wytinck, S M

2009-10-01

To examine the association between fruit and vegetable access in the community and change in fruit and vegetable consumption among participants in community-based health promotion programmes. Fruit and vegetable consumption and perceived access to fresh fruit and vegetables were measured by self-administered questionnaires at programme start, end and 1-year follow-up. Community produce availability was determined by grocery store assessments measuring the display space devoted to fruit and vegetable offerings, as well as price, variety and freshness. A total of nine communities were studied; 130 participants completed the fruit and vegetable portions of the questionnaires and could be linked to grocery store assessments. Participants made modest but significant increases in fruit and vegetable consumption from programme start to end: the average increase was 2.88 (95% CI 1.52, 4.25) servings weekly; the average increase from start to follow-up was 2.52 (95% CI 1.09, 3.95) servings weekly. Greater perceived access to fruits and vegetables was significantly associated with higher increases in fruit and vegetable consumption from programme start to programme end. Greater availability of produce was associated with greater increases in fruit and vegetable servings from programme start to programme end as measured by store assessments. Environmental factors, such as access to fruits and vegetables, can modify the effects of community interventions. Interventions with the goal of increasing fruit and vegetable consumption should consider focusing on increasing access to fresh fruits and vegetables in target communities. Similarly, researchers may want to study access as an intervention, not just a contextual variable.

An integrated community-based outpatient therapeutic feeding programme for severe acute malnutrition in rural Southern Ethiopia: Recovery, fatality, and nutritional status after discharge.

PubMed

Tadesse, Elazar; Worku, Amare; Berhane, Yemane; Ekström, Eva-Charlotte

2018-04-01

A scaled up and integrated outpatient therapeutic feeding programme (OTP) brings the treatment of severely malnourished children closer to the community. This study assessed recovery from severe acute malnutrition (SAM), fatality, and acute malnutrition up to 14 weeks after admission to a programme integrated in the primary health care system. In this cohort study, 1,048 children admitted to 94 OTPs in Southern Ethiopia were followed for 14 weeks. Independent anthropometric measurements and information on treatment outcome were collected at four home visits. Only 32.7% (248/759) of children with SAM on admission fulfilled the programme recovery criteria at the time of discharge (i.e., gained 15% in weight, or oedema, if present at admission, was resolved at discharge). Of all children admitted to the programme for whom nutritional assessment was done 14 weeks later, 34.6% (321/928) were severely malnourished, and 37.5% (348/928) were moderately malnourished; thus, 72.1% were acutely malnourished. Of the children, 27/982 (2.7%) had died by 14 weeks, of whom all but one had SAM on admission. Children with severe oedema on admission had the highest fatality rate (12.0%, 9/75). The median length of admission to the programme was 6.6 weeks (interquartile range: 5.3, 8.4 weeks). Despite children participating for the recommended duration of the programme, many children with SAM were discharged still acutely malnourished and without reaching programme criteria for recovery. For better outcome of OTP, constraints in service provision by the health system as well as challenges of service utilization by the beneficiaries should be identified and addressed. © 2017 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.

Rethinking peer support for diabetes in Vancouver's South-Asian community: a feasibility study.

PubMed

Tang, T S; Sohal, P S; Garg, A K

2015-08-01

To examine the feasibility and potential health impact of a diabetes self-management education and support intervention involving peer support on glycaemic control and diabetes distress. A total of 41 South-Asian adults with Type 2 diabetes were recruited for a 24-week diabetes self-management education and support pilot intervention involving peer support. The intervention consisted of six weekly education sessions co-facilitated by a certified diabetes educator and two peer leaders, followed by 18 weekly support sessions facilitated by two peer leaders. Education sessions were guided entirely by participants' self-management questions and also emphasized goal setting and action planning. Support sessions were based on empowerment principles and participants discussed self-management challenges, shared emotions, asked self-management questions, problem-solved in a group, set goals, and developed and evaluated action plans. Feasibility outcomes included recruitment and retention. Primary health-related outcomes included HbA1c levels and diabetes distress (measured at baseline, 6 and 24 weeks). Programme satisfaction was also assessed. Pre-established criteria for recruitment and retention were met. Paired t-tests showed no changes in HbA1c and diabetes distress at 6 weeks. At 24 weeks, HbA1c levels deteriorated [54 mmol/mol (7.1%) vs 61 mmol/mol (7.7%)] while diabetes distress scores improved (2.0 vs 1.7). Although feasible, findings suggest this peer-support model may have a positive impact on diabetes distress, but not on HbA1c levels. Culturally responsive modifications (e.g. intervention location) to the pilot model are needed and could lead to more favourable health outcomes for this community. Such a re-designed peer-support model will require further investigation. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

[Assessment on the short-term impact regarding the community-based interventions to improve physical activities in three urban areas of Hangzhou city].

PubMed

Gao, Fang; Liu, Qing-min; Ren, Yan-jun; He, Ping-ping; LV, Jun; Li, Li-ming

2013-06-01

To evaluate the short-term impact of comprehensive community based intervention on physical activity (PA) of adults living in the three urban communities of Hangzhou city. Within the framework of Community Interventions for Health (CIH) Program, a community trial was conducted in two urban areas (Xiacheng district and Gongshu district)and an urban area(Xihu district)as control, by a parallel comparison and random grouping based quasi-experimental design. Two independent questionnaire-based surveys of cross-sectional samples in the intervention and comparison areas were used to assess the short-term impact of the intervention program. A total of 2016 adults at baseline and 2016 adults at follow-up stages, completed the survey, including 1016 adults from the intervention areas and 1000 from the comparison area. Over the two-year intervention period, the cognitive level on benefits of physical activity in the intervention areas were trending downward. The changes observed in the comparison area did not show statistical significance. Intervention areas showed a statistically significant increase (1204 vs. 1386, P = 0.023) in the level of physical activity(metabolic equivalent, MET-minutes/week)compared with the comparison area(918 vs. 924, P = 0.201). And results remained the same after eliminating the possible effects of age factor. After a two-year intervention, beneficial changes were noted in the intervention areas with respect to the level of physical activity. A community-based intervention program on physical activity seemed feasible and effective in the urban areas of Hangzhou.

Rationale and study protocol for the 'eCoFit' randomized controlled trial: Integrating smartphone technology, social support and the outdoor physical environment to improve health-related fitness among adults at risk of, or diagnosed with, Type 2 Diabetes.

PubMed

Wilczynska, Magdalena; Lubans, David R; Cohen, Kristen E; Smith, Jordan J; Robards, Sara L; Plotnikoff, Ronald C

2016-07-01

The prevalence and risk of Type 2 Diabetes (T2D) has dramatically increased over the past decade. Physical activity (PA) has significant benefits for the treatment and prevention of T2D. The aim of this study is to develop, implement and evaluate a community-based PA intervention to improve aerobic and muscular fitness among adults at risk of, or diagnosed with T2D. The eCoFit pilot intervention will be evaluated using a randomized controlled trial (RCT) design. The 20-week (Phases 1 and 2) multi-component intervention was guided by Social Cognitive Theory, Health Action Process Approach Model, and Cognitive Behavior Therapy strategies. Phase 1 (Weeks 1-10) includes: i) 5 group face-to-face sessions consisting of outdoor training and cognitive mentoring; and ii) the use of the eCoFit smartphone application with a description of where and how to use the outdoor environment to be more physically active. Phase 2 (Weeks 11-20) includes the use of the eCoFit smartphone application only. Assessments are to be conducted at baseline, 10-weeks (primary end-point) and 20-weeks (secondary end-point) post-baseline. Primary outcomes are cardio-respiratory fitness and muscular fitness (lower body). Secondary outcomes include physical, behavioral, mental health and quality of life, and social-cognitive outcomes. eCoFit is an innovative, multi-component intervention, which integrates smartphone technology, social support and the outdoor physical environment to promote aerobic and resistance training PA among adults at risk of, or diagnosed with T2D. The findings will be used to guide future interventions and to develop and implement effective community-based prevention programs. Australian New Zealand Clinical Trials Registry No: ACTRN12615000990527. Copyright © 2016 Elsevier Inc. All rights reserved.

Community College Compressed Calendars: Results of a Student Survey and a Faculty Survey.

ERIC Educational Resources Information Center

Carley, Michael

This document reports that many community colleges are considering changes in their traditional semester calendars. In California, the most common question facing colleges is whether to switch from the traditional (in California) 18-week semester to a 16-week one. This paper details the results of a student and faculty survey conducted at…

A Fire Safety Pre-Educational Plan.

ERIC Educational Resources Information Center

Rosenbaum, Lynn

A weekly dance at a community center was used to develop a teachable moment for active senior citizens regarding fire safety, in order to reduce their injuries and possible loss of life. A target group of active senior citizens 70 years of age and older who frequent the weekly community center dance was established for the program. The program…

A community continuity programme: volunteer faculty mentors and continuity learning.

PubMed

McGeehan, John; English, Richard; Shenberger, Keith; Tracy, Gerald; Smego, Raymond

2013-02-01

Longitudinal generalist preceptorship experiences early in medical education can have beneficial effects on how students practise the art and science of medicine, regardless of their eventual career choices. We evaluated the first 2 years of implementation of an integrated, regional campus-based, early clinical experience programme, the Community Continuity Program, at our new community-based medical school that is under the supervision of volunteer primary care faculty members acting as continuity mentors (CMs). Curricular components for years 1 and 2 consisted of three annual 1-week community-based experiences with CMs, extensive physical diagnosis practice, interprofessional learning activities, a multigenerational family care experience, a mandatory Community Health Research Project (CHRP) in year 1 and a mandatory Quality Improvement Project in year 2. Outcome measures included student, faculty member and programme evaluations, student reflective narratives in portal-based e-journals, a Liaison Committee on Medical Education (LCME) self-study student survey and serial level-of-empathy surveys.   Students found all elements of this integrated community experience programme beneficial and worthwhile, especially the CMs and the use of standardised and real-life patients. CMs noted effective and professional student-patient interactions. The number of reflective e-journal postings per student during year1 ranged from 14 to 81 (mean, 47). Serial empathy questionnaires administered over 2 years demonstrated preservation of student empathy, and students believed that the programme had a positive effect on their personal level of empathy.   An integrative, longitudinal, community-based, early clinical experience programme driven by volunteer CMs provides patient-centered instruction for preclinical students in the clinical, social, behavioural, ethical and research foundations of medicine. © Blackwell Publishing Ltd 2013.

Action observation training of community ambulation for improving walking ability of patients with post-stroke hemiparesis: a randomized controlled pilot trial.

PubMed

Park, Hyun-Ju; Oh, Duck-Won; Choi, Jong-Duk; Kim, Jong-Man; Kim, Suhn-Yeop; Cha, Yong-Jun; Jeon, Su-Jin

2017-08-01

To investigate the effects of action observation training involving community-based ambulation for improving walking ability after stroke. Randomized, controlled pilot study. Inpatient rehabilitation hospital. A total of 25 inpatients with post-stroke hemiparesis were randomly assigned to either the experimental group ( n = 12) or control group ( n = 13). Subjects of the experimental group watched video clips demonstrating four-staged ambulation training with a more complex environment factor for 30 minutes, three times a week for four weeks. Meanwhile, subjects of the control group watched video clips, which showed different landscape pictures. Walking function was evaluated before and after the four-week intervention using a 10-m walk test, community walk test, activities-specific balance confidence scale, and spatiotemporal gait measures. Changes in the values for the 10-m walk test (0.17 ±0.19 m/s vs. 0.05 ±0.08 m/s), community walk test (-151.42 ±123.82 seconds vs. 67.08 ±176.77 seconds), and activities-specific balance confidence (6.25 ±5.61 scores vs. 0.72 ±2.24 scores) and the spatiotemporal parameters (i.e. stride length (19.00 ±11.34 cm vs. 3.16 ±11.20 cm), single support (5.87 ±5.13% vs. 0.25 ±5.95%), and velocity (15.66 ±12.34 cm/s vs. 2.96 ±10.54 cm/s)) indicated a significant improvement in the experimental group compared with the control group. In the experimental group, walking function and ambulation confidence was significantly different between the pre- and post-intervention, whereas the control group showed a significant difference only in the 10-m walk test. Action observation training of community ambulation may be favorably used for improving walking function of patients with post-stroke hemiparesis.

Passive Suicidal Ideation and Community Mental Health Resources in South Africa.

PubMed

Collins, Pamela Y; Kondos, Leeza; Pillai, Aravind; Joestl, Sarah S; Frohlich, Janet

2016-07-01

South African communities continue to experience elevated incidence and prevalence of HIV infection. Passive suicidal ideation (PSI) may be one expression of distress in high prevalence communities. We report the prevalence of PSI and examine the relationship between PSI and participation in community organizations in a semi-rural sample of South African adults (N = 594). The prevalence of PSI in the 2 weeks prior to the interview was 9.1 %. Members of burial societies (Χ (2) = 7.34; p = 0.01) and stokvels (Χ (2) = 4.1; p = 0.04) (community-based savings groups) reported significantly less PSI compared to other respondents. Using a multivariate model adjusted for demographic characteristics, psychological distress, and socioeconomic status, we found lower odds of reporting PSI for members of burial societies (OR 0.48, CI 0.25 -0.91). Participation in community organizations that provide contextually salient resources in settings with high levels of distress may be a resource for mental health.

Development of Clinical Pharmacy in Switzerland: Involvement of Community Pharmacists in Care for Older Patients.

PubMed

Hersberger, Kurt E; Messerli, Markus

2016-03-01

The role of the community pharmacist in primary care has been undergoing change in Switzerland in parallel to international developments: it has become more clinically and patient oriented. Special services of community pharmacists to older patients taking long-term or multiple medications, discharged from hospitals or experiencing cognitive impairment or disability have been developed. These services require more clinical knowledge and skills from community pharmacists and are based on, for example, 'simple or intermediate medication reviews' focused primarily to improve medication adherence and rational drug use by a patient. Reflecting the new role of community pharmacies, this article describes the current services provided by community pharmacies in Switzerland, e.g., 'polymedication check', 'weekly pill organizer', and 'services for chronic patients', as well as new Swiss educational and reimbursement systems supporting development of these services. In the international context, involvement of community pharmacists in patient-oriented care is growing. This review summarizes positive and negative experiences from implementation of community pharmacy services in Switzerland and provides examples for the development of such services in other countries.

Small Steps Are Easier Together: a goal-based ecological intervention to increase walking by women in rural worksites.

PubMed

Warren, Barbour S; Maley, Mary; Sugarwala, Laura J; Wells, Martin T; Devine, Carol M

2010-01-01

Small Steps Are Easier Together (SmStep) was a locally-instituted, ecologically based intervention to increase walking by women. Participants were recruited from 10 worksites in rural New York State in collaboration with worksite leaders and Cooperative Extension educators. Worksite leaders were oriented and chose site specific strategies. Participants used pedometers and personalized daily and weekly step goals. Participants reported steps on web logs and received weekly e-mail reports over 10 weeks in the spring of 2008. Of 188 enrollees, 114 (61%) reported steps. Weekly goals were met by 53% of reporters. Intention to treat analysis revealed a mean increase of 1503 daily steps. Movement to a higher step zone over their baseline zone was found for: 52% of the sedentary (n=80); 29% of the low active (n=65); 13% of the somewhat active (n=28); and 18% of the active participants (n=10). This placed 36% of enrollees at the somewhat active or higher zones (23% at baseline, p<0.005). Workers increased walking steps through a goal-based intervention in rural worksites. The SmStep intervention provides a model for a group-based, locally determined, ecological strategy to increase worksite walking supported by local community educators and remote messaging using email and a web site. Copyright (c) 2010 Elsevier Inc. All rights reserved.

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

Hann, Jr, Roy W.; Randall, Robert E.

This report describes nekton communities off Freeport, Texas prior to brine disposal based on trawl studies in the period October 1977 to February 1980. Trawling was conducted aboard chartered commercial shrimp trawlers along a transect in depths of 3 to 25 fathoms to describe the general background of nekton communities off Freeport. An array of stations were occupied at the diffuser site in 12 fathoms of water to describe in detail nekton communities near the diffuser. Collections at each station, in general, were made once a month during the day and once a month at night, cruises being about twomore » weeks apart in time. Projected diffuser locations, stations occupied, etc., changed during the course of the project, and the Materials and Methods (Section 4.2) should be consulted for details.« less

Some ecological implications of a neem (azadirachtin) insecticide disturbance to zooplankton communities in forest pond enclosures.

PubMed

Kreutzweiser, David P; Sutton, Trent M; Back, Richard C; Pangle, Kevin L; Thompson, Dean G

2004-04-28

A neem-based insecticide, Neemix 4.5, was applied to forest pond enclosures at concentrations of 10, 17, and 28 microg l(-1) azadirachtin (the active ingredient). At these test concentrations, significant, concentration-dependent reductions in numbers of adult copepods were observed, but immature copepod and cladoceran populations were unaffected. There was no evidence of recovery of adult copepods within the sampling season (May to October). The ecological significance of this disturbance to the zooplankton community was examined by determining biomass as a measure of food availability for higher predators, plankton community respiration, dissolved oxygen (DO) concentrations, and conductivity as functional indicators of ecosystem stress, and zooplankton food web stability as a measure of effects on trophic structure. The selective removal or reduction of adult copepods was sufficient to measurably reduce total zooplankton biomass for several weeks mid-season. During the period of maximal impact (about 4-9 weeks after the applications), total plankton community respiration was significantly reduced, and this appeared to contribute to significant, concentration-dependent increases in dissolved oxygen and decreases in conductivity among treated enclosures. The reductions in adult copepods resulted in negative effects on zooplankton food web stability through eliminations of a trophic link and reduced interactions and connectance. Comparing the results here to those from a previous study with tebufenozide, which was selectively toxic to cladocerans and had little effect on food web stability, indicates that differential sensitivity among taxa can influence the ecological significance of pesticide effects on zooplankton communities.

Predictors of Abstinence: NIDA Multi-site Buprenorphine/Naloxone Treatment Trial in Opioid Dependent Youth

PubMed Central

Subramaniam, Geetha A.; Warden, Diane; Minhajuddin, Abu; Fishman, Marc J.; Stitzer, Maxine L.; Adinoff, Bryon; Trivedi, Madhukar; Weiss, Roger; Potter, Jennifer; Poole, Sabrina A.; Woody, George E.

2013-01-01

Objective To examine predictors of opioid abstinence in buprenorphine/naloxone (Bup/Nal) assisted psychosocial treatment for opioid dependent youth Method Secondary analyses of data from 152 youth (ages 15–21) randomly assigned to 12 weeks of extended Bup/Nal therapy or up to 2 weeks of Bup/Nal detoxification, both with weekly individual and group drug counseling. Logistic regression models were constructed to identify baseline and during-treatment predictors of opioid positive urines (OPU) at week-12. Predictors were selected based on significance or trend toward significance (i.e. p<0.1) and backward stepwise selection was used, controlling for treatment group, to produce final independent predictors at p ≤ 0.05. Results Youth presenting to treatment with past 30-day injection drug use (IDU) and more active medical/psychiatric problems were less likely to have a week-12 OPU. Those with early treatment opioid abstinence (i.e. weeks 1 and 2); and those who received additional non-study treatments during the study were less likely to have a week-12 OPU; and those not completing 12 weeks of treatment were more likely to have an OPU. Conclusions Youth with advanced illness (i.e. reporting IDU and additional health problems), and those receiving ancillary treatments to augment study treatment were more likely to have lower opioid use. Treatment success in the first 2 weeks and completion of 12 weeks of treatment were associated with lower rates of OPU. These findings suggest that youth with advanced illness respond well to Bup/Nal treatment, and identify options for tailoring treatment for opioid-dependent youth presenting at community-based settings. PMID:22024000

FIT for FUNCTION: study protocol for a randomized controlled trial.

PubMed

Richardson, Julie; Tang, Ada; Guyatt, Gordon; Thabane, Lehana; Xie, Feng; Sahlas, Demetrios; Hart, Robert; Fleck, Rebecca; Hladysh, Genevieve; Macrae, Louise

2018-01-15

The current state of evidence suggests that community-based exercise programs are beneficial in improving impairment, function, and health status, and are greatly needed for persons with stroke. However, limitations of these studies include risk of bias, feasibility, and cost issues. This single-blinded, randomized controlled trial (RCT) of 216 participants with stroke will compare the effectiveness of a 12-week YMCA community-based wellness program (FIT for FUNCTION) specifically designed for community-dwelling persons with stroke to persons who receive a standard YMCA membership. The primary outcome will be community reintegration using the Reintegration to Normal Living Index at 12 and 24 weeks. Secondary outcomes include measurement of physical activity level using the Rapid Assessment of Physical Activity and accelerometry; balance using the Berg Balance Scale; lower extremity function using the Short Physical Performance Battery; exercise capacity using the 6-min walk test; grip strength and isometric knee extension strength using hand held dynamometry; and health-related quality of life using the European Quality of Life 5-Dimension Questionnaire. We are also assessing cardiovascular health and lipids; glucose and inflammatory markers will be collected following 12-h fast for total cholesterol, insulin, glucose, and glycated hemoglobin. Self-efficacy for physical activity will be assessed with a single question and self-efficacy for managing chronic disease will be assessed using the Stanford 6-item Scale. The Patient Activation Measure will be used to assess the patient's level of knowledge, skill, and confidence for self-management. Healthcare utilization and costs will be evaluated. Group, time, and group × time interaction effects will be estimated using generalized linear models for continuous variables, including relevant baseline variables as covariates in the analysis that differ appreciably between groups at baseline. Cost data will be treated as non-parametric and analyzed using a Mann-Whitney U test. This is a RCT with broad study eligibility criteria intended to recruit a wide spectrum of individuals living in the community with stroke. If positive benefits are demonstrated, results will provide strong research evidence to support the implementation of structured, community-based exercise and education/self-management programs for a broad range of people living in the community with stroke. ClinicalTrials.gov, NCT02703805 . Registered on 14 October 2014.

Association between community garden participation and fruit and vegetable consumption in rural Missouri.

PubMed

Barnidge, Ellen K; Hipp, Pamela R; Estlund, Amy; Duggan, Kathleen; Barnhart, Kathryn J; Brownson, Ross C

2013-11-19

Fruit and vegetable consumption reduces chronic disease risk, yet the majority of Americans consume fewer than recommended. Inadequate access to fruits and vegetables is increasingly recognized as a significant contributor to low consumption of healthy foods. Emerging evidence shows the effectiveness of community gardens in increasing access to, and consumption of, fruits and vegetables. Two complementary studies explored the association of community garden participation and fruit and vegetable consumption in rural communities in Missouri. The first was with a convenience sample of participants in a rural community garden intervention who completed self-administered surveys. The second was a population-based survey conducted with a random sample of 1,000 residents in the intervention catchment area. Participation in a community garden was associated with higher fruit and vegetable consumption. The first study found that individuals who worked in a community garden at least once a week were more likely to report eating fruits and vegetables because of their community garden work (X² (125) = 7.78, p = .0088). Population-based survey results show that 5% of rural residents reported participating in a community garden. Those who reported community garden participation were more likely to report eating fruits 2 or more times per day and vegetables 3 or more times per day than those who did not report community garden participation, even after adjusting for covariates (Odds Ratio [OR] = 2.76, 95% Confidence Interval [CI] = 1.35 to 5.65). These complementary studies provide evidence that community gardens are a promising strategy for promoting fruit and vegetable consumption in rural communities.

Considerations for conducting Web-based survey research with people living with human immunodeficiency virus using a community-based participatory approach.

PubMed

O'Brien, Kelly K; Solomon, Patricia; Worthington, Catherine; Ibáñez-Carrasco, Francisco; Baxter, Larry; Nixon, Stephanie A; Baltzer-Turje, Rosalind; Robinson, Greg; Zack, Elisse

2014-03-13

Web or Internet-based surveys are increasingly popular in health survey research. However, the strengths and challenges of Web-based surveys with people living with human immunodeficiency virus (HIV) are unclear. The aim of this article is to describe our experience piloting a cross-sectional, Web-based, self-administered survey with adults living with HIV using a community-based participatory research approach. We piloted a Web-based survey that investigated disability and rehabilitation services use with a sample of adults living with HIV in Canada. Community organizations in five provinces emailed invitations to clients, followed by a thank you/reminder one week later. We obtained survey feedback in a structured phone interview with respondents. Participant responses were transcribed verbatim and analyzed using directed content analysis. Of 30 people living with HIV who accessed the survey link, 24/30 (80%) initiated and 16/30 (53%) completed the survey instrument. A total of 17 respondents participated in post-survey interviews. Participants described the survey instrument as comprehensive, suggesting content validity. The majority (13/17, 76%) felt instruction and item wording were clear and easy to understand, and found the software easy to navigate. Participants felt having a pop-up reminder directing them to missed items would be useful. Strengths of implementing the Web-based survey included: our community-based participatory approach, ease of software use, ability for respondents to complete the questionnaire on one's own time at one's own pace, opportunity to obtain geographic variation, and potential for respondent anonymity. Considerations for future survey implementation included: respondent burden and fatigue, the potentially sensitive nature of HIV Web-based research, data management and storage, challenges verifying informed consent, varying computer skills among respondents, and the burden on community organizations. Overall, results provide considerations for researchers conducting community-based participatory Web-based survey research with people living with HIV.

Considerations for Conducting Web-Based Survey Research With People Living With Human Immunodeficiency Virus Using a Community-Based Participatory Approach

PubMed Central

Solomon, Patricia; Worthington, Catherine; Ibáñez-Carrasco, Francisco; Baxter, Larry; Nixon, Stephanie A; Baltzer-Turje, Rosalind; Robinson, Greg; Zack, Elisse

2014-01-01

Background Web or Internet-based surveys are increasingly popular in health survey research. However, the strengths and challenges of Web-based surveys with people living with human immunodeficiency virus (HIV) are unclear. Objective The aim of this article is to describe our experience piloting a cross-sectional, Web-based, self-administered survey with adults living with HIV using a community-based participatory research approach. Methods We piloted a Web-based survey that investigated disability and rehabilitation services use with a sample of adults living with HIV in Canada. Community organizations in five provinces emailed invitations to clients, followed by a thank you/reminder one week later. We obtained survey feedback in a structured phone interview with respondents. Participant responses were transcribed verbatim and analyzed using directed content analysis. Results Of 30 people living with HIV who accessed the survey link, 24/30 (80%) initiated and 16/30 (53%) completed the survey instrument. A total of 17 respondents participated in post-survey interviews. Participants described the survey instrument as comprehensive, suggesting content validity. The majority (13/17, 76%) felt instruction and item wording were clear and easy to understand, and found the software easy to navigate. Participants felt having a pop-up reminder directing them to missed items would be useful. Conclusions Strengths of implementing the Web-based survey included: our community-based participatory approach, ease of software use, ability for respondents to complete the questionnaire on one’s own time at one’s own pace, opportunity to obtain geographic variation, and potential for respondent anonymity. Considerations for future survey implementation included: respondent burden and fatigue, the potentially sensitive nature of HIV Web-based research, data management and storage, challenges verifying informed consent, varying computer skills among respondents, and the burden on community organizations. Overall, results provide considerations for researchers conducting community-based participatory Web-based survey research with people living with HIV. PMID:24642066

Speech Correction for Children with Cleft Lip and Palate by Networking of Community-Based Care.

PubMed

Hanchanlert, Yotsak; Pramakhatay, Worawat; Pradubwong, Suteera; Prathanee, Benjamas

2015-08-01

Prevalence of cleft lip and palate (CLP) is high in Northeast Thailand. Most children with CLP face many problems, particularly compensatory articulation disorders (CAD) beyond surgery while speech services and the number of speech and language pathologists (SLPs) are limited. To determine the effectiveness of networking of Khon Kaen University (KKU) Community-Based Speech Therapy Model: Kosumphisai Hospital, Kosumphisai District and Maha Sarakham Hospital, Mueang District, Maha Sarakham Province for reduction of the number of articulations errors for children with CLP. Eleven children with CLP were recruited in 3 1-year projects of KKU Community-Based Speech Therapy Model. Articulation tests were formally assessed by qualified language pathologists (SLPs) for baseline and post treatment outcomes. Teachings on services for speech assistants (SAs) were conducted by SLPs. Assigned speech correction (SC) was performed by SAs at home and at local hospitals. Caregivers also gave SC at home 3-4 days a week. Networking of Community-Based Speech Therapy Model signficantly reduced the number of articulation errors for children with CLP in both word and sentence levels (mean difference = 6.91, 95% confidence interval = 4.15-9.67; mean difference = 5.36, 95% confidence interval = 2.99-7.73, respectively). Networking by Kosumphisai and Maha Sarakham of KKU Community-Based Speech Therapy Model was a valid and efficient method for providing speech services for children with cleft palate and could be extended to any area in Thailand and other developing countries, where have similar contexts.

Beliefs and implementation of evidence-based practice among community health nurses: A cross-sectional descriptive study.

PubMed

Pereira, Filipa; Pellaux, Victoria; Verloo, Henk

2018-03-08

To describe beliefs about evidence-based practice and record levels of implementation among community health nurses working independently and in community healthcare centres in the canton of Valais, Switzerland. In many settings, evidence-based practice is considered a key means of delivering better and secure health care. However, there is a paucity of published studies on the implementation of evidence-based practice in community health care. Cross-sectional descriptive study (n = 100). Beliefs about evidence-based practice and levels of implementation were measured using validated scales developed by Melnyk et al. (Worldviews on Evidence-Based Nursing, 5, 2008, 208). Information on respondents' sociodemographic and professional characteristics was collected. Data were analysed using descriptive and inferential statistics. The final response rate was 32.3% (n = 100). More than half of respondents had previously heard about evidence-based practice; most believed in the value of using evidence to guide their practice and were prepared to improve their skills to be able to do so. However, the rate of implementation of evidence-based practice in daily practice in the 8 weeks before the survey was poor. Statistically significant positive associations were found between beliefs about evidence-based practice and how respondents had heard about it and between implementation rates and whether they had heard about evidence-based practice and how they had done so. Evidence-based practices requiring scientific knowledge and skills were implemented less frequently. Greater professional community healthcare experience and management roles did not increase implementation of evidence-based practice. The systematic implementation of evidence-based practice by community health nurses working independently and in healthcare centres in Valais was rare, despite their positive beliefs about it. These results revealed the level of implementation of evidence-based practice by nurses in community healthcare settings in Valais. Further research is required to better understand their needs and expectations and to develop suitable strategies that will allow the integration of evidence-based practice into nurses' daily practice. © 2018 The Authors Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

Efficacy of Short Term Training in Education of Children with Mental Retardation to Teachers of Visually Impaired Students.

ERIC Educational Resources Information Center

Narayan, J.; Subba Rao, T. A.; Reddy, O. R.

1998-01-01

A one-week inservice program on mental retardation was provided to 24 teachers of students with visual impairments in India. Emphasis was on community based rehabilitation and the teaching of children with mental retardation who also have visual impairment. Testing revealed participants had gained knowledge and their evaluations indicated they…

Seven Oaks Met School Builds Curriculum around Each Student

ERIC Educational Resources Information Center

Pearson, George

2009-01-01

This article features Seven Oaks School Division Met School in Winnipeg, a high school that limits class size to 15, tailors its curriculum to the needs and interests of its individual students, places students in community-based internships two days a week, and keeps the teacher--called an advisor--with the same group of students from Grade 9…

Public Scholarship within an Urban School District: A Community and University Partnership Approach to Service-Learning

ERIC Educational Resources Information Center

Booker, Angela; Montgomery-Block, Kindra; Scott, Zenae; Reyes, bel; Onyewuenyi, Adaurennaya

2011-01-01

This article reports on a collaborative partnership, based in principles of public scholarship and designed to serve local, at-risk or high-risk youth. The program is a six-week summer service-learning initiative in the Sacramento, California, area developed for transitioning 9th grade students through a multi-agency partnership. The project…

Taking steps together: a family- and community-based obesity intervention for urban, multiethnic children.

