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PubMedDate not supplied

A community partnership model for developing a Center for Cancer Nursing Education and Research.

This article describes a partnership model used to establish the Center for Cancer Nursing Education and Research at the University of Louisville (U of L) School of Nursing. The model was used to bring together area nursing education programs, institutions providing cancer nursing care, and related community groups. The need for the project was directly related to the high cancer morbidity and mortality in the community. The U of L's strategic agenda and strong commitment to cancer prevention and care provided a growth opportunity for the recognition of nurses' role in cancer care. Nurses are positioned to influence cancer care across the continuum from prevention to end of life, and building the capacity for cancer nursing is essential to building a system of cancer care. This article describes an innovative partnership model used to stimulate a community-wide focus on cancer nursing. The organizational structure, development of partner relationships, description of project activities, and outcomes are presented along with a discussion of the said model's benefits and potential for replication.

Community-Institutional Relations↗
PubMed2006

Institutional and economic determinants of public health system performance.

OBJECTIVES: Although a growing body of evidence demonstrates that availability and quality of essential public health services vary widely across communities, relatively little is known about the factors that give rise to these variations. We examined the association of institutional, financial, and community characteristics of local public health delivery systems and the performance of essential services. METHODS: Performance measures were collected from local public health systems in 7 states and combined with secondary data sources. Multivariate, linear, and nonlinear regression models were used to estimate associations between system characteristics and the performance of essential services. RESULTS: Performance varied significantly with the size, financial resources, and organizational structure of local public health systems, with some public health services appearing more sensitive to these characteristics than others. Staffing levels and community characteristics also appeared to be related to the performance of selected services. CONCLUSIONS: Reconfiguring the organization and financing of public health systems in some communities-such as through consolidation and enhanced intergovernmental coordination-may hold promise for improving the performance of essential services.

Community Health Services↗
PubMed2003

Are there threshold numbers for protected forests?

Maintenance of forests biodiversity is intimately related on the one hand to the species and community-related ecological needs of flora and fauna living in the forest and on the other hand the disturbance regimes of the specific forest type. Populations of plants and animals need minimum biotopes for their ontogeny; for assuring their survival they depend on a minimum of connected suitable areas. Specific traits of forest types are based upon different disturbance regimes, ranging from small-scale internal processes (e.g. regeneration, growth, senescence, mortality, gap dynamics) generating normal forest cycles (i.e. regular sequences, e.g. regeneration, optimum, decay phases) to potentially chaotic and large-scale, frequently external, disturbances, e.g. fire, landslides, or beetle attacks. Forest protection may meet the needs of these very different demands by varied protected area networks going from small (>100 ha), medium (1000 ha) to large-scale reserves (National Parks, several thousands of ha). According to this triple protection concept not only graduated threshold numbers, but also threshold sizes and threshold areas for forest protection must be defined. To realize this concept the regional and local conditions (forest area, forest cover percentage, forest composition, socio-economic targets) must always be taken in consideration.

Animals↗
PubMed1978

Issues critical to the survival of community mental health.

The author delineates some of the critical issues that face community mental health, with the opportunity for either growth and further development or regression into a decentralized type of custodial care. These issues include clarifying boundaries and priorities, caring for chronically ill deinstitutionalized patients, providing differentiated care, collaborating with the community, relating to the rest of psychiatry and medicine, defining the community psychiatrist's role, maintaining psychiatric manpower, undertaking evaluation research, and achieving stable funding. Psychiatry's response to these issues will help determine the resolution of this crisis and the future viability and direction of community mental health.

Chronic Disease↗
PubMedDate not supplied

Pastoral care: marketing "high touch".

Marketing pastoral care skills is important both within and without the health care organization. To increase administrators' awareness of the value of the pastoral care department, for example, chaplains must be able to demonstrate that their activities can affect the bottom line. They must therefore develop a system of accountability that defines and measures their services in objective terms. Such a system would include the reporting of monthly visit statistics as well as the collection of data from patients and personnel on the adequacy of pastoral care services. Other awareness-building activities could include participation in nursing practice rounds, in-service presentations, involvement in hospital social events, and placement of articles about pastoral care in hospital publications. Activities that would help to foster good community relations and thereby improve census include participation in the area clergy association, work with local church groups that visit the sick and the homebound, providing speakers to community organizations, and sponsoring a memorial Mass for families of patients who have died at the hospital. Pastoral care staff should not feel threatened by the changing health care environment. Instead they must recognize the opportunity it provides to create ways to minister to a new mix of patients and to reach new groups.

Catholicism↗
PubMedDate not supplied

Community readiness: the journey to community healing.

Community readiness is a research-based theory that provides a basic understanding of the intervention process in communities. This theory allows us to accurately describe the developmental level of a community relative to a specific issue or problem. In order to move the community toward implementing and maintaining efforts that are effective and sustainable, community mobilization must be based on involvement of multiple systems and utilization of within-community resources and strengths. Successful local prevention and intervention efforts must be conceived from models that are community-specific, culturally relevant, and consistent with the level of readiness of the community to implement an intervention. The community readiness model is an innovative method for assessing the level of readiness of a community to develop and implement prevention programming. It can be used as both a research tool to assess distribution of levels of readiness across a group of communities or as a tool to guide prevention efforts at the individual level. This tool has proven useful in addressing a gamut of problems ranging from health and nutritional issues to environmental and social issues. The model identifies specific characteristics related to different levels of problem awareness and readiness for change.

