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PubMed2005

[Study on actual situation of community industrial physicians for small and medium-sized enterprises and their involvement in community occupational health services].

The subjects of this study were 405 Japan Medical Association authorized industrial physicians, Community Industrial Physicians (CIPs), who belonged to the Shinjuku, Nakano, and Suginami Words' regional medical associations in the jurisdiction of the Shinjuku Labor Standards Inspection Office. Between November and December, 2003, the CIPs were mailed a questionnaire requesting information about their affiliations and activities, and as indicators of their willingness to participate in Community Occupational Health Services, they were asked about the pros and cons of having their names published as Industrial Physicians, and/or practitioners for Regional Occupational Health Centers, or Regular Health Checks. 152 replies were received, effective response rate of 37.5%, and among these 94 replies were from CIPs who work as part-time industrial physician. Overall, CIPs attend Community Occupational Health Services (COHS) voluntarily, and wish to participate in them more in the future. CIPs who work as part-time industrial physician have knowledge of working safety and hygiene and are providing advice and guidance on working conditions and environments. Also, they are well informed about support services for small and medium-sized enterprises which is thought to be connected with their willingness to participate in COHS. Furthermore, it is important that part-time CIPs activities are appreciated by their respective place of work.

Adult↗
PubMed2005

A community-based intervention designed to increase preventive health care seeking among adolescents: the Gonorrhea Community Action Project.

OBJECTIVES: We evaluated the effectiveness of an intervention designed to increase preventive health care seeking among adolescents. METHODS: Adolescents and young adults aged 12 to 21 years, recruited from community-based organizations in 2 different communities, were randomized into either a 3-session intervention or a control condition. We estimated outcomes from 3-month follow-up data using logistic and ordinary least squares regression. RESULTS: Female intervention participants were significantly more likely than female control participants to have scheduled a health care appointment (odds ratio [OR]=3.04), undergone a checkup (OR=2.87), and discussed with friends or family members the importance of undergoing a checkup (OR=4.5). There were no differences between male intervention and male control participants in terms of outcomes. CONCLUSIONS: This theory-driven, community-based group intervention significantly increased preventive health care seeking among female adolescents. Further research is needed, however, to identify interventions that will produce successful outcomes among male adolescents.

Adolescent↗
PubMed2006

Community-based participatory research: conducting a formative assessment of factors that influence youth wellness in the Hualapai community.

OBJECTIVES: Using a community-based participatory research approach, a tribe-university team conducted a formative assessment of local factors that influence youth wellness to guide the design of a culturally and locally relevant health promotion program. METHODS: Open-ended interviews with key informants, a school self-assessment using the Centers for Disease Control's School Health Index, and a locally generated environmental inventory provided data that were triangulated to yield a composite of influential factors and perceived need within the community. RESULTS: Family involvement and personal goal setting were identified as key to youth wellness. Supportive programs were described as having consistent adult leadership, structured activities, and a positive local and regional image. Availability of illicit drugs and alcohol, poor teacher attitude, and lack of adult involvement were significant negative factors that impact youth behavior. CONCLUSIONS: Local/native (emic) and university/nonnative (etic) perspectives and abilities can be combined to yield a culturally relevant formative assessment that is useful to public health planning. In this collaborative effort, standard means of data collection and analysis were modified in some cases to enhance and build upon the knowledge and skills of community researchers.

Adolescent↗
PubMed2000

Possible community immunity to small round structured virus gastroenteritis in a rural aboriginal community.

In April 1998 an outbreak of gastroenteritis affected visitors, but none of the Aboriginal residents, at a Territory Health Services luncheon in a rural Aboriginal community in Central Australia. The epidemiological features and identification of Small Round Structured Virus (SRSV) from two participants suggest that this was an outbreak caused by a SRSV. The attack rate in the visitors who ate or drank food at the luncheon was 73% (11 of 15). Seventeen Aboriginal residents were interviewed, none had gastroenteritis. The community potable water supply was contaminated with faecal bacteria around the time of the outbreak. No particular food could be implicated and laboratory examination of foods was not possible. It is proposed that past exposure to SRSVs may have resulted in the Aboriginal residents developing clinical immunity to infection. The process and consequences of the investigation in this community are also discussed.

Adult↗
PubMed2006

Student and community outcomes in service-learning: part 2--community outcomes.

