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At least 1,531 records · Page 85Linked to original sources
PubMed2004

Impact of resistance to antiretroviral therapy in the minority community.

The development of resistance to antiretroviral therapies has become a formidable barrier to providing optimal treatment of HIV infection in the United States. The emergence of new mutations resistant to antiretroviral agents and a rise in transmission of resistant viruses contribute to an increased risk of treatment failure. Resistance testing of both treatment-experienced and treatment-naive patients i snow recommended for identification of the most effective treatment regimen; however, resistance testing is not universally available or easily interpreted. Furthermore, poor adherence to a treatment regimen or treatment with less potent antiretroviral agents can lead to exposure of virus to subinhibitory levels of drug and the development of resistance. In this article, we discuss several issues that specifically impact the development and transmission of resistant HIV in patients belonging to ethnic minorities and teh implementation of strategies that will overcome resistance as an obstacle to optimal treatment.

Anti-HIV Agents↗
PubMed1997

Cell communities and robustness in development.

The robustness of patterning events in development is a key feature that must be accounted for in proposed models of these events. When considering explicitly cellular systems, robustness can be exhibited at different levels of organization. Consideration of two widespread patterning mechanisms suggests that robustness at the level of cell communities can result from variable development at the level of individual cells; models of these mechanisms show how interactions between participating cells guarantee community-level robustness. Cooperative interactions enhance homogeneity within communities of like cells and the sharpness of boundaries between communities of distinct cells, while competitive interactions amplify small inhomogeneities within communities of initially equivalent cells, resulting in fine-grained patterns of cell specialization.

Animals↗
PubMed2002

Molecular typing techniques to characterize the development of a lactic acid bacteria community on vacuum-packaged beef.

The development of a community of lactic acid bacteria from vacuum-packaged beef was investigated during a 6-week storage trial at 2 degrees C. The lactic acid bacteria population was monitored by using molecular techniques to identify a random sample of isolates at biweekly intervals during the storage trial. The polymerase chain reaction and a randomly amplified polymorphic DNA technique were used to identify and distinguish populations of lactic acid bacteria that developed during the storage trial. At week 0, the population of lactic acid bacteria was 3.5 log cfu/120 cm2 and by week 6, the population reached a maximum of 7.6 log cfu/120 cm2. A sampling from the week 0 population indicated a mixed community of Lactobacillus curvatus, Lactobacillus sakei and Leuconostoc spp. However, the sampling from week 6 indicated the population composition had changed to one where a single Leuconostoc strain predominated. This strain demonstrated antagonism towards the growth of other lactic acid bacteria isolated during the study. Additionally, the strain inhibited the growth of foodborne pathogens Escherichia coli O157:H7 and Listeria monocytogenes. DNA sequence data from the 16S rRNA gene suggested that the isolate may be a Leuconostoc gelidum strain.

Animals↗
PubMed1982

Life-span development of institutionalized and community-based mentally retarded residents.

Life-span development of mentally retarded residents in institution and community settings was examined. Results showed that significant growth in adaptive behavior occurred for all groups of residents regardless of their level of retardation. Furthermore, the shapes of these growth curves were parallel across the different levels of retardation over the age range studies (5 to 50 years). Measures of the quality of the environment were available for institutionalized residents and were found to be unrelated to adaptive behavior growth; however, environmental quality was associated with initial levels of adaptive behavior, suggesting that for institutionalized residents, adaptive behavior competence may determine the type of environment provided.

Adaptation, Psychological↗
PubMed2003

Improved cognitive and motor development in a community-based intervention of psychosocial stimulation in northeast Brazil.

