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PubMedDate not supplied

Prevalence of Mycoplasma pneumoniae and Chlamydia pneumoniae in children with community acquired pneumonia.

A prospective one year study was performed on 62 children admitted at the All India Institute of Medical Sciences with community acquired pneumonia (CAP) for the prevalence of Mycoplasma pneumoniae and Chlamydia pneumoniae. Diagnosis of infection with M. pneumoniae was based on serological tests viz microparticle agglutination test for detection of IgM antibodies and indirect immunofluorescence test for antigen detection from throat swabs (sensitivity 85.7%, specificity 93.3%). The indirect solid-phase enzyme immunoassay for detection of IgG antibodies was used to determine the prevalence of C. pneumoniae (sensitivity 88.8%, specificity 75.8%). Seventeen patients (27.4%) were found to have serological evidence of M. pneumoniae infection whereas only 4 (6.4%) patients were seropositive for C. pneumoniae. Results of this study indicate that M. Pneumoniae plays a significant role in CAP in infants and young children. Thus specialized laboratory testing for these agents should be more widely used thereby affecting empiric antibiotic regimens.

Antibodies, Bacterial↗
PubMed2006

Microbicides 2006 conference.

Current HIV/AIDS statistics show that women account for almost 60% of HIV infections in Sub-Saharan Africa. HIV prevention tools such as male and female condoms, abstinence and monogamy are not always feasible options for women due to various socio-economic and cultural factors. Microbicides are products designed to be inserted in the vagina or rectum prior to sex to prevent HIV acquisition. The biannual Microbicides conference took place in Cape Town, South Africa from 23-26 April 2006. The conference was held for the first time on the African continent, the region worst affected by the HIV/AIDS pandemic. The conference brought together a record number of 1,300 scientists, researchers, policy makers, healthcare workers, communities and advocates. The conference provided an opportunity for an update on microbicide research and development as well as discussions around key issues such as ethics, acceptability, access and community involvement. This report discusses the current status of microbicide research and development, encompassing basic and clinical science, social and behavioural science, and community mobilisation and advocacy activities.

Journal Article↗
PubMed2001

Role of traditional birth attendants in improving reproductive health: lessons from the family health project, Sindh.

OBJECTIVE PURPOSE OF THE STUDY: Despite strenuous efforts, the maternal mortality rate in Pakistan remains high. The national figure of 340 maternal deaths per 100,000 live births tends to hide the fact that in some rural areas it is as high as 700 per 100,000 live births. Not surprisingly, in Pakistan only 20% of births are attended by a trained health professional. In most rural areas, home to almost 70% of the population, traditional birth attendants (TBAs) deliver 90% of the births. TBAs, therefore, play a crucial role in the delivery of maternal health care in Pakistan. Realizing the importance of TBAs, the Family Health Project (FHP) of the Department of Health Sindh, financed by the World Bank, tried to enhance their knowledge and skills through comprehensive training programs. FHP provided training to 650 TBAs in 10 districts. The training was provided by the Department of Community Health Sciences (CHS) of the Aga Khan University (AKU) who acted as technical consultant to the project. STUDY DESIGN: A community-based qualitative post-intervention survey. RESULTS: Post-intervention survey of this seven-year project (1992-1999) revealed that (a) the training enhanced the knowledge and skills of the TBAs, (b) the trained TBAs provide more broader health care services and (c) they enjoy greater community acceptance and provide greater consumer satisfaction. It also showed that the TBAs remain the most available and accessible health resource in most rural settings. CONCLUSION: It is imperative that TBAs and their continuing training should remain central to any reproductive health intervention along with an effective referral system linking them to well-equipped emergency obstetric care facilities. However, the assessment clearly demonstrated that an integrated referral system backed by effective emergency obstetric care is essential to the success of the TBA training program.

Humans↗
PubMed1986

Practical training of medical students in community medicine. Eight years experience from the University of Tromsø.

From its beginning, the Medical School at the University of Tromsø aimed at obtaining a better balance between clinical medicine, basic science and community medicine in its curriculum. This was obtained by using the integrated model for teaching, having a separate study-block for community medicine, incorporating field work in local hospitals and with district doctors and requiring the students to write a scientific paper before qualifying. The 8-week field training with a district doctor started in 1978. Evaluations from these eight years have been analysed and show that students, during these eight weeks, are involved in many aspects of family- and community medicine. The programme has been given positive evaluations from both students and teachers. We conclude that the field training given to medical students in Tromsø is an efficient way of preparing the medical students for future clinical work both inside and outside institutions.

Clinical Clerkship↗
PubMedDate not supplied

Building a health research relationship between First Nations and the University in Manitoba.

