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PubMedDate not supplied

Development of a community nurse-led continence service.

Extrapolations from prevalence studies suggest that on average 56,000 adults experience urinary incontinence in Glasgow, a third of whom will have been incontinent during the last week. A review by a multidisciplinary health gain commissioning team concluded that existing continence services in Glasgow had developed opportunistically and that problems exist, e.g. prescription of products without full assessment of continence problems. In response to this situation, a new community nurse-led continence service was introduced in 1995. This article describes the development and evaluation of this new service. For the past 3 years the service has employed five staff nurses and a physiotherapist. The team is solely employed to promote continence. It carries out assessments both in nursing and residential homes and community clinics. The planned evaluation will assess the effectiveness of this team in promoting continence and the future demand for continence nurse-led services.

Adult↗
PubMed2006

Building effective community partnerships for youth development: lessons learned from ACT for Youth.

Assets Coming Together (ACT) for Youth is a community-based, public health youth development (YD) initiative across New York State. Diverse community partnerships and a wide range of community settings have participated in this statewide effort, providing a rich laboratory to study effective partnership development. Based on the experience of the first 6 years of ACT for Youth, this report discusses lessons learned in partnership development in ACT for Youth with attention to the most effective partnerships. The most effective partnerships were differentiated by their ability to accomplish four tasks: (1) clearly define the purpose and vision of the initiative, (2) establish a community development partnership organizational structure and membership, (3) develop collaborative work processes, and (4) create sustained momentum. These elements will receive close attention in future YD efforts in New York State, and should be used to inform YD efforts in other states or communities.

Adolescent↗
PubMed2001

Mental health service provision in England.

OBJECTIVE: To describe mental health service provision for adults of working age in England. METHOD: Services in an inner London area are described so as to illustrate current patterns of service organization in England. National trends are then discussed. RESULTS: Despite relatively low public expenditure, substantial progress has been made in deinstitutionalization and development of comprehensive community-based services. Persisting difficulties include high staff turnover, a minority of patients. who do not engage with community services, user and carer dissatisfaction with emergency services, and social exclusion because of stigma. Recent government policy advocates resolving some of these problems using new service models such as assertive outreach and crisis teams. CONCLUSION: Closure of the large asylums has largely been accomplished. England is now entering a new phase in community service development, with a range of innovative developments aimed at resolving problems still encountered after the initial phases of integrated community service development.

Adult↗
PubMed1983

A community program in primary care for control of cardiovascular risk factors: steps in program development.

A community program for the control of cardiovascular risk factors, the CHAD program, was integrated into the primary care system of a family practice in Jerusalem. The steps used in introducing a community orientation in primary health care are used as a basis for description of the program. In the preliminary steps cardiovascular diseases and their risk factors were defined as the priority for the adult population of the community. Community diagnosis was undertaken to serve as a baseline for program content and evaluation. Planning for intervention included setting up objectives and planning strategies using standardized guidelines, and preparation of the staff and the community. Methods of implementation and surveillance are described. Two examples of evaluation of the program are cited.

Adult↗
PubMed1997

[The statute of deinstitutionalization in Great Britain].

The aim of this article is to explain the current status of deinstitutionalisation and of community care development by studying the extent to which community care can or should take over the functions of the asylum. These functions include those that are manifest, or explicit, and those that are latent, or unintended but implicit (Bachrach 1976). The continuing relevance of both sets of functions is argued to be exerting a powerful influence on the processes of asylum closure and community care development. The results include delayed asylum closures and transinstitutionnalisation, the shift of some patients from asylums to other institutions, which stifle the development of community care by concentrating spending in hospitals.

Community Mental Health Services↗
PubMedDate not supplied

Discharge of mothers and babies from hospital after birth of a healthy full-term infant: developing criteria through a community-wide consensus process.

OBJECTIVE: To ensure safe care of mothers and babies after birth, irrespective of length of hospital stay, and to ensure effective links between hospital and community postnatal services. METHODS: Program aimed toward consumers and professionals working with them in Ottawa-Carleton (750,000 persons.) All pregnant women in the community included. Program developed by professionals, institutions and community agencies. Information on current practices elsewhere and early discharge literature studied. New provincial survey on practice changes performed in Ontario. Emergency room utilization data analyzed. Discharge and post-discharge criteria, and a common prenatal education curriculum, developed. RESULTS: Multidisciplinary, multi-sectoral committees, institutions and agencies have developed programs for appropriate discharge practice and improved postnatal follow-up. Professionals have supported flexible discharge guidelines. CONCLUSIONS: Provided discharge criteria and follow-up are available, flexible discharge timing and safety appear compatible. The Ottawa-Carleton process to develop criteria and programs has allowed a collaborative, consensus-based approach to 'early' newborn discharge.

Community Participation↗
PubMed2006

Developing a virtual community for health sciences library book selection: Doody's Core Titles.

PURPOSE: The purpose of this article is to describe Doody's Core Titles in the Health Sciences as a new selection guide and a virtual community based on an effective use of online systems and to describe its potential impact on library collection development. SETTING/PARTICIPANTS/RESOURCES: The setting is the availability of health sciences selection guides. Participants include Doody Enterprise staff, Doody's Library Board of Advisors, content specialists, and library selectors. Resources include the online system used to create Doody's Core Titles along with references to complementary databases. BRIEF DESCRIPTION: Doody's Core Titles is described and discussed in relation to the literature of selection guides, especially in comparison to the Brandon/Hill selected lists that were published from 1965 to 2003. Doody's Core Titles seeks to fill the vacuum created when the Brandon/Hill lists ceased publication. Doody's Core Titles is a unique selection guide based on its method of creating an online community of experts to identify and score a core list of titles in 119 health sciences specialties and disciplines. RESULTS/OUTCOME: The result is a new selection guide, now available annually, that will aid health sciences librarians in identifying core titles for local collections. EVALUATION METHOD: Doody's Core Titles organizes the evaluation of core titles that are identified and recommended by content specialists associated with Doody's Book Review Service and library selectors. A scoring mechanism is used to create the selection of core titles, similar to the star rating system employed in other Doody Enterprise products and services.

