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PubMed1994

Empowering lesbian and gay communities: a call for collaboration with community psychology.

This article traces the history of empowerment efforts in lesbian and gay communities. Despite considerable progress, lesbians and gay men remain marginalized in American society. Their personal, family, and community development is hampered by social and institutional barriers to empowerment. Three powerful disempowering problems of contemporary lesbian and gay communities are detailed: (1) stresses related to coming out; (2) heterosexism; and, (3) difficulties identifying with a community. Four domains are suggested for future collaboration between community psychologists and lesbian/gay communities: (1) anti-lesbian/anti-gay prejudice, discrimination, and violence; (2) mental health and health enhancement; (3) the HIV/AIDS epidemic; and, (4) civil rights. Future collaborations must build on successful-social change strategies already used by activists in lesbian and gay communities.

Civil Rights↗
PubMed2004

Diversity of arbuscular mycorrhizal fungi across a fragmented forest in Panama: insular spore communities differ from mainland communities.

It is now understood that alterations in the species composition of soil organisms can lead to changes in aboveground communities. In this study, we assessed the importance of spatial scale and forest size on changes in arbuscular mycorrhizal fungal (AMF) spore communities by sampling AMF spores in soils of forested mainland and island sites in the vicinity of Gatun Lake, Republic of Panama. We encountered a total of 27 AMF species or morphospecies, with 17, 8, 1 and 1 from the genera Glomus, Acaulospora, Sclerosystis, and Scutellospora, respectively. At small scales (<100 m2), we found little evidence for spatial structuring of AMF communities (decay of Morisita-Horn community similarity with distance). However, at large spatial scales, we found that the AMF spore community of a mainland plot was more similar to other mainland plots several kilometers (>5) away than to nearby island plots (within 0.7 km). Likewise, most island plots were more similar to other island plots regardless of geographic separation. There was no decay in AMF species richness (number of species), or Shannon diversity (number of species and their spore numbers) either with decreasing forest-fragment size, or with decreasing plant species richness. Of the six most common species that composed almost 70% of the total spore volume, spores of Glomus "tsh" and G. clavisporum were more common in soils of mainland plots, while spores of Glomus "small brown" and Acaulospora mellea were more abundant in soils of island plots. None of these common AMF species showed significant associations with soil chemistry or plant diversity. We suggest that the convergence of common species found in AMF spore communities in soils of similar forest sizes was a result of forest fragmentation. Habitat-dependent convergence of AMF spore communities may result in differential survival of tree seedlings regenerating on islands versus mainland.

Analysis of Variance↗
PubMed1996

Community surveillance of coronary heart disease in the Atherosclerosis Risk in Communities (ARIC) Study: methods and initial two years' experience.

The community surveillance component of the Atherosclerosis Risk in Communities (ARIC) Study is designed to estimate patterns and trends of coronary heart disease (CHD) incidence, case fatality, and mortality in four U.S. communities. Community surveillance involves ongoing review of death certificates and hospital discharge records to identify CHD events in community residents aged 35-74 years. Interviews with next of kin and questionnaires completed by physicians and medical examiners or coroners were used to collect information on deaths, and review and abstraction of hospital records were used to collect information on possible fatal and nonfatal myocardial infarctions (MIs). Events were classified using standardized criteria. The initial 2-years' experience with case ascertainment and availability of information needed for classification of events is described. Average annual age-adjusted attack rates of definite MI and CHD mortality rates for blacks in two communities and whites in the four communities are presented and compared with rates based on unvalidated hospital discharge data and vital statistics. Age-adjusted rates based on ARIC classification of definite MI were lower than those based on hospital discharge diagnosis code 410 (e.g., 5.60/1000 and 11.50/1000 among Forsyth County white men, respectively). Age-adjusted rates of definite fatal CHD based on ARIC classification were similarly lower than rates based on underlying cause of death code 410; for example, Jackson black men had rates of 2.82/1000 and 4.52/1000 for definite fatal CHD and UCOD 410-414 or 429.2, respectively.