PubMed

Anderson, John D; Newby, Rachel; Kehm, Rebecca; Barland, Patricia; Hearst, Mary O

2015-04-01

Successful childhood obesity intervention models that build sustainable behavioral change are needed, particularly in low-income, ethnic minority communities disparately affected by this problem. Families were referred to Taking Steps Together (TST) by their primary care provider if at least one child had a body mass index ≥85%. The TST intervention comprised 16 weekly 2-hour classes including educational activities, group cooking/eating, and physical activities for parents and children. TST's approach emphasized building self-efficacy, targeting both children and parents for healthy change, and fostering intrinsic motivation for healthier living. Pre-post intervention data were collected on health-related behaviors using a survey, and trained staff measured weight and height. Adults (n = 33) and children (n = 62) were largely Hispanic/Latino and low-income. Adults and children significantly increased their fruit and vegetable consumption and weekly physical activity, and adults significantly decreased sugared beverage consumption and screen time. No change in body mass index was observed for adults or children. This family-focused childhood obesity intervention integrated evidence-based principles with a nonprescriptive approach and produced significant improvements in key healthy behaviors for both adults and children. © 2014 Society for Public Health Education.

Home-based neurologic music therapy for arm hemiparesis following stroke: results from a pilot, feasibility randomized controlled trial

PubMed Central

Street, Alexander J; Magee, Wendy L; Bateman, Andrew; Parker, Michael; Odell-Miller, Helen; Fachner, Jorg

2017-01-01

Objective: To assess the feasibility of a randomized controlled trial to evaluate music therapy as a home-based intervention for arm hemiparesis in stroke. Design: A pilot feasibility randomized controlled trial, with cross-over design. Randomization by statistician using computer-generated, random numbers concealed in opaque envelopes. Setting: Participants’ homes across Cambridgeshire, UK. Subjects: Eleven people with stroke and arm hemiparesis, 3–60 months post stroke, following discharge from community rehabilitation. Interventions: Each participant engaged in therapeutic instrumental music performance in 12 individual clinical contacts, twice weekly for six weeks. Main measures: Feasibility was estimated by recruitment from three community stroke teams over a 12-month period, attrition rates, completion of treatment and successful data collection. Structured interviews were conducted pre and post intervention to establish participant tolerance and preference. Action Research Arm Test and Nine-hole Peg Test data were collected at weeks 1, 6, 9, 15 and 18, pre and post intervention by a blinded assessor. Results: A total of 11 of 14 invited participants were recruited (intervention n = 6, waitlist n = 5). In total, 10 completed treatment and data collection. Conclusion: It cannot be concluded whether a larger trial would be feasible due to unavailable data regarding a number of eligible patients screened. Adherence to treatment, retention and interview responses might suggest that the intervention was motivating for participants. Trial registration: ClinicalTrials.gov identifier NCT 02310438. PMID:28643570

Correlates of Caregiver Participation in a Brief, Community-Based Dementia Care Management Program.

PubMed

Mavandadi, Shahrzad; Patel, Samir; Benson, Amy; DiFilippo, Suzanne; Streim, Joel; Oslin, David

2017-11-10

The evidence base for dementia care management interventions for informal caregivers (CGs) is strong, yet enrollment and sustained engagement in academic and community-based research trials is low. This study sought to examine rates and correlates of participation in a community-based, telephone-delivered dementia care management program designed to address logistic and practical barriers to participation in CG trials and services. Participants included 290 CGs of older, community-dwelling, low-income care recipients (CRs) who met criteria for enrollment in a collaborative dementia care management program that provides assessment, psychosocial support and education, and connection to community resources via telephone. Cross-sectional analyses examined the association between CG-related (e.g., financial status, relationship to CR, caregiving burden) and CR-related (e.g., functional limitations, symptom severity) factors and CG enrollment and engagement. The majority of CGs were non-Hispanic White, female, financially stable, and adult children of the CRs. Over half of CGs lived with the CR and provided 20 or more hours of care per week. Roughly half of CGs refused care management services. Adjusted logistic regression models revealed that perceived caregiving burden and financial status were related to initial enrollment and engagement in services once enrolled, respectively. A significant proportion of CGs refuse free, convenient, evidence-based dementia care management services, underscoring the need for further examination of correlates of program acceptance. Nonetheless, community-based programs that address barriers may improve enrollment and engagement rates among CGs, including those who are especially vulnerable to negative CG and CR outcomes. Published by Oxford University Press on behalf of The Gerontological Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Tai Chi: moving for better balance -- development of a community-based falls prevention program.

PubMed

Li, Fuzhong; Harmer, Peter; Mack, Karin A; Sleet, David; Fisher, K John; Kohn, Melvin A; Millet, Lisa M; Xu, Junheng; Yang, Tingzhong; Sutton, Beth; Tompkins, Yvaughn

2008-05-01

This study was designed to develop an evidence- and community based falls prevention program -- Tai Chi: Moving for Better Balance. A mixed qualitative and quantitative approach was used to develop a package of materials for program implementation and evaluation. The developmental work was conducted in 2 communities in the Pacific Northwest. Participants included a panel of experts, senior service program managers or activity coordinators, and older adults. Outcome measures involved program feasibility and satisfaction. Through an iterative process, a program package was developed. The package contained an implementation plan and class training materials (ie, instructor's manual, videotape, and user's guidebook). Pilot testing of program materials showed that the content was appropriate for the targeted users (community-living older adults) and providers (local senior service organizations). A feasibility survey indicated interest and support from users and providers for program implementation. A 2-week pilot evaluation showed that the program implementation was feasible and evidenced good class attendance, high participant satisfaction, and interest in continuing Tai Chi. The package of materials developed in this study provides a solid foundation for larger scale implementation and evaluation of the program in community settings.

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…

The Effectiveness of One-to-One Tutoring by Community Tutors for At-Risk Beginning Readers.

ERIC Educational Resources Information Center

Vadasy, Patricia F.; Jenkins, Joseph R.; Antil, Lawrence R.; Wayne, Susan K.; O'Connor, Rollanda E.

1997-01-01

Twenty at-risk first graders received 30 minutes of individual instruction from community tutors four days a week for up to 23 weeks. Subjects outperformed the control group on all reading, decoding, spelling and segmenting, and writing measures. Tutors who implemented the program with a high degree of fidelity achieved significant effect sizes in…

Academic Effects and Cost Benefit of a Four-Day Week at College of DuPage, an Illinois Community College.

ERIC Educational Resources Information Center

Wallace, Carol C.

The implementation of a four-day week (Monday-Thursday) for on-campus classes at the College of DuPage, an Illinois community college, was assessed in terms of student registration; class enrollment; student success rates; instructional quality; and savings resulting from driving differences, energy use, and building maintenance. Withdrawal and…

Social capital, the miniaturization of community and high alcohol consumption: a population-based study.

PubMed

Lindström, Martin

2005-01-01

To study the impact of social participation, trust, and the miniaturization of community, i.e. high social participation/low trust, on the risk of high alcohol consumption. The Scania 2000 public health survey is a cross-sectional, postal questionnaire study. A total of 13 604 persons aged 18-80 years were included. A logistic regression model was used to investigate the association between the social capital variables and high alcohol consumption (168.0 g/week or more for men and 108.0 g/week or more for women). The multivariate analyses analysed the importance of confounders (age, country of origin, education, and economic stress) on the risk of high alcohol consumption according to the social capital variables. A 14.0% proportion of all men and 7.8% of all women had an alcohol consumption above recommended levels. High alcohol consumption above recommended levels was not associated with social participation but negatively associated with trust among men. The miniaturization of community category, i.e. high social participation/low trust, had significantly higher risks of high alcohol consumption compared to the high social capital (high social participation/high trust) category among men. High social participation combined with low trust, i.e. the miniaturization of community, is positively associated high alcohol consumption among men. A structural/social factor which may affect the amount of alcohol consumed has thus been identified in this study.

Liking and hyperlinking: Community detection in online child sexual exploitation networks.

PubMed

Westlake, Bryce G; Bouchard, Martin

2016-09-01

The online sexual exploitation of children is facilitated by websites that form virtual communities, via hyperlinks, to distribute images, videos, and other material. However, how these communities form, are structured, and evolve over time is unknown. Collected using a custom-designed webcrawler, we begin from known child sexual exploitation (CE) seed websites and follow hyperlinks to connected, related, websites. Using a repeated measure design we analyze 10 networks of 300 + websites each - over 4.8 million unique webpages in total, over a period of 60 weeks. Community detection techniques reveal that CE-related networks were dominated by two large communities hosting varied material -not necessarily matching the seed website. Community stability, over 60 weeks, varied across networks. Reciprocity in hyperlinking between community members was substantially higher than within the full network, however, websites were not more likely to connect to homogeneous-content websites. Copyright © 2016 Elsevier Inc. All rights reserved.

Infection Surveillance Protocol for a Multicountry Population-based Study in South Asia to Determine the Incidence, Etiology and Risk Factors for Infections Among Young Infants of 0 to 59 Days Old.

PubMed

Islam, Mohammad Shahidul; Baqui, Abdullah H; Zaidi, Anita K; Bhutta, Zulfiqar A; Panigrahi, Pinaki; Bose, Anuradha; Soofi, Sajid B; Kazi, Abdul Momin; Mitra, Dipak K; Isaac, Rita; Nanda, Pritish; Connor, Nicholas E; Roth, Daniel E; Qazi, Shamim A; El Arifeen, Shams; Saha, Samir K

2016-05-01

Insufficient knowledge of the etiology and risk factors for community-acquired neonatal infection in low-income countries is a barrier to designing appropriate intervention strategies for these settings to reduce the burden and treatment of young infant infection. To address these gaps, we are conducting the Aetiology of Neonatal Infection in South Asia (ANISA) study among young infants in Bangladesh, India and Pakistan. The objectives of ANISA are to establish a comprehensive surveillance system for registering newborns in study catchment areas and collecting data on bacterial and viral etiology and associated risk factors for infections among young infants aged 0-59 days. We are conducting active surveillance in 1 peri-urban and 4 rural communities. During 2 years of surveillance, we expect to enroll an estimated 66,000 newborns within 7 days of their birth and to follow-up them until 59 days of age. Community health workers visit each young infant in the study area 3 times in the first week of life and once a week thereafter. During these visits, community health workers assess the newborns using a clinical algorithm and refer young infants with signs of suspected infection to health care facilities where study physicians reassess them and provide care if needed. On physician confirmation of suspected infection, blood and respiratory specimens are collected and tested to identify the etiologic agent. ANISA is one of the largest initiatives ever undertaken to understand the etiology of young infant infection in low-income countries. The data generated from this surveillance will help guide evidence-based decision making to improve health care in similar settings.

Sustained economic benefits of resistance training in community-dwelling senior women.

PubMed

Davis, Jennifer C; Marra, Carlo A; Robertson, M Clare; Najafzadeh, Mehdi; Liu-Ambrose, Teresa

2011-07-01

To determine whether the health and cost benefits of resistance training were sustained 12 months after formal cessation of the intervention. Cost-utility analysis conducted alongside a randomized controlled trial. Community-dwelling women aged 65 to 75 living in Vancouver, British Columbia. One hundred twenty-three of the 155 community-dwelling women aged 65 to 75 years who originally were randomly allocated to once-weekly resistance training (n=54), twice-weekly resistance training (n=52), or twice-weekly balance and tone exercises (control group; n=49) participated in the 12-month follow-up study. Of these, 98 took part in the economic evaluation (twice-weekly balance and tone exercises, n=28; once-weekly resistance training, n=35; twice-weekly resistance training, n=35). The primary outcome measure was incremental cost per quality-adjusted life year (QALY) gained. Healthcare resource utilization was assessed over 21 months (2009 prices); health status was assessed using the EuroQol-5D to calculate QALYs using a 21-month time horizon. Once- and twice-weekly resistance training were less costly than balance and tone classes, with incremental mean healthcare costs of Canadian dollars (CAD$)1,857 and CAD$1,077, respectively. The incremental QALYs for once- and twice-weekly resistance training were -0.051 and -0.081, respectively, compared with balance and tone exercises. The cost benefits of participating in a 12-month resistance training intervention were sustained for the once- and twice-weekly resistance training group, whereas the health benefits were not. © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

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

PubMed

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

2018-06-20

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

Effects of Adding an Internet-Based Pain Coping Skills Training Protocol to a Standardized Education and Exercise Program for People With Persistent Hip Pain (HOPE Trial): Randomized Controlled Trial Protocol

PubMed Central

Rini, Christine; Keefe, Francis; French, Simon; Nelligan, Rachel; Kasza, Jessica; Forbes, Andrew; Dobson, Fiona; Haxby Abbott, J.; Dalwood, Andrew; Vicenzino, Bill; Harris, Anthony; Hinman, Rana S.

2015-01-01

Background Persistent hip pain in older people is usually due to hip osteoarthritis (OA), a major cause of pain, disability, and psychological dysfunction. Objective The purpose of this study is to evaluate whether adding an Internet-based pain coping skills training (PCST) protocol to a standardized intervention of education followed by physical therapist–instructed home exercise leads to greater reductions in pain and improvements in function. Design An assessor-, therapist-, and participant-blinded randomized controlled trial will be conducted. Setting The study will be conducted in a community setting. Participants The participants will be 142 people over 50 years of age with self-reported hip pain consistent with hip OA. Intervention Participants will be randomly allocated to: (1) a control group receiving a 24-week standardized intervention comprising an 8-week Internet-based education package followed by 5 individual physical therapy exercise sessions plus home exercises (3 times weekly) or (2) a PCST group receiving an 8-week Internet-based PCST protocol in addition to the control intervention. Measurements Outcomes will be measured at baseline and 8, 24, and 52 weeks, with the primary time point at 24 weeks. Primary outcomes are hip pain on walking and self-reported physical function. Secondary outcomes include health-related quality-of-life, participant-perceived treatment response, self-efficacy for pain management and function, pain coping attempts, pain catastrophizing, and physical activity. Measurements of adherence, adverse events, use of health services, and process measures will be collected at 24 and 52 weeks. Cost-effectiveness will be assessed at 52 weeks. Limitations A self-reported diagnosis of persistent hip pain will be used. Conclusions The findings will help determine whether adding an Internet-based PCST protocol to standardized education and physical therapist–instructed home exercise is more effective than education and exercise alone for persistent hip pain. This study has the potential to guide clinical practice toward innovative modes of psychosocial health care provision. PMID:26023213

Effects of Adding an Internet-Based Pain Coping Skills Training Protocol to a Standardized Education and Exercise Program for People With Persistent Hip Pain (HOPE Trial): Randomized Controlled Trial Protocol.

PubMed

Bennell, Kim L; Rini, Christine; Keefe, Francis; French, Simon; Nelligan, Rachel; Kasza, Jessica; Forbes, Andrew; Dobson, Fiona; Abbott, J Haxby; Dalwood, Andrew; Vicenzino, Bill; Harris, Anthony; Hinman, Rana S

2015-10-01

Persistent hip pain in older people is usually due to hip osteoarthritis (OA), a major cause of pain, disability, and psychological dysfunction. The purpose of this study is to evaluate whether adding an Internet-based pain coping skills training (PCST) protocol to a standardized intervention of education followed by physical therapist-instructed home exercise leads to greater reductions in pain and improvements in function. An assessor-, therapist-, and participant-blinded randomized controlled trial will be conducted. The study will be conducted in a community setting. The participants will be 142 people over 50 years of age with self-reported hip pain consistent with hip OA. Participants will be randomly allocated to: (1) a control group receiving a 24-week standardized intervention comprising an 8-week Internet-based education package followed by 5 individual physical therapy exercise sessions plus home exercises (3 times weekly) or (2) a PCST group receiving an 8-week Internet-based PCST protocol in addition to the control intervention. Outcomes will be measured at baseline and 8, 24, and 52 weeks, with the primary time point at 24 weeks. Primary outcomes are hip pain on walking and self-reported physical function. Secondary outcomes include health-related quality-of-life, participant-perceived treatment response, self-efficacy for pain management and function, pain coping attempts, pain catastrophizing, and physical activity. Measurements of adherence, adverse events, use of health services, and process measures will be collected at 24 and 52 weeks. Cost-effectiveness will be assessed at 52 weeks. A self-reported diagnosis of persistent hip pain will be used. The findings will help determine whether adding an Internet-based PCST protocol to standardized education and physical therapist-instructed home exercise is more effective than education and exercise alone for persistent hip pain. This study has the potential to guide clinical practice toward innovative modes of psychosocial health care provision. © 2015 American Physical Therapy Association.

Comprehensive geriatric intervention program with and without weekly class-style exercise: research protocol of a cluster randomized controlled trial in Kyoto-Kameoka Study

PubMed Central

Yoshida, Tsukasa; Yoshinaka, Yasuko; Yoshimoto, Mie; Tanaka, Yoko; Itoi, Aya; Yamagata, Emi; Ebine, Naoyuki; Ishikawa-Takata, Kazuko; Kimura, Misaka

2018-01-01

Objective The number of long-term care (LTC) users and the associated expenditures in Japan are increasing dramatically. The national government recommends LTC prevention through activation of communities. However, there is no clear evidence of the effect of population-based comprehensive geriatric intervention program (CGIP) for restraints of LTC users and the associated expenditures in the future. The aims of the current paper are to describe the study protocol and progress of a cluster randomized controlled trial (RCT) with a CGIP in Kameoka City. Methods The cluster RCT involved random allocation of regions as intervention (n=4,859) and nonintervention (n=7,195). Participants were elderly persons aged ≥65 years without LTC certification who had responded to a mailing survey. The residents living in intervention regions were invited to a physical check-up, and 1,463 people participated (30.3%). These individuals were invited to the CGIP, and 526 accepted. The CGIP comprised instructions on: 1) low-load resistance training using bodyweight, ankle weights, and elastic bands; 2) increasing daily physical activity; 3) oral motor exercise and care; and 4) a well-balanced diet based on a program from Ministry of Health, Labour and Welfare. We allocated the intervention regions randomly into home-based self-care program alone (HB group, 5 regions, n=275) and home-based program+weekly class-style session (CS group, 5 regions, n=251). We evaluated the effects of the CGIP at 12 weeks and at 12 or 15 months on physical function, and are conducting follow-up data collection for an indefinite period regarding LTC certification, medical costs, and mortality. Results and discussion The study was launched with good response rates in each phase. Participants of both groups significantly increased their step counts by ~1,000 per day from the baseline during the CGIP. This RCT will provide valuable information and evidence about effectiveness of a community-based CGIP. PMID:29872280

Harm reduction with pharmacotherapy for homeless people with alcohol dependence: Protocol for a randomized controlled trial

PubMed Central

Collins, Susan E.; Saxon, Andrew J.; Duncan, Mark H.; Smart, Brian F.; Merrill, Joseph O.; Malone, Daniel K.; Jackson, T. Ron; Clifasefi, Seema L.; Joesch, Jutta; Ries, Richard K.

2014-01-01

Background Interventions requiring abstinence from alcohol are neither preferred by nor shown to be highly effective with many homeless individuals with alcohol dependence. It is therefore important to develop lower-threshold, patient-centered interventions for this multimorbid and high-utilizing population. Harm-reduction counseling requires neither abstinence nor use reduction and pairs a compassionate style with patient-driven goal-setting. Extended-release naltrexone (XR-NTX), a monthly injectable formulation of an opioid receptor antagonist, reduces craving and may support achievement of harm-reduction goals. Together, harm-reduction counseling and XR-NTX may support alcohol harm reduction and quality-of-life improvement. Aims Study aims include testing: a) the relative efficacy of XR-NTX and harm-reduction counseling compared to a community-based, supportive-services-as-usual control, b) theory-based mediators of treatment effects, and c) treatment effects on publicly funded service costs. Methods This RCT involves four arms: a) XR-NTX+harm-reduction counseling, b) placebo+harm-reduction counseling, c) harm-reduction counseling only, and d) community-based, supportive-services-as-usual control conditions. Participants are currently/formerly homeless, alcohol dependent individuals (N=300). Outcomes include alcohol variables (i.e., craving, quantity/frequency, problems and biomarkers), health-related quality of life, and publicly funded service utilization and associated costs. Mediators include 10-point motivation rulers and the Penn Alcohol Craving Scale. XR-NTX and harm-reduction counseling are administered every 4 weeks over the 12-week treatment course. Follow-up assessments are conducted at weeks 24 and 36. Discussion If found efficacious, XR-NTX and harm-reduction counseling will be well-positioned to support reductions in alcohol-related harm, decreases in costs associated with publicly funded service utilization, and increases in quality of life among homeless, alcohol-dependent individuals. PMID:24846619

Cost-Effectiveness of an Internet-Delivered Treatment for Substance Abuse: Data from a Multisite Randomized Controlled Trial

PubMed Central

Murphy, Sean M.; Campbell, Aimee N. C.; Ghitza, Udi E.; Kyle, Tiffany L.; Bailey, Genie L.; Nunes, Edward V.; Polsky, Daniel

2016-01-01

Background Substance misuse and excessive alcohol consumption are major public health issues. Internet-based interventions for substance use disorders (SUDs) are a relatively new method for addressing barriers to access and supplementing existing care. This study examines cost-effectiveness in a multisite, randomized trial of an internet-based version of the community reinforcement approach (CRA) with contingency management (CM) known as the Therapeutic Education System (TES). Methods Economic evaluation of the 12-week trial with follow-up at 24 and 36 weeks. 507 individuals who were seeking therapy for alcohol or other substance use disorders at 10 outpatient community-based treatment programs were recruited and randomized to either treatment as usual (TAU) or TES+TAU. Sub-analyses were completed on participants with a poorer prognosis (i.e., those not abstinent at study entry). Results From the provider’s perspective, TES+TAU as it was implemented in this study costs $278 (SE=87) more than TAU alone after 12 weeks. The quality-adjusted life years gained by TES+TAU and TAU were similar; however, TES+TAU has at least a 95% chance of being considered cost-effective for providers and payers with willingness-to-pay thresholds as low as $20,000 per abstinent year. Findings for the subgroup not abstinent at study entry are slightly more favorable. Conclusions With regard to the clinical outcome of abstinence, our cost-effectiveness findings of TES+TAU compare favorably to those found elsewhere in the CM literature. The analyses performed here serve as an initial economic framework for future studies integrating technology into SUD therapy. Clinical trial registration NCT01104805. PMID:26880594

Harm reduction with pharmacotherapy for homeless people with alcohol dependence: protocol for a randomized controlled trial.

PubMed

Collins, Susan E; Saxon, Andrew J; Duncan, Mark H; Smart, Brian F; Merrill, Joseph O; Malone, Daniel K; Jackson, T Ron; Clifasefi, Seema L; Joesch, Jutta; Ries, Richard K

2014-07-01

Interventions requiring abstinence from alcohol are neither preferred by nor shown to be highly effective with many homeless individuals with alcohol dependence. It is therefore important to develop lower-threshold, patient-centered interventions for this multimorbid and high-utilizing population. Harm-reduction counseling requires neither abstinence nor use reduction and pairs a compassionate style with patient-driven goal-setting. Extended-release naltrexone (XR-NTX), a monthly injectable formulation of an opioid receptor antagonist, reduces craving and may support achievement of harm-reduction goals. Together, harm-reduction counseling and XR-NTX may support alcohol harm reduction and quality-of-life improvement. Study aims include testing: a) the relative efficacy of XR-NTX and harm-reduction counseling compared to a community-based, supportive-services-as-usual control, b) theory-based mediators of treatment effects, and c) treatment effects on publicly funded service costs. This RCT involves four arms: a) XR-NTX+harm-reduction counseling, b) placebo+harm-reduction counseling, c) harm-reduction counseling only, and d) community-based, supportive-services-as-usual control conditions. Participants are currently/formerly homeless, alcohol dependent individuals (N=300). Outcomes include alcohol variables (i.e., craving, quantity/frequency, problems and biomarkers), health-related quality of life, and publicly funded service utilization and associated costs. Mediators include 10-point motivation rulers and the Penn Alcohol Craving Scale. XR-NTX and harm-reduction counseling are administered every 4weeks over the 12-week treatment course. Follow-up assessments are conducted at weeks 24 and 36. If found efficacious, XR-NTX and harm-reduction counseling will be well-positioned to support reductions in alcohol-related harm, decreases in costs associated with publicly funded service utilization, and increases in quality of life among homeless, alcohol-dependent individuals. Copyright © 2014 Elsevier Inc. All rights reserved.

Cost-effectiveness of an internet-delivered treatment for substance abuse: Data from a multisite randomized controlled trial.

PubMed

Murphy, Sean M; Campbell, Aimee N C; Ghitza, Udi E; Kyle, Tiffany L; Bailey, Genie L; Nunes, Edward V; Polsky, Daniel

2016-04-01

Substance misuse and excessive alcohol consumption are major public health issues. Internet-based interventions for substance use disorders (SUDs) are a relatively new method for addressing barriers to access and supplementing existing care. This study examines cost-effectiveness in a multisite, randomized trial of an internet-based version of the community reinforcement approach (CRA) with contingency management (CM) known as the Therapeutic Education System (TES). Economic evaluation of the 12-week trial with follow-up at 24 and 36 weeks. 507 individuals who were seeking therapy for alcohol or other substance use disorders at 10 outpatient community-based treatment programs were recruited and randomized to either treatment as usual (TAU) or TES+TAU. Sub-analyses were completed on participants with a poorer prognosis (i.e., those not abstinent at study entry). From the provider's perspective, TES+TAU as it was implemented in this study costs $278 (SE=87) more than TAU alone after 12 weeks. The quality-adjusted life years gained by TES+TAU and TAU were similar; however, TES+TAU has at least a 95% chance of being considered cost-effective for providers and payers with willingness-to-pay thresholds as low as $20,000 per abstinent year. Findings for the subgroup not abstinent at study entry are slightly more favorable. With regard to the clinical outcome of abstinence, our cost-effectiveness findings of TES+TAU compare favorably to those found elsewhere in the CM literature. The analyses performed here serve as an initial economic framework for future studies integrating technology into SUD therapy. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Impact of high-concentrate feeding and low ruminal pH on methanogens and protozoa in the rumen of dairy cows.

PubMed

Hook, Sarah E; Steele, Michael A; Northwood, Korinne S; Wright, André-Denis G; McBride, Brian W

2011-07-01

Non-lactating dairy cattle were transitioned to a high-concentrate diet to investigate the effect of ruminal pH suppression, commonly found in dairy cattle, on the density, diversity, and community structure of rumen methanogens, as well as the density of rumen protozoa. Four ruminally cannulated cows were fed a hay diet and transitioned to a 65% grain and 35% hay diet. The cattle were maintained on an high-concentrate diet for 3 weeks before the transition back to an hay diet, which was fed for an additional 3 weeks. Rumen fluid and solids and fecal samples were obtained prior to feeding during weeks 0 (hay), 1, and 3 (high-concentrate), and 4 and 6 (hay). Subacute ruminal acidosis was induced during week 1. During week 3 of the experiment, there was a significant increase in the number of protozoa present in the rumen fluid (P=0.049) and rumen solids (P=0.004), and a significant reduction in protozoa in the rumen fluid in week 6 (P=0.003). No significant effect of diet on density of rumen methanogens was found in any samples, as determined by real-time PCR. Clone libraries were constructed for weeks 0, 3, and 6, and the methanogen diversity of week 3 was found to differ from week 6. Week 3 was also found to have a significantly altered methanogen community structure, compared to the other weeks. Twenty-two unique 16S rRNA phylotypes were identified, three of which were found only during high-concentrate feeding, three were found during both phases of hay feeding, and seven were found in all three clone libraries. The genus Methanobrevibacter comprised 99% of the clones present. The rumen fluid at weeks 0, 3, and 6 of all the animals was found to contain a type A protozoal population. Ultimately, high-concentrate feeding did not significantly affect the density of rumen methanogens, but did alter methanogen diversity and community structure, as well as protozoal density within the rumen of nonlactating dairy cattle. Therefore, it may be necessary to monitor the rumen methanogen and protozoal communities of dairy cattle susceptible to depressed pH when methane abatement strategies are being investigated.

“Straight from the heavens into your bucket”: domestic rainwater harvesting as a measure to improve water security in a subarctic indigenous community

PubMed Central

Mercer, Nicholas; Hanrahan, Maura

2017-01-01

ABSTRACT Background: Black Tickle-Domino is an extremely water-insecure remote Inuit community in the Canadian subarctic that lacks piped-water. Drinking water consumption in the community is less than a third of the Canadian national average. Water insecurity in the community contributes to adverse health, economic, and social effects and requires urgent action. Objectives: To test the ability of domestic rainwater harvesting (DRWH) for the first time in the subarctic with the goal of improving water access and use in the community. Design: This project utilised quantitative weekly reporting of water collection and use, as well as focus group discussions. DRWH units were installed at seven water-insecure households chosen by the local government. Results were measured over a 6-week period in 2016. Results: Participants harvested 19.07 gallons of rainwater per week. General purpose water consumption increased by 17% and water retrieval efforts declined by 40.92%. Households saved $12.70 CDN per week. Participants reported perceived improvements to psychological health. Because no potable water was collected, drinking water consumption did not increase. The study identified additional water-insecurity impacts. Conclusion: DRWH cannot supply drinking water without proper treatment and filtration; however, it can be a partial remedy to water insecurity in the subarctic. DRWH is appropriately scaled, inexpensive, and participants identified several significant benefits. PMID:28422581

"Straight from the heavens into your bucket": domestic rainwater harvesting as a measure to improve water security in a subarctic indigenous community.

PubMed

Mercer, Nicholas; Hanrahan, Maura

2017-01-01

Black Tickle-Domino is an extremely water-insecure remote Inuit community in the Canadian subarctic that lacks piped-water. Drinking water consumption in the community is less than a third of the Canadian national average. Water insecurity in the community contributes to adverse health, economic, and social effects and requires urgent action. To test the ability of domestic rainwater harvesting (DRWH) for the first time in the subarctic with the goal of improving water access and use in the community. This project utilised quantitative weekly reporting of water collection and use, as well as focus group discussions. DRWH units were installed at seven water-insecure households chosen by the local government. Results were measured over a 6-week period in 2016. Participants harvested 19.07 gallons of rainwater per week. General purpose water consumption increased by 17% and water retrieval efforts declined by 40.92%. Households saved $12.70 CDN per week. Participants reported perceived improvements to psychological health. Because no potable water was collected, drinking water consumption did not increase. The study identified additional water-insecurity impacts. DRWH cannot supply drinking water without proper treatment and filtration; however, it can be a partial remedy to water insecurity in the subarctic. DRWH is appropriately scaled, inexpensive, and participants identified several significant benefits.

Evaluation of a Community Reintegration Outpatient Program Service for Community-Dwelling Persons with Spinal Cord Injury

PubMed Central

Bain, Patricia; Hébert, Debbie; Hitzig, Sander L.

