Evidence for cultural differences between neighboring chimpanzee communities.

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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.

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.

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.

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.

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

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

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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…

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.

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

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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

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

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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…

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

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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.

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

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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

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

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

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.

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

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.

Ground-Based Midcourse Defense (GMD) Sea-Based X-Band Radar (SBX) Placement and Operation, Adak, Alaska

Science.gov (United States)

2005-08-03

Zielinski , Environmental Specialist, EDAW, Inc. B.S., 1984, Biology, University of Alabama in Birmingham Years of Experience: 20 6-2 GMD SBX Placement...Management and Division of Water Permitting Juneau AK Anchorage AK Leroy Phillips Dave Jensen US Army Corps of Engineers The Aleut Corporation Elmendorf AFB AK...Army Corps of Engineers Office of Habitat Management and Elmendorf AFB AK Permitting Anchorage AK Dave Jensen Lari Belisle The Aleut Corporation Federal

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.

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

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...

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

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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.

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

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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.

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.

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

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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…

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.

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

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.

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

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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.

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.

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

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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

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

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

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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…

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

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

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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

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

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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.

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

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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…

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

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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.

Community empowerment and community cohesion: parallel agendas for community building in England?

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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.

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

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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

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

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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

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

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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

Strengthening Chronic Disease Prevention Programming: The Toward Evidence-Informed Practice (TEIP) Program Evidence Tool

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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

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

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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

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

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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.

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

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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

Comparative Eskimo Dictionary with Aleut Cognates.

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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…

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

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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.

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

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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.

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

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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…

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

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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.

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

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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

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.

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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

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

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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.

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

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.

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.

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.

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.

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…

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

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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.

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

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.

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.

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

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.

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.

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.

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.

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.

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

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

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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

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.

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…

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.

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.

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).

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.

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.

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

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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.

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.

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

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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

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

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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

Postpartum family planning: current evidence on successful interventions.

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Blazer, Cassandra; Prata, Ndola

2016-01-01

We reviewed existing evidence of the efficacy of postpartum family planning interventions targeting women in the 12 months postpartum period in low- and middle-income countries. We searched for studies from January 1, 2004 to September 19, 2015, using the US Preventive Services Task Force recommendations to assess evidence quality. Our search resulted in 26 studies: 11 based in sub-Saharan Africa, six in the Middle East and North Africa, and nine in Asia. Twenty of the included studies assessed health facility-based interventions. Three were focused on community interventions, two had community and facility components, and one was a workplace program. Overall quality of the evidence was moderate, including evidence for counseling interventions. Male partner involvement, integration with other service delivery platforms, such as prevention of mother-to-child transmission of HIV and immunization, and innovative product delivery programs may increase knowledge and use during the postpartum period. Community-based and workplace strategies need a much stronger base of evidence to prompt recommendations.

7 CFR 3100.41 - Authorities.

Science.gov (United States)

2010-01-01

... administrative and other facilities in central business districts. (l) American Indian Religious Freedom Act of... for American Indians their inherent right of freedom to believe, express, and exercise the traditional religions of the American Indian, Eskimo, Aleut, and Native Hawaiians. ...

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

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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

Evolving prosocial and sustainable neighborhoods and communities.

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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.

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

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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 .

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

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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

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

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

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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.

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

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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.

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.

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

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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.

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

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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.

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

Conflict Resolution Practices of Arctic Aboriginal Peoples

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Gendron, R.; Hille, C.

2013-01-01

This article presents an overview of the conflict resolution practices of indigenous populations in the Arctic. Among the aboriginal groups discussed are the Inuit, the Aleut, and the Saami. Having presented the conflict resolution methods, the authors discuss the types of conflicts that are

Using communities that care for community child maltreatment prevention.

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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).

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

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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…

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

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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.

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

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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

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.

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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

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

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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

Healthy Native Community Fellowship: An Indigenous Leadership Program to Enhance Community Wellness

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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.

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).

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).

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).

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.

Partnered Evaluation of a Community Engagement Intervention: Use of a “Kickoff” Conference in a Randomized Trial for Depression Care Improvement in Underserved Communities

Science.gov (United States)

Mendel, Peter; Ngo, Victoria K.; Dixon, Elizabeth; Stockdale, Susan; Jones, Felica; Chung, Bowen; Jones, Andrea; Masongsong, Zoe; Khodyakov, Dmitry

2013-01-01

Community partnered research and engagement strategies are gaining recognition as innovative approaches to improving healthcare systems and reducing health disparities in underserved communities. These strategies may have particular relevance for mental health interventions in low income, minority communities in which there often is great stigma and silence surrounding conditions such as depression and difficulty in implementing improved access and quality of care. At the same time, there is a relative dearth of evidence on the effectiveness of specific community engagement interventions and on the design, process, and context of these interventions necessary for understanding their implementation and generalizability. This paper evaluates one of a number of community engagement strategies employed in the Community Partners in Care (CPIC) study, the first randomized controlled trial of the role of community engagement in adapting and implementing evidence-based depression care. We specifically describe the unique goals and features of a community engagement “kickoff” conference as used in CPIC and provide evidence on the effectiveness of this type of intervention by analyzing its impact on: 1) stimulating a dialogue, sense of collective efficacy, and opportunities for learning and networking to address depression and depression care in the community, 2) activating interest and participation in CPIC’s randomized trial of two different ways to implement evidence-based quality improvement (QI) programs for depression across diverse community agencies, and 3) introducing evidence-based toolkits and collaborative care models to potential participants in both intervention conditions and other community members. We evaluated the effectiveness of the conference through a community-partnered process in which both community and academic project members were involved in study design, data collection and analysis. Data sources include participant conference evaluation

42 CFR 457.10 - Definitions and use of terms.

Science.gov (United States)

2010-10-01

...) means— (1) A member of a Federally recognized Indian tribe, band, or group; (2) An Eskimo or Aleut or... targeted low-income child. Emergency medical condition means a medical condition manifesting itself by... average knowledge of health and medicine, could reasonably expect the absence of immediate medical...

42 CFR 136.302 - Definitions.

Science.gov (United States)

2010-10-01

... the natural child or grandchild of any such member, or (2) is an Eskimo or Aleut or other Alaska... assisting environmental engineers and others in environmental health control and preventive medicine... of Education of the Department of Health and Human Services. (n) School of medicine, school of...

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…

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.

Achieving public health impact in youth violence prevention through community-research partnerships.

Science.gov (United States)

Massetti, Greta M; Vivolo, Alana M

2010-01-01

Violence is a leading cause of death and disability for U.S. youth. The U.S. Centers for Disease Control and Prevention (CDC)'s Division of Violence Prevention (DVP) is committed to developing communities' capacity to engage in evidence-based youth violence (YV) prevention. We discuss the characteristics of communities that exert influence on the development and epidemiology of YV, and discuss opportunities for how community-research partnerships can enhance efforts to prevent violence in communities. The needs for YV prevention are unique; the nature and phenomenology of violence are community specific. Communities also vary widely in infrastructure and systems to support coordinated, evidence-based YV prevention strategies. These conditions highlight the need for community-research partnerships to enhance community capacity, employ local resources, and engage community members in the research process. DVP is committed to working towards creating communities in which youth are safe from violence. Approaches to YV prevention that emphasize community-research partnerships to build capacity and implement evidence-based prevention strategies can provide a supportive context for achieving that goal.

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.

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 ...

78 FR 10206 - Notice of Final Supplementary Rules for Public Lands Managed by the Ukiah Field Office in Lake...

Science.gov (United States)

2013-02-13

... online at the Web site specified in ADDRESSES. Regulatory Flexibility Act Congress enacted the Regulatory... lands held for the benefit of Indians, Aleuts, or Eskimos, Indian resources, or tribal property rights...-motorized, foot-launched aircraft. Hunting means the pursuit of game by any person in possession of a...

50 CFR 17.3 - Definitions.

Science.gov (United States)

2010-10-01

... part; Authentic native articles of handicrafts and clothing means items made by an Indian, Aleut, or... species, or a fire or other natural catastrophic event in areas prone to such events). Conservation plan... captive populations of the affected species: (a) Provision of health care, management of populations by...

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

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)

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.

Postpartum family planning: current evidence on successful interventions

Directory of Open Access Journals (Sweden)

Blazer C

2016-04-01

Full Text Available Cassandra Blazer, Ndola Prata Bixby Center for Population, Health, and Sustainability, School of Public Health, University of California, Berkeley, CA, USA Abstract: We reviewed existing evidence of the efficacy of postpartum family planning interventions targeting women in the 12 months postpartum period in low- and middle-income countries. We searched for studies from January 1, 2004 to September 19, 2015, using the US Preventive Services Task Force recommendations to assess evidence quality. Our search resulted in 26 studies: 11 based in sub-Saharan Africa, six in the Middle East and North Africa, and nine in Asia. Twenty of the included studies assessed health facility-based interventions. Three were focused on community interventions, two had community and facility components, and one was a workplace program. Overall quality of the evidence was moderate, including evidence for counseling interventions. Male partner involvement, integration with other service delivery platforms, such as prevention of mother-to-child transmission of HIV and immunization, and innovative product delivery programs may increase knowledge and use during the postpartum period. Community-based and workplace strategies need a much stronger base of evidence to prompt recommendations. Keywords: postpartum period, family planning, birth spacing, interventions, systematic review, contraception, less developed countries

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.

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

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.

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.

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...

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.

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

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).

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.

Current Ethnomusicology in Alaska.

Science.gov (United States)

Johnston, Thomas F.

The systematic study of Eskimo, Indian, and Aleut musical sound and behavior in Alaska, though conceded to be an important part of white efforts to foster understanding between different cultural groups and to maintain the native cultural heritage, has received little attention from Alaskan educators. Most existing ethnomusical studies lack one or…

Strategy for Enlisting Lateral Entrants Via Computer Technology (SELECT): An Automated System for Determining Rating and Pay Grade Qualification for Potential Navy Lateral Entry Accessions

Science.gov (United States)

1983-09-01

Filipino (6- ) Mexican American/Chicano (7: ) Eskimo (8- ) Aleut (9: ) Cuban American (D- ) India (E’ ) Malaysian (G ) Chinese (J" 1...INTERNSHIP PHOTOGRAPHY/ CINEMA (2,2,3,3); FILM PRODUCTION (0,2,3,3); PORTRAITURE (0,1,1,1); TECH PHOTOGRAPHY (0,0,1,2); PERSNNEL SUPERVISION (0,0,1,3

Just-in-Time Training of the Evidence-Based Public Health Framework, Oklahoma, 2016-2017.

Science.gov (United States)

Douglas, Malinda R; Lowry, Jon P; Morgan, Latricia A

2018-03-07

Training of practitioners on evidence-based public health has shown to be beneficial, yet overwhelming. Chunking information and proximate practical application are effective techniques to increase retention in adult learning. Evidence-based public health training for practitioners from African American and Hispanic/Latino community agencies and tribes/tribal nations incorporated these 2 techniques. The community-level practitioners alternated attending training and implementing the steps of the evidence-based public health framework as they planned state-funded programs. One year later, survey results showed that participants reported increased confidence in skills that were reinforced by practical and practiced application as compared with posttraining survey results. In addition, at 1 year, reported confidence in skills that were not fortified by proximate application decreased when compared with posttraining confidence levels. All 7 community programs successfully created individualized evidence-based action plans that included evidence-based practices and policies across socioecological levels that fit with the unique culture and climate of their own community.

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.

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

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.

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…

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.

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.

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.

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....

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.

Wound care guidelines and formulary for community nurses.

Science.gov (United States)

Baeyens, T A

2000-03-01

Community nursing is experiencing significant change as a result of developments such as improved technology, care in the community and earlier discharge of patients from hospital. Because of this, increasingly complex clinical care is required in the community, and it has been noted that community nurses are 'under considerable pressure' and show 'evidence of high stress and low morale'. Wound care is one area in which community nurses constantly battle to keep abreast of continual change. Growing product availability and diversity of use, changes in dressing techniques and the ever-increasing costs associated with wound care mean decision-making in wound care is often a complex task. In the Grampian region, a handbook of evidence-based practice guidelines with a product formulary was developed and distributed to all community nurses. The handbook was designed to ease the decision-making process by evaluating evidence-based practice and local preferences to recommend and guide nurses towards effective clinical practice and cost efficiency. All grades of district nurse in the region have been issued with their own copy of the handbook. It is presented in an A5 ring-binder format to make it easy to carry and to facilitate updating using loose-leaf inserts. The use of logos, extra information boxes and colour coding makes it easy for users to find specific areas of interest in the handbook. The success of the handbook has led to debate on the potential for development of a similar resource for use by practice nurses and in local community hospitals.

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.

American Native Oral Tradition: Legal Safeguards and Public Domain--A Discussion.

Science.gov (United States)

Bland, Laurel LeMieux

Demonstrating the fact that the United States recognizes tribal groups (American Indians, Eskimos, and/or Aleuts) as sovereign bodies and conducts business and civil affairs with them accordingly, this paper examines an area in U.S. Law that is either unclear or entirely lacking--the treatment of tribal right to ownership or control of the…

Niigugim Qalgadangis (Atkan Food).

Science.gov (United States)

Dirks, Moses; Dirks, Lydia

A history of food gathering and food preparation techniques of Alaska natives on Atka Island in the Aleutians are presented in Western Aleut and English with illustrations by J. Leslie Boffa and Mike Dirks. Directions are given for preparing: various plants, including wild rice; salted, dried, or smoked fish; baked flour; fried dough; boiled…

Alaska Native Languages: Past, Present, and Future. Alaska Native Language Center Research Papers No. 4.

Science.gov (United States)

Krauss, Michael E.

Three papers (1978-80) written for the non-linguistic public about Alaska Native languages are combined here. The first is an introduction to the prehistory, history, present status, and future prospects of all Alaska Native languages, both Eskimo-Aleut and Athabaskan Indian. The second and third, presented as appendixes to the first, deal in…

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.

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...

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.

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

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

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,.

Community nurses and self-management of blood glucose.

Science.gov (United States)

Abbott, S; Burns, J; Gleadell, A; Gunnell, C

2007-01-01

Self-monitoring of blood glucose (SMBG) is commonly recommended to patients with diabetes, although the rationale for this is unclear. This small research project was designed to explore the reasons why nurses working in the community recommend SMBG. Seven interviews were carried out with community nurses caring primarily for housebound patients. Those interviewed believed that a sound evidence-base supported the recommendation that patients test their blood, but not urine, for glucose levels. Though nurses believed in the importance of patient choice and empowerment, the scope for these was limited among housebound patients. There was no evidence that patients understood how to respond to test results, or that comprehensive care planning was normal practice. Although small, this study suggests that nurses working in community settings may need to update their knowledge. It also suggests that a national debate is necessary to disseminate better the evidence about SMBG, and its implications for nursing practice.

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.

Native Cultures and Language: Challenges for Land Managers in Alaska

Science.gov (United States)

Thomas J. Gallagher

1992-01-01

Many of the Aleuts, Inuits, and Indians of Alaska continue to live a traditional lifestyle. Eighty-eight percent of the land they use for subsistence activities, however, is managed by federal or state agencies. Clear communication across cultures is essential if Native people are to be represented in agency land management decisions. Problems in communication relate...

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

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...

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…

Community Education for Family Planning in the U.S.: A Systematic Review.

Science.gov (United States)

Carter, Marion W; Tregear, Michelle L; Moskosky, Susan B

2015-08-01

Community education may involve activities that seek to raise awareness and promote behavior change, using mass media, social media, and other media or interpersonal methods in community settings. This systematic review evaluated the evidence of the effects of community education on select short- and medium-term family planning outcomes. Using an analytic approach drawn from the U.S. Preventive Services Task Force, multiple databases were searched for articles published from January 1985 through February 2011 describing studies of community education related to family planning in the U.S. Included articles were reviewed and assessed for potential bias using a standardized process in 2011. An updated, targeted review for the 2011-2014 period was conducted in early 2015. Seventeen papers were identified. Most (nine) related to mass media interventions; three involved targeted print media, two involved text messaging or e-mail, two described outcome workers conducting community education, and one involved community theater. Study designs, strength of evidence, and levels of possible bias varied widely. Twelve of 15 studies that addressed outcomes such as increased awareness found positive associations with those outcomes, with six also reporting null findings. Seven of eight studies that addressed use of services reported positive associations, with two also reporting null findings. The targeted, additional review identified two other studies. Evidence related to community education for family planning purposes is limited and highly variable. As goals of community education are usually limited to shorter-term outcomes, the evidence suggests that a range of approaches may be effective. Published by Elsevier Inc.

Assessing community perspectives of the community based education and service model at Makerere University, Uganda: a qualitative evaluation

Directory of Open Access Journals (Sweden)

Okullo Isaac

2011-03-01

Full Text Available Abstract Background Community partnerships are defined as groups working together with shared goals, responsibilities, and power to improve the community. There is growing evidence that these partnerships contribute to the success and sustainability of community-based education and service programs (COBES, facilitating change in community actions and attitudes. Makerere University College of Health Sciences (MakCHS is forging itself as a transformational institution in Uganda and the region. The College is motivated to improve the health of Ugandans through innovative responsive teaching, provision of service, and community partnerships. Evaluating the COBES program from the community perspective can assist the College in refining an innovative and useful model that has potential to improve the health of Ugandans. Methods A stratified random sample of 11 COBES sites was selected to examine the community’s perception of the program. Key Informant Interviews of 11 site tutors and 33 community members were completed. The data was manually analyzed and themes developed. Results Communities stated the students consistently engaged with them with culturally appropriate behaviour. They rated the student’s communication as very good even though translators were frequently needed. Half the community stated they received some feedback from the students, but some communities interpreted any contact after the initial visit as feedback. Communities confirmed and appreciated that the students provided a number of interventions and saw positive changes in health and health seeking behaviours. The community reflected that some programs were more sustainable than others; the projects that needed money to implement were least sustainable. The major challenges from the community included community fatigue, and poor motivation of community leaders to continue to take students without compensation. Conclusions Communities hosting Makerere students valued the

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…

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.

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…

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.

Considerations for community-based mHealth initiatives: insights from three Beacon Communities.

Science.gov (United States)

Abebe, Nebeyou A; Capozza, Korey L; Des Jardins, Terrisca R; Kulick, David A; Rein, Alison L; Schachter, Abigail A; Turske, Scott A

2013-10-15

Mobile health (mHealth) is gaining widespread attention for its potential to engage patients in their health and health care in their daily lives. Emerging evidence suggests that mHealth interventions can be used effectively to support behavior change, but numerous challenges remain when implementing these programs at the community level. This paper provides an overview of considerations when implementing community-based mHealth initiatives, based on the experiences of three Beacon Communities across the United States that have launched text messaging (short message service, SMS) pilot programs aimed at diabetes risk reduction and disease management. The paper addresses lessons learned and suggests strategies to overcome challenges related to developing text message content, conducting marketing and outreach, enrolling participants, engaging providers, evaluating program effectiveness, and sustaining and scaling the programs.

Considerations for Community-Based mHealth Initiatives: Insights From Three Beacon Communities

Science.gov (United States)

2013-01-01

Mobile health (mHealth) is gaining widespread attention for its potential to engage patients in their health and health care in their daily lives. Emerging evidence suggests that mHealth interventions can be used effectively to support behavior change, but numerous challenges remain when implementing these programs at the community level. This paper provides an overview of considerations when implementing community-based mHealth initiatives, based on the experiences of three Beacon Communities across the United States that have launched text messaging (short message service, SMS) pilot programs aimed at diabetes risk reduction and disease management. The paper addresses lessons learned and suggests strategies to overcome challenges related to developing text message content, conducting marketing and outreach, enrolling participants, engaging providers, evaluating program effectiveness, and sustaining and scaling the programs. PMID:24128406

Creating A Sustainable Model of Spine Care in Underserved Communities

DEFF Research Database (Denmark)

Haldeman, Scott; Nordin, Margareta; Outerbridge, Geoff

2015-01-01

The world lacks sustainable models of care to manage spinal disorders in poor and underserved communities. The purpose of this article is to: (1) review the rationale and importance of developing a sustainable evidence-based model of care at low cost for people with spinal disorders in underserved...... adequate care, World Spine Care (WSC) was established to "improve lives in underserved communities through sustainable, integrated, evidence-based, spinal care." WSC is comprised of volunteers and institutions from 6 continents and several countries, and incorporates a Board of Directors, an executive...... are adapted to and integrated within each community in collaboration with local decision makers, existing health care workers and traditional healers. Cornerstones of WSC's emphasis on long-term sustainability are (1) education of community partners, governments and local health professionals, and (2...

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.

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.

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.

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…

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...

The practice of OTC counseling by community pharmacists in Parana, Brazil

Directory of Open Access Journals (Sweden)

Halila GC

2015-12-01

Full Text Available Background: In order to provide appropriate advice to the patient at the time of dispensing and over-the-counter (OTC medication counseling, community pharmacists need access to current and reliable information about medicines. Brazilian pharmacists have assumed new functions such as prescribing medication, in a dependent model, based in protocols. Objective: To examine the practice of community pharmacists in a Brazilian State, focusing on OTC recommendation. Method: A cross-sectional survey of community pharmacists in a state of Brazil was conducted from October 2013 to January 2014, with data collection through a pre-piloted self-administered anonymous survey via Survey Monkey® platform. Following ethical approval, the online instrument was sent to 8,885 pharmacists registered in Parana State, Brazil, focusing on professionals working in community pharmacies. The questionnaire assessed the community pharmacy setting, the search for information, the knowledge of the evidence-based practice, the important factors to consider when recommending an OTC medicine, and the pharmacist prescribing. Responses were imported into SPSS® (version 22.0 for analysis. Nonparametric tests were used to assess the association between responses and demographic information with a significance level less than 5% (p<0.05. Results: Of the pharmacists, 97.4% dispensed medications and counseled patients for a median of six hours per day. Product's efficacy (97% and adverse effects (62.3% were the most important factors taken into account when counseling a nonprescription medicine. Few pharmacists knew the meaning of terms related to evidence-based health. Most respondents agreed that pharmacists have the necessary training to prescribe. Conclusion: Over-the-counter medication counseling is a daily practice among Brazilian pharmacists. Learning needs exist for community pharmacists in relation to evidence-based practice. Thus, sources of information with good evidence

Science, policy, and stakeholders: developing a consensus science plan for Amchitka Island, Aleutians, Alaska.

Science.gov (United States)

Burger, Joanna; Gochfeld, Michael; Kosson, David S; Powers, Charles W; Friedlander, Barry; Eichelberger, John; Barnes, David; Duffy, Lawrence K; Jewett, Stephen C; Volz, Conrad D

2005-05-01

trustees (U S Fish and Wildlife Service), representatives of the Aleut and Pribilof Island communities, and other stakeholders was essential for plan development and approval, although this created tensions because of the different objectives of each group. The complicated process of developing a Science Plan involved iterations and interactions with multiple agencies and organizations, scientists in several disciplines, regulators, and the participation of Aleut people in their home communities, as well as the general public. The importance of including all parties in all phases of the development of the Science Plan was critical to its acceptance by a broad range of regulators, agencies, resource trustees, Aleutian/Pribilof communities, and other stakeholders.

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...

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.

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.

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

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

Service functions of private community health stations in China: A comparison analysis with government-sponsored community health stations.

Science.gov (United States)

Hou, Wanli; Fan, Hong; Xu, Jing; Wang, Fang; Chai, Yun; Xu, Hancheng; Li, Yongbin; Liu, Liqun; Wang, Bin; Jin, Jianqiang; Lu, Zuxun

2012-04-01

In China, with the restructuring of health care system moving forward, private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical care services in urban areas. However, only limited evidence is available concerning the service functions of private community health facilities in China. The aim of this study was to explore the functions of private community health stations (PCHSs) to provide evidence-based recommendations for policy-making and practice in the development of urban community health services systems. A total of 818 PCHSs and 4320 government-sponsored community health stations (GCHSs) located in 28 cities of China were investigated in 2008. The percentages of stations that provided health services and the annual workload per community health worker (CHW) were compared between the two types of institutions. The results showed that the percentages of PCHSs providing public health services were significantly higher than those of GCHSs (P0.05). The annual workloads of all the public health services and basic medical services per CHW in PCHSs were lighter than those in GCHSs (P0.05). At present, the GCHSs are still the mainstream in urban China, which will last for a long period in future. However, our findings showed that the annual workloads of CHWs in PCHSs were no heavier than those in GCHSs, and the PCHSs were willing to provide public health services. In view of current inadequacy of health resources in China, it is feasible to further develop PCHSs under the guidance of the government, given that PCHSs can perform the basic functions of community health services, which is useful for the formation of public-private partnerships (PPP) and the improvement of community health services.

