WorldWideScience

Sample records for aleut communities evidence

  1. Collaboration versus communication: The Department of Energy's Amchitka Island and the Aleut Community

    International Nuclear Information System (INIS)

    Burger, Joanna; Gochfeld, Michael; Pletnikoff, Karen

    2009-01-01

    Increasingly managers and scientists are recognizing that solving environmental problems requires the inclusion of a wide range of disciplines, governmental agencies, Native American tribes, and other stakeholders. Usually such inclusion involves communication at the problem-formulation phase, and at the end to report findings. This paper examines participatory research, the differences between the traditional stakeholder involvement method of communication (often one-way, at the beginning and the end), compared to full collaboration, where parties are actively involved in the scientific process. Using the Department of Energy's (DOE) Amchitka Island in the Aleutians as a case study, we demonstrate that the inclusion of Aleut people throughout the process resulted in science that was relevant not only to the agency's needs and to the interested and affected parties, but that led to a solution. Amchitka Island was the site of three underground nuclear tests from 1965 to 1971, and virtually no testing of radionuclide levels in biota, subsistence foods, or commercial fish was conducted after the 1970s. When DOE announced plans to close Amchitka, terminating its managerial responsibility, without any further testing of radionuclide levels in biota, there was considerable controversy, which resulted in the development of a Science Plan to assess the potential risks to the marine environment from the tests. The Consortium for Risk Evaluation with Stakeholder Participation (CRESP) was the principle entity that developed and executed the science plan. Unlike traditional science, CRESP embarked on a process to include the Alaskan Natives of the Aleutian Islands (Aleuts), relevant state and federal agencies, and other stakeholders at every phase. Aleuts were included in the problem-formulation, research design refinement, the research, analysis of data, dissemination of research findings, and public communication. This led to agreement with the results, and to developing a

  2. Lessons about Conflict from the Pribilof Aleuts: A Personal Account.

    Science.gov (United States)

    Merculieff, Ilarion

    1996-01-01

    An Aleut community leader from the Pribilof Islands (Alaska) reflects on what he learned from the economic crisis that threatened the viability of his community during the 1980s. He suggests that the spiritual healing of the individual is central to the healing of the whole community, elimination of conflict, and fulfillment of any vision for the…

  3. Changes in Aleut concerns following the stakeholder-driven Amchitka independent science assessment.

    Science.gov (United States)

    Burger, Joanna; Gochfeld, Michael

    2009-08-01

    There is widespread agreement that stakeholders should be included in the problem-formulation phase of addressing environment problems and, more recently, there have been attempts to include stakeholders in other phases of environmental research. However, there are few studies that evaluate the effects of including stakeholders in all phases of research aimed at solving environmental problems. Three underground nuclear blasts were detonated on Amchitka Island from 1965 to 1971. Considerable controversy developed when the Department of Energy (DOE) decided to "close" Amchitka. Concerns were voiced by subsistence Aleuts living in the region, resource trustees, and the State of Alaska, among others. This article evaluates perceptions of residents of three Aleutian village before (2003) and after (2005) the Consortium for Risk Evaluation with Stakeholder Participation's (CRESP) Amchitka Independent Science Assessment (AISA). The CRESP AISA provided technical information on radionuclide levels in biota to inform questions of seafood safety and food chain health. CRESP used the questions asked at public meetings in the Aleut communities of Atka, Nikolski, and Unalaska to evaluate attitudes and perceptions before and after the AISA. Major concerns before the AISA were credibility/trust of CRESP and the DOE, and information about biological methodology of the study. Following the AISA, people were most concerned about health effects and risk reduction, and trust issues with CRESP declined while those for the DOE remained stable. People's relative concerns about radionuclides declined, while their concerns about mercury (not addressed in the AISA) increased, and interest in ecological issues (population changes of local species) and the future (continued biomonitoring) increased from 2003 to 2005. These results suggest that questions posed at public meetings can be used to evaluate changes in attitudes and perceptions following environmental research, and the results are

  4. Community and evidence-based approaches to healthcare ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-04-29

    Apr 29, 2016 ... This project developed community connections, shared cross-cultural teaching experiences, and fostered local community partnerships. Participants in the course were encouraged to continue providing evidence-based care throughout their careers. UniLúrio now plans to include the community-based ...

  5. Getting to Scale: Evidence, Professionalism, and Community

    Science.gov (United States)

    Slavin, Robert E.

    2016-01-01

    Evidence-based reform, in which proven programs are scaled up to reach many students, is playing an increasing role in American education. This article summarizes articles in this issue to explain how Reading Recovery has managed to sustain itself and go to scale over more than 30 years. It argues that Reading Recovery has succeeded due to a focus…

  6. Building evaluative culture in community services: Caring for evidence.

    Science.gov (United States)

    Mayne, John

    2017-05-25

    An organization with a strong evaluative culture engages in self-reflection, evidence-based learning and experimentation. It sees evidence as essential for managing well, but building such a culture is challenging. Community service organizations seek to provide effective services for their clients. To build an evaluative culture, they need to acquire basic monitoring and evaluation capabilities, be provided with opportunities for using these capabilities and be adequately motivated to care about evidence as a means to improve services to their clients. Leadership along with a phased in approach are key in bringing about these behaviour changes. Copyright © 2017. Published by Elsevier Ltd.

  7. Community participation in ecotourism: Evidence From Tafi Atome, Ghana.

    Directory of Open Access Journals (Sweden)

    Afenyo Ewoenam Afua

    2012-01-01

    Full Text Available One of the tenets of community-based ecotourism is to ensure maximum local participation in ecotourism development. However, there are evidences to show that local community’s participation in ecotourism development can assume many forms. This paper focused on the Tafi Atome Monkey Sanctuary; a community-based ecotourism project in a rural community in Ghana and sought to identify what form the local community’s participation in the management of the project had assumed. Data for this study was obtained from a resident survey conducted in the community between November and December, 2010. The study found out that the local community had a high degree of control over the management of the project. Nevertheless, some groups of people felt excluded from participating in decision making processes concerning the project. It was therefore recommended that the local tourism management board takes into consideration the inclusion of all identifiable sub groupings in the community is to ensure that there are all represented when decision concerning the project are to be made.

  8. Evidence for cultural differences between neighboring chimpanzee communities.

    Science.gov (United States)

    Luncz, Lydia V; Mundry, Roger; Boesch, Christophe

    2012-05-22

    The majority of evidence for cultural behavior in animals has come from comparisons between populations separated by large geographical distances that often inhabit different environments. The difficulty of excluding ecological and genetic variation as potential explanations for observed behaviors has led some researchers to challenge the idea of animal culture. Chimpanzees (Pan troglodytes verus) in the Taï National Park, Côte d'Ivoire, crack Coula edulis nuts using stone and wooden hammers and tree root anvils. In this study, we compare for the first time hammer selection for nut cracking across three neighboring chimpanzee communities that live in the same forest habitat, which reduces the likelihood of ecological variation. Furthermore, the study communities experience frequent dispersal of females at maturity, which eliminates significant genetic variation. We compared key ecological factors, such as hammer availability and nut hardness, between the three neighboring communities and found striking differences in group-specific hammer selection among communities despite similar ecological conditions. Differences were found in the selection of hammer material and hammer size in response to changes in nut resistance over time. Our findings highlight the subtleties of cultural differences in wild chimpanzees and illustrate how cultural knowledge is able to shape behavior, creating differences among neighboring social groups. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. A review of CARE's Community Score Card experience and evidence.

    Science.gov (United States)

    Gullo, Sara; Galavotti, Christine; Altman, Lara

    2016-12-01

    The global community's growing enthusiasm for the potential of social accountability approaches to improve health system performance and accelerate health progress makes it imperative that we learn from social accountability intervention implementation experience and results. To this end, we carried out a review of Cooperative for Assistance and Relief Everywhere, Inc. (CARE)'s experience with the Community Score Card© (CSC)-a social accountability approach CARE developed in Malawi. We reviewed projects that CARE implemented between 2002 and 2013 that employed the CSC and that had at least one evaluation in English. We systematically collected and synthesized information from evaluations on the projects' characteristics, CSC-related outcomes and challenges. Eight projects, spanning five countries, met our inclusion criteria. The projects applied the CSC to various focus areas, mostly health. We identified one to three evaluations, mostly qualitative, for each project. While the evaluations had many limitations, consistency of the results, as well as the range of outcomes, suggests that the CSC is contributing to significant changes. All projects reported CSC-related governance outcomes and service outcomes. There is promising evidence that the CSC can contribute to citizen empowerment, service provider and power-holder effectiveness, accountability and responsiveness and spaces for negotiation between the two that are expanded, effective and inclusive. There is also evidence that the CSC may contribute to improvements in service availability, access, utilization and quality. The CSC seems particularly suited to building trust and strengthening relationships between the community and service providers and to improving the user-centred dimension of quality. All of the projects reported challenges, with ensuring national responsiveness and inclusion of marginalized groups in the CSC process proving to be the most intractable. To improve health system performance and

  10. An empirical approach to selecting community-based alcohol interventions: combining research evidence, rural community views and professional opinion

    Directory of Open Access Journals (Sweden)

    Shakeshaft Anthony

    2012-01-01

    Full Text Available Abstract Background Given limited research evidence for community-based alcohol interventions, this study examines the intervention preferences of rural communities and alcohol professionals, and factors that influence their choices. Method Community preferences were identified by a survey of randomly selected individuals across 20 regional Australian communities. The preferences of alcohol professionals were identified by a survey of randomly selected members of the Australasian Professional Society on Alcohol and Other Drugs. To identify preferred interventions and the extent of support for them, a budget allocation exercise was embedded in both surveys, asking respondents to allocate a given budget to different interventions. Tobit regression models were estimated to identify the characteristics that explain differences in intervention preferences. Results Community respondents selected school programs most often (88.0% and allocated it the largest proportion of funds, followed by promotion of safer drinking (71.3%, community programs (61.4% and police enforcement of alcohol laws (60.4%. Professionals selected GP training most often (61.0% and allocated it the largest proportion of funds, followed by school programs (36.6%, community programs (33.8% and promotion of safer drinking (31.7%. Community views were susceptible to response bias. There were no significant predictors of professionals' preferences. Conclusions In the absence of sufficient research evidence for effective community-based alcohol interventions, rural communities and professionals both strongly support school programs, promotion of safer drinking and community programs. Rural communities also supported police enforcement of alcohol laws and professionals supported GP training. The impact of a combination of these strategies needs to be rigorously evaluated.

  11. Community of Inquiry Method and Language Skills Acquisition: Empirical Evidence

    Science.gov (United States)

    Preece, Abdul Shakhour Duncan

    2015-01-01

    The study investigates the effectiveness of community of inquiry method in preparing students to develop listening and speaking skills in a sample of junior secondary school students in Borno state, Nigeria. A sample of 100 students in standard classes was drawn in one secondary school in Maiduguri metropolis through stratified random sampling…

  12. Making products available among community health workers: Evidence for improving community health supply chains from Ethiopia, Malawi, and Rwanda

    Directory of Open Access Journals (Sweden)

    Yasmin Chandani

    2014-12-01

    Full Text Available A UNICEF review of the challenges to scaling up integrated community case management (iCCM found that drug shortages were a common bottleneck. In many settings, little thought has gone into the design of supply chains to the community level and limited evidence exists for how to address these unique challenges. SC4CCM’s purpose was to conduct intervention research to identify proven, simple, affordable solutions that address the unique supply chain challenges faced by CHWs and to demonstrate that supply chain constraints at the community level can be overcome.

  13. Challenges And Lessons Learned From Communities Using Evidence To Adopt Strategies To Improve Healthy Food Environments.

    Science.gov (United States)

    Willems Van Dijk, Julie A; Catlin, Bridget; Cofsky, Abbey; Carroll, Carrie

    2015-11-01

    Communities across the United States are increasingly tackling the complex task of changing their local environments and cultures to improve access to and consumption of healthy food. Communities that have received the Robert Wood Johnson Foundation Culture of Health Prize have deployed numerous evidence-informed strategies to enhance their local food environments. Their experiences can provide lessons for other communities working to improve health. In this article we examine how the prize-winning communities worked in a multidisciplinary collective manner to implement evidence-based strategies, deployed suites of strategies to expand the reach of food-related work, balanced evidence against innovation, and measured their own progress. Most of the communities also faced challenges in using evidence effectively to implement strategies to promote healthy food environments. Policy makers can accelerate the adoption of evidence-informed approaches related to food and health by embedding them in program standards and funding requirements. Establishing opportunities for ongoing training to enhance community practitioners' evaluation skills and collaborative leadership would also improve the effectiveness of community implementation of these strategies. Project HOPE—The People-to-People Health Foundation, Inc.

  14. Adapting Evidence-Based Mental Health Treatments in Community Settings: Preliminary Results from a Partnership Approach

    Science.gov (United States)

    Southam-Gerow, Michael A.; Hourigan, Shannon E.; Allin, Robert B., Jr.

    2009-01-01

    This article describes the application of a university-community partnership model to the problem of adapting evidence-based treatment approaches in a community mental health setting. Background on partnership research is presented, with consideration of methodological and practical issues related to this kind of research. Then, a rationale for…

  15. Psychosocial influences on safety climate: evidence from community pharmacies.

    Science.gov (United States)

    Phipps, Denham L; Ashcroft, Darren M

    2011-12-01

    To examine the relationship between psychosocial job characteristics and safety climate. Cross-sectional survey. Community pharmacies in Great Britain. Participants A random sample of community pharmacists registered in Great Britain (n = 860). Survey instruments Effort-reward imbalance (ERI) indicator and Job Content Questionnaire (JCQ). Main outcome measures Pharmacy Safety Climate Questionnaire (PSCQ). The profile of scores from the ERI indicated a relatively high risk of adverse psychological effects. The profile of scores from the JCQ indicated both high demand on pharmacists and a high level of psychological and social resources to meet these demands. Path analysis confirmed a model in which the ERI and JCQ measures, as well as the type of pharmacy and pharmacist role, predicted responses to the PSCQ (χ(2)(36) = 111.38, p demand) accounted for the effect of job characteristics on safety climate ratings; each had differential effects on the PSCQ scales. The safety climate in community pharmacies is influenced by perceptions of job characteristics, such as the level of job demands and the resources available to meet these demands. Hence, any efforts to improve safety should take into consideration the effect of the psychosocial work environment on safety climate. In addition, there is a need to address the presence of work-related stressors, which have the potential to cause direct or indirect harm to staff and service users. The findings of the current study provide a basis for future research to improve the safety climate and well-being, both in the pharmacy profession and in other healthcare settings.

  16. Relationship of Evidence-Based Practice and Treatments: A Survey of Community Mental Health Providers

    Science.gov (United States)

    DiMeo, Michelle A.; Moore, G. Kurt; Lichtenstein, Carolyn

    2012-01-01

    Evidence-based treatments (EBTs) are "interventions" that have been proven effective through rigorous research methodologies. Evidence-based practice (EBP), however, refers to a "decision-making process" that integrates the best available research, clinician expertise, and client characteristics. This study examined community mental health service…

  17. Promoting community practitioners' use of evidence-based approaches to increase breast cancer screening.

    Science.gov (United States)

    Leeman, Jennifer; Moore, Alexis; Teal, Randall; Barrett, Nadine; Leighton, Ashely; Steckler, Allan

    2013-07-01

    Many women do not get mammography screenings at the intervals recommended for early detection and treatment of breast cancer. The Guide to Community Preventive Services (Community Guide) recommends a range of evidence-based strategies to improve mammography rates. However, nurses and others working in community-based settings make only limited use of these strategies. We report on a dissemination intervention that partnered the University of North Carolina with the Susan G. Komen Triangle Affiliate to disseminate Community Guide breast cancer screening strategies to community organizations. The intervention was guided by social marketing and diffusion of innovation theory and was designed to provide evidence and support via Komen's existing relationships with grantee organizations. The present study reports the findings from a formative evaluation of the intervention, which included a content analysis of 46 grant applications pre- and post intervention and focus groups with 20 grant recipients. © 2013 Wiley Periodicals, Inc.

  18. Essential elements for community engagement in evidence-based youth violence prevention.

    Science.gov (United States)

    Miao, Tai-An; Umemoto, Karen; Gonda, Deanna; Hishinuma, Earl S

    2011-09-01

    In the field of youth violence prevention, there has been increasing emphasis on "evidence based" programs and principles shown through scientific research as reaching their intended outcomes. Community mobilization and engagement play a critical role in many evidence-based programs and strategies, as it takes a concerted effort among a wide range of people within a community to alter behavior and maintain behavioral change. How do concerned individuals and groups within a community engage others within and outside of that community to effectively plan, develop and implement appropriate EB programs as well as evaluate the outcomes and impacts of locally developed programs yet to be proven? The authors discuss five elements essential for community engagement in evidence-based youth violence prevention based on their work in a university-community partnership through the Asian/Pacific Islander Youth Violence Prevention Center (API Center), a National Academic Center for Excellence on Youth Violence Prevention Center supported by the Centers for Disease Control and Prevention. They include: (a) aligning EBPs with a community's shared vision and values; (b) establishing an inclusive environment for the planning, implementation and evaluation of EBPs; (c) nurturing collaboration for increased effectiveness and efficacy of EBPs; (d) building adequate leadership and community capacity to develop and sustain EBPs; and (e) building a learning community for evaluation and self-reflection. The authors propose placing greater emphasis on "evaluative thinking" and organizational capacity for evaluation as we pursue evidence-based practices for youth violence prevention. This is especially important for ethnic groups for which an evidence base is not well established.

  19. When will community management conserve biodiversity? Evidence from Malawi

    Directory of Open Access Journals (Sweden)

    Joy E. Hecht

    2008-12-01

    Full Text Available Both development practitioners and conservation organizations are focused on community ownership and management of natural resources as a way to create incentives for the conservation of biodiversity. This has led to the implementation of a number of large community-based conservation projects in sub-Saharan Africa, in countries including Namibia, Zimbabwe, Malawi, Zambia, and Rwanda. While the concept is logical, and valuation studies may suggest that conservation is more valuable than other uses of the resources in some areas, there has been little detailed analysis of the financial costs and benefits to the communities, to determine whether they would actually have an incentive to conserve if they had more extensive legal rights to the resources. This paper assesses the conditions under which this approach may be viable, based on a valuation study of the resources of Mount Mulanje in southern Malawi.Les spécialistes du développement et les organisations de conservation s’intéressent à la propriété et à la gestion communautaire des ressources naturelles comme moyen de créer des mesures d’incitation en faveur de la conservation de la biodiversité. Cette approche a conduit à la mise en œuvre d’un certain nombre de grands projets de conservation communautaires en Afrique subsaharienne, notamment en Namibie, au Zimbabwe, au Malawi, en Zambie et au Rwanda. Même si cette approche est logique et si les études d’évaluation semblent suggérer que, dans certaines régions, la conservation est plus utile que l’exploitation des ressources, il existe peu d’analyses détaillées sur les coûts et les avantages financiers que cela engendrerait pour les communautés, analyses qui permettraient de déterminer si le développement des droits légaux des communautés sur ces ressources les inciterait à les conserver. Ce rapport évalue les conditions de viabilité de cette approche sur la base d’une étude d’évaluation des

  20. A Systematic Review of Economic Evidence on Community Hypertension Interventions.

    Science.gov (United States)

    Zhang, Donglan; Wang, Guijing; Joo, Heesoo

    2017-12-01

    Effective community-based interventions are available to control hypertension. It is important to determine the economics of these interventions. Peer-reviewed studies from January 1995 through December 2015 were screened. Interventions were categorized into educational interventions, self-monitoring interventions, and screening interventions. Incremental cost-effectiveness ratios were summarized by types of interventions. The review was conducted in 2016. Thirty-four articles were included in the review (16 from the U.S., 18 from other countries), including 25 on educational interventions, three on self-monitoring interventions, and six on screening interventions. In the U.S., five (31.3%) studies on educational interventions were cost saving. Among the studies that found the interventions cost effective, the median incremental costs were $62 (range, $40-$114) for 1-mmHg reduction in systolic blood pressure (SBP) and $13,986 (range, $6,683-$58,610) for 1 life-year gained. Outside the U.S., educational interventions cost from $0.62 (China) to $29 (Pakistan) for 1-mmHg reduction in SBP. Self-monitoring interventions, evaluated in the U.S. only, cost $727 for 1-mmHg reduction in SBP and $41,927 for 1 life-year gained. For 1 quality-adjusted life-year, screening interventions cost from $21,734 to $56,750 in the U.S., $613 to $5,637 in Australia, and $7,000 to $18,000 in China. Intervention costs to reduce 1 mmHg blood pressure or 1 quality-adjusted life-year were higher in the U.S. than in other countries. Most studies found that the three types of interventions were either cost effective or cost saving. Quality of economic studies should be improved to confirm the findings. Copyright © 2017 American Journal of Preventive Medicine. All rights reserved.

  1. Tangible Evidence, Trust and Power: Public Perceptions of Community Environmental Health Studies

    Science.gov (United States)

    Scammell, Madeleine Kangsen; Senier, Laura; Darrah-Okike, Jennifer; Brown, Phil; Santos, Susan

    2009-01-01

    Communities with environmental health concerns in the USA frequently request studies from their local or state departments of public health. This paper presents findings from three focus groups conducted in communities north of Boston that have been the subject of two different environmental health studies. The focus groups were designed to elicit residents’ perceptions of environmental health, and of the particular studies conducted in their communities. In all focus groups, participants had difficulty accepting the findings of health studies that contradicted their own experiences of environmental exposures and illness. Our results suggest that lay knowledge, informed in varying degrees by the experience of what we term “tangible evidence,” creates a lens through which communities interpret a health study’s findings. The differences in reliance on tangible evidence were related to participants’ sense of trust in public officials, and the institutions responsible for conducting health studies. Participants from the wealthier, predominantly white communities discussed trust in study design and methodologies used. In contrast, participants from the lower income, higher minority communities assessed health studies with reference to their trust (or lack thereof) in study sponsors and public health institutions. Participants’ experience of tangible evidence, trust or distrust in health agencies and research institutions, and a sense of relative community power, influence how they assess the findings of environmental health studies and may have implications for pubic health. PMID:18995942

  2. Community and school mental health professionals' knowledge and use of evidence based substance use prevention programs.

    Science.gov (United States)

    Evans, Steven W; Randy Koch, J; Brady, Christine; Meszaros, Peggy; Sadler, Joanna

    2013-07-01

    Youth with learning and behavioral problems are at elevated risk for substance use during adolescence. Although evidence-based substance use prevention and screening practices are described in the literature, the extent with which these are provided to these youth is unclear. Mental health professionals in schools and community mental health centers are in an ideal position to conduct substance use screening and prevention practices since they have frequent contact with this high risk group. In order to determine whether these mental health professionals were using evidence based substance use screening and prevention programs with these youth, we analyzed 345 completed surveys from mental health professionals in schools and community clinics throughout a mid-Atlantic state. Results indicated that a large portion of the respondents were unfamiliar with evidence based practices and they were infrequently used. Implications for the division of labor at schools and community mental health centers are discussed in relation to time allotment and priority for these procedures.

  3. Building an evidence base for community health: a review of the quality of program evaluations.

    Science.gov (United States)

    Jolley, Gwyn M; Lawless, Angela P; Baum, Fran E; Hurley, Catherine J; Fry, Denise

    2007-11-01

    An assessment of the quality of program evaluations conducted in South Australian community health services investigated how effective evaluation reporting is in producing an evidence base for community health. Evaluation reports were assessed by a team of reviewers. Practitioner workshops allowed an understanding of the uses of evaluation and what promotes or acts as a barrier to undertaking evaluations. Community health services do undertake a good deal of evaluation. However, reports were not generally explicit in dealing with the principles that underpin community health. Few engaged with program theory or rationale. Typically, reports were of short-term projects with uncertain futures so there may seem little point in considering issues of long-term health outcomes and transferability to other settings. The most important issue from our study is the lack of investment in applied health services research of the sort that will be required to produce the evidence for practice that policy makers desire. The current lack of evidence for community health reflects failure of the system to invest in research and evaluation that is adequately resourced and designed for complex community settings.

  4. Measuring Costs to Community-Based Agencies for Implementation of an Evidence-Based Practice.

    Science.gov (United States)

    Lang, Jason M; Connell, Christian M

    2017-01-01

    Healthcare reform has led to an increase in dissemination of evidence-based practices. Cost is frequently cited as a significant yet rarely studied barrier to dissemination of evidence-based practices and the associated improvements in quality of care. This study describes an approach to measuring the incremental, unreimbursed costs in staff time and direct costs to community-based clinics implementing an evidence-based practice through participating in a learning collaborative. Initial implementation costs exceeding those for providing "treatment as usual" were collected for ten clinics implementing trauma-focused cognitive behavioral therapy through participation in 10-month learning collaboratives. Incremental implementation costs of these ten community-based clinic teams averaged the equivalent of US$89,575 (US$ 2012). The most costly activities were training, supervision, preparation time, and implementation team meetings. Recommendations are made for further research on implementation costs, dissemination of evidence-based practices, and implications for researchers and policy makers.

  5. Implementation of evidence-based practice by nurses working in community settings and their strategies to mentor student nurses to develop evidence-based practice: A qualitative study.

    Science.gov (United States)

    Brooke, Joanne Mary; Mallion, Jaimee

    2016-08-01

    The aim of the study was to explore how community nurses apply the best available evidence to their practice, and how they mentor student nurses to conceptualize and implement evidence-based practice in community settings. In the UK, the expansion of health-care provision in the community has supported the development of highly skilled community nurses. However, there is limited literature regarding the strategies used by community nurses to implement evidence-based practice and mentor student nurses to conceptualize evidence-based practice in community placements. An exploratory qualitative approach applying inductive reasoning to focus group data was used. As a result, nurses working for a community NHS Foundation Trust in South England with a mentor qualification were invited to participate in one of the seven focus groups, 33 nurses participated. Data were analyzed with thematic analysis. The themes discussed in this paper are: 'our practice is evidence-based' as guidelines and policies provided structure, but occasionally stifled autonomous clinical decision-making, and 'time' as a barrier and facilitator to mentoring student nurses in community settings. In conclusion, nurses need to develop the ability to incorporate patients' needs and wishes within evidence-based care. Time was a facilitator for some community mentors, but protected time is required to complete the necessary practice documentation of student nurses. © 2016 John Wiley & Sons Australia, Ltd.

  6. Adding evidence-based interventions to assertive community treatment : a feasibility study

    NARCIS (Netherlands)

    Sytema, Sjoerd; Jörg, Frederike; Nieboer, Roeline; Wunderink, Lex

    OBJECTIVE: This 24-month study, conducted in The Netherlands, examined the feasibility of enhancing the effectiveness of assertive community treatment (ACT) by adding evidence-based interventions. METHODS: A total of 159 patients were randomly assigned to two ACT teams, one providing standard ACT

  7. Can evidence change the rate of back surgery? A randomized trial of community-based education.

    Science.gov (United States)

    Goldberg, H I; Deyo, R A; Taylor, V M; Cheadle, A D; Conrad, D A; Loeser, J D; Heagerty, P J; Diehr, P

    2001-01-01

    Timely adoption of clinical practice guidelines is more likely to happen when the guidelines are used in combination with adjuvant educational strategies that address social as well as rational influences. To implement the conservative, evidence-based approach to low-back pain recommended in national guidelines, with the anticipated effect of reducing population-based rates of surgery. A randomized, controlled trial. Ten communities in western Washington State with annual rates of back surgery above the 1990 national average (158 operations per 100,000 adults). Spine surgeons, primary care physicians, patients who were surgical candidates, and hospital administrators. The five communities randomized to the intervention group received a package of six educational activities tailored to local needs by community planning groups. Surgeon study groups, primary care continuing medical education conferences, administrative consensus processes, videodisc-aided patient decision making, surgical outcomes management, and generalist academic detailing were serially implemented over a 30-month intervention period. Quarterly observations of surgical rates. After implementation of the intervention, surgery rates declined in the intervention communities but increased slightly in the control communities. The net effect of the intervention is estimated to be a decline of 20.9 operations per 100,000, a relative reduction of 8.9% (P = 0.01). We were able to use scientific evidence to engender voluntary change in back pain practice patterns across entire communities.

  8. Building resilience to food insecurity in rural communities: Evidence from traditional institutions in Zimbabwe

    Directory of Open Access Journals (Sweden)

    Emmanuel Mavhura

    2017-06-01

    Full Text Available Many rural communities that depend on smallholder farming face food insecurity induced by climate-related disasters. In response, some communities are taking the initiative to cope and adapt to climate-related disasters. Using case study material from the Zambezi Valley, Zimbabwe, this article examines how traditional institutions are enhancing resilience to food insecurity in rural areas. The data were collected through interviews and focus groups involving traditional leaders, ward councillors, village civil protection members and villagers selected in the valley. The findings point to how the Zunde raMambo informal safety net, nhimbe form of collective work and the practice of share-rearing arrangement to access draught power help save lives and alleviate food insecurity induced by flood or drought disasters. The study concludes that the three schemes are evidence of community reorganisation or change in response to food insecurity. They are a form of absorptive capacities enabling the community to cope with food insecurity.

  9. CULTURAL ADAPTATIONS OF EVIDENCE-BASED HOME-VISITATION MODELS IN TRIBAL COMMUNITIES.

    Science.gov (United States)

    Hiratsuka, Vanessa Y; Parker, Myra E; Sanchez, Jenae; Riley, Rebecca; Heath, Debra; Chomo, Julianna C; Beltangady, Moushumi; Sarche, Michelle

    2018-05-01

    The Tribal Maternal, Infant, and Early Childhood Home Visiting (Tribal MIECHV) Program provides federal grants to tribes, tribal consortia, tribal organizations, and urban Indian organizations to implement evidence-based home-visiting services for American Indian and Alaska Native (AI/AN) families. To date, only one evidence-based home-visiting program has been developed for use in AI/AN communities. The purpose of this article is to describe the steps that four Tribal MIECHV Programs took to assess community needs, select a home-visiting model, and culturally adapt the model for use in AI/AN communities. In these four unique Tribal MIECHV Program settings, each program employed a rigorous needs-assessment process and developed cultural modifications in accordance with community strengths and needs. Adaptations occurred in consultation with model developers, with consideration of the conceptual rationale for the program, while grounding new content in indigenous cultures. Research is needed to improve measurement of home-visiting outcomes in tribal and urban AI/AN settings, develop culturally grounded home-visiting interventions, and assess the effectiveness of home visiting in AI/AN communities. © 2018 Michigan Association for Infant Mental Health.

  10. Why We Need Evidence-Based, Community-Wide Approaches for Prevention of Teen Pregnancy.

    Science.gov (United States)

    Barfield, Wanda D; Warner, Lee; Kappeler, Evelyn

    2017-03-01

    Teen pregnancy and childbearing have declined over the past two decades to historic lows. The most recent declines have occurred during a time of coordinated national efforts focused on teen pregnancy. This article highlights a federal partnership to reduce teen pregnancy through the implementation of innovative, evidence-based approaches in affected communities, with a focus on reaching African-American and Latino/Hispanic youth. This initiative has the potential to transform the design and implementation of future teen pregnancy prevention efforts and provide a model that can be replicated in communities across the nation. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  11. Making products available among community health workers: Evidence for improving community health supply chains from Ethiopia, Malawi, and Rwanda.

    Science.gov (United States)

    Chandani, Yasmin; Andersson, Sarah; Heaton, Alexis; Noel, Megan; Shieshia, Mildred; Mwirotsi, Amanda; Krudwig, Kirstin; Nsona, Humphreys; Felling, Barbara

    2014-12-01

    A UNICEF review of the challenges to scaling up integrated community case management (iCCM) found that drug shortages were a common bottleneck. In many settings, little thought has gone into the design of supply chains to the community level and limited evidence exists for how to address these unique challenges. SC4CCM's purpose was to conduct intervention research to identify proven, simple, affordable solutions that address the unique supply chain challenges faced by CHWs and to demonstrate that supply chain constraints at the community level can be overcome. SC4CCM selected three countries to implement supply chain innovations and developed a theory of change (TOC) framework for the learning phase, which identified the main drivers of product availability and was used for baseline assessments, design, implementation and evaluation of interventions in Ethiopia, Malawi, and Rwanda. Interventions were developed in each country and tested over 12-24 months. Mixed-method follow up assessments were conducted in each country in 2012-2013. The Supply Chain for Community Case Management (SC4CCM) Project then simplified the TOC into a Community Health Supply Chain (CHSC) framework to enable cross country analysis. The findings from interventions in the three countries suggest that the greatest supply chain benefits are realized when all three CHSC framework elements (data flow, product flow, and effective people) are in place and working together. The synergistic effect of these three elements on supply chain performance was most effectively demonstrated by results from the Enhanced Management and Quality Collaborative interventions in Malawi and Rwanda, respectively, which were characterized by lower mean stockout rates and higher in stock rates on day of visit, when compared to other interventions. Many conditions are necessary to ensure continuous product availability at the community level, however a supply chain works best when three key elements (product flow, data

  12. Making products available among community health workers: Evidence for improving community health supply chains from Ethiopia, Malawi, and Rwanda

    Science.gov (United States)

    Chandani, Yasmin; Andersson, Sarah; Heaton, Alexis; Noel, Megan; Shieshia, Mildred; Mwirotsi, Amanda; Krudwig, Kirstin; Nsona, Humphreys; Felling, Barbara

    2014-01-01

    Background A UNICEF review of the challenges to scaling up integrated community case management (iCCM) found that drug shortages were a common bottleneck. In many settings, little thought has gone into the design of supply chains to the community level and limited evidence exists for how to address these unique challenges. SC4CCM’s purpose was to conduct intervention research to identify proven, simple, affordable solutions that address the unique supply chain challenges faced by CHWs and to demonstrate that supply chain constraints at the community level can be overcome. Methods SC4CCM selected three countries to implement supply chain innovations and developed a theory of change (TOC) framework for the learning phase, which identified the main drivers of product availability and was used for baseline assessments, design, implementation and evaluation of interventions in Ethiopia, Malawi, and Rwanda. Interventions were developed in each country and tested over 12–24 months. Mixed–method follow up assessments were conducted in each country in 2012–2013. The Supply Chain for Community Case Management (SC4CCM) Project then simplified the TOC into a Community Health Supply Chain (CHSC) framework to enable cross country analysis Results The findings from interventions in the three countries suggest that the greatest supply chain benefits are realized when all three CHSC framework elements (data flow, product flow, and effective people) are in place and working together. The synergistic effect of these three elements on supply chain performance was most effectively demonstrated by results from the Enhanced Management and Quality Collaborative interventions in Malawi and Rwanda, respectively, which were characterized by lower mean stockout rates and higher in stock rates on day of visit, when compared to other interventions. Conclusions Many conditions are necessary to ensure continuous product availability at the community level, however a supply chain works

  13. Implementation Measurement for Evidence-Based Violence Prevention Programs in Communities.

    Science.gov (United States)

    Massetti, Greta M; Holland, Kristin M; Gorman-Smith, Deborah

    2016-08-01

    Increasing attention to the evaluation, dissemination, and implementation of evidence-based programs (EBPs) has led to significant advancements in the science of community-based violence prevention. One of the prevailing challenges in moving from science to community involves implementing EBPs and strategies with quality. The CDC-funded National Centers of Excellence in Youth Violence Prevention (YVPCs) partner with communities to implement a comprehensive community-based strategy to prevent violence and to evaluate that strategy for impact on community-wide rates of violence. As part of their implementation approach, YVPCs document implementation of and fidelity to the components of the comprehensive youth violence prevention strategy. We describe the strategies and methods used by the six YVPCs to assess implementation and to use implementation data to inform program improvement efforts. The information presented describes the approach and measurement strategies employed by each center and for each program implemented in the partner communities. YVPCs employ both established and innovative strategies for measurement and tracking of implementation across a broad range of programs, practices, and strategies. The work of the YVPCs highlights the need to use data to understand the relationship between implementation of EBPs and youth violence outcomes.

  14. An online community of practice to support evidence-based physiotherapy practice in manual therapy.

    Science.gov (United States)

    Evans, Cathy; Yeung, Euson; Markoulakis, Roula; Guilcher, Sara

    2014-01-01

    The purpose of this study was to explore how a community of practice promoted the creation and sharing of new knowledge in evidence-based manual therapy using Wenger's constructs of mutual engagement, joint enterprise, and shared repertoire as a theoretical framework. We used a qualitative approach to analyze the discussion board contributions of the 19 physiotherapists who participated in the 10-week online continuing education course in evidence-based practice (EBP) in manual therapy. The course was founded on community of practice, constructivism, social, and situated learning principles. The 1436 postings on 9 active discussion boards revealed that the community of practice was a social learning environment that supported strong participation and mutual engagement. Design features such as consistent facilitation, weekly guiding questions, and collaborative assignments promoted the creation and sharing of knowledge. Participants applied research evidence to the contexts in which they worked through reflective comparison of what they were reading to its applicability in their everyday practice. Participants' shared goals contributed to the common ground established in developing collective knowledge about different study designs, how to answer research questions, and the difficulties of conducting sound research. An online longitudinal community of practice utilized as a continuing education approach to deliver an online course based on constructivist and social learning principles allowed geographically dispersed physiotherapists to be mutually engaged in a joint enterprise in evidence-based manual therapy. Advantages included opportunity for reflection, modeling, and collaboration. Future studies should examine the impact of participation on clinical practice. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital

  15. Advancing community stakeholder engagement in biomedical HIV prevention trials: principles, practices and evidence.

    Science.gov (United States)

    Newman, Peter A; Rubincam, Clara

    2014-12-01

    Community stakeholder engagement is foundational to fair and ethically conducted biomedical HIV prevention trials. Concerns regarding the ethical engagement of community stakeholders in HIV vaccine trials and early terminations of several international pre-exposure prophylaxis trials have fueled the development of international guidelines, such as UNAIDS' good participatory practice (GPP). GPP aims to ensure that stakeholders are effectively involved in all phases of biomedical HIV prevention trials. We provide an overview of the six guiding principles in the GPP and critically examine them in relation to existing social and behavioral science research. In particular, we highlight the challenges involved in operationalizing these principles on the ground in various global contexts, with a focus on low-income country settings. Increasing integration of social science in biomedical HIV prevention trials will provide evidence to advance a science of community stakeholder engagement to support ethical and effective practices informed by local realities and sociocultural differences.

  16. Achieving Health Equity Through Community Engagement in Translating Evidence to Policy: The San Francisco Health Improvement Partnership, 2010?2016

    OpenAIRE

    Grumbach, Kevin; Vargas, Roberto A.; Fleisher, Paula; Arag?n, Tom?s J.; Chung, Lisa; Chawla, Colleen; Yant, Abbie; Garcia, Estela R.; Santiago, Amor; Lang, Perry L.; Jones, Paula; Liu, Wylie; Schmidt, Laura A.

    2017-01-01

    Background The San Francisco Health Improvement Partnership (SFHIP) promotes health equity by using a novel collective impact model that blends community engagement with evidence-to-policy translational science. The model involves diverse stakeholders, including ethnic-based community health equity coalitions, the local public health department, hospitals and health systems, a health sciences university, a school district, the faith community, and others sectors. Community Context We report o...

  17. Translating evidence into practice: pursuing perfection in pneumococcal vaccination in a rural community.

    Science.gov (United States)

    Doyle, D M; Dauterive, R; Chuang, K H; Ellrodt, A G

    2001-11-01

    There are many challenges to effectively and efficiently translating evidence into practice. Potential strategies include (1) training more evidence-based practitioners in the art and science of evidence-based medicine, (2) enhancing the quality and availability of systematic reviews, and (3) more effectively linking evidence-based practitioners and evidence users through comprehensive behavioral change initiatives. Herein we explore the third strategy and highlight the key elements of success for a program using behavioral change strategies. We present a clinical model based on clear understanding of the "problem," a systematic approach to diagnosis, selection of scientifically sound treatment options, and effective evaluation with appropriate modification of the treatment plan. A successful program begins with effective team leadership, the expression of a clinically compelling case for change, and commitment to the pursuit of perfection in the delivery of key evidence-based interventions. The team must then diagnose behavioral barriers to change, using a systematic approach based on a published rigorous differential diagnosis framework. This diagnostic step provides the foundation for selection of effective dissemination and implementation strategies (treatments) proven to improve processes of care and clinical outcomes. Finally the team must evaluate progress toward perfection, reviewing interim data and adjusting the treatment regimen to newly diagnosed barriers. We then present a specific project (improving pneumococcal immunization rates in our rural community) and interim results to demonstrate the use of the framework in the real world.

  18. Meeting the needs of a community: teaching evidence-based youth violence prevention initiatives to members of strategic communities.

    Science.gov (United States)

    Ruffolo, Daria C; Andresen, Pamela A; Winn, Keith L

    2013-01-01

    Youth violence is among the most serious health threats in the nation today. Violence disproportionately affects young people and people of color. Although the national rates of violent injury and homicide have shown a decline in most regions of the United States over the past 15 years, the rates of violence and related injuries among youth remain unacceptably high. The prevention of youth violence has been a priority of health departments nationwide, including the Cook County Department of Public Health. The goal of this project was to provide key community leaders, social service workers, and nurses within suburban Cook County with educational sessions on Blueprints for Violence Prevention, an initiative to promote evidence-based youth violence prevention programs.

  19. Conceptualising a model to guide nursing and midwifery in the community guided by an evidence review.

    Science.gov (United States)

    Leahy-Warren, Patricia; Mulcahy, Helen; Benefield, Lazelle; Bradley, Colin; Coffey, Alice; Donohoe, Ann; Fitzgerald, Serena; Frawley, Tim; Healy, Elizabeth; Healy, Maria; Kelly, Marcella; McCarthy, Bernard; McLoughlin, Kathleen; Meagher, Catherine; O'Connell, Rhona; O'Mahony, Aoife; Paul, Gillian; Phelan, Amanda; Stokes, Diarmuid; Walsh, Jessica; Savage, Eileen

    2017-01-01

    Successful models of nursing and midwifery in the community delivering healthcare throughout the lifespan and across a health and illness continuum are limited, yet necessary to guide global health services. Primary and community health services are the typical points of access for most people and the location where most care is delivered. The scope of primary healthcare is complex and multifaceted and therefore requires a practice framework with sound conceptual and theoretical underpinnings. The aim of this paper is to present a conceptual model informed by a scoping evidence review of the literature. A scoping evidence review of the literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Databases included CINAHL, MEDLINE, PsycINFO and SocINDEX using the EBSCO platform and the Cochrane Library using the keywords: model, nursing, midwifery, community, primary care. Grey literature for selected countries was searched using the Google 'advanced' search interface. Data extraction and quality appraisal for both empirical and grey literature were conducted independently by two reviewers. From 127 empirical and 24 non-empirical papers, data extraction parameters, in addition to the usual methodological features, included: the nature of nursing and midwifery; the population group; interventions and main outcomes; components of effective nursing and midwifery outcomes. The evidence was categorised into six broad areas and subsequently synthesised into four themes. These were not mutually exclusive: (1) Integrated and Collaborative Care; (2) Organisation and Delivery of Nursing and Midwifery Care in the Community; (3) Adjuncts to Nursing Care and (4) Overarching Conceptual Model. It is the latter theme that is the focus of this paper. In essence, the model depicts a person/client on a lifespan and preventative-curative trajectory. The health related needs of the client, commensurate with their point

  20. The Juggling Act of Supervision in Community Mental Health: Implications for Supporting Evidence-Based Treatment.

    Science.gov (United States)

    Dorsey, Shannon; Pullmann, Michael D; Kerns, Suzanne E U; Jungbluth, Nathaniel; Meza, Rosemary; Thompson, Kelly; Berliner, Lucy

    2017-11-01

    Supervisors are an underutilized resource for supporting evidence-based treatments (EBTs) in community mental health. Little is known about how EBT-trained supervisors use supervision time. Primary aims were to describe supervision (e.g., modality, frequency), examine functions of individual supervision, and examine factors associated with time allocation to supervision functions. Results from 56 supervisors and 207 clinicians from 25 organizations indicate high prevalence of individual supervision, often alongside group and informal supervision. Individual supervision serves a wide range of functions, with substantial variation at the supervisor-level. Implementation climate was the strongest predictor of time allocation to clinical and EBT-relevant functions.

  1. Reducing the fear of falling through a community evidence-based intervention.

    Science.gov (United States)

    Beauvais, Audrey; Beauvais, John E

    2014-02-01

    Falls and the fear of falling are major health concerns among older adults. The purpose of this study was to assess the effects of an evidence-based fall prevention program on the fear of falling and health-related quality of life among community-dwelling elders. The program consisted of 6 classes that covered topics such as risk factors for falls, balance exercises, medications, safe footwear, and home safety. Of those elders who were most fearful at baseline, the fall prevention program decreased their fear of falling and improved 1 dimension of their health-related quality of life.

  2. The Effectiveness of Distance Education across Virginia's Community Colleges: Evidence from Introductory College-Level Math and English Courses

    Science.gov (United States)

    Xu, Di; Jaggars, Shanna Smith

    2011-01-01

    Although online learning is rapidly expanding in the community college setting, there is little evidence regarding its effectiveness among community college students. In the current study, the authors used a statewide administrative data set to estimate the effects of taking one's first college-level math or English course online rather than face…

  3. Behavioural interventions for urinary incontinence in community-dwelling seniors: an evidence-based analysis.

    Science.gov (United States)

    2008-01-01

    In early August 2007, the Medical Advisory Secretariat began work on the Aging in the Community project, an evidence-based review of the literature surrounding healthy aging in the community. The Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the ministry's newly released Aging at Home Strategy.After a broad literature review and consultation with experts, the secretariat identified 4 key areas that strongly predict an elderly person's transition from independent community living to a long-term care home. Evidence-based analyses have been prepared for each of these 4 areas: falls and fall-related injuries, urinary incontinence, dementia, and social isolation. For the first area, falls and fall-related injuries, an economic model is described in a separate report.Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html, to review these titles within the Aging in the Community series.AGING IN THE COMMUNITY: Summary of Evidence-Based AnalysesPrevention of Falls and Fall-Related Injuries in Community-Dwelling Seniors: An Evidence-Based AnalysisBehavioural Interventions for Urinary Incontinence in Community-Dwelling Seniors: An Evidence-Based AnalysisCaregiver- and Patient-Directed Interventions for Dementia: An Evidence-Based AnalysisSocial Isolation in Community-Dwelling Seniors: An Evidence-Based AnalysisThe Falls/Fractures Economic Model in Ontario Residents Aged 65 Years and Over (FEMOR) OBJECTIVE: To assess the effectiveness of behavioural interventions for the treatment and management of urinary incontinence (UI) in community-dwelling seniors. TARGET POPULATION AND CONDITION Urinary incontinence defined as "the complaint of any involuntary leakage of urine" was identified as 1 of the key predictors in a senior's transition from independent community living to admission to a long-term care

  4. Evidence gaps in advanced cancer care: community-based clinicians' perspectives and priorities for CER.

    Science.gov (United States)

    Lowry, Sarah J; Loggers, Elizabeth T; Bowles, Erin J A; Wagner, Edward H

    2012-05-01

    Although much effort has focused on identifying national comparative effectiveness research (CER) priorities, little is known about the CER priorities of community-based practitioners treating patients with advanced cancer. CER priorities of managed care-based clinicians may be valuable as reflections of both payer and provider research interests. We conducted mixed methods interviews with 10 clinicians (5 oncologists and 5 pharmacists) at 5 health plans within the Health Maintenance Organization Cancer Research Network. We asked, "What evidence do you most wish you had when treating patients with advanced cancer" and questioned participants on their impressions and knowledge of CER and pragmatic clinical trials (PCTs). We conducted qualitative analyses to identify themes across interviews. Ninety percent of participants had heard of CER, 20% had heard of PCTs, and all rated CER/PCTs as highly relevant to patient and health plan decision making. Each participant offered between 3 and 10 research priorities. Half (49%) involved head-to-head treatment comparisons; another 20% involved comparing different schedules or dosing regimens of the same treatment. The majority included alternative outcomes to survival (eg, toxicity, quality of life, noninferiority). Participants cited several limitations to existing evidence, including lack of generalizability, funding biases, and rapid development of new treatments. Head-to-head treatment comparisons remain a major evidence need among community- based oncology clinicians, and CER/PCTs are highly valued methods to address the limitations of traditional randomized trials, answer questions of cost-effectiveness or noninferiority, and inform data-driven dialogue and decision making by all stakeholders.

  5. Selecting, Adapting, and Implementing Evidence-based Interventions in Rural Settings: An Analysis of 70 Community Examples.

    Science.gov (United States)

    Smith, Tina Anderson; Adimu, Tanisa Foxworth; Martinez, Amanda Phillips; Minyard, Karen

    2016-01-01

    This paper explores how communities translate evidence-based and promising health practices to rural contexts. A descriptive, qualitative analysis was conducted using data from 70 grantees funded by the Federal Office of Rural Health Policy to implement evidence-based health practices in rural settings. Findings were organized using The Interactive Systems Framework for Dissemination and Implementation. Grantees broadly interpreted evidence-based and promising practices, resulting in the implementation of a patchwork of health-related interventions that fell along a spectrum of evidentiary rigor. The cohort faced common challenges translating recognized practices into rural community settings and reported making deliberate modifications to original models as a result. Opportunities for building a more robust rural health evidence base include investments to incentivize evidence-based programming in rural settings; rural-specific research and theory-building; translation of existing evidence using a rural lens; technical assistance to support rural innovation; and prioritization of evaluation locally.

  6. Beliefs and implementation of evidence-based practice among community health nurses: A cross-sectional descriptive study.

    Science.gov (United States)

    Pereira, Filipa; Pellaux, Victoria; Verloo, Henk

    2018-03-08

    To describe beliefs about evidence-based practice and record levels of implementation among community health nurses working independently and in community healthcare centres in the canton of Valais, Switzerland. In many settings, evidence-based practice is considered a key means of delivering better and secure health care. However, there is a paucity of published studies on the implementation of evidence-based practice in community health care. Cross-sectional descriptive study (n = 100). Beliefs about evidence-based practice and levels of implementation were measured using validated scales developed by Melnyk et al. (Worldviews on Evidence-Based Nursing, 5, 2008, 208). Information on respondents' sociodemographic and professional characteristics was collected. Data were analysed using descriptive and inferential statistics. The final response rate was 32.3% (n = 100). More than half of respondents had previously heard about evidence-based practice; most believed in the value of using evidence to guide their practice and were prepared to improve their skills to be able to do so. However, the rate of implementation of evidence-based practice in daily practice in the 8 weeks before the survey was poor. Statistically significant positive associations were found between beliefs about evidence-based practice and how respondents had heard about it and between implementation rates and whether they had heard about evidence-based practice and how they had done so. Evidence-based practices requiring scientific knowledge and skills were implemented less frequently. Greater professional community healthcare experience and management roles did not increase implementation of evidence-based practice. The systematic implementation of evidence-based practice by community health nurses working independently and in healthcare centres in Valais was rare, despite their positive beliefs about it. These results revealed the level of implementation of evidence-based practice by

  7. Preparing facilitators from community-based organizations for evidence-based intervention training in Second Life.

    Science.gov (United States)

    Valladares, Angel Felix; Aebersold, Michelle; Tschannen, Dana; Villarruel, Antonia Maria

    2014-09-30

    A major barrier to the use and scale-up of evidence-based interventions are challenges related to training and capacity building. A cost-effective and highly interactive multi-user virtual environment, Second Life (SL) is a promising alternative for comprehensive face-to-face facilitator training. The purpose of this study was to examine the feasibility of using SL to train facilitators from community-based organizations to use ¡Cuídate! (Take Care of Yourself), one of the few evidence-based interventions developed and tested with Latino youth to reduce sexual risk behaviors. We recruited 35 participants from community-based organizations throughout the United States to participate in the SL ¡Cuídate! Training of Facilitators. Preparation to use SL consisted of four phases: (1) recruitment and computer capacity screening, (2) enrollment, (3) orientation to the SL program, and (4) technical support throughout the synchronous training sessions. Technical difficulties, the associated cause, and the mitigation strategy implemented were recorded during each session. Participants completed evaluations including perceptions of self-efficacy and confidence to complete the necessary skills to participate in SL training. Overall, participants reported high levels of self-efficacy for all skills necessary to participate in SL training. Based on an 11-point scale (0-10), self-efficacy to download and access the software was rated the highest: mean 8.29 (SD 2.19). Interacting with items in SL had the lowest mean score: mean 7.49 (SD 2.89). The majority of technical difficulties experienced by participants were related to inadequate Internet connections or computer malfunctions. Our findings support the feasibility of using SL for the ¡Cuídate! Training of Facilitators. The process used in this study to prepare participants to use SL can be used as a basis for other evidence-based intervention training in SL. This study is an important contribution to developing cost

  8. Engaging parents in evidence-based treatments in schools: Community perspectives from implementing CBITS.

    Science.gov (United States)

    Santiago, Catherine Decarlo; Pears, Gillian; Baweja, Shilpa; Vona, Pamela; Tang, Jennifer; Kataoka, Sheryl H

    2013-12-01

    This study explored parent engagement in an evidence-based treatment, the Cognitive Behavioral Intervention for Trauma in Schools (CBITS), which was delivered in a school setting. To examine the successes and challenges in engaging parents in this school-based program, we conducted qualitative interviews by phone to obtain data from clinicians, parents, and other school personnel across eleven schools from 3 different regions of the United States. Almost all of these schools served low-income and ethnically diverse communities. We describe general impressions of parent engagement, parent reactions and preferences with regard to CBITS, barriers to parent engagement, and how to overcome barriers from multiple perspectives. Parent engagement across schools varied, with extensive outreach and relatively good parent engagement in CBITS described in some schools, while in other schools, efforts to engage parents were not as consistent. Implications for future efforts to engage parents in school-based treatments are discussed.

  9. Evident?

    DEFF Research Database (Denmark)

    Plant, Peter

    2012-01-01

    Quality assurance and evidence in career guidance in Europe are often seen as self-evident approaches, but particular interests lie behind......Quality assurance and evidence in career guidance in Europe are often seen as self-evident approaches, but particular interests lie behind...

  10. Getting to uptake: do communities of practice support the implementation of evidence-based practice?

    Science.gov (United States)

    Barwick, Melanie A; Peters, Julia; Boydell, Katherine

    2009-02-01

    Practitioners are increasingly encouraged to adopt evidence-based practices (EBP) leading to a need for new knowledge translation strategies to support implementation and practice change. This study examined the benefits of a community of practice in the context of Ontario's children's mental health sector where organizations are mandated to adopt a standardized outcome measure to monitor client response to treatment. Readiness for change, practice change, content knowledge, and satisfaction with and use of implementation supports were examined among practitioners newly trained on the measure who were randomly assigned to a community of practice (CoP) or a practice as usual (PaU) group. CoP practitioners attended 6 sessions over 12 months; PaU practitioners had access to usual implementation supports. Groups did not differ on readiness for change or reported practice change, although CoP participants demonstrated greater use of the tool in practice, better content knowledge and were more satisfied with implementation supports than PaU participants. CoPs present a promising model for translating EBP knowledge and promoting practice change in children's mental health that requires further study.

  11. Reef fish communities in the central Red Sea show evidence of asymmetrical fishing pressure

    KAUST Repository

    Kattan, Alexander; Coker, Darren James; Berumen, Michael L.

    2017-01-01

    In order to assess human impacts and develop rational restoration goals for corals reefs, baseline estimates of fish communities are required. In Saudi Arabian waters of the Red Sea, widespread unregulated fishing is thought to have been ongoing for decades, but there is little direct evidence of the impact on reef communities. To contextualize this human influence, reef-associated fish assemblages on offshore reefs in Saudi Arabia and Sudan in the central Red Sea were investigated. These reefs have comparable benthic environments, experience similar oceanographic influences, and are separated by less than 300 km, offering an ideal comparison for identifying potential anthropogenic impacts such as fishing pressure. This is the first study to assess reef fish biomass in both these regions, providing important baselines estimates. We found that biomass of top predators on offshore Sudanese reefs was on average almost three times that measured on comparable reefs in Saudi Arabia. Biomass values from some of the most remote reefs surveyed in Sudan’s far southern region even approach those previously reported in the Northwestern Hawaiian Islands, northern Line Islands, Pitcairn Islands, and other isolated Pacific islands and atolls. The findings suggest that fishing pressure has significantly altered the fish community structure of Saudi Arabian Red Sea reefs, most conspicuously in the form of top predator removal. The results point towards the urgent need for enhanced regulation and enforcement of fishing practices in Saudi Arabia, while making a strong case for protection in the form of no-take marine protected areas to maintain preservation of the relatively intact southern Sudanese Red Sea.

  12. Reef fish communities in the central Red Sea show evidence of asymmetrical fishing pressure

    KAUST Repository

    Kattan, Alexander

    2017-03-09

    In order to assess human impacts and develop rational restoration goals for corals reefs, baseline estimates of fish communities are required. In Saudi Arabian waters of the Red Sea, widespread unregulated fishing is thought to have been ongoing for decades, but there is little direct evidence of the impact on reef communities. To contextualize this human influence, reef-associated fish assemblages on offshore reefs in Saudi Arabia and Sudan in the central Red Sea were investigated. These reefs have comparable benthic environments, experience similar oceanographic influences, and are separated by less than 300 km, offering an ideal comparison for identifying potential anthropogenic impacts such as fishing pressure. This is the first study to assess reef fish biomass in both these regions, providing important baselines estimates. We found that biomass of top predators on offshore Sudanese reefs was on average almost three times that measured on comparable reefs in Saudi Arabia. Biomass values from some of the most remote reefs surveyed in Sudan’s far southern region even approach those previously reported in the Northwestern Hawaiian Islands, northern Line Islands, Pitcairn Islands, and other isolated Pacific islands and atolls. The findings suggest that fishing pressure has significantly altered the fish community structure of Saudi Arabian Red Sea reefs, most conspicuously in the form of top predator removal. The results point towards the urgent need for enhanced regulation and enforcement of fishing practices in Saudi Arabia, while making a strong case for protection in the form of no-take marine protected areas to maintain preservation of the relatively intact southern Sudanese Red Sea.

  13. The Importance of Community Consultations for Generating Evidence for Health Reform in Ukraine

    Directory of Open Access Journals (Sweden)

    Olena Hankivsky

    2017-03-01

    Full Text Available Background The paper presents the results of community consultations about the health needs and healthcare experiences of the population of Ukraine. The objective of community consultations is to engage a community in which a research project is studying, and to gauge feedback, criticism and suggestions. It is designed to seek advice or information from participants directly affected by the study subject of interest. The purpose of this study was to collect first-hand perceptions about daily life, health concerns and experiences with the healthcare system. This study provides policy-makers with additional evidence to ensure that health reforms would include a focus not only on health system changes but also social determinants of health (SDH. Methods The data collection consisted of the 21 community consultations conducted in 2012 in eleven regions of Ukraine in a mix of urban and rural settings. The qualitative data was coded in MAXQDA 11 software and thematic analysis was used as a method of summarizing and interpreting the results. Results The key findings of this study point out the importance of the SDH in the lives of Ukrainians and how the residents of Ukraine perceive that health inequities and premature mortality are shaped by the circumstances of their daily lives, such as: political and economic instability, environmental pollution, low wages, poor diet, insufficient physical activity, and unsatisfactory state of public services. Study participants repeatedly discussed these conditions as the reasons for the perceived health crisis in Ukraine. The dilapidated state of the healthcare system was discussed as well; high out-of-pocket (OOP payments and lack of trust in doctors appeared as significant barriers in accessing healthcare services. Additionally, the consultations highlighted the economic and health gaps between residents of rural and urban areas, naming rural populations among the most vulnerable social groups in Ukraine

  14. The Importance of Community Consultations for Generating Evidence for Health Reform in Ukraine.

    Science.gov (United States)

    Hankivsky, Olena; Vorobyova, Anna; Salnykova, Anastasiya; Rouhani, Setareh

    2016-08-17

    The paper presents the results of community consultations about the health needs and healthcare experiences of the population of Ukraine. The objective of community consultations is to engage a community in which a research project is studying, and to gauge feedback, criticism and suggestions. It is designed to seek advice or information from participants directly affected by the study subject of interest. The purpose of this study was to collect first-hand perceptions about daily life, health concerns and experiences with the healthcare system. This study provides policy-makers with additional evidence to ensure that health reforms would include a focus not only on health system changes but also social determinants of health (SDH). The data collection consisted of the 21 community consultations conducted in 2012 in eleven regions of Ukraine in a mix of urban and rural settings. The qualitative data was coded in MAXQDA 11 software and thematic analysis was used as a method of summarizing and interpreting the results. The key findings of this study point out the importance of the SDH in the lives of Ukrainians and how the residents of Ukraine perceive that health inequities and premature mortality are shaped by the circumstances of their daily lives, such as: political and economic instability, environmental pollution, low wages, poor diet, insufficient physical activity, and unsatisfactory state of public services. Study participants repeatedly discussed these conditions as the reasons for the perceived health crisis in Ukraine. The dilapidated state of the healthcare system was discussed as well; high out-of-pocket (OOP) payments and lack of trust in doctors appeared as significant barriers in accessing healthcare services. Additionally, the consultations highlighted the economic and health gaps between residents of rural and urban areas, naming rural populations among the most vulnerable social groups in Ukraine. The study concludes that any meaningful reforms of

  15. What older people want: evidence from a study of remote Scottish communities.

    Science.gov (United States)

    King, Gerry; Farmer, Jane

    2009-01-01

    The growing proportions of older people in rural areas have implications for the provision of health and social care services. Older people are more likely to have complex health needs compared with other age groups, requiring a full range of primary, community and acute hospital services. The provision of services to older people in rural areas is challenged by diseconomies of scale, travel costs and difficulties in attracting staff. Policy-makers are requested to include the 'voice' of older people to help provide services that match needs and context. In spite of this, what older people want from health and social care services is a neglected area of investigation. The reported study was conducted in 2005/2006 as part of a European Union Northern Periphery Programme (EU NPP) project called Our Life as Elderly. Its aims were to explore the views of those aged 55 years and over and living in remote communities about current and future health and social care service provision for older people. Evidence was to be collected that could inform policy-makers about changing or improving service delivery. This article summarises emergent themes and considers their implications. The study selected two small remote mainland Scottish Highland communities for in-depth case study. Semi-structured interviews (n = 23), 10 'informal conversations' and 4 focus groups were held with community members aged 55 years and over, in order to provide different types of qualitative data and 'layers' of data to allow reflection. Data analysis was assisted by computerised data management software and performed using the 'framework analysis' approach. Participants did not consider themselves 'old' and expressed the need for independence in older age to be supported by services. Several aspects of services that were undergoing change or restructuring were identified, including arrangements for home care services, meals provision and technological support. Participants valued elements of the

  16. Factors associated with an evidence-based measure of implementation for the Adolescent Community Reinforcement Approach.

    Science.gov (United States)

    Garner, Bryan R; Hunter, Sarah B; Slaughter, Mary E; Han, Bing; Godley, Susan H

    2017-11-01

    An evidence-based measure of implementation (EBMI) is an implementation outcome measure shown to have predictive validity with one or more future-measured constructs of importance. The current study sought to identify correlates and predictors of an EBMI called procedure exposure. Garner et al. (2016) found procedure exposure to be an EBMI for the Adolescent Community Reinforcement Approach (A-CRA). The dataset included 76 community-based substance use treatment organizations located across the United States. Organizational-level regression analyses, which were framed within the context of Chaudoir et al. (2013) framework for predicting implementation outcomes, were used to examine predictors of A-CRA procedure exposure RESULTS: The Washington Circle's treatment initiation performance measure (B=5.05 [SE=1.60], p=0.002), as well as session exposure (B=0.18 [SE=0.06], p=0.003), were significant predictors of A-CRA procedure exposure in the backward stepwise regression analysis (Adjusted R-square=0.55). The Washington Circle's treatment engagement performance measure (B=7.93 [SE=0.77], pCRA procedure exposure but were not retained in the final model. Organizations implementing A-CRA are encouraged to make the following high priorities: (a) scheduling and completing a subsequent treatment session within 14days of their index session (treatment initiation) and (b) providing a targeted number of treatment sessions to each client (session exposure). To the extent organizations do this, they may be more likely to achieve higher levels of A-CRA procedure exposure. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Community-based tourism in practice: evidence from three coastal communities in Bohuslän, Sweden

    Directory of Open Access Journals (Sweden)

    Lindström Kristina N.

    2016-09-01

    Full Text Available Local involvement in tourism development is defined as a key issue for sustainable tourism, however it is often questioned and less seldom implemented in reality. Reasons behind this condition are lack of knowledge and practical experience on community-based tourism as a bottom-up approach. In this paper it is argued that local involvement in tourism development is both a democratic right and a strategic destination management tool. The paper scrutinizes a process of collaboration and local participation in a tourism development project within three coastal communities on the Swedish West Coast. A mixed-methods approach was employed in the project with the specific aim of investigating attitudes to the community and tourism development and of involving community stakeholders in exploring alternative avenues of tourism development. The article describes four phases of the process of local involvement in a tourism development project: step 1, formation of a representative project group and negotiation of community-based approach; step 2, consulting local stakeholders and employing a mixed-methods approach; step 3, elaborating results with local stakeholders; step 4, increased community collaboration.

  18. An evidence-based health workforce model for primary and community care

    Directory of Open Access Journals (Sweden)

    Leach Matthew J

    2011-08-01

    Full Text Available Abstract Background The delivery of best practice care can markedly improve clinical outcomes in patients with chronic disease. While the provision of a skilled, multidisciplinary team is pivotal to the delivery of best practice care, the occupational or skill mix required to deliver this care is unclear; it is also uncertain whether such a team would have the capacity to adequately address the complex needs of the clinic population. This is the role of needs-based health workforce planning. The objective of this article is to describe the development of an evidence-informed, needs-based health workforce model to support the delivery of best-practice interdisciplinary chronic disease management in the primary and community care setting using diabetes as a case exemplar. Discussion Development of the workforce model was informed by a strategic review of the literature, critical appraisal of clinical practice guidelines, and a consensus elicitation technique using expert multidisciplinary clinical panels. Twenty-four distinct patient attributes that require unique clinical competencies for the management of diabetes in the primary care setting were identified. Patient attributes were grouped into four major themes and developed into a conceptual model: the Workforce Evidence-Based (WEB planning model. The four levels of the WEB model are (1 promotion, prevention, and screening of the general or high-risk population; (2 type or stage of disease; (3 complications; and (4 threats to self-care capacity. Given the number of potential combinations of attributes, the model can account for literally millions of individual patient types, each with a distinct clinical team need, which can be used to estimate the total health workforce requirement. Summary The WEB model was developed in a way that is not only reflective of the diversity in the community and clinic populations but also parsimonious and clear to present and operationalize. A key feature of the

  19. Evidence based policy making in the European Union. The role of the scientific community

    Energy Technology Data Exchange (ETDEWEB)

    Majcen, Spela [Euro-Mediterranean Univ. (EMUNI), Portoroz (Slovenia)

    2017-03-15

    In the times when the acquis of the European Union (EU) has developed so far as to reach a high level of technical complexity, in particular in certain policy fields such as environmental legislation, it is important to look at what kind of information and data policy decisions are based on. This position paper looks at the extent to which evidence-based decision-making process is being considered in the EU institutions when it comes to adopting legislation in the field of environment at the EU level. The paper calls for closer collaboration between scientists and decision-makers in view of ensuring that correct data is understood and taken into consideration when drafting, amending, negotiating and adopting new legal texts at all levels of the EU decision-making process. It concludes that better awareness of the need for such collaboration among the decision-makers as well as the scientific community would benefit the process and quality of the final outcomes (legislation).

  20. Evidence based policy making in the European Union: the role of the scientific community.

    Science.gov (United States)

    Majcen, Špela

    2017-03-01

    In the times when the acquis of the European Union (EU) has developed so far as to reach a high level of technical complexity, in particular in certain policy fields such as environmental legislation, it is important to look at what kind of information and data policy decisions are based on. This position paper looks at the extent to which evidence-based decision-making process is being considered in the EU institutions when it comes to adopting legislation in the field of environment at the EU level. The paper calls for closer collaboration between scientists and decision-makers in view of ensuring that correct data is understood and taken into consideration when drafting, amending, negotiating and adopting new legal texts at all levels of the EU decision-making process. It concludes that better awareness of the need for such collaboration among the decision-makers as well as the scientific community would benefit the process and quality of the final outcomes (legislation).

