Alcoholism detoxification services in a rural community: a formal development approach.
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Alcoholism↗
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Community psychology in Hong Kong: past, present, and future.
The expansion of mental health services during the 1960s from a single remote mental hospital to centers and clinics in mainstream communities fostered the development of community psychology in Hong Kong. Few psychologists were initially involved in the local community mental health movement, but its momentum resulted in increasing numbers of practitioner psychologists working in community-based service settings. Community psychology in Hong Kong today consists primarily of service delivery, but also includes applied research, community organization/consultation, and community education. Despite having many parallels with the American situation, key concepts underpinning the practice of community psychology in the Territory possess their own character as a reflection of nuances in the local scene. Prospects for the continued development of community psychology in Hong Kong appear favorable. Of special relevance is the field's potential contribution to a better understanding of the psychological phenomena associated with the Territory's sociopolitical transformation in 1997.
Community Mental Health Services↗
Nurse practitioners develop leadership in community problem-solving.
If nurse practitioners are to become agents of change within the community, a shift in focus from the individual/family/caseload to one that includes population/community will be required. The nurse practitioner will need to develop the skills of community coalition building and grantsmanship. Graduate preparation in primary care nursing can provide an opportunity to develop the necessary knowledge and skills for leadership in community problem-solving by incorporating reality-based learning experiences into the curriculum. A model for guiding graduate study is presented.
Community Participation↗
Development of a community intervention programme on miners' health and working environment in Nicaragua.
Since 1983, a broad research and development programme has been carried out with the support of Sweden through the Swedish Agency for Research Cooperation in Developing Countries (SAREC). One of the medical research and development projects deals with the environment and state of health of the population of an entire village, and is referred to as the Abdon Vega project. It is pursued by the Department of Social and Preventive Medicine of the University of León, Nicaragua, with the support of the Department of Social Medicine at the Karolinska Institute in Stockholm. The project comprises two stages. The first one centres on the state of health of the workers and the mining environment. This article reports on the objectives of the project and the study area. It presents experience from the development work up to now and the difficulties encountered.
Community Health Services↗
The development of community-based programs for autistic adolescents.
Now that its legislative mandate has been expanded to include services to autistic adolescents and adults, North Carolina's statewide program (TEACCH) has been developing the materials and programs necessary to serve these older clients in community-based settings. The development of diagnostic, assessment, and curriculum materials along with a full range of day and residential programs is described along with efforts at intensive intervention and sex education. Although TEACCH's adolescent program is only in a preliminary stage, its efforts may be of use to others pursuing similar goals.
Adolescent↗
Development of a community health service: a unique collaborative alliance.
This case study describes the development of a public health satellite facility, the Health Source of Grandview, Missouri, a collaborative alliance sponsored by a public teaching/community medical center and a religious-sponsored community medical center. The needs and alternative solutions are examined and planning processes are discussed, including the issue of community needs and values as well as roadblocks and barriers to collaboration, and how this model meets the criteria for the new paradigm of community collaboration and partnership espoused by so many in this era of health care reform.
Community Health Services↗
Linking community and ecosystem development on Mount St. Helens.
In the two decades following the 1980 eruption of Mount St. Helens in Washington State, the N2-fixing colonizer Lupinus lepidus is associated with striking heterogeneity in plant community and soil development. We report on differences in nutrient availability and plant tissue chemistry between older, dense patches (core) of L. lepidus and more recently established low density patches (edge). In addition, we conducted a factorial nitrogen and phosphorus fertilization experiment in core patches to examine the degree of N and P limitation in early primary succession. We found that there were no significant differences in N or P availability between core and edge L. lepidus patches during the dry summer months, although nutrient availability is very low across the landscape. In the high density patches we found lower tissue N content and higher fiber content in L. lepidus tissue than in the younger edge patches. The addition of nutrients substantially altered plant community composition, with N addition causing an increase in other forb biomass and a corresponding competition-induced decline in L. lepidus biomass. The majority of the positive biomass response came from Hypochaeris radicata. In the second year of the fertilization experiment, the addition of N significantly increased total community biomass while L. lepidus biomass declined by more than 50%. The response of every species other than L. lepidus to N additions suggests that N may be the macronutrient most limiting plant production on Mount St. Helens but that the gains in productivity were somewhat offset by a decline of the dominant species. By the third year of the experiment, L. lepidus began to increase in abundance with P addition. This result suggests co-limitation of the community by N and P.
