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PubMed2007

Building little safe and civilized communities: community crime prevention with Chinese characteristics?

This article describes a community crime prevention program in China, set against a background of rapid economic development, large internal population migration, and increasing crime rates. Traditional social control in China has been transformed to adapt to the new reform era, yet some mechanisms remain intact. Crime prevention measures and strategies resemble those adopted in the West; however, the differences, constituting the so-called Chinese characteristics with community crime prevention are significant.

China↗
PubMed2002

Increasing breastfeeding initiation and duration at a community level: an evaluation of Sagkeeng First Nation's community health nurse and peer counselor programs.

The effectiveness of two Sagkeeng First Nation breastfeeding initiatives--prenatal instruction by a community health nurse and a postpartum peer counselor (PC) program for breastfeeding women--was evaluated at a community level through chart audits (1992 to 1997, n = 283). Breastfeeding initiation rates increased from 38% in 1995 to 60% in 1997 (OR = 2.2, 95% CI 1.2-4.1, P = .01, adjusted for birth weight and parity). PC clients were half as likely to wean (RR = 0.5, 95% CI 0.25-0.98, P = .04, adjusted for birth weight and parity), with 61% still breastfeeding at 2 months (vs 48% nonclients) and 56% at 6 months (vs 19%). PC clients had fewer problems (median 1 vs 2, P = .044) and greater satisfaction with breastfeeding (median 5 vs 4, P = .07). Qualitative interviews (n = 22) confirmed PC clients as more satisfied and more confident about breastfeeding, with fewer problems and more information.

Breast Feeding↗
PubMed2001

The European Community Respiratory Health Survey: what are the main results so far? European Community Respiratory Health Survey II.

The European Community Respiratory Health Survey (ECRHS) was the first study to assess the geographical variation in asthma and allergy in adults using the same instruments and definitions. The database of the ECRHS includes information from approximately 140,000 individuals from 22 countries. The aim of this review is to summarize the results of the ECRHS to date. The ECRHS has shown that there are large geographical differences in the prevalence of asthma, atopy and bronchial responsiveness, with high prevalence rates in English speaking countries and low prevalence rates in the Mediterranean region and Eastern Europe. Analyses of risk factors have highlighted the importance of occupational exposure for asthma in adulthood. The association between sensitization to individual allergens and bronchial responsiveness was strongest for indoor allergens (mite and cat). Analysis of treatment practices has confirmed that the treatment of asthma varies widely between countries and that asthma is often undertreated. In conclusion, the European Community Respiratory Health Survey has shown that the prevalence of asthma varies widely. The fact that the geographical pattern is consistent with the distribution of atopy and bronchial responsiveness supports the conclusion that the geographical variations in the prevalence of asthma are true and most likely due to environmental factors.

Asthma↗
PubMed1988

The practice of community psychiatric nursing and mental health social work in Salford. Some implications for community care.

The context and content of work undertaken with individual clients by community psychiatric nurses (CPNs) and mental health social workers (MHSWs) in Salford were found to be significantly different. Although there were some areas of overlap, the ways in which the two professions worked were quite distinct. MHSWs discussed a wide range of topics and were as concerned with clients' interactions with family and community networks as they were with symptoms. Their interviews with schizophrenic clients followed a similar pattern to those with other groups, and they worked closely with psychiatrists and other mental health staff. CPNs, on the other hand, focused mainly on psychiatric symptoms, treatment arrangements, and medications, and spent significantly less time with individual psychotic clients than they did with patients suffering from neuroses. They were as likely to be in contact with general practitioners as they were with psychiatrists, and had fewer contacts with other mental health staff than the MHSWs. There was evidence that the long-term care of chronic psychiatric patients living outside hospital required more co-ordinated long-term multidisciplinary input.

Community Mental Health Services↗
PubMed1991

Compulsory psychiatric treatment in the community. I. A controlled study of compulsory community treatment with extended leave under the Mental Health Act: special characteristics of patients treated and impact of treatment.