Supporting the spread of health technology in community services.

Science.gov (United States)

Sitton-Kent, Lucy; Humphreys, Catriona; Miller, Phillip

2018-03-02

Health technology has been proposed as a route to financial savings and improved patient safety for many years within the NHS. Nurses have a key role to play in transforming care through such technology but, despite high-level endorsement, implementation of health technology has been uneven across NHS community services. This article looks at three promising applications of health technology in community nursing: mobile access to digital care records; digital imaging; and remote face-to-face consultations. Current evidence for these technologies gives some indication of what is required before health technologies can benefit patients. Rapidly changing health technologies make it difficult for community services to make fully informed decisions when implementing them. There are challenges in predicting the full financial and efficiency impacts, in making robust estimates of costs and workload implications and in anticipating the effects on patient care and staff experience. Despite these problems, there is mounting evidence of the benefits of technological innovations available to community nurses and their patients.

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.

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…

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.

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…

Engaging community organizations in falls prevention for older adults: Moving from research to action.

Science.gov (United States)

Markle-Reid, Maureen F; Dykeman, Catherine S; Reimer, Holly D; Boratto, Lorna J; Goodall, Carol E; McGugan, Jennifer L

2015-04-29

Falls prevention (FP) evidence abounds but falls rates remain relatively unaffected. This study aimed to explore community service providers' use of evidence-based FP interventions, attitudes toward implementation, knowledge and capacity for FP engagement, collaboration in FP, and organizational readiness to implement evidence. To our knowledge, this is the first study exploring the potential for broader integration of FP throughout communities. A purposive sampling of providers (n = 84), in varied roles within diverse senior-serving community organizations (both health and non-health sectors) across disparate geographies, completed a structured survey as part of a larger mixed methods study. Nearly all (90%) reported already implementing at least one evidence-based FP practice. The majority indicated that falls were preventable (82%) and a top concern for older adults (75%), and that FP would be beneficial to their clients (75%). There were, however, notable differences between health and non-health sectors in their: confidence in providing FP activities (86% vs. 47%), desire for future collaboration (86% vs. 56%) and already knowing how best to provide FP activities (49% vs. 36%). Only some (21%) perceived that staff to a great extent had the necessary knowledge and skills, and few (10%) perceived that available resources could support FP activities. Community service providers generally supported FP, but resources limited implementation, particularly in non-health sectors. Translating FP evidence to better fit community settings, and fostering collaboration to bridge resource gaps, suggest a public health role in the broader integration of FP within and across community sectors.

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

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

When There Is Not Enough Evidence and When Evidence Is Not Enough: An Australian Indigenous Smoking Policy Study.

Science.gov (United States)

Vujcich, Daniel; Rayner, Mike; Allender, Steven; Fitzpatrick, Ray

2016-01-01

The Indigenous Tobacco Control Initiative and Tackling Indigenous Smoking Measure were both announced by the Australian Government at a time when its rhetoric around the importance of evidence-based policy making was strong. This article will (1) examine how the Rudd Government used evidence in Indigenous tobacco control policy making and (2) explore the facilitators of and barriers to the use of evidence. Data were collected through (1) a review of primary documents largely obtained under the Freedom of Information Act 1982 (Commonwealth of Australia) and (2) interviews with senior politicians, senior bureaucrats, government advisors, Indigenous health advocates, and academics. Through the Freedom of Information Act process, 24 previously undisclosed government documents relevant to the making of Indigenous tobacco control policies were identified. Interviewees ( n  = 31, response rate 62%) were identified through both purposive and snowball recruitment strategies. The Framework Analysis method was used to analyze documentary and interview data. Government policy design was heavily influenced by the recommendations presented in government authored/commissioned literature reviews. Resulting policies were led by equivocal evidence for improved tobacco control outcomes among Indigenous Australians. Many of the cited studies had methodological limitations. In the absence of high-quality evidence, some policy makers supported policy recommendations that were perceived to be popular among the Indigenous community. Other policy makers recognized that there were barriers to accumulating rigorous, generalizable evidence; in the absence of such evidence, the policy makers considered that the "need for action" could be combined with the "need for research" by introducing innovative strategies and evaluating them. Despite the absence of high-quality evidence, the formulation and adoption of Indigenous tobacco policy was neither irrational nor reckless. The decision to

Building a Community-Academic Partnership: Implementing a Community-Based Trial of Telephone Cognitive Behavioral Therapy for Rural Latinos

Directory of Open Access Journals (Sweden)

Eugene Aisenberg

2012-01-01

Full Text Available Concerns about the appropriate use of EBP with ethnic minority clients and the ability of community agencies to implement and sustain EBP persist and emphasize the need for community-academic research partnerships that can be used to develop, adapt, and test culturally responsive EBP in community settings. In this paper, we describe the processes of developing a community-academic partnership that implemented and pilot tested an evidence-based telephone cognitive behavioral therapy program. Originally demonstrated to be effective for urban, middle-income, English-speaking primary care patients with major depression, the program was adapted and pilot tested for use with rural, uninsured, low-income, Latino (primarily Spanish-speaking primary care patients with major depressive disorder in a primary care site in a community health center in rural Eastern Washington. The values of community-based participatory research and community-partnered participatory research informed each phase of this randomized clinical trial and the development of a community-academic partnership. Information regarding this partnership may guide future community practice, research, implementation, and workforce development efforts to address mental health disparities by implementing culturally tailored EBP in underserved communities.

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.

Family intervention in Indigenous communities: emergent issues in conducting outcome research.

Science.gov (United States)

Turner, Karen; Sanders, Matthew

2007-01-01

Indigenous children and youth are at greater risk of emotional and behavioural problems than non-Indigenous youth, with family life stresses and parenting style identified as common risk factors. There is substantial evidence that parenting programs can improve family relationships and improve child outcomes, however little research has focused on Indigenous communities. Our team is conducting research to evaluate a culturally sensitive adaptation of a mainstream intervention, the Group Triple P---Positive Parenting Program, for Indigenous families. This paper shares some of the insights into research and clinical issues gained as non-Indigenous researchers working with urban, rural and remote Indigenous communities. The experience of the research team and feedback from practitioners and parents have been drawn on for this discussion. Parenting programs need to be sensitive to the political and cultural context in which parenting takes place, flexibly incorporate cultural practices and expectations, and develop an evidence base of outcomes for families in diverse communities. As research is needed to evaluate the acceptability and effectiveness of these programs, culturally sensitive research practices are also necessary and the value of program evaluation and its benefit to the community must be clear. Community acceptance of the research process and the intervention itself is vital and may be influenced by community perceptions, current priorities, and local issues. If our overall aim is to increase the skilled health and mental health workforce in Indigenous communities and their use of evidence-based interventions, ongoing collaborative relationships between research institutions and service providers will serve to further this aim.

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.

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

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.

The factors controlling species density in herbaceous plant communities: An assessment

Science.gov (United States)

Grace, J.B.

1999-01-01

This paper evaluates both the ideas and empirical evidence pertaining to the control of species density in herbaceous plant communities. While most theoretical discussions of species density have emphasized the importance of habitat productivity and disturbance regimes, many other factors (e.g. species pools, plant litter accumulation, plant morphology) have been proposed to be important. A review of literature presenting observations on the density of species in small plots (in the vicinity of a few square meters or less), as well as experimental studies, suggests several generalizations: (1) Available data are consistent with an underlying unimodal relationship between species density and total community biomass. While variance in species density is often poorly explained by predictor variables, there is strong evidence that high levels of community biomass are antagonistic to high species density. (2) Community biomass is just one of several factors affecting variations in species density. Multivariate analyses typically explain more than twice as much variance in species density as can be explained by community biomass alone. (3) Disturbance has important and sometimes complex effects on species density. In general, the evidence is consistent with the intermediate disturbance hypothesis but exceptions exist and effects can be complex. (4) Gradients in the species pool can have important influences on patterns of species density. Evidence is mounting that a considerable amount of the observed variability in species density within a landscape or region may result from environmental effects on the species pool. (5) Several additional factors deserve greater consideration, including time lags, species composition, plant morphology, plant density and soil microbial effects. Based on the available evidence, a conceptual model of the primary factors controlling species density is presented here. This model suggests that species density is controlled by the effects of

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…

Teen Pregnancy Prevention: Implementation of a Multicomponent, Community-Wide Approach.

Science.gov (United States)

Mueller, Trisha; Tevendale, Heather D; Fuller, Taleria R; House, L Duane; Romero, Lisa M; Brittain, Anna; Varanasi, Bala

2017-03-01

This article provides an overview and description of implementation activities of the multicomponent, community-wide initiatives of the Teenage Pregnancy Prevention Program initiated in 2010 by the Office of Adolescent Health and the Centers for Disease Control and Prevention. The community-wide initiatives applied the Interactive Systems Framework for dissemination and implementation through training and technical assistance on the key elements of the initiative: implementation of evidence-based teen pregnancy prevention (TPP) interventions; enhancing quality of and access to youth-friendly reproductive health services; educating stakeholders about TPP; working with youth in communities most at risk of teen pregnancy; and mobilizing the community to garner support. Of nearly 12,000 hours of training and technical assistance provided, the majority was for selecting, implementing, and evaluating an evidence-based TPP program. Real-world implementation of a community-wide approach to TPP takes time and effort. This report describes implementation within each of the components and shares lessons learned during planning and implementation phases of the initiative. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

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.

Protective Factors for Youth Exposed to Violence in Their Communities: A Review of Family, School, and Community Moderators.

Science.gov (United States)

Ozer, Emily J; Lavi, Iris; Douglas, Laura; Wolf, Jennifer Price

2017-01-01

This review provides a comprehensive investigation of the pattern and strength of findings in the literature regarding the environmental moderators of the relationship between exposure to community violence and mental health among children and adolescents. Twenty-nine studies met criteria for inclusion in our analysis of family, school, and community variables as moderators. Dependent variables included internalizing (e.g., anxiety, depression, posttraumatic stress disorder) and externalizing symptoms (e.g., aggression, substance use). Effect sizes for the interactions of exposure to violence and potential moderators were summarized by their patterns of protective processes. The majority of studies in the literature examined family characteristics as moderators of the exposure to violence-symptom relationship, rather than school- or community-level factors. Our results indicated more consistent patterns for (a) close family relationships and social support for internalizing symptoms and (b) close family relationships for externalizing symptoms. Overall, the most common type of protective pattern was protective-stabilizing, in which youth with higher levels of the environmental attribute demonstrate relative stability in mental health despite exposure to violence. We found no consistent evidence that parental monitoring-a dimension inversely associated with exposure to violence in prior studies-moderated the relationship between exposure to violence and symptoms. The study emphasizes the importance of strengthening family support for young people's exposure to community violence; more research is needed to provide a solid evidence base for the role of school and community-level protective factors for youth exposed to violence.

A knowledge translation project on community-centred approaches in public health.

Science.gov (United States)

Stansfield, J; South, J

2018-03-01

This article examines the development and impact of a national knowledge translation project aimed at improving access to evidence and learning on community-centred approaches for health and wellbeing. Structural changes in the English health system meant that knowledge on community engagement was becoming lost and a fragmented evidence base was seen to impact negatively on policy and practice. A partnership started between Public Health England, NHS England and Leeds Beckett University in 2014 to address these issues. Following a literature review and stakeholder consultation, evidence was published in a national guide to community-centred approaches. This was followed by a programme of work to translate the evidence into national strategy and local practice.The article outlines the key features of the knowledge translation framework developed. Results include positive impacts on local practice and national policy, for example adoption within National Institute for Health and Care Evidence (NICE) guidance and Local Authority public health plans and utilization as a tool for local audit of practice and commissioning. The framework was successful in its non-linear approach to knowledge translation across a range of inter-connected activity, built on national leadership, knowledge brokerage, coalition building and a strong collaboration between research institute and government agency.

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.

Community health workers and mobile technology: a systematic review of the literature.

Science.gov (United States)

Braun, Rebecca; Catalani, Caricia; Wimbush, Julian; Israelski, Dennis

2013-01-01

In low-resource settings, community health workers are frontline providers who shoulder the health service delivery burden. Increasingly, mobile technologies are developed, tested, and deployed with community health workers to facilitate tasks and improve outcomes. We reviewed the evidence for the use of mobile technology by community health workers to identify opportunities and challenges for strengthening health systems in resource-constrained settings. We conducted a systematic review of peer-reviewed literature from health, medical, social science, and engineering databases, using PRISMA guidelines. We identified a total of 25 unique full-text research articles on community health workers and their use of mobile technology for the delivery of health services. Community health workers have used mobile tools to advance a broad range of health aims throughout the globe, particularly maternal and child health, HIV/AIDS, and sexual and reproductive health. Most commonly, community health workers use mobile technology to collect field-based health data, receive alerts and reminders, facilitate health education sessions, and conduct person-to-person communication. Programmatic efforts to strengthen health service delivery focus on improving adherence to standards and guidelines, community education and training, and programmatic leadership and management practices. Those studies that evaluated program outcomes provided some evidence that mobile tools help community health workers to improve the quality of care provided, efficiency of services, and capacity for program monitoring. Evidence suggests mobile technology presents promising opportunities to improve the range and quality of services provided by community health workers. Small-scale efforts, pilot projects, and preliminary descriptive studies are increasing, and there is a trend toward using feasible and acceptable interventions that lead to positive program outcomes through operational improvements and

Community health workers and mobile technology: a systematic review of the literature.

Directory of Open Access Journals (Sweden)

Rebecca Braun

Full Text Available In low-resource settings, community health workers are frontline providers who shoulder the health service delivery burden. Increasingly, mobile technologies are developed, tested, and deployed with community health workers to facilitate tasks and improve outcomes. We reviewed the evidence for the use of mobile technology by community health workers to identify opportunities and challenges for strengthening health systems in resource-constrained settings.We conducted a systematic review of peer-reviewed literature from health, medical, social science, and engineering databases, using PRISMA guidelines. We identified a total of 25 unique full-text research articles on community health workers and their use of mobile technology for the delivery of health services.Community health workers have used mobile tools to advance a broad range of health aims throughout the globe, particularly maternal and child health, HIV/AIDS, and sexual and reproductive health. Most commonly, community health workers use mobile technology to collect field-based health data, receive alerts and reminders, facilitate health education sessions, and conduct person-to-person communication. Programmatic efforts to strengthen health service delivery focus on improving adherence to standards and guidelines, community education and training, and programmatic leadership and management practices. Those studies that evaluated program outcomes provided some evidence that mobile tools help community health workers to improve the quality of care provided, efficiency of services, and capacity for program monitoring.Evidence suggests mobile technology presents promising opportunities to improve the range and quality of services provided by community health workers. Small-scale efforts, pilot projects, and preliminary descriptive studies are increasing, and there is a trend toward using feasible and acceptable interventions that lead to positive program outcomes through operational

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...

Filling the implementation gap: a community-academic partnership approach to early intervention in psychosis.

Science.gov (United States)

Hardy, Kate V; Moore, Melissa; Rose, Demian; Bennett, Robert; Jackson-Lane, Carletta; Gause, Michael; Jackson, Alma; Loewy, Rachel

2011-11-01

The aim of this study was to describe the development of a sustainable community early psychosis programme created through an academic-community partnership in the United States to other parties interested in implementing early psychosis services founded upon evidence-based practices within community settings. The service was developed around a sustainable core of key components, founded upon evidence-based practice, with additional flexible elements that could be adapted to the needs of the individual commissioning county. This paper describes the ways in which funding was sourced and secured as well as the partnerships developed through this process. Successful development of the Prevention and Recovery from Early Psychosis (PREP) programme in San Francisco County, California. PREP clinicians have received extensive training in the evidence-based approaches that are available through the programme and treated 30 clients and their families in the first year of operation. Development of a sustainable community programme of this type in a non-universal health-care setting, which is historically seen as non-integrated, required extensive partnering with agencies familiar with local resources. Implementation of the community-academic partnership bridged the gap between research and practice with successful integration of fidelity practice at the community level. The community partners were effective in sourcing funding and allocating resources, while the academic side of the partnership provided training in evidence-based models and oversight of clinical implementation of the model. Stringent evaluation of the impact of the service is our next focus. © 2011 Blackwell Publishing Asia Pty Ltd.

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

Marketing activity in the community pharmacy sector - A scoping review.

Science.gov (United States)

Mirzaei, Ardalan; Carter, Stephen R; Schneider, Carl R

2018-02-01

Community pharmacy ownership requires engaging with marketing strategies to influence consumer behaviour. There is a plethora of information from trade journals, expert opinion, and published discussion surrounding this issue. Despite this, evidence relating to the efficacy of marketing activity within the pharmacy sector is scant. To review how marketing activity has been conceptualised in the community pharmacy sector and to determine the evidence for the effect of marketing activity. Seven databases were systematically searched using a scoping review framework with the reporting protocol of PRISMA-P. The search yielded 33 studies that were analysed for year of publication, journal, country of focus, and framework of marketing. The majority of marketing research papers focused on the United States and were published in healthcare journals. These were various marketing strategy elements, including; segmentation, targeting, differentiation, and positioning. Also evident was research regarding marketing mix, which predominately involved the "4Ps" model. Actual marketing activity comprised little of the research. Research into marketing activity in community pharmacy is limited, and little evidence is available to show the effects of such activities. Future research needs to demonstrate the causality for the effect of marketing activities on consumer behaviour and economic outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

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,…

Promoting Community Conversations About Research to End Suicide: learning and behavioural outcomes of a training-of-trainers model to facilitate grassroots community health education to address Indigenous youth suicide prevention.

Science.gov (United States)

Wexler, Lisa; Trout, Lucas; Rataj, Suzanne; Kirk, Tanya; Moto, Roberta; McEachern, Diane

2017-01-01

Alaska Native (AN) youth suicide remains a substantial and recalcitrant health disparity, especially in rural/remote communities. Promoting Community Conversations About Research to End Suicide (PC CARES) is a community health intervention that responds to the need for culturally responsive and evidence-supported prevention practice, using a grassroots approach to spark multilevel and community-based efforts for suicide prevention. This paper describes theoretical and practical considerations of the approach, and assesses the feasibility and preliminary learning and behavioural outcomes of the training-of-trainers model. It details the training of a first cohort of intervention facilitators in Northwest Alaska (NWA). Thirty-two people from 11 NWA village communities completed the PC CARES facilitator training, preparing them to implement the intervention in their home communities. Facilitator pre-post surveys focused on readiness to facilitate, a group quiz assessed participants' understanding of relevant research evidence, and practice facilitation exercises demonstrated competency. Curriculum fidelity and accuracy scores were calculated using audio recordings from learning circles conducted by facilitators in their home communities. Facilitator reflections describe the successes of the model and identify several areas for improvement. As of March 2017, 20 of the 32 trained facilitators in 10 of the 11 participating villages have hosted 54 LCs, with a total of 309 unique community members. Coding of these LCs by 2 independent raters indicate acceptable levels of fidelity and accurate dissemination of research evidence by facilitators. Facilitator reflections were positive overall, suggesting PC CARES is feasible, acceptable and potentially impactful as a way to translate research to practice in under-resourced, rural AN communities. PC CARES represents a practical community education and mobilisation approach to Indigenous youth suicide prevention that displays

The role of content marketing in social media content communities

Directory of Open Access Journals (Sweden)

Charmaine du Plessis

2017-10-01

Full Text Available Background: Content marketing has become a leading marketing technique in digital marketing communication and uses the point of view of consumers to build relationships by creating and sharing engaging content in social media that enhance their daily lives. Existing research on social media communities has focused mainly on social media marketing and virtual brand community perspectives while content marketing’s valuable and unobtrusive role in social media content communities has largely been overlooked. Objective: The purpose of this article was to investigate content marketing’s role in social media content communities to engage with the target audience in an innate manner. Method: This study made use of a directed, inductive content analysis of 51 practitioner documents relating to business-to-consumer content marketing practices to add another perspective to existing research on communities in social media. The content analysis was facilitated by using QDA Miner, a widely adopted and reliable qualitative data analysis software programme. Results: Three categories emerged from the data namely building content communities, platform-specific content and understanding channels. These categories provide sufficient evidence of how brands make use of social media content communities to connect with the target audience in an unobtrusive manner, in addition to being present in virtual brand communities. Conclusion: The findings make several contributions to the existing literature. Firstly, it provides a clearer distinction between brand and social media content communities. Secondly, it extends conceptions about social media communities to include content communities and, thirdly, it provides sufficient evidence of how content marketing could benefit a brand by naturally becoming part of social media conversations.

The roles of community pharmacists in cardiovascular disease prevention and management

Directory of Open Access Journals (Sweden)

George J

2011-05-01

Full Text Available There is ample evidence in the international literature forpharmacist involvement in the prevention and managementof cardiovascular disease (CVD conditions in primary care.Systematic reviews and meta-analyses have confirmed thesignificant clinical benefits of pharmacist interventions for arange of CVD conditions and risk factors. Evidence generatedin research studies of Australian community pharmacistinvolvement in CVD prevention and management issummarised in this article.Commonwealth funding through the Community PharmacyAgreements has facilitated research to establish the feasibilityand effectiveness of new models of primary care involvingcommunity pharmacists. Australian community pharmacistshave been shown to effect positive clinical, humanistic andeconomic outcomes in patients with CVD conditions.Improvements in blood pressure, lipid levels, medicationadherence and CVD risk have been demonstrated usingdifferent study designs. Satisfaction for GPs, pharmacists andconsumers has also been reported. Perceived ‘turf’encroachment, expertise of the pharmacist, space, time andremuneration are challenges to the implementation of diseasemanagement services involving community pharmacists.

Social Anthropological Considerations on the Predictability and Unpredictability of Community Outcomes

Science.gov (United States)

Smith, Gregory O.

This chapter surveys community process in a circumscribed area of central Italy in a comparative effort to show how simple quantitative methods can provide insights into the nature of community constitution. It is evident that individual and psychological processes are rooted in community experience, and in order to have a fuller understanding of the various system levels discussed in this volume, it is valuable also to have some insights into the organizational dynamics of localized communities.

Dietary inequalities: what is the evidence for the effect of the neighbourhood food environment?

Science.gov (United States)

Black, Christina; Moon, Graham; Baird, Janis

2016-01-01

This review summarises the evidence for inequalities in community and consumer nutrition environments from ten previous review articles, and also assesses the evidence for the effect of the community and consumer nutrition environments on dietary intake. There is evidence for inequalities in food access in the US but trends are less apparent in other developed countries. There is a trend for greater access and availability to healthy and less healthy foods relating to better and poorer dietary outcomes respectively. Trends for price show that higher prices of healthy foods are associated with better dietary outcomes. More nuanced measures of the food environment, including multi-dimensional and individualised approaches, would enhance the state of the evidence and help inform future interventions. PMID:24200470

Strategies of Building a Stronger Sense of Community for Sustainable Neighborhoods: Comparing Neighborhood Accessibility with Community Empowerment Programs

Directory of Open Access Journals (Sweden)

Te-I Albert Tsai

2014-05-01

Full Text Available New Urbanist development in the U.S. aims at enhancing a sense of community and seeks to return to the design of early transitional neighborhoods which have pedestrian-oriented environments with retail shops and services within walking distances of housing. Meanwhile, 6000 of Taiwan’s community associations have been running community empowerment programs supported by the Council for Cultural Affairs that have helped many neighborhoods to rebuild so-called community cohesion. This research attempts to evaluate whether neighborhoods with facilities near housing and shorter travel distances within a neighborhood would promote stronger social interactions and form a better community attachment than neighborhoods that have various opportunities for residents to participate in either formal or informal social gatherings. After interviewing and surveying residents from 19 neighborhoods in Taipei’s Beitou District, and correlating the psychological sense of community with inner neighborhood’s daily travel distances and numbers of participatory activities held by community organizations under empowerment programs together with frequencies of regular individual visits and casual meetings, statistical evidence yielded that placing public facilities near residential locations is more effective than providing various programs for elevating a sense of community.

Antibiotic misuse in the community--a contributor to resistance?

LENUS (Irish Health Repository)

Carey, B

2012-02-03

The problem of antibiotic resistance is associated with the indiscriminate usage of antibiotics. Efforts have been directed at encouraging the rational use of these drugs to reduce the volume of antibiotic consumption and decrease resistance rates. There is evidence to suggest that the misuse of antibiotics by patients may also contribute to the problem. We describe a survey of a random selection of patients attending a General Practitioners\\' surgery over a six week period in an effort to estimate the level of non-compliance to antibiotic therapy in the community. The results suggest that there may be a significant level of antibiotic misuse prevalent in the local community. We discuss these results and present evidence in the literature suggesting how antibiotic misuse may affect resistance in the community. The factors affecting patient compliance to therapy are outlined along with suggested measures to improve compliance among patients.

