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University-assisted community school program of West Philadelphia: democratic partnerships that make a difference.

The university-assisted community school model is showing results for children and youth in West Philadelphia. The University of Pennsylvania's (Penn's) Center for Community Partnerships has coordinated universitywide efforts, in partnership with the community, in order to create and develop community school programs. The Sayre program aims to become a university-assisted community school, with a comprehensive community problem-solving curriculum and communitywide program that is fully integrated across both the Sayre curriculum and the curriculum of a number of Penn's schools. The Penn-Sayre project demonstrates that higher education can be a permanent anchor for revitalizing schools and communities if the vast resources it possesses, particularly its faculty, students, and staff, are brought to bear in a coordinated fashion.

Adolescent↗

Community resiliency: the potential for community health nursing theory development.

There is insufficient theory development within community health nursing that addresses the community as a collective and not simply as groupings of aggregates. Conceptual clarification of nursing's domains is needed, however, before theory development can take place. In an attempt to rectify this situation, this article discusses the environment domain. Community resiliency, or the ability of a community to deal with adversity and in so doing reach a higher level of functioning, is presented as a useful framework to gain greater understanding of this particular domain. Findings from research that have resulted in a community resiliency model for describing the environment domain, within which rural-based community health nurses (CHNs) work, are presented. The relevance for community health nursing theory is included with recommendations for future research and subsequent theory development.

Canada↗

Health education to promote community involvement in the control of tropical diseases.

Health Education is any combination of learning activities that promote voluntary adaptations in health-related behaviour. In pursuing this definition, health workers generally work in two main directions, a community development approach and a behavioristic, communications approach. While Health Education in tropical, developing countries often takes the developmental approach with full community involvement, including the setting of programme priorities, Health Education for disease control has more often been characterized as the behavioristic mode utilizing simplistic, professionally determined messages and short-term campaigns to attempt to influence health behaviours related to disease transmission. Efforts in Idere, Nigeria, have tried to merge the two approaches building on community concern about one endemic tropical disease, Guinea worm. From this base, volunteer village health worker (VHW) training was developed. VHWs, once trained, developed their own association, which served as an organizational base for further health development programming, directed by the VHWs themselves.

Community Health Planning↗

Obstacles to and future goals of ten comprehensive community health promotion projects.

Over 100 project staff, community coalition members, and other representatives from 10 comprehensive community health promotion projects in the western United States were surveyed two years into a three year funding cycle about: (1) the problems or obstacles they judged as preventing successful completion of their current goals and objectives, and (2) future goals and objectives they envisioned for their projects. The key issues confronting respondents were diverse, although issues around the process of implementing community health promotion programs were cited more frequently than issues related to the content of health promotion. When respondents were asked to prioritize Future Goals in the second survey, consensus across communities was obtained despite broad differences in the type of community surveyed and the health problem targeted. This study identifies the common organizational and community development problems faced by newly emerging community health promotion programs and has implications for other communities involved in designing, implementing, and evaluating community-wide health promotion programs.

Community Health Services↗

Whole-plant growth stage ontology for angiosperms and its application in plant biology.

Plant growth stages are identified as distinct morphological landmarks in a continuous developmental process. The terms describing these developmental stages record the morphological appearance of the plant at a specific point in its life cycle. The widely differing morphology of plant species consequently gave rise to heterogeneous vocabularies describing growth and development. Each species or family specific community developed distinct terminologies for describing whole-plant growth stages. This semantic heterogeneity made it impossible to use growth stage description contained within plant biology databases to make meaningful computational comparisons. The Plant Ontology Consortium (http://www.plantontology.org) was founded to develop standard ontologies describing plant anatomical as well as growth and developmental stages that can be used for annotation of gene expression patterns and phenotypes of all flowering plants. In this article, we describe the development of a generic whole-plant growth stage ontology that describes the spatiotemporal stages of plant growth as a set of landmark events that progress from germination to senescence. This ontology represents a synthesis and integration of terms and concepts from a variety of species-specific vocabularies previously used for describing phenotypes and genomic information. It provides a common platform for annotating gene function and gene expression in relation to the developmental trajectory of a plant described at the organismal level. As proof of concept the Plant Ontology Consortium used the plant ontology growth stage ontology to annotate genes and phenotypes in plants with initial emphasis on those represented in The Arabidopsis Information Resource, Gramene database, and MaizeGDB.

