Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Community Relations”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 307 records · Page 17Linked to original sources
PubMed1993

Bone marrow transplant for sickle cell disease--the dilemma.

Sickle cell disease is the family of clinically significant haemoglobin disorders which have in common the inheritance of the sickle beta haemoglobin chain gene. The homozygous SS condition, also known as sickle cell anaemia, can present a varied clinical picture from asymptomatic through to frequent painful vaso-occlusive crises and even death as a result of complications of the disease. S beta zero thalassaemia and the rate haemoglobin SD disease present a similar picture to SS, while S beta plus thalassaemia and haemoglobin SC disease generally have milder clinical features than SS and present somewhat later in life. The present debate about bone marrow transplant (BMT) for sickle cell disease, among both physicians and community, relates to SS patients, definition and markers of disease severity, the effect of BMT on sickle related organ damage, the efficacy of BMT for SS, and its complications, both early and long-term.

Africa↗
PubMed1992

A multicomponent model for substance abuse treatment. The Addiction Research and Treatment Corporation.

This paper reviews the activities of the Addiction Research and Treatment Corporation (ARTC), a substance abuse treatment agency, located in Brooklyn, New York, which services approximately 2,300 patients annually. ARTC's history, treatment, and research activities are first described. We then proceed to detail the ARTC's employee health maintenance and community relations programs. A multicomponent treatment model is then outlined, which emphasizes the interactive role of the above functions within an optimal treatment network.

Female↗
PubMed2006

Policy and practice in Myanmar's protected area system.

Myanmar's protected area (PA) system began nearly 150 years ago under royal patronage. Park policies and practices, embodied in 19 pieces of legislation developed sporadically during and after the colonial period. As a result of the FAO-UNDP's Nature Conservation and National Parks Project (1981-1985) the government established the Nature & Wildlife Conservation Division and placed it within the Forest Department as the agency responsible for PA management. As a consequence the number of parks increased from 14 to 33. Myanmar's median park size is less than 50 km(2), but only five parks (15%) are larger than 1000 km(2). Most parks conserve terrestrial habitats; parks encompassing inland wetlands, mangrove, and marine habitats are limited in number and size. Existing PAs unequally represent Myanmar's ecosystems; the Malay Transition, Burmese coast, Burmese Transition and Cardamom Mountains bio-units are under-represented within the system. The effective total PA size (i.e., area of all parks less the area of 13 paper parks) is currently about 2.1%. Budgetary support for parks increased 11% since 1996, but is insufficient to address park needs, particularly in remote parks that are understaffed. Limited education and training of PA staff is a major factor limiting effective park management. Fifty-eight percent of park wardens are educated as foresters, and 42% have university degrees. The average posting in a park is 4 years, which is less than ideal for management continuity. Recommended actions to secure Myanmar's PAs include evaluation and reformulation of policies, increasing representation of Myanmar's habitats within the PA system, management planning, and standardizing protocols for anti-poaching patrols and other forms of law enforcement. Improved leadership training for wardens and range forest officers can also improve park management. Funding for community relations and more integrated management of parks and people can reduce conflicts, while environmental education and outreach activities can provide some needed services. Finally, new ways and means are needed to support these activities. Myanmar's PAs need creative and sustainable means of support, including partnerships with non-government organizations to supplement traditional means of support.

Animals↗
PubMed2006

The current burden of pneumococcal disease in England and Wales.

OBJECTIVE: To evaluate the potential impact of various pneumococcal conjugate vaccination strategies, it is critical to ascertain the pre-vaccination epidemiology and to have a detailed evaluation of the current burden of pneumococcal disease. METHOD: A variety of national data sources and GP sentinel surveillance systems were used to estimate the incidence, number of hospital admissions, deaths, and GP consultations due to pneumococcal disease in England and Wales. Clinical outcomes included pneumococcal meningitis, bacteraemia, pneumonia and otitis media. A statistical model was used to attribute GP consultation recorded as pneumonia and acute otitis media to specific aetiological causes when these were not recorded. RESULTS: The burden of pneumococcal disease is considerable, with incidence rates of both invasive and non-invasive disease peaking in children (<5 years) and in the elderly (75+ years). Around 5800 hospitalisations specifically mentioning Streptococcus pneumoniae are estimated to occur annually in England and Wales, almost 40,000 for lobar pneumonia and over 15,000 for otitis media. There may be an additional 70,000 GP consultations for pneumococcal related community acquire pneumonia and over 630,000 for otitis media. A significant proportion of hospitalisations and GP consultations for pneumococcal disease occur among high-risk groups, with over 80% of hospital admissions reporting more than one diagnosis.