Adult↗
PubMed2004

Trade-offs in community properties through time in a desert rodent community.

Resource limitation represents an important constraint on ecological communities, which restricts the total abundance, biomass, and community energy flux a given community can support. However, the exact relationship among these three measures of biological activity remains unclear. Here we use a simple framework that links abundance and biomass with an energetic constraint. Under constant energetic availability, it is expected that changes in abundance and biomass can result from shifts in the distribution of individual masses. We test these predictions using long-term data from a desert rodent community. Total energy use for the community has not changed directionally for 25 years, but species composition has. As a result, the average body size has decreased by almost 50%, and average abundance has doubled. These results lend support to the idea of resource limitation on desert rodent communities and demonstrate that systems are able to maintain community energy flux in the face of environmental change, through changes in composition and structure.

Animals↗
PubMed1996

Durability of tobacco control activities in 11 north American communities: life after the Community Intervention Trial for Smoking Cessation (COMMIT).

Durability of tobacco control activities in the 11 intervention sites of the Community Intervention Trial for Heavy Smokers (COMMIT) was examined. Although continuation of COMMIT activities was not a major goal, all communities made plans to continue some tobacco control activity. Information was gathered at focus groups of former COMMIT volunteers and staff who were assembled in each community and asked to describe tobacco control activities in their communities during the past 12-16 months-the period after the termination of COMMIT funding. It was found that a tobacco coalition, board or other structure was still operating in nine of the 11 communities and 10 had some level of paid staff dedicated to smoking control. There was also substantial activity in three of the four channels that COMMIT used as an intervention framework: worksites, public education and cessation resources. Many communities were currently engaged in considerable smoking control activity aimed at youth, an area that was intentionally de-emphasized by COMMIT. Implications for the durability of health promotion programs by communities are discussed.

Adolescent↗
PubMed2000

Building community in the healthcare workplace, Part 4. Partnering with union members to create community.

Squeezed between mounting budget pressures and staffing demands, healthcare managers have little room to maneuver as they are buffeted by incessant new strategies. So what is the constant that they can use to keep a steady course through all the chaos? We suggest the overarching constant is "community in the workplace." Although community building may have both short- and long-term benefits, it is not a strategy but a career-long philosophy to help managers tie together all the facets of their daily work into a more meaningful and satisfying purpose. This article, part 4 in a 4-part series, discusses partnering with union leaders and members to create a sense of community in the organization. Using a case study of an organization that had significant success implementing the community philosophy, this article describes concepts, structures, and processes that work, and a few that do not, in a unionized environment. Part 1 (July/August) described the negative dynamics that obstruct sustainable change and reasons for moving to community at work. Part 2 (September) discussed the basic characteristics and principles of community building. Part 3 (October) illustrated community implementation options and obstacles.

Humans↗
PubMed2001

Suicide prevention in Aboriginal communities: application of community gatekeeper training.

OBJECTIVE: Concern over the high rate of suicide among Aboriginal people on the south coast of NSW led to the development of a project aimed at preventing youth suicide in the Aboriginal communities of the Shoalhaven. This paper describes the development, implementation and evaluation of the project. METHOD: Following extensive consultation with the Aboriginal community, a range of culturally appropriate interventions were developed. The main focus was a series of community gatekeeper training workshops, which aimed to increase the potential of members of the Aboriginal community to identify and support people at risk of suicide and to facilitate their access to helping services. RESULTS: Evaluation of the workshops demonstrated an increase in participants' knowledge about suicide, greater confidence in identification of people who are suicidal, and high levels of intentions to provide help. Attitudes, subjective norms and barriers predicted intentions to help. CONCLUSIONS: The project indicated community members could be successfully trained in the recognition of individuals at risk of suicidal behaviour. Gatekeepers' attitudes and perceived barriers to helping predicted intentions to help those in need. There is a need for longer-term follow-up to assess the extent to which new knowledge and skills are used in practice. IMPLICATIONS: Suicide awareness and skills training have been demonstrated to be an effective early intervention strategy. Gatekeeper training empowers Aboriginal communities and is generally accepted. There is demand for such programs outside the Shoalhaven. The project has a methodological framework that can be easily adapted by other communities.

