COPCORD--an unrecognized fountainhead of community rheumatology in developing countries.
Explore the source record for details and available documents.
Community Health Services↗
SEARCH · Search PubMed
Results for “Community Development”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
[Models of community participation in health programs].
Study of some Latin American experiences of community participation in health programs permit consideration of the following as minimum requirements for the establishment of interrelationships between local health agencies and the community: a local health system; a participating health team; respect for the community; contact with community organizations; and contact with private and governmental organizations at a local level. The models for community participation in health are manifold and the experiences have been countless. For teaching purposes and based on Latin American experiences several considerations are made regarding: community health volunteers; local health councils; local councils for community development; and health brigades. Finally, it is stressed that active and organized community participation in health activities is the best guarantee of success in implementing integral health programs.
Community Health Services↗
Health Action Zones and the problem of community.
Health Actions Zones (HAZs) have been identified as initiatives reflecting the 'third way' policies espoused by the UK New Labour Government. Like other area-based or zone initiatives, HAZ programmes are designed to tackle inequalities and exclusion in some of the most deprived areas of the UK. This is to be achieved through partnerships between the public, private and voluntary sectors, and most significantly, communities themselves. Health Action Zones embrace communities and attempt to foster involvement in health improvement, often using established community development models. The present paper uses the findings of an ongoing process study into the development of one zone in the north-east of England to consider community involvement in practice. The benefits and challenges of involving communities in the HAZ process are presented, and the relevance of this for future programmes and policy are discussed.
Catchment Area, Health↗
The Community Study Stuttgart.
A basic objective of the "Community Study Stuttgart", a part of the German Cardiovascular Prevention Study (GCP), which began in April 1984 and will end in December 1991, is to develop and utilize globally applicable intervention measures through which cardiovascular risk factors can be reduced effectively under the population's living conditions in the Federal Republic of Germany. Vital elements of intervention include exerting influence on individual health behaviour as well as creating and developing community structures and provisions to foster health. The intervention is directed towards behaviour in the sectors of nutrition, physical activity and (non-)smoking, but psychosocial constellations will also be taken into consideration. The long-range goal of the study is a reduction in the incidence of ischaemic heart diseases and cerebrovascular diseases (as well as the ensuring reduction in total mortality) among the community populations as compared to the average population of the same age in the Federal Republic of Germany. The intervention concept is based on a broadened pathogenetic chain in which the so-called classic somatic risk factors for cardiovascular diseases have been supplemented by behaviour-related psychosocial factors and living conditions which influence health behaviour. Each of the target variables is significant in itself within the intervention concept. In the study, it is assumed that the community framework is of essential relevance to daily life and affects community members' knowledge, attitudes and opportunities for realization. On the basis of scientific studies on the lifestyle concept, an intervention concept was developed which centres on the population of defined communities.(ABSTRACT TRUNCATED AT 250 WORDS)
Cardiovascular Diseases↗
Long-term care policy for elders in Hong Kong.
The context in which aged care policy is being developed in Hong Kong is characterized not only by rapid demographic aging and social change, but also by new political and administrative systems being built on a colonial legacy. This article begins with a description of the demographic profile and trends in population aging, noting particular differences in marriage and family formation that differentiate Hong Kong from other developed countries and that also show marked changes between generations. While past social policies can be credited with contributing to the achievement of high life expectancy in Hong Kong, these policies were unevenly developed, with little provision for income security in old age or for long-term care. Both issues have come to the fore in policy development in recent years, culminating in the formation of the Elderly Commission in 1997 and revitalizing the level of attention given to developing community care. A clear policy agenda has been drawn up to promote the development of a long-term care system, addressing issues of integration; role differentiation for assessment and service provision, including new contractual arrangements; quality assurance; and financing. The political and administrative changes are seen to present opportunities for containing residential care and forging a care system founded on community services.
Aged↗
[Research in tropical medicine and primary health care in Peru].