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

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.

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.

Asthma in the community: Designing instruction to help students explore scientific dilemmas that impact their lives

Science.gov (United States)

Tate, Erika Dawn

School science instruction that connects to students' diverse home, cultural, or linguistic experiences can encourage lifelong participation in the scientific dilemmas that impact students' lives. This dissertation seeks effective ways to support high school students as they learn complex science topics and use their knowledge to transform their personal and community environments. Applying the knowledge integration perspective, I collaborated with education, science, and community partners to design a technology enhanced science module, Improving Your Community's Asthma Problem. This exemplar community science curriculum afforded students the opportunity to (a) investigate a local community health issue, (b) interact with relevant evidence related to physiology, clinical management, and environmental risks, and (c) construct an integrated understanding of the asthma problem in their community. To identify effective instructional scaffolds that engage students in the knowledge integration process and prepare them to participate in community science, I conducted 2 years of research that included 5 schools, 10 teachers, and over 500 students. This dissertation reports on four studies that analyzed student responses on pre-, post-, and embedded assessments. Researching across four design stages, the iterative design study investigated how to best embed the visualizations of the physiological processes breathing, asthma attack, and the allergic immune response in an inquiry activity and informed evidence-based revisions to the module. The evaluation study investigated the impact of this revised Asthma module across multiple classrooms and differences in students' prior knowledge. Combining evidence of student learning from the iterative and evaluation studies with classroom observations and teacher interviews, the longitudinal study explored the impact of teacher practices on student learning in years 1 and 2. In the final chapter, I studied how the Asthma module and

When There is Not Enough Evidence and When Evidence is Not Enough: An Australian Indigenous Smoking Policy Study

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Daniel Vujcich

2016-10-01

Full Text Available BACKGROUND: The Indigenous Tobacco Control Initiative and Tackling Indigenous Smoking Measure were both announced by the Australian Government at a time when its rhetoric around the importance of evidence-based policy making was strong. This article will (1 examine how the Rudd Government used evidence in Indigenous tobacco control policy making and (2 explore the facilitators of and barriers to the use of evidence. METHODS: Data were collected through: (1 a review of primary documents largely obtained under the Freedom of Information Act 1982 (Commonwealth of Australia and (2 interviews with senior politicians, senior bureaucrats, government advisors, Indigenous health advocates and academics. Through the Freedom of Information Act process, 24 previously undisclosed government documents relevant to the making of Indigenous tobacco control policies were identified. Interviewees (n=31, response rate 62% were identified through both purposive and snowball recruitment strategies. The Framework Analysis method was used to analyse documentary and interview data.RESULTS: Government policy design was heavily influenced by recommendations presented in government authored/commissioned literature reviews. Resulting policies were led by equivocal evidence for improved tobacco control outcomes among Indigenous Australians. Many of the cited studies had methodological limitations. In the absence of high quality evidence, some policy makers supported policy recommendations that were perceived to be popular among the Indigenous community. Other policy makers recognised that there were barriers to accumulating rigorous, generalizable evidence; in the absence of such evidence, the policy makers considered that the ‘need for action’ could be combined with the ‘need for research’ by introducing innovative strategies and evaluating them.DISCUSSION: Despite the absence of high quality evidence, the formulation and adoption of Indigenous Tobacco policy was

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

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

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

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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.

Reflection: Working Toward Peaceful, Healthy Communities

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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.

Preventing adolescent suicide: a community takes action.

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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.

Short-term hurricane impacts on a neotropical community of marked birds and implications for early-stage community resilience.

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Johnson, Andrew B; Winker, Kevin

2010-11-30

Populations in fragmented ecosystems risk extirpation through natural disasters, which must be endured rather than avoided. Managing communities for resilience is thus critical, but details are sketchy about the capacity for resilience and its associated properties in vertebrate communities. We studied short-term resilience in a community of individually marked birds, following this community through the catastrophic destruction of its forest habitat by Hurricane Iris in Belize, Central America. We sampled for 58 d immediately before the storm, 28 d beginning 11 d after Hurricane Iris, and for 69 d approximately one year later. Our data showed that the initial capacity for resilience was strong. Many banded individuals remained after the storm, although lower post-hurricane recapture rates revealed increased turnover among individuals. Changes occurred in community dynamics and in abundances among species and guilds. Survivors and immigrants both were critical components of resilience, but in a heterogeneous, species-specific manner. Delayed effects, including higher fat storage and increased species losses, were evident one year later.

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

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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"…

When will community management conserve biodiversity? Evidence from Malawi

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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

Dietary inequalities: what is the evidence for the effect of the neighbourhood food environment?

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Black, Christina; Moon, Graham; Baird, Janis

2014-05-01

This review summarises the evidence for inequalities in community and consumer nutrition environments from ten previous review articles, and also assesses the evidence for the effect of the community and consumer nutrition environments on dietary intake. There is evidence for inequalities in food access in the US but trends are less apparent in other developed countries. There is a trend for greater access and availability to healthy and less healthy foods relating to better and poorer dietary outcomes respectively. Trends for price show that higher prices of healthy foods are associated with better dietary outcomes. More nuanced measures of the food environment, including multidimensional and individualised approaches, would enhance the state of the evidence and help inform future interventions. © 2013 The Authors. Published by Elsevier Ltd All rights reserved.

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

Quantitative phylogenetic assessment of microbial communities indiverse environments

Energy Technology Data Exchange (ETDEWEB)

von Mering, C.; Hugenholtz, P.; Raes, J.; Tringe, S.G.; Doerks,T.; Jensen, L.J.; Ward, N.; Bork, P.

2007-01-01

The taxonomic composition of environmental communities is an important indicator of their ecology and function. Here, we use a set of protein-coding marker genes, extracted from large-scale environmental shotgun sequencing data, to provide a more direct, quantitative and accurate picture of community composition than traditional rRNA-based approaches using polymerase chain reaction (PCR). By mapping marker genes from four diverse environmental data sets onto a reference species phylogeny, we show that certain communities evolve faster than others, determine preferred habitats for entire microbial clades, and provide evidence that such habitat preferences are often remarkably stable over time.

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…

Promoting evidence-based practice in pharmacies.

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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.

Constructing "Packages" of Evidence-Based Programs to Prevent Youth Violence: Processes and Illustrative Examples From the CDC's Youth Violence Prevention Centers.

Science.gov (United States)

Kingston, Beverly; Bacallao, Martica; Smokowski, Paul; Sullivan, Terri; Sutherland, Kevin

2016-04-01

This paper describes the strategic efforts of six National Centers of Excellence in Youth Violence Prevention (YVPC), funded by the U.S. Centers for Disease Control and Prevention, to work in partnership with local communities to create comprehensive evidence-based program packages to prevent youth violence. Key components of a comprehensive evidence-based approach are defined and examples are provided from a variety of community settings (rural and urban) across the nation that illustrate attempts to respond to the unique needs of the communities while maintaining a focus on evidence-based programming and practices. At each YVPC site, the process of selecting prevention and intervention programs addressed the following factors: (1) community capacity, (2) researcher and community roles in selecting programs, (3) use of data in decision-making related to program selection, and (4) reach, resources, and dosage. We describe systemic barriers to these efforts, lessons learned, and opportunities for policy and practice. Although adopting an evidence-based comprehensive approach requires significant upfront resources and investment, it offers great potential for preventing youth violence and promoting the successful development of children, families and communities.

Alcohol and Substance Use in the Jewish Community: A Pilot Study

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Melanie Baruch

2015-01-01

Full Text Available Awareness of addictions in the Jewish community is becoming increasingly prevalent, and yet, a gap exists in the literature regarding addictions in this community. Knowledge about the prevalence of addictions within Jewish communities is limited; some believe that Jews cannot be affected by addictions. To address this gap, a pilot study was conducted to gather preliminary evidence relating to addictions and substance use in the Jewish community. Results indicate that a significant portion of the Jewish community knows someone affected by an addiction and that over 20% have a family history of addiction. Future research needs are discussed.

Secondary Infections with Ebola Virus in Rural Communities, Liberia and Guinea, 2014-2015.

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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.

Contrasting responses of insect communities to grazing intensity in lowland heathlands

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Wallis de Vries, Michiel; Noordijk, Jinze; Colijn, Ed O.; Smit, John T.; Veling, Kars

2016-01-01

Grazing at low stocking rates is often recommended for the preservation of the characteristic biodiversity of open landscapes. However, the fine-tuning of grazing management still lacks a good evidence base. This is particularly true for insect communities, as available evidence indicates that

HRET patient safety leadership fellowship: the role of "community" in patient safety.

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Leonhardt, Kathryn Kraft

2010-01-01

Community engagement is widely endorsed but poorly defined as a strategy to improve patient safety. With strong evidence that engaging patients can positively influence health outcomes, it is presumed that community engagement could improve patient safety. Leaning on the models from other disciplines such as public health, the adequate knowledge and application of the principles of community engagement are critical for this approach to be effective. This article provides a description of the theories supporting patient partnership and community engagement, reviews critical elements of successful community-based programs, and identifies the potential for empowering communities to improve patient safety.

Ambivalence about supervised injection facilities among community stakeholders.

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Strike, Carol; Watson, Tara Marie; Kolla, Gillian; Penn, Rebecca; Bayoumi, Ahmed M

2015-08-21

Community stakeholders express a range of opinions about supervised injection facilities (SIFs). We sought to identify reasons for ambivalence about SIFs amongst community stakeholders in two Canadian cities. We used purposive sampling methods to recruit various stakeholder representatives (n = 141) for key informant interviews or focus group discussions. Data were analyzed using a thematic process. We identified seven reasons for ambivalence about SIFs: lack of personal knowledge of evidence about SIFs; concern that SIF goals are too narrow and the need for a comprehensive response to drug use; uncertainty that the community drug problem is large enough to warrant a SIF(s); the need to know more about the "right" places to locate a SIF(s) to avoid damaging communities or businesses; worry that a SIF(s) will renew problems that existed prior to gentrification; concern that resources for drug use prevention and treatment efforts will be diverted to pay for a SIF(s); and concern that SIF implementation must include evaluation, community consultation, and an explicit commitment to discontinue a SIF(s) in the event of adverse outcomes. Stakeholders desire evidence about potential SIF impacts relevant to local contexts and that addresses perceived potential harms. Stakeholders would also like to see SIFs situated within a comprehensive response to drug use. Future research should determine the relative importance of these concerns and optimal approaches to address them to help guide decision-making about SIFs.

What Can Be Done about School Shootings? A Review of the Evidence

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Borum, Randy; Cornell, Dewey G.; Modzeleski, William; Jimerson, Shane R.

2010-01-01

School shootings have generated great public concern and fostered a widespread impression that schools are unsafe for many students; this article counters those misapprehensions by examining empirical evidence of school and community violence trends and reviewing evidence on best practices for preventing school shootings. Many of the school safety…

Brookings supports breastfeeding: using public deliberation as a community-engaged approach to dissemination of research.

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Anderson, Jenn; Kuehl, Rebecca A; Mehltretter Drury, Sara A; Tschetter, Lois; Schwaegerl, Mary; Yoder, Julia; Gullickson, Heidi; Lamp, Jamison; Bachman, Charlotte; Hildreth, Marilyn

2017-12-01

Empirical evidence demonstrates myriad benefits of breastfeeding for mother and child, along with benefits to businesses that support breastfeeding. Federal and state legislation requires workplace support for pumping and provides protections for public breastfeeding. Yet, many are unaware of these laws, and thus, support systems remain underdeveloped. We used a community-based approach to spread awareness about the evidence-based benefits of breastfeeding and breastfeeding support. We worked to improve breastfeeding support at the local hospital, among local employers, and throughout the broader community. Our coalition representing the hospital, the chamber of commerce, the university, and local lactation consultants used a public deliberation model for dissemination. We held focus groups, hosted a public conversation, spoke to local organizations, and promoted these efforts through local media. The hospital achieved Baby-Friendly status and opened a Baby Café. Breastfeeding support in the community improved through policies, designated pumping spaces, and signage that supports public breastfeeding at local businesses. Community awareness of the benefits of breastfeeding and breastfeeding support increased; the breastfeeding support coalition remains active. The public deliberation process for dissemination engaged the community with evidence-based promotion of breastfeeding support, increased agency, and produced sustainable results tailored to the community's unique needs.

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

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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…

Ecological risk assessment in a large river-reservoir. 2: Fish community

International Nuclear Information System (INIS)

Suter, G.W. II; Barnthouse, L.W.; Efroymson, R.A.; Jager, H.

1999-01-01

This paper summarizes the assessment of risks to fishes in the Clinch River Operable Unit due to contaminants released by the US Department of Energy's activities on its Oak Ridge Reservation in Tennessee. This paper focuses on the most contaminated area, the Poplar Creek (PC) embayment. The assessment is of interest because of its use of five distinct lines of evidence: fish community surveys, fish body burdens, toxicity tests of ambient waters, suborganismal bioindicators, and single chemical toxicity tests. None of these lines of evidence provided unambiguous evidence of a significant risk, but the surveys indicated that the fish community in PC was depauperate, polychlorinated biphenyl body burdens may have been at toxic levels in catfish, one of the three tests of ambient water showed clear toxicity, some of the indicators were indicative of toxic effects, and concentrations that have been toxic in the laboratory were detected periodically. Interpretation was further complicated by upstream contamination of both the Clinch River and PC. The risk characterization was performed by evaluating each line of evidence separately and then weighing the evidence using an ecoepidemiological approach

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

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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…

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

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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.

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

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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.

Discovering determinants influencing faith community nursing practice.

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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.

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.

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

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

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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.

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.

Community-based restaurant interventions to promote healthy eating: a systematic review.

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Valdivia Espino, Jennifer N; Guerrero, Natalie; Rhoads, Natalie; Simon, Norma-Jean; Escaron, Anne L; Meinen, Amy; Nieto, F Javier; Martinez-Donate, Ana P

2015-05-21

Eating in restaurants is associated with high caloric intake. This review summarizes and evaluates the evidence supporting community-based restaurant interventions. We searched all years of PubMed and Web of Knowledge through January 2014 for original articles describing or evaluating community-based restaurant interventions to promote healthy eating. We extracted summary information and classified the interventions into 9 categories according to the strategies implemented. A scoring system was adapted to evaluate the evidence, assigning 0 to 3 points to each intervention for study design, public awareness, and effectiveness. The average values were summed and then multiplied by 1 to 3 points, according to the volume of research available for each category. These summary scores were used to determine the level of evidence (insufficient, sufficient, or strong) supporting the effectiveness of each category. This review included 27 interventions described in 25 studies published since 1979. Most interventions took place in exclusively urban areas of the United States, either in the West or the South. The most common intervention categories were the use of point-of-purchase information with promotion and communication (n = 6), and point-of-purchase information with increased availability of healthy choices (n = 6). Only the latter category had sufficient evidence. The remaining 8 categories had insufficient evidence because of interventions showing no, minimal, or mixed findings; limited reporting of awareness and effectiveness; low volume of research; or weak study designs. No intervention reported an average negative impact on outcomes. Evidence about effective community-based strategies to promote healthy eating in restaurants is limited, especially for interventions in rural areas. To expand the evidence base, more studies should be conducted using robust study designs, standardized evaluation methods, and measures of sales, behavior, and health outcomes.

An analysis of state legislation on community trails.

Science.gov (United States)

Eyler, Amy; Lankford, Tina; Chriqui, Jamie; Evenson, Kelly R; Kruger, Judy; Tompkins, Nancy; Voorhees, Carolyn; Zieff, Susan; Aytur, Semra; Brownson, Ross

2010-03-01

Trails provide opportunities for recreation, transportation and activity. The purpose of this article is to describe state legislation related to community trails, to analyze legislation content, and to evaluate legislation on inclusion of evidence-informed elements. State trail legislation from 2001 to 2008 was identified using online legislative databases. An analysis of evidence-informed elements included in the legislation was conducted. These elements included: funding, liability, accessibility, connectivity, and maintenance. Of the total 991 trail bills, 516 (52.0%) were appropriations bills, of which 167 (32.2%) were enacted. We analyzed 475 (48%) nonappropriation trail bills of which 139 (29.3%) were enacted. The percentage of enactment of appropriations bills decreased over time while enactment of nonappropriations trail bills increased. Over half of the nonappropriations trail bills included at least 1 evidence-informed element, most commonly funding. Few bills contained liability, connectivity, accessibility, or maintenance. There is opportunity for providing evidence-informed information to policy-makers to potentially influence bill content. The number of bills with a funding element demonstrates that fiscal support for trails is an important policy lever that state legislatures may use to support trails. Lastly, trails should be considered in over-all state-level physical activity legislation to provide opportunities for communities to be active.

Predicting prediabetes in a rural community: a survey among the Karen ethnic community, Thasongyang, Thailand.

Science.gov (United States)

Lorga, Thaworn; Aung, Myo Nyein; Naunboonruang, Prissana; Thinuan, Payom; Praipaksin, Nara; Deesakul, Tida; Inwan, Utumporn; Yingtaweesak, Tawatchai; Manokulanan, Pratumpan; Suangkaew, Srisomporn; Payaprom, Apiradee

2012-01-01

Diabetes is a growing epidemic in both urban and rural communities worldwide. We aimed to survey fasting plasma glucose (FPG) status and awareness of diabetes in the rural Karen ethnic community. We investigated the predictors of impaired fasting plasma glucose (IFG) status, which would be easily applicable for prevention of diabetes in a rural community. This was a community-based cross-sectional study conducted at Thasongyang, the most north-western district in Thailand. A total of 299 Karen ethnic rural residents were included in the study. FPG, body mass index, and waist circumference were prospectively measured. We assessed the awareness of diabetes and lifestyle-related health behavior with closed questionnaires in a rural community setting. On screening for FPG, 16.72% of the Karen ethnic residents had hyperglycemia: 3.68% in the diabetic range and 13.04% in the prediabetic range respectively. After adjustment for age, sex, and BMI, waist circumference (adjusted odds ratio [aOR] 3.5, 95% confidence interval [CI] 1.29-9.57), and having a diabetic blood relative (aOR 4.6, CI 1.81-11.71) are significant predictors of IFG status. It is necessary to promote awareness of diabetes among the Karen ethnic community. Application of simple evidence-based predictors of the prediabetic state may lead to timely and effective prevention of diabetes in rural settings.

The failure of community benefit.

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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.

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.

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

Developing Traditional Chinese Medicine in the Era of Evidence-Based Medicine: Current Evidences and Challenges

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Fung, Foon Yin; Linn, Yeh Ching

2015-01-01

Evidence-based medicine (EBM), by integrating individual clinical expertise with the best available clinical evidence from systematic research, has in recent years been established as the standard of modern medical practice for greater treatment efficacy and safety. Traditional Chinese Medicine (TCM), on the other hand, evolved as a system of medical practice from ancient China more than 2000 years ago based on empirical knowledge as well as theories and concepts which are yet to be mapped by scientific equivalents. Despite the expanding TCM usage and the recognition of its therapeutic benefits worldwide, the lack of robust evidence from the EBM perspective is hindering acceptance of TCM by the Western medicine community and its integration into mainstream healthcare. For TCM to become an integral component of the healthcare system so that its benefits can be rationally harnessed in the best interests of patients, it is essential for TCM to demonstrate its efficacy and safety by high-level evidence in accordance with EBM, though much debate remains on the validity and feasibility of applying the EBM model on this traditional practice. This review aims to discuss the current status of research in TCM, explore the evidences available on its efficacy and safety, and highlight the issues and challenges faced in applying EBM to TCM. PMID:25949261

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.

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.

Association between community garden participation and fruit and vegetable consumption in rural Missouri.

Science.gov (United States)

Barnidge, Ellen K; Hipp, Pamela R; Estlund, Amy; Duggan, Kathleen; Barnhart, Kathryn J; Brownson, Ross C

2013-11-19

Fruit and vegetable consumption reduces chronic disease risk, yet the majority of Americans consume fewer than recommended. Inadequate access to fruits and vegetables is increasingly recognized as a significant contributor to low consumption of healthy foods. Emerging evidence shows the effectiveness of community gardens in increasing access to, and consumption of, fruits and vegetables. Two complementary studies explored the association of community garden participation and fruit and vegetable consumption in rural communities in Missouri. The first was with a convenience sample of participants in a rural community garden intervention who completed self-administered surveys. The second was a population-based survey conducted with a random sample of 1,000 residents in the intervention catchment area. Participation in a community garden was associated with higher fruit and vegetable consumption. The first study found that individuals who worked in a community garden at least once a week were more likely to report eating fruits and vegetables because of their community garden work (X² (125) = 7.78, p = .0088). Population-based survey results show that 5% of rural residents reported participating in a community garden. Those who reported community garden participation were more likely to report eating fruits 2 or more times per day and vegetables 3 or more times per day than those who did not report community garden participation, even after adjusting for covariates (Odds Ratio [OR] = 2.76, 95% Confidence Interval [CI] = 1.35 to 5.65). These complementary studies provide evidence that community gardens are a promising strategy for promoting fruit and vegetable consumption in rural communities.

Me, Myself, and my Community. Antecedents, Processes, and Effects of Adolescent Volunteering

NARCIS (Netherlands)

van Goethem, A.A.J.

2014-01-01

There is a general concern that adolescents are mainly focused on “me, myself, and I” and lack community involvement, but there is also evidence showing that a substantial number of adolescents do contribute to their community by volunteering. The purpose of this doctoral thesis was to better

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.

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.

A community of scholars or scholars of the community? A note on the limits of relevance.

Science.gov (United States)

Cox, K R

1984-09-01

Universities are increasingly expected to be accountable for the large sums of public money they spend. Universities in Australia are currently under pressure to turn out graduates who are technically trained for immediate entry into the work force. Universities are expected to teach knowledge and skills which are relevant to what the community needs now. If the universities accept such obligations of accountability and relevance, what are the implications for the university enterprise? Over the past decade, medical schools have attempted to spell out their purposes, writing their overall goals and then specific objectives to guide teaching in all departments. These lists of goals and objectives usually incorporate a strong orientation to meeting current community needs. One expression of these community needs is the call for 'Health for all by the year 2000', supported by all governments through the World Health Organization. Turning out graduates to provide community health care would be a relevant goal which an accountable medical school could hardly deny. What evidence is available about university responses to such needs?

Implementation of oral health initiatives by Australian rural communities: Factors for success.

Science.gov (United States)

Taylor, Judy; Carlisle, Karen; Farmer, Jane; Larkins, Sarah; Dickson-Swift, Virginia; Kenny, Amanda

2018-01-01

In this paper, we consider factors significant in the success of community participation in the implementation of new oral health services. Our analysis draws on data from the Rural Engaging Communities in Oral Health (Rural ECOH) study (2014-2016). We aimed to assess the Australian relevance of a Scottish community participation framework for health service development; Remote Service Futures. Internationally, community participation in planning of health initiatives is common, but less common in new service implementation. Health managers query the legitimacy of "lay" community members, whether they will persist, and whether they can act as change agents. Our data provide evidence that helps answer these queries. Six communities, located within regions covered by two large rural primary healthcare organisations (Medicare Locals), were selected in two Australian states. Two university-based facilitators worked with a group of local residents (for each community) to monitor implementation of new oral health initiatives designed through participatory processes. Data about implementation were collected through interviews with 28 key stakeholders at the beginning of implementation and 12 months later. Data were coded, themed and analysed abductively. Five themes emerged; the inter-relationship between community motivation to participate with the fortunes of the oral health initiatives, having the "right" people involved, continuing involvement of sponsors and/or significant people, trusting working relationships between participants and perceiving benefits from participation. Findings provide evidence of a role for community participation in implementing new community services if solid partnerships with relevant providers can be negotiated and services are seen to be relevant and useful to the community. © 2017 John Wiley & Sons Ltd.

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

Integrating chemical and biological status assessment: Assembling lines of evidence for the evaluation of river ecosystem risk

International Nuclear Information System (INIS)

Munoz Gracia, Isabel; Sabater, Sergi

2014-01-01

This paper describes various approaches to evaluating ecological risk in rivers affected by multiple chemical stressors, with emphasis on biofilm and invertebrate community responses. Metrics should be considered as different lines of evidence that, when weighted, form an advanced weight of evidence approach to establishing the environmental risk on a basin scale. Combination of field surveys to obtain observational data of communities, in situ experiments, toxicological sediment tests and a good chemical description of the medium (water and sediment) helps give an integrative view of the chemical and biological state of a river ecosystem. The greater and more distinct the variables used, the greater is our ability to identify the effects of major stressors impairing communities. Weight of evidence is an integrative methodology for tackling the challenge of determining causal relations and applying this knowledge in the decision-making processes of river management.