2014-01-01

Objective. To evaluate the effectiveness of a community reintegration outpatient (CROP) service for promoting well-being and community participation following spinal cord injury (SCI). Participants. Community-dwelling adults (N = 14) with traumatic and nontraumatic SCI. Interventions. The CROP service is a 12-week (1 × week; 120 minutes) interprofessional closed therapeutic education service. Main Outcome Measure(s). Moorong Self-Efficacy Scale (MSES); Impact on Participation and Autonomy (IPA); Positive Affect and Negative Affect Scale (PANAS); Coping Inventory of Stressful Situations (CISS); World Health Organization Quality of Life (WHOQOL-BREF); semistructured qualitative interviews. Methods. Twenty-one participants were recruited from two subsequent CROP services, with only 14 persons completing all data assessments. Data were collected at baseline (week 0), at exit (week 12), and at a three-month follow-up. Semistructured interviews were conducted at exit. Results. Self-efficacy (MSES) and positive affect (PANAS) improved from baseline to exit (P < .05), but the changes were not maintained at follow-up. Qualitative analysis identified four major themes related to therapeutic benefits: (1) role of self; (2) knowledge acquisition; (3) skill application; and (4) group processes. Conclusions. Participation in a therapeutic education service has the potential to improve well-being in persons with SCI, but there is a need to identify strategies to maintain long-term gains. PMID:25574397

The contributions of community learning centres (CLCs) to personal and community development in Myanmar

NASA Astrophysics Data System (ADS)

Le, Ai Tam Pham

2018-05-01

Community learning centres (CLCs) have been widely established in the Asia-Pacific region as locally managed institutions that offer non-formal educational opportunities and community development activities. Myanmar officially has more than 3,000 centres, which is one of the highest numbers in the region. This article examines the operation of CLCs and their contributions to personal and community development in Padaung, Myanmar. The author's research is based on six weeks of fieldwork in Myanmar for data collection including semi-structured interviews, focus group discussions and informal conversations. Her findings suggest that CLCs can contribute to the improvement of both individuals' quality of life and communities' social capital, which facilitates mutually beneficial collective action. The findings also support the conclusion that CLCs can provide additional educational opportunities beyond the formal system, especially for adults and members of rural communities, e.g. farmers. However, due to constraints in terms of budget, implementing capacity and socio-economic factors, the outreach of CLC activities is still somewhat limited and has yet to reach its full potential.

Recruitment of older adults with type 2 diabetes into a community-based exercise and nutrition randomised controlled trial.

PubMed

Miller, Eliza G; Nowson, Caryl A; Dunstan, David W; Kerr, Deborah A; Solah, Vicky; Menzies, David; Daly, Robin M

2016-09-26

Recruitment of participants into long-term community-based lifestyle intervention trials, particularly adults with a chronic disease, is often slow and challenging. Currently there is limited data on successful recruitment strategies suitable for older adults with type 2 diabetes into community-based exercise and nutrition programs, and no information on cost estimates associated with such recruitment. The aim of this report is to describe the recruitment strategies used and the success of each approach in recruiting older adults with type 2 diabetes into a 6-month community-based exercise and nutritional supplementation randomised controlled trial (RCT). A secondary aim is to assess the costs associated with the recruitment methods used. The Resistance Exercise, Vitamin D and Muscle Protein Intervention Trial (REVAMP-IT) for type 2 diabetes is a 24-week RCT targeting 202 adults with type 2 diabetes which is designed to evaluate whether post-exercise ingestion of a whey- protein and vitamin D-enriched drink can enhance the effects of progressive resistance training (PRT) on glycaemic control, body composition and cardiometabolic health. Participants in this trial were randomly allocated to either: (1) the Lift for Life® community-based PRT program combined with additional whey protein and vitamin D, or (2) the Lift for Life® PRT program alone. Recruitment strategies included state and local newspaper and radio advertisements, targeted mail-outs, doctor and allied health referrals, community presentations, web-based media and word of mouth. The number of expressions of interest, participants screened and included in the trial, and how they first heard about the study were recorded by research staff during the screening process. Reasons for ineligibility or non-participation in the trial were also recorded as was the cost of each recruitment method used. A total of 1157 expressions of interest were received over a 21-month recruitment period. Overall 959 (83 %) individuals were screened and found to be ineligible for the trial or chose not to participate or could not be contacted further following their initial enquiry. As a result, 198 participants were randomised to the 24-week intervention. The most effective recruitment strategies were targeted mass mail-outs (39 % of the total participant sample), state (27 %) and local (14 %) print media. In total recruitment expenditure was AUD$40,421, which equated to AUD$35 per enquiry and AUD$204 per eligible participant. Targeted mail-outs and state print media were the most expensive strategies each accounting for 38 % of total expenditure. To recruit around 200 older adults with type 2 diabetes into a community-based lifestyle intervention trial in a timely manner, it is important to ensure that an adequate budget is allocated to recruitment as targeted mail-outs and state/local print media were the most costly but effective strategies. Australian New Zealand Clinical Trials Registry reference ACTRN12613000592741 . Registered on 27 May 2013.

Effectiveness of a combination of cognitive behavioral therapy and task-oriented balance training in reducing the fear of falling in patients with chronic stroke: study protocol for a randomized controlled trial.

PubMed

Liu, Tai-Wa; Ng, Gabriel Y F; Ng, Shamay S M

2018-03-07

The consequences of falls are devastating for patients with stroke. Balance problems and fear of falling are two major challenges, and recent systematic reviews have revealed that habitual physical exercise training alone cannot reduce the occurrence of falls in stroke survivors. However, recent trials with community-dwelling healthy older adults yielded the promising result that interventions with a cognitive behavioral therapy (CBT) component can simultaneously promote balance and reduce the fear of falling. Therefore, the aim of the proposed clinical trial is to evaluate the effectiveness of a combination of CBT and task-oriented balance training (TOBT) in promoting subjective balance confidence, and thereby reducing fear-avoidance behavior, improving balance ability, reducing fall risk, and promoting independent living, community reintegration, and health-related quality of life of patients with stroke. The study will constitute a placebo-controlled single-blind parallel-group randomized controlled trial in which patients are assessed immediately, at 3 months, and at 12 months. The selected participants will be randomly allocated into one of two parallel groups (the experimental group and the control group) with a 1:1 ratio. Both groups will receive 45 min of TOBT twice per week for 8 weeks. In addition, the experimental group will receive a 45-min CBT-based group intervention, and the control group will receive 45 min of general health education (GHE) twice per week for 8 weeks. The primary outcome measure is subjective balance confidence. The secondary outcome measures are fear-avoidance behavior, balance ability, fall risk, level of activities of daily living, community reintegration, and health-related quality of life. The proposed clinical trial will compare the effectiveness of CBT combined with TOBT and GHE combined with TOBT in promoting subjective balance confidence among chronic stroke patients. We hope our results will provide evidence of a safe, cost-effective, and readily transferrable therapeutic approach to clinical practice that reduces fear-avoidance behavior, improves balance ability, reduces fall risk, promotes independence and community reintegration, and enhances health-related quality of life. ClinicalTrials.gov, NCT02937532 . Registered on 17 October 2016.

A model for partnering first-year student pharmacists with community-based older adults.

PubMed

Martin, Beth A; Porter, Andrea L; Shawl, Lauren; Motl Moroney, Susannah E

2012-06-18

To design, integrate, and assess the effectiveness of an introductory pharmacy practice experience intended to redefine first-year student pharmacists' views on aging and medication use through their work with a healthy, community-based older-adult population. All students (N = 273) completed live skills training in an 8-hour boot camp provided during orientation week. Teams were assigned an independently living senior partner, completed 10 visits and reflections, and documented health-related information using an electronic portfolio (e-portfolio). As determined by pre- and post-experience survey instruments, students gained significant confidence in 7 skill areas related to communication, medication interviews, involving the partner in health care, and applying patient-care skills. Student reflections, in-class presentations, and e-portfolios documented that personal attitudes toward seniors changed over time. Senior partners enjoyed mentoring and interacting with students and many experienced health improvements as a result of the interaction. The model for partnering first-year student pharmacists with community-based older adults improved students' skills and fostered their connections to pharmacist roles and growth as person-centered providers.

Effects of varenicline therapy in combination with advanced behavioral support on smoking cessation and quality of life in inpatients with acute exacerbation of COPD, bronchial asthma, or community-acquired pneumonia: A prospective, open-label, preference-based, 52-week, follow-up trial.

PubMed

Politis, Alexios; Ioannidis, Vasileios; Gourgoulianis, Konstantinos I; Daniil, Zoe; Hatzoglou, Chrissi

2018-05-01

Quitting smoking is the most important element in the therapeutic management of chronic respiratory diseases. Combining pharmacotherapy with behavioral support increases smoking cessation success rates. In addition, hospitalized smokers have increased motivation to quit. We investigated the efficacy on smoking cessation, of varenicline in combination with behavioral support, in smokers hospitalized due to (a) acute exacerbation of chronic obstructive pulmonary disease (COPD), or (b) bronchial asthma attack, or (c) community-acquired pneumonia (CAP). The method used is prospective, open-label, preference-based, parallel group, 52-week trial. Patients chose the smoking cessation intervention they preferred: a standard regimen of varenicline combined with post-discharge advanced behavioral support (group A) or one private consultation session during hospitalization (group B). Follow-up phone calls were scheduled in weeks 1, 2, and 4 and months 3, 6, and 9. The final hospital visit was performed in week 52. Primary outcome was success rate defined as the percentage (%) of smoking abstinence at week 52 and secondary outcomes were (a) changes in quality of life (QoL) indicated by the scores on the Short Form 36 (SF36) questionnaire and (b) predictors of smoking abstinence investigated with multiple binary logistic regression. One hundred one patients were enrolled, 44 (43.6%) in group A and 57 (56.4%) in group B. Respective abstinence rates were 54.5% and 15.8% at week 12 and 52.3% and 14.0% at week 52. Scores on SF36 were statistically significantly increased in both groups. Predictors of smoking abstinence were varenicline (odds ratio (OR) 7.29; 95% confidence interval (CI) 2.15, 24.77; p = 0.001), age (OR 1.07; 95%CI 1.00, 1.15; p = 0.042), Fagerstrom score (OR 0.37; 95%CI 0.20, 0.68; p = 0.001), SF36 domains "vitality" (OR 1.12; 95%CI 1.04, 1.21; p = 0.003), and "social functioning" (OR 0.95; 95%CI 0.90, 1.00; p = 0.041). Varenicline in combination with behavioral support resulted in high abstinence rates inpatients hospitalized for exacerbation of COPD, asthma attack, or CAP, and improved QoL.

Development and Assessment of Student Social/Civic Responsibility and Ethical Reasoning. TLTC Paper No. 5. CRLT Occasional Paper No. 36

ERIC Educational Resources Information Center

Hallman, Samantha K.

2016-01-01

University of Michigan (U-M) students visit community-based organizations in Detroit on a weekly basis to work on projects aimed at improving the well being of children and their families, such as tutoring youth in after school programs. Their site visits are supplemented by relevant readings, class discussions and written reflections on topics…

Can Social Support in the Guise of an Oral Health Education Intervention Promote Mother-Infant Bonding in Chinese Immigrant Mothers and Their Infants?

ERIC Educational Resources Information Center

Yuan, Si-Yang; Freeman, Ruth

2011-01-01

Objective: To examine if social support in the guise of a culturally sensitive, community-based oral health intervention could promote mother-infant bonding in socially-isolated immigrant mothers. Design: A quasi-experimental design. Participants: A convenience sample of 36 Chinese immigrant mothers with 8-week-old infants was divided into…

Guidelines for School and Community Programs To Promote Lifelong Physical Activity among Young People. Morbidity and Mortality Weekly Report: Recommendations and Reports.

ERIC Educational Resources Information Center

MMWR, 1997

1997-01-01

This report summarizes recommendations for encouraging physical activity among young people so they will continue to engage in physical activity in adulthood and obtain the benefits of physical activity throughout life. The guidelines are based on an in-depth review of research, theory, and current practice in physical education, exercise science,…

The Effects of Two Schedules of Instruction with Constant Time Delay on the Receptive Word Learning Skills of Preschool Children with Developmental Delays

ERIC Educational Resources Information Center

Spino, Margie A.

2013-01-01

Young children with special needs in inclusive settings may be provided special education services by itinerant early childhood special education (ECSE) teachers. These teachers typically travel to the community-based preschool program and work with a child for about 1 hour, 1 day each week. Research suggests that once itinerant ECSE teachers…

A Pilot Study of a Group-Based HIV and STI Prevention Intervention for Lesbian, Bisexual, Queer, and Other Women Who Have Sex with Women in Canada.

PubMed

Logie, Carmen H; Lacombe-Duncan, Ashley; Weaver, James; Navia, Daniela; Este, David

2015-06-01

Limited research has evaluated interventions to reduce HIV and sexually transmitted infection (STI) vulnerability among lesbian, bisexual, and queer (LBQ) women, and other women who have sex with women. The Queer Women Conversations (QWC) study examined the effectiveness of a group-based psycho-educational HIV/STI intervention with LBQ women in Toronto and Calgary, Canada. We conducted a nonrandomized cohort pilot study. Participants completed a pre-test, post-test, and 6-week follow-up. The primary outcome was sexual risk practices, while secondary objectives included intrapersonal (self-esteem, STI knowledge, resilient coping, depression), interpersonal (safer sex self-efficacy), community (community connectedness, social support), and structural (sexual stigma, access to healthcare) factors. The study was registered at http://clinicaltrials.gov. Forty-four women (mean age 28.7 years) participated in a weekend retreat consisting of six consecutive sessions tailored for LBQ women. Sessions covered a range of topics addressing behavioral and social-structural determinants of HIV/STI risk, including STI information, safer sex negotiation skills, and addressing sexual stigma. Adjusted for socio-demographic characteristics, sexual risk practices (β2=-2.96, 95% CI -4.43, -1.50), barrier use self-efficacy (β2=1.52, 95% CI 0.51, 2.53), STI knowledge (β2=4.41, 95% CI 3.52, 5.30), and sexual stigma (β2=-2.62, 95% CI -3.48, -1.75) scores showed statistically significant changes 6 weeks post-intervention. Initial increases in safer sex self-efficacy, social support, and community connectedness were not sustained at 6-week follow up, highlighting the need for booster sessions or alternative approaches to address social factors. Study results may inform HIV/STI prevention interventions, sexual health care provision, and support services tailored for LBQ women.

Effectiveness and feasibility of the early start denver model implemented in a group-based community childcare setting.

PubMed

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

2014-12-01

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 over 12 months were compared to those of 30 peers with ASD undergoing a different intervention program delivered in a similar community long-day care service. Children in both groups made gains in cognitive, adaptive and social skills. Participants in the ESDM group showed significantly higher gains in developmental rate and receptive language.

Efficacy of ankle control balance training on postural balance and gait ability in community-dwelling older adults: a single-blinded, randomized clinical trial.

PubMed

Lee, Kyeongjin; Lee, Yong Woo

2017-09-01

[Purpose] This study was conducted to investigate the effects of ankle control balance training (ACBT) on postural balance and gait ability in community-dwelling older adults. [Subjects and Methods] Fifty-four subjects were randomly divided into two groups, with 27 subjects in the ACBT group and 27 subjects in the control group. Subjects in the ACBT group received ACBT for 60 minutes, twice per week for 4 weeks, and all subjects had undergone fall prevention education for 60 minutes, once per week for 4 weeks. The main outcome measures, including the Berg balance scale; the functional reach test and one leg stance test for postural balance; and the timed up-and-go test and 10-meter walking test for gait ability, were assessed at baseline and after 4 weeks of training. [Results] The postural balance and gait ability in the ACBT group improved significantly compared to those in the control group, except BBS. [Conclusion] The results of this study showed improved postural balance and gait abilities after ACBT and that ACBT is a feasible method for improving postural balance and gait ability in community-dwelling older adults.

Efficacy of ankle control balance training on postural balance and gait ability in community-dwelling older adults: a single-blinded, randomized clinical trial

PubMed Central

Lee, Kyeongjin; Lee, Yong Woo

2017-01-01

[Purpose] This study was conducted to investigate the effects of ankle control balance training (ACBT) on postural balance and gait ability in community-dwelling older adults. [Subjects and Methods] Fifty-four subjects were randomly divided into two groups, with 27 subjects in the ACBT group and 27 subjects in the control group. Subjects in the ACBT group received ACBT for 60 minutes, twice per week for 4 weeks, and all subjects had undergone fall prevention education for 60 minutes, once per week for 4 weeks. The main outcome measures, including the Berg balance scale; the functional reach test and one leg stance test for postural balance; and the timed up-and-go test and 10-meter walking test for gait ability, were assessed at baseline and after 4 weeks of training. [Results] The postural balance and gait ability in the ACBT group improved significantly compared to those in the control group, except BBS. [Conclusion] The results of this study showed improved postural balance and gait abilities after ACBT and that ACBT is a feasible method for improving postural balance and gait ability in community-dwelling older adults. PMID:28931994

Comparison of two modes of delivery of an exercise prescription scheme.

PubMed

Foley, Louise; Maddison, Ralph; Jones, Zanta; Brown, Paul; Davys, Anne

2011-07-08

Green Prescription (GRx) referrals from health professionals have been shown to be effective for increasing the physical activity levels of patients. Little is known about which methods of delivering the programme represents the best value for money. The purpose of this paper was to compare the cost and outcomes of two modes of delivery of a GRx programme. One mode offered phone support involving monthly telephone calls over a 3-4 month period to encourage physical activity participation. A second mode offered community support via weekly face-to-face support group meetings in which physical activities were offered. The evaluation involved staff interviews, patient interviews and analysis of GRx records for the 2007 calendar year. There was a large rate of drop-out (68%) from GRx referral to registration. For those who registered, there was a clear preference for community support, and engagement of Maori and Pacific peoples was higher in this mode of delivery. The proportion (but not absolute number) of people who successfully completed their mode of delivery was higher with phone support. However, participants in community support self-reported a significantly greater number of days of exercise per week than those in phone support. The total expected cost per person for phone support was $102.07 and $108.15 for community support. A greater proportion of participants in community support were very satisfied overall with their mode of delivery. The two modes were comparable in cost and outcomes, though there was greater penetration of target ethnic populations in community support. Providing a choice of GRx mode of delivery allows participants to choose based on their personal and cultural needs.

The feasibility of voluntary counselling and HIV testing for pregnant women using community volunteers in Zimbabwe.

PubMed

Shetty, Avinash K; Mhazo, Miriam; Moyo, Sostain; von Lieven, Andrea; Mateta, Patrick; Katzenstein, David A; Maldonado, Yvonne; Hill, David; Bassett, Mary T

2005-11-01

The purpose of this pilot project was to assess the feasibility and acceptability of voluntary counselling and HIV testing (VCT) by pregnant women using community volunteers in Zimbabwe to prevent mother to child transmission (MTCT) of HIV. From July 1999 to June 2001, a short-course zidovudine (ZDV)-based perinatal HIV prevention programme was initiated in two antenatal clinics. Community volunteers, recruited from local community organizations, underwent a two-week training course in VCT, which included HIV/AIDS facts, systematic counselling approach, and practical counselling techniques using scripts and role-play. Rapid HIV testing was performed after informed consent. Lay counsellors conducted individual pre- and post-test counselling for HIV. A total of 35 women community volunteers were trained in VCT; 34 graduated and committed to work four hours per week in the clinic. Of the 6051 pregnant women presenting for antenatal clinics (ANC), 1824 (30%) underwent pre-test counselling and 1547 (26%) were tested, and 429 (28%) were HIV infected. Overall, 1283 (83%) returned for their test results including 406 (95%) of HIV-infected women. Of the 406 HIV-infected women who collected their test results, only 203 (50%) opted for ZDV prophylaxis to prevent MTCT of HIV. Over the two-year study period, two counsellors died and three sought employment at other organizations. Adherence to duty roster was 97% and no breach of confidentiality was reported. Despite many challenges, VCT delivered by community volunteers is feasible and acceptable for pregnant women aiming to reduce their risk of transmitting HIV to their infants. This programme is being implemented at several urban and rural MTCT sites in Zimbabwe and can serve as a model for other resource-poor countries.

A randomized trial of computer-based communications using imagery and text information to alter representations of heart disease risk and motivate protective behaviour.

PubMed

Lee, Tarryn J; Cameron, Linda D; Wünsche, Burkhard; Stevens, Carey

2011-02-01

Advances in web-based animation technologies provide new opportunities to develop graphic health communications for dissemination throughout communities. We developed imagery and text contents of brief, computer-based programmes about heart disease risk, with both imagery and text contents guided by the common-sense model (CSM) of self-regulation. The imagery depicts a three-dimensional, beating heart tailored to user-specific information. A 2 × 2 × 4 factorial design was used to manipulate concrete imagery (imagery vs. no imagery) and conceptual information (text vs. no text) about heart disease risk in prevention-oriented programmes and assess changes in representations and behavioural motivations from baseline to 2 days, 2 weeks, and 4 weeks post-intervention. Sedentary young adults (N= 80) were randomized to view one of four programmes: imagery plus text, imagery only, text only, or control. Participants completed measures of risk representations, worry, and physical activity and healthy diet intentions and behaviours at baseline, 2 days post-intervention (except behaviours), and 2 weeks (intentions and behaviours only) and 4 weeks later. The imagery contents increased representational beliefs and mental imagery relating to heart disease, worry, and intentions at post-intervention. Increases in sense of coherence (understanding of heart disease) and worry were sustained after 1 month. The imagery contents also increased healthy diet efforts after 2 weeks. The text contents increased beliefs about causal factors, mental images of clogged arteries, and worry at post-intervention, and increased physical activity 2 weeks later and sense of coherence 1 month later. The CSM-based programmes induced short-term changes in risk representations and behaviour motivation. The combination of CSM-based text and imagery appears to be most effective in instilling risk representations that motivate protective behaviour. ©2010 The British Psychological Society.

Effect of peer support on prevention of postnatal depression among high risk women: multisite randomised controlled trial.

PubMed

Dennis, C-L; Hodnett, E; Kenton, L; Weston, J; Zupancic, J; Stewart, D E; Kiss, A

2009-01-15

To evaluate the effectiveness of telephone based peer support in the prevention of postnatal depression. Multisite randomised controlled trial. Seven health regions across Ontario, Canada. 701 women in the first two weeks postpartum identified as high risk for postnatal depression with the Edinburgh postnatal depression scale and randomised with an internet based randomisation service. Proactive individualised telephone based peer (mother to mother) support, initiated within 48-72 hours of randomisation, provided by a volunteer recruited from the community who had previously experienced and recovered from self reported postnatal depression and attended a four hour training session. Edinburgh postnatal depression scale, structured clinical interview-depression, state-trait anxiety inventory, UCLA loneliness scale, and use of health services. After web based screening of 21 470 women, 701 (72%) eligible mothers were recruited. A blinded research nurse followed up more than 85% by telephone, including 613 at 12 weeks and 600 at 24 weeks postpartum. At 12 weeks, 14% (40/297) of women in the intervention group and 25% (78/315) in the control group had an Edinburgh postnatal depression scale score >12 (chi(2)=12.5, P<0.001; number need to treat 8.8, 95% confidence interval 5.9 to 19.6; relative risk reduction 0.46, 95% confidence interval 0.24 to 0.62). There was a positive trend in favour of the intervention group for maternal anxiety but not loneliness or use of health services. For ethical reasons, participants identified with clinical depression at 12 weeks were referred for treatment, resulting in no differences between groups at 24 weeks. Of the 221 women in the intervention group who received and evaluated their experience of peer support, over 80% were satisfied and would recommend this support to a friend. Telephone based peer support can be effective in preventing postnatal depression among women at high risk. ISRCTN 68337727.

Bacterial community shift in the coastal Gulf of Mexico salt-marsh sediment microcosm in vitro following exposure to the Mississippi Canyon Block 252 oil (MC252).

PubMed

Koo, Hyunmin; Mojib, Nazia; Huang, Jonathan P; Donahoe, Rona J; Bej, Asim K

2015-08-01

In this study, we examined the responses by the indigenous bacterial communities in salt-marsh sediment microcosms in vitro following treatment with Mississippi Canyon Block 252 oil (MC252). Microcosms were constructed of sediment and seawater collected from Bayou La Batre located in coastal Alabama on the Gulf of Mexico. We used an amplicon pyrosequencing approach on microcosm sediment metagenome targeting the V3-V5 region of the 16S rRNA gene. Overall, we identified a shift in the bacterial community in three distinct groups. The first group was the early responders (orders Pseudomonadales and Oceanospirillales within class Gammaproteobacteria), which increased their relative abundance within 2 weeks and were maintained 3 weeks after oil treatment. The second group was identified as early, but transient responders (order Rhodobacterales within class Alphaproteobacteria; class Epsilonproteobacteria), which increased their population by 2 weeks, but returned to the basal level 3 weeks after oil treatment. The third group was the late responders (order Clostridiales within phylum Firmicutes; order Methylococcales within class Gammaproteobacteria; and phylum Tenericutes), which only increased 3 weeks after oil treatment. Furthermore, we identified oil-sensitive bacterial taxa (order Chromatiales within class Gammaproteobacteria; order Syntrophobacterales within class Deltaproteobacteria), which decreased in their population after 2 weeks of oil treatment. Detection of alkane (alkB), catechol (C2,3DO) and biphenyl (bph) biodegradation genes by PCR, particularly in oil-treated sediment metacommunity DNA, delineates proliferation of  the hydrocarbon degrading bacterial community. Overall, the indigenous bacterial communities in our salt-marsh sediment in vitro microcosm study responded rapidly and shifted towards members of the taxonomic groups that are capable of surviving in an MC252 oil-contaminated environment.

Daughters and mothers exercising together: effects of home- and community-based programs.

PubMed

Ransdell, Lynda B; Taylor, Alison; Oakland, Darcie; Schmidt, Jenny; Moyer-Mileur, Laurie; Shultz, Barry

2003-02-01

This pilot study compares the effectiveness of home- and community-based physical activity interventions that target mothers and daughters to increase physical activity and improve health-related fitness. Mothers (45.18 +/- 7.49 yr) and daughters (15.41 +/- 1.33 yr) were randomly assigned to a community-based (CB) (N = 20 participants) or home-based (HB) (N = 14 participants) program. CB participants attended three instructor-led sessions per week for 12 wk. HB participants were asked to participate in 3 sessions per week for 12 wk in a program similar to the CB program. The main difference between the programs was that CB activities were completed at a fitness facility within a university and HB activities were completed in or near the home. Before and after the intervention, changes in health-related fitness and physical activity were assessed. A series of 2 (group assignment) x 2 (time) ANOVAs were conducted to assess changes separately for mothers and daughters. CB participants attended 77% of the sessions, and none of the pairs dropped out. HB participants completed 70% of the recommended sessions, and three pairs dropped out. Mothers and daughters in both groups significantly increased their participation in aerobic, muscular strength, and flexibility activities (P = 0.02 to 0.000). Daughters in both groups significantly improved their muscular endurance (sit-ups,P = 0.000). Mothers in both groups improved their muscular strength (push-ups, P = 0.003), muscular endurance (sit-ups, P = 0.000), flexibility (sit-and-reach, P = 0.008), and aerobic capacity (1-mile walk, P = 0.002). Positive changes in diastolic blood pressure also occurred (P = 0.008). Mothers and daughters responded positively to CB and HB physical activity programs. Home-based physical activity programming is a cost-effective means to increase physical activity and improve health-related fitness in these groups.

Transforming physics educator identities: TAs help TAs become teaching professionals

NASA Astrophysics Data System (ADS)

Gretton, Anneke L.; Bridges, Terry; Fraser, James M.

2017-05-01

Research-based instructional strategies have been shown to dramatically improve student learning, but widespread adoption of these pedagogies remains limited. Post-secondary teaching assistants (TAs), with their current positions in course delivery and future roles as academic leaders, are an essential target group for teacher training. However, the literature suggests that successful TA professional development must address not only pedagogical practices but also the cultivation of physics educator identity. The primary goal of this study is to build a framework for TA professional development that strengthens the TA's identity as a physics educator. We base this framework on Etienne Wenger's model for communities of practice and Côté and Levine's personality and social structure identity perspective. We explore this framework in the context of a 12-week, low-cost, TA-led and TA-centered professional development intervention. Our qualitative and quantitative data suggest that this efficient community-based intervention strengthened TAs' identification as physics educators.

Association between community garden participation and fruit and vegetable consumption in rural Missouri

PubMed Central

2013-01-01

Background Fruit and vegetable consumption reduces chronic disease risk, yet the majority of Americans consume fewer than recommended. Inadequate access to fruits and vegetables is increasingly recognized as a significant contributor to low consumption of healthy foods. Emerging evidence shows the effectiveness of community gardens in increasing access to, and consumption of, fruits and vegetables. Methods Two complementary studies explored the association of community garden participation and fruit and vegetable consumption in rural communities in Missouri. The first was with a convenience sample of participants in a rural community garden intervention who completed self-administered surveys. The second was a population-based survey conducted with a random sample of 1,000 residents in the intervention catchment area. Results Participation in a community garden was associated with higher fruit and vegetable consumption. The first study found that individuals who worked in a community garden at least once a week were more likely to report eating fruits and vegetables because of their community garden work (X2 (125) = 7.78, p = .0088). Population-based survey results show that 5% of rural residents reported participating in a community garden. Those who reported community garden participation were more likely to report eating fruits 2 or more times per day and vegetables 3 or more times per day than those who did not report community garden participation, even after adjusting for covariates (Odds Ratio [OR] = 2.76, 95% Confidence Interval [CI] = 1.35 to 5.65). Conclusion These complementary studies provide evidence that community gardens are a promising strategy for promoting fruit and vegetable consumption in rural communities. PMID:24252563

Feasibility and Initial Efficacy Evaluation of a Community-Based Cognitive-Behavioral Lifestyle Intervention to Prevent Excessive Weight Gain During Pregnancy in Latina Women.

PubMed

Gesell, Sabina B; Katula, Jeffrey A; Strickland, Carmen; Vitolins, Mara Z

2015-08-01

About 48 % of US women gain more weight during pregnancy than recommended by the Institute of Medicine (IOM). Excessive gestational weight gain is a major risk factor for obesity in both women and offspring over their lifetimes, and should be avoided. This study was designed to test the feasibility and initial efficacy of a prenatal behavioral intervention in a sample of low-income, predominantly Latina women. The intervention was delivered in groups of 8-10 women in a community recreation center, and structured to reduce the proportion of women who gained weight in excess of IOM guidelines. Recruitment targets were met in 3 months: 135 pregnant women (>10 and <28 weeks) were randomly assigned to receive a 12-week intervention (n = 68) or usual care (n = 67). Retention rate was 81 %. On average, women attended 4 of 12 group sessions, and each session had 4 of the 8-10 assigned participants in attendance. Initial efficacy analyses were based on 87 women. Compared to usual care, fewer normal-weight women in the intervention exceeded IOM recommendations (47.1 % usual care vs. 6.7 % intervention; absolute difference 40.4 %; p = .036). Recommendations for recruitment, retention, and delivery are discussed. A community-based cognitive-behavioral lifestyle intervention during pregnancy was feasible in a hard-to-reach, high-risk population of low-income Latina women, and showed efficacy in preventing excessive gestational weight gain. Due to frequently changing work schedules, strategies are needed to either increase attendance at group sessions (e.g., within a group prenatal care format) or to build core skills necessary for behavior change through other modalities.

The effects of Tai-Chi in conjunction with thera-band resistance exercise on functional fitness and muscle strength among community-based older people.

