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At least 613 records · Page 34Linked to original sources
PubMed2000

HIV prevention community planning and communities of color: do resources track the epidemic?

The Centers for Disease Control and Prevention (CDC) funds provided to state, local, and territorial health departments for HIV-prevention activities are prioritized with the substantial involvement of HIV-prevention community planning groups (CPGs). This article examines whether or not these funds (more than $261 million in fiscal year 1998) are allocated in a way that mirrors the HIV/AIDS epidemic in terms of race/ethnicity. AIDS prevalence data were used to reflect disease burden, and were compared to budget data submitted by health departments to the CDC. The budget data report expenditures by race/ethnicity for two major types of activities: (1) health education and risk reduction (more than $104 million); and (2) counseling, testing, referral, and partner notification (more than $91 million). The rank order correlation between funding and AIDS prevalence data for the five specific racial/ethnic categories was .900 (n = 5, p < .05) for health education and risk reduction (HERR) activities, and 1.000 (n = 5, p < .05) for counseling, testing, referral, and partner notification (CTRPN) activities. From 1997 to 1998, the proportion of funds targeted and accounted for by race/ethnicity increased from 79 percent to 88 percent for HERR, and from 71 percent to 84 percent for CTRPN activities. With regard to race/ethnicity, health departments and CPGs appear to be actively targeting and accounting for HIV prevention resources, and we will argue that relatively small changes in counseling and testing resources for African-American and Latino/Latina communities would result in a close match between AIDS prevalence data and devoted resources.

Centers for Disease Control and Prevention, U.S.↗
PubMed2001

Can a sustainable community intervention reduce the health gap?--10-year evaluation of a Swedish community intervention program for the prevention of cardiovascular disease.

OBJECTIVES: This paper evaluates the 10-year outcomes of a Northern Sweden community intervention program for the prevention of cardiovascular disease (CVD), with special reference to the social patterning of risk development. METHODS: Using a quasi-experimental design, trends in risk factors and predicted mortality in an intervention area (Norsjö municipality) are compared with those in a reference area (Northern Sweden region) by repeated independent cross-sectional surveys. RESULTS: There were significant differences in changes in total cholesterol level and systolic blood pressure between the intervention and reference populations. The predicted coronary heart disease mortality (based on the North Karelia risk equation). after adjustment for age and education, was reduced by 36% in the intervention area and by 1% in the reference area. CONCLUSIONS: We conclude that a long-term community-based CVD prevention program which combines population and individual strategies can substantially promote a health shift in CVD risk in a high risk rural population. When evaluated for different social strata, we found no signs of an increasing health gap between socially privileged and less privileged groups. Socially less-privileged groups benefited the most from the present prevention program.

Adult↗
PubMed2002

Community interventions to promote healthy social environments: early childhood development and family housing. A report on recommendations of the Task Force on Community Preventive Services.

The sociocultural environment exerts a fundamental influence on health. Interventions to improve education, housing, employment, and access to health care contribute to healthy and safe environments and improved community health. The Task Force on Community Preventive Services (the Task Force) has conducted systematic reviews of early childhood development interventions and family housing interventions. The topics selected provide a unique, albeit small, beginning of the review of evidence that interventions do effectively address sociocultural factors that influence health. Based on these reviews, the Task Force strongly recommends publicly funded, center-based, comprehensive early childhood development programs for low-income children aged 3-5 years. The basis for the recommendation is evidence of effectiveness in preventing developmental delay, assessed by improvements in grade retention and placement in special education. The Task Force also recommends housing subsidy programs for low-income families, which provide rental vouchers for use in the private housing market and allow families choice in residential location. This recommendation is based on outcomes of improved neighborhood safety and families' reduced exposure to violence. The Task Force concludes that insufficient evidence is available on which to base a recommendation for or against creation of mixed-income housing developments that provide safe and affordable housing in neighborhoods with adequate goods and services. This report provides additional information regarding these recommendations, briefly describes how the reviews were conducted, and discusses implications for applying the interventions locally.

Child Development↗
PubMed2000

Strategies for reducing exposure to environmental tobacco smoke, increasing tobacco-use cessation, and reducing initiation in communities and health-care systems. A report on recommendations of the Task Force on Community Preventive Services.