This article is the second of a two-part series reporting outcomes from a service-learning program implemented in a bachelor of science in nursing program. Part 1 (on pages 512-515) described students' perceptions of outcomes realized from the program, and Part 2 describes the community outcomes. The purposes of the program were to provide students with history-taking, blood pressure, and heart rate assessment skills, and beginning counseling skills, as well as to provide the university community with blood pressure screening and counseling in a convenient and accessible location. Data on community outcomes were collected on a continual basis during the hypertension screening and counseling program implementation. Clients were anonymously surveyed on health behavior actions taken after their screening and on the screening process. More than 700 client screenings were performed over 2 years, with positive health behavior changes being reported by clients.

Clinical Clerkship↗
PubMedDate not supplied

Cancer prevention in the community: a survey of community residents.

Lifestyle exposures account for the greatest proportion of risk factors for cancer, yet these exposures have proven most difficult to alter. Despite intensive intervention efforts, many behaviour change programs are ill suited to the community. This research was undertaken to increase our understanding of prevention activities of interest to a sample of residents in two Ontario communities. 248 (62.3%) adult residents responded to a semi-structured self-administered questionnaire including open-ended questions on health issues, exposures and prevention activities of interest. While some of the beliefs expressed by respondents might have been anticipated (e.g., cigarette smoking and family history increase risk of cancer), others were not (e.g., only between 40 and 75% of respondents thought a high fat diet increased risk). Furthermore, many of those with personal health concerns expressed an interest in prevention. This process is proposed as a first step in launching more appropriate and sustainable community-based health promotion programs for cancer prevention.

Adult↗
PubMed1975

Education in community medicine with an emphasis on the health of an Aboriginal community: a pilot project.

An outline is given of a pilot project to introduce medical students to the broad concept of community medical practice with the emphasis on a rural Aboriginal community. The subjective experiences of the students are recorded and discussed. It is suggested that similar projects are essential to give balance to the bias of hospital training of medical students and to attract doctors to this discipline. The main advantages of such a scheme are that it broadens the perspective of the medical student, widens his potential choice of career, and gives him insight into the medical needs of a socioeconomically deprived group and into the wider role that a doctor can play in the health of the community.

Attitude of Health Personnel↗
PubMed2005

The Community Physicians' Network (CPN): an academic-community partnership to eliminate healthcare disparities.

INTRODUCTION: Disparities in health care are maintained by three primary factors: 1) patient factors which include multiple risk factors and comorbidities; 2) healthcare practitioner factors comprising inconsistent application of practice guidelines due to a limited database of clinical trials of effective therapies in African Americans and other underrepresented minorities; and 3) barriers in the healthcare delivery system resulting in poor access to care. The Morehouse School of Medicine Community Physicians' Network (CPN) was established to address disparities in health care by focusing on provider-specific strategies. OBJECTIVES: To: 1) use disease-specific registries to identify treatment gaps and facilitate quality improvement processes among CPN practices; 2) develop practice-specific and guideline-based educational messages to promote quality care; 3) engage and train CPN-physicians for participation in approved NIH, other government, and industry-supported clinical protocols; and 4) develop a data repository of all CPN-sponsored clinical trials that include significant numbers of African Americans and other underrepresented minorities. METHODS: The disease-specific outpatient registries will have the following features: 1) data structures and data elements will use standard database codes and a data dictionary; 2) HIPPA-compliant data abstraction and data transfer tool; 3) baseline chart review to establish practice patterns and provide practice-specific feedback; 4) annual update of registry; 5) data registry and repository maintained on Morehouse School of Medicine's secure servers; 6) registry publications will include only aggregate data, without identification of contributing practices; 7) an electronic medical records platform will be encouraged as the ultimate data management tool for CPN practices. In addition, up to three continuing medical education (CME) programs each year will feature national speakers and promote evidence-based practice guidelines. RESULTS: Eighty-five primary care and subspecialty practices are actively enrolled in CPN with a total of 385,000 annual outpatient visits. The makeup of insurance status is: HMO/PPO (45%); Medicare only (19%); Medicare HMO (11%); Medicare plus (8%); Medicaid (6%); Uninsured (11%). CONCLUSIONS: The Community Physicians' Network will address specific gaps in the health care of African-American and other minority patients by promoting quality care among its members and by facilitating participation in approved clinical trial protocols. The unique academic community partnership is consistent with the NIH roadmap goal of eliminating healthcare disparities.

