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PubMed1990

Providers link health with human service.

This issue's cover story looks at a handful of hospital leaders who appear to be radically redefining their hospital's role, but who are really just returning to the basics of hospital management and the basic hospital mission of community service. These CEOs of innercity hospitals are taking a leadership role in community development programs, ranging from literacy to housing. They bring together community groups to solve problems, work to find funding for projects, and attract new business to the hospital's service area. They also provide community residents with a sense of hope and a sense of stability. But their actions have ramifications that extend beyond their communities. These leaders may also be providing other health care executives with an approach to strategic planning that will add new meaning to the term "community hospital" in the 1990s.

Chicago↗

PubMed2005

Development of macrofaunal communities on dredged material used for mudflat enhancement: a comparison of three beneficial use schemes after one year.

In recent years, dredged material has become regarded as a potential resource and used to create and/or improve intertidal habitats ('beneficial use' schemes). This paper presents the results of a sampling programme to investigate the short-term macrofaunal recovery of three beneficial use schemes in south-east England in terms of species and functional diversity. Environmental parameters (sediment redox potential, and water, organic carbon and silt/clay contents) and univariate community attributes (total individuals and species, diversity, evenness and biomass) at the recharge sites had attained reference levels at two schemes while assemblages differed significantly in terms of species composition at all three schemes. While trophic group proportionality had re-established at one scheme, an increased grazer dominance was apparent at another while the proportion of sub-surface deposit feeders decreased at the third. Total individuals and species number of the developing communities were negatively correlated with sediment redox potential at 4 cm and % silt/clay, respectively. The implications of these results for monitoring the recovery of future fine-grained beneficial use schemes are discussed.

Animals↗

PubMedDate not supplied

Development of a community health intensity rating scale.

The purpose of this study was to develop and validate a patient classification method for community health that would enable the categorization of patients based on their nursing care requirements. The Community Health Intensity Rating Scale (CHIRS) was developed by integrating nursing theory with nursing practice. Groups of nurse experts in community health developed prototype definitions for 15 community health parameters that incorporated both patient characteristics and critical indicators of care as descriptors of nursing care requirements. The tool was then pilot tested using staff nurses from three home health agencies. Validation of the tool was accomplished by a retrospective rating of 560 charts from two home health agencies. By quantifying the CHIRS score using nursing visits as a measure of resource consumption, it was possible to show that nursing resource consumption increased with each increasing level of CHIRS rating. Reliability and validity were established for the tool.

Adolescent↗

PubMed2003

Working with Toronto neighbourhoods toward developing indicators of community capacity.

Often the goal of health and social development agencies is to assess communities and work with them to improve community capacity. Particularly for health promoters working in community settings and to ensure consistency in the definition of health promotion, the evaluation of health promotion programmes should be based on strengths and assets, yet existing information for planning and evaluation purposes usually focuses on problems and deficits. A model and definition of community capacity, grounded in community experience and focusing on strengths and assets, was developed following a 4-year, multi-site, qualitative, action research project in four Toronto neighbourhoods. There was significant community involvement in the four Community Advisory Committees, one for each study site. Semi-structured, open-ended interviews and focus groups were conducted with 161 residents and agency workers identified by the Community Advisory Committees. The data were analyzed with the assistance of NUDIST software. Thematic analysis was undertaken in two stages: (i) within each site and (ii) across sites, with the latter serving as the basis for the development of indicators of community capacity. This paper presents a summary of the research, the model and the proposed indicators. The model locates talents and skills of community members in a larger context of socioenvironmental conditions, both inside and outside the community, which can act to enable or constrain the expression of these talents and skills. The significance of the indicators of community capacity proposed in the study is that they focus on identifying and measuring the facilitating and constraining socioenvironmental conditions.

Community Health Services↗

PubMed2005

Promising programs to serve low-income families in poverty neighborhoods.