Tropical medicine's fundamental task is to improve health in the tropics. By adopting primary health care strategies, it satisfies the real needs of the population while doing research, improving its effectiveness and social impact. We illustrate this with some examples drawn from our experience, where this potentiation is evident. A sanitary dermatology study, based on health auxiliaries and promoters, encompassed a whole jungle province, with 68,977 km2 and 103,681 inhabitants. It resulted in an excellent relationship with the populations, and findings of significance for early diagnosis and control of hanseniasis and other diseases. It also facilitated an extension of activities to include the entire Amazonian Region, with specific concentration on training of the health personnel. Clinico-epidemiological studies on leishmaniasis in Andean valleys incorporated activities of sanitary education, health care, aspects of community development, etc., and extended into other geographic areas. Migrant workers from high-altitude communities in Cusco who have been to the jungle and acquired cutaneous or mucocutaneous leishmaniasis formed Patient Associations. The latter now receive support for their health and development needs from health authorities and many institutions; our Institute contributes with improved therapeutic procedures and further epidemiologic studies to orient preventive and control measures.
Humans↗
The use of Trivial Pursuit in teaching community living skills to adults with developmental disabilities.
The use of gaming provides variety, motivation, and renewed interest in activities developing community living skills. In this study, Trivial Pursuit, a popular adult game, was adapted for use with 16 adults with mental retardation attending a developmental center day treatment program. Game questions were developed for six categories of independent living based on the McCarron-Dial Street Survival Skills Questionnaire (SSSQ) and Curriculum Guide. A two-group, pretest-posttest design was used to evaluate the effectiveness of the game in teaching independent living skills. An analysis of variance on the measurement scale and for the total score on the SSSQ indicated significant differences in improvement rate after eight sessions with the game. Additionally, subjects found the Trivial Pursuit format interesting and absorbing. Results suggest that the gaming approach can be a valuable adjunct to traditional independent living training programs.
Activities of Daily Living↗
Safe beds: the new partner in Niagara's crisis system.
Over the past few years and for a variety or reasons, consumers/survivors in the Niagara Region have indicated that an alternative to hospitalization is needed. This paper describes the community-development process which led to the creation of a crisis-response system consisting of Community Crisis Care (CCC) and a Safe Beds program operated by the Canadian Mental Health Association St. Catharines and District. The system is described, as well as the partnerships that are critical to the program's success. Evaluative data are presented along with a discussion of critical learnings. Future considerations for program improvement also are discussed.
Adult↗
A case for social marketing and education for acceptance and implementation of preventive health and occupational safety measure programs for rural communities.
The environment in which acceptance and implementation of preventive health and occupational safety occurs is not conducive to the message being heard, nor are people acting upon the message. Diffusion of innovation and community development models are explored for possible approaches to health education in the rural community. In particular, the community-oriented primary care approach to medical practice is discussed. In addition, the responsibility of the rural community is outlined.
Agriculture↗
Coronary heart disease: interplay between changing concepts of aetiology, risk distribution, and social strategies for prevention.
Epidemic diseases move in grand cycles, accompanying changes in culture, social organization, and environment. Coronary heart disease (CHD), a mass disease of twentieth century industrialized society, has a predominantly environmental aetiology. Although the major biomedical risk factors appear to have been identified over the past 40 years of epidemiological research, we are not certain why CHD is now on the wane in most Western nations. In Australia, CHD death rates have, since 1968, declined much more in professional and white-collar men than in blue-collar men. Any substantial reduction in CHD rates will require a generalized population shift towards a lower CHD risk profile. Numerically, the greatest gains should come from reducing the CHD risk of the bulk of the population, who are currently at medium risk of CHD. Notions of risk need, in the first instance, to be based on up-to-date knowledge of biomedical risk factors and mechanisms in order to develop optimal intervention strategies. A population-based strategy can be achieved via community education and structural modification of the social environment. The latter approach will require public health research into broader questions of the social-environmental influences on population cardiovascular health: for example, research into the social, political, and economic determinants of national food and nutrition policies; and into the various environmental (including workplace) changes that will facilitate risk-lowering behaviour. Hopefully, intervention strategies in such areas, set within a community development context, will be developed within the incipient National Program for Better Health.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
Using consecutive Rapid Participatory Appraisal studies to assess, facilitate and evaluate health and social change in community settings.