Adolescent↗
PubMed2005

Trust and health worker performance: exploring a conceptual framework using South African evidence.

Two relationships of particular importance to health care provision are those between patient and provider, and health worker and employer. This paper presents an analytical framework that establishes the key dimensions of trust within these relationships, and suggests how they may combine in influencing health system responsiveness. The paper then explores the relevance of the framework by using it to analyse case studies of primary care providers in South Africa. The analysis suggests that respectful treatment is the central demand of primary care service users, in terms of positive attitudes/behaviours, thoroughness, and technical competence, as well as institutions that support fair treatment. It is argued that such treatment is necessary for, and integral to, patient-provider trust. The findings also suggest that the notion of workplace trust (combining trust in colleagues, supervisor and employing organisation) has relevance to provider experiences of their workplaces, and so can provide important insights for strengthening management. Nonetheless, given the limitations of this preliminary analysis, further research is needed to develop the notion of workplace trust and to test what role it has, along with that of provider-community relations, in influencing health worker performance.

Efficiency↗
PubMed2003

Cyanobacterial postgenomic research and systems biology.

The genomic era brought with it the capacity to unlock complex interactions in organisms and biological systems. Currently, by exploiting genomic and associated protein information through in silico analyses, postgenomic research is developing rapidly. This field, which encompasses functional genomics, structural genomics, transcriptomics, pharmacogenomics, proteomics and metabolomics, allows for a systems-wide approach to biological studies. To date, bacterial postgenomic research has focused mainly on a few representative pathogenic species, leaving the vast majority of the microbial community relatively overlooked. Amongst the under-represented microorganisms are the cyanobacteria, which are important for their beneficial natural product production, bioremediation and energy applications. Here, we highlight the current status of cyanobacterial postgenomic research and assess the potential for future metabolic engineering and "cell factory" or "microbial cell" development.

Biotechnology↗
PubMed2003

Physical violence, intimate partner violence, and emotional abuse among adult American Indian men and women in Montana.

BACKGROUND: Little is known about the experience of American Indian communities relative to physical violence (PV), intimate partner violence (IPV), and emotional abuse. METHODS: A random sample of adult American Indians living on or near the seven Montana reservations were interviewed through an adapted Behavioral Risk Factor Surveillance System telephone survey in 2001 (N = 1,006). Victimization from physical violence was defined as PV or sexual assault committed by any person. Respondents who reported experiencing PV and who reported that the perpetrator was a current or former spouse, boyfriend, girlfriend, or date were categorized as experiencing IPV. Emotional abuse was defined as fear for one's safety or being controlled by another individual. RESULTS: Nine, one, and twelve percent of men reported experiencing PV, IPV, and emotional abuse in the past year, respectively. Five percent of women reported PV in the past year, 3% reported IPV, and 18% reported emotional abuse. Men who reported PV in the past year were more likely to be younger and report more days of physical and mental health problems in the past month. Women reporting PV in the past year were more likely to be younger and have more days with mental health problems in the past month. Few men (7%) or women (12%) reported ever being assessed for PV or safety. CONCLUSIONS: Recent PV, IPV, and emotional abuse are prevalent for both American Indian men and women. Strategies to increase screening for PV and effective interventions for violence are needed.

Adult↗
PubMed1982

Cost-effectiveness in eyebanking.

The current operating budget for American eyebanks is more than $5 million per year, and an increasing portion of this expense is being paid by third-party payers. American eyebanks were surveyed to determine what a reasonable cost per transplant tissue might be and to see if recommendations could be made that would help optimize cost-effectiveness in American eyebanking. Most well-run eyebanks needed between $222 to $464 to process each donor cornea for transplantation. This cost-effective goal was most often met if the bank provided at least 150 corneas annually and if there was a full-time professional staff using modern tissue preservation techniques. An eyebank unable to meet these goals should consider obtaining its tissue from the nearest cost-effective eyebank, allowing the redirection of charitable contributions to other more cost-effective eye care-related community activities.