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

From Tobacco to Obesity Prevention Policies: A Framework for Implementing Community-Driven Policy Change.

Science.gov (United States)

Walter, Lauren; Dumke, Kelly; Oliva, Ariana; Caesar, Emily; Phillips, Zoë; Lehman, Nathan; Aragon, Linda; Simon, Paul; Kuo, Tony

2018-04-01

Efforts to reverse the obesity epidemic require policy, systems, and environmental (PSE) change strategies. Despite the availability of evidence-based and other promising PSE interventions, limited evidence exists on the "how-to" of transitioning them into practice. For the past 13 years, the Los Angeles County Department of Public Health has been building capacity among community residents and other stakeholders to create effective community coalitions and to implement well-designed policy strategy campaigns using an evidence-based approach to policy change, the policy adoption model (PAM). Implementing a phase-based approach to policy change, the PAM was initially used to support the passage of over 140 tobacco control and prevention policies in Los Angeles County. Following these successes, Los Angeles County Department of Public Health applied the PAM to obesity prevention, operationalizing the policy process by training community residents and other stakeholders on the use of the model. The PAM has shown to be helpful in promoting PSE change in tobacco control and obesity prevention, suggesting a local-level model potentially applicable to other fields of public health seeking sustainable, community-driven policy change.

Community for Data Integration 2014 annual report

Science.gov (United States)

Langseth, Madison L.; Chang, Michelle Y.; Carlino, Jennifer; Birch, Daniella D.; Bradley, Joshua; Bristol, R. Sky; Conzelmann, Craig; Diehl, Robert H.; Earle, Paul S.; Ellison, Laura E.; Everette, Anthony L.; Fuller, Pamela L.; Gordon, Janice M.; Govoni, David L.; Guy, Michelle R.; Henkel, Heather S.; Hutchison, Vivian B.; Kern, Tim; Lightsom, Frances L.; Long, Joseph W.; Longhenry, Ryan; Preston, Todd M.; Smith, Stan W.; Viger, Roland J.; Wesenberg, Katherine; Wood, Eric C.

2015-10-02

The U.S. Geological Survey (USGS) researches Earth science to help address complex issues affecting society and the environment. In 2006, the USGS held the first Scientific Information Management Workshop to bring together staff from across the organization to discuss the data and information management issues affecting the integration and delivery of Earth science research and investigate the use of “communities of practice” as mechanisms to share expertise about these issues. Out of this effort emerged the Council for Data Integration, which was conceived as an official organizational function that would help guide data integration activities and formalize communities of practice into working groups; however, by 2009 it became evident that many members of the Council for Data Integration had an interest in developing data integration solutions and sharing expertise in a less formal, grassroots manner, which transformed the Council into a Community for Data Integration (CDI). As of 2014, the CDI represents a dynamic community of practice focused on advancing science data and information management and integration capabilities across the USGS and the CDI community.

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

Engaging Karen refugee students in science learning through a cross-cultural learning community

Science.gov (United States)

Harper, Susan G.

2017-02-01

This research explored how Karen (first-generation refugees from Burma) elementary students engaged with the Next Generation Science Standards (NGSS) practice of constructing scientific explanations based on evidence within the context of a cross-cultural learning community. In this action research, the researcher and a Karen parent served as co-teachers for fourth- and fifth-grade Karen and non-Karen students in a science and culture after-school programme in a public elementary school in the rural southeastern United States. Photovoice provided a critical platform for students to create their own cultural discourses for the learning community. The theoretical framework of critical pedagogy of place provided a way for the learning community to decolonise and re-inhabit the learning spaces with knowledge they co-constructed. Narrative analysis of video transcripts of the after-school programme, ethnographic interviews, and focus group discussions from Photovoice revealed a pattern of emerging agency by Karen students in the scientific practice of constructing scientific explanations based on evidence and in Karen language lessons. This evidence suggests that science learning embedded within a cross-cultural learning community can empower refugee students to construct their own hybrid cultural knowledge and leverage that knowledge to engage in a meaningful way with the epistemology of science.

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.

Best practice principles for community-based obesity prevention: development, content and application.

Science.gov (United States)

King, L; Gill, T; Allender, S; Swinburn, B

2011-05-01

Best practice in obesity prevention has generally been defined in terms of 'what' needs to be done while neglecting 'how'. A multifaceted definition of best practice, which combines available evidence on what actions to take, with an established process for interpreting this information in a specific community context, provides a more appropriate basis for defining the principles of best practice in community-based obesity prevention. Based on analysis of a range of literature, a preliminary set of principles was drafted and progressively revised through further analyses of published literature and a series of consultations. The framework for best practice principles comprises: community engagement, programme design and planning, evaluation, implementation and sustainability, and governance. Specific principles were formulated within this framework. While many principles were generic, distinctive features of obesity prevention were also covered. The engagement of end-users influenced the design of the formatting of the outputs, which represent three levels of knowledge transfer: detailed evidence summaries, guiding questions for programme planners and a briefer set of questions for simpler communication purposes. The best practice principles provide a valuable mechanism for the translation of existing evidence and experience into the decision-making processes for planning, implementing and evaluating the complex community-based interventions needed for successful obesity prevention. © 2010 The Authors. obesity reviews © 2010 International Association for the Study of Obesity.

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

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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.

Community-acquired pneumonia in older patients: does age influence systemic cytokine levels in community-acquired pneumonia?

LENUS (Irish Health Repository)

Kelly, Emer

2009-03-01

Community-acquired pneumonia (CAP) is a major cause of death in the elderly. The age-related increase in comorbid illnesses plays a part but the effect of aging on the immune response may be equally important. We aimed to evaluate patients with CAP for evidence of a muted response to infection in elderly patients admitted to hospital compared with a younger patient group.

Stakeholder Education for Community-Wide Health Initiatives: A Focus on Teen Pregnancy Prevention.

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Finley, Cara; Suellentrop, Katherine; Griesse, Rebecca; House, Lawrence Duane; Brittain, Anna

2018-01-01

Teen pregnancies and births continue to decline due in part to implementation of evidence-based interventions and clinical strategies. While local stakeholder education is also thought to be critical to this success, little is known about what types of strategies work best to engage stakeholders. With the goal of identifying and describing evidence-based or best practice strategies for stakeholder education in community-based public health initiatives, we conducted a systematic literature review of strategies used for effective stakeholder education. Over 400 articles were initially retrieved; 59 articles met inclusion criteria. Strategies were grouped into four steps that communities can use to support stakeholder education efforts: identify stakeholder needs and resources, develop a plan, develop tailored and compelling messaging, and use implementation strategies. These strategies lay a framework for high-quality stakeholder education. In future research, it is important to prioritize evaluating specific activities taken to raise awareness, educate, and engage a community in community-wide public health efforts.

Sustaining health education research programs in Aboriginal communities.

Science.gov (United States)

Wisener, Katherine; Shapka, Jennifer; Jarvis-Selinger, Sandra

2017-09-01

Despite evidence supporting the ongoing provision of health education interventions in First Nations communities, there is a paucity of research that specifically addresses how these programs should be designed to ensure sustainability and long-term effects. Using a Community-Based Research approach, a collective case study was completed with three Canadian First Nations communities to address the following research question: What factors are related to sustainable health education programs, and how do they contribute to and/or inhibit program success in an Aboriginal context? Semi-structured interviews and a sharing circle were completed with 19 participants, including members of community leadership, external partners, and program staff and users. Seven factors were identified to either promote or inhibit program sustainability, including: 1) community uptake; 2) environmental factors; 3) stakeholder awareness and support; 4) presence of a champion; 5) availability of funding; 6) fit and flexibility; and 7) capacity and capacity building. Each factor is provided with a working definition, influential moderators, and key evaluation questions. This study is grounded in, and builds on existing research, and can be used by First Nations communities and universities to support effective sustainability planning for community-based health education interventions.

Soil Microbial Community Successional Patterns during Forest Ecosystem Restoration ▿†

OpenAIRE

Banning, Natasha C.; Gleeson, Deirdre B.; Grigg, Andrew H.; Grant, Carl D.; Andersen, Gary L.; Brodie, Eoin L.; Murphy, D. V.

2011-01-01

Soil microbial community characterization is increasingly being used to determine the responses of soils to stress and disturbances and to assess ecosystem sustainability. However, there is little experimental evidence to indicate that predictable patterns in microbial community structure or composition occur during secondary succession or ecosystem restoration. This study utilized a chronosequence of developing jarrah (Eucalyptus marginata) forest ecosystems, rehabilitated after bauxite mini...

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

Directory of Open Access Journals (Sweden)

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.

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...

What Factors Are Important in Smoking Cessation Amongst Deprived Communities?: A Qualitative Study

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Henderson, Hazel J.; Memon, Anjum; Lawson, Kate; Jacobs, Barbara; Koutsogeorgou, Eleni

2011-01-01

Objective: There is limited evidence regarding effective smoking cessation interventions in deprived communities. This study explored what factors are considered most important in smoking cessation, from the perspective of a group of NHS Stop Smoking Service users from a deprived community. Design: A qualitative study. Setting: A deprived…

Utilization of an interorganizational network analysis to evaluate the development of community capacity among a community-academic partnership.

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Clark, Heather R; Ramirez, Albert; Drake, Kelly N; Beaudoin, Christopher E; Garney, Whitney R; Wendel, Monica L; Outley, Corliss; Burdine, James N; Player, Harold D

2014-01-01

Following a community health assessment the Brazos Valley Health Partnership (BVHP) organized to address fragmentation of services and local health needs. This regional partnership employs the fundamental principles of community-based participatory research, fostering an equitable partnership with the aim of building community capacity to address local health issues. This article describes changes in relationships as a result of capacity building efforts in a community-academic partnership. Growth in network structure among organizations is hypothesized to be indicative of less fragmentation of services for residents and increased capacity of the BVHP to collectively address local health issues. Each of the participant organizations responded to a series of questions regarding its relationships with other organizations. Each organization was asked about information sharing, joint planning, resource sharing, and formal agreements with other organizations. The network survey has been administered 3 times between 2004 and 2009. Network density increased for sharing information and jointly planning events. Growth in the complexity of relationships was reported for sharing tangible resources and formal agreements. The average number of ties between organizations as well as the strength of relationships increased. This study provides evidence that the community capacity building efforts within these communities have contributed to beneficial changes in interorganizational relationships. Results from this analysis are useful for understanding how a community partnership's efforts to address access to care can strengthen a community's capacity for future action. Increased collaboration also leads to new assets, resources, and the transfer of knowledge and skills.

Coalition Building for Health: A Community Garden Pilot Project with Apartment Dwelling Refugees.

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Eggert, Lynne K; Blood-Siegfried, Jane; Champagne, Mary; Al-Jumaily, Maha; Biederman, Donna J

2015-01-01

Refugees often experience compromised health from both pre- and post-migration stressors. Coalition theory has helped guide the development of targeted programs to address the health care needs of vulnerable populations. Using the Community Coalition Action Theory as a framework, a coalition was formed to implement a community garden with apartment-dwelling refugees. Outcomes included successful coalition formation, a community garden, reported satisfaction from all gardeners with increased vegetable intake, access to culturally meaningful foods, and evidence of increased community engagement. The opportunity for community health nurses to convene a coalition to affect positive health for refugees is demonstrated.

The Search Conference as a Method in Planning Community Health Promotion Actions

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Magnus, Eva; Knudtsen, Margunn Skjei; Wist, Guri; Weiss, Daniel; Lillefjell, Monica

2016-01-01

Aims: The aim of this article is to describe and discuss how the search conference can be used as a method for planning health promotion actions in local communities. Design and methods: The article draws on experiences with using the method for an innovative project in health promotion in three Norwegian municipalities. The method is described both in general and how it was specifically adopted for the project. Results and conclusions: The search conference as a method was used to develop evidence-based health promotion action plans. With its use of both bottom-up and top-down approaches, this method is a relevant strategy for involving a community in the planning stages of health promotion actions in line with political expectations of participation, ownership, and evidence-based initiatives. Significance for public health This article describe and discuss how the Search conference can be used as a method when working with knowledge based health promotion actions in local communities. The article describe the sequences of the conference and shows how this have been adapted when planning and prioritizing health promotion actions in three Norwegian municipalities. The significance of the article is that it shows how central elements in the planning of health promotion actions, as participation and involvements as well as evidence was a fundamental thinking in how the conference were accomplished. The article continue discussing how the method function as both a top-down and a bottom-up strategy, and in what way working evidence based can be in conflict with a bottom-up strategy. The experiences described can be used as guidance planning knowledge based health promotion actions in communities. PMID:27747199

Strengthening Chronic Disease Prevention Programming: the Toward Evidence-Informed Practice (TEIP) Program Assessment Tool

Science.gov (United States)

Albert, Dayna; Fortin, Rebecca; Lessio, Anne; Herrera, Christine; Hanning, Rhona; Rush, Brian

2013-01-01

Best practices identified solely on the strength of research evidence may not be entirely relevant or practical for use in community-based public health and the practice of chronic disease prevention. Aiming to bridge the gap between best practices literature and local knowledge and expertise, the Ontario Public Health Association, through the Toward Evidence-Informed Practice initiative, developed a set of resources to strengthen evidence-informed decision making in chronic disease prevention programs. A Program Assessment Tool, described in this article, emphasizes better processes by incorporating review criteria into the program planning and implementation process. In a companion paper, “Strengthening Chronic Disease Prevention Programming: The Toward Evidence-Informed Practice (TEIP) Program Evidence Tool,” we describe another tool, which emphasizes better evidence by providing guidelines and worksheets to identify, synthesize, and incorporate evidence from a range of sources (eg, peer-reviewed literature, gray literature, local expertise) to strengthen local programs. The Program Assessment Tool uses 19 criteria derived from literature on best and promising practices to assess and strengthen program planning and implementation. We describe the benefits, strengths, and challenges in implementing the tool in 22 community-based chronic disease prevention projects in Ontario, Canada. The Program Assessment Tool helps put best processes into operation to complement adoption and adaptation of evidence-informed practices for chronic disease prevention. PMID:23721789

Promoting the inclusion of Afghan women and men in research: reflections from research and community partners involved in implementing a 'proof of concept' project.

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Riggs, Elisha; Yelland, Jane; Szwarc, Josef; Casey, Sue; Chesters, Donna; Duell-Piening, Philippa; Wahidi, Sayed; Fouladi, Fatema; Brown, Stephanie

2015-01-31

With mounting evidence that poor maternal and child health outcomes are related to the social determinants of health, researchers need to engage with vulnerable and isolated communities to gather the evidence that is essential to determine appropriate solutions. Conventional research methods may not ensure the degree and quality of participation that is necessary for meaningful study findings. Participatory methods provide reciprocal opportunities for often excluded communities to both take part in, and guide the conduct of research. The Having a baby in a new country research project was undertaken to provide evidence about how women and men of refugee background experience health services at the time of having a baby. This two year, multifaceted proof of concept study comprised: 1) an organisational partnership to oversee the project; 2) a community engagement framework including: female and male Afghan community researchers, community and sector stakeholder advisory groups and community consultation and engagement. Inclusive research strategies that address power imbalances in research, and diversity of and within communities, are necessary to obtain the evidence required to address health inequalities in vulnerable populations. Such an approach involves mindfully adapting research processes to ensure that studies have regard for the advice of community members about the issues that affect them. Researchers have much to gain by committing time and resources to engaging communities in reciprocal ways in research processes.

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

Community gardening, community farming and other local community-based gardening interventions to prevent overweight and obesity in high-income and middle-income countries: protocol for a systematic review.

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Heise, Thomas L; Romppel, Matthias; Molnar, Sandra; Buchberger, Barbara; Berg, Agnes van den; Gartlehner, Gerald; Lhachimi, Stefan K

2017-06-15

The worldwide prevalence of overweight/obesity has continued to rise over the last decades. To reverse this trend, public health authorities are exploring cost-effective interventions, especially in high-income and middle-income countries. Community gardening offers a unique opportunity for individuals to enhance physical activity levels and improve their diet. However, synthesised evidence on the short-term or long-term effectiveness and on the costs of community gardening interventions to prevent overweight/obesity remains limited. Therefore, this review will investigate: (1) the effectiveness of voluntary participation in community gardening compared with no or a control intervention on overweight/obesity and associated health outcomes, (2) effects on different subgroups of populations and (3) the costs of community gardening interventions. We will conduct a systematic review, limited to evaluations of community gardening interventions with controlled quantitative and interrupted time series designs. To identify relevant articles, we will systematically search 12 academic and 5 grey literature databases, as well as 2 trial registers and 6 websites. Articles will then be assessed for eligibility based on a predefined set of criteria. At least two independent reviewers will assess each article for relevance, before evaluating the methodological quality and potential bias of the studies. Data relevant to the objectives of this review will be extracted and cross-validated. Any disagreements will be mediated by a third reviewer. If feasible, meta-analyses of primary outcomes (overweight/obesity, physical activity, food intake, energy intake) will be conducted. We will use the Grading of Recommendations Assessment, Development and Evaluation method to assess the overall quality of evidence. For this review, no ethical approval is required as we will only extract and analyse secondary data. We aim to submit the final review manuscript to an open access journal for

Re-embedding science in the realities of local communities

DEFF Research Database (Denmark)

Mortensen, Jonas Egmose; Nielsen, Kurt Aagaard; Eames, Malcolm

leads to sustainable solutions. A major question facing the S&T policy community, and indeed society at large, is therefore how science and technology can be more effectively harnessed to addressing the sustainability needs and priorities of particular communities. It is in this context that this paper...... in particular times and places, in particular practices and communities of actors. Whilst it is widely acknowledged that science, technology and innovation have a critical role to play in addressing the challenges of sustainable development it is far from evident that investment in science and technology per se...... examines whether new approaches to upstream engagement in science and technology can further knowledge channels between local communities and academia. Building on the insights from critical theory; mode-2 conceptualisations of knowledge production; and the experiences from the Citizen Science...

Basidiomycete fungal communities in Australian sclerophyll forest soil are altered by repeated prescribed burning.

Science.gov (United States)

Anderson, Ian C; Bastias, Brigitte A; Genney, David R; Parkin, Pamela I; Cairney, John W G

2007-04-01

Soil basidiomycetes play key roles in forest nutrient and carbon cycling processes, yet the diversity and structure of below ground basidiomycete communities remain poorly understood. Prescribed burning is a commonly used forest management practice and there is evidence that single fire events can have an impact on soil fungal communities but little is known about the effects of repeated prescribed burning. We have used internal transcribed spacer (ITS) terminal restriction fragment length polymorphism (T-RFLP) analysis to investigate the impacts of repeated prescribed burning every two or four years over a period of 30 years on soil basidiomycete communities in an Australian wet sclerophyll forest. Detrended correspondence analysis of ITS T-RFLP profiles separated basidiomycete communities in unburned control plots from those in burned plots, with those burned every two years being the most different from controls. Burning had no effect on basidiomycete species richness, thus these differences appear to be due to changes in community structure. Basidiomycete communities in the unburned control plots were vertically stratified in the upper 20 cm of soil, but no evidence was found for stratification in the burned plots, suggesting that repeated prescribed burning results in more uniform basidiomycete communities. Overall, the results demonstrate that repeated prescribed burning alters soil basidiomycete communities, with the effect being greater with more frequent burning.

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

Parents and Communities as Partners in Teaching Writing in Canadian Middle Grades Classrooms

Science.gov (United States)

McClay, Jill Kedersha; Peterson, Shelley Stagg; Nixon, Rhonda

2012-01-01

Educators have long recognized that parental and community supports are important underpinnings for children's success in school. With respect to the teaching of writing, however, little research has been conducted to provide evidence of effective practices teachers use to involve parents and communities. As part of a national Canadian study of…

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).

An exploration of a fire-affected community undergoing change in New Zealand

Science.gov (United States)

Pamela J. Jakes; Laura Kelly; Lisa Langer

2010-01-01

In the first case study of a fire-affected community in New Zealand's rural-urban interface, researchers found evidence to support findings raised in other countries regarding evacuation, blaming behaviour and perceptions of risk. Differences were evident based on ownership tenure, including less awareness of wildfire risk and preparedness among those with shorter...

Roadmap for a participatory research-practice partnership to implement evidence.

Science.gov (United States)

Harrison, Margaret B; Graham, Ian D

2012-12-01

Our research team has undertaken implementation of evidence in the form of practice guideline recommendations for populations in hospital, community, and long-term care settings with diverse provider and patient populations (people with chronic wounds, e.g., pressure and leg ulcers, heart failure, stroke, diabetes, palliative care, cancer, and maternity care). Translating evidence into clinical practice at the point of care is a complex and often overwhelming challenge for the health system as well as for individual practitioners. To ensure that best available evidence is integrated into practice, "local evidence" needs to be generated and this process accomplishes a number of things: it focuses all involved on the "same page," identifies important facilitating factors as well as barriers, provides empirical support for planning, and in itself is a key aspect of implementation. In doing this work, we developed a roadmap, the Queen's University Research Roadmap for Knowledge Implementation (QuRKI) that outlines three major phases of linked research and implementation activity: (1) issue identification/clarification; (2) solution building; and (3) implementation, evaluation, and nurturing the change. In this paper, we describe our practical experience as researchers working at point-of-care and how research can be used to facilitate the implementation of evidence. An exemplar is used to illustrate the fluid interplay of research and implementation activities and present the range of supporting research. QuRKI serves as a guide for researchers in the formation of a strategic alliance with the practice community for undertaking evidence-informed reorganization of care. Using this collaborative approach, researchers play an integral role in focusing on, and using evidence during all discussions. We welcome further evaluation of its usefulness in the field. © 2012 Sigma Theta Tau International.

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).

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

Directory of Open Access Journals (Sweden)

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.

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.

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

EPISTEMIC COMMUNITIES AND SERVICE DELIVERY CHOICES IN SPANISH MUNICIPAL ADMINISTRATIONS

Directory of Open Access Journals (Sweden)

Miquel SALVADOR

2015-12-01

Full Text Available This article contributes to the debate on the use of alternative formulas for public service provision with arguments related to epistemic communities’ influence. Drawing on the literature on models of local public service delivery, the role of internal epistemic communities is discussed and tested through the consideration of two different communities related to specific municipal areas such as personal and urban services. The results demonstrate that the association of urban services’ epistemic communities with alternative formulas for direct provision to deliver services is greater than in the case of personal services’ epistemic community. Those findings contribute to the academic debate not only with arguments and evidence that reinforces the role of variables included in previous research but also by introducing the role of epistemic communities in determining some policy options (as the use of local public-service delivery formulas.

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

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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

How has the economic downturn affected communities and implementation of science-based prevention in the randomized trial of communities that care?

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Kuklinski, Margaret R; Hawkins, J David; Plotnick, Robert D; Abbott, Robert D; Reid, Carolina K

2013-06-01

This study examined implications of the economic downturn that began in December 2007 for the Community Youth Development Study (CYDS), a longitudinal randomized controlled trial of the Communities That Care (CTC) prevention system. The downturn had the potential to affect the internal validity of the CYDS research design and implementation of science-based prevention in study communities. We used archival economic indicators and community key leader reports of economic conditions to assess the extent of the economic downturn in CYDS communities and potential internal validity threats. We also examined whether stronger economic downturn effects were associated with a decline in science-based prevention implementation. Economic indicators suggested the downturn affected CYDS communities to different degrees. We found no evidence of systematic differences in downturn effects in CTC compared to control communities that would threaten internal validity of the randomized trial. The Community Economic Problems scale was a reliable measure of community economic conditions, and it showed criterion validity in relation to several objective economic indicators. CTC coalitions continued to implement science-based prevention to a significantly greater degree than control coalitions 2 years after the downturn began. However, CTC implementation levels declined to some extent as unemployment, the percentage of students qualifying for free lunch, and community economic problems worsened. Control coalition implementation levels were not related to economic conditions before or after the downturn, but mean implementation levels of science-based prevention were also relatively low in both periods.

Not-for-profit hospitals' provision of community benefit: is there a trade-off between charity care and other benefits provided to the community?

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Singh, Simone Rauscher

2013-01-01

For decades, not-for-profit hospitals have been required to provide community benefit in exchange for tax exemption. To fulfill this requirement, hospitals engage in a variety of activities ranging from free and reduced cost care provided to individual patients to services aimed at improving the health of the community at large. Limited financial resources may restrict hospitals' ability to provide the full range of community benefits and force them to engage in trade-offs. We analyzed the composition of not-for-profit hospitals' community benefit expenditures and explored whether hospitals traded off between charity care and spending on other community benefit activities. Data for this study came from Maryland hospitals' state-level community benefit reports for 2006-2010. Bivariate Spearman's rho correlation analysis was used to examine the relationships among various components of hospitals' community benefit activities. We found no evidence of trade-offs between charity care and activities targeted at the health and well-being of the community at large. Consistently, hospitals that provided more charity care did not offset these expenditures by reducing their spending on other community benefit activities, including mission-driven health services, community health services, and health professions education. Hospitals' decisions about how to allocate community benefit dollars are made in the context of broader community health needs and resources. Concerns that hospitals serving a disproportionate number of charity patients might provide fewer benefits to the community at large appear to be unfounded.

