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PubMed2003

Developing a virtual interdisciplinary research community in higher education.

As multidisciplinary collaboration in both clinical and research settings is becoming a key aspect of contemporary health care, strategies to enhance interprofessional interaction in postgraduate research programmes can offer important experiences to facilitate ongoing interprofessional relationships. This paper provides a retrospective appraisal of a strategy which used computer-mediated communication to develop a virtual community network, known as'health_voice' accessed through a web page. The rationale for developing the network is presented, and the process of designing and establishing the web-site through an action research approach is described The outcome of the strategy is reviewed with regard to the relationships between the real' and 'virtual' community. Reflections on the developmental process contextualise the initiative within a concept of a community-of-practice. It is acknowledged that the use of a virtual arena for communication within a research community involves a cultural change in the dynamics of higher degree teaching and learning. Future plans to further embed the virtual environment within a postgraduate research culture are given.

Cooperative Behavior↗
PubMed1994

Social responsibility and the academic medical center: building community-based systems for the nation's health.

Academic medical centers have fulfilled several of their missions with immense success but have failed to fulfill others. They have responded only modestly to the needs of the nation's underserved rural and urban communities. The author calls on academic medical centers to take an aggressively active role in building the medical infrastructure now missing in these communities and outlines a multi-part agenda for institutional commitment. It includes developing community-based systems of primary care, outreach programs, and social supports; training professionals committed to serving isolated and poor communities; and performing research that will extend the knowledge base to include the health and social issues of the disadvantaged. (Examples are given of institutions that have pioneered these kinds of community-based activities.) To build the new infrastructure, financing must be secured (various sources are discussed), a community-based faculty must be developed, and each institution's leadership--the medical school dean, the hospital executive, and the department chairmen--must come together around a new agenda and support it materially and psychologically, making whatever changes are needed in the corporate culture. The author warns that if centers do not undertake this responsibility for the health of the underserved, a critical job will go undone, a huge opportunity will have been missed, and American society will be the poorer.

Academic Medical Centers↗
PubMed2001

The Vulnerable Elders Survey: a tool for identifying vulnerable older people in the community.

OBJECTIVES: To develop a simple method for identifying community-dwelling vulnerable older people, defined as persons age 65 and older at increased risk of death or functional decline. To assess whether self-reported diagnoses and conditions add predictive ability to a function-based survey. DESIGN: Analysis of longitudinal survey data. SETTING: A nationally representative community-based survey. PARTICIPANTS: Six thousand two hundred five Medicare beneficiaries age 65 and older. MEASUREMENTS: Bivariate and multivariate analyses of the Medicare Current Beneficiary Survey; development and comparison of scoring systems that use age, function, and self-reported diagnoses to predict future death and functional decline. RESULTS: A multivariate model using function, self-rated health, and age to predict death or functional decline was only slightly improved when self-reported diagnoses and conditions were included as predictors and was significantly better than a model using age plus self-reported diagnoses alone. These analyses provide the basis for a 13-item function-based scoring system that considers age, self-rated health, limitation in physical function, and functional disabilities. A score of >or=3 targeted 32% of this nationally representative sample as vulnerable. This targeted group had 4.2 times the risk of death or functional decline over a 2-year period compared with those with scores <3. The receiver operating characteristics curve had an area of.78. An alternative scoring system that included self-reported diagnoses did not substantially improve predictive ability when compared with a function-based scoring system. CONCLUSIONS: A function-based targeting system effectively and efficiently identifies older people at risk of functional decline and death. Self-reported diagnoses and conditions, when added to the system, do not enhance predictive ability. The function-based targeting system relies on self-report and is easily transported across care settings.

Activities of Daily Living↗
PubMed2004

Microbial community structure and biomass in developing drinking water biofilms.

Traditional techniques to study microbes, such as culturable counts, microbial biomass, or microbial activity, do not give information on the microbial ecology of drinking water systems. The aim of this study was to analyze whether the microbial community structure and biomass differed in biofilms collected from two Finnish drinking water distribution systems (A and B) receiving conventionally treated (coagulation, filtration, disinfection) surface water. Phospholipid fatty acid methyl esters (PLFAs) and lipopolysaccharide 3-hydroxy fatty acid methyl esters (LPS 3-OH-FAs) were analyzed from biofilms as a function of water residence time and development time. The microbial communities were rather stabile through the distribution systems, as water residence time had minor effects on PLFA profiles. In distribution system A, the microbial community structure in biofilms, which had developed in 6 weeks, was more complex than those grown for 23 or 40 weeks. The microbial communities between the studied distribution systems differed, possibly reflecting the differences in raw water, water purification processes, and distribution systems. The viable microbial biomass, estimated on the basis of PLFAs, increased with increasing water residence time in both distribution systems. The quantitative amount of LPS 3-OH-FAs increased with increasing development time of biofilms of distribution system B. In distribution system A, LPS 3-OH-FAs were below the detection limit.