  1. Modeling determinants of growth: evidence for a community-based target in height?

    Science.gov (United States)

    Aßmann, Christian; Hermanussen, Michael

    2013-07-01

    Human growth is traditionally envisaged as a target-seeking process regulated by genes, nutrition, health, and the state of an individual's social and economic environment; it is believed that under optimal physical conditions, an individual will achieve his or her full genetic potential. Using a panel data set on individual height increments, we suggest a statistical modeling approach that characterizes growth as first-order trend stationary and allows for controlling individual growth tempo via observable measures of individual maturity. A Bayesian framework and corresponding Markov-chain Monte Carlo techniques allowing for a conceptually stringent treatment of missing values are adapted for parameter estimation. The model provides evidence for the adjustment of the individual growth rate toward average height of the population. The increase in adult body height during the past 150 y has been explained by the steady improvement of living conditions that are now being considered to have reached an optimum in Western societies. The current investigation questions the notion that the traditional concept in the understanding of this target-seeking process is sufficient. We consider an additional regulator that possibly points at community-based target seeking in growth.

  2. Evidence based policy making in the European Union. The role of the scientific community

    International Nuclear Information System (INIS)

    Majcen, Spela

    2017-01-01

    In the times when the acquis of the European Union (EU) has developed so far as to reach a high level of technical complexity, in particular in certain policy fields such as environmental legislation, it is important to look at what kind of information and data policy decisions are based on. This position paper looks at the extent to which evidence-based decision-making process is being considered in the EU institutions when it comes to adopting legislation in the field of environment at the EU level. The paper calls for closer collaboration between scientists and decision-makers in view of ensuring that correct data is understood and taken into consideration when drafting, amending, negotiating and adopting new legal texts at all levels of the EU decision-making process. It concludes that better awareness of the need for such collaboration among the decision-makers as well as the scientific community would benefit the process and quality of the final outcomes (legislation).

  3. Protection enhances community and habitat stability: evidence from a mediterranean marine protected area.

    Science.gov (United States)

    Fraschetti, Simonetta; Guarnieri, Giuseppe; Bevilacqua, Stanislao; Terlizzi, Antonio; Boero, Ferdinando

    2013-01-01

    Rare evidences support that Marine Protected Areas (MPAs) enhance the stability of marine habitats and assemblages. Based on nine years of observation (2001-2009) inside and outside a well managed MPA, we assessed the potential of conservation and management actions to modify patterns of spatial and/or temporal variability of Posidonia oceanica meadows, the lower midlittoral and the shallow infralittoral rock assemblages. Significant differences in both temporal variations and spatial patterns were observed between protected and unprotected locations. A lower temporal variability in the protected vs. unprotected assemblages was found in the shallow infralittoral, demonstrating that, at least at local scale, protection can enhance community stability. Macrobenthos with long-lived and relatively slow-growing invertebrates and structurally complex algal forms were homogeneously distributed in space and went through little fluctuations in time. In contrast, a mosaic of disturbed patches featured unprotected locations, with small-scale shifts from macroalgal stands to barrens, and harsh temporal variations between the two states. Opposite patterns of spatial and temporal variability were found for the midlittoral assemblages. Despite an overall clear pattern of seagrass regression through time, protected meadows showed a significantly higher shoot density than unprotected ones, suggesting a higher resistance to local human activities. Our results support the assumption that the exclusion/management of human activities within MPAs enhance the stability of the structural components of protected marine systems, reverting or arresting threat-induced trajectories of change.

  4. Do human parents face a quantity-quality tradeoff?: evidence from a Shuar community.

    Science.gov (United States)

    Hagen, Edward H; Barrett, H Clark; Price, Michael E

    2006-07-01

    A number of evolutionary theories of human life history assume a quantity-quality tradeoff for offspring production: parents with fewer offspring can have higher biological fitness than those with more. Direct evidence for such a tradeoff, however, is mixed. We tested this assumption in a community of Ecuadorian Shuar hunter-horticulturalists, using child anthropometry as a proxy for fitness. We measured the impact of household consumer/producer (CP) ratio on height, weight, skinfold thicknesses, and arm and calf circumferences of 85 children and young adults. To control for possible "phenotypic" correlates that might mask the effect of CP ratio on anthropometry, we also measured household garden productivity, wealth, and social status. Regression models of the age-standardized variables indicated a significant negative impact of CP ratio on child growth and nutrition. The age-standardized height and weight of children in households with the largest CP ratio (10) were 1.38 and 1.44 standard deviations, respectively, below those of children in households with the smallest CP ratio (2). Surprisingly, garden productivity, wealth, and status had little to no effect on the fitness proxies. There was, however, an interesting and unexpected interaction between status and sex: for females, but not males, higher father status correlated significantly with higher values on the proxies.

  5. Career-Technical Education and Labor Market Outcomes: Evidence from California Community Colleges. A CAPSEE Working Paper

    Science.gov (United States)

    Stevens, Ann; Kurlaender, Michal; Grosz, Michel

    2015-01-01

    This paper estimates the earnings returns to vocational, or career-technical, education programs in the nation's largest community college system. While career-technical education (CTE) programs have often been mentioned as an attractive alternative to four-year colleges for some students, very little systematic evidence exists on the returns to…

  6. Parent Perspectives of an Evidence-Based Intervention for Children with Autism Served in Community Mental Health Clinics

    Science.gov (United States)

    Stadnick, Nicole A.; Drahota, Amy; Brookman-Frazee, Lauren

    2013-01-01

    Research suggests that improvements to community mental health (CMH) care for children with autism spectrum disorders (ASD) are needed. Recent research examining the feasibility of training CMH therapists to deliver a package of evidence-based practice intervention strategies (EBPs) targeting challenging behaviors for school-age children with ASD…

  7. Community engagement to enhance child survival and early development in low- and middle-income countries: an evidence review.

    Science.gov (United States)

    Farnsworth, S Katherine; Böse, Kirsten; Fajobi, Olaoluwa; Souza, Patricia Portela; Peniston, Anne; Davidson, Leslie L; Griffiths, Marcia; Hodgins, Stephen

    2014-01-01

    As part of a broader evidence summit, USAID and UNICEF convened a literature review of effective means to empower communities to achieve behavioral and social changes to accelerate reductions in under-5 mortality and optimize early child development. The authors conducted a systematic review of the effectiveness of community mobilization and participation that led to behavioral change and one or more of the following: child health, survival, and development. The level and nature of community engagement was categorized using two internationally recognized models and only studies where the methods of community participation could be categorized as collaborative or shared leadership were eligible for analysis. The authors identified 34 documents from 18 countries that met the eligibility criteria. Studies with shared leadership typically used a comprehensive community action cycle, whereas studies characterized as collaborative showed clear emphasis on collective action but did not undergo an initial process of community dialogue. The review concluded that programs working collaboratively or achieving shared leadership with a community can lead to behavior change and cost-effective sustained transformation to improve critical health behaviors and reduce poor health outcomes in low- and middle-income countries. Overall, community engagement is an understudied component of improving child outcomes.

  8. Evidence-Based Approaches to Remedy and Also to Prevent Abuse of Community-Dwelling Older Persons

    Directory of Open Access Journals (Sweden)

    Donna M. Wilson

    2011-01-01

    Full Text Available Elder abuse is a global issue, with an estimated 4–10% of older persons in Canada abused each year. Although Canadian legislation has been created to prevent and punish the abuse of older persons living in nursing homes and other care facilities, community-dwelling older persons are at greater risk of abuse. This paper highlights the importance of evidence-based actions targeted at three determinants of health: (a personal health practices and coping skills, (b social support networks, and (c social environments. Two research studies are profiled as case studies that illustrate the ready possibility and value of two specific types of actions on community-based older-person abuse. This paper argues for the immediate and widespread adoption of these evidence-based measures and for additional empirical evidence to guide the correction of underreporting of abuse, raise awareness of its serious nature, and increase options to not only stop it but ultimately prevent it.

  9. Community health workers for non-communicable diseases prevention and control in developing countries: Evidence and implications.

    Science.gov (United States)

    Jeet, Gursimer; Thakur, J S; Prinja, Shankar; Singh, Meenu

    2017-01-01

    National programs for non-communicable diseases (NCD) prevention and control in different low middle income countries have a strong community component. A community health worker (CHW) delivers NCD preventive services using informational as well as behavioural approaches. Community education and interpersonal communication on lifestyle modifications is imparted with focus on primordial prevention of NCDs and screening is conducted as part of early diagnosis and management. However, the effectiveness of health promotion and screening interventions delivered through community health workers needs to be established. This review synthesised evidence on effectiveness of CHW delivered NCD primary prevention interventions in low and middle-income countries (LMICs). A systematic review of trials that utilised community health workers for primary prevention/ early detection strategy in the management of NCDs (Diabetes, cardiovascular diseases (CVD), cancers, stroke, Chronic Obstructive Pulmonary Diseases (COPD)) in LMICs was conducted. Digital databases like PubMed, EMBASE, OVID, Cochrane library, dissertation abstracts, clinical trials registry web sites of different LMIC were searched for such publications between years 2000 and 2015. We focussed on community based randomised controlled trial and cluster randomised trials without any publication language limitation. The primary outcome of review was percentage change in population with different behavioural risk factors. Additionally, mean overall changes in levels of several physical or biochemical parameters were studied as secondary outcomes. Subgroup analyses was performed by the age and sex of participants, and sensitivity analyses was conducted to assess the robustness of the findings. Sixteen trials meeting the inclusion criteria were included in the review. Duration, study populations and content of interventions varied across trials. The duration of the studies ranged from mean follow up of 4 months for some risk

  10. Comparative Eskimo Dictionary with Aleut Cognates.

    Science.gov (United States)

    Fortescue, Michael, Ed.; And Others

    This dictionary covers 10 Eskimo dialects (Alutiiq, Central Alaskan Yupik, Naukan, Central Siberian Yupik, Sirenik, Seward Peninsula Inuit, North Alaskan Inuit, Western Canadian Inuit, Eastern Canadian Inuit, Greenlandic Inuit). An introductory section details the classification of languages and dialects and their phonologies, and discusses the…

  11. Community-based tourism in practice: evidence from three coastal communities in Bohuslän, Sweden

    OpenAIRE

    Lindström Kristina N.; Larson Mia

    2016-01-01

    Local involvement in tourism development is defined as a key issue for sustainable tourism, however it is often questioned and less seldom implemented in reality. Reasons behind this condition are lack of knowledge and practical experience on community-based tourism as a bottom-up approach. In this paper it is argued that local involvement in tourism development is both a democratic right and a strategic destination management tool. The paper scrutinizes a process of collaboration and local p...

  12. Evidence for the functional significance of diazotroph community structure in soil.

    Science.gov (United States)

    Hsu, Shi-Fang; Buckley, Daniel H

    2009-01-01

    Microbial ecologists continue to seek a greater understanding of the factors that govern the ecological significance of microbial community structure. Changes in community structure have been shown to have functional significance for processes that are mediated by a narrow spectrum of organisms, such as nitrification and denitrification, but in some cases, functional redundancy in the community seems to buffer microbial ecosystem processes. The functional significance of microbial community structure is frequently obscured by environmental variation and is hard to detect in short-term experiments. We examine the functional significance of free-living diazotrophs in a replicated long-term tillage experiment in which extraneous variation is minimized and N-fixation rates can be related to soil characteristics and diazotroph community structure. Soil characteristics were found to be primarily impacted by tillage management, whereas N-fixation rates and diazotroph community structure were impacted by both biomass management practices and interactions between tillage and biomass management. The data suggest that the variation in diazotroph community structure has a greater impact on N-fixation rates than do soil characteristics at the site. N-fixation rates displayed a saturating response to increases in diazotroph community diversity. These results show that the changes in the community structure of free-living diazotrophs in soils can have ecological significance and suggest that this response is related to a change in community diversity.

  13. What reassurances do the community need regarding life extension? Evidence from studies of community attitudes and an analysis of film portrayals.

    Science.gov (United States)

    Underwood, Mair

    2014-04-01

    It is increasingly recognized that community attitudes impact on the research trajectory, entry, and reception of new biotechnologies. Yet biogerontologists have generally been dismissive of public concerns about life extension. There is some evidence that biogerontological research agendas have not been communicated effectively, with studies finding that most community members have little or no knowledge of life extension research. In the absence of knowledge, community members' attitudes may well be shaped by issues raised in popular portrayals of life extension (e.g., in movies). To investigate how popular portrayals of life extension may influence community attitudes, I conducted an analysis of 19 films depicting human life extension across different genres. I focussed on how the pursuit of life extension was depicted, how life extension was achieved, the levels of interest in life extension shown by characters in the films, and the experiences of extended life depicted both at an individual and societal level. This paper compares the results of this analysis with the literature on community attitudes to life extension and makes recommendations about the issues in which the public may require reassurance if they are to support and accept life extension technologies.

  14. Implementation outcomes of evidence-based quality improvement for depression in VA community based outpatient clinics

    Directory of Open Access Journals (Sweden)

    Fortney John

    2012-04-01

    Full Text Available Abstract Background Collaborative-care management is an evidence-based practice for improving depression outcomes in primary care. The Department of Veterans Affairs (VA has mandated the implementation of collaborative-care management in its satellite clinics, known as Community Based Outpatient Clinics (CBOCs. However, the organizational characteristics of CBOCs present added challenges to implementation. The objective of this study was to evaluate the effectiveness of evidence-based quality improvement (EBQI as a strategy to facilitate the adoption of collaborative-care management in CBOCs. Methods This nonrandomized, small-scale, multisite evaluation of EBQI was conducted at three VA Medical Centers and 11 of their affiliated CBOCs. The Plan phase of the EBQI process involved the localized tailoring of the collaborative-care management program to each CBOC. Researchers ensured that the adaptations were evidence based. Clinical and administrative staff were responsible for adapting the collaborative-care management program for local needs, priorities, preferences and resources. Plan-Do-Study-Act cycles were used to refine the program over time. The evaluation was based on the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance Framework and used data from multiple sources: administrative records, web-based decision-support systems, surveys, and key-informant interviews. Results Adoption: 69.0% (58/84 of primary care providers referred patients to the program. Reach: 9.0% (298/3,296 of primary care patients diagnosed with depression who were not already receiving specialty care were enrolled in the program. Fidelity: During baseline care manager encounters, education/activation was provided to 100% (298/298 of patients, barriers were assessed and addressed for 100% (298/298 of patients, and depression severity was monitored for 100% (298/298 of patients. Less than half (42.5%, 681/1603 of follow-up encounters during the acute

  15. Are informal carers and community care workers effective in managing malnutrition in the older adult community? A systematic review of current evidence.

    Science.gov (United States)

    Marshall, S; Bauer, J; Capra, S; Isenring, E

    2013-01-01

    Enhancing the effectiveness of the community and aged care workforce to prevent malnutrition and functional decline is important in reducing hospital and aged care facility demand. To investigate the impact of nutrition-related interventions delivered to or by informal carers and non-clinical community care workers on malnutrition-related health outcomes of community-dwelling older adults (≥65 years). Intervention studies were searched for using six electronic databases for English-language publications from January 1980 to 30 May 2012. Nine studies were eligible for inclusion. The strength and quality of the evidence was moderate (six studies with level II intervention evidence, five with positive quality). Types of interventions used were highly varied. The majority of interventions were delivered to informal carers (6 studies), with three of these studies also involving older adult care recipients. Five interventions were targeted at identifying, preventing and/or treating malnutrition specifically (two positive quality, three neutral quality, n=2368). As a result of these interventions, nutritional status improved or stabilized (two positive quality, two neutral quality, n=2333). No study reported an improvement in functional status but two successfully prevented further decline in their participants (two neutral quality, n=1097). Interventions targeted at identifying, preventing and/or treating malnutrition were able to improve or prevent decline in nutritional and functional status, without increasing informal carer burden. The findings of this review support the involvement of non-clinical community care workers and informal carers as part of the nutritional care team for community-dwelling older adults.

  16. A community of learners in the evidence-based dental clinic

    NARCIS (Netherlands)

    Schoonheim-Klein, M.; Wesselink, P.R.; Vervoorn, J.M.

    2012-01-01

    An increasing emphasis has been placed on the need for an evidence-based approach in dentistry. This calls for effort in dental education to develop and implement tools for the application of evidence in clinical decision-making (evidence-based decision-making, EBDM). Aim:  To evaluate whether the

  17. Biocrust-forming mosses mitigate the impact of aridity on soil microbial communities in drylands: observational evidence from three continents.

    Science.gov (United States)

    Delgado-Baquerizo, Manuel; Maestre, Fernando T; Eldridge, David J; Bowker, Matthew A; Jeffries, Thomas C; Singh, Brajesh K

    2018-04-02

    Recent research indicates that increased aridity linked to climate change will reduce the diversity of soil microbial communities and shift their community composition in drylands, Earth's largest biome. However, we lack both a theoretical framework and solid empirical evidence of how important biotic components from drylands, such as biocrust-forming mosses, will regulate the responses of microbial communities to expected increases in aridity with climate change. Here we report results from a cross-continental (North America, Europe and Australia) survey of 39 locations from arid to humid ecosystems, where we evaluated how biocrust-forming mosses regulate the relationship between aridity and the community composition and diversity of soil bacteria and fungi in dryland ecosystems. Increasing aridity was negatively related to the richness of fungi, and either positively or negatively related to the relative abundance of selected microbial phyla, when biocrust-forming mosses were absent. Conversely, we found an overall lack of relationship between aridity and the relative abundance and richness of microbial communities under biocrust-forming mosses. Our results suggest that biocrust-forming mosses mitigate the impact of aridity on the community composition of globally distributed microbial taxa, and the diversity of fungi. They emphasize the importance of maintaining biocrusts as a sanctuary for soil microbes in drylands. © 2018 The Authors. New Phytologist © 2018 New Phytologist Trust.

  18. Field-based evidence for consistent responses of bacterial communities to copper contamination in two contrasting agricultural soils

    Directory of Open Access Journals (Sweden)

    Jing eLi

    2015-02-01

    Full Text Available Copper contamination on China’s arable land could pose severe economic, ecological and healthy consequences in the coming decades. As the drivers in maintaining ecosystem functioning, the responses of soil microorganisms to long-term copper contamination in different soil ecosystems are still debated. This study investigated the impacts of copper gradients on soil bacterial communities in two agricultural fields with contrasting soil properties. Our results revealed consistent reduction in soil microbial biomass carbon (SMBC with increasing copper levels in both soils, coupled by significant declines in bacterial abundance in most cases. Despite of contrasting bacterial community structures between the two soils, the bacterial diversity in the copper-contaminated soils showed considerably decreasing patterns when copper levels elevated. High-throughput sequencing revealed copper selection for major bacterial guilds, in particular, Actinobacteria showed tolerance, while Acidobacteria and Chloroflexi were highly sensitive to copper. The thresholds that bacterial communities changed sharply were 800 and 200 added copper mg kg-1 in the fluvo-aquic soil and red soil, respectively, which were similar to the toxicity thresholds (EC50 values characterized by SMBC. Structural equation model (SEM analysis ascertained that the shifts of bacterial community composition and diversity were closely related with the changes of SMBC in both soils. Our results provide field-based evidence that copper contamination exhibits consistently negative impacts on soil bacterial communities, and the shifts of bacterial communities could have largely determined the variations of the microbial biomass.

  19. Community Reinforcement and the Dissemination of Evidence-Based Practice: Implications for Public Policy

    Science.gov (United States)

    Milford, Jaime L.; Austin, Julia L.; Smith, Jane Ellen

    2007-01-01

    The Community Reinforcement Approach (CRA) and Community Reinforcement and Family Training (CRAFT) are both highly effective and empirically validated psychosocial approaches to the treatment of addictions whose unique designs may help achieve certain public health objectives. Literature will be reviewed to examine the potential impact of CRA and…

  20. How Can Placement Policy Improve Math Remediation Outcomes? Evidence from Experimentation in Community Colleges

    Science.gov (United States)

    Ngo, Federick; Melguizo, Tatiana

    2016-01-01

    Changing placement policy may help to improve developmental education student outcomes in community colleges, but there is little understanding of the impacts of these reforms. We take advantage of heterogeneous placement policy in a large urban community college district in California to compare the effects of math remediation under different…

  1. Does External Funding Help Adaptation? Evidence from Community-Based Water Management in the Colombian Andes

    Science.gov (United States)

    Murtinho, Felipe; Eakin, Hallie; López-Carr, David; Hayes, Tanya M.

    2013-11-01

    Despite debate regarding whether, and in what form, communities need external support for adaptation to environmental change, few studies have examined how external funding impacts adaptation decisions in rural resource-dependent communities. In this article, we use quantitative and qualitative methods to assess how different funding sources influence the initiative to adapt to water scarcity in the Colombian Andes. We compare efforts to adapt to water scarcity in 111 rural Andean communities with varied dependence on external funding for water management activities. Findings suggest that despite efforts to use their own internal resources, communities often need external support to finance adaptation strategies. However, not all external financial support positively impacts a community’s abilities to adapt. Results show the importance of community-driven requests for external support. In cases where external support was unsolicited, the results show a decline, or “crowding-out,” in community efforts to adapt. In contrast, in cases where communities initiated the request for external support to fund their own projects, findings show that external intervention is more likely to enhance or “crowds-in” community-driven adaptation.

  2. Framework for an Evidence-Based Physical Activity Intervention: Promoting Healthy Communities

    Directory of Open Access Journals (Sweden)

    Laura E. Bruno

    2017-05-01

    Conclusions: Opportunities to participate in a community based intervention program should be extended throughout all communities in an effort to improve holistic well-being. Further, type and duration as well as point of data collection of such programs should be differentiated in future research.

  3. Decentralization and Educational Performance: Evidence from the PROHECO Community School Program in Rural Honduras

    Science.gov (United States)

    Di Gropello, Emanuela; Marshall, Jeffery H.

    2011-01-01

    We analyze the effectiveness of the Programa Hondureno de Educacion Comunitaria (PROHECO) community school program in rural Honduras. The data include standardized tests and extensive information on school, teacher, classroom and community features for 120 rural schools drawn from 15 states. Using academic achievement decompositions we find that…

  4. Community College Student Alcohol Use: Developing Context-Specific Evidence and Prevention Approaches

    Science.gov (United States)

    Wall, Andrew F.; BaileyShea, Chelsea; McIntosh, Scott

    2012-01-01

    The objective of this study was to examine the prevalence of heavy alcohol use, related harm, and implications for prevention among community college students. We used data from 7,965 students at 19 community colleges who responded to the Core Alcohol and Other Drug Survey. This secondary analysis of the survey data found heavy consumption among…

  5. Indicators of activity-friendly communities: an evidence-based consensus process.

    Science.gov (United States)

    Brennan Ramirez, Laura K; Hoehner, Christine M; Brownson, Ross C; Cook, Rebeka; Orleans, C Tracy; Hollander, Marla; Barker, Dianne C; Bors, Philip; Ewing, Reid; Killingsworth, Richard; Petersmarck, Karen; Schmid, Thomas; Wilkinson, William

    2006-12-01

    Regular physical activity, even at modest intensities, is associated with many health benefits. Most Americans, however, do not engage in the recommended levels. As practitioners seek ways to increase population rates of physical activity, interventions and advocacy efforts are being targeted to the community level. Yet, advocates, community leaders, and researchers lack the tools needed to assess local barriers to and opportunities for more active, healthy lifestyles. Investigators used a systematic review process to identify key indicators of activity-friendly communities that can assess and improve opportunities for regular physical activity. Investigators conducted a comprehensive literature review of both peer-reviewed literature and fugitive information (e.g., reports and websites) to generate an initial list of indicators for review (n=230). The review included a three-tiered, modified Delphi consensus-development process that incorporated input of international, national, state, and local researchers and practitioners from academic institutions, federal and state government agencies, nonprofit organizations, and funding agencies in public health, transportation, urban planning, parks and recreation, and public policy. Ten promising indicators of activity-friendly communities were identified: land use environment, access to exercise facilities, transportation environment, aesthetics, travel patterns, social environment, land use economics, transportation economics, institutional and organizational policies, and promotion. Collaborative, multidisciplinary approaches are underway to test, refine, and expand this initial list of indicators and to develop measures that communities, community leaders, and policymakers can use to design more activity-friendly community environments.

  6. Changes in the North Sea fish community: evidence of indirect effects of fishing?

    DEFF Research Database (Denmark)

    Daan, N.; Gislason, Henrik; Pope, J.

    2005-01-01

    , but such changes may simply reflect the cumulative, direct effects of fishing through selective removal of large individuals. If there is resilience in a fish community towards fishing, we may expect increases in specific components, for instance as a consequence of an associated reduction in predation and....... Taking average fishing mortality of assessed commercial species as an index of exploitation rate of the fish community, it appears that fishing effort reached its maximum in the mid-1980s and has declined slightly since. If the observed changes in the community are caused by indirect effects of fishing...

  7. COMMUNITY STRESS, DEMORALIZATION AND BODY MASS INDEX: EVIDENCE FOR SOCIAL SIGNAL TRANSDUCTION. (R827027)

    Science.gov (United States)

    Quantification of the relationship between community-level chronic stress from neighborhood conditions and individual morale has rarely been reported. In this work, pregnant women were recruited at the prenatal clinics of Harlem Hospital and Columbia Presbyterian Medical Cente...

  8. Preventing malaria in pregnancy through community-directed interventions: evidence from Akwa Ibom State, Nigeria

    Directory of Open Access Journals (Sweden)

    Ishola Gbenga

    2011-08-01

    Full Text Available Abstract Background Despite massive anti-malaria campaigns across the subcontinent, effective access to intermittent preventive treatment (IPTp and insecticide-treated nets (ITNs among pregnant women remain low in large parts of sub-Saharan Africa. The slow uptake of malaria prevention products appears to reflect lack of knowledge and resistance to behavioural change, as well as poor access to resources, and limited support of programmes by local communities and authorities. Methods A recent community-based programme in Akwa Ibom State, Nigeria, is analysed to determine the degree to which community-directed interventions can improve access to malaria prevention in pregnancy. Six local government areas in Southern Nigeria were selected for a malaria in pregnancy prevention intervention. Three of these local government areas were selected for a complementary community-directed intervention (CDI programme. Under the CDI programme, volunteer community-directed distributors (CDDs were appointed by each village and kindred in the treatment areas and trained to deliver ITNs and IPTp drugs as well as basic counseling services to pregnant women. Findings Relative to women in the control area, an additional 7.4 percent of women slept under a net during pregnancy in the treatment areas (95% CI [0.035, 0.115], p-value Conclusion The presented results suggest that the inclusion of community-based programmes can substantially increase effective access to malaria prevention, and also increase access to formal health care access in general, and antenatal care attendance in particular in combination with supply side interventions. Given the relatively modest financial commitments they require, community-directed programmes appear to be a cost-effective way to improve malaria prevention; the participatory approach underlying CDI programmes also promises to strengthen ties between the formal health sector and local communities.

  9. Building social capital in post-conflict communities: evidence from Nicaragua.

    Science.gov (United States)

    Brune, Nancy E; Bossert, Thomas

    2009-03-01

    Studies of social capital have focused on the static relationship between social capital and health, governance and economic conditions. This study is a first attempt to evaluate interventions designed to improve the levels of social capital in post-conflict communities in Nicaragua and to relate those increases to health and governance issues. The two-year study involved a baseline household survey of approximately 200 households in three communities in Nicaragua, the implementation of systematic interventions designed to increase social capital in two of the locales (with one control group), and a second household survey administered two years after the baseline survey. We found that systematic interventions promoting management and leadership development were effective in improving some aspects of social capital, in particular the cognitive attitudes of trust in the communities. Interventions were also linked to higher levels of civic participation in governance processes. As in other empirical studies, we also found that higher levels of social capital were significantly associated with some positive health behaviors. The behavioral/structural components of social capital (including participation in groups and social networks) were associated with more desirable individual health behaviors such as the use of modern medicine to treat children's respiratory illnesses. Attitudinal components of social capital were positively linked to community health behaviors such as working on community sanitation campaigns. The findings presented here should be of interest to policy makers interested in health policy and social capital, as well as those working in conflict-ridden communities in the developing world.

  10. Community trust and household health: A spatially-based approach with evidence from rural Honduras.

    Science.gov (United States)

    Zarychta, Alan

    2015-12-01

    What is the relationship between community trust and household health? Scholars working to understand the effects of trust and social capital on human health tend to focus on individual characteristics or social environments, frequently without integrating these two dimensions. In light of this, the present paper makes contributions in both conceptualization and measurement. First, I develop a spatially-based approach for operationalizing community trust as the product of individual orientation and social environment. This approach highlights the need for a household to trust its neighbors and for those neighbors to reciprocate trust in order to constitute the psychological and material mechanisms critical for linking social context to individual health. Second, I illustrate the utility of this measure by evaluating the relationship between community trust and self-rated health status using an original population census survey from 2009 to 2010 for two municipalities in western Honduras (approximately 2800 households with a response rate of 94.9%). I implement spatial regression analysis and show that there is a positive and substantively meaningful relationship between community trust and household health; households that are trusting and surrounded by similarly trusting neighbors report better health status, while those in uncertain or mutually distrusting environments report worse health. The theory and results presented here suggest an important link between trust and social capital at the community level, which is particularly salient for rural regions in developing countries where health resources are scarce and community-based interventions are common. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Evidence for the Treatment of Osteoporosis with Vitamin D in Residential Care and in the Community Dwelling Elderly

    Directory of Open Access Journals (Sweden)

    John A. A. Geddes

    2013-01-01

    Full Text Available Introduction. Vitamin D is common treatment for osteoporosis. Both age >70 years and living in residential care are associated with increased fracture risk. Community dwelling elderly are a heterogeneous group who may have more similatiry with residential care groups than younger community dwelling counterparts. Aims. To review the evidence for cholecalciferol or ergocalciferol tretment of osteoporosis in either community dwelling patients aged ≥70 years of age, or redidential care patients. Secondly endpoints were changes in bone mineral denisty, and in bone turnover markers. Methods. We performed a literature search using search terms for osteoporosis and vitamin D. Treatment for at least one year was required. Results. Only one residential care study using cholecalciferol, showed non-vertebral and hip fracture reduction in vitamin D deficient subjects. In the community setting one quasi randomised study using ergocalciferol showed reduction in total but not hip or non-vertebral fracture, and a second randomised study showed increased hip fracture risk. Three studies reported increases in hip bone mineral denisty. Discussion. A minority of studies demonstrated a fracture benefit form vitamin D and one suggested possible harm in a community setting. Current practice should be to only offer this treatment to subjects identified as deficient.

  12. Implementing Evidence-Based Teen Pregnancy-Prevention Interventions in a Community-Wide Initiative: Building Capacity and Reaching Youth.

    Science.gov (United States)

    House, L Duane; Tevendale, Heather D; Martinez-Garcia, Genevieve

    2017-03-01

    To describe efforts to implement evidence-based interventions (EBIs) within multicomponent, community-wide initiatives to reduce teen pregnancy. During 2011-2014, we collected information about the capacity (i.e., knowledge, confidence, training, and experience) of state and community-based organizations to support implementation of the following: EBIs, number and characteristics of youth served by EBIs, type of EBIs implemented, EBI settings, hours of training, and technical assistance provided. State and community-based organizations reported these data annually; however, training and technical assistance was reported monthly. We used aggregated data from these annual and monthly reports to describe the implementation of EBIs in the community-wide initiative project. From baseline in 2011-2014, state and community-based organizations increased their capacities to support program partners in delivering EBIs. They provided 5,015 hours of technical assistance and training on topics, including ensuring adequate capacity, process and outcome evaluation, program planning, and continuous quality improvement. Program partners increased the number of youth reached by an EBI in targeted communities by 349%, from 4,304 in the first year of implementation in 2012 to 19,344 in 2014. Most youth in 2014 received sexuality education programs (59%), whereas smaller percentages received abstinence-based, youth development, and clinic-based programs. Most youth were reached through schools (72%) and community-based organizations (16%), and smaller numbers were reached in other settings (e.g., faith-based organizations, health centers). Building and monitoring the capacity of program partners to deliver EBIs through technical assistance and training is important. In addition, partnering with schools leads to reaching more youth. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  13. Adoption of an evidence-based colorectal cancer screening promotion program by community organizations serving Filipino Americans

    Science.gov (United States)

    2014-01-01

    Background Filipino Americans have low rates of colorectal cancer (CRC) screening and high CRC mortality. To reduce this disparity, we conducted a dissemination trial in which we offered two levels of technical assistance to community organizations to disseminate an evidence-based CRC screening promotion program among their Filipino American members. This report describes the recruitment of organizations and adoption – the proportion and representativeness of organizations that decided to implement the program. Methods During the recruitment phase, we completed organizational assessments with 44 community-based organizations (previous partners in research, organizations that were referred to us, or new organizations) to assess their eligibility to participate (having ≥ 150 Filipino American members age 50+). We compared organizational characteristics of organizations that did and did not adopt our CRC screening promotion program. Results Twenty two of the 44 community organizations that completed the assessment adopted the CRC screening promotion program (50%). Adoption was highest among organizations that had previously partnered with us (11/14 = 79%) and among organizations that were referred to us by community partners (5/10 = 50%) and lowest among new organizations (6/20 = 30%). Few organizational differences were found between adopters and non-adopters. Conclusions The high rate of adoption among organizations that were referred by community partners or had partnered with us in the past underscores the importance of community resources, community-academic relationships, and partnership in the dissemination process. However, the moderate rate of adoption among new organizations and the demands of completing documentation and assessments in our trial to advance dissemination research raise questions regarding the generalizability of study findings. PMID:24618267

  14. Community

    Science.gov (United States)

    stability Science & Innovation Collaboration Careers Community Environment Science & Innovation Recruitment Events Community Commitment Giving Campaigns, Drives Economic Development Employee Funded neighbor pledge: contribute to quality of life in Northern New Mexico through economic development

  15. Building a Culture of Evidence: A Case Study of a California Community College

    Science.gov (United States)

    Baker, Jill H.; Sax, Caren L.

    2012-01-01

    The purpose of this study was to better understand the practices associated with building a culture of evidence and to identify the factors influencing the success of such an endeavor. By definition, a culture of evidence is based upon practices employing data and research to inform decision making at all levels of the institution, with the…

  16. Examining Evidence Construction as the Transformation of the Material World into Community Knowledge

    Science.gov (United States)

    Manz, Eve

    2016-01-01

    Recent consensus documents in science education (e.g., the Next Generation Science Standards) emphasize helping students develop facility with constructing and critiquing both claims and the evidence that supports them. While students typically view evidence as necessary for supporting scientific claims, they tend to "objectify"…

  17. Primary prevention of metabolic syndrome in the community using an evidence-based exercise program.

    Science.gov (United States)

    Dalleck, Lance C; Van Guilder, Gary P; Quinn, Esther M; Bredle, Don L

    2013-10-01

    The purpose of the present study was to examine the effectiveness of a community-based exercise program to lower metabolic syndrome (MetS) risk factors. MetS components were retrospectively analyzed in 332 adults (190 women, 142 men) before and after a 14-week supervised community exercise program between January 2007 and May 2012 at the University of Wisconsin-Eau Claire. Except for total cholesterol, all health outcome variables, including the 5 MetS components, improved following community exercise. Individuals having MetS decreased from 22.3% before participation to 13.5% at end (pexercise program is an effective method to reduce cardiovascular risk in adults by substantially decreasing the prevalence of MetS and its components. Greater volumes of exercise may increase the likelihood of MetS risk factor elimination. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Community health workers for non-communicable diseases prevention and control in developing countries: Evidence and implications.

    Directory of Open Access Journals (Sweden)

    Gursimer Jeet

    Full Text Available National programs for non-communicable diseases (NCD prevention and control in different low middle income countries have a strong community component. A community health worker (CHW delivers NCD preventive services using informational as well as behavioural approaches. Community education and interpersonal communication on lifestyle modifications is imparted with focus on primordial prevention of NCDs and screening is conducted as part of early diagnosis and management. However, the effectiveness of health promotion and screening interventions delivered through community health workers needs to be established.This review synthesised evidence on effectiveness of CHW delivered NCD primary prevention interventions in low and middle-income countries (LMICs.A systematic review of trials that utilised community health workers for primary prevention/ early detection strategy in the management of NCDs (Diabetes, cardiovascular diseases (CVD, cancers, stroke, Chronic Obstructive Pulmonary Diseases (COPD in LMICs was conducted. Digital databases like PubMed, EMBASE, OVID, Cochrane library, dissertation abstracts, clinical trials registry web sites of different LMIC were searched for such publications between years 2000 and 2015. We focussed on community based randomised controlled trial and cluster randomised trials without any publication language limitation. The primary outcome of review was percentage change in population with different behavioural risk factors. Additionally, mean overall changes in levels of several physical or biochemical parameters were studied as secondary outcomes. Subgroup analyses was performed by the age and sex of participants, and sensitivity analyses was conducted to assess the robustness of the findings.Sixteen trials meeting the inclusion criteria were included in the review. Duration, study populations and content of interventions varied across trials. The duration of the studies ranged from mean follow up of 4 months

  19. A Systematic Review of Evidence-Based Community Pharmacy Services Aimed at the Prevention of Cardiovascular Disease.

    Science.gov (United States)

    Sabater-Hernández, Daniel; Sabater-Galindo, Marta; Fernandez-Llimos, Fernando; Rotta, Inajara; Hossain, Lutfun N; Durks, Desire; Franco-Trigo, Lucia; Lopes, Livia A; Correr, Cassyano J; Benrimoj, Shalom I

    2016-06-01

    Cardiovascular disease (CVD) is the leading cause of death worldwide and has a substantial impact on people's health and quality of life. CVD also causes an increased use of health care resources and services, representing a significant proportion of health care expenditure. Integrating evidence-based community pharmacy services is seen as an asset to reduce the burden of CVD on individuals and the health care system. To (a) identify community pharmacy evidence-based services designed to help prevent CVD and (b) provide fundamental information that is needed to assess their potential adaptation to other community pharmacy settings. This review used the DEPICT database, which includes 488 randomized controlled trials (RCT) that address the evaluation of pharmacy services. Articles reviewing these RCTs were identified for the DEPICT database through a systematic search of the following databases: MEDLINE, Scopus, SciELO (Scientific Electronic Library Online), and DOAJ (Directory of Open Access Journals). The DEPICT database was reviewed to identify evidence-based services delivered in the community pharmacy setting with the purpose of preventing CVD. An evidence-based service was defined as a service that has been shown to have a positive effect (compared with usual care) in a high-quality RCT. From each evidence-based service, fundamental information was retrieved to facilitate adaptation to other community pharmacy settings. From the DEPICT database, 14 evidence-based community pharmacy services that addressed the prevention of CVD were identified. All services, except 1, targeted populations with a mean age above 60 years. Pharmacy services encompassed a wide range of practical applications or techniques that can be classified into 3 groups: activities directed at patients, activities directed at health care professionals, and assessments to gather patient-related information in order to support the previous activities. This review provides pharmacy service

  20. Access to HIV community services by vulnerable populations: evidence from an enhanced HIV/AIDS surveillance system.

    Science.gov (United States)

    Madden, H C E; Phillips-Howard, P A; Hargreaves, S C; Downing, J; Bellis, M A; Vivancos, R; Morley, C; Syed, Q; Cook, P A

    2011-05-01

    HIV disproportionately affects vulnerable populations such as black and minority ethnic groups, men who have sex with men (MSM) and migrants, in many countries including those in the UK. Community organisations in the UK are charitable non-governmental organisations with a proportion of the workforce who volunteer, and provide invaluable additional support for people living with HIV (PLWHIV). Information on their contribution to HIV care in vulnerable groups is relatively sparse. Data generated from an enhanced HIV surveillance system in North West England, UK, was utilised for this study. We aimed to determine the characteristics of individuals who chose to access community services in addition to clinical services (1375 out of 4195 records of PLWHIV in clinical services). Demographic information, risk factors including residency status, uniquely gathered in this region, and deprivation scores were examined. Multivariate logistic regression modelling was conducted to predict the relative effect of patient characteristics on attendance at community services. Attendance at community services was highest in those living in the most, compared with least, deprived areas (p<0.001), and was most evident in MSM and heterosexuals. Compared to white UK nationals attendance was significantly higher in non-UK nationals of uncertain residency status (Adjusted odds ratio [AOR] = 21.91, 95% confidence interval [CI] 10.48-45.83; p<0.001), refugees (AOR = 5.75, 95% CI 3.3-10.03; p<0.001), migrant workers (AOR = 5.48, 95% CI 2.22-13.51; p<0.001) and temporary visitors (AOR = 3.44, 95% CI 1.68-7.05; p<0.001). Community services, initially established predominantly to support MSM, have responded to the changing demography of HIV and reach the most vulnerable members of society. Consequent to their support of migrant populations, community services are vital for the management of HIV in black and minority groups. Paradoxically, this coincides with increasing funding pressures on these

  1. Changes in the North Sea fish community: evidence of indirect effects of fishing?

    NARCIS (Netherlands)

    Daan, N.; Gislason, H.; Pope, J.G.; Rice, J.C.

    2005-01-01

    We investigate changes in the North Sea fish community with particular reference to possible indirect effects of fishing, mediated through the ecosystem. In the past, long-term changes in the slope of size spectra of research vessel catches have been related to changes in fishing effort, but such

  2. Homogeneity in Community-Based Rape Prevention Programs: Empirical Evidence of Institutional Isomorphism

    Science.gov (United States)

    Townsend, Stephanie M.; Campbell, Rebecca

    2007-01-01

    This study examined the practices of 24 community-based rape prevention programs. Although these programs were geographically dispersed throughout one state, they were remarkably similar in their approach to rape prevention programming. DiMaggio and Powell's (1991) theory of institutional isomorphism was used to explain the underlying causes of…

  3. Using a portfolio of evidence in a community-based project module: reflection in perspective

    Directory of Open Access Journals (Sweden)

    PH van der Westhuizen

    2014-01-01

    Full Text Available Community-based learning is a relatively new field in South Africa. It has only been extensively included in academic programmes at universities for about fifteen years.Students have to make a positive contribution to individuals in their communities (Dukhan 2008:21 and develop a combination of knowledge, skills, values and motivation in order to make a difference, and to promote the quality of life in a community (O Connor 2006: 52.Too often assessment reflects on a single quantitative measure or symbol to indicate a level of achievement. This aggregate does not, however, indicate the student‟s particular weaknesses and strengths, and whether or not he or she possesses competencies in a specific aspect. A more objective method/procedure of reporting assessment on levels of achievement and competency obtained is the compilation of a portfolio. The main aim of this paper is to provide some guidelines for the compilation and implementation of portfolios as a tool in authentic assessment for the student, but also acts as a document that would guide a community into the sustainability of the project.

  4. Differences between Girls and Boys in Emerging Language Skills: Evidence from 10 Language Communities

    Science.gov (United States)

    Eriksson, Marten; Marschik, Peter B.; Tulviste, Tiia; Almgren, Margareta; Perez Pereira, Miguel; Wehberg, Sonja; Marjanovic-Umek, Ljubica; Gayraud, Frederique; Kovacevic, Melita; Gallego, Carlos

    2012-01-01

    The present study explored gender differences in emerging language skills in 13,783 European children from 10 non-English language communities. It was based on a synthesis of published data assessed with adapted versions of the MacArthur-Bates Communicative Development Inventories (CDIs) from age 0.08 to 2.06. The results showed that girls are…

  5. Community socioeconomic context and its influence on intermediary determinants of child health : evidence from Colombia

    OpenAIRE

    Osorio Mejía, Ana María; Bolancé, Catalina; Madise, Nyovani

    2014-01-01

    Intermediary determinants are the most immediate mechanisms through which socioeconomic position shapes health inequities. This study examines the effect of community socioeconomic context on different indicators representing intermediary determinants of child health. In the context of Colombia, a developing country with a clear economic expansion, but one of the most unequal countries in the world, two categories of intermediary determinants, namely behavioural and psychoso...

  6. Evidence of Ash Tree (Fraxinus spp.) Specific Associations with Soil Bacterial Community Structure and Functional Capacity

    Science.gov (United States)

    Michael P. Ricketts; Charles E. Flower; Kathleen S. Knight; Miquel A. Gonzalez-Meler

    2018-01-01

    The spread of the invasive emerald ash borer (EAB) across North America has had enormous impacts on temperate forest ecosystems. The selective removal of ash trees (Fraxinus spp.) has resulted in abnormally large inputs of coarse woody debris and altered forest tree community composition, ultimately affecting a variety of ecosystem processes. The...

  7. Evidence for selective bacterial community structuring in the freshwater sponge Ephydatia fluviatilis

    NARCIS (Netherlands)

    Costa, Rodrigo; Keller-Costa, Tina; Gomes, Newton C. M.; Nunes da Rocha, Ulisses; van Overbeek, Leo; van Elsas, Jan Dirk

    To understand the functioning of sponges, knowledge of the structure of their associated microbial communities is necessary. However, our perception of sponge-associated microbiomes remains mainly restricted to marine ecosystems. Here, we report on the molecular diversity and composition of bacteria

  8. Evidence for selective bacterial community structuring in the freshwater sponge Ephydatia fluviatilis.

    NARCIS (Netherlands)

    Costa, R.; Keller-Costa, T.; Gomes, N.C.M.; Nunes da Rocha, U.; Overbeek, van L.S.; Elsas, J.D.

    2013-01-01

    To understand the functioning of sponges, knowledge of the structure of their associated microbial communities is necessary. However, our perception of sponge-associated microbiomes remains mainly restricted to marine ecosystems. Here, we report on the molecular diversity and composition of bacteria

  9. Re-evaluating the health of coral reef communities: baselines and evidence for human impacts across the central Pacific.

    Science.gov (United States)

    Smith, Jennifer E; Brainard, Rusty; Carter, Amanda; Grillo, Saray; Edwards, Clinton; Harris, Jill; Lewis, Levi; Obura, David; Rohwer, Forest; Sala, Enric; Vroom, Peter S; Sandin, Stuart

    2016-01-13

    Numerous studies have documented declines in the abundance of reef-building corals over the last several decades and in some but not all cases, phase shifts to dominance by macroalgae have occurred. These assessments, however, often ignore the remainder of the benthos and thus provide limited information on the present-day structure and function of coral reef communities. Here, using an unprecedentedly large dataset collected within the last 10 years across 56 islands spanning five archipelagos in the central Pacific, we examine how benthic reef communities differ in the presence and absence of human populations. Using islands as replicates, we examine whether benthic community structure is associated with human habitation within and among archipelagos and across latitude. While there was no evidence for coral to macroalgal phase shifts across our dataset we did find that the majority of reefs on inhabited islands were dominated by fleshy non-reef-building organisms (turf algae, fleshy macroalgae and non-calcifying invertebrates). By contrast, benthic communities from uninhabited islands were more variable but in general supported more calcifiers and active reef builders (stony corals and crustose coralline algae). Our results suggest that cumulative human impacts across the central Pacific may be causing a reduction in the abundance of reef builders resulting in island scale phase shifts to dominance by fleshy organisms. © 2016 The Author(s).

  10. Balancing "fidelity" and community context in the adaptation of asthma evidence-based interventions in the "real world".

    Science.gov (United States)

    Lara, Marielena; Bryant-Stephens, Tyra; Damitz, Maureen; Findley, Sally; Gavillán, Jesús González; Mitchell, Herman; Ohadike, Yvonne U; Persky, Victoria W; Valencia, Gilberto Ramos; Smith, Lucia Rojas; Rosenthal, Michael; Thyne, Shannon; Uyeda, Kimberly; Viswanathan, Meera; Woodell, Carol

    2011-11-01

    The Merck Childhood Asthma Network (MCAN) initiative selected five sites (New York City, Puerto Rico, Chicago, Los Angeles, and Philadelphia) to engage in translational research to adapt evidence-based interventions (EBIs) to improve childhood asthma outcomes. The authors summarize the sites' experience by describing criteria defining the fidelity of translation, community contextual factors serving as barriers or enablers to fidelity, types of adaptation conducted, and strategies used to balance contextual factors and fidelity in developing a "best fit" for EBIs in the community. A conceptual model captures important structural and process-related factors and helps frame lessons learned. Site implementers and intervention developers reached consensus on qualitative rankings of the levels of fidelity of implementation for each of the EBI core components: low fidelity, adaptation (major vs. minor), or high fidelity. MCAN sites were successful in adapting core EBI components based on their understanding of structural and other contextual barriers and enhancers in their communities. Although the sites varied regarding both the EBI components they implemented and their respective levels of fidelity, all sites observed improvement in asthma outcomes. Our collective experiences of adapting and implementing asthma EBIs highlight many of the factors affecting translation of evidenced-based approaches to chronic disease management in real community settings.

  11. A community change in the algal endosymbionts of a scleractinian coral following a natural bleaching event: field evidence of acclimatization.

    Science.gov (United States)

    Jones, A M; Berkelmans, R; van Oppen, M J H; Mieog, J C; Sinclair, W

    2008-06-22

    The symbiosis between reef-building corals and their algal endosymbionts (zooxanthellae of the genus Symbiodinium) is highly sensitive to temperature stress, which makes coral reefs vulnerable to climate change. Thermal tolerance in corals is known to be substantially linked to the type of zooxanthellae they harbour and, when multiple types are present, the relative abundance of types can be experimentally manipulated to increase the thermal limits of individual corals. Although the potential exists for this to translate into substantial thermal acclimatization of coral communities, to date there is no evidence to show that this takes place under natural conditions. In this study, we show field evidence of a dramatic change in the symbiont community of Acropora millepora, a common and widespread Indo-Pacific hard coral species, after a natural bleaching event in early 2006 in the Keppel Islands (Great Barrier Reef). Before bleaching, 93.5% (n=460) of the randomly sampled and tagged colonies predominantly harboured the thermally sensitive Symbiodinium type C2, while the remainder harboured a tolerant Symbiodinium type belonging to clade D or mixtures of C2 and D. After bleaching, 71% of the surviving tagged colonies that were initially C2 predominant changed to D or C1 predominance. Colonies that were originally C2 predominant suffered high mortality (37%) compared with D-predominant colonies (8%). We estimate that just over 18% of the original A. millepora population survived unchanged leaving 29% of the population C2 and 71% D or C1 predominant six months after the bleaching event. This change in the symbiont community structure, while it persists, is likely to have substantially increased the thermal tolerance of this coral population. Understanding the processes that underpin the temporal changes in symbiont communities is key to assessing the acclimatization potential of reef corals.

  12. Conservation of forest birds: evidence of a shifting baseline in community structure.

    Directory of Open Access Journals (Sweden)

    Chadwick D Rittenhouse

    2010-08-01

    Full Text Available Quantifying changes in forest bird diversity is an essential task for developing effective conservation actions. When subtle changes in diversity accumulate over time, annual comparisons may offer an incomplete perspective of changes in diversity. In this case, progressive change, the comparison of changes in diversity from a baseline condition, may offer greater insight because changes in diversity are assessed over longer periods of times. Our objectives were to determine how forest bird diversity has changed over time and whether those changes were associated with forest disturbance.We used North American Breeding Bird Survey data, a time series of Landsat images classified with respect to land cover change, and mixed-effects models to associate changes in forest bird community structure with forest disturbance, latitude, and longitude in the conterminous United States for the years 1985 to 2006. We document a significant divergence from the baseline structure for all birds of similar migratory habit and nest location, and all forest birds as a group from 1985 to 2006. Unexpectedly, decreases in progressive similarity resulted from small changes in richness (<1 species per route for the 22-year study period and modest losses in abundance (-28.7 - -10.2 individuals per route that varied by migratory habit and nest location. Forest disturbance increased progressive similarity for Neotropical migrants, permanent residents, ground nesting, and cavity nesting species. We also documented highest progressive similarity in the eastern United States.Contemporary forest bird community structure is changing rapidly over a relatively short period of time (e.g., approximately 22 years. Forest disturbance and forest regeneration are primary factors associated with contemporary forest bird community structure, longitude and latitude are secondary factors, and forest loss is a tertiary factor. Importantly, these findings suggest some regions of the United

  13. Conservation of forest birds: evidence of a shifting baseline in community structure.

    Science.gov (United States)

    Rittenhouse, Chadwick D; Pidgeon, Anna M; Albright, Thomas P; Culbert, Patrick D; Clayton, Murray K; Flather, Curtis H; Huang, Chengquan; Masek, Jeffrey G; Stewart, Susan I; Radeloff, Volker C

    2010-08-02

    Quantifying changes in forest bird diversity is an essential task for developing effective conservation actions. When subtle changes in diversity accumulate over time, annual comparisons may offer an incomplete perspective of changes in diversity. In this case, progressive change, the comparison of changes in diversity from a baseline condition, may offer greater insight because changes in diversity are assessed over longer periods of times. Our objectives were to determine how forest bird diversity has changed over time and whether those changes were associated with forest disturbance. We used North American Breeding Bird Survey data, a time series of Landsat images classified with respect to land cover change, and mixed-effects models to associate changes in forest bird community structure with forest disturbance, latitude, and longitude in the conterminous United States for the years 1985 to 2006. We document a significant divergence from the baseline structure for all birds of similar migratory habit and nest location, and all forest birds as a group from 1985 to 2006. Unexpectedly, decreases in progressive similarity resulted from small changes in richness (<1 species per route for the 22-year study period) and modest losses in abundance (-28.7 - -10.2 individuals per route) that varied by migratory habit and nest location. Forest disturbance increased progressive similarity for Neotropical migrants, permanent residents, ground nesting, and cavity nesting species. We also documented highest progressive similarity in the eastern United States. Contemporary forest bird community structure is changing rapidly over a relatively short period of time (e.g., approximately 22 years). Forest disturbance and forest regeneration are primary factors associated with contemporary forest bird community structure, longitude and latitude are secondary factors, and forest loss is a tertiary factor. Importantly, these findings suggest some regions of the United States may

  14. DNA pyrosequencing evidence for large diversity differences between natural and managed coffee mycorrhizal fungal communities

    OpenAIRE

    De Beenhouwer , Matthias; Muleta , Diriba; Peeters , Bram; Van Geel , Maarten; Lievens , Bart; Honnay , Olivier

    2015-01-01

    International audience; Arabica coffee is a major agricultural commodity worldwide, representing 60 % of the world’s coffee production. Arabica coffee is cultivated in more than 36 countries and is a key cash crop for many developing countries. Despite the coffee’s huge economic importance, there is very limited knowledge on the association of arbuscular mycorrhizal fungi with coffee roots. Therefore, we assessed the mycorrhizal diversity and community composition in Arabica coffee (Coffea ar...

  15. Evidence of Ash Tree (Fraxinus spp. Specific Associations with Soil Bacterial Community Structure and Functional Capacity

    Directory of Open Access Journals (Sweden)

    Michael P. Ricketts

    2018-04-01

    Full Text Available The spread of the invasive emerald ash borer (EAB across North America has had enormous impacts on temperate forest ecosystems. The selective removal of ash trees (Fraxinus spp. has resulted in abnormally large inputs of coarse woody debris and altered forest tree community composition, ultimately affecting a variety of ecosystem processes. The goal of this study was to determine if the presence of ash trees influences soil bacterial communities and/or functions to better understand the impacts of EAB on forest successional dynamics and biogeochemical cycling. Using 16S rRNA amplicon sequencing of soil DNA collected from ash and non-ash plots in central Ohio during the early stages of EAB infestation, we found that bacterial communities in plots with ash differed from those without ash. These differences were largely driven by Acidobacteria, which had a greater relative abundance in non-ash plots. Functional genes required for sulfur cycling, phosphorus cycling, and carbohydrate metabolism (specifically those which breakdown complex sugars to glucose were estimated to be more abundant in non-ash plots, while nitrogen cycling gene abundance did not differ. This ash-soil microbiome association implies that EAB-induced ash decline may promote belowground successional shifts, altering carbon and nutrient cycling and changing soil properties beyond the effects of litter additions caused by ash mortality.

  16. Achieving Health Equity Through Community Engagement in Translating Evidence to Policy: The San Francisco Health Improvement Partnership, 2010–2016

    Science.gov (United States)

    Vargas, Roberto A.; Fleisher, Paula; Aragón, Tomás J.; Chung, Lisa; Chawla, Colleen; Yant, Abbie; Garcia, Estela R.; Santiago, Amor; Lang, Perry L.; Jones, Paula; Liu, Wylie; Schmidt, Laura A.

    2017-01-01

    Background The San Francisco Health Improvement Partnership (SFHIP) promotes health equity by using a novel collective impact model that blends community engagement with evidence-to-policy translational science. The model involves diverse stakeholders, including ethnic-based community health equity coalitions, the local public health department, hospitals and health systems, a health sciences university, a school district, the faith community, and others sectors. Community Context We report on 3 SFHIP prevention initiatives: reducing consumption of sugar sweetened beverages (SSBs), regulating retail alcohol sales, and eliminating disparities in children’s oral health. Methods SFHIP is governed by a steering committee. Partnership working groups for each initiative collaborate to 1) develop and implement action plans emphasizing feasible, scalable, translational-science–informed interventions and 2) consider sustainability early in the planning process by including policy and structural interventions. Outcome Through SFHIP’s efforts, San Francisco enacted ordinances regulating sale and advertising of SSBs and a ballot measure establishing a soda tax. Most San Francisco hospitals implemented or committed to implementing healthy-beverage policies that prohibited serving or selling SSBs. SFHIP helped prevent Starbucks and Taco Bell from receiving alcohol licenses in San Francisco and helped prevent state authorization of sale of powdered alcohol. SFHIP increased the number of primary care clinics providing fluoride varnish at routine well-child visits from 3 to 14 and acquired a state waiver to allow dental clinics to be paid for dental services delivered in schools. Interpretation The SFHIP model of collective impact emphasizing community engagement and policy change accomplished many of its intermediate goals to create an environment promoting health and health equity. PMID:28333598

  17. Community.

    Science.gov (United States)

    Grauer, Kit, Ed.

    1995-01-01

    Art in context of community is the theme of this newsletter. The theme is introduced in an editorial "Community-Enlarging the Definition" (Kit Grauer). Related articles include: (1) "The Children's Bridge is not Destroyed: Heart in the Middle of the World" (Emil Robert Tanay); (2) "Making Bridges: The Sock Doll…

  18. Do systematic reviews address community healthcare professionals' wound care uncertainties? Results from evidence mapping in wound care.

    Science.gov (United States)

    Christie, Janice; Gray, Trish A; Dumville, Jo C; Cullum, Nicky A

    2018-01-01

    Complex wounds such as leg and foot ulcers are common, resource intensive and have negative impacts on patients' wellbeing. Evidence-based decision-making, substantiated by high quality evidence such as from systematic reviews, is widely advocated for improving patient care and healthcare efficiency. Consequently, we set out to classify and map the extent to which up-to-date systematic reviews containing robust evidence exist for wound care uncertainties prioritised by community-based healthcare professionals. We asked healthcare professionals to prioritise uncertainties based on complex wound care decisions, and then classified 28 uncertainties according to the type and level of decision. For each uncertainty, we searched for relevant systematic reviews. Two independent reviewers screened abstracts and full texts of reviews against the following criteria: meeting an a priori definition of a systematic review, sufficiently addressing the uncertainty, published during or after 2012, and identifying high quality research evidence. The most common uncertainty type was 'interventions' 24/28 (85%); the majority concerned wound level decisions 15/28 (53%) however, service delivery level decisions (10/28) were given highest priority. Overall, we found 162 potentially relevant reviews of which 57 (35%) were not systematic reviews. Of 106 systematic reviews, only 28 were relevant to an uncertainty and 18 of these were published within the preceding five years; none identified high quality research evidence. Despite the growing volume of published primary research, healthcare professionals delivering wound care have important clinical uncertainties which are not addressed by up-to-date systematic reviews containing high certainty evidence. These are high priority topics requiring new research and systematic reviews which are regularly updated. To reduce clinical and research waste, we recommend systematic reviewers and researchers make greater efforts to ensure that research

  19. Training Community Mental Health Therapists to Deliver a Package of Evidence-Based Practice Strategies for School-Age Children with Autism Spectrum Disorders: A Pilot Study

    Science.gov (United States)

    Brookman-Frazee, Lauren I.; Drahota, Amy; Stadnick, Nicole

    2012-01-01

    Research on moving evidence-based practice (EBP) intervention strategies to community service settings for children with autism spectrum disorders (ASD) is urgently needed. The current pilot study addresses this need by examining the feasibility, acceptability and preliminary outcomes of training therapists practicing in community mental health…

  20. Community Response to Impaired Drinking Water Quality: Evidence from Bottled Water Sales

    Science.gov (United States)

    Allaire, M.; Zheng, S.; Lall, U.

    2017-12-01

    Drinking water contaminants pose a harm to public health. When confronted with elevated contaminate levels, individuals can take averting actions to reduce exposure, such as bottled water purchases. This study addresses a problem of national interest given that 9 to 45 million people have been affected by drinking water quality violations in each of the past 34 years. Moreover, few studies address averting behavior and avoidance costs due to water quality violations. This study assesses how responses might differ across baseline risk of impaired water quality and demographics of service area. We match a panel of weekly supermarket sales data with geocoded violations data for 67 counties in the Southeast from 2006-2015. We estimate the change in bottled water sales due to drinking water violations using a fixed effects model. Observing market behavior also allows us to calculate the cost of these averting actions. Critical findings from this study contribute to understanding how communities respond to water quality violations. We find that violations have considerable effects on bottled water consumption. Sales increase 8.1 percent due to violations related to microorganisms and 31.2 percent due to Tier 1 violations, which pose an immediate health risk. In addition, we calculate a national cost of averting actions of $26 million for microorganism violations from 2006-2015, which represents a lower-bound estimate. Averting costs vary considerably across the U.S. and some counties bear a particularly large burden, such as in California and Texas. Overall, this study provides insight into how averting behavior differs across contaminant type, water utility characteristics, and community demographics. Such knowledge can aid public health agencies, water systems, and environmental regulators to direct assistance to communities most in need.

  1. Multiple Household Water Sources and Their Use in Remote Communities With Evidence From Pacific Island Countries

    Science.gov (United States)

    Elliott, Mark; MacDonald, Morgan C.; Chan, Terence; Kearton, Annika; Shields, Katherine F.; Bartram, Jamie K.; Hadwen, Wade L.

    2017-11-01

    Global water research and monitoring typically focus on the household's "main source of drinking-water." Use of multiple water sources to meet daily household needs has been noted in many developing countries but rarely quantified or reported in detail. We gathered self-reported data using a cross-sectional survey of 405 households in eight communities of the Republic of the Marshall Islands (RMI) and five Solomon Islands (SI) communities. Over 90% of households used multiple sources, with differences in sources and uses between wet and dry seasons. Most RMI households had large rainwater tanks and rationed stored rainwater for drinking throughout the dry season, whereas most SI households collected rainwater in small pots, precluding storage across seasons. Use of a source for cooking was strongly positively correlated with use for drinking, whereas use for cooking was negatively correlated or uncorrelated with nonconsumptive uses (e.g., bathing). Dry season water uses implied greater risk of water-borne disease, with fewer (frequently zero) handwashing sources reported and more unimproved sources consumed. Use of multiple sources is fundamental to household water management and feasible to monitor using electronic survey tools. We contend that recognizing multiple water sources can greatly improve understanding of household-level and community-level climate change resilience, that use of multiple sources confounds health impact studies of water interventions, and that incorporating multiple sources into water supply interventions can yield heretofore-unrealized benefits. We propose that failure to consider multiple sources undermines the design and effectiveness of global water monitoring, data interpretation, implementation, policy, and research.

  2. Windstorms as mediator of soil nematode community changes: Evidence from European spruce forest

    Directory of Open Access Journals (Sweden)

    Renčo M.

    2017-03-01

    Full Text Available Nematode communities in a Norway spruce forest in High Tatra National Park, Slovakia were monitored for the period of several years (2006 and 2013. Unfortunately, in May 2014 natural windstorm damaged the forest. This disastrous event, together with preliminary obtained results allowed us to compare the direct impact of windstorm damage of forest habitat on soil nematode assemblages. The forest destruction by windstorm had a significant effect on the total nematode abundance, the abundance of omnivores and herbivores, as well as the nematode species diversity. The most dominant species, representing 55 % of the total nematode fauna, in the plot studied were Acrobeloides nanus followed by Malenchus exiguus, Filenchus vulgaris, Plectus communis, Plectus parvus and Tylencholaimus mirabilis. The abundance of bacterivorous signifi cantly increased after the windstorm, meanwhile the abundance of omnivores, fungivores, and herbivores ectoparasites and epidermal/root hair feeders showed an opposite trend. Of the evaluative indicators, Shannon species diversity (H’spp, maturity index (MI, maturity index 2-5 (MI2-5, sigma maturity index (ΣMI, enrichment index (EI and structure index (SI decreased significantly after windstorm. The EI and SI indexes characterized soil ecosystems before windstorm (2006 - 2013 as maturing with low or moderate disturbance, but soil ecosystems shortly after the windstorm (2014 were degraded and nutrient depleted. This also corresponded with graphical display of metabolic footprints characteristics of soil food web. Overall, the nematode communities differed significantly before and after forest damage. These results suggest the role of nematode communities as indicators of environment condition quality or its disruption.

  3. LifeSteps: An Evidence-based Health Promotion Program for Underserved Populations – A Community Service Learning Approach

    Directory of Open Access Journals (Sweden)

    Melanie Austin-McCain

    2015-04-01

    Full Text Available Chronic diseases are the most common, costly, and preventable of all health problems in the United States. Chronic diseases represent the leading causes of death and are experienced at higher rates by minority populations (CDC, 2012. Innovative community-based health promotion programs are recommended that meet the diverse needs of underserved populations (Yeary, et al., 2011. LifeSteps is being developed as an evidence-based health promotion program focusing on health and wellness, a domain area defined within the Occupational Therapy Practice Framework (OTPF, 2008. LifeSteps will utilize a client-centered approach to coach individuals in making health behavior changes. Fieldwork and service-learning components are incorporated integrating clinical practice, academic study, and collaboration with community providers. Program evaluation measures based on the Transtheoretical Model (TTM have been identified to address all phases of program planning. The LifeSteps health promotion program aligns with local, national, and international objectives and addresses the need for programs that meet the diverse needs of underserved populations. Occupational therapists are in a unique position for implementing community-based interventions that promote health and contribute to a healthier society.

  4. Correlates of social and emotional loneliness in older people: evidence from an English community study.

    Science.gov (United States)

    Dahlberg, Lena; McKee, Kevin J

    2014-05-01

    Loneliness is an important influence on quality of life in old age and has been conceptualised as consisting of two dimensions, social and emotional. This article describes analyses that sought to produce models of social and emotional loneliness in older people, using demographic, psychological and health, and social variables. Older people (aged 65+, n=1255) from the Barnsley metropolitan area of the United Kingdom were recruited randomly from within a stratified sampling frame and received a questionnaire-based interview (response rate: 68.1%). The questionnaire contained items and scales on demographic, psychological and health, and social characteristics, and a validated measure of loneliness that assesses both social and emotional loneliness. Of the respondents, 7.7% were found to be severely or very severely lonely, while another 38.3% were moderately lonely. Social and emotional loneliness shared 19.36% variance. Being male, being widowed, low well-being, low self-esteem, low-income comfort, low contact with family, low contact with friends, low activity, low perceived community integration, and receipt of community care were significant predictors of social loneliness (R=0.50, R2=0.25, F(18, 979)=18.17, psocial loneliness. Consequently, policy on loneliness in older people should be directed to developing a range of divergent intervention strategies if both emotional and social loneliness are to be reduced.

  5. Evidence for serial discontinuity in the fish community of a heavily impounded river

    Science.gov (United States)

    Miranda, Leandro E.; Dembkowski, D.J.

