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At least 595 records · Page 33Linked to original sources
PubMed1997

[Recent trend toward development of community medicine].

The author evaluated the present status of community medical activities in Hokkaido from standpoint of various actual data obtained by recent investigation. As many districts are in the face of shortage of doctors, it is concluded to promote the following subjects, 1) strengthening of district center hospitals, 2) education and maintenance of community medical doctors, 3) synthetic system of health, medicare and welfare, and 4) introduction of multimedia system. Our foundation has started several new works, such as doctor center model system, training system of primary care doctor, and network activities of community doctors. It is mandatory to form wide consensus among the person concerned, such as client, doctor, medical association, university, and municipality.

Community Health Planning↗
PubMedDate not supplied

Salt intake in an urban, developing South African community.

INTRODUCTION: Present guidelines for the diagnosis and management of hypertension indicate that a reduction in sodium (Na(+)) intake levels and an increase in potassium (K(+)) intake levels are critical components of blood pressure (BP) control. Whether this is being successfully implemented in urban, developing communities in South Africa is uncertain. AIMS: The first was to assess how mean 24-hour urinary Na(+) and K(+) excretion rates, used as an index of salt intake, compared against recommended daily allowances (RDA) for Na(+) and K(+) intake in an urban, developing South African community. The second was to determine the relationship between hypertension awareness and treatment, and 24- hour urinary Na(+) and K(+)excretion rates in this community. METHODS: Four hundred and thirty-eight subjects living in metropolitan areas of Johannesburg, of whom 291 had complete 24-hour urine collections and BP measurements, obtained on three separate occasions, were randomly recruited. Thirty-one per cent of the sample of 291 subjects were hypertensive (either receiving therapy or with an average BP measured on three separate occasions > or =140/90 mmHg). Sixty-seven per cent of hypertensives were aware of their hypertension and were being treated for it. On average, 82% of subjects had 24-hour Na+ excretion values above the RDA for Na(+) intake of 65 mmol/day. All subjects had 24- hour K(+) excretion rates below the RDA for K(+) intake (120 mmol/day). The mean value for 24-hour urinary Na(+) and K(+) excretion rates (mmol/24 hours) in patients who were aware of their hypertension and receiving treatment for it (n = 61; Na(+) = 112 +/- 54, K(+) = 32 +/- 16) was similar to that of patients who were unaware of their hypertension (n = 30; Na(+) = 102 +/- 49, K(+) = 28 +/- 13), or to normotensives (n = 200; Na(+) = 117 +/- 56, K(+) = 33 +/- 17). Hypertension awareness and treatment were not associated with electrolyte excretion rates either when considered alone or after adjusting for age, gender, body mass index, alcohol and tobacco intake, the presence of diabetes mellitus and the type of antihypertensive therapy (multivariate regression analysis). Moreover, the proportion of patients who were aware of their hypertension, were receiving treatment for it, and who had 24-hour Na(+) excretion values above the RDA for Na(+) intake (80%) was similar to the proportion noted in those who were unaware of their hypertension (73%), and to normotensives (84%). CONCLUSIONS: The lack of relationship between either hypertension awareness and treatment, and Na(+) and K(+) intake levels suggests that current recommendations for a reduced Na(+) and increased K(+) intake in hypertensives do not translate into clinical practice in urban, developing communities of South Africa.

Adolescent↗
PubMed1983

The needs of the abused child in the community.

The development of community awareness of child abuse has followed medical awareness and is specifically concerned with prevention and early intervention. Contact between community services and 304 infants from a birth cohort in a poor socio-economic status, multi-ethnic urban municipality was documented to investigate how these services could provide effective community approaches to the problem. While perinatal and medical services provided fragmented care, the Maternal and Child Health Service was the only agency to contact all families, including those of the 21 abused or "at risk" infants. It is suggested that such local universal services should form the basis of a community approach to the needs of the abused or "at risk" child.

Adolescent↗
PubMedDate not supplied

Resource dependency and community participation in primary health care.

Great hope is accorded to community participation in health. A large number of potential benefits are attributed to participatory processes, including better addressing community needs through more locally adapted organizational processes and improvement in health outcomes. To this end, many governments around the world have adopted policies and programmes of community participation as part of their strategy to implement primary health care services. In Mexico this is, in great part, realized through the module programme of the Ministry of Health. A module is characterized by various village based health posts (casas de salud), each operated by a community volunteer and associated with a health committee, all of which are supervised by a nurse from a nearby health centre. The southern Mexican state of Oaxaca was chosen for a study of the module programme (during the period 1987-1992) to gain a better understanding of how organizational processes impact on the implementation and outcomes of community participation programmes in large institutions (i.e. the Ministry of Health). The resource dependency perspective formed the basis for the theoretical framework used. Some 75 towns and villages were visited and about 170 health related personnel from all over the state were interviewed to obtain data on the operation and impact of the module programme. As predicted by resource dependency theory, which postulates that organizations will react to pressures in their external environment to secure the resources needed for survival, the findings of this research led to the conclusion that the Ministry of Health had co-opted the resources of the communities it was involving in the module programme in order to meet its policy objectives, especially those related to expanding service coverage. Community participation in the module programme was found to have been implemented entirely for its utility in supplying resources and not for democratic or intrinsic values. This strategy, identified as the resource dependency approach to community participation, led to several flaws in the participatory process and resulted in far less than what could potentially have been achieved in terms of improving health outcomes. Ultimately, the participatory mechanisms became additional dependencies of the health system and not integral components of a process of community development. Large institutional programmes of community participation can benefit by understanding this approach and avoiding its inherent problems.

