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PubMed1991

Dual chain migration: post-1965 Filipino immigration to the United States.

In analyzing Filipino migration to the United States since 1965, the authors identify two distinct chains of immigrants. One derives from the Filipinos who entered the country prior to 1965; the other comes from the flow of highly trained professionals who immigrated during the late 1960s and early 1970s. "To establish the historical basis for the two patterns of immigration that unfolded in the post-1965 period, the article begins with a brief examination of Filipino immigration to the United States. An analysis of the modes of entry used in both chains follows this overview. The study concludes with a discussion of the degree of convergence in these two chains and the consequences of each for contemporary Filipino-American community development." Data are from published U.S. census material and from Immigration and Naturalization Service reports and tapes dating from 1972 to 1985.

Americas↗

PubMed2006

The use of time-series data in the assessment of macrobenthic community change after the cessation of sewage-sludge disposal in Liverpool Bay (UK).

Sewage sludge was disposed of in Liverpool Bay for over 100 years. Annual amounts increased from 0.5 million tonnes per annum in 1900 to approximately 2 million tonnes per annum by 1995. Macrofauna and a suite of environmental variables were collected at a station adjacent to, and a reference station distant from, the disposal site over 13 years, spanning a pre- (1990-1998) and post- (1999-2003) cessation period. Univariate and multivariate analyses of the time-series data showed significant community differences between reference and disposal site stations and multivariate analyses revealed station-specific community development post-disposal. Temporal variability of communities collected at the disposal station post-cessation was higher than during years of disposal, when temporally stable dominance patterns of disturbance-tolerant species had established. Alterations of community structure post-disturbance reflected successional changes possibly driven by facilitation. Subtle faunistic changes at the Liverpool Bay disposal site indicate that the near-field effects of the disposal of sewage sludge were small and therefore could be considered environmentally acceptable.

Analysis of Variance↗

PubMed1997

Improving cancer pain management in communities: main results from a randomized controlled trial.

The purpose of this randomized controlled community trial is to evaluate the effects of a community intervention utilizing opinion leaders and educational strategies on the cancer pain management knowledge, attitudes, and the practices of physicians and nurses, and cancer pain reported by patients. Six Minnesota communities participated in the study. The three communities randomized to the intervention received educational programs over 15 months. The clinical community opinion leaders participated in a minifellowship, developed community task forces, and interacted with their peers. This strategy was reinforced with community outreach programs, clinical practice guidelines, educational materials, and media events. The primary study end point was patients' pain intensity score. Comparing intervention to control communities, pain prevalence declined slightly, pain management index improved slightly, pain intensity scores increased slightly, patient and family attitude scores did not change, and physicians' and nurses' knowledge and attitude scores improved slightly. None of these changes, however, reached statistical significance. Participation in at least one intervention program improved physicians' and nurses' knowledge and attitude scores that approached statistical significance. Our results suggest that community opinion leaders combined with other educational programs may improve cancer pain management, but this strategy requires further study. The results suggest that more intense intervention application may be effective. Effective strategies to improve cancer pain management remain elusive.

Cohort Studies↗

PubMed2000

The NIMBY phenomenon: community residents' concerns about housing for deinstitutionalized people.

This article reports the findings of a study on community opposition to group homes in Montreal, Canada. This qualitative study set out to explore the underlying dynamics of what happens when a community rejects a group home. With the use of a naturalistic paradigm, three actual incidents of community opposition were studied. Nineteen interviews were conducted with community residents, elected officials, and group home developers. Community residents did not support deinstitutionalization and social integration policies and argued against group homes. The findings of this study, never reported before in previous research, have important implications for social workers and social planners.

Attitude to Health↗

PubMed2006

Structure and function of bacterial communities emerging from different sources under identical conditions.

The aim of this study was to compare two major hypotheses concerning the formation of bacterial community composition (BCC) at the local scale, i.e., whether BCC is determined by the prevailing local environmental conditions or by "metacommunity processes." A batch culture experiment where bacteria from eight distinctly different aquatic habitats were regrown under identical conditions was performed to test to what extent similar communities develop under similar selective pressure. Differently composed communities emerged from different inoculum communities, as determined by terminal restriction fragment length polymorphism analysis of the 16S rRNA gene. There was no indication that similarity increased between communities upon growth under identical conditions compared to that for growth at the ambient sampling sites. This suggests that the history and distribution of taxa within the source communities were stronger regulating factors of BCC than the environmental conditions. Moreover, differently composed communities were different with regard to specific functions, such as enzyme activities, but maintained similar broad-scale functions, such as biomass production and respiration.