Adult↗
PubMed1996

Does community residence mean more community contact for people with severe, long-term psychiatric disabilities?

The focus of the debate over hospital versus community care for those with severe and enduring mental health problems has shifted somewhat towards ensuring the quality of care provided by services regardless of their location. One factor that is generally assumed to be an important indicator of quality of care is the opportunity for community contact that users of a residential service have. This is illustrated by its inclusion in most instruments designed to assess quality of care in psychiatric services. The present study set out to examine the amount of community contact made by residents of three units of a London psychiatric rehabilitation service. Level of community contact was indeed found to be unrelated to the location of these facilities on a hospital site or in the community. However, interesting differences did emerge across units in the type of community contact made by residents and in the identity of residents' companions on community trips.

Activities of Daily Living↗
PubMed2006

Microarray-based analysis of subnanogram quantities of microbial community DNAs by using whole-community genome amplification.

Microarray technology provides the opportunity to identify thousands of microbial genes or populations simultaneously, but low microbial biomass often prevents application of this technology to many natural microbial communities. We developed a whole-community genome amplification-assisted microarray detection approach based on multiple displacement amplification. The representativeness of amplification was evaluated using several types of microarrays and quantitative indexes. Representative detection of individual genes or genomes was obtained with 1 to 100 ng DNA from individual or mixed genomes, in equal or unequal abundance, and with 1 to 500 ng community DNAs from groundwater. Lower concentrations of DNA (as low as 10 fg) could be detected, but the lower template concentrations affected the representativeness of amplification. Robust quantitative detection was also observed by significant linear relationships between signal intensities and initial DNA concentrations ranging from (i) 0.04 to 125 ng (r2 = 0.65 to 0.99) for DNA from pure cultures as detected by whole-genome open reading frame arrays, (ii) 0.1 to 1,000 ng (r2 = 0.91) for genomic DNA using community genome arrays, and (iii) 0.01 to 250 ng (r2 = 0.96 to 0.98) for community DNAs from ethanol-amended groundwater using 50-mer functional gene arrays. This method allowed us to investigate the oligotrophic microbial communities in groundwater contaminated with uranium and other metals. The results indicated that microorganisms containing genes involved in contaminant degradation and immobilization are present in these communities, that their spatial distribution is heterogeneous, and that microbial diversity is greatly reduced in the highly contaminated environment.

Biomass↗
PubMed1999

Flagellate predation on a bacterial model community: interplay of size-selective grazing, specific bacterial cell size, and bacterial community composition.

The influence of grazing by the bacterivorous nanoflagellate Ochromonas sp. strain DS on the taxonomic and morphological structures of a complex bacterial community was studied in one-stage chemostat experiments. A bacterial community, consisting of at least 30 different strains, was fed with a complex carbon source under conditions of low growth rate (0.5 day(-1) when nongrazed) and low substrate concentration (9 mg liter(-1)). Before and after the introduction of the predator, the bacterial community composition was studied by in situ techniques (immunofluorescence microscopy and fluorescent in situ hybridization), as well as by cultivation on agar media. The cell sizes of nonspecifically stained and immunofluorescently labeled bacteria were measured by image analysis. Grazing by the flagellate caused a bidirectional change in the morphological structure of the community. Medium-size bacterial cells, which dominated the nongrazed community, were largely replaced by smaller cells, as well as by cells contained in large multicellular flocs. Cell morphological changes were combined with community taxonomic changes. After introduction of the flagellate, the dominating strains with medium-size cells were largely replaced by single-celled strains with smaller cells on the one hand and, on the other hand, by Pseudomonas sp. strain MWH1, which formed the large, floc-like forms. We assume that size-selective grazing was the major force controlling both the morphological and the taxonomic structures of the model community.

Aeromonas↗
PubMed2006

A review of methods to detect cases of severely malnourished children in the community for their admission into community-based therapeutic care programs.