This paper describes the emergence of a formal partnership between Manitoba First Nations and researchers in the Department of Community Health Sciences at the University of Manitoba. This partnership reflects two decades of a working relationship in Manitoba involving university researchers and First Nations communities, as well as new and innovative approaches to developing organizations, training initiatives and projects that strengthen First Nations principles of governance. The emerging trust that has developed between the Manitoba First Nations and the University has made it possible to extend this partnership into building further research capacity and evidence-based decision-making among First Nations. Discussions between the Assembly of Manitoba Chiefs and the Northern Health Research Unit resulted in the development of a Manitoba First Nations Centre for Aboriginal Health Research. Its mission is to initiate, coordinate and support research activities designed to assist First Nations and Aboriginal communities and organizations in their efforts to promote healing, wellness and improved health services in their communities. Much of the health research described in this journal was facilitated through this partnership, which demonstrated the value of partnerships and new funding opportunities to better address the health information needs of First Nations communities, particularly at a time when Aboriginal communities were highly skeptical of the value of academic research.

Community Participation↗
PubMed1976

The role of the health facilitator in community health education.

A community health education program has been established by the Department of Community Health Sciences of Duke University Medical Center in two target areas of Durham County, North Carolina. The program trains unpaid lay people, "health facilitators", to whom others already turn for help, to increase their competency for advising and referring community residents to appropriate community resources. Several methods for identifying potential health facilitators have been developed. Evaluation of the role of health facilitators hinges upon designing measures to demonstrate their existence in the community and the impact that they make. To be successful, the training of health facilitators should result in improving the quality of the advice they give their fellows. It is also important to assess the cultural acceptability of the facilitators' advice and to ensure that their helping role in the community is not disturbed by the possible professionalization of their role due to the training program.

Adolescent↗
PubMed2002

Womens' perceptions regarding obstetric complications and care in a poor fishing community in Karachi.

OBJECTIVE: To assess the knowledge of women about obstetric complications and care. METHODS: The study was conducted in a remote coastal community in Karachi in 1999, where the Department of Community Health Sciences of Aga Khan University is operating its primary health care project since 1996. The information was collected using a structured questionnaire, interviewing a representative sample of 329 married-women of reproductive age, selected systematically from the community. RESULTS: The mean age of the respondents was 29 years. On average they were married for 11 years and had four living children. Almost half of them had no antenatal care in their last pregnancy and 75% delivered at home. The findings indicate a poor knowledge of common and serious pregnancy related complications based on their perception related to danger signs. Five percent of the women perceived absent/decreased fetal movement as a danger sign of pregnancy. Other reported danger signs included premature uterine contraction by 3%, premature rupture of membranes by 3%, convulsions by 13%, obstructed labor by 23% and bleeding by 39%. Moreover, the women's perception regarding obstetric care suggests that unsafe practices prevail: 86% of women thought that a case of ante-partum hemorrhage should be examined internally and 50% thought that no precaution is required to sterilize the instrument for cutting the cord. CONCLUSION: There is a clear need to create awareness regarding obstetric complications through a targeted community based health educational intervention aiming to promote early recognition of the obstetric emergency at the household level and also to create a demand of safe obstetric practices.

Adult↗
PubMedDate not supplied

Vitamin D deficiency rickets in children: prevalence and need for community education.

Nutritional rickets caused by a deficiency in vitamin D can be a crippling disease and is still prevalent today. Many feel that the vitamin D supplementation present in dairy products prevents any risk of developing vitamin D deficiency rickets. However, a combination of factors such as pigmented skin, inadequate sunlight, breastfeeding past 6 months with no supplementation, and insufficient calcium intake by the nursing mother and her baby often contribute to rickets diagnosed in children. Educating the medical community and those families at risk is critical to eradicate this preventable disease. Steps can be taken using stages of the Organizational Change Theory to involve school nurses, community health centers, and pediatricians in identifying these high-risk children. With prompt diagnosis and treatment, all symptoms can abate, with healthy bone growth resulting.

Child↗
PubMed1991

Disciplines within general practice.

The disciplines within general practice derive partly from its community setting, and partly from the nature of professional expertise. The maladies range from a high prevalence of low risk, self-limited illness to a low prevalence of high risk, persistent disease. Each set calls on different knowledge and skills. The setting offers the substrate for studying social and behavioural sciences and community health development in action. Choosing a few particular fields, and developing those with rigour, could strengthen general practice as a discipline with special insights and skills to offer all branches of clinical practice. Four fields of activity have been identified. In each, general practice has a clear responsibility and opportunity. I have suggested some knowledge and skill areas for their success--clinical 'working' knowledge, decision making and judgment, predictive knowledge, planning knowledge, calibration of investigators, intuitive knowledge, local knowledge, leadership skills and people management, measurement of burden of illness, calculation of cost-benefit trade-offs, building of local databases, re-learning fine discrimination in clinical perception, and understanding of community development. These subjects have not been part of formal medical education, or of much academic study in family practice. Despite their being central to the success of daily practice, the curriculum is silent about the study of these areas of practical knowledge, reasoning, judgment and skill. Worse, we do not have a common language to express clearly what we are talking about. Experience and skill lie within the practitioner, and are used in practical, concrete situations.(ABSTRACT TRUNCATED AT 250 WORDS)

Family Practice↗
PubMed1995

[The City and Health--an analysis of recent (socio-) historical literature].