BACKGROUND: To investigate how a relatively socio-economically deprived community's needs have changed over time, assess which recommendations from an earlier assessment were implemented and sustained, and consider whether serial Rapid Participatory Appraisal is an effective health research tool that can promote community development and has utility in assessing longitudinal change. METHODS: Rapid Participatory Appraisal involves communities in identifying and challenging their own health-related needs. Information on ten health and social aspects was collated from existing documentation, neighbourhood observations, and interviews with a range of residents and key informants, providing a composite picture of the community's structure, needs and services. RESULTS: The perceived needs after 10 years encompassed a wide construct of health, principally the living environment, housing, and lack of finance. Most identified upstream determinants of health rather than specific medical conditions as primary concerns. After the initial Rapid Participatory Appraisal many interviewees took the recommendations forward, working to promote a healthier environment and advocate for local resources. Interventions requiring support from outwith the community were largely not sustained. CONCLUSION: Rapid Participatory Appraisal proved valuable in assessing long-term change. The community's continuing needs were identified, but they could not facilitate and sustain change without the strategic support of key regional and national agencies. Many repeatedly voiced concerns lay outwith local control: local needs assessment must be supported at higher levels to be effective.
Adult↗
The use and performance of BioSand filters in the Artibonite Valley of Haiti: a field study of 107 households.
INTRODUCTION: Approximately one billion people world-wide lack access to adequate amounts of safe water. Most are in developing countries, especially in rapidly expanding urban fringes, poor rural areas, and indigenous communities. METHODS: In February and March 2005, a field study of 107 households was conducted to evaluate the use and performance of the Manz BioSand filter in the Artibonite Valley of Haiti. Approximately 2000 filters had been installed in this area over the preceding 5 years by the staff in Community Development at Hospital Albert Schweitzer, Deschappelle, Haiti. Interviews, observations, and water samplings were carried-out by two teams of Haitian enumerators, each consisting of a nurse and a filter technician. Water analyses were performed by Haitian lab technicians using the membrane filtration method to determine Escherichia coli counts. The enumerators and the lab technicians completed a 2 week training program before beginning the study; they worked under the direct supervision of the primary investigator. Laboratory quality was monitored by running 10% blank and 10% duplicate samples. RESULTS: The households contained an average of 5.4 persons. Filters had been in use for an average of 2.5 years, and participants were generally satisfied with their filter's performance. Shallow, hand-dug wells provided the only source of water for 61% of the households, with 26% using water piped from springs or deep wells, and 13% having access to both. Only 3% had plumbing in their homes. Source water from shallow wells contained an average of 234 E. coli cfu/100 mL. Piped sources averaged 195 E. coli cfu/100 mL. Of the source water samples 26% contained 0-10 E. coli cfu/100 mL. Of the filtered water samples 97% contained 0-10 E. coli cfu/100 mL (80% with 0 cfu/100 mL, and 17% with 1-10 cfu/100 mL). Overall bacterial removal efficiency for the filters was calculated to be 98.5%. Turbidity decreased from an average of 6.2 NTU in source water samples to 0.9 NTU in the filtered water. None of the households treated the water after filtering; 91% used the filtered water only for drinking. No problems related to filter construction were observed; 13% were found to have significantly decreased flow rates (all restored by cleaning the filter). Recontamination was found to occur, with only 3% of the samples from the filters' spouts containing >10 E. coli cfu/100 mL and 22% of the stored filtered water samples at point-of-use containing >10 cfu/100 mL. CONCLUSION: The Manz BioSand filters are an attractive option for supplying water treatment to family units in rural areas of poorly developed countries.
Developing Countries↗
Setting up a community health house.
In 1990 Mid Glamorgan health authority agreed to fund a 'community health house' on a deprived council estate in the Welsh valleys, and for the local health visitor to devote part of her time to supporting the project. Rosamund Bryar and Lyn Fisk describe the challenge to conventional health visiting management and practice in the community development approach to health promotion with vulnerable families.
Community Health Centers↗
Sanitation: a call on resources for promoting urban child health.