Black or African American↗
PubMed1990

[Geriatric psychiatry in the regimen of community psychiatry. 1. Community psychiatric services for patients living at home].

On 1.1.1988 three community psychiatric teams were established in the gerontopsychiatric fields under the Copenhagen County Hospital, Nordvang. The objects were to supervise and treat patients over the age of 65 in their own homes or in nursing homes. This article is an account of the functions of two teams concerning patients living in their own homes during the period 1st January to 31st December 1988. A total of 125 patients were referred and 31 were admitted, five of these because of lack of nursing home beds. Women and persons living alone were most frequently involved. On the initiative of the teams, it proved possible to obtain increased covering by measures in the primary community in various fields. The frequency of psychopharmacological treatment was high and this was in agreement with the observation that 33% were psychotic and that many demented patients presented secondary psychiatric symptoms requiring treatment. It is concluded that it was possible to treat these patients in their own homes to a great extent, that the psychiatric service for elderly persons is improved and that cooperation between the hospital, referring general practitioner and the primary community had increased.

Aged↗
PubMed1986

Symposium on surgical manpower in the smaller community. The Canadian Association of General Surgeons and the community surgeon.

The relationship between the Canadian Association of General Surgeons and the community surgeon is a symbiotic one. Despite the controversy about medical costs and the oversupply of physicians, there is and will continue to be an increased need for general surgeons in Canada. Highly trained general surgeons are needed in medium-sized and smaller communities where the bulk of general surgery is done. The Canadian Association of General Surgeons sponsors research in education that will affect surgical knowledge and the training and future of community surgeons.

Canada↗
PubMed1984

Correlates of community opposition to community residences for mentally retarded persons.

A sample of 43 community residences was studied in order to examine the correlates of community opposition. Residence that conducted public education were significantly more likely to encounter opposition than were residences that did not. The point in the development of the residence at which the community became aware of the existence of the facility was also found to be related to the extent of opposition encountered. Implications for policy and practice were discussed.

Adult↗
PubMed1983

An alternative strategy in community health care: community-oriented primary health care.

The need for alternative strategies in providing personal health services in the community is discussed in relation to Israel, which has a widespread network of community-based curative clinics and preventive family health centers. Community-oriented primary health care (C-OPHC) is the major alternative strategy, which has been developed and evaluated by the Hadassah Teaching and Research Health Center in Kiryat Hayovel, a neighborhood of Jerusalem. The case for adapting this C-OPHC approach throughout the country is presented in a review of existing primary health care services.

Child↗
PubMed1980

A community programme for rehabilitation and secondary prevention for patients with acute myocardial infarction as part of a comprehensive community programme for control of cardiovascular diseases (North Karelia Project).

The comprehensive community programme for the control of cardiovascular diseases in North Karelia includes a special subprogramme for the rehabilitation and secondary prevention among patients with an acute myocardial infarction (AMI). The target group of the programme were persons under the age of 65 who had an AMI according to the community-based AMI register and had survived the acute phase of the disease. The programme consisted of systematic long-term medical follow-up at an outpatient MI clinic and of decentralized local group-rehabilitation with special emphasis on secondary prevention. The main component of the programme were health education and submaximal physical exercise, aiming at the reduction of the known secondary risk factors and the improvement of the general well-being of the patients. The feasibility of this programme was good. During the five-year period from 1973 to 1977 a total of 1308 persons under the age of 65 survived an AMI. Out of these patients 515 visited the outpatient MI clinic and 575 took part in the rehabilitation groups. The participation rate in the rehabilitation groups in the whole community increased during the period from 24% to 63%. During the programme period there was a reduction in incidence of recurrent infarctions and new vocational invalidity pensions among the patients with AMI.

Adult↗
PubMed1994

Community based education in speech pathology and audiology at the University of Durban-Westville in an under served community.