    2016-01-01

    In the Tennessee River, USA, we examined lengthwise patterns in fish community structure and species richness within and among nine reservoirs organized in sequence and connected through navigational locks. Within reservoirs, the riverine, transition and lacustrine zones supported distinct, although overlapping, nearshore fish assemblages; differences were also reflected in measures of species richness. Spatial patterns were most apparent for rheophilic species, which increased in species richness and representation upstream within each reservoir and downstream across the chain of reservoirs. This pattern resembled a sawtooth wave, with the amplitude of the wave peaking in the riverine zone below each dam, and progressively higher wave amplitude developing downstream in the reservoir chain. The observed sawtooth pattern supports the serial discontinuity concept in that the continuity of the riverine fish community is interrupted by the lacustrine conditions created behind each dam. Upstream within each reservoir, and downstream in the chain of reservoirs, habitat characteristics become more riverine. To promote sustainability of rheophilic fishes and maintain biodiversity in impounded rivers, conservation plans could emphasize maintenance and preservation of riverine environments of the reservoir's upper reaches, while remaining cognizant of the broader basin trends that provide opportunities for a lengthwise array of conservation and management policy. 

  6. Reports of evidence planting by police among a community-based sample of injection drug users in Bangkok, Thailand

    Directory of Open Access Journals (Sweden)

    Lai Calvin

    2009-10-01

    Full Text Available Abstract Background Drug policy in Thailand has relied heavily on law enforcement-based approaches. Qualitative reports indicate that police in Thailand have resorted to planting drugs on suspected drug users to extort money or provide grounds for arrest. The present study sought to describe the prevalence and factors associated with this form of evidence planting by police among injection drug users (IDU in Bangkok. Methods Multivariate logistic regression was used to identify factors associated with evidence planting of drugs by police among a community-based sample of IDU in Bangkok. We also examined the prevalence and average amount of money paid by IDU to police in order to avoid arrest. Results 252 IDU were recruited between July and August, 2008, among whom 66 (26.2% were female and the median age was 36.5 years. In total, 122 (48.4% participants reported having drugs planted on them by police. In multivariate analyses, this form of evidence planting was positively associated with midazolam use (Adjusted Odds Ratio [AOR] = 2.84; 95% Confidence Interval [CI]: 1.58 - 5.11, recent non-fatal overdose (AOR = 2.56; 95%CI: 1.40 - 4.66, syringe lending (AOR = 2.08; 95%CI: 1.19 - 3.66, and forced drug treatment (AOR = 1.88; 95%CI: 1.05 - 3.36. Among those who reported having drugs planted on them, 59 (48.3% paid police a bribe in order to avoid arrest. Conclusion A high proportion of community-recruited IDU participating in this study reported having drugs planted on them by police. Drug planting was found to be associated with numerous risk factors including syringe sharing and participation in government-run drug treatment programs. Immediate action should be taken to address this form of abuse of power reportedly used by police.

  7. Reports of evidence planting by police among a community-based sample of injection drug users in Bangkok, Thailand.

    Science.gov (United States)

    Fairbairn, Nadia; Kaplan, Karyn; Hayashi, Kanna; Suwannawong, Paisan; Lai, Calvin; Wood, Evan; Kerr, Thomas

    2009-10-07

    Drug policy in Thailand has relied heavily on law enforcement-based approaches. Qualitative reports indicate that police in Thailand have resorted to planting drugs on suspected drug users to extort money or provide grounds for arrest. The present study sought to describe the prevalence and factors associated with this form of evidence planting by police among injection drug users (IDU) in Bangkok. Multivariate logistic regression was used to identify factors associated with evidence planting of drugs by police among a community-based sample of IDU in Bangkok. We also examined the prevalence and average amount of money paid by IDU to police in order to avoid arrest. 252 IDU were recruited between July and August, 2008, among whom 66 (26.2%) were female and the median age was 36.5 years. In total, 122 (48.4%) participants reported having drugs planted on them by police. In multivariate analyses, this form of evidence planting was positively associated with midazolam use (Adjusted Odds Ratio [AOR] = 2.84; 95% Confidence Interval [CI]: 1.58 - 5.11), recent non-fatal overdose (AOR = 2.56; 95%CI: 1.40 - 4.66), syringe lending (AOR = 2.08; 95%CI: 1.19 - 3.66), and forced drug treatment (AOR = 1.88; 95%CI: 1.05 - 3.36). Among those who reported having drugs planted on them, 59 (48.3%) paid police a bribe in order to avoid arrest. A high proportion of community-recruited IDU participating in this study reported having drugs planted on them by police. Drug planting was found to be associated with numerous risk factors including syringe sharing and participation in government-run drug treatment programs. Immediate action should be taken to address this form of abuse of power reportedly used by police.

  8. Achieving Health Equity Through Community Engagement in Translating Evidence to Policy: The San Francisco Health Improvement Partnership, 2010-2016.

    Science.gov (United States)

    Grumbach, Kevin; Vargas, Roberto A; Fleisher, Paula; Aragón, Tomás J; Chung, Lisa; Chawla, Colleen; Yant, Abbie; Garcia, Estela R; Santiago, Amor; Lang, Perry L; Jones, Paula; Liu, Wylie; Schmidt, Laura A

    2017-03-23

    The San Francisco Health Improvement Partnership (SFHIP) promotes health equity by using a novel collective impact model that blends community engagement with evidence-to-policy translational science. The model involves diverse stakeholders, including ethnic-based community health equity coalitions, the local public health department, hospitals and health systems, a health sciences university, a school district, the faith community, and others sectors. We report on 3 SFHIP prevention initiatives: reducing consumption of sugar sweetened beverages (SSBs), regulating retail alcohol sales, and eliminating disparities in children's oral health. SFHIP is governed by a steering committee. Partnership working groups for each initiative collaborate to 1) develop and implement action plans emphasizing feasible, scalable, translational-science-informed interventions and 2) consider sustainability early in the planning process by including policy and structural interventions. Through SFHIP's efforts, San Francisco enacted ordinances regulating sale and advertising of SSBs and a ballot measure establishing a soda tax. Most San Francisco hospitals implemented or committed to implementing healthy-beverage policies that prohibited serving or selling SSBs. SFHIP helped prevent Starbucks and Taco Bell from receiving alcohol licenses in San Francisco and helped prevent state authorization of sale of powdered alcohol. SFHIP increased the number of primary care clinics providing fluoride varnish at routine well-child visits from 3 to 14 and acquired a state waiver to allow dental clinics to be paid for dental services delivered in schools. The SFHIP model of collective impact emphasizing community engagement and policy change accomplished many of its intermediate goals to create an environment promoting health and health equity.

  9. Whither voluntary communities of co-located patients in Vietnam? Empirical evidence from a 2016 medical survey dataset

    Directory of Open Access Journals (Sweden)

    Quan-Hoang Vuong

    2016-12-01

    Full Text Available Background: Empirical evidence on quality of life of poor patients falls short for policy-making in Vietnam. Financial burdens and isolation give rise to Vietnamese voluntary co-location clusters where patients seek to rely on each other. These communities, although important, have been under-researched. Increasingly, there are questions about their sustainability. Aim & Objectives: This study aims to identify factors that affect sustainability of such co-location clusters, seeking to measure the community prospect through critical determinants as seen by member patients. An in-depth analysis is expected to yield insights that help shape future policies contributing to improvement of healthcare systems.  Material & Method: A dataset containing responses from 336 patients living in four clusters in Hanoi was obtained from a survey during 2015Q4-2016Q1. The processing of data is performed using R 3.2.3, employing baseline category logit models (BCL. Coefficients are estimated to compute empirical probabilities. Results: 1 There is a 50% probability that a patient seeing his/her benefits as unsatisfactory views the community prospect as dim; 2 The more a patient contributes time/effort, the less he/she believes in future growth; 3 There is a 80.8% probability that a patient who makes a significant financial contribution and receives back in-kind benefits predicts no growth. Conclusion: Patients predict community growth when receiving what they need/expect. There exists a kind of “liquidity preference”. Only 14% and 32% make significant financial and labor contributions, respectively. There exists a “risk aversion” attitude, viewing contribution as certain while future benefits to be uncertain.

  10. Gender, social support, and well-being: Evidence from a Greek community sample

    Directory of Open Access Journals (Sweden)

    Konstantinos Kafetsios

    2007-12-01

    Full Text Available The importance of social support for psychological well-being has been aptly highlighted in epidemiological and psychological research. However, it is not clear from the existing research whether gender differences in structural (relationship status, network size, frequency of interactions with friends and functional (support satisfaction aspects of social support exist and -if they do- to what extent they affect males’ and females’ well-being. Hierarchical regression analyses of crossectional data from a Greek community sample showed that support satisfaction was an important predictor of well-being outcomes in males whereas several structural indicators were predictors of different well-being outcomes in females. Females’ anxiety, perceived stress, and loneliness were adversely affected by frequency of interaction with acquaintances. The results are discussed with regard to gender-role differences that may be underlying the social support effects on well-being, as well as related cultural values.

  11. First Evidence of an Important Organic Matter Trophic Pathway between Temperate Corals and Pelagic Microbial Communities.

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    J A Fonvielle

    Full Text Available Mucus, i.e., particulate and dissolved organic matter (POM, DOM released by corals, acts as an important energy carrier in tropical ecosystems, but little is known on its ecological role in temperate environments. This study assessed POM and DOM production by the temperate coral Cladocora caespitosa under different environmental conditions. The subsequent enzymatic degradation, growth of prokaryotes and virus-like particles (VLPs as well as changes in the structure of the prokaryotic communities were also monitored. C. caespitosa produced an important quantity of mucus, which varied according to the environmental conditions (from 37.8 to 67.75 nmol carbon h-1 cm-2, but remained higher or comparable to productions observed in tropical corals. It has an important nutritional value, as highlighted by the high content in dissolved nitrogen (50% to 90% of the organic matter released. Organic matter was rapidly degraded by prokaryotes' enzymatic activities, and due to its nitrogen content, aminopeptidase activity was 500 fold higher than the α-glucosidase activity. Prokaryotes, as well as VLPs, presented a rapid growth in the mucus, with prokaryote production rates as high as 0.31 μg h-1 L-1. Changes in bacterial and archaeal communities were observed in the ageing mucus and between mucus and the water column, suggesting a clear impact of mucus on microorganism diversity. Overall, our results show that the organic matter released by temperate corals, such as C. caespitosa, which can form reef structures in the Mediterranean Sea, stimulates microbial activity and thereby functions as a significant carbon and nitrogen supplier to the microbial loop.

  12. Community-wide job loss and teenage fertility: evidence from North Carolina.

    Science.gov (United States)

    Ananat, Elizabeth Oltmans; Gassman-Pines, Anna; Gibson-Davis, Christina

    2013-12-01

    Using North Carolina data for the period 1990-2010, we estimate the effects of economic downturns on the birthrates of 15- to 19-year-olds, using county-level business closings and layoffs as a plausibly exogenous source of variation in the strength of the local economy. We find little effect of job losses on the white teen birthrate. For black teens, however, job losses to 1 % of the working-age population decrease the birthrate by around 2 %. Birth declines start five months after the job loss and then last for more than one year. Linking the timing of job losses and conceptions suggests that black teen births decline because of increased terminations and perhaps also because of changes in prepregnancy behaviors. National data on risk behaviors also provide evidence that black teens reduce sexual activity and increase contraception use in response to job losses. Job losses seven to nine months after conception do not affect teen birthrates, indicating that teens do not anticipate job losses and lending confidence that job losses are "shocks" that can be viewed as quasi-experimental variation. We also find evidence that relatively advantaged black teens disproportionately abort after job losses, implying that the average child born to a black teen in the wake of job loss is relatively more disadvantaged.

  13. Moving from tacit knowledge to evidence-based practice: the Kaiser Permanente community partners study.

    Science.gov (United States)

    Enguídanos, Susan M; Jamison, Paula M

    2006-01-01

    For several decades both medical and social work practices have failed to consistently include measures to determine the effectiveness of their care and practices. This is especially true of care management practices. With the growth and aging of our population, this is of particular concern when many of our resources for older adults are channeled into services such as geriatric care management. This article describes a randomized controlled trial that tested the effectiveness of four levels of geriatric care management. Results from this study did not support the tacit knowledge of the clinicians in terms of the effectiveness of their practices. This article describes the study methods and results, and how evidence from this study impacted subsequent service provided by geriatric care managers.

  14. Association between virtues and posttraumatic growth: preliminary evidence from a Chinese community sample after earthquakes

    Directory of Open Access Journals (Sweden)

    Wenjie Duan

    2015-04-01

    Full Text Available Objective. Relationship, vitality, and conscientiousness are three fundamental virtues that have been recently identified as important individual differences to health, well being, and positive development. This cross-sectional study attempted to explore the relationship between the three constructs and post-traumatic growth (PTG in three directions, including indirect trauma samples without post-traumatic stress disorder (PTSD, direct trauma samples without PTSD, and direct trauma samples with PTSD.Methods. A total of 340 community participants from Sichuan Province, Mainland China involved in the study, most of which experienced Wenchuan and Lushan Earthquake. Participants were required to complete the self-reported questionnaire packages at one time point for obtaining their scores on virtues (Chinese Virtues Questionnaire, PTSD (PTSD Checklist-Specific, and PTG (Post-traumatic Growth Inventory-Chinese.Results. Significant and positive correlations between the three virtues and PTG were identified (r = .39–.56; p < .01. Further regression analysis by stepwise method reveled that: in the indirect trauma samples, vitality explained 32% variance of PTG. In reference to the direct trauma sample without PTSD, both relationship and conscientiousness explained 32% variance of PTG, whereas in the direct trauma sample with PTSD, only conscientiousness accounted for 31% the variance in PTG.Conclusion.This cross-sectional investigation partly revealed the roles of different virtues in trauma context. Findings suggest important implications for strengths-based treatment.

  15. Do national drug policies influence antiretroviral drug prices? Evidence from the Southern African Development community.

    Science.gov (United States)

    Liu, Yao; Galárraga, Omar

    2017-03-01

    The efficacy of low- and middle-income countries’ (LMIC) national drug policies in managing antiretroviral (ARV) pharmaceutical prices is not well understood. Though ARV drug prices have been declining in LMIC over the past decade, little research has been done on the role of their national drug policies. This study aims to (i) analyse global ARV prices from 2004 to 2013 and (ii) examine the relationship of national drug policies to ARV prices. Analysis of ARV drug prices utilized data from the Global Price Reporting Mechanism from the World Health Organization (WHO). Ten of the most common ARV drugs (first-line and second-line) were selected. National drug policies were also assessed for 12 countries in the South African Development Community (SADC), which self-reported their policies through WHO surveys. The best predictor of ARV drug price was generic status—the generic versions of 8 out of 10 ARV drugs were priced lower than branded versions. However, other factors such as transaction volume, HIV prevalence, national drug policies and PEPFAR/CHAI involvement were either not associated with ARV drug price or were not consistent predictors of price across different ARV drugs. In the context of emerging international trade agreements, which aim to strengthen patent protections internationally and potentially delay the sale of generic drugs in LMIC, this study shines a spotlight on the importance of generic drugs in controlling ARV prices. Further research is needed to understand the impact of national drug policies on ARV prices.

  16. Further evidence of community education effects on fertility in sub-Saharan Africa

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    Øystein Kravdal

    2012-11-01

    Full Text Available BACKGROUND Earlier investigations have shown that a woman's chance of having a child, or various proximate determinants of her fertility, are influenced by the socioeconomic resources in the community in which she lives, net of her own resources. METHODS This study, which is based on DHS surveys from 28 countries in sub-Saharan Africa, adds to the knowledge about this issue. With a focus on first and higher-order birth rates, four specific questions are addressed. RESULTS One result is that the effects of the average education in the census enumeration area in which a woman lives, net of her own education, have remained stable or become stronger over the last decade. Second, these effects are most pronounced among women who score high on indicators of socioeconomic development, which suggests that they may become further strengthened. Third, effects even appear when a fixed-effects approach - based on data from two DHS surveys with GPS coordinates in each country - is employed to control for unobserved constant characteristics of units at a slightly higher level than the census enumeration area. Fourth, local processes seem to be particularly important: the education among women in the province or nearest census enumeration areas does not have a similar fertility-depressing effect.

  17. Resilience to adult psychopathology following childhood maltreatment: evidence from a community sample.

    Science.gov (United States)

    Collishaw, Stephan; Pickles, Andrew; Messer, Julie; Rutter, Michael; Shearer, Christina; Maughan, Barbara

    2007-03-01

    Child abuse is an important risk for adult psychiatric morbidity. However, not all maltreated children experience mental health problems as adults. The aims of the present study were to address the extent of resilience to adult psychopathology in a representative community sample, and to explore predictors of a good prognosis. Data are drawn from a follow-up of the Isle of Wight study, an epidemiological sample assessed in adolescence and at midlife. Ratings of psychiatric disorder, peer relationships and family functioning were made in adolescence; adult assessments included a lifetime psychiatric history, personality and social functioning assessments, and retrospective reports of childhood sexual and physical abuse. Ten percent of individuals reported repeated or severe physical or sexual abuse in childhood. Prospective measures revealed increased rates of adolescent psychiatric disorders in this group. Rates of adult psychopathology were also high. A substantial minority of abused individuals reported no mental health problems in adult life. Resilience of this kind was related to perceived parental care, adolescent peer relationships, the quality of adult love relationships, and personality style. Good quality relationships across childhood, adolescence and adulthood appear especially important for adult psychological well being in the context of childhood abuse.

  18. Pedagogical Scholarship in Public Health: A Call for Cultivating Learning Communities to Support Evidence-Based Education.

    Science.gov (United States)

    Merzel, Cheryl; Halkitis, Perry; Healton, Cheryl

    Public health education is experiencing record growth and transformation. The current emphasis on learning outcomes necessitates attention to creating and evaluating the best curricula and learning methods for helping public health students develop public health competencies. Schools and programs of public health would benefit from active engagement in pedagogical research and additional platforms to support dissemination and implementation of educational research findings. We reviewed current avenues for sharing public health educational research, curricula, and best teaching practices; we identified useful models from other health professions; and we offered suggestions for how the field of public health education can develop communities of learning devoted to supporting pedagogy. Our goal was to help advance an agenda of innovative evidence-based public health education, enabling schools and programs of public health to evaluate and measure success in meeting the current and future needs of the public health profession.

  19. Evidence for hybridization and introgression within a species-rich oak (Quercus spp. community

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    Finkeldey Reiner

    2007-11-01

    Full Text Available Abstract Background Analysis of interspecific gene flow is crucial for the understanding of speciation processes and maintenance of species integrity. Oaks (genus Quercus, Fagaceae are among the model species for the study of hybridization. Natural co-occurrence of four closely related oak species is a very rare case in the temperate forests of Europe. We used both morphological characters and genetic markers to characterize hybridization in a natural community situated in west-central Romania and which consists of Quercus robur, Q. petraea, Q. pubescens, and Q. frainetto, respectively. Results On the basis of pubescence and leaf morphological characters ~94% of the sampled individuals were assigned to pure species. Only 16 (~6% individual trees exhibited intermediate morphologies or a combination of characters of different species. Four chloroplast DNA haplotypes were identified in the study area. The distribution of haplotypes within the white oak complex showed substantial differences among species. However, the most common haplotypes were present in all four species. Furthermore, based on a set of 7 isozyme and 6 microsatellite markers and using a Bayesian admixture analysis without any a priori information on morphology we found that four genetic clusters best fit the data. There was a very good correspondence of each species with one of the inferred genetic clusters. The estimated introgression level varied markedly between pairs of species ranging from 1.7% between Q. robur and Q. frainetto to 16.2% between Q. pubescens and Q. frainetto. Only nine individuals (3.4% appeared to be first-generation hybrids. Conclusion Our data indicate that natural hybridization has occurred at relatively low rates. The different levels of gene flow among species might be explained by differences in flowering time and spatial position within the stand. In addition, a partial congruence between phenotypically and genetically intermediate individuals was

  20. Economic institutions and economic growth: Empirical evidence from the Economic Community of West African States

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    Lazarus Z. Wanjuu

    2017-12-01

    Background: Economic institutions are considered as the fundamental cause of economic growth. Economic institutions affect economic growth through allocation of resources like physical and human capital. Unfortunately, there is dearth of empirical studies showing the impact of economic institutions on growth of the Economic Community of West African States (ECOWAS. Aim: This study investigates the impact of economic institutions on economic growth of the ECOWAS. Setting and method: The study applied cause and effect relationship. The study used econometric research techniques of unit root and co-integration tests to establish the time series properties of the data; the vector error correction and co-integration regression models to estimate the population parameters. The research data comprised data obtained from the United Nations Conference on Trade and Development (UNCTAD, the Transparency International (TI and Heritage Foundation databases. The variables employed were the real gross domestic product (GDP per capita (RGDPPC, corruption perception index (CPI, property rights protection (PROPRGT, private investment per capita (INVESPC, government expenditure per capita (GOEXPPC and trade openness (TRAOPN. Results: The results of the data analysed showed that economic institutions represented by the property rights index engender RGDPPC growth in ECOWAS. The CPI could not stimulate RGDPPC growth in ECOWAS. The results also show that all the other variables stimulated growth except trade openness. Conclusion: The study concludes that good economic institutions, private investments, and government intervention by providing security, economic and social infrastructural facilities are conducive for economic growth in the ECOWAS region. The study recommended that more efforts be made at curbing corruption in the region

  1. Factors that distinguish aggression toward animals from other antisocial behaviors: Evidence from a community sample.

    Science.gov (United States)

    Alleyne, Emma; Parfitt, Charlotte

    2018-05-25

    Animal cruelty is a form of passive and active aggression that is largely undocumented and unreported. Given that animals are voiceless victims, we have to rely on witnesses and frontline staff (e.g., veterinarians) to report incidents of abuse, which suggests the number of convicted animal abusers is an under-representation of actual perpetrators. The primary aim of the current study was to identify the static and dynamic factors that distinguish animal abusers from non-abuse offenders (i.e., individuals who self-reported antisocial behavior, but not animal abuse), and non-offenders (i.e., individuals who have not engaged in any antisocial behavior) in a community sample. The secondary aim was to identify the potential pathways that distinguish animal abuse perpetration from other types of antisocial behavior. Three hundred and eighty-four participants took part in this retrospective, correlational study. We found that animal abusers share similar socio-demographic characteristics to other offenders but are distinct in their exposure to animal harm/killing during childhood. Low animal-oriented empathy and low self-esteem distinguished animal abusers from non-abuse offenders when controlling for confound variables and other psychological characteristics. We also found that low animal-oriented empathy mediated the relationship between childhood exposure to animal killing and animal abuse perpetration, and that this relationship was stronger among participants with anger regulation issues. This is the first study to examine similarities and differences between animal abusers, non-abuse offenders, and non-offenders on socio-demographic and psychological characteristics. The findings highlight potential treatment targets that are unique to animal abusers with implications for prevention and intervention strategies. © 2018 Wiley Periodicals, Inc.

  2. Community capacity to acquire, assess, adapt, and apply research evidence: a survey of Ontario's HIV/AIDS sector

    Directory of Open Access Journals (Sweden)

    Rourke Sean B

    2011-05-01

    Full Text Available Abstract Background Community-based organizations (CBOs are important stakeholders in health systems and are increasingly called upon to use research evidence to inform their advocacy, program planning, and service delivery. To better support CBOs to find and use research evidence, we sought to assess the capacity of CBOs in the HIV/AIDS sector to acquire, assess, adapt, and apply research evidence in their work. Methods We invited executive directors of HIV/AIDS CBOs in Ontario, Canada (n = 51 to complete the Canadian Health Services Research Foundation's "Is Research Working for You?" survey. Findings Based on responses from 25 organizations that collectively provide services to approximately 32,000 clients per year with 290 full-time equivalent staff, we found organizational capacity to acquire, assess, adapt, and apply research evidence to be low. CBO strengths include supporting a culture that rewards flexibility and quality improvement, exchanging information within their organization, and ensuring that their decision-making processes have a place for research. However, CBO Executive Directors indicated that they lacked the skills, time, resources, incentives, and links with experts to acquire research, assess its quality and reliability, and summarize it in a user-friendly way. Conclusion Given the limited capacity to find and use research evidence, we recommend a capacity-building strategy for HIV/AIDS CBOs that focuses on providing the tools, resources, and skills needed to more consistently acquire, assess, adapt, and apply research evidence. Such a strategy may be appropriate in other sectors and jurisdictions as well given that CBO Executive Directors in the HIV/AIDS sector in Ontario report low capacity despite being in the enviable position of having stable government infrastructure in place to support them, benefiting from long-standing investment in capacity building, and being part of an active provincial network. CBOs in other

  3. Testing evidence routine practice: Using an implementation framework to embed a clinically proven asthma service in Australian community pharmacy.

    Science.gov (United States)

    Fuller, Joanne M; Saini, Bandana; Bosnic-Anticevich, Sinthia; Garcia Cardenas, Victoria; Benrimoj, Shalom I; Armour, Carol

    Community pharmacists are well placed and evidence clearly demonstrates that they can be suitably trained to deliver professional services that improve the management of asthma patients in clinical, economic and humanistic terms. However the gap between this evidence and practice reality remains wide. In this study we measure the implementation process as well as the service benefits of an asthma service model. Using an effectiveness-implementation hybrid design, a defined implementation process (progression from Exploration through Preparation and Testing to Operation stages) supporting an asthma service (promoting asthma control and inhaler technique) was tested in 17 community pharmacies across metropolitan Sydney. Seven pharmacies reached the Operation stage of implementation. Eight pharmacies reached the Testing stage of implementation and two pharmacies did not progress beyond the Preparation stage of implementation. A total of 128 patients were enrolled in the asthma service with 110 patients remaining enrolled at the close of the study. Asthma control showed a positive trend throughout the service with the overall proportion of patients with 'poor' asthma control at baseline decreasing from 72% to 57% at study close. There was a statistically significant increase in the proportion of patients with correct inhaler technique from 12% at Baseline (Visit 1) to 33% at Visit 2 and 57% at study close. Implementation of the asthma service varied across pharmacies. Different strategies specific to practice sites at different stages of the implementation model may result in greater uptake of professional services. The asthma service led to improved patient outcomes overall with a positive trend in asthma control and significant change in inhaler technique. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Implementing evidence-based practice in community mental health agencies: a multiple stakeholder analysis.

    Science.gov (United States)

    Aarons, Gregory A; Wells, Rebecca S; Zagursky, Karen; Fettes, Danielle L; Palinkas, Lawrence A

    2009-11-01

    We sought to identify factors believed to facilitate or hinder evidence-based practice (EBP) implementation in public mental health service systems as a step in developing theory to be tested in future studies. Focusing across levels of an entire large public sector mental health service system for youths, we engaged participants from 6 stakeholder groups: county officials, agency directors, program managers, clinical staff, administrative staff, and consumers. Participants generated 105 unique statements identifying implementation barriers and facilitators. Participants rated each statement on importance and changeability (i.e., the degree to which each barrier or facilitator is considered changeable). Data analyses distilled statements into 14 factors or dimensions. Descriptive analyses suggest that perceptions of importance and changeability varied across stakeholder groups. Implementation of EBP is a complex process. Cross-system-level approaches are needed to bring divergent and convergent perspectives to light. Examples include agency and program directors facilitating EBP implementation by supporting staff, actively sharing information with policymakers and administrators about EBP effectiveness and fit with clients' needs and preferences, and helping clinicians to present and deliver EBPs and address consumer concerns.

  5. Application of mixed-methods design in community-engaged research: Lessons learned from an evidence-based intervention for Latinos with chronic illness and minor depression.

    Science.gov (United States)

    Aguado Loi, Claudia X; Alfonso, Moya L; Chan, Isabella; Anderson, Kelsey; Tyson, Dinorah Dina Martinez; Gonzales, Junius; Corvin, Jaime

    2017-08-01

    The purpose of this paper is to share lessons learned from a collaborative, community-informed mixed-methods approach to adapting an evidence-based intervention to meet the needs of Latinos with chronic disease and minor depression and their family members. Mixed-methods informed by community-based participatory research (CBPR) were employed to triangulate multiple stakeholders' perceptions of facilitators and barriers of implementing the adapted intervention in community settings. Community partners provided an insider perspective to overcome methodological challenges. The study's community informed mixed-methods: research approach offered advantages to a single research methodology by expanding or confirming research findings and engaging multiple stakeholders in data collection. This approach also allowed community partners to collaborate with academic partners in key research decisions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Enhancing capacity among faith-based organizations to implement evidence-based cancer control programs: a community-engaged approach.

    Science.gov (United States)

    Leyva, Bryan; Allen, Jennifer D; Ospino, Hosffman; Tom, Laura S; Negrón, Rosalyn; Buesa, Richard; Torres, Maria Idalí

    2017-09-01

    Evidence-based interventions (EBIs) to promote cancer control among Latinos have proliferated in recent years, though adoption and implementation of these interventions by faith-based organizations (FBOs) is limited. Capacity building may be one strategy to promote implementation. In this qualitative study, 18 community key informants were interviewed to (a) understand existing capacity for health programming among Catholic parishes, (b) characterize parishes' resource gaps and capacity-building needs implementing cancer control EBIs, and (c) elucidate strategies for delivering capacity-building assistance to parishes to facilitate implementation of EBIs. Semi-structured qualitative interviews were conducted. Key informants concurred about the capacity of Catholic parishes to deliver health programs, and described attributes of parishes that make them strong partners in health promotion initiatives, including a mission to address physical and mental health, outreach to marginalized groups, altruism among members, and existing engagement in health programming. However, resource gaps and capacity building needs were also identified. Specific recommendations participants made about how existing resources might be leveraged to address challenges include to: establish parish wellness committees; provide "hands-on" learning opportunities for parishioners to gain program planning skills; offer continuous, tailored, on-site technical assistance; facilitate relationships between parishes and community resources; and provide financial support for parishes. Leveraging parishes' existing resources and addressing their implementation needs may improve adoption of cancer control EBIs.

  7. Cocaine in surface waters: a new evidence-based tool to monitor community drug abuse

    Science.gov (United States)

    Zuccato, Ettore; Chiabrando, Chiara; Castiglioni, Sara; Calamari, Davide; Bagnati, Renzo; Schiarea, Silvia; Fanelli, Roberto

    2005-01-01

    Background Cocaine use seems to be increasing in some urban areas worldwide, but it is not straightforward to determine the real extent of this phenomenon. Trends in drug abuse are currently estimated indirectly, mainly by large-scale social, medical, and crime statistics that may be biased or too generic. We thus tested a more direct approach based on 'field' evidence of cocaine use by the general population. Methods Cocaine and its main urinary metabolite (benzoylecgonine, BE) were measured by mass spectrometry in water samples collected from the River Po and urban waste water treatment plants of medium-size Italian cities. Drug concentration, water flow rate, and population at each site were used to estimate local cocaine consumption. Results We showed that cocaine and BE are present, and measurable, in surface waters of populated areas. The largest Italian river, the Po, with a five-million people catchment basin, steadily carried the equivalent of about 4 kg cocaine per day. This would imply an average daily use of at least 27 ± 5 doses (100 mg each) for every 1000 young adults, an estimate that greatly exceeds official national figures. Data from waste water treatment plants serving medium-size Italian cities were consistent with this figure. Conclusion This paper shows for the first time that an illicit drug, cocaine, is present in the aquatic environment, namely untreated urban waste water and a major river. We used environmental cocaine levels for estimating collective consumption of the drug, an approach with the unique potential ability to monitor local drug abuse trends in real time, while preserving the anonymity of individuals. The method tested here – in principle extendable to other drugs of abuse – might be further refined to become a standardized, objective tool for monitoring drug abuse. PMID:16083497

  8. Cocaine in surface waters: a new evidence-based tool to monitor community drug abuse

    Directory of Open Access Journals (Sweden)

    Bagnati Renzo

    2005-08-01

    Full Text Available Abstract Background Cocaine use seems to be increasing in some urban areas worldwide, but it is not straightforward to determine the real extent of this phenomenon. Trends in drug abuse are currently estimated indirectly, mainly by large-scale social, medical, and crime statistics that may be biased or too generic. We thus tested a more direct approach based on 'field' evidence of cocaine use by the general population. Methods Cocaine and its main urinary metabolite (benzoylecgonine, BE were measured by mass spectrometry in water samples collected from the River Po and urban waste water treatment plants of medium-size Italian cities. Drug concentration, water flow rate, and population at each site were used to estimate local cocaine consumption. Results We showed that cocaine and BE are present, and measurable, in surface waters of populated areas. The largest Italian river, the Po, with a five-million people catchment basin, steadily carried the equivalent of about 4 kg cocaine per day. This would imply an average daily use of at least 27 ± 5 doses (100 mg each for every 1000 young adults, an estimate that greatly exceeds official national figures. Data from waste water treatment plants serving medium-size Italian cities were consistent with this figure. Conclusion This paper shows for the first time that an illicit drug, cocaine, is present in the aquatic environment, namely untreated urban waste water and a major river. We used environmental cocaine levels for estimating collective consumption of the drug, an approach with the unique potential ability to monitor local drug abuse trends in real time, while preserving the anonymity of individuals. The method tested here – in principle extendable to other drugs of abuse – might be further refined to become a standardized, objective tool for monitoring drug abuse.

  9. Music training improves speech-in-noise perception: Longitudinal evidence from a community-based music program.

    Science.gov (United States)

    Slater, Jessica; Skoe, Erika; Strait, Dana L; O'Connell, Samantha; Thompson, Elaine; Kraus, Nina

    2015-09-15

    Music training may strengthen auditory skills that help children not only in musical performance but in everyday communication. Comparisons of musicians and non-musicians across the lifespan have provided some evidence for a "musician advantage" in understanding speech in noise, although reports have been mixed. Controlled longitudinal studies are essential to disentangle effects of training from pre-existing differences, and to determine how much music training is necessary to confer benefits. We followed a cohort of elementary school children for 2 years, assessing their ability to perceive speech in noise before and after musical training. After the initial assessment, participants were randomly assigned to one of two groups: one group began music training right away and completed 2 years of training, while the second group waited a year and then received 1 year of music training. Outcomes provide the first longitudinal evidence that speech-in-noise perception improves after 2 years of group music training. The children were enrolled in an established and successful community-based music program and followed the standard curriculum, therefore these findings provide an important link between laboratory-based research and real-world assessment of the impact of music training on everyday communication skills. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Behavior change for newborn survival in resource-poor community settings: bridging the gap between evidence and impact.

    Science.gov (United States)

    Kumar, Vishwajeet; Kumar, Aarti; Darmstadt, Gary L

    2010-12-01

    Despite an established evidence base of simple, affordable, and low-cost interventions to avert neonatal deaths, global progress in reducing neonatal mortality has stagnated in recent years. Under-recognition of the critical role played by behavior change in ensuring adoption and dissemination of innovations is a major reason for this gap between evidence and impact. A general lack of understanding of the mechanisms underlying behavior change at a population level coupled with an under-appreciation of the sociocultural context of newborn care behaviors has underscored ill-informed approaches towards behavior change that have met with limited success. This article draws upon available evidence from prevention-oriented, community-based newborn survival trials to derive insights into the role of behavior change in neonatal mortality reduction. We propose a simple model, the intervention-causation pathway, to explain the pathway through which behavior change interventions may lead to reductions in mortality. Further, we explore the unique nature of newborn care behaviors and their underlying sociocultural context, along with state-of-the-art advances in social, behavioral, and management sciences. These principles form the basis of the behavior change management framework that has successfully guided intervention design and implementation, leading to high impact on neonatal mortality reduction, in Uttar Pradesh, India. We describe how the behavior change management framework can be applied to inform the design of theoretically and empirically sound behavior change interventions with greater precision, predictability and pace towards reduction in neonatal mortality. We finally touch upon key overarching principles that should guide intervention execution for maximal impact. Copyright © 2010 Elsevier Inc. All rights reserved.

  11. Frailty as a Risk Factor for Falls Among Community Dwelling People: Evidence From a Meta-Analysis.

    Science.gov (United States)

    Cheng, Mei-Hsun; Chang, Shu-Fang

    2017-09-01

    likely to experience recurrent falls. In addition, the evidence-based study indicated that once older people enter the prefrail stage, they are likely to experience falls. Therefore, older adults should be evaluated for the possibility of geriatric syndromes such as frailty, which may be addressed to reduce the risk for bone fractures and death. Professional nurses should use frailty assessment indicators as early as possible to evaluate the possibility of frailty in community-dwelling older people. Meanwhile, effective frailty prevention strategies should be applied to prevent frailty, thereby reducing the incidence of falls and enhancing older persons' quality of life. © 2017 Sigma Theta Tau International.

  12. Analysis of Hospital Community Benefit Expenditures’ Alignment With Community Health Needs: Evidence From a National Investigation of Tax-Exempt Hospitals

    Science.gov (United States)

    Young, Gary J.; Daniel Lee, Shoou-Yih; Song, Paula H.; Alexander, Jeffrey A.

    2015-01-01

    Objectives. We investigated whether federally tax-exempt hospitals consider community health needs when deciding how much and what types of community benefits to provide. Methods. Using 2009 data from hospital tax filings to the Internal Revenue Service and the 2010 County Health Rankings, we employed both univariate and multivariate analyses to examine the relationship between community health needs and the types and levels of hospitals’ community benefit expenditures. The study sample included 1522 private, tax-exempt hospitals throughout the United States. Results. We found some patterns between community health needs and hospitals’ expenditures on community benefits. Hospitals located in communities with greater health needs spent more as a percentage of their operating budgets on benefits directly related to patient care. By contrast, spending on community health improvement initiatives was unrelated to community health needs. Conclusions. Important opportunities exist for tax-exempt hospitals to improve the alignment between their community benefit activities and the health needs of the community they serve. The Affordable Care Act requirement that hospitals conduct periodic community health needs assessments may be a first step in this direction. PMID:25790412

  13. Prevention of falls and fall-related injuries in community-dwelling seniors: an evidence-based analysis.

    Science.gov (United States)

    2008-01-01

    In early August 2007, the Medical Advisory Secretariat began work on the Aging in the Community project, an evidence-based review of the literature surrounding healthy aging in the community. The Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the ministry's newly released Aging at Home Strategy.After a broad literature review and consultation with experts, the secretariat identified 4 key areas that strongly predict an elderly person's transition from independent community living to a long-term care home. Evidence-based analyses have been prepared for each of these 4 areas: falls and fall-related injuries, urinary incontinence, dementia, and social isolation. For the first area, falls and fall-related injuries, an economic model is described in a separate report.Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html, to review these titles within the Aging in the Community series.AGING IN THE COMMUNITY: Summary of Evidence-Based AnalysesPrevention of Falls and Fall-Related Injuries in Community-Dwelling Seniors: An Evidence-Based AnalysisBehavioural Interventions for Urinary Incontinence in Community-Dwelling Seniors: An Evidence-Based AnalysisCaregiver- and Patient-Directed Interventions for Dementia: An Evidence-Based AnalysisSocial Isolation in Community-Dwelling Seniors: An Evidence-Based AnalysisThe Falls/Fractures Economic Model in Ontario Residents Aged 65 Years and Over (FEMOR) OBJECTIVE: To identify interventions that may be effective in reducing the probability of an elderly person's falling and/or sustaining a fall-related injury. Although estimates of fall rates vary widely based on the location, age, and living arrangements of the elderly population, it is estimated that each year approximately 30% of community-dwelling individuals aged 65 and older, and 50% of those aged 85

  14. Hydrological, ecological, land use, economic, and sociocultural evidence for resilience of traditional irrigation communities in New Mexico, USA

    Science.gov (United States)

    Fernald, A.; Guldan, S.; Boykin, K.; Cibils, A.; Gonzales, M.; Hurd, B. H.; Lopez, S.; Ochoa, C. G.; Ortiz, M.; Rivera, J.; Rodriguez, S.; Steele, C. M.

    2014-02-01

    Southwestern US irrigated landscapes are facing upheaval due to climate change-induced water scarcity and economic change-induced land use conversion. Clues to community longevity are found in the traditionally irrigated valleys of northern New Mexico. Human systems have interacted with hydrologic processes over the last 400 yr in river fed irrigated valleys to create linked systems. In this study, we asked if concurrent data from multiple disciplines show that human adapted hydrologic and socioeconomic systems have created conditions for resilience. We identify and describe several areas of resilience: hydrological, ecological, land use, economic, and sociocultural. We found that there are multiple hydrologic benefits of the water seepage from the traditional irrigation systems; it recharges groundwater that recharges rivers, supports threatened biodiversity by maintaining riparian vegetation, and ameliorates impacts of climate change by prolonging streamflow hydrographs. In terms of land use and economics, place-based adaptability manifests itself in transformations of irrigation infrastructure and specific animal and crop systems; as grazing has diminished over time on public land watersheds, it has increased on irrigated valley pastures while outside income allows irrigators to retain their land. Sociocultural evidence shows that traditional local knowledge about the hydrosocial cycle of acequia operations is a key factor in acequia resilience. When irrigators are confronted with unexpected disturbances or changing climate that affect water supply, they adapt specific practices while maintaining community cohesion. Our ongoing work will quantify the multiple disciplinary components of these systems, translate them into a common language of causal loop diagrams, and model future scenarios to identify thresholds and tipping points of sustainability. Early indications are that these systems are not immune to upheaval, but have astonishing resilience.

  15. Health conditions in people with spinal cord injury: Contemporary evidence from a population-based community survey in Switzerland.

    Science.gov (United States)

    Brinkhof, Martin W G; Al-Khodairy, Abdul; Eriks-Hoogland, Inge; Fekete, Christine; Hinrichs, Timo; Hund-Georgiadis, Margret; Meier, Sonja; Scheel-Sailer, Anke; Schubert, Martin; Reinhardt, Jan D

    2016-02-01

    Health conditions in people with spinal cord injury are major determinants for disability, reduced well-being, and mortality. However, population-based evidence on the prevalence and treatment of health conditions in people with spinal cord injury is scarce. To investigate health conditions in Swiss residents with spinal cord injury, specifically to analyse their prevalence, severity, co-occurrence, and treatment. Cross-sectional data (n = 1,549) from the community survey of the Swiss Spinal Cord Injury (SwiSCI) cohort study, including Swiss residents with spinal cord injury aged over 16 years, were analysed. Nineteen health conditions and their self-reported treatment were assessed with the spinal cord injury Secondary Conditions Scale and the Self-Administered Comorbidity Questionnaire. Prevalence and severity were compared across demographics and spinal cord injury characteristics. Co-occurrence of health conditions was examined using a binary non-metric dissimilarity measure and multi-dimensional scaling. Treatment rates were also examined. Number of concurrent health conditions was high (median 7; interquartile range 4-9; most frequent: spasticity, chronic pain, sexual dysfunction). Prevalence of health conditions increased with age and was higher in non-traumatic compared with traumatic spinal cord injury. Spinal cord injury specific conditions co-occurred. Relative frequencies of treatment were low (median 44%, interquartile range 25-64%), even for significant or chronic problems. A high prevalence of multimorbidity was found in community-dwelling persons with spinal cord injury. Treatment for some highly prevalent health conditions was infrequent.

  16. How does context influence performance of community health workers in low- and middle-income countries? Evidence from the literature.

    Science.gov (United States)

    Kok, Maryse C; Kane, Sumit S; Tulloch, Olivia; Ormel, Hermen; Theobald, Sally; Dieleman, Marjolein; Taegtmeyer, Miriam; Broerse, Jacqueline E W; de Koning, Korrie A M

    2015-03-07

    Community health workers (CHWs) are increasingly recognized as an integral component of the health workforce needed to achieve public health goals in low- and middle-income countries (LMICs). Many factors intersect to influence CHW performance. A systematic review with a narrative analysis was conducted to identify contextual factors influencing performance of CHWs. We searched six databases for quantitative, qualitative, and mixed-methods studies that included CHWs working in promotional, preventive or curative primary health care services in LMICs. We differentiated CHW performance outcome measures at two levels: CHW level and end-user level. Ninety-four studies met the inclusion criteria and were double read to extract data relevant to the context of CHW programmes. Thematic coding was conducted and evidence on five main categories of contextual factors influencing CHW performance was synthesized. Few studies had the influence of contextual factors on CHW performance as their primary research focus. Contextual factors related to community (most prominently), economy, environment, and health system policy and practice were found to influence CHW performance. Socio-cultural factors (including gender norms and values and disease related stigma), safety and security and education and knowledge level of the target group were community factors that influenced CHW performance. Existence of a CHW policy, human resource policy legislation related to CHWs and political commitment were found to be influencing factors within the health system policy context. Health system practice factors included health service functionality, human resources provisions, level of decision-making, costs of health services, and the governance and coordination structure. All contextual factors can interact to shape CHW performance and affect the performance of CHW interventions or programmes. Research on CHW programmes often does not capture or explicitly discuss the context in which CHW

  17. Evidence of a high-Andean, mid-Holocene plant community: An ancient DNA analysis of glacially preserved remains.

    Science.gov (United States)

    Gould, Billie A; León, Blanca; Buffen, Aron M; Thompson, Lonnie G

    2010-09-01

    Around the world, tropical glaciers and ice caps are retreating at unprecedented rates because of climate change. In at least one location, along the margin of the Quelccaya Ice Cap in southeastern Peru, ancient plant remains have been continually uncovered since 2002. We used genetic analysis to identify plants that existed at these sites during the mid-Holocene. • We examined remains between 4576 and 5222 yr old, using PCR amplification, cloning, and sequencing of a fragment of the chloroplast trnL intron. We then matched these sequences to sequences in GenBank. • We found evidence of at least five taxa characteristic of wetlands, which occur primarily at lower elevations in the region today. • A diverse community most likely existed at these locations the last time they were ice-free and thus has the potential to reestablish with time. This is the first genetic analysis of vegetation uncovered by receding glacial ice, and it may become one of many as ancient plant materials are newly uncovered in a changing climate.

  18. Serological Evidence of Hantavirus Infection in Apparently Healthy People from Rural and Slum Communities in Southern Chile

    Directory of Open Access Journals (Sweden)

    Claudia Muñoz-Zanzi

    2015-04-01

    Full Text Available Hantavirus disease in America has been recognizable because of its rapid progression in clinical cases, occurrence in previously healthy young adults, and high case fatality rate. Hantavirus disease has been proposed now to define the diversity of clinical manifestations. Since 1995, a total of 902 cases of hantavirus pulmonary syndrome have been reported in Chile, caused by Andes virus (ANDV, with overall fatality of 32%. This report describes the sero-epidemiology of hantavirus in apparently healthy people in rural and urban slum communities from southern Chile. Ten of 934 samples yielded a positive result resulting in a seroprevalence of 1.07% (95% confidence intervals: 0.05%–2.0%. A higher proportion of positive samples was found among individuals from rural villages (1.3% and slums (1.5% compared with farms (0.5%. Seropositivity was associated with age (p = 0.011, low education level (p = 0.006 and occupations linked to the household (homemaker, retired, or student (p = 0.016. No evidence of infection was found in 38 sigmodontinae rodents trapped in the peri-domestic environment. Our findings highlight that exposure risk was associated with less documented risk factors, such as women in slum and rural villages, and the occurrence of infection that may have presented as flu-like illness that did not require medical attention or was misdiagnosed.

  19. The Labor Market Returns to Math in Community College: Evidence Using the Education Longitudinal Study of 2002. A CAPSEE Working Paper

    Science.gov (United States)

    Belfield, Clive

    2015-01-01

    This paper examines the returns to math courses relative to those in courses in other subjects for students who started their postsecondary education at community college. The limited available evidence presumes that college-level math is valuable in the labor market relative to other coursework. Using data on college transcript and earnings from…

  20. Clinical Decision-Making in Community Children's Mental Health: Using Innovative Methods to Compare Clinicians with and without Training in Evidence-Based Treatment

    Science.gov (United States)

    Baker-Ericzén, Mary J.; Jenkins, Melissa M.; Park, Soojin; Garland, Ann F.

    2015-01-01

    Background: Mental health professionals' decision-making practice is an area of increasing interest and importance, especially in the pediatric research and clinical communities. Objective: The present study explored the role of prior training in evidence-based treatments (EBTs) on clinicians' assessment and treatment formulations using…

  1. Community-Based Addiction Treatment Staff Attitudes about the Usefulness of Evidence-Based Addiction Treatment and CBO Organizational Linkages to Research Institutions

    Science.gov (United States)

    Lundgren, Lena; Krull, Ivy; Zerden, Lisa de Saxe; McCarty, Dennis

    2011-01-01

    This national study of community-based addiction-treatment organizations' (CBOs) implementation of evidence-based practices explored CBO Program Directors' (n = 296) and clinical staff (n = 518) attitudes about the usefulness of science-based addiction treatment. Through multivariable regression modeling, the study identified that identical…

  2. Community barcoding reveals little effect of ocean acidification on the composition of coastal plankton communities: Evidence from a long-term mesocosm study in the Gullmar Fjord, Skagerrak.

    Directory of Open Access Journals (Sweden)

    Julia A F Langer

    Full Text Available The acidification of the oceans could potentially alter marine plankton communities with consequences for ecosystem functioning. While several studies have investigated effects of ocean acidification on communities using traditional methods, few have used genetic analyses. Here, we use community barcoding to assess the impact of ocean acidification on the composition of a coastal plankton community in a large scale, in situ, long-term mesocosm experiment. High-throughput sequencing resulted in the identification of a wide range of planktonic taxa (Alveolata, Cryptophyta, Haptophyceae, Fungi, Metazoa, Hydrozoa, Rhizaria, Straminipila, Chlorophyta. Analyses based on predicted operational taxonomical units as well as taxonomical compositions revealed no differences between communities in high CO2 mesocosms (~ 760 μatm and those exposed to present-day CO2 conditions. Observed shifts in the planktonic community composition were mainly related to seasonal changes in temperature and nutrients. Furthermore, based on our investigations, the elevated CO2 did not affect the intraspecific diversity of the most common mesozooplankter, the calanoid copepod Pseudocalanus acuspes. Nevertheless, accompanying studies found temporary effects attributed to a raise in CO2. Differences in taxa composition between the CO2 treatments could, however, only be observed in a specific period of the experiment. Based on our genetic investigations, no compositional long-term shifts of the plankton communities exposed to elevated CO2 conditions were observed. Thus, we conclude that the compositions of planktonic communities, especially those in coastal areas, remain rather unaffected by increased CO2.

  3. Community barcoding reveals little effect of ocean acidification on the composition of coastal plankton communities: Evidence from a long-term mesocosm study in the Gullmar Fjord, Skagerrak.

    Science.gov (United States)

    Langer, Julia A F; Sharma, Rahul; Schmidt, Susanne I; Bahrdt, Sebastian; Horn, Henriette G; Algueró-Muñiz, María; Nam, Bora; Achterberg, Eric P; Riebesell, Ulf; Boersma, Maarten; Thines, Marco; Schwenk, Klaus

    2017-01-01

    The acidification of the oceans could potentially alter marine plankton communities with consequences for ecosystem functioning. While several studies have investigated effects of ocean acidification on communities using traditional methods, few have used genetic analyses. Here, we use community barcoding to assess the impact of ocean acidification on the composition of a coastal plankton community in a large scale, in situ, long-term mesocosm experiment. High-throughput sequencing resulted in the identification of a wide range of planktonic taxa (Alveolata, Cryptophyta, Haptophyceae, Fungi, Metazoa, Hydrozoa, Rhizaria, Straminipila, Chlorophyta). Analyses based on predicted operational taxonomical units as well as taxonomical compositions revealed no differences between communities in high CO2 mesocosms (~ 760 μatm) and those exposed to present-day CO2 conditions. Observed shifts in the planktonic community composition were mainly related to seasonal changes in temperature and nutrients. Furthermore, based on our investigations, the elevated CO2 did not affect the intraspecific diversity of the most common mesozooplankter, the calanoid copepod Pseudocalanus acuspes. Nevertheless, accompanying studies found temporary effects attributed to a raise in CO2. Differences in taxa composition between the CO2 treatments could, however, only be observed in a specific period of the experiment. Based on our genetic investigations, no compositional long-term shifts of the plankton communities exposed to elevated CO2 conditions were observed. Thus, we conclude that the compositions of planktonic communities, especially those in coastal areas, remain rather unaffected by increased CO2.

  4. Reducing rural maternal mortality and the equity gap in northern Nigeria: the public health evidence for the Community Communication Emergency Referral strategy

    Directory of Open Access Journals (Sweden)

    Aradeon SB

    2016-03-01

    Full Text Available Susan B Aradeon,1 Henry V Doctor2 1Freelance International Consultant (Social and Behavioral Change Communication, Aventura, FL, USA; 2Department of Information, Evidence and Research, Regional Office for the Eastern Mediterranean, World Health Organization, Nasr City, Cairo, Egypt Abstract: The Sustainable Development Goal (SDG maternal mortality target risks being underachieved like its Millennium Development Goal (MDG predecessor. The MDG skilled birth attendant (SBA strategy proved inadequate to end preventable maternal deaths for the millions of rural women living in resource-constrained settings. This equity gap has been successfully addressed by integrating a community-based emergency obstetric care strategy into the intrapartum care SBA delivery strategy in a large scale, northern Nigerian health systems strengthening project. The Community Communication Emergency Referral (CCER strategy catalyzes community capacity for timely evacuations to emergency obstetric care facilities instead of promoting SBA deliveries in environments where SBA availability and accessibility will remain inadequate for the near and medium term. Community Communication is an innovative, efficient, equitable, and culturally appropriate community mobilization approach that empowers low- and nonliterate community members to become the communicators. For the CCER strategy, this community mobilization approach was used to establish and maintain emergency maternal care support structures. Public health evidence demonstrates the success of integrating the CCER strategy into the SBA strategy and the practicability of this combined strategy at scale. In intervention sites, the maternal mortality ratio reduced by 16.8% from extremely high levels within 4 years. Significantly, the CCER strategy contributed to saving one-third of the lives saved in the project sites, thereby maximizing the effectiveness of the SBAs and upgraded emergency obstetric care facilities. Pre- and

  5. Designing healthy communities: creating evidence on metrics for built environment features associated with walkable neighbourhood activity centres.

    Science.gov (United States)

    Gunn, Lucy Dubrelle; Mavoa, Suzanne; Boulangé, Claire; Hooper, Paula; Kavanagh, Anne; Giles-Corti, Billie

    2017-12-04

    Evidence-based metrics are needed to inform urban policy to create healthy walkable communities. Most active living research has developed metrics of the environment around residential addresses, ignoring other important walking locations. Therefore, this study examined: metrics for built environment features surrounding local shopping centres, (known in Melbourne, Australia as neighbourhood activity centres (NACs) which are typically anchored by a supermarket); the association between NACs and transport walking; and, policy compliance for supermarket provision. In this observational study, cluster analysis was used to categorize 534 NACs in Melbourne, Australia by their built environment features. The NACS were linked to eligible Victorian Integrated Survey of Travel Activity 2009-2010 (VISTA) survey participants (n=19,984). Adjusted multilevel logistic regressions estimated associations between each cluster typology and two outcomes of daily walking: any transport walking; and, any 'neighbourhood' transport walking. Distance between residential dwellings and closest NAC was assessed to evaluate compliance with local planning policy on supermarket locations. Metrics for 19 built environment features were estimated and three NAC clusters associated with walkability were identified. NACs with significantly higher street connectivity (mean:161, SD:20), destination diversity (mean:16, SD:0.4); and net residential density (mean:77, SD:65) were interpreted as being 'highly walkable' when compared with 'low walkable' NACs, which had lower street connectivity (mean:57, SD:15); destination diversity (mean:11, SD:3); and net residential density (mean:10, SD:3). The odds of any daily transport walking was 5.85 times higher (95% CI: 4.22, 8.11), and for any 'neighborhood' transport walking 8.66 (95% CI: 5.89, 12.72) times higher, for residents whose closest NAC was highly walkable compared with those living near low walkable NACs. Only highly walkable NACs met the policy

  6. Delivering an evidence-based outdoor journey intervention to people with stroke: Barriers and enablers experienced by community rehabilitation teams

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    Middleton Sandy

    2010-01-01

    Full Text Available Abstract Background Transferring knowledge from research into practice can be challenging, partly because the process involves a change in attitudes, roles and behaviour by individuals and teams. Helping teams to identify then target potential barriers may aid the knowledge transfer process. The aim of this study was to identify barriers and enablers, as perceived by allied health professionals, to delivering an evidence-based (Level 1 outdoor journey intervention for people with stroke. Methods A qualitative design and semi-structured interviews were used. Allied health professionals (n = 13 from two community rehabilitation teams were interviewed, before and after receiving feedback from a medical record audit and attending a training workshop. Interviews allowed participants to identify potential and actual barriers, as well as enablers to delivering the intervention. Qualitative data were analysed using theoretical domains described by Michie and colleagues. Results Two barriers to delivery of the intervention were the social influence of people with stroke and their family, and professionals' beliefs about their capabilities. Other barriers included professionals' knowledge and skills, their role identity, availability of resources, whether professionals remembered to provide the intervention, and how they felt about delivering the intervention. Enablers to delivering the intervention included a belief that they could deliver the intervention, a willingness to expand and share professional roles, procedures that reminded them what to do, and feeling good about helping people with stroke to participate. Conclusions This study represents one step in the quality improvement process. The interviews encouraged reflection by staff. We obtained valuable data which have been used to plan behaviour change interventions addressing identified barriers. Our methods may assist other researchers who need to design similar behaviour change interventions.

  7. The true costs of participatory sanitation: Evidence from community-led total sanitation studies in Ghana and Ethiopia.

    Science.gov (United States)

    Crocker, Jonny; Saywell, Darren; Shields, Katherine F; Kolsky, Pete; Bartram, Jamie

    2017-12-01

    Evidence on sanitation and hygiene program costs is used for many purposes. The few studies that report costs use top-down costing methods that are inaccurate and inappropriate. Community-led total sanitation (CLTS) is a participatory behavior-change approach that presents difficulties for cost analysis. We used implementation tracking and bottom-up, activity-based costing to assess the process, program costs, and local investments for four CLTS interventions in Ghana and Ethiopia. Data collection included implementation checklists, surveys, and financial records review. Financial costs and value-of-time spent on CLTS by different actors were assessed. Results are disaggregated by intervention, cost category, actor, geographic area, and project month. The average household size was 4.0 people in Ghana, and 5.8 people in Ethiopia. The program cost of CLTS was $30.34-$81.56 per household targeted in Ghana, and $14.15-$19.21 in Ethiopia. Most program costs were from training for three of four interventions. Local investments ranged from $7.93-$22.36 per household targeted in Ghana, and $2.35-$3.41 in Ethiopia. This is the first study to present comprehensive, disaggregated costs of a sanitation and hygiene behavior-change intervention. The findings can be used to inform policy and finance decisions, plan program scale-up, perform cost-effectiveness and benefit studies, and compare different interventions. The costing method is applicable to other public health behavior-change programs. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  8. Implications of climate change on human comfort in buildings: evidence from Nkontompo community of Sekondi-Takoradi, Ghana

    Energy Technology Data Exchange (ETDEWEB)

    Amos-Abanyie, S. [Kwame Nkrumah Univ. of Science and Technology, Kumasi (GH)

    2006-07-01

    Climate change has become the most talked about issue in recent times. The impact of climate change is likely to become more evident in the coming decades. Currently, atmospheric conditions, especially in the dry season, are getting hotter and drier with increased heat waves. Increased demand for air conditioning for space cooling as a result of internal discomfort in buildings is already manifesting. This could put an additional stress on the already over-burdened energy capactiy of the nation. The study on implications of climate change on human comfort in buidlings was conducted in Nkontompo community, a suburb of Sekondi-Takoradi Metropolitan area of the Shama-Ahanta District of the Western Region of Ghana. The objectives of this study are to assemble and disseminate information about some of the possible impacts of climate change on the built environment. This is to set the platform for building professionals to identify possible adaptive measures to serve as basis for development of standards to maintain and enhance the quality of life in buildings. The results showed that there were significant changes in temperature, precipitation, and relative humidity. A rise in temperature and humidity levels constitutes a potential hazard to health and human comfort and accelerates many degradation processes and material damage. Subsequently, the amount of energy needed to maintain the condition of air in spaces at comfort levels keeps increasing. It is therefore imperative that landlords and other property owners should be effectively guided by qualified professionals within the framework of policy guidelines based on sound research.

  9. Using Evidence Based Practice in LIS Education: Results of a Test of a Communities of Practice Model

    Directory of Open Access Journals (Sweden)

    Joyce Yukawa

    2010-03-01

    the end of the course may indicate that an effective balance between face‐to‐face and online media was achieved. At the meso‐level, students valued learning in community for developing mutual respect, confidence building, risk taking, deeper and more varied learning, learning with and from their peers, and greater enjoyment in the classes. Students found that the online environments were useful for organizing the class objectives and subject matter, “staying connected” between classes, sharing ideas, keeping track of their work, and preparing them for future work in blended environments. At the macro‐level, the findings of the effects on student growth related to core LIS concepts, practices, professional identity and leadership skills were inconclusive. However, students’ expressed a high regard for the value of collaboration, and there were indications that the model supported differentiated learning of professional knowledge and skills.Conclusion ‐ The findings strongly suggest that the use of the CoP model had positive effects on the learning process. Students’ high regard for the value of collaboration appears to be a clear effect of using the CoP model. The assessment methods were sufficient for testing the efficacy of most aspects of the model under the limited conditions of this study. Student responses led to refinements in both the model and methods. This study contributes to social constructivist learning approaches and LIS curricular development by presenting an innovative model for supporting professional growth among adult learners, as well as a conceptual framework to guide evidence based practice. Further testing and refinement of the model in other contexts and by other educators are needed to ensure that the model is robust and broadly applicable.

  10. A Multi-level Examination of how the Organizational Context Relates to Readiness to Implement Prevention and Evidence-Based Programming in Community Settings

    Science.gov (United States)

    Chilenski, Sarah M.; Olson, Jonathan R.; Schulte, Jill A.; Perkins, Daniel F.; Spoth, Richard

    2015-01-01

    Prior theoretical and empirical research suggests that multiple aspects of an organization’s context are likely related to a number of factors, from their interest and ability to adopt new programming, to client outcomes. A limited amount of the prior research has taken a more community-wide perspective by examining factors that associate with community readiness for change, leaving how these findings generalize to community organizations that conduct prevention or positive youth development programs unknown. Thus for the current study, we examined how the organizational context of the Cooperative Extension System (CES) associates with current attitudes and practices regarding prevention and evidence-based programming. Attitudes and practices have been found in the empirical literature to be key indicators of an organization’s readiness to adopt prevention and evidence-based programming. Based on multi-level mixed models, results indicate that organizational management practices distinct from program delivery may affect an organization’s readiness to adopt and implement new prevention and evidence-based youth programs, thereby limiting the potential public health impact of evidence-based programs. Openness to change, openness of leadership, and communication were the strongest predictors identified within this study. An organization’s morale was also found to be a strong predictor of an organization’s readiness. The findings of the current study are discussed in terms of implications for prevention and intervention. PMID:25463014

  11. Comprehensive review of the evidence regarding the effectiveness of community-based primary health care in improving maternal, neonatal and child health: 7. shared characteristics of projects with evidence of long-term mortality impact.

    Science.gov (United States)

    Perry, Henry B; Rassekh, Bahie M; Gupta, Sundeep; Freeman, Paul A

    2017-06-01

    There is limited evidence about the long-term effectiveness of integrated community-based primary health care (CBPHC) in improving maternal, neonatal and child health. However, the interventions implemented and the approaches used by projects with such evidence can provide guidance for ending preventable child and maternal deaths by the year 2030. A database of 700 assessments of the effectiveness of CBPHC in improving maternal, neonatal and child health has been assembled, as described elsewhere in this series. A search was undertaken of these assessments of research studies, field project and programs (hereafter referred to as projects) with more than a single intervention that had evidence of mortality impact for a period of at least 10 years. Four projects qualified for this analysis: the Matlab Maternal Child Health and Family Planning (MCH-FP) P in Bangladesh; the Hôpital Albert Schweitzer in Deschapelles, Haiti; the Comprehensive Rural Health Project (CRHP) in Jamkhed, India; and the Society for Education, Action and Research in Community Health (SEARCH) in Gadchiroli, India. These four projects have all been operating for more than 30 years, and they all have demonstrated reductions in infant mortality, 1- to 4-year mortality, or under-5 mortality for at least 10 years. They share a number of characteristics. Among the most notable of these are: they provide comprehensive maternal, child health and family planning services, they have strong community-based programs that utilize community health workers who maintain regular contact with all households, they have develop strong collaborations with the communities they serve, and they all have strong referral capabilities and provide first-level hospital care. The shared features of these projects provide guidance for how health systems around the world might improve their effectiveness in improving maternal, neonatal and child health. Strengthening these features will contribute to achieving the goal of

  12. Restoring State Control Over Forest Resources Through Administrative Procedures: Evidence From a Community Forestry Programme in Central Java, Indonesia

    Directory of Open Access Journals (Sweden)

    Ahmad Maryudi

    2012-01-01

    Full Text Available In recent years, community forestry has emerged as a means to reform power constellations with regard to forest governance. Through community forestry, the central state promised to devolve several forest rights to local communities and encouraged them to get involved in decision making processes and the implementation of forest activities. However, experience in some countries indicates that the implementation of community forestry programmes is rarely followed by genuine power devolution to local forest users. Instead, these programmes may even serve as a means to retain or restore the central state’s control over forests. Using a case study of a community forestry programme implemented in Java, Indonesia, by a state forest company, this paper argues that the implementation of community forestry is also driven by the state’s interests to regain control over the forests. Research in eight villages in Central Java province reveals that the community forestry programmes are carefully structured according to numerous administrative procedures and estab- lish a mode of control through a bureaucratic design. ----- In den letzten Jahren hat sich community forestry als Mittel zur Reform von Machtkonstellationen in Bezug auf die Verwaltung von Wäldern herausgebildet. Der Zentralstaat versprach durch community forestry bestimmte Waldrechte an lokale Communities abzugeben und ermutigte sie, sich an Entscheidungsprozessen und der Implementierung von Forstaktivitäten zu beteiligen. Erfahrungen in einigen Ländern zeigen jedoch, dass die Implementierung von community forestry-Programmen selten mit einem tatsächlichen Machttransfer an lokale ForstnutzerInnen einhergeht, sondern diese Programme sogar als Mittel zur Rückgewinnung von zentralstaatlicher Kontrolle über Wälder dienen können. Anhand eines Fallbeispiels eines community forestry-Programms, das in Java, Indonesien, von einem staatlichen Forstunternehmen implementiert wird, argumentiere ich

  13. Effects of a community scorecard on improving the local health system in Eastern Democratic Republic of Congo: qualitative evidence using the most significant change technique.

    Science.gov (United States)

    Ho, Lara S; Labrecque, Guillaume; Batonon, Isatou; Salsi, Viviana; Ratnayake, Ruwan

    2015-01-01

    More than a decade of conflict has weakened the health system in the Democratic Republic of Congo and decreased its ability to respond to the needs of the population. Community scorecards have been conceived as a way to increase accountability and responsiveness of service providers, but there is limited evidence of their effects, particularly in fragile and conflict-affected contexts. This paper describes the implementation of community scorecards within a community-driven reconstruction project in two provinces of eastern Democratic Republic of Congo. Between June 2012 and November 2013, 45 stories of change in the health system were collected from village development committee, health committee, community members (20 men and 18 women) and healthcare providers (n = 7) in 25 sites using the Most Significant Change technique. Stories were analyzed qualitatively for content related to the types and mechanisms of change observed. The most salient changes were related to increased transparency and community participation in health facility management, and improved quality of care. Quality of care included increased access to services, improved patient-provider relationships, improved performance of service providers, and improved maintenance of physical infrastructure. Changes occurred through many different mechanisms including provider actions in response to information, pressure from community representatives, or supervisors; and joint action and improved collaboration by health facility committees and providers. Although it is often assumed that confrontation is a primary mechanism for citizens to change state-provided services, this study demonstrates that healthcare providers may also be motivated to change through other means. Positive experiences of community scorecards can provide a structured space for interface between community members and the health system, allowing users to voice their opinions and preferences and bridge information gaps for both

  14. An evidence synthesis of the international knowledge base for new care models to inform and mobilise knowledge for multispecialty community providers (MCPs).