Poor sanitation is known to increase the risk of morbidity and mortality from diarrhea among children. Several studies have found a high correlation between childhood morbidity and availability of sanitation services. It has been estimated that 1.7 million deaths each year, or 3.1 percent of all deaths are attributable to inadequate access to water, sanitation and hygiene. The urgency for sanitation in the urban environment stems from the fact that the urban poor live in crowded slums and informal settlements where sanitation facilities are particularly important for children's health and personal dignity. Demand for sanitation services has remained low, as livelihood priorities have been more pressing. There is a pressing need to get Governments and society to recognize the appalling toll created by poor sanitary conditions in urban poor settlements. Serious efforts should be made to develop local, national and international campaigns which promote convergence among programs aimed at urban health infrastructure, community development and education; motivate people to demand and maintain better sanitation; and place sanitation to the forefront of development and political dialogue.
Child↗
Impacts of Cd and Zn on the development of periphytic diatom communities in artificial streams located along a river pollution gradient.
Many field and experimental studies have been conducted to reveal modifications of periphytic diatom communities under metal pollution, but most of the approaches presented drawbacks: variability of environmental factors for field studies and lack of representativity for experimental ones. An original approach that allows growth of periphytic communities under conditions more controlled than in the field and more realistic than experimental investigations was developed to try conclusions being drawn on the real impact of metallic pollution. Artificial streams were placed on the river bank at three sites along the pollution gradient (Cd/Zn) of the River Lot (SW France): reference (upstream pollution discharge), slightly polluted (around 1.5 microg Cd x L(-1) and 50 microg Zn x L(-1)), and polluted (around 6 microg Cd x L(-1) and 400 microg Zn x L(-1)) sites. Structural characteristics of diatom communities growing in these artificial streams, on glass substrates, and under homogenized current velocity and water depth were compared after four durations (1, 2, 3, and 4 weeks) to study effects of metal on first steps of community development. Marked perturbations of diatom community development were observed overall in the polluted site: after 1 week, early biofilms differed already by taxonomic composition; after 4 weeks, cell density was significantly lower than in the reference site and taxonomic composition was very different. These results, generated by a methodology intermediate between field and experimental approaches, compare well with literature findings based on more traditional approaches, strongly attesting that metallic pollution affects diatom community architecture and induce rising of abnormal cells.
Biofilms↗
Police and mental health professionals. Collaborative responses to the impact of violence on children and families.
Coordinating responses through the Child Development-Community Policing Program has led to multiple changes in the delivery of clinical and police services. Mental health clinicians and police officers have developed a common language for assessing and responding to the needs of children and families who have been exposed to or involved in violence. Learning from each other, these unlikely partners have established close working relationships that improve and expand the range of interventions they are able to provide while preserving the areas of expertise and responsibilities of each professional group. The immediate access to witnesses, victims, and perpetrators of violent crimes through the consultation service provides a unique opportunity to expand the understanding of clinical phenomena from the acute traumatic moment to longer-term adaptation, symptom formation, and recovery. In turn, the initiative introduces the systematic study of basic psychological and neurobiologic functions involved in traumatization as well as the investigation of psychotherapeutic and pharmacologic therapies. Similarly, program involvement with juvenile offenders has led to a coordinated response from the police, mental health, and juvenile justice systems. This project provides an opportunity to develop detailed psychological profiles and typologies of children engaged in different levels of antisocial behavior as well as to determine the characteristics that might predict with whom community-based interventions might be most successful. A recent survey of New Haven public school students has yielded promising evidence that community policing and the program are having a positive impact on the quality of life. In a survey of sixth-, eighth-, and tenth-grade students there were substantial improvements in students' sense of safety and experience of violence between 1992 and 1996. When asked if they felt safe in their neighborhood, there was an increase in the percentage of positive responses from 57% to 62% for sixth-grade students, 48% to 66% for eighth-grade students, and 53% to 73% for tenth-grade students, and when asked if they had seen someone shot or stabbed there was a decrease in positive responses