Agriculture↗

PubMed1998

[Community nutrition strategy project: an innovation in community health].

The strategy of the community nutrition project is based on the utilization of the community development structures to deliver the nutrition services. These structures, represented in Senegal by youth associations, women groups, GIEs and NGOs, are part of the decentralization process, and as such play an important role in health and health development activities in poor urban districts. The Community Nutrition Project (CNP), funded for five years by the World Bank, German Cooperation (KFW), World Food Program (WFP) and the Senegalese government aims to halt further deterioration in the nutrition status of the most vulnerable groups in the poorest urban districts of Senegal. All nutrition services and particularly the IEC services have been entirely contracted out the first year to 76 GIEs involving 323 unemployed persons, operating as micro-enterprises "MIC" and 17 "GIEs" of unemployed physicians, pharmacists, and social workers for a total of 34 persons, organized as "maître d'Oeuvre communautaires "MOC", in charge of the supervision tasks. Each community nutrition center recruits and monitors every six months 460 to 600 beneficiaries composed of women at six months of pregnancy, lactating mother of children under 6 months, and a group of children aged from 6 to 35 months old. An average of 87% of registered children in the nutrition centers are weekly or monthly weighted. Thus the proportion of malnourished children in cohort of children followed from January to July 1996 has decreased from 70% to 25% within six months. The malnutrition rate has been reduced up to 65% after six months.

Adult↗

PubMed2001

Community perception of Malayan filariasis in the rural areas of Cherthala Taluk of Kerala State, south India.

Lymphatic filariasis, one of the major public health problems can be controlled with the active participation of the community. The human factors involved in the disease transmission are important. The knowledge on the community perception and practice is essential to develop community oriented control programmes. A descriptive study was conducted in the filariasis endemic area of Cherthala, Kerala State, India, to identify the level of people's perception on Malayan filariasis. Two methods namely, interviews and uncontrolled observation were used in the study. A total of 450 respondents (150 microfilaria carriers, 150 chronic patients and 150 normals) were interviewed. The study results showed that majority of the respondents (86.7%) were aware that the disease was caused by a parasite and 93.6% had awareness on transmission of the disease through mosquito bite. The knowledge on the preventive measures against filariasis was also high (78.2%) among the sampled respondents. The strategy for community mobilization in filariasis control programme is discussed in view of high awareness.

Animals↗

PubMedDate not supplied

A framework for health promotion ... a framework for AIDS.

During the 1980s, many AIDS prevention programs and interventions were established. However, program planning was often done with little consideration of the theoretical models useful for implementing successful interventions. In order to refine our AIDS prevention work in the future, it is necessary to look at theoretical frameworks to ensure we are designing and implementing effective and efficient AIDS prevention programs. It is suggested in this article that the health promotion framework is uniquely suited to AIDS prevention work. Challenges involved in the application of this framework are considered. Specific health promotion strategies such as community development, mutual aid, public policy and strengthening community health services are examined. The author concludes that health promotion is an effective model to address a comprehensive, coordinated, ethical response to HIV/AIDS prevention in Canada.

Acquired Immunodeficiency Syndrome↗

PubMed1997

Studying the future: a Delphi survey of how multi-disciplinary clinical staff view the likely development of two community mental health centres over the course of the next two years.

Two community mental health centres (CMHCs) in North Staffordshire, England were the sites for a recent Delphi survey of multi-disciplinary clinical staff. The views of staff were sought on the likely developments over the next 2 years, at the CMHC where they worked. Each group of staff independently produced healthy numbers of suggestions, with few contradictions; and displayed predominantly positive attitudes, both towards particular suggestions and the future in general. Summarized results were classified within seven themes, producing similar distribution patterns for both CMHCs. The most frequently occurring themes were changing staff roles and CMHC functions and developments in therapies and skills. Mid-placed themes concerned community development and communication/continuity. The least frequently reported themes covered general management, user involvement and quality assurance. Issues raised by the study are discussed and related to other published works, followed by consideration of how the findings might be utilized. Clinical staff have generated a large number of suggestions and, importantly, via rounds of confidential voting, indicated the group consensus on each item. Consequently, management of change should stand a high chance of success. Finally, one means of taking the findings forward is described.

Attitude of Health Personnel↗

PubMed2006

Reducing under-five mortality through Hôpital Albert Schweitzer's integrated system in Haiti.