Reducing tobacco-related morbidity and death is an ongoing challenge for health-care providers, health-care systems, and public health programs. Interventions are available that a) reduce exposure to environmental tobacco smoke, b) reduce tobacco-use initiation, and c) increase tobacco-use cessation. The Task Force on Community Preventive Services has conducted systematic reviews on 14 selected interventions, which are appropriate for communities and health-care systems, and has made recommendations regarding use of these interventions. This report summarizes the recommendations, identifies sources that offer full reviews of the interventions and details about applying the interventions locally, and provides an update of the Task Force's work.

Guidelines as Topic↗
PubMed1990

Graduate training in community medicine at Mount Sinai: the development of the Master of Science in Community Medicine.

This paper describes the philosophy, process, and outcome of the integration of independent study and classroom training with existing clinical and research experiences in The Mount Sinai Medical Center Department of Community Medicine's general preventive medicine and occupational medicine residencies leading to the creation of the Master of Science in Community Medicine.

Community Medicine↗
PubMedDate not supplied

[Sexually transmitted diseases and community health services. I. Community diagnosis].

The ambition of Community Health Services in the fight against Sexual Transmitted Diseases (S.T.D.) in developing countries is to enable the exposed population to benefit by cheap but also most efficient preventive and curative measures. This paper mentions and illustrates by examples the different stages of this approach. Community diagnosis identifies the groups and the areas at risk and determines their respective degree of priority, by confronting the epidemiological importance of S.T.D. with the chances of successful attempts to overcome it. The initial evaluation of the endemia is obtained thanks to pertinent epidemiological rates which are collected by a "sentinel notification system" in controlled collectivities or in the population in general. The feasibility of the operations is evaluated by leaning on logistical, psychological and political aspects so as to fix an order of priority.

Community Health Services↗
PubMed1986

Symposium on surgical manpower in the smaller community. The advantages and disadvantages of practising surgery in a small community.

The advantages of practice in a community encompassing a population of about 35 000 include readily available beds and operating rooms, a relative diversity of surgical problems, increased job satisfaction and solid community support through service clubs and other volunteer organizations. Disadvantages in some situations can include lack of investigational facilities and of internists for consultation. A lack of surgical assistants, anesthetists and intensive-care-unit support are other potential negative factors. The quest for continuing medical education requires definite resolve, and practice finesse must be well honed.

Canada↗
PubMed1995

Community care in Scotland: progress from a community care implementation unit perspective.

Of necessity, this account of progress has been presented in summary form and has related to the particular focus of the CCIU's work. Significant progress has been achieved in many respects and many of the initial teething problems have been overcome. However, there is scope for improvement in the delivery of quality services for vulnerable people in our communities as we strive to offer real choice to them and their families in the provision of community care. Achieving this will be assisted greatly by agencies getting better at developing and implementing jointly their strategic thinking, working more closely on the 'joins' in the system and recognising the strengths of other players.

Community Health Services↗
PubMed1997

A community-wide Responsible Beverage Service program in three communities: early findings.

Evidence accumulating over the past 10 years or so suggests that commercial servers of alcoholic beverages will intervene to reduce levels of impairment among their patrons and will refuse service to intoxicated customers. While some Responsible Beverage Service (RBS) programs have had significant effects on server and patron behavior, others have not. This leads us to consider issues of implementation and program effectiveness. In the current paper, a community-wide RBS program is described in some detail. The program was comprised by a larger comprehensive community intervention project in three sites across California and South Carolina. Process evaluation data, to track program implementation and proximal effects, provide early findings. Expressed support for RBS principles was high for both the public and the hospitality industry in all sites. A telephone survey of managers also suggests that prevention policies at bars and restaurants are beginning to show up, but a direct measure of server intervention with heavy drinkers does not yet demonstrate a program effect.

Alcoholic Beverages↗
PubMedDate not supplied

A community crossword puzzle. An interdisciplinary approach to community-based learning.

Finding methods to involve communities in the education of health professionals presents a challenge to educators. An East Tennessee State University program found that a Community Crossword Puzzle helped students and faculty meet course objectives within the interdisciplinary curriculum of a rural health care education program.

Community Health Nursing↗
PubMed2006

Informing the policy agenda: the community voices experience on dental health for children in North Carolina's rural communities.

Dental decay is one of the nation's most common childhood diseases and the rate of decay for low-income children in North Carolina is nearly double that of children living above the poverty line. A number of factors impede the utilization of dental services by children; these factors can be grouped into three broad categories: patient factors, provider factors (including availability and provider willingness to provide treatment that is often difficult and time consuming) and payor factors. Addressing the dental health crisis for children in low-income families can only be accomplished by tackling multiple contributors to the problem simultaneously. A Community Voices program in North Carolina demonstrated that key policy strategies must be addressed at the state and national levels to ensure that interventions have the greatest possible impact, measured in terms of improved dental health status and high patient satisfaction rates.

