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At least 1,549 records · Page 86Linked to original sources
PubMed2004

[Children: improving the prevention and early advancement in children with behavioral- and developmental disorders in the Ennepe-Ruhr District].

Developmental behavioural disorders in early childhood are a serious public health problem, because they signify a higher risk of social, regulatory and emotional impairment in later life. The public health office in Ennepe-Ruhr develops in cooperation with the communities a programme of health promotion for children and their families. An important motive is continually rising costs for supporting children with developmental problems. An element in the programme is a project of counselling mothers with babies and toddlers with excessive crying, serious sleep disorders and anxiety problems. This example of early intervention promises short-term relief, early identification of problem children and the strengthening of parental resources. A key issue is the introduction of a systematic evaluation of all communal funding for measures of support for preschool children. It shows that such measures start relatively late, and the coordination at community level is not always optimal. Some progress has been made, but criteria to measure the efficiency of current health promotion are still lacking. According to public health research early intervention for risk groups (single mothers, migrant families or families depending on public assistance) promises to give children and their families a better social and health perspective in life. It should be a primary health target for communities to develop evidence-based health programmes for children, focussing on mental and social well-being. Studies indicate that such interventions might have positive financial results.

Adolescent↗
PubMedDate not supplied

Utilizing a national performance standards local public health assessment instrument in a community assessment process: the Clarendon County Turning Point Initiative.

The Clarendon County Turning Point Initiative was launched with the goals of conducting a community-wide health assessment and developing a community health improvement plan. For the community assessment, the National Association of County and City Health Officials' (NACCHO's) Mobilizing for Action through Planning and Partnerships (MAPP) model was used. One of the assessments conducted through the MAPP model was the National Public Health Performance Standards Local Public Health Systems Assessment. The process for conducting the assessment using the local performance instrument is described. Clarendon County Turning Point Initiative conducted a one-and-a-half-day retreat to complete the local performance instrument. The committee planning the process identified and recruited stakeholders, collected data/information from stakeholders, and hired a consultant to facilitate the one-and-a-half-day retreat. The data analyzed with the local performance instrument identified opportunities and gaps in public health services in Clarendon County.

Community Health Services↗
PubMed2006

Air quality management using modern remote sensing and spatial technologies and associated societal costs.

This paper presents a study of societal costs related to public health due to the degradation of air quality and the lack of physical activity, both affected by our built environment. The paper further shows road safety as another public health concern. Traffic fatalities are the number one cause of death in the world. Traffic accidents result in huge financial loss to the people involved and the related public health cost is a significant part of the total societal cost. Motor vehicle exhausts and industrial emissions, gasoline vapors, and chemical solvents as well as natural sources emit nitrogen oxides and volatile organic compounds, which are precursors to the formation of ground-level Ozone. High concentration values of ground-level Ozone in hot summer days produce smog and lead to respiratory problems and loss in worker's productivity. These factors and associated economic costs to society are important in establishing public policy and decision-making for sustainable transportation and development of communities in both industrialized and developing countries. This paper presents new science models for predicting ground-level Ozone and related air quality degradation. The models include predictor variables of daily climatological data, traffic volume and mix, speed, aviation data, and emission inventory of point sources. These models have been implemented in the user friendly AQMAN computer program and used for a case study in Northern Mississippi. Lifecycle benefits from reduced societal costs can be used to implement sustainable transportation policies, enhance investment decision-making, and protect public health and the environment.

Air Pollutants↗
PubMed2005

Recruiting African-American research participation in the Jackson Heart Study: methods, response rates, and sample description.