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.

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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

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.

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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

Review of the Evidence for Oral Health Promotion Effectiveness

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Satur, Julie G.; Gussy, Mark G.; Morgan, Michael V.; Calache, Hanny; Wright, Clive

2010-01-01

Dental caries, periodontal diseases, tooth loss and oral cancers have significant burden of disease effects, quality of life and cost implications for the Australian community. Oral health promotion is a key approach to addressing these conditions endorsed as part of the National Oral Health Plan. Understanding the evidence for effectiveness of…

Education and Communities at the “Margins”: The Contradictions of Western Education for Islamic Communities in Sub-Saharan Africa

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Obed Mfum-Mensah

2017-05-01

Full Text Available This paper employs postcolonial framework to discuss the contradictions of promoting western education in Islamic communities in sub-Saharan Africa (SSA. Prior to colonization, Islamic education was an important socializing process that instilled strong Islamic identity in Islamic communities in SSA. European encounters in SSA and the introduction of western education shifted the socializing process and reconfigured SSA societies and dislocated Islamic communities in the region. I argue that Islamic communities’ marginalization educationally since the colonial era is partly the result of their resistance to western colonization and all its forms. In the first part of the paper I discuss postcolonial discourse and education. The second part discusses education and religion nexus in sub-Saharan Africa. It uses recent Pew Research for example as evidence to delineate the Muslim-Christian gaps in education by age categories and gender. The third part outlines ways western education became a tool for reconfiguring Islamic communities and the rationales behind Islamic communities’ resistance to this form of education. The concluding section discusses contemporary efforts to promote education in Islamic communities in SSA within the rubric of Education for All (EFA.

Digital Evidence Education in Schools of Law

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Aaron Alva

2012-06-01

Full Text Available An examination of State of Connecticut v. Julie Amero provides insight into how a general lack of understanding of digital evidence can cause an innocent defendant to be wrongfully convicted. By contrast, the 101-page opinion in Lorraine v. Markel American Insurance Co. provides legal precedence and a detailed consideration for the admission of digital evidence. An analysis of both cases leads the authors to recommend additions to Law School curricula designed to raise the awareness of the legal community to ensure such travesties of justice, as in the Amero case, don’t occur in the future. Work underway at the University of Washington designed to address this deficiency is discussed.

Evidence of suppression of onchocerciasis transmission in the Venezuelan Amazonian focus.

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Botto, Carlos; Basañez, María-Gloria; Escalona, Marisela; Villamizar, Néstor J; Noya-Alarcón, Oscar; Cortez, José; Vivas-Martínez, Sarai; Coronel, Pablo; Frontado, Hortencia; Flores, Jorge; Graterol, Beatriz; Camacho, Oneida; Tovar, Yseliam; Borges, Daniel; Morales, Alba Lucia; Ríos, Dalila; Guerra, Francisco; Margeli, Héctor; Rodriguez, Mario Alberto; Unnasch, Thomas R; Grillet, María Eugenia

2016-01-27

The World Health Organization (WHO) has set goals for onchocerciasis elimination in Latin America by 2015. Most of the six previously endemic countries are attaining this goal by implementing twice a year (and in some foci, quarterly) mass ivermectin (Mectizan®) distribution. Elimination of transmission has been verified in Colombia, Ecuador and Mexico. Challenges remain in the Amazonian focus straddling Venezuela and Brazil, where the disease affects the hard-to-reach Yanomami indigenous population. We provide evidence of suppression of Onchocerca volvulus transmission by Simulium guianense s.l. in 16 previously hyperendemic Yanomami communities in southern Venezuela after 15 years of 6-monthly and 5 years of 3-monthly mass ivermectin treatment. Baseline and monitoring and evaluation parasitological, ophthalmological, entomological and serological surveys were conducted in selected sentinel and extra-sentinel communities of the focus throughout the implementation of the programme. From 2010 to 2012-2015, clinico-parasitological surveys indicate a substantial decrease in skin microfilarial prevalence and intensity of infection; accompanied by no evidence (or very low prevalence and intensity) of ocular microfilariae in the examined population. Of a total of 51,341 S. guianense flies tested by PCR none had L3 infection (heads only). Prevalence of infective flies and seasonal transmission potentials in 2012-2013 were, respectively, under 1% and 20 L3/person/transmission season. Serology in children aged 1-10 years demonstrated that although 26 out of 396 (7%) individuals still had Ov-16 antibodies, only 4/218 (2%) seropositives were aged 1-5 years. We report evidence of recent transmission and morbidity suppression in some communities of the focus representing 75% of the Yanomami population and 70% of all known communities. We conclude that onchocerciasis transmission could be feasibly interrupted in the Venezuelan Amazonian focus.

Results from the Data & Democracy initiative to enhance community-based organization data and research capacity.

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Carroll-Scott, Amy; Toy, Peggy; Wyn, Roberta; Zane, Jazmin I; Wallace, Steven P

2012-07-01

In an era of community-based participatory research and increased expectations for evidence-based practice, we evaluated an initiative designed to increase community-based organizations' data and research capacity through a 3-day train-the-trainer course on community health assessments. We employed a mixed method pre-post course evaluation design. Various data sources collected from 171 participants captured individual and organizational characteristics and pre-post course self-efficacy on 19 core skills, as well as behavior change 1 year later among a subsample of participants. Before the course, participants reported limited previous experience with data and low self-efficacy in basic research skills. Immediately after the course, participants demonstrated statistically significant increases in data and research self-efficacy. The subsample reported application of community assessment skills to their work and increased use of data 1 year later. Results suggest that an intensive, short-term training program can achieve large immediate gains in data and research self-efficacy in community-based organization staff. In addition, they demonstrate initial evidence of longer-term behavior change related to use of data and research skills to support their community work.

Understanding evidence: a statewide survey to explore evidence-informed public health decision-making in a local government setting.

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Armstrong, Rebecca; Waters, Elizabeth; Moore, Laurence; Dobbins, Maureen; Pettman, Tahna; Burns, Cate; Swinburn, Boyd; Anderson, Laurie; Petticrew, Mark

2014-12-14

The value placed on types of evidence within decision-making contexts is highly dependent on individuals, the organizations in which the work and the systems and sectors they operate in. Decision-making processes too are highly contextual. Understanding the values placed on evidence and processes guiding decision-making is crucial to designing strategies to support evidence-informed decision-making (EIDM). This paper describes how evidence is used to inform local government (LG) public health decisions. The study used mixed methods including a cross-sectional survey and interviews. The Evidence-Informed Decision-Making Tool (EvIDenT) survey was designed to assess three key domains likely to impact on EIDM: access, confidence, and organizational culture. Other elements included the usefulness and influence of sources of evidence (people/groups and resources), skills and barriers, and facilitators to EIDM. Forty-five LGs from Victoria, Australia agreed to participate in the survey and up to four people from each organization were invited to complete the survey (n = 175). To further explore definitions of evidence and generate experiential data on EIDM practice, key informant interviews were conducted with a range of LG employees working in areas relevant to public health. In total, 135 responses were received (75% response rate) and 13 interviews were conducted. Analysis revealed varying levels of access, confidence and organizational culture to support EIDM. Significant relationships were found between domains: confidence, culture and access to research evidence. Some forms of evidence (e.g. community views) appeared to be used more commonly and at the expense of others (e.g. research evidence). Overall, a mixture of evidence (but more internal than external evidence) was influential in public health decision-making in councils. By comparison, a mixture of evidence (but more external than internal evidence) was deemed to be useful in public health decision

Towards evidence-based critical thinking medicine? Uses of best evidence in flawless argumentations.

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Jenicek, Milos

2006-08-01

Uses of informal logic and critical thinking methodology are increasingly taught, learnt and advantageously applied in such diverse domains as law, the military, business, and education. Health sciences are also following this trend. However, production and critical appraisal of evidence as already practiced in Evidence-Based Medicine must be coupled with equally rigorous uses in order to ensure appropriate health problem understanding and decision-making. Making most proposals and decisions in medicine is the conclusion of an argumentation process that lies behind any communication between health professionals working with patients, performing research or sharing ideas about health problems, their interpretations and solutions with numerous stakeholders in public life. Modern critical thinking and decision making in medicine is not instantly mastered, but is instead a learnt experience as anything else in professional and social interactions. The modern argument as outlined, illustrated and applied to health problems in this essay is an extension of a previously established way of thinking in Evidence-Based Medicine. Ideally, health professionals, their patients and all other stakeholders should speak the same language and it is up to us to make this possible. Evidence and critical thinking - based medicine might be a solution. As modern critical thinkers, we are at the forefront and we must see to it that patients and professional and general communities benefit from this more so even than from other remarkable historical and current contributions to the well-being of those under our care.

Effectiveness of participatory planning for community management of fisheries in Bangladesh.

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Sultana, Parvin; Abeyasekera, Savitri

2008-01-01

This study provides statistical evidence that support for community-based management of resources was more effective when initiated through a process known as participatory action plan development (PAPD). Thirty-six sites were studied where community management of fisheries was facilitated by NGOs. All involved community participation and establishing local fisheries management institutions. However, communities were able to take up more conservation-related interventions and faced fewer conflicts in the 18 sites where a PAPD was the basis for collective action and institution development. This indicates the value and effectiveness of adopting good practice in participatory planning, such as PAPD, which helps diverse stakeholders find common problems and solutions for natural resource management.

Soil biodiversity and soil community composition determine ecosystem multifunctionality

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Wagg, Cameron; Bender, S. Franz; Widmer, Franco; van der Heijden, Marcel G. A.

2014-01-01

Biodiversity loss has become a global concern as evidence accumulates that it will negatively affect ecosystem services on which society depends. So far, most studies have focused on the ecological consequences of above-ground biodiversity loss; yet a large part of Earth’s biodiversity is literally hidden below ground. Whether reductions of biodiversity in soil communities below ground have consequences for the overall performance of an ecosystem remains unresolved. It is important to investigate this in view of recent observations that soil biodiversity is declining and that soil communities are changing upon land use intensification. We established soil communities differing in composition and diversity and tested their impact on eight ecosystem functions in model grassland communities. We show that soil biodiversity loss and simplification of soil community composition impair multiple ecosystem functions, including plant diversity, decomposition, nutrient retention, and nutrient cycling. The average response of all measured ecosystem functions (ecosystem multifunctionality) exhibited a strong positive linear relationship to indicators of soil biodiversity, suggesting that soil community composition is a key factor in regulating ecosystem functioning. Our results indicate that changes in soil communities and the loss of soil biodiversity threaten ecosystem multifunctionality and sustainability. PMID:24639507

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

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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...

Improving medication adherence: a framework for community pharmacy-based interventions

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Pringle J

2015-11-01

Full Text Available Janice Pringle,1 Kim C Coley2 1Program Evaluation and Research Unit, Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA; 2Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA Abstract: Evidence supports that patient medication adherence is suboptimal with patients typically taking less than half of their prescribed doses. Medication nonadherence is associated with poor health outcomes and higher downstream health care costs. Results of studies evaluating pharmacist-led models in a community pharmacy setting and their impact on medication adherence have been mixed. Community pharmacists are ideally situated to provide medication adherence interventions, and effective strategies for how they can consistently improve patient medication adherence are necessary. This article suggests a framework to use in the community pharmacy setting that will significantly improve patient adherence and provides a strategy for how to apply this framework to develop and test new medication adherence innovations. The proposed framework is composed of the following elements: 1 defining the program's pharmacy service vision, 2 using evidence-based, patient-centered communication and intervention strategies, 3 using specific implementation approaches that ensure fidelity, and 4 applying continuous evaluation strategies. Within this framework, pharmacist interventions should include those services that capitalize on their specific skill sets. It is also essential that the organization's leadership effectively communicates the pharmacy service vision. Medication adherence strategies that are evidence-based and individualized to each patient's adherence problems are most desirable. Ideally, interventions would be delivered repeatedly over time and adjusted when patient's adherence circumstances change. Motivational interviewing principles are particularly well

Increasing advance personal planning: the need for action at the community level.

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Waller, Amy; Sanson-Fisher, Rob; Ries, Nola; Bryant, Jamie

2018-05-09

Advance personal planning is the process by which people consider, document and communicate their preferences for personal, financial and health matters in case they lose the ability to make decisions or express their wishes in the future. Advance personal planning is most often undertaken by individuals who are seriously ill, often in the context of a medical crisis and/or at the time of admission to hospital. However, the clinical utility and legal validity of the planning process may be compromised in these circumstances. Patients may lack sufficient capacity to meaningfully engage in advance personal planning; there may be insufficient time to adequately reflect on and discuss wishes with key others; and there may also be limited opportunity for inter-professional input and collaboration in the process. Here, we propose an agenda for research to advance the science of advance personal planning by promoting a 'whole community' approach. Adoption of advance personal planning at a community level may be achieved using a variety of strategies including public media campaigns, intervening with professionals across a range of health care and legal settings, and mobilising support from influential groups and local government. One potentially promising method for encouraging earlier adoption of advance personal planning among a broader population involves a community action approach, whereby multiple evidence-based strategies are integrated across multiple access points. Community action involves calling on community members, professionals, community and/or government organisations to work collaboratively to design and systematically implement intervention strategies with the aim of bringing about desired behaviour change. An example of a community action trial to improving uptake and quality of advance personal planning is described. While promising, there is a need for rigorous evidence to demonstrate whether a community action approach is effective in

Managing workplace stress in community pharmacy organisations: lessons from a review of the wider stress management and prevention literature.

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Jacobs, Sally; Johnson, Sheena; Hassell, Karen

2018-02-01

Workplace stress in community pharmacy is increasing internationally due, in part, to pharmacists' expanding roles and escalating workloads. Whilst the business case for preventing and managing workplace stress by employers is strong, there is little evidence for the effectiveness of organisational stress management interventions in community pharmacy settings. To identify and synthesise existing evidence for the effectiveness of organisational solutions to workplace stress from the wider organisational literature which may be adaptable to community pharmacies. A secondary synthesis of existing reviews. Publications were identified through keyword searches of electronic databases and the internet; inclusion and exclusion criteria were applied; data about setting, intervention, method of evaluation, effectiveness and conclusions (including factors for success) were extracted and synthesised. Eighteen reviews of the stress management and prevention literature were identified. A comprehensive list of organisational interventions to prevent or manage workplace stress, ordered by prevalence of evidence of effectiveness, was produced, together with an ordered list of the benefits both to the individual and employing organisation. An evidence-based model of best practice was derived specifying eight factors for success: top management support, context-specific interventions, combined organisational and individual interventions, a participative approach, clearly delineated tasks and responsibilities, buy-in from middle management, change agents as facilitators and change in organisational culture. This literature review provides community pharmacy organisations with evidence from which to develop effective and successful stress management strategies to support pharmacists and pharmacy staff. Well-designed trials of stress management interventions in community pharmacy organisations are still required. © 2017 Royal Pharmaceutical Society.

Roaming of dogs in remote Indigenous communities in northern Australia and potential interaction between community and wild dogs.

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Bombara, C; Dürr, S; Gongora, J; Ward, M P

2017-06-01

To investigate the roaming of Indigenous community dogs and potential interaction with wild dogs and dingoes. Cross-sectional survey and longitudinal follow-up study. Six remote Indigenous communities in Cape York Peninsula and Arnhem Land in northern Australia were selected. Hair samples were collected from community dogs and microsatellite DNA analyses were used to determine hybrid (>10% dingo DNA) status. Dogs were fitted with GPS collars and home range (ha) was estimated during monitoring periods of up to 3 days. In Cape York Peninsula, 6% of the 35 dogs sampled were dingo hybrids, whereas in Arnhem Land 41% of the 29 dogs sampled were hybrids. The median extended home range was estimated to be 4.54 ha (interquartile range, 3.40 - 7.71). Seven community dogs were identified with an estimated home range > 20 ha and home ranges included the bushland surrounding communities. No significant difference in home ranges was detected between hybrid and non-hybrid dogs. Study results provide some evidence (dingo hybridisation, bushland forays) of the potential interaction between domestic and wild dogs in northern Australia. The nature of this interaction needs further investigation to determine its role in disease transmission; for example, in the case of a rabies incursion in this region. © 2017 Australian Veterinary Association.

Anti-social behaviour, community and radical moral communitarianism

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Roger Hopkins-Burke

2015-12-01

Full Text Available This article offers an insight into the lives of individuals who are repeat victims of antisocial behaviour (ASB. Drawing on data derived from 15 case studies, the authors demonstrate the plight that such victims endure on a daily basis. The research reveals that a number of victims feel abandoned by their communities and the authorities and, how for many, there is an overwhelming sense of being “trapped” within their own homes. The article also offers evidence to support previous claims that police crime data only captures a small proportion of the actual number of incidents of ASB that occur. We conclude by proposing an emphasis on individual and community responsibility and suggest that by adopting a radical moral communitarian approach ASB could be reduced as part of rebuilding communities.

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

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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.

Traditional knowledge for promotion of socioeconomic inclusion of local communities

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Waldemiro Francisco Sorte Junior

2012-06-01

Full Text Available This paper discusses the key role played by public research institutes for promoting socioeconomic inclusion of local communities based on traditional knowledge and traditional medicine. Nongovernmental organizations and cooperatives have had an important role in raising financial resources, being involved with advocacy of local communities and advancing legislation changes. But strict best manufacturing practices regulations imposed by the Brazilian National Health Surveillance Agency on the requirements for approval and commercialization of drugs based on herbal medicine products call for the involvement of strong public research institutes capable of supporting community-based pharmacies. Thus, public research institutes are pivotal as they can conduct scientific research studies to evidence the efficacy of herbal medicine products and help building the capacity of local communities to comply with current regulations.

Community Health Workers Promote Civic Engagement and Organizational Capacity to Impact Policy.

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Sabo, Samantha; Flores, Melissa; Wennerstrom, Ashley; Bell, Melanie L; Verdugo, Lorena; Carvajal, Scott; Ingram, Maia

2017-12-01

Community health workers (CHW) have historically served to link structurally vulnerable populations to broad support systems. Emerging evidence suggests that CHWs engage in various forms of advocacy to promote policy and systems change. We assessed the impact of CHW community advocacy on community change, defined as civic engagement, organizational capacity and policy and systems change. Data are drawn from the 2014 National Community Health Worker Advocacy Survey (N = 1776) aimed to identify the state of the CHW profession, and their impact on health disparities through community advocacy and policy engagement. Our primary analysis used multiple linear regression to assess the association between CHW advocacy and community change. As predicted, there was a significant, positive association between CHW advocacy and change in community conditions. Additionally, both adjusted and sensitivity models had similar standardized beta estimates for advocacy, and adjusted R 2 statistics. CHW advocacy predicts positive change in community conditions and further advances the CHW Community Advocacy Framework designed to support and monitor CHW community advocacy to reduce health disparities through advocacy and policy change.

Eliciting health care priorities in developing countries: experimental evidence from Guatemala.

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Font, Joan Costa; Forns, Joan Rovira; Sato, Azusa

2016-02-01

Although some methods for eliciting preferences to assist participatory priority setting in health care in developed countries are available, the same is not true for poor communities in developing countries whose preferences are neglected in health policy making. Existing methods grounded on self-interested, monetary valuations that may be inappropriate for developing country settings where community care is provided through 'social allocation' mechanisms. This paper proposes and examines an alternative methodology for eliciting preferences for health care programmes specifically catered for rural and less literate populations but which is still applicable in urban communities. Specifically, the method simulates a realistic collective budget allocation experiment, to be implemented in both rural and urban communities in Guatemala. We report evidence revealing that participatory budget-like experiments are incentive compatible mechanisms suitable for revealing collective preferences, while simultaneously having the advantage of involving communities in health care reform processes. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Links between plant and fungal communities across a deforestation chronosequence in the Amazon rainforest.

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Mueller, Rebecca C; Paula, Fabiana S; Mirza, Babur S; Rodrigues, Jorge L M; Nüsslein, Klaus; Bohannan, Brendan J M

2014-07-01

Understanding the interactions among microbial communities, plant communities and soil properties following deforestation could provide insights into the long-term effects of land-use change on ecosystem functions, and may help identify approaches that promote the recovery of degraded sites. We combined high-throughput sequencing of fungal rDNA and molecular barcoding of plant roots to estimate fungal and plant community composition in soil sampled across a chronosequence of deforestation. We found significant effects of land-use change on fungal community composition, which was more closely correlated to plant community composition than to changes in soil properties or geographic distance, providing evidence for strong links between above- and below-ground communities in tropical forests.

Helminth community structure and diet of three Afrotropical anuran species: a test of the interactive-versus-isolationist parasite communities hypothesis

Directory of Open Access Journals (Sweden)

G. C. Akani

2011-09-01

Full Text Available The interactive-versus-isolationist hypothesis predicts that parasite communities should be depauperated and weakly structured by interspecific competition in amphibians. A parasitological survey was carried out to test this hypothesis using three anuran species from Nigeria, tropical Africa (one Bufonidae; two Ranidae. High values of parasite infection parameters were found in all three species, which were infected by nematodes, cestodes and trematodes. Nonetheless, the parasite communities of the three anurans were very depauperated in terms of number of species (4 to 6. Interspecific competition was irrelevant in all species, as revealed by null models and Monte Carlo permutations. Cluster analyses revealed that, in terms of parasite community composition, the two Ranidae were similar, whereas the Bufonidae was more different. However, when prevalence, intensity, and abundance of parasites are combined into a multivariate analysis, each anuran species was clearly spaced apart from the others, thus revealing considerable species-specific differences in terms of their parasite communities. All anurans were generalists and probably opportunistic in terms of dietary habits, and showed no evidence of interspecific competition for food. Overall, our data are widely consistent with expectations driven from the interactive-versus-isolationist parasite communities hypothesis.

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

A systematic review on community-based interventions for elder abuse and neglect.

Science.gov (United States)

Fearing, Gwendolyn; Sheppard, Christine L; McDonald, Lynn; Beaulieu, Marie; Hitzig, Sander L

2017-03-01

Elder abuse and neglect is a societal issue that requires prevention and intervention strategies at the practice and policy level. A systematic review on the efficacy of community-based elder abuse interventions was undertaken to advance the state of knowledge in the field. The peer-reviewed literature between 2009 and December 2015 were searched across four databases. Two raters independently reviewed all articles, assessed their methodological quality, and used a modified Sackett Scale to assign levels of evidence. Four thousand nine hundred and five articles were identified; nine were selected for inclusion. Although there was Level-1 evidence for psychological interventions (n = 2), only one study on strategies for relatives (START) led to a reported decrease in elder abuse. There was Level-4 evidence for conservatorship, an elder abuse intervention/prevention program (ECARE), and a multidisciplinary intervention (n = 4), in which one study yielded significant decreases in elder abuse and/or neglect. The remaining three were classified as Level-5 evidence (n = 3) for elder mediation and multidisciplinary interventions. There are limited studies with high levels of evidence for interventions that decrease elder abuse and neglect. The scarcity of community-based interventions for older adults and caregivers highlights the need for further work to elevate the quality of studies.

A method for the statistical interpretation of friction ridge skin impression evidence: Method development and validation.

Science.gov (United States)

Swofford, H J; Koertner, A J; Zemp, F; Ausdemore, M; Liu, A; Salyards, M J

2018-04-03

The forensic fingerprint community has faced increasing amounts of criticism by scientific and legal commentators, challenging the validity and reliability of fingerprint evidence due to the lack of an empirically demonstrable basis to evaluate and report the strength of the evidence in a given case. This paper presents a method, developed as a stand-alone software application, FRStat, which provides a statistical assessment of the strength of fingerprint evidence. The performance was evaluated using a variety of mated and non-mated datasets. The results show strong performance characteristics, often with values supporting specificity rates greater than 99%. This method provides fingerprint experts the capability to demonstrate the validity and reliability of fingerprint evidence in a given case and report the findings in a more transparent and standardized fashion with clearly defined criteria for conclusions and known error rate information thereby responding to concerns raised by the scientific and legal communities. Published by Elsevier B.V.

Development of a community based management protocol for ...

African Journals Online (AJOL)

It is evident that water quality management would only be effective by changing the practices that contribute to diffuse pollution. This paper is based on a project that employed a systematic approach to involve and mobilise rural communities in water quality control programmes. The aim of the project is to develop ...

