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PubMed1981

An innovative placement in mental health for baccalaureate nursing students.

To summarize the whole experience, I will simply say that the problem of finding a clinical placement in mental health was successfully resolved. Drawing on past experience, fitting together the goals of our nursing program with an unmet health care need in the community, developing a plan, negotiating for an opportunity to implement the plan and evaluating the effectiveness of that plan have all taken place. The outcome was positive for all involved. Nursing students in our program will continue to have an experience in Adult Foster Care Homes because we all grew from the experience. As a result of this experience I can say that a clinical placement in Adult Foster Care Homes provides not only service to the community, but also a valuable learning experience for baccalaureate nursing students. My students left their experience with an increased awareness of the multiple health needs of the chronically mentally ill. And more importantly, they left the experience with increased skills toward meeting the health care needs of that population. This awareness and skill will be invaluable as they continue to work with clients in all community and institutional settings.

Community Health Nursing↗
PubMed2004

Learning to work together: developing academic and community research partnerships.

BACKGROUND: Community-based participatory research (CBPR) has been promoted as an important collaborative methodology for addressing local health concerns. However, academic physicians and researchers usually are not trained to work with communities as partners. METHODS: Key characteristics of effective community-academic partnerships are examined based on experiences with 2 CBPR projects in Wisconsin. RESULTS: These 2 projects increasingly have involved the respective communities and researchers in a collaboration. The steps they have taken illustrate the qualities of successful CBPR partnerships: ongoing development of joint community and researcher analysis, communication, and mobilization to search for relevant solutions to important community health problems. To sustain this kind of partnership, it is critical for researchers using the CBPR approach to understand how their academic-scientific perspective differs as well as converges with the community members' practical-experiential perspective. CONCLUSIONS: Health care researchers can effectively make use of partnerships with communities by following defined CBPR steps for developing mutually agreed upon research agendas, timelines, and goals. This, in turn, builds the capacity of communities to initiate and engage in future collaborative research projects concerning health issues.

Academic Medical Centers↗
PubMedDate not supplied

Using cognitive mapping to develop a community-based family intervention.

OBJECTIVE: To describe the development of a consumer-oriented intervention for increasing intake of fruits and vegetables (FVs) in families (n=265). METHOD: A cognitive-mapping approach was used to specify intervention performance objectives and a tailoring strategy. RESULTS: MDS and hierarchical cluster analysis indicated that FV perceptions are organized into 6 clusters arrayed along 3 dimensions. In combination with 3 general family-functioning measures, 11 perceptions explained approximately 18% of the variance in parent FVI. K-means cluster analysis revealed 4 types of families. CONCLUSION: Cognitive mapping provides a systematic approach for including qualitative data in the design of tailored interventions.

Adult↗
PubMed1997

Developing leaders in public health: the role of executive training programs.

The growing complexity of the nation's health care system is creating new challenges and opportunities for public health officials, and a renewed concern for leadership training among these officials. A focus group conducted with public health officials at local, state, and national levels reveals perceptions about the predominant trends effecting public health practice, the leadership skills required for effective public health practice, and the strategies that are needed for providing appropriate leadership training to public health executives. Officials indicate that public health practice is undergoing substantial changes in response to the growth of managed care and integrated delivery systems, changes in public health funding sources and levels, and efforts to privatize the delivery of public health services. The skills identified as critical for effective leadership in this environment include the ability to guide organizational behavior and cultivate interorganizational relationships; apply scientific knowledge to public health problems, and build and sustain community coalitions. In light of these skills, public health officials identify four essential components of an optimally effective executive training program in public health leadership: exposure to the core scientific disciplines within public health; exposure to organization theory and management science; training in community development and empowerment; and training in ethics and social justice. All of the officials agree with the need for distance learning programs for executives in public health leadership, and most officials also support the need for doctoral-level training in public health practice.

Community Participation↗
PubMedDate not supplied

Saskatchewan public health nursing survey. Perceptions of roles and activities.

OBJECTIVE: To explore perceived roles and activities of Saskatchewan public health nurses (PHNs). METHODS: This replication study surveyed Saskatchewan PHNs using the instrument developed by the Hamilton-Wentworth Social and Public Health Services Division in a 1992 survey of Ontario PHNs. This instrument is based on the roles and activities for community/public health nurses described by the Canadian Public Health Association (1990). Descriptive statistics were used to analyze the 124 responses received. RESULTS: Most of the nurses perceived that they were at least somewhat prepared for all of the roles. The activities of: caring for individuals and families; immunizing; educating individuals, families, and groups; acting as a resource person for clients and lay helpers; linking those needing services to appropriate community resources; and using marketing strategies were carried out most often by PHNs. Activities within the roles of community developer, policy formulator, researcher and evaluator, and resource manager/planner/coordinator were carried out to a much lesser degree. The roles and activities being done less often were also the ones PHNs felt less prepared to do. INTERPRETATION: It is important, as health authorities begin to support a more preventive approach to health care, that PHNs are competent in the roles outlined by the Canadian Public Health Association. As well as preparing new graduates for these roles, it is essential to provide continuing education for practicing PHNs. Public health administrators must also support public health nurses in carrying out these roles.