"The City and Health" - this title joints two all-encompassing words. The city is the birthplace of modern civilization. Today, we are confronted with huge urban agglomarations--beyond our grasp and nearly out of control. Are we dealing with transitory phenomena, such as the filthy and inhuman cities of the early industrial era seem from the historical point of view? This is our hope. Here inevitably, we strike upon the term "Health". For in the endeavor to create in a city first permanent and then "proper" conditions and finally to achieve proper behaviour, health became a central term. Today, to be healthy is our most heartfelt desire. Still, we do nor know what health is. The theme "City and Health" is therefore significant, historically as well as at present. So a brief historical survey will illustrate a few elements characteristic of the interrelationship of health and the city from the civilizational point of view ( = 1.). To determine the historical point of our inquiry, we will then outline the recent discussion on urban history ( = 2.). Upon this ground, we shall discuss cities as a special expression of community, the sciences of health as a special type of medicine, and the modern industrial living conditions with regard to the recent socio-historical and medico-historical literature published since 1980 ( = 3.).

Community Health Services↗
PubMed2001

Theory-practice integration in selected clinical situations.

The current changes in health care systems challenge knowledgeable, mature and independent practitioners to integrate theoretical content with practice. The aim of this study was to investigate the problems of integrating theory with practice in selected clinical nursing situations. The study focused on rendering of family planning services to clients as a component of Community Nursing Science. Structured observation schedules were used to observe the theoretical content of the curriculum as well as the practical application of what has been taught in the clinical area. The findings of the study revealed that there was a need for an integrated holistic curriculum, which would address the needs of the community. It was concluded that a problem-based and community-based curriculum, intersectoral collaboration between college and hospital managements and student involvement in all processes of teaching and learning would improve the integration of theory and practice. There also appeared to be a need for tutors to be more involved in clinical teaching and accompaniment.

Community Health Nursing↗
PubMed2001

Can there be a meaningful participation of Croat expatriates in Croatian science?

The author discusses the possible role for Croat expatriate scientific community in Croatian science. He argues that proper leadership could engage Croatian expatriate scientific community in supporting the foundation of a multidisciplinary science institute in Split, Croatia. The institute could play a key role in regional economic development focused on health, energy, and environment. Establishment and maintenance of a program of such magnitude requires a diminished and more flexible role of the government and introduction of the private sector in a government-private partnership. Development of necessary attitudes and economic base will take time.

Croatia↗
PubMed1984

The Life Sciences Programme of the European Space Agency, and opportunities for radiation biology experiments.

With the advent of Europe's commitment to contribute the European Space Agency (ESA) to the NASA Space Transportation System (STS) by means of the Spacelab programme, a new area for research opportunities on Life Sciences has been created for the European scientific community. Although considered as a young and new discipline, the goals of Life Sciences research in space had soon been defined by the ESA advising Life Sciences Working Group in the beginning of 1977. The programme proposals of the various subdisciplines concentrated on the advantageous use of the microgravity environment, to study in more depth the gravity relevance of biological systems. It included, however, also the use of other factors during space flight which cannot be reproduced or adequately simulated on the ground: cosmic radiation in its total spectrum, particularly HZE particles, solar and UV radiation, vacuum, and the combination of radiation and weightlessness, etc. On this basis, call for proposals in the various subdisciplines resulted in experiments also in the field of radiation biology which were flown on the Spacelab 1 mission and which were selected for later missions. In particular, ESA is providing the science community with mission opportunities on Spacelab, either European or International, with platforms to be launched by STS, and with so called multi-user facilities (e.g. Biorack). Typically, the experiments will be the responsibility of the scientists, the integration and mission phase the responsibility of ESA. Both mission definition and experiment selection rests with the ultimate decision of the responsible ESA Programme Board. A further description of missions envisioned, the Spacelab facility, platforms, multi-user facilities and areas of research applicable to radiobiology will be given. ESA's continuing interaction with the scientific community through the Life Sciences Working Group, and the advice on future programmes will be stressed as a vital factor contributing to a European Life Sciences Programme in Space.

Adaptation, Physiological↗
PubMed1995

Network is a verb. The experience of the network of community-oriented educational institutions for health sciences.

The process of networking has great potential for facilitating and accelerating global health development. This article presents some of the experiences of the Network of Community-Oriented Educational Institutions for Health Sciences. Three components are identified, each of which is illustrated by a specific Network activity: (1) tasks and projects, (2) information and communications technology, (3) people and institutions--the human factor. Some important lessons have been learned. Because people are the key to successful networking, there is a need to strengthen the research about how networks function. Encouraging progress is being made toward more effective global collaboration.

Community Health Services↗