PubMed

Lin, Shu-Fen; Sung, Huei-Chuan; Li, Tzai-Li; Hsieh, Tsung-Cheng; Lan, Hsiao-Chin; Perng, Shoa-Jen; Smith, Graeme D

2015-05-01

The aim of this study was to investigate the effects of Tai-Chi in conjunction with thera-band resistance exercise on functional fitness and muscle strength in community-based older people. Tai-Chi is known to improve functional fitness in older people. Tai-Chi is usually performed with free hands without resistance training and usually focuses on training lower limbs. To date, no study has examined the use of Tai-Chi in conjunction with thera-band resistance exercise in this population. Cluster randomised trial design. Older people at six senior day care centres in Taiwan were assigned to thera-band resistance exercise or control group using a cluster randomisation. The thera-band resistance exercise group (n = 48) received sixty minute thera-band resistance exercise twice weekly for a period of 16 weeks. The control group (n = 47) underwent routine activities in the day care centre, receiving no Tai-Chi or resistance exercise. After receiving the thera-band resistance exercise, intervention participants displayed a significant increase in muscle strength of upper and lower extremities. Significant improvements were recorded on most measures of the Senior Fitness Test, with the exception of the chair-stand and back-scratch test. Thera-band resistance exercise has the potential to improve functional fitness and muscle strength in community-based older people. Thera-band resistance exercise potentially offers a safe and appropriate form of physical activity that nursing staff can easily incorporate into the daily routine of older people in day care centres, potentially improving functional performance and muscle strength. © 2015 John Wiley & Sons Ltd.

Parenting in 2 Worlds: Pilot Results from a Culturally Adapted Parenting Program for Urban American Indians

PubMed Central

Kulis, Stephen; Ayers, Stephanie L.; Baker, Tahnee

2014-01-01

This study reports the implementation and feasibility of a culturally adapted parenting curriculum, Parenting in 2 Worlds (P2W), which we designed specifically for urban American Indian families by means of community-based participatory research and then pilot tested in three Arizona cities. Data come from matched pre- and post-test surveys completed in 2012 by 75 American Indian parents of adolescents aged 10–17 who participated in the pilot version of P2W. P2W is a 10-workshop program administered twice a week for five weeks by trained American Indian community facilitators. Parents completed pretest surveys during Workshop 1 and post-test surveys five weeks later during Workshop 10. Paired t tests assessed changes in parenting outcomes, cultural identity, and child anti-social behavior. Changes from pre- to post-test demonstrated statistically significant improvements in several parenting outcomes (discipline, involvement, self-agency, and supervision), a strengthened sense of ethnic and cultural identity and Native spirituality, and a decrease in the child’s anti-social behavior. These results, which show significant if preliminary improvements in parenting skills and family functioning, suggest the feasibility of implementing a culturally grounded parenting intervention for urban American Indian parents. PMID:25367804

[Insert Your Science Here] Week: Creating science-driven public awareness campaigns

NASA Astrophysics Data System (ADS)

Mattson, Barbara; Mitchell, Sara; McElvery, Raleigh; Reddy, Francis; Wiessinger, Scott; Skelly, Clare; Saravia, Claire; Straughn, Amber N.; Washington, Dewayne

2018-01-01

NASA Goddard’s in-house Astrophysics Communications Team is responsible for facilitating the production of traditional and social media products to provide understanding and inspiration about NASA’s astrophysics missions and discoveries. Our team is largely driven by the scientific news cycle of launches, mission milestones, anniversaries, and discoveries, which can leave a number of topics behind, waiting for a discovery to be highlighted. These overlooked topics include compelling stories about ongoing research, underlying science, and science not tied to a specific mission. In looking for a way to boost coverage of these unsung topics, we struck upon an idea of creating “theme weeks” which bring together the broader scientific community around a topic, object, or scientific concept. This poster will present the first two of our Goddard-led theme weeks: Pulsar Week and Dark Energy Week. We will describe the efforts involved, our metrics, and the benefits and challenges we encountered. We will also suggest a template for doing this for your own science based on our successes.

Challenging body weight: evidence from a community-based intervention on weight, behaviour and motivation.

PubMed

Blais, Louise T; Mack, Diane E; Wilson, Philip M; Blanchard, Chris M

2017-08-01

The objective of this study was to examine the effectiveness of a 12 week weight loss intervention within a commercial fitness centre on body weight, moderate to vigorous physical activity (MVPA), dietary intake, and behavioural regulations for exercise and healthy eating. Using a quasi-experimental design, the intervention group received weekly coaching sessions and bi-weekly seminars designed to increase MVPA and improve dietary intake. Outcome variables were assessed at three time points over a six month period. Results showed a significant interaction for body weight (p = .04) and dietary changes (p < .05) following the weight loss challenge but were not maintained across the six month period. Changes in behavioural regulations favoured the intervention condition. Results imply that a 12 week weight loss challenge within a commercial fitness centre may be effective at prompting short-term weight loss and support the internalization of behavioural regulations specific to healthy eating and exercise.

AppVis: Enabling data-rich apps in app inventor

NASA Astrophysics Data System (ADS)

Harunani, Farzeen

MIT App Inventor has enabled middle school students to learn computing while creating their own apps--including apps that serve community needs. However, few resources exist for building apps that gather and share data. There is a need for new tools and an instructional materials for students to build data-enabled, community-focused apps. We developed an extension for App Inventor, called AppVis, which allows app-makers to publish and retrieve data from iSENSE, our existing web-based collaborative data visualization platform. We used AppVis and supporting instructional materials in two one-week summer camps attended by a total of 33 middle school students. Based on student interview data and analysis of their final apps, our approach was broadly accessible to a diverse population of students. Students were motivated to build apps that could be used by their own communities. This thesis presents the design of AppVis and results from students' work in summer camps.

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.

Text and Structural Data Mining of Influenza Mentions in Web and Social Media

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

Corley, Courtney D.; Cook, Diane; Mikler, Armin R.

Text and structural data mining of Web and social media (WSM) provides a novel disease surveillance resource and can identify online communities for targeted public health communications (PHC) to assure wide dissemination of pertinent information. WSM that mention influenza are harvested over a 24-week period, 5-October-2008 to 21-March-2009. Link analysis reveals communities for targeted PHC. Text mining is shown to identify trends in flu posts that correlate to real-world influenza-like-illness patient report data. We also bring to bear a graph-based data mining technique to detect anomalies among flu blogs connected by publisher type, links, and user-tags.

Implementation of Text-Messaging and Social Media Strategies in a Multilevel Childhood Obesity Prevention Intervention: Process Evaluation Results.

PubMed

Loh, Ivory H; Schwendler, Teresa; Trude, Angela C B; Anderson Steeves, Elizabeth T; Cheskin, Lawrence J; Lange, Sarah; Gittelsohn, Joel

2018-01-01

Social media and text messaging show promise as public health interventions, but little evaluation of implementation exists. The B'more Healthy Communities for Kids (BHCK) was a multilevel, multicomponent (wholesalers, food stores, recreation centers) childhood obesity prevention trial that included social media and text-messaging components. The BHCK was implemented in 28 low-income areas of Baltimore City, Maryland, in 2 waves. The texting intervention targeted 241 low-income African American caregivers (of 283), who received 3 texts/week reinforcing key messages, providing nutrition information, and weekly goals. Regular posting on social media platforms (Facebook, Instagram, Twitter) targeted community members and local stakeholders. High implementation standards were set a priori (57 for social media, 11 for texting), with low implementation defined as <50%, medium as 50% to 99%, high as ≥100% of the high standard for each measure. Reach, dose delivered, and fidelity were assessed via web-based analytic tools. Between waves, social media implementation improved from low-moderate to high reach, dose delivered, and fidelity. Text messaging increased from moderate to high in reach and dose delivered, fidelity decreased from high to moderate. Data were used to monitor and revise the BHCK intervention throughout implementation. Our model for evaluating text messaging-based and social media-based interventions may be applicable to other settings.

Healthcare-seeking Behaviour for Common Infectious Disease-related Illnesses in Rural Kenya: A Community-based House-to-house Survey

PubMed Central

Flannery, Brendan; Onyango, Bernard; Larson, Charles; Alaii, Jane; Zhang, Xingyou; Hamel, Mary J.; Breiman, Robert F.; Feikin, Daniel R.

2011-01-01

Community surveys of healthcare-use determine the proportion of illness episodes not captured by health facility-based surveillance, the methodology used most commonly to estimate the burden of disease in Africa. A cross-sectional survey of households with children aged less than five years was conducted in 35 of 686 census enumeration areas in rural Bondo district, western Kenya. Healthcare sought for acute episodes of diarrhoea or fever in the past two weeks or pneumonia in the past year was evaluated. Factors associa-ted with healthcare-seeking were analyzed by logistic regression accounting for sample design. In total, 6,223 residents of 981 households were interviewed. Of 1,679 children aged less than five years, 233 (14%) had diarrhoea, and 736 (44%) had fever during the past two weeks; care at health facilities was sought for one-third of these episodes. Pneumonia in the past year was reported for 64 (4%) children aged less than five years; 88% sought healthcare at any health facility and 48% at hospitals. Seeking healthcare at health facilities was more likely for children from households with higher socioeconomic status and with more symptoms of severe illness. Health facility and hospital-based surveillance would underestimate the burden of disease substantially in rural western Kenya. Seeking healthcare at health facilities and hospitals varied by syndrome, severity of illness, and characteristics of the patient. PMID:21528791

Increasing collective efficacy for physical activity: Design and rationale of Moms UNITE for Health.

PubMed

Dlugonski, Deirdre; Das, Bhibha M; Martin, Tiesha

2015-11-01

Mothers are a population that engages in low levels of physical activity due to unique barriers to physical activity. As such, there is a need to develop and implement physical activity interventions for mothers that can be delivered in community settings. The objective of this article is to describe the Moms UNITE (Using Networks to Increase Togetherness and Efficacy) for Health walking intervention. This intervention, based on social cognitive theory, is designed to compare a collective efficacy enhanced intervention to a standard intervention for increasing physical activity and secondary outcomes. In this 6-week, randomized controlled trial, mothers will be assigned to either the standard or intervention (collective efficacy) group. Both groups will receive the same walking intervention and an evidence-based health education program. Strategies and messages focusing on building collective efficacy will be used in the intervention group. Data will be collected at baseline, post-intervention, and follow-up (after a 3 month no-intervention period) using a mixed methods approach. Quantitative data will include anthropometric measurements, objective physical activity, and questionnaires assessing self- and collective-efficacy. Post-intervention focus groups and weekly process evaluation surveys will describe participants' experiences within the program. This paper will serve as a theoretical framework for researchers and public health practitioners to develop and implement community-based walking programs for mothers. Copyright © 2015 Elsevier Inc. All rights reserved.

Community-based fortified dietary intervention improved health outcomes among low-income African-American women.

PubMed

Salihu, Hamisu M; Adegoke, Korede K; Das, Rachita; Wilson, Ronee E; Mazza, Jessica; Okoh, Jennifer O; Naik, Eknath; Berry, Estrellita Lo

2016-08-01

Poor dietary exposure disproportionately affects African-Americans and contributes to the persistence of disparities in health outcomes. In this study, we hypothesized that fortified dietary intervention (FDI) will improve measured dietary and related health outcomes and will be acceptable among low-income African-American women living in Tampa, FL. These objectives were tested using a prospective experimental study using pretest and posttest design with a control group, using a community-based participatory research approach. The intervention (FDI) was designed by the community through structural modification of a preexisting, diet-based program by the addition of a physical and mental health component. Paired sample t tests were used to examine preintervention and postintervention changes in study outcomes. A total of 49 women participated in the study, 26 in the FDI group and 23 controls. Two weeks postintervention, there were significant improvements in waist circumference and health-related quality of life related to physical health (P< .0001), physical fitness subscores (P= .002), and nutritional subscores (P= .001) in the FDI group. Among overweight/obese women, improvement in health-related quality of life related to physical health, a significant decrease in depressive score, and a reduction in waist circumference were noted. In the control group, a decrease in waist circumference was observed. Implementation of the FDI through a community-based participatory research approach is feasible and effective among low-income African-American women in general and overweight/obese women in particular. Social reengineering of a nutritional intervention coupled with community-based approach will enhance health outcomes of low-income women. Copyright © 2016 Elsevier Inc. All rights reserved.

3 CFR 8455 - Proclamation 8455 of November 20, 2009. National Farm-City Week, 2009

Code of Federal Regulations, 2010 CFR

2010-01-01

... Farm-City Week, 2009 8455 Proclamation 8455 Presidential Documents Proclamations Proclamation 8455 of November 20, 2009 Proc. 8455 National Farm-City Week, 2009By the President of the United States of America... communities are critical to our economy and to the nourishment of our people. During National Farm-City Week...

A population-based study on health-related quality of life among urban community residents in Shenyang, Northeast of China.

PubMed

Song, Tian; Ding, Yan-wei; Sun, Yan; He, Yi-Ni; Qi, Dian-Jun; Wu, Ying; Wu, Bin; Lang, Lang; Yu, Kai; Zhao, Xin; Zhu, Liang-liang; Wang, Shuang; Yu, Xiao-Song

2015-09-19

Due to the rising standard of living environment and advances in public health and medical care in China, it has been a tendency in recent years that health-related quality of life (HRQoL) has been increasingly acknowledged in community health management. However, large-scale population-based study on evaluating HQRoL in northeast of China was not conducted. This article aims to investigate the HRQoL in community residents in Northeast China and explore the associated factors. Stratified multiple-stage sampling method was used in the cross-sectional survey to investigate HRQoL of community residents in northeast of China. Univariate analysis and multiple linear regressions were used to analyze the factors associated to HRQoL of the community residents. The results were confirmed that HRQoL in general population was well performed for the first time in northeast of China in a large scale population. Community residents had better mental health than physical health. The factors influencing HRQoL included gender, age, educational level, marital status, ethnic group, chronic disease status, having breakfast frequency weekly and sleep quality. However, drinking and smoking habits did not affect residents' HRQoL. In this study, the result of the large-scale survey was satisfactory in northeast of China, providing HRQoL status of community residents. Policies on specific health management in community public health would emphasize on lifestyle behaviors especially eating habits in order to improving HRQoL.

Examining the Transition to a Four-Day School Week and Investigating Post-Change Faculty/Staff Work-Life Balance: A Community College Case Study

ERIC Educational Resources Information Center

Cardinale, Nelly

2013-01-01

This single descriptive embedded case study examined the process of implementing a four-day work/school week at a community college and investigated post-change faculty/staff work-life balance. All of the students attending this college live at home. The change was implemented due to state funding shortfalls, increasing college utility expenses…

Home-based balance training programme using Wii Fit with balance board for Parkinsons's disease: a pilot study.

PubMed

Esculier, Jean-Francois; Vaudrin, Joanie; Bériault, Patrick; Gagnon, Karine; Tremblay, Louis E

2012-02-01

To evaluate the effects of a home-based balance training programme using visual feedback (Nintendo Wii Fit game with balance board) on balance and functional abilities in subjects with Parkinson's disease, and to compare the effects with a group of paired healthy subjects. Ten subjects with moderate Parkinson's disease and 8 healthy elderly subjects. Subjects participated in a 6-week home-based balance training programme using Nintendo Wii Fit and balance board. Baseline measures were taken before training for the Sit-to-Stand test (STST), Timed-Up-and-Go (TUG), Tinetti Performance Oriented Mobility Assessment (POMA), 10-m walk test, Community Balance and Mobility assessment (CBM), Activities-specific Balance and Confidence scale (ABC), unipodal stance duration, and a force platform. All measurements were taken again after 3 and 6 weeks of training. The Parkinson's disease group significantly improved their results in TUG, STST, unipodal stance, 10-m walk test, CBM, POMA and force platform at the end of the 6-week training programme. The healthy subjects group significantly improved in TUG, STST, unipodal stance and CBM. This pilot study suggests that a home-based balance programme using Wii Fit with balance board could improve static and dynamic balance, mobility and functional abilities of people affected by Parkinson's disease.

Community point distribution of insecticide-treated bed nets and community health worker hang-up visits in rural Zambia: a decision-focused evaluation.

PubMed

Wang, Paul; Connor, Alison L; Joudeh, Ammar S; Steinberg, Jeffrey; Ndhlovu, Ketty; Siyolwe, Musanda; Ntebeka, Bristol; Chibuye, Benjamin; Hamainza, Busiku

2016-03-03

In 2013, the Zambian Ministry of Health through its National Malaria Control Programme distributed over two million insecticide-treated bed nets (ITNs) in four provinces using a door-to-door distribution strategy, and more than 6 million ITNs were allocated to be distributed in 2014. This study was commissioned to measure attendance rates at a community point distribution and to examine the impact of follow-up community health worker (CHW) hang-up visits on short and medium-term ITN retention and usage with a view of informing optimal ITN distribution strategy in Zambia. Households received ITNs at community point distributions conducted in three rural communities in Rufunsa District, Zambia. Households were then randomly allocated into five groups to receive CHW visits to hang any unhung ITNs at different intervals: 1-3, 5-7, 10-12, 15-17 days, and no hang-up visit. Follow-up surveys were conducted among all households at 7-11 weeks after distribution and at 5-6 months after distribution to measure short- and medium-term household retention and usage of ITNs. Of the 560 pre-registered households, 540 (96.4 %) attended the community point distribution. Self-installation of ITNs by households increased over the first 10 days after the community point distribution. Retention levels remained high over time with 90.2 % of distributed ITNs still in the household at 7-11 weeks and 85.7 % at 5-6 months. Retention did not differ between households that received a CHW visit and those that did not. At 7-11 weeks, households had an average of 73.8 % of sleeping spaces covered compared to 80.3 % at 5-6 months. On average, 65.6 % of distributed ITNs were hanging at 7-11 weeks compared to 63.1 % at 5-6 months. While a CHW hang-up visit was associated with increased usage at 7-11 weeks, this difference was no longer apparent at 5-6 months. This evaluation revealed that (1) the community point distributions achieved high attendance rates followed by acceptable rates of short-term and medium-term ITN retention and usage, as compared to reported rates achieved by door-to-door distributions in the recent past, (2) CHW hang-up visits had a modest short-term impact on ITN usage but no medium-term effect, and (3) community point distributions can yield sizeable time savings compared to door-to-door distributions.

The first community-based sexually transmitted disease/HIV intervention trial for female sex workers in China.

PubMed

Wu, Zunyou; Rou, Keming; Jia, Manhong; Duan, Song; Sullivan, Sheena G

2007-12-01

This study was the first community-based intervention to test feasibility and effectiveness of an intervention targeting sex workers in China. Prospective, community-based, pre/post-intervention trial. Thirty establishments in Chengjiang, 34 in Ruili and 23 in Longchuan were selected for the study. The study participants were female sex workers. Out-reach workers visited the establishments to conduct intervention activities over 6 weeks. The activities included lectures, discussion, video and audio cassettes, and distribution of educational folders and condoms. Pre- and post-intervention cross-sectional surveys assessed changes in sexually transmitted disease (STD)/AIDS knowledge and condom use. After the intervention, knowledge of the three HIV transmission routes increased from 25 to 88% (P < 0.01), knowledge that condoms can reduce the risk of STD/HIV infection increased from 56 to 94% (P < 0.01). Condom use at last sex and in the last three sexual encounters increased from 61 to 85% (P < 0.01) and from 41 to 70%, respectively. Multivariate analyses indicated that the intervention was an independent factor (P < 0.01) for these changes. The intervention programme was effective at increasing HIV/AIDS knowledge and condom use rates among sex workers in the community and should be expanded.

Predicting Teacher Participation in a Classroom-Based, Integrated Preventive Intervention for Preschoolers.

PubMed

Baker, Courtney N; Kupersmidt, Janis B; Voegler-Lee, Mary Ellen; Arnold, David H; Willoughby, Michael T

2010-01-01

Preschools provide a promising setting in which to conduct preventive interventions for childhood problems, but classroom programs can only be effective if teachers are willing and able to implement them. This study is one of the first to investigate predictors of the frequency of teacher participation in a classroom-based, randomized controlled trial of an integrated prevention program for preschoolers. The intervention was designed to promote school readiness with an integrated social and academic program, to be implemented by teachers with the support of classroom consultants. The current study is part of a larger project conducted with Head Start and community child care centers that serve primarily economically disadvantaged families; 49 teachers from 30 centers participated in this study. Overall, teachers conducted approximately 70% of the program activities. Participation decreased significantly over time from the first to the final week of the intervention, and also decreased within each week of the intervention, from the first to the final weekly activity. Teachers working at community child care centers implemented more intervention activities than did Head Start teachers. Teacher concerns about the intervention, assessed prior to training, predicted less participation. In addition, teachers' participation was positively related to their perception that their centers and directors were supportive, collegial, efficient, and fair, as well as their job satisfaction and commitment. Teacher experience, education, ethnicity, and self-efficacy were not significantly related to participation. In multi-level models that considered center as a level of analysis, substantial variance was accounted for by centers, pointing to the importance of considering center-level predictors in future research.

Predicting Teacher Participation in a Classroom-Based, Integrated Preventive Intervention for Preschoolers

PubMed Central

Baker, Courtney N.; Kupersmidt, Janis B.; Voegler-Lee, Mary Ellen; Arnold, David H.; Willoughby, Michael T.

2009-01-01

Preschools provide a promising setting in which to conduct preventive interventions for childhood problems, but classroom programs can only be effective if teachers are willing and able to implement them. This study is one of the first to investigate predictors of the frequency of teacher participation in a classroom-based, randomized controlled trial of an integrated prevention program for preschoolers. The intervention was designed to promote school readiness with an integrated social and academic program, to be implemented by teachers with the support of classroom consultants. The current study is part of a larger project conducted with Head Start and community child care centers that serve primarily economically disadvantaged families; 49 teachers from 30 centers participated in this study. Overall, teachers conducted approximately 70% of the program activities. Participation decreased significantly over time from the first to the final week of the intervention, and also decreased within each week of the intervention, from the first to the final weekly activity. Teachers working at community child care centers implemented more intervention activities than did Head Start teachers. Teacher concerns about the intervention, assessed prior to training, predicted less participation. In addition, teachers' participation was positively related to their perception that their centers and directors were supportive, collegial, efficient, and fair, as well as their job satisfaction and commitment. Teacher experience, education, ethnicity, and self-efficacy were not significantly related to participation. In multi-level models that considered center as a level of analysis, substantial variance was accounted for by centers, pointing to the importance of considering center-level predictors in future research. PMID:21103189

Feasibility, Acceptability, and Initial Efficacy of a Knowledge-Contact Program to Reduce Mental Illness Stigma and Improve Mental Health Literacy in Adolescents

PubMed Central

Pinto-Foltz, Melissa D.; Logsdon, M. Cynthia; Myers, John A.

2011-01-01

The purpose of this school-based cluster-randomized trial was to determine the initial acceptability, feasibility, and efficacy of an existing community-based intervention, In Our Own Voice, in a sample of US adolescent girls aged 13–17 years (n=156). In Our Own Voice is a knowledge-contact intervention that provides knowledge about mental illness to improve mental health literacy and facilitates intergroup contact with persons with mental illness as a means to reduce mental illness stigma. This longitudinal study was set in two public high schools located in a southern urban community of the U.S. Outcomes included measures of mental illness stigma and mental health literacy. Findings support the acceptability and feasibility of the intervention for adolescents who enrolled in the study. Findings to support the efficacy of In Our Own Voice to reduce stigma and improve mental health literacy are mixed. The intervention did not reduce mental illness stigma or improve mental health literacy at one week follow up. The intervention did not reduce mental illness stigma at 4 and 8 weeks follow up. The intervention did improve mental health literacy at 4 and 8 weeks follow up. Previous studies have assessed the preliminary efficacy In Our Own Voice among young adults; rarely has In Our Own Voice been investigated longitudinally and with adolescents in the United States. This study provides initial data on the effects of In Our Own Voice for this population and can be used to further adapt the intervention for adolescents. PMID:21624729

The Subseasonal Experiment (SubX) to Advance National Weather Service Predictions for Weeks 3-4

NASA Astrophysics Data System (ADS)

Mariotti, A.; Barrie, D.; Archambault, H. M.

2017-12-01

There is great practical interest in developing skillful predictions of extremes for lead times extending beyond the two-week theoretical predictability skill barrier for weather forecasts to the subseasonal-to-seasonal (S2S) time scale. The processes and phenomena specific to S2S are posited to require a unified approach to science, modeling, and predictions that draws expertise from both the weather and climate/seasonal communities. Based on this premise, in 2016, the NOAA Climate Program Office Modeling, Analysis, Predictions and Projections (MAPP) program, in partnership with the National Weather Service Office of Science and Technology Integration, launched a major research and transition initiative to meet NOAA's emerging research and transition needs for developing skillful S2S predictions. A major component of this initiative is an experiment to test single- and multi-model ensembles for subseasonal prediction, called the Subseasonal Experiment (SubX). SubX, which engages six modeling groups, is producing real time experimental forecasts based on weather, climate, and Earth system models for weeks 3-4. The project investigators are evaluating, testing, and optimizing this system, and the hindcast and real time forecast data are available to the broad community. SubX research is targeted at a number of important decision-making contexts including drought and extremes, as well as the broad variety of phenomena that are meaningful at subseasonal timescales (e.g., MJO, ENSO, stratosphere/troposphere coupling, etc.). This presentation will discuss the design and status of SubX in the broader context of MAPP program S2S prediction research.

A population-based study on the association between the intake of soft drinks and periodontal disease in Taiwanese adults aged 35-44 years (KCIS no. 33).

PubMed

Fann, Jean Ching-Yuan; Lai, Hongmin; Chiu, Sherry Yueh-Hsia; Yen, Amy Ming-Fang; Chen, Sam Li-Sheng; Chen, Hsiu-Hsi

2016-06-01

To elucidate the association between the intake of soft drinks and periodontal disease (PD) among Taiwanese middle-aged adults. The cross-sectional design was employed to assess a dose-response relationship between the intake of soft drinks and PD after controlling for relevant confounding factors, with adjusted odds ratios obtained from a multivariate logistic regression model. Keelung Community-based Integrated Screening (KCIS) programme, Keelung, Taiwan. Participants (n 10 213) aged 35-44 years who had undergone oral checks for PD between 2005 and 2009. A dose-response relationship between the intake of soft drinks and elevated risk for PD defined by community periodontal index ≥3 (the current status of PD) was noted (P=0·02 by trend test). Compared with infrequent intake of soft drinks (≤2 times/week), the adjusted OR increased from 1·05 (95 % CI 0·92, 1·20) for the frequency of 3-4 times/week to 1·17 (95 % CI 1·03, 1·34) for the frequency of ≥5 times/week. A similar trend (P<0·01) was also observed for PD defined by loss of attachment ≥1 (representing the long-term cumulative gum damage due to PD). A dose-response relationship between the intake frequency of soft drinks and PD was observed in Taiwanese middle-aged adults. Such evidence could be used in health promotion to support reductions in soft drink intake.

[Community Service Program, Westmont College.

ERIC Educational Resources Information Center

Kistler, Christina

This report describes a 2-year project at Westmont College, California, which established a Community Service Program with the purposes of decreasing student debt and increasing student participation in community organizations. Eligible students worked 8-10 hours per week for a qualified community agency and received credit towards tuition for the…

Effectiveness of Aromatherapy Massage and Inhalation on Symptoms of Depression in Chinese Community-Dwelling Older Adults.

PubMed

Xiong, Mei; Li, Yanzhang; Tang, Ping; Zhang, Yuping; Cao, Min; Ni, Junwei; Xing, Mengmeng

2018-03-22

Geriatric depression is a major public health problem in China. The study compared the intervention and follow-up effects of aromatherapy massage and inhalation on symptoms of depression in community-dwelling older adults after an 8-week intervention. A prospective, randomized controlled trial was conducted on community-dwelling adults ≥60 years old, with symptoms of depression. Participants were randomly assigned, by Latin Square, to aromatherapy massage, inhalation, or control groups (each n = 20). The aromatherapy massage group received 30 min of aromatherapy massage with 5 mL oil, twice weekly for 8 weeks. The oil contained 50 μL (one drop) of compound essential oils (lavender [Lavandula angustifolia], sweet orange [Citrus sinensis], and bergamot (Citrus bergamia in a 2:1:1 ratio)], diluted in sweet almond oil to a concentration of 1%. The aromatherapy inhalation group received 30 min of nasal inhalation of 50 μL of the compound essential oils blended in 10 mL of purified water, twice weekly for 8 weeks. The control group received no intervention. The Geriatric Depression Scale Short Form (GDS-SF) and Patient Health Questionnaire-9 (PHQ-9) were used for assessment at pretest, posttest, and 6- and 10-week follow-ups in all groups. 5-Hydroxytryptamine (5-HT) concentration was assessed pretest and posttest. Postintervention, the aromatherapy massage and inhalation groups demonstrated significantly lower GDS-SF and PHQ-9 scores than control participants. Compared with the pretest, the GDS-SF and PHQ-9 scores for depressive symptoms in both experimental groups remained lower at posttest (8 weeks), 6-week (14 weeks), and 10-week (18 weeks) follow-ups. However, the GDS-SF and PHQ-9 scores did not differ among the four time points in the control group. The posttest 5-HT concentrations in the aromatherapy massage and inhalation groups were increased over pretest values. Both aromatherapy massage and aromatherapy inhalation may have important implications for intervening depression in older adults.

NASA Astrophysics EPO Community: Enhancing STEM Instruction

NASA Astrophysics Data System (ADS)

Bartolone, L.; Manning, J.; Lawton, B.; Meinke, B. K.; Smith, D. A.; Schultz, G.; NASA Astrophysics EPO community

2015-11-01

The NASA Science Mission Directorate (SMD) Astrophysics Education and Public Outreach (EPO) community and Forum work together to capitalize on the cutting-edge discoveries of NASA Astrophysics missions to enhance Science, Technology, Engineering, and Math (STEM) instruction. In 2010, the Astrophysics EPO community identified online professional development for classroom educators and multiwavelength resources as a common interest and priority for collaborative efforts. The result is NASA's Multiwavelength Universe, a 2-3 week online professional development experience for classroom educators. The course uses a mix of synchronous sessions (live WebEx teleconferences) and asynchronous activities (readings and activities that educators complete on their own on the Moodle, and moderated by course facilitators). The NASA SMD Astrophysics EPO community has proven expertise in providing both professional development and resources to K-12 Educators. These mission- and grant-based EPO programs are uniquely poised to foster collaboration between scientists with content expertise and educators with pedagogy expertise. We present examples of how the NASA Astrophysics EPO community and Forum engage the K-12 education community in these ways, including associated metrics and evaluation findings.

Veggie Van Pilot Study: Impact of a Mobile Produce Market for Underserved Communities on Fruit and Vegetable Access and Intake

PubMed Central

Leone, Lucia A.; Haynes-Maslow, Lindsey; Ammerman, Alice S.

2016-01-01

We conducted a pilot evaluation of the Veggie Van, a mobile produce market that brings weekly boxes of reduced-cost locally grown fruits and vegetables (F&V) to lower-income communities and offers cooking and nutrition education to customers. We conducted surveys just prior to starting Veggie Van at each of 3 sites and again at 2–3 months. F&V intake was measured with a 2-question item and a 10-item food frequency questionnaire (FFQ) in a subset of participants. At baseline, average servings/day of F&V was 4.9 (SD = 2.6, n = 60). At follow-up, individuals who reported shopping at Veggie Van frequently (n = 32) increased their F&V consumption by 0.41 servings/day compared with a decrease of −1.19 for those who rarely/never used Veggie Van (n = 27), a total difference of 1.6 servings/day (P = .01). There were no statistically significant differences in F&V consumption between groups based on the FFQ measure. Frequent shoppers reported additional health improvements and increases in their ability to buy enough F&V. We conclude that offering weekly boxes of affordable F&V paired with education in underserved communities may improve F&V consumption for frequent program users. PMID:28529669

Veggie Van Pilot Study: Impact of a Mobile Produce Market for Underserved Communities on Fruit and Vegetable Access and Intake.