from 43% to 28% for sixth-grade students, 46% to 31% for eighth-grade students, and 34% to 28% for tenth-grade students. Today, we are all too familiar with the developmental trajectory that leads children into violent crime. Newspaper articles and clinical case reports have taken on a dreary repetitiveness. These young criminals are often poor, minority, inner-city children who are known to many agencies to be at risk because of family disorganization, neglect, and abuse. They are failing in school or are already on the streets. One day they are victims and the very next they are assailants. We are all familiar with the inadequacies in the social response to these children, from their preschool years through the point at which they become assailants themselves. What is shocking is that the age at which children make the transition from being abused to being abusive seems to be getting earlier, and the number appears to be increasing. On the positive side, there is an increased awareness of the need and the ability of the various sectors of society to respond in concert. The institutions that function in the inner city--schools, police, mental health and child welfare agencies, churches--are all concerned about the same children and families. By working together, with a shared orientation to the best interests of the children, they can intervene earlier and more effectively: first, to disrupt the trajectory leading to violence; and, second, to help those children who are already caught in the web of exposure to violent crime and inner-city trauma. The experience with community-based policing and mental health in New Haven, now being replicated throughout the United States, can thus stand as a model of an active social response to an overwhel
Adolescent↗
The WAMI Rural Hospital Project. Part 3: Building health care leadership in rural communities.
The WAMI Rural Hospital Project (RHP) intervention combined aspects of community development, strategic planning and organizational development to address the leadership issues in six Northwest rural hospitals. Hospitals and physicians, other community health care providers and local townspeople were involved in this intervention, which was accomplished in three phases. In the first phase, extensive information about organizational effectiveness was collected at each site. Phase two consisted of 30 hours of education for the physician, board, and hospital administrator community representatives covering management, hospital board governance, and scope of service planning. In the third phase, each community worked with a facilitator to complete a strategic plan and to resolve conflicts addressed in the management analyses. The results of the evaluation demonstrated that the greatest change noted among RHP hospitals was improvement in the effectiveness of their governing boards. All boards adopted some or all of the project's model governance plan and had successfully completed considerable portions of their strategic plans by 1989. Teamwork among the management triad (hospital, board, and medical staff) was also substantially improved. Other improvements included the development of marketing plans for the three hospitals that did not initially have them and more effective use of outside consultants. The project had less impact on improving the functioning of the medical chief of staff, although this was not a primary target of the intervention. There was also relatively less community interest in joining regional health care associations. The authors conclude that an intervention program tailored to address specific community needs and clearly identified leadership deficiencies can have a positive effect on rural health care systems.
Alaska↗
Abundance of narG, nirS, nirK, and nosZ genes of denitrifying bacteria during primary successions of a glacier foreland.
Quantitative PCR of denitrification genes encoding the nitrate, nitrite, and nitrous oxide reductases was used to study denitrifiers across a glacier foreland. Environmental samples collected at different distances from a receding glacier contained amounts of 16S rRNA target molecules ranging from 4.9 x 10(5) to 8.9 x 10(5) copies per nanogram of DNA but smaller amounts of narG, nirK, and nosZ target molecules. Thus, numbers of narG, nirK, nirS, and nosZ copies per nanogram of DNA ranged from 2.1 x 10(3) to 2.6 x 10(4), 7.4 x 10(2) to 1.4 x 10(3), 2.5 x 10(2) to 6.4 x 10(3), and 1.2 x 10(3) to 5.5 x 10(3), respectively. The densities of 16S rRNA genes per gram of soil increased with progressing soil development. The densities as well as relative abundances of different denitrification genes provide evidence that different denitrifier communities develop under primary succession: higher percentages of narG and nirS versus 16S rRNA genes were observed in the early stage of primary succession, while the percentages of nirK and nosZ genes showed no significant increase or decrease with soil age. Statistical analyses revealed that the amount of organic substances was the most important factor in the abundance of eubacteria as well as of nirK and nosZ communities, and copy numbers of these two genes were the most important drivers changing the denitrifying community along the chronosequence. This study yields an initial insight into the ecology of bacteria carrying genes for the denitrification pathway in a newly developing alpine environment.
Austria↗