Alcoholism↗
PubMed2002

Longitudinal study on the adaptive and challenging behaviors of deinstitutionalized adults with mental retardation.

Adaptive and challenging behavior changes associated with movement from Minnesota's state institutions to community homes were examined. Most of the 148 participants who moved had severe or profound mental retardation, significant challenging behavior, and several decades of institutionalization. Adaptive and challenging behavior were assessed in the institution and thereafter annually in the community. Relative to institutional levels, adaptive behavior declined among residents who moved to community ICFs/MR but was unchanged for the HCBS Waiver group. Challenging behavior tended to worsen initially but, except for internalized behavior, no longer differed from institutional levels by the second community assessment. Change in challenging behavior was unrelated to community residence type. Previous papers involving these participants showed consistent lifestyle enhancements and reduced service costs relative to the institution.

Activities of Daily Living↗
PubMed2006

Experiences and demands of families with mentally ill people at home in Botswana.

PURPOSE: To describe the experiences and demands of families who care for their mentally ill relatives at home in Botswana. DESIGN: Grounded theory design with triangulated data sources. METHODS: A convenience sample was drawn from both urban and rural areas and composed of both men and women. Data-collection methods included in-depth interviews, focus group discussions and field observations. Data were collected using an interview protocol in the local language. Interviews were audiotaped, transcribed, and translated into English. Analysis was done by open and axial coding and grouping like data together to generate core categories, using the constant comparison method. FINDINGS: The interview data revealed a myriad of experiences and problems that families encountered in providing care to their relatives. The situation was perceived as difficult and burdensome because of lack of control and inadequate resources. The complexity of the situation required negotiation between the family members, their ill relatives, and health professionals. CONCLUSIONS: This study indicated some of the difficulties caregivers encounter and the coping mechanisms they use to deal with the day-to-day care of their ill relatives. Community resources are needed to assist families to effectively care for their relatives.

Adaptation, Psychological↗
PubMed1990

[Psychiatric-psychosocial activities in West Germany: old and new responsibilities].

Through the Federal German Government's incentives (1976-1985) brought about considerable experience with community based psychiatric services many desideratas and shortcomings stood the reformist efforts: above all, the needs of long term patients remained unmet. At the same time a necessary integration into communities' everyday life culture still is out of reach. The author stresses the biases of the natural-science-medical paradigm when confronted with the demands of social psychiatry. The author suggests some organizational measures to help community related services on their ways.

Community Mental Health Services↗
PubMed2004

Communications. This year's model.

Guy's and St Thomas' has launched its own magazine to improve community relations. 30,000 copies are distributed across Lambeth and Southwark. The front cover features local people rather than celebrities or models.

Community-Institutional Relations↗
PubMed2002

Effects of T4 lysozyme release from transgenic potato roots on bacterial rhizosphere communities are negligible relative to natural factors.

Rhizosphere bacterial communities of two transgenic potato lines which produce T4 lysozyme for protection against bacterial infections were analyzed in comparison to communities of wild-type plants and transgenic controls not harboring the lysozyme gene. Rhizosphere samples were taken from young, flowering, and senescent plants at two field sites in three consecutive years. The communities were characterized in a polyphasic approach. Cultivation-dependent methods included heterotrophic plate counts, determination of species composition and diversity based on fatty acid analysis of isolates, and community level catabolic profiling. Cultivation-independent analyses were based on denaturing gradient gel electrophoresis (DGGE) of 16S rRNA gene fragments amplified from rhizosphere DNA using primers specific for Bacteria, Actinomycetales, or alpha- or beta-Proteobacteria. Several bands of the DGGE patterns were further characterized by sequence analysis. All methods revealed that environmental factors related to season, field site, or year but not to the T4 lysozyme expression of the transgenic plants influenced the rhizosphere communities. For one of the T4 lysozyme-producing cultivars, no deviation in the rhizosphere communities compared to the control lines was observed. For the other, differences were detected at some of the samplings between the rhizosphere community structure and those of one or all other cultivars which were not attributable to T4 lysozyme production but most likely to differences observed in the growth characteristics of this cultivar.

Bacteria↗
PubMed1994

Capacity crisis. The U.S. health care system is bulging with hospital beds--but emotions run high when talks turn to cutting the excess.

Closing down hospital beds is a tough proposition all around; no executive looks forward to the operational, financial, human resources and community relations issues involved. But the forward march of managed care is forcing the issue. In an overbedded health care system, executives are struggling to come up with answers to the capacity crisis.

Bed Occupancy↗
PubMed1988

Measuring corporate culture to ensure mission fulfillment.