PubMed

Leone, Lucia A; Haynes-Maslow, Lindsey; Ammerman, Alice S

2017-01-01

We conducted a pilot evaluation of the Veggie Van, a mobile produce market that brings weekly boxes of reduced-cost locally grown fruits and vegetables (F&V) to lower-income communities and offers cooking and nutrition education to customers. We conducted surveys just prior to starting Veggie Van at each of 3 sites and again at 2-3 months. F&V intake was measured with a 2-question item and a 10-item food frequency questionnaire (FFQ) in a subset of participants. At baseline, average servings/day of F&V was 4.9 (SD = 2.6, n = 60). At follow-up, individuals who reported shopping at Veggie Van frequently (n = 32) increased their F&V consumption by 0.41 servings/day compared with a decrease of -1.19 for those who rarely/never used Veggie Van (n = 27), a total difference of 1.6 servings/day (P = .01). There were no statistically significant differences in F&V consumption between groups based on the FFQ measure. Frequent shoppers reported additional health improvements and increases in their ability to buy enough F&V. We conclude that offering weekly boxes of affordable F&V paired with education in underserved communities may improve F&V consumption for frequent program users.

Skills acquired in research and public health in the specialty of family and community nursing in the Valencian Community.

PubMed

García-Martínez, Pedro; Lozano-Vidal, Ruth; Herraiz-Ortiz, María Del Carmen; Collado-Boira, Eladio

To evaluate the acquisition of skills in research and public health specialists in family and community nursing. Descriptive and analytical study on a population of specialist nurse members of with the Valencian Primary Nurse Society. Measured with anonymous self-administered questionnaire on activities implemented and turnaround time in the training period. The questionnaire was conducted and reviewed based on the training programme of the specialty. Sixteen of the 41 specialists responded. The four year groups of nurses who had finished their training were represented as well as seven national teaching units. The results show high heterogeneity in the activities developed in the training. The average rotation in public health is 7.07 weeks, with range of 0 to 16 weeks. The mean number of educational sessions is 2.69 in the two years. The average number of research projects is 1.19. The result shows a specialisation process with training gaps in the skills of research and public health that could be remedied. Some practitioners claim that they finish their specialisation without undertaking research activities or completing the minimum proposed shifts. There is no process of improvement in the four year groups studied. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Microbiome Responses to an Uncontrolled Short-Term Diet Intervention in the Frame of the Citizen Science Project.

PubMed

Klimenko, Natalia S; Tyakht, Alexander V; Popenko, Anna S; Vasiliev, Anatoly S; Altukhov, Ilya A; Ischenko, Dmitry S; Shashkova, Tatiana I; Efimova, Daria A; Nikogosov, Dmitri A; Osipenko, Dmitrii A; Musienko, Sergey V; Selezneva, Kseniya S; Baranova, Ancha; Kurilshikov, Alexander M; Toshchakov, Stepan M; Korzhenkov, Aleksei A; Samarov, Nazar I; Shevchenko, Margarita A; Tepliuk, Alina V; Alexeev, Dmitry G

2018-05-08

Personalized nutrition is of increasing interest to individuals actively monitoring their health. The relations between the duration of diet intervention and the effects on gut microbiota have yet to be elucidated. Here we examined the associations of short-term dietary changes, long-term dietary habits and lifestyle with gut microbiota. Stool samples from 248 citizen-science volunteers were collected before and after a self-reported 2-week personalized diet intervention, then analyzed using 16S rRNA sequencing. Considerable correlations between long-term dietary habits and gut community structure were detected. A higher intake of vegetables and fruits was associated with increased levels of butyrate-producing Clostridiales and higher community richness. A paired comparison of the metagenomes before and after the 2-week intervention showed that even a brief, uncontrolled intervention produced profound changes in community structure: resulting in decreased levels of Bacteroidaceae , Porphyromonadaceae and Rikenellaceae families and decreased alpha-diversity coupled with an increase of Methanobrevibacter , Bifidobacterium , Clostridium and butyrate-producing Lachnospiraceae - as well as the prevalence of a permatype (a bootstrapping-based variation of enterotype) associated with a higher diversity of diet. The response of microbiota to the intervention was dependent on the initial microbiota state. These findings pave the way for the development of an individualized diet.

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.

Determination of nasal and oropharyngeal microbiomes in a multicenter population-based study - findings from Pretest 1 of the German National Cohort.

PubMed

Akmatov, Manas K; Koch, Nadine; Vital, Marius; Ahrens, Wolfgang; Flesch-Janys, Dieter; Fricke, Julia; Gatzemeier, Anja; Greiser, Halina; Günther, Kathrin; Illig, Thomas; Kaaks, Rudolf; Krone, Bastian; Kühn, Andrea; Linseisen, Jakob; Meisinger, Christine; Michels, Karin; Moebus, Susanne; Nieters, Alexandra; Obi, Nadia; Schultze, Anja; Six-Merker, Julia; Pieper, Dietmar H; Pessler, Frank

2017-05-12

We examined acceptability, preference and feasibility of collecting nasal and oropharyngeal swabs, followed by microbiome analysis, in a population-based study with 524 participants. Anterior nasal and oropharyngeal swabs were collected by certified personnel. In addition, participants self-collected nasal swabs at home four weeks later. Four swab types were compared regarding (1) participants' satisfaction and acceptance and (2) detection of microbial community structures based on deep sequencing of the 16 S rRNA gene V1-V2 variable regions. All swabbing methods were highly accepted. Microbial community structure analysis revealed 846 phylotypes, 46 of which were unique to oropharynx and 164 unique to nares. The calcium alginate tipped swab was found unsuitable for microbiome determinations. Among the remaining three swab types, there were no differences in oropharyngeal microbiomes detected and only marginal differences in nasal microbiomes. Microbial community structures did not differ between staff-collected and self-collected nasal swabs. These results suggest (1) that nasal and oropharyngeal swabbing are highly feasible methods for human population-based studies that include the characterization of microbial community structures in these important ecological niches, and (2) that self-collection of nasal swabs at home can be used to reduce cost and resources needed, particularly when serial measurements are to be taken.

Ecologically optimizing exercise maintenance in men and women post-cardiac rehabilitation: Protocol for a randomized controlled trial of efficacy with economics (ECO-PCR).

PubMed

Reid, Robert; Blanchard, Chris M; Wooding, Evyanne; Harris, Jennifer; Krahn, Murray; Pipe, Andrew; Chessex, Caroline; Grace, Sherry L

2016-09-01

Exercise-based cardiac rehabilitation (CR) participation results in increased cardio-metabolic fitness, which is associated with reduced mortality. However, many graduates fail to maintain exercise post-program. ECO-PCR investigates the efficacy and cost-effectiveness of a social ecologically-based intervention to increase long-term exercise maintenance following the completion of CR. A three-site, 2-group, parallel randomized controlled trial is underway. 412 male and 192 female (N=604) supervised CR participants are being recruited just before CR graduation. Participants are randomized (1:1 concealed allocation) to intervention or usual care. A 50-week exercise facilitator intervention has been designed to assist CR graduates in the transition from structured, supervised exercise to self-managed home- or community-based (e.g., Heart Wise Exercise programs) exercise. The intervention consists of 8 telephone contacts over the 50week period: 3 individual and 5 group. Assessments occur at CR graduation, and 26, 52 and 78weeks post-randomization. The primary outcome is change in minutes of accelerometer-measured moderate to vigorous-intensity physical activity (MVPA) from CR graduation to 52weeks post-randomization. Secondary measures include exercise capacity, quality of life, and cardiovascular risk factors. Analyses will be undertaken based on intention-to-treat. For the primary outcome, an analysis of variance will be computed to test the change in minutes of MVPA in each group between CR graduation and 52week follow-up (2 [arm]×2 [time]). Secondary objectives will be assessed using mixed-model repeated measures analyses to compare differences between groups over time. Mean costs and quality-adjusted life years for each arm will be estimated. Copyright © 2016 Elsevier Inc. All rights reserved.

From gene to protein: A 3-week intensive course in molecular biology for physical scientists.

PubMed

Nadeau, Jay L

2009-07-01

This article describes a 3-week intensive molecular biology methods course based upon fluorescent proteins, which is successfully taught at the McGill University to advanced undergraduates and graduates in physics, chemical engineering, biomedical engineering, and medicine. No previous knowledge of biological terminology or methods is expected, so the material could readily be adapted to earlier undergraduates or students in other fields. The course emphasizes hands-on experience with one half-hour of lecture and 3 and a half hours of laboratory 4 days per week, for a total of 39 hours. The materials are simple and low in cost and all software used is free, making the budget accessible to small universities and community colleges that possess basic teaching wet labs. Conceptual understanding is reinforced with lab reports and an independent final paper on a subject of the student's choice. The final paper describes a possible thesis project, not necessarily the student's own, with assessment based upon grasping of key concepts and methods of molecular biology. Copyright © 2009 International Union of Biochemistry and Molecular Biology, Inc.

Impact of an exercise program on muscular and functional performance and plasma levels of interleukin 6 and soluble receptor tumor necrosis factor in prefrail community-dwelling older women: a randomized controlled trial.

PubMed

Lustosa, Lygia Paccini; Máximo Pereira, Leani Souza; Coelho, Fernanda Matos; Pereira, Daniele Sirineu; Silva, Juscélio Pereira; Parentoni, Adriana Netto; Dias, Rosângela Correa; Domingues Dias, João Marcos

2013-04-01

To examine the impact of a muscle resistance program (MRP) on muscular and functional performance and on interleukin 6 (IL-6) and soluble tumor necrosis factor receptor-1 (sTNFr1) plasma levels in prefrail community-dwelling women. Randomized controlled trial crossover design with a postintervention and short-term follow-up. University hospital. Prefrail community-dwelling women (N=32; ≥65y). The MRP was designed based on the exercise at 75% of each participant's maximum load (10wk, 3 times/wk). Plasma concentrations of IL-6 and sTNFr1 (high-sensitivity enzyme-linked immunosorbent assay kits), muscle strength of the knee extensors (isokinetic), and functional performance (Timed Up & Go [TUG] test and 10-meter walk test [10MWT]). There were significant differences in functional and muscular performance between the pre-MRP, post-MRP, and 10-week follow-up period. After the MRP, both functional (TUG, pre-MRP=11.1s vs post-MRP=10.4s, P=.00; 10MWT, pre-MRP=4.9s vs post-MRP, 4.4s, P=.00) and muscular performances (pre-MRP=77.8% and post-MRP=83.1%, P=.02) improved. After cessation of the MRP (follow-up period), sTNFr1 plasma levels increased by 21.4% at 10-week follow-up (post-MRP, 406.4pg/mL; 10-week follow-up, 517.0pg/mL; P=.03). There were significant differences in sTNFr1 (P=.01). The MRP was effective in improving functional and muscular performances, although alterations in plasma levels of IL-6 and sTNFr1 could not be identified after the MRP. Cessation of the MRP after 10 weeks resulted in increased plasma levels of sTNFr1. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Effects of an individualised nutritional education and support programme on dietary habits, nutritional knowledge and nutritional status of older adults living alone.

PubMed

Ahn, Jeong-Ah; Park, JeeWon; Kim, Chun-Ja

2017-09-07

The effects of an individualised nutritional education and support programme on dietary habits, nutritional knowledge and nutritional status of 71 older adults living alone were examined. Although a regular dietary meal plan is recommended for improving nutritional status of older adults living alone, little research is done in this field in Korea. A pre- and post-test controlled quasi-experimental design was used at public health centres. The intervention group participated in an intensive nutritional education and support programme once a week for 8 weeks with dietary menus provided by home visiting nurses/dieticians; control group received usual care. Dietary habits and nutritional knowledge were assessed using structured questionnaires; nutritional intake status was analysed using Computer Aided Nutritional Analysis Program 5.0. The mean age of participants was 77.6 years, and 81.7% of the participants were women. At 8 weeks, there were significant interactions of group by time for dietary habits, nutritional knowledge and selected nutritional status of protein, iron and vitamins of B 2 and C. Changes over time in the mean score of dietary habits and nutritional knowledge were significantly improved in the intervention group compared to the control group. The percentages of normal nutrition intake of protein, iron and vitamins A and C in the intervention group were significantly higher than the control group at 8 weeks. Nutritional education and support programme positively impacted dietary habits, nutritional knowledge and selected nutritional status in older adults living alone, and we highlight the need for community-based nutritional education and counselling programmes. Older adults living alone in a community have relatively poor nutritional status and thus require tailored nutritional intervention according to objective nutritional analysis. It is necessary to link visiting nurses with dieticians in the community to manage effective nutritional programme continuously. © 2017 John Wiley & Sons Ltd.

National Dissemination of StrongWomen–Healthy Hearts: A Community-Based Program to Reduce Risk of Cardiovascular Disease Among Midlife and Older Women

PubMed Central

Seguin, Rebecca A.; Chui, Kenneth K. H.; Clark, Valerie; Corbin, Marilyn A.; Goldberg, Jeanne P.; Heidkamp-Young, Eleanor; Lichtenstein, Alice H.; Wiker, Nancy; Nelson, Miriam E.

2015-01-01

Objectives. We describe the national dissemination of an evidence-based community cardiovascular disease prevention program for midlife and older women using the RE-AIM (reach effectiveness adoption implementation maintenance) framework and share key lessons learned during translation. Methods. In a 2010 to 2014 collaboration between the StrongWomen program and the National Extension Association of Family and Consumer Sciences, we assessed reach, adoption, implementation, and maintenance using survey methods, and we assessed effectiveness using a pretest–posttest within-participants design, with weight change as the primary outcome. Results. Overall reach into the population was 15 per 10 000. Of 85 trained leaders, 41 (48%) adopted the program. During the 12-week intervention, weight decreased by 0.5 kilograms, fruit and vegetable intake increased by 2.1 servings per day, and physical activity increased by 1238 metabolic equivalent (MET)-minutes per week (all P < .001). Average fidelity score was 4.7 (out of possible 5). Eleven of 41 adopting leaders (27%) maintained the program. Conclusions. The StrongWomen–Healthy Hearts program can be implemented with high fidelity in a variety of settings while remaining effective. These data provide direction for program modification to improve impact as dissemination continues. PMID:26469644

Medical students, early general practice placements and positive supervisor experiences.

PubMed

Henderson, Margaret; Upham, Susan; King, David; Dick, Marie-Louise; van Driel, Mieke

2018-03-01

Introduction Community-based longitudinal clinical placements for medical students are becoming more common globally. The perspective of supervising clinicians about their experiences and processes involved in maximising these training experiences has received less attention than that of students. Aims This paper explores the general practitioner (GP) supervisor perspective of positive training experiences with medical students undertaking urban community-based, longitudinal clinical placements in the early years of medical training. Methods Year 2 medical students spent a half-day per week in general practice for either 13 or 26 weeks. Transcribed semi-structured interviews from a convenience sample of participating GPs were thematically analysed by two researchers, using a general inductive approach. Results Identified themes related to the attributes of participating persons and organisations: GPs, students, patients, practices and their supporting institution; GPs' perceptions of student development; and triggers enhancing the experience. A model was developed to reflect these themes. Conclusions Training experiences were enhanced for GPs supervising medical students in early longitudinal clinical placements by the synergy of motivated students and keen teachers with support from patients, practice staff and academic institutions. We developed an explanatory model to better understand the mechanism of positive experiences. Understanding the interaction of factors enhancing teaching satisfaction is important for clinical disciplines wishing to maintain sustainable, high quality teaching.

Neonatal death in low- to middle-income countries: a global network study.

PubMed

Belizán, José M; McClure, Elizabeth M; Goudar, Shivaprasad S; Pasha, Omrana; Esamai, Fabian; Patel, Archana; Chomba, Elwyn; Garces, Ana; Wright, Linda L; Koso-Thomas, Marion; Moore, Janet; Althabe, Fernando; Kodkany, Bhala S; Sami, Neelofar; Manasyan, Albert; Derman, Richard J; Liechty, Edward A; Hibberd, Patricia; Carlo, Waldemar A; Hambidge, K Michael; Buekens, Pierre; Jobe, Alan H; Goldenberg, Robert L

2012-09-01

To determine population-based neonatal mortality rates in low- and middle-income countries and to examine gestational age, birth weight, and timing of death to assess the potentially preventable neonatal deaths. A prospective observational study was conducted in communities in five low-income countries (Kenya, Zambia, Guatemala, India, and Pakistan) and one middle-income country (Argentina). Over a 2-year period, all pregnant women in the study communities were enrolled by trained study staff and their infants followed to 28 days of age. Between October 2009 and March 2011, 153,728 babies were delivered and followed through day 28. Neonatal death rates ranged from 41 per 1000 births in Pakistan to 8 per 1000 in Argentina; 54% of the neonatal deaths were >37 weeks and 46% weighed 2500 g or more. Half the deaths occurred within 24 hours of delivery. In our population-based low- and middle-income country registries, the majority of neonatal deaths occurred in babies >37 weeks' gestation and almost half weighed at least 2500 g. Most deaths occurred shortly after birth. With access to better medical care and hospitalization, especially in the intrapartum and early neonatal period, many of these neonatal deaths might be prevented. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Effect of maltitol-containing chewing gum use on the composition of dental plaque microbiota in subjects with active dental caries.

PubMed

Prosdocimi, Erica M; Kistler, James O; Moazzez, Rebecca; Thabuis, Clementine; Perreau, Caroline; Wade, William G

2017-01-01

Background : Sugar alcohols such as xylitol are incorporated in a number of oral hygiene products for their anti-cariogenic properties while chewing gum is known to be beneficial to oral hygiene. Objective : The aim of this study was to determine the composition of the dental plaque microbiota in patients with active caries before and after using a chewing gum supplemented with maltitol. Design : Forty subjects with active caries were randomly allocated to chew maltitol gum or gum base for two weeks. A healthy control group used gum base for two weeks. Plaque samples were collected before and after treatment and the microbiota analysed by pyrosequencing of 16S rRNA genes. Results : A total of 773,547 sequences were obtained from 117 samples. There was no difference in structure of the bacterial communities between groups (AMOVA). There was a significant difference in community membership between groups, (AMOVA, p=0.009). There was a significant difference between the control group after treatment and the maltitol patient group after treatment (p<0.001). A. naeslundii HOT-176 and Actinomyces HOT-169 were significantly reduced following use of maltitol chewing gum in patients. Conclusions : This study has shown that chewing gum containing maltitol had minor effects on the composition of the plaque microbiome.

75 FR 48853 - National Health Center Week, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-11

... Part IV The President Proclamation 8545--National Health Center Week, 2010 #0; #0; #0..., 2010 National Health Center Week, 2010 By the President of the United States of America A Proclamation America's community health centers are a vital component of our health care system, providing underserved...

Longitudinal informed consent competency in stable community patients with schizophrenia: A one-week training and one-year follow-up study.

PubMed

Wang, Xueqin; Yu, Xin; Appelbaum, Paul S; Tang, Hongyu; Yao, Guizhong; Si, Tianmei; Ma, Yating; Li, Tao; Yu, Ling; Shi, Chuan; Ma, Yibin; Li, Lingli

2016-01-01

This study explores the efficacy of a one-week informed consent information training process for improving competence to provide consent in stable community patients with schizophrenia over a one-year follow-up period. A one-week training session designed to enhance competence to provide informed consent for research was conducted. The training was guided by a research protocol that provided detailed explanations of each major conceptual unit. Participants were followed for one year, and comprised 50 stable community outpatients with schizophrenia who were randomly assigned to either an intervention group (IG, n=33) or a control group (CG, n=17) that did not receive any training. The Chinese Mandarin MacArthur Competence Assessment Tool-Clinical Research (MacCAT-CR) was used to assess competence for informed consent pre-training (baseline), post-training (one week later), and at the end of one year. A repeated measures analysis comparing the IG and CG at pre-training, post-training and the one-year follow-up revealed significant improvements in the Understanding and Appreciation subscale following the one-week training. However, by the end of one year, scores returned to baseline levels, with the exception of the Appreciation subscale, which was below baseline. There were significant main effects across time on the Appreciation and Reasoning subscales, indicating considerable changes over time. The CG showed no significant changes from pre-training to one week later or at one-year follow-up for all subscales. The capacities of understanding and appreciation can be improved in stable community patients with schizophrenia after one week of training; however, this training effect is not sustained one year later. The results suggest that more intensive or periodic trainings may be needed to maintain long-term competence levels in patients with schizophrenia, particularly with regard to their capacity to appreciate the nature and consequences of study participation. Copyright © 2015 Elsevier B.V. All rights reserved.

Change in Care Dependency of Stroke Patients: A Longitudinal and Multicenter Study.

PubMed

Nursiswati, Nursiswati; Halfens, Ruud J G; Lohrmann, Christa

2017-06-01

The study was conducted to investigate the change of care dependency in stroke patients from inpatient wards and outpatient units in Indonesia. This study is longitudinal and multicentered. One hundred and nine patients were included from four hospitals on the island of Java. Care dependency was assessed using the Indonesian version of the 15-item Care Dependency Scale (CDS) at five points in time: at inpatient wards for admission and discharge and at outpatient units after discharge in the 1st week, the 5th week, and the 13th week. Most of the patients were male (65.1%), and diagnosed with ischemic stroke (71.5%). The results showed that care dependency in stroke patients decreased significantly from admission to discharge, as well as from the 5th to the 13th week as measured by the CDS. At admission, 23.0% of the patients were completely dependent on care, and at the 13th week about 1.0% were. Patients' care dependency decreased significantly in all care dependency items of the CDS in the inpatient ward, but five care dependency items of the CDS did not significantly decrease in the outpatient unit. Based on the findings of this study, we recommend that hospital-based and community-based services should include continual care dependence monitoring using this comprehensive instrument. Care dependency is subject to change over time, therefore nurses have to plan and tailor adequate nursing care measures to patient needs in the different stages, especially with respect to the aspect of mobility. Copyright © 2017. Published by Elsevier B.V.

A therapeutic skating intervention for children with autism spectrum disorder.

PubMed

Casey, Amanda Faith; Quenneville-Himbeault, Gabriel; Normore, Alexa; Davis, Hanna; Martell, Stephen G

2015-01-01

The purpose of this study was to evaluate the effects of a highly structured therapeutic skating intervention on motor outcomes and functional capacity in 2 boys with autism spectrum disorder aged 7 and 10 years. This multiple-baseline, single-subject study assigned participants to three 1-hour skating sessions per week for 12 weeks focusing on skill and motor development. Multiple data points assessed (a) fidelity to the intervention and (b) outcomes measures including the Pediatric Balance Scale, Timed Up and Go, floor to stand, Six-Minute Walk Test, goal attainment, and weekly on-ice testing. Improvements were found in balance, motor behavior, and functional capacity by posttest with gains remaining above pretest levels at follow-up. Therapeutic skating may produce physical benefits for children with autism spectrum disorder and offer a viable, inexpensive community-based alternative to other forms of physical activity.

Report on the Joint Eglin Acoustic Week III

NASA Technical Reports Server (NTRS)

Watts, Michael E.; Conner, David A.; Smith, Charles E.

2008-01-01

A series of three flight tests have been conducted at Eglin Air Force Base located in the Florida panhandle. The first was the Acoustics Week flight test conducted in September 2003. The second was the NASA Heavy Lift Rotorcraft Acoustic Flight Test conducted in October-November 2005. The most recent was the Eglin Acoustic Week III test conducted in August-September 2007. This series of tests have acquired acoustic data for a number of rotary and fixed wing aircraft that are used to generate noise semi-spheres used in predicting the acoustic footprint for prescribed flight operations. This extensive database can be used to determine the impact of flight operations on communities around a terminal area. Another valuable use of the semi-spheres is determining the long-range propagation of noise for civilian and military purposes. This paper will describe the third in this series of tests.

Aquatic therapy for boys with Duchenne muscular dystrophy (DMD): an external pilot randomised controlled trial.

PubMed

Hind, Daniel; Parkin, James; Whitworth, Victoria; Rex, Saleema; Young, Tracey; Hampson, Lisa; Sheehan, Jennie; Maguire, Chin; Cantrill, Hannah; Scott, Elaine; Epps, Heather; Main, Marion; Geary, Michelle; McMurchie, Heather; Pallant, Lindsey; Woods, Daniel; Freeman, Jennifer; Lee, Ellen; Eagle, Michelle; Willis, Tracey; Muntoni, Francesco; Baxter, Peter

2017-01-01

Standard treatment of Duchenne muscular dystrophy (DMD) includes regular physiotherapy. There are no data to show whether adding aquatic therapy (AT) to land-based exercises helps maintain motor function. We assessed the feasibility of recruiting and collecting data from boys with DMD in a parallel-group pilot randomised trial (primary objective), also assessing how intervention and trial procedures work. Ambulant boys with DMD aged 7-16 years established on steroids, with North Star Ambulatory Assessment (NSAA) score ≥8, who were able to complete a 10-m walk test without aids or assistance, were randomly allocated (1:1) to 6 months of either optimised land-based exercises 4 to 6 days/week, defined by local community physiotherapists, or the same 4 days/week plus AT 2 days/week. Those unable to commit to a programme, with >20% variation between NSAA scores 4 weeks apart, or contraindications to AT were excluded. The main outcome measures included feasibility of recruiting 40 participants in 6 months from six UK centres, clinical outcomes including NSAA, independent assessment of treatment optimisation, participant/therapist views on acceptability of intervention and research protocols, value of information (VoI) analysis and cost-impact analysis. Over 6 months, 348 boys were screened: most lived too far from centres or were enrolled in other trials; 12 (30% of the targets) were randomised to AT ( n  = 8) or control ( n  = 4). The mean change in NSAA at 6 months was -5.5 (SD 7.8) in the control arm and -2.8 (SD 4.1) in the AT arm. Harms included fatigue in two boys, pain in one. Physiotherapists and parents valued AT but believed it should be delivered in community settings. Randomisation was unattractive to families, who had already decided that AT was useful and who often preferred to enrol in drug studies. The AT prescription was considered to be optimised for three boys, with other boys given programmes that were too extensive and insufficiently focused. Recruitment was insufficient for VoI analysis. Neither a UK-based RCT of AT nor a twice weekly AT therapy delivered at tertiary centres is feasible. Our study will help in the optimisation of AT service provision and the design of future research. ISRCTN41002956.

Comparison of a mobile phone-based malaria reporting system with source participant register data for capturing spatial and temporal trends in epidemiological indicators of malaria transmission collected by community health workers in rural Zambia.

PubMed

Hamainza, Busiku; Killeen, Gerry F; Kamuliwo, Mulakwa; Bennett, Adam; Yukich, Joshua O

2014-12-12

Timeliness, completeness, and accuracy are key requirements for any surveillance system to reliably monitor disease burden and guide efficient resource prioritization. Evidence that electronic reporting of malaria cases by community health workers (CHWs) meet these requirements remains limited. Residents of two adjacent rural districts in Zambia were provided with both passive and active malaria testing and treatment services with malaria rapid diagnostic tests (RDTs) and artemisinin-based combination therapy by 42 CHWs serving 14 population clusters centred around public sector health facilities. Reference data describing total numbers of RDT-detected infections and diagnostic positivity (DP) were extracted from detailed participant register books kept by CHWs. These were compared with equivalent weekly summaries relayed directly by the CHWs themselves through a mobile phone short messaging system (SMS) reporting platform. Slightly more RDT-detected malaria infections were recorded in extracted participant registers than were reported in weekly mobile phone summaries but the difference was equivalent to only 19.2% (31,665 versus 25,583, respectively). The majority (81%) of weekly SMS reports were received within one week and the remainder within one month. Overall mean [95% confidence limits] difference between the numbers of register-recorded and SMS-reported RDT-detected malaria infections per CHW per week, as estimated by the Bland Altman method, was only -2.3 [-21.9, 17.2]. The mean [range] for both the number of RDT-detected malaria infections (86 [0, 463] versus 73.6 [0, 519], respectively)) and DP (22.8% [0.0 to 96.3%] versus 23.2% [0.4 to 75.8%], respectively) reported by SMS were generally very consistent with those recorded in the reference paper-based register data and exhibited similar seasonality patterns across all study clusters. Overall, mean relative differences in the SMS reports and reference register data were more consistent with each other for DP than for absolute numbers of RDT-detected infections, presumably because this indicator is robust to variations in patient reporting rates by location, weather, season and calendar event because these are included in both the nominator and denominator. The SMS reports captured malaria transmission trends with adequate accuracy and could be used for population-wide, continuous, longitudinal monitoring of malaria transmission.

Feasibility of a rural palliative supportive service.

PubMed

Pesut, B; Hooper, B P; Robinson, C A; Bottorff, J L; Sawatzky, R; Dalhuisen, M

2015-01-01

Healthcare models for the delivery of palliative care to rural populations encounter common challenges: service gaps, the cost of the service in relation to the population, sustainability, and difficulty in demonstrating improvements in outcomes. Although it is widely agreed that a community capacity-building approach to rural palliative care is essential, how that approach can be achieved, evaluated and sustained remains in question. The purpose of this community-based research project is to test the feasibility and identify potential outcomes of implementing a rural palliative supportive service (RPaSS) for older adults living with life-limiting chronic illness and their family caregiver in the community. This paper reports on the feasibility aspects of the study. RPaSS is being conducted in two co-located rural communities with populations of approximately 10 000 and no specialized palliative services. Participants living with life-limiting chronic illness and their family caregivers are visited bi-weekly in the home by a nurse coordinator who facilitates symptom management, teaching, referrals, psychosocial and spiritual support, advance care planning, community support for practical tasks, and telephone-based support for individuals who must commute outside of the rural community for care. Mixed-method collection strategies are used to collect data on visit patterns; healthcare utilization; family caregiver needs; and participant needs, functional performance and quality of life. A community-based advisory committee worked with the investigative team over a 1-year period to plan RPaSS, negotiating the best fit between research methods and the needs of the community. Recruitment took longer than anticipated with service capacity being reached at 8 months. Estimated service capacity of one nurse coordinator, based on bi-weekly visits, is 25 participants and their family caregivers. A total of 393 in-person visits and 53 telephone visits were conducted between January 2013 and May 2014. Scheduled in-person visit duration showed a mean of 67 minutes. During this same time period only 19 scheduled visits were declined, and there was no study attrition except through death, indicating a high degree of acceptability of the intervention. The primary needs that were addressed during these visits have been related to chronic disease management, and the attending physical symptoms were addressed through teaching and support. The use of structured quality of life and family caregiver needs assessments has been useful in facilitating communication, although some participants experienced the nature of the questions as too personal in the early stages of the relationship with the nurse coordinator. Findings from this study illustrate the feasibility of providing home-based services for rural older adults living with life-limiting chronic illness. The RPaSS model has the potential to smooth transitions and enhance quality of life along the disease trajectory and across locations of care by providing a consistent source of support and education. This type of continuity has the potential to foster the patient- and family-centered approach to care that is the ideal of a palliative approach. Further, the use of a rural community capacity-building approach may contribute to sustainability, which is a particularly important part of rural health service delivery.

[Effects of a Positive Psychotherapy Program on Positive Affect, Interpersonal Relations, Resilience, and Mental Health Recovery in Community-Dwelling People with Schizophrenia].