Community-Institutional Relations↗
PubMed2000

The economic impact of AIDS in Africa.

The experience of acquired immune deficiency syndrome (AIDS) in Africa is very different from that in the developed world. In the West, AIDS affects few people, and for those who are infected, it is an increasingly manageable illness. In Africa, huge numbers of people are being infected - mainly young adults through sexual intercourse. This is having a dramatic effect on key demographic indicators. Child mortality in some countries has doubled, while up to 25 years of life expectancy have been lost. The economic impact of AIDS is difficult to establish, but it is certainly leading to increased poverty in African families and communities. Development advances are being reversed, but the impact is incremental rather than catastrophic.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Foetal alcohol syndrome in Saskatchewan: unchanged incidence in a 20-year period.

Despite major initiatives in public and professional education about foetal alcohol syndrome (FAS) in Saskatchewan in the last 20 years, its incidence rate has not fallen. The rate was 0.515 per 1,000 live births in 1973-1977 and 0.589 in 1988-1992. Two hundred and seven (207) cases were ascertained, the majority being patients of the Alvin Buckwold Child Development Program in Saskatoon. These individuals were severely handicapped: 72% had at least one malformation, the mean intelligence quotient was 67.8 (range 35-106) and 45.9% had a behaviour problem. Only 25.6% still lived with their biological parents when last seen, and only 27 of 108 cases were in a regular class at school without additional support being necessary. New approaches are needed to reduce the incidence of FAS. Emphasis should be placed on individual case-finding, counselling for high-risk women, and community development programs. We are currently attempting this through a provincial coordinating committee.

Adolescent↗
PubMed2006

Collaborative environmental planning in river management: an application of multicriteria decision analysis in the White River Watershed in Vermont.

Multicriteria decision analysis (MCDA) provides a well-established family of decision tools to aid stakeholder groups in arriving at collective decisions. MCDA can also function as a framework for the social learning process, serving as an educational aid in decision problems characterized by a high level of public participation. In this paper, the framework and results of a structured decision process using the outranking MCDA methodology preference ranking organization method of enrichment evaluation (PROMETHEE) are presented. PROMETHEE is used to frame multi-stakeholder discussions of river management alternatives for the Upper White River of Central Vermont, in the northeastern United States. Stakeholders met over 10 months to create a shared vision of an ideal river and its services to communities, develop a list of criteria by which to evaluate river management alternatives, and elicit preferences to rank and compare individual and group preferences. The MCDA procedure helped to frame a group process that made stakeholder preferences explicit and substantive discussions about long-term river management possible.

Community Participation↗
PubMed2006

The greater Denver Latino Cancer Prevention/Control Network. Prevention and research through a community-based approach.

The Latino/a Research & Policy Center (LRPC), at the University of Colorado (UC) at Denver and Health Sciences Center built the Greater Denver Latino Cancer Prevention Network, a successful cancer prevention network, in 6 Denver metro area counties. The Network consisted of 23 Latino community-based organizations, health clinics, social service agencies, faith-based groups, and employee-based organizations; 2 migrant health clinics; and 14 scientific partners including the UC Comprehensive Cancer Center, the Colorado Department of Public Health and Environment, and the American Cancer Society. The Network focused on 5 significant cancers: breast, cervical, lung, colorectal, and prostate cancer. The Steering Committee initiated a review process for junior researchers that resulted in 5 NCI-funded pilot projects. Pilot projects were conducted with various Latino populations. The Network developed community education and health promotion projects including the bilingual outreach play The Cancer Monologues. The Network's partnership also started and held 2 annual health fairs, Dia de la Mujer Latina/Day of the Latina Woman, and annual health prevention summits. The Special Population Network (SPN) adapted and revised a clinical trials education outreach module that reached Network community partners. SPN partners recruited Latino/a students to cancer research through a6-week NCI training program held yearly at the UCHSC campus. The Network methodology of bringing together the Latino community with the scientific community increased the level of awareness of cancer in the Latino community and increased cancer research and the level of engagement of the scientific partners with the Latino community. Cancer 2006. (c) 2006 American Cancer Society.

Biomedical Research↗
PubMed2003

Global gene expression in Escherichia coli biofilms.

