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PubMed2004

Health related virtual communities and electronic support groups: systematic review of the effects of online peer to peer interactions.

OBJECTIVE: To compile and evaluate the evidence on the effects on health and social outcomes of computer based peer to peer communities and electronic self support groups, used by people to discuss health related issues remotely. DESIGN AND DATA SOURCES: Analysis of studies identified from Medline, Embase, CINAHL, PsycINFO, Evidence Based Medicine Reviews, Electronics and Communications Abstracts, Computer and Information Systems Abstracts, ERIC, LISA, ProQuest Digital Dissertations, Web of Science. SELECTION OF STUDIES: We searched for before and after studies, interrupted time series, cohort studies, or studies with control groups; evaluating health or social outcomes of virtual peer to peer communities, either as stand alone interventions or in the context of more complex systems with peer to peer components. MAIN OUTCOME MEASURES: Peer to peer interventions and co-interventions studied, general characteristics of studies, outcome measures used, and study results. RESULTS: 45 publications describing 38 distinct studies met our inclusion criteria: 20 randomised trials, three meta-analyses of n of 1 trials, three non-randomised controlled trials, one cohort study, and 11 before and after studies. Only six of these evaluated "pure" peer to peer communities, and one had a factorial design with a "peer to peer only" arm, whereas 31 studies evaluated complex interventions, which often included psychoeducational programmes or one to one communication with healthcare professionals, making it impossible to attribute intervention effects to the peer to peer community component. The outcomes measured most often were depression and social support measures; most studies did not show an effect. We found no evidence to support concerns over virtual communities harming people. CONCLUSIONS: No robust evidence exists of consumer led peer to peer communities, partly because most peer to peer communities have been evaluated only in conjunction with more complex interventions or involvement with health professionals. Given the abundance of unmoderated peer to peer groups on the internet, research is required to evaluate under which conditions and for whom electronic support groups are effective and how effectiveness in delivering social support electronically can be maximised.

Clinical Trials as Topic↗
PubMed1993

[Social medicine in medical education exemplified by the Witten/Herdecke University].

In 1992 a problem-based curriculum was introduced into the Medical Faculty of the University of Witten/Herdecke (UWH). First experiences with this approach indicate that--for several reasons discussed--community related health issues have not been sufficiently addressed. Therefore, it is recommended to give students access to field experiences in community health. At the UWH this is accomplished by a community-related practicum which connects students with a variety of community health services. A parallel course discusses students' experiences in a problem based manner and population related studies are developed.

Clinical Clerkship↗
PubMed1982

Competition theory, evolution, and the concept of an ecological niche.

This article examines some of the main tenets of competition theory in light of the theory of evolution and the concept of an ecological niche. The principle of competitive exclusion and the related assumption that communities exist at competitive equilibrium - fundamental parts of many competition theories and models - may be violated if non-equilibrium conditions exist in natural communities or are incorporated into competition models. Furthermore, these two basic tenets of competition theory are not compatible with the theory of evolution. Variation in ecologically significant environmental factors and non-equilibrium in population numbers should occur in most natural communities, and such changes have important effects on community relations, niche overlap, and the evolution of ecosystems. Ecologists should view competition as a process occurring within a complex dynamic system, and should be wary of theoretical positions built upon simple laboratory experiments or simplistic mathematical models. In considering the relationship between niche overlap and competition, niche overlap should not be taken as a sufficient condition for competition; many factors may prevent or diminish competition between population with similar resource utilization patterns. The typically opposing forces of intraspecific and interspecific competition need to be simultaneously considered, for it is the balance between them that in large part determines niche boundaries.

Animals↗
PubMed2006

Rocky-shore communities as indicators of water quality: a case study in the Northwestern Mediterranean.

The collection of 152 samples from the upper sublittoral zone along the rocky coasts of Catalonia (Northwestern Mediterranean) was carried out in 1999 in order to test the suitability of littoral communities to be used as indicators of water quality in the frame of the European Water Framework Directive. Detrended correspondence analysis were performed to distinguish between different communities and to relate communities composition to water quality. Samples collected in reference sites were included in the analysis. Mediterranean rocky shore communities situated in the upper sublittoral zone can be used as indicators of the water quality: there is a gradient from high to bad status that comprises from dense Cystoseira mediterranea forests to green algae dominated communities. The geographical patterns in the distribution of these communities show that the best areas are situated in the Northern coast, where tourism is the main economic resource of the area, and the worst area is situated close to the metropolitan zone of Barcelona with high population and industrial development. Thus, Mediterranean sublittoral rocky shore communities are useful indicators of water quality and multivariate analysis are a suitable statistical tool for the assessment of the ecological status.