PubMed

Kim, Jinhee; Na, Hyunjoo

2017-10-01

Recently, the interest in positive psychotherapy is growing, which can help to encourage positive relationships and develop strengths of people. This study was conducted to investigate the effects of a positive psychotherapy program on positive affect, interpersonal relations, resilience, and mental health recovery in community-dwelling people with schizophrenia. The research was conducted using a randomized control group pretest-posttest design. A total of 57 adults with schizophrenia participated in this study. The study participants in experimental group received a positive psychotherapy program (n=28) and the participants in control group received only the usual treatment in community centers (n=29). The positive psychotherapy program was provided for 5 weeks (of 10 sessions, held twice/week, for 60 minutes). The study outcomes included positive affect, interpersonal relations, resilience, and mental health recovery. The collected data were analyzed using repeated measures ANOVA for examining study hypothesis. Results showed that interpersonal relations (F=11.83, p=.001) and resilience (F=9.62, p=.003) significantly increased in the experimental group compared to the control group. Although experimental group showed a slight increase in positive affect, it was not significant. The study findings confirm that the positive psychotherapy program is effective for improving interpersonal relations and resilience of community-dwelling people with schizophrenia. Based on the findings, we believe that the positive psychotherapy program would be acceptable and helpful to improve recovery of mental health in schizophrenia. © 2017 Korean Society of Nursing Science

Using videovoice methods to enhance community outreach and engagement for the National Children's Study.

PubMed

Warren, Christopher M; Knight, Roger; Holl, Jane L; Gupta, Ruchi S

2014-05-01

The National Children's Study (NCS) is a prospective observational study examining the effects of environmental influences on child health and development in the United States. Videovoice is a health advocacy and promotion methodology wherein participants use participatory videography and interviewing techniques to identify issues of concern, communicate knowledge, and advocate for community health. This study describes a videovoice project, implemented in six Cook County, IL, communities targeted by the NCS for participant recruitment. A 6-week, videovoice training was conducted to train and empower NCS community outreach and engagement personnel. Pre/post evaluations were administered, and participant footage was qualitatively analyzed to identify overarching themes informing future outreach. Participants reported significant increases (p < .05) in videography/photography skills, community outreach/communication abilities, and awareness of important community health issues. Major themes included the following: high community knowledge of local health issues, low community knowledge of the NCS, and identification of barriers to participation. Two promotional videos were created to address these barriers and educate communities about the NCS. A 6-week, videovoice project was effective in training NCS community outreach personnel and enhancing NCS community engagement within six target Cook County, IL, communities via the production of community-engaged NCS promotional videos.

The Ground-Dwelling Arthropod Community of Península Valdés in Patagonia, Argentina

PubMed Central

Cheli, Germán H.; Corley, J. C.; Bruzzone, O.; del Brío, M.; Martínez, F.; Román, N. Martínez; Ríos, I.

2010-01-01

This is the first study based on a planned and intensive sampling effort that describes the community composition and structure of the ground-dwelling arthropod assemblage of Península Valdés (Patagonia). It was carried out using pitfall traps, opened for two weeks during the summers of 2005, 2006 and 2007. A total of 28, 111 individuals were caught. Ants (Hymenoptera: Formicidae) dominated this community, followed by beetles (Coleoptera) and spiders (Araneae). The most abundant species were Pheidole bergi Mayr (Hymenoptera: Formicidae) and Blapstinus punctulatus Solier (Coleoptera: Tenebrionidae). Two new species were very recently described as new based on specimens collected during this study: Valdesiana curiosa Carpintero, Dellapé & Cheli (Hemiptera, Miridae) and Anomaloptera patagonica Dellapé & Cheli (Hemiptera, Oxycarenidae). The order Coleoptera was the most diverse taxa. The distribution of abundance data was best described by the logarithmic series model both at the family and species levels, suggesting that ecological relationships in this community could be controlled by a few factors. The community was dominated by predators from a trophic perspective. This suggests that predation acts as an important factor driving the distribution and abundances of surface-dwelling arthropods in this habitat and as such serves as a key element in understanding desert, above-ground community structure. These findings may also be useful for management and conservation purposes in arid Patagonia. PMID:20572783

The ground-dwelling arthropod community of Península Valdés in Patagonia, Argentina.

PubMed

Cheli, Germán H; Corley, J C; Bruzzone, O; Brío, M Del; Martínez, F; Román, N Martínez; Ríos, I

2010-01-01

This is the first study based on a planned and intensive sampling effort that describes the community composition and structure of the ground-dwelling arthropod assemblage of Península Valdés (Patagonia). It was carried out using pitfall traps, opened for two weeks during the summers of 2005, 2006 and 2007. A total of 28,111 individuals were caught. Ants(Hymenoptera: Formicidae) dominated this community, followed by beetles (Coleoptera) and spiders (Araneae). The most abundant species were Pheidole bergi Mayr (Hymenoptera:Formicidae) and Blapstinus punctulatus Solier (Coleoptera: Tenebrionidae). Two new species were very recently described as new based on specimens collected during this study: Valdesianacuriosa Carpintero, Dellapé & Cheli (Hemiptera, Miridae) and Anomaloptera patagonica Dellapé& Cheli (Hemiptera, Oxycarenidae). The order Coleoptera was the most diverse taxa. The distribution of abundance data was best described by the logarithmic series model both at the family and species levels, suggesting that ecological relationships in this community could be controlled by a few factors. The community was dominated by predators from a trophic perspective. This suggests that predation acts as an important factor driving the distribution and abundances of surface-dwelling arthropods in this habitat and as such serves as a key element in understanding desert, above-ground community structure. These findings may also be useful for management and conservation purposes in arid Patagonia.

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

PubMed

Bopp, Melissa; Fallon, Elizabeth

2008-01-01

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

Web-Based Telepresence Exercise Program for Community-Dwelling Elderly Women With a High Risk of Falling: Randomized Controlled Trial.

PubMed

Hong, Jeeyoung; Kong, Hyoun-Joong; Yoon, Hyung-Jin

2018-05-28

While physical exercise is known to help prevent falls in the elderly, bad weather and long distance between the home and place of exercise represent substantial deterrents for the elderly to join or continue attending exercise programs outside their residence. Conventional modalities for home exercise can be helpful but do not offer direct and prompt feedback to the participant, which minimizes the benefit. We aimed to develop an elderly-friendly telepresence exercise platform and to evaluate the effects of a 12-week telepresence exercise program on fall-related risk factors in community-dwelling elderly women with a high risk of falling. In total, 34 women aged 68-91 years with Fall Risk Assessment scores >14 and no medical contraindication to physical training-based therapy were recruited in person from a senior citizen center. The telepresence exercise platform included a 15-inch tablet computer, custom-made peer-to-peer video conferencing server system, and broadband Internet connectivity. The Web-based program included supervised resistance exercises performed using elastic resistance bands and balance exercise for 20-40 minutes a day, three times a week, for 12 weeks. During the telepresence exercise session, each participant in the intervention group was supervised remotely by a specialized instructor who provided feedback in real time. The women in the control group maintained their lifestyle without any intervention. Fall-related physical factors (body composition and physical function parameters) and psychological factors (Korean Falls Efficacy Scale score, Fear of Falling Questionnaire score) before and after the 12-week interventional period were examined in person by an exercise specialist blinded to the group allocation scheme. Of the 30 women enrolled, 23 completed the study. Compared to women in the control group (n=13), those in the intervention group (n=10) showed significant improvements on the scores for the chair stand test (95% confidence interval -10.45 to -5.94, P<.001), Berg Balance Scale (95% confidence interval -2.31 to -0.28, P=.02), and Fear of Falling Questionnaire (95% confidence interval 0.69-3.5, P=.01). The telepresence exercise program had positive effects on fall-related risk factors in community-dwelling elderly women with a high risk of falling. Elderly-friendly telepresence technology for home-based exercises can serve as an effective intervention to improve fall-related physical and psychological factors. Clinical Research Information Service KCT0002710; https://cris.nih.go.kr/cris/en/search/ search_result_st01.jsp?seq=11246 (Archived by WebCite at http://www.webcitation.org/6zdSUEsmb). ©Jeeyoung Hong, Hyoun-Joong Kong, Hyung-Jin Yoon. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 28.05.2018.

Preventing Australian football injuries with a targeted neuromuscular control exercise programme: comparative injury rates from a training intervention delivered in a clustered randomised controlled trial

PubMed Central

Twomey, Dara M; Fortington, Lauren V; Doyle, Tim L A; Elliott, Bruce C; Akram, Muhammad; Lloyd, David G

2016-01-01

Background Exercise-based training programmes are commonly used to prevent sports injuries but programme effectiveness within community men's team sport is largely unknown. Objective To present the intention-to-treat analysis of injury outcomes from a clustered randomised controlled trial in community Australian football. Methods Players from 18 male, non-elite, community Australian football clubs across two states were randomly allocated to either a neuromuscular control (NMC) (intervention n=679 players) or standard-practice (control n=885 players) exercise training programme delivered as part of regular team training sessions (2× weekly for 8-week preseason and 18-week regular-season). All game-related injuries and hours of game participation were recorded. Generalised estimating equations, adjusted for clustering (club unit), were used to compute injury incidence rates (IIRs) for all injuries, lower limb injuries (LLIs) and knee injuries sustained during games. The IIRs were compared across groups with cluster-adjusted Injury Rate Ratios (IRRs). Results Overall, 773 game injuries were recorded. The lower limb was the most frequent body region injured, accounting for 50% of injuries overall, 96 (12%) of which were knee injuries. The NMC players had a reduced LLI rate compared with control players (IRR: 0.78 (95% CI 0.56 to 1.08), p=0.14.) The knee IIR was also reduced for NMC compared with control players (IRR: 0.50 (95% CI 0.24 to 1.05), p=0.07). Conclusions These intention-to-treat results indicate that positive outcomes can be achieved from targeted training programmes for reducing knee and LLI injury rates in men's community sport. While not statistically significant, reducing the knee injury rate by 50% and the LLI rate by 22% is still a clinically important outcome. Further injury reductions could be achieved with improved training attendance and participation in the programme. PMID:26399611

Adapted physical activity is beneficial on balance, functional mobility, quality of life and fall risk in community-dwelling older women: a randomized single-blinded controlled trial.

PubMed

Kovács, E; Prókai, L; Mészáros, L; Gondos, T

2013-06-01

Exercise programmes have important role in prevention of falls, but to date, we have little knowledge about the effects of Adapted Physical Activity programme on balance of older women. The aim of this study was to investigate the effects of an Adapted Physical Activity programme on balance, risk of falls and quality of life in community-dwelling older women. This was a randomized controlled study. Community, in a local sport centre. Older women aged over 60 years. Seventy-six women were randomised to an exercise group providing Adapted Physical Activity programme for 25 weeks or a control group (in which they did not participate in any exercise programme). The one-leg stance test, Timed Up and Go test, incidence of fall and the quality of life (SF-36V2) were measured at baseline and after 25 weeks. The one-leg stance test and the Timed Up and Go test in the exercise group was significantly better than in the control group after the intervention period (P=0.005; P=0.001, respectively). The Physical Functioning, Vitality and General Health subdomains of quality of life were also significantly better in the exercise group compared to the control group (P=0.004; P=0.005; P=0.038, respectively). Relative risk was 0.40 (90% CI 0.174 to 0.920) and the number needed to treat was 5 (95% CI 2.3 to 23.3). This 25-week Adapted Physical Activity programme improves static balance, functional mobility, as well as Physical Functioning, Vitality and General Health subdomains of quality of life. Based on our results, the Adapted Physical Activity programme may be a promising fall prevention exercise programme improving static balance and functional mobility for community-dwelling older women.

Stakeholder involvement in the design of a patient-centered comparative effectiveness trial of the "On the Move" group exercise program in community-dwelling older adults.

PubMed

Brach, Jennifer S; Perera, Subashan; Gilmore, Sandra; VanSwearingen, Jessie M; Brodine, Deborah; Wert, David; Nadkarni, Neelesh K; Ricci, Edmund

2016-09-01

Group exercise programs for older adults often exclude the timing and coordination of movement. Stakeholder involvement in the research process is strongly encouraged and improves the relevance and adoption of findings. We describe stakeholder involvement in the design of a clinical trial of a group-based exercise program that incorporates timing and coordination of movement into the exercises. The study was a cluster randomized, single-blind intervention trial to compare the effects on function, disability and mobility of a standard group exercise program and the "On the Move" group exercise program in older adults residing in independent living facilities and senior apartment buildings, and attending community centers. Exercise classes were twice weekly for 12weeks delivered by study exercise leaders and facility activity staff personnel. The primary outcomes function, disability and mobility were assessed at baseline and post-intervention. Function and disability were assessed using the Late Life Function and Disability Instrument, and mobility using the Six-Minute Walk Test and gait speed. Patient and provider stakeholders had significant input into the study aims, design, sample, intervention, outcomes and operational considerations. A community-based exercise program to improve walking can be developed to address both investigator identified missing components in current exercise to improve walking and stakeholder defined needs and interest for the activity program. Involvement of stakeholders substantially improves the relevance of research questions, increases the transparency of research activities and may accelerate the adoption of research into practice. Copyright © 2016 Elsevier Inc. All rights reserved.

Stakeholder involvement in the design of a patient-centered comparative effectiveness trial of the “On the Move” group exercise program in community-dwelling older adults

PubMed Central

Brach, Jennifer S.; Perera, Subashan; Gilmore, Sandra; VanSwearingen, Jessie M.; Brodine, Deborah; Wert, David; Nadkarni, Neelesh K.; Ricci, Edmund

2016-01-01

Background Group exercise programs for older adults often exclude the timing and coordination of movement. Stakeholder involvement in the research process is strongly encouraged and improves the relevance and adoption of findings. We describe stakeholder involvement in the design of a clinical trial of a group-based exercise program that incorporates timing and coordination of movement into the exercises. Methods The study was a cluster randomized, single-blind intervention trial to compare the effects on function, disability and mobility of a standard group exercise program and the “On the Move” group exercise program in older adults residing in independent living facilities and senior apartment buildings, and attending community centers. Exercise classes were twice weekly for 12 weeks delivered by study exercise leaders and facility activity staff personnel. Outcomes The primary outcomes function, disability and mobility were assessed at baseline and post-intervention. Function and disability were assessed using the Late Life Function and Disability Instrument, and mobility using the Six-Minute Walk Test and gait speed. Stakeholders Patient and provider stakeholders had significant input into the study aims, design, sample, intervention, outcomes and operational considerations. Summary A community-based exercise program to improve walking can be developed to address both investigator identified missing components in current exercise to improve walking and stakeholder defined needs and interest for the activity program. Involvement of stakeholders substantially improves the relevance of research questions, increases the transparency of research activities and may accelerate the adoption of research into practice. PMID:27521806

Design of a randomized, controlled, comparative-effectiveness trial testing a Family Model of Diabetes Self-Management Education (DSME) vs. Standard DSME for Marshallese in the United States.

PubMed

Kim Yeary, Karen Hye-Cheon; Long, Christopher R; Bursac, Zoran; McElfish, Pearl Anna

2017-06-01

Type 2 diabetes (T2D) is a significant public health problem, with U.S. Pacific Islander communities-such as the Marshallese-bearing a disproportionate burden. Using a community-based participatory approach (CBPR) that engages the strong family-based social infrastructure characteristic of Marshallese communities is a promising way to manage T2D. Led by a collaborative community-academic partnership, the Family Model of Diabetes Self-Management Education (DSME) aimed to change diabetes management behaviors to improve glycemic control in Marshallese adults with T2D by engaging the entire family. To test the Family Model of DSME, a randomized, controlled, comparative effectiveness trial with 240 primary participants was implemented. Half of the primary participants were randomly assigned to the Standard DSME and half were randomly assigned to the Family Model DSME. Both arms received ten hours of content comprised of 6-8 sessions delivered over a 6-8 week period. The Family Model DSME was a cultural adaptation of DSME, whereby the intervention focused on engaging family support for the primary participant with T2D. The Standard DSME was delivered to the primary participant in a community-based group format. Primary participants and participating family members were assessed at baseline and immediate post-intervention, and will also be assessed at 6 and 12 months. The Family Model of DSME aimed to improve glycemic control in Marshallese with T2D. The utilization of a CBPR approach that involves the local stakeholders and the engagement of the family-based social infrastructure of Marshallese communities increase potential for the intervention's success and sustainability.

A randomized controlled trial of an enhanced interdisciplinary community based group program for people with Parkinson's disease: study rationale and protocol.

PubMed

Peters, Catherine; Currin, Michelle; Tyson, Sara; Rogers, Anthea; Healy, Susan; McPhail, Steven; Brauer, Sandra G; Heathcote, Katharine; Comans, Tracy

2012-01-09

Parkinson's disease (PD) is a progressive, chronic neurodegenerative disorder for which there is no known cure. Physical exercise programs may be used to assist with the physical management of PD. Several studies have demonstrated that community based physical therapy programs are effective in reducing physical aspects of disability among people with PD. While multidisciplinary therapy interventions may have the potential to reduce disability and improve the quality of life of people with PD, there is very limited clinical trial evidence to support or refute the use of a community based multidisciplinary or interdisciplinary programs for people with PD. A two group randomized trial is being undertaken within a community rehabilitation service in Brisbane, Australia. Community dwelling adults with a diagnosis of Idiopathic Parkinson's disease are being recruited. Eligible participants are randomly allocated to a standard exercise rehabilitation group program or an intervention group which incorporates physical, cognitive and speech activities in a multi-tasking framework. Outcomes will be measured at 6-week intervals for a period of six months. Primary outcome measures are the Montreal Cognitive Assessment (MoCA) and the Timed Up and Go (TUG) cognitive test. Secondary outcomes include changes in health related quality of life, communication, social participation, mobility, strength and balance, and carer burden measures. This study will determine the immediate and long-term effectiveness of a unique multifocal, interdisciplinary, dual-tasking approach to the management of PD as compared to an exercise only program. We anticipate that the results of this study will have implications for the development of cost effective evidence based best practice for the treatment of people with PD living in the community.

A community-based exercise intervention transitions metabolically abnormal obese adults to a metabolically healthy obese phenotype

PubMed Central

Dalleck, Lance C; Van Guilder, Gary P; Richardson, Tara B; Bredle, Donald L; Janot, Jeffrey M

2014-01-01

Background Lower habitual physical activity and poor cardiorespiratory fitness are common features of the metabolically abnormal obese (MAO) phenotype that contribute to increased cardiovascular disease risk. The aims of the present study were to determine 1) whether community-based exercise training transitions MAO adults to metabolically healthy, and 2) whether the odds of transition to metabolically healthy were larger for obese individuals who performed higher volumes of exercise and/or experienced greater increases in fitness. Methods and results Metabolic syndrome components were measured in 332 adults (190 women, 142 men) before and after a supervised 14-week community-based exercise program designed to reduce cardiometabolic risk factors. Obese (body mass index ≥30 kg · m2) adults with two to four metabolic syndrome components were classified as MAO, whereas those with no or one component were classified as metabolically healthy but obese (MHO). After community exercise, 27/68 (40%) MAO individuals (P<0.05) transitioned to metabolically healthy, increasing the total number of MHO persons by 73% (from 37 to 64). Compared with the lowest quartiles of relative energy expenditure and change in fitness, participants in the highest quartiles were 11.6 (95% confidence interval: 2.1–65.4; P<0.05) and 7.5 (95% confidence interval: 1.5–37.5; P<0.05) times more likely to transition from MAO to MHO, respectively. Conclusion Community-based exercise transitions MAO adults to metabolically healthy. MAO adults who engaged in higher volumes of exercise and experienced the greatest increase in fitness were significantly more likely to become metabolically healthy. Community exercise may be an effective model for primary prevention of cardiovascular disease. PMID:25120373

Testing the Community-Based Learning Collaborative (CBLC) implementation model: a study protocol.

PubMed

Hanson, Rochelle F; Schoenwald, Sonja; Saunders, Benjamin E; Chapman, Jason; Palinkas, Lawrence A; Moreland, Angela D; Dopp, Alex

2016-01-01

High rates of youth exposure to violence, either through direct victimization or witnessing, result in significant health/mental health consequences and high associated lifetime costs. Evidence-based treatments (EBTs), such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), can prevent and/or reduce these negative effects, yet these treatments are not standard practice for therapists working with children identified by child welfare or mental health systems as needing services. While research indicates that collaboration among child welfare and mental health services sectors improves availability and sustainment of EBTs for children, few implementation strategies designed specifically to promote and sustain inter-professional collaboration (IC) and inter-organizational relationships (IOR) have undergone empirical investigation. A potential candidate for evaluation is the Community-Based Learning Collaborative (CBLC) implementation model, an adaptation of the Learning Collaborative which includes strategies designed to develop and strengthen inter-professional relationships between brokers and providers of mental health services to promote IC and IOR and achieve sustained implementation of EBTs for children within a community. This non-experimental, mixed methods study involves two phases: (1) analysis of existing prospective quantitative and qualitative quality improvement and project evaluation data collected pre and post, weekly, and monthly from 998 participants in one of seven CBLCs conducted as part of a statewide initiative; and (2) Phase 2 collection of new quantitative and qualitative (key informant interviews) data during the funded study period to evaluate changes in relations among IC, IOR, social networks and the penetration and sustainment of TF-CBT in targeted communities. Recruitment for Phase 2 is from the pool of 998 CBLC participants to achieve a targeted enrollment of n = 150. Study aims include: (1) Use existing quality improvement (weekly/monthly online surveys; pre-post surveys; interviews) and newly collected quantitative (monthly surveys) and qualitative (key informant interviews) data and social network analysis to test whether CBLC strategies are associated with penetration and sustainment of TF-CBT; and (2) Use existing quantitative quality improvement (weekly/monthly on-line surveys; pre/post surveys) and newly collected qualitative (key informant interviews) data and social network analysis to test whether CBLC strategies are associated with increased IOR and IC intensity. The proposed research leverages an on-going, statewide implementation initiative to generate evidence about implementation strategies needed to make trauma-focused EBTs more accessible to children. This study also provides feasibility data to inform an effectiveness trial that will utilize a time-series design to rigorously evaluate the CBLC model as a mechanism to improve access and sustained use of EBTs for children.

The Effects of Social Environments on Time Spent Gaming: Focusing on the Effects of Communities and Neighborhoods.

PubMed

Lim, Tee Teng; Jung, Sun Young; Kim, Eunyi

2018-04-01

This study examined the impact of community and neighborhood on time spent computer gaming. Computer gaming for over 20 hours a week was set as the cutoff line for "engaged use" of computer games. For the analysis, this study analyzed data for about 1,800 subjects who participated in the Korean Children and Youth Panel Survey. The main findings are as follows: first, structural community characteristics and neighborhood social capital affected the engaged use of computer games. Second, adolescents who reside in regions with a higher divorce rate or higher residential mobility were likely to exhibit engaged use of computer games. Third, adolescents who highly perceive neighborhood social capital exhibited lower possibility of engaged use of computer games. Based on these findings, practical implications and directions for further study are suggested.

'TXT2BFiT' a mobile phone-based healthy lifestyle program for preventing unhealthy weight gain in young adults: study protocol for a randomized controlled trial.

PubMed

Hebden, Lana; Balestracci, Kate; McGeechan, Kevin; Denney-Wilson, Elizabeth; Harris, Mark; Bauman, Adrian; Allman-Farinelli, Margaret

2013-03-18

Despite international efforts to arrest increasing rates of overweight and obesity, many population strategies have neglected young adults as a target group. Young adults are at high risk for unhealthy weight gain which tends to persist throughout adulthood with associated chronic disease health risks. TXT2BFiT is a nine month two-arm parallel-group randomized controlled trial aimed at improving weight management and weight-related dietary and physical activity behaviors among young adults. Participants are recruited via general practice (primary medical care) clinics in Sydney, New South Wales, Australia. All participants receive a mailed resource outlining national physical activity and dietary guidelines and access to the study website. Additional resources accessible to the intervention arm via the study website include Smartphone mobile applications, printable handouts, an interactive healthy weight tracker chart, and a community blog. The study consists of two phases: (1) Intensive phase (weeks 1 to 12): the control arm receives four short message service (SMS) text messages; the intervention arm receives eight SMS messages/week tailored to their baseline stage-of-change, one Email/week, and personalized coaching calls during weeks 0, 2, 5, 8, and 11; and (2) Maintenance phase (weeks 14 to 36): the intervention arm receives one SMS message/month, one Email/month and booster coaching calls during months 5 and 8. A sample of N = 354 (177 per arm) is required to detect differences in primary outcomes: body weight (kg) and body mass index (kg/m2), and secondary outcomes: physical activity, sitting time, intake of specific foods, beverages and nutrients, stage-of-change, self-efficacy and participant well-being, at three and nine months. Program reach, costs, implementation and participant engagement will also be assessed. This mobile phone based program addresses an important gap in obesity prevention efforts to date. The method of intervention delivery is via platforms that are highly accessible and appropriate for this population group. If effective, further translational research will be required to assess how this program might operate in the broader community. Australian New Zealand Clinical Trials Registry ACTRN12612000924853.

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 disposable adhesive patch for stress urinary incontinence.

PubMed

North, B B

1998-04-01

Stress urinary incontinence (SUI) affects 5 million women in the United States. Current surgical and pharmacological management options are often unsuccessful, forcing many sufferers to rely on bulky and uncomfortable sanitary protection. This study evaluated the safety, efficacy, and acceptability of a small, disposable adhesive patch designed to seal the urethral opening and prevent urine leakage. Thirty-seven women with mild-to-moderate SUI were recruited from a suburban community. Each volunteer participated in a 21-week protocol that included a 1-week qualifying period, 4-week (pretest) control period, 12-week patch-use period, and 4-week (posttest) control period. Patch efficacy was evaluated with quantitative (leakage into sanitary napkin) and qualitative (voiding diary) measures of urine leakage. Symptom questionnaires were also completed. Overall leakage was reduced by 60%, from 1.1 +/- .3 standard error of the mean (SEM) to .44 +/- .11 (SEM) grams of urine per hour. Perception of dryness, measured by voiding diaries, improved 67%, from 13.3 +/- 1.9 (SEM) to 4.3 +/- 0.9 (SEM) leakage episodes per week. Safety evaluation included peri-urethral cytology, urinalysis and urine culture, and vaginal cultures. All measures were unaffected by 3 months of patch use. Acceptability was assessed with questionnaires that measured the impact of patch use on activities of daily living and overall quality of life. Women reported a significant improvement in both measures. All but one volunteer found that the patch was comfortable and were able to place it correctly between the inner labia with written instructions only. The disposable patch significantly reduced urine leakage resulting from SUI in community-based women. Dryness improved significantly, both by measurement of actual leakage and by the subject's perception of dryness. The maturation index of the vestibular tissues showed an increase in the number of superficial cells during patch use. Otherwise, there were no significant changes in vulvar tissues, urine composition, or microbial flora (in vaginal and urine samples). Volunteers reported that the patch improved their overall quality of life.

The usefulness of school-based syndromic surveillance for detecting malaria epidemics: experiences from a pilot project in Ethiopia.

PubMed

Ashton, Ruth A; Kefyalew, Takele; Batisso, Esey; Awano, Tessema; Kebede, Zelalem; Tesfaye, Gezahegn; Mesele, Tamiru; Chibsa, Sheleme; Reithinger, Richard; Brooker, Simon J

2016-01-09

Syndromic surveillance is a supplementary approach to routine surveillance, using pre-diagnostic and non-clinical surrogate data to identify possible infectious disease outbreaks. To date, syndromic surveillance has primarily been used in high-income countries for diseases such as influenza--however, the approach may also be relevant to resource-poor settings. This study investigated the potential for monitoring school absenteeism and febrile illness, as part of a school-based surveillance system to identify localised malaria epidemics in Ethiopia. Repeated cross-sectional school- and community-based surveys were conducted in six epidemic-prone districts in southern Ethiopia during the 2012 minor malaria transmission season to characterise prospective surrogate and syndromic indicators of malaria burden. Changes in these indicators over the transmission season were compared to standard indicators of malaria (clinical and confirmed cases) at proximal health facilities. Subsequently, two pilot surveillance systems were implemented, each at ten sites throughout the peak transmission season. Indicators piloted were school attendance recorded by teachers, or child-reported recent absenteeism from school and reported febrile illness. Lack of seasonal increase in malaria burden limited the ability to evaluate sensitivity of the piloted syndromic surveillance systems compared to existing surveillance at health facilities. Weekly absenteeism was easily calculated by school staff using existing attendance registers, while syndromic indicators were more challenging to collect weekly from schoolchildren. In this setting, enrolment of school-aged children was found to be low, at 54%. Non-enrolment was associated with low household wealth, lack of parental education, household size, and distance from school. School absenteeism is a plausible simple indicator of unusual health events within a community, such as malaria epidemics, but the sensitivity of an absenteeism-based surveillance system to detect epidemics could not be rigorously evaluated in this study. Further piloting during a demonstrated increase in malaria transmission within a community is recommended.

Cost-Effectiveness of a Community Exercise and Nutrition Program for Older Adults: Texercise Select

PubMed Central

Akanni, Olufolake (Odufuwa); Smith, Matthew Lee; Ory, Marcia G.

2017-01-01

The wide-spread dissemination of evidence-based programs that can improve health outcomes among older populations often requires an understanding of factors influencing community adoption of such programs. One such program is Texercise Select, a community-based health promotion program previously shown to improve functional health, physical activity, nutritional habits and quality of the life among older adults. This paper assesses the cost-effectiveness of Texercise Select in the context of supportive environments to facilitate its delivery and statewide sustainability. Participants were surveyed using self-reported instruments distributed at program baseline and conclusion. Program costs were based on actual direct costs of program implementation and included costs of recruitment and outreach, personnel costs and participant incentives. Program effectiveness was measured using quality-adjusted life year (QALY) gained, as well as health outcomes, such as healthy days, weekly physical activity and Timed Up-and-Go (TUG) test scores. Preference-based EuroQol (EQ-5D) scores were estimated from the number of healthy days reported by participants and converted into QALYs. There was a significant increase in the number of healthy days (p < 0.05) over the 12-week program. Cost-effectiveness ratios ranged from $1374 to $1452 per QALY gained. The reported cost-effective ratios are well within the common cost-effectiveness threshold of $50,000 for a gained QALY. Some sociodemographic differences were also observed in program impact and cost. Non-Hispanic whites experienced significant improvements in healthy days from baseline to the follow-up period and had higher cost-effectiveness ratios. Results indicate that the Texercise Select program is a cost-effective strategy for increasing physical activity and improving healthy dietary practices among older adults as compared to similar health promotion interventions. In line with the significant improvement in healthy days, physical activity and nutrition-related outcomes among participants, this study supports the use of Texercise Select as an intervention with substantial health and cost benefits. PMID:28531094

[Effects of community health promotion project for garlic cultivating farmers based on self-efficacy theory and community capacity building framework].

PubMed

Kim, Hyang-Sook; Gu, Mee Ock

2011-02-01

This study was conducted to test the effects of a community health promotion project for farmers cultivating garlic. Bandura's self-efficacy theory (1986) and Chaskin's community capacity framework (2001) were used as the theoretical framework. A nonequivalent control group pretest-posttest design was used. Study participants were 72 garlic farmers (intervention: 36, control: 36). The community health promotion project consisted of health promotion program and community capacity building strategies and was provided for 12 weeks (8 during farming off-season and 4 during farming season). Data were collected between February 23 and May 31, 2009 and were analyzed using chi-square test, Fisher's exact test, t-test, and repeated measure ANOVA using SPSS/WIN 12.0. For the experimental group, significant improvement was found for self-efficacy, farming related health behavior, physical fitness (muscle strength, muscle endurance, upper body flexibility, lower body flexibility, cardiovascular endurance, balance, agility), farmer's syndrome, and health related quality of life as compared to the control group. The findings of the study indicate that the community health promotion project for garlic farmers is effective and can be recommended as a nursing intervention for health promotion of garlic cultivating farmers.

