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At least 1,189 records · Page 66Linked to original sources
PubMed1993

Exposure to air pollution from transitional household fuels in a South African population.

Exposure to high levels of particulate matter is one of the risks associated with a household utilizing low quality coal as primary household energy source. In South Africa more than 20 million people rely on traditional (wood) and transitional (coal and paraffin) fuels to fulfil their basic energy needs--cooking and space heating. Personal exposures to TSP in a coal burning Township in the Vaal Triangle (central South Africa) were determined during the winter and summer of 1991 and 1992. Personal monitoring of TSP were conducted over a 12 hour period. Forty five children, age 8-12, participated. Exposures varied from 294 to 2304 micrograms/m3. The average 12 hour exposure during a summer day (8:30 a.m.-8:30 p.m.) was 662 micrograms/m3 (N = 15) compared to 1333 micrograms/m3 for a winter school day (N = 13). The difference was highly significant (P < 0.0002). The study identified the following risk factors associated with exposure: season (winter higher than summer), gender (boys higher than girls), and day of the week (school days higher: schools are situated in the centre of completely unelectrified areas). Statistical significant difference between personal exposures to TSP were documented between electrified vs unelectrified (utilize coal only) areas. The study confirmed other reports of extremely high exposures to air pollution documented in developing communities across the globe.

Air Pollutants↗
PubMed2006

The third generation of therapeutic communities: the early development of the TC for addictions in Europe.

AIMS: It is the goal of this study to investigate the first development of the drug-free therapeutic community (TC) in Europe. The paper aims at systemizing information, scattered all over Europe and is the first stage in an ongoing study to record the development of the European TC movement and its influences. DESIGN: After a study of the grey (hidden) literature, TC pioneers and experts per country were contacted to further elaborate the first findings. Subsequently, a preliminary summary of our findings was published in the Newsletter of the European Federation of Therapeutic Communities (EFTC), inviting additional information and corrections. The authors completed the results for this article with relevant first-hand information, obtained through interviews with European pioneers. FINDINGS: The findings are summarized under three topics: chronology, interconnections and European identity. It was found that from 1968 until 1989, a new therapeutic approach arose all over Europe, modeled after Synanon, Daytop and Phoenix House, New York, through Phoenix House, London and Emiliehoeve in the Netherlands. Therapeutic communities were established in Belgium, Finland, Germany, Greece, Ireland, Italy, Norway, Spain, Sweden and Switzerland as well. These communities were closely-knit and interconnected in their reaction against psychiatric and methadone treatment. The European TCs developed an own identity compared to the American ones. CONCLUSIONS: The European TCs adapted the model of their American predecessors to their own culture, influenced more by milieu-therapy and social learning. Instead of harsh behaviorism, more emphasis was placed on dialogue and understanding. Professionals occupied a more pivotal role and took over the dominant position of ex-addicts. Research, executed by TC professionals gradually entered the TC. A generic network of TC connections, through which the development evolved, was uncovered, and clear regional trends can be observed.

Europe↗
PubMed2006

Developing a strategic approach for IV therapy in the community.

The development of home intravenous therapy (IVT) services is of benefit to patients and organizations, particularly as it can facilitate early discharge from hospital or avoid hospital admission. However in providing an IVT education/refresher programme to local primary care trusts, we have found that not all of them, by their own admission, could engage in the expansion of IVT services as they did not have measures in place to support robust service delivery. Building on the authors' recent experience of assisting staff, via an education/refresher programme, to update their services, this article offers direction to other PCTs who may be struggling to update their services in times of reform and unprecedented change within the health service.

Clinical Competence↗
PubMed1996

International migration and development in Mexican communities.

The theoretical and empirical literature generally regards international migration as producing a cycle of dependency and stunted development in sending communities. Most migrants' earnings are spent on consumption; few funds are channeled into productive investment. We argue that this view is misleading because it ignores the conditions under which productive investment is likely to be possible and profitable. We analyze the determinants of migrants' savings and remittance decisions, using variables defined at the individual, household, community, and macroeconomic levels. We identify the conditions under which U.S. earnings are repatriated to Mexico as remittances and savings, and indicate the factors leading to their productive investment.

Adult↗
PubMedDate not supplied

Development of the community nurse in learning disability: 1.

Many accounts have described the role of the community nurse in learning disability and the nature and purpose of intervention in this situation. This article, the first in a two-part series, discusses the development of community nursing education and the need for more research.

Community Health Nursing↗
PubMed2004

Investigating the health of rural communities: toward framework development.

How healthy are the residents of rural Canada? How healthy are Canada's rural communities? Members of an interdisciplinary research team at the Brandon University Rural Development Institute, Manitoba, Canada, formed a partnership with rural stakeholders in an attempt to strengthen and build capacity in rural communities. One component of this research was the development of a framework to assist residents of rural communities to assess the health and sustainability of their community. Through dialogue with partners and review of the literature, a preliminary framework can be generated. This article formed the first step in the creation of such a framework. The article begins with common term and concept development, extends to a critical analysis of framework literature and culminates with consideration of steps to be taken next in the establishment of a framework and indicators that are both meaningful and useful for rural residents and their communities.