OBJECTIVE: The sampling and recruitment methods, response rate, and cohort description for the all-African-American Jackson Heart Study (JHS) are detailed. METHODS: Four subsamples of participants residing in the Jackson, Mississippi metropolitan statistical area (MSA) were included: random, volunteer, ARIC (continuing from Atherosclerosis Risk in Communities study), and family. A community-driven recruitment model was developed, and community representatives guided recruitment. RESULTS: 96% (n=5,302) of target enrollment was achieved with diversity in sex, education, and income. The JHS cohort provides a sample of African-American adults for longitudinal investigation. DISCUSSION: Cohort recruitment was challenging. The JHS experiences provide useful lessons for observational epidemiological studies recruiting African-American research participation. Co-participation of researchers and researched in study design and realistic evidence of community benefit were crucial to recruitment success.

Adult↗
PubMed1998

Development and evaluation of a community based, multiagency course for medical students: descriptive survey.

OBJECTIVE: To develop and evaluate an effective, community based, multiagency course (involving doctors, nurses, non-health statutory workers, and voluntary organisations) for all Leicester medical students, in response to the General Medical Council's recommendation of preparing the doctors of tomorrow to handle society's medical problems. DESIGN: Survey evaluating a task oriented, problem solving course, designed by medical students in partnership with the University of Leicester and the local community. The students, staff, and participating agencies and patients all helped in the evaluation of the first course. The students' performance on the course was also individually assessed. SETTING: Inner city housing estate with Jarman index 64.1 in Leicester. SUBJECTS: All third year medical students at Leicester University. MAIN OUTCOME MEASURES: Results of the student assignments and students' responses to a questionnaire. Results of feedback questionnaires distributed to the patients and agency representatives. RESULTS: In a two month period, 168 students completed the first course. 163 students passed the criterion referenced assignment, 50 of whom achieved an "excellent" grade. 166 completed the questionnaire, with 159 wishing to see the course continue in the present format and 149 saying that the course linked theoretical teaching with the practical experiences gained in the community. CONCLUSIONS: The University of Leicester has a viable mechanism for providing a community based, multiagency course for all its medical students. Many of the principles applied in the development and implementation of the course could be transferred to other medical schools.

Adult↗
PubMedDate not supplied

Changing focus of practice for community health nurses: advancing the practice role.

Many parents lack support in their parenting role that was once provided through extended families and community structures. Thus, some new parents experience high levels of stress and low self-esteem associated with the challenges of parenting. The lack of support also results in family discord and breakdown with the family environment having the potential to adversely impact children's mental and physical wellbeing and development. The Community Mothers Program (CMP) was initially developed in England and offers support to families during the first year of parenting. The program aims to provide parents with the support once experienced from within the extended family. It also aims to enrich community development by building the capacity of community members living in local communities to support parents. This paper describes the impact of the CMP when implemented into Western Australian as well as the changes to the professional practice role of community child health nurses involved in the program. The Community Mothers Program has proved to be very successful. The success is attributed to the partnership model established between community members, parents, and child health nurses.

Community Health Nursing↗
PubMed2003

The development of a feasible community-specific cardiovascular disease prevention program: triangulation of methods and sources.

Triangulation of methods, sources, and investigators can lead to a multidimensional understanding of a particular issue. In this study, the combination of qualitative and quantitative data collection methods, and information from community and coalition members resulted in the development of a tailored community-specific intervention. Three components were triangulated after analyzing each separately. A household survey of community members between the ages of 25 and 64 years was conducted to identify knowledge, attitudes, and behaviors related to cardiovascular disease and to assess risk factor levels. Focus group discussions were conducted with community members to describe facilitators and barriers to healthy lifestyles, as well as possible interventions. Natural group discussions with coalition members analyzed the relevance, feasibility, affordability, acceptability, and sustainability of specific intervention activities. Results from the different components were compared and contrasted. Areas of added information, validation, and contradiction were analyzed and guided the development of intervention activities.

Adult↗
PubMed1976

The role of the individual and the community in the research, development, and use of biologicals with criteria for guidelines: a memorandum.