Arabidopsis↗

Bridging community intervention and mental health services research.

OBJECTIVE: This article explores the potential of community intervention perspectives for increasing the relevance, reach, and public health impact of mental health services research. METHOD: The authors reviewed community intervention strategies, including public health and community development and empowerment interventions, and contrast community intervention with practice-based quality improvement and policy research. RESULTS: A model was proposed to integrate health services and community intervention research, building on the evidence-based strength of quality improvement and participatory methods of community intervention to produce complementary functions, such as linking community-based case finding and referral with practice-based quality improvement, enhanced by community-based social support for treatment adherence. CONCLUSIONS: The community intervention approach is a major paradigm for affecting public health or addressing health disparities. Despite challenges in implementation and evaluation, it represents a promising approach for extending the reach of mental health services interventions into diverse communities.

Community Health Planning↗

Impact of sanitation and health education on intestinal parasite infection among primary school aged children of Sherpur, Bangladesh.

This study was carried out in 1999-2000 in the northern part of Bangladesh to determine the impact of sanitary latrine use and of health education on intestinal parasites in school-aged children. The children were between 5 and 13 years of age and stool samples revealed that more than half (53%) of the study sample was still infected with one or more intestinal parasites even after 4 years of intervention. Ascariasis was found to have the highest prevalence rate (36.2%) and hookworm the lowest (10.7%). Intestinal parasite infection was significantly lower (P < 0.05) among those who used a sanitary latrine and received health education. This result is consistent with observations that the effect of sanitation and health education is slow to develop. Concerted primary healthcare activities with community development efforts should be undertaken to improve the overall living condition of the people of this area to control this problem.

Adolescent↗

Health politics meets post-modernism: its meaning and implications for community health organizing.

In this article, post-modern theory is described and applied to health politics with examples from community health organizing, social movements, and health promotion. Post-modernism questions conventional assumptions about concepts such as representation, participation, empowerment, community, identity, causality, accountability, responsibility, authority, and roles in community health promotion (those of expert, leader, and organizer). I compare post-modern social movements with their modern counterparts: the organizational forms, leadership styles, and substantive intellectual orientations of the two differ. I explain the social planning, community development, and social action models of community health organizing, comparing them with the priorities of post-modern social movements, and show the similarities and differences between them as to structural preferences, process, and strategies. Finally, and most importantly, I present the implicit lessons that post-modernism offers to health politics and outline the strengths and weaknesses of this approach to health politics.

Community Health Services↗

[Evaluation of community-based rehabilitation programs in Ghana and Benin].

This article describes two community-based rehabilitation programs set up for disabled persons in Ghana and Benin in the early 1990s. Both programs were based on the model described by the World Health Organization but differed greatly with regard to implementation. This difference had great impact on the respective effectiveness, efficiency and viability. Analysis of 624 disabled persons ranging in age from 0 to 30 years showed better progress in the Beninese group for all areas considered with a resulting improvement in quality of life. Assessment of the cost-effectiveness indicated that spending was higher and less effective in Ghana for globally less benefit than in Benin. Data also suggested that differences in implementation impacted program viability since the Ghana program collapsed in 1999 while the Beninese program is ongoing. The authors speculate that the differences in the two programs were related to failure to observe the basic principles of any community development strategy in Ghana. For successful community response to difficult local situations, populations require technical assistance from outside sources. National authorities must provide players at both lower levels with the necessary resources including subsidies, training, salaries, planning, monitoring and legislation. These basic rules were largely applied in Benin but almost completely ignored in Ghana.

Adolescent↗

Community interdisciplinary education to promote partnerships in family violence prevention.