Ecosystem↗
Contexts of social relationship development among assertive community treatment clients.
This exploratory qualitative study examined contexts and processes of social relationship development as experienced by adults with schizophrenia participating in assertive community treatment (ACT) programs. Semistructured interviews with 20 ACT clients diagnosed with schizophrenia-spectrum disorders and 2 ACT staff members were analyzed using grounded theory analysis methods. Results showed that aside from contacts with family members and providers, participants' interactions with fellow mental health clients tended to dominate social interactions, and that this pattern appeared to be influenced by both the concentration of social opportunities in daily activities of service utilization and the ACT program emphasis upon facilitating relationships between clients. Participants described their relationships with other mental health clients in primarily positive terms, yet several participants expressed dissatisfaction and desired greater integration into mainstream social networks. Implications for mental health service delivery are discussed.
Adult↗
A community effect in animal development.
In animal development, the first tissues to be formed include such major components as muscle, nerve cord, notochord and the eye. In the vertebrates, all of these tissues are formed by embryonic induction, a process by which some of the cells within a mass of tissue are caused to change their direction of differentiation as a result of close proximity to cells of another kind. The induced cells typically form a solid coherent mass with a distinct border between them and the remaining uninduced cells. This clean separation between induced and uninduced cells is much sharper than can readily be explained as a result of the induction process. We describe here the culture of amphibian cell and tissue recombinations in solid gels containing cytochalasin in which cell division and cell movement is inhibited during response to induction. This has revealed an effect in which the ability of a cell to respond to induction by differentiating as muscle is enhanced by, or even dependent on, other neighbouring cells differentiating in the same way at the same time. This seems to be a newly described process in animal development, termed the community effect. It helps to explain the formation of blocks of tissue from sheets of cells, and could be of widespread occurrence and significance in morphogenesis resulting from embryonic induction.
Animals↗
Evaluation issues and strategies for community-based organizations developing women's HIV prevention programs.
This article discusses issues and strategies for program evaluation particularly useful for community-based organizations (CBOs) involved in the development and implementation of HIV preventing programs for women. The approach the authors present is an extension of a traditional public health paradigm suggested for use in the development and evaluation of violence prevention programs. This study incorporates Becker's Health Belief Model, which provides a framework for viewing the influence of various psychosocial variables on health-related behavior, into this development and evaluation paradigm. Factors influencing the successful development and evaluation of HIV prevention programs for women are reviewed and discussed. The purpose of this article is to provide some guidance to CBOs to strengthen their evaluation strategies and to encourage their use of evaluation during all phases of program development and implementation.
Community Networks↗
Community wellness: a group empowerment model for rural America.
Because answers to rural health problems no longer reside solely at the federal or state level, county Extension agents in Georgia are playing a pivotal role in helping communities empower themselves with the Community Wellness program. Community Wellness is a process-oriented program that encompasses community-based program planning; facilitates interventions based on an assessment of community-specific health needs; encourages empowerment of the community; and develops a community-wide support system. County Extension agents and other leaders serve as catalysts to bring together members of the community to identify health needs, develop strategies to solve problems, and implement solutions. Four case histories describe how this model has strengthened community infrastructure, developed human capital, and created rural leadership. A discussion of barriers to implementation and lessons learned follows.
Community Health Services↗
Detritus-dependent development of the microbial community in an experimental system: qualitative analysis by denaturing gradient gel electrophoresis.