Ecosystem↗
PubMed1982

Representation of social work agencies: new definition, special issues, and practice model.

Social Work administrators currently must respond to very diverse audiences in representing their agencies and programs. While skills in public relations, reporting, and community relations are viewed as essential, professional social work literature provides only limited conceptualizations and practice models. The authors propose a new definition of representation in social work agencies and suggest functional areas within which organized activities can be developed. The paper also includes: 1) a discussion of how several special issues such as the perception of welfare as stigma and agency interdependency affect the implementation of representational strategies; 2) a planning model that will assist administrators in strengthening the representation of their agencies' programs.

Administrative Personnel↗
PubMed1999

Holistic approach to health education on AIDS.

OBJECTIVE: To identify a method for health education using the example of an educational seminar on AIDS prevention and control at Hebei Medical University in China, 1994. METHODS: Our goal is the theoretical formulation of a unified community approach for problem solving through the combination of the self regulative approach and the case analytical approach. "Quality improvement", "essential quality" and "human ecosystems" provide the basic ideas for better understanding the integration of culture, science and technology within the "cultural norm". RESULTS: The present seminar was successfully organized for Chinese medical students based on the theme of "living with AIDS". Through this program, we identified that self regulative and case analytical approach were major issues for holistic approach to health education. We also identified that a community approach provides the scientific basis for health education in the community. CONCLUSIONS: The present paper generates a healthcare paradigm for surveillance in health/medical education. Through a better understanding of community approach, we related "community care" (emphasizing self, mutual, professional and institutional care) to the "practical norm"; and "preventive epidemiology" (emphasizing the unification of quality and quantity, as well as systems and population) to the "research norm".

Acquired Immunodeficiency Syndrome↗
PubMed1998

[A review of the European community directives relating to materials and articles intended to come into contact with food products in the light of Polish legislation].

The integration of Poland with the European Community makes the harmonization of Polish legislation necessary. Among numerous Directives, which provisions should be introduced into domestic legislation before Poland enters the European Union, the Directives related to materials and articles intended to contact with food consist a large group. The review and analysis of 17 Directives that appeared up to the end of year 1997 have been done. The list of these Directives is shown in the Table I. The framework Directive 89/109/EEC on the approximation of the laws of the Member States relating to materials and articles intended to come into contact with foodstuffs have been comprehensively discussed together with the specific Directives concerning the following matters: symbol which should accompany the materials and articles intendet to contact with food: Directive 80/590/EEC; plastics materials: Directive 90/128/EEC with later ammendments provided by the Directives: 90/128/EEC, 93/9/EEC, 95/3/EC and 96/11/EC; vinyl chloride monomer (acceptable limit and analytical method): Directives: 78/142/EEC, 80/766/EEC and 81/432/EEC, regenerated cellulose film-Directives: 93/10/ECC i 93/111/EEC; ceramic articles: Directive 84/500/EEC; testing migration of constituents of plastic materials-Directives: 85/572/EEC and 82/711/EEC with later ammendments: Directives: 93/8/EEC, 97/48/EC, The relevant Polish regulatory provisions concerning the matters related to materials and articles intendet to contact with foodstuffs have also been discussed. The need for harmonization of Polish regulations with the relevant legislation adopted by the Member States of the European Community was emphasized.

Humans↗
PubMed1999

Primary care physicians' training and their community involvement.

BACKGROUND AND OBJECTIVES: Physicians who incorporate a community perspective into their clinical practice can provide more effective care, but little is known about the type of training that helps physicians include this perspective. This study examines associations between physicians' current level of involvement in their communities and a range of prior educational experiences. METHODS: We obtained data from 247 recently graduated primary care physicians through a nationwide mail survey. Physicians described their community-related training experiences during medical school and residency. They also described their current involvement in each of 4 domains of community work. Associations between different training experiences and physicians' current community involvement were examined. RESULTS: Subjects generally reported limited community-related training. Physicians who did receive training in content relevant to a given community domain were significantly more involved in that domain as practicing physicians. Rotating in rural locations and having a mentor active in the community also were associated with greater current community involvement. CONCLUSIONS: These data provide evidence that formal training experiences can influence how actively physicians will later interact with their communities. We should provide medical students and residents with educational content in all 4 domains of community work, place them in carefully selected locations, and arrange mentor relationships.

Community Health Services↗
PubMed1979

Idiopathic hypertrophic subaortic stenosis as observed in a large community hospital: relation to age and history of hypertension.