Book Selection↗
PubMed2000

Community-acquired pneumonia: development of a bedside predictive model and scoring system to identify the aetiology.

Although initial presentation has been commonly used to select empirical therapy in patients with community-acquired pneumonia (CAP), few studies have provided a quantitative estimation of its value. The objective of this study was to analyse whether a combination of basic clinical and laboratory information performed at bedside can accurately predict the aetiology of pneumonia. A prospective study was developed among patients admitted to the Emergency Department University Hospital Arnau de Vilanova, Lleida, Spain, with CAP. Informed consent was obtained from patients in the study. At entry, basic clinical (age, comorbidity, symptoms and physical findings) and laboratory (white blood cell count) information commonly used by clinicians in the management of respiratory infections, was recorded. According to microbiological results, patients were assigned to the following categories: bacterial (Streptococcus pneumoniae and other pyogenic bacteria), virus-like (Mycoplasma pneumoniae, Chlamydia spp and virus) and unknown pneumonia. A scoring system to identify the aetiology was derived from the odds ratio (OR) assigned to independent variables, adjusted by a logistic regression model. The accuracy of the prediction rule was tested by using receiver operating characteristic curves. One hundred and three consecutive patients were classified as having virus-like (48), bacterial (37) and unknown (18) pneumonia, respectively. Independent predictors related to bacterial pneumonia were an acute onset of symptoms (OR 31; 95% CI, 6-150), age greater than 65 or comorbidity (OR 6.9; 95% CI, 2-23), and leukocytosis or leukopenia (OR 2; 95% CI, 0.6-7). The sensitivity and specificity of the scoring system to identify patients with bacterial pneumonia were 89% and 94%, respectively. The prediction rule developed from these three variables classified the aetiology of pneumonia with a ROC curve area of 0.84. Proper use of basic clinical and laboratory information is useful to identify the aetiology of CAP. The prediction rule may help clinicians to choose initial antibiotic therapy.

Adolescent↗
PubMed2001

The Community Readiness Survey. Development and initial validation.

This article reports on the development and evaluation of a mail survey measuring population attitudes toward substance use of potential receptivity of communities to different prevention efforts. The Community Readiness Survey was designed through a series of prevention practitioner and consultant meetings and focus groups. Psychometric evaluation revealed five distinct domains: perception of alcohol, tobacco, or other drug problem; support for prevention; permissive attitudes toward teen substance use; perception of adolescent access; and perception of community commitment. Evidence of construct validity was demonstrated by the small but significant relationships between selected scale scores and community readiness as evaluated by prevention planners.

Attitude to Health↗
PubMed2002

The process to develop a meaningful community health assessment in New York State.

Conducting and producing a meaningful Community Health Assessment (CHA) is an important and essential public health service and a mandatory biennial activity for New York State's (NYS) Local Health Departments. The Assessment Initiative project has allowed the NYS Department of Health to better understand and identify strategies to strengthen CHAs and to develop training, education, and technical assistance programs. The Assessment Initiative project has benefited from participation, coordination, and sharing of resources and expertise with other community health improvement initiatives in NYS, including those that emphasize collaborative approaches to health improvement, workforce development, and expanding access to data.

Community Health Planning↗
PubMed2004

Managing nutritional programmes in developing countries.

Improving community nutrition in developing countries requires a detailed epidemiological picture of the prevalent nutritional problems in different regions and age groups. This makes it possible to identify priorities, sensitize policy-makers, establish political commitment and design appropriate community programmes for income generation and education for the best use of food resources. Experiences acquired from community-based nutritional programmes show that ownership of a programme by the community and using a tailor-made approach are essential factors in the successful implementation of programmes. A multifaceted approach is needed, involving a range of sectors-agriculture, commerce, education and health--and commitment at all levels from government to communities and individuals.

Communication↗
PubMed2001

Developing a community-specific health-related quality of life (HRQOL) questionnaire for asthma: the Asthma-Specific Quality of Life Questionnaire for Native American Adults (AQLQ-NAA).

The Asthma Quality of Life Questionnaire for Native American Adults (AQLQ-NAA) was developed by modifying the Asthma Quality of Life Questionnaire-Marks (AQLQ-M) using the focus group technique. The 19-item AQLQ-NAA has emphasis on restrictions in social, community, and cultural activities. Higher scores indicate a better quality of life. The modified questionnaire was administered to a sample of 51 Native American adults with asthma at the Albuquerque USPHS Indian Hospital and its affiliated field clinics. Principal components analysis identified three domains with eigenvalues greater than 1.00: Community and Social Restrictions (CSR), Psychological Impact (PIM), and Symptoms (SYM). Cronbach's coefficient alpha for the AQLQ-NAA was 0.95 and ranged from 0.82 to 0.93 for the individual domains, indicating good internal consistency. The AQLQ-NAA score correlated negatively and significantly to urgent care visits, physician visits, and total number of medications taken for asthma in the past 6 and 12 months (p < 0.05). Additionally, the AQLQ-NAA score was correlated positively and significantly to medication adherence in the past 6 and 12 months (p < 0.05). Similar patterns of correlations were found with all three domain scores. These results indicated that there is evidence for the construct validity of the AQLQ-NAA and its domains. The AQLQ-NAA should provide a useful measure of HRQOL in asthma-specific medical interventions for the population in which it was developed.

Adult↗