In South Africa there is increasing awareness both in academic and clinical domains of the inadequacy of education and training of health personnel, in preparing graduates to meet the service needs of the disadvantaged majority. A feasibility study is reported in which the regular curriculum of final year speech, language therapy/audiology students was adapted to provide a more relevant, more appropriate learning experience. This comprised a community based action research programme in a Zulu peri-rural community. A qualitative critical analysis of the project is presented, in an attempt to identify factors that could be likely to hinder and promote the greatly needed process of curriculum transformation within the university; and in the process of strengthening the role that the university can play in meeting the needs of the community it serves.

Audiology↗
PubMed1996

Community-level prevention of human immunodeficiency virus infection among high-risk populations: the AIDS Community Demonstration Projects.

The AIDS Community Demonstration Projects (ACDPs) were community-level human immunodeficiency virus-prevention programs targeting high-risk populations in five U.S. cities. For the intervention design, researchers developed a common study protocol based on behavior-change theories and models. This report describes the common study protocol used in the ACDPs, the preliminary findings, and the conclusions regarding the design, implementation, and evaluation of a community-level intervention; specific case studies from each project site are also described.

Clinical Protocols↗
PubMedDate not supplied

A community health report card: comprehensive assessment for tracking community health (CATCH).

A systematic method for assessing the health status of communities has been under development at the University of South Florida since 1991. The system, known as CATCH, draws 226 indicators from multiple sources and uses an innovative comparative framework and weighted evaluation criteria to produce a rank-ordered community problem list. The CATCH results from II Floridian counties have focused attention on high priority health problems and provided a framework for measuring the impact of health expenditures on community health status outcomes. The method and plans to create an automated data warehouse to support its expansion and enrichment are described.

Community Health Planning↗
PubMed1998

[Prognostic factors and etiology in patients with severe community-acquired pneumonia admitted at the ICU. Spanish multicenter study. Study Group on Severe Community-Acquired Pneumonia in Spain].

OBJECTIVE: To determine the techniques used for the etiological diagnosis of community-acquired pneumonia in patients admitted to the intensive care unit (ICU) and to describe the predominant causative organisms as well as prognostic factors of ICU mortality. PATIENTS AND METHODS: A total of 262 patients with community-acquired pneumonia admitted to 26 ICUs between 1 November of 1991 and 31 October of 1992 were included in a prospective, open, multicenter study. RESULTS: The diagnostic techniques most frequently used were blood culture (243 cases) and simple tracheal aspirate (166 cases). Simple tracheal aspirate (58.4%), bronchoalveolar lavage (47.7%), and protected-specimen brush (44.2%) were the techniques that showed the highest diagnostic reliability. In 220 cases, techniques considered of high diagnostic probability were employed. With the use of these procedures, the most frequent causative pathogens were Streptococcus pneumoniae (13.6%) and Legionella pneumophila (9.5%). In 100 cases (45.5%), no pathogen was isolated. A total of 88 patients (33.6%) died during the ICU stay. Predictive variables of poor outcome selected by means of a multivariate analysis were as follows: multisystemic failure (OR = 28.6; 95% CI: 12.8-65.1; p = 0.0001), APACHE II at the time of ICU admission (OR = 5.3; 95% CI: 2.5-11.3; p = 0.0001), progression and/or spread of lung infection (OR = 4.5; 95% CI: 2.4-8.4; p = 0.0001), and shock on admission (OR = 8.48; 95% CI: 4.5-15.9; p = 0.0001). CONCLUSIONS: In 45.5% of patients with community-acquired pneumonia admitted to ICU, no causative pathogen was identified. The prognosis of these patients was influenced by the severity of disease assessed by APACHE II score and presence of multisystemic failure and shock at the time of ICU admission.

Community-Acquired Infections↗
PubMed2003

[Home medical care network in the community supporting hospital--nursing consultant acting for community coordination].

Tama Nambu-Chiiki Hospital is a secondary medical institution providing the acute short-term care centered on cancer treatment and emergency medical service, which few other medical institutions in the region provide. The hospital, which has no system to directly support home medical care by house visit or visiting nurses, needs to coordinate home medical care with other community medical institutions. 2 nurses serve as the Nursing Consultants who provide consultation services over the issues related to home medical care and other issues face to face or by phone and coordinate home medical care with other community medical institutions. Medical coordination based on trust and understanding of home medical care by hospital staffs are essential for the smooth transfer to home medical care. Activities of the hospital are studied to cope with the changes in healthcare trend.

Community Health Nursing↗