Use of nicotine replacement therapy in socioeconomically deprived young smokers: a community-based pilot randomised controlled trial.

PubMed

Roddy, Elin; Romilly, Nick; Challenger, Alison; Lewis, Sarah; Britton, John

2006-10-01

Smoking is common in young people, particularly in disadvantaged groups, and continued smoking has a major impact on quality and quantity of life. Although many young smokers want to stop smoking, little is known about the design and effectiveness of cessation services for them. To determine whether nicotine replacement therapy (NRT) when combined with counselling is effective in young smokers in a deprived area of Nottingham, UK. We surveyed smoking prevalence and attitudes to smoking and quitting in young people accessing an open access youth project in a deprived area of Nottingham, and used the information gained to design a community based smoking cessation service incorporating a randomised controlled trial of nicotine patches against placebo given in association with individual behavioural support. We resurveyed smoking prevalence among project attendees after completing the pilot study. Of 264 young people surveyed (median age 14 years, range 11-21), 49% were regular smokers. A total of 98 young people were recruited and randomised to receive either active nicotine patches on a six week reducing dose regimen (49 participants), or placebo (49 participants). Adherence to therapy was low, the median duration being one week, and 63 participants did not attend any follow up. At four weeks, five subjects receiving active NRT and two receiving placebo were abstinent, and at 13 weeks none were. Adverse effects were more common in the active group but none were serious. Smoking prevalence among 246 youth project attendees surveyed after the trial was 44%. This study suggests that NRT in this context is unlikely to be effective in young smokers, not least because of low adherence to therapy. It also suggests that young smokers want help with smoking cessation, but that establishing the efficacy of smoking cessation services for young people who need them most will be very difficult.

Effects of a pediatric weight management program with and without active video games a randomized trial.

PubMed

Trost, Stewart G; Sundal, Deborah; Foster, Gary D; Lent, Michelle R; Vojta, Deneen

2014-05-01

Active video games may offer an effective strategy to increase physical activity in overweight and obese children. However, the specific effects of active gaming when delivered within the context of a pediatric weight management program are unknown. To evaluate the effects of active video gaming on physical activity and weight loss in children participating in an evidence-based weight management program delivered in the community. Group-randomized clinical trial conducted during a 16-week period in YMCAs and schools located in Massachusetts, Rhode Island, and Texas. Seventy-five overweight or obese children (41 girls [55%], 34 whites [45%], 20 Hispanics [27%], and 17 blacks [23%]) enrolled in a community-based pediatric weight management program. Mean (SD) age of the participants was 10.0 (1.7) years; body mass index (BMI) z score, 2.15 (0.40); and percentage overweight from the median BMI for age and sex, 64.3% (19.9%). All participants received a comprehensive family-based pediatric weight management program (JOIN for ME). Participants in the program and active gaming group received hardware consisting of a game console and motion capture device and 1 active game at their second treatment session and a second game in week 9 of the program. Participants in the program-only group were given the hardware and 2 games at the completion of the 16-week program. Objectively measured daily moderate-to-vigorous and vigorous physical activity, percentage overweight, and BMI z score. Participants in the program and active gaming group exhibited significant increases in moderate-to-vigorous (mean [SD], 7.4 [2.7] min/d) and vigorous (2.8 [0.9] min/d) physical activity at week 16 (P < .05). In the program-only group, a decline or no change was observed in the moderate-to-vigorous (mean [SD] net difference, 8.0 [3.8] min/d; P = .04) and vigorous (3.1 [1.3] min/d; P = .02) physical activity. Participants in both groups exhibited significant reductions in percentage overweight and BMI z scores at week 16. However, the program and active gaming group exhibited significantly greater reductions in percentage overweight (mean [SD], -10.9%[1.6%] vs -5.5%[1.5%]; P = .02) and BMI z score (-0.25 [0.03] vs -0.11 [0.03]; P < .001). CONCLUSIONS AND RELEVANCE Incorporating active video gaming into an evidence-based pediatric weight management program has positive effects on physical activity and relative weight. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01757925.

Incorporating leadership knowledge and skills into the dental education community.

PubMed

Slavkin, Harold C; Lawrence, Lisa

2007-06-01

Leadership has been studied for the past four decades with an emphasis upon leadership and the transformation of various cultures, especially within the private sector. It is also becoming evident that leaders and leadership skills are often derived from core personal values and perceptions of what is and what could be. This summary describes an eleven-week selective course termed "Dean's Leadership Course" at the School of Dentistry at the University of Southern California. This selective course (a non-credit elective learning opportunity outside the formal curriculum) recruits a modest team of learners consisting of faculty, staff, and students and approaches leadership within the context of a "learning organization" coupled with case-based and problem-based learning. At the conclusion of this eleven-week course, participants are granted continuing education credit. This summary encourages others in dental education to consider the compelling opportunity to nurture and cultivate leadership within the university dental school environs.

A cluster randomized controlled trial of lay health worker support for prevention of mother to child transmission of HIV (PMTCT) in South Africa.

PubMed

Peltzer, Karl; Weiss, Stephen M; Soni, Manasi; Lee, Tae Kyoung; Rodriguez, Violeta J; Cook, Ryan; Alcaide, Maria Luisa; Setswe, Geoffrey; Jones, Deborah L

2017-12-16

We evaluate the impact of clinic-based PMTCT community support by trained lay health workers in addition to standard clinical care on PMTCT infant outcomes. In a cluster randomized controlled trial, twelve community health centers (CHCs) in Mpumalanga Province, South Africa, were randomized to have pregnant women living with HIV receive either: a standard care (SC) condition plus time-equivalent attention-control on disease prevention (SC; 6 CHCs; n  = 357), or an enhanced intervention (EI) condition of SC PMTCT plus the "Protect Your Family" intervention (EI; 6 CHCs; n  = 342). HIV-infected pregnant women in the SC attended four antenatal and two postnatal video sessions and those in the EI, four antenatal and two postnatal PMTCT plus "Protect Your Family" sessions led by trained lay health workers. Maternal PMTCT and HIV knowledge were assessed. Infant HIV status at 6 weeks postnatal was drawn from clinic PCR records; at 12 months, HIV status was assessed by study administered DNA PCR. Maternal adherence was assessed by dried blood spot at 32 weeks, and infant adherence was assessed by maternal report at 6 weeks. The impact of the EI was ascertained on primary outcomes (infant HIV status at 6 weeks and 12 months and ART adherence for mothers and infants), and secondary outcomes (HIV and PMTCT knowledge and HIV transmission related behaviours). A series of logistic regression and latent growth curve models were developed to test the impact of the intervention on study outcomes. In all, 699 women living with HIV were recruited during pregnancy (8-24 weeks), and assessments were completed at baseline, at 32 weeks pregnant (61.7%), and at 6 weeks (47.6%), 6 months (50.6%) and 12 months (59.5%) postnatally. Infants were tested for HIV at 6 weeks and 12 months, 73.5% living infants were tested at 6 weeks and 56.7% at 12 months. There were no significant differences between SC and EI on infant HIV status at 6 weeks and at 12 months, and no differences in maternal adherence at 32 weeks, reported infant adherence at 6 weeks, or PMTCT and HIV knowledge by study condition over time. The enhanced intervention administered by trained lay health workers did not have any salutary impact on HIV infant status, ART adherence, HIV and PMTCT knowledge. Trial registration clinicaltrials.gov: number NCT02085356.

The effect of a supervised community-based exercise program on balance, balance confidence, and gait in individuals with lower limb amputation.

PubMed

Miller, Carol A; Williams, Jennifer E; Durham, Katey L; Hom, Selena C; Smith, Julie L

2017-10-01

Many individuals with lower limb loss report concern with walking ability after completing structured traditional rehabilitation. The purpose of this study was to explore the impact of a supervised community-based exercise program on balance, balance confidence, and gait in individuals with lower limb amputation. Repeated measures. The supervised exercise program was offered biweekly for 6 weeks. The GAITRite System by CIR Systems, Inc., the Figure-of-8 Walk Test, and Activity-specific Balance Confidence Scale were used to measure clinical outcomes pre- and post-intervention. In total, 16 participants with lower limb amputation (mean age: 50.8 years) completed the study. A multivariate, repeated measures analysis of variance indicated a statistically significant effect of training across six clinical outcome measures ( F(6, 10) = 4.514, p = .018). Moderate effect sizes were found for the Figure-of-8 Walk Test ( η 2 = .586), Activity-specific Balance Confidence Scale ( η 2 = .504), and gait velocity at comfortable walking speed ( η 2 = .574). The average increase in gait speed was clinically meaningful at .14 m/s. The supervised community-based exercise program implemented in this study was designed to address specific functional needs for individuals with lower limb loss. Each participant experienced clinically meaningful improvements in balance, balance confidence, and walking ability. Clinical relevance The provision of a supervised community-based exercise program, after traditional rehabilitation, provides opportunity to offer a continuum of care that may enhance prosthetic functional ability and active participation in the community for individuals with lower limb amputation.

An interprofessional education project to address the health care needs of women transitioning from prison to community reentry.

PubMed

Busen, Nancy H

2014-01-01

With the implementation of the Patient Protection and Affordable Care Act, the need for health care providers to work collaboratively in teams to provide cost-effective, quality health care has become even more apparent because an estimated additional 22 million Americans gain health care coverage by 2014. The need for evidenced-based care that combines the expertise of various disciplines has been acknowledged by policy makers and health educators. With support from national Association for Prevention, Teaching and Research, an interprofessional education course was designed and implemented by health professionals in nursing, nutrition, and dentistry, in collaboration with a local community agency, to address the health care needs of women transitioning from prison to the community. Health care needs of women in prison are often overlooked, and access to care is limited. When released from prison, utilization of even basic health services is rare. Four interactive teaching-learning sessions were offered at a residential facility for women in transition over a 12-week period. Topics were selected based on feedback from the participants and included stress reduction, self-beast examination, hypertension, and common dental conditions. Teaching methods and materials were interactive and designed for sustainability. The model for this interprofessional education project, which employed a service-learning approach, can be adapted for other communities. Working with our communities requires innovative thinking to be effective but provides an enriching life experience to those involved. A community-based reciprocal learning environment benefits all partners in the real-world environment. Copyright © 2014 Elsevier Inc. All rights reserved.

Community-based child health nurses: an exploration of current practice.

PubMed

Borrow, Stephanie; Munns, Ailsa; Henderson, Saras

2011-12-01

The purpose of this research was to define, the practice domain of community-based child health nursing in light of widespread political, economic and social changes in Western Australia. The project was conducted by a group of nurse researchers with experience in child health nursing from the School of Nursing and Midwifery at Curtin University and the Child and Adolescent Community Health Division at the Department of Health, Western Australia. The overall aim of the project was to map the scope of nursing practice in the community child health setting in Western Australia and to identify the decision making framework that underpins this nursing specialty. Given the widespread social, economic and health service management changes, it was important for nurses involved with, or contemplating a career in, community-based child health to have the role accurately defined. In addition, consumer expectations of the service needed to be explored within the current climate. A descriptive qualitative study was used for this project. A purposive sample of 60 participants was drawn from the pool of child health nurses in the South Metropolitan Community Health Service, North Metropolitan Health Service and Western Australian Country Health Service. Following ethical approval data was collected via participants keeping a 2-week work diary. The data was coded and thematic analysis was applied. Several themes emerged from the analysis which were validated by follow up focus group interviews with participants. This clearly demonstrated common, recurring issues. The results identified that the community-based child health nurses are currently undertaking a more complex and expanded child health service role for an increasingly diverse client population, over their traditional practices which are still maintained. Excessive workloads and lack of human and non human resources also presented challenges. There are increasing requirements for child health nurses to engage in community development and capacity building, often through a multidisciplinary partnership, which requires them to have sound brokerage and facilitation skills to enable community inclusion and inter-agency collaboration at the local level. The study has highlighted the importance and multifaceted nature of the role of the community-based child health nurse. To enable them to function optimally, the following suggestions/recommendations are offered. These being: More physical resources be allocated to community-based child health nursing More resources allocated to assist community-based child health nurses to support culturally and linguistically diverse families Mapping of child health nurses' workloads The development of community health client dependency rating criteria reflecting the social determinants of health in order for health service refinement of staffing allocations based on an acuity scale Specific staff development opportunities to reflect the increased workload complexity Managerial support for the implementation of formal clinical (reflective) supervision Additional clerical assistance with non-nursing duties.

Community-Based Adaptive Physical Activity Program for Chronic Stroke: Feasibility, Safety, and Efficacy of the Empoli Model

PubMed Central

Stuart, Mary; Benvenuti, Francesco; Macko, Richard; Taviani, Antonio; Segenni, Lucianna; Mayer, Federico; Sorkin, John D.; Stanhope, Steven J.; Macellari, Velio; Weinrich, Michael

2010-01-01

Objective To determine whether Adaptive Physical Activity (APA-stroke), a community-based exercise program for participants with hemiparetic stroke, improves function in the community. Methods Nonrandomized controlled study in Tuscany, Italy, of participants with mild to moderate hemiparesis at least 9 months after stroke. Forty-nine participants in a geographic health authority (Empoli) were offered APA-stroke (40 completed the study). Forty-four control participants in neighboring health authorities (Florence and Pisa) received usual care (38 completed the study). The APA intervention was a community-based progressive group exercise regimen that included walking, strength, and balance training for 1 hour, thrice a week, in local gyms, supervised by gym instructors. No serious adverse clinical events occurred during the exercise intervention. Outcome measures included the following: 6-month change in gait velocity (6-Minute Timed Walk), Short Physical Performance Battery (SPPB), Berg Balance Scale, Stroke Impact Scale (SIS), Barthel Index, Hamilton Rating Scale for Depression, and Index of Caregivers Strain. Results After 6 months, the intervention group improved whereas controls declined in gait velocity, balance, SPPB, and SIS social participation domains. These between-group comparisons were statistically significant at P < .00015. Individuals with depressive symptoms at baseline improved whereas controls were unchanged (P < .003). Oral glucose tolerance tests were performed on a subset of participants in the intervention group. For these individuals, insulin secretion declined 29% after 6 months (P = .01). Conclusion APA-stroke appears to be safe, feasible, and efficacious in a community setting. PMID:19318465

Effects of a Safe Transportation Educational Program for Older Drivers on Driving Exposure and Community Participation: A Randomized Controlled Trial.

PubMed

Coxon, Kristy; Chevalier, Anna; Brown, Julie; Clarke, Elizabeth; Billot, Laurent; Boufous, Soufiane; Ivers, Rebecca; Keay, Lisa

2017-03-01

To ascertain whether a safe-transportation program can change driving exposure while maintaining community participation of older drivers. Randomized controlled trial. Northwest Sydney. Drivers aged 75 and older (mean 80 ± 4) (n = 380). Intervention group participated in an individualized, one-on-one safe-transportation program adapted from the Knowledge Enhances Your Safety curriculum. A registered occupational therapist delivered the intervention in two sessions held approximately 1 month apart. An in-vehicle monitoring device hardwired into participants' vehicles measured driving exposure. Community participation was measured using the Keele Assessment of Participation. A staging algorithm based on the Precaution Adoption Process Model measured behavior change toward increased and sustained driving self-regulation. Main outcomes were distance driven per week over 12 months and community participation. Secondary outcomes were behavior change, depressive symptoms, and alternate transportation use. Generalized estimating equations were used to model effect on driving exposure, adjusting for weekly measures, and ordinal regression was used to analyze differences in behavior change profiles between groups using an intention-to-treat approach. Participants were randomized after baseline assessment-190 each to the intervention and control groups. One hundred eighty-three of 190 completed the intervention and 366 of 380 completed the study. On average, participants drove 140 ± 167 km/wk. Although there was no significant difference between the groups in distance driven per week over 12 months (between-group difference -5.5 km, 95% confidence interval (CI) = -24.5-13.5 km, p = .57), intervention group participants showed greater readiness to engage in self-regulatory driving practices, such as reporting avoiding driving at night or at rush hours, than control group participants (odds ratio (OR) = 1.6, 95% CI = 1.1-2.3, P = .02). At 12 months, use of alternate transportation was similar (between-group difference 0.1, 95% CI = -1.4-1.6, P = .90). Although there was no difference in community participation (between-group difference -0.1, 95% CI = -0.6-0.3, P = .59), older drivers with low function in the intervention group were 3.1 times as likely to report depressive symptoms (95% CI = 1.04-9.2, P = .04) than those with low function in the control group. An individualized safe-transportation program can promote behavior change but did not translate to significant differences in weekly mileage after 12 months. Longer follow-up may detect changes over time. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Effects of a community-based multicomponent rehabilitation programme for patients with fibromyalgia: protocol for a randomised controlled trial.

PubMed

Haugmark, Trond; Hagen, Kåre Birger; Provan, Sella Aarrestad; Bærheim, Elisebeth; Zangi, Heidi A

2018-06-04

People with fibromyalgia (FM) suffer from symptoms such as widespread pain, non-refreshing sleep, fatigue and reduced quality of life. Effects of pharmacological treatment are questionable and non-pharmacological treatments are recommended as first-line therapy. To date the majority of patients with FM in Norway are not offered any targeted treatment. The aim of this randomised controlled trial is to investigate the effects of a community-based multicomponent rehabilitation programme comprising an acceptance-based and mindfulness-based group intervention, the Vitality Training Programme (VTP), followed by tailored physical activity counselling. General practitioners refer potential participants to a rheumatologist in specialist healthcare for diagnostic clarification and assessment of comorbidities. Inclusion criteria are widespread pain/FM ≥3 months, age 20-50 and work participation (minimum part-time) within the last 2 years. The intervention group attends the VTP comprising 10 weekly 4 hour group sessions plus a booster session after 6 months. Thereafter, they receive 12 weeks of individually tailored physical exercise counselled by physiotherapists at community-based Healthy Life Centers. The control group follows treatment as usual. The primary outcome is Patient Global Impression of Change. Secondary outcomes include self-reported pain, fatigue and sleep quality, psychological distress, mindfulness, health-related quality of life, physical activity, work ability and exercise beliefs and habits. To achieve a power of 80% and allow for 10% dropout, 70 participants are needed in each arm. All analyses will be conducted on intention-to-treat bases and measured as differences between groups at 12 months follow-up. The study is approved and granted by the Norwegian South-Eastern Regional Health Authority (reference 2016015). Ethics approval was obtained from Regional Committee for Medical and Health Research Ethics (reference 2015/2447/REK sør-øst A). Results will be submitted to appropriate journals and presented in relevant conferences and social media. ISRCTN 96836577. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Web-based physiotherapy for people moderately affected with Multiple Sclerosis; quantitative and qualitative data from a randomized, controlled pilot study.

PubMed

Paul, Lorna; Coulter, Elaine H; Miller, Linda; McFadyen, Angus; Dorfman, Joe; Mattison, Paul George G

2014-09-01

To explore the effectiveness and participant experience of web-based physiotherapy for people moderately affected with Multiple Sclerosis (MS) and to provide data to establish the sample size required for a fully powered, definitive randomized controlled study. A randomized controlled pilot study. Rehabilitation centre and participants' homes. Thirty community dwelling adults moderately affected by MS (Expanded Disability Status Scale 5-6.5). Twelve weeks of individualised web-based physiotherapy completed twice per week or usual care (control). Online exercise diaries were monitored; participants were telephoned weekly by the physiotherapist and exercise programmes altered remotely by the physiotherapist as required. The following outcomes were completed at baseline and after 12 weeks; 25 Foot Walk, Berg Balance Scale, Timed Up and Go, Multiple Sclerosis Impact Scale, Leeds MS Quality of Life Scale, MS-Related Symptom Checklist and Hospital Anxiety and Depression Scale. The intervention group also completed a website evaluation questionnaire and interviews. Participants reported that website was easy to use, convenient, and motivating and would be happy to use in the future. There was no statistically significant difference in the primary outcome measure, the timed 25ft walk in the intervention group (P=0.170), or other secondary outcome measures, except the Multiple Sclerosis Impact Scale (P=0.048). Effect sizes were generally small to moderate. People with MS were very positive about web-based physiotherapy. The results suggested that 80 participants, 40 in each group, would be sufficient for a fully powered, definitive randomized controlled trial. © The Author(s) 2014.

Marine Microcosm Experiments on Effects of Copper and Tributylin-Based Antifouling Paint Leachates

DTIC Science & Technology

1988-06-01

consumers in HliOrg microcosms were probably the thick carpets of green algae ( Cladophora socialis) that developed in those tanks during leachate and...and bottom substrate in the SPG-4 tanks were dominated by a low-diversity community composed primarily of Cladophora socialis, a filamentous green...coverage and diversity of species after 4 weeks of’ exposure. Moderate to thick growths of filamentous green algae ( Cladophora socialis) covered with

Influence of Sampling Effort on the Estimated Richness of Road-Killed Vertebrate Wildlife

NASA Astrophysics Data System (ADS)

Bager, Alex; da Rosa, Clarissa A.

2011-05-01

Road-killed mammals, birds, and reptiles were collected weekly from highways in southern Brazil in 2002 and 2005. The objective was to assess variation in estimates of road-kill impacts on species richness produced by different sampling efforts, and to provide information to aid in the experimental design of future sampling. Richness observed in weekly samples was compared with sampling for different periods. In each period, the list of road-killed species was evaluated based on estimates the community structure derived from weekly samplings, and by the presence of the ten species most subject to road mortality, and also of threatened species. Weekly samples were sufficient only for reptiles and mammals, considered separately. Richness estimated from the biweekly samples was equal to that found in the weekly samples, and gave satisfactory results for sampling the most abundant and threatened species. The ten most affected species showed constant road-mortality rates, independent of sampling interval, and also maintained their dominance structure. Birds required greater sampling effort. When the composition of road-killed species varies seasonally, it is necessary to take biweekly samples for a minimum of one year. Weekly or more-frequent sampling for periods longer than two years is necessary to provide a reliable estimate of total species richness.

Influence of sampling effort on the estimated richness of road-killed vertebrate wildlife.

PubMed

Bager, Alex; da Rosa, Clarissa A

2011-05-01

Road-killed mammals, birds, and reptiles were collected weekly from highways in southern Brazil in 2002 and 2005. The objective was to assess variation in estimates of road-kill impacts on species richness produced by different sampling efforts, and to provide information to aid in the experimental design of future sampling. Richness observed in weekly samples was compared with sampling for different periods. In each period, the list of road-killed species was evaluated based on estimates the community structure derived from weekly samplings, and by the presence of the ten species most subject to road mortality, and also of threatened species. Weekly samples were sufficient only for reptiles and mammals, considered separately. Richness estimated from the biweekly samples was equal to that found in the weekly samples, and gave satisfactory results for sampling the most abundant and threatened species. The ten most affected species showed constant road-mortality rates, independent of sampling interval, and also maintained their dominance structure. Birds required greater sampling effort. When the composition of road-killed species varies seasonally, it is necessary to take biweekly samples for a minimum of one year. Weekly or more-frequent sampling for periods longer than two years is necessary to provide a reliable estimate of total species richness.

A 9-Week Jaques-Dalcroze Eurhythmics Intervention Improves Single and Dual-Task Gait Speed in Community-Dwelling Older People.

PubMed

Ferguson-Stegall, Lisa; Vang, Mandy; Wolfe, Anthony S; Thomsen, Kathy M

2017-09-01

Falls are a major public health concern among older adults, and most occur while walking, especially under dualtask conditions. Jaques-Dalcroze eurhythmics (JDE) is a music-based movement training program that emphasizes multitask coordinated movement. A previous 6-mo JDE study in older people demonstrated improved gait and balance; however, the effects of short-term JDE interventions on fall risk-related outcomes are largely unknown. We conducted a preliminary investigation on whether a 9-week JDE intervention improved gait and stability in a community-dwelling older cohort, hypothesizing that improvements would occur in all outcome measures. Nine participants (78.9 ± 12.3 y) completed the supervised JDE intervention (once/week for 60 min). Gait speed was determined by the 6-m timed walk test (6MTW); dual-task gait speed was determined by another 6MTW while counting backward from 50 aloud; and coordinated stability was assessed using a Swaymeter-like device. Gait speed (0.92 ± 0.11 vs 1.04 ± 0.12 m/sec, P = .04) and dual-task gait speed (0.77 ± 0.09 vs 0.92 ± 0.11 m/sec, P = .0005) significantly improved. This novel intervention is an effective short-term physical activity option for those that plan physical activity or fall-risk reduction programs for the older people.

Birth of the Four-Day Work Week.

ERIC Educational Resources Information Center

Hellyer, Lyle

Indian Hills Community College, faced with rising utility bills dues to inadequate insulation in the campus's older buildings, now utilizes a four-day week during the winter quarter as an energy conservation measure. Planning for the implementation of the four-day week, which began in 1976, was coordinated by an overall energy committee made up of…

Sing Your Lungs Out: a qualitative study of a community singing group for people with chronic obstructive pulmonary disease (COPD)

PubMed Central

McNaughton, Amanda; Aldington, Sarah; Williams, Gayle; Levack, William M M

2016-01-01

Objective To explore the ways in which participation in a community singing group contributed to the health and well-being of patients with chronic obstructive pulmonary disease (COPD). Design Qualitative description, based on transcripts from individual interviews and a focus group meeting with people with COPD participating in the singing group, regarding their experience. Setting Urban community, Wellington, New Zealand. Participants 23 people (13 women and 10 men), 51–91 years with COPD (21) or interstitial lung disease (2). Results The weekly singing group was a well-attended activity, with self-reported benefits to health and well-being. 4 key themes were identified: being in the ‘right space’, connection, purpose and growth, and participation in a meaningful physical activity. Conclusions This study helps us to better understand how participation in a community singing group can benefit the health and well-being of patients with COPD. Trial registration number ACTRN12615000736549; Results. PMID:27650768

Aboriginal Consumption of Estuarine Food Resources and Potential Implications for Health through Trace Metal Exposure; A Study in Gumbaynggirr Country, Australia.

PubMed

Russell, Shaina; Sullivan, Caroline A; Reichelt-Brushett, Amanda J

2015-01-01

Fishing and resource use continues to be an essential aspect of life for many Aboriginal communities throughout Australia. It is important for dietary sustenance, and also retains deep social, cultural and economic significance, playing a fundamental role in maintaining group cohesion, transferring cultural knowledge and affirming Indigenous identities. We surveyed approximately 20% of the Gumbaynggirr Aboriginal community of Nambucca Heads, New South Wales, Australia. This paper explores Gumbaynggirr Connection to Country and engagement in cultural practice. It quantifies fishing efforts and consumption of seafood within the community. We found 95% of the sample group fish, with the highest rate of fishing being 2-3 times a week (27%). Furthermore, 98% of participants eat seafood weekly or more frequently, up to more than once a day (24%). Survey results revealed that Myxus elongatus (Sand mullet) and naturally recruited Saccostrea glomerata (Sydney rock oysters) continue to be important wild resources to the Gumbaynggirr community. Trace metals were measured in M. elongatus and S. glomerata samples collected by community participants in this study. Maximum levels prescribed in the Australia New Zealand Food Standards Code were not exceeded in the edible tissue for either species, however both species exceeded the generally expected levels for zinc and copper and S. glomerata samples exceeded the generally expected level for selenium. Furthermore the average dietary exposure to trace metals from consuming seafood was calculated for the surveyed population. Trace metal intake was then compared to the provisional tolerable weekly intake prescribed by the Joint Expert Committee on Food Additives. This process revealed that copper and selenium intake were both within the provisional tolerable weekly intake, while there is no guideline for zinc. Furthermore, participants relying heavily on wild resources from the Nambucca River estuary may exceed the provisional tolerable weekly intake for cadmium. This suggests the need for further investigation of this issue to minimize any possible health risk.

Aboriginal Consumption of Estuarine Food Resources and Potential Implications for Health through Trace Metal Exposure; A Study in Gumbaynggirr Country, Australia

PubMed Central

Russell, Shaina; Sullivan, Caroline A.; Reichelt-Brushett, Amanda J.

2015-01-01

Fishing and resource use continues to be an essential aspect of life for many Aboriginal communities throughout Australia. It is important for dietary sustenance, and also retains deep social, cultural and economic significance, playing a fundamental role in maintaining group cohesion, transferring cultural knowledge and affirming Indigenous identities. We surveyed approximately 20% of the Gumbaynggirr Aboriginal community of Nambucca Heads, New South Wales, Australia. This paper explores Gumbaynggirr Connection to Country and engagement in cultural practice. It quantifies fishing efforts and consumption of seafood within the community. We found 95% of the sample group fish, with the highest rate of fishing being 2-3 times a week (27%). Furthermore, 98% of participants eat seafood weekly or more frequently, up to more than once a day (24%). Survey results revealed that Myxus elongatus (Sand mullet) and naturally recruited Saccostrea glomerata (Sydney rock oysters) continue to be important wild resources to the Gumbaynggirr community. Trace metals were measured in M. elongatus and S. glomerata samples collected by community participants in this study. Maximum levels prescribed in the Australia New Zealand Food Standards Code were not exceeded in the edible tissue for either species, however both species exceeded the generally expected levels for zinc and copper and S. glomerata samples exceeded the generally expected level for selenium. Furthermore the average dietary exposure to trace metals from consuming seafood was calculated for the surveyed population. Trace metal intake was then compared to the provisional tolerable weekly intake prescribed by the Joint Expert Committee on Food Additives. This process revealed that copper and selenium intake were both within the provisional tolerable weekly intake, while there is no guideline for zinc. Furthermore, participants relying heavily on wild resources from the Nambucca River estuary may exceed the provisional tolerable weekly intake for cadmium. This suggests the need for further investigation of this issue to minimize any possible health risk. PMID:26098897

Assessing prescription drug abuse using functional principal component analysis (FPCA) of wastewater data.

PubMed

Salvatore, Stefania; Røislien, Jo; Baz-Lomba, Jose A; Bramness, Jørgen G

2017-03-01

Wastewater-based epidemiology is an alternative method for estimating the collective drug use in a community. We applied functional data analysis, a statistical framework developed for analysing curve data, to investigate weekly temporal patterns in wastewater measurements of three prescription drugs with known abuse potential: methadone, oxazepam and methylphenidate, comparing them to positive and negative control drugs. Sewage samples were collected in February 2014 from a wastewater treatment plant in Oslo, Norway. The weekly pattern of each drug was extracted by fitting of generalized additive models, using trigonometric functions to model the cyclic behaviour. From the weekly component, the main temporal features were then extracted using functional principal component analysis. Results are presented through the functional principal components (FPCs) and corresponding FPC scores. Clinically, the most important weekly feature of the wastewater-based epidemiology data was the second FPC, representing the difference between average midweek level and a peak during the weekend, representing possible recreational use of a drug in the weekend. Estimated scores on this FPC indicated recreational use of methylphenidate, with a high weekend peak, but not for methadone and oxazepam. The functional principal component analysis uncovered clinically important temporal features of the weekly patterns of the use of prescription drugs detected from wastewater analysis. This may be used as a post-marketing surveillance method to monitor prescription drugs with abuse potential. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

[Effects of active parenting today based on goal attainment theory on parenting stress, parenting behavior, and parenting satisfaction in mothers of school-age children].