BACKGROUND: The complexity and cost of measuring weight-for-height make it unsuitable for use by community-based volunteers. This has led community therapeutic care programs to adopt a two-stage screening and admission procedure in which mid-upper-arm circumference (MUAC) is used for referral and weight-for-height is used for admission. Such a procedure results in many individuals being referred for care on the basis of MUAC but subsequently being refused treatment because they do not meet the weight-for-height admission criterion. This "problem of rejected referrals" has proved to be a major barrier to program uptake. OBJECTIVE: To systematically review methods to detect cases of severely malnourished children in the community for their admission into community-based therapeutic care programs. METHODS: Clinical and anthropometric methods for case detection of severely malnourished children in the community were reviewed with regard to their ability to reflect both mortality risk and nutritional status. RESULTS: MUAC, with the addition of the presence of bipedal edema, was found to be the indicator best suited to screening and case detection of malnutrition in the community. The case definition "MUAC < 110 mm OR the presence of bipedal edema," with MUAC measured by a color-banded strap, is suitable for screening and case detection of malnutrition in the community for children aged between 6 and 59 months. Monitoring and discharge criteria were also reviewed. CONCLUSIONS: There is no compelling evidence to support a move away from using weight in combination with clinical criteria for monitoring and discharge.

Anthropometry↗
PubMed1986

The meaning of community in community mental health.

This article critically reviews the development of community mental health in both theory and practice and explores new directions and dilemmas for future policy and programs. First, we trace the dialectical development of the ideology of community mental health and the rediscovery of community. Second, we outline the two key transitions: (a) from professionals to natural helpers and (b) from catchment areas to natural networks. Third, we offer alternative conceptions of community from the sociological literature and suggest ways that these can benefit new program planning. We conclude with a series of policy questions that legitimate the expansion of community mental health beyond the parochial confines of the local community.

Catchment Area, Health↗
PubMed2005

Anchors of the community: community schools in Chicago.

In partnership with Chicago's public and private sectors, Chicago Public Schools (CPS) has successfully implemented a citywide education reform effort, designed to transform Chicago's neighborhood schools into vibrant centers of the community. Mayor Richard M. Daley and Arne Duncan, CEO of CPS, launched the Community Schools Initiative in January 2002. What started as an idea that was developed by a local foundation has now grown into the largest-scale community school effort in the nation, with sixty-seven schools in operation and a plan to move to one hundred community schools by 2007. This initiative currently involves seventeen private funders, ten technical assistance providers, thirty-four community-based organizations that offer on-site services to children and families, and over three hundred additional community partnerships that provide one-day events such as health fairs and violence prevention workshops.

Adolescent↗
PubMed1998

From the board room to the community room: a health improvement collaboration that's working. Community Health Improvement Partners.

BACKGROUND: Health systems and clinics in San Diego have joined with public health and academic representatives to develop collaborative, innovative, and effective ways to address the region's ever-increasing health care needs. Community Health Improvement Partners (CHIP) was established in a local environment with a highly developed managed care marketplace, a diverse county population, no public hospital, and a growing number of uninsured. The catalyst for the 25-member CHIP coalition was 1994 legislation that required not-for-profit, private hospitals to, among other things, conduct a health needs assessment of its community (every three years) and prepare a community benefit plan and report (annually). After the production of the needs assessment, members implemented a priority-setting process and a combined countywide community benefit plan. THE CHIP WORK TEAMS: Of 12 self-managed work teams formed in 1996, 7 are still meeting in some capacity--addressing access to care for the underinsured and uninsured, chronic disease management in underserved areas, community diabetes care, health education and access to care for African immigrants (new Americans), adolescent health, mental health, and violence prevention. BENEFITS OF A COMMUNITY HEALTH IMPROVEMENT COALITION: The participation of the full spectrum and variety of health care stakeholders at the table, unique to San Diego, has enabled CHIP to serve as an open forum for frank discussions of critical and, at times, controversial health care issues. CONCLUSION: The difficulties with collaboration are not be to be minimized. CHIP hopes to live up to its aspirations to make a difference through accomplishments that are cost-effective to truly improve the health of San Diego residents.