    Science.gov (United States)

    Turner, Alison; Mulla, Abeda; Booth, Andrew; Aldridge, Shiona; Stevens, Sharon; Battye, Fraser; Spilsbury, Peter

    2016-10-01

    NHS England's Five Year Forward View (NHS England, Five Year Forward View, 2014) formally introduced a strategy for new models of care driven by simultaneous pressures to contain costs, improve care and deliver services closer to home through integrated models. This synthesis focuses on a multispecialty community provider (MCP) model. This new model of care seeks to overcome the limitations in current models of care, often based around single condition-focused pathways, in contrast to patient-focused delivery (Royal College of General Practitioners, The 2022 GP: compendium of evidence, 2012) which offers greater continuity of care in recognition of complex needs and multimorbidity. The synthesis, an innovative combination of best fit framework synthesis and realist synthesis, will develop a "blueprint" which articulates how and why MCP models work, to inform design of future iterations of the MCP model. A systematic search will be conducted to identify research and practice-derived evidence to achieve a balance that captures the historical legacy of MCP models but focuses on contemporary evidence. Sources will include bibliographic databases including MEDLINE, PreMEDLINE, CINAHL, Embase, HMIC and Cochrane Library; and grey literature sources. The Best Fit synthesis methodology will be combined with a synthesis following realist principles which are particularly suited to exploring what works, when, for whom and in what circumstances. The aim of this synthesis is to provide decision makers in health and social care with a practical evidence base relating to the multispecialty community provider (MCP) model of care. PROSPERO CRD42016039552 .

  15. A systematic community-based participatory approach to refining an evidence-based community-level intervention: the HOLA intervention for Latino men who have sex with men.

    Science.gov (United States)

    Rhodes, Scott D; Daniel, Jason; Alonzo, Jorge; Duck, Stacy; García, Manuel; Downs, Mario; Hergenrather, Kenneth C; Alegría-Ortega, José; Miller, Cindy; Boeving Allen, Alex; Gilbert, Paul A; Marsiglia, Flavio F

    2013-07-01

    Our community-based participatory research partnership engaged in a multistep process to refine a culturally congruent intervention that builds on existing community strengths to promote sexual health among immigrant Latino men who have sex with men (MSM). The steps were the following: (1) increase Latino MSM participation in the existing partnership, (2) establish an Intervention Team, (3) review the existing sexual health literature, (4) explore needs and priorities of Latino MSM, (5) narrow priorities based on what is important and changeable, (6) blend health behavior theory with Latino MSM's lived experiences, (7) design an intervention conceptual model, (8) develop training modules and (9) resource materials, and (10) pretest and (11) revise the intervention. The developed intervention contains four modules to train Latino MSM to serve as lay health advisors known as Navegantes. These modules synthesize locally collected data with other local and national data; blend health behavior theory, the lived experiences, and cultural values of immigrant Latino MSM; and harness the informal social support Latino MSM provide one another. This community-level intervention is designed to meet the expressed sexual health priorities of Latino MSM. It frames disease prevention within sexual health promotion.

  16. A Web-Based Toolkit to Provide Evidence-Based Resources About Crystal Methamphetamine for the Australian Community: Collaborative Development of Cracks in the Ice.

    Science.gov (United States)

    Champion, Katrina Elizabeth; Chapman, Cath; Newton, Nicola Clare; Brierley, Mary-Ellen; Stapinski, Lexine; Kay-Lambkin, Frances; Nagle, Jack; Teesson, Maree

    2018-03-20

    The use of crystal methamphetamine (ice) and the associated harms for individuals, families, and communities across Australia has been the subject of growing concern in recent years. The provision of easily accessible, evidence-based, and up-to-date information and resources about crystal methamphetamine for the community is a critical component of an effective public health response. This paper aims to describe the codevelopment process of the Web-based Cracks in the Ice Community Toolkit, which was developed to improve access to evidence-based information and resources about crystal methamphetamine for the Australian community. Development of the Cracks in the Ice Community Toolkit was conducted in collaboration with community members across Australia and with experts working in the addiction field. The iterative process involved the following: (1) consultation with end users, including community members, crystal methamphetamine users, families and friends of someone using crystal methamphetamine, health professionals, and teachers (n=451) via a cross-sectional Web-based survey to understand information needs; (2) content and Web development; and (3) user testing of a beta version of the Web-based toolkit among end users (n=41) and experts (n=10) to evaluate the toolkit's acceptability, relevance, and appeal. Initial end user consultation indicated that the most commonly endorsed reasons for visiting a website about crystal methamphetamine were "to get information for myself" (185/451, 41.0%) and "to find out how to help a friend or a family member" (136/451, 30.2%). Community consultation also revealed the need for simple information about crystal methamphetamine, including what it is, its effects, and when and where to seek help or support. Feedback on a beta version of the toolkit was positive in terms of content, readability, layout, look, and feel. Commonly identified areas for improvement related to increasing the level of engagement and personal connection

  17. Camino Verde (The Green Way: evidence-based community mobilisation for dengue control in Nicaragua and Mexico: feasibility study and study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Neil Andersson

    2017-05-01

    Full Text Available Abstract Background Since the Aedes aegypti mosquitoes that transmit dengue virus can breed in clean water, WHO-endorsed vector control strategies place sachets of organophosphate pesticide, temephos (Abate, in household water storage containers. These and other pesticide-dependent approaches have failed to curb the spread of dengue and multiple dengue virus serotypes continue to spread throughout tropical and subtropical regions worldwide. A feasibility study in Managua, Nicaragua, generated instruments, intervention protocols, training schedules and impact assessment tools for a cluster randomised controlled trial of community-based approaches to vector control comprising an alternative strategy for dengue prevention and control in Nicaragua and Mexico. Methods/Design The Camino Verde (Green Way is a pragmatic parallel group trial of pesticide-free dengue vector control, adding effectiveness to the standard government dengue control. A random sample from the most recent census in three coastal regions of Guerrero state in Mexico will generate 90 study clusters and the equivalent sampling frame in Managua, Nicaragua will generate 60 clusters, making a total of 150 clusters each of 137–140 households. After a baseline study, computer-driven randomisation will allocate to intervention one half of the sites, stratified by country, evidence of recent dengue virus infection in children aged 3–9 years and, in Nicaragua, level of community organisation. Following a common evidence-based education protocol, each cluster will develop and implement its own collective interventions including house-to-house visits, school-based programmes and inter-community visits. After 18 months, a follow-up study will compare dengue history, serological evidence of recent dengue virus infection (via measurement of anti-dengue virus antibodies in saliva samples and entomological indices between intervention and control sites. Discussion Our hypothesis is that

  18. Camino Verde (The Green Way): evidence-based community mobilisation for dengue control in Nicaragua and Mexico: feasibility study and study protocol for a randomised controlled trial.

    Science.gov (United States)

    Andersson, Neil; Arostegui, Jorge; Nava-Aguilera, Elizabeth; Harris, Eva; Ledogar, Robert J

    2017-05-30

    Since the Aedes aegypti mosquitoes that transmit dengue virus can breed in clean water, WHO-endorsed vector control strategies place sachets of organophosphate pesticide, temephos (Abate), in household water storage containers. These and other pesticide-dependent approaches have failed to curb the spread of dengue and multiple dengue virus serotypes continue to spread throughout tropical and subtropical regions worldwide. A feasibility study in Managua, Nicaragua, generated instruments, intervention protocols, training schedules and impact assessment tools for a cluster randomised controlled trial of community-based approaches to vector control comprising an alternative strategy for dengue prevention and control in Nicaragua and Mexico. The Camino Verde (Green Way) is a pragmatic parallel group trial of pesticide-free dengue vector control, adding effectiveness to the standard government dengue control. A random sample from the most recent census in three coastal regions of Guerrero state in Mexico will generate 90 study clusters and the equivalent sampling frame in Managua, Nicaragua will generate 60 clusters, making a total of 150 clusters each of 137-140 households. After a baseline study, computer-driven randomisation will allocate to intervention one half of the sites, stratified by country, evidence of recent dengue virus infection in children aged 3-9 years and, in Nicaragua, level of community organisation. Following a common evidence-based education protocol, each cluster will develop and implement its own collective interventions including house-to-house visits, school-based programmes and inter-community visits. After 18 months, a follow-up study will compare dengue history, serological evidence of recent dengue virus infection (via measurement of anti-dengue virus antibodies in saliva samples) and entomological indices between intervention and control sites. Our hypothesis is that informed community mobilisation adds effectiveness in controlling

  19. Micro-regional planning: evidence-based community buy-in for health development in five of Mexico’s poorest rural districts

    Directory of Open Access Journals (Sweden)

    Arrizón Ascencio

    2011-12-01

    Full Text Available Abstract Background Community participation was a core tenet of Primary Health Care as articulated in the 1970s. How this could be generated and maintained was less clear. This historical article describes development of protocols for evidence-based community mobilisation in five local administrative units (municipios in the Mexican state of Guerrero between 1992 and 1995. Methods A sample of five to eight sentinel sites represented each of the most impoverished municipalities of the poorest five of the state's seven regions. A 1992 baseline survey of diarrhoea and its actionable determinants provided the substrate for discussion with local planners and communities. Municipal planners used different strategies to promote participation. In one municipality, new health committees took control of water quality. In another, municipal authorities hired health promoters; a song promoted oral rehydration, and house-to-house interpersonal discussions promoted chlorination. In the poorest and most mountainous municipality, radio casera (home-made radio soap operas used local "stars". In the largest and most disparate municipality, a child-to-family scheme relied on primary and secondary school teachers. The research team assessed outcomes at intervals and used the results to reinforce local planning and action. Results Diarrhoea rates declined in all five municipalities, and there were several positive intermediate outcomes from the communication strategies – changing knowledge, household practices and uptake of services. There was a strong link between specific contents of the communication package and the changing knowledge or practices. Conclusions Apart from these evidence-based interventions, other factors probably contributed to the decline of childhood diarrhoea. But, by monitoring implementation of planning decisions and the impact this has at community level, micro-regional planning can stimulate and reinforce actions likely to improve the

  20. Changes in community perspectives on the roles and rules of church forests in northern Ethiopia: evidence from a panel survey of four Ethiopian Orthodox communities

    Directory of Open Access Journals (Sweden)

    Travis William Reynolds

    2017-04-01

    Full Text Available Some of the only Afromontane forest in northern Ethiopia today is on lands managed by followers of the Ethiopian Orthodox Church, where for centuries priests and communities have conserved forest groves around church buildings. The ecological value of the thousands of church forests in Ethiopia has been widely acknowledged, but little is known about the diverse local institutions that govern these resources, or how such institutions might be changing in response to Ethiopia’s rapid recent economic development. This study uses a unique panel survey to explore changes in community perspectives on the social and ecological roles of church forests, and rules governing church forest use, in four Orthodox communities over time. Our sample consists of 122 household surveys conducted in 2002 and a further 122 surveys from 2014, with 71 households interviewed in both periods. We find that reported uses of church forests vary across forests and over time, with larger forests more likely to be used for extractive purposes such as firewood and construction timber, while smaller forests have become more restricted to renewable or non-extractive uses such as natural medicines, honey, and prayer. Results of logistic regression suggest church followers’ support for preserving church forests increases with age and access to alternative sources of firewood – including exotic Eucalyptus spp. plantations which are increasingly widespread in northern Ethiopia. We also observe a shift since 2002 away from an expectation that church followers themselves hold responsibility for rule enforcement in church forests to a perceived sharing of responsibility by church authorities (i.e. priests and government (i.e. police in 2014. Together the progressive introduction of exotic tree species in church forests combined with the erosion of religious norms surrounding local forest governance may threaten the integrity and diversity of these unique social-ecological systems.

  1. The effect of the PROSPER partnership model on cultivating local stakeholder knowledge of evidence-based programs: a five-year longitudinal study of 28 communities.

    Science.gov (United States)

    Crowley, D Max; Greenberg, Mark T; Feinberg, Mark E; Spoth, Richard L; Redmond, Cleve R

    2012-02-01

    A substantial challenge in improving public health is how to facilitate the local adoption of evidence-based interventions (EBIs). To do so, an important step is to build local stakeholders' knowledge and decision-making skills regarding the adoption and implementation of EBIs. One EBI delivery system, called PROSPER (PROmoting School-community-university Partnerships to Enhance Resilience), has effectively mobilized community prevention efforts, implemented prevention programming with quality, and consequently decreased youth substance abuse. While these results are encouraging, another objective is to increase local stakeholder knowledge of best practices for adoption, implementation and evaluation of EBIs. Using a mixed methods approach, we assessed local stakeholder knowledge of these best practices over 5 years, in 28 intervention and control communities. Results indicated that the PROSPER partnership model led to significant increases in expert knowledge regarding the selection, implementation, and evaluation of evidence-based interventions. Findings illustrate the limited programming knowledge possessed by members of local prevention efforts, the difficulty of complete knowledge transfer, and highlight one method for cultivating that knowledge.

  2. Number and timing of antenatal HIV testing: Evidence from a community-based study in Northern Vietnam

    DEFF Research Database (Denmark)

    Hanh, Nguyen Tt; Gammeltoft, Tine; Rasch, Vibeke

    2011-01-01

    scaled up to reach first level health facilities. METHODS: A cross-sectional community-based study was conducted among 1108 recently delivered mothers through face-to-face interviews following a structured questionnaire that focused on socio-economic characteristics, experiences of antenatal care and HIV...

  3. How does context influence performance of community health workers in low- and middle-income countries? : Evidence from the literature

    NARCIS (Netherlands)

    Kok, Maryse C; Kane, Sumit; Tulloch, Olivia; Ormel, Hermen; Theobald, Sally; Dieleman, Marjolein; Taegtmeyer, Miriam; Broerse, Jacqueline E W; de Koning, Korrie A M

    2015-01-01

    BACKGROUND: Community health workers (CHWs) are increasingly recognized as an integral component of the health workforce needed to achieve public health goals in low- and middle-income countries (LMICs). Many factors intersect to influence CHW performance. A systematic review with a narrative

  4. Labor Market Trajectories for Community College Graduates: New Evidence Spanning the Great Recession. A CAPSEE Working Paper

    Science.gov (United States)

    Minaya, Veronica; Scott-Clayton, Judith

    2017-01-01

    Over the past few years, a multitude of studies have examined the labor market returns to community college credentials, taking advantage of new administrative datasets that link college transcripts to quarterly earnings records and allow for comparisons of students' earnings before and after enrollment. These studies, however, typically follow…

  5. High resilience of two coastal plankton communities to 21st century seawater acidification: Evidence from microcosm studies

    DEFF Research Database (Denmark)

    Nielsen, Lasse Tor; Jakobsen, Hans Henrik; Hansen, Per Juul

    2010-01-01

    Increased free CO2 and ocean acidification are among the consequences of anthropogenic carbon emissions. Responses of marine protists to increased levels of CO2 are highly species-specific, and this has been suggested to cause an alteration in plankton species composition, community functions...

  6. Mutual replacement of species in space in a grassland community: is there an evidence for functional complementarity of replacement groups?

    Czech Academy of Sciences Publication Activity Database

    Herben, Tomáš; Březina, Stanislav; Hadincová, Věroslava; Krahulec, František; Skálová, Hana

    2013-01-01

    Roč. 122, č. 1 (2013), s. 111-121 ISSN 0030-1299 R&D Projects: GA ČR GA206/09/1471 Institutional support: RVO:67985939 Keywords : community dynamics * biomass * removal experiments Subject RIV: EF - Botanics Impact factor: 3.559, year: 2013

  7. Community-based health care is an essential component of a resilient health system: evidence from Ebola outbreak in Liberia

    Directory of Open Access Journals (Sweden)

    Kendra Siekmans

    2017-01-01

    Full Text Available Abstract Background Trained community health workers (CHW enhance access to essential primary health care services in contexts where the health system lacks capacity to adequately deliver them. In Liberia, the Ebola outbreak further disrupted health system function. The objective of this study is to examine the value of a community-based health system in ensuring continued treatment of child illnesses during the outbreak and the role that CHWs had in Ebola prevention activities. Methods A descriptive observational study design used mixed methods to collect data from CHWs (structured survey, n = 60; focus group discussions, n = 16, government health facility workers and project staff. Monthly data on child diarrhea and pneumonia treatment were gathered from CHW case registers and local health facility records. Results Coverage for community-based treatment of child diarrhea and pneumonia continued throughout the outbreak in project areas. A slight decrease in cases treated during the height of the outbreak, from 50 to 28% of registers with at least one treatment per month, was attributed to directives not to touch others, lack of essential medicines and fear of contracting Ebola. In a climate of distrust, where health workers were reluctant to treat patients, sick people were afraid to self-identify and caregivers were afraid to take children to the clinic, CHWs were a trusted source of advice and Ebola prevention education. These findings reaffirm the value of recruiting and training local workers who are trusted by the community and understand the social and cultural complexities of this relationship. “No touch” integrated community case management (iCCM guidelines distributed at the height of the outbreak gave CHWs renewed confidence in assessing and treating sick children. Conclusions Investments in community-based health service delivery contributed to continued access to lifesaving treatment for child pneumonia and diarrhea

  8. Community-based health care is an essential component of a resilient health system: evidence from Ebola outbreak in Liberia.

    Science.gov (United States)

    Siekmans, Kendra; Sohani, Salim; Boima, Tamba; Koffa, Florence; Basil, Luay; Laaziz, Saïd

    2017-01-17

    Trained community health workers (CHW) enhance access to essential primary health care services in contexts where the health system lacks capacity to adequately deliver them. In Liberia, the Ebola outbreak further disrupted health system function. The objective of this study is to examine the value of a community-based health system in ensuring continued treatment of child illnesses during the outbreak and the role that CHWs had in Ebola prevention activities. A descriptive observational study design used mixed methods to collect data from CHWs (structured survey, n = 60; focus group discussions, n = 16), government health facility workers and project staff. Monthly data on child diarrhea and pneumonia treatment were gathered from CHW case registers and local health facility records. Coverage for community-based treatment of child diarrhea and pneumonia continued throughout the outbreak in project areas. A slight decrease in cases treated during the height of the outbreak, from 50 to 28% of registers with at least one treatment per month, was attributed to directives not to touch others, lack of essential medicines and fear of contracting Ebola. In a climate of distrust, where health workers were reluctant to treat patients, sick people were afraid to self-identify and caregivers were afraid to take children to the clinic, CHWs were a trusted source of advice and Ebola prevention education. These findings reaffirm the value of recruiting and training local workers who are trusted by the community and understand the social and cultural complexities of this relationship. "No touch" integrated community case management (iCCM) guidelines distributed at the height of the outbreak gave CHWs renewed confidence in assessing and treating sick children. Investments in community-based health service delivery contributed to continued access to lifesaving treatment for child pneumonia and diarrhea during the Ebola outbreak, making communities more resilient when

  9. Community-based environmental management for malaria control: evidence from a small-scale intervention in Dar es Salaam, Tanzania.

    Science.gov (United States)

    Castro, Marcia C; Tsuruta, Atsuko; Kanamori, Shogo; Kannady, Khadija; Mkude, Sixbert

    2009-04-08

    Historically, environmental management has brought important achievements in malaria control and overall improvements of health conditions. Currently, however, implementation is often considered not to be cost-effective. A community-based environmental management for malaria control was conducted in Dar es Salaam between 2005 and 2007. After community sensitization, two drains were cleaned followed by maintenance. This paper assessed the impact of the intervention on community awareness, prevalence of malaria infection, and Anopheles larval presence in drains. A survey was conducted in neighbourhoods adjacent to cleaned drains; for comparison, neighbourhoods adjacent to two drains treated with larvicides and two drains under no intervention were also surveyed. Data routinely collected by the Urban Malaria Control Programme were also used. Diverse impacts were evaluated through comparison of means, odds ratios (OR), logistic regression, and time trends calculated by moving averages. Individual awareness of health risks and intervention goals were significantly higher among sensitized neighbourhoods. A reduction in the odds of malaria infection during the post-cleaning period in intervention neighbourhoods was observed when compared to the pre-cleaning period (OR = 0.12, 95% CI 0.05-0.3, p water was flowing at normal velocity). A three-month moving average of the percentage of water habitats in that drain containing pupae and/or Anopheles larvae indicated a decline in larval density. In the other drain, lack of proper resources and local commitment limited success. Although environmental management was historically coordinated by authoritarian/colonial regimes or by industries/corporations, its successful implementation as part of an integrated vector management framework for malaria control under democratic governments can be possible if four conditions are observed: political will and commitment, community sensitization and participation, provision of financial

  10. Seasonality, water use and community management of water systems in rural settings: Qualitative evidence from Ghana, Kenya, and Zambia.

    Science.gov (United States)

    Kelly, Emma; Shields, Katherine F; Cronk, Ryan; Lee, Kristen; Behnke, Nikki; Klug, Tori; Bartram, Jamie

    2018-07-01

    The sustainability of rural, community-managed water systems in sub-Saharan Africa depends in part on the ability of local water committees to repair breakdowns and carry out the operation and maintenance (O&M) of the system. Much of sub-Saharan Africa has two distinct seasons that affect the availability of water sources and how people use water. Little is known about how seasonality affects water system management. This qualitative study is based on 320 interviews and focus group discussions and examines the effects of season on community water use and management in Ghana, Kenya and Zambia. Participants revealed that seasonality affects water availability, water system breakdowns, resource mobilization, committee activity, and external support availability. In the rainy season, participants typically reported spending less time and money on water collection because rainwater harvesting and seasonal streams, ponds, wells and reservoirs are available. In the dry season, people used improved groundwater sources more often and spent more money and time collecting water. Although seasonal changes in household water demand and use have been examined previously, our data suggest that seasonality also influences community management through differential water system use, system breakdowns and management characteristics. We found that water committees generally have less money, time and access to external support during the rainy season, making them less able to carry out O&M. Our results suggest that community engagement should take place over a long period of time so that seasonal patterns in management can be understood and incorporated into water committee training. External support actors should make a more targeted effort to understand the cultural and economic patterns in a community in order to train committees with appropriate management strategies. Copyright © 2018 Elsevier B.V. All rights reserved.

  11. Barriers to implementing evidence-based practices in addiction treatment programs: comparing staff reports on Motivational Interviewing, Adolescent Community Reinforcement Approach, Assertive Community Treatment, and Cognitive-behavioral Therapy.

    Science.gov (United States)

    Amodeo, M; Lundgren, L; Cohen, A; Rose, D; Chassler, D; Beltrame, C; D'Ippolito, M

    2011-11-01

    This qualitative study explored barriers to implementing evidence-based practices (EBPs) in community-based addiction treatment organizations (CBOs) by comparing staff descriptions of barriers for four EBPs: Motivational Interviewing (MI), Adolescent Community Reinforcement Approach (A-CRA), Assertive Community Treatment (ACT), and Cognitive-behavioral Therapy (CBT). The CBOs received CSAT/SAMHSA funding from 2003 to 2008 to deliver services using EBPs. Phone interview responses from 172 CBO staff directly involved in EBP implementation were analyzed using content analysis, a method for making inferences and developing themes from the systematic review of participant narratives (Berelson, 1952). Staff described different types of barriers to implementing each EBP. For MI, the majority of barriers involved staff resistance or organizational setting. For A-CRA, the majority of barriers involved specific characteristics of the EBP or client resistance. For CBT, the majority of barriers were associated with client resistance, and for ACT, the majority of barriers were associated with resources. EBP designers, policy makers who support EBP dissemination and funders should include explicit strategies to address such barriers. Addiction programs proposing to use specific EBPs must consider whether their programs have the organizational capacity and community capacity to meet the demands of the EBP selected. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Community food environments and healthy food access among older adults: A review of the evidence for the Senior Farmers' Market Nutrition Program (SFMNP).

    Science.gov (United States)

    O'Dare Wilson, Kellie

    2017-04-01

    Although an array of federal, state, and local programs exist that target food insecurity and the specific nutritional needs of seniors, food insecurity among older adults in the United States remains a persistent problem, particularly in minority and rural populations. Food insecurity is highly predictive of inadequate fresh fruit and vegetable (FFV) consumption in particular. The Senior Farmers' Market Nutrition Program (SFMNP) is a community-based program to help seniors purchase FFVs at farmer's markets in their neighborhoods. The SFMNP continues to grow; however, little is known about the effectiveness of the program. The purposes of this article are to (1) highlight the importance of community and neighborhood based food insecurity programs, specifically emphasizing the importance of FFV access for seniors, (2) review the current state of the evidence on the SFMNP, and (3) provide recommendations for researchers and policy-makers wishing to continue to advance the knowledge base in neighborhood-based food security among older adults.

  13. Partnership for Healthier Asians: Disseminating Evidence-Based Practices in Asian-American Communities Using a Market-Oriented and Multilevel Approach

    Science.gov (United States)

    Kim, Karen; Quinn, Michael; Chandrasekar, Edwin; Patel, Reena

    2016-01-01

    Background One of the greatest challenges facing health promotion and disease prevention is translating research findings into evidence-based practices (EBP). There is currently a limited research base to inform the design of dissemination action plans, especially within medically underserved communities. Objective The objective of this paper is to describe an innovative study protocol to disseminate colorectal cancer (CRC) screening guidelines in seven Asian subgroups. Methods This study integrated a market-oriented Push-Pull-Infrastructure Model, Diffusion of Innovation Theory, and community-based participatory research approach to create a community-centered dissemination framework. Consumer research, through focus groups and community-wide surveys, was centered on the adopters to ensure a multilevel intervention was well designed and effective. Results Collaboration took place between an academic institution and eight community-based organizations. These groups worked together to conduct thorough consumer research. A sample of 72 Asian Americans participated in 8 focus groups, and differences were noted across ethnic groups. Furthermore, 464 community members participated in an Individual Client Survey. Most participants agreed that early detection of cancer was important (434/464, 93.5%), cancer could happen to anyone (403/464, 86.9%), CRC could be prevented (344/464, 74.1%), and everyone should screen for CRC (389/464, 83.8%). However, 35.8% (166/464) of participants also felt that people were better off not knowing it they had cancer, and 45.5% (211/464) would screen only when they had symptoms. Most participants indicated that they would screen upon their doctor’s recommendation, but half reported that they only saw a doctor when they were sick. Data collection currently is underway for a multilevel intervention (community health advisor and social marketing campaign) and will conclude March 2016. We expect that analysis and results will be available by

  14. Partnership for Healthier Asians: Disseminating Evidence-Based Practices in Asian-American Communities Using a Market-Oriented and Multilevel Approach.

    Science.gov (United States)

    Kim, Karen; Quinn, Michael; Chandrasekar, Edwin; Patel, Reena; Lam, Helen

    2016-06-16

    One of the greatest challenges facing health promotion and disease prevention is translating research findings into evidence-based practices (EBP). There is currently a limited research base to inform the design of dissemination action plans, especially within medically underserved communities. The objective of this paper is to describe an innovative study protocol to disseminate colorectal cancer (CRC) screening guidelines in seven Asian subgroups. This study integrated a market-oriented Push-Pull-Infrastructure Model, Diffusion of Innovation Theory, and community-based participatory research approach to create a community-centered dissemination framework. Consumer research, through focus groups and community-wide surveys, was centered on the adopters to ensure a multilevel intervention was well designed and effective. Collaboration took place between an academic institution and eight community-based organizations. These groups worked together to conduct thorough consumer research. A sample of 72 Asian Americans participated in 8 focus groups, and differences were noted across ethnic groups. Furthermore, 464 community members participated in an Individual Client Survey. Most participants agreed that early detection of cancer was important (434/464, 93.5%), cancer could happen to anyone (403/464, 86.9%), CRC could be prevented (344/464, 74.1%), and everyone should screen for CRC (389/464, 83.8%). However, 35.8% (166/464) of participants also felt that people were better off not knowing it they had cancer, and 45.5% (211/464) would screen only when they had symptoms. Most participants indicated that they would screen upon their doctor's recommendation, but half reported that they only saw a doctor when they were sick. Data collection currently is underway for a multilevel intervention (community health advisor and social marketing campaign) and will conclude March 2016. We expect that analysis and results will be available by June 2016. This study outlines a

  15. Communities of different plant diversity respond similarly to drought stress: experimental evidence from field non-weeded and greenhouse conditions

    Czech Academy of Sciences Publication Activity Database

    Lanta, V.; Doležal, Jiří; Zemková, D.; Lepš, Jan

    2012-01-01

    Roč. 99, č. 6 (2012), s. 473-482 ISSN 0028-1042 R&D Projects: GA AV ČR IAA600050802; GA ČR GA206/09/1471; GA ČR GA526/09/0963 Institutional research plan: CEZ:AV0Z60050516; CEZ:AV0Z50070508 Institutional support: RVO:67985939 ; RVO:60077344 Keywords : Biodiversity * Community stability * Drought Subject RIV: EH - Ecology, Behaviour Impact factor: 2.144, year: 2012

  16. TAXATION AND INTERNAL MIGRATION - EVIDENCE FROM THE SWISS CENSUS USING COMMUNITY-LEVEL VARIATION IN INCOME TAX RATES

    OpenAIRE

    Liebig, Thomas; Puhani, Patrick A.; Sousa-Poza, Alfonso

    2006-01-01

    We investigate the relationship between income tax rate variation and internal migration for the unique case of Switzerland, whose system of determining tax rates primarily at the community level results in enough variation to permit analysis of their influence on migration. Specifically, using Swiss census data, we analyze migratory responses to tax rate variations for various groups defined by age, education, and nationality/residence permit. The results suggest that young Swiss college gra...

  17. Impact of community engagement on public acceptance towards waste-to-energy incineration projects: Empirical evidence from China.

    Science.gov (United States)

    Liu, Yong; Sun, Chenjunyan; Xia, Bo; Cui, Caiyun; Coffey, Vaughan

    2018-02-20

    As one of the most popular methods for the treatment of municipal solid waste (MSW), waste-to-energy (WTE) incineration offers effective solutions to deal with the MSW surge and globe energy issues. Nevertheless, the construction of WTE facilities faces considerable and strong opposition from local communities due to the perceived potential risks. The present study aims to understand whether, and how, community engagement improves local residents' public acceptance towards waste-to-energy (WTE) incineration facilities using a questionnaire survey conducted with nearby residents of two selected WTE incineration plants located in Zhejiang province, China. The results of data analysis using Structural Equation Modeling (SEM) reveal that firstly, a lower level of public acceptance exists among local residents of over the age of 35, of lower education levels, living within 3 km from the WTE Plant and from WTE incineration Plants which are under construction. Secondly, the public trust of local government and other authorities was positively associated with the public acceptance of the WTE incineration project, both directly and indirectly based on perceived risk. Thirdly, community engagement can effectively enhance public trust in local government and other authorities related to the WTE incineration project. The findings contribute to the literature on MSW treatment policy-making and potentially hazardous facility siting, by exploring the determinants of public acceptance towards WTE incineration projects. Copyright © 2018 Elsevier Ltd. All rights reserved.

  18. The Global Spine Care Initiative: applying evidence-based guidelines on the non-invasive management of back and neck pain to low- and middle-income communities.

    Science.gov (United States)

    Chou, Roger; Côté, Pierre; Randhawa, Kristi; Torres, Paola; Yu, Hainan; Nordin, Margareta; Hurwitz, Eric L; Haldeman, Scott; Cedraschi, Christine

    2018-02-19

    The purpose of this review was to develop recommendations for the management of spinal disorders in low-income communities, with a focus on non-invasive pharmacological and non-pharmacological therapies for non-specific low back and neck pain. We synthesized two evidence-based clinical practice guidelines for the management of low back and neck pain. Our recommendations considered benefits, harms, quality of evidence, and costs, with attention to feasibility in medically underserved areas and low- and middle-income countries. Clinicians should provide education and reassurance, advise patients to remain active, and provide information about self-care options. For acute low back and neck pain without serious pathology, primary conservative treatment options are exercise, manual therapy, superficial heat, and nonsteroidal anti-inflammatory drugs (NSAIDs). For patients with chronic low back and neck pain without serious pathology, primary treatment options are exercise, yoga, cognitive behavioral therapies, acupuncture, biofeedback, progressive relaxation, massage, manual therapy, interdisciplinary rehabilitation, NSAIDs, acetaminophen, and antidepressants. For patients with spinal pain with radiculopathy, clinicians may consider exercise, spinal manipulation, or NSAIDs; use of other interventions requires extrapolation from evidence regarding effectiveness for non-radicular spinal pain. Clinicians should not offer treatments that are not effective, including benzodiazepines, botulinum toxin injection, systemic corticosteroids, cervical collar, electrical muscle stimulation, short-wave diathermy, transcutaneous electrical nerve stimulation, and traction. Guidelines developed for high-income settings were adapted to inform a care pathway and model of care for medically underserved areas and low- and middle-income countries by considering factors such as costs and feasibility, in addition to benefits, harms, and the quality of underlying evidence. The selection of

  19. No evidence of enemy release in pathogen and microbial communities of common wasps (Vespula vulgaris in their native and introduced range.

    Directory of Open Access Journals (Sweden)

    Philip J Lester

    Full Text Available When invasive species move to new environments they typically experience population bottlenecks that limit the probability that pathogens and parasites are also moved. The invasive species may thus be released from biotic interactions that can be a major source of density-dependent mortality, referred to as enemy release. We examined for evidence of enemy release in populations of the common wasp (Vespula vulgaris, which attains high densities and represents a major threat to biodiversity in its invaded range. Mass spectrometry proteomic methods were used to compare the microbial communities in wasp populations in the native (Belgium and England and invaded range (Argentina and New Zealand. We found no evidence of enemy release, as the number of microbial taxa was similar in both the introduced and native range. However, some evidence of distinctiveness in the microbial communities was observed between countries. The pathogens observed were similar to a variety of taxa observed in honey bees. These taxa included Nosema, Paenibacillus, and Yersina spp. Genomic methods confirmed a diversity of Nosema spp., Actinobacteria, and the Deformed wing and Kashmir bee viruses. We also analysed published records of bacteria, viruses, nematodes and fungi from both V. vulgaris and the related invader V. germanica. Thirty-three different microorganism taxa have been associated with wasps including Kashmir bee virus and entomophagous fungi such as Aspergillus flavus. There was no evidence that the presence or absence of these microorganisms was dependent on region of wasp samples (i.e. their native or invaded range. Given the similarity of the wasp pathogen fauna to that from honey bees, the lack of enemy release in wasp populations is probably related to spill-over or spill-back from bees and other social insects. Social insects appear to form a reservoir of generalist parasites and pathogens, which makes the management of wasp and bee disease difficult.

  20. No evidence of enemy release in pathogen and microbial communities of common wasps (Vespula vulgaris) in their native and introduced range.

    Science.gov (United States)

    Lester, Philip J; Bosch, Peter J; Gruber, Monica A M; Kapp, Eugene A; Peng, Lifeng; Brenton-Rule, Evan C; Buchanan, Joe; Stanislawek, Wlodek L; Archer, Michael; Corley, Juan C; Masciocchi, Maitè; Van Oystaeyen, Annette; Wenseleers, Tom

    2015-01-01

    When invasive species move to new environments they typically experience population bottlenecks that limit the probability that pathogens and parasites are also moved. The invasive species may thus be released from biotic interactions that can be a major source of density-dependent mortality, referred to as enemy release. We examined for evidence of enemy release in populations of the common wasp (Vespula vulgaris), which attains high densities and represents a major threat to biodiversity in its invaded range. Mass spectrometry proteomic methods were used to compare the microbial communities in wasp populations in the native (Belgium and England) and invaded range (Argentina and New Zealand). We found no evidence of enemy release, as the number of microbial taxa was similar in both the introduced and native range. However, some evidence of distinctiveness in the microbial communities was observed between countries. The pathogens observed were similar to a variety of taxa observed in honey bees. These taxa included Nosema, Paenibacillus, and Yersina spp. Genomic methods confirmed a diversity of Nosema spp., Actinobacteria, and the Deformed wing and Kashmir bee viruses. We also analysed published records of bacteria, viruses, nematodes and fungi from both V. vulgaris and the related invader V. germanica. Thirty-three different microorganism taxa have been associated with wasps including Kashmir bee virus and entomophagous fungi such as Aspergillus flavus. There was no evidence that the presence or absence of these microorganisms was dependent on region of wasp samples (i.e. their native or invaded range). Given the similarity of the wasp pathogen fauna to that from honey bees, the lack of enemy release in wasp populations is probably related to spill-over or spill-back from bees and other social insects. Social insects appear to form a reservoir of generalist parasites and pathogens, which makes the management of wasp and bee disease difficult.

  1. Effect of Community Engagement Interventions on Patient Safety and Risk Reduction Efforts in Primary Health Facilities: Evidence from Ghana.

    Directory of Open Access Journals (Sweden)

    Robert Kaba Alhassan

    Full Text Available Patient safety and quality care remain major challenges to Ghana's healthcare system. Like many health systems in Africa, this is largely because demand for healthcare is outstripping available human and material resource capacity of healthcare facilities and new investment is insufficient. In the light of these demand and supply constraints, systematic community engagement (SCE in healthcare quality assessment can be a feasible and cost effective option to augment existing quality improvement interventions. SCE entails structured use of existing community groups to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements identified and rewards provided if the quality gaps are closed.This paper evaluates whether or not SCE, through the assessment of health service quality, improves patient safety and risk reduction efforts by staff in healthcare facilities.A randomized control trail was conducted in 64 primary healthcare facilities in the Greater Accra and Western regions of Ghana. Patient risk assessments were conducted in 32 randomly assigned intervention and control facilities. Multivariate multiple regression test was used to determine effect of the SCE interventions on staff efforts towards reducing patient risk. Spearman correlation test was used to ascertain associations between types of community groups engaged and risk assessment scores of healthcare facilities.Clinic staff efforts towards increasing patient safety and reducing risk improved significantly in intervention facilities especially in the areas of leadership/accountability (Coef. = 10.4, p<0.05 and staff competencies (Coef. = 7.1, p<0.05. Improvement in service utilization and health resources could not be attributed to the interventions because these were outside the control of the study and might have been influenced by institutional or national level developments between the baseline and follow-up period

  2. The impact of gated Communities on property values: evidence of changes in real estate markets -Los Angeles, 1980-2000

    Directory of Open Access Journals (Sweden)

    Renaud Le Goix

    2007-05-01

    Full Text Available The paper focuses on how gated communities, as private means of providing public infrastructure and security, real estate products and club-economies, produce changes in housing market patterns. Based on an empirical study of Los Angeles (California data, it aims to trace to what extent gates and walls favor property values and if the presence of gated communities produces over time (1980-2000 a deterrent effect on non-gated properties abutting the enclave, or close to it. Resulting from a demand for security, gated communities are a leading offer from the homebuilding industry. But their spread emerges from a partnership between local governments and land developers. Both agree to charge the homebuyer with the cost of urban sprawl (construction and maintenance costs of infrastructure within the gates. Such a structuring of residential space is particularly desirable on the urban edges, where the cost of urban sprawl exceeds the financial assets of local public authorities. New private developments provide local governments with new wealthy taxpayers at almost no cost. As compensation, the homebuyer is granted private and exclusive access to sites and amenities (lakes, beaches, etc.. Such exclusivity favors the location rent, and usually positively affects the property values within the gated enclaves. But it is also assumed that operating cost of private governance are paid for by the increase of property values. Market failure nevertheless occurs when costs rise above sustainable levels compared to property values. Changes produced by gates yield to at least two outcomes. At first sight, residential enclosures produce a price premium, thus being a smart investment. Furthermore, gated communities might well be able to generate enough property value to pay off the price of private governance. But this analysis holds only on a short term basis. In the long term, larger and wealthier gated communities are successful in shielding their property

  3. Bacterial biomass and activity in the deep waters of the eastern Atlantic—evidence of a barophilic community

    Science.gov (United States)

    Patching, J. W.; Eardly, D.

    1997-09-01

    Bacterial biomass and activity were investigated in deep waters at two sites in the eastern Atlantic, of similar depth (4560-4800 m), but varying in their nutritional status. The Northern (N) site was eutrophic and subject to a strong seasonal input of surface derived organic matter (phytodetritus) to the sediment. The Southern (S) site was oligotrophic. Deep water at this site does not appear to receive any strong seasonal input. Bacterial numbers in the deep water column at the N site showed no significant seasonal variation but were greater than those at the S site. Deep water bacteria were typically small and free-living. From biovolume determinations, it was estimated that mean concentrations of bacterial organic carbon at depths greater than 500 m were 0.12 (0.03-0.29) μg C 1 -1 and 0.02 (0.01-0.04) μg C 1 -1 at the N and S sites, respectively. Rates of thymidine and leucine incorporation were used as indicators of bacterial activity. Bacterial communities in water in contact with the sediment (SCW; sediment contact water) at both sites (but especially at the S site) were strongly barophilic at in situ temperatures (2.5-4.1°C). The barophilic response of thymidine incorporation was enhanced when SCW samples from the N site were incubated at 11.5°C. It is proposed that this result indicated an elevating effect of pressure on cardinal temperatures and that the SCW community was obligately psychrophilic when unpressurised. Comparison of cell-specific incorporation rates determined under in situ conditions showed bacteria in the SCW to have levels of activity comparable with bacteria from a depth of 150 m. Thymidine incorporation rates were highest in SCW samples taken at the N site in May 1988 and September 1989. Thymidine incorporation by SCW samples taken immediately before (10 April 1994) the main spring-bloom-associated deposition of phytodetritus was significantly lower and comparable with that determined for the oligotrophic S site. The attributes

  4. Community-based distribution of iron-folic acid supplementation in low- and middle-income countries: a review of evidence and programme implications.

    Science.gov (United States)

    Kavle, Justine A; Landry, Megan

    2018-02-01

    The present literature review aimed to review the evidence for community-based distribution (CBD) of iron-folic acid (IFA) supplementation as a feasible approach to improve anaemia rates in low- and middle-income countries. The literature review included peer-reviewed studies and grey literature from PubMed, Cochrane Library, LILAC and Scopus databases. Low- and middle-income countries. Non-pregnant women, pregnant women, and girls. CBD programmes had moderate success with midwives and community health workers (CHW) who counselled on health benefits and compliance with IFA supplementation. CHW were more likely to identify and reach a greater number of women earlier in pregnancy, as women tended to present late to antenatal care. CBD channels had greater consistency in terms of adequate supplies of IFA in comparison to clinics and vendors, who faced stock outages. Targeting women of reproductive age through school and community settings showed high compliance and demonstrated reductions in anaemia. CBD of IFA supplementation can be a valuable platform for improving knowledge about anaemia, addressing compliance and temporary side-effects of IFA supplements, and increasing access and coverage of IFA supplementation. Programmatic efforts focusing on community-based platforms should complement services and information provided at the health facility level. Provision of training and supportive supervision for CHW on how to counsel women on benefits, side-effects, and when, why, and how to take IFA supplements, as part of behaviour change communication, can be strengthened, alongside logistics and supply systems to ensure consistent supplies of IFA tablets at both the facility and community levels.

  5. Arsenic release from shallow aquifers of the Hetao basin, Inner Mongolia: evidence from bacterial community in aquifer sediments and groundwater.

    Science.gov (United States)

    Li, Yuan; Guo, Huaming; Hao, Chunbo

    2014-12-01

    Indigenous microbes play crucial roles in arsenic mobilization in high arsenic groundwater systems. Databases concerning the presence and the activity of microbial communities are very useful in evaluating the potential of microbe-mediated arsenic mobilization in shallow aquifers hosting high arsenic groundwater. This study characterized microbial communities in groundwaters at different depths with different arsenic concentrations by DGGE and one sediment by 16S rRNA gene clone library, and evaluated arsenic mobilization in microcosm batches with the presence of indigenous bacteria. DGGE fingerprints revealed that the community structure changed substantially with depth at the same location. It indicated that a relatively higher bacterial diversity was present in the groundwater sample with lower arsenic concentration. Sequence analysis of 16S rRNA gene demonstrated that the sediment bacteria mainly belonged to Pseudomonas, Dietzia and Rhodococcus, which have been widely found in aquifer systems. Additionally, NO3(-)-reducing bacteria Pseudomonas sp. was the largest group, followed by Fe(III)-reducing, SO4(2-)-reducing and As(V)-reducing bacteria in the sediment sample. These anaerobic bacteria used the specific oxyanions as electron acceptor and played a significant role in reductive dissolution of Fe oxide minerals, reduction of As(V), and release of arsenic from sediments into groundwater. Microcosm experiments, using intact aquifer sediments, showed that arsenic release and Fe(III) reduction were microbially mediated in the presence of indigenous bacteria. High arsenic concentration was also observed in the batch without amendment of organic carbon, demonstrating that the natural organic matter in sediments was the potential electron donor for microbially mediated arsenic release from these aquifer sediments.

  6. Home-based malaria management in children by women: Evidence from a malaria endemic community in sub-Saharan Africa

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    Doreen Nkiru Eugene-Ezebilo

    2015-07-01

    Full Text Available Objective: To examine the medicines and dosage that mothers who engage in home-based malaria management administer to children aged ≤ 5 years having signs and symptoms associated with malaria and to discuss the possibilities of designing an effective home-based malaria management strategy. Methods: The data were obtained from face-to-face semi-structured interviews conducted with mothers in the Ugbowo Community of Benin City, Nigeria who were selected using multistage systematic random sampling technique. The data were analyzed by qualitative content analysis, arithmetic mean, simple percentages and bar chart. Results: Approximately 90% of the interviewees engaged in home-based malaria management and 10% patronized the hospital. Most of the interviewees who engaged in home-based malaria management administered medicines that stimulates the production of red blood cells and supplies vitamins to children having signs and symptoms of malaria, followed by painkillers and anti-malaria and cough medicine was the least. Of the anti-malaria medicines administered to children, almost 80% of the interviewees administered chloroquine to children, 15% quinine and 3% halfan. Approximately 60% of the interviewees had the correct knowledge of the dosage regime for chloroquine, 38% for quinine and 9% for halfan. Conclusions: Although home-based malaria management is important, it cannot serve as a substitute to the hospital. Some diseases have signs and symptoms that are similar to that of malaria which implies that administering anti-malaria medicines to a child without confirmatory tests might lead to irredeemable complications in that child. If the strategy is to make home-based malaria management effective and sustainable mothers, community health officials should be involved in designing the strategy. Simple rapid diagnostic test kits for malaria should be made available to community health officials and pharmacists so that confirmatory tests could be

  7. Derivation and validation of the Personal Support Algorithm: an evidence-based framework to inform allocation of personal support services in home and community care.

    Science.gov (United States)

    Sinn, Chi-Ling Joanna; Jones, Aaron; McMullan, Janet Legge; Ackerman, Nancy; Curtin-Telegdi, Nancy; Eckel, Leslie; Hirdes, John P

    2017-11-25

    Personal support services enable many individuals to stay in their homes, but there are no standard ways to classify need for functional support in home and community care settings. The goal of this project was to develop an evidence-based clinical tool to inform service planning while allowing for flexibility in care coordinator judgment in response to patient and family circumstances. The sample included 128,169 Ontario home care patients assessed in 2013 and 25,800 Ontario community support clients assessed between 2014 and 2016. Independent variables were drawn from the Resident Assessment Instrument-Home Care and interRAI Community Health Assessment that are standardised, comprehensive, and fully compatible clinical assessments. Clinical expertise and regression analyses identified candidate variables that were entered into decision tree models. The primary dependent variable was the weekly hours of personal support calculated based on the record of billed services. The Personal Support Algorithm classified need for personal support into six groups with a 32-fold difference in average billed hours of personal support services between the highest and lowest group. The algorithm explained 30.8% of the variability in billed personal support services. Care coordinators and managers reported that the guidelines based on the algorithm classification were consistent with their clinical judgment and current practice. The Personal Support Algorithm provides a structured yet flexible decision-support framework that may facilitate a more transparent and equitable approach to the allocation of personal support services.

  8. Derivation and validation of the Personal Support Algorithm: an evidence-based framework to inform allocation of personal support services in home and community care

    Directory of Open Access Journals (Sweden)

    Chi-Ling Joanna Sinn

    2017-11-01

    Full Text Available Abstract Background Personal support services enable many individuals to stay in their homes, but there are no standard ways to classify need for functional support in home and community care settings. The goal of this project was to develop an evidence-based clinical tool to inform service planning while allowing for flexibility in care coordinator judgment in response to patient and family circumstances. Methods The sample included 128,169 Ontario home care patients assessed in 2013 and 25,800 Ontario community support clients assessed between 2014 and 2016. Independent variables were drawn from the Resident Assessment Instrument-Home Care and interRAI Community Health Assessment that are standardised, comprehensive, and fully compatible clinical assessments. Clinical expertise and regression analyses identified candidate variables that were entered into decision tree models. The primary dependent variable was the weekly hours of personal support calculated based on the record of billed services. Results The Personal Support Algorithm classified need for personal support into six groups with a 32-fold difference in average billed hours of personal support services between the highest and lowest group. The algorithm explained 30.8% of the variability in billed personal support services. Care coordinators and managers reported that the guidelines based on the algorithm classification were consistent with their clinical judgment and current practice. Conclusions The Personal Support Algorithm provides a structured yet flexible decision-support framework that may facilitate a more transparent and equitable approach to the allocation of personal support services.

  9. Associations of socioeconomic determinants with community clinic awareness and visitation among women: evidence from Bangladesh Demographic and Health Survey-2011.

    Science.gov (United States)

    Sarker, Mohammad Abul Bashar; Harun-Or-Rashid, Md; Reyer, Joshua A; Hirosawa, Tomoya; Yoshida, Yoshitoku; Islam, Mohammod Monirul; Siddique, Md Ruhul Furkan; Hossain, Shaila; Sakamoto, Junichi; Hamajima, Nobuyuki

    2015-10-21

    Although Bangladesh has achieved tremendous success in health care over the last four decades, it still lagged behind in the areas of maternal and child malnutrition and primary health care (PHC). To increase access to PHC, the Bangladesh government established approximately 18,000 community clinics (CCs). The purpose of this study was to examine the associations of socioeconomic determinants of women aged 12-49 years with the CCs awareness and visitation. We analyzed secondary data provided by Bangladesh Demographic and Health Survey-2011. A two-stage cluster sampling was used to collect the data. A total of 18,222 ever married women aged 12-49 years were identified from selected households and 17,842 were interviewed. The main outcome measures of our study were awareness and visitation of CCs. Bivariate logistic regression was used to calculate odds ratio (OR) and 95% confidence interval (CI) to examine the associations between the awareness and visiting CCs with socioeconomic determinants. Low prevalence of awareness about CC (18 %) was observed among studied women and only 17 % of them visited CCs. Significant associations (P economic conditions, young age, and primary education. Awareness and access to CCs might be increased through community activities that involve health care workers. The government should also lower barriers to PHC access through CCs by providing adequate logistics, such as human resources and equipment.

  10. The family and community lives of older people after the Second World War: new evidence from York.

    Science.gov (United States)

    Freeman, Mark; Wannell, Louise

    2009-01-01

    This article uses the findings of a detailed and unpublished survey, carried out in York in 1947 and 1948, to examine the support networks, social lives and economic conditions of older people in a period when considerable sociological attention was being paid to this section of the population. It is argued that the sociology of old age in this period overstated the role of families, and downplayed the involvement of the wider community, in the social networks of older people. The article also shows that even many of those who were physically restricted in some way could participate fully in social activities. Friends, visiting and social clubs played an important role in many lives. However, the financial circumstances of many older people restricted many areas of social participation, and contemporaneous poverty surveys probably understated the real extent of poverty among the elderly. These high levels of poverty themselves underscore the importance of the family and community support networks that are uncovered using the York data.

  11. Predictors of sustainability for community-managed handpumps in sub-Saharan Africa: evidence from Liberia, Sierra Leone, and Uganda.

    Science.gov (United States)

    Foster, Tim

    2013-01-01

    Rural water supply sustainability has remained an enduring policy challenge in sub-Saharan Africa for decades. Drawing on the largest data set assembled on rural water points in sub-Saharan Africa to date, this paper employs logistic regression analyses to identify operational, technical, institutional, financial, and environmental predictors of functionality for over 25 000 community-managed handpumps in Liberia, Sierra Leone, and Uganda. Risk factors significantly associated with nonfunctionality across all three countries were (a) system age, (b) distance from district/county capital, and (c) absence of user fee collection. In at least one of the three countries, other variables found to have significant multivariable adjusted associations with functionality status included well type, handpump type, funding organization, implementing organization, spare parts proximity, availability of a handpump mechanic, regular servicing, regular water committee meetings, women in key water committee positions, rainfall season, and perceived water quality. While the findings reinforce views that a multifaceted range of conditions is critical for the sustainability of community-managed handpumps, they also demonstrate that these factors remain absent from a high proportion of cases. Governments and development partners must significantly strengthen postconstruction support for operation and maintenance systems, and greater efforts are needed to test and evaluate alternative models for managing handpump water supplies.

  12. Household and community income, economic shocks and risky sexual behavior of young adults: evidence from the Cape Area Panel Study 2002 and 2005.

    Science.gov (United States)

    Dinkelman, Taryn; Lam, David; Leibbrandt, Murray

    2007-11-01

    To describe recent trends in adolescent sexual behavior in Cape Town, South Africa, and to determine whether household and community poverty and negative economic shocks predict risky sexual behavior. Matched survey data on 2993 African and coloured youth from the Cape Area Panel Study 2002 and 2005. Sexual debut, multiple sexual partners in past year, condom use at last sex, measured in 2002 and 2005. We tested for changes over time in reported sexual behavior and estimate multivariate probit models to measure the association between 2002 individual, household and community characteristics and 2005 sexual behavior. There was a statistically significant increase in condom use and a decrease in the incidence of multiple sexual partners between 2002 and 2005 for young women aged 17-22 years. Young women in households with 10% higher income were 0.53% less likely to debut sexually by 2005; young men in communities with a 10% higher poverty rate were 5% less likely to report condom use at last sex. Negative economic shocks are associated with a 0.04% increase in the probability of multiple partnerships for young women. Education is positively correlated with sexual debut for young women and with multiple partnerships for both sexes. Trends in sexual behavior between 2002 and 2005 indicate significant shifts towards safer practices. There is little evidence of a relationship between negative economic shocks, household and community poverty, and risky behavior. We hypothesize that the unexpected positive relationship between education and sexual debut may be driven by peer effects in schools with substantial age mixing.

  13. Biomarker Evidence of Relatively Stable Community Structure in the Northern South China Sea during the Last Glacial and Holocene

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    Juan He

    2008-01-01

    Full Text Available High-resolution molecular abundance records for several marine biomarkers during the last glacial and Holocene have been generated for core MD05-2904 (19 _ 116 _ 2066 mwater depth from the northern South China Sea. The UK' 37 SST record indicates a 4.4 C cooling during the Last Glacial Maximum for this site, consistent with previous reconstructions. The contents of C37 alkenones, dinosterol, brassicasterol, and C30 alkyl diols are used as productivity proxies for haptophytes, dinoflagellates, diatoms, and eustigmatophytes, respectively. These records reveal that both individual phytoplankton group and total productivity increased by several factors during the LGM compared with those for the Holocene, in response to increased nutrient supply. However, the community structure based on biomarker percentages remained relatively stable during the last glacial-Holocene transition, although there were short-term oscillations.

  14. Alternative approaches to community participation beyond formal structures: evidence from Langa within the municipality of Cape Town

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    Adam Andani

    2018-05-01

    Full Text Available While ward committees and Integrated Development Planning (IDP representative forums constitute formal participatory mechanisms in South Africa’s local government, little is known about the potential of local approaches in enhancing participation in municipal planning. This paper examines alternative approaches to participation based on research conducted in Langa – a township situated on the Cape Flats of Cape Town. The paper highlights approaches to residents’ participation in planning tested during the ‘interregnum’ – the period when ward committees are in abeyance due to elections. The study found that, while IDP participatory processes facilitated awareness of participation, ward councillors were crucial in operationalising participation that reflects the diversity of the community.

  15. Do Countries Consistently Engage in Misinforming the International Community about Their Efforts to Combat Money Laundering? Evidence Using Benford's Law.

    Science.gov (United States)

    Deleanu, Ioana Sorina

    2017-01-01

    Indicators of compliance and efficiency in combatting money laundering, collected by EUROSTAT, are plagued with shortcomings. In this paper, I have carried out a forensic analysis on a 2003-2010 dataset of indicators of compliance and efficiency in combatting money laundering, that European Union member states self-reported to EUROSTAT, and on the basis of which, their efforts were evaluated. I used Benford's law to detect any anomalous statistical patterns and found that statistical anomalies were also consistent with strategic manipulation. According to Benford's law, if we pick a random sample of numbers representing natural processes, and look at the distribution of the first digits of these numbers, we see that, contrary to popular belief, digit 1 occurs most often, then digit 2, and so on, with digit 9 occurring in less than 5% of the sample. Without prior knowledge of Benford's law, since people are not intuitively good at creating truly random numbers, deviations thereof can capture strategic alterations. In order to eliminate other sources of deviation, I have compared deviations in situations where incentives and opportunities for manipulation existed and in situations where they did not. While my results are not a conclusive proof of strategic manipulation, they signal that countries that faced incentives and opportunities to misinform the international community about their efforts to combat money laundering may have manipulated these indicators. Finally, my analysis points to the high potential for disruption that the manipulation of national statistics has, and calls for the acknowledgment that strategic manipulation can be an unintended consequence of the international community's pressure on countries to put combatting money laundering on the top of their national agenda.

  16. Do Countries Consistently Engage in Misinforming the International Community about Their Efforts to Combat Money Laundering? Evidence Using Benford's Law.

    Directory of Open Access Journals (Sweden)

    Ioana Sorina Deleanu

    Full Text Available Indicators of compliance and efficiency in combatting money laundering, collected by EUROSTAT, are plagued with shortcomings. In this paper, I have carried out a forensic analysis on a 2003-2010 dataset of indicators of compliance and efficiency in combatting money laundering, that European Union member states self-reported to EUROSTAT, and on the basis of which, their efforts were evaluated. I used Benford's law to detect any anomalous statistical patterns and found that statistical anomalies were also consistent with strategic manipulation. According to Benford's law, if we pick a random sample of numbers representing natural processes, and look at the distribution of the first digits of these numbers, we see that, contrary to popular belief, digit 1 occurs most often, then digit 2, and so on, with digit 9 occurring in less than 5% of the sample. Without prior knowledge of Benford's law, since people are not intuitively good at creating truly random numbers, deviations thereof can capture strategic alterations. In order to eliminate other sources of deviation, I have compared deviations in situations where incentives and opportunities for manipulation existed and in situations where they did not. While my results are not a conclusive proof of strategic manipulation, they signal that countries that faced incentives and opportunities to misinform the international community about their efforts to combat money laundering may have manipulated these indicators. Finally, my analysis points to the high potential for disruption that the manipulation of national statistics has, and calls for the acknowledgment that strategic manipulation can be an unintended consequence of the international community's pressure on countries to put combatting money laundering on the top of their national agenda.

  17. Adequate Consultation And Dialogue With Local Community Unlocking The Untapped Potential For Peace And Development Evidences From South Omo Zone

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    Mohammed Yimer

    2017-10-01

    Full Text Available The paper argues that adequate consultation and public wide dialogues at the grass root level are the two potential entry points in times of development interventions. This will foster peace among the nearby people and led a foundation for the subsequent development. The study was undertaken to examine whether the agro-pastoral communities of South Omo zone were jeopardized as a result of the Omo Kuraz Sugar development project or not. It also targeted whether there was adequate consultation with the local people at the earliest days of the project. Adopting Ethnographic design the study accompanied by primary data collected through participant observation focus group discussion and key informant interview indicated that there were attempts to consult the indigenous people though not adequate. It also indicated that despite the absence of compensation for the local displaced people due to their mobile life the people were not endangered as a result of the project. This project as a development project that is established at the communal land of the agro-pastoralists is providing training for the nearby people to hire them in its various offices. Far from the claims of the various oversees institutions propounded as if the agro-pastoral communities were miserably suffered from such a project the people consider it as if it is their own project. The study implied that South Omo zone is a counter example of how local level consultation and a wide range of dialogue are indispensable preconditions to foster peace and development in many pastoral and agro-pastoral areas of the country.

  18. Metagenomic Evidence for H2 Oxidation and H2 Production by Serpentinite-Hosted Subsurface Microbial Communities

    Science.gov (United States)

    Brazelton, William J.; Nelson, Bridget; Schrenk, Matthew O.

    2012-01-01

    Ultramafic rocks in the Earth’s mantle represent a tremendous reservoir of carbon and reducing power. Upon tectonic uplift and exposure to fluid flow, serpentinization of these materials generates copious energy, sustains abiogenic synthesis of organic molecules, and releases hydrogen gas (H2). In order to assess the potential for microbial H2 utilization fueled by serpentinization, we conducted metagenomic surveys of a marine serpentinite-hosted hydrothermal chimney (at the Lost City hydrothermal field) and two continental serpentinite-hosted alkaline seeps (at the Tablelands Ophiolite, Newfoundland). Novel [NiFe]-hydrogenase sequences were identified at both the marine and continental sites, and in both cases, phylogenetic analyses indicated aerobic, potentially autotrophic Betaproteobacteria belonging to order Burkholderiales as the most likely H2-oxidizers. Both sites also yielded metagenomic evidence for microbial H2 production catalyzed by [FeFe]-hydrogenases in anaerobic Gram-positive bacteria belonging to order Clostridiales. In addition, we present metagenomic evidence at both sites for aerobic carbon monoxide utilization and anaerobic carbon fixation via the Wood–Ljungdahl pathway. In general, our results point to H2-oxidizing Betaproteobacteria thriving in shallow, oxic–anoxic transition zones and the anaerobic Clostridia thriving in anoxic, deep subsurface habitats. These data demonstrate the feasibility of metagenomic investigations into novel subsurface habitats via surface-exposed seeps and indicate the potential for H2-powered primary production in serpentinite-hosted subsurface habitats. PMID:22232619

  19. Metagenomic evidence for h(2) oxidation and h(2) production by serpentinite-hosted subsurface microbial communities.

    Science.gov (United States)

    Brazelton, William J; Nelson, Bridget; Schrenk, Matthew O

    2012-01-01

    Ultramafic rocks in the Earth's mantle represent a tremendous reservoir of carbon and reducing power. Upon tectonic uplift and exposure to fluid flow, serpentinization of these materials generates copious energy, sustains abiogenic synthesis of organic molecules, and releases hydrogen gas (H(2)). In order to assess the potential for microbial H(2) utilization fueled by serpentinization, we conducted metagenomic surveys of a marine serpentinite-hosted hydrothermal chimney (at the Lost City hydrothermal field) and two continental serpentinite-hosted alkaline seeps (at the Tablelands Ophiolite, Newfoundland). Novel [NiFe]-hydrogenase sequences were identified at both the marine and continental sites, and in both cases, phylogenetic analyses indicated aerobic, potentially autotrophic Betaproteobacteria belonging to order Burkholderiales as the most likely H(2)-oxidizers. Both sites also yielded metagenomic evidence for microbial H(2) production catalyzed by [FeFe]-hydrogenases in anaerobic Gram-positive bacteria belonging to order Clostridiales. In addition, we present metagenomic evidence at both sites for aerobic carbon monoxide utilization and anaerobic carbon fixation via the Wood-Ljungdahl pathway. In general, our results point to H(2)-oxidizing Betaproteobacteria thriving in shallow, oxic-anoxic transition zones and the anaerobic Clostridia thriving in anoxic, deep subsurface habitats. These data demonstrate the feasibility of metagenomic investigations into novel subsurface habitats via surface-exposed seeps and indicate the potential for H(2)-powered primary production in serpentinite-hosted subsurface habitats.

  20. Metagenomic evidence for H2 oxidation and H2 production by serpentinite-hosted subsurface microbial communities

    Directory of Open Access Journals (Sweden)

    William J Brazelton

    2012-01-01

    Full Text Available Ultramafic rocks in the Earth’s mantle represent a tremendous reservoir of carbon and reducing power. Upon tectonic uplift and exposure to fluid flow, serpentinization of these materials generates copious energy, sustains abiogenic synthesis of organic molecules, and releases hydrogen gas (H2. In order to assess the potential for microbial H2 utilization fueled by serpentinization, we conducted metagenomic surveys of a marine serpentinite-hosted hydrothermal chimney (at the Lost City hydrothermal field and two continental serpentinite- hosted alkaline seeps (at the Tablelands Ophiolite, Newfoundland. Novel [NiFe]-hydrogenase sequences were identified at both the marine and continental sites, and in both cases, phylogenetic analyses indicated aerobic, potentially autotrophic Betaproteobacteria belonging to order Burkholderiales as the most likely H2-oxidizers. Both sites also yielded metagenomic evidence for microbial H2 production catalyzed by [FeFe]-hydrogenases in anaerobic Gram- positive bacteria belonging to order Clostridiales. In addition, we present metagenomic evidence at both sites for aerobic carbon monoxide utilization and anaerobic carbon fixation via the Wood-Ljungdahl pathway. In general, our results point to H2-oxidizing Betaproteobacteria thriving in shallow, oxic-anoxic transition zones and the anaerobic Clostridia thriving in anoxic, deep subsurface habitats. These data demonstrate the feasibility of metagenomic investigations into novel subsurface habitats via surface-exposed seeps and indicate the potential for H2- powered primary production in serpentinite-hosted subsurface habitats.

  1. Assessing public flood risk perception for understanding the level of risk preparedness - Evidence from a community-based survey (the Bend Subcarpathians, Romania)

    Science.gov (United States)

    Balteanu, Dan; Micu, Dana; Dumitrascu, Monica; Chendes, Viorel; Dragota, Carmen; Kucsicsa, Gheorghita; Grigorescu, Ines; Persu, Mihaela; Costache, Andra

    2016-04-01

    Floods (slow-onset and rapid) are among the costliest hydro-meteorological hazards in Romania, with strong societal and economic impacts, especially in small rural settlements, with a limited adaptive capacity to their adverse effects induced by the regional socio-economic context (e.g. aging population, low economic power). The study-area is located in the Bend Subcarpathians (Romania), a region with high tectonic mobility (the Seismic Vrancea Region), active slope processes (e.g. shallow and deep-seated landslides, mud flow, gully erosion) and increasing frequency of flash floods associated to heavy rainfalls. The study was conducted in the framework of the project "Vulnerability of the environment and human settlements to floods in the context of Global Environmental Change - VULMIN" (PN-II-PT-PCCA-2011-3.1-1587), funded by the Ministry of National Education over the 2012-2016 period (http://www.igar-vulmin.ro). Prior research derived valuable insights into the local population vulnerability to extreme hydro-meteorological events, revealing an increased individual experience to past hydrological events, a high level of worry associated to flood recurrence, a low rate of the perceived trustworthiness in national institutions and authorities, as well as evident differences between the perception of community members and local authorities in terms of risk preparedness. In the present study, an attempt has been made for developing an advanced understanding of the current level of flood risk preparedness within some communities strongly affected by the floods of 1970-1975, 2005 and 2010. The recent events had a significant impact on local communities and infrastructure in terms of the financial losses, causing a visible stress and even psychological trauma on some residents of the most affected households. The selected communities are located in areas affected by recurrent hydro-meteorological hazards (floods and flash floods), with return periods below 10 years. A

  2. Effects of Evidence-Based Fall Reduction Programing on the Functional Wellness of Older Adults in a Senior Living Community: A Clinical Case Study.

    Science.gov (United States)

    Harnish, Andrew; Dieter, William; Crawford, Albert; Shubert, Tiffany E

    2016-01-01

    Older adults at a high risk of falls may be referred to a physical therapist. A physical therapy episode of care is designed for the transition of an older adult from a high fall risk to a moderate to low fall risk. However, these episodes of care are limited in time and duration. There is compelling evidence for the efficacy of group-based exercise classes to address risk, and transitioning an older adult from physical therapy to a group-based program may be an effective way to manage risk through the continuum of care. The purpose of this study was to translate research findings into a "real world" setting, and demonstrate the efficacy of integrating evidence-based fall prevention exercises into pre-existing exercise classes at a senior living facility as a "proof of concept" model for future programing. Twenty-four participants aged 65 years and older living in a senior living community and the community were stratified into group-based exercise classes. Cutoff scores from functional outcome measures were used to stratify participants. Exercises from The Otago Exercise Program were implemented into the classes. Functional outcome measures collected included the 10-Meter Walk Test, 30-Second Sit to Stand, and Timed Up and Go (TUG). Number of falls, hospitalizations, and physical therapy episodes of care were also tracked. Data were compared to a control group in a different senior living community that offered classes with similar exercises aimed at improving strength and mobility. The classes were taught by an exercise physiologist and were of equal duration and frequency. Participants demonstrated significant improvements in all functional outcome measures. TUG mean improved from 13.5 to 10.4 s ( p  = 0.034). The 30-Second Sit to Stand mean improved from 10.5 to 13.4 ( p  = 0.002). The 10-Meter Walk Test improved from 0.81 to 0.98 m/s ( p  falls or hospitalizations, and two participants required physical therapy episodes of care. Implementing an

  3. The Social Perspective on the Renewable Energy Autonomy of Geographically Isolated Communities: Evidence from a Mediterranean Island

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    Fontina Petrakopoulou

    2017-02-01

    Full Text Available The use of renewable energy sources can provide a path toward sustainable development and regional energy independence. In particular, renewable-based energy autonomy constitutes a viable option in remote areas. This work presents a survey on the use of renewable energy as part of an energy autonomy plan on a Mediterranean island. The study also included personal communications with residents and local community leaders. The results show an overall positive attitude toward renewable energy applications. The majority of the respondents support the implementation of renewable-based, small-scale projects corresponding to local energy autonomy scenarios. They are, furthermore, convinced that a wider use of renewable technologies can reduce the environmental impact of conventional fuels. However, although people are aware of technologies widely used on the island, they are much less so when it comes to less prominent technologies (wave energy, fuel cells, etc.. People tend to be more open to installations of solar, wind and geothermal energy, while generally they dislike nuclear and coal power plants. Lastly, the majority of the respondents believe that local policies on energy issues should change, while they also perceive the lack of political will as one of the most important obstacles to the implementation of renewable technologies.