Ancilla Systems, Inc., Elk Grove Village, Il, developed a mission-based performance evaluation program to provide tangible evidence of mission fulfillment and ensure the provision of high-quality healthcare. the program--Characteristics of Service--translates the language of healthcare action and evaluates corporate culture to ensure that it fulfills the expectations of its sponsor. The nine Characteristics of Service are: Respect for the dignity of all persons. Orientation toward the family unit. Quality and personalized services. Local health systems with a spectrum of services responsive to the unique needs of the community. Formal and informal partnerships with physicians. Active participation and collaboration with related community service agencies and other healthcare providers. Faithfulness to Catholic identity through close relationships with Church and religious institute resources. Effective political advocacy through education. Research and development of innovative approaches to healthcare. In establishing the behavior standards that would exemplify the characteristics, program developers used terms that correspond to specific, observable, measurable performance. All healthcare facilities are evaluated on how well they meet the behavior standards. The evaluation process includes data collection, analysis, and a final report. Data collection begins with a review of regular hospital-conducted surveys, which provide quantifiable information to measure performance against key expected behaviors. Additional data are derived from medical staff development plans and the monthly quality assurance audit. On-site surveys fill information gaps that remain after all written reports are collected.

Catholicism↗
PubMed1993

Activating communities for health promotion: a process evaluation method.

OBJECTIVES: To date, evaluations of community-based prevention programs have focused on assessing outcomes, not the process of organizing communities for health promotion. An approach was developed to analyze community organization efforts aimed at advancing community health objectives. These organizational processes are referred to as community activation. METHODS: Information was gathered from 762 informants through a key informant survey conducted in 28 western communities. The data collected included informant ratings of community activation and information about interorganizational activities analyzed through network analytic techniques. RESULTS: Activation levels, as measured by informant ratings, varied across communities. Program coordination, as measured by network analysis, occurred, on average, approximately 30% of the time. Higher income communities tended to be more activated than lower income communities. CONCLUSIONS: There is a widely recognized need for improved information about health-related community organization activities. It appears possible to gather such information through key informant surveys and to develop measures of community organization status that can be used in the evaluation of community health promotion programs.

Community Participation↗
PubMed1984

Four critical areas in governance.

How well hospitals weather today's increasingly stormy environment depends upon the performance of their trustees in handling four essential areas of governance: strategic planning, financing, quality assurance, and community relations. This article considers, for each of these areas, the responsibilities of trustees, the problems they face in meeting their responsibilities, and some ways of dealing with these problems.

Community-Institutional Relations↗
PubMed2002

Involvement of family and community medicine professionals in community projects.

OBJECTIVE: Medical schools are being challenged to continue their excellence in education, research, and patient care while responding to the health needs of the public. The objective of our study was to determine the nature and type of community involvement of professionals in departments of family and community medicine. STUDY DESIGN: We mailed a 24-item structured survey to a random national sample of family medicine professionals. POPULATION: Survey recipients included 770 full-time physician and nonphysician active members of the Society of Teachers of Family Medicine. OUTCOMES MEASURED: Our survey assessed community activities, challenges and incentives to those activities, and desired resources for working in the community. RESULTS: A total of 446 usable surveys were returned (58% response rate). Ninety-five percent of respondents had participated in a community activity within the previous year. More male respondents precepted medical students or residents and educated faculty on topics regarding community education; more older respondents participated by sitting on community health boards or councils. Insufficient release time and lack of funding were the 2 most frequently cited barriers to community-based activities. CONCLUSIONS: Most faculty are involved in community-related teaching and service. Reasons for low levels of research and subgroup differences, especially among women and young faculty, merit further research.

Academic Medical Centers↗
PubMed1995

Lack of evidence for wild poliovirus circulation--United States, 1993.

Following the isolation of wild poliovirus type 3 during January-February 1993 among members of a religious community objecting to vaccination in Alberta, Canada, surveillance for poliomyelitis was enhanced among related communities in the United States (1). In addition, during May-July 1993, a series of surveys was conducted in seven states (Iowa, Missouri, New York, Ohio, Pennsylvania, Washington, and Wisconsin) to determine whether wild poliovirus was circulating or had circulated recently among members of these religious communities residing in the states. This report summarizes the results of these surveys.

Canada↗
PubMed1983

To love them and to leave them? A review of a Samoan community and health service research project in New Zealand.

The place of Samoan and other Polynesian healing practices and related community projects in New Zealand society has only recently become a subject for study. This paper is an attempt to circumscribe for the people, both Samoan and non-Samoan, with whom I have been working, some of our cross-cultural associations in this field. To do this I have focused on moments in a process which has as many histories and as many futures as there are people participating in it. The interpretation presented here is a chronicle of significant information and events belonging to a 3-year period (1978-1980 inclusive). Behind the choice, to concentrate on describing the process of our dialogue and action rather than the end results--our 'successes' past and present--lie some fundamental questions. Can the growing understanding and on-going communication of people involved in community projects be documented so that this process is appreciated as valuable? This work takes a long commitment by researchers, even if they are members of the community project, and questions of practicality are raised. Is there a method of documentation which is acceptable both to the funding institutions that sponsor community health projects and to the people who are engaged in them? Could the present commonly accepted short-term assessment of end results, which I find objectionable, be right? And researchers evaluating community health projects, should they continue to become involved with the people they are studying for short times and then withdraw--to love them and leave them?

Communication↗