The character of idiopathic hypertrophic subaortic stenosis (IHSS) was studied retrospectively in a large community hospital for the six-year period, 1968--1974. Cases were discovered by examining the records of the Cardiac Non-Invasive Laboratory (phono- and echocardiography). Of the 46 cases of IHSS identified, 39 were in patients of the 50--81 age group. Thirty-two (82 percent) of the 39 patients were women, and 25 (78 percent) of these had a significant degree of hypertension. The hypertension had been present for more than five years in 62 percent of the cases. In 84 percent of the elderly females, the cardiac murmur had been present for less than ten years, and in 65 percent for less than five years. There was no family history of IHSS. Eighteen of the 46 IHSS patients underwent cardiac catheterization which confirmed the accuracy of the cardiographic data in all cases. The results of this study indicated that IHSS is usually nonfamilial, predominates in elderly females, and tends to be acquired after a lengthy period of hypertension. Cardiographic data appear highly specific diagnostically, often rendering cardiac catheterization unnecessary. Previous studies have not clearly defined the role of hypertension in the development of IHSS, at least partly because of the highly selective nature of most series reported from referral centers. These series often contain large numbers of younger patients.

Adolescent↗
PubMed1994

[Community requirements relating to drugs derived from human blood and plasma].

Since the adoption of the first pharmaceutical directive in 1965, the pharmaceutical legislation of the European Community has constantly pursued two objectives: the protection of public health and the free movement of products. Directive 89/381/EEC covers stable industrially prepared blood derivatives, intended for a large number of patients, namely albumin, coagulation factors and immunoglobulins. Whole blood, plasma and cellular components are excluded from the scope of the directive. As a consequence of the inclusion of blood derivatives in Community pharmaceutical legislation, these products are now subject to its general provisions regarding manufacturing and marketing authorization. The principles of good manufacturing practice laid down in Directive 91/356/EEC and detailed in a guide for manufacturers have become mandatory, as well as the tests in Directive 91/507/EEC aimed at demonstrating quality, safety and efficacy for the purpose of marketing authorization. The European format for the application file as well as the Community procedures for marketing authorization are applicable. In addition to these general provisions, which are applicable to all medicinal products, Directive 89/381/EEC contains several elements which are specific to medicinal products derived from human blood or plasma. The measures for selection and control of blood donors recommended by the Council of Europe and the World Health Organization have become compulsory. Moreover, for these particularly sensitive products, the Council has explicitly demanded the application of validated manufacturing and purification processes, in order to guarantee, insofar as the state of technology permits, the absence of specific viral contamination. For new medicinal products, the Directive entered into force on 1 January 1992. For products already on the market, a transitional period of one year was provided, during which the Member States had to proceed with the review of these products. The objective of Community self-sufficiency in blood and blood derivatives by voluntary unpaid donations is clearly expressed in the text of the Directive and the Member States have to inform the Commission on measures taken in this area. Thus, in adopting the Directive, the 12 Member States established as an objective that self-sufficiency be attained through voluntary unpaid blood donation. But, in addition to the Directive, the general rules of the EC Treaty are applicable, namely with regard to free movement of products, public procurement and monopolies.

Blood↗
PubMedDate not supplied

Recruitment strategies for studying dementia in later life among diverse cultural groups.

This article provides conceptual and theoretical guidance on approaches to enhance recruiting and retaining diverse populations in dementia research by using a sociocultural perspective and constructivist approach. Informed by this conceptual and theoretical guidance, the article also discusses some of the major barriers to recruitment with ideas on how to address these barriers. Further discussion is provided on building community relations and capacity, and strategies to increase the level of participation in dementia care research. The article ends with best strategies for addressing barriers to recruitment and retention, building community relations and capacity, and increasing participation in research projects.

Age Factors↗
PubMedDate not supplied

[The ecology of communities of related animal species (research approaches and methods exemplified by terrestrial vertebrates)].

The review is dedicated to some old and modern problems in studying of the assemblages of phylogenetically related species among terrestrial vertebrates. The classical approach by Robert Mac-Arthur, discussed elsewhere summarized briefly. Although an explanative potential of competition theory seems exhausted there is no new paradigm that can simply explain species diversity in natural communities. From the beginning of 90's community ecology became very complex and controversial discipline. At the same time it is still a pioneering science. We have not enough comparative data on geo2 graphically distinct communities studied under the unified methods of data collection and analysis. Some recent results of intercontinental comparisons signify to the high degree of individualism in structure of geographically isolated communities. This makes doubtful any extrapolation from one region to another. Examination and explanation of processes is still the most contradictory field in community ecology. Confusion of causes and effects is continuing to be serious methodological problem. Much of attention was paid recently to the macroecological approach. A desire for reconsideration of some "old rules" of biodiversity is explained by advances in paleozoology, biogeography and systematic, as well as by some unsatisfactory explanations within the framework of competition theory.

Animals↗