Following in-patient psychiatric treatment under Section 3 of the Mental Health Act, some patients have in the past remained on Section after discharge, and subsequently the Section has been renewed while the patient remained 'on leave'. People treated thus with 'extended leave' probably resemble closely those who would be placed on a community treatment order if this were available. A group of these extended-leave patients was compared with a control group, matched for age, sex and diagnosis, selected by consultant psychiatrists as not requiring treatment using a community treatment order. The two groups showed very few differences, but the extended-leave patients more commonly had a history of recent dangerousness and non-compliance with psychiatric treatment. Use of extended leave improved treatment compliance, reduced time spent in hospital, and reduced levels of dangerousness.

Case-Control Studies↗
PubMed2006

Managing sexually transmitted infections in community sexual health clinics: an audit of a community service.

Traditional hospital-based genitourinary (GU) medicine services have been overwhelmed by the current sexual health crisis. In November 2001, the Community Sexual and Reproductive Health department in Lewisham, South East London started a treatment service for uncomplicated sexually transmitted infections (STI). An audit was conducted to evaluate the effectiveness of and demand for this service. Two years after its introduction the number of chlamydia tests increased by 94%, the number of men attending the service doubled, GU medicine referrals halved and the number of STI treatments had risen by 90%, mainly for chlamydia. Proposed national outcome standards were exceeded with treatment of 84% of chlamydia clients with a median delay of 14 days, partner notification documented in 88% of chlamydia treatments and 0.45 contacts per case of chlamydia treated. Community-based services can provide successful testing, treatment and partner notification for uncomplicated STI despite increasing demand and such services should be properly recognized, encouraged and financially supported.

Chlamydia Infections↗
PubMed2026

Relational care in community mental health: Evaluating staff experiences in Intensive Community Care Services (ICCS) vs treatment as usual.

BACKGROUND: The quality of healthcare delivery relies heavily on building strong relationships between healthcare providers (HCPs) and clients. This study presents the results of a process evaluation for a Randomised Controlled Trial (RCT) examining the effectiveness of Intensive Community Care Service (ICCS) vs Treatment as Usual (TAU; inpatient or core community CAMHS). METHODS: Thirty-four semi-structured interviews were conducted with staff across various services, including 20 from ICCS and 14 other TAU services. A thematic decomposition analysis was conducted on the data, and specific themes relevant to staff experiences of young people's engagement with services and overall recovery. RESULTS: Three main themes were observed in the HCP data (1. Relational Ecologies: barriers and enablers to engagement, 2. flexibility of approach amidst systemic pressures and 3. the web of trust in the relationship-building process). HCPs highlighted the necessity of developing trust and rapport through non-clinical engagement strategies, such as informal visits and personalised interactions. HCPs emphasised that without trust, treatment effectiveness diminishes, necessitating a tailored approach rather than a one-size-fits-all model. The flexibility in duration of treatment and methods of engagement was noted as crucial in accommodating individual client needs and fostering an open, trusting environment necessary for long-term recovery. CONCLUSION: The findings highlight the vital importance of relational care models, especially ICCS, in addressing the complex needs of Children and Young People (CYP). Flexible, family-centred approaches improve trust, engagement, and long-term recovery outcomes. Recommendations include tackling systemic barriers and expanding relational care models within CAMHS to meet increasing mental health demands effectively. Further research should investigate scalable strategies for integrating these insights into wider mental health service frameworks.

Humans↗
PubMedDate not supplied

The Pfizer Foundation's Community Health Ventures program: providing models for community health partnerships.

In response to its concern for the future of community health centers (CHCs) and those who receive care in these centers, in 1997 the Pfizer Foundation created and funded Community Health Ventures (CHV), a four-year, $3.6 million grant-making program. It was designed to increase the capacity of centers to adjust to a changing health care environment. This descriptive special report discusses the outcomes of the program, including its impact on CHCs and their patients, and offers recommendations for funders on how to establish effective partnerships with CHCs.

Chronic Disease↗
PubMed2001

A controlled trial of a critical pathway for treating community-acquired pneumonia: the CAPITAL study. Community-Acquired Pneumonia Intervention Trial Assessing Levofloxacin.