Adolescent↗
PubMed1981

Community support systems: scaling community acceptance.

In recommendations for community support systems, there are expectations of public involvement in unprecedented proportions; yet evidence of fundamental shifts in attitudes and behaviors toward the mentally ill is lacking. Considerations of the complexity of public acceptance led to the development of a scale used to measure the extent of support for the chronically mentally ill among 574 randomly selected adults in Leon County, Florida. Comparison of the general population with residents in a neighborhood known to be opposed to community-based services served to establish the validity of the scale. The findings led to recommendations for future research in this area.

Adult↗
PubMed1984

The stratified microbial community at Laguna Figueroa, Baja California, Mexico: a possible model for prephanerozoic laminated microbial communities preserved in cherts.

The microbial mat community of the evaporite flat at North Pond, Laguna Figueroa (Baja California, Mexico) was actively involved in the production of laminated sediments prior to 1978. Heavy rains in 1979 and 1980 flooded the mat with 1 and 3 meters of meteoric water respectively. The flooding deposited up to 10 cm of silicoclastic sediment over the Microcoleus-dominated mat and resulted in the cessation of laminated sediment deposition. In 1982, the surface had been recolonized by species of cyanobacteria (Spirulina, Oscillatoria) and purple photosynthetic bacteria (Chromatium, Thiocapsa). The silicoclastic sediments and residual evaporites, which overlaid the laminated sediment, had been reworked into an anaerobic, sulfide-rich mud and contained well preserved sheaths of filamentous and coccoid bacteria. The Swaziland Sequence in the Barberton mountain land (which includes the Onverwacht and Fig Tree Group as well as the Swartkoppie zone between them) contains laminated sediments and carbon-rich chert. Structurally preserved microfossils have been found in the smooth black chert but not in the laminae. We concur with others who suggested that the laminated sediments from the Swaziland Sequence were deposited by an active stratified microbial community. However, we propose that these organisms which were preserved were originally buried in the associated sulfide-rich muds and were subsequently silicified.

Bacteria↗
PubMed1999

Parasite communities of the Salzhaff (Northwest Mecklenburg, Baltic Sea). I. Structure and dynamics of communities of littoral fish, especially small-sized fish.

The parasites of ten fish species, including four Gobiidae, three Gasterosteidae, two Syngnathidae, and one Zoarcidae from the Salzhaff region, Northwest Mecklenburg, Baltic Sea, were investigated in 1995 and 1996. As many as 36 parasite species, represented by diverse groups of helminths and protozoans as well as annelids and copepods, are found during 4 seasons in these hosts. By far the most abundant group is represented by digeneans, comprising 15 species, followed by 7 cestodans and 6 nematodes. With regard to component communities, 8 host-parasite combinations are core and secondary species with more than 40% prevalence in which generalists such as the digeneans Podocotyle atomon and Cryptocotyle concavum (in 3 hosts). C. lingua, Diplostomum spathaceum, and Acanthostomum balthicum, and the nematode Hysterothylacium are involved. Also, specialists such as Aphalloides timmi in Pomatoschistus microps as well as Magnibursatus caudofilamentosa and Thersitina gasterostei in Gasterosteus aculeatus attain high levels of prevalence. A comparison of different investigations reveals greater prevalence of allogenic and autogenic parasite species with 3 host cycles in the Rerik-Riff (free Baltic) and higher levels of prevalence of autogenic parasite species with 1 or 2 host cycles in the entire Salzhaff. The component communities of gobies from Dahmeshöved, Lübeck Bight, attain generally lower degrees of prevalence than those of the Salzhaff region. The infracommunities consist mostly of 1-3 parasite species per host specimen; this value is surpassed on occasion in P. microps (maximum 7 species) and in G. aculeatus (maximum 9 species, which may compete for 5 microhabitats in a host specimen). In this context the theory of empty niches propagated by some parasitologists is critically discussed and substituted by the assumption of variable niche widths. The seasonality of the more abundant parasites is either unclear--as in the case of C. concavum--or evident--as in the case of P. atomon, which prevail in early spring and summer, or A. timmi, which dominate in late summer, as do M. caudofilamentosa, which is absent in spring. The main causes of the infestation of fish hosts may be their ages and the availability of parasites due to the presence of intermediate hosts.