Computers↗
PubMed1997

What is the normal pattern of uterine involution? An investigation of postpartum uterine involution measured by the distance between the symphysis pubis and the uterine fundus using a paper tape measure.

OBJECTIVE: To describe normal postnatal uterine involution in a small sample of healthy primiparous women, and estimate the proportion who have a decline in the distance between the symphysis pubis and the uterine fundus (S-FD) slow enough to have the potentiality to trigger further clinical action, using currently accepted criteria for intervention. SETTING: A maternity unit in the south of England that has approximately 6000 deliveries per annum and the related community areas. METHODS: Daily measurement of the S-FD was carried out in 28 healthy women from within 18 hours of delivery until the uterine fundus was no longer palpable abdominally. Graphs showing the daily measurements and correlation coefficients were used to describe involution. The proportion of healthy women who would have been identified as healthy by the screening method was estimated (its specificity). FINDINGS: Considerable variability was found in the pattern of uterine involution that was experienced by the women who had a normal puerperium. The measurement of the S-FD has a low specificity with only 6 of the 28 women (21.4%; 95% CI 8.3% to 40.9% having had no episodes of the S-FD declining slowly (less than 1 cm over three days). There was a weak, positive correlation between the S-FD measurement on day one and the day on which the uterus ceased to be palpable (r = 0.426, P = 0.03). No relationship was found between method of baby feeding and the day on which the uterus ceased to be palpable. IMPLICATIONS FOR PRACTICE: The measurement of S-FD using a paper tape measure should not form part of routine postpartum assessment.

Adolescent↗
PubMed2002

The roles and relationships of psychiatrists and other service providers in mental health services.

OBJECTIVE: A number of the problems facing psychiatry are identified as having common origins in unresolved issues about teamwork. The aim is to identify the issues and to formulate recommendations for dealing with these obstacles. METHOD: The Royal Australian and New Zealand College of Psychiatrists Professional Liaison Committee (Australia) of the Board of Professional and Community Relations convened a number of meetings and discussions, with external assistance from JW and TT. RESULTS: Much of contemporary mental health care is delivered either directly or indirectly by several persons, often working in teams. Teamwork and collaboration are central to good working relationships and service delivery. Effective teamwork and collaboration is supported by key elements including agreed goals, an agreed approach, effective communication styles, established ground rules, clear team roles, and competent leadership. The obstacles to effective teamwork and collaboration are discussed in terms of the following: ambiguity and conflict over roles; conflict and confusion over leadership; differing understandings of clinical responsibility and accountability; interprofessional misperceptions; and differing rewards between the professions. CONCLUSIONS: Developing an understanding of these issues opens the way to a series of recommendations in relation to education, professional organizations, and workplaces and government, which can be considered by a number of sectors and groups.

Continuity of Patient Care↗
PubMed2003

Shortages of rural mental health professionals.

This study presents a conceptual model of the supply and demand for mental health professionals. It uses national data to profile differences in the supply of mental health professionals in different types of rural and urban areas. It contrasts the availability of general health and mental health professionals. It examines shortage areas identified in 2000 and their related community characteristics. Because of the absence of data on a national level to describe many types of mental health professionals state licensure data for one state were used to show the volume and distribution of these practitioners. To improve rural mental health service delivery it will be necessary to implement system changes to promote the increased availability, competency, and support of rural health professionals.

Health Services Accessibility↗
PubMed1998

Societal and personal costs of obesity.

The economic costs of obesity can be broken down into three levels: 1. DIRECT COSTS: Costs to the community, related to the diversion of resources to the diagnosis and treatment of diseases directly related to obesity, as well as the treatment of obesity itself. These costs have been estimated to vary between 1-5% of total healthcare costs for various countries. Usually, the cost of obesity alone has been calculated, although it is known that the costs associated with being overweight [body mass index (BMI) 25-30 kg/m2] are also substantial because of the large proportion of individuals involved. These constitute costs to the health service (visits to general practitioners, consultations with medical specialists, hospital admissions and medication). 2. SOCIETAL OR INDIRECT COSTS: These costs are related to the loss of productivity caused by absenteeism, disability pensions and premature death. There is a lack of good economic analysis on this subject, although research from Sweden, Finland and the Netherlands has clearly shown that obesity is associated with increased sick leave and disability pensions. 3. PERSONAL COSTS: Obese subjects may earn less than their lean counterparts because of job discrimination (related to the stigma associated with obesity, or due to diseases and disabilities caused by obesity). Many insurance companies (particularly life insurance) charge higher premiums with increasing degrees of overweight. Obesity is further related to poor physical functioning and limitations in daily life. Some of these require assistance or adaptations which may be costly for an individual. In conclusion, there is much indirect information that obesity and overweight contribute substantially to healthcare-related costs. Data on aspects such as societal costs and personal costs are too fragmentary to allow calculation of the expenses involved. An appropriate analysis of all costs associated with obesity is important in order to persuade responsible bodies to develop strategies towards the prevention and long-term management of obesity.