  4. Successful Strategies to Engage Research Partners for Translating Evidence into Action in Community Health: A Critical Review

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    Jon Salsberg

    2015-01-01

    Full Text Available Objectives. To undertake a critical review describing key strategies supporting development of participatory research (PR teams to engage partners for creation and translation of action-oriented knowledge. Methods. Sources are four leading PR practitioners identified via bibliometric analysis. Authors’ publications were identified in January 1995–October 2009 in PubMed, Embase, ISI Web of Science and CAB databases, and books. Works were limited to those with a process description describing a research project and practitioners were first, second, third, or last author. Results. Adapting and applying the “Reliability Tested Guidelines for Assessing Participatory Research Projects” to retained records identified five key strategies: developing advisory committees of researchers and intended research users; developing research agreements; using formal and informal group facilitation techniques; hiring co-researchers/partners from community; and ensuring frequent communication. Other less frequently mentioned strategies were also identified. Conclusion. This review is the first time these guidelines were used to identify key strategies supporting PR projects. They proved effective at identifying and evaluating engagement strategies as reported by completed research projects. Adapting these guidelines identified gaps where the tool was unable to assess fundamental PR elements of power dynamics, equity of resources, and member turnover. Our resulting template serves as a new tool to measure partnerships.

  5. Structural validity and reliability of the Positive and Negative Affect Schedule (PANAS): evidence from a large Brazilian community sample.

    Science.gov (United States)

    Carvalho, Hudson W de; Andreoli, Sérgio B; Lara, Diogo R; Patrick, Christopher J; Quintana, Maria Inês; Bressan, Rodrigo A; Melo, Marcelo F de; Mari, Jair de J; Jorge, Miguel R

    2013-01-01

    Positive and negative affect are the two psychobiological-dispositional dimensions reflecting proneness to positive and negative activation that influence the extent to which individuals experience life events as joyful or as distressful. The Positive and Negative Affect Schedule (PANAS) is a structured questionnaire that provides independent indexes of positive and negative affect. This study aimed to validate a Brazilian interview-version of the PANAS by means of factor and internal consistency analysis. A representative community sample of 3,728 individuals residing in the cities of São Paulo and Rio de Janeiro, Brazil, voluntarily completed the PANAS. Exploratory structural equation model analysis was based on maximum likelihood estimation and reliability was calculated via Cronbach's alpha coefficient. Our results provide support for the hypothesis that the PANAS reliably measures two distinct dimensions of positive and negative affect. The structure and reliability of the Brazilian version of the PANAS are consistent with those of its original version. Taken together, these results attest the validity of the Brazilian adaptation of the instrument.

  6. Lessons from game theory about healthcare system price inflation: evidence from a community-level case study.

    Science.gov (United States)

    Agee, Mark D; Gates, Zane

    2013-02-01

    Game theory is useful for identifying conditions under which individual stakeholders in a collective action problem interact in ways that are more cooperative and in the best interest of the collective. The literature applying game theory to healthcare markets predicts that when providers set prices for services autonomously and in a noncooperative fashion, the market will be susceptible to ongoing price inflation. We compare the traditional fee-for-service pricing framework with an alternative framework involving modified doctor, hospital and insurer pricing and incentive strategies. While the fee-for-service framework generally allows providers to set prices autonomously, the alternative framework constrains providers to interact more cooperatively. We use community-level provider and insurer data to compare provider and insurer costs and patient wellness under the traditional and modified pricing frameworks. The alternative pricing framework assumes (i) providers agree to manage all outpatient claims; (ii) the insurer agrees to manage all inpatient clams; and (iii) insurance premiums are tied to patients' healthy behaviours. Consistent with game theory predictions, the more cooperative alternative pricing framework benefits all parties by producing substantially lower administrative costs along with higher profit margins for the providers and the insurer. With insurance premiums tied to consumers' risk-reducing behaviours, the cost of insurance likewise decreases for both the consumer and the insurer.

  7. Investigation of Endophytic Bacterial Community in Supposedly Axenic Cultures of Pineapple and Orchids with Evidence on Abundant Intracellular Bacteria.

    Science.gov (United States)

    Esposito-Polesi, Natalia Pimentel; de Abreu-Tarazi, Monita Fiori; de Almeida, Cristina Vieira; Tsai, Siu Mui; de Almeida, Marcílio

    2017-01-01

    Asepsis, defined as the absence of microbial contamination, is one of the most important requirements of plant micropropagation. In long-term micropropagated cultures, there may occasionally occur scattered microorganism growth in the culture medium. These microorganisms are common plant components and are known as latent endophytes. Thus, the aim of this research was to investigate the presence of endophytic bacteria in asymptomatic pineapple and orchid microplants, which were cultivated in three laboratories for 1 year. Isolation and characterization of bacterial isolates, PCR-DGGE from total genomic DNA of microplants and ultrastructural analysis of leaves were performed. In the culture-dependent technique, it was only possible to obtain bacterial isolates from pineapple microplants. In this case, the bacteria genera identified in the isolation technique were Bacillus, Acinetobacter, and Methylobacterium. The scanning electron microscopy and transmission electron microscopy (SEM and TEM) analyses revealed the presence of endophytic bacteria in intracellular spaces in the leaves of pineapple and orchid microplants, independent of the laboratory or cultivation protocol. Our results strongly indicate that there are endophytic bacterial communities inhabiting the microplants before initiation of the in vitro culture and that some of these endophytes persist in their latent form and can also grow in the culture medium even after long-term micropropagation, thus discarding the concept of "truly axenic plants."

  8. Successful strategies to engage research partners for translating evidence into action in community health: a critical review.

    Science.gov (United States)

    Salsberg, Jon; Parry, David; Pluye, Pierre; Macridis, Soultana; Herbert, Carol P; Macaulay, Ann C

    2015-01-01

    To undertake a critical review describing key strategies supporting development of participatory research (PR) teams to engage partners for creation and translation of action-oriented knowledge. Sources are four leading PR practitioners identified via bibliometric analysis. Authors' publications were identified in January 1995-October 2009 in PubMed, Embase, ISI Web of Science and CAB databases, and books. Works were limited to those with a process description describing a research project and practitioners were first, second, third, or last author. Adapting and applying the "Reliability Tested Guidelines for Assessing Participatory Research Projects" to retained records identified five key strategies: developing advisory committees of researchers and intended research users; developing research agreements; using formal and informal group facilitation techniques; hiring co-researchers/partners from community; and ensuring frequent communication. Other less frequently mentioned strategies were also identified. This review is the first time these guidelines were used to identify key strategies supporting PR projects. They proved effective at identifying and evaluating engagement strategies as reported by completed research projects. Adapting these guidelines identified gaps where the tool was unable to assess fundamental PR elements of power dynamics, equity of resources, and member turnover. Our resulting template serves as a new tool to measure partnerships.

  9. Clinical practice guidelines within the Southern African development community: a descriptive study of the quality of guideline development and concordance with best evidence for five priority diseases

    Science.gov (United States)

    2012-01-01

    Background Reducing the burden of disease relies on availability of evidence-based clinical practice guidelines (CPGs). There is limited data on availability, quality and content of guidelines within the Southern African Development Community (SADC). This evaluation aims to address this gap in knowledge and provide recommendations for regional guideline development. Methods We prioritised five diseases: HIV in adults, malaria in children and adults, pre-eclampsia, diarrhoea in children and hypertension in primary care. A comprehensive electronic search to locate guidelines was conducted between June and October 2010 and augmented with email contact with SADC Ministries of Health. Independent reviewers used the AGREE II tool to score six quality domains reporting the guideline development process. Alignment of the evidence-base of the guidelines was evaluated by comparing their content with key recommendations from accepted reference guidelines, identified with a content expert, and percentage scores were calculated. Findings We identified 30 guidelines from 13 countries, publication dates ranging from 2003-2010. Overall the 'scope and purpose' and 'clarity and presentation' domains of the AGREE II instrument scored highest, median 58%(range 19-92) and 83%(range 17-100) respectively. 'Stakeholder involvement' followed with median 39%(range 6-75). 'Applicability', 'rigour of development' and 'editorial independence' scored poorly, all below 25%. Alignment with evidence was variable across member states, the lowest scores occurring in older guidelines or where the guideline being evaluated was part of broader primary healthcare CPG rather than a disease-specific guideline. Conclusion This review identified quality gaps and variable alignment with best evidence in available guidelines within SADC for five priority diseases. Future guideline development processes within SADC should better adhere to global reporting norms requiring broader consultation of stakeholders

  10. The effects of community income inequality on health: Evidence from a randomized control trial in the Bolivian Amazon.

    Science.gov (United States)

    Undurraga, Eduardo A; Behrman, Jere R; Leonard, William R; Godoy, Ricardo A

    2016-01-01

    Research suggests that poorer people have worse health than the better-off and, more controversially, that income inequality harms health. But causal interpretations suffer from endogeneity. We addressed the gap by using a randomized control trial among a society of forager-farmers in the Bolivian Amazon. Treatments included one-time unconditional income transfers (T1) to all households and (T2) only to the poorest 20% of households, with other villages as controls. We assessed the effects of income inequality, absolute income, and spillovers within villages on self-reported health, objective indicators of health and nutrition, and adults' substance consumption. Most effects came from relative income. Targeted transfers increased the perceived stress of participants in better-off households. Evidence suggests increased work efforts among better-off households when the lot of the poor improved, possibly due to a preference for rank preservation. The study points to new paths by which inequality might affect health. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Molecular evidence for a diverse green algal community growing in the hair of sloths and a specific association with Trichophilus welckeri (Chlorophyta, Ulvophyceae

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    Chiarello Adriano G

    2010-03-01

    Full Text Available Abstract Background Sloths are slow-moving arboreal mammals inhabiting tropical rainforests in Central and South America. The six living species of sloths are occasionally reported to display a greenish discoloration of their pelage. Trichophilus welckeri, a green algal species first described more than a century ago, is widely believed to discolor the animals fur and provide the sloth with effective camouflage. However, this phenomenon has not been explored in any detail and there is little evidence to substantiate this widely held opinion. Results Here we investigate the genetic diversity of the eukaryotic community present in fur of all six extant species of sloth. Analysis of 71 sloth hair samples yielding 426 partial 18S rRNA gene sequences demonstrates a diverse eukaryotic microbial assemblage. Phylogenetic analysis reveals that sloth fur hosts a number of green algal species and suggests that acquisition of these organisms from the surrounding rainforest plays an important role in the discoloration of sloth fur. However, an alga corresponding to the morphological description of Trichophilus welckeri was found to be frequent and abundant on sloth fur. Phylogenetic analysis demonstrated the retention of this alga on the fur of sloths independent of geographic location. Conclusions These results demonstrate a unique diverse microbial eukaryotic community in the fur of sloths from Central and South America. Our analysis streghtens the case for symbiosis between sloths and Trichophilus welckeri.

  12. Providers' perspectives of factors influencing implementation of evidence-based treatments in a community mental health setting: A qualitative investigation of the training-practice gap.

    Science.gov (United States)

    Marques, Luana; Dixon, Louise; Valentine, Sarah E; Borba, Christina P C; Simon, Naomi M; Wiltsey Stirman, Shannon

    2016-08-01

    This study aims to elucidate relations between provider perceptions of aspects of the consolidated framework for implementation research (Damschroder et al., 2009) and provider attitudes toward the implementation of evidence-based treatments (EBTs) in an ethnically diverse community health setting. Guided by directed content analysis, we analyzed 28 semistructured interviews that were conducted with providers during the pre-implementation phase of a larger implementation study for cognitive processing therapy for posttraumatic stress disorder (Resick et al., 2008). Our findings extend the existing literature by also presenting provider-identified client-level factors that contribute to providers' positive and negative attitudes toward EBTs. Provider-identified client-level factors include the following: client motivation to engage in treatment, client openness to EBTs, support networks of family and friends, client use of community and government resources, the connection and relationship with their therapist, client treatment adherence, client immediate needs or crises, low literacy or illiteracy, low levels of education, client cognitive limitations, and misconceptions about therapy. These results highlight the relations between provider perceptions of their clients, provider engagement in EBT training, and subsequent adoption of EBTs. We present suggestions for future implementation research in this area. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  13. Community-based human-elephant conflict mitigation: The value of an evidence-based approach in promoting the uptake of effective methods.

    Directory of Open Access Journals (Sweden)

    Donny Gunaryadi

    Full Text Available Human-elephant conflict (HEC is a serious threat to elephants and can cause major economic losses. It is widely accepted that reduction of HEC will often require community-based methods for repelling elephants but there are few tests of such methods. We tested community-based crop-guarding methods with and without novel chili-based elephant deterrents and describe changes in farmers' willingness to adopt these methods following our demonstration of their relative effectiveness. In three separate field-trials that took place over almost two years (October 2005 -May 2007 in two villages adjacent to Way Kambas National Park (WKNP in Indonesia, we found that community-based crop-guarding was effective at keeping Asian elephants (Elephas maximus out of crop fields in 91.2% (52 out of 57, 87.6% (156 out of 178, and 80.0% (16 out of 20 of attempted raids. Once the method had been shown to be effective at demonstration sites, farmers in 16 villages around WKNP voluntarily adopted it during the July 2008 to March 2009 period and were able to repel elephants in 73.9% (150 out of 203 of attempted raids, with seven villages repelling 100% of attempted raids. These 16 villages had all experienced high levels of HEC in the preceding years; e.g. they accounted for >97% of the 742 HEC incidents recorded for the entire park in 2006. Our work shows, therefore, that a simple evidence-based approach can facilitate significant reductions in HEC at the protected area scale.

  14. Adapting the Healthy Eating Index 2010 for the Canadian Population: Evidence from the Canadian Community Health Survey

    Science.gov (United States)

    Ng, Alena Praneet; L’Abbé, Mary R.

    2017-01-01

    The Healthy Eating Index (HEI) is a diet quality index shown to be associated with reduced chronic disease risk. Older versions of the HEI have been adapted for Canadian populations; however, no Canadian modification of the Healthy Eating Index-2010 (HEI-2010) has been made. The aims of this study were: (a) to develop a Canadian adaptation of the HEI-2010 (i.e., Healthy Eating Index-Canada 2010 (HEI-C 2010)) by adapting the recommendations of the HEI-2010 to Canada’s Food Guide (CFG) 2007; (b) to evaluate the validity and reliability of the HEI-C 2010; and (c) to examine relationships between HEI-C 2010 scores with diet quality and the likelihood of being obese. Data from 12,805 participants (≥18 years) were obtained from the Canadian Community Health Survey Cycle 2.2. Weighted multivariate logistic regression was used to test the association between compliance to the HEI-C 2010 recommendations and the likelihood of being obese, adjusting for errors in self-reported dietary data. The total mean error-corrected HEI-C 2010 score was 50.85 ± 0.35 out of 100. Principal component analysis confirmed multidimensionality of the HEI-C 2010, while Cronbach’s α = 0.78 demonstrated internal reliability. Participants in the fourth quartile of the HEI-C 2010 with the healthiest diets were less likely to consume refined grains and empty calories and more likely to consume beneficial nutrients and foods (p-trend < 0.0001). Lower adherence to the index recommendations was inversely associated with the likelihood of being obese; this association strengthened after correction for measurement error (Odds Ratio: 1.41; 95% Confidence Interval: 1.17–1.71). Closer adherence to Canada’s Food Guide 2007 assessed through the HEI-C 2010 was associated with improved diet quality and reductions in the likelihood of obesity when energy intake and measurement errors were taken into account. Consideration of energy requirements and energy density in future updates of Canada’s Food

  15. Adapting the Healthy Eating Index 2010 for the Canadian Population: Evidence from the Canadian Community Health Survey

    Directory of Open Access Journals (Sweden)

    Mahsa Jessri

    2017-08-01

    Full Text Available The Healthy Eating Index (HEI is a diet quality index shown to be associated with reduced chronic disease risk. Older versions of the HEI have been adapted for Canadian populations; however, no Canadian modification of the Healthy Eating Index-2010 (HEI-2010 has been made. The aims of this study were: (a to develop a Canadian adaptation of the HEI-2010 (i.e., Healthy Eating Index-Canada 2010 (HEI-C 2010 by adapting the recommendations of the HEI-2010 to Canada’s Food Guide (CFG 2007; (b to evaluate the validity and reliability of the HEI-C 2010; and (c to examine relationships between HEI-C 2010 scores with diet quality and the likelihood of being obese. Data from 12,805 participants (≥18 years were obtained from the Canadian Community Health Survey Cycle 2.2. Weighted multivariate logistic regression was used to test the association between compliance to the HEI-C 2010 recommendations and the likelihood of being obese, adjusting for errors in self-reported dietary data. The total mean error-corrected HEI-C 2010 score was 50.85 ± 0.35 out of 100. Principal component analysis confirmed multidimensionality of the HEI-C 2010, while Cronbach’s α = 0.78 demonstrated internal reliability. Participants in the fourth quartile of the HEI-C 2010 with the healthiest diets were less likely to consume refined grains and empty calories and more likely to consume beneficial nutrients and foods (p-trend < 0.0001. Lower adherence to the index recommendations was inversely associated with the likelihood of being obese; this association strengthened after correction for measurement error (Odds Ratio: 1.41; 95% Confidence Interval: 1.17–1.71. Closer adherence to Canada’s Food Guide 2007 assessed through the HEI-C 2010 was associated with improved diet quality and reductions in the likelihood of obesity when energy intake and measurement errors were taken into account. Consideration of energy requirements and energy density in future updates of Canada

  16. Translating Evidence for Low Back Pain Management into a Consumer-Focussed Resource for Use in Community Pharmacies: A Cluster-Randomised Controlled Trial

    Science.gov (United States)

    2013-01-01

    Background This cluster-randomised controlled trial determined the effectiveness of an evidence-based, pamphlet intervention in improving low back pain (LBP)-related beliefs among pharmacy consumers. Methods Thirty five community pharmacies were randomised to three groups: pamphlet+education intervention [n = 11]; pamphlet only intervention [n = 11]; control: usual care [n = 13]. Eligibility requirements for clusters included: community-based pharmacies and proprietor participation consent. Pharmacy consumers (N = 317) aged 18–65 years currently experiencing LBP participated. Intervention group allocation depended on the pharmacy attended. Individual-level outcomes were measured at pre-intervention (T0), at two (T1) and eight (T2) weeks post-intervention and included beliefs about LBP [Back Pain Beliefs Questionnaire (BBQ); Fear Avoidance Beliefs Questionnaire (FABQ)]. Secondary outcomes included pain severity, activity impairment and pamphlet perceived usefulness. Blinding to group allocation included primary investigators, outcome assessors and the statistician. Pharmacy staff and consumers were un-blinded. Results Of 35 pharmacies recruited (317 consumers), no clusters were lost to follow-up. Follow-up was available for n = 24 at 2 weeks only; n = 38 at 8 weeks only; n = 148 at both time points, with n = 148+24+38 = 210 analysed (107 excluded: no follow up). Adjusting for baseline scores demonstrated no significant differences in beliefs (2 or at 8 weeks) between pamphlet (with or without education) versus control, or between ‘pamphlet with’ versus ‘without’ education. Work-related fear (FABQ) was significantly lower in consumers receiving pamphlet (with or without education) versus control (difference −2.3, 95%CI: −4.4 to −0.2). There was no significant difference between “pamphlet with” versus “pamphlet without” groups. Consumers receiving the “pamphlet with” reported greater perceived usefulness

  17. Producing adornment: Evidence of different levels of expertise in the production of obsidian items of adornment at two late Neolithic communities in northern Mesopotamia

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    Elizabeth Healey

    2014-09-01

    Full Text Available In the Near East obsidian is of particular interest to archaeologists because it is an exotic material and best known for is use in tool manufacture, but it is also occasionally used to make items of personal adornment. Some of these items are very highly finished, while others appear much more rudimentary though it is by no means obvious why this should be. Here we will review such artefacts at two contemporary late Neolithic communities, Domuztepe in SE Anatolia and Tell Arpachiyah in northern Iraq. Both have seemingly unusually high numbers of such objects as well as evidence for obsidian tool production on site. At Domuztepe some objects are highly finished while others appear much more ad hoc. At Arpachiyah on the other hand, the objects appear very similar to each other so as to seem standardised or at least the product of a single workshop. Our main aim in this paper is to try to unravel the evidence needed to determine whether they were produced on site, or whether they were acquired as finished objects (or both.

  18. La contribución de la Evidencia Cualitativa al campo del cuidado y la salud comunitaria The contribution of qualitative evidence to care and community health

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    Carmen de la Cuesta Benjumea

    2005-11-01

    Full Text Available Para mostrar la contribución de la evidencia cualitativa a la práctica de la enfermería y la salud comunitaria, se hace necesario primero examinar lo que es evidencia y cual es la relación que hay entre la investigación y la práctica. En este artículo argumento que la evidencia es necesariamente plural, que no se produce en un vacío social o histórico y que para valorar su uso se deben examinar los presupuestos y las expectativas que hay sobre la contribución de la investigación a la práctica. Al valorar su impacto éste se debe contextualizar. La investigación cualitativa está encaminada hacia la producción de un conocimiento válido y relevante y no a la solución de problemas prácticos; produce evidencia cuya relevancia es más bien general y no específica, por tanto su impacto es indirecto. Los criterios de evaluación del movimiento de la práctica basada en la evidencia se han de ampliar y se han de cuestionar los intentos de jerarquizar las evidencias con parámetros exclusivamente positivistas; el trabajo cualitativo es interpretativo y subjetivo y por ello se resiste a una jerarquización en niveles. Respecto a su uso las responsabilidades son compartidas. Mientras que la responsabilidad de los investigadores es hacer que la evidencia sea accesible, potente y evocativa, la de los lectores es valorar su ajuste y relevancia a las situaciones específicas. Uno de los mayores retos a los que nos enfrentamos los profesionales de la salud es al de la validación e incorporación de los hallazgos a la práctica.In order to show the contribution of qualitative evidence to nursing practice and community health, there is a need to examine first what is meant by evidence and the relationship between research and practice. This paper argues that evidence is necessarily plural and that is not produced in a social or historical vacuum. The assumptions and expectations about the contribution of research to practice need also to be

  19. Factors Associated with Relapse among Heroin Addicts: Evidence from a Two-Year Community-Based Follow-Up Study in China

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    Chao Rong

    2016-01-01

    Full Text Available Background: Many countries including China are facing a serious opiate dependence problem. Anti-drug work effectiveness was affected by the high relapse rate all over the world. This study aims to analyze the factors influencing heroin addict relapse, and to provide evidence for generating relapse prevention strategies. Methods: A community-based follow-up study was conducted in China between October 2010 and September 2012. A total of 554 heroin addicts in accordance with the inclusion criteria from 81 streets in 12 districts of Shanghai, China were divided into 4 groups: group 1—daily dosage taken orally of 60 mL of methadone or under combined with psychological counseling and social supports (n = 130; group 2—daily dosage taken orally of over 60 mL of methadone combined with psychological counseling and social supports (n = 50; group 3—JTT (Jitai tablets combined with psychological counseling and social supports (n = 206; group 4—JTT combined with social supports (n = 168. Results: Log-rank test results showed that the cumulative relapse rate differences among four groups during the two-year follow-up period were not statistically significant (χ2 = 5.889, p = 0.117. Multivariate Cox regression analysis results showed that only three independent variables were still statistically significant, including compliance with participation in psychological counseling (OR = 3.563, p = 0.000, the years of drug use (OR = 1.078, p = 0.001and intervention model. Conclusions: Using the detoxification medications combined with appropriate psychological counseling and social support measures will help improve the effectiveness of relapse prevention, which is a kind of alternative community detoxification pattern. Appropriate and standard psychological counseling is very important for anti-drug treatment. The longer the drug addiction lasts, the longer the anti-drug treatment takes.

  20. Evidence for validity of five secondary data sources for enumerating retail food outlets in seven American Indian Communities in North Carolina

    Science.gov (United States)

    2012-01-01

    Background Most studies on the local food environment have used secondary sources to describe the food environment, such as government food registries or commercial listings (e.g., Reference USA). Most of the studies exploring evidence for validity of secondary retail food data have used on-site verification and have not conducted analysis by data source (e.g., sensitivity of Reference USA) or by food outlet type (e.g., sensitivity of Reference USA for convenience stores). Few studies have explored the food environment in American Indian communities. To advance the science on measuring the food environment, we conducted direct, on-site observations of a wide range of food outlets in multiple American Indian communities, without a list guiding the field observations, and then compared our findings to several types of secondary data. Methods Food outlets located within seven State Designated Tribal Statistical Areas in North Carolina (NC) were gathered from online Yellow Pages, Reference USA, Dun & Bradstreet, local health departments, and the NC Department of Agriculture and Consumer Services. All TIGER/Line 2009 roads (>1,500 miles) were driven in six of the more rural tribal areas and, for the largest tribe, all roads in two of its cities were driven. Sensitivity, positive predictive value, concordance, and kappa statistics were calculated to compare secondary data sources to primary data. Results 699 food outlets were identified during primary data collection. Match rate for primary data and secondary data differed by type of food outlet observed, with the highest match rates found for grocery stores (97%), general merchandise stores (96%), and restaurants (91%). Reference USA exhibited almost perfect sensitivity (0.89). Local health department data had substantial sensitivity (0.66) and was almost perfect when focusing only on restaurants (0.91). Positive predictive value was substantial for Reference USA (0.67) and moderate for local health department data (0

  1. Determinants of Agricultural Diversification in a Hotspot Area: Evidence from Colonist and Indigenous Communities in the Sumaco Biosphere Reserve, Ecuadorian Amazon

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    Bolier Torres

    2018-05-01

    Full Text Available With data from a household survey covering migrant settlers and indigenous (Kichwa communities in the Sumaco Biosphere Reserve (SBR, this study analyses the drivers of agricultural diversification/specialisation, focusing on the role of ethnicity and the livelihood strategies (LS they follow. Data were collected using the Poverty and Environment Network methodology of the Center for International Forestry Research (CIFOR-PEN. In order to establish the drivers of agricultural diversification, the number of crops and the Shannon index of crops areas were used as the dependent variables in ordinary least square (OLS models, while a multinomial logit model (MLM was used to assess a household’s degree of diversification. The results of the OLS regression provides evidence supporting the notion that households, with Livestock-based and Wage-based livelihood strategies (LS are less diversified and more specialized than households with Crop-based LS. Ethnicity has a positive and significant effect on agricultural diversification, with Kichwa farms more diversified than those of their migrant colonist counterparts. The results of the multinomial logit model (MLM show that large Kichwa households, with Crop-based and Forest-based LS are more likely to adopt a highly diversified agricultural strategy. Based on these findings, we recommend a redirection of agricultural incentives, towards the adoption of diversified agricultural systems, as a strategy to promote more sustainable production systems in the Ecuadorian Amazon Region.

  2. Effectiveness of home- and community-based rehabilitation in a large cohort of patients disabled by cerebrovascular accident: evidence of a dose-response relationship.

    Science.gov (United States)

    Altman, Irwin M; Swick, Shannon; Malec, James F

    2013-09-01

    To (1) assess the effectiveness of home- and community-based rehabilitation (HCBR) in a large cohort of individuals with disabilities secondary to cerebrovascular accident (CVA); and (2) evaluate the responsiveness to treatment of the Mayo-Portland Adaptability Inventory (MPAI-4) to changes resulting from HCBR in this patient group. Retrospective analysis of program evaluation data for treatment completers and noncompleters. HCBR conducted in 7 geographically distinct U.S. cities. Individuals with CVA (n=738) who completed the prescribed course of rehabilitation (completed course of treatment [CCT]) compared with 150 individuals who were precipitously discharged (PD) before program completion. HCBR delivered by certified professional staff on an individualized basis. Mayo-Portland Adaptability Inventory (MPAI-4) completed by professional consensus on admission and at discharge. With the use of analysis of covariance, MPAI-4 total scores at discharge for CCT participants were compared with those of PD participants, with admission MPAI-4, age, length of stay, and time since event as covariates. CCT participants showed greater improvement than PD participants (F=99.48, PMPAI-4 indexes than those in the PD group who were discharged before completing the prescribed program. This dose-response relationship provides evidence of a causal relationship between treatment and outcome. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  3. Health Co-Benefits of Green Building Design Strategies and Community Resilience to Urban Flooding: A Systematic Review of the Evidence.

    Science.gov (United States)

    Houghton, Adele; Castillo-Salgado, Carlos

    2017-12-06

    Climate change is increasingly exacerbating existing population health hazards, as well as resulting in new negative health effects. Flooding is one particularly deadly example of its amplifying and expanding effect on public health. This systematic review considered evidence linking green building strategies in the Leadership in Energy and Environmental Design ® (LEED) Rating System with the potential to reduce negative health outcomes following exposure to urban flooding events. Queries evaluated links between LEED credit requirements and risk of exposure to urban flooding, environmental determinants of health, co-benefits to public health outcomes, and co-benefits to built environment outcomes. Public health co-benefits to leveraging green building design to enhance flooding resilience included: improving the interface between humans and wildlife and reducing the risk of waterborne disease, flood-related morbidity and mortality, and psychological harm. We conclude that collaborations among the public health, climate change, civil society, and green building sectors to enhance community resilience to urban flooding could benefit population health.

  4. Environmental exposure to BDE47 is associated with increased diabetes prevalence: Evidence from community-based case-control studies and an animal experiment

    Science.gov (United States)

    Zhang, Zhan; Li, Shushu; Liu, Lu; Wang, Li; Xiao, Xue; Sun, Zhenzhen; Wang, Xichen; Wang, Chao; Wang, Meilin; Li, Lei; Xu, Qiujin; Gao, Weimin; Wang, Shou-Lin

    2016-06-01

    Brominated flame retardants exposure has been associated with increasing trends of diabetes and metabolic disease. Thus, the purpose of this study was to provide evidence of polybrominated diphenyl ethers (PBDEs) exposure in relation to diabetes prevalence and to reveal the potential underlying mechanism in epidemiological and animal studies. All the participants received a questionnaire, health examination, and the detection of 7 PBDE congeners in serum in two independent community-based studies from 2011 to 2012 in China. Male rats were exposed to 2,2’4,4’-tetrabromodiphenyl ether (BDE47) for 8 weeks to explore its effects on glucose homeostasis and potential mechanisms using high-throughput genomic analysis. Among the 7 congeners, BDE47 showed significant high detection rate and concentration in cases in Study I and Study II. Every tertile of BDE47 exposure significantly increased the risk of diabetes prevalence in Study I (Ptrend = 0.001) and Study II (Ptrend treatments induced hyperglycemia in rats. Furthermore, gene microarray analysis showed that diabetes pathway and three gene ontology terms involved in glucose transport were enriched. The results indicated that environmental exposure to BDE47 was associated with increased diabetes prevalence. However, further prospective and mechanistic studies are needed to the causation of diabetes in relation to BDE47.

  5. Exploring the ambivalent evidence base of mobile health (mHealth) : A systematic literature review on the use of mobile phones for the improvement of community health in Africa

    NARCIS (Netherlands)

    de Kruijf, J.G.; Krah, E.F.M.

    2016-01-01

    Background Africa is labelled the world's fastest-growing ‘mobile region’. Considering such growth and the fragility of the continent's healthcare, mHealth has flourished. This review explores mHealth for community health in Africa in order to assess its still ambivalent evidence base. Methods Using

  6. Baseline results from the Lichen Community Indicator Program in the Pacific Northwest: Air quality patterns and evidence of a nitrogen pollution problem

    Science.gov (United States)

    Sarah Jovan

    2009-01-01

    Why Are Epiphytic Lichen Communities Important? Lichens are one of the bioindicators used by the Forest Inventory and Analysis (FIA) Program to monitor forest health. To obtain data for use in its Lichen Community Indicator Program, FIA samples a regular network of permanent field plots to determine the composition of epiphytic, i.e., tree dwelling, lichen communities...

  7. Evidence for Community Transmission of Community-Associated but Not Health-Care-Associated Methicillin-Resistant Staphylococcus Aureus Strains Linked to Social and Material Deprivation: Spatial Analysis of Cross-sectional Data.

    Directory of Open Access Journals (Sweden)

    Olga Tosas Auguet

    2016-01-01

    of Deprivation 2010 (including the Index of Multiple Deprivation and several deprivation domains and subdomains and the 2011 England and Wales census demographic and socioeconomic indicators (including numbers of households by deprivation dimension and indicators of population health. Both CA-and HA-MRSA were associated with household deprivation (CA-MRSA relative risk [RR]: 1.72 [1.03-2.94]; HA-MRSA RR: 1.57 [1.06-2.33], which was correlated with hospital attendance (Pearson correlation coefficient [PCC] = 0.76. HA-MRSA was also associated with poor health (RR: 1.10 [1.01-1.19] and residence in communal care homes (RR: 1.24 [1.12-1.37], whereas CA-MRSA was linked with household overcrowding (RR: 1.58 [1.04-2.41] and wider barriers, which represent a combined score for household overcrowding, low income, and homelessness (RR: 1.76 [1.16-2.70]. CA-MRSA was also associated with recent immigration to the UK (RR: 1.77 [1.19-2.66]. For the area-level variation in RR for CA-MRSA, 28.67% was attributable to the spatial arrangement of target geographies, compared with only 0.09% for HA-MRSA. An advantage to our study is that it provided a representative sample of usual residents receiving care in the catchment areas. A limitation is that relationships apparent in aggregated data analyses cannot be assumed to operate at the individual level.There was no evidence of community transmission of HA-MRSA strains, implying that HA-MRSA cases identified in the community originate from the hospital reservoir and are maintained by frequent attendance at health care facilities. In contrast, there was a high risk of CA-MRSA in deprived areas linked with overcrowding, homelessness, low income, and recent immigration to the UK, which was not explainable by health care exposure. Furthermore, areas adjacent to these deprived areas were themselves at greater risk of CA-MRSA, indicating community transmission of CA-MRSA. This ongoing community transmission could lead to CA-MRSA becoming the

  8. Evidence for Community Transmission of Community-Associated but Not Health-Care-Associated Methicillin-Resistant Staphylococcus Aureus Strains Linked to Social and Material Deprivation: Spatial Analysis of Cross-sectional Data.

    Science.gov (United States)

    Tosas Auguet, Olga; Betley, Jason R; Stabler, Richard A; Patel, Amita; Ioannou, Avgousta; Marbach, Helene; Hearn, Pasco; Aryee, Anna; Goldenberg, Simon D; Otter, Jonathan A; Desai, Nergish; Karadag, Tacim; Grundy, Chris; Gaunt, Michael W; Cooper, Ben S; Edgeworth, Jonathan D; Kypraios, Theodore

    2016-01-01

    Deprivation 2010 (including the Index of Multiple Deprivation and several deprivation domains and subdomains) and the 2011 England and Wales census demographic and socioeconomic indicators (including numbers of households by deprivation dimension) and indicators of population health. Both CA-and HA-MRSA were associated with household deprivation (CA-MRSA relative risk [RR]: 1.72 [1.03-2.94]; HA-MRSA RR: 1.57 [1.06-2.33]), which was correlated with hospital attendance (Pearson correlation coefficient [PCC] = 0.76). HA-MRSA was also associated with poor health (RR: 1.10 [1.01-1.19]) and residence in communal care homes (RR: 1.24 [1.12-1.37]), whereas CA-MRSA was linked with household overcrowding (RR: 1.58 [1.04-2.41]) and wider barriers, which represent a combined score for household overcrowding, low income, and homelessness (RR: 1.76 [1.16-2.70]). CA-MRSA was also associated with recent immigration to the UK (RR: 1.77 [1.19-2.66]). For the area-level variation in RR for CA-MRSA, 28.67% was attributable to the spatial arrangement of target geographies, compared with only 0.09% for HA-MRSA. An advantage to our study is that it provided a representative sample of usual residents receiving care in the catchment areas. A limitation is that relationships apparent in aggregated data analyses cannot be assumed to operate at the individual level. There was no evidence of community transmission of HA-MRSA strains, implying that HA-MRSA cases identified in the community originate from the hospital reservoir and are maintained by frequent attendance at health care facilities. In contrast, there was a high risk of CA-MRSA in deprived areas linked with overcrowding, homelessness, low income, and recent immigration to the UK, which was not explainable by health care exposure. Furthermore, areas adjacent to these deprived areas were themselves at greater risk of CA-MRSA, indicating community transmission of CA-MRSA. This ongoing community transmission could lead to CA-MRSA becoming the

  9. Training, supervision and quality of care in selected integrated community case management (iCCM) programmes: A scoping review of programmatic evidence.

    Science.gov (United States)

    Bosch-Capblanch, Xavier; Marceau, Claudine

    2014-12-01

    To describe the training, supervision and quality of care components of integrated Community Case Management (iCCM) programmes and to draw lessons learned from existing evaluations of those programmes. Scoping review of reports from 29 selected iCCM programmes purposively provided by stakeholders containing any information relevant to understand quality of care issues. The number of people reached by iCCM programmes varied from the tens of thousands to more than a million. All programmes aimed at improving access of vulnerable populations to health care, focusing on the main childhood illnesses, managed by Community Health Workers (CHW), often selected bycommunities. Training and supervision were widely implemented, in different ways and intensities, and often complemented with tools (eg, guides, job aids), supplies, equipment and incentives. Quality of care was measured using many outcomes (eg, access or appropriate treatment). Overall, there seemed to be positive effects for those strategies that involved policy change, organisational change, standardisation of clinical practices and alignment with other programmes. Positive effects were mostly achieved in large multi-component programmes. Mild or no effects have been described on mortality reduction amongst the few programmes for which data on this outcome was available to us. Promising strategies included teaming-up of CHW, micro-franchising or social franchising. On-site training and supervision of CHW have been shown to improve clinical practices. Effects on caregivers seemed positive, with increases in knowledge, care seeking behaviour, or caregivers' basic disease management. Evidence on iCCM is often of low quality, cannot relate specific interventions or the ways they are implemented with outcomes and lacks standardisation; this limits the capacity to identify promising strategies to improve quality of care. Large, multi-faceted, iCCM programmes, with strong components of training, supervision, which

  10. Training, supervision and quality of care in selected integrated community case management (iCCM) programmes: A scoping review of programmatic evidence

    Science.gov (United States)

    Bosch–Capblanch, Xavier; Marceau, Claudine

    2014-01-01

    Aim To describe the training, supervision and quality of care components of integrated Community Case Management (iCCM) programmes and to draw lessons learned from existing evaluations of those programmes. Methods Scoping review of reports from 29 selected iCCM programmes purposively provided by stakeholders containing any information relevant to understand quality of care issues. Results The number of people reached by iCCM programmes varied from the tens of thousands to more than a million. All programmes aimed at improving access of vulnerable populations to health care, focusing on the main childhood illnesses, managed by Community Health Workers (CHW), often selected bycommunities. Training and supervision were widely implemented, in different ways and intensities, and often complemented with tools (eg, guides, job aids), supplies, equipment and incentives. Quality of care was measured using many outcomes (eg, access or appropriate treatment). Overall, there seemed to be positive effects for those strategies that involved policy change, organisational change, standardisation of clinical practices and alignment with other programmes. Positive effects were mostly achieved in large multi–component programmes. Mild or no effects have been described on mortality reduction amongst the few programmes for which data on this outcome was available to us. Promising strategies included teaming–up of CHW, micro–franchising or social franchising. On–site training and supervision of CHW have been shown to improve clinical practices. Effects on caregivers seemed positive, with increases in knowledge, care seeking behaviour, or caregivers’ basic disease management. Evidence on iCCM is often of low quality, cannot relate specific interventions or the ways they are implemented with outcomes and lacks standardisation; this limits the capacity to identify promising strategies to improve quality of care. Conclusion Large, multi–faceted, iCCM programmes, with strong

  11. Evidence for a genetic overlap between body dysmorphic concerns and obsessive-compulsive symptoms in an adult female community twin sample.

    Science.gov (United States)

    Monzani, Benedetta; Rijsdijk, Fruhling; Iervolino, Alessandra C; Anson, Martin; Cherkas, Lynn; Mataix-Cols, David

    2012-06-01

    Body dysmorphic disorder (BDD) is thought to be etiologically related to obsessive-compulsive disorder (OCD) but the available evidence is incomplete. The current study examined the genetic and environmental sources of covariance between body dysmorphic and obsessive-compulsive symptoms in a community sample of adult twins. A total of 2,148 female twins (1,074 pairs) completed valid and reliable measures of body dysmorphic concerns and obsessive-compulsive symptoms. The data were analyzed using bivariate twin modeling methods and the statistical programme Mx. In the best-fitting model, the covariation between body dysmorphic and obsessive-compulsive traits was largely accounted for by genetic influences common to both phenotypes (64%; 95% CI: 0.50-0.80). This genetic overlap was even higher when specific obsessive-compulsive symptom dimensions were considered, with up to 82% of the phenotypic correlation between the obsessing and symmetry/ordering symptom dimensions and dysmorphic concerns being attributable to common genetic factors. Unique environmental factors, although influencing these traits individually, did not substantially contribute to their covariation. The results remained unchanged when excluding individuals reporting an objective medical condition/injury accounting for their concern in physical appearance. The association between body dysmorphic concerns and obsessive-compulsive symptoms is largely explained by shared genetic factors. Environmental risk factors were largely unique to each phenotype. These results support current recommendations to group BDD together with OCD in the same DSM-5 chapter, although comparison with other phenotypes such as somatoform disorders and social phobia is needed. Copyright © 2012 Wiley Periodicals, Inc.

  12. Improving the representation of river-groundwater interactions in land surface modeling at the regional scale: Observational evidence and parameterization applied in the Community Land Model

    KAUST Repository

    Zampieri, Matteo

    2012-02-01

    Groundwater is an important component of the hydrological cycle, included in many land surface models to provide a lower boundary condition for soil moisture, which in turn plays a key role in the land-vegetation-atmosphere interactions and the ecosystem dynamics. In regional-scale climate applications land surface models (LSMs) are commonly coupled to atmospheric models to close the surface energy, mass and carbon balance. LSMs in these applications are used to resolve the momentum, heat, water and carbon vertical fluxes, accounting for the effect of vegetation, soil type and other surface parameters, while lack of adequate resolution prevents using them to resolve horizontal sub-grid processes. Specifically, LSMs resolve the large-scale runoff production associated with infiltration excess and sub-grid groundwater convergence, but they neglect the effect from loosing streams to groundwater. Through the analysis of observed data of soil moisture obtained from the Oklahoma Mesoscale Network stations and land surface temperature derived from MODIS we provide evidence that the regional scale soil moisture and surface temperature patterns are affected by the rivers. This is demonstrated on the basis of simulations from a land surface model (i.e., Community Land Model - CLM, version 3.5). We show that the model cannot reproduce the features of the observed soil moisture and temperature spatial patterns that are related to the underlying mechanism of reinfiltration of river water to groundwater. Therefore, we implement a simple parameterization of this process in CLM showing the ability to reproduce the soil moisture and surface temperature spatial variabilities that relate to the river distribution at regional scale. The CLM with this new parameterization is used to evaluate impacts of the improved representation of river-groundwater interactions on the simulated water cycle parameters and the surface energy budget at the regional scale. © 2011 Elsevier B.V.

  13. Testing a Web-Based, Trained-Peer Model to Build Capacity for Evidence-Based Practices in Community Mental Health Systems.

    Science.gov (United States)

    German, Ramaris E; Adler, Abby; Frankel, Sarah A; Stirman, Shannon Wiltsey; Pinedo, Paola; Evans, Arthur C; Beck, Aaron T; Creed, Torrey A

    2018-03-01

    Use of expert-led workshops plus consultation has been established as an effective strategy for training community mental health (CMH) clinicians in evidence-based practices (EBPs). Because of high rates of staff turnover, this strategy inadequately addresses the need to maintain capacity to deliver EBPs. This study examined knowledge, competency, and retention outcomes of a two-phase model developed to build capacity for an EBP in CMH programs. In the first phase, an initial training cohort in each CMH program participated in in-person workshops followed by expert-led consultation (in-person, expert-led [IPEL] phase) (N=214 clinicians). After this cohort completed training, new staff members participated in Web-based training (in place of in-person workshops), followed by peer-led consultation with the initial cohort (Web-based, trained-peer [WBTP] phase) (N=148). Tests of noninferiority assessed whether WBTP was not inferior to IPEL at increasing clinician cognitive-behavioral therapy (CBT) competency, as measured by the Cognitive Therapy Rating Scale. WBTP was not inferior to IPEL at developing clinician competency. Hierarchical linear models showed no significant differences in CBT knowledge acquisition between the two phases. Survival analyses indicated that WBTP trainees were less likely than IPEL trainees to complete training. In terms of time required from experts, WBTP required 8% of the resources of IPEL. After an initial investment to build in-house CBT expertise, CMH programs were able to use a WBTP model to broaden their own capacity for high-fidelity CBT. IPEL followed by WBTP offers an effective alternative to build EBP capacity in CMH programs, rather than reliance on external experts.

  14. Clinical Decision-Making in Community Children's Mental Health: Using Innovative Methods to Compare Clinicians With and Without Training in Evidence-Based Treatment.

    Science.gov (United States)

    Baker-Ericzén, Mary J; Jenkins, Melissa M; Park, Soojin; Garland, Ann F

    2015-02-01

    Mental health professionals' decision-making practice is an area of increasing interest and importance, especially in the pediatric research and clinical communities. The present study explored the role of prior training in evidence-based treatments on clinicians' assessment and treatment formulations using case vignettes. Specifically, study aims included using the Naturalistic Decision Making (NDM) cognitive theory to 1) examine potential associations between EBT training and decision-making processes (novice versus expert type), and 2) explore how client and family contextual information affects clinical decision-making. Forty-eight clinicians across two groups (EBT trained=14, Not EBT trained=34) participated. Clinicians were comparable on professional experience, demographics, and discipline. The quasi-experimental design used an analog "think aloud" method where clinicians read case vignettes about a child with disruptive behavior problems and verbalized case conceptualization and treatment planning out-loud. Responses were coded according to NDM theory. MANOVA results were significant for EBT training status such that EBT trained clinicians' displayed cognitive processes more closely aligned with "expert" decision-makers and non-EBT trained clinicians' decision processes were more similar to "novice" decision-makers, following NDM theory. Non-EBT trained clinicians assigned significantly more diagnoses, provided less detailed treatment plans and discussed fewer EBTs. Parent/family contextual information also appeared to influence decision-making. This study offers a preliminary investigation of the possible broader impacts of EBT training and potential associations with development of expert decision-making skills. Targeting clinicians' decision-making may be an important avenue to pursue within dissemination-implementation efforts in mental health practice.

  15. Measurement properties of a novel survey to assess stages of organizational readiness for evidence-based interventions in community chronic disease prevention settings

    Directory of Open Access Journals (Sweden)

    Stamatakis Katherine A

    2012-07-01

    Full Text Available Abstract Background There is a great deal of variation in the existing capacity of primary prevention programs and policies addressing chronic disease to deliver evidence-based interventions (EBIs. In order to develop and evaluate implementation strategies that are tailored to the appropriate level of capacity, there is a need for an easy-to-administer tool to stage organizational readiness for EBIs. Methods Based on theoretical frameworks, including Rogers’ Diffusion of Innovations, we developed a survey instrument to measure four domains representing stages of readiness for EBI: awareness, adoption, implementation, and maintenance. A separate scale representing organizational climate as a potential mediator of readiness for EBIs was also included in the survey. Twenty-three questions comprised the four domains, with four to nine items each, using a seven-point response scale. Representatives from obesity, asthma, diabetes, and tobacco prevention programs serving diverse populations in the United States were surveyed (N = 243; test-retest reliability was assessed with 92 respondents. Results Confirmatory factor analysis (CFA was used to test and refine readiness scales. Test-retest reliability of the readiness scales, as measured by intraclass correlation, ranged from 0.47–0.71. CFA found good fit for the five-item adoption and implementation scales and resulted in revisions of the awareness and maintenance scales. The awareness scale was split into two two-item scales, representing community and agency awareness. The maintenance scale was split into five- and four-item scales, representing infrastructural maintenance and evaluation maintenance, respectively. Internal reliability of scales (Cronbach’s α ranged from 0.66–0.78. The model for the final revised scales approached good fit, with most factor loadings >0.6 and all >0.4. Conclusions The lack of adequate measurement tools hinders progress in dissemination and implementation

  16. Factors affecting medication adherence in community-managed patients with hypertension based on the principal component analysis: evidence from Xinjiang, China.

    Science.gov (United States)

    Zhang, Yuji; Li, Xiaoju; Mao, Lu; Zhang, Mei; Li, Ke; Zheng, Yinxia; Cui, Wangfei; Yin, Hongpo; He, Yanli; Jing, Mingxia

    2018-01-01

    The analysis of factors affecting the nonadherence to antihypertensive medications is important in the control of blood pressure among patients with hypertension. The purpose of this study was to assess the relationship between factors and medication adherence in Xinjiang community-managed patients with hypertension based on the principal component analysis. A total of 1,916 community-managed patients with hypertension, selected randomly through a multi-stage sampling, participated in the survey. Self-designed questionnaires were used to classify the participants as either adherent or nonadherent to their medication regimen. A principal component analysis was used in order to eliminate the correlation between factors. Factors related to nonadherence were analyzed by using a χ 2 -test and a binary logistic regression model. This study extracted nine common factors, with a cumulative variance contribution rate of 63.6%. Further analysis revealed that the following variables were significantly related to nonadherence: severity of disease, community management, diabetes, and taking traditional medications. Community management plays an important role in improving the patients' medication-taking behavior. Regular medication regimen instruction and better community management services through community-level have the potential to reduce nonadherence. Mild hypertensive patients should be monitored by community health care providers.

  17. Evaluation of community-based oral health promotion and oral disease prevention--WHO recommendations for improved evidence in public health practice

    DEFF Research Database (Denmark)

    Petersen, Poul Erik; Kwan, Stella

    2004-01-01

    Systematic evaluation is an integral part of the organisation and delivery of community oral health care programmes, ensuring the effectiveness of these community-based interventions. As for general health promotion programmes the common problems from effectiveness reviews of oral health...... a challenge to oral health professionals to integrate community oral health programmes into a wider health agenda. Public health research focusing on the development of evaluation methodologies has identified a variety of issues including the importance of using pluralistic evaluation approaches (quantitative...... of the evaluation of oral health promotion and oral disease prevention programmes. The aims of the workshop were to: (1) identify common problems and challenges in evaluating community-based oral health interventions; (2) explore developments in the evaluation approaches in public health; (3) share experiences...

  18. Factors affecting medication adherence in community-managed patients with hypertension based on the principal component analysis: evidence from Xinjiang, China

    Directory of Open Access Journals (Sweden)

    Zhang YJ

    2018-05-01

    Full Text Available Yuji Zhang,* Xiaoju Li,* Lu Mao, Mei Zhang, Ke Li, Yinxia Zheng, Wangfei Cui, Hongpo Yin, Yanli He, Mingxia Jing Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, China *These authors contributed equally to this work Purpose: The analysis of factors affecting the nonadherence to antihypertensive medications is important in the control of blood pressure among patients with hypertension. The purpose of this study was to assess the relationship between factors and medication adherence in Xinjiang community-managed patients with hypertension based on the principal component analysis.Patients and methods: A total of 1,916 community-managed patients with hypertension, selected randomly through a multi-stage sampling, participated in the survey. Self-designed questionnaires were used to classify the participants as either adherent or nonadherent to their medication regimen. A principal component analysis was used in order to eliminate the correlation between factors. Factors related to nonadherence were analyzed by using a χ2-test and a binary logistic regression model.Results: This study extracted nine common factors, with a cumulative variance contribution rate of 63.6%. Further analysis revealed that the following variables were significantly related to nonadherence: severity of disease, community management, diabetes, and taking traditional medications.Conclusion: Community management plays an important role in improving the patients’ medication-taking behavior. Regular medication regimen instruction and better community management services through community-level have the potential to reduce nonadherence. Mild hypertensive patients should be monitored by community health care providers. Keywords: hypertension, medication adherence, factors, principal component analysis, community management, China

  19. Development of a theory and evidence-based program to promote community treatment of fevers in children under five in a rural district in Southern Ghana: An intervention mapping approach

    Directory of Open Access Journals (Sweden)

    Mercy Abbey

    2017-01-01

    Full Text Available Abstract Background This paper describes the development and implementation of a program to promote prompt and appropriate care seeking for fever in children under the age of five. Designed as a multicomponent program, the intervention comprises elements to influence the behavior of caregivers of children, Community Health Workers, professional health care providers and the wider community. Methods Following the six fundamental steps of the Intervention Mapping protocol, we involved relevant stakeholders from the commencement of planning to program end. The IM protocol also recommends various behavior change methods to guide intervention development. Results The intervention components implemented were successful in achieving program goals. For example, the intervention resulted in the primary outcome of reductions in all-cause mortality of 30% and 44%, among children treated with an antimalarial and those treated with the antimalarial plus an antibiotic respectively. Most Community Health Workers were retained on the program, with an attrition rate of 21.2% over a period of 30 months and the Community Health Workers rate of adherence to performance guidelines was high at 94.6%. Conclusion We were able to systematically develop a theory- and evidence-based health promotion program based on the Intervention Mapping protocol. This article contributes to the response to recent calls for a more detailed description of the development of interventions and trials. The intervention mapping approach can serve as a guide for others interested in developing community- based health interventions in similar settings.

  20. Development of a theory and evidence-based program to promote community treatment of fevers in children under five in a rural district in Southern Ghana: An intervention mapping approach.

    Science.gov (United States)

    Abbey, Mercy; Bartholomew, L Kay; Chinbuah, Margaret A; Gyapong, Margaret; Gyapong, John O; van den Borne, Bart

    2017-01-25

    This paper describes the development and implementation of a program to promote prompt and appropriate care seeking for fever in children under the age of five. Designed as a multicomponent program, the intervention comprises elements to influence the behavior of caregivers of children, Community Health Workers, professional health care providers and the wider community. Following the six fundamental steps of the Intervention Mapping protocol, we involved relevant stakeholders from the commencement of planning to program end. The IM protocol also recommends various behavior change methods to guide intervention development. The intervention components implemented were successful in achieving program goals. For example, the intervention resulted in the primary outcome of reductions in all-cause mortality of 30% and 44%, among children treated with an antimalarial and those treated with the antimalarial plus an antibiotic respectively. Most Community Health Workers were retained on the program, with an attrition rate of 21.2% over a period of 30 months and the Community Health Workers rate of adherence to performance guidelines was high at 94.6%. We were able to systematically develop a theory- and evidence-based health promotion program based on the Intervention Mapping protocol. This article contributes to the response to recent calls for a more detailed description of the development of interventions and trials. The intervention mapping approach can serve as a guide for others interested in developing community- based health interventions in similar settings.

  1. Identifying community healthcare supports for the elderly and the factors affecting their aging care model preference: evidence from three districts of Beijing

    Directory of Open Access Journals (Sweden)

    Tianyang Liu

    2016-11-01

    Full Text Available Abstract Background The Chinese tradition of filial piety, which prioritized family-based care for the elderly, is transitioning and elders can no longer necessarily rely on their children. The purpose of this study was to identify community support for the elderly, and analyze the factors that affect which model of old-age care elderly people dwelling in communities prefer. Methods We used the database “Health and Social Support of Elderly Population in Community”. Questionnaires were issued in 2013, covering 3 districts in Beijing. A group of 1036 people over 60 years in age were included in the study. The respondents’ profile variables were organized in Andersen’s Model and community healthcare resource factors were added. A multinomial logistic model was applied to analyze the factors associated with the desired aging care models. Results Cohabiting with children and relying on care from family was still the primary desired aging care model for seniors (78 %, followed by living in institutions (14.8 % and living at home independently while relying on community resources (7.2 %. The regression result indicated that predisposing, enabling and community factors were significantly associated with the aging care model preference. Specifically, compared with those who preferred to cohabit with children, those having higher education, fewer available family and friend helpers, and shorter distance to healthcare center were more likely to prefer to live independently and rely on community support. And compared with choosing to live in institutions, those having fewer available family and friend helpers and those living alone were more likely to prefer to live independently and rely on community. Need factors (health and disability condition were not significantly associated with desired aging care models, indicating that desired aging care models were passive choices resulted from the balancing of family and social caring resources

  2. Understanding Loan Aversion in Education: Evidence from High School Seniors, Community College Students, and Adults. CEPA Working Paper No. 16-15

    Science.gov (United States)

    Boatman, Angela; Evans, Brent; Soliz, Adela

    2016-01-01

    Student loans are a crucial aspect of financing a college education for millions of Americans, yet we have surprisingly little empirical evidence concerning individuals' unwillingness to borrow money for educational purposes. This study provides the first large-scale quantitative evidence of levels of loan aversion in the United States. Using…

  3. Rural men's subjective well-being and the role of social support and sense of community: evidence for the potential benefit of enhancing informal networks.

    Science.gov (United States)

    Kutek, Stephanie M; Turnbull, Deborah; Fairweather-Schmidt, A Kate

    2011-02-01

    To examine the effects of social support and sense of community on rural men's subjective well-being, considering the main effects and stress-buffer models. Cross-sectional population-based survey, non-probability sampling frame primarily convenience sampling. Community-based setting. A total of 185 men aged 18+ years from rural South Australia. Subjective well-being, measured by the Satisfaction With Life Scale. Two-step hierarchical multiple regression analysis was conducted, with subjective well-being as the dependent variable, controlling for independent variables of age, living alone and farm employment. Social support was the most effective predictor of well-being, followed by stress, and only a very modest contribution from sense of community; total variance explained was 56% (F(6,178) = 37.77, P well-being and sense of community/well-being relationships (mediation analysis). Results demonstrated the benefits of social support on well-being using the stress-buffer and main effects models, within a sample of rural men, and explored the relatively unexamined relationship between sense of community and well-being. Rural men have considerable stress impacting their well-being. This study identifies that it is critical for individuals, organisations and policy makers to be aware of the capacity of both social supports and sense of community to buffer stress and promote well-being within rural men. Furthermore, structural, community-based approaches might have greater capacity to cost-effectively provide this support, contrasting with the growing trend towards individual-based approaches for mental health. © 2011 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

  4. Net Loss of CaCO3 from a subtropical calcifying community due to seawater acidification: mesocosm-scale experimental evidence

    Directory of Open Access Journals (Sweden)

    K. S. Rodgers

    2009-08-01

    Full Text Available Acidification of seawater owing to oceanic uptake of atmospheric CO2 originating from human activities such as burning of fossil fuels and land-use changes has raised serious concerns regarding its adverse effects on corals and calcifying communities. Here we demonstrate a net loss of calcium carbonate (CaCO3 material as a result of decreased calcification and increased carbonate dissolution from replicated subtropical coral reef communities (n=3 incubated in continuous-flow mesocosms subject to future seawater conditions. The calcifying community was dominated by the coral Montipora capitata. Daily average community calcification or Net Ecosystem Calcification (NEC=CaCO3 production – dissolution was positive at 3.3 mmol CaCO3 m−2 h−1 under ambient seawater pCO2 conditions as opposed to negative at −0.04 mmol CaCO3 m−2 h−1 under seawater conditions of double the ambient pCO2. These experimental results provide support for the conclusion that some net calcifying communities could become subject to net dissolution in response to anthropogenic ocean acidification within this century. Nevertheless, individual corals remained healthy, actively calcified (albeit slower than at present rates, and deposited significant amounts of CaCO3 under the prevailing experimental seawater conditions of elevated pCO2.

  5. An individual-level meta-analysis assessing the impact of community-level sanitation access on child stunting, anemia, and diarrhea: Evidence from DHS and MICS surveys.

    Science.gov (United States)

    Larsen, David A; Grisham, Thomas; Slawsky, Erik; Narine, Lutchmie

    2017-06-01

    A lack of access to sanitation is an important risk factor child health, facilitating fecal-oral transmission of pathogens including soil-transmitted helminthes and various causes of diarrheal disease. We conducted a meta-analysis of cross-sectional surveys to determine the impact that community-level sanitation access has on child health for children with and without household sanitation access. Using 301 two-stage demographic health surveys and multiple indicator cluster surveys conducted between 1990 and 2015 we calculated the sanitation access in the community as the proportion of households in the sampled cluster that had household access to any type of sanitation facility. We then conducted exact matching of children based on various predictors of living in a community with high access to sanitation. Using logistic regression with the matched group as a random intercept we examined the association between the child health outcomes of stunted growth, any anemia, moderate or severe anemia, and diarrhea in the previous two weeks and the exposure of living in a community with varying degrees of community-level sanitation access. For children with household-level sanitation access, living in a community with 100% sanitation access was associated with lowered odds of stunting (adjusted odds ratio [AOR] = 0.97, 95%; confidence interval (CI) = 0.94-1.00; n = 14,153 matched groups, 1,175,167 children), any anemia (AOR = 0.73; 95% CI = 0.67-0.78; n = 5,319 matched groups, 299,033 children), moderate or severe anemia (AOR = 0.72, 95% CI = 0.68-0.77; n = 5,319 matched groups, 299,033 children) and diarrhea (AOR = 0.94; 95% CI = 0.91-0.97); n = 16,379 matched groups, 1,603,731 children) compared to living in a community with sanitation access. For children without household-level sanitation access, living in communities with 0% sanitation access was associated with higher odds of stunting (AOR = 1.04, 95% CI = 1.02-1.06; n = 14,153 matched groups, 1,175,167 children), any

  6. Tools to Make Online Students and Community Partners in a Service Learning Project More "AT-EASE"--Evidence from a Finance Class

    Science.gov (United States)

    Butchey, Deanne

    2014-01-01

    The impact of service learning as a pedagogy to ensure efficient and effective experiential learning is well recognized, but in business schools, there is a perception that a steep learning curve exists for the students, faculty, and community. We use a tool to motivate and build competence in participants of a service learning project undertaken…

  7. Economic Evaluation of Community-Based HIV Prevention Programs in Ontario: Evidence of Effectiveness in Reducing HIV Infections and Health Care Costs.

    Science.gov (United States)

    Choi, Stephanie K Y; Holtgrave, David R; Bacon, Jean; Kennedy, Rick; Lush, Joanne; McGee, Frank; Tomlinson, George A; Rourke, Sean B

    2016-06-01

    Investments in community-based HIV prevention programs in Ontario over the past two and a half decades are assumed to have had an impact on the HIV epidemic, but they have never been systematically evaluated. To help close this knowledge gap, we conducted a macro-level evaluation of investment in Ontario HIV prevention programs from the payer perspective. Our results showed that, from 1987 to 2011, province-wide community-based programs helped to avert a total of 16,672 HIV infections, saving Ontario's health care system approximately $6.5 billion Canadian dollars (range 4.8-7.5B). We also showed that these community-based HIV programs were cost-saving: from 2005 to 2011, every dollar invested in these programs saved about $5. This study is an important first step in understanding the impact of investing in community-based HIV prevention programs in Ontario and recognizing the impact that these programs have had in reducing HIV infections and health care costs.

  8. Putting out the welcome mat-targeting outreach efforts under the Affordable Care Act: Evidence from the Minnesota Community Application Agent Program.

    Science.gov (United States)

    Dybdal, Kristin; Blewett, Lynn A; Pintor, Jessie Kemmick; Johnson, Kelli

    2015-01-01

    An evaluation of the Minnesota Community Application Agent (MNCAA) Program was conducted for the MN Minnesota Department of Human Services and funded by the Health Resources and Services Administration's State Health Access Program grant. The MNCAA evaluation assessed effectiveness in reaching disparate populations, explored overall program value, and sought lessons applicable to the Navigator programs required under the Affordable Care Act. Mixed-methods approach using quantitative analysis of tracking and payment data and interviews with key informants to elicit "lessons learned" about the MNCAA program. The MNCAA program offers incentive payments and technical assistance to community partner organizations that assist individuals in applying for public health care coverage. A total of 140 unique community organizations participated in the MNCAA program in 2008 to 2012. Outreach staff and directors from participating MNCAAs and state/local government officials were interviewed. The article highlights a strategy for targeting outreach to individuals eligible for Medicaid coverage or subsidies under the Affordable Care Act by presenting evaluation findings from a unique outreach program to increase access to care for vulnerable populations in Minnesota. Almost two-thirds of applicants were successfully enrolled but lengthy waiting periods persisted. Seventy percent of applications came from health care organizations. Only 13% of applicants assisted by MNCAAs were new to public health care programs. Most MNCAAs believed that the incentive payment-$25 per successful enrollee-was insufficient. Significant expertise in enrolling individuals in public health care programs exists within a core group of community organizations. Incentives to leverage the capacity of community organizations must be accompanied by recruiting and training. Outreach providers and navigators also need timely access to client information. More investment in financial incentives will be required.

  9. Comprehensive review of the evidence regarding the effectiveness of community-based primary health care in improving maternal, neonatal and child health: 8. summary and recommendations of the Expert Panel.

    Science.gov (United States)

    Black, Robert E; Taylor, Carl E; Arole, Shobha; Bang, Abhay; Bhutta, Zulfiqar A; Chowdhury, A Mushtaque R; Kirkwood, Betty R; Kureshy, Nazo; Lanata, Claudio F; Phillips, James F; Taylor, Mary; Victora, Cesar G; Zhu, Zonghan; Perry, Henry B

    2017-06-01

    The contributions that community-based primary health care (CBPHC) and engaging with communities as valued partners can make to the improvement of maternal, neonatal and child health (MNCH) is not widely appreciated. This unfortunate reality is one of the reasons why so few priority countries failed to achieve the health-related Millennium Development Goals by 2015. This article provides a summary of a series of articles about the effectiveness of CBPHC in improving MNCH and offers recommendations from an Expert Panel for strengthening CBPHC that were formulated in 2008 and have been updated on the basis of more recent evidence. An Expert Panel convened to guide the review of the effectiveness of community-based primary health care (CBPHC). The Expert Panel met in 2008 in New York City with senior UNICEF staff. In 2016, following the completion of the review, the Panel considered the review's findings and made recommendations. The review consisted of an analysis of 661 unique reports, including 583 peer-reviewed journal articles, 12 books/monographs, 4 book chapters, and 72 reports from the gray literature. The analysis consisted of 700 assessments since 39 were analyzed twice (once for an assessment of improvements in neonatal and/or child health and once for an assessment in maternal health). The Expert Panel recommends that CBPHC should be a priority for strengthening health systems, accelerating progress in achieving universal health coverage, and ending preventable child and maternal deaths. The Panel also recommends that expenditures for CBPHC be monitored against expenditures for primary health care facilities and hospitals and reflect the importance of CBPHC for averting mortality. Governments, government health programs, and NGOs should develop health systems that respect and value communities as full partners and work collaboratively with them in building and strengthening CBPHC programs - through engagement with planning, implementation (including the

  10. Expanding perceptions of subsistence fish consumption: evidence of high commercial fish consumption and dietary mercury exposure in an urban coastal community.