Collective efficacy in Denver, Colorado: Strengthening neighborhoods and health through community gardens.

Science.gov (United States)

Teig, Ellen; Amulya, Joy; Bardwell, Lisa; Buchenau, Michael; Marshall, Julie A; Litt, Jill S

2009-12-01

Community gardens are viewed as a potentially useful environmental change strategy to promote active and healthy lifestyles but the scientific evidence base for gardens is limited. As a step towards understanding whether gardens are a viable health promotion strategy for local communities, we set out to examine the social processes that might explain the connection between gardens, garden participation and health. We analyzed data from semi-structured interviews with community gardeners in Denver. The analysis examined social processes described by community gardeners and how those social processes were cultivated by or supportive of activities in community gardens. After presenting results describing these social processes and the activities supporting them, we discuss the potential for the place-based social processes found in community gardens to support collective efficacy, a powerful mechanism for enhancing the role of gardens in promoting health.

Is Sectorial Diversification a Solution to Unemployment. Evidence from EU Regions

NARCIS (Netherlands)

Longhi, S.; Nijkamp, P.; Traistaru, I.

2005-01-01

There is a growing interest in the academic and policy making communities in understanding the effects of sectoral specialisation on labour market performance. The existing empirical evidence, mainly based on US data, generally finds a positive correlation between sectoral specialisation and labour

A constructive Indian country response to the evidence-based program mandate.

Science.gov (United States)

Walker, R Dale; Bigelow, Douglas A

2011-01-01

Over the last 20 years governmental mandates for preferentially funding evidence-based "model" practices and programs has become doctrine in some legislative bodies, federal agencies, and state agencies. It was assumed that what works in small sample, controlled settings would work in all community settings, substantially improving safety, effectiveness, and value-for-money. The evidence-based "model" programs mandate has imposed immutable "core components," fidelity testing, alien programming and program developers, loss of familiar programs, and resource capacity requirements upon tribes, while infringing upon their tribal sovereignty and consultation rights. Tribal response in one state (Oregon) went through three phases: shock and rejection; proposing an alternative approach using criteria of cultural appropriateness, aspiring to evaluability; and adopting logic modeling. The state heard and accepted the argument that the tribal way of knowing is different and valid. Currently, a state-authorized tribal logic model and a review panel process are used to approve tribal best practices for state funding. This constructive response to the evidence-based program mandate elevates tribal practices in the funding and regulatory world, facilitates continuing quality improvement and evaluation, while ensuring that practices and programs remain based on local community context and culture. This article provides details of a model that could well serve tribes facing evidence-based model program mandates throughout the country.

Community Health Workers as Support for Sickle Cell Care

Science.gov (United States)

Hsu, Lewis L.; Green, Nancy S.; Ivy, E. Donnell; Neunert, Cindy; Smaldone, Arlene; Johnson, Shirley; Castillo, Sheila; Castillo, Amparo; Thompson, Trevor; Hampton, Kisha; Strouse, John J.; Stewart, Rosalyn; Hughes, TaLana; Banks, Sonja; Smith-Whitley, Kim; King, Allison; Brown, Mary; Ohene-Frempong, Kwaku; Smith, Wally R.; Martin, Molly

2016-01-01

Community health workers are increasingly recognized as useful for improving health care and health outcomes for a variety of chronic conditions. Community health workers can provide social support, navigation of health systems and resources, and lay counseling. Social and cultural alignment of community health workers with the population they serve is an important aspect of community health worker intervention. Although community health worker interventions have been shown to improve patient-centered outcomes in underserved communities, these interventions have not been evaluated with sickle cell disease. Evidence from other disease areas suggests that community health worker intervention also would be effective for these patients. Sickle cell disease is complex, with a range of barriers to multifaceted care needs at the individual, family/friend, clinical organization, and community levels. Care delivery is complicated by disparities in health care: access, delivery, services, and cultural mismatches between providers and families. Current practices inadequately address or provide incomplete control of symptoms, especially pain, resulting in decreased quality of life and high medical expense. The authors propose that care and care outcomes for people with sickle cell disease could be improved through community health worker case management, social support, and health system navigation. This report outlines implementation strategies in current use to test community health workers for sickle cell disease management in a variety of settings. National medical and advocacy efforts to develop the community health workforce for sickle cell disease management may enhance the progress and development of “best practices” for this area of community-based care. PMID:27320471

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.

Psychiatric morbidity in two urban communities in Nigeria | Mba ...

African Journals Online (AJOL)

Background: There is a welter of evidence for an inverse relationship between socio-economic status (SES) and mental health. The relationship is grossly under researched in the developing countries. Objective: To ascertain rates of gross psychiatric morbidity and some demographic correlations in two communities with ...

COPD360social Online Community: A Social Media Review.

Science.gov (United States)

Stellefson, Michael; Paige, Samantha R; Alber, Julia M; Stewart, Margaret

2018-06-01

People living with chronic obstructive pulmonary disease (COPD) commonly report feelings of loneliness and social isolation due to lack of support from family, friends, and health care providers. COPD360social is an interactive and disease-specific online community and social network dedicated to connecting people living with COPD to evidence-based resources. Through free access to collaborative forums, members can explore, engage, and discuss an array of disease-related topics, such as symptom management. This social media review provides an overview of COPD360social, specifically its features that practitioners can leverage to facilitate patient-provider communication, knowledge translation, and community building. The potential of COPD360social for chronic disease self-management is maximized through community recognition programming and interactive friend-finding tools that encourage members to share their own stories through blogs and multimedia (e.g., images, videos). The platform also fosters collaborative knowledge dissemination and helping relationships among patients, family members, friends, and health care providers. Successful implementation of COPD360social has dramatically expanded patient education and self-management support resources for people affected by COPD. Practitioners should refer patients and their families to online social networks such as COPD360social to increase knowledge and awareness of evidence-based chronic disease management practices.

Signals of Climate Change in Butterfly Communities in a Mediterranean Protected Area

Science.gov (United States)

Zografou, Konstantina; Kati, Vassiliki; Grill, Andrea; Wilson, Robert J.; Tzirkalli, Elli; Pamperis, Lazaros N.; Halley, John M.

2014-01-01

The European protected-area network will cease to be efficient for biodiversity conservation, particularly in the Mediterranean region, if species are driven out of protected areas by climate warming. Yet, no empirical evidence of how climate change influences ecological communities in Mediterranean nature reserves really exists. Here, we examine long-term (1998–2011/2012) and short-term (2011–2012) changes in the butterfly fauna of Dadia National Park (Greece) by revisiting 21 and 18 transects in 2011 and 2012 respectively, that were initially surveyed in 1998. We evaluate the temperature trend for the study area for a 22-year-period (1990–2012) in which all three butterfly surveys are included. We also assess changes in community composition and species richness in butterfly communities using information on (a) species’ elevational distributions in Greece and (b) Community Temperature Index (calculated from the average temperature of species' geographical ranges in Europe, weighted by species' abundance per transect and year). Despite the protected status of Dadia NP and the subsequent stability of land use regimes, we found a marked change in butterfly community composition over a 13 year period, concomitant with an increase of annual average temperature of 0.95°C. Our analysis gave no evidence of significant year-to-year (2011–2012) variability in butterfly community composition, suggesting that the community composition change we recorded is likely the consequence of long-term environmental change, such as climate warming. We observe an increased abundance of low-elevation species whereas species mainly occurring at higher elevations in the region declined. The Community Temperature Index was found to increase in all habitats except agricultural areas. If equivalent changes occur in other protected areas and taxonomic groups across Mediterranean Europe, new conservation options and approaches for increasing species’ resilience may have to be

Signals of climate change in butterfly communities in a Mediterranean protected area.

Science.gov (United States)

Zografou, Konstantina; Kati, Vassiliki; Grill, Andrea; Wilson, Robert J; Tzirkalli, Elli; Pamperis, Lazaros N; Halley, John M

2014-01-01

The European protected-area network will cease to be efficient for biodiversity conservation, particularly in the Mediterranean region, if species are driven out of protected areas by climate warming. Yet, no empirical evidence of how climate change influences ecological communities in Mediterranean nature reserves really exists. Here, we examine long-term (1998-2011/2012) and short-term (2011-2012) changes in the butterfly fauna of Dadia National Park (Greece) by revisiting 21 and 18 transects in 2011 and 2012 respectively, that were initially surveyed in 1998. We evaluate the temperature trend for the study area for a 22-year-period (1990-2012) in which all three butterfly surveys are included. We also assess changes in community composition and species richness in butterfly communities using information on (a) species' elevational distributions in Greece and (b) Community Temperature Index (calculated from the average temperature of species' geographical ranges in Europe, weighted by species' abundance per transect and year). Despite the protected status of Dadia NP and the subsequent stability of land use regimes, we found a marked change in butterfly community composition over a 13 year period, concomitant with an increase of annual average temperature of 0.95°C. Our analysis gave no evidence of significant year-to-year (2011-2012) variability in butterfly community composition, suggesting that the community composition change we recorded is likely the consequence of long-term environmental change, such as climate warming. We observe an increased abundance of low-elevation species whereas species mainly occurring at higher elevations in the region declined. The Community Temperature Index was found to increase in all habitats except agricultural areas. If equivalent changes occur in other protected areas and taxonomic groups across Mediterranean Europe, new conservation options and approaches for increasing species' resilience may have to be devised.

Signals of climate change in butterfly communities in a Mediterranean protected area.

Directory of Open Access Journals (Sweden)

Konstantina Zografou

Full Text Available The European protected-area network will cease to be efficient for biodiversity conservation, particularly in the Mediterranean region, if species are driven out of protected areas by climate warming. Yet, no empirical evidence of how climate change influences ecological communities in Mediterranean nature reserves really exists. Here, we examine long-term (1998-2011/2012 and short-term (2011-2012 changes in the butterfly fauna of Dadia National Park (Greece by revisiting 21 and 18 transects in 2011 and 2012 respectively, that were initially surveyed in 1998. We evaluate the temperature trend for the study area for a 22-year-period (1990-2012 in which all three butterfly surveys are included. We also assess changes in community composition and species richness in butterfly communities using information on (a species' elevational distributions in Greece and (b Community Temperature Index (calculated from the average temperature of species' geographical ranges in Europe, weighted by species' abundance per transect and year. Despite the protected status of Dadia NP and the subsequent stability of land use regimes, we found a marked change in butterfly community composition over a 13 year period, concomitant with an increase of annual average temperature of 0.95°C. Our analysis gave no evidence of significant year-to-year (2011-2012 variability in butterfly community composition, suggesting that the community composition change we recorded is likely the consequence of long-term environmental change, such as climate warming. We observe an increased abundance of low-elevation species whereas species mainly occurring at higher elevations in the region declined. The Community Temperature Index was found to increase in all habitats except agricultural areas. If equivalent changes occur in other protected areas and taxonomic groups across Mediterranean Europe, new conservation options and approaches for increasing species' resilience may have to be

A systematic review of community-based interventions for emerging zoonotic infectious diseases in Southeast Asia

Science.gov (United States)

Halton, Kate; Sarna, Mohinder; Barnett, Adrian; Leonardo, Lydia; Graves, Nicholas

2013-01-01

Executive Summary Background Southeast Asia has been at the epicentre of recent epidemics of emerging and re-emerging zoonotic diseases. Community-based surveillance and control interventions have been heavily promoted but the most effective interventions have not been identified. Objectives This review evaluated evidence for the effectiveness of community-based surveillance interventions at monitoring and identifying emerging infectious disease; the effectiveness of community-based control interventions at reducing rates of emerging infectious disease; and contextual factors that influence intervention effectiveness. Inclusion criteria Participants Communities in Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand and Viet Nam. Types of intervention(s) Non-pharmaceutical, non-vaccine, and community-based surveillance or prevention and control interventions targeting rabies, Nipah virus, dengue, SARS or avian influenza. Types of outcomes Primary outcomes: measures: of infection or disease; secondary outcomes: measures of intervention function. Types of studies Original quantitative studies published in English. Search strategy Databases searched (1980 to 2011): PubMed, CINAHL, ProQuest, EBSCOhost, Web of Science, Science Direct, Cochrane database of systematic reviews, WHOLIS, British Development Library, LILACS, World Bank (East Asia), Asian Development Bank. Methodological quality Two independent reviewers critically appraised studies using standard Joanna Briggs Institute instruments. Disagreements were resolved through discussion. Data extraction A customised tool was used to extract quantitative data on intervention(s), populations, study methods, and primary and secondary outcomes; and qualitative contextual information or narrative evidence about interventions. Data synthesis Data was synthesised in a narrative summary with the aid of tables. Meta-analysis was used to statistically pool quantitative results. Results

Theory- and Evidence- Based Intervention: Practice-Based Evidence--Integrating Positive Psychology into a Clinical Psychological Assessment and Intervention Model and How to Measure Outcome

Science.gov (United States)

Nissen, Poul

2011-01-01

In this paper, a model for assessment and intervention is presented. This model explains how to perform theory- and evidence- based as well as practice-based assessment and intervention. The assessment model applies a holistic approach to treatment planning, which includes recognition of the influence of community, school, peers, family and the…

Engaging stakeholder communities as body image intervention partners: The Body Project as a case example.

Science.gov (United States)

Becker, Carolyn Black; Perez, Marisol; Kilpela, Lisa Smith; Diedrichs, Phillippa C; Trujillo, Eva; Stice, Eric

2017-04-01

Despite recent advances in developing evidence-based psychological interventions, substantial changes are needed in the current system of intervention delivery to impact mental health on a global scale (Kazdin & Blase, 2011). Prevention offers one avenue for reaching large populations because prevention interventions often are amenable to scaling-up strategies, such as task-shifting to lay providers, which further facilitate community stakeholder partnerships. This paper discusses the dissemination and implementation of the Body Project, an evidence-based body image prevention program, across 6 diverse stakeholder partnerships that span academic, non-profit and business sectors at national and international levels. The paper details key elements of the Body Project that facilitated partnership development, dissemination and implementation, including use of community-based participatory research methods and a blended train-the-trainer and task-shifting approach. We observed consistent themes across partnerships, including: sharing decision making with community partners, engaging of community leaders as gatekeepers, emphasizing strengths of community partners, working within the community's structure, optimizing non-traditional and/or private financial resources, placing value on cost-effectiveness and sustainability, marketing the program, and supporting flexibility and creativity in developing strategies for evolution within the community and in research. Ideally, lessons learned with the Body Project can be generalized to implementation of other body image and eating disorder prevention programs. Copyright © 2015 Elsevier Ltd. All rights reserved.

Community-based management of multiple drug resistant tuberculosis in a tertiary hospital in Tanzania: a best practice implementation project.

Science.gov (United States)

Jelly, Isaya; Peters, Micah D J

2017-12-01

The World Health Organization (WHO) has prioritized collaboration with communities in its 2016 "End TB" implementation strategy. Acknowledging the difficulties that some communities face in gaining access to health facilities due to barriers such as stigma, discrimination, healthcare expenditure, transport and income loss, partnering with communities in the roll-out of community-based TB management activities is vital. The aim of this project was to make a contribution to promoting evidence-based practice with regards to the community-based management of multidrug-resistant tuberculosis (MDR-TB) at Kibong'oto National Infectious Disease Hospital, Tanzania, and thereby supporting improvements in patient outcomes and resource utilization. The project utilized the Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI PACES) program to facilitate the collection of pre- and post-audit data. The Getting Research into Practice (GRiP) module was also used to analyze the potential barriers and for designing the final action plan. This project was conducted in three phases over a three-month period at the MDR-TB unit in a referral hospital in Northern Tanzania. The project showed that there were significant improvements in compliance rates in staff education and documentation of patients' suitability and preferences in receiving community-based care for MDR-TB. The compliance rate of criterion 2, which was already 100% at baseline, was slightly lower at follow-up. The project achieved significant improvements in the delivery of evidence-based practice with regards to community-based management of MDR-TB.

Police, Prevention, Social Capital and Communities in El Salvador

Directory of Open Access Journals (Sweden)

Ricardo Antonio Argueta Hernández

2014-05-01

Full Text Available This article analyzes the relationship between police and the community. In El Salvador, the role traditionally played by police has been that of the repressor of crime, with no concern for community outreach. However, over the last two years, the law enforcement agency has had an about face in terms of its attention to the problem of violence and crime. As a result, it has introduced the community police philosophy. That is, a law enforcement agency that empowers active participation in the community in identifying and preventing problems that affect it, meaning that community participation is promoted in terms of tasks tied to citizen security. Currently, what is under consideration is the degree to which there is a process of strengthening the bonds of solidarity, constructive relationships between neighbors, and the existence of social capital that contributes to cooperation between law enforcement and community in preventing violence and crime. Evidently the results of this new form of taking on public security will not be obtained immediately. It requires both the agents and commanders to be convinced that this philosophy can yield good results in crime prevention. However, the community must also become an active player in co-producing security.DOI: http://dx.doi.org/10.5377/rpsp.v1i1.1391

The development of a network for community-based obesity prevention: the CO-OPS Collaboration

Science.gov (United States)

2011-01-01

Background Community-based interventions are a promising approach and an important component of a comprehensive response to obesity. In this paper we describe the Collaboration of COmmunity-based Obesity Prevention Sites (CO-OPS Collaboration) in Australia as an example of a collaborative network to enhance the quality and quantity of obesity prevention action at the community level. The core aims of the CO-OPS Collaboration are to: identify and analyse the lessons learned from a range of community-based initiatives aimed at tackling obesity, and; to identify the elements that make community-based obesity prevention initiatives successful and share the knowledge gained with other communities. Methods Key activities of the collaboration to date have included the development of a set of Best Practice Principles and knowledge translation and exchange activities to promote the application (or use) of evidence, evaluation and analysis in practice. Results The establishment of the CO-OPS Collaboration is a significant step toward strengthening action in this area, by bringing together research, practice and policy expertise to promote best practice, high quality evaluation and knowledge translation and exchange. Future development of the network should include facilitation of further evidence generation and translation drawing from process, impact and outcome evaluation of existing community-based interventions. Conclusions The lessons presented in this paper may help other networks like CO-OPS as they emerge around the globe. It is important that networks integrate with each other and share the experience of creating these networks. PMID:21349185

Evaluating Community Inclusion: A Novel Treatment Program for Children with Autism Spectrum Disorders

Directory of Open Access Journals (Sweden)

Natalie J. Webb

2015-11-01

Full Text Available A state-funded, non-profit organization developed an innovative inclusion program for children with Autism spectrum disorders and developmental delays, Including Special Kids, which offers activities for children with developmental delays alongside typically developing children in collaboration with well-established local youth programs. This case study examines the ISK intervention program at the original community host sites to determine if the evidence supports a measurable and demonstrable change in behaviors in a real-world setting that may lead to increased quality of life and greater inclusion in the community. Using evidence-based data, we measured the progress of 30 children over 6-24 months. Children participating in the program showed average improvement in all but two function areas and improvement in all composite scores. While these results do not prove program success, they offer an indication that the program helps children learn skills and behaviors to successfully navigate and become part of community-based, after-school recreational programs.

Knowledge and attitude of nurses to Community Psychiatry services ...

African Journals Online (AJOL)

McRoy

2014-07-26

Jul 26, 2014 ... purpose of this study was to determine the knowledge and attitude of. Registered Nurses (RNs) towards Community Psychiatric services. Methods: A ... disseminate information and care for mentally ill people and their ... is evidence in the literature to suggest that ... patient's daily life creating an individually.

Measuring progress of collaborative action in a community health effort

Directory of Open Access Journals (Sweden)

Vicki L. Collie-Akers

2013-12-01

Full Text Available OBJECTIVE: To measure the progress made by the collaborative actions of multisectorial partners in a community health effort using a systematic method to document and evaluate community/system changes over time. METHODS: This was a community-based participatory research project engaging community partners of the Latino Health for All Coalition, which based on the Health for All model, addresses health inequity in a low-income neighborhood in Kansas City, Kansas, United States of America. Guided by three research questions regarding the extent to which the Coalition catalyzed change, intensity of change, and how to visually display change, data were collected on community/system changes implemented by the community partners from 2009-2012. These changes were characterized and rated according to intensity (event duration, population reach, and strategy and by other categories, such as social determinant of health mechanism and sector. RESULTS: During the 4-year study period, the Coalition implemented 64 community/system changes. These changes were aligned with the Coalition's primary goals of healthy nutrition, physical activity, and access to health screenings. Community/system efforts improved over time, becoming longer in duration and reaching more of the population. CONCLUSIONS: Although evidence of its predictive validity awaits further research, this method for documenting and characterizing community/system changes enables community partners to see progress made by their health initiatives.

The History of Evidence-Based Practice in Nursing Education and Practice.

Science.gov (United States)

Mackey, April; Bassendowski, Sandra

Beginning with Florence Nightingale in the 1800s and evolving again within the medical community, evidence-based practice continues to advance along with the nursing discipline. Evidence-based practice is foundational to undergraduate and graduate nursing education and is a way for the nursing discipline to minimize the theory to practice gap. This article discusses the concept of evidence-based practice from a historical perspective as it relates to nursing in the educational and practice domains. The concept evidence-based practice is defined, and the similarities and differences to evidence-based medicine are discussed. It is crucial that registered nurses be proactive in their quest for research knowledge, so the gap between theory and practice continues to close. Utilizing nursing best practice guidelines, reviewing and implementing applicable research evidence, and taking advantage of technological advances are all ways in which nursing can move forward as a well-informed discipline. Copyright © 2016 Elsevier Inc. All rights reserved.

An evaluation of a community dietetics intervention on the management of malnutrition for healthcare professionals.

LENUS (Irish Health Repository)

Kennelly, S

2010-12-01

Healthcare professionals working in the community setting have limited knowledge of the evidence-based management of malnutrition. The present study aimed to evaluate a community dietetics intervention, which included an education programme for healthcare professionals in conjunction with the introduction of a community dietetics service for patients \\'at risk\\' of malnutrition. Changes in nutritional knowledge and the reported management of malnourished patients were investigated and the acceptability of the intervention was explored.

Concluding the Series on Evidence-Based Practice: The Spread of Excellence in Child and Adolescent Psychiatry

Science.gov (United States)

Hamilton, John D.

2008-01-01

The child and adolescent psychiatry community has been using large systems of information and new technologies to improve its performance.Evidence-based approach is used by practitioners to find and implement feasible therapies and medication. The different procedures involved of evidence-based practice, as used in child and adolescent psychology,…

Youth in Community Decision-Making: A Study of Youth-Adult Partnerships

Directory of Open Access Journals (Sweden)

Shelley Murdock

2008-03-01

Full Text Available Involving youth in community and organizational decision-making is widely believed to lead to stronger communities. A promising strategy to foster decision-making is youth-adult partnerships in which youth and adults work collaboratively, sharing their strengths, collective knowledge, and decision-making power. A qualitative study of eight youth organizations showed that those organizations employing youth-adult partnership strategies were most effective in increasing youth's contributions to their communities. This article explores the elements of youth-adult partnership that were evident among successful organizations including: mutual respect, meaningful roles for youth, unique contributions of adults and youth, and shared decision-making and implications for youth development programs.

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. 

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.

Evaluating a dignity care intervention for palliative care in the community setting: community nurses' perspectives.

Science.gov (United States)

McIlfatrick, Sonja; Connolly, Michael; Collins, Rita; Murphy, Tara; Johnston, Bridget; Larkin, Philip

2017-12-01

To evaluate a dignity care intervention provided by community nurses seeking to address dignity concerns for people with advanced and life-limiting conditions. Evidence would suggest that dying people fear a loss of dignity and a central focus of palliative care is to assist people to die with dignity. Whilst community nurses have a key role to play in the delivery of palliative care, specific interventions for dignity are lacking. A mixed methods study using online survey and focus group interviews and thematic analysis to examine data. Twenty four community nurses implemented the dignity care intervention for people with advanced and life-limiting conditions were recruited from four pilot sites across Ireland. Four focus group interviews and on line survey were conducted between March-June 2015. The community nurses found the dignity care intervention useful. It helped the nurses to provide holistic end-of-life care and assisted in the overall assessment of palliative care patients, identifying areas that might not otherwise have been noted. Whilst it was a useful tool for communication, they noted that it stimulated some emotionally sensitive conversations for which they felt unprepared. Implementing the dignity care intervention in practice was challenging. However, the dignity care intervention facilitated holistic assessment and identified patient dignity-related concerns that may not have been otherwise identified. Further support is required to overcome barriers and enable dignity-conserving care. Ensuring dignity is a key aspect of palliative and end-of-life care; however, community nurses may not feel equipped to address this aspect of care. Implementing a dignity care intervention can assist in identifying patient dignity-related concerns and provision of holistic care. Community nurses need more training to assist in difficult conversations relating to dignity and end-of-life care. © 2017 John Wiley & Sons Ltd.