Recent clinical trials in patients with community-acquired pneumonia (CAP) demonstrated that switching from intravenous to oral antibiotic therapy is safe once clinical improvement is evident, thereby facilitating early hospital discharge. This study evaluated the use of a critical pathway to improve the efficiency of treating CAP in 1743 patients at 19 teaching and community hospitals in Canada. Hospitals were randomized to continue conventional management of CAP (10 hospitals) or implement a critical pathway (9 hospitals). The main clinical outcome measure was patients' scores (assessed 6 wks after hospital presentation) on the Short-Form 36 Physical Component Summary, a quality-of-life questionnaire. Secondary clinical outcome measures included occurrence of complications, readmission rates, and mortality. The primary economic outcome measure was resource utilization, measured by the number of bed days/patient managed (BDPM). Clinical outcomes were good in both groups, with no significant differences between the two management strategies. However, use of the clinical pathway was associated with a 1.7-day reduction in BDPM and fewer admissions of low-risk patients.

Administration, Oral↗
PubMed2003

Impact of atypical coverage for patients with community-acquired pneumonia managed on the medical ward: results from the United States Community-Acquired Pneumonia Project.

STUDY OBJECTIVE: As current guidelines for treatment of community-acquired pneumonia (CAP) recommend empiric antimicrobial coverage for atypical pathogens, we evaluated the need for atypical coverage by examining length of hospital stay (LOS) and mortality in patients with CAP who were managed on the medical ward. METHODS: Medical records of patients with CAP admitted from January 1, 1997-December 31, 2001, from 176 United States nonteaching community hospitals were reviewed. Patients were divided into one of three mutually exclusive groups on the basis of intravenous antimicrobials received on days 1 or 2 of hospital stay: ceftriaxone monotherapy, ceftriaxone plus a macrolide, or levofloxacin. Variables evaluated for their ability to predict outcome were patient age, year of hospital admission, geographic region, preadmission setting, preadmission antimicrobial treatment, timing of antimicrobial administration, comorbid disease, and duration of intravenous antimicrobial treatment. The impact of initial antimicrobial regimen on LOS and mortality was evaluated in regression models while controlling for significant predictors of outcome. RESULTS: Of 8975 patients evaluated, 2453 met the inclusion criteria. Significant differences were noted among patients who received ceftriaxone (932 patients), ceftriaxone plus a macrolide (872), and levofloxacin (649) with respect to mean +/- SD age (72 +/- 16, 67 +/- 18, and 70 +/- 17 yrs, respectively; p<0.0001), admission from a nursing home (21%, 11%, and 15%, respectively; p<0.0001), and duration of intravenous antimicrobial treatment (4.4 +/- 2.7, 4.0 +/- 2.6, and 3.6 +/- 2.5 days, respectively; p<0.0001). The LOS predictors were age, geographic region, coexisting heart failure, and duration of intravenous antimicrobial therapy. Mortality predictors were age, admission from a nursing home, coexisting heart failure, and coexisting cancer. After controlling for these predictors of outcome, no significant differences were noted among the three groups for LOS (5.5 +/- 3.5, 4.8 +/- 2.9, and 4.8 +/- 2.9 days, respectively; p=0.2791) or mortality (3.1%, 2.0%, and 2.6%, respectively; p=0.8461). CONCLUSION: Initial coverage for atypical pathogens does not affect LOS or mortality among patients with CAP managed on the medical ward.

Aged↗
PubMed2004

The effectiveness of community-based animal health workers, for the poor, for communities and for public safety.