In view of the widely recognized need to use available vaccines and other biologicals and to develop new ones to control many diseases of world-wide importance, this Memorandum considers the increasingly complex problems that face investigators and public authorities that must review and approve pre-licensing studies and also large-scale regular use. It is stressed that the proper conduct of biologicals research in human beings must be considered from the scientific, sociological, ethical, and legal points of view. The Declaration of Helsinki is regarded of fundamental importance and its applicability to biologicals research is discussed. Recommendations are made for continued international collaboration in this field and "Criteria on the Role of the Individual and the Community in the Research, Development, and Use of Biologicals" are formulated. General criteria and specific criteria related to the design of field trials, human involvement in field trials, and surveillance of safety and effectiveness of biologicals in routine use are discussed.

Biological Products↗
PubMed1997

Development of a urinary riboflavin adherence marker for a wheat bran fiber community intervention trial.

Development of a reliable marker of adherence to high-fiber diets is essential for accurately assessing dietary fiber intake in community interventions and clinical trials. The objective of this study was to evaluate the feasibility of using a riboflavin tracer incorporated into wheat bran cereal to determine fiber intake and compare results to the more traditional methodology of measuring stool weight. The inpatient phase of the study established that the excretion of urinary riboflavin was highly correlated with the dose of the riboflavin-spiked wheat bran cereal (r = 0.95, P < 0.005) and could be used as a biomarker to validate fiber supplement intake. The outpatient clinical intervention included a group of seven African-American men and women, who were asked to incorporate 1/2 cup of wheat bran cereal (11.6 g of dietary fiber) into their daily diet for a 6-week period. The cereal was spiked with a 28-mg dose of riboflavin. Baseline measurements of urinary riboflavin and stool weight were compared to postintervention levels. Comparison of pre- and postintervention measures of riboflavin excretion showed a significant increase (0.8 +/- 0.1 versus 6.0 +/- 0.6 mg/day, P < 0.02), which confirmed a high level of adherence to the dietary intervention. Although wet stool weights at baseline were significantly lower than postintervention (106 +/- 20 versus 146 +/- 23 g/day; P < 0.03), differences in dry stool weights did not reach significant levels (28 +/- 4 versus 33 +/- 5 g/day, P < 0.30). Furthermore, pre- and poststool measurements overlapped and could not provide definitive data on participant adherence. These results indicate that the riboflavin tracer was a more sensitive biomarker of wheat bran fiber supplementation than stool weight and provided an accurate method for validating adherence to the dietary intervention. A riboflavin marker provides a valid technique for adherence assessment in large-scale community trials, in which collection of 3-day fecal samples is not a manageable option.

Aged↗
PubMed2001

[Development and evaluation of a QOL questionnaire for elderly subject living in a community].

A comprehensive, basic and simple QOL questionnaire for elderly subjects living in a community was developed, and its validity and reliability were examined. The subjects were 2944 individuals of 65 years or older living in 5 areas of metropolitan Tokyo and in a town of Aichi Prefecture. The QOL questionnaire with 19 questions was developed based on the component of QOL by Lawton and concept of QOL by Koyano. The questionnaire consisted of 6 subscales (daily activity, satisfaction with health, satisfaction with human support, satisfaction with economic state, symptom of depression and positive mental attitude). Factor analysis revealed that the 19 questions could be clearly separated into 6 components in Tokyo and Aichi districts with total variances of 70.8% and 78.4%, respectively. Scores of daily activity and positive mental attitude were significantly lower with older subjects in both men and women. However, scores for other subscales did not differ with age. Primary factors which are considered to affect QOL were compared with the 6 QOL subscales of this study. Being an outpatient had a significant relation to daily activity and satisfaction with health, presence of a spouse to satisfaction with human support, depressive state, positive mental attitude and possession of ones own room to satisfaction with economical state, and belief in religion to positive mental attitude. The results suggest that the present questionnaire include the basic components necessary for evaluation of QOL in elderly subjects living in a community. Further research is required to examine the validity of this questionnaire with correction of questions.

Aged↗
PubMed2005

Study of urban community survey in India: growing trend of high prevalence of hypertension in a developing country.