    Science.gov (United States)

    Holloman, Erica L; Newman, Michael C

    2012-02-01

    Through collaborative partnerships established between current researchers and The Moton Community House (a local community center), African American women (ages 16-49yrs) from the Southeast Community of Newport News, Virginia, USA were surveyed to assess the reproducibility and consistency of fish consumption patterns (ingestion rates, exposure frequencies, weight, and fish consumption rates) derived from a community-specific fish consumption survey. Women were also surveyed to assess the reliability of the survey responses, and to estimate daily mercury intake. Fish consumption patterns were reproducible and the survey responses were reliable. Comparison between years revealed that fish consumption patterns remained consistent over time. In addition, the high fish consumption rate estimated in 2008 (147.8g/day; 95% CI: 117.6-185.8g/day) was confirmed with a rate (134.9g/day; 95% CI: 88-207g/day) not materially different and still considerably higher than mean fish consumption rates reported for U.S. women. Daily mercury intake rates were estimated using consumption data from 2008 and three consumption scenarios (canned white, canned light, and no tuna) due to confirmed differences in mercury concentration between canned white and light tuna. Arithmetic mean daily mercury intake rates were 0.284μg/kg bw/day (95% CI: 0.229-0.340μg/kg bw/day) using canned white tuna, 0.212μg/kg bw/day (95% CI: 0.165-0.259μg/kg bw/day) using light tuna, and 0.197μg/kg bw/day (95% CI: 0.151-0.243μg/kg bw/day) using no tuna. Approximately 58%-73% of the daily mercury intake rates for African American women in the Southeast Community exceeded US EPA's oral reference dose (RfD) of 0.10μg/kg bw/day for mercury. In addition, 2% of the rates exceeded a level (1.00μg/kg bw/day) documented to produce adverse health effects. Past and current investigations confirmed that even though women in this community were not subsistence fishers, they are subsistence fish consumers. Copyright

  11. Evidence-based policy responses to strengthen health, community and legislative systems that care for women in Australia with female genital mutilation / cutting.

    Science.gov (United States)

    Varol, Nesrin; Hall, John J; Black, Kirsten; Turkmani, Sabera; Dawson, Angela

    2017-05-18

    The physical and psychological impact of female genital mutilation / cutting (FGM/C) can be substantial, long term, and irreversible. Parts of the health sector in Australia have developed guidelines in the management of FGM/C, but large gaps exist in community and professional knowledge of the consequences and treatment of FGM/C. The prevalence of FGM/C amongst Australian women is unknown. Our article reviews the literature on research on FGM/C in Australia, which focuses on health system response to women and girls with FGM/C. Recommendations are made for policy reform in health, legislation, and community programs to provide the best healthcare, protect children, and help communities abandon this harmful practice. Midwives and doctors in Australia acknowledged a lack of knowledge on FGM/C, clinical guidelines and consequences for maternity care. In a metropolitan Australian hospital with specialised FGM/C care, women with FGM/C had similar obstetric outcomes as women without FGM/C, underlining the importance of holistic FGM/C clinics. Greater focus on integration of refugee and migrant populations into their new cultures may be an important way of facilitating the abandonment of this practice, as is education of communities that practise FGM/C, and experts involved in the care and protection of children. Men could be important advocates for protecting women and girls from violence and FGM/C through a man-to-man strategy with programs focussing on men's health and other personal issues, education, and communication. The Australian Government has identified gender-based violence as an area of priority and has been implementing a National plan to reduce violence against women and their children 2010-2022. A multidisciplinary network of experts on FGM/C could be established within this taskforce to develop well-defined and rapid referral pathways to care for and protect these children, as well as coordinate education and prevention programs to help communities

  12. Community Collectivization and Consistent Condom Use Among Female Sex Workers in Southern India: Evidence from Two Rounds of Behavioral Tracking Surveys.

    Science.gov (United States)

    Vejella, Shanti; Patel, Sangram Kishor; Saggurti, Niranjan; Prabhakar, Parimi

    2016-04-01

    Community collectivization is an integral part of condom use and HIV risk reduction interventions among key population. This study assesses community collectivization among female sex workers (FSWs), and explores its relationship with sex workers' consistent condom use (CCU) with different partners considering the interaction effect of time and collectivization. Data were drawn from two rounds of cross-sectional surveys collected during 2010 (N1 = 1986) and 2012 (N2 = 1973) among FSWs in Andhra Pradesh, India. Results of the multiple logistic regression analysis show that, CCU with regular and occasional clients increased over the inter-survey period among FSWs with a high collective efficacy (AOR 2.9 and 6.1) and collective agency (AOR 14.4 and 19.0) respectively. The association of high levels of collectivization with CCU and self-efficacy for condom use are central to improve the usefulness and sustainability of HIV prevention programs worldwide.

  13. The role of community social capital in the relationship between socioeconomic status and adolescent life satisfaction: mediating or moderating? Evidence from Czech data.

    Science.gov (United States)

    Buijs, Thomas; Maes, Lea; Salonna, Ferdinand; Van Damme, Joris; Hublet, Anne; Kebza, Vladimir; Costongs, Caroline; Currie, Candace; De Clercq, Bart

    2016-12-12

    The concept of social capital has been extensively used to explain the relationship between socioeconomic status (SES) and adolescent health and well-being. Much less is known about the specific mechanism through which social capital impacts the relationship. This paper investigates whether an individual's perception of community social capital moderates or mediates the association between SES and life satisfaction. This study employs cross-sectional data from the 2009-2010 Czech Health Behaviour in School-Aged Children survey: a WHO Collaborative Cross-National Study (HBSC). A sample of 4425 adolescents from the 5 th , 7 th and 9 th grade (94.5% school response rate, 87% student response) was used to perform multilevel analysis. We found that pupils' life satisfaction was positively related to both family affluence and perceived wealth. Moreover, we found the cognitive component of social capital to be positively associated with life satisfaction. Additionally, a significant interaction was found, such that the social gradient in life satisfaction was flattened when pupils reported high levels of perceived community social capital. The present findings suggest that community social capital acts as an unequal health resource for adolescents, but could potentially represent opportunities for public health policy to close the gap in socioeconomic disparities.

  14. Exploring the evidence base for how people with dementia and their informal carers manage their medication in the community: a mixed studies review.

    Science.gov (United States)

    Aston, Lydia; Hilton, Andrea; Moutela, Tiago; Shaw, Rachel; Maidment, Ian

    2017-10-18

    Little is known about the general medicines management issues for people with dementia living in the community. This review has three aims: firstly to explore and evaluate the international literature on how people with dementia manage medication; assess understanding of medicines management from an informal carers perspective; and lastly to understand the role that healthcare professionals play in assisting this population with medicines management. A mixed studies review was conducted. Web of Knowledge, PubMed and Cochrane Library were searched post-1999 for studies that explored medicines management in people with dementia dwelling in the community, and the role healthcare professionals play in supporting medicines management in people with dementia. Following screening, nine articles were included. Data from included studies were synthesised using a convergent synthesis approach and analysed thematically to combine findings from studies using a range of methods (qualitative, quantitative and mixed methods). Four themes were generated from the synthesis: The nature of the disease and the effects this had on medicines management; the additional responsibilities informal carers have; informal caregivers' knowledge of the importance of managing medication and healthcare professionals' understanding of medicines management in people with dementia. Consequently, these were found to affect management of medication, in particular adherence to medication. This review has identified that managing medication for people with dementia dwelling in the community is a complex task with a frequently associated burden on their informal caregivers. Healthcare professionals can be unaware of this burden. The findings warrant the need for healthcare professionals to undergo further training in supporting medicines management for people with dementia in their own homes.

  15. Do Management and Leadership Practices in the Context of Decentralisation Influence Performance of Community Health Fund? Evidence From Iramba and Iringa Districts in Tanzania.

    Science.gov (United States)

    Joseph, Chakupewa; Maluka, Stephen Oswald

    2016-09-26

    In early 1990s, Tanzania like other African countries, adopted health sector reform (HSR). The most strongly held centralisation system that informed the nature of services provision including health was, thus, disintegrated giving rise to decentralisation system. It was within the realm of HSR process, user fees were introduced in the health sector. Along with user fees, various types of health insurances, including the Community Health Fund (CHF), were introduced. While the country's level of enrolment in the CHF is low, there are marked variations among districts. This paper highlights the role of decentralised health management and leadership practices in the uptake of the CHF in Tanzania. A comparative exploratory case study of high and low performing districts was carried out. In-depth interviews were conducted with the members of the Council Health Service Board (CHSB), Council Health Management Team (CHMT), Health Facility Committees (HFCs), in-charges of health facilities, healthcare providers, and Community Development Officers (CDOs). Minutes of the meetings of the committees and district annual health plans and district annual implementation reports were also used to verify and triangulate the data. Thematic analysis was adopted to analyse the collected data. We employed both inductive and deductive (mixed coding) to arrive to the themes. There were no differences in the level of education and experience of the district health managers in the two study districts. Almost all district health managers responsible for the management of the CHF had attended some training on management and leadership. However, there were variations in the personal initiatives of the top-district health leaders, particularly the district health managers, the council health services board and local government officials. Similarly, there were differences in the supervision mechanisms, and incentives available for the health providers, HFCs and board members in the two study

  16. The effects of childbirth on women’s activity change and occupational mobility in Europe: Evidence from the European Community Household Panel.

    OpenAIRE

    Chzhen, Yekaterina

    2009-01-01

    This paper uses comparable longitudinal data from the European Community Household Panel from 1994 to 2001 to examine the effects of recent childbirth on the relative risks of switching to part-time, inactivity or unemployment for full-time women, as well as the effect of switching from full-time time to part-time work on the risk of occupational downgrading, in 13 European countries. Once important human capital and workplace characteristics are controlled for, full-time female workers who g...

  17. Association of individual and community factors with C-reactive protein and 25-hydroxyvitamin D: Evidence from the National Health and Nutrition Examination Survey (NHANES

    Directory of Open Access Journals (Sweden)

    Weiwen Chai

    2016-12-01

    Full Text Available Many individual and community/neighborhood factors may contribute to inflammation and vitamin D deficiency leading to the development of chronic diseases. This study examined the associations of serum C-reactive protein (CRP and 25-hydroxyvitamin D [25(OHD] levels with individual and community/neighborhood (tract-level or county-level factors using a nationally representative sample from 2001–2006 National Health and Nutrition Examination Survey (NHANES. Data from the 2001–2006 waves of the continuous NHANES was merged with the 2000 census and other neighborhood data sources constructed using geographic information system. Associations between multilevel factors and biomarker levels were assessed using multilevel random-intercept regression models. 6643 participants aged 19–65 (3402 men and 3241 women were included in the analysis. Family income-to-needs ratio was inversely associated with CRP (P=0.002 and positively associated with 25(OHD levels (P=0.0003. County crime rates were positively associated with CRP (P=0.007 and inversely associated with 25(OHD levels (P=0.0002. The associations with income-to-needs ratio were significant in men [CRP, P=0.005; 25(OHD, P=0.005] but not in women. For county crime rates, the association was only significant in women for CRP (P=0.004 and was significant in both men (P=0.01 and women (P=0.001 for 25(OHD. Additionally, overall CRP was positively associated with age (P<0.0001, female sex (P<0.0001, Hispanic race/ethnicity (P=0.0001, current smokers (P<0.0001, body mass index (BMI, P<0.0001, and participants who were US-born (P=0.02. Non-Hispanic black (P<0.0001 and Hispanic race/ethnicity (P<0.0001, current smoker (P=0.047, and higher BMI (P<0.0001 were associated with lower serum 25(OHD levels. No significant associations were observed between other community/neighborhood variables and serum CRP and 25(OHD levels. The current results suggest that family income-to-needs ratio and county crime rate may

  18. Do Management and Leadership Practices in the Context of Decentralisation Influence Performance of Community Health Fund? Evidence From Iramba and Iringa Districts in Tanzania

    Directory of Open Access Journals (Sweden)

    Chakupewa Joseph

    2017-05-01

    Full Text Available Background In early 1990s, Tanzania like other African countries, adopted health sector reform (HSR. The most strongly held centralisation system that informed the nature of services provision including health was, thus, disintegrated giving rise to decentralisation system. It was within the realm of HSR process, user fees were introduced in the health sector. Along with user fees, various types of health insurances, including the Community Health Fund (CHF, were introduced. While the country’s level of enrolment in the CHF is low, there are marked variations among districts. This paper highlights the role of decentralised health management and leadership practices in the uptake of the CHF in Tanzania. Methods A comparative exploratory case study of high and low performing districts was carried out. In-depth interviews were conducted with the members of the Council Health Service Board (CHSB, Council Health Management Team (CHMT, Health Facility Committees (HFCs, in-charges of health facilities, healthcare providers, and Community Development Officers (CDOs. Minutes of the meetings of the committees and district annual health plans and district annual implementation reports were also used to verify and triangulate the data. Thematic analysis was adopted to analyse the collected data. We employed both inductive and deductive (mixed coding to arrive to the themes. Results There were no differences in the level of education and experience of the district health managers in the two study districts. Almost all district health managers responsible for the management of the CHF had attended some training on management and leadership. However, there were variations in the personal initiatives of the top-district health leaders, particularly the district health managers, the council health services board and local government officials. Similarly, there were differences in the supervision mechanisms, and incentives available for the health providers

  19. Mixed Methods for Implementation Research: Application to Evidence-Based Practice Implementation and Staff Turnover in Community Based Organizations Providing Child Welfare Services

    Science.gov (United States)

    Aarons, Gregory A.; Fettes, Danielle L.; Sommerfeld, David H.; Palinkas, Lawrence

    2013-01-01

    Many public sector services systems and provider organizations are in some phase of learning about or implementing evidence-based interventions. Child welfare service systems represent a context where implementation spans system, management, and organizational concerns. Research utilizing mixed methods that combine qualitative and quantitative design, data collection, and analytic approaches are particularly well-suited to understanding both the process and outcomes of dissemination and implementation efforts in child welfare systems. This paper describes the process of using mixed methods in implementation research and provides an applied example of an examination of factors impacting staff retention during an evidence-based intervention implementation in a statewide child welfare system. We integrate qualitative data with previously published quantitative analyses of job autonomy and staff turnover during this statewide implementation project in order to illustrate the utility of mixed method approaches in providing a more comprehensive understanding of opportunities and challenges in implementation research. PMID:22146861

  20. Mixed methods for implementation research: application to evidence-based practice implementation and staff turnover in community-based organizations providing child welfare services.

    Science.gov (United States)

    Aarons, Gregory A; Fettes, Danielle L; Sommerfeld, David H; Palinkas, Lawrence A

    2012-02-01

    Many public sector service systems and provider organizations are in some phase of learning about or implementing evidence-based interventions. Child welfare service systems represent a context where implementation spans system, management, and organizational concerns. Research utilizing mixed methods that combine qualitative and quantitative design, data collection, and analytic approaches are particularly well suited to understanding both the process and outcomes of dissemination and implementation efforts in child welfare systems. This article describes the process of using mixed methods in implementation research and provides an applied example of an examination of factors impacting staff retention during an evidence-based intervention implementation in a statewide child welfare system. The authors integrate qualitative data with previously published quantitative analyses of job autonomy and staff turnover during this statewide implementation project in order to illustrate the utility of mixed method approaches in providing a more comprehensive understanding of opportunities and challenges in implementation research.

  1. Community Participation, Natural Resource Management and the Creation of Innovative Tourism Products: Evidence from Italian Networks of Reserves in the Alps

    Directory of Open Access Journals (Sweden)

    Umberto Martini

    2017-12-01

    Full Text Available The paper analyses value co-creation and social innovation focusing on a new approach to the management of Natura 2000 areas: the Networks of Reserves (NoRs. NoRs have been set up in Trentino (an Italian alpine area to create an ecological network within the territory, with a particular focus on the socio-economic dimensions of nature conservation and with a bottom-up approach. The research investigates the role of NoRs by using a quali-quantitative approach to analyse the attitudes and awareness of private stakeholders, public actors and local communities. In-depth interviews with NoRs coordinators and key players in tourism organizations were carried out. 167 online questionnaires were sent out to local stakeholders. The research investigates community participation and stakeholder engagement in NoRs’ projects and activities, whether and how socio-economic development has occurred, and whether and how innovative sustainable tourism offers have been created. It confirms the role of NoRs in relation to the conservation and valorisation of natural resources through the stimulation of activities such as environmental interpretation and education. The research demonstrates the effectiveness of bottom-up processes for the co-creation of sustainable tourism offers and the fostering of social innovation. NoRs have proved to be successful in overcoming the major impediments to the functioning of the Natura 2000 network highlighted in the literature.

  2. Is Self-Reported Physical Activity Participation Associated with Lower Health Services Utilization among Older Adults? Cross-Sectional Evidence from the Canadian Community Health Survey

    Directory of Open Access Journals (Sweden)

    Koren L. Fisher

    2015-01-01

    Full Text Available Purpose. To examine relationships between leisure time physical activity (LTPA and health services utilization (H in a nationally representative sample of community-dwelling older adults. Methods. Cross-sectional data from 56,652 Canadian Community Health Survey respondents aged ≥ 50 years (48% M; 52% F; mean age 63.5 ± 10.2 years were stratified into three age groups and analysed using multivariate generalized linear modeling techniques. Participants were classified according to PA level based on self-reported daily energy expenditure. Nonleisure PA (NLPA was categorized into four levels ranging from mostly sitting to mostly lifting objects. Results. Active 50–65-year-old individuals were 27% less likely to report any GP consultations ORadj=0.73; P<0.001 and had 8% fewer GP consultations annually (IRRadj=0.92; P<0.01 than their inactive peers. Active persons aged 65–79 years were 18% less likely than inactive respondents to have been hospitalized overnight in the previous year (ORadj=0.82, P<0.05. Higher levels of NLPA were significantly associated with lower levels of HSU, across all age groups. Conclusion. Nonleisure PA appeared to be a stronger predictor of all types of HSU, particularly in the two oldest age groups. Considering strategies that focus on reducing time spent in sedentary activities may have a positive impact on reducing the demand for health services.

  3. Knee pain and future self-reliance in older adults: evidence from a community-based 3-year cohort study in Japan.

    Science.gov (United States)

    Nishiwaki, Yuji; Michikawa, Takehiro; Yamada, Mutsuko; Eto, Norihito; Takebayashi, Toru

    2011-01-01

    Although knee pain is common in older persons and can cause ambulatory limitation, its impact on self-reliance has rarely been examined in Japan, particularly in a community setting. The aim of this 3-year cohort study was to investigate the association of knee pain with dependence in activities of daily living (ADL) and mortality in community-dwelling older Japanese adults. In 2005, presence of knee pain was assessed by a home visit survey of 1391 older adults aged 65 years or older (participation proportion = 97.3%). A total of 1265 participants who were ADL-independent at baseline were followed for 3 years, and information on outcomes, namely death and dependence in ADL, was collected. Participants who always had knee pain were more likely to become dependent in ADL than those who reported no knee pain (multivariate-adjusted OR, 1.98; 95% CI, 1.03-3.83); however, always having knee pain was not associated with mortality or a composite outcome of ADL dependence and death. Further analyses of each component of ADL dependence revealed that knee pain was associated with a need for assistance at home (long-term care eligibility, bathing, dressing, and transferring), but not with institutionalization. The participants were highly representative of the target population and the rate of follow-up was almost perfect (99.4%). The results suggest that knee pain is associated with future dependence in ADL, particularly a need for assistance at home.

  4. Alcohol consumption and risky sexual behaviour in the fishing communities: evidence from two fish landing sites on Lake Victoria in Uganda.

    Science.gov (United States)

    Tumwesigye, Nazarius M; Atuyambe, Lynn; Wanyenze, Rhoda K; Kibira, Simon Ps; Li, Qing; Wabwire-Mangen, Fred; Wagner, Glenn

    2012-12-11

    The fishing communities are among population groups that are most at risk of HIV infection, with some studies putting the HIV prevalence at 5 to 10 times higher than in the general population. Alcohol consumption has been identified as one of the major drivers of the sexual risk behaviour in the fishing communities. This paper investigates the relationship between alcohol consumption patterns and risky behaviour in two fishing communities on Lake Victoria. Face-to-face interviews were conducted among 303 men and 172 women at the fish landing sites; categorised into fishermen, traders of fish or fish products and other merchandise, and service providers such as casual labourers and waitresses in bars and hotels, including 12 female sexual workers. Stratified random sampling methodology was used to select study units. Multivariable analysis was conducted to assess independent relationship between alcohol consumption and sexual risky behaviour. Measures of alcohol consumption included the alcohol use disorder test score (AUDIT), having gotten drunk in previous 30 days, drinking at least 2 times a week while measures for risky behaviour included engaging in transactional sex, inconsistent condom use, having sex with non-regular partner and having multiple sexual partners. The level of harmful use of alcohol in the two fishing communities was quite high as 62% of the male and 52% of the female drinkers had got drunk in previous 30 days. The level of risky sexual behaviour was equally high as 63% of the men and 59% of the women had unprotected sex at last sexual event. Of the 3 occupations fishermen had the highest levels of harmful use of alcohol and risky sexual behaviour followed by service providers judging from values of most indicators. The kind of alcohol consumption variables correlated with risky sexual behaviour variables, varied by occupation. Frequent alcohol consumption, higher AUDIT score, having got drunk, longer drinking hours and drinking any day of

  5. Alcohol consumption and risky sexual behaviour in the fishing communities: evidence from two fish landing sites on Lake Victoria in Uganda

    Directory of Open Access Journals (Sweden)

    Tumwesigye Nazarius M

    2012-12-01

    Full Text Available Abstract Background The fishing communities are among population groups that are most at risk of HIV infection, with some studies putting the HIV prevalence at 5 to 10 times higher than in the general population. Alcohol consumption has been identified as one of the major drivers of the sexual risk behaviour in the fishing communities. This paper investigates the relationship between alcohol consumption patterns and risky behaviour in two fishing communities on Lake Victoria. Methods Face-to-face interviews were conducted among 303 men and 172 women at the fish landing sites; categorised into fishermen, traders of fish or fish products and other merchandise, and service providers such as casual labourers and waitresses in bars and hotels, including 12 female sexual workers. Stratified random sampling methodology was used to select study units. Multivariable analysis was conducted to assess independent relationship between alcohol consumption and sexual risky behaviour. Measures of alcohol consumption included the alcohol use disorder test score (AUDIT, having gotten drunk in previous 30 days, drinking at least 2 times a week while measures for risky behaviour included engaging in transactional sex, inconsistent condom use, having sex with non-regular partner and having multiple sexual partners. Results The level of harmful use of alcohol in the two fishing communities was quite high as 62% of the male and 52% of the female drinkers had got drunk in previous 30 days. The level of risky sexual behaviour was equally high as 63% of the men and 59% of the women had unprotected sex at last sexual event. Of the 3 occupations fishermen had the highest levels of harmful use of alcohol and risky sexual behaviour followed by service providers judging from values of most indicators. The kind of alcohol consumption variables correlated with risky sexual behaviour variables, varied by occupation. Frequent alcohol consumption, higher AUDIT score, having

  6. Large-scale coral recruitment patterns on Mona Island, Puerto Rico: evidence of a transitional community trajectory after massive coral bleaching and mortality

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    Edwin A. Hernández-Delgado

    2014-09-01

    Full Text Available Coral reefs have largely declined across the northeastern Caribbean following the 2005 massive bleaching event. Climate change-related sea surface warming and coral disease outbreaks of a white plague-like syndrome and of yellow band disease (YBD have caused significant coral decline affecting massive reef building species (i.e., Orbicella annularis species complex which show no apparent signs of recovery through larval sexual recruitment. We addressed coral recruit densities across three spur and groove reef locations along the western shelf of remote Mona Island, Puerto Rico: Punta Capitán (PCA, Pasa de Las Carmelitas (PLC, and Las Carmelitas-South (LCS. Data were collected during November 2012 along 93 haphazard transects across three depth zones (<5m, 5-10m, 10-15m. A total of 32 coral species (9 octocorals, 1 hydrocoral, 22 scleractinians were documented among the recruit community. Communities had low densities and dominance by short-lived brooder species seven years after the 2005 event. Mean coral recruit density ranged from 1.2 to 10.5/m2 at PCA, 6.3 to 7.2/m² at LCS, 4.5 to 9.5/m² at PLC. Differences in coral recruit community structure can be attributed to slight variation in percent macroalgal cover and composition as study sites had nearly similar benthic spatial heterogeneity. Dominance by ephemeral coral species was widespread. Recovery of largely declining massive reef-building species such as the O. annularis species complex was limited or non-existent. The lack of recovery could be the combined result of several mechanisms involving climate change, YBD disease, macroalgae, fishing, urchins and Mona Island’s reefs limited connectivity to other reef systems. There is also for rehabilitation of fish trophic structure, with emphasis in recovering herbivore guilds and depleted populations of D. antillarum. Failing to recognize the importance of ecosystem-based management and resilience rehabilitation may deem remote coral reefs

  7. Communities of archaea and bacteria in a subsurface radioactive thermal spring in the Austrian Central Alps, and evidence of ammonia-oxidizing Crenarchaeota.

    Science.gov (United States)

    Weidler, Gerhard W; Dornmayr-Pfaffenhuemer, Marion; Gerbl, Friedrich W; Heinen, Wolfgang; Stan-Lotter, Helga

    2007-01-01

    Scanning electron microscopy revealed great morphological diversity in biofilms from several largely unexplored subterranean thermal Alpine springs, which contain radium 226 and radon 222. A culture-independent molecular analysis of microbial communities on rocks and in the water of one spring, the "Franz-Josef-Quelle" in Bad Gastein, Austria, was performed. Four hundred fifteen clones were analyzed. One hundred thirty-two sequences were affiliated with 14 bacterial operational taxonomic units (OTUs) and 283 with four archaeal OTUs. Rarefaction analysis indicated a high diversity of bacterial sequences, while archaeal sequences were less diverse. The majority of the cloned archaeal 16S rRNA gene sequences belonged to the soil-freshwater-subsurface (1.1b) crenarchaeotic group; other representatives belonged to the freshwater-wastewater-soil (1.3b) group, except one clone, which was related to a group of uncultivated Euryarchaeota. These findings support recent reports that Crenarchaeota are not restricted to high-temperature environments. Most of the bacterial sequences were related to the Proteobacteria (alpha, beta, gamma, and delta), Bacteroidetes, and Planctomycetes. One OTU was allied with Nitrospina sp. (delta-Proteobacteria) and three others grouped with Nitrospira. Statistical analyses suggested high diversity based on 16S rRNA gene analyses; the rarefaction plot of archaeal clones showed a plateau. Since Crenarchaeota have been implicated recently in the nitrogen cycle, the spring environment was probed for the presence of the ammonia monooxygenase subunit A (amoA) gene. Sequences were obtained which were related to crenarchaeotic amoA genes from marine and soil habitats. The data suggested that nitrification processes are occurring in the subterranean environment and that ammonia may possibly be an energy source for the resident communities.

  8. CTX-M-producing Escherichia coli in a maternity ward: a likely community importation and evidence of mother-to-neonate transmission.

    Science.gov (United States)

    Dubois, Véronique; De Barbeyrac, Bertille; Rogues, Anne-Marie; Arpin, Corinne; Coulange, Laure; Andre, Catherine; M'zali, Fatima; Megraud, Francis; Quentin, Claudine

    2010-07-01

    To investigate the high prevalence of extended-spectrum beta-lactamase (ESBL)-producing strains of Escherichia coli (4%, 10/250 consecutive isolates) recovered during a 5 month period in the maternity ward of the University Hospital of Bordeaux, France. beta-Lactam resistance transfer was analysed by conjugation and transformation. ESBLs were characterized by isoelectric focusing, PCR amplification and sequencing. The relatedness of the strains was examined by PFGE and phylogenetic group determination. Plasmids were characterized by incompatibility group and restriction analysis. Ten ESBL-producing E. coli were isolated from urinary or genital samples of eight mothers and from gastric fluids of two newborns of carrier mothers. The patients were hospitalized in five different units of the maternity ward. Transconjugants, obtained for 7 of the 10 strains, and wild-type strains exhibited various antibiotypes. Different CTX-M enzymes were characterized: CTX-M-1 (n = 4); CTX-M-14 (n = 3); CTX-M-32 (n = 2); and CTX-M-28 (n = 1). The strains recovered from two mothers and their respective babies were identical. All the other strains were epidemiologically unrelated. Furthermore, various plasmids were identified. Environmental samples from the common echographic and sampling rooms did not reveal the presence of ESBL-producing enterobacteria. The data argue against the occurrence of a nosocomial outbreak and support the hypothesis of an importation of community-acquired ESBL-producing strains into the hospital through colonized/infected patients. At present, not only patients transferred from other hospitals or long-term care facilities are at risk of carrying ESBL-producing enterobacteria on hospital admission, but also community patients.

  9. Further evidence for the validity of a response inconsistency scale for the Personality Inventory for DSM-5 in Italian community-dwelling adolescents, community-dwelling adults, and clinical adults.

    Science.gov (United States)

    Somma, Antonella; Borroni, Serena; Kelley, Shannon E; Edens, John F; Fossati, Andrea

    2018-03-22

    Response inconsistency represents a major component of careless responding. Keeley, J. W., Webb, Peterson, Roussin, and Flanagan (2016) proposed a measure of response inconsistency for the Personality Inventory for DSM-5 (PID-5-VRIN). In order to evaluate the ability of the PID-5-VRIN scale to detect inconsistent responding, we examined 3 independent archival samples of Italian community-dwelling adolescents (N = 1,264), community-dwelling adults (N = 2,143), and clinical adults (N = 706) who were administered the PID-5. The impact of PID-5-VRIN scores on the associations with interview-based personality disorder (PD) scores was also assessed among clinical adults. PID-5-VRIN item pairs showed correlational values of at least medium size by conventional standards. Moreover, the PID-5-VRIN seemed to be efficient in discriminating real data from random responses in all samples. In line with Keeley and colleagues' findings, a PID-5-VRIN total score of 17 represented the best balance between sensitivity and specificity in all samples. Clinical adult participants who met this threshold for invalidity also obtained significantly higher scores on the majority of PID-5 trait scales. When the correlations between selected PID-5 trait scale scores and the corresponding interview-based ratings of DSM-5 Section II PDs were considered, appreciable differences in the magnitude and/or direction of association were observed between participants scoring below the PID-5-VRIN cutoff and those meeting the threshold for invalidity (≥17). As a whole, our data suggest that the PID-5-VRIN represents an efficient means of assessing inconsistent responding on the PID-5. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  10. Seasonal fluctuations of small mammal and flea communities in a Ugandan plague focus: evidence to implicate Arvicanthis niloticus and Crocidura spp. as key hosts in Yersinia pestis transmission.

    Science.gov (United States)

    Moore, Sean M; Monaghan, Andrew; Borchert, Jeff N; Mpanga, Joseph T; Atiku, Linda A; Boegler, Karen A; Montenieri, John; MacMillan, Katherine; Gage, Kenneth L; Eisen, Rebecca J

    2015-01-08

    The distribution of human plague risk is strongly associated with rainfall in the tropical plague foci of East Africa, but little is known about how the plague bacterium is maintained during periods between outbreaks or whether environmental drivers trigger these outbreaks. We collected small mammals and fleas over a two year period in the West Nile region of Uganda to examine how the ecological community varies seasonally in a region with areas of both high and low risk of human plague cases. Seasonal changes in the small mammal and flea communities were examined along an elevation gradient to determine whether small mammal and flea populations exhibit differences in their response to seasonal fluctuations in precipitation, temperature, and crop harvests in areas within (above 1300 m) and outside (below 1300 m) of a model-defined plague focus. The abundance of two potential enzootic host species (Arvicanthis niloticus and Crocidura spp.) increased during the plague season within the plague focus, but did not show the same increase at lower elevations outside this focus. In contrast, the abundance of the domestic rat population (Rattus rattus) did not show significant seasonal fluctuations regardless of locality. Arvicanthis niloticus abundance was negatively associated with monthly precipitation at a six month lag and positively associated with current monthly temperatures, and Crocidura spp. abundance was positively associated with precipitation at a three month lag and negatively associated with current monthly temperatures. The abundance of A. niloticus and Crocidura spp. were both positively correlated with the harvest of millet and maize. The association between the abundance of several small mammal species and rainfall is consistent with previous models of the timing of human plague cases in relation to precipitation in the West Nile region. The seasonal increase in the abundance of key potential host species within the plague focus, but not outside of

  11. Prospective association of the SHARE-operationalized frailty phenotype with adverse health outcomes: evidence from 60+ community-dwelling Europeans living in 11 countries.

    Science.gov (United States)

    Macklai, Nejma S; Spagnoli, Jacques; Junod, Julien; Santos-Eggimann, Brigitte

    2013-01-03

    Among the many definitions of frailty, the frailty phenotype defined by Fried et al. is one of few constructs that has been repeatedly validated: first in the Cardiovascular Health Study (CHS) and subsequently in other large cohorts in the North America. In Europe, the Survey of Health, Aging and Retirement in Europe (SHARE) is a gold mine of individual, economic and health information that can provide insight into better understanding of frailty across diverse population settings. A recent adaptation of the original five CHS-frailty criteria was proposed to make use of SHARE data and measure frailty in the European population. To test the validity of the SHARE operationalized frailty phenotype, this study aims to evaluate its prospective association with adverse health outcomes. Data are from 11,015 community-dwelling men and women aged 60+ participating in wave 1 and 2 of the Survey of Health, Aging and Retirement in Europe, a population-based survey. Multivariate logistic regression analyses were used to assess the 2-year follow up effect of SHARE-operationalized frailty phenotype on the incidence of disability (disability-free at baseline) and on worsening disability and morbidity, adjusting for age, sex, income and baseline morbidity and disability. At 2-year follow up, frail individuals were at increased risk for: developing mobility (OR 3.07, 95% CI, 1.02-9.36), IADL (OR 5.52, 95% CI, 3.76-8.10) and BADL (OR 5.13, 95% CI, 3.53-7.44) disability; worsening mobility (OR 2.94, 95% CI, 2.19- 3.93) IADL (OR 4.43, 95% CI, 3.19-6.15) and BADL disability (OR 4.53, 95% CI, 3.14-6.54); and worsening morbidity (OR 1.77, 95% CI, 1.35-2.32). These associations were significant even among the prefrail, but with a lower magnitude of effect. The SHARE-operationalized frailty phenotype is significantly associated with all tested health outcomes independent of baseline morbidity and disability in community-dwelling men and women aged 60 and older living in Europe. The

  12. Prospective association of the SHARE-operationalized frailty phenotype with adverse health outcomes: evidence from 60+ community-dwelling Europeans living in 11 countries

    Directory of Open Access Journals (Sweden)

    Macklai Nejma S

    2013-01-01

    Full Text Available Abstract Background Among the many definitions of frailty, the frailty phenotype defined by Fried et al. is one of few constructs that has been repeatedly validated: first in the Cardiovascular Health Study (CHS and subsequently in other large cohorts in the North America. In Europe, the Survey of Health, Aging and Retirement in Europe (SHARE is a gold mine of individual, economic and health information that can provide insight into better understanding of frailty across diverse population settings. A recent adaptation of the original five CHS-frailty criteria was proposed to make use of SHARE data and measure frailty in the European population. To test the validity of the SHARE operationalized frailty phenotype, this study aims to evaluate its prospective association with adverse health outcomes. Methods Data are from 11,015 community-dwelling men and women aged 60+ participating in wave 1 and 2 of the Survey of Health, Aging and Retirement in Europe, a population-based survey. Multivariate logistic regression analyses were used to assess the 2-year follow up effect of SHARE-operationalized frailty phenotype on the incidence of disability (disability-free at baseline and on worsening disability and morbidity, adjusting for age, sex, income and baseline morbidity and disability. Results At 2-year follow up, frail individuals were at increased risk for: developing mobility (OR 3.07, 95% CI, 1.02-9.36, IADL (OR 5.52, 95% CI, 3.76-8.10 and BADL (OR 5.13, 95% CI, 3.53-7.44 disability; worsening mobility (OR 2.94, 95% CI, 2.19- 3.93 IADL (OR 4.43, 95% CI, 3.19-6.15 and BADL disability (OR 4.53, 95% CI, 3.14-6.54; and worsening morbidity (OR 1.77, 95% CI, 1.35-2.32. These associations were significant even among the prefrail, but with a lower magnitude of effect. Conclusions The SHARE-operationalized frailty phenotype is significantly associated with all tested health outcomes independent of baseline morbidity and disability in community-dwelling men

  13. The 'constructive regulation' of phosphates and phosphogypsum : a new, evidence-based approach to regulating a NORM industry vital to the global community

    International Nuclear Information System (INIS)

    Hilton, Julian; Birky, Brian; Johnston, A.E.

    2008-01-01

    Full text: IAEA has included phosphate production among twelve NORM industries identified for scrutiny and possible regulation. 'Wet' production results in 1) phosphoric acid, as phosphate essential for world-wide food production; and 2) phosphogypsum (PG), which in some countries is used in both agriculture and construction. Phosphate deposits contain 238 U and 232 Th and their decay products; some have sufficient U content for commercial recovery. This puts the industry within the scope of the IAEA Fundamental Safety Principles, and of the International Basic Safety Standards (BSS). Phosphogypsum is a test case for defining and managing NORM industry residues and wastes as typical activity concentrations are extremely low but worldwide stockpiles amount to billions of tonnes. In some jurisdictions, phosphogypsum is regulated as a hazardous, radioactive waste rather than as a resource - with costly results. The phosphate industry is undergoing its most profound change since World War II, led by surging demand from Brazil, Russia, India and China, Established production centres, such as Morocco, are increasing capacity; major new facilities are being built, such as Ma'aden, Saudi Arabia. In consequence, many local jurisdictions face unfamiliar challenges and seek guidance on how to proceed. New research both on phosphate and phosphogypsum has significantly changed our understanding of the domain. A five year study of phosphogypsum use in Huelva, Spain, presents a model of a coherent, evidence-based approach, grounded in sound policy, good science and best practices. The 'constructive regulation' approach builds directly on evidence and lessons learned from a long, continuous tradition of PG use in Spain, Brazil and the United States. It draws on the results of the Stack Free by '53? project to modify John Nash's cooperative game and bargaining theory as a basis for defining a new sustainable point of equilibrium in which phosphogypsum production and consumption are

  14. Big Five personality traits may inform public health policy and preventive medicine: Evidence from a cross-sectional and a prospective longitudinal epidemiologic study in a Swiss community.

    Science.gov (United States)

    Hengartner, Michael P; Kawohl, Wolfram; Haker, Helene; Rössler, Wulf; Ajdacic-Gross, Vladeta

    2016-05-01

    Some evidence documents the importance of personality assessments for health research and practise. However, no study has opted to test whether a short self-report personality inventory may comprehensively inform health policy. Data were taken from a population-based epidemiologic survey in Zurich, Switzerland, conducted from 2010-2012. A short form of the Big Five Inventory was completed by n=1155 participants (54.4% women; mean age=29.6 years), while health-related outcomes were taken from a comprehensive semi-structured clinical interview. A convenience subsample averaging n=171 participants additionally provided laboratory measures and n=133 were subsequently followed-up at least once over a maximal period of 6 months. Personality traits, in particular high neuroticism and low conscientiousness, related significantly to poor environmental resources such as low social support (R(2)=0.071), health-impairing behaviours such as cannabis use (R(2)=0.071), and psychopathology, including negative affect (R(2)=0.269) and various mental disorders (R(2)=0.060-0.195). The proportion of total variance explained was R(2)=0.339 in persons with three or more mental disorders. Personality significantly related to some laboratory measures including total cholesterol (R(2)=0.095) and C-Reactive Protein (R(2)=0.062). Finally, personality prospectively predicted global psychopathological distress and vegetative symptoms over a 6-month observation period. Personality relates consistently to poor socio-environmental resources, health-impairing behaviours and psychopathology. We also found some evidence for an association with metabolic and immune functions that are assumed to influence health. A short personality inventory could provide valuable information for preventive medicine when used as a means to screen entire populations for distinct risk exposure, in particular with respect to psychopathology. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Genetic structure of a natural oak community in central Italy: Evidence of gene flow between three sympatric white oak species (Quercus, Fagaceae

    Directory of Open Access Journals (Sweden)

    Gaby Antonecchia

    2015-12-01

    Full Text Available Incomplete reproductive barriers between species, especially in sympatric areas where several species coexist, may result in hybridization and an increase in genetic diversity. Here we assessed the amount of genetic diversity in a community of three interfertile and sympatric European oaks (Quercus frainetto Ten., Q. petraea Liebl. Matt. and Q. pubescens Willd. situated in central Italy. We used 11 microsatellite markers derived from Expressed Sequence Tag (EST-SSRs and we implemented a Bayesian clustering analysis to assign individuals to species or hybrids. All genotyped loci were polymorphic for all the species and three genetic clusters corresponding to each species were detected. Significant differences and a higher level of gene flow were observed between the three oak species. Occurrence of hybrids varied markedly within the studied area: hybrids between Q. petraea and Q, pubescens were the most frequent, while hybrids between Q. petraea and Q. frainetto were particularly rare. Q. pubescens and Q. petraea showed the highest number of alleles compared to Q. frainetto,which was characterized by a low number of private, but highly frequent, alleles. However, Q. frainetto showed a lower genetic diversity and a stronger reproductive isolation from the other two oak species.

  16. Assessing evidence for avian-to-human transmission of influenza A/H9N2 virus in rural farming communities in northern Vietnam.

    Science.gov (United States)

    Hoa, Le Nguyen Minh; Tuan, Nguyen Anh; My, Pham Ha; Huong, Tran Thi Kieu; Chi, Nguyen Thi Yen; Hau Thu, Trang Thi; Carrique-Mas, Juan; Duong, Mai Thuy; Tho, Nguyen Dang; Hoang, Nguyen Dang; Thanh, To Long; Diep, Nguyen Thi; Duong, Nguyen van; Toan, Tran Khanh; Tung, Trinh Son; Mai, Le Quynh; Iqbal, Munir; Wertheim, Heiman; van Doorn, H Rogier; Bryant, Juliet E; The Vizions Consortium

    2017-08-01

    Rural farming communities in northern Vietnam do not routinely practice vaccination for influenza A viruses (IAV) for either humans or poultry, which enables us to study transmission intensity via seroepidemiology. Using samples from a longitudinal cohort of farming households, we determined the number of symptomatic and asymptomatic human infections for seasonal IAV and avian A/H9 over 2 years. As expected, we detected virologically confirmed acute cases of seasonal IAV in humans, as well as large numbers of subclinical seroconversions to A/H1pdm [55/265 (21 %)], A/H3 [95/265 (36 %)] and A/H9 [24/265 (9 %)]. Five of the A/H9 human seroconverters likely represented true infections rather than heterosubtypic immunity, because the individuals seroconverted solely to A/H9. Among co-located poultry, we found significantly higher seroprevalance for A/H5 compared to A/H9 in both chickens and ducks [for northern study sites overall, 337/1105 (30.5 %) seropositive for A/H5 and 123/1105 (11.1 %) seropositive for A/H9].

  17. Depression, disability and functional status among community-dwelling older adults in South Africa: evidence from the first South African National Income Dynamics Study.

    Science.gov (United States)

    Tomita, Andrew; Burns, Jonathan K

    2013-12-01

    This study examined the relationship between depression and functional status among a community-dwelling older population of 65 years and older in South Africa. Data from the first wave of the South African National Income Dynamics Study were used, this being the first longitudinal panel survey of a nationally representative sample of households. The study focused on the data for resident adults 65 years and older (n = 1,429). Depression was assessed using the 10-item version of the Center for Epidemiologic Studies Depression Scale. Functional status, pertaining to both difficulty and dependence in activities of daily living (ADL), instrumental activities of daily living (IADL), and physical functioning and mobility (PFM), were assessed using 11 items. Functional challenges were generally higher in the older age group. There was a significant association between depression and functional dependence in ADL (adjusted OR = 2.57 [CI: 1.03-6.41]), IADL (adjusted OR = 2.76 [CI: 1.89-4.04]), and PFM (adjusted OR = 1.66 [CI: 1.18-2.33]), but the relationship between depression and functional status, particularly PFM, appeared weaker in older age. The relationship between depression symptoms and function is complex. Functional characteristics between older and younger old populations are diverse, and caution is indicated against overgeneralizing the challenges related to depression and function among this target population. Copyright © 2013 John Wiley & Sons, Ltd.

  18. Co-ownership and Collaboration: Insights into the Measurement of Impact and Change from Evidence-Based Community and State Violence Prevention Partnerships

    Directory of Open Access Journals (Sweden)

    Tariro Mutongwizo

    2015-04-01

    Full Text Available Effective partnerships in community crime and violence prevention interventions are challenging to foster. While this may be the case, their merits cannot be denied, thus it is necessary to involve diverse stakeholders in processes that aim to address violence and crime prevention in order to better approach the causes of crime. However practical experiences have identified the challenges of crime prevention partnerships, particularly in developing indicators that appropriately measure and work to monitor and evaluate progress. It has also been noted that it is difficult to discern which interventions yield success, particularly in partnerships with various stakeholders. This article therefore encourages joint assessments from the onset of crime prevention projects with the development of indicators that are relatable to all partners. The paper will draw on three violence and crime prevention pilot projects, conducted in South Africa. The discussion will focus on the processes of developing performance measurement frameworks and the challenges and successes experienced throughout the monitoring, evaluation and learning process.

  19. The impact of stakeholder values and power relations on community-based health insurance coverage: qualitative evidence from three Senegalese case studies.

    Science.gov (United States)

    Mladovsky, Philipa; Ndiaye, Pascal; Ndiaye, Alfred; Criel, Bart

    2015-07-01

    Continued low rates of enrolment in community-based health insurance (CBHI) suggest that strategies proposed for scaling up are unsuccessfully implemented or inadequately address underlying limitations of CBHI. One reason may be a lack of incorporation of social and political context into CBHI policy. In this study, the hypothesis is proposed that values and power relations inherent in social networks of CBHI stakeholders can explain levels of CBHI coverage. To test this, three case studies constituting Senegalese CBHI schemes were studied. Transcripts of interviews with 64 CBHI stakeholders were analysed using inductive coding. The five most important themes pertaining to social values and power relations were: voluntarism, trust, solidarity, political engagement and social movements. Analysis of these themes raises a number of policy and implementation challenges for expanding CBHI coverage. First is the need to subsidize salaries for CBHI scheme staff. Second is the need to develop more sustainable internal and external governance structures through CBHI federations. Third is ensuring that CBHI resonates with local values concerning four dimensions of solidarity (health risk, vertical equity, scale and source). Government subsidies is one of the several potential strategies to achieve this. Fourth is the need for increased transparency in national policy. Fifth is the need for CBHI scheme leaders to increase their negotiating power vis-à-vis health service providers who control the resources needed for expanding CBHI coverage, through federations and a social movement dynamic. Systematically addressing all these challenges would represent a fundamental reform of the current CBHI model promoted in Senegal and in Africa more widely; this raises issues of feasibility in practice. From a theoretical perspective, the results suggest that studying values and power relations among stakeholders in multiple case studies is a useful complement to traditional health

  20. Evidence for short duration of antibiotic treatment for non-severe community acquired pneumonia (CAP in children - are we there yet? A systematic review of randomised controlled trials

    Directory of Open Access Journals (Sweden)

    Shalom Ben-Shimol

    2014-03-01

    Full Text Available Context: The ideal duration of antibiotic treatment for childhood community acquired pneumonia (CAP has not yet been established. Objective: A literature search was conducted to evaluate the efficacy of shorter than 7 days duration of oral antibiotic treatment for childhood non-severe CAP. Data sources: A systematic literature search was performed using the PubMed database. The search was limited to randomised controlled trials (RCTs conducted between January 1996 and May 2013 in children up to 18 years old. Search terms included pneumonia, treatment, duration, child, children, days, short, respiratory infection and non-severe (nonsevere. Study selection: Only RCTs of oral antibiotic treatment for non-severe CAP in children were included. Data extraction: Independent extraction of articles was done by 3 authors using a preformed questionnaire. Data synthesis: Eight articles meeting the selection criteria were identified: 7 from 2 developing countries (India and Pakistan, and 1 from a developed country (The Netherlands. Studies from developing countries used the World Health Organization clinical criteria for diagnosing CAP, which includes mainly tachypnoea. None of those studies included fever, chest radiography or any laboratory test in their case definition. The Dutch study case definition used laboratory tests and chest radiographies (x-rays in addition to clinical criteria. Five articles concluded that 3 days of treatment are sufficient for non-severe childhood CAP, 2 articles found 5 days treatment to be sufficient, and one article found no difference between 3 days of amoxicillin treatment and placebo. Conclusions: The efficacy of short duration oral antibiotic treatment for non-severe CAP in children has not been established in developed countries. Current RCTs from developing countries used clinical criteria that may have failed to appropriately identify children with true bacterial pneumonia necessitating antibiotic treatment. More RCTs

  1. Do Countries Consistently Engage in Misinforming the International Community about Their Efforts to Combat Money Laundering? Evidence Using Benford’s Law

    Science.gov (United States)

    2017-01-01

    Indicators of compliance and efficiency in combatting money laundering, collected by EUROSTAT, are plagued with shortcomings. In this paper, I have carried out a forensic analysis on a 2003–2010 dataset of indicators of compliance and efficiency in combatting money laundering, that European Union member states self-reported to EUROSTAT, and on the basis of which, their efforts were evaluated. I used Benford’s law to detect any anomalous statistical patterns and found that statistical anomalies were also consistent with strategic manipulation. According to Benford’s law, if we pick a random sample of numbers representing natural processes, and look at the distribution of the first digits of these numbers, we see that, contrary to popular belief, digit 1 occurs most often, then digit 2, and so on, with digit 9 occurring in less than 5% of the sample. Without prior knowledge of Benford’s law, since people are not intuitively good at creating truly random numbers, deviations thereof can capture strategic alterations. In order to eliminate other sources of deviation, I have compared deviations in situations where incentives and opportunities for manipulation existed and in situations where they did not. While my results are not a conclusive proof of strategic manipulation, they signal that countries that faced incentives and opportunities to misinform the international community about their efforts to combat money laundering may have manipulated these indicators. Finally, my analysis points to the high potential for disruption that the manipulation of national statistics has, and calls for the acknowledgment that strategic manipulation can be an unintended consequence of the international community’s pressure on countries to put combatting money laundering on the top of their national agenda. PMID:28122058

  2. Factors affecting the delivery of community pharmacist-led medication reviews: evidence from the MedsCheck annual service in Ontario

    Directory of Open Access Journals (Sweden)

    Petros Pechlivanoglou

    2016-11-01

    Full Text Available Abstract Background Medication reviews have become part of pharmacy practice across developed countries. This study aimed to identify factors affecting the likelihood of eligible Ontario seniors receiving a pharmacy-led medication review called MedsCheck annual (MCA. Methods We designed a cohort study using a random sample of pharmacy claims for MCA-eligible Ontario seniors using linked administrative data from April 2012 to March 2013. Guided by a conceptual framework, we constructed a generalized-estimating-equations model to estimate the effect of patient, pharmacy and community factors on the likelihood of receiving MCA. Results Of the 2,878,958 eligible claim-dates, 65,605 included an MCA. Compared to eligible individuals who did not receive an MCA, recipients were more likely to have a prior MCA (OR = 3.03, receive a new medication on the claim-date (OR = 1.78, be hypertensive (OR = 1.18 or have a recent hospitalization (OR = 1.07. MCA recipients had fewer medications (e.g., OR = 0.44 for ≥12 medications versus 0–4 medications, and were less likely to receive an MCA in a rural (OR = 0.74 or high-volume pharmacy (OR = 0.65. Conclusions The most important determinant of receiving an MCA was having had a prior MCA. Overall, MCA recipients were healthier, younger, urban-dwelling, and taking fewer medications than non-recipients. Policies regarding current and future medication review programs may need to evolve to ensure that those at greatest need receive timely and comprehensive medication reviews.

  3. Do mental health problems in childhood predict chronic physical conditions among males in early adulthood? Evidence from a community-based prospective study.

    Science.gov (United States)

    Goodwin, R D; Sourander, A; Duarte, C S; Niemelä, S; Multimäki, P; Nikolakaros, G; Helenius, H; Piha, J; Kumpulainen, K; Moilanen, I; Tamminen, T; Almqvist, F

    2009-02-01

    Previous studies have documented associations between mental and physical health problems in cross-sectional studies, yet little is known about these relationships over time or the specificity of these associations. The aim of the current study was to examine the relationship between mental health problems in childhood at age 8 years and physical disorders in adulthood at ages 18-23 years. Multiple logistic regression analyses were used to examine the relationship between childhood mental health problems, reported by child, parent and teacher, and physical disorders diagnosed by a physician in early adulthood. Significant linkages emerged between childhood mental health problems and obesity, atopic eczema, epilepsy and asthma in early adulthood. Specifically, conduct problems in childhood were associated with a significantly increased likelihood of obesity and atopic eczema; emotional problems were associated with an increased likelihood of epilepsy and asthma; and depression symptoms at age 8 were associated with an increased risk of asthma in early adulthood. Our findings provide the first evidence of an association between mental health problems during childhood and increased risk of specific physical health problems, mainly asthma and obesity, during early adulthood, in a representative sample of males over time. These data suggest that behavioral and emotional problems in childhood may signal vulnerability to chronic physical health problems during early adulthood.

  4. Evidence for lower variability of coronary artery calcium mineral mass measurements by multi-detector computed tomography in a community-based cohort-Consequences for progression studies

    International Nuclear Information System (INIS)

    Hoffmann, Udo; Siebert, Uwe; Bull-Stewart, Arabella; Achenbach, Stephan; Ferencik, Maros; Moselewski, Fabian; Brady, Thomas J.; Massaro, Joseph M.; O'Donnell, Christopher J.

    2006-01-01

    Purpose: To compare the measurement variability for coronary artery calcium (CAC) measurements using mineral mass compared with a modified Agatston score (AS) or volume score (VS) with multi-detector CT (MDCT) scanning, and to estimate the potential impact of these methods on the design of CAC progression studies. Materials and methods: We studied 162 consecutive subjects (83 women, 79 men, mean age 51 ± 11 years) from a general Caucasian community-based cohort (Framingham Heart Study) with duplicate runs of prospective electrocardiographically-triggered MDCT scanning. Each scan was independently evaluated for the presence of CAC by four experienced observers who determined a 'modified' AS, VS and mineral mass. Results: Of the 162 subjects, CAC was detected in both scans in 69 (42%) and no CAC was detected in either scan in 72 (45%). Calcium scores were low in the 21/162 subjects (12%) for whom CAC was present in one but not the other scan (modified AS 0.96). However, the mean interscan variability was significantly different between mineral mass, modified AS, and VS (coefficient of variation 26 ± 19%, 41 ± 28% and 34 ± 25%, respectively; p < 0.04), with significantly smaller mean differences in pair-wise comparisons for mineral mass compared with modified AS (p < 0.002) or with VS (p < 0.03). The amount of CAC but not heart rate was an independent predictor of interscan variability (r = -0.638, -0.614 and -0.577 for AS, VS, and mineral mass, respectively; all p < 0.0001). The decreased interscan variability of mineral mass would allow a sample size reduction of 5.5% compared with modified AS for observational studies of CAC progression and for randomized clinical trials. Conclusion: There is significantly reduced interscan variability of CAC measurements with mineral mass compared with the modified AS or VS. However, the measurement variability of all quantification methods is predicted by the amount of CAC and is inversely correlated to the extent of partial

  5. Association between insulin resistance and low relative appendicular skeletal muscle mass: evidence from a cohort study in community-dwelling older men and women participants.

    Science.gov (United States)

    Alemán-Mateo, Heliodoro; López Teros, Miriam T; Ramírez, Fátima A; Astiazarán-García, Humberto

    2014-07-01

    It has been hypothesized that insulin resistance plays a role in the development of the loss of skeletal muscle; however, no cohort studies on insulin resistance and low relative appendicular skeletal muscle mass (ASM) have been published to date. Thus, we examined whether insulin resistance is associated with low relative ASM after a 4.6-year follow-up period among apparently healthy older men and women participants. This is a combined retrospective-prospective cohort study, which includes 147 community-dwelling older men and women participants. ASM was measured by dual-energy x-ray absorptiometry at baseline and follow-up. Participants with a relative change in ASM below the sex-specific 15th value were classified as the low relative ASM group. Homeostatic model assessment was used to quantify insulin resistance. Logistic regression calculated odds ratios and 95% confidence intervals for development of low relative ASM, adjusted for covariates. The loss of ASM in the low relative ASM and normal groups was -1.8kg and -0.35kg, respectively (p ≤ .05). The low relative ASM group was older and had higher insulin and homeostatic model assessment of insulin resistance values at baseline. The risk of developing low relative ASM at 4.6-year follow-up was 2.9 times higher (95% CI, 1.00-7.8; p = .04) among the participants with homeostatic model assessment of insulin resistance levels more than 2.3. After adjusting for age, the risk increased to 3.9 times higher (95% CI, 1.3-11.5; p = .03). Insulin resistance was associated with low relative ASM at 4.6-year follow-up after accounting for several covariates in a cohort of apparently healthy, well-functioning young older men and women. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Vitamin B-12, apolipoprotein E genotype, and cognitive performance in community-living older adults: evidence of a gene-micronutrient interaction.

    Science.gov (United States)

    Feng, Lei; Li, Jialiang; Yap, Keng-Bee; Kua, Ee-Heok; Ng, Tze-Pin

    2009-04-01

    The relation between vitamin B-12 and cognitive function in older adults is unclear. Limited evidence suggests that the relation is modulated by apolipoprotein E epsilon4. Hence, it is important to further examine this gene-nutrient interaction. The aim was to investigate the role of apolipoprotein E (APOE) epsilon4 as a genetic predisposing factor modulating the effect of vitamin B-12 on cognitive function. A battery of neuropsychological tests, including the Mini-Mental State Examination (MMSE) for global cognition, was administered at the baseline assessment to 539 Chinese adults aged > or =55 y. The MMSE was repeated at a median 18 mo (n = 376) and a median of 38 mo (n = 247) after baseline. The interaction of vitamin B-12 and APOE epsilon4 on cognitive function was examined in a linear mixed-effects model for MMSE and in a multiple linear regression model for neuropsychological test scores. APOE epsilon4 was associated with a lower MMSE score. Vitamin B-12 (natural log transformed) was positively related to MMSE score, and this association was much stronger in APOE epsilon4 carriers than in APOE epsilon4 noncarriers (P for interaction = 0.016). Significant interactions between natural log-transformed vitamin B-12 and APOE epsilon4 were also found for the Digit Span Backward Longest Sequence (P for interaction = 0.013) and Rey Auditory Verbal Learning Test immediate recall (P for interaction = 0.005). Better performance in these 2 tests was associated with vitamin B-12 in APOE epsilon4 carriers but not in APOE epsilon4 noncarriers. The association between vitamin B-12 and cognitive function was moderated by APOE epsilon4 status.

  7. Long-Term Sustainability of Evidence-Based Prevention Interventions and Community Coalitions Survival: a Five and One-Half Year Follow-up Study.

    Science.gov (United States)

    Johnson, Knowlton; Collins, David; Shamblen, Steve; Kenworthy, Tara; Wandersman, Abraham

    2017-07-01

    This study examines (1) coalition survival, (2) prevalence of evidence-based prevention interventions (EBPIs) to reduce substance abuse implemented as part of the Tennessee Strategic Prevention Framework (SPF) State Incentive Grant (SIG), (3) EBPI sustainability, and (4) factors that predict EBPI sustainability. Secondary data were collected on 27 SPF SIG-funded coalitions and 88 EBPI and non-EBPI implementations. Primary data were collected by a telephone interview/web survey five and one-half years after the SPF SIG ended. Results from secondary data show that 25 of the 27 coalitions survived beyond the SPF SIG for one to five and one-half years; 19 coalitions (70%) were still active five and one-half years later. Further, 88 EBPIs and non-EBPIs were implemented by 27 county SPF SIG coalitions. Twenty-one (21) of 27 coalitions (78%) implemented one to three EBPIs, totaling 37 EBPI implementations. Based on primary survey data on 29 of the 37 EBPI implementations, 28 EBPIs (97%) were sustained between two and five and one-half years while 22 EBPI implementations (76%) were sustained for five and one-half years. When controlling for variability among coalitions (nesting of EBPIs in coalitions), increases in data resources (availability of five types of prevention data) was a strong predictor of length of EBPI sustainability. Positive change in extramural funding resources and level of expertise during SPF SIG implementation, as well as level of coalition formalization at the end of the SPF SIG predicted EBPI sustainability length. One intervention attribute (trialability) also predicted length of sustainability. Implications are discussed.

  8. Ecosystemic forest management approach to ensure forest sustainability and socio-economic development of forest dependent communities: Evidence from Southeast Cameroon

    Directory of Open Access Journals (Sweden)

    J. Mbairamadji

    2010-09-01

    Full Text Available Forests provide a full spectrum of goods and services that contribute to the socio-economic development of forest dependent communities. In tropical countries, the diversity of stakeholders depending on forests with their divergent interests and expectations, make sustainable forest management (SFM difficult to achieve. Although several studies advocate the decentralization of forest management and public participation as important processes for SFM, little has been done to demonstrate how these processes could contribute to forest sustainability and socioeconomic development of forest dependent communities. Moreover, almost no seminal paper has demonstrated how to integrate the ecological, economical and social issues of forest management, which have nevertheless been recognized as essential for sustainable forest management. This study develops an ecosystemic forest management approach based on “Stakeholder-Resource-Usage-Institution” dynamics as an appropriate framework for ensuring forest sustainability and socio-economic development. This approach is supported with lessons drawn on the limitations and pitfalls of the traditional forest management approach in Southeast Cameroon.Les forêts fournissent toute une gamme de biens et de services qui contribuent au développement socio-économique des communautés dépendantes de la forêt. Dans les régions tropicales, la diversité des parties prenantes qui dépendent des forêts rend la gestion durable des forêts difficile du fait d’attentes et d’intérêts divergents. Bien que plusieurs études estiment la décentralisation de la gestion des forêts et la participation publique comme importantes pour la gestion durable des forêts, peu d’initiatives ont été prises pour démontrer la manière dont ces actions pourraient contribuer à la durabilité de la forêt et au développement socio-économique des communautés dépendant de la forêt. En outre, aucun article majeur n’a d

  9. Web-Based Interventions to Improve Mental Health, General Caregiving Outcomes, and General Health for Informal Caregivers of Adults With Chronic Conditions Living in the Community: Rapid Evidence Review.

    Science.gov (United States)

    Ploeg, Jenny; Markle-Reid, Maureen; Valaitis, Ruta; McAiney, Carrie; Duggleby, Wendy; Bartholomew, Amy; Sherifali, Diana

    2017-07-28

    Most adults with chronic conditions live at home and rely on informal caregivers to provide support. Caregiving can result in negative impacts such as poor mental and physical health. eHealth interventions may offer effective and accessible ways to provide education and support to informal caregivers. However, we know little about the impact of Web-based interventions for informal caregivers of community-dwelling adults with chronic conditions. The purpose of this rapid evidence review was to assess the impact of Web-based interventions on mental health, general caregiving outcomes, and general health for informal caregivers of persons with chronic conditions living in the community. A rapid evidence review of the current literature was employed to address the study purpose. EMBASE, MEDLINE, PsychInfo, CINAHL, Cochrane, and Ageline were searched covering all studies published from January 1995 to July 2016. Papers were included if they (1) included a Web-based modality to deliver an intervention; (2) included informal, unpaid adult caregivers of community-living adults with a chronic condition; (3) were either a randomized controlled trial (RCT) or controlled clinical trial (CCT); and (4) reported on any caregiver outcome as a result of use or exposure to the intervention. A total of 20 papers (17 studies) were included in this review. Study findings were mixed with both statistically significant and nonsignificant findings on various caregiver outcomes. Of the 17 included studies, 10 had at least one significant outcome. The most commonly assessed outcome was mental health, which included depressive symptoms, stress or distress, and anxiety. Twelve papers examined the impact of interventions on the outcome of depressive symptoms; 4 found a significant decrease in depressive symptoms. Eight studies examined the outcome of stress or distress; 4 of these found a significant reduction in stress or distress as a result of the intervention. Three studies examined the

  10. Health system context and implementation of evidence-based practices-development and validation of the Context Assessment for Community Health (COACH) tool for low- and middle-income settings.

    Science.gov (United States)

    Bergström, Anna; Skeen, Sarah; Duc, Duong M; Blandon, Elmer Zelaya; Estabrooks, Carole; Gustavsson, Petter; Hoa, Dinh Thi Phuong; Källestål, Carina; Målqvist, Mats; Nga, Nguyen Thu; Persson, Lars-Åke; Pervin, Jesmin; Peterson, Stefan; Rahman, Anisur; Selling, Katarina; Squires, Janet E; Tomlinson, Mark; Waiswa, Peter; Wallin, Lars

    2015-08-15

    The gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs. A supportive context is considered a key element for successful implementation of evidence-based practices (EBP). There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs). Thus, this project aimed to develop and psychometrically validate a tool for this purpose. The development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool. Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries. The tool was validated for use amongst physicians, nurse/midwives and community health workers. The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties. The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge. Aspects of organizational context that were identified as influencing the implementation of EBPs in high-income settings were also found to be relevant in LMICs. However, there were additional aspects of context of relevance in LMICs specifically Resources, Community engagement, Commitment to work and Informal payment. Use of the COACH tool will allow

  11. Evidence-based policy

    DEFF Research Database (Denmark)

    Vohnsen, Nina Holm

    2013-01-01

    -makers and the research community (e.g. Boden & Epstein 2006; House of Commons 2006; Cartwright et al 2009; Rod 2010; Vohnsen 2011). This article intends to draw out some general pitfalls in the curious meeting of science and politics by focusing on a particular attempt to make evidence-based legislation in Denmark (for...

  12. The Role of Preference on Outcomes of People Receiving Evidence-Informed Community Wound Care in Their Home or in a Nurse-Clinic Setting: A Cohort Study (n = 230

    Directory of Open Access Journals (Sweden)

    Margaret B. Harrison

    2014-09-01

    Full Text Available This study followed a cohort of community-dwelling individuals receiving wound-care in a large urban-rural region. During a randomized control trial (RCT evaluating outcomes of receiving care in a nurse-clinic or at home, many approached were willing to participate if they could choose their location of care. This provided a unique opportunity to enroll them as a “choice” cohort, following them in the same manner as the trial participants but allowing them to select their setting of care. The objective was to investigate the role of preference and location of care on care outcomes, including satisfaction with care, healing, health-related quality of life (HRQL, pain, and resource use. This is a secondary analysis of a prospective cohort of 126 individuals enrolled in an RCT to receive care at home or in a nurse-clinic (Allocated group, and an additional 104 who received care at home or in a nurse-clinic based on their preference (Choice group. Mobile individuals with a leg ulcer of venous or mixed venous etiology, referred for community leg ulcer care, were eligible. Specially-trained nurses provided care to both groups using an evidence-informed protocol. Baseline data included socio-demographic, circumstance-of-living and a detailed wound assessment. Mean age of the cohort was 68 years. Satisfaction, healing, recurrence, pain, HRQL, and resource utilization did not differ between groups. If available, individuals should have an option of care venue given almost half of those approached indicated a clear preference for clinic or home. With outcomes being similar, health care planners and decision-makers, as well as individuals and their families, can feel confident that the setting of care will not impact the outcomes. However, larger studies in other contexts are needed to explore the interaction between choice and setting.

  13. The Role of Preference on Outcomes of People Receiving Evidence-Informed Community Wound Care in Their Home or in a Nurse-Clinic Setting: A Cohort Study (n = 230).

    Science.gov (United States)

    Harrison, Margaret B; VanDenKerkhof, Elizabeth G; Hopman, Wilma M; Carley, Meg E

    2014-09-19

    This study followed a cohort of community-dwelling individuals receiving wound-care in a large urban-rural region. During a randomized control trial (RCT) evaluating outcomes of receiving care in a nurse-clinic or at home, many approached were willing to participate if they could choose their location of care. This provided a unique opportunity to enroll them as a "choice" cohort, following them in the same manner as the trial participants but allowing them to select their setting of care. The objective was to investigate the role of preference and location of care on care outcomes, including satisfaction with care, healing, health-related quality of life (HRQL), pain, and resource use. This is a secondary analysis of a prospective cohort of 126 individuals enrolled in an RCT to receive care at home or in a nurse-clinic (Allocated group), and an additional 104 who received care at home or in a nurse-clinic based on their preference (Choice group). Mobile individuals with a leg ulcer of venous or mixed venous etiology, referred for community leg ulcer care, were eligible. Specially-trained nurses provided care to both groups using an evidence-informed protocol. Baseline data included socio-demographic, circumstance-of-living and a detailed wound assessment. Mean age of the cohort was 68 years. Satisfaction, healing, recurrence, pain, HRQL, and resource utilization did not differ between groups. If available, individuals should have an option of care venue given almost half of those approached indicated a clear preference for clinic or home. With outcomes being similar, health care planners and decision-makers, as well as individuals and their families, can feel confident that the setting of care will not impact the outcomes. However, larger studies in other contexts are needed to explore the interaction between choice and setting.