The development of community animal health (CAH) is an invaluable tool for addressing a series of challenges, particularly for the policy-maker, whose prime concern is public welfare. This paper examines three of the major challenges which confront governments, particularly the governments of less-developed countries, namely, the collapse of government services, the crucial issue of poverty reduction and the misuse of animal drugs. Although CAH is a potentially powerful tool for approaching all of these problems, the authors argue that CAH can only be fully exploited on a macroscopic level by developing strong institutions to support and regulate such community initiatives. In some countries, developing such institutions depends upon accepting the more fundamental and controversial principle of legalising non-professional animal health service providers who work within the private sector. In Section 1, the authors outline the three principal challenges which face governments, particularly in developing countries, and to which CAH offers a potential solution. Sections 2 to 4 investigate the evidence relating to each of these challenges in turn. Section 5 briefly draws on the lessons that have been generated by field experiences over the years, to propose how governments may develop CAH systems to their best advantage.

Animal Welfare↗
PubMed2002

Pursuing community-oriented primary care in a Russian closed nuclear city: the Sarov-Los Alamos community health partnership.

The Russian health care system historically has not relied on medical evidence to guide practice, uses centralized management, and is burdened by overspecialization. In 1999, a community health partnership was established between Sarov, Russia, and Los Alamos, NM, 2 cities linked by their nuclear weapons histories. Health problems addressed include asthma and diabetes, pediatric dental caries, low prevalence of breastfeeding, and adolescent drug abuse and sexually transmitted diseases. A community-oriented primary care approach was adopted that includes (1) implementing a "train the trainers" strategy to educate health professionals and lay people, (2) adapting established clinical practice guidelines based on local resources, (3) restricting use of expensive or limited resources, and (4) securing commitments from local government for expendable supplies and medications.

Adolescent↗
PubMed1988

Evaluation of community-based rehabilitation in Punjab, Pakistan: I: Use of the WHO manual, 'Training disabled people in the community'.

The WHO community-based rehabilitation programme has been tested in a village and a slum area in Pakistan. House-to-house surveys by physicians identified medical diagnoses and impairments and handicaps according to the ICIDH. Volunteer local supervisors from the communities were taught to identify and train disabled persons according to the CBR manual. The effect of training was evaluated after 1-2 years by an occupational therapist, using questions from the same manual. Of the 82 persons followed up, 80% showed improvement in function. The prevalence of disablement identified by the local supervisors and of handicap identified by a physician agreed well, and was of the order of 5%.

Community Health Services↗
PubMed1994

Communicating with the business community. A hospital launches two outreach efforts to educate community leaders.

Several years ago the management of Saint Francis Medical Center in Peoria, IL, decided that, with healthcare issues becoming increasingly complex, the hospital needed to find ways to share information with its community. Saint Francis's outreach effort began in 1991 with the launching of a Leadership Roundtable. Under its auspices, local leaders in business, finance, government, education, religion, and the media gather once a month to hear hospital staff members outline some aspect of healthcare or healthcare reform. A question-and-answer period follows. In 1993 James Moore, a Saint Francis administrator, began writing a monthly column on healthcare reform for a business publication that serves central Illinois. Moore's column explains to businesspeople how various healthcare reform proposals could affect them. With the column, as with the Leadership Roundtable, Saint Francis has strengthened its communication with the community.

Catholicism↗
PubMedDate not supplied

A community-based alternative: the comprehensive community health models initiative.

Health care is undergoing a quiet revolution in communities across America as purchasers, providers and consumers explore new options for controlling health care costs, expanding access and improving health status. A major Michigan effort in this regard is the Comprehensive Community Health Models (CCHMs) Initiative funded by the W.K. Kellogg Foundation.

Community Health Planning↗
PubMed1992

Community options for community care in Australia.

Australia's trial community options projects help meet those individual needs of the aged, the disabled, and others trying to avoid institutionalization that are beyond the capacity of home and community agencies. The next step is to spread the good news.

Aged↗
PubMed2000

Community care partnership: planning with the community.

We are at the threshold of transitioning from an illness delivery system to a health delivery system. "Partnerships for Health in the New Millennium," kicked off in January 2000 by Donna E. Shalala, Secretary of Health and Human Services, and Surgeon General David Satcher, launching "Healthy People 2010," have provided us with the prevention agenda for our nation. The leadership challenge ahead for us in the communities where we live and work is to develop a shared vision of health with our community partners which is committed to eliminating disparities in health for all our populations.

Community Networks↗