Animals↗
PubMed2005

Spatial variation in insect community and species responses to habitat loss and plant community composition.

Several experimental studies have examined species responses to manipulations of habitat area and spatial arrangement, but plant composition and spatial variation in species distributions also affect animal responses to habitat alteration. We used an experimental approach to study the combined effects of habitat area, edge, and plant community composition on the spatial structure of insect species richness and composition. The abundance of three guilds (herbivores, predators and parasitoids) and individual species were also analyzed. Habitat patches were created that differed in area and edge by selectively mowing portions of 15 mx15 m plots in a 1.7-ha old field. Spatial and environmental variables were used to predict insect responses in separate multiple regression and ordination models. The variation in species responses due to spatial and environmental variables was then partitioned by combining these variables into an overall regression or ordination. Spatial and environmental variables contributed similar percentages to the total variance in insect species richness, abundance or composition. No significant effects of habitat area were observed in any response variable. Herbivore abundance showed positive responses to legume or grass cover, as well as spatial variation that was unrelated to environmental variables. Predators and parasitoids had greater effects of plant species richness and habitat edge, and less unexplained spatial variation. Individual species differed in their responses to plant variables, depending on host specialization or intraspecific aggregation. Our study highlights the importance of plant community composition and spatial variation apart from environmental variables. Spatial variation stems both from species responses to environmental features as well as species differences in habitat specialization and intraspecific aggregation.

Animals↗
PubMed2006

Effectiveness of community-based injury prevention. Long-term injury rate levels, changes, and trends for 14 Swedish WHO-designated Safe Communities.

This study investigates the injury rate levels, changes, and trends between 1987 and 2002 for the 14 Swedish municipalities designated as WHO Safe Communities. The injury rate was defined as the number of injured patients discharged from hospital per 1000 persons. Injury rates were age standardised. Each municipality was compared with its respective municipality group, according to a classification of Sweden's 288 municipalities into nine groups based on numerous structural parameters. The average injury rate levels for the 14 WHO-designated Safe Community municipalities ranged from 11.54 to 19.09 per 1000 population during the study period, which was defined as the time period during which a municipality's injury prevention program has been operational. Eleven of 14 municipalities had higher levels than their corresponding municipality groups. Five of the 14 municipalities "outperformed" their respective municipality groups and achieved a greater relative injury rate decrease during the study period. The trends for the 14 municipalities in relation to their municipality groups showed an inconsistent pattern, with only four municipalities exhibiting overall favourable trends for the study period.

Accident Prevention↗
PubMed2000

Developing an evidence-based Guide to Community Preventive Services--methods. The Task Force on Community Preventive Services.

Systematic reviews and evidence-based recommendations are increasingly important for decision making in health and medicine. Over the past 20 years, information on the science of synthesizing research results has exploded. However, some approaches to systematic reviews of the effectiveness of clinical preventive services and medical care may be less appropriate for evaluating population-based interventions. Furthermore, methods for linking evidence to recommendations are less well developed than methods for synthesizing evidence. The Guide to Community Preventive Services: Systematic Reviews and Evidence-Based Recommendations (the Guide) will evaluate and make recommendations on population-based and public health interventions. This paper provides an overview of the Guide's process to systematically review evidence and translate that evidence into recommendations. The Guide reviews evidence on effectiveness, the applicability of effectiveness data, (i.e., the extent to which available effectiveness data is thought to apply to additional populations and settings), the intervention's other effects (i.e., important side effects), economic impact, and barriers to implementation of interventions. The steps for obtaining and evaluating evidence into recommendations involve: (1) forming multidisciplinary chapter development teams, (2) developing a conceptual approach to organizing, grouping, selecting and evaluating the interventions in each chapter; (3) selecting interventions to be evaluated; (4) searching for and retrieving evidence; (5) assessing the quality of and summarizing the body of evidence of effectiveness; (6) translating the body of evidence of effectiveness into recommendations; (7) considering information on evidence other than effectiveness; and (8) identifying and summarizing research gaps. Systematic reviews of and evidence-based recommendations for population-health interventions are challenging and methods will continue to evolve. However, using an evidence-based approach to identify and recommend effective interventions directed at specific public health goals may reduce errors in how information is collected and interpreted, identify important gaps in current knowledge thus guiding further research, and enhance the Guide users' ability to assess whether recommendations are valid and prudent from their own perspectives. Over time, all of these advantages could help to increase agreement regarding appropriate community health strategies and help to increase their implementation.

Decision Making↗