This review of promising programs to address the challenges facing low-income families living in distressed neighborhoods reveals three key themes: (1) Earnings and asset development programs are used to increase the economic self-sufficiency of low-income families and include: place-based employment programs, a focus on good jobs, the use of work incentives, programs that promote banking, car and home ownership, and the use of the Earned Income Tax Credit; (2) Family strengthening programs are used to improve health and educational outcomes, as well as link families to needed support and benefit services and include: nurse home visitation, parenting education, early childhood educational programs, and facilitating the receipt of support services; and (3) Neighborhood strengthening programs are used to improve features of the neighborhood, collaboration among service providers, and resident involvement in neighborhood affairs and include: the use of community development corporations, comprehensive community initiatives and community organizing strategies.

Family↗

PubMedDate not supplied

Partners in collaboration: The Homan Square Project.

The Homan Square Project, a collaborative community development effort, exemplifies the World Health Organization's model for cities. This article describes the implementation of a health care component--a joint venture between the College of Nursing at Rush University and Rush Primary Care Institute of the Rush System for Health--in partnership with the North Lawndale community coalition on Chicago's West Side. The health care programs and services include a primary health care clinic, school-based health centers, family education and counseling programs, and screening services linking the community to secondary/tertiary care systems. Investment of resources toward the health care component of the Homan Square Project includes paid and contributed time of nurse practitioner faculty in areas such as prenatal care, women's health, school nursing, parenting skills, and mental health. Based on preliminary evaluation of the health program, outcomes have focused on the types, quality, and quantity of services delivered to the community. Overall, the Homan Square Project has provided a unique opportunity for the interface of service delivery and academic education with the goal of improving the quality of life for a developing inner-city community.

Adult↗

PubMed1985

Antibiotics, sore throats and rheumatic fever.

From a retrospective study of hospital records, it is calculated that the present incidence of rheumatic fever in Scottish children is 0.6 per 100 000 per year. This is in keeping with recent research from other developed communities. An attempt is made to assess the relative risk of developing rheumatic fever after antibiotic-treated streptococcal sore throats and non-antibiotic-treated streptococcal sore throats. The risk in both cases is low (probably in the order of 1:30 000) and there is no evidence that prescribing antibiotics for prodromal sore throats confers benefit.

Adolescent↗

PubMed1999

Encouraging schools to promote health: impact of the Western Australian School Health Project (1992-1995).

The Western Australian School Health (WASH) Project, a school health promotion intervention operating over a four-year period (1992-1995), provided a comprehensive, year-long intervention to help successive groups of schools develop health promotion programs. The WASH Project worked with self-selected school communities and used community development strategies to support participating schools in identifying and responding to health concerns relevant to their students. This paper reports the school impact results of the WASH Project. School impact data involved 24 variables categorized into two areas: school organizational factors supportive of health promotion, and school health promotion factors. Two methods of analysis were used: logistic regression indicating the direction of change, and linear regression indicating the magnitude of change. Results demonstrated that schools successfully made organizational changes, such as the allocation of additional time, personnel, and monetary resources, to support health promotion.

Adolescent↗

PubMed1977

Self-care in urban settings.

A variety of indicators favors the development of self-care systems for inner-city populations. This cannot be conceived as an isolated individual or a family enterprise. To be effective, self-care must be a community concept. This type of system requires (1) an information base; (2)an organized method of dissemination in a community; (3) support structures; and (4) an evaluation sybsystem. A community-oriented system would be an alternative and a complement to formal health services; individuals and families would manage common health problems, but would have ready access to formal services through community organizations. Links must also be provided between personal self-care and other forms of community development.

Community Health Services↗

PubMed2003

Promoting breast-feeding in a deprived area: the influence of a peer support initiative.

The present article describes a qualitative study designed to evaluate the effectiveness of a peer-support intervention to promote breast-feeding in a deprived area. The aims of the study were to: explore stakeholders' experiences of the intervention; explore the development of a 'culture' of breast-feeding; and consider the potential of the initiative for building community capacity. The methods used in the research were in-depth interviews, diaries and direct observation. The findings describe the social and cultural barriers to breast-feeding experienced by women, and the ways in which professional and lay participants in the peer-support project attempt to reduce them. The advantages of partnership working between health professionals and lay volunteers are then explored. These include: sharing the workload; providing an informal tier of support to mothers; and importantly, offering support and advice stemming from personal experience. For lay supporters, the benefits of taking part in the project range from personal satisfaction at being recognised as skilled, to gains in confidence which potentially open up further educational and training opportunities. In conclusion, it is suggested that the 'success' of such interventions is unlikely to be captured solely by monitoring breast-feeding rates, but needs to take into account the wider context of community development.