It is now apparent that microorganisms undergo significant changes during the transition from planktonic to biofilm growth. These changes result in phenotypic adaptations that allow the formation of highly organized and structured sessile communities, which possess enhanced resistance to antimicrobial treatments and host immune defence responses. Escherichia coli has been used as a model organism to study the mechanisms of growth within adhered communities. In this study, we use DNA microarray technology to examine the global gene expression profile of E. coli during sessile growth compared with planktonic growth. Genes encoding proteins involved in adhesion (type 1 fimbriae) and, in particular, autoaggregation (Antigen 43) were highly expressed in the adhered population in a manner that is consistent with current models of sessile community development. Several novel gene clusters were induced upon the transition to biofilm growth, and these included genes expressed under oxygen-limiting conditions, genes encoding (putative) transport proteins, putative oxidoreductases and genes associated with enhanced heavy metal resistance. Of particular interest was the observation that many of the genes altered in expression have no current defined function. These genes, as well as those induced by stresses relevant to biofilm growth such as oxygen and nutrient limitation, may be important factors that trigger enhanced resistance mechanisms of sessile communities to antibiotics and hydrodynamic shear forces.

Base Sequence↗
PubMed1996

Effect of oxygen, inoculum composition and flow rate on development of mixed-culture oral biofilms.

The effect of aeration on the development of a defined biofilm consortium of oral bacteria was investigated in a two-stage chemostat system. An inoculum comprising 10 species, including both facultatively anaerobic and obligately anaerobic bacteria, and species associated with oral health and disease, was inoculated into an anaerobic first-stage chemostat vessel. The effluent from this chemostat was linked to an aerated [200 ml CO2/air (5:95, v/v) min-1] second-stage vessel, in which removable hydroxyapatite discs were inserted to allow biofilm formation. Comparisons were made of planktonic and biofilm communities in the aerated second-stage vessel by means of viable counts. Both planktonic and early biofilm communities were dominated by Neisseria subflava, comprising > 40% of total c.f.u. in the fluid phase, and > 80% of c.f.u. in 2 h biofilms. Obligate anaerobes persisted in this mixed culture, and succession in biofilms led them to predominate only after 7 d. Despite the continuous addition of air, the dissolved oxygen tension (dO2) within the culture remained low (< 5% of air saturation), and the redox potential (Eh) was -275 mV. In order to assess the significance of the presence of N. subflava in community development, a subsequent experiment omitted this aerobe from the inoculum, to produce a nine-species culture. The planktonic phase was predominated by three streptococcal species, Prevotella nigrescens and Fusobacterium nucleatum. Biofilms again underwent successional changes, with anaerobes increasing in proportion with time. In contrast to the culture including N. subflava, dO2 was 50-60% of air saturation, and the Eh was +50 mV. In the final experiment, the rate of addition of first-stage culture was reduced to 1/10 of that in the previous experiment, in order to determine whether anaerobes were growing, rather than merely persisting in the aerated culture. The data for the planktonic phase indicated that the anaerobes were growing in aerated (dO2 40-50%, Eh +100 mV) conditions. Once again, anaerobes increased in proportion in older biofilms. The study indicates that mixed cultures can protect obligate anaerobes from the toxic effects of oxygen, both in the biofilm and planktonic modes of growth.

Bacteria, Anaerobic↗
PubMed2000

Rapid transition in the structure of a coral reef community: the effects of coral bleaching and physical disturbance.

Coral reef communities are in a state of change throughout their geographical range. Factors contributing to this change include bleaching (the loss of algal symbionts), storm damage, disease, and increasing abundance of macroalgae. An additional factor for Caribbean reefs is the aftereffects of the epizootic that reduced the abundance of the herbivorous sea urchin, Diadema antillarum. Although coral reef communities have undergone phase shifts, there are few studies that document the details of such transitions. We report the results of a 40-month study that documents changes in a Caribbean reef community affected by bleaching, hurricane damage, and an increasing abundance of macroalgae. The study site was in a relatively pristine area of the reef surrounding the island of San Salvador in the Bahamas. Ten transects were sampled every 3-9 months from November 1994 to February 1998. During this period, the corals experienced a massive bleaching event resulting in a significant decline in coral abundance. Algae, especially macroalgae, increased in abundance until they effectively dominated the substrate. The direct impact of Hurricane Lili in October 1996 did not alter the developing community structure and may have facilitated increasing algal abundance. The results of this study document the rapid transition of this reef community from one in which corals and algae were codominant to a community dominated by macroalgae. The relatively brief time period required for this transition illustrates the dynamic nature of reef communities.

Animals↗
PubMedDate not supplied

Community-based HIV education and prevention workers respond to a changing environment.