The Community Child Health Network Life Stress Interview: a brief chronic stress measure for community health research.

Science.gov (United States)

Tanner Stapleton, Lynlee R; Dunkel Schetter, Christine; Dooley, Larissa N; Guardino, Christine M; Huynh, Jan; Paek, Cynthia; Clark-Kauffman, Elizabeth; Schafer, Peter; Woolard, Richard; Lanzi, Robin Gaines

2016-07-01

Chronic stress is implicated in many theories as a contributor to a wide range of physical and mental health problems. The current study describes the development of a chronic stress measure that was based on the UCLA Life Stress Interview (LSI) and adapted in collaboration with community partners for use in a large community health study of low-income, ethnically diverse parents of infants in the USA (Community Child Health Network [CCHN]). We describe the instrument, its purpose and adaptations, implementation, and results of a reliability study in a subsample of the larger study cohort. Interviews with 272 mothers were included in the present study. Chronic stress was assessed using the CCHN LSI, an instrument designed for administration by trained community interviewers to assess four domains of chronic stress, each rated by interviewers. Significant correlations ranging from small to moderate in size between chronic stress scores on this measure, other measures of stress, biomarkers of allostatic load, and mental health provide initial evidence of construct and concurrent validity. Reliability data for interviewer ratings are also provided. This relatively brief interview (15 minutes) is available for use and may be a valuable tool for researchers seeking to measure chronic stress reliably and validly in future studies with time constraints.

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

Soil microbial community successional patterns during forest ecosystem restoration.

Science.gov (United States)

Banning, Natasha C; Gleeson, Deirdre B; Grigg, Andrew H; Grant, Carl D; Andersen, Gary L; Brodie, Eoin L; Murphy, D V

2011-09-01

Soil microbial community characterization is increasingly being used to determine the responses of soils to stress and disturbances and to assess ecosystem sustainability. However, there is little experimental evidence to indicate that predictable patterns in microbial community structure or composition occur during secondary succession or ecosystem restoration. This study utilized a chronosequence of developing jarrah (Eucalyptus marginata) forest ecosystems, rehabilitated after bauxite mining (up to 18 years old), to examine changes in soil bacterial and fungal community structures (by automated ribosomal intergenic spacer analysis [ARISA]) and changes in specific soil bacterial phyla by 16S rRNA gene microarray analysis. This study demonstrated that mining in these ecosystems significantly altered soil bacterial and fungal community structures. The hypothesis that the soil microbial community structures would become more similar to those of the surrounding nonmined forest with rehabilitation age was broadly supported by shifts in the bacterial but not the fungal community. Microarray analysis enabled the identification of clear successional trends in the bacterial community at the phylum level and supported the finding of an increase in similarity to nonmined forest soil with rehabilitation age. Changes in soil microbial community structure were significantly related to the size of the microbial biomass as well as numerous edaphic variables (including pH and C, N, and P nutrient concentrations). These findings suggest that soil bacterial community dynamics follow a pattern in developing ecosystems that may be predictable and can be conceptualized as providing an integrated assessment of numerous edaphic variables.

Community-based dental education and the importance of faculty development.

Science.gov (United States)

McAndrew, Maureen

2010-09-01

Community-based dental education offers a variety of positive learning experiences for students while providing needed dental services for the underserved. More dental students are being instructed by a growing body of largely volunteer community-based faculty who practice in a wide range of community settings including community hospitals and clinics, nursing homes, and private practices. These geographically dispersed instructors may have little experience as educators. Their practice styles and their motivation to improve teaching effectiveness are likely to differ from the styles and motivation of school-based faculty members. Moreover, many dental schools have begun to emphasize practices that may be unfamiliar to community-based faculty such as evidence-based practice. Providing faculty development for them is challenging, yet crucial to the success of these programs and dental education in general. Fundamental elements that must be considered for effective community faculty development programming include fostering a culture of respect between school-based and community faculty members, basing programs on the actual needs of these educators, integrating principles of adult learning theory, and establishing ongoing institutional support. This article provides background on this movement, reviews the literature for faculty development programs geared specifically to community-based educators, makes recommendations for development programs for these dental educators, and includes suggestions for future research.

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.)

What Do We Mean by 'Community Resilience'? A Systematic Literature Review of How It Is Defined in the Literature.

Science.gov (United States)

Patel, Sonny S; Rogers, M Brooke; Amlôt, Richard; Rubin, G James

2017-02-01

Government, industry and charitable organisations have an increasing focus on programs intended to support community resilience to disasters. But has consensus been reached as to what defines 'community resilience' and what its core characteristics are? We undertook a systematic literature review of definitions of community resilience related to disasters. We conducted an inductive thematic analysis of the definitions and descriptions that we identified, in order to determine the proposed characteristics of community resilience prior to, during and after a disaster. We identified 80 relevant papers. There was no evidence of a common, agreed definition of community resilience. In spite of this, evidence was found of nine core elements of community resilience that were common among the definitions. The core elements were: local knowledge, community networks and relationships, communication, health, governance and leadership, resources, economic investment, preparedness, and mental outlook. Within these core elements, we identified 19 sub-elements linked to community resilience. Our findings show that community resilience remains an amorphous concept that is understood and applied differently by different research groups. Yet in spite of the differences in conception and application, there are well-understood elements that are widely proposed as important for a resilient community. A focus on these individual elements may be more productive than attempting to define and study community resilience as a distinct concept.

Understanding Community: thoughts and experiences of young people

Directory of Open Access Journals (Sweden)

Hilary Yerbury

2009-08-01

Full Text Available This ethnographic study of members of Generation X and Generation Y seeks to explore the ways they understand and experience community. Their comments and stories were gathered through interviews collected towards the end of 2006 and the early part of 2007. These provide richly textured evidence of their need to belong, to maintain everyday relationships and to collaborate with others at the same time as they commodify relationships or share information but not necessarily beliefs and values. Consequences of globalisation such as individualisation, transience in relationships, immediacy in communication, the blurring of boundaries between work and leisure, between public and private and the reliance on information and communication technologies are part of their everyday lives. Some study participants feel dis-embedded from their traditional social relationships and seek to establish new ones, whereas others feel comfortable joking with anonymous others. Their intellectualised constructs of community and descriptions of the lived reality of community find reflections in a range of theoretical constructs in the literature, both reinforcing and shifting scholarly understandings of the concept of community.

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

The Academic Consequences of Employment for Students Enrolled in Community College. CCRC Working Paper No. 46

Science.gov (United States)

Dadgar, Mina

2012-01-01

College students are increasingly combining studying with paid employment, and community college students tend to work even longer hours compared with students at four-year colleges. Yet, there is little evidence on the academic consequences of community college students' term-time employment. Using a rare administrative dataset from Washington…

Plurality and equality in the Learning Communities

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Mimar Ramis-Salas

2015-09-01

Full Text Available Purpose: to present empirical evidence of the success generated as a result of the types of organization of the centres and the classrooms in the CA. The inclusion of the plurality of voices of families from very different origins allows for an education that based on the plurality and diversity manages to achieve a greater equality in the results of all children. Design/methodology/approach: the present article is based on 1 review of the scientific literature in journals selected in the Journal Citation Reports about the types of participation of migrant families and from cultural minorities and their effect on the education of their children; and 2 on the collection of testimonies of migrant and cultural minority families through qualitative techniques. Findings and Originality/value: empirical evidence is presented about how the types of management and organization of the families participation in the classroom and the school of Learning communities maximize the plurality of voices (migrant and cultural minority families and contribute to improve the results of the children of the social groups who are most underprivileged and who obtain a greater improvement in the results levelling them with those of the mainstream society. Research limitations/implications: complexity to achieve a climate of ideal egalitarian dialogue in the framework of the communicative research data collection techniques Social implications: the article emphasizes the fact that evidence based actions achieve social and educational transformation, contributing to respond to the objectives of Europe 2020 to achieve more inclusive societies. Originality/value: how through implementing certain forms of classroom and school organization based on the inclusion of the plurality of voices, we contribute evidence of the improvement of the management of the center and the transformation of the relations with the community, beyond the educational success.

Emotionally Numb: Desensitization to Community Violence Exposure among Urban Youth

Science.gov (United States)

Kennedy, Traci M.; Ceballo, Rosario

2016-01-01

Community violence exposure (CVE) is associated with numerous psychosocial outcomes among youth. Although linear, cumulative effects models have typically been used to describe these relations, emerging evidence suggests the presence of curvilinear associations that may represent a pattern of emotional desensitization among youth exposed to…

Color categories: Evidence for the cultural relativity hypothesis

OpenAIRE

Roberson, Debi; Davidoff, Jules B.; Davies, Ian R. L.; Shapiro, Laura R.

2005-01-01

The question of whether language affects our categorization of perceptual continua is of particular interest for the domain of color where constraints on categorization have been proposed both within the visual system and in the visual environment. Recent research (Roberson, Davies, & Davidoff, 2000; Roberson et al., in press) found substantial evidence of cognitive color differences between different language communities, but concerns remained as to how representative might be a tiny, extrem...

Responses of Coral-Associated Bacterial Communities to Local and Global Stressors

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Jamie M. McDevitt-Irwin

2017-08-01

Full Text Available The microbial contribution to ecological resilience is still largely overlooked in coral reef ecology. Coral-associated bacteria serve a wide variety of functional roles with reference to the coral host, and thus, the composition of the overall microbiome community can strongly influence coral health and survival. Here, we synthesize the findings of recent studies (n = 45 that evaluated the impacts of the top three stressors facing coral reefs (climate change, water pollution and overfishing on coral microbiome community structure and diversity. Contrary to the species losses that are typical of many ecological communities under stress, here we show that microbial richness tends to be higher rather than lower for stressed corals (i.e., in ~60% of cases, regardless of the stressor. Microbial responses to stress were taxonomically consistent across stressors, with specific taxa typically increasing in abundance (e.g., Vibrionales, Flavobacteriales, Rhodobacterales, Alteromonadales, Rhizobiales, Rhodospirillales, and Desulfovibrionales and others declining (e.g., Oceanosprillales. Emerging evidence also suggests that stress may increase the microbial beta diversity amongst coral colonies, potentially reflecting a reduced ability of the coral host to regulate its microbiome. Moving forward, studies will need to discern the implications of stress-induced shifts in microbiome diversity for the coral hosts and may be able to use microbiome community structure to identify resilient corals. The evidence we present here supports the hypothesis that microbial communities play important roles in ecological resilience, and we encourage a focus on the microbial contributions to resilience for future research.

The Influence of Community Health Resources on Effectiveness and Sustainability of Community and Lay Health Worker Programs in Lower-Income Countries: A Systematic Review.

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Daniel H de Vries

Full Text Available Despite the availability of practical knowledge and effective interventions required to reduce priority health problems in low-income countries, poor and vulnerable populations are often not reached. One possible solution to this problem is the use of Community or Lay Health Workers (CLHWs. So far, however, the development of sustainability in CLHW programs has failed and high attrition rates continue to pose a challenge. We propose that the roles and interests which support community health work should emerge directly from the way in which health is organized at community level. This review explores the evidence available to assess if increased levels of integration of community health resources in CLHW programs indeed lead to higher program effectiveness and sustainability.This review includes peer-reviewed articles which meet three eligibility criteria: 1 specific focus on CLHWs or equivalent; 2 randomized, quasi-randomized, before/after methodology or substantial descriptive assessment; and 3 description of a community or peer intervention health program located in a low- or middle-income country. Literature searches using various article databases led to 2930 hits, of which 359 articles were classified. Of these, 32 articles were chosen for extensive review, complemented by analysis of the results of 15 other review studies. Analysis was conducted using an excel based data extraction form. Because results showed that no quantitative data was published, a descriptive synthesis was conducted. The review protocol was not proactively registered. Findings show minimal inclusion of even basic community level indicators, such as the degree to which the program is a community initiative, community input in the program or training, the background and history of CLHW recruits, and the role of the community in motivation and retention. Results show that of the 32 studies, only one includes one statistical measure of community integration. As a result

Predicting prediabetes in a rural community: a survey among the Karen ethnic community, Thasongyang, Thailand

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Lorga T

2012-03-01

Full Text Available Thaworn Lorga1, Myo Nyein Aung1,2, Prissana Naunboonruang1, Payom Thinuan1, Nara Praipaksin3, Tida Deesakul3, Utumporn Inwan3, Tawatchai Yingtaweesak4, Pratumpan Manokulanan1, Srisomporn Suangkaew1, Apiradee Payaprom41Boromarajonani College of Nursing Nakhon Lampang (BCNLP, Lampang, Thailand; 2Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan; 3Baan Rekati Health Station, Thasongyang, Tak, Thailand; 4Thasongyang Hospital, Thasongyang, Tak, ThailandBackground: Diabetes is a growing epidemic in both urban and rural communities worldwide.Aim: We aimed to survey fasting plasma glucose (FPG status and awareness of diabetes in the rural Karen ethnic community. We investigated the predictors of impaired fasting plasma glucose (IFG status, which would be easily applicable for prevention of diabetes in a rural community.Materials and methods: This was a community-based cross-sectional study conducted at Thasongyang, the most north-western district in Thailand. A total of 299 Karen ethnic rural residents were included in the study. FPG, body mass index, and waist circumference were prospectively measured. We assessed the awareness of diabetes and lifestyle-related health behavior with closed questionnaires in a rural community setting.Results: On screening for FPG, 16.72% of the Karen ethnic residents had hyperglycemia: 3.68% in the diabetic range and 13.04% in the prediabetic range respectively. After adjustment for age, sex, and BMI, waist circumference (adjusted odds ratio [aOR] 3.5, 95% confidence interval [CI] 1.29–9.57, and having a diabetic blood relative (aOR 4.6, CI 1.81–11.71 are significant predictors of IFG status.Conclusion: It is necessary to promote awareness of diabetes among the Karen ethnic community. Application of simple evidence-based predictors of the prediabetic state may lead to timely and effective prevention of diabetes in rural settings.Keywords: diabetes, prediabetes, fasting plasma

Putting the public (back) into public health: leadership, evidence and action.

Science.gov (United States)

South, J; Connolly, A M; Stansfield, J A; Johnstone, P; Henderson, G; Fenton, K A

2018-03-13

There is a strong evidence-based rationale for community capacity building and community empowerment as part of a strategic response to reduce health inequalities. Within the current UK policy context, there are calls for increased public engagement in prevention and local decision-making in order to give people greater control over the conditions that determine health. With reference to the challenges and opportunities within the English public health system, this essay seeks to open debate about what is required to mainstream community-centred approaches and ensure that the public is central to public health. The essay sets out the case for a reorientation of public health practice in order to build impactful action with communities at scale leading to a reduction in the health gap. National frameworks that support local practice are described. Four areas of challenge that could potentially drive an implementation gap are discussed: (i) achieving integration and scale, (ii) effective community mobilization, (iii) evidencing impact and (iv) achieving a shift in power. The essay concludes with a call to action for developing a contemporary public health practice that is rooted in communities and offers local leadership to strengthen local assets, increase community control and reduce health inequalities.

Experimental evidence of a symbiosis between red-cockaded woodpeckers and fungi.

Science.gov (United States)

Jusino, Michelle A; Lindner, Daniel L; Banik, Mark T; Rose, Kevin R; Walters, Jeffrey R

2016-03-30

Primary cavity excavators, such as woodpeckers, are ecosystem engineers in many systems. Associations between cavity excavators and fungi have long been hypothesized to facilitate cavity excavation, but these relationships have not been experimentally verified. Fungi may help excavators by softening wood, while excavators may facilitate fungal dispersal. Here we demonstrate that excavators facilitate fungal dispersal and thus we report the first experimental evidence of a symbiosis between fungi and a cavity excavator, the red-cockaded woodpecker (RCW,Picoides borealis). Swab samples of birds showed that RCWs carry fungal communities similar to those found in their completed excavations. A 26-month field experiment using human-made aseptically drilled excavations in live trees, half of which were inaccessible to RCWs, demonstrated that RCWs directly alter fungal colonization and community composition. Experimental excavations that were accessible to RCWs contained fungal communities similar to natural RCW excavations, whereas inaccessible experimental excavations contained significantly different fungal communities. Our work demonstrates a complex symbiosis between cavity excavators and communities of fungi, with implications for forest ecology, wildlife management, and conservation. © 2016 The Author(s).

Paleo-eskimo mtDNA genome reveals matrilineal discontinuity in Greenland

DEFF Research Database (Denmark)

Gilbert, Marcus Thomas Pius; Kivisild, Toomas; Grønnow, Bjarne

2008-01-01

a mitochondrial genome from a Paleo-Eskimo human by using 3400-to 4500-year-old frozen hair excavated from an early Greenlandic Saqqaq settlement. The sample is distinct from modern Native Americans and Neo-Eskimos, falling within haplogroup D2a1, a group previously observed among modern Aleuts and Siberian......The Paleo-Eskimo Saqqaq and Independence I cultures, documented from archaeological remains in Northern Canada and Greenland, represent the earliest human expansion into the New World's northern extremes. However, their origin and genetic relationship to later cultures are unknown. We sequenced...

The search conference as a method in planning community health promotion actions

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Eva Magnus

2016-08-01

Full Text Available Aims: The aim of this article is to describe and discuss how the search conference can be used as a method for planning health promotion actions in local communities. Design and methods: The article draws on experiences with using the method for an innovative project in health promotion in three Norwegian municipalities. The method is described both in general and how it was specifically adopted for the project. Results and conclusions: The search conference as a method was used to develop evidence-based health promotion action plans. With its use of both bottom-up and top-down approaches, this method is a relevant strategy for involving a community in the planning stages of health promotion actions in line with political expectations of participation, ownership, and evidence-based initiatives.

Increasing Research Capacity in Underserved Communities: Formative and Summative Evaluation of the Mississippi Community Research Fellows Training Program (Cohort 1

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Danielle Fastring

2018-02-01

Full Text Available BackgroundThe Mississippi Community Research Fellows Training Program (MSCRFTP is a 15-week program conducted in Jackson, MS, USA consisting of training in the areas of evidence-based public health, research methods, research ethics, and cultural competency. The purpose of the program was to increase community knowledge and understanding of public health research, develop community-based projects that addressed health disparity in the participants’ community, increase individual and community capacity, and to engage community members as equal partners in the research process.MethodsA comprehensive evaluation of the MSCRFTP was conducted that included both quantitative and qualitative methods. All participants were asked to complete a baseline, midterm, and final assessment as part of their program requirements. Knowledge gained was assessed by comparing baseline assessment responses to final assessment responses related to 27 key content areas addressed in the training sessions. Assessments also collected participants’ attitudes toward participating in research within their communities, their perceived influence over community decisions, and their perceptions of community members’ involvement in research, satisfaction with the program, and the program’s impact on the participants’ daily practice and community work.ResultsTwenty-one participants, the majority of which were female and African-American, completed the MSCRFTP. Knowledge of concepts addressed in 15 weekly training sessions improved significantly on 85.2% of 27 key areas evaluated (p < 0.05. Two mini-grant community based participatory research projects proposed by participants were funded through competitive application. Most participants agreed that by working together, the people in their community could influence decisions that affected the community. All participants rated their satisfaction with the overall program as “very high” (76.2%, n = 16 or �

Bacterial Communities Associated with the Lichen Symbiosis▿ †

Science.gov (United States)

Bates, Scott T.; Cropsey, Garrett W. G.; Caporaso, J. Gregory; Knight, Rob; Fierer, Noah

2011-01-01

Lichens are commonly described as a mutualistic symbiosis between fungi and “algae” (Chlorophyta or Cyanobacteria); however, they also have internal bacterial communities. Recent research suggests that lichen-associated microbes are an integral component of lichen thalli and that the classical view of this symbiotic relationship should be expanded to include bacteria. However, we still have a limited understanding of the phylogenetic structure of these communities and their variability across lichen species. To address these knowledge gaps, we used bar-coded pyrosequencing to survey the bacterial communities associated with lichens. Bacterial sequences obtained from four lichen species at multiple locations on rock outcrops suggested that each lichen species harbored a distinct community and that all communities were dominated by Alphaproteobacteria. Across all samples, we recovered numerous bacterial phylotypes that were closely related to sequences isolated from lichens in prior investigations, including those from a lichen-associated Rhizobiales lineage (LAR1; putative N2 fixers). LAR1-related phylotypes were relatively abundant and were found in all four lichen species, and many sequences closely related to other known N2 fixers (e.g., Azospirillum, Bradyrhizobium, and Frankia) were recovered. Our findings confirm the presence of highly structured bacterial communities within lichens and provide additional evidence that these bacteria may serve distinct functional roles within lichen symbioses. PMID:21169444

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…

Exploration in sensitive areas: Convincing the community

International Nuclear Information System (INIS)

Stejskal, I.V.

1995-01-01

The Exmouth region WA is known for the Ningaloo Reef, an environmentally sensitive region covered by petroleum exploration permits. This paper discusses the issue of carrying out drilling operations in an environmentally sensitive area. Despite the successful drilling of two wells in the area in 1993, and an environmental management strategy developed by the operating company, the continuing policy of not allowing drilling in Ningaloo Marine Park was an example of government, the local community and the widespread public disregarding of scientific evidence and the environmental record of the oil and gas industry. Nevertheless, the communications program was a success and the exploration company now has an environmental policy that reflects the importance of community and government education and consultation. 1 fig., 1 photo., 11 refs

Establishing the infrastructure to conduct comparative effectiveness research toward the elimination of disparities: a community-based participatory research framework.

Science.gov (United States)

Wilson, Danyell S; Dapic, Virna; Sultan, Dawood H; August, Euna M; Green, B Lee; Roetzheim, Richard; Rivers, Brian

2013-11-01

In Tampa, Florida, researchers have partnered with community- and faith-based organizations to create the Comparative Effectiveness Research for Eliminating Disparities (CERED) infrastructure. Grounded in community-based participatory research, CERED acts on multiple levels of society to enhance informed decision making (IDM) of prostate cancer screening among Black men. CERED investigators combined both comparative effectiveness research and community-based participatory research to design a trial examining the effectiveness of community health workers and a digitally enhanced patient decision aid to support IDM in community settings as compared with "usual care" for prostate cancer screening. In addition, CERED researchers synthesized evidence through the development of systematic literature reviews analyzing the effectiveness of community health workers in changing knowledge, attitudes and behaviors of African American adults toward cancer prevention and education. An additional systematic review analyzed chemoprevention agents for prostate cancer as an emerging technique. Both of these reviews, and the comparative effectiveness trial supporting the IDM process, add to CERED's goal of providing evidence to eliminate cancer health disparities.

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.

Epidemiological Evidence on the Link Between Drug Use and Suicidal Behaviors Among Adolescents

OpenAIRE

Wilcox, Holly C.

2004-01-01

Depression, substance abuse, and aggressive behavior disorders have shown to be among the most influential risk factors for suicide in community and clinical studies of adolescents and adults. Increasing evidence suggests that adolescents who use and abuse alcohol and drugs are at increased risk for suicidal ideation, attempted suicide, and completed suicide, although conclusive evidence has not yet been presented suggesting that drug use causes suicidal thoughts and behaviors. This paper rev...

Utilizing Benchmarking to Study the Effectiveness of Parent-Child Interaction Therapy Implemented in a Community Setting

Science.gov (United States)

Self-Brown, Shannon; Valente, Jessica R.; Wild, Robert C.; Whitaker, Daniel J.; Galanter, Rachel; Dorsey, Shannon; Stanley, Jenelle

2012-01-01

Benchmarking is a program evaluation approach that can be used to study whether the outcomes of parents/children who participate in an evidence-based program in the community approximate the outcomes found in randomized trials. This paper presents a case illustration using benchmarking methodology to examine a community implementation of…

Microbial community dynamics in the rhizosphere of a cadmium hyper-accumulator

Science.gov (United States)

Wood, J. L.; Zhang, C.; Mathews, E. R.; Tang, C.; Franks, A. E.

2016-11-01

Phytoextraction is influenced by the indigenous soil microbial communities during the remediation of heavy metal contaminated soils. Soil microbial communities can affect plant growth, metal availability and the performance of phytoextraction-assisting inocula. Understanding the basic ecology of indigenous soil communities associated with the phytoextraction process, including the interplay between selective pressures upon the communities, is an important step towards phytoextraction optimization. This study investigated the impact of cadmium (Cd), and the presence of a Cd-accumulating plant, Carpobrotus rossii (Haw.) Schwantes, on the structure of soil-bacterial and fungal communities using automated ribosomal intergenic spacer analysis (ARISA) and quantitative PCR (qPCR). Whilst Cd had no detectable influence upon fungal communities, bacterial communities underwent significant structural changes with no reduction in 16S rRNA copy number. The presence of C. rossii influenced the structure of all communities and increased ITS copy number. Suites of operational taxonomic units (OTUs) changed in abundance in response to either Cd or C. rossii, however we found little evidence to suggest that the two selective pressures were acting synergistically. The Cd-induced turnover in bacterial OTUs suggests that Cd alters competition dynamics within the community. Further work to understand how competition is altered could provide a deeper understanding of the microbiome-plant-environment and aid phytoextraction optimization.