Journal Article↗
PubMed1983

Comparison of data elements in guidelines developed independently in community hospital oncology programs.

In summary we would like to thank the communities that participated in this study. A comparison of data elements in the guidelines developed by these communities demonstrated similarity in areas of diagnosis, pretreatment evaluation and staging. In the area of treatment it was apparent that physicians writing these guidelines were less autocratic in that more flexibility, more options and less specificity in recommendations was found. That this is not necessarily unfavorable is reflected in the fact that variations existed where the cancer literature is unsettled.

Community Health Services↗
PubMedDate not supplied

Developing the MAPP community health improvement tool.

From 1997 to 2001, the National Association of County and City Health Officials, in collaboration with the Centers for Disease Control and Prevention's Public Health Practice Program Office, developed a new community strategic planning tool, titled Mobilizing for Action through Planning and Partnerships (MAPP). This article provides a chronological description of the development of MAPP, devoting significant attention to pivotal decisions, development milestones, and distinguishing features of this new public health planning tool. All phases of the development ensured a practice-driven process, ongoing substantive input from the field, careful attention to research and literature, and intentional linkage with related efforts. This deliberate process laid the foundation for a tool that is not only well grounded in research and concepts but also relevant for practical use in communities. The process also demonstrates how practice-based research can be conducted in a way that effectively balances the need for applied relevance with intellectual integrity.

Community Health Planning↗
PubMedDate not supplied

Developing and marketing a community pharmacy-based asthma management program.

OBJECTIVE: To develop a community pharmacy-based asthma management program and successfully market the program to a managed care organization. SETTING: Community-based ambulatory care. PRACTICE DESCRIPTION: Independent community pharmacy. PRACTICE INNOVATION: Development of a structured, stepwise approach to creating, testing, delivering, and marketing a community pharmacy-based disease management program. MAIN OUTCOME MEASUREMENTS: Peak expiratory flow rates, quality of life, use of health care services, HMO contract renewal. RESULTS: A pharmacy-based asthma management program was developed, pilot tested, and successfully marketed to a local HMO. During the first full year of the program, HMO patients experienced significant improvements in quality of life and decreases in use of health care services, including a 77% decrease in hospitalization, a 78% decrease in emergency room visits, and a 25% decrease in urgent care visits. A contract that pays the pharmacy a flat fee for each patient admitted to the program has recently been renewed for a third year. CONCLUSION: The program has proved to be an effective, practical, and profitable addition to the portfolio of services offered by the pharmacy.

Adolescent↗
PubMed2003

Bringing faculty development to community-based preceptors.

Community-based education of health profession students has increased dramatically, yet providing faculty development to a large, dispersed, and diverse population of community-based faculty is challenging. The authors describe lessons learned from 1997 to 2000 in developing, using, and disseminating a collection of preceptor development materials designed to be relevant to community-based faculty and easy to use. These activities were carried out by the Preceptor Development Program, which was developed by the Mountain Area Health Education Center of Asheville, North Carolina, which works with over 500 community preceptors of health profession students and medical residents. The program includes materials on nine core faculty development topics in a variety of formats: seminars, monographs, Web modules, and one-page summary "thumbnails." Faculty developers can download these free, customizable materials from the Web and are encouraged to adapt them for their own use.

Curriculum↗
PubMed2002

Primary care groups and trusts: a threat or an opportunity for the development of community-based nursing in England.

AIMS OF THE STUDY: To examine the role of Primary Care Groups and Trusts (PCG/T) in relation to nurses working in general practice and community health services. BACKGROUND: Over the past two decades there have been rapid changes in the numbers and roles of nurses working in primary care and community based settings. The establishment of Primary Care Groups offers health care professionals, including nurses, the chance to develop local primary care services and to integrate community and primary care nursing. These developments may offer opportunities or pose threats to nursing staff. RESEARCH METHODS: Data are drawn from a longitudinal study of a randomly selected sample of Primary Care Groups in England (n = 72). In a second survey of Groups carried out in autumn/winter 2000, Primary Care Group chairs and chief officers were interviewed by telephone. RESULTS: Response rates were 97% for both chairs and chief officers (69 of each). Chairs indicated that in most areas Primary Care Groups were consulting with local nurses to develop policy. Fifty-seven (85%) reported that investment in nursing staff and nursing services was a high priority in their area. Twenty-eight (41%) indicated that nurse-led services designed to increase patient access had already been established in their area, and 20 (29%) were planning new nurse-led services. Many developments had been initiated by Primary Care Groups. Initiatives to integrate community and general practice based staff were underway in most areas. CONCLUSIONS: Primary Care Groups and Trusts are initiating changes in general practice and community based services which are likely to have long-term and important implications for nurses in terms of their roles, conditions of work and future careers. It is important that nurses are consulted and are involved in developing and implementing policy change.

Community Health Nursing↗
PubMedDate not supplied

Effect of otitis media on development: a community-based study.