The purpose of this study was to understand the culture, values, skills and activities of staff involved in education and prevention activities in community-based AIDS Service Organizations (ASOs) in Ontario, Canada, and to understand the role of evaluation research in their prevention programming. In this qualitative study, 33 staff members from 11 ASOs participated in semi-structured interviews that were analyzed using the grounded theory approach. ASO staff experience tension between a historical grassroots organizational culture characterized by responsiveness and relevance and a more recent culture of professionalization. Target populations have changed from being primarily gay men to an almost unlimited variety of communities. Program emphasis has shifted from education and knowledge dissemination to a broadly based mandate of health promotion, community development, and harm reduction. Integration of evidence of effectiveness, social-behavioral theory, or systematic evaluation is uncommon. Understanding these points of tension is important for the nursing profession when it is engaged with ASOs in programming or evaluation research.

Attitude of Health Personnel↗
PubMed2005

Ecological theory in practice: illustrations from a community-based intervention to promote the health of recent mothers.

We present a qualitative case study where we used four principles of ecological theory from community psychology as a template to assess the dynamics about how a preventive community intervention was transacted in eight communities in Victoria, Australia. The principles were cycling of resources, interdependence, adaptation, and succession. Ecological thinking focuses on key resources in communities. That is, the people, events, and settings that are the foundations of thinking about communities as systems. The data set consists of field diaries kept by and serial interviews with nine community development workers over a 2-year period. We found that the analysis highlighted a process-oriented way of representing the intervention, one that sees beyond the intervention's technical components (or packaged elements) to the complexities of the cultural and political change processes occurring beneath. The value of this is the attention focussed on likely project sustainability.

Community Networks↗
PubMed1984

Serum-IgE levels in rural Namibian infants.

Serum IgE levels were examined in 237 infants ages 2 wk to 12 mo in a remote rural area of Namibia. There was a wide range of values (0.5 to 884 IU/ml). The highest value in the first month of life was 295 IU/ml. Median values for the age groups 2 wk to 3 mo, 3 to 6 mo, and 6 to 12 mo were higher than those reported from Western countries. Values in general increased with age, but only 4% of the variation is explicable on this basis. There were differences between median values for male and female infants, but they did not reach statistical significance at the 5% level. Levels between Baster and Nama infants, the main ethnic groups in the area, did not differ. The median IgE levels in breast-fed infants, although high, tended to be lower than those in weaned infants. The differences were not statistically significant (p greater than 0.05). Investigations did not suggest that parasitic infestations or atopy were of significant importance. It was not possible to identify the factor(s) responsible for the high IgE levels. They must have been operative from very early life. However, the basic immunologic mechanisms involved are presumably genetically determined and similar to those responsible for the corresponding high IgG, IgA, and IgM levels reported in infants from developing communities.

Breast Feeding↗
PubMed1988

Oral hygiene behavior and periodontal status in European adolescents: an overview.

The object of this review is to examine toothbrushing as a health behavior in European adolescents. The aims are to investigate the role of environmental and social factors on toothbrushing as a health behavior, to illustrate the importance of such factors in the prevention of periodontal diseases and to demonstrate how a knowledge of these factors can aid the development of specific health education programs. In order to do this the results of many studies concerned with oral hygiene behavior from different European countries have been examined. It is from the detailed study of these various European investigations that the results section is composed. The findings from this review demonstrate that toothbrushing as a health behavior is influenced by both environmental and social factors, that both of these factors affect the incidence of gingivitis and periodontal disease in the countries examined, and that when they are incorporated into health education programs based on the community development approach they can aid behavior change.

Adolescent↗
PubMed2005

Building the community school movement: vision, organization, and leadership.

On a local level, creating and sustaining community schools requires leadership from local government, schools, businesses, and nonprofit organizations. These groups must provide the fuel and direction to move the community school strategy forward along a common vision and with strategic methods for financing. At the federal level, it must continue to build constituency for community schools if it is to succeed, although the community school movement has made great strides in recent years. There is not now a coherent federal framework to support the community school vision. The proposed Full Services Community Schools legislation would build a national constituency and legislate key principles advocated by the Coalition for Community Schools: developing districtwide community school strategies, focusing on results, and improving coordination of funding streams.

Child↗
PubMedDate not supplied

UN/Thai programme for drug abuse control in Thailand-A report on phase I:February 1972-June 1979.

The paper describes the principal achievements of the UN/Thai programme for drug abuse control which was carried out during the years 1972-1979. The programme was of a pilot nature and covered five selected key villages and 25 satellite villages in the north of Thailand. The major components of the programme were crop replacement and community development, treatment and rehabilitation, and drug information and education. The Royal Thai Government has accepted the achievements of this project as models for greatly expanded programmes for the eradication of the opium poppy cultivation. Two key villages-Ban Mae Tho and Hui Tund Jaw which were included in a pilot programme have provided to be opium free.

Agriculture↗