Family violence is a major social and health problem in the United States. Educational approaches are needed that help professionals and communities develop more effective skills to work with families and communities. This article describes a statewide, interdisciplinary, community-based educational program for professionals and paraprofessionals and a 6-month post-evaluation. Participants reported knowledge and skill development in assessment and interventions, improved use of violence prevention data for planning and interventions, and increased community partnerships and collaborations. Recommendations address violence prevention leadership, funding, infrastructure, interdisciplinary professional education, greater community awareness, and policy development.

Cooperative Behavior↗

Community demonstration project initiative: technical support for program development at the community level.

Select population groups are at greater than average risk for cancer incidence and mortality. Lack of experience reaching high-risk populations, particularly those characterized by high proportions of the socioeconomically disadvantaged, presented a challenge to the American Cancer Society (ACS). A partial solution was to integrate outreach to high-risk populations into ACS national priorities and to fund community demonstration projects consistent with these priorities. Technical assistance (TA), which includes expert advice and problem solving, was provided during the first phase to facilitate the development of these projects into "model" projects to learn what initiatives can best be disseminated, or diffused, into target populations. TA also was used to assess how it can enhance the potential for replication. Evaluation of this initiative resulted in a plan to disseminate model projects to selected ACS divisions with varied resources and capabilities (e.g., outreach to high-risk populations, planning, program development, and evaluation) for replication. During the next phase, projects will be evaluated to document the role of TA in facilitating local empowerment and nationwide diffusion of effective cancer prevention and control programs.

Community Health Services↗

Achieving community justice through faith-based initiatives.

Prior to 1996, most churches and other faith-based organizations were ineligible to receive federal funding for community services. In a little noticed provision of the Welfare Reform Act of 1996 known as 'charitable choice,' the federal government allowed religious groups to receive money for social programs without requiring them to censor their religious expression or give up their religious identity. States, with varying degrees of vigor and success, have partnered with faith-based organizations to provide community services that serve the purpose of transitioning people from welfare to work. Recent political developments and legislation suggest an expanded role for faith-based organizations to receive federal money to develop community services, including money for community justice projects. The Comment begins with an overview of the political and legal contexts that allow the development of promoting community justice initiatives through faith-based efforts. Next, there is a discussion of practical considerations that influence decisions of churches and faith-based organizations to participate in these activities. Finally, there is discussion of the roles social scientists and others might play to facilitate community justice initiatives through faith-based efforts.

Financing, Government↗

The role of multilateral institutions.

In line with its mission of alleviating poverty through support for environmentally and socially sustainable economic development, The World Bank (along with some other multilateral development banks) is working to help developing countries capture a share of the emerging global market in greenhouse-gas-emissions reductions ('carbon trading'). Under the Kyoto Protocol of the United Nations Framework Convention on Climate Change (UNFCCC), the Joint Implementation instrument and the Clean Development Mechanism now provide an opening for substantial international resource transfers and potential for supporting sustainable development through the transfer of cleaner technologies or sustainable forestry and agro-forestry practices. For example, carbon sequestration represents a non-extractive non-consumptive sustainable use of living natural resources that can be incorporated within a multiple-use 'integrated ecosystem management' approach. The World Bank initiated the Prototype Carbon Fund (PCF) in April 2000, to help spur the development of a global carbon market and to 'learn by doing' how to use carbon-purchase transactions across a range of energy-sector technologies (and some forestry applications) to achieve environmentally credible and cost-effective emissions reductions that benefit developing countries and economies in transition. Building on the success of the PCF ($145 million raised from public and private-sector investors), The World Bank expects to launch two new funds in 2002: the Biocarbon Fund and the Community Development Carbon Fund. These funds will target synergies between carbon markets and objectives such as biodiversity conservation, combating desertification and small-scale community-driven development. Experience from the PCF shows that developing countries can have a comparative advantage in supplying this global market, as emissions reductions can be achieved in developing countries in the range of $3-$5 per ton of CO(2) equivalent, compared with a marginal abatement cost of $10-$15 per ton of CO(2) equivalent in most countries within the Organization for Economic Cooperation and Development. However, realizing this economic potential over the next decade, and targeting the market to the rural poor, will require substantial assistance with project development and government legal and institutional capacity building. Specific needs include raising awareness of the potential of carbon markets at all levels (particularly in energy and land-use sectors), clarifying property rights, particularly in the case of communally held land and resources, ensuring the existence of an attractive investment climate, eliminating policies that create perverse incentives and constraints, and mitigating logistical, political and 'reputational' risks that could deter private-sector investors. It will also be necessary to find ways to reconcile the short-term needs of the rural poor and the typically long-term revenue stream associated with carbon sequestration.