Otitis media history until age 3 years were recorded for 233 children as part of the surveillance in a Community Program for Promotion of Growth and Development (PROD) conducted in a western neighborhood of Jerusalem. Recurrent otitis media (6 or more episodes) occurred more frequently among children who were of North African or Asian origin, of lower social class and maternal education, and whose duration of breast feeding was less than 26 weeks. Children with recurrent otitis media also failed the 7-month hearing test more frequently than other children. The mean Developmental Quotient score at 2 years and the mean Stanford Binet score at 3 years were statistically significantly lower among children with recurrent otitis media, even after controlling for maternal origin and length of breast feeding. These findings underscore the importance of early identification and early intervention for otitis media.

Child Development↗
PubMed1999

The awesome Asthma School Days Program: educating children, inspiring a community.

Program planners developed an educational program to improve the health of children with asthma in grades three to five in Milwaukee (Wis.) Public Schools. During 1997-1998, 1,400 students from 74 elementary schools participated in the Awesome Asthma School Days education program. In a cross-sectional survey, about 40% of children reported play interrupted and sleep disturbed by asthma, more than 50% of children reported exposure to smoke in their home, most children lacked asthma self-care tools, and most children with persistent symptoms did not use an anti-inflammatory inhaler. The educational program improved students' expectations about normal play and sleep and improved their understanding of asthma. Leaders in Milwaukee used the survey results to develop a community action plan. The educational program, surveys, community partnerships, and strategic plans can be replicated in other schools.

Adult↗
PubMedDate not supplied

How do teams practise community psychiatry?

The development of community psychiatry has modified the practice of psychiatry both with respect to place of practice (in the community) and mode of practice (focused on the multi-disciplinary team approach). Administrators, however, tend to evaluate the activities of teams working outside the hospital against the standards for a medical model based on a professional-patient relationship. These standards do not take into account activities carried out in the community. The purpose of this study is to present an instrument that will make it possible to evaluate the activities of the various professionals as a function of the time actually allocated to the various activities and the satisfaction of the different professionals involved. This demonstrates that the time spent outside clinics is very low except for the social workers, and that the professionals feel somewhat dissatisfied with this.

Attitude of Health Personnel↗
PubMed2004

Additional health and development activities for community-directed distributors of ivermectin: threat or opportunity for onchocerciasis control?

We studied the involvement of community-directed distributors (CDDs) of ivermectin for onchocerciasis control in other health and development activities in Nigeria, Togo and Cameroon. Most CDDs (82%) were involved in additional activities, especially EPI, water and sanitation and community development projects. These activities did not take up much time and were not considered an important burden. Ivermectin treatment coverage did not decline with increasing number of additional activities. Other health programmes are interested in building on the experiences and structures of community-directed treatment with ivermectin and involving CDDs in their health programmes. Some, such as EPI, provide financial incentives. Incentives by other programmes may enhance the performance of CDDs when they are selected on the basis of their CDD status. CDDs, health personnel and community members have very positive attitudes towards greater involvement of CDDs in additional health and development activities. We conclude that additional activities for CDDs do not pose a threat to but rather provide an opportunity to strengthen sustainability and effectiveness of ivermectin treatment.

Adult↗
PubMed2003

Effects of organic pollution on the initial development of fouling communities in a tropical bay, Brazil.

Transplantation of artificial panels between a polluted and an unpolluted site was used to evaluate eutrophication effects on the development of fouling communities in Ilha Grande Bay, SE Brazil. Organic pollution changed the relative dominance of species in the fouling communities of transplanted panels, although, their richness, evenness, and specific composition did not change. The chlorophyte Ulva sp. occurred only in the polluted site and in panels transplanted to it, whereas the bryozoan Aetea lingulata was found only in the unpolluted site and in panels transplanted to this site. These species are therefore good pollution indicators. The best pollution indicators, however, were amphipods and Spionidae polychaetes which formed mucous tubes. These groups had significantly higher values of percent cover (p<0.0001) in the polluted site and in panels transferred to it. The dominance shift is the first evidence that more meaningful changes can occur in the structure of fouling communities on a long-term scale.

Analysis of Variance↗
PubMed2001

The community integration measure: development and preliminary validation.

OBJECTIVE: To present a new measure of community integration, the Community Integration Measure (CIM), and to offer preliminary information about its psychometric properties. DESIGN: Validation study. SETTING: Community. PARTICIPANTS: Ninety-two participants placed in 3 subgroups (brain injury survivors, n = 41; significant others, n = 36; college students, n = 15). MAIN OUTCOME MEASURES: The distributional properties, factor structure, internal consistency reliability, content validity, discriminant validity, concurrent validity, and construct validity of the CIM. RESULTS: All items correlated positively with each other and with the total score. Principal components factor analysis confirmed a 1-factor structure, which explained 44.1% of the variance. Internal consistency reliability, using Cronbach's alpha, was.87. Content validity was assured by the development procedure, correspondence with the theoretical model, and direct use of consumer language. Discriminant validity was supported by the CIM's ability to differentiate between subsamples. Criterion validity was supported by using correlations with the Community Integration Questionnaire. Construct validity was supported by correlations with the Interpersonal Support Evaluation List. CONCLUSION: The CIM offers a brief, easily administered measure of community integration that conforms to an empirically derived theoretical model and is psychometrically sound.

Activities of Daily Living↗