Community Participation↗
PubMed1992

Social and environmental factors in 10 aboriginal communities in the Northern Territory: relationship to hospital admissions of children.

OBJECTIVE: To identify social and environmental differences associated with differences in admission rates of children from 10 rural Aboriginal communities in the Northern Territory. DESIGN: Between March 1986 and December 1987, records of hospital admissions of the cohort of children for 1976-1985 were examined retrospectively; cross-sectional measurements of 74 historical, social and environmental characteristics of each community were collected. SAMPLE: All 1961 children born between 1 January 1976 and 31 December 1985 and still living in the 10 communities. METHOD: Scores on social and environmental factors for each community were generated by factor analysis. Generalised linear interactive modelling was used to investigate the association between these scores and admission rates. RESULTS: Mean admissions per child-year at risk were higher in Central Australian communities (range, 0.41-0.93) than Top End communities (0.26-0.38). Factor I accounted for 30% of the social and environmental differences between communities: communities with a high score on this factor had more houses, fewer shared toilets, more electrical appliances, better personal hygiene and a history of mission administration. High scores on this factor were predictive of lower admission rates and the factor explained most of the differences in admission rates between the Top End and Central Australian communities. Factor VI, correlated with dilapidated dwellings and fewer Aboriginal Health Workers, explained some differences in admission rates between six Top End communities. CONCLUSIONS: Social and environmental factors correlated with the degree of community development are associated with the health of Aboriginal children. Improved development programs should be community-controlled and evaluated to identify the social, educational, behavioural and environmental changes that are most effective in improving health.

Child, Preschool↗
PubMed1998

Alaska Native community assessment: health care services, knowledge of health issues, and health education.

This project gathered information from 32 Alaska Native communities in Bristol Bay, located in southwestern Alaska, regarding use of health care services and knowledge of health care issues. It also educated residents about health care and their role in improving health status, enabling participants to feel that their involvement in planning health care services is important. In conjunction with the University of Washington Community Development Program and the Alaska Center for Rural Health, a household survey was developed. A coordinator in each community was trained, and packets of surveys and health education materials were delivered to each household or post-office box. Completed surveys were returned, confidentially, to the village clinic. An English/Yup'ik cassette tape explaining the project was also available. Results were analyzed by the University of Washington. The findings were determined to be accurate with a 95% confidence level. Of surveys delivered to households, there was a 66% return rate and an overall return rate of 45%.

Adult↗
PubMed1996

Exploring approaches to the administration of a long-term care facility: The application of a community planning and development process.

This article outlines the approaches taken to the management of two long-term care facilities by the County of Huron in southwestern Ontario in 1994. Lay-offs, a move to new facilities, loss of local political confidence, changes in key administrative personnel and low staff morale prompted the county to ask an interim administrative team to develop and implement an appropriate response. The article explains how community development and planning principles and techniques were applied to the management of the homes to achieve an overall improvement in communication, staff morale and attitude. These approaches may prove helpful to other administrations facing major change.

Aged↗
PubMed2002

Strengthening primary health care: building the capacity of rural communities to access health funding.

Present health funding models can place onerous pressures on rural health services. Staff may lack the time, resources, access to data, and the expertise needed to complete complex and lengthy funding submissions. This present study describes an innovative capacity-building approach to working with Victorian rural communities seeking to access health care funding through the Regional Health Services Program. This approach used several strategies: engaging stakeholders in targeted rural communities, developing an information kit and running a workshop on preparing submissions to the Regional Health Services Program, facilitating community consultations, and providing ongoing support with submissions. Six rural communities were supported in this way. Four have been funded to date, with a combined annual recurrent budget for new primary health care services of over $2.5 million. Each community has developed a service delivery model that meets the particular needs of their local area. This capacity-building approach is both effective and replicable to other health funding opportunities.

Budgets↗
PubMedDate not supplied

Maintaining family planning acceptance levels through development incentives in Northeastern Thailand.

The results of a two-year longitudinal study of the effect that development program incentives have upon family planning in Northeastern Thailand are presented. These incentives, implemented by the Population and Community Development Association, Thailand, included animal raising and agricultural, home industry, and environmental activities. An experimental design including baseline and follow-up surveys supplemented by a continuous monitoring system was utilized to test hypotheses on the family planning impacts of the incentives. Findings indicate that the incentives contributed significantly to the maintenance of high levels of family planning practice through the program period 1982-1984.

Contraception Behavior↗