Correlations between the biomass of phytoplankton and the biomass of bacteria and between the biomass of bacteria and the biomass of protozoans suggest that there is coupling between these compartments of the "microbial loop." To investigate this coupling on the species level, bacteria and protozoans from untreated lake water inocula were allowed to grow on detritus of the green alga Ankistrodesmus falcatus or the cyanobacterium Oscillatoria limnetica in continuous-flow systems for 1 month. Denaturing gradient gel electrophoresis (DGGE) of the 16S and 18S rRNA genes was used to monitor the development of the bacterial community structure and the eukaryotic community structure, respectively. Nonmetric multidimensional scaling of the DGGE profiles revealed the changes in the microbial community structure. This analysis showed that significantly different bacterial communities developed on the green algal detritus and on the cyanobacterial detritus. Although similar results were obtained for the eukaryotic communities, the differences were not significant. Hence, our findings indicate that the origin of detritus can affect the structure of at least the bacterial community. A phylogenetic analysis of 20 18S ribosomal DNA clones that were isolated from the continuous cultures revealed that many sequences were related to the sequences of bacterivorous protozoans (members of the Ciliophora, Rhizopoda, Amoeba, and Kinetoplastida). One clone grouped in a recently established clade whose previously described members are all parasites. The affiliations of about 20% of the clones could not be determined.
Animals↗
Participatory health development in rural Nepal: clarifying the process of community empowerment.
Community-based participatory development empowers villagers to develop community cohesion and confidence, increase their ability to identify, analyze, and priorize their own needs, and organize the resources to meet these needs. An important first step in the process involves establishing a cohesive and functional community group. The authors believe that this is best accomplished through villagers' critical examination of their experiences with development including their understanding of reasons for success or failure, and the gradual emergence of a model of working together that acknowledges and builds on participation and collective expertise. This approach to development is demonstrating encouraging results in a rural area of western Nepal in a university affiliated Canadian/Nepali Health Development Project. This paper describes two mini-projects to illustrate the evolution of group formation through reflection, analysis, and action, and identifies outcomes that could serve as indicators of community empowerment. The paper also presents a generic model of empowerment, and offers lessons learned by the project through the application of the empowerment process to sustainable health development.
Community Participation↗
Community approaches to developing health care services.
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Community Health Services↗
Resistance development in community-acquired strains of methicillin-resistant Staphylococcus aureus: an in vitro study.
This study compares in vitro antimicrobial resistance development between strains of Staphylococcus aureus including newly described community-acquired methicillin-resistant strains (CA-MRSA). High-level resistance developed in all strains of S. aureus after exposure to rifampicin and gentamicin and in some strains after fusidic acid exposure, independent of methicillin resistance phenotype. Resistance did not develop after exposure to clindamycin, cotrimoxazole, ciprofloxacin, linezolid, or vancomycin. These results have important implications for therapy of CA-MRSA infections.
Community-Acquired Infections↗
A community based approach in developing health policies: implications for Asia-Pacific nations.
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Asia, Southeastern↗
Youths and communities: toward comprehensive strategies for youth development.
Society's conventional response to problems of young people--such as teenage pregnancy, school dropout, substance abuse, juvenile delinquency, and violence--is to target a specific problem and develop intervention or prevention programs for individuals who manifest the problem or are at high risk of it. Research shows that overlapping risk and protective factors affect the occurrence of all of these problems and that prevention strategies aimed at enhancing youths' development, reducing communities' specific risks, and strengthening protective factors are likely to be more successful than programs addressing the problem behaviors themselves. Among such strategies deserving wider consideration are "comprehensive community initiatives" that create collaborative partnerships among public officials, service providers, primary institutions, and citizens to promote the well-being of children, youths, and families.
Adolescent↗
Developing personal and community learning in graduate nursing education through community engagement.
Community engagement through service-learning was introduced into a graduate program in nursing education to develop student leadership skills, interest in learning, and social responsibility. With faculty expertise and guidance, students worked in partnership with underserved community agencies. The goal of sustainability was accomplished by developing faculty expertise in service-learning as a method of instruction and integrating community engagement into academic assignments within existing courses. Opportunities to reflect on the benefits of the experiences were considered crucial to bridging service to learning in the community. Evaluation findings indicate that students gained insight into community needs and resources as they moved outside traditional health care settings. Graduates increased their understanding of their role as a resource to the community, and community agencies saw the value of a nurse educated at an advanced practice level.
Attitude of Health Personnel↗