The aim of the study was to compare the development of children with and without a programme of psychosocial stimulation in 'control' and 'intervention' sites in a poorly resourced area of northeast Brazil. The sample (n = 156, born 1998) was from a larger cohort. The cohort was tested at 12 months (baseline) with the Bayley Scales of Infant Development. All children in the intervention site with a mental development index (MDI) and/or psychomotor development index (PDI) < or = 100 were enrolled. Each time such a child was enrolled, the next child tested in that site of the same sex and with an index of 101 to 115 was also enrolled, and the next two children matched for sex and scores of < or = 100 and 101 to 115 in the control sites were recruited in parallel. The intervention comprised 14 contacts between 13 and 17 months of age. All children were tested again at age 18 months. The intervention and control groups were similar at baseline for a range of socioeconomic, demographic, environmental, and biological variables, and their MDI and PDI were also similar. At 18 months, the mean differences between the intervention and control groups were + 9.4 points for MDI and + 8.2 points for PDI (p < 0.001 in each case). For children with an initial score of < or = 100, the mean difference between the intervened and control groups was + 11.2 points for MDI (p < 0.001), and + 10.8 points for PDI (p = 0.001). The intervention was thus associated with significant improvements in cognitive and motor development.

Activities of Daily Living↗
PubMed2004

A review of community consultation in the development of a multi purpose service in rural and remote Australia.

This paper examines the role of community consultation and participation in the process of establishing a Multi Purpose Service (MPS) program in two towns in Western Australia. Information was gathered through written documents and semi-structured interviews with individuals who were integral to the process. Consumer involvement in health care is increasing, and while claims of being community driven underpinned the MPS program, our findings suggest otherwise. Conflicts of interest, a lack of representation, and misunderstandings about the meaning of community consultation were present throughout the process of implementation. Moreover, official reports either ignore or downplay these events. We conclude that more attention must be paid to the role of the community in the health reform agenda generally and the MPS program specifically.

Australia↗
PubMedDate not supplied

Reducing disparities for African Americans with diabetes: progress made by the REACH 2010 Charleston and Georgetown Diabetes Coalition.

Racial and Ethnic Approaches to Community Health (REACH 2010) is a U.S. Centers for Disease Control and Prevention demonstration program that responds to the U.S. Department of Health and Human Services' goal to eliminate racial and ethnic disparities in health status by the year 2010. As part of REACH 2010, community projects were funded to develop, implement, and evaluate community action plans to improve health care and outcomes for racial and ethnic populations. This article describes the program and details the progress of the REACH 2010: Charleston and Georgetown Diabetes Coalition in reducing disparities in care. Approaches employed by the Coalition included community development, empowerment, and education related to diabetes; health systems change associated with access, care, and education; and coalition advocacy. Racial disparities were identified for 12,000 African Americans with diabetes in this urban/rural South Carolina community. After 24 months, significant differences that initially ranged from 11% to 28% in African Americans (when compared with whites/others) were not observed on 270 chart audits for A1C, lipid and kidney testing, eye examinations, and blood pressure control. Future efforts will focus on maintaining progress, eliminating other disparities, and identifying the contributions of each intervention in eliminating racial disparities.

Black or African American↗
PubMed1996

Informal family caregiving to older people with dementia: research priorities for community psychiatric nursing.

The paper reviews the literature relating to the provision of community psychiatric nursing to demented elderly people and their informal family caregivers, and develops priorities for research in that particular area of nursing. Initially, the development of community psychiatric nursing with elderly demented people is examined. Various theoretical models articulating the family's experience of dementia are examined as a basis for identifying various priorities for research in the area. Empirical evidence relating to the efficacy of various interventions is briefly discussed. Various priorities are made regarding the development of research relating to the development of community psychiatric nursing with elderly demented people and their informal caregivers. Finally the paper is placed in the context of the present policy of refocusing psychiatric nursing on to people with serious and enduring mental disorders. It is argued that this policy should include elderly demented people not just younger people with functional mental disorders.

Age Factors↗
PubMed1980

A case for community psychiatric nurses.