Absenteeism↗
PubMed2000

[Self-assessment by patients of impairment caused by obstructive sleep apnea syndrome].

BACKGROUND AND OBJECTIVE: The compliance of the nasal continuous positive airway pressure treatment (nCPAP) of the obstructive sleep apnea syndrome (OSAS) depends on the patients' awareness and improvement of the symptoms. Therefore, we studied the relevance of OSAS in different aspects of the quality of life and important aspects of daily life (driving performance, working place). METHODS: 352 patients with OSAS filled in a questionnaire of sociodemographic data and impairment of quality of life. The relevance of OSAS was evaluated with polysomnography and parameters of daytime sleepiness. RESULTS: The number of women was lower than expected from community related data. The apnea/hypopnea index was 29.9 +/- 23.4/h at baseline measurement and was reduced to 8.8 +/- 9.6/h with nCPAP (p < 0.001). The arousal index (baseline 26.6 +/- 15.3/h) fell with treatment significantly (17.7 +/- 9.2 Arousals/h, p < 0.001). The error rate in the driving simulator test was 7.8 +/- 8.9% (normal value 5.75 +/- 1.4). It was normalised with nCPAP (5.8 +/- 9.5, p < 0.001). 42.3% of patients reported about sleep apnea related symptoms for more than five years before diagnosis. The patients rated their physical fitness on a scale (0 to 6) at 2.9 +/- 1.3. It increased significantly with treatment to 3.4 +/- 1.3 an (p < 0.001). The mental activity improved significantly, too. The daytime sleepiness improved from 3.4 +/- 1.5 to 3.1 +/- 1.5 (p < 0.001). 32.3% of the patients reported that they fell asleep while steering at least once in the last month, 13.0% reported about more than five episodes/month. 5.3% of the patients thought their job in danger because of OSAS. 65.1% felt their performance in job to be impaired. CONCLUSION: OSAS impairs patients in different aspects of daily life, especially in the working place. The latency between the onset of symptoms and diagnosis is longer than expected. NCPAP treatment improves the symptoms of OSAS significantly both in criteria of polysomnography and self-assessment of the patients.

Activities of Daily Living↗
PubMed2001

Breastfeeding determinants and a suggested framework for action in Europe.

This is a background paper for the EURODIET initiative. A number of international initiatives and documents were identified, such as the Baby-Friendly Hospital Initiative, the International Code of Marketing of Breast Milk Substitutes and a number of consensus reports from professional groups, that propose ways forward for breastfeeding promotion. These point at a range of initiatives on different levels. The determinants for successful breastfeeding have to be identified. They can be categorised into five groups; socio-demographic, psycho-social, health care related, community- and policy attributes. A framework for future breastfeeding promoting efforts on European level is suggested, within which these determinants are considered. A common surveillance system needs to be built in Europe, where determinants of breastfeeding are included. There is also a need for a surveillance system which makes it possible to use the collected data on local level, not only on national and supranational level. Combined with a thorough review of the effectiveness of already existing breastfeeding promotion programmes, a co-ordinated EU-EFTA action plan on breastfeeding should be formulated and implemented within a few years. Urgent action could take place in parallel, especially targeting young, low-income, less educated mothers.

Breast Feeding↗
PubMed2004

Canadian Total Diet Study in 1998: pesticide levels in foods from Whitehorse, Yukon, Canada, and corresponding dietary intake estimates.

