The community nurse in a developing psychogeriatric service.
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Aged↗
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Results for “Community Development”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
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Water supply and sanitation in remote indigenous communities--priorities for health development.
OBJECTIVE: To review available national and State/Territory survey data on water supply and sanitation in remote Indigenous Australian communities and to discuss the findings in terms of priorities for health and infrastructure development. METHODS: Descriptive analysis of data on relevant variables from available data sources. RESULTS: All relevant published reports arose from only two data sources: the Community Housing and Infrastructure Needs Surveys, and from a Northern Territory-wide survey of community-owned dwellings. The data show that many communities do not have a reliable water supply and experience frequent and prolonged breakdown in sewerage systems. For example, 12% of communities of 50 people or more experienced five or more periods of water restrictions in a one-year period, and 10% of communities experienced sewage overflow or leakage 20 or more times in a one-year period. Items of basic household infrastructure regarded as essential for household hygiene are missing or not functional in many community-owned dwellings. For example, in about one-third of houses bathroom taps and toilet drainage required major repairs. CONCLUSION AND IMPLICATIONS: Given the widely accepted importance of water and sanitation to health, the data support the contention that poor environmental conditions are a major cause of poor health in remote communities and provide some measure at a national level of the magnitude of the problem. Action to ensure easy access to adequate quantities of water and secure sanitation should receive greater priority. There is need for better quality information systems to monitor progress, equity and accountability in the delivery of water and sanitation services.
Australia↗
Developments in hospital and community links.
This is the first of our reports from the King's Fund Development Centre, highlighting units which have developed experience in a particular aspect of nursing care and are keen to disseminate their work. This report reviews work being done in nursing units to improve the links between primary and secondary care, and is based on a Nursing Development Network day held last year.
Clinical Nursing Research↗
Global community health and sustainable human development.
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Community Health Services↗
Long-term health problems and community care.
The development of comprehensive local community services is patchy. If people with mental health problems are to receive appropriate and effective care, the resources need to be distributed differently, coordinated more effectively and focused on those with severe and long-term problems.
Chronic Disease↗
Developing care in the community: GPs and the HIV epidemic.
Services for HIV infection and AIDS in Parkside DHA have been largely hospital based with little active involvement of local GPs. In response to the wishes of those with HIV/AIDS and predicted increases in the number of patients the DHA is now developing an AIDS strategy which identifies the development of primary and community care as a major objective. A postal survey of all 263 GPs within the DHA was undertaken in order to ascertain their views about the role of primary care in the management of HIV infection/AIDS. Replies were received from 75% (196). The responses to the survey indicated both the potential of general practice and willingness of GPs to be involved in the care of this client group. However, two key issues in developing this strategy were identified. These were information exchange and confidentiality. It is suggested that both hospitals and general practice must develop rigorous confidentiality policies to overcome these difficulties.
Communication↗
An evaluation of palliative care services in the community.
To develop palliative care services, it is imperative first to evaluate local services and identify any gaps in provision. A mapping exercise and a postal questionnaire were used in an attempt to canvass the views of patients and carers using a service in Gloucestershire. This article reports on the methodology and the findings of the questionnaire.
Attitude of Health Personnel↗
Novel role for specialist nurses in managing diabetes in the community.
To develop care of diabetes further a specialist nurse established contact with general practices in Sheffield Health District and identified difficulties in providing a service for diabetics. One hundred and thirty practices were visited, and full data were collected from 104. Each practice agreed to establish a register of diabetics, and information and support were subsequently provided to help in developing services. In collecting information from each practice the nurse covered specific points on staff, facilities, and organisation. Over two years the service offered in 60 practices considerably improved, allowing a minimum standard of diabetic care to be achieved. This allowed coordinated and effective referral of certain patients from hospital diabetic clinics and improved services to those not attending any clinics.
Community Health Nursing↗
Lessons from the Essential Access Community Hospital Program for rural health network development.
The Essential Access Community Hospital (EACH) Program is testing a concept for limited-service hospitals established under Medicare called the Rural Primary Care Hospital (RPCH). The program uses cost-based reimbursement and relaxed regulatory requirements to help low-volume rural hospitals shift emphasis from acute care to primary care and emergency services. RPCHs must form "horizontal" networks with larger hospitals and may form "vertical" arrangements with ambulatory service providers and practitioners. A small number of rural hospitals have converted to the RPCH status since the program entered the implementation stage in late 1993. It is unclear how many other hospitals will convert given uncertainty regarding the financial impact of RPCH conversion and concerns with certain requirements. The program illustrates how payment policies can provide incentives for network development and reflects the importance of physician involvement and technical assistance in developing limited-service hospitals. In addition, it appears that EACH/RPCH networks that form under the program may serve as building blocks for broader networks, as the seven states involved in the program look to develop rural health networks that go beyond the EACH/RPCH model.
Comprehensive Health Care↗
Community based intervention on adolescent risk taking: using research for community action.
OBJECTIVES: To use research on adolescent risk taking behaviour as an impetus for a community to develop locally based injury prevention strategies. DESIGN: Case study, based on a community action model and formative evaluation. This involved: a community profile on adolescent risk taking behaviour; interviews with service providers; dissemination of research findings to local policy makers; development and implementation of a community action plan to address adolescent risk taking; and assessment of its impact. SETTING: A rural town with a population of 10,195 situated in the North Island of New Zealand. SUBJECTS: School aged adolescents and the safety policies and practices of community organisations involved with adolescents. RESULTS: Risk taking behaviours identified by the community profile included: drink-driving, substance abuse, carrying of weapons with intent to harm, and suicidal ideation. Community members identified that risk taking behaviour associated with alcohol in relation to: (1) violence (self directed and assault) and (2) road related injuries should be the focus of their activities. The strategies identified focused on advocacy, education, legal/regulatory change, and environmental modification. Evaluation conducted six months after intervention identified increased community awareness of the adverse effects of adolescent risk taking and some changes in policies and practice related to adolescent safety. CONCLUSIONS: Providing a community with local information that has high relevance for its members may act as a stimulus for the development of injury prevention initiatives. While this case study illustrated that a comprehensive approach focusing on adolescent risk taking behaviour, rather than on isolated injury problems, may be an appropriate way to highlight escalating adolescent injury rates, it also demonstrates the limitations of a short time frame for a community development project.