California↗
PubMed1998

Significant elements of community involvement in participatory action research: evidence from a community project.

Participatory action research (PAR) has been heralded as an important research methodology to address issues of research relevance, community involvement, democracy, emancipation and liberation. Increasingly, nurse researchers are turning to PAR as a method of choice. Although nursing interest in PAR is expanding little is known about how to successfully involve the community in research. This article attends to this dearth of information by presenting the results of a study investigating the significant elements of community involvement in PAR. Through the use of qualitative research methods, five themes emerged that describe the community participation process: (a) planning for participation, (b) the structural components of community participation, (c) living the philosophy, (d) enhancing the credibility, and (e) the type of leadership required to facilitate community participation. It is hoped that by sharing these results others may consider the knowledge gleaned from this project as they plan and proceed with the challenges and rewards inherent in PAR.

Community Health Nursing↗
PubMed2006

Communities' awareness, perception and participation in the Community-Based Medical Education of the University of Maiduguri.

BACKGROUND: Community-based medical education (CBME) is no longer a new innovation in medical education since the establishment of The Network: Towards Unity for Health (The Network: TUFH) 25 years ago. The CBME of the University of Maiduguri medical college is 14 years old and has never been assessed in terms of the population it serves. The study was conducted to determine the level of awareness, perception, and participation of the communities in CBME. METHODS: A cross-sectional survey was carried out in 11 village units of three Local Government Areas (LGAs) using a 14-item structured questionnaire administered to adults in randomly selected households. The questionnaire was based on guide questions used for focus group discussions held earlier with community leaders. RESULTS: Awareness of students' visits among respondents was 73.7%. Knowledge of the frequency of presence of the students in the communities was 72.2%. "To examine and treat" (33.6%) and "to ask questions" (16.6%) were the most prominent reasons given for the visits. The majority of respondents perceived the visits as beneficial (72.2%). More frequent visits were requested by 54.4% of the respondents. The communities were willing to be more accessible and felt that the LGAs should provide more logistic support to the program. DISCUSSION: This study revealed that communities were aware of students' visits and knew reasons for the visits, thought visits were beneficial, and were willing to provide more support for these visits.

Adult↗
PubMed2001

Doing community-driven research: a description of Seattle Partners for Healthy Communities.

Seattle Partners, an Urban Research Center (URC) funded by the Centers for Disease Control and Prevention (CDC), is a partnership of community agency representatives, community activists, public health professionals, academics, and health care providers whose mission is to improve the health of urban Seattle, Washington, communities by conducting community-based participatory research. This article describes the development and characteristics of Seattle Partners. Using primarily qualitative methods, including periodic in-depth interviews, evaluators identified the components necessary for Seattle Partners to maintain a collaborative and establish a research center driven by community interests. Seattle Partners is run by an unrestricted and inclusive board that has spent 5 years developing both an operating structure and various research interventions. Operating under Community Collaboration Principles, the board identified social determinants of health as the priority area in which to work. Collaboration, "small and concrete" accomplishments, skilled individuals, and funder support directly influence the success of the center. Decision making, project selection, and board composition have all been challenges to work through. Learning how to do and sustain the work are lessons being learned as Seattle Partners matures.

Centers for Disease Control and Prevention, U.S.↗
PubMed1994

Community analysis: a collaborative community practice project.

Lack of access to health care is a concern in many communities. A group of representatives from health, social service, other community agencies and nursing education meet regularly to address issues in providing care to homeless, low-income, and uninsured persons in Spokane, Washington. This group's efforts has been hampered by lack of clearly identified factors that adversely affect access to care. One aspect of community analysis performed by this group used a collaborative community practice model. Community diagnoses were determined from information collected from service providers. Community health nursing faculty, as clinical specialists, can play a role in such a collaborative process.

Community Health Nursing↗