The Canadian Total Diet Study is a national survey to determine the level of chemical contaminants in the Canadian food supply. Food samples were collected from Whitehorse, Yukon, supermarkets as part of the study in 1998. Whitehorse was chosen as a sampling centre, despite its small population (n = 19,000), to determine if residue levels were different in foods available in northern communities relative to levels observed in previous studies in the more populated south. Foods were prepared as for consumption before pesticide residue analysis. Residue levels observed in most foods were similar to levels observed in samples from previous surveys from southern Canadian cities. Malathion and DDE (1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene), a transformation product of DDT (1,1,1-trichloro-2,2-bis(p-chlorophenyl(ethane), were the two most frequently detected compounds (26.4 and 25.8%, respectively). The majority of pesticides, however, had a detection frequency of < 5%. In general, pesticides in food composites were well below maximum residue limits established in the Canadian Food and Drug Regulations. Chlorpropham and captan had the highest dietary intakes (2.16 and 1.94 micrograms (kg body weight-day)-1, respectively), based on the results from Whitehorse. No dietary intakes above the acceptable daily intakes, however, were observed for any of the 39 pesticides investigated in any age-sex category, where an acceptable daily intake has been proposed.

Adolescent↗
PubMedDate not supplied

Levo-alpha-acetylmethadol (LAAM): clinical, research, and policy issues of a new pharmacotherapy for opioid addiction.

A number of issues are relevant to the development and use of levo-alpha-acetylmethadol (LAAM) as a treatment alternative to methadone. A brief history of methadone maintenance treatment is provided and variants of standard methadone treatment are discussed. The history and current status of LAAm are discussed, as well as its advantages over methadone. In addition, relevant clinical, research, and policy issues are addressed. LAAm has advantages over methadone specifically with regard to thrice-weekly dosing, potential to reduce HIV/AIDS risk, possible cost savings, and possible improved clinic-community relations. The effective and cost-effective implementation of LAAM as a new treatment for opioid addiction requires attention to a number of issues: (1) LAAM as an HIV prevention measure through its potential risk-reduction effects, (2) the sue of LAAM with specific high-risk subgroups, (3) causes of differential rates of treatment dropout and their amenability to intervention, (4) the role fo patient choice in long-term maintenance treatment, (5) the impact of LAAM on clinic operations, (6) the potential for LAAM as a take-home medication, and (7) the costs of implementing and sustaining LAAM maintenance services.

Heroin Dependence↗
PubMed2006

Factors associated with teachers' implementation of HIV/AIDS education in secondary schools in Cape Town, South Africa.

This study investigated the factors influencing whether high school teachers implemented HIV/AIDS education. The independent variables included constructs derived from expectancy value theories, teachers' generic dispositions, their training experience, characteristics of their interactive context and the school climate. We conducted a postal survey of 579 teachers responsible for AIDS education in all 193 public high schools in Cape Town. Questionnaires were completed and returned by 324 teachers (56% response rate) from 125 schools. Many teachers (222; 70%) had implemented HIV/AIDS education during 2003, and female teachers were more likely to have implemented than males (74% vs. 58%). The teacher characteristics associated with teaching HIV/AIDS were previous training, self-efficacy, student-centeredness, beliefs about controllability and the outcome of HIV/AIDS education, and their responsibility. The existence of a school HIV/AIDS policy, a climate of equity and fairness, and good school-community relations were the school characteristics associated with teaching HIV/AIDS. These findings demonstrate the value of teacher training and school policy formulation. They also demonstrate the value and importance of interventions that go beyond a sexual health agenda, focussing on broader school development to improve school functioning and school climate.

Adult↗
PubMed1991

Evaluation of a mass-media-led campaign to increase Pap smear screening.

A health education campaign designed to encourage women between the ages of 18 and 70, especially 'older' women (defined as those 50 and over), to have a Pap smear took place in New South Wales (NSW), Australia in early 1988. The campaign involved the mass media, some related community activities and mailing of an educational package to all General Practitioners. According to a sample survey the media campaign was recalled by just over 40% of its target audience. Outcome evaluation was based on the analysis of Pap smear records for a representative 10% sample (N = 338 000) of women registered with the Australian universal health insurance scheme in NSW and three control States. From logistic regression models we estimate that, for women over 50 years and older in NSW, there was a 30% increase overall in Pap smears during the 4 months following the campaign and a 50% increase amongst those who had not had a smear in the previous 2 years. Smaller increases were observed in some other States. Increases of 13-20% were observed among the younger age groups in NSW. Although the campaign appears to have prompted short-term increases in screening rates, the effect is too small to make a substantial impact on the size of the under-screened population.

Adolescent↗