Bacteria↗
PubMed2005

Development of clinical sign based algorithms for community based assessment of omphalitis.

BACKGROUND: In developing countries, newborn omphalitis contributes significantly to morbidity and mortality. Community based identification and management of omphalitis will require standardised clinical sign based definitions. OBJECTIVE: To identify optimal sign based algorithms to define omphalitis in the community and to evaluate the reliability and validity of cord assessments by non-specialist health workers for clinical signs of omphalitis. DESIGN: Within a trial of the impact of topical antiseptics on umbilical cord infection in rural Nepal, digital images of the umbilical cord were collected. Workers responsible for in-home examinations of the umbilical cord evaluated the images for signs of infection (pus, redness, swelling). Intraworker and interworker agreement was evaluated, and sensitivity and specificity compared with a physician generated gold standard ranking were estimated. RESULTS: Sensitivity and specificity of worker evaluations were high for pus (90% and 96% respectively) and moderate for redness (57% and 95% respectively). Swelling was the least reliably identified sign. Measures of observer agreement were similar to that previously recorded between experts evaluating subjective skin conditions. A composite definition for omphalitis that combined pus and redness without regard to swelling was the most sensitive and specific. CONCLUSIONS: Two sign based algorithms for defining omphalitis are recommended for use in the community. Focusing on redness extending to the skin around the base of the stump will identify cases of moderate and high severity. Requiring both the presence of pus and redness will result in a definition with very high specificity and moderate to high sensitivity.

Algorithms↗
PubMed1991

A Canadian model for developing mental health services in rural communities through linkages with urban centers.

The development of mental health care services in rural areas has been a constant challenge in most countries of significant geographical size. By use of a case study from Canada, the development of a relationship between rural and urban mental health services was described. Issues including referral patterns, service accessibility, professional recruitment and the development of service in rural regions were studied. It is advanced that mental health administrators, policy-makers, clinical service coordinators and educators will find that this approach to the development of mental health services in rural areas has some utility in Canada and in other countries.

Canada↗
PubMedDate not supplied

Community health nursing education: where we are going and how to get there.

This article discusses practical aspects of providing community health nursing (CHN) education in community-based care in partnership with a community. Changing from traditional CHN clinicals to more current models involves a shift in values and implementation of principles leading to the change. These values are: refocusing the purpose of CHN education; broad (generalist) scope of practice; problem-solving as a means of discovery; collaboration with peers, faculty, community, and service providers; and working to empower individuals, families, and the community, as well as the students themselves. Principles for developing community-based educational programs in partnership with a community are: examining and incorporating critical concepts; identifying community needs and basing activities on these needs; providing services as a means of studying the community and its problems/needs; expanding and refining services based on problems/needs and assets of the community; and maintaining services based on problems/needs and assets of the community. Each principle is discussed in a process and application format.

Community Health Nursing↗
PubMed2005

Recruitment of benthic organisms onto a planned artificial reef: shifts in community structure one decade post-deployment.

Most artificial reef (AR) studies have examined the early colonization stages of benthic communities, while only a few have monitored the development of AR communities beyond the initial successional phases and evaluated the time scale needed for such development. In addition, despite the proliferation of AR studies, comparative studies between artificial and natural reefs (NRs) are scarce. We present here the monitoring results of initial (1-2 year) and progressed (10 year) stages of the developing benthic communities of a purpose-planned AR submerged at Eilat, Israel (Red Sea), and compare them to its adjacent NR. Visual surveys of macro-invertebrates were conducted on the initial stages and coral communities were characterized at the progressed stage, using belt transects. The results demonstrate a distinct shift in species composition of the AR communities along the monitoring periods: from a soft coral dominated community, comprised mainly of Dendronephthya hemprichi, in initial developmental stages of up to two years post-deployment, to a community dominated by the sponge Crella cyatophora at year 10. Distinct differences in coral species count, living cover and diversity were found between the AR and its neighboring NR. We estimate the time frame required to develop a progressed diverse AR community to be well over a decade, even in tropical ecosystems. The factors shaping the species composition of purpose-designed ARs in a coral reef environment, including structural design, spatial orientation, depth and age, are discussed.

Animals↗
PubMedDate not supplied

Community-based rehabilitation: does it change community attitudes towards people with disability?

To achieve the goal of 'Health for All by the Year 2000' the World Health Organization (WHO) adopted an approach to rehabilitation described as community-based rehabilitation (CBR). A major objective of CBR is to develop positive community attitudes towards people with disabilities. To determine whether this objective can be achieved, post hoc measurement of attitudes towards people with disabilities was carried out in a community in which CBR had been established and in a control community. It is shown that both groups exhibited neutral attitudes. The community exposed to CBR obtained a mean attitude score significantly (p < 0.001) closer to the positive end of the scale than did the control community. It is concluded that communities in which CBR is being carried out develop more favourable attitudes towards people with disabilities than do those in which no such programme has been implemented.