  14. News Workshop: Getting the measure of space Conference: Respecting the evidence receives a great response Event: Communities meet to stimulate science in Wales Teachers: A day to polish up on A-level practicals Development: Exhilarating physics CPD day is a hit in London Lecture: The universe as a classroom

    Science.gov (United States)

    2013-07-01

    Workshop: Getting the measure of space Conference: Respecting the evidence receives a great response Event: Communities meet to stimulate science in Wales Teachers: A day to polish up on A-level practicals Development: Exhilarating physics CPD day is a hit in London Lecture: The universe as a classroom

  15. Atitudes e barreiras à prática de enfermagem baseada na evidência em contexto comunitário Actitudes y barreras para la práctica de enfermería basada en la evidencia en un contexto comunitário Attitudes and barriers to evidence-based nursing practice in a community context

    Directory of Open Access Journals (Sweden)

    Rui Pedro Gomes Pereira

    2012-07-01

    adopción de una práctica de enfermería basada en la evidencia en un contexto comunitario, b describir las actitudes de las enfermeras en relación con la práctica basada en la evidencia. Metodología: se desarrolló un estudio transversal, exploratorio y descriptivo que tuvo lugar en una unidad local de salud en el norte de Portugal, recurriendo a la versión de prueba del “Cuestionario de Actitudes Práctica Basada en Evidencias” (McKenna, Ashton y Keeney, 2004. Los resultados coinciden con los de estudios internacionales, aunque tengan en cuenta las especificidades nacionales. En general, las barreras identificadas son de diversas etiologías: personal, organizacional, cultural y científica. En conclusión, una PBE cumple con la obligación social de la enfermería, funda su credibilidad entre las ciencias de la salud y es sostiene eventuales cambios a nivel político. Es fundamental identificar las barreras y actitudes, independientemente de sus orígenes de modo a estructurar futuras estrategias de intervención.Background: Several studies have identified barriers to evidence-based practice (EBP. Most of these investigations were carried out in different contexts. Therefore research is needed to identify barriers and attitudes to EBP in a community context, given the importance and reorganization of primary health care. The research objectives were: a to identify perceived barriers to the adoption of evidence-based nursing practice in a community setting; b to describe nurses’ attitudes related to evidence-based practice. Methodology: we developed an exploratory and descriptive cross-sectional study, which took place in local health unit in northern Portugal, using the test version of the “Questionnaire Attitudes to Evidence Based Practice” (McKenna, Ashton and Keeney, 2004. The results were considered in relation to those of international studies but taking into account national specificities. Overall, the barriers identified have various etiologies

  16. Vitamin D, Calcium, or Combined Supplementation for the Primary Prevention of Fractures in Community-Dwelling Adults: Evidence Report and Systematic Review for the US Preventive Services Task Force.

    Science.gov (United States)

    Kahwati, Leila C; Weber, Rachel Palmieri; Pan, Huiling; Gourlay, Margaret; LeBlanc, Erin; Coker-Schwimmer, Manny; Viswanathan, Meera

    2018-04-17

    Osteoporotic fractures result in significant morbidity and mortality. To update the evidence for benefits and harms of vitamin D, calcium, or combined supplementation for the primary prevention of fractures in community-dwelling adults to inform the US Preventive Services Task Force. PubMed, EMBASE, Cochrane Library, and trial registries through March 21, 2017; references; and experts. Surveillance continued through February 28, 2018. English-language randomized clinical trials (RCTs) or observational studies of supplementation with vitamin D, calcium, or both among adult populations; studies of populations that were institutionalized or had known vitamin D deficiency, osteoporosis, or prior fracture were excluded. Dual, independent review of titles/abstracts and full-text articles and study quality rating using predefined criteria. Random-effects meta-analysis used when at least 3 similar studies were available. Incident fracture, mortality, kidney stones, cardiovascular events, and cancer. Eleven RCTs (N = 51 419) in adults 50 years and older conducted over 2 to 7 years were included. Compared with placebo, supplementation with vitamin D decreased total fracture incidence (1 RCT [n = 2686]; absolute risk difference [ARD], -2.26% [95% CI, -4.53% to 0.00%]) but had no significant association with hip fracture (3 RCTs [n = 5496]; pooled ARD, -0.01% [95% CI, -0.80% to 0.78%]). Supplementation using vitamin D with calcium had no effect on total fracture incidence (1 RCT [n = 36 282]; ARD, -0.35% [95% CI, -1.02% to 0.31%]) or hip fracture incidence (2 RCTs [n = 36 727]; ARD from the larger trial, -0.14% [95% CI, -0.34% to 0.07%]). The evidence for calcium alone was limited, with only 2 studies (n = 339 total) and very imprecise results. Supplementation with vitamin D alone or with calcium had no significant effect on all-cause mortality or incident cardiovascular disease; ARDs ranged from -1.93% to 1.79%, with CIs consistent with no

  17. Prevention and Treatment of Smoking and Tobacco Use During Pregnancy in Selected Indigenous Communities in High-Income Countries of the United States, Canada, Australia, and New Zealand: An Evidence-Based Review.

    Science.gov (United States)

    Gould, Gillian S; Lim, Ling Li; Mattes, Joerg

    2017-10-01

    Tobacco smoking during pregnancy is the most important modifiable risk factor for adverse pregnancy outcomes and long-term health complications for mother and baby. Tobacco use during pregnancy has decreased in high-income countries but not in Indigenous women in Australia, New Zealand, the United States, and Canada. This evidence-based review focuses on tobacco use among Indigenous pregnant women in high-income countries that share a history of European colonization. Indigenous women are more likely to use tobacco because of socioeconomic disadvantage, social norms, and poor access to culturally appropriate tobacco cessation support. Complications arising from tobacco smoking during pregnancy, such as low birth weight, prematurity, perinatal death, and sudden infant death syndrome, are much higher in Indigenous populations. Effective approaches to cessation in pregnant nonindigenous women involves behavioral counseling, with or without nicotine replacement therapy (NRT). Higher nicotine metabolism during pregnancy and poor adherence may affect therapeutic levels of NRT. Only two randomized trials were conducted among Indigenous women: neither found a statistically significant difference in cessation rates between the treatment and comparison arms. Considerations should be given to (1) whole life course approaches to reduce tobacco use in Indigenous women, (2) prohibiting tobacco promotion and reducing access to alcohol for minors to prevent smoking initiation in Indigenous youth, and (3) training health-care professionals in culturally appropriate smoking cessation care to improve access to services. It is critical to ensure acceptability and feasibility of study designs, consult with the relevant Indigenous communities, and preempt implementation challenges. Research is needed into the effect of reducing or stopping smoking during pregnancy when using NRT on subsequent maternal and infant outcomes. Copyright © 2017 The Authors. Published by Elsevier Inc. All

  18. Community Economics

    OpenAIRE

    武藤, 宣道; Nobumichi, MUTOH

    2000-01-01

    This paper examines the new field of community economics with respect to Japan. A number of studies in community economics have already been produced in OECD countries including the United States. Although these are of great interest, each country has its own historical, socioeconomic context and must therefore develop its own approach to community economics. Community-oriented economics is neither macro-nor micro-economics in the standard economics textbook sense. Most community economics st...

  19. Establishing the NeuroRecovery Network Community Fitness and Wellness facilities: multi-site fitness facilities provide activity-based interventions and assessments for evidence-based functional gains in neurologic disorders.

    Science.gov (United States)

    Tolle, Heather; Rapacz, Andrew; Weintraub, Barry; Shogren, Carrie; Harkema, Susan J; Gibson, Jeremy L

    2017-08-17

    Physical fitness is a necessity for those living with a spinal cord injury, yet access to fitness facilities, equipment, and specially trained fitness experts are limited. This article introduces the concept of a network of fitness facilities specially geared towards individuals with spinal cord injury and other neurological disorders. The Community Fitness and Wellness branch of the NeuroRecovery Network was created to provide a continuum of care after traditional rehabilitation for individuals living with a spinal cord injury and other neurological disorders. Community Fitness and Wellness facilities translate activity-based interventions performed during rehabilitation into a community setting as well as provide other fitness and wellness opportunities. Community Fitness and Wellness facilities are staffed by professionals with training on the specialized needs of individuals living with spinal cord injury or other neurological disorders. Standardized assessments evaluate functional, health, and quality of life gains at regular intervals. A national database gathers information on standardized interventions and assessment outcomes providing a mechanism for evaluation of interventions performed in the community setting. The establishment of Community Fitness and Wellness facilities allows for the quick translation and evaluation of novel, effective approaches from research to individuals in the community. Implications for Rehabilitation Fitness needs of individuals with spinal cord injury living in the community necessitate the use of special equipment and trained staff. Community Fitness and Wellness Programs offer specially trained staff and adaptive equipment providing a continuity of care for those with spinal cord injuries and other neurological disorders.

  20. Evidence and evidence gaps - an introduction.

    Science.gov (United States)

    Dreier, Gabriele; Löhler, Jan

    2016-01-01

    , databases, information portals with processed evidence as well as specific journals and finally teaching are appropriate vehicles. One problem is the multitude of information so that knowledge gaps may affect the clinical routine despite actually existing evidence. Generally, it still takes several years until new knowledge is implemented in daily routine. Tasks: The German Society of Oto-Rhino-Laryngology, Head and Neck Surgery (Deutsche Gesellschaft für Hals-, Nasen- und Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V., DGHNOKHC) and the Professional Association of Otolaryngologists (Deutscher Berufsverband der HNO-Ärzte e.V., BVHNO) have fundamental interest in supporting their members in generating, processing, and providing evidence as well as accompanying knowledge transfer. It encompasses the fields of diagnostics, therapy, and prognosis in the same way as prevention and applies to medicinal products as well as to medical devices or surgical procedures. The base for this is the regular assessment of evidence gaps, also in the area of established procedures, that has to be followed by a prioritization of research questions and the subsequent initiation of clinical research. In addition, large trials verifying therapies and diagnostics, for example in the context of daily conditions after approval, can only be conducted combining all resources in the ENT community. Method, results, and outlook: Together, the executive committees of the DGHNOKHC and the BVHNO founded the German Study Center of Oto-Rhino-Laryngology, Head and Neck Surgery (Deutsches Studienzentrum für Hals-, Nasen- und Ohren-Heilkunde, Kopf- und Hals-Chirurgie, DSZ-HNO). First projects have been initiated, among those a clinical trial on the therapy of sudden hearing loss supported by the BMBF and a survey on evidence gaps in oto-rhino-laryngology. It seems to be both reasonable and feasible to make available methodological expertise via such an infrastructure of a study center for physicians in

  1. Community colleges and economic mobility

    OpenAIRE

    Natalia A. Kolesnikova

    2010-01-01

    This paper examines the role of community colleges in the U.S. higher education system and their advantages and shortcomings. In particular, it discusses the population of community college students and economic returns to community college education for various demographic groups. It offers new evidence on the returns to an associate's degree. Furthermore, the paper uses data from the National Survey of College Graduates to compare educational objectives, progress, and labor market outcomes ...

  2. Evidence logics with relational evidence

    DEFF Research Database (Denmark)

    Baltag, Alexandru; Occhipinti, Andrés

    2017-01-01

    We introduce a family of logics for reasoning about relational evidence: evidence that involves an ordering of states in terms of their relative plausibility. We provide sound and complete axiomatizations for the logics. We also present several evidential actions and prove soundness...

  3. Experiencing local community resilience in action : Learning from post-disaster communities

    NARCIS (Netherlands)

    Imperiale, Angelo Jonas; Vanclay, Frank

    2016-01-01

    Although increasing attention has been given to the need to engage local communities and facilitate community resilience, discrepancies between theory and practice remain evident. Myths, misconceptions and mistakes persist in post-disaster emergency operations, and in the reconstruction and

  4. Digital evidence

    Directory of Open Access Journals (Sweden)

    Lukić Tatjana

    2012-01-01

    Full Text Available Although computer makes human activities faster and easier, innovating and creating new forms of work and other kinds of activities, it also influenced the criminal activity. The development of information technology directly affects the development of computer forensics without which, it can not even imagine the discovering and proving the computer offences and apprehending the perpetrator. Information technology and computer forensic allows us to detect and prove the crimes committed by computer and capture the perpetrators. Computer forensics is a type of forensics which can be defined as a process of collecting, preserving, analyzing and presenting digital evidence in court proceedings. Bearing in mind, that combat against crime, in which computers appear as an asset or object of the offense, requires knowledge of digital evidence as well as specific rules and procedures, the author in this article specifically addresses the issues of digital evidence, forensic (computer investigation, specific rules and procedures for detecting, fixing and collecting digital evidence and use of this type of evidence in criminal proceedings. The author also delas with international standards regarding digital evidence and cyber-space investigation.

  5. Real-world evidence analysis of palbociclib prescribing patterns for patients with advanced/metastatic breast cancer treated in community oncology practice in the USA one year post approval.

    Science.gov (United States)

    Kish, J K; Ward, M A; Garofalo, D; Ahmed, H V; McRoy, L; Laney, J; Zanotti, G; Braverman, J; Yu, H; Feinberg, B A

    2018-05-02

    Rapidly evolving understanding of cancer biology has presented novel opportunities to translate that understanding into clinically relevant therapy. Palbociclib, a novel, first-in-class cyclin-dependent kinase (CDK) 4/6 inhibitor was approved in the USA in February 2015 for the treatment of advanced/metastatic breast cancer. We examined real-world evidence in the first year post approval to understand the clinical and demographic characteristics of patients treated with palbociclib in community oncology practices and the dosing, treatment, and complete blood count (CBC) monitoring patterns. This was a retrospective observational study of structured data from a US electronic medical record (EMR) database. Female patients receiving palbociclib after 31 January 2015 were followed through 31 March 2016. Our methodological rules were constructed to aggregate drugs received according to the order in which they are given, i.e., identify the line of therapy as first, second, or third line, etc., using treatment order and course description fields from the EMR. There were 763 patients initiating palbociclib who met the selection criteria. Of those, 612 (80.2%) received palbociclib concomitantly with letrozole. Mean follow up was 6.4 months and mean age at palbociclib initiation was 64 years. Of patients with a known starting dose (n = 417), 79.9% started on palbociclib 125 mg. Dose reductions were observed in 20.1% of patients. Percentages of patients according to line of therapy at initiation of palbociclib were first-line, 39.5%; second-line, 15.7%; third-line, 13.1%; and fourth-line therapy or later, 31.7%. On average, two CBC tests were conducted during the first cycle of palbociclib treatment. Overall, 74.6% of patients had a neutropenic event during follow up including 47.3% and 8.0% of patients with a grade 3 or 4 occurrence, respectively. Real-world palbociclib use one year post US approval demonstrates a more heterogeneous patient population than that

  6. What is Evidence? (editorial

    Directory of Open Access Journals (Sweden)

    Denise Koufogiannakis

    2011-06-01

    , feedback from our users, project evaluations, and accumulated experiences over the course of careers. These things are not easily shared and often do not find a place in publications because they are too local. But data that comes from a local context is in fact often the most important evidence source thata LIS professional can consult because it gives us information that is directly applicable to, and about our users. For example, usage stats on ejournals, feedback and comments about our services, usability testing on a website, titles on our interlibrary loan requests; these are just a few examples of local evidence that is invaluable to our decision making. This local data doesn’t often mean much to others, but it is of utmost importance to our local knowledge. The trick is to figure out what local information to collect, and how to use it. And remember to use it. This is where others’ experiences of how they use such local evidence can give us ideas and inspiration.As well, we hold a great deal of evidence in our professional knowledge that progressively is built up by library and information professionals over the course of their career. Much of this is tacit, but worthwhile trying to draw out and make explicit. Evidence is shown to us every single day - as we practice our profession, we learn what works and what doesn’t in certain situations. We have practical, real-life experiences to draw upon that are wrapped in different contexts. As professionals we have foundations that form the basis of our knowledge, in a field where we have already learned from our education, training, and on-the-job experience. We build up skills and know-how that are not necessarily written down, but which provide us with a great deal of specialized knowledge. As we learn how to most effectively provide good service, or build quality collections for our users, or build relationships within our community, all these things provide us with evidence of how to be a better professional

  7. Development of a theory and evidence-based program to promote community treatment of fevers in children under five in a rural district in Southern Ghana: An intervention mapping approach

    OpenAIRE

    Abbey, Mercy; Bartholomew, L. Kay; Chinbuah, Margaret A.; Gyapong, Margaret; Gyapong, John O.; van den Borne, Bart

    2017-01-01

    Background This paper describes the development and implementation of a program to promote prompt and appropriate care seeking for fever in children under the age of five. Designed as a multicomponent program, the intervention comprises elements to influence the behavior of caregivers of children, Community Health Workers, professional health care providers and the wider community. Methods Following the six fundamental steps of the Intervention Mapping protocol, we involved relevant stakehold...

  8. Community relations

    International Nuclear Information System (INIS)

    O'Neil, C.

    1997-01-01

    The interaction of the oil and gas companies with the Northern communities regarding drilling activities was an important aspect of oil and gas operations conducted in the Beaufort Sea. During the 1960s the industry and aboriginal people basically ignored each other. Later, the industry put more emphasis on community consultation until finally two-way communication was established. Respect for the land and the environment were very important to aboriginal people who depended on the land and its resources for their traditional way of life. Community relations policies by the various companies involved in the area, and the impact they have had on their respective communities were recounted. Not all efforts were successful, however, the companies and the communities learned from their experiences, and by the time operations ceased, the communities seemed to be more appreciative of the ways they were being treated by the oil companies. 22 figs

  9. Claiming Community

    DEFF Research Database (Denmark)

    Jensen, Steffen Bo

    As its point of departure this working paper takes the multitude of different uses and meanings of the concept of community in local politics in Cape Town. Instead of attempting to define it in substantive terms, the paper takes a social constructivist approach to the study of community...... is termed community work. First, the paper explores how community has become a governmental strategy, employed by the apartheid regime as well, although in different ways, as post-apartheid local government. Secondly, the paper explores the ways in which community becomes the means in which local residents...... lay claim on the state, as well as how it enters into local power struggles between different political groups within the township. In the third part, the paper explores how the meanings of community and the struggles to realise it have changed as South Africa, nationally and locally, has become...

  10. Biclique communities

    DEFF Research Database (Denmark)

    Jørgensen, Sune Lehmann; Hansen-Schwartz, Martin; Hansen, Lars Kai

    2008-01-01

    We present a method for detecting communities in bipartite networks. Based on an extension of the k-clique community detection algorithm, we demonstrate how modular structure in bipartite networks presents itself as overlapping bicliques. If bipartite information is available, the biclique...... community detection algorithm retains all of the advantages of the k-clique algorithm, but avoids discarding important structural information when performing a one-mode projection of the network. Further, the biclique community detection algorithm provides a level of flexibility by incorporating independent...

  11. Community assembly and coexistence in communities of arbuscular mycorrhizal fungi.

    Science.gov (United States)

    Vályi, Kriszta; Mardhiah, Ulfah; Rillig, Matthias C; Hempel, Stefan

    2016-10-01

    Arbuscular mycorrhizal fungi are asexual, obligately symbiotic fungi with unique morphology and genomic structure, which occupy a dual niche, that is, the soil and the host root. Consequently, the direct adoption of models for community assembly developed for other organism groups is not evident. In this paper we adapted modern coexistence and assembly theory to arbuscular mycorrhizal fungi. We review research on the elements of community assembly and coexistence of arbuscular mycorrhizal fungi, highlighting recent studies using molecular methods. By addressing several points from the individual to the community level where the application of modern community ecology terms runs into problems when arbuscular mycorrhizal fungi are concerned, we aim to account for these special circumstances from a mycocentric point of view. We suggest that hierarchical spatial structure of arbuscular mycorrhizal fungal communities should be explicitly taken into account in future studies. The conceptual framework we develop here for arbuscular mycorrhizal fungi is also adaptable for other host-associated microbial communities.

  12. [Community Nutrition].

    Science.gov (United States)

    Aranceta, Javier

    2004-06-01

    In the last 20 years, Public Health Nutrition focused mainly on the qualitative aspects which may influence the onset of chronic diseases, quality of life, physical and mental performance and life expectancy. This applied knowledge organised as part of preventive and health promotion programs led to the development of Community Nutrition. The aim of Community Nutrition actions is to adequate lifestyles related to food consumption patterns in order to improve the quality of life and contribute to health promotion of the population in the community where programs and services are delivered. Key functions to develop in a Community Nutrition Unit consist in the identification and assessment of nutrition problems in the community as well as the design, implementation and evaluation of intervention programs by means of appropriate strategies. These should aim at different populations groups and settings, such as work places, schools, high risk groups or the general public. Nowadays, Community Nutrition work efforts should focus on three main aspects: nutrition education in schools and in the community; food safety and food security and the development and reinforcement of food preparation skills across all age groups. Social catering services, either in schools, the work place or at the community level, need to ensure adequate nutritional supply, provide foods contributing to healthy eating practices as well as to enhance culinary traditions and social learning. Food safety and food security have become a top priority in Public Health. The concepts referes to the availability of food safe and adequate as well as in sufficient amount in order to satisfy nutrition requirements of all individuals in the community. Social changes along new scientific developments will introduce new demands in Community Nutrition work and individual dietary counselling will become a key strategy. In order to face new challenges, community nutrition pactitioners require a high quality

  13. Civic communities and urban violence.

    Science.gov (United States)

    Doucet, Jessica M; Lee, Matthew R

    2015-07-01

    Civic communities have a spirit of entrepreneurialism, a locally invested population and an institutional structure fostering civic engagement. Prior research, mainly confined to studying rural communities and fairly large geographic areas, has demonstrated that civic communities have lower rates of violence. The current study analyzes the associations between the components of civic communities and homicide rates for New Orleans neighborhoods (census tracts) in the years following Hurricane Katrina. Results from negative binomial regression models adjusting for spatial autocorrelation reveal that community homicide rates are lower where an entrepreneurial business climate is more pronounced and where there is more local investment. Additionally, an interaction between the availability of civic institutions and resource disadvantage reveals that the protective effects of civic institutions are only evident in disadvantaged communities. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Community noise

    Science.gov (United States)

    Bragdon, C. R.

    Airport and community land use planning as they relate to airport noise reduction are discussed. Legislation, community relations, and the physiological effect of airport noise are considered. Noise at the Logan, Los Angeles, and Minneapolis/St. Paul airports is discussed.

  15. Effects of temperature increase in insect community

    International Nuclear Information System (INIS)

    Tuda, Midori; Fujii, Koichi

    1993-01-01

    Temperature will rise by 2degC in the near future. Potential effects of the rise on biological community are predicted with little evidence on the subjects. Individualistic responses of component species in community are often ignored. We performed experiments on a lab host-parasitoid community and tested the hypothesis that individualistic changes in developmental schedules by temperature rise can generate drastic community change. (author)

  16. Community Drive

    DEFF Research Database (Denmark)

    Magnussen, Rikke

    2018-01-01

    Schools and educational institutions are challenged by not adequately educating students for independent knowledge collaboration and solving of complex societal challenges (Bundsgaard & Hansen, 2016; Slot et al., 2017). As an alternative strategy to formal learning has Community-driven research...... opportunity to break boundaries between research institutions and surrounding communities through the involvement of new types of actors, knowledge forms and institutions (OECD, 2011). This paper presents the project Community Drive a three year cross disciplinary community-driven game– and data-based project....... In the paper we present how the project Community Drive initiated in May 2018 is based on results from pilot projects conducted from 2014 – 2017. Overall these studies showed that it is a strong motivational factor for students to be given the task to change their living conditions through redesign...

  17. Community Ecology

    CERN Document Server

    1988-01-01

    This book presents the proceedings of a workshop on community ecology organized at Davis, in April, 1986, sponsored by the Sloan Foundation. There have been several recent symposia on community ecology (Strong et. al., 1984, Diamond and Case, 1987) which have covered a wide range of topics. The goal of the workshop at Davis was more narrow: to explore the role of scale in developing a theoretical approach to understanding communities. There are a number of aspects of scale that enter into attempts to understand ecological communities. One of the most basic is organizational scale. Should community ecology proceed by building up from population biology? This question and its ramifications are stressed throughout the book and explored in the first chapter by Simon Levin. Notions of scale have long been important in understanding physical systems. Thus, in understanding the interactions of organisms with their physical environment, questions of scale become paramount. These more physical questions illustrate the...

  18. Is immunising all patients with chronic lung disease in the community against influenza cost effective? : Evidence from a general practice based clinical prospective cohort study in Utrecht, The Netherlands

    NARCIS (Netherlands)

    Hak, E; van Essen, G A; Buskens, E; Stalman, W; de Melker, R A

    STUDY OBJECTIVE: There is little information on the potential benefit of immunising all patients with chronic lung disease in the community against influenza. The clinical effectiveness and economic benefit was established of the influenza vaccination programme in a general practice based cohort of

  19. European Community.

    Science.gov (United States)

    1987-05-01

    The European Community was established in 1951 to reconcile France and Germany after World War II and to make possible the eventual federation of Europe. By 1986, there were 12 member countries: France, Italy, Belgium, the Federal Republic of Germany, Luxembourg, the Netherlands, Denmark, Ireland, the United Kingdom, Greece, Spain, and Portugal. Principal areas of concern are internal and external trade, agriculture, monetary coordination, fisheries, common industrial and commercial policies, assistance, science and research, and common social and regional policies. The European Community has a budget of US$34.035 billion/year, funded by customs duties and 1.4% of each member's value-added tax. The treaties establishing the European Community call for members to form a common market, a common customs tariff, and common agricultural, transport, economic, and nuclear policies. Major European Community institutions include the Commission, Council of Ministers, European Parliament, Court of Justice, and Economic and Social Committee. The Community is the world's largest trading unit, accounting for 15% of world trade. The 2 main goals of the Community's industrial policy are to create an open internal market and to promote technological innovation in order to improve international competitiveness. The European Community aims to contribute to the economic and social development of Third World countries as well.

  20. Natural Communities

    Data.gov (United States)

    Kansas Data Access and Support Center — This dataset shows the locations of known tracts of high quality natural communities in Kansas, generalized to the PLSS section. It is not a compehensive dataset of...

  1. COMMUNITY OPHTHALMOLOGY

    African Journals Online (AJOL)

    2016-11-04

    Nov 4, 2016 ... The Role of Research in Social Marketing: The Community Eye. Outreach Clinic .... Serious thought was given to the possibility of establishing static eye care .... Information obtained included vital statistics, work history, job.

  2. Using communities that care for community child maltreatment prevention.

    Science.gov (United States)

    Salazar, Amy M; Haggerty, Kevin P; de Haan, Benjamin; Catalano, Richard F; Vann, Terri; Vinson, Jean; Lansing, Michaele

    2016-03-01

    The prevention of mental, emotional, and behavioral (MEB) disorders among children and adolescents is a national priority. One mode of implementing community-wide MEB prevention efforts is through evidence-based community mobilization approaches such as Communities That Care (CTC). This article provides an overview of the CTC framework and discusses the adaptation process of CTC to prevent development of MEBs through preventing child abuse and neglect and bolstering child well-being in children aged 0 to 10. Adaptations include those to the intervention itself as well as those to the evaluation approach. Preliminary findings from the Keeping Families Together pilot study of this evolving approach suggest that the implementation was manageable for sites, and community board functioning and community adoption of a science-based approach to prevention in pilot sites looks promising. Implications and next steps are outlined. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  3. Oil spill effects on macrofaunal communities and bioturbation of pristine marine sediments (Caleta Valdés, Patagonia, Argentina): experimental evidence of low resistance capacities of benthic systems without history of pollution.

    Science.gov (United States)

    Ferrando, Agustina; Gonzalez, Emilia; Franco, Marcos; Commendatore, Marta; Nievas, Marina; Militon, Cécile; Stora, Georges; Gilbert, Franck; Esteves, José Luis; Cuny, Philippe

    2015-10-01

    The Patagonian coast is characterized by the existence of pristine ecosystems which may be particularly sensitive to oil contamination. In this study, a simulated oil spill at acute and chronic input levels was carried out to assess the effects of contamination on the macrobenthic community structure and the bioturbation activity of sediments sampled in Caleta Valdés creek. Superficial sediments were either noncontaminated or contaminated by Escalante crude oil and incubated in the laboratory for 30 days. Oil contamination induced adverse effects on macrobenthic community at both concentrations with, for the highest concentration, a marked decrease of approximately 40 and 55 % of density and specific richness, respectively. Besides the disappearance of sensitive species, some other species like Oligochaeta sp. 1, Paranebalia sp., and Ostracoda sp. 2 species have a higher resistance to oil contamination. Sediment reworking activity was also affected by oil addition. At the highest level of contamination, nearly no activity was observed due to the high mortality of macroorganisms. The results strongly suggest that an oil spill in this protected marine area with no previous history of contamination would have a deep impact on the non-adapted macrobenthic community.

  4. Community concepts.

    Science.gov (United States)

    Yeung, Thomas; Bates, Tony

    2004-03-01

    Since the publication of "Sustainable Communities--building for the future", Government attention has focused largely on high-density affordable housing in the four "growth areas": Thames Gateway; Ashford; Milton Keynes--South Midlands, and London--Stansted--Cambridge. In this article, Thomas Yeung and Tony Bates suggest that a greater and more sustainable impact would be achieved if architects, planners, and developers considered the potential for community-based water and waste management and on-site energy generation and distribution right from the start of the project. In particular, they consider that the communal nature of hospitals, universities, and public/community housing provides a great opportunity for on-site renewable CHP and/or distributed heating, which could combine global environmental benefits with improved local amenities. They describe a simple model for prioritising energy management in the built environment, and draw on lessons learnt at ETRCL in Dagenham and BedZED in Surrey to offer a few recommendations for Government and developers. Tony Bates is the business development manager for Scott Wilson in the South East and is responsible for the promotion of sustainable communities through relationships with architects, developers, land owners and local authorities. Thomas Yeung leads the Energy Infrastructure Technologies group in Scott Wilson. This team offers an integrated approach to clean community-based energy generation, energy management, waste and water management, sustainable transport, and sustainable buildings/communities.

  5. Community expectations

    International Nuclear Information System (INIS)

    Kraemer, L.

    2004-01-01

    Historically, the relationship between the nuclear generator and the local community has been one of stability and co-operation. However in more recent times (2000-2003) the nuclear landscape has had several major issues that directly effect the local nuclear host communities. - The associations mandate is to be supportive of the nuclear industry through ongoing dialogue, mutual cooperation and education, - To strengthen community representation with the nuclear industry and politically through networking with other nuclear host communities. As a result of these issues, the Mayors of a number of communities started having informal meetings to discuss the issues at hand and how they effect their constituents. These meetings led to the official formation of the CANHC with representation from: In Canada it is almost impossible to discuss decommissioning and dismantling of Nuclear Facilities without also discussing Nuclear Waste disposal for reasons that I will soon make clear. Also I would like to briefly touch on how and why expectation of communities may differ by geography and circumstance. (author)

  6. Evolving prosocial and sustainable neighborhoods and communities.

    Science.gov (United States)

    Biglan, Anthony; Hinds, Erika

    2009-01-01

    In this review, we examine randomized controlled trials of community interventions to affect health. The evidence supports the efficacy of community interventions for preventing tobacco, alcohol, and other drug use; several recent trials have shown the benefits of community interventions for preventing multiple problems of young people, including antisocial behavior. However, the next generation of community intervention research needs to reflect more fully the fact that most psychological and behavioral problems of humans are interrelated and result from the same environmental conditions. The evidence supports testing new comprehensive community interventions that focus on increasing nurturance in communities. Nurturing communities will be ones in which families, schools, neighborhoods, and workplaces (a) minimize biologically and socially toxic events, (b) richly reinforce prosocial behavior, and (c) foster psychological acceptance. Such interventions also have the potential to make neighborhoods more sustainable.

  7. Contribution of community-based newborn health promotion to reducing inequities in healthy newborn care practices and knowledge: evidence of improvement from a three-district pilot program in Malawi.

    Science.gov (United States)

    Callaghan-Koru, Jennifer A; Nonyane, Bareng A S; Guenther, Tanya; Sitrin, Deborah; Ligowe, Reuben; Chimbalanga, Emmanuel; Zimba, Evelyn; Kachale, Fannie; Shah, Rashed; Baqui, Abdullah H

    2013-11-07

    Inequities in both health status and coverage of health services are considered important barriers to achieving Millennium Development Goal 4. Community-based health promotion is a strategy that is believed to reduce inequities in rural low-income settings. This paper examines the contributions of community-based programming to improving the equity of newborn health in three districts in Malawi. This study is a before-and-after evaluation of Malawi's Community-Based Maternal and Newborn Care (CBMNC) program, a package of facility and community-based interventions to improve newborn health. Health Surveillance Assistants (HSAs) within the catchment area of 14 health facilities were trained to make pregnancy and postnatal home visits to promote healthy behaviors and assess women and newborns for danger signs requiring referral to a facility. "Core groups" of community volunteers were also trained to raise awareness about recommended newborn care practices. Baseline and endline household surveys measured the coverage of the intervention and targeted health behaviors for this before-and-after evaluation. Wealth indices were constructed using household asset data and concentration indices were compared between baseline and endline for each indicator. The HSAs trained in the intervention reached 36.7% of women with a pregnancy home visit and 10.9% of women with a postnatal home visit within three days of delivery. Coverage of the intervention was slightly inequitable, with richer households more likely to receive one or two pregnancy home visits (concentration indices (CI) of 0.0786 and 0.0960), but not significantly more likely to receive a postnatal visit or know of a core group. Despite modest coverage levels for the intervention, health equity improved significantly over the study period for several indicators. Greater improvements in inequities were observed for knowledge indicators than for coverage of routine health services. At endline, a greater proportion of

  8. Rhetoric and Reality of Community Participation in Health Planning ...

    African Journals Online (AJOL)

    community oriented health programmes. The fourth principle of ... vary between projects, programmes, countries and even within and ... evidence on mechanisms for inclusion of community ..... [7, 50] Celedon [75] report from Chile, however,.

  9. Probing community nurses' professional basis

    DEFF Research Database (Denmark)

    Schaarup, Clara; Pape-Haugaard, Louise; Jensen, Merete Hartun

    2017-01-01

    Complicated and long-lasting wound care of diabetic foot ulcers are moving from specialists in wound care at hospitals towards community nurses without specialist diabetic foot ulcer wound care knowledge. The aim of the study is to elucidate community nurses' professional basis for treating...... diabetic foot ulcers. A situational case study design was adopted in an archetypical Danish community nursing setting. Experience is a crucial component in the community nurses' professional basis for treating diabetic foot ulcers. Peer-to-peer training is the prevailing way to learn about diabetic foot...... ulcer, however, this contributes to the risk of low evidence-based practice. Finally, a frequent behaviour among the community nurses is to consult colleagues before treating the diabetic foot ulcers....

  10. The Communities Advancing Resilience Toolkit (CART): an intervention to build community resilience to disasters.

    Science.gov (United States)

    Pfefferbaum, Rose L; Pfefferbaum, Betty; Van Horn, Richard L; Klomp, Richard W; Norris, Fran H; Reissman, Dori B

    2013-01-01

    Community resilience has emerged as a construct to support and foster healthy individual, family, and community adaptation to mass casualty incidents. The Communities Advancing Resilience Toolkit (CART) is a publicly available theory-based and evidence-informed community intervention designed to enhance community resilience by bringing stakeholders together to address community issues in a process that includes assessment, feedback, planning, and action. Tools include a field-tested community resilience survey and other assessment and analytical instruments. The CART process encourages public engagement in problem solving and the development and use of local assets to address community needs. CART recognizes 4 interrelated domains that contribute to community resilience: connection and caring, resources, transformative potential, and disaster management. The primary value of CART is its contribution to community participation, communication, self-awareness, cooperation, and critical reflection and its ability to stimulate analysis, collaboration, skill building, resource sharing, and purposeful action.

  11. Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 4: Prognostic value of B-type natriuretic peptides (BNP and NT-proBNP) in community-acquired pneumonia.

    Science.gov (United States)

    Hodgson, David; Nee, Patrick; Sultan, Laith

    2012-10-01

    A short cut review was carried out to establish the prognostic value of B-type natriuretic peptides (BNP and NT-proBNP) in community acquired pneumonia (CAP). Three cohort studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line was that B-type natriuretic peptides have prognostic value in CAP but further prospective studies were needed to assess their application in clinical practice.

  12. The Role of Preference on Outcomes of People Receiving Evidence-Informed Community Wound Care in Their Home or in a Nurse-Clinic Setting: A Cohort Study (n = 230)

    OpenAIRE

    Harrison, Margaret B.; VanDenKerkhof, Elizabeth G.; Hopman, Wilma M.; Carley, Meg E.

    2014-01-01

    This study followed a cohort of community-dwelling individuals receiving wound-care in a large urban-rural region. During a randomized control trial (RCT) evaluating outcomes of receiving care in a nurse-clinic or at home, many approached were willing to participate if they could choose their location of care. This provided a unique opportunity to enroll them as a “choice” cohort, following them in the same manner as the trial participants but allowing them to select their setting of care. Th...

  13. The narrative psychology of community health workers.

    Science.gov (United States)

    Murray, Michael; Ziegler, Friederike

    2015-03-01

    Community health psychology is an approach which promotes community mobilisation as a means of enhancing community capacity and well-being and challenging health inequalities. Much of the research on this approach has been at the more strategic and policy level with less reference to the everyday experiences of community workers who are actively involved in promoting various forms of community change. This article considers the narrative accounts of a sample of 12 community workers who were interviewed about their lives. Their accounts were analysed in terms of narrative content. This revealed the tensions in their everyday practice as they attempted to overcome community divisions and management demands for evidence. Common to all accounts was a commitment to social justice. These findings are discussed with reference to opportunities and challenges in the practice of community work. © The Author(s) 2015.

  14. Designed communities?

    DEFF Research Database (Denmark)

    Stender, Marie

    2013-01-01

    In current residential spaces there seem to be an increasing emphasis on small-scale communities. A number of new, high profiled residential complexes thus seek to promote new ways of social living by rethinking architectural design, typologies and concepts. In this paper I explore the emergence ...

  15. Walkable Communities

    Centers for Disease Control (CDC) Podcasts

    2008-04-18

    This podcast is for a general audience and discusses the benefits of walkable communities, as they relate to health, the environment, and social interaction.  Created: 4/18/2008 by National Center for Environmental Health (NCEH), ATSDR.   Date Released: 5/8/2008.

  16. Interfirm communities

    DEFF Research Database (Denmark)

    Bergenholtz, Carsten

    2012-01-01

    . These results yield a paradox which the present paper aims to address. Based on an in-depth case study of how a high-tech small firm organizes its interfirm activity, I show how a hybrid social relation, that is neither weak nor strong, is a useful conception for interfirm communities. Hereby, the study also...

  17. Summary of Canadian Guidelines for the Initial Management of Community-Acquired Pneumonia: An Evidence-Based Update by the Canadian Infectious Disease Society and the Canadian Thoracic Society

    Directory of Open Access Journals (Sweden)

    Lionel A Mandell

    2000-01-01

    Full Text Available Community-acquired pneumonia (CAP is a serious illness with a significant impact on individual patients and society as a whole. Over the past several years, there have been significant advances in the knowledge and understanding of the etiology of the disease, and an appreciation of problems such as mixed infections and increasing antimicrobial resistance. The development of additional fluoroquinolone agents with enhanced activity against Streptococcus pneumoniae has been important as well. It was decided that the time had come to update and modify the previous CAP guidelines, which were published in 1993. The current guidelines represent a joint effort by the Canadian Infectious Diseases Society and the Canadian Thoracic Society, and they address the etiology, diagnosis and initial management of CAP. The diagnostic section is based on the site of care, and the treatment section is organized according to whether one is dealing with outpatients, inpatients or nursing home patients.

  18. Community empowerment and community cohesion: parallel agendas for community building in England?

    Directory of Open Access Journals (Sweden)

    Marjorie Mayo

    2009-02-01

    Full Text Available Community empowerment and community capacity building have been central to government agendas in Britain over the past decade. Agendas for tackling the so-called ‘War on Terrorism’ and promoting community cohesion have become increasingly significant in addition, especially since the bombings in London in 2005. This article focuses upon the current gap between these differing agendas. This is particularly relevant in an era of increasing globalisation, with considerable debate on the impact of migration, and anxieties about previous approaches to multiculturalism that have been the subject of growing criticism. Having set out these gaps in public policy and research in this field, the article examines the evidence from research, including 100 interviews together with focus groups conducted in three localities in England, identifying the problems, in terms of the lack of engagement of ‘new communities’ and in terms of the potential tensions within and between communities. There was, however, encouraging evidence that strategies were being developed to develop more inclusive, more democratically accountable and more effective forms of community engagement. The article concludes by summarising potential implications for building community cohesion and social solidarity.

  19. Strengthening Chronic Disease Prevention Programming: The Toward Evidence-Informed Practice (TEIP) Program Evidence Tool

    Science.gov (United States)

    Albert, Dayna; Fortin, Rebecca; Herrera, Christine; Hanning, Rhona; Lessio, Anne; Rush, Brian

    2013-01-01

    In public health and chronic disease prevention there is increasing priority for effective use of evidence in practice. In Ontario, Canada, despite various models being advanced, public health practitioners are seeking ways to identify and apply evidence in their work in practical and meaningful ways. In a companion article, “Strengthening Chronic Disease Prevention Programming: The Toward Evidence-Informed Practice (TEIP) Program Assessment Tool,” we describe use of a tool to assess and strengthen program planning and implementation processes using 19 criteria derived from best and promising practices literature. In this article, we describe use of a complementary Program Evidence Tool to identify, synthesize, and apply a range of evidence sources to strengthen the content of chronic disease prevention programming. The Program Evidence Tool adapts tools of evidence-based medicine to the unique contexts of community-based health promotion and chronic disease prevention. Knowledge management tools and a guided dialogue process known as an Evidence Forum enable community stakeholders to make appropriate use of evidence in diverse social, political, and structural contexts. Practical guidelines and worksheets direct users through 5 steps: 1) define an evidence question, 2) develop a search strategy, 3) collect and synthesize evidence, 4) interpret and adapt evidence, and 5) implement and evaluate. We describe the Program Evidence Tool’s benefits, strengths, challenges, and what was learned from its application in 4 Ontario public health departments. The Program Evidence Tool contributes to the development and understanding of the complex use of evidence in community-based chronic disease prevention. PMID:23721788

  20. Community Evolution

    OpenAIRE

    Saganowski, Stanisław; Bródka, Piotr; Kazienko, Przemysław

    2016-01-01

    The continuous interest in the social network area contributes to the fast development of this field. The new possibilities of obtaining and storing data facilitate deeper analysis of the entire social network, extracted social groups and single individuals as well. One of the most interesting research topic is the network dynamics and dynamics of social groups in particular, it means analysis of group evolution over time. It is the natural step forward after social community extraction. Havi...

  1. 77 FR 41168 - Marine Mammals; Subsistence Taking of Northern Fur Seals; St. Paul Island

    Science.gov (United States)

    2012-07-12

    ... Administrative Procedure Act (APA). The Pribilof Island Community of St. Paul Island, Aleut Community of St. Paul... comment on from the resulting list and click on the ``Submit a Comment'' icon on the right of that line... Adobe PDF file formats only. Information related to the request for rulemaking is available on the...

  2. Parent-Adolescent Sexual and Reproductive Health Communication Is Very Limited and Associated with Adolescent Poor Behavioral Beliefs and Subjective Norms: Evidence from a Community Based Cross-Sectional Study in Eastern Ethiopia.

    Directory of Open Access Journals (Sweden)

    Yadeta Dessie

    Full Text Available While parent-adolescent sexual and reproductive health (SRH communication is one potential source of SRH information for adolescents, it appears to be inadequately practiced in Ethiopia. This study was designed to investigate the factors that limit or improve parent-adolescent SRH communication in Harar, Eastern Ethiopia.A community based cross-sectional study was done on 4,559 adolescents of age 13-18. SRH communication was measured using a nine-item scale whose response ranged from "not at all" to "always." Summated composite score ranging from 0-36 was generated; higher score indicates high SRH communication. A median value of the composite score was 4 out of the possible 36 with an Interquartile Range (IQR of 7. Respondents were ranked as very poor, poor and satisfactory communicators based on 33rd and 67th percentiles values. Generalized ordered logit model was applied to investigate the factors associated with SRH communication.Results showed that the adolescents who were more likely to practice poor-very poor/very poor SRH communication were those who had poor behavioral beliefs on and poor subjective norms of communicating sexual issues with parents and those who perceived their parents' reproductive health (RH knowledge as poor. Nonetheless, the probability of poor-very poor/very poor SRH communication was less with high adolescent-parent communication quality, television co-viewing and discussions, and self-disclosure.Curtailing the adolescents' underlying poor beliefs and norms, and improving adolescent-parent communication quality, self-disclosure, and television co-viewing and discussions are essential to engage the parents in sexual and reproductive health education of the adolescents.

  3. Online Communities

    DEFF Research Database (Denmark)

    Sørensen, Henrik; Lassen, Astrid Heidemann; Gorm Hansen, Katrine

    ”Online Communities” er et medie for brugere og fagfolk, hvor de kan mødes digitalt for at dele erfaringer, og dette kan anvendes som inspiration indenfor Brugerdreven Innovation. Via ”desk research” kan virksomheder opnå adgang til varierende mængder af brugere på en forholdsvist enkelt måde. I...... denne rapport beskrives eksperimentets opbygning, resultater og mulige værdi. Vi håber hermed på at kunne give praktisk indsigt i, hvorledes virksomheder fra byggematerialeindustrien kan agere i online communities....

  4. Community gardening: a parsimonious path to individual, community, and environmental resilience.

    Science.gov (United States)

    Okvat, Heather A; Zautra, Alex J

    2011-06-01

    The goal of this paper is to introduce community gardening as a promising method of furthering well-being and resilience on multiple levels: individual, social group, and natural environment. We examine empirical evidence for the benefits of gardening, and we advocate the development and testing of social ecological models of community resilience through examination of the impact of community gardens, especially in urban areas. The definition of community is extended beyond human social ties to include connections with other species and the earth itself, what Berry (1988) has called an Earth community. We discuss the potential contribution of an extensive network of community gardens to easing the global climate change crisis and address the role of community psychologists in community gardening research and policy-oriented action.

  5. Community schools unfolded: a review of the literature

    NARCIS (Netherlands)

    Heers, M.; van Klaveren, C.; Groot, W.; Maassen van den Brink, H.

    2011-01-01

    Community schools are quickly increasing in number, but there is no evidence whether they are more effective than traditional schools. No study has empirically compared community schools to other schools. This study reviews the literature on the effectiveness of community schools. We focus on their

  6. Developing Learning Communities: Using Communities of Practice within Community Psychology

    Science.gov (United States)

    Lawthom, Rebecca

    2011-01-01

    The idea that communities need to be inclusive is almost axiomatic. The process, whereby, community members engage in inclusive practices is far less understood. Similarly, UK universities are being encouraged to include the wider community and extent campus boundaries. Here, I suggest a particular theoretical lens which sheds light on engagement…

  7. A nuclear community's perspective

    International Nuclear Information System (INIS)

    1987-09-01

    This submission delineates a perspective derived from the experience of a community which has lived with the nuclear industry since its beginnings in Canada, 45 years ago. Much has been accomplished in both basic and applied research in that time, and the industry continues to be recognized worldwide as a leader in solving high-technology problems. However, recent funding cuts have seriously jeopardized the industry's ability to maintain this high standard. Current anti-nuclear attitudes among our elected and appointed officials respond more to today's political fashions than tomorrow's evident needs. The town of Deep River believes that the industry has demonstrated a superb safety record in the past. If common sense prevails in matters of safety, and if appropriate levels of funding are maintained, the nuclear industry will continue to be a source of pride for all concerned

  8. A phylogenetic community approach for studying termite communities in a West African savannah.

    Science.gov (United States)

    Hausberger, Barbara; Korb, Judith

    2015-10-01

    Termites play fundamental roles in tropical ecosystems, and mound-building species in particular are crucial in enhancing species diversity, from plants to mammals. However, it is still unclear which factors govern the occurrence and assembly of termite communities. A phylogenetic community approach and null models of species assembly were used to examine structuring processes associated with termite community assembly in a pristine savannah. Overall, we did not find evidence for a strong influence of interspecific competition or environmental filtering in structuring these communities. However, the presence of a single species, the mound-building termite Macrotermes bellicosus, left a strong signal on structuring and led to clustered communities of more closely related species. Hence, this species changes the assembly rules for a whole community. Our results show the fundamental importance of a single insect species for community processes, suggesting that more attention to insect species is warranted when developing conservation strategies. © 2015 The Author(s).

  9. Utility-driven evidence for healthy cities

    DEFF Research Database (Denmark)

    de Leeuw, Evelyne; Skovgaard, Thomas

    2005-01-01

    The question whether the WHO Healthy Cities project 'works' has been asked ever since a number of novel ideas and actions related to community health, health promotion and healthy public policy in the mid 1980s came together in the Healthy Cities Movement initiated by the World Health Organization....... The question, however, has become more urgent since we have entered an era in which the drive for 'evidence' seems all-pervasive. The article explores the nature of evidence, review available evidence on Healthy Cities accomplishments, and discusses whether enough evidence has been accumulated on different...... performances within the realm of Healthy Cities. A main point of reference is the European Healthy Cities Project (E-HCP). Building on the information gathered through documentary research on the topic, it is concluded that there is fair evidence that Healthy Cities works. However, the future holds great...

  10. Evidence synthesis software.

    Science.gov (United States)

    Park, Sophie Elizabeth; Thomas, James

    2018-06-07

    It can be challenging to decide which evidence synthesis software to choose when doing a systematic review. This article discusses some of the important questions to consider in relation to the chosen method and synthesis approach. Software can support researchers in a range of ways. Here, a range of review conditions and software solutions. For example, facilitating contemporaneous collaboration across time and geographical space; in-built bias assessment tools; and line-by-line coding for qualitative textual analysis. EPPI-Reviewer is a review software for research synthesis managed by the EPPI-centre, UCL Institute of Education. EPPI-Reviewer has text mining automation technologies. Version 5 supports data sharing and re-use across the systematic review community. Open source software will soon be released. EPPI-Centre will continue to offer the software as a cloud-based service. The software is offered via a subscription with a one-month (extendible) trial available and volume discounts for 'site licences'. It is free to use for Cochrane and Campbell reviews. The next EPPI-Reviewer version is being built in collaboration with National Institute for Health and Care Excellence using 'surveillance' of newly published research to support 'living' iterative reviews. This is achieved using a combination of machine learning and traditional information retrieval technologies to identify the type of research each new publication describes and determine its relevance for a particular review, domain or guideline. While the amount of available knowledge and research is constantly increasing, the ways in which software can support the focus and relevance of data identification are also developing fast. Software advances are maximising the opportunities for the production of relevant and timely reviews. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise

  11. 45 CFR 1336.10 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... their own economic and social goals. Indian tribe means a distinct political community of Indians which... Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES... et seq.). Alaskan Native means a person who is an Alaskan Indian, Eskimo, or Aleut, or any...

  12. 76 FR 329 - Marine Mammals; File No. 14330

    Science.gov (United States)

    2011-01-04

    .... Paul, St. George, Otter, and Walrus Islands, and Sea Lion Rock, all of the Pribilof Island group in the... hereby given that the Aleut Community of St. Paul Island, Tribal Government, Ecosystem Conservation..., Disentanglement, and Island Sentinel program responsibilities as established under the co-management agreement...

  13. 76 FR 18725 - Marine Mammals; File Nos. 14330 and 14335

    Science.gov (United States)

    2011-04-05

    ... (Phoca vitulina) on St. Paul, St. George, Otter, and Walrus Islands, and Sea Lion Rock, all of the... marine mammals in Alaska: (File No. 14330) the Aleut Community of St. Paul Island, Tribal Government, Ecosystem Conservation Office, St. Paul Island, AK; and (File No. 14335) the Alaska SeaLife Center, Seward...

  14. 78 FR 42756 - Marine Mammals; File No. 14330

    Science.gov (United States)

    2013-07-17

    ... Islands, and Sea Lion Rock, all of the Pribilof Island group in the Bering Sea. The amendment was to... hereby given that the Aleut Community of St. Paul Island, Tribal Government, Ecosystem Conservation Office, St. Paul Island, AK, has applied for an amendment to Scientific Research Permit No. 14330-01...

  15. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Elton

    2004-01-01

    The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...

  16. Involving the Community

    International Development Research Centre (IDRC) Digital Library (Canada)

    Step 3: Identifying the different community groups and other stakeholders concerned .... How can two-way communication enhance community participation in ...... for maintenance and the rights of specific community groups to drinkable water.

  17. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Elton

    2003-01-01

    The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...

  18. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Jr, Elton L

    2007-01-01

    The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...

  19. Community Mentoring: A Tool for Successful Communities

    Science.gov (United States)

    Dodge, Kathryn E.

    2015-01-01

    Mentoring occurs in an ad hoc and largely invisible manner in communities. This mentoring happens through modeling, storytelling, and asking open-ended questions. If Extension specialists and agents were more conscious and intentional about teaching community members and leaders about community mentoring, they would be more successful in resolving…

  20. Keeping "Community" in a Community Land Trust

    Science.gov (United States)

    Gray, Karen A.; Galande, Mugdha

    2011-01-01

    This instrumental case study examined the role of grassroots community organizing in a community land trust (CLT) in a southern U.S. city. Twenty-nine homeowners, renters, board members, community members, and current and former CLT employees were interviewed. In addition, two focus groups of 11 and six participants composed of CLT residents and…

  1. Evidence and evidence gaps in tinnitus therapy

    Science.gov (United States)

    Hesse, Gerhard

    2016-01-01

    A nearly endless number of procedures has been tried and in particular sold for the treatment of tinnitus, unfortunately they have not been evaluated appropriately in an evidence-based way. A causal therapy, omitting the tinnitus still does not exist, actually it cannot exist because of the various mechanisms of its origin. However or perhaps because of that, medical interventions appear and reappear like fashion trends that can never be proven by stable and reliable treatment success. This contribution will discuss and acknowledge all current therapeutic procedures and the existing or non-existing evidence will be assessed. Beside external evidence, the term of evidence also encompasses the internal evidence, i.e. the experience of the treating physician and the patient’s needs shall be included. While there is no evidence for nearly all direct procedures that intend modulating or stimulating either the cochlea or specific cervical regions such as the auditory cortex, there are therapeutic procedures that are acknowledged in clinical practice and have achieved at least a certain degree of evidence and generate measurable effect sizes. Those are in particular habituation therapy and psychotherapeutic measures, especially if they are combined with concrete measures for improved audio perception (hearing aids, CI, hearing therapies). PMID:28025604

  2. Evidence for an active rare biosphere within freshwater protists community.

    Science.gov (United States)

    Debroas, Didier; Hugoni, Mylène; Domaizon, Isabelle

    2015-03-01

    Studies on the active rare biosphere at the RNA level are mainly focused on Bacteria and Archaea and fail to include the protists, which are involved in the main biogeochemical cycles of the earth. In this study, the richness, composition and activity of the rare protistan biosphere were determined from a temporal survey of two lakes by pyrosequencing. In these ecosystems, the always rare OTUs represented 77.2% of the total OTUs and 76.6% of the phylogenetic diversity. From the various phylogenetic indices computed, the phylogenetic units (PUs) constituted exclusively by always rare OTUs were discriminated from the other PUs. Therefore, the rare biosphere included mainly taxa that are distant from the reference databases compared to the dominant ones. In addition, the rarest OTUs represented 59.8% of the active biosphere depicted by rRNA and the activity (rRNA:rDNA ratio) increased with the rarity. The high rRNA:rDNA ratio determined in the rare fraction highlights that some protists were active at low abundances and contribute to ecosystem functioning. Interestingly, the always rare and active OTUs were characterized by seasonal changes in relation with the main environmental parameters measured. In conclusion, the rare eukaryotes represent an active, dynamic and overlooked fraction in the lacustrine ecosystems. © 2015 John Wiley & Sons Ltd.

  3. Evidence from Student-Community Engagement in Ghana

    African Journals Online (AJOL)

    2017-05-01

    TTFPP), where .... Participatory Rural Appraisal (PRA) which was developed in the 1980s. PRA gives local people the opportunity "to share, enhance and analyse their ... Then, cognitive engagement draws on the idea of ...

  4. Evaluating Community Readiness to Implement Environmental and Policy-Based Alcohol Abuse Prevention Strategies in Wisconsin

    Science.gov (United States)

    Paltzer, Jason; Black, Penny; Moberg, D. Paul

    2013-01-01

    Background: Matching evidence-based alcohol prevention strat- egies with a community's readiness to support those strategies is the basis for the Tri-Ethnic Community Readiness Model (CRM). The purpose of this evaluation was to assess the association of a community's readiness to address alcohol abuse in their community with the implementation of…

  5. Community-based knowledge translation: unexplored opportunities

    Directory of Open Access Journals (Sweden)

    Armstrong Rebecca

    2011-06-01

    Full Text Available Abstract Background Knowledge translation is an interactive process of knowledge exchange between health researchers and knowledge users. Given that the health system is broad in scope, it is important to reflect on how definitions and applications of knowledge translation might differ by setting and focus. Community-based organizations and their practitioners share common characteristics related to their setting, the evidence used in this setting, and anticipated outcomes that are not, in our experience, satisfactorily reflected in current knowledge translation approaches, frameworks, or tools. Discussion Community-based organizations face a distinctive set of challenges and concerns related to engaging in the knowledge translation process, suggesting a unique perspective on knowledge translation in these settings. Specifically, community-based organizations tend to value the process of working in collaboration with multi-sector stakeholders in order to achieve an outcome. A feature of such community-based collaborations is the way in which 'evidence' is conceptualized or defined by these partners, which may in turn influence the degree to which generalizable research evidence in particular is relevant and useful when balanced against more contextually-informed knowledge, such as tacit knowledge. Related to the issues of evidence and context is the desire for local information. For knowledge translation researchers, developing processes to assist community-based organizations to adapt research findings to local circumstances may be the most helpful way to advance decision making in this area. A final characteristic shared by community-based organizations is involvement in advocacy activities, a function that has been virtually ignored in traditional knowledge translation approaches. Summary This commentary is intended to stimulate further discussion in the area of community-based knowledge translation. Knowledge translation, and exchange

  6. On Community Education and Community Development

    Directory of Open Access Journals (Sweden)

    Dušana Findeisen

    1996-12-01

    Full Text Available In this paper Dušana Findeisen introduces community education and development. She particularly insists upon the fact that in the future our life will not be organised around a paid full time job and that we will be forced into searching other ways of getting involved into society and to acquire our social identity. Community education is one of the ways we could eventually choose. Since community development education in Slovenia has not developed yet the author begins by describing some basic concepts like community and history of community education and community development movement. Further on, she introduces the Andragogical Summer School based in a small Slovenian town, its aim being to encourage Slovenian adult educators to encourage community development projects.

  7. Preventing adolescent suicide: a community takes action.

    Science.gov (United States)

    Pirruccello, Linda M

    2010-05-01

    Suicide is the third leading cause of death for adolescents and young people in the United States. The etiology of suicide in this population has eluded policy makers, researchers, and communities. Although many suicide prevention programs have been developed and implemented, few are evidence-based in their effectiveness in decreasing suicide rates. In one northern California community, adolescent suicide has risen above the state's average. Two nurses led an effort to develop and implement an innovative grassroots community suicide prevention project targeted at eliminating any further teen suicide. The project consisted of a Teen Resource Card, a community resource brochure targeted at teens, and education for the public and school officials to raise awareness about this issue. This article describes this project for other communities to use as a model. Risk and protective factors are described, and a comprehensive background of adolescent suicide is provided.

  8. Brand communities embedded in social networks.

    Science.gov (United States)

    Zaglia, Melanie E

    2013-02-01

    Brand communities represent highly valuable marketing, innovation management, and customer relationship management tools. However, applying successful marketing strategies today, and in the future, also means exploring and seizing the unprecedented opportunities of social network environments. This study combines these two social phenomena which have largely been researched separately, and aims to investigate the existence, functionality and different types of brand communities within social networks. The netnographic approach yields strong evidence of this existence; leading to a better understanding of such embedded brand communities, their peculiarities, and motivational drivers for participation; therefore the findings contribute to theory by combining two separate research streams. Due to the advantages of social networks, brand management is now able to implement brand communities with less time and financial effort; however, choosing the appropriate brand community type, cultivating consumers' interaction, and staying tuned to this social engagement are critical factors to gain anticipated brand outcomes.

  9. Brand communities embedded in social networks☆

    Science.gov (United States)

    Zaglia, Melanie E.

    2013-01-01

    Brand communities represent highly valuable marketing, innovation management, and customer relationship management tools. However, applying successful marketing strategies today, and in the future, also means exploring and seizing the unprecedented opportunities of social network environments. This study combines these two social phenomena which have largely been researched separately, and aims to investigate the existence, functionality and different types of brand communities within social networks. The netnographic approach yields strong evidence of this existence; leading to a better understanding of such embedded brand communities, their peculiarities, and motivational drivers for participation; therefore the findings contribute to theory by combining two separate research streams. Due to the advantages of social networks, brand management is now able to implement brand communities with less time and financial effort; however, choosing the appropriate brand community type, cultivating consumers’ interaction, and staying tuned to this social engagement are critical factors to gain anticipated brand outcomes. PMID:23564989

  10. [Evidence and Evidence Gaps - an Introduction].

    Science.gov (United States)

    Dreier, G; Löhler, J

    2016-04-01

    Treating patients requires the inclusion of existing evidence in any health care decision, to be able to choose the best diagnosis or treatment measure or to make valid prognosis statements for a particular patient in consideration of the physician's own expertise.The basis are clinical trials, the results of which are ideally gathered in systematic reviews, rated, summarized and published. In addition to the GCP (Good Clinical Practice)-compliant planning, conducting and analysis of clinical studies it is essential, that all study results are made publicly available, in order to avoid publication bias. This includes the public registration of planned and discontinued trials. In the last 25 years, the evidence-based medicine (EbM) has increasingly found its way into clinical practice and research. Here EbM is closely associated with the names Archibald Cochrane and David Sackett. In Germany, both the German Cochrane Centre (DCZ) and the network of evidence-based medicine (DNEbM) were established approximately 15 years ago. In the international Cochrane Collaboration clinicians and other scientists like statisticians interdisciplinary work side by side to develop the methods of evidence-based medicine and to address the topics of evidence generation and processing as well as the transfer of knowledge. Challenge: Existing evidence primarily serves doctors to support their decision-making, but is also the basis for providing scientific proof for a health care intervention's benefit to patients and ultimately payers/health insurances. The closure of existing evidence gaps requires substantial human and financial resources, a complex organizational structure and can only succeed with the involvement of clinical and methodological expertise and specific knowledge in the field of clinical research. In addition, the knowledge must be transferred into practice, using journals, guidelines, conferences, databases, information portals with processed evidence and not least the

  11. Healthy Native Community Fellowship: An Indigenous Leadership Program to Enhance Community Wellness

    Directory of Open Access Journals (Sweden)

    Rebecca Rae

    2016-11-01

    Full Text Available The Healthy Native Communities Fellowship (HNCF is a grassroots evidence-based mentorship and leadership program that develops the skills and community-building capacities of leaders and community teams to improve health status through several intermediate social and cultural mechanisms: (a strengthening social participation (also known as social capital or cohesion; (b strengthening cultural connectedness and revitalization of cultural identity; and (c advocating for health-enhancing policies, practices, and programs that strengthen systems of prevention and care, as well as address the structural social determinants of health. This leadership program uses a community-based participatory research (CBPR approach and participatory evaluation to investigate how the work of local American Indian and Alaska Native leaders (fellows and their community coalitions contributes to individual, family, and community level health outcomes.

  12. Community development planning

    International Nuclear Information System (INIS)

    Gray, S.I.

    1983-01-01

    The focus of this paper will be methods of local community involvement in the community development planning efforts which will be required at the recommended sites. Community development planning will include capital improvement plans, housing plans, zoning changes, business development plans and other community service and fiscal plans required to meet the projected needs of new residents as a result of the repository construction and operation. This paper will present, (1) the need for community planning, (2) methods of responding to community planning needs, (3) current community planning issues to be addressed. 2 references, 1 figure

  13. Community perceptions and attitudes on malaria case management and the role of community health workers.

    Science.gov (United States)

    Owek, Collins J; Oluoch, Elizabeth; Wachira, Juddy; Estambale, Benson; Afrane, Yaw A

    2017-07-04

    Community Case Management of malaria (CCMm) is one of the new approaches adopted by the World Health Organization for malaria endemic countries to reduce the burden of malaria for vulnerable populations. It is based on the evidence that well-trained and supervised community health workers (CHWs) can provide prompt and adequate treatment to fever cases within 24 h to help reduce morbidity and mortality associated with malaria among under-five children. The perception and attitudes of the community members on the CHWs' role is of greater importance for acceptance of their services. The aim of the study was to assess community's perception and attitude towards CCMm and on CHWs who undertake it. This study was conducted in five districts in western Kenya where Community Case Management was being undertaken. This was a qualitative cross-sectional study in which in-depth interviews and focus group discussions were conducted with mothers of under-five children and key stakeholders. Overall, there were more positive expressions of perceptions and attitudes of the community members towards the CCMm programme and the role of CHWs. The positive perceptions included among others; recognition and appreciation of services of CHWs, bringing health services to close proximity to the community, avoiding long queues in the health facilities, provision of health education that encourages good health practices, and promotion of positive health-seeking behaviour from within the communities. This programme is not without challenges as some of the negative perceptions expressed by the community members included the fact that some clinicians doubt the capacity of CHWs on dispensing drugs in the community, some CHWs do not keep client's secrets and mistrust of CHWs due to conflicting information by government. It was evident that the community had more positive perceptions and attitudes towards the role of CHWs in CCMm than negative ones. There should however, be deliberate efforts

  14. Community participation to design rural primary healthcare services.

    Science.gov (United States)

    Farmer, Jane; Nimegeer, Amy

    2014-03-21

    This paper explores how community participation can be used in designing rural primary healthcare services by describing a study of Scottish communities. Community participation is extolled in healthcare policy as useful in planning services and is understood as particularly relevant in rural settings, partly due to high social capital. Literature describes many community participation methods, but lacks discussion of outcomes relevant to health system reconfiguration. There is a spectrum of ideas in the literature on how to design services, from top-down standard models to contextual plans arising from population health planning that incorporates community participation. This paper addresses an evidence gap about the outcomes of using community participation in (re)designing rural community health services. Community-based participatory action research was applied in four Scottish case study communities in 2008-10. Data were collected from four workshops held in each community (total 16) and attended by community members. Workshops were intended to produce hypothetical designs for future service provision. Themes, rankings and selections from workshops are presented. Community members identified consistent health priorities, including local practitioners, emergency triage, anticipatory care, wellbeing improvement and health volunteering. Communities designed different service models to address health priorities. One community did not design a service model and another replicated the current model despite initial enthusiasm for innovation. Communities differ in their receptiveness to engaging in innovative service design, but some will create new models that fit in a given budget. Design diversity indicates that context influences local healthcare planning, suggesting community participation impacts on design outcomes, but standard service models maybe useful as part of the evidence in community participation discussions.

  15. Rediscovering community: Interethnic relationships and community gardening

    Directory of Open Access Journals (Sweden)

    August John Hoffman

    2010-11-01

    Full Text Available Community service work, volunteerism and mentoring have recently become popular topics of research as effective methods in improving self-esteem and civic responsibility. In the current study we explored the relationship between participation in a community service gardening program and ethnocentrism. We hypothesised that an inverse correlation would emerge where students who participated in a community service-gardening program would increase their perceptions of the importance of community service work and decrease their scores in ethnocentrism. Results of the paired samples t-test strongly support the hypothesis that community service gardening work significantly reduces reports of ethnocentrism: t(10 = -2.52, (p < .03 for community college students. The ramifications of the study and ramifications for future research are offered.