Adult↗

PubMed2004

[Dynamics and species-diversities of artificial Sonneratia apetala, Sonneratia caseolaris and Kandelia candel communities].

Studies on the dynamics and species-diversities of artificial Sonneratia apetala, Sonneratia caseolaris and Kandelia candel communities showed that the arbor layer of S. apetala and S. caseolaris communities contained two distinctive sub-layers. The upper layer was composed of S. apetala or S. caseolaris, and the medium layer was composed of K. candel and Aegiceras corniculatum. The dominant population S. apetala or S. caseolaris in S. apetala and S. caseolaris communities only had old-aged individuals but no regenerations appeared recently, while K. candel and A. corniculatum were actively progressive populations, which would possibly become dominant populations during the course of community development, showing that S. apetala and S. caseolaris were pioneer species for plantation, which could promote natural colonization of regional mangrove species when planted at open mudflat. K. candel was the actively progressive population in K. candel community, its natural regeneration and succession could be successful, while A. corniculatum and B. sexangula were initially progressive populations. The species composition and species-diversities of S. apetala and S. caseolaris communities were similar, both contained the main species in K. candel community, namely, K. candel, A. corniculatum and Bruguiera sexangula, showing that S. apetala and S. caseolaris could co-exist with these regional species. To introduce and plant them could help to form complicated and diversified mangrove communities. During the early stage of the development, the species-diversities of S. apetala and S. caseolaris communities were higher when their planting density was high. The species-diversities grew slightly higher when the communities became older.

Biodiversity↗

PubMed2003

Addressing the needs of lesbian, gay, bisexual, transgendered, queer, and questioning clients within university psychiatric services: reflections and recommendations.

Concerns still exist among lesbian-, gay-, bisexual-, transgendered-, and queer-identified individuals (LGBTQ individuals) about their reception and treatment by psychiatric service providers. The Psychiatric Service at the University of Toronto and the Office of LGBTQ Resources and Programs convened a committee to address expanding the capacities of the Service related to the needs of LGBTQ and questioning students. In this paper, we describe the committee's role, initiatives, and successes and discuss challenges encountered in the process. The model of community development drawn from in this work can be adapted for use in other community health settings.

Bisexuality↗

PubMed1998

Third world medicine in first world cities: capital accumulation, uneven development and public health.

This paper addresses issues of public health and access to care for the urban poor in the context of current U.S. urban, economic and industrial policy. The pathologies that threaten "inner city" neighborhoods are the result of decades of political neglect, economic exploitation and resource withdrawal, which themselves stem directly from public and corporate sector strategies to facilitate capital accumulation and consolidation. The resulting conditions of uneven development between wealthy and impoverished local sectors mirror similar relationships between First and Third World countries. These same patterns are reflected and reproduced in the health care "industry" itself, where growing corporate dominance has developed alongside a concomitant reduction in support for public sector and community-based care. These trends create and exacerbate conditions that place poor and minority populations at risk. Community development and political empowerment, as well as the overall corporate hegemony that increasingly characterizes the political economy of the U.S.A., are essential public health considerations that must be included in any meaningful health policy or health care reform proposals.

Cities↗

PubMed1998

How to understand a community--community assessment for the promotion of health-related physical activity.

A definition of the concept of community is given and the principles and the major components of community assessment for health-related physical activity are presented. Definitions of community can include a focus on geographic, social or cultural elements. Basically community assessment deals with a process having two main aspects. The first, quantitative and descriptive aspect consists of a community profile, a wellness profile, a behavioural profile and a service profile. The second, qualitative and analytical aspect deals with organizational capabilities and the community's readiness for change. This information can be used for programme planning, implementation, and evaluation in the process of community development.

Adolescent↗

PubMed1977

Effects of pentachlorophenol on the development of estuarine communities.