Adult↗
PubMed1987

Terms of empowerment/exemplars of prevention: toward a theory for community psychology.

In order to develop theory any community of scientists must agree as to what constitutes its phenomena of interest. A distinction is made between phenomena of interest and exemplars. The concept "prevention" is viewed as an exemplar, whereas the concept "empowerment" is suggested as a leading candidate for the title "phenomena of interest" to Community Psychology. The ecological nature of empowerment theory is described, and some of the terms of empowerment (definitions, conditions, and periods of time) are explicated. Eleven assumptions, presuppositions, and hypotheses are offered as guidelines for theory development and empirical study.

Humans↗
PubMed1988

Acetylene as a substrate in the development of primordial bacterial communities.

The fermentation of atmospheric acetylene by anaerobic bacteria is proposed as the basis of a primordial heterotrophic food chain. The accumulation of fermentation products (acetaldehyde, ethanol, acetate and hydrogen) would create niches for sulfate-respiring bacteria as well as methanogens. Formation of acetylene-free environments in soils and sediments would also alter the function of nitrogenase from detoxification to nitrogen-fixation. The possibility of an acetylene-based anaerobic food chain in Jovian-type atmospheres is discussed.

Acetylene↗
PubMed2006

Development of the microbial communities in Lake Donghu in relation to water quality.

There is increasing recognition that protozoa is very useful in monitoring and evaluating water ecological healthy and quality. In order to study the relationship between structure and function of protozoan communities and water qualities, six sampling stations were set on Lake Donghu, a hypereutrophic subtropical Chinese lake. Microbial communities and protists sampling from the six stations was conducted by PFU (Polyurethane foam unit) method. Species number (S), diversity index (DI), percentage of phytomastigophra, community pollution value (CPV), community similarity and heterophy index (HI) were mensurated. The measured indicators of water quality included total phosphorus (TP), dissolved oxygen (DO), Chemical oxygen demand (COD), NH(4)(+), NO(2)(-) and NO(3)(-). Every month water samples from stations I, II, III, IV were chemically analyzed for a whole year, Among the chemically analyzed stations, station I was the most heavily polluted, station II was the next, stations III and IV had similar pollution degrees. The variable tendencies of COD, TP, NH(3), NO(2)(-), NO(3)(-), and DO during the year was approximately coincident among the six stations. Analysis from the community parameters showed that the pollution of station 0 was much more serious than others, and station V was the most slight. Of the community parameters, CPV and HI were sensitive in reflecting the variables of the water quality. Community similarity index was also sensitive in dividing water qualities and the water quality status of different stations could be correctly classified by the cluster analysis. DI could reflect the tendency of water quality gradient, species number and percentage of Phytomastigophora was not obvious in indicating the water quality gradient.

Animals↗
PubMedDate not supplied

The development of the Community-based Nurse-midwifery Education Program: An innovation in distance learning.

Since the inception of nurse-midwifery education 80 years ago, educators have looked for ways in which to educate enough nurse-midwives. The application of distance learning to nurse-midwifery education expanded opportunities for a greater number of students to have access to an education in nurse midwifery. The story of the Community-based Nurse-midwifery Education Program is presented as an exemplar.

Clinical Competence↗
PubMed2001

Development of the phytoplankton community in a pit-lake in relation to water quality changes.

An open pit-lake was formed at a Northern Saskatchewan mine site after flooding with lake water in early 1992. Since then, water and phytoplankton samples have been collected regularly from the artificial lake over seven years. The resulting data set provides a unique opportunity to examine the physical and chemical changes in water quality and phytoplankton community over time. Seventeen major variables were examined in a principal component analysis. Axes 1, 2 and 4 are significantly correlated to other three variables, the number of days (since the first sampling after flooding of the pit), water temperature and depth, respectively. Total suspended solid (TSS), dissolved oxygen, total phosphorus (Total-P), arsenic, and iron decreased over time while Mg, Ca, K, Na, total organic carbon and HCO3 increased. Canonical correspondence analysis was used to infer the relationship between water quality variables and phytoplankton community structure, which changed substantially over the survey period. TSS, Total-P and arsenic were considered to be the key factors driving the change in phytoplankton community composition.

Canada↗
PubMed2004

Democratic development of standards: the community of communities--a quality network of therapeutic communities.

As the inevitability of regulation and accountability dawned on the British Therapeutic Community movement at the end of the 1990s, a polarised debate took place. The product of that debate is now an action research based system of audit, with its principles and methods based on therapeutic community practice. This paper is written four years after the discussions started, and describes how the "Community of Communities" was conceived, what its methods are, some of the results from it first year of operation, and reflection about the nature of the process itself

Community Mental Health Services↗