Air Pollution↗

A community partnership programme addresses the needs of three partners in a unique way.

The process for the establishment of a community development programme between three partners, namely the community of Mangaung, the University of the Orange Free State and the Health Department of the Free State is discussed from the beginning. The phases of the process, the related stumbling blocks, the reasons for success, the scope of the programme, as well as the extent to which the three partners benefited from it, are discussed.

Community Health Planning↗

[Community health documentation as an instrument for further developing recommendations in community health].

The local health conference in a North Rhine-Westphalian county of Germany has made proposals to improve immunisation rates against measles, mumps and rubella. Another target was to prevent decubitus by elderly patients in hospitals, nursing homes and in the outpatient nursing. Local public health reports were the basis for the development of (local) health targets in the health conference. The data of 12,830 immunisation papers from 11-19-year old students showed immunisation rates against measles, mumps and rubella from 44% to 14% depending on the type of school. Virus hepatitis B immunisation rates are 32% in the county. There were also great differences between local towns of the county. The decubitus data showed rates from 2.3% in nursing homes to 5.1% in the outpatient sector. It is also shown that health reports and health conferences help to improve local conditions in public and individual health.

Adolescent↗

Enhancing the continuum are for substance abusers.

BACKGROUND: In 2001, Pikes Peak Mental Health Center (Colorado Springs, Colorado) spearheaded a community collaboration to increase service capacity for substance abusers and reduce recidivism. In 2003, a Substance Abuse Advisory Council generated community support through substance abuse education activities and fund raising. It developed a program that entailed a recovery home and shelter for clients, intensive case management, and outpatient programs. METHODS: A task force was initiated to develop community solutions. Each stakeholder evaluated the issue of substance abuse as it related to his or her agency's perspective and collaborated to develop solutions within a broader community context. The project's goals were to (1) establish community awareness regarding the discrepancies between quality in care and the complex interactions of substance abuse variables, (2) eliminate the fragmentation between care providers, and (3) produce an enhanced continuum of care. RESULTS: Improvements were evident in all six performance measures (p < .05)--detoxification access, services, and continuum of care. For example, overall reduction in the recidivism rate has shown a 23% decrease since the project's inception. Capacity increased by 42% from 2004 to 2005. Since 2003, self-referrals to the detoxification unit have increased by 44%. DISCUSSION: On the basis of the outcomes, Pikes Peak Mental Health Center's Detoxification/Acute Unit has obtained funding to continue and expand existing services to target the indigent behavioral health community.

Awards and Prizes↗

A mental health worker for minority ethnic communities.

The Mental Health Workforce Strategy for England outlined a commitment to ensure that the mental health workforce had the skills, capabilities and capacity to meet the needs of people with mental health problems. One of its commitments involves creating new roles, including the community development worker for black and minority ethnic communities. This article outlines the key components of the role and how it is intended to ensure the mental health needs of black and minority ethnic communities are met.

Career Mobility↗

Young people and social action: youth participation in the United Kingdom and United States.

This chapter provides two case studies of projects in the United Kingdom and United States using a social action approach to encourage youth participation and civic engagement. The authors provide a snapshot of U.K. and U.S. policy related to inclusionary practice in youth development work, along with testimony from youth participating in the two community development initiatives. As part of the positive youth development approach, youth inclusion is seen as a key to policy, programs, planning, and practice with young people. Educators, researchers, and practitioners using participatory methodologies have continued to move the youth development field forward. Social action provides a theory and practice that enhances community building, social cohesion, and positive youth development.

Adolescent↗