Pentachlorophenol affected the composition of communities of estuarine organisms developed in sand from planktonic larvae in estuarine water that flowed through ten control aquaria and ten aquaria per exposure concentration averaging 7, 76, or 622 microgram/liter. Annelids, arthropods, and mollusks were the numerically dominant phyla when animals were collected in a 1-mm-mesh sieve after 9 wk of exposure. Mollusks were markedly fewer at 7 microgram/liter; annelids and arthropods at 76 microgram/liter. Almost no animals occurred at 622 microgram/liter. The total numbers of individuals and species were significantly less (alpha=0.01) in aquaria exposed to 76 microgram/liter than in those unexposed or exposed to 7 microgram/liter.

Animals↗

PubMed2005

Succession of bacterial community structure and diversity in a paddy soil oxygen gradient.

Cultivation-independent techniques were applied to assess the succession and phylogenetic composition of bacterial communities in a vertical oxygen gradient in flooded, unplanted paddy soil microcosms. Microsensor measurements showed that within 6 h of flooding, oxygen was depleted from 200 microM at the floodwater-soil interface to undetectable amounts at a depth of approximately 2 mm and below. The gradient was quite stable over time, although the oxygen depletion was less pronounced 84 days than 6 h after flooding. Community fingerprint patterns were obtained by terminal restriction fragment length polymorphism (T-RFLP) analysis from the oxic, transition, and anoxic zones of triplicate soil microcosms at 0, 1 and 6 h, and 1, 2, 7, 21, 30, 42, 84, and 168 days after flooding. Correspondence analyses revealed that T-RFLP patterns obtained using either community DNA or RNA were affected by time and oxygen zone, and that there was a significant interaction between the effects of time and oxygen zone. The temporal dynamics of bacterial populations were resolved more clearly using RNA than using DNA. At the RNA level, successional community dynamics were most pronounced from 1 h to 2 days and less pronounced from 2 to 21 days after flooding, for both oxic and anoxic zones. No effect of time or oxygen zone on the community dynamics was observed from 21 to 168 days after flooding. Dominant early successional populations were identified by cloning and comparative sequence analysis of environmental 16S rRNA and 16S rRNA genes as members of the Betaproteobacteria (oxic zone) and the clostridial cluster I (anoxic zone). Dominant late successional populations belonged to the Verrucomicrobia and Nitrospira (detected mainly in the oxic zone), and to the Myxococcales (detected mainly in the anoxic zone). In conclusion, the bacterial community developed through successional stages, leading at the RNA level to almost stable community patterns within 21 days after flooding. This principal finding, in combination with the phylogenetic identity of early- and late-appearing populations, suggests that the community dynamics can be explained by the principles of r- and K-selection.

Bacteria↗

PubMed1998

Identifying and defining the dimensions of community capacity to provide a basis for measurement.

Although community capacity is a central concern of community development experts, the concept requires clarification. Because of the potential importance of community capacity to health promotion, the Division of Chronic Disease Control and Community Intervention, Centers for Disease Control and Prevention (CDC), convened a symposium in December 1995 with the hope that a consensus might emerge regarding the dimensions that are integral to community capacity. This article describes the dimensions that the symposium participants suggested as central to the construct, including participation and leadership, skills, resources, social and interorganizational networks, sense of community, understanding of community history, community power, community values, and critical reflection. The dimensions are not exhaustive but may serve as a point of departure to extend and refine the construct and to operationalize ways to assess capacity in communities.

Communicable Disease Control↗

PubMed1994

The hospital community benefit standards program and health reform.

This article suggests that the community hospital can be an important key to health reform at the local level; that community benefit guidelines are acceptable to hospitals and community leaders in a 49-site national demonstration program; and that these guidelines can prove useful for communities in moving toward health reform. Types of community involvement by hospitals are categorized, and examples of each type are developed. Community benefit programs can be a promising approach to effectively respond at the local level to the problems of poor health status, lack of access to care, and increasing health care costs. Addressing financing of care without attention to changes in the delivery system will not lead to effective health reform.

Community Health Services↗