The author reviews the development of community psychiatric nursing services since the Mental Health Act 1959. In particular, the community services to her own catchment population are discussed, analysed and evaluated. A claim is made that community care is cost-effective and makes a contribution to prevention. It is also agreed that the presence of community psychiatric nurses in the community fosters greater tolerance and acceptance of the mentally sick by the community at large.

Community Health Nursing↗
PubMed2002

[Indicators of growth and development of boys from the community of Tuzla].

Properties of growth and development of male children and youth were analyzed by the appropriate sample analysis, which involved total of 1.321 domiciles and refugees, on the researched region. This study included 9 successive school "generations", which were presented by chronologically ordered growths ranged from 10.5 to 19.5 years of age. They were analyzed concerning 6 standard and anthrophometrical properties. The analysis of the data gained its primarily based on the scientific elaboration of the noticed situation in the researched part of population in broader sense after one unnatural and extremely unfavourable period in growth and developing process for large majority of mentioned population. The aims of this study were: the analysis and definition of the principle indicators of growth and development of male children and youths in the Tuzla municipality, then 16 years accelerational trend in course of this period of the ontogenesis as well as the differences between domiciles and refugees. Though bad (war) living conditions had negative effects on ontogenesis of tested children and youths, it was established that growth and development of male children and youth in the region tested was going harmoniously and in limits of average European standards. It still seems that bad living conditions caused a temporary lagging behind in the growth and development, so in some growth categories (from 11 to 15 years) mean value increase could be noticed (for one number of tasted parameters) compared to the sample from 1980 year. Refugees presence caused something less mean values for most indicators. Sixteen year's acceleration trend for the most parameters was established in puberty when it was very clearly visible.

Adolescent↗
PubMed1987

Attitudes towards mental illness in the Athens area: implications for community mental health intervention.

Attitudes towards mental illness were measured in a probability sample of 1574 male and female adults, residents of two boroughs in the greater Athens area before the development of community mental health services in the area. The objective of this study was to identify the components of these attitudes, taking into account the fact that public opinions about mental illness influence the utilization of community mental health services and the level of reintegration of the mentally disabled into society. The instrument used to measure attitudinal dimensions was the Cohen and Struening Opinion about Mental Illness (O.M.I.) scale. Factor analysis revealed five attitude dimensions: social discrimination, social restriction, social care, integration, and etiology. Among the socio-demographic variables age, education, occupational status and place of residence up to 18 years of age affected the factors mainly, reflecting social discrimination and restriction. O.M.I. factor scores underlying the need for social care and reintegration of the mentally ill into society were found to be socially invariant, implying the need for social care and more humane treatment methods for mental patients. Certain population groups responded with rejection or suspicion and considerable fear of the mentally ill, indicating the necessity for the planning of appropriate community mental health intervention programs parallel to the development of community mental health services and psychiatric reforms in Greece.

Adult↗
PubMed1993

The development of a BA in community health nursing/BA in nursing by distance learning.

A new degree course in community health care nursing has been developed at The Robert Gordon University, with validation having taken place on 30 June 1992. It is innovative as it is being offered to students by a part-time distance learning route only, over a minimum time of 18 months and a maximum time of 3.5 years, and is replacing the full-time diploma courses offered in district nursing, health visiting and occupational health nursing. As well as the community health nursing route, a BA in nursing has also been developed for any registered nurse who wishes to top-up to degree level.

Community Health Nursing↗
PubMed2000

Community mental health teams (CMHTs) for people with severe mental illnesses and disordered personality.