  16. Community Involvement - Outreach / Development

    OpenAIRE

    2004-01-01

    Tonya Aiken: Horse Program Success. Kyle Cecil: Natural Resources and the Extension Educator. Karol Dyson: Building Strong Communities through Empowerment. Lisa Dennis: "Food Smart". Theresa M. Ferrari: Community Service Experiences & 4-H Teens. t. Stacey Harper: Connecting the Youth with the Community. Joseph G. Hiller: Extension Work in Indian Country. Alice P. Kersey: Outreach to the NR Community. Carla M. Sousa: Learning from Latino Community Efforts.

  17. Community capacity building and sustainability: outcomes of community-based participatory research.

    Science.gov (United States)

    Hacker, Karen; Tendulkar, Shalini A; Rideout, Catlin; Bhuiya, Nazmim; Trinh-Shevrin, Chau; Savage, Clara P; Grullon, Milagro; Strelnick, Hal; Leung, Carolyn; DiGirolamo, Ann

    2012-01-01

    For communities, the value of community-based participatory research (CBPR) is often manifested in the outcomes of increased capacity and sustainable adoption of evidence-based practices for social change. Educational opportunities that promote discourse between community and academic partners can help to advance CBPR and better define these outcomes. This paper describes a community-academic conference to develop shared definitions of community capacity building and sustainability related to CBPR and to identify obstacles and facilitators to both. "Taking It to the Curbside: Engaging Communities to Create Sustainable Change for Health" was planned by five Clinical Translational Science Institutes and four community organizations. After a keynote presentation, breakout groups of community and academic members met to define community capacity building and sustainability, and to identify facilitators and barriers to achieving both. Groups were facilitated by researcher-community partner teams and conversations were recorded and transcribed. Qualitative analysis for thematic content was conducted by a subset of the planning committee. Important findings included learning that (1) the concepts of capacity and sustainability were considered interconnected; (2) partnership was perceived as both a facilitator and an outcome of CBPR; (3) sustainability was linked to "transfer of knowledge" from one generation to another within a community; and (4) capacity and sustainability were enhanced when goals were shared and health outcomes were achieved. Community capacity building and sustainability are key outcomes of CBPR for communities. Co-learning opportunities that engage and mutually educate both community members and academics can be useful strategies for identifying meaningful strategies to achieve these outcomes.

  18. When community ties lead to violent crimes | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2017-10-20

    Oct 20, 2017 ... Exploring social cohesion and mistrust of the state as drivers of urban ... Evidence suggests that these ties help communities to self-organize and .... acts while weakening social interactions and bonds between neighbours.

  19. Community-based health interventions: principles and applications

    National Research Council Canada - National Science Library

    Guttmacher, Sally; Kelly, Patricia J; Ruiz-Janecko, Yumary

    2010-01-01

    ...: diabetes, cancer, cardiovascular disease, HIV, asthma, and obesity. Following the trend begun by CDC and other agencies, the book takes a proactive and evidence-based approach reducing risk for individuals and communities...

  20. Radioactive waste management - with evidence

    International Nuclear Information System (INIS)

    1988-01-01

    The select committee was appointed to report on the present (1988) situation and future prospects in the field of radioactive waste management in the European Community. The report covers all aspects of the subject. After an introduction the parts of the report are concerned with the control of radiation hazards, the nuclear fuel cycle and radioactive waste, the control of radioactive effluents, storage and disposal of solid radioactive wastes, research programmes, surface storage versus deep geological disposal of long-term wastes, the future of reprocessing and the public debate. Part 10 is a resume of the main conclusions and recommendations. It is recommended that the House of Lords debate the issue. The oral and written evidence presented to the committee is included in the report. (U.K.)

  1. Place, health, and community attachment: Is community capacity associated with self-rated health at the individual level?

    Science.gov (United States)

    Lovell, Sarah A; Gray, Andrew R; Boucher, Sara E

    2017-12-01

    Community-level interventions dominate contemporary public health responses to health inequalities as a lack of political will has discouraged action at a structural level. Health promoters commonly leverage community capacity to achieve programme goals, yet the health implications of low community capacity are unknown. In this study, we analyse perceptions of community capacity at the individual-level to explore how place-based understandings of identity and connectedness are associated with self-rated health. We examine associations between individual community capacity, self-rated health and income using a cross-sectional survey that was disseminated to 303 residents of four small (populations 1500-2000) New Zealand towns. Evidence indicating a relationship between individual community capacity and self-reported health was unconvincing once the effects of income were incorporated. That is, people who rated their community's capacity higher did not have better self-rated health. Much stronger evidence supported the relationship between income and both higher individual community capacity and higher self-rated health. We conclude that individual community capacity may mediate the positive association between income and health, however, overall we find no evidence suggesting that intervening to enhance individual community capacity is likely to improve health outcomes.

  2. Place, health, and community attachment: Is community capacity associated with self-rated health at the individual level?

    Directory of Open Access Journals (Sweden)

    Sarah A. Lovell

    2017-12-01

    Full Text Available Community-level interventions dominate contemporary public health responses to health inequalities as a lack of political will has discouraged action at a structural level. Health promoters commonly leverage community capacity to achieve programme goals, yet the health implications of low community capacity are unknown. In this study, we analyse perceptions of community capacity at the individual-level to explore how place-based understandings of identity and connectedness are associated with self-rated health. We examine associations between individual community capacity, self-rated health and income using a cross-sectional survey that was disseminated to 303 residents of four small (populations 1500–2000 New Zealand towns. Evidence indicating a relationship between individual community capacity and self-reported health was unconvincing once the effects of income were incorporated. That is, people who rated their community's capacity higher did not have better self-rated health. Much stronger evidence supported the relationship between income and both higher individual community capacity and higher self-rated health. We conclude that individual community capacity may mediate the positive association between income and health, however, overall we find no evidence suggesting that intervening to enhance individual community capacity is likely to improve health outcomes.

  3. The failure of community benefit.

    Science.gov (United States)

    Colombo, John D

    2005-01-01

    Though proponents of tax exemption for health care providers continue to extol the virtues of the community-benefit test, Part II of this article illustrates that the train pretty much has already left the station on this front. Both the federal government and the states increasingly look to uncompensated care as the touchstone of exemption for health care providers. To a great extent, this transition back to a "relief of the poor" standard for exemption is the result of the inherent lack of precision in community benefit standards, along with the general trend of empirical evidence that nonprofit health care providers behave similarly to their for-profit counterparts. Faced with this situation, federal and state policymakers naturally have focused on charity care as the one quantifiable behavioral difference to justify exemption. Nevertheless, some empirical evidence suggests that nonprofits may engage in socially desirable behavior other than simply free care for the poor, and the arguments that a mixed ownership system provides the best overall health care model cannot be dismissed out of hand. Thus, despite my past criticisms of the community benefit formulation, I have come to the view that we should seriously consider the options available beyond complete repeal of the community benefit test or a return to a strict charity-care exemption standard. I continue to believe that we should demand a fairly high level of "accountability" from exemption, however, and that exemption should have some direct causal connection to whatever socially-desirable behavior we are seeking. While one option along these lines is to adopt Nina Crimm's approach of rewarding specific behaviors through a deduction or credit system, using "enhancing access" as a test of exemption may provide the best combination of flexibility and verifiable behavioral differences to support continued exemption for health care providers.

  4. Predicting community composition from pairwise interactions

    Science.gov (United States)

    Friedman, Jonathan; Higgins, Logan; Gore, Jeff

    The ability to predict the structure of complex, multispecies communities is crucial for understanding the impact of species extinction and invasion on natural communities, as well as for engineering novel, synthetic communities. Communities are often modeled using phenomenological models, such as the classical generalized Lotka-Volterra (gLV) model. While a lot of our intuition comes from such models, their predictive power has rarely been tested experimentally. To directly assess the predictive power of this approach, we constructed synthetic communities comprised of up to 8 soil bacteria. We measured the outcome of competition between all species pairs, and used these measurements to predict the composition of communities composed of more than 2 species. The pairwise competitions resulted in a diverse set of outcomes, including coexistence, exclusion, and bistability, and displayed evidence for both interference and facilitation. Most pair outcomes could be captured by the gLV framework, and the composition of multispecies communities could be predicted for communities composed solely of such pairs. Our results demonstrate the predictive ability and utility of simple phenomenology, which enables accurate predictions in the absence of mechanistic details.

  5. Community Bioethics: The Health Decisions Community Council.

    Science.gov (United States)

    Gallegos, Tom; Mrgudic, Kate

    1993-01-01

    Sees health care decision making posing variety of complex issues for individuals, families, and providers. Describes Health Decisions Community Council (HDCC), community-based bioethics committee established to offer noninstitutional forum for discussion of health care dilemmas. Notes that social work skills and values for autonomy and…

  6. University-Community Research Partnership for Community ...

    African Journals Online (AJOL)

    This paper analyses the existing university–community partnership in research in Tanzania and proposes a bottom-top model instead of the traditional top-bottom approach which works with perceived needs of communities rather than real needs. Given their core missions, many universities assume that they achieve their ...

  7. LTDNA evidence on trial

    OpenAIRE

    Roberts, Paul

    2016-01-01

    Adopting the interpretative/hermeneutical method typical of much legal scholarship, this article considers two sets of issues pertaining to LTDNA profiles as evidence in criminal proceedings. The section titled Expert Evidence as Forensic Epistemic Warrant addresses some rather large questions about the epistemic status and probative value of expert testimony in general. It sketches a theoretical model of expert evidence, highlighting five essential criteria: (1) expert competence; (2) discip...

  8. Community Environmental Education as a Model for Effective Environmental Programmes

    Science.gov (United States)

    Blair, Morag

    2008-01-01

    The benefits of community environmental education outlined in environmental education literature are supported by the findings and implications of a research study undertaken in New Zealand. Evidence from a two-case case study suggests that environmental programmes guided by the key principles and practices of community environmental education,…

  9. Determinants of Success for Online Communities: An Analysis of Three Communities in Terms of Members' Perceived Professional Development

    Science.gov (United States)

    Hew, Khe Foon

    2009-01-01

    Recent empirical evidence suggests that the updated DeLone and McLean's information systems (D&M IS) model can identify the determinants of success of online communities in terms of member loyalty (Lin and Lee 2006). This study is similarly concerned with the challenge of identifying the determinants of success of online communities, but it…

  10. A la Carte Community

    DEFF Research Database (Denmark)

    Gundelach, Peter; Brincker, Benedikte

    2010-01-01

    and shows that there are high levels of virtual as well as face-to-face interaction among the members. The participants feel that they belong to the community and many also feel that they are recognised as part of the community. However, the members do not share common values neither in relation to software......The exchange of open source software is a phenomenon that is becoming in- creasingly significant to IT users. This article presents the results of a study of the TYPO3 community, a community related to an open source CMS software. The article explores the community, identity and values of TYPO3...... pro- duction nor generally. Instead, they stress that you are free to choose your own values. Against this background, the authors introduce the notion of an ‘a la carte community', i.e. a community where individuals pick and choose their degree of participation and integra- tion into the community...

  11. Monitoring natural phytoplankton communities

    DEFF Research Database (Denmark)

    Haraguchi, L.; Jakobsen, H. H.; Lundholm, Nina

    2017-01-01

    The phytoplankton community can vary within hours (physiology) to years (climatic and anthropogenic responses), and monitoring at different timescales is relevant for understanding community functioning and assessing changes. However, standard techniques used in monitoring programmes are time...

  12. Bayesian community detection

    DEFF Research Database (Denmark)

    Mørup, Morten; Schmidt, Mikkel N

    2012-01-01

    Many networks of scientific interest naturally decompose into clusters or communities with comparatively fewer external than internal links; however, current Bayesian models of network communities do not exert this intuitive notion of communities. We formulate a nonparametric Bayesian model...... for community detection consistent with an intuitive definition of communities and present a Markov chain Monte Carlo procedure for inferring the community structure. A Matlab toolbox with the proposed inference procedure is available for download. On synthetic and real networks, our model detects communities...... consistent with ground truth, and on real networks, it outperforms existing approaches in predicting missing links. This suggests that community structure is an important structural property of networks that should be explicitly modeled....

  13. Student Engagement with Community

    Science.gov (United States)

    Knight-McKenna, Mary; Felten, Peter; Darby, Alexa

    2018-01-01

    Student engagement in the local community comes with both risks and rewards. This chapter explains the cognitive, behavioral, and affective outcomes of student learning in the community, along with noting the importance of preparation and reflection.

  14. Unsewered Communities in Iowa

    Data.gov (United States)

    Iowa State University GIS Support and Research Facility — The unsewered communities file was originally conceived as a representation of communities without a municipal sewer system or on-site septic systems. The selection...

  15. Witness, Service, and Community.

    Science.gov (United States)

    McCarthy, Kathleen Mary

    1997-01-01

    Reviews the mission of Catholic schools as defined by the church and Vatican II. Suggests that schools be responsive to their communities, implement fair policies, remain faithful to the Catholic tradition, and foster participation in the community. (JDI)

  16. Community Challenge Grantees

    Data.gov (United States)

    Department of Housing and Urban Development — HUD's Community Challenge Grants aim to reform and reduce barriers to achieving affordable, economically vital and sustainable communities. The funds are awarded to...

  17. Community Nursing Home (CNH)

    Data.gov (United States)

    Department of Veterans Affairs — The Community Nursing Home (CNH) database contains a list of all Community Nursing Home facilities under local contract to Veterans Health Administration (VHA). CNH...

  18. Community benefits from offshore renewables: The relationship between different understandings of impact, community, and benefit

    DEFF Research Database (Denmark)

    Rudolph, David Philipp; Haggett, Claire; Aitken, Mhairi

    2018-01-01

    This paper presents the findings of a research project evaluating community benefit models for offshore renewables. We identify and analyse UK and international case studies of different forms of community benefit, and provide evidence of how such benefits are delivered. In particular we consider......, and impact are understood is crucial in determining whether or how benefits should be apportioned and delivered; and that these definitions are closely connected to each other. We develop a new series of typologies as a way to understand this. Finally, we assess different mechanisms and schemes of community...

  19. Hermeneutics, evidence ad judgment

    Directory of Open Access Journals (Sweden)

    Michele Taruffo

    2018-03-01

    Full Text Available The text analyzes several topics of the judicial process from the point of view of the important contributions offered by the hermeneutical philosophy. It deals mainly with the construction of factual narratives, the presentation of evidence and the discovery of truth made by the judge in his final judgment based upon the evidence.

  20. The Evidence Movement

    DEFF Research Database (Denmark)

    Hansen, Hanne Foss; Rieper, Olaf

    2009-01-01

    The evidence movement and the idea of systematic reviews, defined as summaries of the results of already existing evaluation and research projects, have gained considerable support in recent years as many international as well as national evidence-producing organizations have been established...

  1. Teaching with Evidence

    Science.gov (United States)

    Crocco, Margaret; Halvorsen, Anne-Lise; Jacobsen, Rebecca; Segall, Avner

    2017-01-01

    In this age of real and fake news, students need to be able to assess the trustworthiness of evidence. The authors' current research examines students' use of evidence in secondary social studies classrooms as students deliberate contemporary public policy issues. The authors found that students shifted their evaluations of the trustworthiness of…

  2. Observational Evidence for Atoms.

    Science.gov (United States)

    Jones, Edwin R., Jr.; Childers, Richard L.

    1984-01-01

    Discusses the development of the concept of atomicity and some of the many which can be used to establish its validity. Chemical evidence, evidence from crystals, Faraday's law of electrolysis, and Avogadro's number are among the areas which show how the concept originally developed from a purely philosophical idea. (JN)

  3. Human capital identification process: linkage for family medicine and community medicine to mobilize the community.

    Science.gov (United States)

    Tanasugarn, Chanuantong; Thongbunjob, Krid

    2012-06-01

    Community diagnosis and approach has shifted from a professional focus to a community focus. The information system has also been developed to reflect socio-cultural information. This new system has been established throughout the country and is being recorded in the computer system. However these data still lack human capital information to promote community mobilization. The present study aims to develop a process which reflects human capital from the insider and outsider points of view and which builds on the existing work system of primary care service, family medicine, and community medicine. The present study applies the participatory action research design with mixed methods including community grand-tour, household survey socio-metric questionnaire and focus group discussion in order to gather insider view of human capital. A key instrument developed in the present study is the socio-metric questionnaire which was designed according to the community grand tour and household survey results. The findings indicate that the process is feasible and the insider point of view given a longer evidence based list of the human capital. The model enhanced a closer relationship between professional and community people and suggested the realistic community mobilizer name list. Human capital identification process is feasible and should be recommended to integrate in the existing work process of the health staff in family and community practice.

  4. Evidence-based radiography

    International Nuclear Information System (INIS)

    Hafslund, Bjorg; Clare, Judith; Graverholt, Birgitte; Wammen Nortvedt, Monica

    2008-01-01

    Evidence-based practice (EBP) offers the integration of the best research evidence with clinical knowledge and expertise and patient values. EBP is a well known term in health care. This paper discusses the implementation of EBP into radiography and introduces the term evidence-based radiography. Evidence-based radiography is radiography informed and based on the combination of clinical expertise and the best available research-based evidence, patient preferences and resources available. In Norway, EBP in radiography is being debated and radiographers are discussing the challenges of implementing EBP in both academic and clinical practice. This discussion paper explains why EBP needs to be a basis for a radiography curriculum and a part of radiographers' practice. We argue that Norwegian radiographers must increase participation in research and developing practice within their specific radiographic domain

  5. Moving an Evidence-Based Policy Agenda Forward: Leadership Tips From the Field.

    Science.gov (United States)

    Garrett, Teresa

    2018-05-01

    Advancing evidence-based policy change is a leadership challenge that nurses should embrace. Key tips to ensure that evidence-based policy changes are successful at the individual, community, and population levels are offered to help nurses through the change process. The public trust in the nursing profession is a leverage point that should be used to advance the use of evidence, expedite change, and improve health for students and across communities.

  6. The Los Angeles County Community Disaster Resilience Project — A Community-Level, Public Health Initiative to Build Community Disaster Resilience

    Directory of Open Access Journals (Sweden)

    David Eisenman

    2014-08-01

    Full Text Available Public health officials need evidence-based methods for improving community disaster resilience and strategies for measuring results. This methods paper describes how one public health department is addressing this problem. This paper provides a detailed description of the theoretical rationale, intervention design and novel evaluation of the Los Angeles County Community Disaster Resilience Project (LACCDR, a public health program for increasing community disaster resilience. The LACCDR Project utilizes a pretest–posttest method with control group design. Sixteen communities in Los Angeles County were selected and randomly assigned to the experimental community resilience group or the comparison group. Community coalitions in the experimental group receive training from a public health nurse trained in community resilience in a toolkit developed for the project. The toolkit is grounded in theory and uses multiple components to address education, community engagement, community and individual self-sufficiency, and partnerships among community organizations and governmental agencies. The comparison communities receive training in traditional disaster preparedness topics of disaster supplies and emergency communication plans. Outcome indicators include longitudinal changes in inter-organizational linkages among community organizations, community member responses in table-top exercises, and changes in household level community resilience behaviors and attitudes. The LACCDR Project is a significant opportunity and effort to operationalize and meaningfully measure factors and strategies to increase community resilience. This paper is intended to provide public health and academic researchers with new tools to conduct their community resilience programs and evaluation research. Results are not yet available and will be presented in future reports.

  7. Knowledge Communities in fives

    NARCIS (Netherlands)

    Andriessen, J.H.E.

    2006-01-01

    Many modern knowledge intensive organisations rely on knowledge sharing communities, often called ‘communities of practice. These communities can be found in many organisations, but their forms and functions appear to be quite diverse. This implies that questions concerning the functioning of

  8. American Indian Community Colleges.

    Science.gov (United States)

    One Feather, Gerald

    With the emergence of reservation based community colleges (th Navajo Community College and the Dakota Community Colleges), the American Indian people, as decision makers in these institutions, are providing Indians with the technical skills and cultural knowledge necessary for self-determination. Confronted with limited numbers of accredited…

  9. The Learning Community.

    Science.gov (United States)

    Boo, Mary Richardson; Decker, Larry E.

    This guide to community education offers strategies and suggestions for responding to the call for more community involvement in partnership efforts that will benefit education and society. First, a brief introduction summarizes the philosophy of community education, defining it as a belief that learning is lifelong and that self-help efforts…

  10. Community Organizing for Healthier Communities: Environmental and Policy Outcomes of a National Initiative.

    Science.gov (United States)

    Subica, Andrew M; Grills, Cheryl T; Villanueva, Sandra; Douglas, Jason A

    2016-12-01

    Childhood obesity is disproportionately prevalent in communities of color, partially because of structural inequities in the social and built environment (e.g., poverty, food insecurity, pollution) that restrict healthy eating and active living. Community organizing is an underexamined, grassroots health promotion approach that empowers and mobilizes community residents to advocate for, and achieve, environmental and policy changes to rectify these structural inequities. This paper presents outcomes of the Robert Wood Johnson Foundation's Communities Creating Healthy Environments initiative: the first national program to apply community organizing to combat childhood obesity-causing structural inequities in communities of color. Twenty-one community-based organizations and tribal nations (grantees) conducted 3-year community organizing-based interventions primarily designed to increase children's healthy food and safe recreational access. Grantees' policy wins (environmental and policy changes resulting from grantee interventions) were measured from 2009 to 2014 using semi-structured interviews conducted quarterly and 6 months post-grant, and independently coded and reviewed in 2015 by researchers and expert community organizers. The 21 grantees achieved 72 policy wins (mean=3.43, SD=1.78) across six domains: two directly addressed childhood obesity by enhancing children's healthy food (37.50%) and recreational access (33.33%), whereas four indirectly addressed obesity by promoting access to quality health care (8.33%); clean environments (9.73%); affordable housing (8.33%); and discrimination- and crime-free neighborhoods (2.78%). These findings provide compelling evidence that community organizing-based interventions designed and led by community stakeholders can achieve diverse environmental and policy solutions to the structural inequities that foment childhood obesity in communities of color. Copyright © 2016 American Journal of Preventive Medicine. Published

  11. Discourse Communities and Communities of Practice

    DEFF Research Database (Denmark)

    Pogner, Karl-Heinz

    2005-01-01

    This paper aims at giving a more detailed description and discussion of two concepts of `community' developed in the research areas of text production/ writing and social learning / information management / knowledge sharing and comparing them with each other. The purpose of this theoretical exer...... production at different Danish workplaces (a consulting engi-neering company, a university department and a bank) and discusses their significance in the context of co-located as well as geographically distrib-uted communities....

  12. Loyalty in Online Communities.

    Science.gov (United States)

    Hamilton, William L; Zhang, Justine; Danescu-Niculescu-Mizil, Cristian; Jurafsky, Dan; Leskovec, Jure

    2017-05-01

    Loyalty is an essential component of multi-community engagement. When users have the choice to engage with a variety of different communities, they often become loyal to just one, focusing on that community at the expense of others. However, it is unclear how loyalty is manifested in user behavior, or whether certain community characteristics encourage loyalty. In this paper we operationalize loyalty as a user-community relation: users loyal to a community consistently prefer it over all others; loyal communities retain their loyal users over time. By exploring a large set of Reddit communities, we reveal that loyalty is manifested in remarkably consistent behaviors. Loyal users employ language that signals collective identity and engage with more esoteric, less popular content, indicating that they may play a curational role in surfacing new material. Loyal communities have denser user-user interaction networks and lower rates of triadic closure, suggesting that community-level loyalty is associated with more cohesive interactions and less fragmentation into subgroups. We exploit these general patterns to predict future rates of loyalty. Our results show that a user's propensity to become loyal is apparent from their initial interactions with a community, suggesting that some users are intrinsically loyal from the very beginning.

  13. Mining with communities

    International Nuclear Information System (INIS)

    Veiga, Marcello M.; Scoble, Malcolm; McAllister, Mary Louise

    2001-01-01

    To be considered as sustainable, a mining community needs to adhere to the principles of ecological sustainability, economic vitality and social equity. These principles apply over a long time span, covering both the life of the mine and post-mining closure. The legacy left by a mine to the community after its closure is emerging as a significant aspect of its planning. Progress towards sustainability is made when value is added to a community with respect to these principles by the mining operation during its life cycle. This article presents a series of cases to demonstrate the diverse potential challenges to achieving a sustainable mining community. These case studies of both new and old mining communities are drawn mainly from Canada and from locations abroad where Canadian companies are now building mines. The article concludes by considering various approaches that can foster sustainable mining communities and the role of community consultation and capacity building. (author)

  14. Evidence and Ethics (Editorial

    Directory of Open Access Journals (Sweden)

    Alison Brettle

    2012-12-01

    discipline the research takes place in, and should be something that we are aware of as consumers of evidence. Within LIS in the UK, ethical principles have been put to the fore within a new professional framework (CILIP Chartered Institute of Library and Information Professionals, 2012a. The framework outlines the broad range of skills required by workers across the LIS profession, placing these on a wheel with ethics and values in the centre, as they underpin the profession. Placing ethics and values at the core in this way helps us set our knowledge into a wider context and, I believe, is one of the ways that we can make a difference as LIS professionals. At the same time, our ethical values and principles help to differentiate us from other professions and help to define what we do as LIS professionals. These ethical principles are outlined in a code (CILIP Chartered Institute of Library and Information Professionals, 2012b, which sets out professional responsibilities in relation to users, colleagues, and the information community and society. The elements which are particularly relevant to EBLIP, and which are espoused in the scope and mission of the journal, include maintaining and enhancing professional knowledge and competence, sharing results of research and development, encouraging best practice, and promoting equitable access to information. There are also ethical codes of practice for journal editors, these include one for LIS editors (Library and Information Science Editorial Committee, 2010 and a more general one which originated in the medical and health domain (Committee on Publication Ethics: COPE, 2011. Both of these guide journal editors in relating to readers, authors, reviewers, and publishers, and both seek to establish best practice for journal publishing. For the EBLIP journal, these codes of practice provide a useful framework for ensuring the journal operates in a professional and ethical way. A recent example where the codes have been used in

  15. Community effectiveness of copepods for dengue vector control: systematic review.

    Science.gov (United States)

    Lazaro, A; Han, W W; Manrique-Saide, P; George, L; Velayudhan, R; Toledo, J; Runge Ranzinger, S; Horstick, O

    2015-06-01

    Vector control remains the only available method for primary prevention of dengue. Several interventions exist for dengue vector control, with limited evidence of their efficacy and community effectiveness. This systematic review compiles and analyses the existing global evidence for community effectiveness of copepods for dengue vector control. The systematic review follows the PRISMA statement, searching six relevant databases. Applying all inclusion and exclusion criteria, 11 articles were included. There is evidence that cyclopoid copepods (Mesocyclops spp.) could potentially be an effective vector control option, as shown in five community effectiveness studies in Vietnam. This includes long-term effectiveness for larval and adult control of Ae. aegypti, as well as dengue incidence. However, this success has so far not been replicated elsewhere (six studies, three community effectiveness studies--Costa Rica, Mexico and USA, and three studies analysing both efficacy and community effectiveness--Honduras, Laos and USA), probably due to community participation, environmental and/or biological factors. Judging by the quality of existing studies, there is a lack of good study design, data quality and appropriate statistics. There is limited evidence for the use of cyclopoid copepods as a single intervention. There are very few studies, and more are needed in other communities and environments. Clear best practice guidelines for the methodology of entomological studies should be developed. © 2015 John Wiley & Sons Ltd.

  16. Moving health promotion communities online: a review of the literature.

    Science.gov (United States)

    Sunderland, Naomi; Beekhuyzen, Jenine; Kendall, Elizabeth; Wolski, Malcom

    There is a need to enhance the effectiveness and reach of complex health promotion initiatives by providing opportunities for diverse health promotion practitioners and others to interact in online settings. This paper reviews the existing literature on how to take health promotion communities and networks into online settings. A scoping review of relevant bodies of literature and empirical evidence was undertaken to provide an interpretive synthesis of existing knowledge on the topic. Sixteen studies were identified between 1986 and 2007. Relatively little research has been conducted on the process of taking existing offline communities and networks into online settings. However, more research has focused on offline (i.e. not mediated via computer networks); 'virtual' (purely online with no offline interpersonal contact); and 'multiplex' communities (i.e. those that interact across both online and offline settings). Results are summarised under three themes: characteristics of communities in online and offline settings; issues in moving offline communities online, and designing online communities to match community needs. Existing health promotion initiatives can benefit from online platforms that promote community building and knowledge sharing. Online e-health promotion settings and communities can successfully integrate with existing offline settings and communities to form 'multiplex' communities (i.e. communities that operate fluently across both online and offline settings).

  17. Evidence: Study Guide. Revision

    National Research Council Canada - National Science Library

    1997-01-01

    ...) correct application of principles of military rules of evidence. This study guide is also intended to be a convenient reference for use by Navy and Marine Corps judge advocates and Coast Guard law...

  18. LTDNA Evidence on Trial

    OpenAIRE

    Paul Roberts; Paul Roberts; Paul Roberts

    2016-01-01

    Adopting the interpretative/hermeneutical method typical of much legal scholarship, this article considers two sets of issues pertaining to LTDNA profiles as evidence in criminal proceedings. Section 1 addresses some rather large questions about the epistemic status and probative value of expert testimony in general. It sketches a theoretical model of expert evidence, highlighting five essential criteria: (1) expert competence; (2) disciplinary domain; (3) methodological validity; (4) materia...

  19. Reflection: Working Toward Peaceful, Healthy Communities

    Directory of Open Access Journals (Sweden)

    Donald L Gault

    2016-03-01

    Full Text Available Family violence is a pervasive problem locally, nationally, and worldwide. Since 1990, staff from Saint Paul-Ramsey County (Minnesota Public Health have worked with hundreds of community members and organizations in a unique partnership approach to preventing violence. The process of developing and sustaining this unique partnership is described, as well impacts and outcomes from work developed and implemented over 25 years of sustained efforts. Implications for practice in community organizing and partnership, violence prevention, public health, and adherence to evidence- and research-based best practice models are discussed.

  20. Discovering determinants influencing faith community nursing practice.

    Science.gov (United States)

    Ziebarth, Deborah Jean

    2014-01-01

    Faith community nursing (FCN) is an important healthcare delivery system for individuals, families, and communities. Determinants are factors that might influence FCN care. A literature review isolated eight determinants that influence practice; however, there are no clear causal relationships linking specific determinants to specific practice changes. Research is needed to assess how determinants influence practice and outcomes, and provide evidence-based solutions to isolate and manage determinants. A Conceptual Model of FCN, Theoretical Definitions and a Diagram of Determinants of FCN Practice are provided.

  1. National Community Solar Platform

    Energy Technology Data Exchange (ETDEWEB)

    Rupert, Bart [Clean Energy Collective, Louisville, CO (United States)

    2016-06-30

    This project was created to provide a National Community Solar Platform (NCSP) portal known as Community Solar Hub, that is available to any entity or individual who wants to develop community solar. This has been done by providing a comprehensive portal to make CEC’s solutions, and other proven community solar solutions, externally available for everyone to access – making the process easy through proven platforms to protect subscribers, developers and utilities. The successful completion of this project provides these tools via a web platform and integration APIs, a wide spectrum of community solar projects included in the platform, multiple groups of customers (utilities, EPCs, and advocates) using the platform to develop community solar, and open access to anyone interested in community solar. CEC’s Incubator project includes web-based informational resources, integrated systems for project information and billing systems, and engagement with customers and users by community solar experts. The combined effort externalizes much of Clean Energy Collective’s industry-leading expertise, allowing third parties to develop community solar without duplicating expensive start-up efforts. The availability of this platform creates community solar projects that are cheaper to build and cheaper to participate in, furthering the goals of DOE’s SunShot Initiative. Final SF 425 Final SF 428 Final DOE F 2050.11 Final Report Narrative

  2. Secondary Infections with Ebola Virus in Rural Communities, Liberia and Guinea, 2014–2015

    Science.gov (United States)

    Nyenswah, Tolbert; Keita, Sakoba; Diallo, Boubakar; Kateh, Francis; Amoah, Aurora; Nagbe, Thomas K.; Raghunathan, Pratima; Neatherlin, John C.; Kinzer, Mike; Pillai, Satish K.; Attfield, Kathleen R.; Hajjeh, Rana; Dweh, Emmanuel; Painter, John; Barradas, Danielle T.; Williams, Seymour G.; Blackley, David J.; Kirking, Hannah L.; Patel, Monita R.; Dea, Monica; Massoudi, Mehran S.; Barskey, Albert E.; Zarecki, Shauna L. Mettee; Fomba, Moses; Grube, Steven; Belcher, Lisa; Broyles, Laura N.; Maxwell, T. Nikki; Hagan, Jose E.; Yeoman, Kristin; Westercamp, Matthew; Mott, Joshua; Mahoney, Frank; Slutsker, Laurence; DeCock, Kevin M.; Marston, Barbara; Dahl, Benjamin

    2016-01-01

    Persons who died of Ebola virus disease at home in rural communities in Liberia and Guinea resulted in more secondary infections than persons admitted to Ebola treatment units. Intensified monitoring of contacts of persons who died of this disease in the community is an evidence-based approach to reduce virus transmission in rural communities. PMID:27268508

  3. Secondary Infections with Ebola Virus in Rural Communities, Liberia and Guinea, 2014-2015.

    Science.gov (United States)

    Lindblade, Kim A; Nyenswah, Tolbert; Keita, Sakoba; Diallo, Boubakar; Kateh, Francis; Amoah, Aurora; Nagbe, Thomas K; Raghunathan, Pratima; Neatherlin, John C; Kinzer, Mike; Pillai, Satish K; Attfield, Kathleen R; Hajjeh, Rana; Dweh, Emmanuel; Painter, John; Barradas, Danielle T; Williams, Seymour G; Blackley, David J; Kirking, Hannah L; Patel, Monita R; Dea, Monica; Massoudi, Mehran S; Barskey, Albert E; Zarecki, Shauna L Mettee; Fomba, Moses; Grube, Steven; Belcher, Lisa; Broyles, Laura N; Maxwell, T Nikki; Hagan, Jose E; Yeoman, Kristin; Westercamp, Matthew; Mott, Joshua; Mahoney, Frank; Slutsker, Laurence; DeCock, Kevin M; Marston, Barbara; Dahl, Benjamin

    2016-09-01

    Persons who died of Ebola virus disease at home in rural communities in Liberia and Guinea resulted in more secondary infections than persons admitted to Ebola treatment units. Intensified monitoring of contacts of persons who died of this disease in the community is an evidence-based approach to reduce virus transmission in rural communities.

  4. Psychological Sense of Community in University Classrooms: Do Achievement Goal Orientations Matter?

    Science.gov (United States)

    Yasuda, Tomoyuki

    2009-01-01

    Studies of Psychological Sense of Community (PSOC) have been conducted in association with various settings, and evidence has shown the impact of PSOC in local neighborhoods and communities, community organizations, and industrial organizations. On the other hand, relatively little is known about the effect of PSOC in student learning…

  5. Erecting Closets and Outing Ourselves: Uncomfortable Reflexivity and Community-Based Research

    Science.gov (United States)

    Reed, Sarah J.; Miller, Robin Lin; Nnawulezi, Nkiru; Valenti, Maria T.

    2012-01-01

    Feminist scholars and community psychologists have argued that reflexivity is a necessary component to conducting socially conscious research. Reflexivity, however, is rarely evident in community psychology. In this article, we share the uncomfortable realities that surfaced during a community-based research project in which we adapted and…

  6. LTDNA Evidence on Trial

    Science.gov (United States)

    Roberts, Paul

    2016-01-01

    Adopting the interpretative/hermeneutical method typical of much legal scholarship, this article considers two sets of issues pertaining to LTDNA profiles as evidence in criminal proceedings. The section titled Expert Evidence as Forensic Epistemic Warrant addresses some rather large questions about the epistemic status and probative value of expert testimony in general. It sketches a theoretical model of expert evidence, highlighting five essential criteria: (1) expert competence; (2) disciplinary domain; (3) methodological validity; (4) materiality; and (5) legal admissibility. This generic model of expert authority, highlighting law's fundamentally normative character, applies to all modern forms of criminal adjudication, across Europe and farther afield. The section titled LTDNA Evidence in UK Criminal Trials then examines English and Northern Irish courts' attempts to get to grips with LTDNA evidence in recent cases. Better appreciating the ways in which UK courts have addressed the challenges of LTDNA evidence may offer some insights into parallel developments in other legal systems. Appellate court rulings follow a predictable judicial logic, which might usefully be studied and reflected upon by any forensic scientist or statistician seeking to operate effectively in criminal proceedings. Whilst each legal jurisdiction has its own unique blend of jurisprudence, institutions, cultures and historical traditions, there is considerable scope for comparative analysis and cross-jurisdictional borrowing and instruction. In the spirit of promoting more nuanced and sophisticated international interdisciplinary dialogue, this article examines UK judicial approaches to LTDNA evidence and begins to elucidate their underlying institutional logic. Legal argument and broader policy debates are not confined to considerations of scientific validity, contamination risks and evidential integrity, or associated judgments of legal admissibility or exclusion. They also crucially

  7. LTDNA Evidence on Trial.

    Science.gov (United States)

    Roberts, Paul

    2016-01-01

    Adopting the interpretative/hermeneutical method typical of much legal scholarship, this article considers two sets of issues pertaining to LTDNA profiles as evidence in criminal proceedings. The section titled Expert Evidence as Forensic Epistemic Warrant addresses some rather large questions about the epistemic status and probative value of expert testimony in general. It sketches a theoretical model of expert evidence, highlighting five essential criteria: (1) expert competence; (2) disciplinary domain; (3) methodological validity; (4) materiality; and (5) legal admissibility. This generic model of expert authority, highlighting law's fundamentally normative character, applies to all modern forms of criminal adjudication, across Europe and farther afield. The section titled LTDNA Evidence in UK Criminal Trials then examines English and Northern Irish courts' attempts to get to grips with LTDNA evidence in recent cases. Better appreciating the ways in which UK courts have addressed the challenges of LTDNA evidence may offer some insights into parallel developments in other legal systems. Appellate court rulings follow a predictable judicial logic, which might usefully be studied and reflected upon by any forensic scientist or statistician seeking to operate effectively in criminal proceedings. Whilst each legal jurisdiction has its own unique blend of jurisprudence, institutions, cultures and historical traditions, there is considerable scope for comparative analysis and cross-jurisdictional borrowing and instruction. In the spirit of promoting more nuanced and sophisticated international interdisciplinary dialogue, this article examines UK judicial approaches to LTDNA evidence and begins to elucidate their underlying institutional logic. Legal argument and broader policy debates are not confined to considerations of scientific validity, contamination risks and evidential integrity, or associated judgments of legal admissibility or exclusion. They also crucially

  8. Career guidance in communities

    DEFF Research Database (Denmark)

    Thomsen, Rie

    for the development of a critically reflexive career guidance practice. The considerations are organised around seven elements. 1. Creating opportunity, structure and access 2. Entering a community and increasing visibility 3. Providing guidance in communities 4. Exploring potentials in guidance situations 5...... in career guidance practices as well as in the lives of the people in the communities. This paper falls into two parts: The first part considers the collective as the starting point for the development of meaningful career guidance activities. Based on previous research on career guidance in communities......The aim of this paper is to inspire practitioners and professionals to leave their offices to bring career guidance into communities that might not identify with career guidance in the first instance. By making the effort to engage with communities, practitioners may bring about a critical change...

  9. Collaborative Communities of Firms

    DEFF Research Database (Denmark)

    2011-01-01

    and developing strategic initiatives that aid the community as a whole. We discuss the facilitator role of the shared services provider, contrasting it with the coordinator role found in other multi-firm organizations, and we show how shared services providers function by describing three examples...... is an organizational model called the collaborative community of firms. This chapter addresses an important organizational role in a collaborative community, that of the shared services provider. The shared services provider acts as a facilitator in the community, helping member firms collaborate with one another...... of collaborative communities of firms from different sectors: the U.S.-based Blade.org and two Denmark-based communities, the Kalundborg Industrial Symbiosis and MG50. Implications for the theory and practice of organization design are discussed....

  10. Interrupting Mythic Community

    Directory of Open Access Journals (Sweden)

    Linnell Secomb

    2013-09-01

    Full Text Available If nation is increasingly perceived as a less than honourable institution formed through war, invasion and geo-political territorialisation, and government is widely denounced as the site of political intrigue and the means of subjectification of citizen–voters, community appears to escape this critique and to be viewed as an idyllic formation based on bonds of affinity. However, this romancing of community is disrupted by trans-cultural and sub-cultural formations that expose the fantasy of a harmonious, homogenous community. While community is often conceived as arising organically from familial, tribal or cultural similarity, or as constituted through a common history and shared cultural institutions, this totalising conception of community is interrupted by the demands of difference and heterogeneity and by a questioning of the idyll of community authenticated in myths of archaic origin.

  11. Community impact management

    International Nuclear Information System (INIS)

    Baril, R.G.

    1983-01-01

    Industrial expansion, whether for resource extraction, refining, production or distribution and particularly the construction of energy facilities, usually has many effects on communities. In the early 1970s, as more experience was gained with large projects and as communities became more sensitive to their needs and rights, the negative effects of projects gained some prominence. Communities questioned whether it was in their best interest to accept changes that large corporations would impose on them. It is in this context that Ontario Hydro, in 1977, set up the first of four community impact agreements for the construction of generating stations. This paper discusses these community impact agreements and how they have become the framework for the management of community impacts. Also, the paper discusses a model for compensating social impacts

  12. Coal, culture and community

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1993-11-01

    16 papers are presented with the following titles: the miners; municipalisation and the millenium - Bolton-upon-Dearne Urban District Council 1899-1914; the traditional working class community revisited; the cultural capital of coal mining communities; activities, strike-breakers and coal communities; the limits of protest - media coverage of the Orgreave picket during the miners` strike; in defence of home and hearth? Families, friendships and feminism in mining communities; young people`s attitudes to the police in mining communities; the determinants of productivity growth in the British coal mining industry, 1976-1989; strategic responses to flexibility - a case study in coal; no coal turned in Yorkshire?; the North-South divide in the Central Coalfields; the psychological effects of redundancy and worklessness - a case study from the coalfields; the Dearne Valley initiative; the future under labour: and coal, culture and the community.

  13. Evidence-based radiology: why and how?

    International Nuclear Information System (INIS)

    Sardanelli, Francesco; Di Leo, Giovanni; Hunink, Myriam G.; Gilbert, Fiona J.; Krestin, Gabriel P.

    2010-01-01

    To provide an overview of evidence-based medicine (EBM) in relation to radiology and to define a policy for adoption of this principle in the European radiological community. Starting from Sackett's definition of EBM we illustrate the top-down and bottom-up approaches to EBM as well as EBM's limitations. Delayed diffusion and peculiar features of evidence-based radiology (EBR) are defined with emphasis on the need to shift from the demonstration of the increasing ability to see more and better, to the demonstration of a significant change in treatment planning or, at best, of a significant gain in patient outcome. The ''as low as reasonably achievable'' (ALARA) principle is thought as a dimension of EBR while EBR is proposed as part of the core curriculum of radiology residency. Moreover, we describe the process of health technology assessment in radiology with reference to the six-level scale of hierarchy of studies on diagnostic tests, the main sources of bias in studies on diagnostic performance, and levels of evidence and degrees of recommendations according to the Centre for Evidence-Based Medicine (Oxford, UK) as well as the approach proposed by the GRADE working group. Problems and opportunities offered by evidence-based guidelines in radiology are considered. Finally, we suggest nine points to be actioned by the ESR in order to promote EBR. Radiology will benefit greatly from the improvement in practice that will result from adopting this more rigorous approach to all aspects of our work. (orig.)

  14. Promoting evidence-based practice in pharmacies.

    Science.gov (United States)

    Toklu, Hale Zerrin

    2015-01-01

    Evidence-based medicine aims to optimize decision-making by using evidence from well-designed and conducted research. The concept of reliable evidence is essential, since the number of electronic information resources is increasing in parallel to the increasing number and type of drugs on the market. The decision-making process is a complex and requires an extensive evaluation as well as the interpretation of the data obtained. Different sources provide different levels of evidence for decision-making. Not all the data have the same value as the evidence. Rational use of medicine requires that the patients receive "medicines appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community." Pharmacists have a crucial role in the health system to maintain the rational use of medicine and provide pharmaceutical care to patients, because they are the drug experts who are academically trained for this purpose. The rational use of the pharmacist's workforce will improve the outcome of pharmacotherapy as well as decreasing the global health costs.

  15. Promoting evidence-based practice in pharmacies

    Directory of Open Access Journals (Sweden)

    Toklu HZ

    2015-09-01

    Full Text Available Hale Zerrin Toklu Department of Pharmacology and Therapeutics, College of Medicine, University of Florida, Gainesville, FL, USA Abstract: Evidence-based medicine aims to optimize decision-making by using evidence from well-designed and conducted research. The concept of reliable evidence is essential, since the number of electronic information resources is increasing in parallel to the increasing number and type of drugs on the market. The decision-making process is a complex and requires an extensive evaluation as well as the interpretation of the data obtained. Different sources provide different levels of evidence for decision-making. Not all the data have the same value as the evidence. Rational use of medicine requires that the patients receive “medicines appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community.” Pharmacists have a crucial role in the health system to maintain the rational use of medicine and provide pharmaceutical care to patients, because they are the drug experts who are academically trained for this purpose. The rational use of the pharmacist's workforce will improve the outcome of pharmacotherapy as well as decreasing the global health costs. Keywords: pharmacist, rational use of medicine, pharmacotherapy, pharmaceutical, outcome

  16. Evidence-based dentistry.

    Science.gov (United States)

    Chambers, David W

    2010-01-01

    Both panegyric and criticism of evidence-based dentistry tend to be clumsy because the concept is poorly defined. This analysis identifies several contributions to the profession that have been made under the EBD banner. Although the concept of clinicians integrating clinical epidemiology, the wisdom of their practices, and patients' values is powerful, its implementation has been distorted by a too heavy emphasis of computerized searches for research findings that meet the standards of academics. Although EBD advocates enjoy sharing anecdotal accounts of mistakes others have made, faulting others is not proof that one's own position is correct. There is no systematic, high-quality evidence that EBD is effective. The metaphor of a three-legged stool (evidence, experience, values, and integration) is used as an organizing principle. "Best evidence" has become a preoccupation among EBD enthusiasts. That overlong but thinly developed leg of the stool is critiqued from the perspectives of the criteria for evidence, the difference between internal and external validity, the relationship between evidence and decision making, the ambiguous meaning of "best," and the role of reasonable doubt. The strongest leg of the stool is clinical experience. Although bias exists in all observations (including searches for evidence), there are simple procedures that can be employed in practice to increase useful and objective evidence there, and there are dangers in delegating policy regarding allowable treatments to external groups. Patient and practitioner values are the shortest leg of the stool. As they are so little recognized, their integration in EBD is problematic and ethical tensions exist where paternalism privileges science over patient's self-determined best interests. Four potential approaches to integration are suggested, recognizing that there is virtually no literature on how the "seat" of the three-legged stool works or should work. It is likely that most dentists

  17. Evidence-Based Toxicology.

    Science.gov (United States)

    Hoffmann, Sebastian; Hartung, Thomas; Stephens, Martin

    Evidence-based toxicology (EBT) was introduced independently by two groups in 2005, in the context of toxicological risk assessment and causation as well as based on parallels between the evaluation of test methods in toxicology and evidence-based assessment of diagnostics tests in medicine. The role model of evidence-based medicine (EBM) motivated both proposals and guided the evolution of EBT, whereas especially systematic reviews and evidence quality assessment attract considerable attention in toxicology.Regarding test assessment, in the search of solutions for various problems related to validation, such as the imperfectness of the reference standard or the challenge to comprehensively evaluate tests, the field of Diagnostic Test Assessment (DTA) was identified as a potential resource. DTA being an EBM discipline, test method assessment/validation therefore became one of the main drivers spurring the development of EBT.In the context of pathway-based toxicology, EBT approaches, given their objectivity, transparency and consistency, have been proposed to be used for carrying out a (retrospective) mechanistic validation.In summary, implementation of more evidence-based approaches may provide the tools necessary to adapt the assessment/validation of toxicological test methods and testing strategies to face the challenges of toxicology in the twenty first century.

  18. Community Gardens as Environmental Health Interventions: Benefits Versus Potential Risks.

    Science.gov (United States)

    Al-Delaimy, W K; Webb, M

    2017-06-01

    The purpose of this paper was to summarize current findings on community gardens relevant to three specific areas of interest as follows: (1) health benefits, (2) garden interventions in developing versus developed countries, and (3) the concerns and risks of community gardening. Community gardens are a reemerging phenomenon in many low- and high-income urban neighborhoods to address the common risk factors of modern lifestyle. Community gardens are not limited to developed countries. They also exist in developing low-income countries but usually serve a different purpose of food security. Despite their benefits, community gardens can become a source of environmental toxicants from the soil of mostly empty lands that might have been contaminated by toxicants in the past. Therefore, caution should be taken about gardening practices and the types of foods to be grown on such soil if there was evidence of contamination. We present community gardens as additional solutions to the epidemic of chronic diseases in low-income urban communities and how it can have a positive physical, mental and social impact among participants. On balance, the benefits of engaging in community gardens are likely to outweigh the potential risk that can be remedied. Quantitative population studies are needed to provide evidence of the benefits and health impacts versus potential harms from community gardens.

  19. MBS Native Plant Communities

    Data.gov (United States)

    Minnesota Department of Natural Resources — This data layer contains results of the Minnesota County Biological Survey (MCBS). It includes polygons representing the highest quality native plant communities...

  20. Communities running energy

    International Nuclear Information System (INIS)

    Wallace, Paula

    2014-01-01

    The conditions for the evolution of community renewable energy are right in some parts of the country. This article reports on some recent developments, with opportunities for business and local government. Many communities across Australia are developing wind and solar projects, but only a fraction are actually generating power. Nicky Ison, researcher of community renewable energy (CRE) at the Institute for Sustainable Futures, is director of the Community Power Agency. The latter is behind a new coalition lobbying the federal government in Australia to establish a $50 million grant program to support the development stage of CRE projects.

  1. Defining political community

    Directory of Open Access Journals (Sweden)

    Sladeček Michal M.

    2002-01-01

    Full Text Available This paper considers the concept of political community, its constitution and value. The starting point is that the concept of community is not sufficiently recognized in modern political theories, as well as in contemporary liberal theory. In the last two decades communitarian and republican political theory attempted to revitalize this notion. The first part of the paper elaborates on the polemics between these three theoretical orientations. The concluding part examines the possibilities and prospect for stable political community in conditions of pluralism of particular social communities and ethnocultural heterogeneity.

  2. Nuclear Community in network

    International Nuclear Information System (INIS)

    Tejedor, E.

    2014-01-01

    The internet has revolutionized the ways of communication and many companies/ organizations have adapted to the change but others have not, or have done it halfway. This presentation is a review of the main characteristics of virtual communities and their typology. The status of the Nuclear Online Community, both pro nuclear and antinuclear is analysed , and their main similarities and differences are discussed. The Pro nuclear Online Community is formed gradually. This presentation attempts to define some ways to increase the scope of the Community and encourage greater dissemination of the characteristics of nuclear energy. (Author)

  3. Evidence-Based Development

    DEFF Research Database (Denmark)

    Hertzum, Morten; Simonsen, Jesper

    2004-01-01

    Systems development is replete with projects that represent substantial resource investments but result in systems that fail to meet users’ needs. Evidence-based development is an emerging idea intended to provide means for managing customer-vendor relationships and working systematically toward...... meeting customer needs. We are suggesting that the effects of the use of a system should play a prominent role in the contractual definition of IT projects and that contract fulfilment should be determined on the basis of evidence of these effects. Based on two ongoing studies of home-care management...

  4. Sustainable communities: Opportunities for integrated infrastructure

    International Nuclear Information System (INIS)

    Panetta, D.

    1992-01-01

    The world's holistic and interconnected relationships are becoming more evident on a daily basis. Areas of concern, previously thought of as independent, are being revealed as interdependent. The choice of technological systems for use in such an interconnected system can often have unforeseen consequences. We have understood that wastewater treatment (WT) effects water quality since the 19th century. However, other important, although less evident relationships exist concerning wastewater treatment. This paper explores some of the impacts that the choice of waste-water treatment technology has on energy, ecology and the community's ability to afford housing, parks and open space. It concludes that the choice and implementation of wastewater treatment systems is of paramount concern to the quality of our lives. Many alternatives currently exist to conventional treatment processes. One of the more successful alternatives is discussed along with its potential to mitigate potential adverse impacts and to function as an amenity in the community rather than simply an expensive requirement

  5. Ethical reflections on Evidence Based Medicine

    Directory of Open Access Journals (Sweden)

    S. Corrao

    2013-05-01

    Full Text Available BACKGROUND According to Potter’s point of view, medical ethics is the science of survival, a bridge between humanistic and scientific culture. The working out of judgements on right or wrong referred to the human being are studied by this science. Methodological quality is fundamental in clinical research, and several technical issues are of paramount importance in trying to answer to the final question “what is the true, the right thing?”. We know they are essential aspects as in medical ethics as in evidence based practice. AIM OF THE STUDY The aim of this paper is to talk about relationships and implications between ethical issues and Evidence Based Medicine (EBM. DISCUSSION EBM represents a new paradigm that introduces new concepts to guide medical-decision making and health-care planning. Its principles are deeply rooted in clinical research methodology since information are derived from sound studies of strong quality. Health-care professionals have to deal with methodological concepts for critical appraisal of literature and implementation of evidences in clinical practice and healthcare planning. The central role of EBM in medical ethics is obvious, but a risk could be possible. The shift from Hippocratic point of view to community-centred one could lose sight of the centrality of the patient. CONCLUSION Both EBM principles and the needs to adequately response to economic restrictions urge a balance between individual and community ethics. All this has to represent an opportunity to place the patient at the centre of medical action considering at the same time community ethics as systemic aim, but without forgetting the risk that economic restrictions push towards veterinary ethics where herd is central and individual needs do not exist.

  6. Perturbation metatranscriptomics for studying complex microbial communities

    DEFF Research Database (Denmark)

    Williams, Rohan B.H.; Kirkegaard, Rasmus Hansen; Arumugam, Krithika

    Studying the functional state of natural or engineered microbial communities presents substantial challenges due to both the complexities of field sampling, and, in the laboratory context, the inability of culture or reactor systems to maintain community composition ex situ over long periods. Here...... correlation between orthologous genes (Pearson r=0.4). We also used these data to annotate uncharacterized genes in the Ca. nitrospira defluvii genome: finding clear evidence for several previously unrecognized denitrification related genes, using a combination of expression profiles and protein domain data...... are associated with the transition from anoxic to aerobic conditions, and are observable at a whole community level and 3) these data provide a means of identifying unannotated genes in reference genomes that are likely to be associated with specific functional processes. More broadly, our approach permits...

  7. Roots of success: cultivating viable community forestry

    Energy Technology Data Exchange (ETDEWEB)

    MacQueen, Duncan

    2009-05-15

    Is community forestry emerging from the shadows? The evidence shows that locally controlled enterprises can be economically viable, and often build on stronger social and environmental foundations than the big private-sector players. Certainly this is an industry in need of a shakeup. Many forests have become flashpoints where agro-industry, large-scale logging concerns and conservation interests clash, while forest-dependent communities are left out in the cold. Meanwhile, governments – driven by concerns over the climate impacts of deforestation – are having to gear up for legal, sustainable forestry production. Community forestry could be crucial to solving many of these challenges. By building on local core capabilities and developing strategic partnerships, they are forging key new business models that could transform the sector.

  8. Evolutionary conceptual analysis: faith community nursing.

    Science.gov (United States)

    Ziebarth, Deborah

    2014-12-01

    The aim of the study was to report an evolutionary concept analysis of faith community nursing (FCN). FCN is a source of healthcare delivery in the USA which has grown in comprehensiveness and complexity. With increasing healthcare cost and a focus on access and prevention, FCN has extended beyond the physical walls of the faith community building. Faith communities and healthcare organizations invest in FCN and standardized training programs exist. Using Rodgers' evolutionary analysis, the literature was examined for antecedents, attributes, and consequences of the concept. This design allows for understanding the historical and social nature of the concept and how it changes over time. A search of databases using the keywords FCN, faith community nurse, parish nursing, and parish nurse was done. The concept of FCN was explored using research and theoretical literature. A theoretical definition and model were developed with relevant implications. The search results netted a sample of 124 reports of research and theoretical articles from multiple disciplines: medicine, education, religion and philosophy, international health, and nursing. Theoretical definition: FCN is a method of healthcare delivery that is centered in a relationship between the nurse and client (client as person, family, group, or community). The relationship occurs in an iterative motion over time when the client seeks or is targeted for wholistic health care with the goal of optimal wholistic health functioning. Faith integrating is a continuous occurring attribute. Health promoting, disease managing, coordinating, empowering and accessing health care are other essential attributes. All essential attributes occur with intentionality in a faith community, home, health institution and other community settings with fluidity as part of a community, national, or global health initiative. A new theoretical definition and corresponding conceptual model of FCN provides a basis for future nursing

  9. Gait as evidence

    DEFF Research Database (Denmark)

    Lynnerup, Niels; Larsen, Peter Kastmand

    2014-01-01

    This study examines what in Denmark may constitute evidence based on forensic anthropological gait analyses, in the sense of pointing to a match (or not) between a perpetrator and a suspect, based on video and photographic imagery. Gait and anthropometric measures can be used when direct facial...

  10. Turning Evidence into Practice

    Science.gov (United States)

    CGH CRTA, Hillary Topazian, attended the National Cancer Institute’s 3rd Symposium on Global Cancer Research; a satellite meeting to the 6th Annual Consortium of Universities for Global Health (CUGH) Conference in Boston. The Symposium centered on the theme of implementation science, a field which studies the integration of research findings and evidence into healthcare policy and practice.

  11. Evidence of Absence software

    Science.gov (United States)

    Dalthorp, Daniel; Huso, Manuela M. P.; Dail, David; Kenyon, Jessica

    2014-01-01

    Evidence of Absence software (EoA) is a user-friendly application used for estimating bird and bat fatalities at wind farms and designing search protocols. The software is particularly useful in addressing whether the number of fatalities has exceeded a given threshold and what search parameters are needed to give assurance that thresholds were not exceeded. The software is applicable even when zero carcasses have been found in searches. Depending on the effectiveness of the searches, such an absence of evidence of mortality may or may not be strong evidence that few fatalities occurred. Under a search protocol in which carcasses are detected with nearly 100 percent certainty, finding zero carcasses would be convincing evidence that overall mortality rate was near zero. By contrast, with a less effective search protocol with low probability of detecting a carcass, finding zero carcasses does not rule out the possibility that large numbers of animals were killed but not detected in the searches. EoA uses information about the search process and scavenging rates to estimate detection probabilities to determine a maximum credible number of fatalities, even when zero or few carcasses are observed.

  12. Fossil wood evidences

    Indian Academy of Sciences (India)

    Climate has played a crucial role in assigning a different kind of topography to Rajasthan and Gujarat since the Cenozoic time. Evidently, three genera, namely, Dipterocarpus Gaert. f., Hopea Roxb. And Shorea Roxb. of the Dipterocarpaceae are described from the Neogene sediments of western India (Rajasthan and ...

  13. Open source community organization

    CSIR Research Space (South Africa)

    Molefe, Onkgopotse M

    2009-05-01

    Full Text Available Open Source communities (OSCs), sometimes referred to as virtual or online communities play a significant role in terms of the contribution they continue to make in producing user-friendly Open Source Software (OSS) solutions. Many projects have...

  14. EMI New User Communities

    CERN Document Server

    Riedel, M

    2013-01-01

    This document provides pieces of information about new user communities that directly or indirectly take advantage of EMI Products. Each user community is described via one specific EMI product use case to understand and communicate the current usage of EMI Products in practice.

  15. Community as Curriculum

    Science.gov (United States)

    Cummins, Jim; Chow, Patricia; Schechter, Sandra R.

    2006-01-01

    This article describes a project involving teachers, parents, and university researchers in collaborations to support multilingual children's development and use of language. Strategies for fostering an inclusive climate included building on the interests and resources of the local community, involving community members in curriculum development,…

  16. Community Music in Australia

    Science.gov (United States)

    Harrison, Gillian

    2010-01-01

    This paper presents a historical perspective to the development of community music in Australia. Finding political support in Australia's progressive arts policies of the late 1970s, community music is discussed as embracing the principles of access and equity and supporting the development of musical skills in the context of social change and…

  17. Decoding communities in networks

    Science.gov (United States)

    Radicchi, Filippo

    2018-02-01

    According to a recent information-theoretical proposal, the problem of defining and identifying communities in networks can be interpreted as a classical communication task over a noisy channel: memberships of nodes are information bits erased by the channel, edges and nonedges in the network are parity bits introduced by the encoder but degraded through the channel, and a community identification algorithm is a decoder. The interpretation is perfectly equivalent to the one at the basis of well-known statistical inference algorithms for community detection. The only difference in the interpretation is that a noisy channel replaces a stochastic network model. However, the different perspective gives the opportunity to take advantage of the rich set of tools of coding theory to generate novel insights on the problem of community detection. In this paper, we illustrate two main applications of standard coding-theoretical methods to community detection. First, we leverage a state-of-the-art decoding technique to generate a family of quasioptimal community detection algorithms. Second and more important, we show that the Shannon's noisy-channel coding theorem can be invoked to establish a lower bound, here named as decodability bound, for the maximum amount of noise tolerable by an ideal decoder to achieve perfect detection of communities. When computed for well-established synthetic benchmarks, the decodability bound explains accurately the performance achieved by the best community detection algorithms existing on the market, telling us that only little room for their improvement is still potentially left.

  18. Caring for the community.

    Science.gov (United States)

    Spitzer, Roxane

    2004-01-01

    Nurses can play a unique role in caring for their communities. The first and most obvious role is the direct care of patients, the underlying raison d'etre of nursing, and second is the indirect care of the patients' families and friends. The hands-on healing image of nurses is held by many people and personified through the years by such real-life examples as Clara Barton. It is also the image that attracts many to nursing and is fueled by desire--the desire to help, to make a positive difference, and to serve people. It is often a powerful one-on-one connection between caregiver and receiver, nurse and patient, that defines the role of nursing. Yet, nurses can--and should--play broader roles in caring for their communities. This includes the internal community within one's own organization, the environment in which nurses work, and the larger external community--or communities--in which one lives. By reaching out and caring for the broader communities, nurses have the opportunity to grow while the communities benefit from their participatory caring. In addition, the image of nursing is enhanced externally. The nurse as community caregiver melds the heart and soul of nursing for a new 21st century model of caring.

  19. Decoding communities in networks.

    Science.gov (United States)

    Radicchi, Filippo

    2018-02-01

    According to a recent information-theoretical proposal, the problem of defining and identifying communities in networks can be interpreted as a classical communication task over a noisy channel: memberships of nodes are information bits erased by the channel, edges and nonedges in the network are parity bits introduced by the encoder but degraded through the channel, and a community identification algorithm is a decoder. The interpretation is perfectly equivalent to the one at the basis of well-known statistical inference algorithms for community detection. The only difference in the interpretation is that a noisy channel replaces a stochastic network model. However, the different perspective gives the opportunity to take advantage of the rich set of tools of coding theory to generate novel insights on the problem of community detection. In this paper, we illustrate two main applications of standard coding-theoretical methods to community detection. First, we leverage a state-of-the-art decoding technique to generate a family of quasioptimal community detection algorithms. Second and more important, we show that the Shannon's noisy-channel coding theorem can be invoked to establish a lower bound, here named as decodability bound, for the maximum amount of noise tolerable by an ideal decoder to achieve perfect detection of communities. When computed for well-established synthetic benchmarks, the decodability bound explains accurately the performance achieved by the best community detection algorithms existing on the market, telling us that only little room for their improvement is still potentially left.

  20. Community of Practice

    DEFF Research Database (Denmark)

    Busch-Jensen, Peter

    2014-01-01

    The concept of “communities of practice” is of relatively recent date. The concept gained momentum with Jean Lave and Etienne Wenger’s book from 1991, Situated learning: Legitimate peripheral participation. Since then, the notion of “communities of practice” has been a focus of attention, not least...

  1. An Enriching Community.

    Science.gov (United States)

    Holland, Nancy A.; Burroughs, Jean

    2001-01-01

    Successful school-community partnerships in Volusia (Florida) Public Schools are the results of marketing creatively, meeting community members' needs, and bringing the right people together. The 3-year old program now offers students of all ages an expanding list of enrichment classes on many subjects for a nominal fee. (MLH)

  2. Community Research Mythology

    Science.gov (United States)

    Waldern, Barbara

    2006-01-01

    This article is dedicated to an in-depth discussion of the theme community and the implications the multiple meanings of community hold for the field of qualitative research. This theme surfaced from Walderns 2003 study entitled Resistance to Research in Vancouvers Downtown Eastside, which dealt with participant resistance to joining research…

  3. Community Information Systems.

    Science.gov (United States)

    Freeman, Andrew

    Information is provided on technological and social trends as background for a workshop designed to heighten the consciousness of workers in community information systems. Initially, the basic terminology is considered in its implications for an integrated perspective of community information systems, with particular attention given to the meaning…

  4. Alaska Community Transit

    Science.gov (United States)

    Grant Information Human Services Funding 5310 5316 (Repealed) 5317 (Repealed) Alaska Mental Health Trust Department of Transportation & Public Facilities/ Alaska Community Transit Search DOT&PF State of Alaska Photo banner DOT&PF> Program Development > Alaska Community Transit Home About Us

  5. Community-Based Care

    Science.gov (United States)

    ... our e-newsletter! Aging & Health A to Z Community-Based Care Basic Facts & Information A variety of healthcare options ... day care centers are either in churches or community centers. Adult day care is commonly used to care for people who ...

  6. Community of Practice

    DEFF Research Database (Denmark)

    Busch-Jensen, Peter

    2012-01-01

    A clear and informative description of the theoretical and methodological content and implications of the concept of Community of Practice......A clear and informative description of the theoretical and methodological content and implications of the concept of Community of Practice...

  7. Community Colleges Today

    Science.gov (United States)

    Crawford, Corinne; Jervis, Angela

    2011-01-01

    Dr. Jill Biden, Vice President Joe Biden's wife, has been teaching in community colleges for the past 18 years. Dr. Biden believes that community colleges are "…uniquely American institutions where anyone who walks through the door is one step closer to realizing the American dream." This is an inspiring sentiment. However, of all the…

  8. It Takes a Community

    Science.gov (United States)

    Jacobson, Reuben; Villarreal, Lisa; Muñoz, José; Mahaffey, Robert

    2018-01-01

    Community schools are a sound education reform strategy that gets results. They start by asking local students and their families what they need to succeed in school, then they reach out to relevant community partners and use the school as the hub for organizing partnerships, services, and supports. By listening closely to the assets and needs of…

  9. The Ethic of Community

    Science.gov (United States)

    Furman, Gail C.

    2004-01-01

    This article proposes the concept of an ethic of community to complement and extend other ethical frames used in education e.g. the ethics of justice, critique, and care. Proceeding from the traditional definition of ethics as the study of moral duty and obligation, ethic of community is defined as the moral responsibility to engage in communal…

  10. UNM in the Community.

    Science.gov (United States)

    Quantum: Research & Scholarship, 1998

    1998-01-01

    Profiles 10 University of New Mexico community programs: University Art Museum, Rio Grande and Four Corners Writing Projects, Blacks in the Southwest (exhibit), New Mexico Engineering Research Institute's Environmental Finance Center, Adolescent Social Action Program, Minority Engineering Programs, Rural Community College Initiative, Valencia…

  11. Creating Learning Communities: An Introduction to Community Education.

    Science.gov (United States)

    Decker, Larry E.; Boo, Mary Richardson

    Schools cannot succeed without collaboration with parents and the community. Defining community education as active community involvement in the education of children, this booklet describes aspects of community education. Community education, the booklet points out, can take place at physical locations such as formal school buildings, which lie…