BACKGROUND: The degree to which local health systems contribute to reductions in under-five mortality in severely impoverished settings has not been well documented. The current study compares the under-five mortality in the Hôpital Albert Schweitzer (HAS) Primary Health Care Service Area with that for Haiti in general. HAS provides an integrated system of community-based primary health care services, hospital care and community development. METHODS: A sample of 10% of the women of reproductive age in the HAS service area was interviewed, and 2390 live births and 149 child deaths were documented for the period 1995-99. Under-five mortality rates were computed and compared with rates for Haiti. In addition, available data regarding inputs, processes and outputs for the HAS service area and for Haiti were assembled and compared. RESULTS: Under-five mortality was 58% less in the HAS service area, and mortality for children 12-59 months of age was 76% less. These results were achieved with an input of fewer physicians and hospital beds per capita than is available for Haiti nationwide, but with twice as many graduate nurses and auxiliary nurses per capita than are available nationwide, and with three cadres of health workers that do not exist nationwide: Physician Extenders, Health Agents and Community Health Volunteers. The population coverage of targeted child survival services was generally 1.5-2 times higher in the HAS service area than in rural Haiti. DISCUSSION: These findings support the conclusion that a well-developed system of primary health care, with outreach services to the household level, integrated with hospital referral care and community development programmes, can make a strong contribution to reducing infant and child mortality in severely impoverished settings.

Adolescent↗

PubMed1987

Community leadership and participation in the Saradidi, Kenya, rural health development programme.

Community participation and leadership in initiating and implementing a health development programme in Saradidi, Kenya were examined. Organization of the area into villages had to be sensitive to existing community organizational structures such as geography, religion, kinship and administrative boundaries. The lowest level government leaders did not always have the support of the community. Some groups such as women and those who were not wealthy were not always included in leadership positions; these people, however, were often most aware of certain village problems. In Saradidi, women's groups were important for community development; they supported the volunteer community health workers and carried out many village health activities. Many village health committees did not function effectively. Village health workers were supported principally by the programme centre. Village income-generating activities were not very successful. Group involvement in income raising ventures proved to be inefficient; many ended up as income draining activities. Village group income projects must be well selected relative to the skills and resources available and the ability of the product to be marketed; only exceptional ones should be encouraged. Those based at the programme's centre were more successful perhaps because of a greater investment in skills, money and marketing. Age was an important factor in accepted leadership roles in Saradidi; most effective leaders were more than 45 years of age. Village health helpers volunteered a significant proportion of their time despite poor support by village health committees and no financial remuneration. The central project structure and the training they received compensated for the lack of guidance by village health committees.

Community Health Services↗

PubMed2002

Focusing on local health needs and promoting new partnerships.

Government reports have stressed the importance of community-based interventions in addressing health inequalities. This article discusses the pivotal role played by a health visitor and school nurse team in identifying the health needs of a local community and working in partnership with local people, key community groups, health and youth workers to address these specific needs. A health needs assessment highlighted the need for a parenting programme to support parents in managing young children's behaviour, a forum for teenagers to socialize and access pertinent health information and health days to raise public awareness of key community health issues. To date the parenting programme and the youth club have been implemented. Evaluation has considered how accessible, appropriate, efficient and effective they have been and the knowledge and skills gained by participants. This community development demonstrates how health promotion works through effective community action.

Community Health Nursing↗

PubMed2005

Community environment and HIV/AIDS-related stigma in China.

This article examines the contextual effects of community environment on individual stigmatizing attitudes toward people with HIV/AIDS in China. Multilevel logistic regression models are used to analyze data on 5,658 respondents aged 15-49 from 66 communities in the Baseline Information, Education, and Communication Survey for HIV/AIDS Prevention in China, conducted by the State Family Planning Commission in 2000. The results show that a high level of HIV/AIDS-related risk behavior in the community and a low level of community development are associated with increased HIV/AIDS-related stigma, after controlling for respondents' sociodemographic characteristics, including extent of knowledge about HIV/AIDS. The findings suggest that interventions for reducing HIV/AIDS-related stigma in China should take into account community characteristics, such as level of HIV/AIDS-related risk behavior and level of development in the community.

Adolescent↗

PubMed2001

Modernisation, the NHS Plan and healthy communities.

This paper reviews the NHS Plan from the perspective of the Government's wider programme of "modernising" public services. Although broadly focussed, particularly highlights older people. Two dimensions of modernisation are identified. The NHS Plan is seen to be patient-cited--rather than citizen-centred. Argues further, that, if the economic, social and environmental causes of ill health are to be addressed more generally and if citizens are to be enabled to live in healthy, sustainable communities, planning for health services should logically be subordinate to planning for health. Health improvement plans should, therefore, be integrated within the wider community strategies for which local authorities are to have lead responsibility. Similarly, as ill health is recognised to be an important aspect of poverty, inequality and social exclusion, there is a strong case for the integration of the regional offices of the NHSE within the wider structure of regional governance. Finally, the personal social services should ensure that the values of social work and social care are not displaced by medical and nursing models which, historically, have shown little understanding of community development processes.