BACKGROUND: Closure of asylums and institutions for the mentally ill, coupled with government policies focusing on reducing the number of hospital beds for people with severe mental illness in favour of providing care in a variety of non-hospital settings underpins the rationale behind care in the community. A major thrust towards community care has been the development of community mental health teams (CMHT). OBJECTIVES: To evaluate the effects of community mental health team (CMHT) treatment for anyone with serious mental illness. SEARCH STRATEGY: Electronic searches of Biological Abstracts (1982-1997), the Cochrane Library (1998, Issue 2), EMBASE (1980-1997), MEDLINE (1966-1997), PsycLIT (1974-1997) and SCISEARCH (1997) were undertaken. The Journal of Personality Disorders was hand searched, and contact was made with colleagues at ENMESH, ISSPD and in forensic psychiatry. SELECTION CRITERIA: All randomised or quasi-randomised controlled trials of CMHT management versus non-team standard care. DATA COLLECTION AND ANALYSIS: The selection of trials, assessment of quality and data extraction was undertaken independently and in parallel by two reviewers. Where possible the data were entered into RevMan and an intention-to-treat analysis undertaken. Tests of heterogeneity were undertaken. MAIN RESULTS: CMHT management may be associated with fewer deaths by suicide and in suspicious circumstances (OR 0.32 CI 0.09-1.12). It causes less people to be dissatisfied with their care (OR 0.34 CI 0.2-0.59) and to leave the studies early (OR 0.61 CI 0.45-0.83). No clear difference was found in admission rates, overall clinical outcomes and duration of in-patient hospital treatment, although this was partly a consequence of poorly presented data. REVIEWER'S CONCLUSIONS: Community mental health team management is not inferior to non-team standard care in any important respects and is superior in promoting greater acceptance of treatment. It may also be superior in reducing hospital admission and avoiding death by suicide.

Community Mental Health Services↗
PubMed1991

The application of operational research (OR) procedures to maternal mortality from puerperal sepsis in a rural community.

An operation research (OR) procedure on maternal mortality from puerperal sepsis was carried out in Irepodun Local Government Area of Kwara State of Nigeria. The study involved ten focus groups discussion (FGD) in two districts of the Local Government Area. The findings were analysed from three broad perspectives, that is, consumers' views, providers' views and community decision takers' views. In general, the analysis revealed that the community knowledge of puerperal sepsis is poor. In addition, limited access and prohibitive cost of orthodox health care services prevented the community from full utilization of the few available health care centres in the community. The study also revealed that there is urgent need to introduce three key interventions for an improved maternity care in the community. These interventions are community health education, health institutions development and community participation in provision of ancillary services such as transportation.

Female↗
PubMed2003

Visual localisation of community health needs to rational decision-making in public health services.

The objectives were to visualise the locations of community health needs and to develop a community health needs assessment geographic information system (GIS) for rational decision-making in public health services. We compiled census data, digital data of basic planning maps, digital data of topographic maps, contents of registers of medical and welfare facilities, and statistics of establishments into a geographical database; visualised geographical distributions of specific community health needs by integrating sets of indicators to reflect individual needs; and quantified their clustering by the nearest neighbour method. The database aggregated 3400 items of demographic, life and environmental factors. Thematic maps and clustering values showed different patterns of geographical distribution of the individual community needs. Means to match needs with services in smaller geographical units were discussed. This GIS will support appropriate resource allocation, intersectoral collaboration and greater transparency in planning and implementing services, by visualising locations of community health needs.

Adolescent↗
PubMedDate not supplied

Involving communities in community assessment.

Focus groups provide an effective means of incorporating the perspectives of "hidden" populations in assessments of community health needs and assets. A series of focus groups was conducted with specifically targeted segments of a community to develop a comprehensive picture of community health. The authors describe the focus group process, major findings, and the use of focus group results in a highly multicultural community. Despite differences in age, length of residence, and ethnicity, the focus groups were remarkably similar in the issues raised. The majority of participants viewed the multicultural nature of the community as an asset but voiced some of the difficulties of living in a multiethnic and multilanguage environment. Similar areas of concern in the community arose from all of the focus groups, including housing and other environmental issues and problems of access to health care. Focus group findings have been used to initiate activity addressing identified community problems. Focus group participation had the added benefit of increasing community members' participation in other community endeavors.

Adolescent↗