Adolescent↗
From neurons to King County neighborhoods: partnering to promote policies based on the science of early childhood development.
A diverse community partnership in the Seattle area developed a policy agenda based on science, organized community support, and committed to monitor policy changes. It found that public health agencies are well positioned to develop a common knowledge base on early childhood development and to initiate community coalitions promoting policies to strengthen environments. It was challenging to maintain participants' focus on environments over time. Providing access to conditions that promote optimal development for all children will require ongoing commitment and alignment of many sectors to move political will and mobilize for change.
Child↗
Enhancing lives through the development of a community-based participatory action research programme.
A community-based participatory action research (PAR) programme that has spanned 5 years is discussed in this article. A primary healthcare philosophy requires research in this practice setting and supports the way healthcare is ideally organized within an integrated team and supported by a community network that includes not only the healthcare workers and service providers but also the community as partners. The principles driving three PAR inquiries are described: the development of a model for prevention of workplace violence; working with clinicians towards improving wound management practice; and management of continence for community-dwelling women living with multiple sclerosis. Participatory action research is a potentially democratic process that is equitable and liberating as participants construct meaning in the process of group discussions. We conclude that the cyclical processes inherent in PAR promote reflection and reconstruction of experiences that can lead to the enhancement of people's lives, either at an individual or community level, or both.
Chronic Disease↗
Expanding community-based health services.
The recently published White Paper on developing community-based health services contains proposals which will have a direct impact on a number of hospital specialties and on the provision of primary and preventive care in the community. Many of these developments are to be welcomed, but a clearer understanding is required of the most appropriate balance between hospital and community services in the future, of the educational implications of changing patterns of care in the NHS and of the resource implications of these reforms.
Chronic Disease↗
Rhode Island Department of Health Strategic Plan: 2004-2010. Goal 5: Healthy human development in Rhode Island communities: improving family and community health opportunities.
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Health Promotion↗
Community participation in the development of primary health services.
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Americas↗
In rural Ugandan communities the traditional kinship/clan system is vital to the success and sustainment of the African Programme for Onchocerciasis Control.
In rural Ugandan communities where onchocerciasis is meso- or hyper-endemic, control of the disease is now being carried out using a strategy of community-directed programmes for the annual distribution of ivermectin to all persons eligible to take the drug. For these programmes to achieve their annual target coverage of at least 90% of the population eligible to take ivermectin, and to continue to sustain themselves for 10-15 years or more, even after external donor funding ceases, it has been found essential to replace the initial community-based strategy, imposed from outside, by a community-directed strategy developed by the community members themselves. Furthermore, it is essential for success that full use be made of the traditional social system, which is very strong in all rural communities in Uganda. This system is based on patrilineal kinships and clans, governed by traditional law, and in it women pay an important role. If this system is ignored or by-passed by government health personnel or by the sponsors and promoters of the programme, the communities are likely to fail to reach their targets. When rural communities increase in size and complexity, following development and the arrival of migrant families, they become semi-urbanized. The kinship/clan system is then weakened, community-directed drug distribution is much more difficult to organize, and coverage targets are not often achieved. This effect is of minor importance in a rural disease, such as onchocerciasis, but is likely to be of greater significance in the control of diseases, such as tuberculosis and lymphatic filariasis, which thrive in urban environments.
Community Health Workers↗
The dynamics of vector-transmitted diseases in human communities.
The development of vector-transmitted disease models and their application to field studies is reviewed. The key concepts of the basic rate of reproduction and disease transmission threshold are explained, and their application to disease control briefly illustrated. The complications involved in producing appropriate models are discussed for the case of the trypanosomatid parasites Leishmania and Trypanosoma that frequently have more than one vertebrate host and are often fatal in the human host. A two-species, vector-borne disease model allows a quantification of the role of animal reservoirs in maintaining human diseases. Human prevalence may be determined more by the parasitological characteristics of wild reservoir species, about which little is generally known, than by any other single feature of the complex interaction between parasites, vectors and hosts. Domestic animals are often ideal reservoirs, maintaining large numbers of vectors and considerably enlarging the parasite pool. When vector-transmitted diseases are fatal to the human host, human and vector dynamics interact in ways which may cause epidemic cycles, low-level endemic equilibria or disease extinction. For both leishmaniasis and trypanosomiasis it is suggested that a very small number of chronic human cases can maintain the disease in the human population over long periods of time between epidemic outbreaks. They may also be important in the maintenance of geographically distinct foci, characteristic of human trypanosomiasis in Africa. Finally there is a plea to establish a tradition of field observation leading to, and being directed by, mathematical models which in turn are modified as the observations accumulate. All too often, one-way traffic between the two results in slow, or misguided, progress.
Animals↗
Asbestos in the workplace and the community.
Information developed by Newhouse in a survey of an asbestos factory in London suggests that the risk of mesothelial tumors is strongly related to both the degree and the length of exposure to asbestos dust.
Air Pollutants↗