West Valley Demonstration Project community relations plan FY 1990/91

International Nuclear Information System (INIS)

Damerow, M.W.

1989-09-01

The purpose of the Community Relations Plan is to fully inform the community about the West Valley Demonstration Project (WVDP) and provide opportunities for public input. A sound approach to community relations is essential to the creation and maintenance of public awareness and community support. The WVDP is a matter of considerable public interest because it deals with nuclear waste. The mission of the WVDP is to solve an existing environmental concern by solidifying high-level radioactive waste and transporting the solidified waste to a federal repository for permanent disposal. The public requires evidence of the continued commitment and demonstrated progress of the industry and government in carrying out the mission in order to sustain confidence that the WVDP is being managed well and will be discussed successfully completed. For this reason, a comprehensive communication plan is essential for the successful completion of the WVDP

Interventions aimed at communities to inform and/or educate about early childhood vaccination.

Science.gov (United States)

Saeterdal, Ingvil; Lewin, Simon; Austvoll-Dahlgren, Astrid; Glenton, Claire; Munabi-Babigumira, Susan

2014-11-19

assessed risk of bias in all included studies. We included two cluster-randomised trials that compared interventions aimed at communities to routine immunisation practices. In one study from India, families, teachers, children and village leaders were encouraged to attend information meetings where they received information about childhood vaccination and could ask questions. In the second study from Pakistan, people who were considered to be trusted in the community were invited to meetings to discuss vaccine coverage rates in their community and the costs and benefits of childhood vaccination. They were asked to develop local action plans and to share the information they had been given and continue the discussions in their communities.The trials show low certainty evidence that interventions aimed at communities to inform and educate about childhood vaccination may improve knowledge of vaccines or vaccine-preventable diseases among intervention participants (adjusted mean difference 0.121, 95% confidence interval (CI) 0.055 to 0.189). These interventions probably increase the number of children who are vaccinated. The study from India showed that the intervention probably increased the number of children who received vaccinations (risk ratio (RR) 1.67, 95% CI 1.21 to 2.31; moderate certainty evidence). The study from Pakistan showed that there is probably an increase in the uptake of both measles (RR 1.63, 95% CI 1.03 to 2.58) and DPT (diptheria, pertussis and tetanus) (RR 2.17, 95% CI 1.43 to 3.29) vaccines (both moderate certainty evidence), but there may be little or no difference in the number of children who received polio vaccine (RR 1.01, 95% CI 0.97 to 1.05; low certainty evidence). There is also low certainty evidence that these interventions may change attitudes in favour of vaccination among parents with young children (adjusted mean difference 0.054, 95% CI 0.013 to 0.105), but they may make little or no difference to the involvement of mothers in decision

Community participation in rural health: a scoping review

Directory of Open Access Journals (Sweden)

Kenny Amanda

2013-02-01

Full Text Available Abstract Background Major health inequities between urban and rural populations have resulted in rural health as a reform priority across a number of countries. However, while there is some commonality between rural areas, there is increasing recognition that a one size fits all approach to rural health is ineffective as it fails to align healthcare with local population need. Community participation is proposed as a strategy to engage communities in developing locally responsive healthcare. Current policy in several countries reflects a desire for meaningful, high level community participation, similar to Arnstein’s definition of citizen power. There is a significant gap in understanding how higher level community participation is best enacted in the rural context. The aim of our study was to identify examples, in the international literature, of higher level community participation in rural healthcare. Methods A scoping review was designed to map the existing evidence base on higher level community participation in rural healthcare planning, design, management and evaluation. Key search terms were developed and mapped. Selected databases and internet search engines were used that identified 99 relevant studies. Results We identified six articles that most closely demonstrated higher level community participation; Arnstein’s notion of citizen power. While the identified studies reflected key elements for effective higher level participation, little detail was provided about how groups were established and how the community was represented. The need for strong partnerships was reiterated, with some studies identifying the impact of relational interactions and social ties. In all studies, outcomes from community participation were not rigorously measured. Conclusions In an environment characterised by increasing interest in community participation in healthcare, greater understanding of the purpose, process and outcomes is a priority for

Kick the habit: a social marketing campaign by Aboriginal communities in NSW.

Science.gov (United States)

Campbell, M A; Finlay, S; Lucas, K; Neal, N; Williams, R

2014-01-01

Tackling smoking is an integral component of efforts to improve health outcomes in Aboriginal communities. Social marketing is an effective strategy for promoting healthy attitudes and influencing behaviours; however, there is little evidence for its success in reducing smoking rates in Aboriginal communities. This paper outlines the development, implementation and evaluation of Kick the Habit Phase 2, an innovative tobacco control social marketing campaign in Aboriginal communities in New South Wales (NSW). The Aboriginal Health & Medical Research Council worked with three Aboriginal communities and a creative agency to develop locally tailored, culturally relevant social marketing campaigns. Each community determined the target audience and main messages, and identified appropriate local champions and marketing tools. Mixed methods were used to evaluate the campaign, including surveys and interviews with community members and Aboriginal Community Controlled Health Service staff. Community survey participants demonstrated high recall of smoking cessation messages, particularly for messages and images specific to the Kick the Habit campaign. Staff participating in interviews reported an increased level of interest from community members in smoking cessation programs, as well as increased confidence and skills in developing further social marketing campaigns. Aboriginal community-driven social marketing campaigns in tobacco control can build capacity, are culturally relevant and lead to high rates of recall in Aboriginal communities.

FIA: An Open Forensic Integration Architecture for Composing Digital Evidence

Science.gov (United States)

Raghavan, Sriram; Clark, Andrew; Mohay, George

The analysis and value of digital evidence in an investigation has been the domain of discourse in the digital forensic community for several years. While many works have considered different approaches to model digital evidence, a comprehensive understanding of the process of merging different evidence items recovered during a forensic analysis is still a distant dream. With the advent of modern technologies, pro-active measures are integral to keeping abreast of all forms of cyber crimes and attacks. This paper motivates the need to formalize the process of analyzing digital evidence from multiple sources simultaneously. In this paper, we present the forensic integration architecture (FIA) which provides a framework for abstracting the evidence source and storage format information from digital evidence and explores the concept of integrating evidence information from multiple sources. The FIA architecture identifies evidence information from multiple sources that enables an investigator to build theories to reconstruct the past. FIA is hierarchically composed of multiple layers and adopts a technology independent approach. FIA is also open and extensible making it simple to adapt to technological changes. We present a case study using a hypothetical car theft case to demonstrate the concepts and illustrate the value it brings into the field.

Do Industries Pollute More in Poorer Neighborhoods? Evidence From Toxic Releasing Plants in Mexico

OpenAIRE

Lopamudra Chakraborti; José Jaime Sainz Santamaría

2015-01-01

Studies on industrial pollution and community pressure in developing countries are rare. We employ previously unused, self-reported toxics pollution data from Mexico to show that there exists some evidence of environmental justice concerns and community pressure in explaining industrial pollution behavior. We obtain historical data on toxic releases into water and land for the time period 2004 to 2012. We focus on 7 major pollutants including heavy metals and cyanide. To address endogeneity c...

A thousand flowers blooming? An examination of community energy in the UK

International Nuclear Information System (INIS)

Seyfang, Gill; Park, Jung Jin; Smith, Adrian

2013-01-01

Community energy has been proposed as a new policy tool to help achieve the transition to a low-carbon energy system, but the evidence base for this strategy is partial and fragmented. We therefore present new empirical evidence from the first independent UK-wide survey of community energy projects. Our survey investigates the objectives, origins and development of these groups across the UK, their activities and their networking activities as a sector. We also examine the strengths and weaknesses of these groups, along with the opportunities and threats presented by wider socioeconomic and political contexts, in order to improve understanding of the sector's potential and the challenges it faces. We highlight several key issues concerning the further development of the sector. First, this highly diverse sector is not reducible to a single entity; its multiple objectives need joined-up thinking among government departments. Second, its civil society basis is fundamental to its success at engaging local communities, and makes the sector quite distinct from the large energy companies these community groups are aiming to work alongside. There are inherent tensions and vulnerabilities in such a model, and limits to how much these groups can achieve on their own: consistent policy support is essential. - Highlights: • The community-led sustainable energy sector is diverse, and growing in the UK. • Sometimes it is more about the community than the energy. • Joined-up policy thinking is needed to properly measure performance and impact. • There are limits to how much civil society-led groups can achieve on their own. • Consistent policy support is essential to the sector's development

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.

Tu Salud ¡Sí Cuenta! Your Health Matters! A Community-wide Campaign in a Hispanic Border Community in Texas.

Science.gov (United States)

Heredia, Natalia I; Lee, MinJae; Mitchell-Bennett, Lisa; Reininger, Belinda M

To evaluate a community-wide campaign, Tu Salud ¡Si Cuenta! (TSSC), in improving eating behaviors and anthropometric outcomes in Hispanic border communities. A quasi-experimental study with matched intervention and comparison communities. Cross-sectional assessments with randomly sampled adults, examined by actual exposure and site (unexposed intervention, exposed intervention, and unexposed comparison). Predominately Mexican Americans located in Brownsville, TX (intervention) and Laredo, TX (control). The TSSC campaign included television and radio segments, community health worker discussions, and newsletters delivered in Brownsville from 2005 to 2010. Healthy and unhealthy eating indices and average hip and waist circumferences. Univariable and multivariable regression models. The sample (n = 799; 400 comparison and 399 intervention) was 98% of Mexican origin; 54% had completed grade 9 or higher. Exposure to any TSSC component was associated with a lower rate of unhealthy food consumption. Compared with the unexposed intervention group, the exposed intervention for the newsletter had a higher rate of healthy eating (adjusted rate ratio = 1.18; P < .01). Compared with the unexposed intervention, the exposed intervention for the community health worker discussion had a smaller hip circumference (adjusted mean difference = -5.77 cm; P < .05) and a smaller waist circumference (adjusted mean difference = -5.25 cm; P < .05). This study provides evidence for the use of community-wide campaigns for nutrition and obesity-related outcomes in Hispanic communities. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

The pathogenic persona of community-associated oral streptococci.

Science.gov (United States)

Whitmore, Sarah E; Lamont, Richard J

2011-07-01

The mitis group streptococci (MGS) are widespread in the oral cavity and are traditionally associated with oral health. However, these organisms have many attributes that contribute to the development of pathogenic oral communities. MGS adhere rapidly to saliva-coated tooth surfaces, thereby providing an attachment substratum for more overtly pathogenic organisms such as Porphyromonas gingivalis, and the two species assemble into heterotypic communities. Close physical association facilitates physiologic support, and pathogens such as Aggregatibacter actinomycetemcomitans display resource partitioning to favour carbon sources generated by streptococcal metabolism. MGS exchange information with community members through a number of interspecies signalling systems including AI-2 and contact dependent mechanisms. Signal transduction systems induced in P. gingivalis are based on protein dephosphorylation mediated by the tyrosine phosphatase Ltp1, and converge on a LuxR-family transcriptional regulator, CdhR. Phenotypic responses in P. gingivalis include regulation of hemin uptake systems and gingipain activity, processes that are intimately linked to the virulence of the organism. Furthermore, communities of S. gordonii with P. gingivalis or with A. actinomycetemcomitans are more pathogenic in animal models than the constituent species alone. We propose that MGS should be considered accessory pathogens, organisms whose pathogenic potential only becomes evident in the context of a heterotypic microbial community. © 2011 Blackwell Publishing Ltd.

Zoonotic Infections in Communities of the James Bay Cree Territory: An Overview of Seroprevalence

Directory of Open Access Journals (Sweden)

Hugues Sampasa-Kanyinga

2013-01-01

Full Text Available The Cree communities of James Bay are at risk for contracting infectious diseases transmitted by wildlife. Data from serological testing for a range of zoonotic infections performed in the general population (six communities, or trappers and their spouses (one community, were abstracted from four population-based studies conducted in Cree territory (Quebec between 2005 and 2009. Evidence of exposure to Trichinella species, Toxoplasma gondii, Toxocara canis, Echinococcus granulosus, Leptospira species, Coxiella burnetii and Francisella tularensis was verified in all communities, whereas antibodies against Sin Nombre virus and California serogroup viruses (Jamestown Canyon and snowshoe hare viruses were evaluated in three and six communities, respectively. Seroprevalence varied widely among communities: snowshoe hare virus (1% to 42%, F tularensis (14% to 37%, Leptospira species (10% to 27%, Jamestown Canyon virus (9% to 24%, C burnetii (0% to 18%, T gondii (4% to 12%, T canis (0% to 10%, E granulosus (0% to 4% and Trichinella species (0% to 1%. No subject had serological evidence of Sin Nombre virus exposure. These data suggest that large proportions of the Cree population have been exposed to at least one of the targeted zoonotic agents. The Cree population, particularly those most heavily exposed to fauna, as well as the medical staff living in these regions, should be aware of these diseases. Greater awareness would not only help to decrease exposures but would also increase the chance of appropriate diagnostic testing.

Does functional redundancy stabilize fish communities?

DEFF Research Database (Denmark)

Rice, Jake; Daan, Niels; Gislason, Henrik

2013-01-01

in abundance or biomass could be accounted for by the Law of Large Numbers, providing no evidence that specific ecological processes or co-adaptations are necessary to produce this effect. This implies that successful conservation policies to maintain the resilience of a marine fish community could be based......Functional redundancy of species sharing a feeding strategy and/or maximum size has been hypothesized to contribute to increased resilience of marine fish communities (the “portfolio effect”). A consistent time-series of survey data of fish in the North Sea was used to examine if trophic functional...... groups or maximum length of species (Lmax) groups with larger numbers of species had lower coefficients of variation in abundance and biomass over time than did groupings with fewer species. Results supported this hypothesis. However, the stabilizing effect of numbers of species in a group on variation...

Integrating Journalism Into Health Promotion: Creating and Disseminating Community Narratives.

Science.gov (United States)

Brown, Louis D; Berryhill, Joseph C; Jones, Eric C

2018-06-01

Media coverage of mental health and other social issues often relies on episodic narratives that suggest individualistic causes and solutions, while reinforcing negative stereotypes. Community narratives can provide empowering alternatives, serving as media advocacy tools used to shape the policy debate on a social issue. This article provides health promotion researchers and practitioners with guidance on how to develop and disseminate community narratives to broaden awareness of social issues and build support for particular programs and policy solutions. To exemplify the community narrative development process and highlight important considerations, this article examines a narrative from a mental health consumer-run organization. In the narrative, people with mental health problems help one another while operating a nonprofit organization, thereby countering stigmatizing media portrayals of people with mental illness as dangerous and incompetent. The community narrative frame supports the use of consumer-run organizations, which are not well-known and receive little funding despite evidence of effectiveness. The article concludes by reviewing challenges to disseminating community narratives, such as creating a product of interest to media outlets, and potential solutions, such as engaging media representatives through community health partnerships and using social media to draw attention to the narratives.

Interprofessional, practice-driven research: reflections of one "community of inquiry" based in acute stroke.

Science.gov (United States)

Hubbard, I J; Vyslysel, G; Parsons, M W

2009-01-01

Research is often scholarship driven and the findings are then channelled into the practice community on the assumption that it is utilising an evidence-based approach in its service delivery. Because of persisting difficulties in bridging the practice-evidence gap in health care, there has been a call for more active links between researchers and practitioners. The authors were part of an interprofessional research initiative which originated from within an acute stroke clinical community. This research initiative aimed to encourage active participation of health professionals employed in the clinical setting and active collaboration across departments and institutions. On reflection, it appeared that in setting up an interprofessional, practice-driven research collaborative, achievements included the instigation of a community of inquiry and the affording of opportunities for allied health professionals to be actively involved in research projects directly related to their clinical setting. Strategies were put in place to overcome the challenges faced which included managing a demanding and frequently changing workplace, and overcoming differences in professional knowledge, skills and expertise. From our experience, we found that interprofessional, practice-driven research can encourage allied health professionals to bridge the practice-evidence gap, and is a worthwhile experience which we would encourage others to consider.

The Role of Microbial Community Composition in Controlling Soil Respiration Responses to Temperature.

Science.gov (United States)

Auffret, Marc D; Karhu, Kristiina; Khachane, Amit; Dungait, Jennifer A J; Fraser, Fiona; Hopkins, David W; Wookey, Philip A; Singh, Brajesh K; Freitag, Thomas E; Hartley, Iain P; Prosser, James I

2016-01-01

Rising global temperatures may increase the rates of soil organic matter decomposition by heterotrophic microorganisms, potentially accelerating climate change further by releasing additional carbon dioxide (CO2) to the atmosphere. However, the possibility that microbial community responses to prolonged warming may modify the temperature sensitivity of soil respiration creates large uncertainty in the strength of this positive feedback. Both compensatory responses (decreasing temperature sensitivity of soil respiration in the long-term) and enhancing responses (increasing temperature sensitivity) have been reported, but the mechanisms underlying these responses are poorly understood. In this study, microbial biomass, community structure and the activities of dehydrogenase and β-glucosidase enzymes were determined for 18 soils that had previously demonstrated either no response or varying magnitude of enhancing or compensatory responses of temperature sensitivity of heterotrophic microbial respiration to prolonged cooling. The soil cooling approach, in contrast to warming experiments, discriminates between microbial community responses and the consequences of substrate depletion, by minimising changes in substrate availability. The initial microbial community composition, determined by molecular analysis of soils showing contrasting respiration responses to cooling, provided evidence that the magnitude of enhancing responses was partly related to microbial community composition. There was also evidence that higher relative abundance of saprophytic Basidiomycota may explain the compensatory response observed in one soil, but neither microbial biomass nor enzymatic capacity were significantly affected by cooling. Our findings emphasise the key importance of soil microbial community responses for feedbacks to global change, but also highlight important areas where our understanding remains limited.

Community health workers: A crucial role in newborn health care and survival

Directory of Open Access Journals (Sweden)

Samira Aboubaker

2014-11-01

Full Text Available There is ample evidence from research and implementation to show that community health workers, when appropriately trained, supplied, supported and supervised, can identify and correctly treat most children for pneumonia, diarrhoea and malaria. Community management of childhood illness is an important contribution to the remarkable progress in reducing child mortality. Globally, the rate of under–five mortality has decreased by nearly half, from 90 deaths per 1000 live births in 1990 to 46 in 2013.

Community-based intervention for blood pressure reduction in Nepal (COBIN trial)

DEFF Research Database (Denmark)

Neupane, Dinesh; McLachlan, Craig S; Christensen, Bo

2016-01-01

. The study will provide detailed information on the burden of blood pressure and also whether treatment targets are being met. Moreover, evidence will be provided on the future role of female community health volunteers for hypertension management in Nepal. The lessons learned from this study may also...... study is to determine the effect of family-based home health education and blood pressure monitoring by trained female community health volunteers. The primary outcome is change in mean systolic blood pressure. A community-based, open-masked, two-armed, cluster-randomized trial will be conducted...... proportion size, 929 individuals for the intervention group and 709 individuals for the control group will participate in the study. Due to the nature of the study, study participants are not compensated or insured. As part of the blood pressure intervention, trained female community health volunteers...

Establishing a Sense of Community, Interaction, and Knowledge Exchange Among Students

DEFF Research Database (Denmark)

Ryberg, Thomas; Davidsen, Jacob

2017-01-01

an academic and social sense of community among the students, through encouraging interaction and knowledge exchange. Studies show that students prefer to use Facebook for academic and social purposes. Consequently, teachers have limited insight into the academic challenges facing students, which...... is problematic when trying to create and support an academic community. Moreover, it is problematic that the institutional system Moodle primarily is used by the teachers to push information in the direction of the students. Thus, we wanted to design a third space that would fit in-between Facebook and Moodle......, and which would allow the students to experience the benefits of participating in an online community with fellow students and teachers. The study shows that teachers are crucial in developing and maintaining the online community. Nevertheless, there was also evidence that some of the online activities...

Evidence-based medicine and hospital reform: tracing origins back to Florence Nightingale.

Science.gov (United States)

Aravind, Maya; Chung, Kevin C

2010-01-01

The use of reliable evidence to evaluate health care interventions has gained strong support within the medical community and in the field of plastic surgery in particular. Evidence-based medicine aims to improve health care and reduce costs through the use of sound clinical evidence in evaluating treatments, procedures, and outcomes. The field is hardly new, however, and most trace its origins back to the work of Cochrane in the 1970s and Sackett in the 1990s. Though she wouldn't know it, Florence Nightingale was applying the concepts of evidence-based reform to the medical profession more than a century before. She used medical statistics to reveal the nature of infection in hospitals and on the battlefield. Moreover, Nightingale marshaled data and evidence to establish guidelines for health care reform. Tracing the origins of evidence-based medicine back to Nightingale underscores how critical this movement is to improving the quality and effectiveness of patient care today.

Does mechanical disturbance affect the performance and species composition of submerged macrophyte communities?

Science.gov (United States)

Zhang, Qian; Xu, Ying-Shou; Huang, Lin; Xue, Wei; Sun, Gong-Qi; Zhang, Ming-Xiang; Yu, Fei-Hai

2014-05-01

Submerged macrophyte communities are frequently subjected to disturbance of various frequency and strength. However, there is still little experimental evidence on how mechanical disturbance affects the performance and species composition of such plant communities. In a greenhouse experiment, we constructed wetland communities consisting of five co-occurring clonal submerged macrophyte species (Hydrilla verticillata, Elodea canadensis, Ceratophyllum demersum, Chara fragilis, and Myriophyllum spicatum) and subjected these communities to three mechanical disturbance regimes (no, moderate and strong disturbance). Strong mechanical disturbance greatly decreased overall biomass, number of shoot nodes and total shoot length, and increased species diversity (evenness) of the total community. It also substantially decreased the growth of the most abundant species (H. verticillata), but did not affect growth of the other four species. Our data reveal that strong disturbance can have different effects on different submerged macrophyte species and thus alters the performance and species composition of submerged macrophyte communities.

Moving communities toward policy change: APPEAL's 4-prong policy change model.

Science.gov (United States)

Tong, Elisa K; Lew, Rod

2013-09-01

Policy change is recognized for underlying much of the success of tobacco control. However, there is little evidence and attention on how Asian American and Native Hawaiian and Pacific Islander (AA and NHPI) communities may engage in policy change. Challenges for AA and NHPI communities include the racial/ethnic and geographic diversity, and tobacco data accurately representing the communities. Over the past decade, the Asian Pacific Partners for Empowerment, Advocacy and Leadership (APPEAL) has worked to develop and implement policy change for AA and NHPI communities. This article describes APPEAL's 4-prong policy change model, in the context of its overall strategic framework for policy change with communities that accounts for varying levels of readiness and leadership capacity, and targets four different levels of policy change (community, mainstream institution, legislative, and corporate). The health promotion implication of this framework for tobacco control policy engagement is for improving understanding of effective pathways to policy change, promoting innovative methods for policy analysis, and translating them into effective implementation and sustainability of policy initiatives. The APPEAL strategic framework can transcend into other communities and health topics that ultimately may contribute to the elimination of health disparities.

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.

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

Practical Approaches to Evaluating Progress and Outcomes in Community-Wide Teen Pregnancy Prevention Initiatives.

Science.gov (United States)

Tevendale, Heather D; Condron, D Susanne; Garraza, Lucas Godoy; House, L Duane; Romero, Lisa M; Brooks, Megan A M; Walrath, Christine

2017-03-01

This paper presents an overview of the key evaluation components for a set of community-wide teen pregnancy prevention initiatives. We first describe the performance measures selected to assess progress toward meeting short-term objectives on the reach and quality of implementation of evidence-based teen pregnancy prevention interventions and adolescent reproductive health services. Next, we describe an evaluation that will compare teen birth rates in intervention communities relative to synthetic control communities. Synthetic controls are developed via a data-driven technique that constructs control communities by combining information from a pool of communities that are similar to the intervention community. Finally, we share lessons learned thus far in the evaluation of the project, with a focus on those lessons that may be valuable for local communities evaluating efforts to reduce teen pregnancy. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

The Community Navigator Study: a feasibility randomised controlled trial of an intervention to increase community connections and reduce loneliness for people with complex anxiety or depression.