The prevalence pattern of hypertension in developing countries is different from that in the developed countries. In India, a very large, populous and typical developing country, community surveys have documented that between three and six decades, prevalence of hypertension has increased by about 30 times among urban dwellers and by about 10 times among the rural inhabitants. Various factors might have contributed to this rising trend and among others, consequences of urbanization such as change in life style pattern, diet and stress, increased population and shrinking employment have been implicated. In this paper, we study the prevalence of hypertension in an urban community of India using the JNC VII criteria, with the aim of identifying the risk factors and suggesting intervention strategies. A total of 1609 respondents out of 1662 individuals participated in our cross-sectional survey of validated and structured questionnaire followed by blood pressure measurement. Results showed pre-hypertensive levels of blood pressures among 35.8% of the participants in systolic group (120-139mm of Hg) and 47.7% in diastolic group (80-89 mm of Hg). Systolic hypertension (140 mm of Hg) was present in 40.9% and diastolic hypertension (90 mm of Hg) in 29.3% of the participants. Age and sex-specific prevalence of hypertension showed progressive rise of systolic and diastolic hypertension in women when compared to men. Men showed progressive rise in systolic hypertension beyond fifth decade of life. Bivariate analysis showed significant relationship of hypertension with age, sedentary occupation, body mass index (BMI), diet, ischemic heart disease, and smoking. Multivariate analysis revealed age and BMI as risk factors, and non-vegetarian diet as protective factor with respect to hypertension. Prevalence of prehypertensives was high among younger subjects - particularly students and laborers who need special attention. Role of non-vegetarian diet as a protective factor might have been related to fish-eating behavior of the sample population, who also use mustard oil as cooking medium - both of which have significant level of essential polyunsaturated fatty acids. The observed prevalence of hypertension in this study and other studies suggest the need for a comprehensive national policy to control hypertension in India, and, in other similar developing countries.

Journal Article↗
PubMed1995

Measuring community leaders' perceived ownership of health education programs: initial tests of reliability and validity.

Development of community ownership is often identified as an important intermediate objective of community health education programs. Community ownership is assumed to be important to program effectiveness and long-term maintenance, but validated measures of this construct have not been available to test this proposition. A measure of community leaders' perceived ownership of health education programs was developed and tested. The Community Ownership Scale identified key functions within a program and asked community leaders to rate the amount of control the leaders themselves, the external sponsoring agency and the local program staff had in each area. The measure was tested with the volunteer leadership of three community health education programs. Predictions about scores were based on the conceptual framework from which the ownership construct was derived. Results of these tests were consistent with predictions, providing evidence for the validity of the measure. Subscale scores showed high levels of internal consistency reliability. This measure could be applied at different stages in the life of a program to monitor the success of efforts to foster community ownership, and to test the relationships between perceived ownership and program effectiveness and maintenance.

Community Participation↗
PubMed1988

Diagnosis and management of dysentery by community health workers.

To develop guidelines for community health workers in the treatment of patients with diarrhoea, diarrhoea prevalence was actively surveyed for a year in a remote rural community of 915,000 persons, and the enteric pathogens and clinical features associated with diarrhoeal illness were determined in a sample of 300 patients. Bloody diarrhoea accounted for 39% of all diarrhoea episodes and 62% of diarrhoea-associated deaths. 51 (50%) of 101 patients with a history of bloody diarrhoea had Shigella infection, compared with 31 (16%) of 199 patients with other types of diarrhoea. A history of bloody diarrhoea was as predictive of the presence of shigella infection (positive predictive value 50%, negative predictive value 86%) as more complex prediction schemes incorporating other clinical features or stool microscopic examination. In the area of Bangladesh where the study was done reduction of diarrhoea-related morbidity and mortality will depend on control and treatment of shigellosis, and community health workers have been instructed to provide antibiotics for patients with a history of bloody dysentery.

Anti-Infective Agents, Urinary↗