PubMed

Park, Kyung Im; Oh, Sangeun

2012-10-01

The purpose of this study was to verify effects of the Active Parenting Today (APT) program based on King's Goal Attainment Theory on parenting stress, parenting behavior, and parenting satisfaction in mothers of school-age children. This was a quasi-experimental study with a non-equivalent control group pre-post test design. Participants were 39 mothers of school-age children (19 in the experiment group and 20 in the control group) who were registered at two community children centers in G city. The experimental group received the APT program (2 hours/session/week) and telephone counseling (2 times/week) for 8 weeks. Data were analyzed using χ²-test, t-test, Fisher exact probability test, and ANCOVA with the SPSS/Win15.0 program. Parenting stress was significantly lower in the experimental group than in the control group. Positive parenting behavior and parenting satisfaction were significantly higher in the experimental group than in the control group. However, negative parenting behavior was not significantly different between the two groups. The results of this study indicate that the APT program based on King's Goal Attainment Theory is useful in reducing parenting stress, creating positive parenting behavior change, and promoting parenting satisfaction in mothers of school-age children.

Promoting First Relationships® : Randomized Trial of a 10-Week Home Visiting Program With Families Referred to Child Protective Services.

PubMed

Oxford, Monica L; Spieker, Susan J; Lohr, Mary Jane; Fleming, Charles B

2016-09-19

We conducted a community-based randomized control trial with intent-to-treat analysis on Promoting First Relationships® (PFR), a 10-week home visiting program. The study included 247 families with 10- to 24-month-old children who had a recent, open child protective services investigation of child maltreatment. Families were randomly assigned to receive either the 10-week home visiting PFR service or a telephone-based, three-call resource and referral (R&R) service. Across postintervention time points, parents in the PFR condition scored higher than families in the R&R condition in parent understanding of toddlers' social emotional needs (d = .35) and observed parental sensitivity (d = .20). Children in the PFR condition scored lower than children in the comparison condition on an observational measure of atypical affective communication (d = .19) and were less likely than children in the comparison group to be placed into foster care through 1-year postintervention (6% vs. 13%, p = .042). No significant differences were found on measures of parenting stress or child social-emotional competence, behavior problems, or secure base behavior. Overall, the results show support for the promise of PFR as an intervention for enhancing parent sensitivity and preventing child removals for families in the child welfare system. © The Author(s) 2016.

Cardiovascular Health Awareness Program (CHAP): a community cluster-randomised trial among elderly Canadians.

PubMed

Kaczorowski, Janusz; Chambers, Larry W; Karwalajtys, Tina; Dolovich, Lisa; Farrell, Barbara; McDonough, Beatrice; Sebaldt, Rolf; Levitt, Cheryl; Hogg, William; Thabane, Lehana; Tu, Karen; Goeree, Ron; Paterson, J Michael; Shubair, Mamdouh; Gierman, Tracy; Sullivan, Shannon; Carter, Megan

2008-06-01

High blood pressure is an important and modifiable cardiovascular disease risk factor that remains under-detected and under-treated. Community-level interventions that address high blood pressure and other modifiable risk factors are a promising strategy to improve cardiovascular health in populations. The present study is a community cluster-randomised trial testing the effectiveness of CHAP (Cardiovascular Health Awareness Program) on the cardiovascular health of older adults. Thirty-nine mid-sized communities in Ontario, Canada were stratified by geographic location and size of the population aged >or=65 years and randomly allocated to receive CHAP or no intervention. In CHAP communities, residents aged >or=65 years were invited to attend cardiovascular risk assessment sessions held in pharmacies over 10 weeks in Fall, 2006. Sessions included blood pressure measurement and feedback to family physicians. Trained volunteers delivered the program with support from pharmacists, community nurses and local organisations. The primary outcome measure is the relative change in the mean annual rate of hospital admission for acute myocardial infarction, congestive heart failure and stroke (composite end-point) among residents aged >or=65 years in intervention and control communities, using routinely collected, population-based administrative health data. This paper highlights considerations in design, implementation and evaluation of a large-scale, community-wide cardiovascular health promotion initiative.

Neural responses to negative outcomes predict success in community-based substance use treatment

PubMed Central

Forster, Sarah E.; Finn, Peter R.; Brown, Joshua W.

2017-01-01

Background and aims Activation in some specific brain regions has demonstrated promise as prognostic indicators in substance dependent individuals (SDIs) but this issue has not yet been explored in SDIs attending typical of community-based treatment. We used a data-driven, exploratory approach to identify brain-based predictors of treatment outcome in a representative community sample of SDIs. The predictive utility of brain-based measures was evaluated against clinical indicators, cognitive-behavioral performance, and self-report assessments. Design Prospective clinical outcome design, evaluating baseline functional magnetic resonance imaging data from the Balloon Analogue Risk Task (BART) as a predictor of 3-month substance use treatment outcomes. Setting Community-based substance use programs in Bloomington, Indiana, USA. Participants Twenty-three SDIs (17 male, ages 18–43) in an intensive outpatient or residential treatment program; abstinent 1–4 weeks at baseline. Measurements Event-related brain response, BART performance, and self-report scores at treatment onset, substance use outcome measure (based on days of use) Findings Using voxel-level predictive modeling and leave-one-out cross-validation, an elevated response to unexpected negative feedback in bilateral amygdala and anterior hippocampus (Amyg/aHipp) at baseline successfully predicted greater substance use over the 3-month study interval (p ≤ 0.006, cluster-corrected). This effect was robust to inclusion of significant non-brain-based covariates. A larger response to negative feedback in bilateral Amyg/aHipp was also associated with faster reward-seeking responses after negative feedback (r(23) = −0.544, p = 0.007; r(23) = −0.588, p = 0.003). A model including Amyg/aHipp activation, faster reward-seeking after negative feedback, and significant self-report scores accounted for 45% of the variance in substance use outcomes in our sample. Conclusions An elevated response to unexpected negative feedback in bilateral amygdala and anterior hippocampus (Amyg/aHipp) appears to predict relapse to substance use in people attending community-based treatment. PMID:28029198

A community-based cross-sectional study of sleep quality in middle-aged and older adults.

PubMed

Zhang, Hui-Shan; Li, Yuan; Mo, Hai-Yun; Qiu, De-Xing; Zhao, Jing; Luo, Jia-Li; Lin, Wei-Quan; Wang, Jia-Ji; Wang, Pei-Xi

2017-04-01

Sleep quality has been widely studied among western countries. However, there is limited population-based evidence on insomnia in Chinese adult populations, especially in middle-aged and older adults. The aims of present study are to (1) examine the prevalence of poor sleep among Chinese middle-age and older adults, (2) compare the Pittsburgh Sleep Quality Index (PSQI) seven domain scores across different physical health statuses, (3) explore factors associated with insomnia. A cross-sectional survey was conducted using a multi-instrument questionnaire. In total, 1563 residents aged 45 or older in the community were interviewed. The Chinese version of the PSQI was used to assess sleep quality while poor sleep was defined as a total PSQI score >5. Socio-demographic, lifestyle and physical health data were also collected. The prevalence of poor sleep among adults aged over 45 years was 20.67 %. Clusters logistic regression analysis identified that migrant workers, single marital status, lower education level, no physical exercise, illness within 2 weeks, and a higher total number of chronic diseases contribute to increased risk of poor sleep (P < 0.05). Among three clusters, physical health has the biggest independent contribution on sleep quality. Our results indicated that poor sleep was common in middle-aged and older adults. It was associated with identity of migrant worker, education level, exercise, illness within 2 weeks and number of chronic disease. Being ill within 2 weeks and having more chronic diseases were the major physical health-related factors contributing to poor sleep in the middle-aged and older people. Physical health may be a major determinant in sleep quality.

Predictors of outcomes following reablement in community-dwelling older adults.

PubMed

Tuntland, Hanne; Kjeken, Ingvild; Langeland, Eva; Folkestad, Bjarte; Espehaug, Birgitte; Førland, Oddvar; Aaslund, Mona Kristin

2017-01-01

Reablement is a rehabilitation intervention for community-dwelling older adults, which has recently been implemented in several countries. Its purpose is to improve functional ability in daily occupations (everyday activities) perceived as important by the older person. Performance and satisfaction with performance in everyday life are the major outcomes of reablement. However, the evidence base concerning which factors predict better outcomes and who receives the greatest benefit in reablement is lacking. The objective of this study was to determine the potential factors that predict occupational performance and satisfaction with that performance at 10 weeks follow-up. The sample in this study was derived from a nationwide clinical controlled trial evaluating the effects of reablement in Norway and consisted of 712 participants living in 34 municipalities. Multiple linear regression was used to investigate possible predictors of occupational performance (COPM-P) and satisfaction with that performance (COPM-S) at 10 weeks follow-up based on the Canadian Occupational Performance Measure (COPM). The results indicate that the factors that significantly predicted better COPM-P and COPM-S outcomes at 10 weeks follow-up were higher baseline scores of COPM-P and COPM-S respectively, female sex, having a fracture as the major health condition and high motivation for rehabilitation. Conversely, the factors that significantly predicted poorer COPM-P and COPM-S outcomes were having a neurological disease other than stroke, having dizziness/balance problems as the major health condition and having pain/discomfort. In addition, having anxiety/depression was a predictor of poorer COPM-P outcomes. The two regression models explained 38.3% and 38.8% of the total variance of the dependent variables of occupational performance and satisfaction with that performance, respectively. The results indicate that diagnosis, functional level, sex and motivation are significant predictors of outcomes following reablement.

Lessons learned from the scaling-up of a weekly multimicronutrient supplementation program in the integrated food security program (PISA).

PubMed

Lechtig, Aarón; Gross, Rainer; Vivanco, Oscar Aquino; Gross, Ursula; López de Romaña, Daniel

2006-01-01

Weekly multimicronutrient supplementation was initiated as an appropriate intervention to protect poor urban populations from anemia. To identify the lessons learned from the Integrated Food Security Program (Programa Integrado de Seguridad Alimentaria [PISA]) weekly multimicronutrient supplementation program implemented in poor urban populations of Chiclayo, Peru. Data were collected from a 12-week program in which multimicronutrient supplements were provided weekly to women and adolescent girls 12 through 44 years of age and children under 5 years of age. A baseline survey was first conducted. Within the weekly multimicronutrient supplementation program, information was collected on supplement distribution, compliance, biological effectiveness, and cost. Supplementation, fortification, and dietary strategies can be integrated synergistically within a micronutrient intervention program. To ensure high cost-effectiveness of a weekly multimicronutrient supplementation program, the following conditions need to be met: the program should be implemented twice a year for 4 months; the program should be simultaneously implemented at the household (micro), community (meso), and national (macro) levels; there should be governmental participation from health and other sectors; and there should be community and private sector participation. Weekly multimicronutrient supplementation programs are cost effective options in urban areas with populations at low risk of energy deficiency and high risk of micronutrient deficiencies.

The Effects of Pilates Training on Balance Control and Self-Reported Health Status in Community-Dwelling Older Adults: A Randomized Controlled Trial.

PubMed

Gabizon, Hadas; Press, Yan; Volkov, Ilia; Melzer, Itshak

2016-07-01

To evaluate the effect of a group-based Pilates training program on balance control and health status in healthy older adults. A single-blind, randomized, controlled trial. General community. A total of 88 community-dwelling older adults (age 71.15 ± 4.30 years), without evidence of functional balance impairment, were recruited and allocated at random to a Pilates intervention group (n = 44) or a control group (n = 44). The Pilates intervention group received 36 training sessions over three months (3 sessions a week), while the control group did not receive any intervention. Standing upright postural stability, performance-based measures of balance, and self-reported health status was assessed in both groups at baseline and at the end of the intervention period. Compared with the control group, the Pilates intervention did not improve postural stability, baseline functional measures of balance, or health status. The results suggest that because Pilates training is not task specific, it does not improve balance control or balance function in independent older adults.

‘Help for Hay Fever’, a goal-focused intervention for people with intermittent allergic rhinitis, delivered in Scottish community pharmacies: study protocol for a pilot cluster randomized controlled trial

PubMed Central

2013-01-01

Background Despite the availability of evidence-based guidelines for managing allergic rhinitis in primary care, management of the condition in the United Kingdom (UK) remains sub-optimal. Its high prevalence and negative effects on quality of life, school performance, productivity and co-morbid respiratory conditions (in particular, asthma), and high health and societal costs, make this a priority for developing novel models of care. Recent Australian research demonstrated the potential of a community pharmacy-based ‘goal-focused’ intervention to help people with intermittent allergic rhinitis to self-manage their condition better, reduce symptom severity and improve quality of life. In this pilot study we will assess the transferability of the goal-focused intervention to a UK context, the suitability of the intervention materials, procedures and outcome measures and collect data to inform a future definitive UK randomized controlled trial (RCT). Methods/Design A pilot cluster RCT with associated preliminary economic analysis and embedded qualitative evaluation. The pilot trial will take place in two Scottish Health Board areas: Grampian and Greater Glasgow & Clyde. Twelve community pharmacies will be randomly assigned to intervention or usual care group. Each will recruit 12 customers seeking advice or treatment for intermittent allergic rhinitis. Pharmacy staff in intervention pharmacies will support recruited customers in developing strategies for setting and achieving goals that aim to avoid/minimize triggers for, and eliminate/minimize symptoms of allergic rhinitis. Customers recruited in non-intervention pharmacies will receive usual care. The co-primary outcome measures, selected to inform a sample size calculation for a future RCT, are: community pharmacy and customer recruitment and completion rates; and effect size of change in the validated mini-Rhinoconjunctivitis Quality of Life Questionnaire between baseline, one-week and six-weeks post-intervention. Secondary outcome measures relate to changes in symptom severity, productivity, medication adherence and self-efficacy. Quantitative data about accrual, retention and economic measures, and qualitative data about participants’ experiences during the trial will be collected to inform the future RCT. Discussion This work will lay the foundations for a definitive RCT of a community pharmacy-based ‘goal-focused’ self-management intervention for people with intermittent allergic rhinitis. Results of the pilot trial are expected to be available in April 2013. Trial registration Current Controlled Trials ISRCTN43606442 PMID:23856015

'Help for Hay Fever', a goal-focused intervention for people with intermittent allergic rhinitis, delivered in Scottish community pharmacies: study protocol for a pilot cluster randomized controlled trial.

PubMed

Porteous, Terry; Wyke, Sally; Smith, Sarah; Bond, Christine; Francis, Jill; Lee, Amanda J; Lowrie, Richard; Scotland, Graham; Sheikh, Aziz; Thomas, Mike; Smith, Lorraine

2013-07-15

Despite the availability of evidence-based guidelines for managing allergic rhinitis in primary care, management of the condition in the United Kingdom (UK) remains sub-optimal. Its high prevalence and negative effects on quality of life, school performance, productivity and co-morbid respiratory conditions (in particular, asthma), and high health and societal costs, make this a priority for developing novel models of care. Recent Australian research demonstrated the potential of a community pharmacy-based 'goal-focused' intervention to help people with intermittent allergic rhinitis to self-manage their condition better, reduce symptom severity and improve quality of life. In this pilot study we will assess the transferability of the goal-focused intervention to a UK context, the suitability of the intervention materials, procedures and outcome measures and collect data to inform a future definitive UK randomized controlled trial (RCT). A pilot cluster RCT with associated preliminary economic analysis and embedded qualitative evaluation. The pilot trial will take place in two Scottish Health Board areas: Grampian and Greater Glasgow & Clyde. Twelve community pharmacies will be randomly assigned to intervention or usual care group. Each will recruit 12 customers seeking advice or treatment for intermittent allergic rhinitis. Pharmacy staff in intervention pharmacies will support recruited customers in developing strategies for setting and achieving goals that aim to avoid/minimize triggers for, and eliminate/minimize symptoms of allergic rhinitis. Customers recruited in non-intervention pharmacies will receive usual care. The co-primary outcome measures, selected to inform a sample size calculation for a future RCT, are: community pharmacy and customer recruitment and completion rates; and effect size of change in the validated mini-Rhinoconjunctivitis Quality of Life Questionnaire between baseline, one-week and six-weeks post-intervention. Secondary outcome measures relate to changes in symptom severity, productivity, medication adherence and self-efficacy. Quantitative data about accrual, retention and economic measures, and qualitative data about participants' experiences during the trial will be collected to inform the future RCT. This work will lay the foundations for a definitive RCT of a community pharmacy-based 'goal-focused' self-management intervention for people with intermittent allergic rhinitis. Results of the pilot trial are expected to be available in April 2013. Current Controlled Trials ISRCTN43606442.

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

PubMed

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

2017-11-25

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

Community-based peer-led diabetes self-management: a randomized trial.

PubMed

Lorig, Kate; Ritter, Philip L; Villa, Frank J; Armas, Jean

2009-01-01

The purpose of this study is to determine the effectiveness of a community-based diabetes self-management program comparing treatment participants to a randomized usual-care control group at 6 months. A total of 345 adults with type 2 diabetes but no criteria for high A1C were randomized to a usual-care control group or 6-week community-based, peer-led diabetes self-management program (DSMP). Randomized participants were compared at 6 months. The DSMP intervention participants were followed for an additional 6 months (12 months total). A1C and body mass index were measured at baseline, 6 months, and 12 months. All other data were collected by self-administered questionnaires. At 6 months, DSMP participants did not demonstrate improvements in A1C as compared with controls. Baseline A1C was much lower than in similar trials. Participants did have significant improvements in depression, symptoms of hypoglycemia, communication with physicians, healthy eating, and reading food labels (P < .01). They also had significant improvements in patient activation and self-efficacy. At 12 months, DSMP intervention participants continued to demonstrate improvements in depression, communication with physicians, healthy eating, patient activation, and self-efficacy (P < .01). There were no significant changes in utilization measures. These findings suggest that people with diabetes without elevated A1C can benefit from a community-based, peer-led diabetes program. Given the large number of people with diabetes and lack of low-cost diabetes education, the DSMP deserves consideration for implementation.

From pipelines to pathways: the Memorial experience in educating doctors for rural generalist practice.

PubMed

Rourke, James; Asghari, Shabnam; Hurley, Oliver; Ravalia, Mohamed; Jong, Michael; Parsons, Wanda; Duggan, Norah; Stringer, Katherine; O'Keefe, Danielle; Moffatt, Scott; Graham, Wendy; Sturge Sparkes, Carolyn; Hippe, Janelle; Harris Walsh, Kristin; McKay, Donald; Samarasena, Asoka

2018-03-01

This report describes the community context, concept and mission of The Faculty of Medicine at Memorial University of Newfoundland (Memorial), Canada, and its 'pathways to rural practice' approach, which includes influences at the pre-medical school, medical school experience, postgraduate residency training, and physician practice levels. Memorial's pathways to practice helped Memorial to fulfill its social accountability mandate to populate the province with highly skilled rural generalist practitioners. Programs/interventions/initiatives: The 'pathways to rural practice' include initiatives in four stages: (1) before admission to medical school; (2) during undergraduate medical training (medical degree (MD) program); (3) during postgraduate vocational residency training; and (4) after postgraduate vocational residency training. Memorial's Learners & Locations (L&L) database tracks students through these stages. The Aboriginal initiative - the MedQuest program and the admissions process that considers geographic or minority representation in terms of those selecting candidates and the candidates themselves - occurs before the student is admitted. Once a student starts Memorial's MD program, the student has ample opportunities to have rural-based experiences through pre-clerkship and clerkship, of which some take place exclusively outside of St. John's tertiary hospitals. Memorial's postgraduate (PG) Family Medicine (FM) residency (vocational) training program allows for deeper community integration and longer periods of training within the same community, which increases the likelihood of a physician choosing rural family medicine. After postgraduate training, rural physicians were given many opportunities for professional development as well as faculty development opportunities. Each of the programs and initiatives were assessed through geospatial rurality analysis of administrative data collected upon entry into and during the MD program and PG training (L&L). Among Memorial MD-graduating classes of 2011-2020, 56% spent the majority of their lives before their 18th birthday in a rural location and 44% in an urban location. As of September 2016, 23 Memorial MD students self-identified as Aboriginal, of which 2 (9%) were from an urban location and 20 (91%) were from rural locations. For Year 3 Family Medicine, graduating classes 2011 to 2019, 89% of placement weeks took place in rural communities and 8% took place in rural towns. For Memorial MD graduating classes 2011-2013 who completed Memorial Family Medicine vocational training residencies, (N=49), 100% completed some rural training. For these 49 residents (vocational trainees), the average amount of time spent in rural areas was 52 weeks out of a total average FM training time of 95 weeks. For Family Medicine residencies from July 2011 to October 2016, 29% of all placement weeks took place in rural communities and 21% of all placement weeks took place in rural towns. For 2016-2017 first-year residents, 53% of the first year training is completed in rural locations, reflecting an even greater rural experiential learning focus. Memorial's pathways approach has allowed for the comprehensive training of rural generalists for Newfoundland and Labrador and the rest of Canada and may be applicable to other settings. More challenges remain, requiring ongoing collaboration with governments, medical associations, health authorities, communities, and their physicians to help achieve reliable and feasible healthcare delivery for those living in rural and remote areas.

The Key to Life Nutrition Program: results from a community-based dietary sodium reduction trial

PubMed Central

Robare, Joseph F; Milas, N Carole; Bayles, Constance M; Williams, Kathy; Newman, Anne B; Lovalekar, Mita T; Boudreau, Robert; McTigue, Kathleen; Albert, Steven M; Kuller, Lewis H

2016-01-01

Objective Evaluation of a dietary Na reduction trial in a community setting. Design Community-based randomized trial. Ten-week nutrition intervention activities focused on lifestyle modification to decrease dietary Na intake, under the supervision of a registered dietitian. Twenty-four hour urine specimens were collected at baseline and follow-up visits to determine 24 h urinary Na excretion. Setting The University of Pittsburgh Center for Healthy Aging, Key to Life Nutrition Program. Subjects Hypertensive adults at least 65 years of age. Results Mean age of participants was 75 years. Twenty-four hour mean urinary Na excretion at baseline was 3174 mg/d. This reduced to 2944 mg/d (P = 0·30) and 2875 mg/d (P ≤ 0·03) at 6-and 12-month follow-ups, respectively. In a sub-sample (urine volume of ≥ 1000 ml, baseline to 12 months), mean urinary Na excretion decreased from 3220 mg/d to 2875 mg/d (P ≤ 0·02). Conclusions Significant reductions in mean 24 h urinary Na were reported, but results fell short of the recommended guidelines of 1500 mg/d for at-risk individuals. Our results reiterate the difficulty in implementing these guidelines in community-based programmes. More aggressive public health efforts, food industry support and health policy changes are needed to decrease Na levels in older adults to the recommended guidelines. PMID:19781124

[Education in medical psychology and community medicine at Karolinska Institutet].

PubMed

Brinck, U; Cederblad, M; Gyllensköld, K; Jersild, P C

1976-01-01

In connection with experiments for the first three years of study the instruction in medical psychology and community medicine has been widened to comprise a total of seven weeks, three during the first term (lectures on basic principles, days devoted to field work, group work), three at the end of the fifth term, and a total of one week's instruction at various times during the sixth term, when the students are given more direct preparation for contacts with patients.

Evaluation of the clinical effect of an on-line course for community nurses on post-partum emotional distress: a community-based longitudinal time-series quasi-experiment.

PubMed

Thome, Marga; Orlygsdottir, Brynja; Elvarsson, Bjarki Thor

2012-09-01

About 14% of Icelandic women suffer post-partum from frequent depressive symptoms, and of those, 12% also report a high degree of parenting stress. Education of nurses and midwives on post-partum distress is crucial in reducing its degree. The purpose of the study is to evaluate the clinical effect of an on-line course for community nurses on post-partum emotional distress. A community-based, longitudinal, time-series quasi-experiment was conducted in four stages from 2001 to 2005. Mothers attending 16 health centres throughout Iceland and scoring ≥ 12 on the Edinburgh Postnatal Depression Scale (EPDS) at the 9th week post-partum were eligible to participate. Health centres were divided into experimental (EHC) and control centres (CHC), and control centres were crossed over to experimental centres the following year and new control centres recruited. Nurses at EHC attended an on-line course on post-partum emotional distress. Participating mothers answered the EPDS; the Parenting Stress Index/Short form and the Fatigue Scale. Nursing diagnoses and interventions were recorded at all study centres. Of the women who were eligible (n = 163), 57% (n = 93) participated. At baseline, 9 weeks post-partum, there were no significant differences between groups of women in the rate of depressive symptoms, fatigue or parenting stress. Women in all groups improved on all distress indicators over time; however, those from the EHC improved statistically and clinically significantly more on depressive symptoms than those from the CHC. Documentation of particular nursing diagnoses and interventions was significantly more frequent at the EHC, but referrals to specialists were significantly less frequent. On-line education for nurses on post-partum emotional distress is feasible and is related to improvement in post-partum depressive symptoms. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.

Assessing the Psychoeducational Approach to Transcendence and Health Program: An Intervention to Foster Self-Transcendence and Well-Being in Community-Dwelling Older Adults.

PubMed

McCarthy, Valerie Lander; Bowland, Sharon; Hall, Lynne A; Connelly, Jennifer

2015-12-01

The late-life developmental process of self-transcendence shapes elders' perspectives on self, others, the nature of this world, and of a dimension beyond the here and now. This qualitative pilot study evaluated the Psychoeducational Approach to Transcendence and Health (PATH) Program, a psychoeducational intervention to promote self-transcendence and well-being in community-dwelling women at a senior center. The intervention involved eight weekly group sessions using group processes, mindfulness practices, creative experiences, and independent at-home practice. The findings supported the underlying theory-based structure and content of the intervention and indicated the intervention may empower elders to attend to self-care, develop acceptance, and learn new skills associated with health and well-being, thus merits further study. Based on insights gained from facilitators' and participants' experiences and perceptions, the intervention will be revised and strengthened. © The Author(s) 2015.

Childhood obesity in America.

PubMed

Van Grouw, Jacqueline M; Volpe, Stella L

2013-10-01

To provide an overview of the current advances in childhood obesity physiology, intervention, and prevention. Structural and functional brain impairments are present in obese adolescents with metabolic syndrome (MetS). Aerobic training for 20 or 40 min per day produced similar affects on metabolic risk factors. Vitamin D supplementation has been shown to improve the metabolic risk factors in obese children; however, obese children require greater doses to treat vitamin D deficiency. A 10-week community-based exergaming weight management program significantly decreased the BMI in obese children. There is surmounting research on MetS and its associated risk factors in obese children. Gaining a comprehensive overview of the factors associated with obesity in children is crucial in developing the most effective intervention strategies. Community-based and family-centered interventions have generated positive results in reducing children's BMI and improving MetS risk factors. In addition to obesity intervention efforts, ongoing prevention initiatives are imperative to reduce the prevalence of childhood obesity.

Placing Evidence-Based Interventions at the Fingertips of School Social Workers.

PubMed

Castillo, Humberto López; Rivers, Tommi; Randall, Catherine; Gaughan, Ken; Ojanen, Tiina; Massey, Oliver Tom; Burton, Donna

2016-07-01

Through a university-community collaborative partnership, the perceived needs of evidence-based practices (EBPs) among school social workers (SSWs) in a large school district in central Florida was assessed. A survey (response rate = 83.6%) found that although 70% of SSWs claim to use EBPs in their everyday practice, 40% do not know where to find them, which may partially explain why 78% of respondents claim to spend 1 to 4 h every week looking for adequate EBPs. From this needs assessment, the translational model was used to address these perceived needs. A systematic review of the literature found 40 tier 2 EBPs, most of which (23%) target substance use, abuse, and dependence. After discussion with academic and community partners, the stakeholders designed, discussed, and implemented a searchable, online, password-protected, interface of these tier 2 EBPs, named Evidence-Based Intervention Toolkit (eBIT). Lessons learned, future directions, and implications of this "one-stop shop" for behavioral health are discussed.

Placing Evidence-based Interventions at the Fingertips of School Social Workers

PubMed Central

Castillo, Humberto López; Rivers, Tommi; Randall, Catherine; Gaughan, Ken; Ojanen, Tiina; Massey, Oliver “Tom”; Burton, Donna

2015-01-01

Through a university-community collaborative partnership, the perceived needs of evidence-based practices (EBP) among school social workers (SSW) in a large school district in central Florida was assessed. A survey (response rate = 83.6%) found that although 70% of SSW claim to use EBP in their everyday practice, 40% do not know where to find them, which may partially explain why 78% of respondents claim to spend 1 to 4 hours every week looking for adequate EBP. From this needs assessment, the translational model was used to address these perceived needs. A systematic review of the literature found forty Tier 2 EBP, most of which (23%) target substance use, abuse, and dependence. After discussion with academic and community partners, the stakeholders designed, discussed, and implemented a searchable, online, password-protected, interface of these Tier 2 EBP, named eBIT (evidence-Based Intervention Toolkit). Lessons learned, future directions, and implications of this “one-stop shop” for behavioral health are discussed. PMID:26659382

Mindfulness meditation-based stress reduction: experience with a bilingual inner-city program.

PubMed

Roth, B; Creaser, T

1997-03-01

This article describes a bilingual mindfulness meditation-based stress reduction program in an inner-city setting. Mindfulness meditation is defined, and the practices of breathing meditation, eating meditation, walking meditation, and mindful yoga are described. Data analysis examined compliance, medical and psychologic symptom reduction, and changes in self-esteem, of English- and Spanish-speaking patients who completed the 8-week Stress Reduction and Relaxation Program at the Community Health Center in Meriden, Conn. Statistically significant decreases in medical and psychologic symptoms and improvement in self-esteem were found. Many program completers reported dramatic changes in attitudes, beliefs, habits, and behaviors. Despite the limitations of the research design, these findings suggest that a mindfulness meditation course can be an effective health care intervention when utilized by English- and Spanish-speaking patients in an inner-city community health center. The article includes a discussion of factors to be considered when establishing a mindfulness meditation-based stress reduction program in a health care setting.

Community-based participatory research to design a faith-enhanced diabetes prevention program: The Better Me Within randomized trial.

PubMed

Kitzman, Heather; Dodgen, Leilani; Mamun, Abdullah; Slater, J Lee; King, George; Slater, Donna; King, Alene; Mandapati, Surendra; DeHaven, Mark

2017-11-01

Reducing obesity positively impacts diabetes and cardiovascular risk; however, evidence-based lifestyle programs, such as the diabetes prevention program (DPP), show reduced effectiveness in African American (AA) women. In addition to an attenuated response to lifestyle programs, AA women also demonstrate high rates of obesity, diabetes, and cardiovascular disease. To address these disparities, enhancements to evidence-based lifestyle programs for AA women need to be developed and evaluated with culturally relevant and rigorous study designs. This study describes a community-based participatory research (CBPR) approach to design a novel faith-enhancement to the DPP for AA women. A long-standing CBPR partnership designed the faith-enhancement from focus group data (N=64 AA adults) integrating five components: a brief pastor led sermon, memory verse, in class or take-home faith activity, promises to remember, and scripture and prayer integrated into participant curriculum and facilitator materials. The faith components were specifically linked to weekly DPP learning objectives to strategically emphasize behavioral skills with religious principles. Using a CBPR approach, the Better Me Within trial was able to enroll 12 churches, screen 333 AA women, and randomize 221 (M age =48.8±11.2; M BMI =36.7±8.4; 52% technical or high school) after collection of objective eligibility measures. A prospective, randomized, nested by church, design will be used to evaluate the faith-enhanced DPP as compared to a standard DPP on weight, diabetes and cardiovascular risk, over a 16-week intervention and 10-month follow up. This study will provide essential data to guide enhancements to evidence-based lifestyle programs for AA women who are at high risk for chronic disease. Copyright © 2017 Elsevier Inc. All rights reserved.