Aged↗

PubMed1995

Speaking truth to power: empowerment ideology as social intervention and policy.

The popularity, and subsequent ambiguity, in the use of the term "empowerment" has created an even greater need for reassessment in the applied context than in the theory and research literatures. This paper outlines some of the areas of community, organizational, and societal level social intervention and policy ostensibly based on the concept of empowerment. These include neighborhood voluntary associations (for environmental protection, community crime prevention, etc.), self-help groups, competence-building primary prevention, organizational management, health care and educational reforms, and national and international community service and community development policies. Issues in applying social research to community organizations and to legislative and administrative policy making are reviewed. Ten recommendations are offered, including the value of a dialectical analysis, for helping researchers and policy makers/administrators make more effective use of empowerment theory and research.

Community Networks↗

PubMed1992

Behavior analysis of residential program development.

When institutions are viewed not as locales but as forms of organizing and regulating human behavior, we see that we "deinstitutionalize" by changing the way we organize and regulate, not necessarily by moving people about. This paper examines residential program development as a process of designing and developing community learning environments. The paper asks "What are the essential behaviors of designing community environments?", that is, what do residential program developers do? Six essential dimensions of program development are identified, and each dimension is critiqued in terms of contemporary practices and needs for innovation. The paper concludes that behavior analysts can play an important role in changing the nature of human service organizations.

Activities of Daily Living↗

PubMed2006

On the reproducibility of microcosm experiments - different community composition in parallel phototrophic biofilm microcosms.

Phototrophic biofilms were cultivated simultaneously using the same inoculum in three identical flow-lane microcosms located in different laboratories. The growth rates of the biofilms were similar in the different microcosms, but denaturing gradient gel electrophoresis (DGGE) analysis of both 16S and 18S rRNA gene fragments showed that the communities developed differently in terms of species richness and community composition. One microcosm was dominated by Microcoleus and Phormidium species, the second microcosm was dominated by Synechocystis and Phormidium species, and the third microcosm was dominated by Microcoleus- and Planktothrix- affiliated species. No clear effect of light intensity on the cyanobacterial community composition was observed. In addition, DGGE profiles obtained from the cultivated biofilms showed a low resemblance with the profiles derived from the inoculum. These findings demonstrate that validation of reproducibility is essential for the use of microcosm systems in microbial ecology studies.

Biofilms↗

PubMed2004

Improving epidemic malaria planning, preparedness and response in Southern Africa. Report on the 1st Southern African Regional Epidemic Outlook Forum, Harare, Zimbabwe, 26-29 September, 2004.

Malaria is a major public health problem for countries in the Southern Africa Development Community (SADC). While the endemicity of malaria varies enormously across this region, many of the countries have districts that are prone to periodic epidemics, which can be regional in their extent, and to resurgent outbreaks that are much more localized. These epidemics are frequently triggered by climate anomalies and often follow periods of drought. Many parts of Southern Africa have suffered rainfall deficit over the past three years and countries expect to see increased levels of malaria when the rains return to more 'normal' levels. Problems with drug and insecticide resistance are documented widely and the region contains countries with the highest rates of HIV prevalence to be found anywhere in the world. Consequently, many communities are vulnerable to severe disease outcomes should epidemics occur. The SADC countries have adopted the Abuja targets for Roll Back Malaria in Africa, which include improved epidemic detection and response, i.e., that 60% of epidemics will be detected within two weeks of onset, and 60% of epidemics will be responded to within two weeks of detection. The SADC countries recognize that to achieve these targets they need improved information on where and when to look for epidemics. The WHO integrated framework for improved early warning and early detection of malaria epidemics has been recognized as a potentially useful tool for epidemic preparedness and response planning. Following evidence of successful adoption and implementation of this approach in Botswana, the SADC countries, the WHO Southern Africa Inter-Country Programme on Malaria Control, and the SADC Drought Monitoring Centre decided to organize a regional meeting where countries could gather to assess their current control status and community vulnerability, consider changes in epidemic risk, and develop a detailed plan of action for the forthcoming 2004-2005 season. The following is a report on the 1st Southern African Regional Epidemic Outlook Forum, which was held in Harare, Zimbabwe, 26th-29th September, 2004.

Africa, Southern↗